2013-10-14T16:46:29-05:00 2012-12-31 391531945 FREYBERG HINKLE ASHLAND POWERS & STOWELL 15420 W CAPITOL DR BROOKFIELD WI 530052621 990 2012-01-01 391932533 PLUMBERS AND STEAMFITTERS LOCAL 400 AND MCA N CENTRAL WI HEALTH & WELFARE TRUST PLUM 9204620400 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 JEFF KNAUS 9204620400 2013-10-14 1 JAMES M ASHLAND CPA P00241858 2627846210 2012 2016-02-25 16:41:14Z JEFF KNAUS 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 52632541 0 X WWW.UA400.ORG X 1998 WI PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 9 9 58 0 0 0 0 0 18919190 19860539 958524 1088329 0 62192 19877714 21011060 0 0 15816370 13912311 1378 0 0 0 0 2194739 4249762 18012487 18162073 1865227 2848987 39182703 42395819 579635 531412 38603068 41864407 PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 0 0 PLUMBERS AND STEAMFITTERS LOCAL 400 HEALTH AND WELFARE PLAN PROVIDES MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION AND OTHER BENEFITS TO APPROXIMATELY 1,800 PLAN PARTICIPANTS, THEIR DEPENDENTS AND BENEFICIARIES. 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 2 0 1 58 1 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X BENEFIT PLAN ADMINISTRATORS 4145773700 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 KIM BASSETT-HEITZMANN 1.00 X 0 0 0 DAVID ALDAG 1.00 X 0 0 0 KEN GROESCHEL JR 1.00 X 0 0 0 TIMOTHY HOWALD 1.00 X 0 0 0 JEFF GAECKE 1.00 X 0 0 0 JEFF KNAUS 1.00 50.00 X X 0 110983 73338 MARK KOENIGS 1.00 X 0 0 0 MIKE AUGUSTIAN 1.00 45.00 X 0 99885 64094 SCOTT WENGER 1.00 X 0 0 0 0 210868 137432 0 0 1 0 BENEFIT PLAN ADMINISTRATORS 11270 W PARK PLACE SUITE 950 MILWAUKEE WI 53224 ADMINISTRATIVE SERVICES 762681 UNITED HEALTHCARE INSURANCE COMPANY 9700 HEALTH CARE LANE MN017-E600 MINNETONKA MN 55343 CLAIMS PROCESSING 603252 REINHART BOERNER VAN DEUREN SC PO BOX 2965 MILWAUKEE WI 53201 LEGAL 110898 CATAMARAN 800 KING ROAD BLVD 4TH FLOOR ROCKVILLE MD 20850 CLAIMS PROCESSING 103777 4 EMPLOYER CONTRIBUTIONS 900099 16865754 16865754 PARTICIPANT CONTRIBUTIONS 900099 2650767 2650767 SUBROGATION 900099 301240 301240 STOP LOSS REIMBURSEMENTS 900099 42778 42778 19860539 1195472 1195472 31514338 31621481 -107143 -107143 -107143 OTHER REIMBURSEMENTS 900099 62192 62192 62192 21011060 19860539 0 1150521 13912311 787488 110898 11340 119859 69750 31348 4818 4973 MDB 1573436 STOP LOSS PREMIUMS 721114 PPO ADMIN FEES 671224 LIFE INSURANCE PREMIUMS 33968 109546 18162073 4047180 4191665 1389511 1575047 1854169 130087 85615 33070208 35019344 215696 39182703 42395819 253296 383365 326339 148047 579635 531412 X 0 0 0 0 38603068 41864407 38603068 41864407 39182703 42395819 2848987 412352 0 X X 0 1 X 1 0 0 DUE TO OTHER LOCALS 32999 PREPAID RETIREE PREMIUMS 115048 148047 X 21303553 412352 412352 20891201 119859 119859 21011060 18042214 0 18042214 119859 119859 18162073 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) OF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN'S MANAGEMENT BELIEVES THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. 0 0 0 JEFF KNAUS 0 110983 0 0 0 0 0 0 0 73338 0 184321 0 0 MIKE AUGUSTIAN 0 99885 0 0 0 0 0 0 0 64094 0 163979 0 0 FORM 990, PART VI, SECTION A, LINE 6 THERE ARE APPROXIMATELY 1,800 MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND. EACH MEMBER IS ALLOWED ONE VOTE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND ELECT THE BOARD OF TRUSTEES FOR THE FUND. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE BOARD OF TRUSTEES ARE VOTED ON BY THE MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO THE RETURN BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST IMMEDIATELY UPON DISCOVERY. EACH PERSON HAS SIGNED AN AGREEMENT STATING THAT HE OR SHE WILL ACT IN ACCORDANCE WITH THE TRUST AGREEMENT. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTATION IS AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C NO CHANGES HAVE BEEN MADE SINCE PRIOR YEAR. 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