MICHIANA AREA ELECTRICAL WORKERS HEALTH & WELFARE FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: MICHIANA AREA ELECTRICAL WORKERS HEALTH & WELFARE FUND (EIN 35-6073323)
Tax period: 2011-05-01 to 2012-04-30
Filed: 2013-02-14
IRS object ID: 201340469349300944
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-02-14T16:29:22-06:00	Timestamp
Tax Period End Date	2012-04-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BENDA GRACE STULZ & COMPANY PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	38800 VAN DYKE AVE STE 100	AddressLine1
City	STERLING HEIGHTS	City
State	MI	State
ZIP Code	48312	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-05-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	356073323	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MICHIANA ELECTRICAL WORKERS	BusinessNameLine1
Business Name Line2	HEALTH & WELFARE FUND	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	MICH	NameControl
Phone	5173217502	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	6525 CENTURION DRIVE	AddressLine1
City	LANSING	City
State	MI	State
ZIP Code	489179275	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	ROGER DOSMANNSTANLEY MILES	Name
Title	CHAIRMAN/SECRETARY	Title
Phone	5173217502	Phone
Date Signed	2012-08-21	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BRYAN STULZ	Name
Phone	5868836240	Phone
Date Prepared	2013-02-14	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	SAME AS ABOVE	NameOfPrincipalOfficerPerson
Gross Receipts	35588736	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1961	YearFormation
State Legal Domicile	MI	StateLegalDomicile
Activity Or Mission Description	PROVIDE HEALTH AND WELFARE BENEFITS	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	8230080	ProgramServiceRevenuePriorYear
Program Service Revenue CY	9490837	ProgramServiceRevenueCY
Investment Income Prior Year	425964	InvestmentIncomePriorYear
Investment Income Current Year	362361	InvestmentIncomeCurrentYear
Other Revenue Prior Year	214839	OtherRevenuePriorYear
Other Revenue Current Year	161878	OtherRevenueCurrentYear
Total Revenue Prior Year	8870883	TotalRevenuePriorYear
Total Revenue Current Year	10015076	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	13139201	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	11465829	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	118840	OtherExpensePriorYear
Other Expenses Current Year	148510	OtherExpensesCurrentYear
Total Expenses Prior Year	13258041	TotalExpensesPriorYear
Total Expenses Current Year	11614339	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-4387158	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1599263	RevenuesLessExpensesCY
Total Assets BOY	9620046	TotalAssetsBOY
Total Assets EOY	5855785	TotalAssetsEOY
Total Liabilities BOY	6567895	TotalLiabilitiesBOY
Total Liabilities EOY	4806632	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	3052151	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1049153	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDE HEALTH AND WELFARE BENEFITS	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	11465829	Expense
Description	TO PROVIDE HOSPITALIZATION, MEDICAL AND OTHER RELATED HEALTH CARE BENEFITS TO ELIGIBLE PLAN PARTICIPANTS.	Description
Total Program Service Expense	11465829	TotalProgramServiceExpense
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	TIC INTERNATIONAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5173217502	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	6525 CENTURION DR	AddressLine1
City	LANSING	City
State	MI	State
ZIP Code	48917	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
ROGER DOSMANN
CHARIMAIN	1.00	X	0	0	0
RON EASTON
TRUSTEE	1.00	X	0	0	0
STANLEY MILES
TRUSTEE	1.00	X	0	0	0
BRIAN SULLIVAN
TRUSTEE	1.00	X	0	0	0
CHRISTOPHER GROVE
TRUSTEE	1.00	X	0	0	0
GARY ROPBERTS
TRUSTEE	1.00	X	0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Field	Value	IRS element (for citing)
Name Person	BLUE CROSS BLUE SHIELD OF MICHIGAN	NamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	27000 W ELEVEN MILE B561	AddressLine1
City	SOUTHFIELD	City
State	MI	State
ZIP Code	48034	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	INSURANCE	DescriptionOfServices
Compensation	564684	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS	230000	8677841	8677841
EMPLOYEE CONTRIBUTIONS	230000	812996	812996

Field	Value	IRS element (for citing)
Total Program Service Revenue	9490837	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	155186	TotalRevenueColumn
Related Or Exempt Function Income	2129	RelatedOrExemptFunctionIncome
Exclusion	$153,057	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	25780835	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	25573660	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	207175	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	207175	TotalRevenueColumn
Related Or Exempt Function Income	207175	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE PART D SUBSIDY	900099	151690	151690
LIQUIDATED DAMAGES	900099	5722	5722
COBRA ASSISTANCE PROGRAM	900099	4466	4466

