2025-11-17T13:48:35-06:00 2024-12-31 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2024-01-01 456038633 DAKOTAS & WESTERN MN ELECTRICAL INDUSTRY HEALTH AND WELFARE FUND DAKO 7012374787 CO NBPA PO BOX 1951 FARGO ND 58107 ED CHRISTIAN SECRETARY 7012374787 2025-11-17 1 0 JACOB D EKLUND P01455813 9528413950 2025-11-15 2024 2025-03-06 01:10:19Z BOB WOLF C/O NBPA PO BOX 1951 FARGO ND 58107 79926300 0 X N/A X 1966 ND TO PROVIDE HEALTH AND WELFARE BENEFITS 18 3 136 0 0 0 0 0 61770865 68622855 1811971 2106656 9383 855 63592219 70730366 0 0 65005689 62334379 0 0 0 0 0 1139275 1312579 66144964 63646958 -2552745 7083408 67879921 78376695 562062 493856 67317859 77882839 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 5 0 1 136 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 CHRIS BAKER TRUSTEE - PAST 1.00 50.00 X 0 28052 4004 CHARLES KACHER TRUSTEE 1.00 40.00 X 0 95490 34325 DANNY ROBINSON TRUSTEE 1.00 40.00 X 0 97756 34912 BOB WOLF TRUSTEE 1.00 48.00 X 0 143324 27705 DYLAN MEYER TRUSTEE 1.00 55.00 X 0 107730 26923 JEREMY DENAULT TRUSTEE 1.00 40.00 X 0 140667 29176 MIKE FANNING TRUSTEE - PAST 1.00 40.00 X 0 36266 4051 MIKE PLANK TRUSTEE 1.00 40.00 X 0 113760 27119 THOMAS EMERSON TRUSTEE 1.00 40.00 X 0 98135 35484 ROBERT JARDING TRUSTEE 1.00 X 0 0 0 PAUL COMEAU TRUSTEE 1.00 X 0 0 0 DUANE HAERTLING TRUSTEE 1.00 X 0 0 0 EDWARD CHRISTIAN SECRETARY 1.00 40.00 X 0 185122 30429 BRIAN SPADER TRUSTEE 1.00 X 0 0 0 TOM KECK TRUSTEE 1.00 X 0 0 0 ANGELA BOWERSOX TRUSTEE 1.00 X 0 0 0 JACOB NYE TRUSTEE 1.00 40.00 X 0 104917 46020 KYLE MCKENNA TRUSTEE 1.00 X 0 0 0 MICHAEL BUNACH TRUSTEE 1.00 X 0 0 0 JOEL VANDERSLICE TRUSTEE 1.00 40.00 X 0 104594 16203 0 1255813 316351 0 0 1 0 BLUECROSS BLUESHIELD OF NORTH DAKOTA 2000 - 44TH STREET SUITE 104 FARGO ND 58103 PLAN ADMINISTRATION AND CLAIMS PROCESSIN 2014048 UNITED ACTUARIAL SERVICES 11590 N MERIDIAN STREET SUITE 610 CARMEL IN 46032 ACTUARIAL SERVICES 103205 OPTUMRX 2300 MAIN STREET IRVINE CA 92614 CLAIMS PROCESSING 101633 3 EMPLOYER CONTRIBUTIONS 900099 59076560 59076560 PRESCRIPTION DRUG REBATES 900099 6004589 6004589 PARTICIPANT CONTRIBUTIONS 900099 3463021 3463021 SUBROGATION SETTLEMENTS 900099 78273 78273 LIQUIDATED DAMAGES 900099 412 412 68622855 2059174 2059174 9243416 9195934 47482 47482 47482 OTHER INCOME 900099 855 855 855 70730366 68622855 0 2107511 62334379 694191 63597 26900 103089 103205 198380 62796 37124 ACA TAX 23297 63646958 -2103037 -373487 2260970 3587664 8696344 12399013 195070 241702 58830574 62521803 67879921 78376695 390319 342206 171743 151650 562062 493856 X 0 0 0 0 67317859 77882839 67317859 77882839 67879921 78376695 7083408 3481572 0 X 0 1 X 1 0 0 X 74108849 3481572 3481572 70627277 103089 103089 70730366 63543869 0 63543869 103089 103089 63646958 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 185122 0 0 0 0 0 12513 0 17916 0 215551 0 0 BOB WOLF TRUSTEE 0 143324 0 0 0 0 0 12396 0 15309 0 171029 0 0 JEREMY DENAULT TRUSTEE 0 140667 0 0 0 0 0 13328 0 15848 0 169843 0 0 JACOB NYE TRUSTEE 0 104917 0 0 0 0 0 23140 0 22880 0 150937 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 CONTRACTOR 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 OFFICE. 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