2024-11-04T16:09:54-06:00 2023-12-31 363168081 SIKICH LLC 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2023-01-01 396078181 PAINTERS LOCAL 802 HEALTH AND WELFARE FUND PAIN 6088343100 2901 W BELTLINE HWY 100 MADISON WI 53713 JEFF MEHRHOFF CHAIRMAN 6088343100 2024-11-04 1 0 BRIDGETTE MUGGE P00671418 2627549400 2024-11-03 2023 2024-10-15 13:58:12Z JEFF MEHRHOFF 2901 W BELTLINE HWY 100 MADISON WI 53713 7784762 0 X N/A X 1999 WI TO PROVIDE HEALTH, DISABILITY, LIFE, AND DENTAL INSURANCE TO UNION MEMBERS AND NONMEMBERS. 6 4 16 6 0 0 0 0 4869712 5972039 -32418 157249 1981 83423 4839275 6212711 0 0 3683129 4185358 0 0 0 0 0 1515114 1495703 5198243 5681061 -358968 531650 5617731 6917597 2869195 3461945 2748536 3455652 TO PROVIDE HEALTH, DISABILITY, LIFE, AND DENTAL INSURANCE TO UNION MEMBERS AND NON-BARGAINING MEMBERS UNDER A COLLECTIVE BARGAINING AGREEMENT. 0 0 TO PROVIDE HOPSITAL, SURGICAL, DENTAL, AND MEDICAL BENEFITS FOR ELIGIBLE MEMBERS AND THEIR FAMILIES THROUGH SELF-INSURANCE. THE PLAN ALSO PROVIDES LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE THROUGH THE PURCHASE OF A GROUP INSURANCE POLICY. 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 1 186 0 16 1 0 0 0 0 0 0 0 0 X 6 4 0 1 0 0 0 0 1 1 0 0 0 1 1 0 0 0 1 0 0 0 X EMILY KRAMER 6088343100 2901 W BELTLINE HWY 100 MADISON WI 53713 JEFF MEHRHOFF CHAIRMAN 1.00 X X 0 139842 89585 BRIAN BAUMGARTNER LABOR TRUSTEE 0.50 X 0 98661 79631 STEVE ARMBRECHT THRU 101223 LABOR TRUSTEE 0.50 X 0 0 0 AMY OLSON THRU 11823 MANAGEMENT TRUSTEE/SEC. TR 0.50 X X 0 0 0 MIKE MALOFSKY MANAGEMENT TRUSTEE 0.50 X 0 0 0 SENAN NASH MANAGEMENT TRUSTEE 0.50 X 0 0 0 BETHANY KELEHER START 11823 MANAGEMENT TRUSTEE/SEC. TR 0.50 X X 0 0 0 RAY LAVALLEE START 101223 LABOR TRUSTEE 0.50 X 0 3953 1535 0 242456 170751 0 0 1 0 0 EMPLOYER CONTRIBUTIONS 525100 5862005 5862005 SELF PAYMENT CONTRIBUTIONS 525100 110034 110034 5972039 154986 154986 1574314 1572051 2263 2263 2263 OTHER INCOME 900001 83423 83423 83423 6212711 5972039 0 240672 4185358 44160 37819 24100 9159 167267 28305 961 9170 STOP-LOSS PREMIUMS 541109 MDB REIMBURSEMENTS 427100 PREFERRED PROVIDER AND 143239 COST CONTAINMENT 44317 18997 5681061 988548 1161179 119092 141943 529748 607889 61975 65557 11098 11098 0 0 3854781 4848122 25750 8000 37837 84907 5617731 6917597 56672 29711 2812523 3432234 2869195 3461945 X 0 0 0 0 2748536 3455652 2748536 3455652 5617731 6917597 X 531650 356204 -180738 X 0 1 X 1 0 11098 11098 0 0 ESTIMATED HEALTH CLAIMS LIABILITY 634000 RECIPROCAL CONTRIBUTIONS PAYABLE 71518 PAYROLL TAX WITHHELD 532 HRA LIABILITY 2726184 3432234 X 6559756 356204 356204 6203552 9159 9159 6212711 5429240 180738 180738 5248502 9159 423400 432559 5681061 PART X, LINE 2: THE IRS HAS DETERMINED AND INFORMED THE PLAN THAT THE PLAN IS QUALIFIED, AND THE TRUST ESTABLISHED UNDER THE PLAN IS TAX-EXEMPT, UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"). THE PLAN HAS BEEN AMENDED SINCE RECEIVING THE EXEMPTION LETTER. HOWEVER, THE TRUSTEES BELIEVE THAT THE PLAN IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE PROVISIONS OF THE IRC. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND 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 IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN MDB 180,738. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT CLAIMS PAYABLE 423,400. 0 0 0 JEFF MEHRHOFF CHAIRMAN 0 139842 0 0 0 0 0 65124 0 24461 0 229427 0 0 BRIAN BAUMGARTNER LABOR TRUSTEE 0 98661 0 0 0 0 0 55700 0 23931 0 178292 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS AN ADMINISTRATION AGREEMENT WITH A THIRD PARTY TO PERFORM CERTAIN MANAGEMENT SERVICES FOR THE PLAN, INCLUDING SUCH SERVICES AS MANAGING DAILY FUND OPERATIONS, ASSISTING IN DEVELOPMENT OF THE ANNUAL BUDGET, REVIEWING AND MANAGING OFFICE EQUIPMENT NEEDS, AND PERFORMING SERVICES FOR COMPLIANCE WITH APPLICABLE LAWS. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OF LOCAL 802 ARE REQUIRED TO APPROVE RATE CHANGES AS INITIALLY DETERMINED BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY EACH TRUSTEE. ONCE APPROVED, THE CHAIRMAN AND SECRETARY/TREASURER SIGN THE FORM 990. FORM 990, PART VI, SECTION C, LINE 19 THE FUND DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN MDB -180,738. BOARD OF TRUSTEES OF PAINTERS LOCAL 802 HEALTH AND WELFARE FUND 2901 W BELTLINE HWY 100 MADISON WI 53713 396078181 JOINT BOARD OF TRUSTEES-PLAN SPONSOR AND PLAN ADMINISTRATOR WI 501(C)(9) 0 PAINTERS & ALLIED TRADES DISTRICT COUNCIL NO 7 PO BOX 189 BIG BEND WI 531030189 320081499 UNION WI 501(C)(5) 0 PAINTERS LOCAL UNION 802 PO BOX 189 BIG BEND WI 531030189 390523644 UNION WI 501(C)(5) 0 PAINTERS LOCAL UNION 802 APPRENTICESHIP AND TRAINING FUND 2901 W BELTLINE HWY 100 MADISON WI 53713 391546758 APPRENTICESHIP PROGRAM WI 501(C)(3) 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990 SCHEDULE R PARTS II, III, & IV ALL-TECH DECORATING APPLETON LATHING BUILD & CON CNC COMMON LINKS CO E&A ENTERPRISES ELITE PAINTING GLASS SERVICE CENTER INC HALLMARK DRYWALL INC HESS SWEITZER P HETZEL-SANFILIPPO INC HOWARD GROTE & SONS INTERIOR INSTALLATION SVC IUPAT DC 7 APPR KLEIN-DICKERT PAINT KOJA CONSTRUCTION LAKE CITY GLASS LIVESEY PAINTING MAVID CONSTRUCT MILW PAINTERS 781 NCI PAINTING LLC OLYMPIC COMPANIES OMNI GLASS & PAINT INC PAL MAR PAINTING PORTA-PAINTING ROCKWELL GROUP. SCHMELZER PAINT STATZ & HARROP STATZ PAINTING SURF PREP INC VERHALEN COMMER WALL TECH INC