TY 2013 Form 990

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............		1	3,098,875
2	Savings and temporary cash investments .........	3,678,600	2	994,750
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	1,677,293	4	2,480,361
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............		8
9	Prepaid expenses and deferred charges ..........	706,351	9	864,476
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation .....	10b			10c
11	Investments—publicly traded securities ..........	32,350,581	11	33,066,594
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........		15
16	Total assets. Add lines 1 through 15 (must equal line 34)......	38,412,825	16	40,505,056
	17	Accounts payable and accrued expenses .........	926,181	17	1,377,514
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	5,430,000	25	7,552,000
26	Total liabilities. Add lines 17 through 25.........	6,356,181	26	8,929,514
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds	32,056,644	32	31,575,542
33	Total net assets or fund balances ...........	32,056,644	33	31,575,542
34	Total liabilities and net assets/fund balances ........	38,412,825	34	40,505,056

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

LABORERS METROPOLITAN DETROIT
HEALTH AND WELFARE FUND

Employer identification number

38-2026006

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............
d	Equipment ................
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
ACCUMULATED ELIGIBILITY CREDITS		4,800,000
CLAIMS INCURRED BUT NOT REPORTED		2,752,000







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		7,552,000
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	23,430,321
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	1,014,014
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	1,014,014
3	Subtract line 2e from line 1.....................			3	22,416,307
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	199,853
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................			4c	199,853
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	22,616,160

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	23,911,423
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................			2e
3	Subtract line 2e from line 1.....................			3	23,911,423
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	199,853
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................			4c	199,853
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	24,111,276

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

LABORERS METROPOLITAN DETROIT
HEALTH AND WELFARE FUND

Employer identification number

38-2026006

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)MICHAEL AARONTRUSTEE	(i) (ii)	132,863			46,124		178,987
(2)MARK PULICETRUSTEE	(i) (ii)	132,623			46,124		178,747
(3)BILL BASSCHAIRMAN	(i) (ii)	131,624			35,608		167,232
(4)PAUL GASSELTRUSTEE	(i) (ii)	131,623			35,608		167,231

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

LABORERS METROPOLITAN DETROIT
HEALTH AND WELFARE FUND

Employer identification number

38-2026006

Return Reference	Explanation
FORM 990, PART VI	LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED, THE FUND, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AN EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES. BECAUSE OF THIS ORGANIZATIONAL REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. LINE 12 - ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, OR OTHER OFFICERS OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED.
FORM 990, PAGE 6, PART VI, LINE 7A	TRUSTEES ARE APPOINTED BY SPONSORING PARTIES OF THE TRUST. UNION TRUSTEES ARE APPOINTED BY PERSONS AUTHORIZED BY THE EACH APPOINTING UNION ORGANIZATON'S EXECUTIVE BOARD, WHO ARE ELECTED PERIODICALLY BY MEMBERS IN GOOD STANDING WHO ARE ELEGIBLE TO VOTE CONSISTENT WITH THE CONSTITUTION OF THE APPOINTING UNION ORGANIZATION. EMPLOYER TRUSTEES ARE APPOINTED BY PERSONS AUTHORIZED BY THEIR EXECUTIVE BOARDS, WHO ARE ELECTED CONSISTENT WITH THE VOTING REQUIREMENTS OF EACH SPECIFIC EMPLOYER ASSOCIATION.
FORM 990, PAGE 6, PART VI, LINE 11B	NO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PAGE 6, PART VI, LINE 19	THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART I ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA.
FORM 990, PART VII	LINE 1A - MICHAEL AARON, MARK PULICE, BILL BASS, PAUL GASSEL, AND JASON CHWALEK SERVED AS TRUSTEES OF THE FUND WITHOUT COMPENSATION FORM THE FUND FOR THOSE SERVCIES. HOWEVER, THEY WERE COMPENSATED AS EMPLOYEES OF EITHER LOCAL 1076 OR 1191 WHICH WERE CONTRIBUTING EMPLOYERS TO THE FUND ANS, AS SUCH, "RELATED ORGANIZTIONS" AS THAT TERM IS DEFINED IN THE INSTRUCTIONS.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

