2024-10-07T09:23:33-05:00 2023-12-31 842885766 ROMOLO & ASSOCIATES LLC 1700 W LUTHY DRIVE PEORIA IL 61615 990 2023-01-01 371117215 CENTRAL ILLINOIS CARPENTERS HEALTH AND WELFARE FUND CENT 2177321919 200 S MADIGAN DRIVE LINCOLN IL 62656 KRISTINA GUASTAFERRI ADMINISTRATIVE MANAGER 2177321919 2024-09-28 1 0 KRISTIN ROMOLO CPA P01381270 3096822001 2024-09-06 2023 2024-10-15 13:58:12Z KRISTINA GUASTAFERRI 200 S MADIGAN LINCOLN IL 62656 52578043 0 X CICHEALTH.ORG X 1982 IL HEALTH AND WELFARE PLAN 10 10 48 0 0 0 0 0 28833619 33428637 1568928 1823808 314455 331033 30717002 35583478 0 0 26821079 31270539 686760 644334 0 0 0 1498394 1586436 29006233 33501309 1710769 2082169 66409380 72884583 4643670 4566330 61765710 68318253 TO PROVIDE HEALTH & WELFARE BENEFITS TO MEMBERS 0 0 TO PROVIDE HEALTH & WELFARE BENEFITS TO MEMBERS 0 0 0 0 0 0 0 0 0 1 1 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 1 350 0 48 1 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 1 0 0 0 X KRISTINA GUASTAFERRI 2177321919 200 S MADIGAN LINCOLN IL 62656 X NATHAN GERMAN- PAST CHAIRMAN 0.00 X X 0 0 0 RIKI DIAL TRUSTEE 0.00 X 0 0 0 JASON BREWER TRUSTEE 0.00 X 0 0 0 JEFF FUERST SECRETARY 0.00 X X 0 0 0 MATT WATCHINISKI TRUSTEE 0.00 X 0 0 0 MATT BENDER TRUSTEE 0.00 X 0 0 0 JEFF BORT TRUSTEE 0.00 X 0 0 0 JOSH ROBERTSON TRUSTEE 0.00 X 0 0 0 MIKE SUNLEY TRUSTEE 0.00 X 0 0 0 NICK HART TRUSTEE 0.00 X 0 0 0 WES ZOBRIST TRUSTEE 0.00 X 0 0 0 KRISTINA GUASTAFERRI ADMIN 40.00 X 0 0 0 0 0 0 0 0 0 0 ROMOLO & ASSOCIATES LLC 1700 W LUTHY DRIVE PEORIA IL 61615 ACCOUNTING/AUDITING 128597 CAVANAGH & O'HARA 2319 WEST JEFFERSON STREET SPRINGFIELD IL 62702 LEGAL 112406 2 EMPLOYER CONTRIBUTIONS 900099 31052236 31052236 PARTICIPANT CONTRIBUTIONS 900099 2376401 2376401 33428637 1719673 1719673 17098700 16991788 2777 106912 -2777 104135 104135 SERVICE FEE 900099 196052 196052 REIMBURSEMENT FROM RSF 900099 133639 133639 MISC 900099 900 900 442 442 331033 35583478 33759670 0 1823808 31270539 361029 80198 152347 50760 111324 126997 82502 191516 161557 190385 42192 4712 102638 36120 BCBS ADMINISTRATIVE FEE 400385 MACRC ADMIN FEES 86875 VISION ADMINISTRATIVE E 29197 PCORI FEES 14524 5512 33501309 10486927 15430738 3278272 3673341 65916 41387 1465557 963998 565613 501559 48435723 49481361 3576929 3756197 66409380 72884583 1515591 1177768 373079 381562 2755000 3007000 4643670 4566330 X 61765710 68318253 61765710 68318253 66409380 72884583 2082169 4470374 0 X 0 1 X 1 0 70014 70014 665256 319680 345576 0 730287 644318 85969 0 501559 POOLED SEPARATE ACCOUNT 3756197 F 3756197 CLAIMS INCURRED BUT NOT REPORTED 3007000 3007000 X 39971350 4470374 4470374 35500976 82502 82502 35583478 33166807 0 33166807 82502 252000 334502 33501309 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, AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE DATED AUGUST 27, 1982, AND THE PLAN'S BOARD OF TRUSTEES BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE INTERNAL REVENUE CODE. THE TOTAL AMOUNTS OF INTEREST AND PENALTIES RECOGNIZED IN THE STATEMENTS OF CHANGES IN NET ASSETS AVAILABLE FOR BENEFITS AND THE TOTAL AMOUNTS OF INTEREST AND PENALTIES RECOGNIZED IN THE STATEMENTS OF NET ASSETS AVAILABLE FOR BENEFITS ARE $0. