2011-09-15T15:12:35-05:00 2010-12-31 FREYBERG HINKLE ASHLAND POWERS & STOWELL 15420 W CAPITOL DR BROOKFIELD WI 530052621 990 2010-01-01 351638874 WISCONSIN SHEET METAL WORKERS HEALTH AND BENEFIT FUND WISC 4147780516 2201 SPRINGDALE ROAD WAUKESHA WI 531862855 PATRICK LANDGRAF 2627981818 2011-09-15 1 JAMES M ASHLAND CPA 2627846210 2010 2016-03-07 17:11:31Z PATRICK LANDGRAF 2201 SPRINGDALE ROAD WAUKESHA WI 531862855 63976335 0 X N/A X 1985 WI TO PROVIDE HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR BENEFICIARIES. 16 16 137 0 0 0 0 0 26880340 26415788 1357854 2523237 44765 34257 28282959 28973282 0 0 21848527 25421696 59212 43052 0 0 0 3551431 3808346 25459170 29273094 2823789 -299812 47308989 47119329 16365310 16573158 30943679 30546171 X PROVIDE HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR BENEFICIARIES. 0 0 25421696 HOSPITAL, SURGICAL, MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS FOR APPROXIMATELY 2,770 MEMBERS AND THEIR FAMILIES 936756 PROVIDE SUPPLEMENTAL MEDICARE WRAPAROUND INSURANCE BENEFITS FOR APPROXIMATELY 750 MEMBERS 271983 PROVIDE MEDICAL CASE MANAGEMENT AND COST MANAGEMENT FOR APPROXIMATELY 2,000 MEMBERS 123800 LIFE INSURANCE AND COBRA PREMIUMS $79,287HSA CONTRIBUTIONS $44,513 123800 26754235 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 437 0 137 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X X SUZANNE TAZALLA 2627981838 2201 SPRINGDALE ROAD WAUKESHA WI 531862855 X PAT LANDGRAF 1.00 X X 0 0 0 TODD BLAIR 1.00 X 0 0 0 ROGER JACKSON 1.00 X 0 0 0 MIKE MOONEY 1.00 X 0 0 0 KEITH KEMPER 1.00 X 0 0 0 RANDALL KROCKA 1.00 X X 0 0 0 BRIAN BILLMAN 1.00 X 0 0 0 ROY STERN 1.00 X 0 0 0 DAVID BULTMAN 1.00 X X 0 0 0 DAVID ALDAG 1.00 X 0 0 0 KENNETH GROESCHEL 1.00 X 0 0 0 ROBERT JOSSART 1.00 X 0 0 0 PETER LENTZ 1.00 X 0 0 0 RICHARD NORTHRUP 1.00 X 0 0 0 DAVID SEITZ 1.00 X 0 0 0 JEFFREY GAECKE 1.00 X 0 0 0 0 0 0 0 0 0 0 BENEFIT PLAN ADMINISTRATORS 11270 W PARK PLACE SUITE 950 MILWAUKEE WI 53224 RECORDKEEPING AND PAYROLL AUDIT SERVICES 736146 UNITED HEALTHCARE 22703 NETWORK PLACE CHICAGO IL 606731227 MEDICAL CLAIMS ADMINISTRATION 560921 THE SEGAL COMPANY 101 N WACKER DRIVE SUITE 500 CHICAGO IL 606061724 ACTUARIAL SERVICES AND CONSULTING 224434 ANTHEM BLUE CROSS AND BLUE SHIELD 220 VIRGINIA AVENUE INDIANAPOLIS IN 46204 MEDICAL CLAIMS ADMINISTRATION 165523 REINHART BOERNER VAN DEUREN 1000 N WATER ST 1700 MILWAUKEE WI 53202 LEGAL SERVICES 107805 5 EMPLOYER CONTRIBUTIONS 900099 21176265 21176265 SELF-PAY CONTRIBUTIONS 900099 4920679 4920679 SASMI 900099 318844 318844 26415788 1439437 1439437 36086853 35003053 1083800 1083800 1083800 CONTRACTOR LATE CHARGE 900099 34257 34257 34257 28973282 27499588 0 1473694 25421696 25421696 43052 43052 408766 408766 145759 145759 56290 56290 90905 90905 224434 224434 25346 25346 35083 35083 30064 30064 10232 10232 12808 12808 99826 79287 20539 CLAIMS ADMINISTRATOR FE 1344548 1344548 SMW PREMIUMS 936756 936756 COST CONTAINMENT PROGRA 271983 271983 HSA CONTRIBUTIONS 44513 44513 BANK FEES 33291 33291 37742 37742 29273094 26754235 2518859 0 7764452 8971161 1920798 2017082 26266 28080 317605 269121 37269 48484 37230520 35750939 329684 303583 47308989 47119329 761628 811724 15603682 15761434 16365310 16573158 X 0 0 0 0 30943679 30546171 30943679 30546171 47308989 47119329 X -299812 -97696 X X 0 1 1 X 0 317605 269121 48484 48484 ESTIMATED HEALTH CLAIMS PAYABLE AND IBNR 2593900 ACCUMULATED BENEFITS - PARTICIPANTS 12586842 DUE TO OTHER FUNDS 580692 15761434 28973282 29273094 -299812 -97696 -97696 -397508 28784681 -97696 -97696 28882377 90905 90905 28973282 29038192 0 29038192 90905 143997 234902 29273094 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FUND ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2010 THERE ARE NO UNCERTAIN POSITIONS. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN HEALTH CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED -541,100. DECREASE IN ACCUMULATED BENEFITS FOR PARTICIPANTS 685,097. FORM 990, PART VI, SECTION B, LINE 11 REVIEWED BY THE ADMINISTRATIVE MANAGER AND PRESENTED TO TRUSTEES FOR APPROVAL PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE EXPECTED TO DISCLOSE ANY OWNERSHIP OR OTHER FINANCIAL RELATIONSHIPS THAT THEY HAVE WITH PARTIES THAT DEAL WITH THE PLAN. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE PLAN OFFICE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -97,696. PART XII, LINE 2C THE BOARD OF TRUSTEES REVIEWS AND APPROVES A DRAFT OF THE AUDITED FINANCIAL STATEMENTS AT THE MEETING. THESE ARE PRESENTED BY THE ACCOUNTANT TO THE BOARD. FORM 990, SCHEDULE D, PART XI, LINE 10 THE $(397,508) REPORTED HERE ON LINE 10 DOES NOT AGREE WITH THE NET INCREASE IN NET ASSETS AVAILABLE FOR BENEFITS PER THE AUDITED FINANCIAL STATEMENTS OF $(253,511). THE DIFFERENCE OF $143,997 IS THE SUM OF THE CHANGES IN BENEFITS PAYABLE OF $(541,100) AND THE ACCUMULATED BENEFIT FOR PARTICIPANTS OF $685,097. THESE ITEMS ARE INCLUDED IN THE FORM 990, BUT ARE ONLY DISCLOSED IN THE NOTES OF THE AUDITED FINANCIAL STATEMENTS.