LABORERS METROPOLITAN DETROIT
HEALTH AND WELFARE FUND

Employer identification number

38-2026006

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) LABORERS V & H TRUST FUND - D & V 700 TOWER DRIVE STE 300 TROY,MI48098 38-6195524	VAC & HOL	MI	501C9		N/A		No
(2) LABORERS PENSION TRUST FUND - D & V 700 TOWER DRIVE STE 300 TROY,MI48098 51-6030973	PENSION	MI	401A		N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) 1 WAY SERVICE INC			N/A					No
(2) 3 LK CONSTRUCTION			N/A					No
(3) 6-K CONSTRUCTION CO			N/A					No
(4) API INC			N/A					No
(5) ADAMO DEMOLITION COMPANY			N/A					No
(6) ADAMS GENERAL CONTRACTING INC			N/A					No
(7) ALBANELLI CEMENT CONTRACTORS			N/A					No
(8) ALFORD CONSTRUCTION GROUP LLC			N/A					No
(9) ALLIED ERECTING & DISMANTLING			N/A					No
(10) ALLSTATE FOUNDATION CO			N/A					No
(11) ALPINE CONTRACTORS			N/A					No
(12) AMALIO CORPORATION			N/A					No
(13) AMERICAN UNDERGROUND SOLUTIONS			N/A					No
(14) ARBOR CONSTRUCTION PERSONNEL			N/A					No
(15) ARISTEO CONSTRUCTION			N/A					No
(16) ASSEMBLERS PRECAST & STEEL SER			N/A					No
(17) ASSEMBLERS INC			N/A					No
(18) ATLAS INDUSTRIAL CONTRACTORS			N/A					No
(19) AUCH GEORGE CO			N/A					No
(20) AUTHORITY CONCRETE GROUP INC			N/A					No
(21) B & B CONCRETE PLACEMENT INC			N/A					No
(22) BMI REFRACTORY SERVICE			N/A					No
(23) BAKER CONSTRUCTION			N/A					No
(24) BARNEY JJ CONSTRUCTION INC			N/A					No
(25) BARTON MALOW CO			N/A					No
(26) BERG DRYWALL LLC			N/A					No
(27) BIERLEIN SERVICES INC			N/A					No
(28) BJ'S SONS CONTRACTING CO INC			N/A					No
(29) BLAZE CONTRACTING INC			N/A					No
(30) BLUE RIBBON CONTRACTING INC			N/A					No
(31) BRAND ENERGY SERVICES			N/A					No
(32) BRANDENBURG INDUSTRIAL SERVICE			N/A					No
(33) BRAZEN & GREER MASONRY INC			N/A					No
(34) BRENCAL CONTRACTORS INC			N/A					No
(35) BRIX CORPORATION			N/A					No
(36) BROADCAST DESIGN & CONSTRUCTION			N/A					No
(37) BYERS D C COMPANY			N/A					No
(38) C & P CONSTRUCTION			N/A					No
(39) C B INCCHRIS VASSEUR			N/A					No
(40) CAMERON CONSTRUCTION COMPANY			N/A					No
(41) CENTRAL CONVEYOR ALSO SHOP			N/A					No
(42) CERCO INC			N/A					No
(43) CHAMPAGNE & MARX EXCAVATING			N/A					No
(44) CHEMSTEEL CONSTRUCTION COMPANY			N/A					No
(45) CHRISTMAN CONSTRUCTORS INC			N/A					No
(46) CI CONTRACTING INC			N/A					No
(47) CITY RENOVATION & TRIM INC			N/A					No
(48) CLARK CONSTRUCTION			N/A					No
(49) CLEAN GREEN ENERGY LLC			N/A					No
(50) COLASANTI SPECIALTY SERVICES			N/A					No
(51) COMET CONTRACTING CO UAP			N/A					No
(52) COMMERCIAL CONSTRUCTION INC			N/A					No
(53) COMMERCIAL CONTRACTING CORP			N/A					No
(54) CONSTRUCTION LABOR SERVICES			N/A					No
(55) CONTEK INC			N/A					No
(56) CONTI CORPORATION			N/A					No
(57) CONTRACTORS TRENCHING			N/A					No
(58) COSTELLA MONTE & CO			N/A					No
(59) COUGAR CONTRACTING INC			N/A					No
(60) CREATIVE CEMENT INC			N/A					No
(61) CREATIVE FLOOR COATING SYSTEMS			N/A					No
(62) CULVER DEVELOPMENT LLC			N/A					No
(63) D 2 ABATEMENT INC			N/A					No
