2024-07-10T13:08:49-05:00 2023-08-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2022-09-01 237422786 WISCONSIN MASONS' HEALTH CARE FUND WISC 8003625474 2901 W BELTLINE HIGHWAY 100 MADISON WI 537134226 JIM VICK CHAIRMAN 8003625474 2024-07-09 1 JIM VICK 999009999 1 BRIDGETTE MUGGE P00671418 2627549400 2024-07-02 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z JIM VICK 2901 W BELTLINE HIGHWAY 100 MADISON WI 537134226 31620840 0 X N/A X 1973 WI TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 18 11 48 11 0 0 0 0 17519573 19619903 1444396 280598 645367 1118197 19609336 21018698 0 0 16622894 20068701 0 0 0 0 0 4300051 4273724 20922945 24342425 -1313609 -3323727 25145408 22892728 8273094 8755923 16872314 14136805 TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 0 0 TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 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 97 0 48 1 0 0 0 0 0 0 0 0 X 18 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X BENESYS INC 8003625474 2901 W BELTLINE HWY SUITE 100 MADISON WI 537134226 JIM VICK CHAIR 1.00 40.00 X X 0 107358 74166 WYNN JONES TRUSTEE 1.00 40.00 X 0 44227 36473 TOBIN BOYLE TRUSTEE 1.00 40.00 X 0 96647 73333 WILLIAM BONLENDER TRUSTEE 1.00 40.00 X 0 99214 71125 TONY FOX START 101322 TRUSTEE 1.00 40.00 X 0 97298 72910 JASON HOFFMAN START 101322 TRUSTEE 1.00 40.00 X 0 96406 73685 MATT QUASIUS SECRETARY/TREASURER 1.00 X X 0 0 0 JEFF LECKWEE TRUSTEE 1.00 X 0 0 0 AARON WESTHUIS THRU 102422 TRUSTEE 1.00 X 0 0 0 BARRY SCHOLZ TRUSTEE 1.00 X 0 0 0 DAVID BOHL TRUSTEE 1.00 X 0 0 0 JEFF STAVER TRUSTEE 1.00 X 0 0 0 JASON MATTILA TRUSTEE 1.00 X 0 0 0 MATT MARCELLIS TRUSTEE 1.00 X 0 0 0 PATRICK MCCABE TRUSTEE 1.00 40.00 X 0 99671 71041 ANDREW REED TRUSTEE 1.00 40.00 X 0 98699 71829 TYLER SWANSON TRUSTEE 1.00 X 0 0 0 DEREK ALLEN TRUSTEE 1.00 X 0 0 0 JOE PAUSHA START 102422 TRUSTEE 1.00 X 0 0 0 MIKE HYATT THRU 101322 TRUSTEE 1.00 40.00 X 0 101879 73444 FELIX RAMIREZ THRU 101322 TRUSTEE 1.00 X 0 0 0 TERRY OWENS THRU 101322 TRUSTEE 1.00 X 0 0 0 0 841399 618006 0 0 1 0 BENEFIT PLAN ADMINISTRATION 2901 WEST BELTLINE HIGHWAY SUITE 1 MADISON WI 53713 CONTRACT ADMINISTRATION 962316 UNITED HEALTHCARE INSURANCE COMPANY PO BOX 88822 MILWAUKEE WI 53228 CLAIMS / PPO EXPENSE 493439 MERCER HEALTH & BENEFITS LLC 155 NORTH WACKER DRIVE STE 1500 CHICAGO IL 60606 CONSULTING 181224 US BANK NATIONAL ASSOCIATION PO BOX 1800 SAINT PAUL MN 55101 BANKING / INVESTMENTS 111599 4 EMPLOYER CONTRIBUTIONS 900099 17560212 17560212 SELF PAY CONTRIBUTIONS 900099 2059691 2059691 19619903 528049 528049 10354691 10602142 -247451 -247451 -247451 STOP LOSS 900099 583143 583143 CHANGE IN MEMBER DOLLAR BANK 900099 361184 361184 SUBROGATION 900099 158196 158196 15674 15674 1118197 21018698 20738100 0 280598 20068701 892456 117583 45819 276015 104586 31766 25277 15694 MEDICARE ADVANTAGE PREM 1090910 PPO SERVICE ADMIN FEES 670303 HRA REIMBURSEMENTS 599983 STOP-LOSS PREMIUMS 189686 213646 24342425 3213564 2463323 2424836 2769346 221547 151344 