2023-11-13T16:12:54-06:00 2022-12-31 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2022-01-01 456038633 DAKOTAS & WESTERN MN ELECTRICAL INDUSTRY HEALTH AND WELFARE FUND DAKO 7012374787 CO NBPA PO BOX 1951 FARGO ND 58107 CHARLES KACHER TRUSTEE 7012374787 2023-11-13 1 CHARLES KACHER 999009999 0 JACOB D EKLUND P01455813 9528413950 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ED CHRISTIAN C/O NBPA PO BOX 1951 FARGO ND 58107 64667501 0 X N/A X 1966 ND TO PROVIDE HEALTH AND WELFARE BENEFITS 18 3 155 0 0 0 0 0 48082796 53403785 2803915 -2295474 3619 1166 50890330 51109477 0 0 51414724 56086415 0 0 0 0 0 1108238 1086333 52522962 57172748 -1632632 -6063271 77871417 65482943 645119 483232 77226298 64999711 PAYMENT OF HEALTH CARE BENEFITS FOR ELIGIBLE PARTICIPANTS AND DEPENDENTS AS PROVIDED BY THE PLAN DOCUMENT. 0 0 THE PLAN PROVIDES HEALTH CARE AND PRESCRIPTION DRUG, DEATH BENEFITS, ACCIDENTAL DEATH AND DISMEMBERMENT, AND DISABILITY BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS OR BENEFICIARIES. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 16 0 1 155 1 0 0 0 0 0 0 0 0 0 0 X 18 3 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BLUECROSS BLUESHIELD OF NORTH DAKOTA 7012374787 C/O NBPA PO BOX 1951 FARGO ND 58107 KORY RAWSTERN - PAST TRUSTEE 1.00 55.00 X 0 66440 18881 RANDY BARTSCH - PAST CHAIRMAN 1.00 48.00 X 0 29116 5552 RANDY STAINBROOK - PAST TRUSTEE 1.00 55.00 X 0 105562 28478 CHRIS CALLIHAN - PAST TRUSTEE 1.00 48.00 X 0 51399 17410 DON BRUEMMER - PAST TRUSTEE 1.00 40.00 X 0 55852 17952 CHRIS BAKER TRUSTEE 1.00 50.00 X 0 87570 35472 JAMIE HELGESON - PAST TRUSTEE 1.00 40.00 X 0 70015 12422 EDWARD CHRISTIAN SECRETARY 1.00 40.00 X 0 159616 24939 ANGELA BOWERSOX TRUSTEE 1.00 X 0 0 0 JILL CLARK - PAST TRUSTEE 1.00 X 0 0 0 JASON BOWMAN TRUSTEE 1.00 40.00 X 0 100799 18077 CHARLES KACHER TRUSTEE 1.00 40.00 X 0 87590 30908 MICHAEL BUNACH TRUSTEE 1.00 X 0 0 0 DYLAN MEYER TRUSTEE 1.00 55.00 X 0 45470 13080 BOB WOLF TRUSTEE 1.00 48.00 X 0 130553 28260 MIKE PLANK TRUSTEE 1.00 40.00 X 0 10783 799 JEREMY DENAULT TRUSTEE 1.00 40.00 X 0 56317 12539 THOMAS EMERSON TRUSTEE 1.00 40.00 X 0 48145 15155 MIKE FANNING TRUSTEE 1.00 40.00 X 0 90072 31117 KYLE MCKENNA TRUSTEE 1.00 X 0 0 0 BRIAN SPADER TRUSTEE 1.00 X 0 0 0 DUANE HAERTLING TRUSTEE 1.00 X 0 0 0 TOM KECK TRUSTEE 1.00 X 0 0 0 ROBERT JARDING TRUSTEE 1.00 X 0 0 0 PAUL COMEAU TRUSTEE 1.00 X 0 0 0 0 1195299 311041 0 0 1 0 NORIDIAN MUTUAL INSURANCE COMPANY 2000 - 44TH STREET SUITE 104 FARGO ND 58103 PLAN ADMINISTRATION AND CLAIMS PROCESSIN 2453575 OPTUMRX 2300 MAIN STREET IRVINE CA 92614 CLAIMS PROCESSING 105490 2 EMPLOYER CONTRIBUTIONS 900099 46022403 46022403 PRESCRIPTION DRUG REBATE 900099 4112235 4112235 PARTICIPANT CONTRIBUTIONS 900099 3229802 3229802 SUBROGATION SETTLEMENTS 900099 