2022-09-13T14:10:46-05:00 2021-10-31 430352985 KERBER ECK & BRAECKEL LLP 3200 ROBBINS ROAD STE 200A SPRINGFIELD IL 62704 990 2020-11-01 366121856 OPERATING ENGINEERS LOCAL NO 965 HEALTH BENEFIT FUND OEU9 2175289659 3520 EAST COOK STREET SPRINGFIELD IL 62703 BRET SCAGGS CHAIRMAN 2175289659 2022-09-09 1 BRET SCAGGS XXX-XX-XXXX MICHELLE REISNER P01631881 2177890960 2022-09-09 2 AAL1 IAL1 2020 2023-04-26 12:10:37Z BRET SCAGGS 3520 EAST COOK STREET SPRINGFIELD IL 62703 22776881 0 X N/A X 1963 IL TO PROVIDE HEALTH AND TEMPORARY DISABILITY BENEFITS TO QUALIFIED PARTICIPANTS FOR WHOM REQUIRED CONTRIBUTIONS HAVE BEEN MADE. 6 5 0 0 0 0 0 0 12190993 14277212 610506 1853369 0 0 12801499 16130581 0 0 12546884 13724434 0 0 0 0 0 574220 1399615 13121104 15124049 -319605 1006532 22470499 25220860 1010617 215654 21459882 25005206 TO PROVIDE HEALTH AND TEMPORARY DISABILITY BENEFITS TO QUALIFIED PARTICIPANTS FOR WHOM REQUIRED CONTRIBUTIONS HAVE BEEN MADE. 0 0 PROVIDE HEALTH AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE MEMBERS 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 2 0 1 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BENEFITS MANAGEMENT GROUP INC 6302303904 1520 KENSINGTON ROAD SUITE 200 OAK BROOK IL 60523 BRET SCAGGS CHAIRMAN 1.00 X X 141010 0 76465 ROBERT BRUNER TRUSTEE 1.00 X 0 0 0 MICHAEL MCQUAY TRUSTEE 1.00 X 130808 0 76465 JASON RHOADES TRUSTEE 1.00 X 130808 0 76465 TRUMAN FLATT TRUSTEE 1.00 X 0 0 0 STEVE HALVERSON SECRETARY/TREASURER 2.00 X X 0 0 0 402626 0 229395 3 0 1 0 BLUE CROSS BLUE SHIELD OF ILLINOIS 300 EAST RANDOLPH STREET CHICAGO IL 60601 PROCESS CLAIMS 274704 BENEFITS MANAGEMENT GROUP INC 903 COMMERCE DRIVE SUITE 304 OAK BROOK IL 60523 MANAGE THE BOOKS FOR THE HEALTH BENEFIT 230400 2 EMPLOYER CONTRIBUTION 525100 11478549 11478549 PARTICIPANT CONTRIBUTION 525100 1896051 1896051 PRESCRIPTION CLAIM REBATES 525100 883480 883480 OTHER 900099 19132 19132 14277212 438748 438748 8060921 6646300 1414621 1414621 1414621 16130581 16130581 0 0 13724434 33614 44528 120826 26729 1100 7644 MEDICARE ADVANTAGE FEES 596095 PPO PROGRAM FEES 274704 HEALTH PLAN ADMINISTRAT 230400 MISCELLANEOUS 42100 21875 15124049 2332841 2731140 1273190 1392022 3050 3050 18805234 21039549 56184 55099 22470499 25220860 1010617 215654 1010617 215654 X 0 0 0 0 21459882 25005206 21459882 25005206 22470499 25220860 1006532 1831464 707328 0 X X 0 1 X 1 0 0 X 16957739 1831464 1831464 15126275 120826 883480 1004306 16130581 14119743 -883480 -883480 15003223 120826 120826 15124049 PART X, LINE 2: THE PLAN HAS RECOGNIZED IN THE FINANCIAL STATEMENTS THE EFFECTS OF ALL TAX POSITIONS AND CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. THE PLAN IS NOT AWARE OF ANY CIRCUMSTANCES OR EVENTS THAT MAKE IT REASONABLY POSSIBLE THAT UNRECOGNIZED TAX BENEFITS MAY INCREASE OR DECREASE WITHIN 12 MONTHS OF THE DATE OF THE STATEMENT OF NET ASSETS AVAILABLE FOR BENEFITS. PENALTIES AND INTEREST ASSESSED BY TAXING AUTHORITIES ARE INCLUDED IN THE ADMINISTRATIVE EXPENSES, IF APPLICABLE. THERE WERE NO INTEREST OR PENALTIES PAID DURING 2021 OR 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: PRESCRIPTION CLAIMS REBATES PART XII, LINE 2D - OTHER ADJUSTMENTS: PRESCRIPTION CLAIMS REBATES 0 0 0 BRET SCAGGS CHAIRMAN 141010 0 0 0 0 0 41365 0 35100 0 217475 0 0 0 MICHAEL MCQUAY TRUSTEE 130808 0 0 0 0 0 41365 0 35100 0 207273 0 0 0 JASON RHOADES TRUSTEE 130808 0 0 0 0 0 41365 0 35100 0 207273 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED. BRET SCAGGS, CHAIRMAN, REVIEWS THE FORM AND SIGNS IT BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH NEW EMPLOYEE OR MEMBER OF THE BOARD MUST REVIEW THE CONFLICT OF INTEREST POLICY AND DETAIL ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES THAT COULD BE CONSIDERED A CONFLICT OF INTEREST. ADDITIONALLY, THIS POLICY MUST BE REVIEWED AND FILLED OUT AGAIN BY EMPLOYEES OR BOARD MEMBERS ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION IS MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: NO CHANGES TO THE OVERSIGHT OR SELECTION PROCESS WERE NOTED DURING THE TAX YEAR. INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL UNION NO 965 3520 EAST COOK STREET SPRINGFIELD IL 62703 370347820 TO REPRESENT MEMBERS OF THE INTERNATIONAL UNION OF OPERATING ENGINEERS. IL 501(C)(5) 0 IUOE LOCAL 965 PEC 3520 EAST COOK STREET SPRINGFIELD IL 62703 262407673 ATTEMPTING TO INFLUENCE ELECTIONS OF LOCAL PUBLIC OFFICES. IL 527 0 OPERATING ENG APPRENTICESHIP & SKILL IMPROVEMENT COMMMITTEE FOR CENTRAL IL 3208 YOUNG ROAD MECHANICSBURG IL 62545 370918073 PROVIDE APPRENTICESHIP TRAINING PROGRAM FOR NEW UNION MEMBERS. 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