Field	Value	IRS element (for citing)
Total Other Revenue	161878	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	10015076	TotalRevenueColumn
Related Or Exempt Function Income	9862019	RelatedOrExemptFunctionIncome
Exclusion	$153,057	ExclusionAmount

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	11465829	Total
Program Services	11465829	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	6600	Total
Management And General	6600	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	15300	Total
Management And General	15300	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	22456	Total
Management And General	22456	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	41490	Total
Management And General	41490	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	15301	Total
Management And General	15301	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	6601	Total
Management And General	6601	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	21892	Total
Management And General	21892	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	14167	Total
Management And General	14167	ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral
MEMBER COMMUNICATIONS	2857	2857
SUMMARY ANNUAL REPORT	1846	1846

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	11614339	Total
Program Services	11465829	ProgramServices
Management And General	148510	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2117638	BOY
EOY	1302926	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	933083	BOY
EOY	1076850	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	682166	BOY
EOY	1050406	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	5887159	BOY
EOY	2425603	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	9620046	BOY
EOY	5855785	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	30907	BOY
EOY	73226	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	6536988	BOY
EOY	4733406	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	6567895	BOY
EOY	4806632	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	3052151	BOY
EOY	1049153	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3052151	BOY
EOY	1049153	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	9620046	BOY
EOY	5855785	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-1599263	ReconcilationRevenueExpenses
Reconcilation Other Changes	-403735	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
ACCUMULATED ELIGIBILITY CREDITS	$3,595,000
CLAIMS INCURRED BUT NOT REPORTED	$999,000
UNSETTLED INVESTMENT TRANSACTIONS	$139,406

Field	Value	IRS element (for citing)
Total Of Amounts	4733406	TotalOfAmounts
Total Revenue	10015076	TotalRevenue
Total Expenses	11614339	TotalExpenses
Excess Or Deficit For Year	-1599263	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-403735	NetUnrealizedGLOnInvestments
Total Adjustments	-403735	TotalAdjustments
Excess Or Deficit Per FS	-2002998	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	9588885	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-403735	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	-403735	RevenueNotRptdF990
Revenue Subtotal	9992620	RevenueSubtotal
Investment Expenses Not Included	22456	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	22456	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	10015076	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	11591883	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	11591883	ExpensesSubtotal
Investment Expenses Not Included2	22456	InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt	22456	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	11614339	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ADDITIONAL INFORMATION	FORM 990, PART VI	LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. THE FUND, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AND EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES, BECASUE OF THIS ORGANIZATIONAL REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. LINE 12 - ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, OR OTHER OFFICER OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF THE BOARD OF TRUSTEES, SUBJECT TO APPROVAL BY AND REVIEW OF THE FUND'S LEGAL COUNSEL. IN ADDITION, EACH TRUSTEE IS PROVIDED A COPY OF THE FUND'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, PRIOR TO ITS FILING WITH THE IRS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. THE FUND DOES NOT HAVE A CONFLICTS OF INTEREST POLICY.
ADDITIONAL INFORMATION	FORM 990, PART VII	LINE 1A - THE TRUSTEES OF THE FUND SERVE WITHOUT COMPENSATION FROM THE FUND, BUT ARE COMPENSATED AS EMPLOYEES OF THE ENTITIES THAT MIGHT BE A "SPONSORING ORGANIZATION OF A VEBA" OR "CONTRIBUTING EMPLOYER OF A VEBA"; HOWEVER, NONE OF THOSE ENTITIES CONTRIBUTED 10% OR MORE OF THE CONTRIBUTIONS TO THE FUND DURING THE TAX YEAR. (SEE THE INSTRUCTIONS TO SCHEDULE R.)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	PART VII	BusinessNameLine1

Field	Value	IRS element (for citing)
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	false	ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	PART VII	BusinessNameLine1

Field	Value	IRS element (for citing)
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Disproportionate Allocations	false	DisproportionateAllocations
General Or Managing Partner	false	GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	PART VII	BusinessNameLine1

Field	Value	IRS element (for citing)
Direct Controlling Entity NA	N/A	DirectControllingEntityNA

