2013-01-09T15:09:43-08:00 2012-05-31 Levinson Simon Hein & Bilkey PC 566 West Lake Street Suite 300 Chicago IL 606611414 990 2011-06-01 237166771 OPERATING ENGINEERS LOCAL 139 HEALTH BENEFIT FUND OPER 2625499190 PO BOX 160 PEWAUKEE WI 53072 RICHARD WANTA 2013-01-09 true Andrew Hein 3126550037 2011 2016-03-07 17:11:31Z 252208157 false false X N/A X 1970 WI TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN 10 10 0 0 0 94825625 100976503 5254076 9492515 0 100079701 110469018 0 88672270 91898723 0 0 0 5812426 5521743 94484696 97420466 5595005 13048552 240446991 252427353 28269196 31033548 212177795 221393805 TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN false false THE PLAN PROVIDES MEDICAL, DENTAL, VISION, LIFE, AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. false false false false false false false false false false true false false false true false true false false false false false false false false false false false false false false false false false false false false false false false false false false false false false true false false false false true 2523 0 true 0 false false false false false false false false false false false false false false false false X 10 10 false true false false false false false true true false false false false true true true true true false false false false X CARDAY ASSOCIATES 2625499190 N27 W23233 ROUNDY DRIVE PEWAUKEE WI 530720130 X DAVID BOHL 3.00 X 0 0 0 RICHARD WANTA 3.00 X 0 0 0 JOHN TOPP 3.00 X 0 0 0 TIM PETERSON 3.00 X 0 0 0 CHARLES BOWEN 3.00 X 0 0 0 DAN SPERBERG 3.00 X 0 0 0 CHARLES WARNER 3.00 X 0 0 0 RYAN OEHLHOF 3.00 X 0 0 0 TOM WOLF 3.00 X 0 0 0 TERRY MCGOWAN 3.00 X 0 0 0 0 false false false CVS CAREMARK 2211 SANDERS ROAD NBT-5 NORTHBROOK IL 60062 RX ADMIN FEE 309905 COMPSYCH 455 N CITYFRONT PLAZA DRIVE CHICAGO IL 60611 MENTAL HEALTH SER 233223 CASE MANAGEMENT SPECIALISTS INC PO BOX 102 NASHOTAH WI 53058 CONSULTING FEES 358355 CARDAY ASSOCIATES INC N27 W23233 ROUNDY DR PEWAUKEE WI 53072 THIRD PARTY ADMIN 1944670 ANTHEMBCBS 4361 IRWIN SIMPSON RD MASON OH 45040 PPO ACCESS AND ADMIN 1788397 5 0 SUBROGATION RECOVERIES 900099 574303 574303 SELF-PAY CONTRIBUTIONS 900099 13657664 13657664 MEDICARE SUBSIDY 900099 1348106 1348106 EMPLOYER CONTRIBUTIONS 900099 85396430 85396430 100976503 9162512 9162512 0 0 0 142069142 141739139 330003 330003 330003 0 0 0 0 110469018 100976503 9492515 0 0 0 91898723 0 0 0 0 0 0 1506724 177409 25260 0 0 393919 2940441 0 58149 139509 0 184524 0 0 6273 0 0 66999 22536 0 97420466 0 0 0 3816378 4128735 0 0 9617746 11043723 0 0 0 0 41972 42872 1350037 1102298 288295 247739 224654318 235057234 0 0 0 2028282 1907050 240446991 252427353 600210 541571 249391 255024 27419595 30236953 28269196 31033548 X 212177795 221393805 212177795 221393805 240446991 252427353 X 13048552 -3832542 X false true true X false false 965718 907836 57882 384319 194462 189857 247739 CLAIMS PAYABLE 2036000 CLAIMS INCURRED BUT NOT REPORTED 8144000 ACCUM PART HEALTH SAV ACCOUNTS 20056953 30236953 110469018 97420466 13048552 -3832542 -3832542 9216010 106242557 -3832542 -3832542 110075099 393919 393919 110469018 94209189 94209189 393919 2817358 3211277 97420466 Part XIII, Line 4b Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S INC IN PART. ACCUM HEALTH REIMB ACCOUNTS $2989558 DEC IN EST CLAIMS INCURRED BUT NOT RPTD $-137800 DEC IN EST CLAIMS PAYABLE $-34400 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE U.S. DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE U.S. DEPARTMENT OF LABOR. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts THE ACTIONS OF THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND ERISA. BOTH ESTABLISH STANDARDS OF CONDUCT FOR PLAN FIDUCIARIES. THE TRUSTEES ARE REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST TO THE ENTIRE BOARD. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process THE BOARD OF TRUSTEES HAVE AUTHORIZED DESIGNATED TRUSTEES (THE CHAIRMAN AND/OR SECRETARY TREASURER) TO REVIEW THE FORM 990 PRIOR TO FILING. A COPY OF THE FILED RETURN IS MADE AVAILABLE TO ALL TRUSTEES TO REVIEW SUBSEQUENT TO FILING. Form 990, Part VI, Line 3 Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company IN ACCORDANCE WITH THE PLAN'S TRUST AGREEMENT, THE TRUSTEES HAVE CONTRACTED THE SERVICES OF A THRID PARTY ADMINISTRATOR, CARDAY ASSOCIATES. THE THIRD PARTY ADMINISTRATOR, UNDER THE DIRECTION OF THE TRUSTEES, ADMINISTERS THE OFFICES OF THE TRUST FUND. LMCT of Operating Engineers Local 139 PO Box 160 Pewaukee WI 53072 364656562 Labor/Management Cooperation Trust WI 501(c)(5) N/A false Wis Oper Eng Skill Improvement & Apprent PO Box 160 Pewaukee WI 53072 391102559 Operating Engineers Training Fund WI 501(c)(3) 2 N/A false false false false false false false false false false false false false false false false false false false