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022, 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. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN HAS NEVER HAD UNRELATED BUSINESS INCOME TAX (UBIT). FOR YEARS IN WHICH THE FORM 990-T HAS BEEN FILED, THOSE YEARS ARE OPEN FOR EXAMINATION FOR THREE YEARS FROM THE DATE OF THE FILING. ALL OTHER TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CLAIMS INCURRED BUT NOT REPORTED 252,000. FORM 990, PART VI, SECTION B, LINE 11B THE AUDITOR PROVIDES THE COMPLETED FORM TO THE PLAN ADMINISTRATOR FOR REVIEW. ONCE THE PLAN ADMINISTRATOR HAS APPROVED THE FORM, SHE SIGNS FORM 8879-TE AND SENDS IT BACK TO THE AUDITOR, WHO THEN ELECTRONICALLY FILES THE RETURN. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST BOARD OF TRUSTEES SEE PART VII FOR LISTING SEE PART IV 2K COMMERCIAL CONSTRUCTION INC 4MC CORPORATION A & R SERVICES INC A&A CONCRETE LLC ABBEY PAVING & SEAL COATING IN ACOUSTICAL CEILINGS LLC AGILE CONSTRUCTION SERVICES LL AL SMITH MECHANICAL LTD ALBERICI CONSTRUCTORS ALLIED CONSTRUCTION ALLIED POWER SERVICES LLC AMERICAN IGLOO BUILDERS ANTIGUA INC APACHE INDUSTRIAL UNITED APCOM POWER INC ASSOCIATED CONSTRUCTORS CO IN ATLANTIC PLANT MAINTENANCE AUPPERLE WILLIAM & SONS INC BABCOCK & WILCOX SOLAR ENERGY BARBER & DEATLEY INC BEDROCK PAINTING INC BENCHMARK CABINETS & MILLWORK BENCHMARK FLOORING INSTALLATIO BERGLUND CONSTRUCTION COMPANY BERKEL & CO CONST INC BIG O SERVICES LLC BISHOP BROTHERS INC BLACK ROCK CONSTRUCTION SERVIC BLACKHAWK FOUNDATION CO INC BORCHERS' DECORATING BOWEN ENGINEERING CORPORATION BRANDSAFWAY INDUSTRIES LLC BROCK INDUSTRIAL SERVICES BROEREN RUSSO CONSTRUCTIONIN BUILDERS SALES & SERVICE CO BUILT UNITED LLC BVCI BYRNE 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ASSOCIATES INC TIEMAN BUILDERS INC TIM LIPE CONSTRUCTION INC TINDALL CONSTRUCTION CO TITAN CARPENTRY LLC TJ WIES CONTRACTING TMF CONSTRUCTION TOBEYS CONSTR & CARTAGE TOMMY LEE ARBUCKLE III TORO CONSTRUCTION CORP TRACK SURFACES COMPANY TRADE-MARK CONST SERVICES IN TSI COMMERCIAL FLOOR COVERING TURBINE PROS TWIN CITY TILE & MARBLE LLC UNION FLOORING SERVICES INC UNIVERSAL PLANT SERVICES US INSULATION LLC (GOLEY IND) VALLEY CONSTRUCTION COMPANY VERMILION MILLWORKS LLC VEYA INC VISSERING CONSTRUCTION VON ALST OPERATING LLC W F JOHNSTON CONSTRUCTION IN WATER COOLING EQUIPMENT INC WATERKOTTE CONSTRUCTION INC WEEDMAN DOOR & HARDWARE WEITZ INDUSTRIAL A DIVISION WENGER TRAFFIC CORPORATION WHEELER CONSTRUCTION CO WHITE CONSTRUCTION INC WIES DRYWALL AND CONSTRUCTION WILLIAM A RANDOLPH INC WILLIAMS BROS CONST INC WINGLE CONSTRUCTION WOODS CONSTRUCTION INC WRIGHT-WAY INTERIOR SYS LLC WT BUILDERS XPR CONSTRUCTION INC ZOBRIST N & SONS INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART IV THIS PLAN IS A VEBA EXEMPT UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE. PER THE INSTRUCTIONS FOR SCHEDULE R, VEBA TRUSTS ARE ONLY REQUIRED TO LIST THE NAMES OF THE SPONSORING ORGANIZATIONS AND CONTRIBUTING EMPLOYERS ON SCHEDULE R. THE PLAN DOES NOT KNOW THE TAXABLE STATUS OF EVERY CONTRIBUTING EMPLOYER AND THEREFORE IS UNABLE TO SPLIT UP THE INFORMATION BETWEEN THE VARIOUS SECTIONS OF SCHEDULE R.