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	ADDITIONAL INFORMATION	Identifier
Return Reference	SCHEDULE R	ReturnReference
Explanation	SCHEDULE R PARTS III IV V IDENTIFICATION OF RELATED ORGANIZATIONS THE FILING ORGANIZATION IS A MULTIEMPLOYER TRUST FUND AS DEFINED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 AS AMENDED THE FUND PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AS OF APRIL 30 2012 THERE WERE 136 CONTRIBUTING EMPLOYERS TO THE FUND UNDER THE INSTRUCTIONS TO SCHEDULE R THOSE EMPLOYERS ARE CONSIDERED RELATED ORGANIZATIONS THE FUNDS ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF ALL CONTRIBUTING EMPLOYERS INCLUDING NAMES ADDRESSES AND OTHER CONTACT INFORMATION HOWEVER THE FUND DOES NOT HAVE AND HAS NO REASONABLE WAY TO OBTAIN MUCH OF THE INFORMATION TO BE REPORTED ON SCHEDULE R SUCH AS EMPLOYER IDENTIFICATION NUMBERS AND THE EMPLOYERS LEGAL STRUCTURE EG CORPORATION OR PARTNERSHIP THE FOLLOWING IS A LISTING OF THOSE CONTRIBUTING EMPLOYERS WHICH IS THE EXTENT OF THE INFORMATION THE FUND HAS WITH RESPECT TO EACH EMPLOYER CONTRIBUTING EMPLOYERS H G SERVICES INC MARTELL ELECTRIC KOONTZWAGNER ELECTRIC CONST MTI GLOBAL SERVICES IBID COUNTY ELECTRIC SHAMBAUGH SON LP HUNT ELECTRIC CORP DAY ZIMMERMAN NPS LINEAR ELECTRIC INC SERVICE ONE PROFESSIONAL GROUP PEMBERTONDAVIS ELECTRIC CO COMMUNICATION CO OF SOUTH BEND SCHWARTZ ELECTRIC INC MEAD WHITECOLIP ELECTRIC BRITE ELECTRIC INC GARMAN ELECTRIC HARTMAN ELECTRIC INC SHAUM ELECTRIC CO INC COLIP ELECTRIC CORP IBEW LOCAL 153 MCMANN ELECTRIC INC TRI CITY DATA ELECTRONIC ELECTRICAL MAINT CONST LLC ELITE ELECTRICAL LLC T G B UNLIMITED INC NORTEC TELECOMMUNICATIONS INC INFRASOURCE UNDERGROUND CONST HI TECH ELECTRIC CO CONNECTIVITY TECHNOLOGY INC SWENEY ELECTRIC SOUTH BEND VICINITY ELEC JATC PRECISION CONTROL SYSTEMS AMPLE ELECTRIC CRAIG ELECTRIC INC VANDERHEYDEN TECHNOLOGIES INC MCDANIEL FIRE SYSTEMS LLC ELECTRIC PLUS INC CONVERGED COMMUNICATION PARTNR SWAN ELECTRIC COMPANY INC KETELHUT ELECTRIC JETTLINE ELECTRIC INC NETWORK CABLING SOLUTIONS RIVERBEND ELECTRIC INC FAIRCHILD COMM SYSTEMS INC ENYART ELECTRIC MOTOR REPAIR SOUTH BEND ELECTRIC INC SERVICE ELECTRIC OF ALLEN CO DAYS CORPORATION ALLIED ELECTRICAL SERVICES INC R D ELECTRIC CO C K ELECTRIC INC SCHENK LIGHTNING ROD CO MOORE ELECTRICAL SERVICE INC SKILL ELECTRIC LLC SCHMITT COMMUNICATIONS INC SARGENT ELECTRIC COMPANY ELECTRICORPE INC MOLTER ELECTRIC PARSONS ELECTRIC LLC STORMS MCMULLEN ELECTRIC INC J J ELECTRIC OF INDIANA INC SHAW SYSTEMS AND INTEGRATION GIESLER ELECTRIC INC STOUFFER ELECTRIC CO F E MORAN INC SPECIAL HAZARD HALLIGAN ELECTRIC INC AE ELECTRIC CO INC J W PHYRE ELECTRIC CO OF IND INDUSTRIAL INST INC AUSTGENS ELECTRIC INC	Explanation