2014-11-06T15:35:57-06:00 2013-12-31 320043599 LEGACY PROFESSIONALS LLP 222 INDIANAPOLIS BOULEVARD SUITE 103 SCHERERVILLE IN 46375 990 2013-01-01 356327302 IRONWORKERS LOCAL 395 TRUST FUND IRON 2197696944 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 JEFFREY CHIDESTER CHAIRMAN 2197696944 2014-11-06 1 RENEE BERG-SPECK P00201492 3123680500 2013 2015-11-30 17:44:51Z JEFFREY CHIDESTER 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 47886354 0 X N/A X 1977 IN PROVIDE HEALTH BENEFITS 4 2 46 0 0 0 0 0 19305034 16371904 1235330 1306175 151 4806 20540515 17682885 0 0 15717285 15518478 0 0 0 0 0 880430 555817 16597715 16074295 3942800 1608590 48010446 50555545 535234 307187 47475212 50248358 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH, LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DENTAL, AND VISION BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 464 0 1 46 1 0 0 0 0 0 0 0 0 X 4 2 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X STEWART C MILLER INC 2197696944 2111 W LINCOLN HIGHWAY MERRILLVILLE IN 46410 JEFFREY CHIDESTER UNION TRUSTEE 2.00 40.00 X 0 132470 49268 DOUGLAS STRAYER UNION TRUSTEE 2.00 40.00 X 0 135638 49268 STEVE MICHAELS EMP TRUSTEE 1.00 X 0 0 0 TED VRENAS-PAST EMP TRUSTEE 1.00 X 0 0 0 SAMUEL TIPTON-NEW EMP TRUSTEE 1.00 X 0 0 0 0 268108 98536 0 0 1 0 BENISTAR PO BOX 36029 NEWARK NJ 07188 MEDICARE PREMIUM FEE 704321 ANTHEM BLUE CROSS BLUE SHIELD 220 VIRGINIA AVE INDIANAPOLIS IN 46204 FEE FOR PROVIDING PPO ACCESS 452425 STEWART C MILLER & CO INC 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 PROVIDES ADMINISTRATIVE SERVICES 326024 EXPRESS SCRIPTS DBA MEDCO 100 PARSONS POND DRIVE FRANKLIN LAKES NJ 07417 RX ADMIN FEE 114749 4 EMPLOYER CONTRIB. 900099 14188766 14188766 PARTICIPANT CONTRIB. 900099 1666630 1666630 PRESCRIPTION REBATES 900099 301205 301205 MEDICARE PART D SUBSIDY 900099 142042 142042 STOP-LOSS RECOVERY PROC 900099 73261 73261 16371904 1289586 1289586 30220058 30203469 16589 16589 16589 CLASS ACTION PROCEEDS 900099 4806 4806 4806 17682885 16371904 0 1310981 15518478 125054 10525 33990 226297 60805 75422 8406 10184 AFFORDABLE CARE ACT - P 5134 16074295 5577871 5901407 3229378 1314386 8935 9812 38961842 43145786 232420 184154 48010446 50555545 535234 224432 0 82755 535234 307187 X 0 0 0 0 47475212 50248358 47475212 50248358 48010446 50555545 1608590 1164556 0 X 0 1 X 1 0 0 DUE TO BROKER 82755 82755 X 18633644 1164556 1164556 17469088 213797 213797 17682885 15860498 0 15860498 213797 213797 16074295 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES. 0 0 0 JEFFREY CHIDESTER UNION TRUSTEE 0 132470 0 0 0 0 0 31701 0 17567 0 181738 0 0 DOUGLAS STRAYER UNION TRUSTEE 0 135638 0 0 0 0 0 31701 0 17567 0 184906 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF TRUSTEES HAS DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO STEWART C. MILLER, INC., AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. THE TRUSTEES REVIEW THE FORM AND UPON FULLY UNDERSTANDING THE COMPLETED FORM 990, THE FORM IS APPROVED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO ANY PARTICIPANT IN THE PLAN WHO COMES INTO THE FUND OFFICE AND REQUESTS TO SEE THEM. 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