39006 39006 LIQUIDATED DAMAGES 900099 339 339 53403785 1432379 1432379 9830171 13558024 -3727853 -3727853 -3727853 OTHER INCOME 900099 1166 1166 1166 51109477 53403785 0 -2294308 56086415 558919 55042 44055 99495 72000 129708 57361 41953 FEES MANDATED BY ACA 27800 57172748 1305136 131058 2380624 1950127 7197281 9593897 193299 66988376 53614562 77871417 65482943 86969 285703 558150 197529 645119 483232 X 0 0 0 0 77226298 64999711 77226298 64999711 77871417 65482943 -6063271 -6140860 -22456 0 X 0 1 X 1 0 0 X 44869122 -6140860 -6140860 51009982 99495 99495 51109477 57073253 0 57073253 99495 99495 57172748 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN UNCERTAIN TAX POSITIONS THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 0 0 EDWARD CHRISTIAN SECRETARY 0 159616 0 0 0 0 0 10779 0 14160 0 184555 0 0 BOB WOLF TRUSTEE 0 130553 0 0 0 0 0 15189 0 13071 0 158813 0 0 FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THE TRUSTEES HAVE DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO BLUECROSS BLUESHIELD OF NORTH DAKOTA DBA AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN. FORM 990, PART VI, SECTION A, LINE 7A NINE TRUSTEES ARE APPOINTED BY THE UNIONS AND NINE TRUSTEES ARE APPOINTED BY THE EMPLOYER CONTRACTORS ASSOCIATIONS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES REVIEW THE PLAN'S CONFLICT OF INTEREST POLICY ANNUALLY WITH THE PLAN ATTORNEY AND ARE REQUIRED TO SIGN AN ANNUAL CERTIFICATION OF COMPLIANCE WITH THE POLICY. IN ADDITION, TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH ITS PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS LAWFUL STATUS AND FIDUCIARY OBLIGATIONS, PERIODIC REVIEWS OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST AT THE PLAN'S OFFICE. DAKOTAS AREAWIDE IBEW-NECA SAVINGS AND RETIREMENT PLAN 2901 1ST AVE N FARGO ND 58102 450348980 PROVIDES RETIREMENT BENEFITS ND 401(A) N/A N/A 0 LOCAL UNION 95 CONTRIBUTING EMPLOYER 0 LOCAL UNION 231 CONTRIBUTING EMPLOYER 0 LOCAL UNION 257 CONTRIBUTING EMPLOYER 0 LOCAL UNION 265 CONTRIBUTING EMPLOYER 0 LOCAL UNION 288 CONTRIBUTING EMPLOYER 0 LOCAL UNION 350 CONTRIBUTING EMPLOYER 0 LOCAL UNION 426 CONTRIBUTING EMPLOYER 0 LOCAL UNION 453 CONTRIBUTING EMPLOYER 0 LOCAL UNION 545 CONTRIBUTING EMPLOYER 0 LOCAL UNION 1250 CONTRIBUTING EMPLOYER 0 LOCAL UNION 1426 CONTRIBUTING EMPLOYER 0 LOCAL UNION 13 CONTRIBUTING EMPLOYER 0 BURLINGTON ELECTRIC CONTRIBUTING EMPLOYER 0 0 CITYWIDE ELECTRIC CONTRIBUTING EMPLOYER 0 0 DARROW ELECTRIC CONTRIBUTING EMPLOYER 0 0 ELECTRIC SERVICE CONTRIBUTING EMPLOYER 0 0 FIRST NATION ELECTRIC CONTRIBUTING EMPLOYER 0 0 GARY & SON ELECTRIC SERV CONTRIBUTING EMPLOYER 0 0 GOODMAN ELECTRIC CONTRIBUTING EMPLOYER 0 0 GUARANTEE ELECTRICAL CONST CONTRIBUTING EMPLOYER 0 0 NEMO 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