19285461 17508715 25145408 22892728 503746 732252 7769348 8023671 8273094 8755923 X 0 0 0 0 16872314 14136805 16872314 14136805 25145408 22892728 -3323727 588218 0 X 0 1 X 1 0 0 CLAIMS PAYABLE 1725000 HRA LIABILITY 6040430 CASH OVERDRAFT 258241 8023671 X 21199913 588218 588218 20611695 45819 361184 407003 21018698 23427422 0 23427422 45819 869184 915003 24342425 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"). THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS") AND IS THEREFORE NOT SUBJECT TO TAX UNDER PRESENT INCOME TAX LAWS. THE PLAN SPONSOR BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF 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. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN MEMBER DOLLAR BANK 361,184. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN MEMBER DOLLAR BANK 361,184. DECREASE IN BENEFIT OBLIGATIONS PAYABLE 508,000. 0 0 0 JIM VICK CHAIR 0 107358 0 0 0 0 0 54624 0 19542 0 181524 0 0 MIKE HYATT THRU 101322 TRUSTEE 0 101879 0 0 0 0 0 52592 0 20852 0 175323 0 0 PATRICK MCCABE TRUSTEE 0 99671 0 0 0 0 0 51499 0 19542 0 170712 0 0 ANDREW REED TRUSTEE 0 98699 0 0 0 0 0 52287 0 19542 0 170528 0 0 WILLIAM BONLENDER TRUSTEE 0 99214 0 0 0 0 0 51583 0 19542 0 170339 0 0 TONY FOX START 101322 TRUSTEE 0 97298 0 0 0 0 0 53368 0 19542 0 170208 0 0 JASON HOFFMAN START 101322 TRUSTEE 0 96406 0 0 0 0 0 54143 0 19542 0 170091 0 0 TOBIN BOYLE TRUSTEE 0 96647 0 0 0 0 0 53791 0 19542 0 169980 0 0 FORM 990, SCHEDULE J, PART I LINE 3 THE RELATED ORGANIZATION, OPERATIVE PLASTERERS & CEMENT MASONS LOCAL 599, USES EXECUTIVE BOARD APPROVAL TO ESTABLISH COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B THE OFFICERS AND ADMINISTRATIVE MANAGER REVIEWS THE FORM 990 WITH THE ACCOUNTANT BEFORE SIGNING AND MAKING A COPY OF THE FORM 990 AVAILABLE FOR ALL TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THERE ARE ANNUAL TRUSTEE QUESTIONNAIRES. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. BAC DISTRICT COUNCIL PO BOX 510617 NEW BERLIN WI 53151 391590426 LABOR UNION WI 501(C)(5) 0 BOARD OF TRUSTEES WI MASONS' HEALTH CARE FUND 2901 W BELTLINE HIGHWAY STE 100 MADISON WI 537134226 237422786 JOINT BOARD OF TRUSTEES WI 501(C)(9) 0 MILWAUKEE AREA BRICKLAYERS APPRENTICESHIP TRAINING FUND 17125 W CLEVELAND AVENUE NEW BERLIN WI 531510741 391333915 APPRENTICESHIP TRAINING WI 501(C)(3) 0 OPERATIVE PLASTERERS & CEMENT MASONS LOCAL 599 8701 N LAUER STREET MILWAUKEE WI 53224 391960564 LABOR UNION WI 501(C)(5) 0 HANSON MASONRY & CONCRETE LLOYD HAMM MASONRY MAVID CONSTRUCTION SERVICE LLC WALLY KING MASONRY LLC AGC OF GREATER MILWAUKEE API INC APPLETON LATHING CORP ARNIE MACKEY CONSTRUCTION ARTEAGA CONSTRUCTION INC BANE NELSON BEDROCK FLINT INC BENEFIT PLAN ADMINISTRATOR OF WI BOLDT OSCAR CONSTRUCTION CO BORTH-WILSON INC BUKACEK CONSTRUCTION INC C&S CONSTRUCTION INC CAMOSY INC CAPELLE BROTHERS & DIEDRICH INC CASTELLAN TILE & TERRAZZO INC CAULKING PLUS INC CLASSIC MARBLE & GRANITE CORNERSTONE CONSTRUCTION CROWLEY MASONRY INC DAROLD BERGER