2023-07-25T13:39:37-05:00 2022-12-31 390747409 REILLY PENNER & BENTON LLP 1233 NORTH MAYFAIR ROAD SUITE 302 MILWAUKEE WI 532263255 990 2022-01-01 366157689 NORTHERN ILLINOIS AND IOWA LABORERS' HEALTH & WELFARE TRUST NORT 3097863361 2837 7TH AVENUE ROCK ISLAND IL 61201 BRADLY LONG TRUSTEE 3097863361 2023-07-18 1 BRADLY LONG 999009999 0 JOSHUA BIERBACH P01449255 4142717800 2023-07-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BRADLY LONG 2837 7TH AVENUE ROCK ISLAND IL 61201 18335134 0 X N/A X 1967 IL THE PLAN PROVIDES HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES REPRESENTED BY THE UNION AND FOR OTHER EMPLOYEES FOR WHOM CONTRIBUTIONS ARE OR HAVE BEEN PAID INTO AND ACCEPTED BY THE PLAN. THE SPOUSES AND OTHER DEPENDENTS OF QUALIFYING EMPLOYEES ARE ALSO ELIGIBLE FOR BENEFITS. 7 7 5 0 0 0 0 0 5822505 6025303 3302604 1798640 1615083 1567076 10740192 9391019 0 0 5714929 5892678 201398 212284 0 0 0 1110176 1207570 7026503 7312532 3713689 2078487 41445522 37322144 7955154 7950432 33490368 29371712 X THE PLAN PROVIDES HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES REPRESENTED BY THE UNION AND FOR OTHER EMPLOYEES FOR WHOM CONTRIBUTIONS ARE OR HAVE BEEN PAID INTO AND ACCEPTED BY THE PLAN. THE SPOUSES AND OTHER DEPENDENTS OF QUALIFYING EMPLOYEES ARE ALSO ELIGIBLE FOR BENEFITS. 0 0 7312532 7592379 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES REPRESENTED BY UNIONS LOCAL NO. 309, NO. 544, AND FOR OTHER ELIGIBLE EMPLOYEES FOR WHOM CONTRIBUTIONS ARE OR HAVE BEEN PAID INTO THE TRUST BY CONTRACTORS. 7312532 0 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 1 0 0 1 184 0 1 5 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 1 1 1 0 X JULIE LAGE 3097863361 2837 7TH AVENUE ROCK ISLAND IL 61201 MIKE HOWARD TRUSTEE 3.00 X 0 0 0 STEVE TONDI TRUSTEE 3.00 X 0 0 0 CLINT HOEGER TRUSTEE 3.00 X 0 0 0 TIMOTHY FOSTER TRUSTEE 3.00 X 0 0 0 DAVID ADAMS TRUSTEE 3.00 X 0 0 0 BRADLY LONG TRUSTEE 3.00 X 0 0 0 PAUL FOLEY TRUSTEE 3.00 X 0 0 0 JULIE LAGE ADMINISTRATOR 40.00 X 95000 0 32358 95000 0 32358 1 0 0 0 0 EMPLOYER CONTRIBUTIONS 525100 5611960 5611960 SELF PAY CONTRIBUTIONS 525100 413343 413343 6025303 763953 763953 9978802 8944115 1034687 1034687 1034687 RECIPROCAL TRANSFERS 525100 968912 968912 RETIREE SUPPLEMENT 525100 564410 564410 MISCELLANEOUS 525100 33754 33754 1567076 9391019 7592379 0 1798640 5892678 5892678 127358 127358 46388 46388 27350 27350 11188 11188 68791 68791 27000 27000 212227 212227 21889 21889 1045 1045 7800 7800 669 669 15858 15858 CLAIMS ADMINISTRATION 443215 443215 RECIPROCAL TRANSFER 304434 304434 CONSULTING 38700 38700 PREFERRED PROVIDER OPTI 35776 35776 30166 30166 7312532 7312532 0 0 19 20 1014887 1085611 788450 734778 7809 15331 36511 32973 1225 3538 39510915 34813788 122217 669078 41445522 37322144 161391 170800 7793763 7779632 7955154 7950432 X 33490368 29371712 33490368 29371712 41445522 37322144 X 2078487 -6264661 67518 X X 0 1 X 1 0 36511 32973 3538 3538 ESTIMATED FUTURE BENEFITS - PARTICIPANTS ELIGIBILITY 7779632 7779632 X 2609697 -6264661 -6264661 8874358 212227 304434 516661 9391019 6742485 0 6742485 212227 357820 570047 7312532 PART X, LINE 2: THE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE DATED AUGUST 28, 1967, STATING THAT THE PLAN IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC), AND, ACCORDINGLY, THE PLAN'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN SPONSOR BELIEVES THAT THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE INTERNAL REVENUE CODE. IN ADDITION, THE PLAN AND THE TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND TO 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 DEPARTMENT OF LABOR OR INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. GENERALLY, FOR UNITED STATES FEDERAL INCOME TAXES, THE PLAN IS ONLY SUBJECT TO EXAMINATION FOR THE CURRENT YEAR'S TAX RETURN AND THE PRECEDING THREE YEARS' RETURNS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECIPROCAL AGREEMENTS 304,434. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECIPROCAL AGREEMENTS 304,434. CHANGE IN BENEFIT OBLIGATIONS PAYABLE 53,386. FORM 990, PART VI, SECTION A, LINE 6 THE PLAN AND RELATED TRUST WERE ESTABLISHED PURSUANT TO A COLLECTIVE BARGAINING AGREEMENT BETWEEN THE LABORERS' INTERNATIONAL UNION OF NORTH AMERICA, LOCAL UNION NO. 309, AFL-CIO THE QUAD CITY BUILDERS ASSOCIATION, INC., AND THE ASSOCIATED CONTRACTORS OF THE QUAD CITIES. THE PLAN PROVIDES HEALTH AND WELFARE BENEFITS TO FULLTIME PARTICIPANTS AND TO THEIR BENEFICIARIES AND COVERED DEPENDENTS. RETIRED MEMBERS ARE ENTITLED TO SIMILAR HEALTH BENEFITS PROVIDED THEY CONTINUE TO REMIT THE MONTHLY PREMIUMS DETERMINED PERIODICALLY BY THE PLAN AS A SELF-PAY MEMBER. FOR EVERY HOUR THAT A PARTICIPANT WORKS, THE UNION CONTRACTOR IS REQUIRED TO PAY A CONTRACTUAL RATE TO FUND THE HEALTH AND WELFARE PLAN. FORM 990, PART VI, SECTION B, LINE 11B THERE IS A FORMAL REVIEW OF THE AUDIT REPORT WHERE BY ALL BOARD MEMBERS ARE PRESENT. FINANCIAL INFORMATION USED IN THE PREPARATION OF THE FORM 990 COMES DIRECTLY FROM THE FINAL AUDIT REPORT AND ITS DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 15 IN DECEMBER OF EACH YEAR THE COMPENSATION COMMITTEE CONDUCTS PERFORMANCE REVIEWS OF ALL ITS EMPLOYEES. RECOMMENDATIONS FOR INCREASE IN COMPENSATION AND BENEFITS PACKAGES ARE PRESENTED TO THE FULL BOARD FOR FINAL APPROVAL. THE COMPENSATION IS THEN DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION SENDS ALL OF ITS PARTICIPANTS A SUMMARY OF THE ANNUAL REPORT FOR THE NORTHERN ILLINOIS & IOWA LABORERS HEALTH & WELFARE TRUST PLAN BASED ON THE FORM 5500. INCLUDED IN THE REPORT IS A SECTION EXPLAINING THE PARTICIPANT'S RIGHTS TO ADDITIONAL INFORMATION AND HOW TO OBTAIN ADDITIONAL INFORMATION FROM THE PLAN ADMINISTRATOR. PARTICIPANTS MAY WRITE OR REQUEST IN PERSON A COPY OF THE REPORT AT NO ADDITIONAL CHARGE. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, TAX RETURNS, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET CHANGE IN ACCUMULATED ELIGIBILITY CREDITS 67,518. 990, PART XII, LINE 2C NO CHANGES HAVE BEEN MADE TO THE PROCESS INVOLVING THE OVERSIGHT OF THE AUDIT. 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31ST AVENUE ROCK ISLAND IL 61201 CONTRIBUTING EMPLOYER IL 0 K & D CUTTING AND CORING INC PO BOX 183 MILAN IL 612640183 CONTRIBUTING EMPLOYER IL 0 KCM CONSTRUCTION PO BOX 425 COLONA IL 61241 CONTRIBUTING EMPLOYER IL 0 KEN CURRY CONSTRUCTION INC 1518 - 12TH STREET EAST MOLINE IL 61244 CONTRIBUTING EMPLOYER IL 0 KIRBY CABLE SERVICES PO BOX 37 PECATONICA IL 61063 CONTRIBUTING EMPLOYER IL 0 KS ENERGY SERVICES 19705 W LINCOLN AVENUE NEW BERLIN WI 53146 CONTRIBUTING EMPLOYER WI 0 KUJO INC 5303 JOHNSBURG ROAD JOHNSBURG IL 60051 CONTRIBUTING EMPLOYER IL 0 LABORERS' LOCAL 309 2835 - 7TH AVENUE ROCK ISLAND IL 61201 CONTRIBUTING EMPLOYER IL 0 LANDMARK LANDSCAPING 802 SE 19TH AVENUE ALEDO IL 61231 CONTRIBUTING EMPLOYER IL 0 LAVERDIERE CONSTUCTION INC 4055 WEST JACKSON STREET MACOMB IL 61455 CONTRIBUTING EMPLOYER IL 0 LEWIS CONSTRUCTION INC 9307 BIRCH STREET SCHOFIELD WI 54476 CONTRIBUTING EMPLOYER WI 0 LOCKWOOD EXCAVATING & CONSTRUCTION INC 945 MONMOUTH BLVD GALESBURG IL 61401 CONTRIBUTING EMPLOYER IL 0 LUNDA CONSTRUCTION PO BOX 669 BLACK RIVER FALLS WI 546150699 CONTRIBUTING EMPLOYER WI 0 M & O ENVIRONMENTAL PO BOX 759 HOMEWOOD IL 60430 CONTRIBUTING EMPLOYER IL 0 MAC INDUSTRIAL SERVICES 1831 N LYNNVILLE ROAD LINDENWOOD IL 61068 CONTRIBUTING EMPLOYER IL 0 MARKET & JOHNSON INC 2350 GALLOWAY STREET EAU CLAIRE WI 54703 CONTRIBUTING EMPLOYER WI 0 MATHY CONSTRUCTION COMPANY BOX 189 ONACASKA WI 54601 CONTRIBUTING EMPLOYER WI 0 MCCARTHY IMPROVEMENT CO 5401 VICTORIA AVENUE DAVENPORT IA 52807 CONTRIBUTING EMPLOYER IA 0 MCCLEARY EXCAVATING CO INC PO BOX 308 BLUE GRASS IA 527260308 CONTRIBUTING EMPLOYER IA 0 MCCLINTOCK TRUCKING & EXCAVATING INC 1701 - 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