2011-04-13T10:40:35-05:00 2010-06-30 BRICKLEY DELONG PC PO BOX 999 MUSKEGON MI 494430999 990 2009-07-01 386519330 West Mi Plumbers Fitters and Service Trades Local 174 Health & Benefits Plan WEST 8007596944 2111 West Lincoln Highway Merrillville IN 46410 MARK D MANGIONE 8007596944 2011-04-06 1 BRENDA K JACOBS 2317265800 2011-04-06 2009 2016-02-24 21:20:13Z MARK D MANGIONE 2111 West Lincoln Highway Merrillville IN 46410 30512524 0 X N/A X HEALTH AND BENEFITS PLAN 1983 MI TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS OF THE WEST MICHIGAN PLUMBERS FITTERS AND SERVICE TRADES UNION LOCAL NO. 174. 9 9 0 0 0 0 0 9099303 7761413 705478 734430 391006 430965 10195787 8926808 0 7601553 7915021 5015 5384 0 0 873853 932358 8480421 8852763 1715366 74045 17633033 18258070 498389 437518 17134644 17820552 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS OF THE WEST MICHIGAN PLUMBERS FITTERS AND SERVICE TRADES UNION LOCAL NO. 174. 0 0 ALL EXPENDITURES ARE FOR PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 808 MEMBERS SERVED. 0 0 0 0 0 0 0 0 0 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 1 0 0 1 101 0 1 0 0 0 0 0 0 9 9 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X STEWART C MILLER & CO INC 8007596944 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 X KIRK STEVENSON 1.00 X 0 0 0 JEFFREY WILKERSON 1.00 X 0 84357 49765 TRACY SIEPKER 1.00 X 0 0 0 SCOTT DIXON 1.00 X 0 0 0 JOHN NIC 1.00 X 0 0 0 CINDY MORSE 1.00 X 0 0 0 HARVEY CUMMINGS II 1.00 X 0 45593 27552 MARK MANGIONE 1.00 X 0 87763 50276 JON PENNING 1.00 X 0 0 0 BUCKLEY GENO 1.00 X 0 46641 26574 0 264354 154167 0 0 0 0 BLUE CROSS BLUE SHIELD OF MICHIGAN 600 E LAFAYETTE DETROIT MI 48231 INSURANCE ADMINISTRATION FEES 331924 1 EMPLR. & PART. CONTRIB 525100 7761413 7761413 7761413 650795 650795 21669351 21585716 83635 83635 83635 PRESCRIPTION DRUG COST 525100 227804 227804 MEDICARE PART D SUBSID 525100 116126 116126 STOP-LOSS REIMBURSEMEN 525100 87035 87035 430965 8926808 8192378 0 734430 7915021 5384 363936 24422 18171 43149 65715 19164 300 3910 372761 CLERICAL FEES 20830 8852763 1429786 1304984 975305 810369 12551 384589 15215391 15758128 17633033 18258070 498389 437518 498389 437518 X 0 0 0 0 17134644 17820552 17134644 17820552 17633033 18258070 X 0 1 1 X 0 0 8926808 8852763 74045 611863 611863 685908 9495522 611863 611863 8883659 43149 43149 8926808 8809614 0 8809614 43149 43149 8852763 Part XII, Line 4b - Other Adjustments: INVESTMENT EXPENSES NETTED IN REVENUE ON F/S; IN EXPENSES ON 990: 43149. Part XIII, Line 4b - Other Adjustments: INVESTMENT EXPENSES NETTED IN REVENUE ON F/S; IN EXPENSES ON 990: 43149. Form 990, Part VI, Section A, line 4 THE ORGANIZATION AMENDED THE PLAN OF BENEFITS AFFECTIVE JULY 1, 2009. A CONFORMED COPY IS ATTACHED TO THE RETURN. Form 990, Part VI, Section A, line 8b THERE ARE NO SUBCOMMITTEES TO THE BOARD OF TRUSTEES. Form 990, Part VI, Section B, line 11 THE PLAN'S CHAIRMAN OF THE BOARD OF TRUSTEES REVIEWS THE RETURN BEFORE SIGNING AND FILING IT. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART XI, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBLITY FOR OVERSIGHT OF THE AUDIT OF THE BENEFIT PLAN AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. LOCAL 174 PENSION PLAN 1008 OMALLEY DRIVE COOPERSVILLE MI 49404 381796240 DEFINED BENEFIT PENSION PLAN THAT COVERS ALL ELIGIBLE MEMBERS. MI 501(c)9 LOCAL 174 401(K) RETIREMENT SAVings plan 1008 OMALLEY DRIVE COOPERSVILLE MI 49404 386519311 DEFINED CONTRIBUTION PENSION PLAN THAT COVERS ALL ELIGIBLE MEMBERS. MI 501(c)9 WEST MI PLUMBERS FITTERS & SERVICE TRADES LOCAL UNION NO 174 1008 OMALLEY DRIVE COOPERSVILLE MI 49404 383420023 COLLECTIVE BARGAINING AND REPRESENTATION OF ALL ELIGIBLE UNION MEMBERS. MI 501(C)5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0