MASONRY DICKOW & CYZAK TILE DOYLE CONTRACTORS INC EDGAR PRAGER & SONS FABCON INC FINDORFF & SON INC FOWLER & HAMMER INC G&W PLASTERING INC GEGARE TILE INC GEORGE SIEGFRIED CONSTRUCTION CO HARBOR CITY MASONRY INC HAROLD ARDNT HILLSIDE DAMPROOFING INC IEI GENERAL CONTRACTORS INC INTERIOR INSTALLATION J&J LEE CONSTRUCTION JAC MASONRY INC JH HASSINGER INC JOHNSON TERRAZZO COMPANY JP CULLEN & SONS INC JUROWSKI RJ CONSTRUCTION INC KMI CONSTRUCTION LLC KOTZE CONSTRUCTION COMPANY INC LEWIS CONSTRUCTION INC LIPPERT TILE CO INC LUNDA CONSTRUCTION MA MORTENSON CO MAAS BROS CONSTRUCTION COMPANY MACCO'S COMMERCIAL INTERIORS MARKET & JOHNSON INC MARTELL CONSTRUCTION MEGAL CONSTRUCTION COMPANY MIRON CONSTRUCTION COMPANY INC NATIONAL MACHINERY POELLINGERS INC PUKALL COMPANY INC QUASIUS BROTHERS INC REFRACTORY SERVICE INC RESCH'S TILE INC RILEY CONSTRUCTION INC ROSSI CONSTRUCTION SCHERRER CONSTRUCTION COMPANY INC SCHMITT JOSEPH & SONS CO SCIACHITANO CAULKING INC SERVAIS TILE & STONE INC SID'S SEALANTS SMITH CD CONSTRUCTION COMPANY INC STEBBIBS ENGINEERING COMPANY STRETAR MASONRY & CONCRETE SUPERIOR MASONRY BUILDERS VONASEK & SCHIEFFER INC WALSH MASONRY INC WINKLER MASONRY INC WISCONSIN TERRAZZO TILE INC ZEISE FRANK CONSTRUCTION INC 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE R, PARTS II-IV IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, THE FUND HAD ADDITIONAL EMPLOYERS THAT HAVE NOT YET RESPONDED TO THE FUNDS EFFORT TO OBTAIN THE TAX CLASSIFICATION. THE CONTRIBUTING EMPLOYERS ARE: AARON KOWALSKI MASONRY LLC, ACOUSTICS ASSOCIATES INC., B&D MASONRY AND RESTORATION, BAC LOCAL UNION 15 WELFARE, BADGER WASHING, BARTHENHEIER CONSTRUCTION, BERGLUND CONSTRUCTION, BINDELLI BROTHERS, BRICK MASONS, BRICKLAYERS OF WESTERN PA, CARDINAL CONSTRUCTION, CEMENT M&P LOCAL 518, CHICAGO MASONRY LOCAL 21, CHICAGO TILE #67, CONSTRUCTION & TURNAROUND, CONSTRUCTION INDUSTRY, CONTRACT TILE & CARPET, CR MEYER & SONS (MADISON), CREATIVE ERECTORS, DG SKOUSE COMPANY, DIAMOND MASONRY, EMPRESS SURFACE SOLUTIONS, G FONTANA AND SONS, GILLESPIE & POWERS, HOUSE OF STONE, ICONIC FINISHES LLC, IMTEF, INTERNATIONAL HEALTH, IOWA BUILDERS HEALTH FUND, IOWA LABORERS DC HEALTH & WELFARE, IVAN RICE & SONS, J.P. PHILLIPS INC, JIMMY Z MASONRY, JOHNSON'S CARPET ONE 55807, JS MASONRY LLC, JT THORPE & SON, JW FLOORING INC, JW SEALANTS, KELLEHER CONST. INC., KINGSTON TILE CO., MASONRY WELFARE TRUST, MASS BRICLAYERS , MEL BJURSTROM MASONRY LLC, MN & ND BRICKLAYERS, MOUNT HOREB MASONRY, NORTHERN ILL & IOWA LAB, OHIO BRICKLAYERS, QUALITY BUILDING RESTORATION INC., RAY THEOBALD MASONRY CONSTRUCTION, READY TITLE LLC, REVOLUTION INDUSTRIAL SERVICES, ROCKFOARD CENTRAL TILE & T, SCHAEFER GROUP, INC., STEINHAMMER MASSORY LLC, SUMMIT CONCRETE & MASONRY, SWANSON SPRAY SYSTEMS, TAPPING TROWEL MASONRY, TITAN CITY CEMENT MASONS, TVJ MASONRY, INC., TWIN CITY CEMENT MASONS, VAN MINSEL BROS., WAUMANDEE CREEK SEALANTS, WAYNES CAULKING INC., WI LABORERS FUND, WILLIAM A. HEIN CONSTRUCTION CO., WILLIAM REFRACTORY SERVICES