(64) D-4 ENTERPRISES			N/A					No
(65) D'ALOISIO MASONRY			N/A					No
(66) DAN'S CEMENT			N/A					No
(67) DAN'S EXCAVATING INC			N/A					No
(68) DEARBORN MID-WEST CONVEYOR CO			N/A					No
(69) DE-CAL INC			N/A					No
(70) DELUCA OLIVER C CO			N/A					No
(71) DEMARIA BUILDING COMPANY INC			N/A					No
(72) DEMREX INDUSTRIAL SERV INC			N/A					No
(73) DENN-CO CONSTRUCTION INC			N/A					No
(74) DETROIT CONCRETE CONSTRUCTION			N/A					No
(75) DETROIT LABORERS DEL COMM			N/A					No
(76) DEVON INDUSTRIAL GROUP			N/A					No
(77) DIAMOND INDUSTRIAL			N/A					No
(78) DICLAUDIO MASON CONSTRACTORS			N/A					No
(79) DICOSMO CONSTRUCTION			N/A					No
(80) DIVERSIFIED CONSTRUCTION SPCL			N/A					No
(81) DIXON INC			N/A					No
(82) DRV JOINT SEALANT CONTRACTORS			N/A					No
(83) DULUTH ENVIRONMENTAL SERVICES			N/A					No
(84) DURR SYSTEMS INC			N/A					No
(85) DYCON INC			N/A					No
(86) E & L DEVELOPMENT INC			N/A					No
(87) E & R MASONRY CONST INC			N/A					No
(88) E L MECHANICAL			N/A					No
(89) E L S CONSTRUCTION			N/A					No
(90) EAGLE EXCAVATION INC			N/A					No
(91) EQUIPMENT RECYCLING SOLUTIONS			N/A					No
(92) ERICKSON & LINDSTROM			N/A					No
(93) EUGENIO PAINTING COMPANY			N/A					No
(94) FABCON INCORPORATED			N/A					No
(95) FANELLI CONST INC			N/A					No
(96) FASTDECKS INC			N/A					No
(97) FERRINI CEMENT COMPANY			N/A					No
(98) FESSLER & BOWMAN			N/A					No
(99) FIRM BUILT CONST CO			N/A					No
(100) FLAGG CLEANING SYSTEMS INC			N/A					No
(101) FORT WAYNE CONTRACTING INC			N/A					No
(102) G M REFRACTORIES INC			N/A					No
(103) GALLAGHER-KAISER CORPORATION			N/A					No
(104) GEMELLI CONCRETE LLC			N/A					No
(105) GIFFIN INC			N/A					No
(106) GILARDONE COMPANY LLC			N/A					No
(107) GLASSROCKOMI			N/A					No
(108) GRANGER CONSTRUCTION CO			N/A					No
(109) GREAT LAKES REG ORGANIZING			N/A					No
(110) GREENE JOHN E COMPANY			N/A					No
(111) GRUNWELL CASHERO COMPANY			N/A					No
(112) HAMON CUSTODIS INC			N/A					No
(113) HANSCHMANN MASONRY			N/A					No
(114) HARDMAN CONSTRUCTION INC			N/A					No
(115) HARMON CONSTRUCTION INC			N/A					No
(116) HARNISH FIREPROOFING			N/A					No
(117) HARNISH WILLIAM E ACOUSTICAL			N/A					No
(118) HARSCO INFRA FKA PATENT CONST			N/A					No
(119) HARTWELL CEMENT			N/A					No
(120) HATZEL & BUEHLER INC			N/A					No
(121) HMCHICKS MASON CONTRACTORS			N/A					No
(122) HOLLY CONSTRUCTION CO			N/A					No
(123) HOLLY J C CONTRACTING			N/A					No
(124) HOOVER WELLS LLC			N/A					No
(125) IAFRATE ANGELO CONSTRUCTION			N/A					No
(126) IDEAL CONTRACTING			N/A					No
(127) IMPERIAL CONSTRUCTION CO INC			N/A					No
(128) INDEPENDENCE EXCAVATING			N/A					No
(129) INTEGRITY INTERIORS INC			N/A					No
(130) INTERNATIONAL CHIMNEY CORP			N/A					No
(131) INTERNATIONAL IND CONTR CORP			N/A					No
(132) ISIS LAND ENTERPRISES INC			N/A					No
(133) JASMAN CONSTRUCTION INC			N/A					No
(134) JAY DEE CONTRACTORS INC			N/A					No
(135) JERICO CONSTRUCTION INC			N/A					No
(136) JOHNSON CONTROLS INC			N/A					No
(137) K & W CONCRETE CONST INC			N/A					No
