2023-12-01T10:31:30-06:00 2023-07-31 351327464 SACKRIDER & COMPANY INC 1925 Wabash Ave Terre Haute IN 47807 990 2022-08-01 350917610 Mid Central Operating Engineers Health & Welfare Fund MIDC 8122324384 1100 Poplar Street Terre Haute IN 47807 Tom Ridge Chairman 8122324384 2023-12-01 1 Tom Ridge 999009999 0 Craig A Todd CPA P00593406 8122329492 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z 1100 Poplar Street Terre Haute IN 47807 171946110 0 X www.midcentral.org X 1954 IN To provide health and welfare benefits to members. 8 8 85 0 0 0 0 0 116540290 130541390 4374830 2734787 0 0 120915120 133276177 0 0 103257019 102938531 1379484 1550640 0 0 0 6389429 6542334 111025932 111031505 9889188 22244672 164227966 188569151 2961168 3133091 161266798 185436060 To provide health and welfare benefits to members. 0 0 111014430 130541390 Administration of group insurance plan covering active and retired members and dependents of Locals 841, 318, 103, and 649 - International Union of Operating Engineers. 111014430 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 852 0 1 85 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 IN X Cheryl Cottrell Administrator 8122324384 1100 Poplar Street Terre Haute IN 47807 X Tom Ridge Chairman 2.00 X X 0 0 0 Robert Rood Trustee 2.00 X 0 0 0 John Ballard Vice Chairman 2.00 X X 0 0 0 Dee Stahlhut Trustee 2.00 X 0 0 0 Darren Smith Trustee 2.00 X 0 0 0 Steve Crider Trustee 2.00 X 0 0 0 James Bruner Asst. Sec/Treas 2.00 X X 0 0 0 Holly Adams Sec/Treas 2.00 X X 0 0 0 Cheryl Cottrell Executive Admin 40.00 X 120956 0 50152 120956 0 50152 1 0 1 0 OptumRx 9900 Bren Rd East Minnetonka MN 55343 RX Benefit Mgt. 31564661 Anthem Insurance Company 220 Virginia Avenue Indianapolis IN 46204 PPO 2728541 Indiana Center for Recovery 1004 W 1st St Bloomington IN 47403 Inpatient Services 264114 Pekin Memorial Hospital PO Box 843151 Kansas City MO 64184 Inpatient Services 155575 Union Hospital PO Box 3589 Terre Haute IN 47803 Inpatient Services 128124 8 Contributions 900099 130261668 130261668 Liquidated damages 900099 232921 232921 Reimbursed expenses 900099 35486 35486 Other additions 900099 11315 11315 130541390 3905343 3905343 37499377 38669933 -1170556 -1170556 -1170556 133276177 130541390 0 2734787 102938531 102938531 823360 823360 225264 225264 429275 429275 72741 72741 53985 53985 85003 85003 540551 540551 165874 165874 63854 63854 20177 20177 34150 17075 17075 42275 42275 26109 26109 Anthem benefit administ 2728541 2728541 Clinic Service Fees 1551303 1551303 Repairs & maintenance 208535 208535 Clinic Lab Fees 205662 205662 816315 816315 111031505 111014430 17075 0 1450076 5188168 23835308 34959710 16994416 17653947 1347839 895362 498979 452477 121437783 130303445 11404 11404 164227966 188569151 593076 919472 2368092 2213619 2961168 3133091 X 0 0 0 0 161266798 185436060 161266798 185436060 164227966 188569151 X 22244672 1924590 0 X 0 1 X 0 0 7500 7500 891669 477476 414193 448670 417886 30784 452477 Due to other funds 2213619 2213619 X 134660217 1924590 1924590 132735627 540550 540550 133276177 110490955 0 110490955 540550 540550 111031505 Part X, Line 2: Financial statement footnote 11 addresses uncertain tax positions. The plan administrator has analyzed the tax positions taken by the plan and has concluded there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. X 0 0 0 Cheryl Cottrell Executive Admin 120956 0 0 0 0 0 0 0 50152 0 171108 0 0 0 Part I, Line 3 On an annual basis, the board of trustees reviews and approves the Executive Administrator's performance and salary. Form 990, Part VI, Section B, line 11b Line 11b Explanation - All Trustees do not review the annual Form 990; however, the Administrator does review the Form 990 upon its completion prior to it being filed with the IRS. Additionally, the signing officer reviews prior to signing and submitting to the IRS. Form 990, Part VI, Section B, line 15a Annually, the board of trustees reviews the job performance of the Fund's administrator, and through majority vote of the trustees, determines the compensation level for the administrator for the next fiscal year. Form 990, Part VI, Section C, line 19 On an annual basis, the Fund has prepared the summary annual report (SAR) that is available to the general public. The SAR is available at the Fund office during normal business hours or upon request. Additionally, the annual audited financial statements are available for review upon request. Form 990, Part XI, Line 2c A committee has not been established to oversee the financial statement audit. The full board assumes responsibility for oversight of the audit and by majority vote, approves the plan auditors annually. See Sch R Part IV See Sch R Part IV See Sch R Part IV IN 47807 IN See Sch R Part IV See Sch R Part IV See Sch R Part IV IN 47807 IN 3 Phase Line Construction 300 Westgate Dr Carol Stream IL 60188 020486688 IL 0 3D COMPANY INC 3200 E COUNTY ROAD 350 N MUNCIE IN 47303 352094565 IN 0 30-A CONSTRUCTION LLC PO BOX 315 BARGERSVILLE IN 46106 IN 618 Civil Contracting LLC 514 Country Club Rd Centralia IL 62801 844551339 IL 0 A & A CONCRETE LLC 1852 CR 3500 N LUDLOW IL 60949 822153206 IL 0 A & B DRILLING INC 1339 E 700 N HUNTINGTON IN 46750 822246644 IN 0 A & R SERVICES INC 711 KETTERING URBANA IL 61803 371361135 IL 0 A & W PLUMBING 11 ALIANCE AVE MURPHYSBORO IL 62966 721605688 IL 0 A A A Queen Bee Construction Inc PO Box 91 Camby IN 46113 274434599 IN 0 A P I INC CONSTRUCTION 1100 OLD HWY 8 NW NEW BRIGHTON MN 55112 MN ALL MASONRY CONSTRUCTION CO INC 1425 S 55TH CT CICERO IL 60804 IN A N J Electric Inc 1710 N Main Morton IL 61550 474544121 IL 0 Abbey Paving & Seal Coating Inc 1949 County Line Rd 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