(138) KING MASONRY INC			N/A					No
(139) KVAERNER NAC			N/A					No
(140) LJH CONSTRUCTION			N/A					No
(141) LV PAINTING & CONSTRACTING INC			N/A					No
(142) LABELLE ELECTRIC SERVICE INC			N/A					No
(143) LABOR SERVICES LLC			N/A					No
(144) LABORERS L-1076			N/A					No
(145) LABORERS L-1191			N/A					No
(146) LANDRY GEORGE INC			N/A					No
(147) LDJ ASSOCIATES INC			N/A					No
(148) LEE MACHINERY MOVERS INC			N/A					No
(149) LEIDAL & HART MASON CONTRACTOR			N/A					No
(150) LESCO DESIGN & MFG COMPANY			N/A					No
(151) LOWE CONSTRUCTION CO INC			N/A					No
(152) MANFREDI CONSTRUCTION INC			N/A					No
(153) MASONRY DEVELOPERS INC			N/A					No
(154) MATRIX CONSTRUCTION SERVICES			N/A					No
(155) MATRIX NORTH AMERICAN CONSTRUCTION			N/A					No
(156) MCCARTHY & SMITH INC			N/A					No
(157) MCCORMICK WILLIE AND ASSOC			N/A					No
(158) MCINTOSH GEORGE INC			N/A					No
(159) MEDINA GLASS BLOCK INC			N/A					No
(160) METALLIZERS OF MID-AMERICA			N/A					No
(161) MICRO ELECTRIC LTD			N/A					No
(162) MID AMERICAN CONSTRUCTION SERV			N/A					No
(163) MID-AMERICAN GUNITE INC			N/A					No
(164) MIG EAST LLC			N/A					No
(165) MONARCH WELDING & ENG INC			N/A					No
(166) MOORTRENCH AMERICAN CORP			N/A					No
(167) MORETTI FOUNDATION CO INC			N/A					No
(168) MOTOR CITY ELECTRIC COMPANY			N/A					No
(169) MUIRHEAD CONSTRUCTION			N/A					No
(170) MUNRO ELECTRIC CO INC			N/A					No
(171) N B PROCESSING INC			N/A					No
(172) NSS CONSTRUCTION INC			N/A					No
(173) NATIONAL ENVIRONMENTAL GROUP			N/A					No
(174) NATIONAL MICROBIOLOGICAL MGMT			N/A					No
(175) NAVETTA MASON CONTRACTORS			N/A					No
(176) NEDROW REFRACTORIES			N/A					No
(177) NEHEMIAH MASONRY			N/A					No
(178) NICHOLSON CONSTRUCTION			N/A					No
(179) NIEMI CORPORATION THE			N/A					No
(180) NILES INDUSTRIAL LLC			N/A					No
(181) NORTH AMERICAN DISMANTLING			N/A					No
(182) NORTH CHANNEL CONST CO INC			N/A					No
(183) NORTHERN INDUSTRIAL CONST INC			N/A					No
(184) NOWAK R C AND COMPANY			N/A					No
(185) OAKLAND PLUMBING COMPANY			N/A					No
(186) OMI REFRACTORIES LLC			N/A					No
(187) ORION WATERPROOFING LLC			N/A					No
(188) PACITTO & FOREST CONST CO			N/A					No
(189) PALLISCO CONCRETE CO INC			N/A					No
(190) PAPALAS JOHN A & COMPANY			N/A					No
(191) PCI CONSTRUCTION SERVICES LLC			N/A					No
(192) POMPONIO CONSTRUCTION			N/A					No
(193) POURED BRICK WALLS INC			N/A					No
(194) POWER PROCESS PIPING INC			N/A					No
(195) PREFERRED BLDG SERVICES LLC			N/A					No
(196) PRO IMAGE FACILITY SERVICES			N/A					No
(197) PROCESS PIPING & EQUIPMENT			N/A					No
(198) PROGRESSIVE MECHANICAL INC			N/A					No
(199) PRO-POUR CONCRETE CONSTRUCTION			N/A					No
(200) R & R CONSTRUCTION SERVICES			N/A					No
(201) R B V CONTRACTING INC			N/A					No
(202) R J INDUSTRIAL EMPLOYEES			N/A					No
(203) R M F NOOTER INC			N/A					No
(204) RPB CLEANING SPECIALISTS			N/A					No
(205) RAM CONSTRUCTION SERVICES			N/A					No
(206) RAYMOND EXCAVATING CO			N/A					No
(207) REESE CONTRACTING INC			N/A					No
(208) REICHENBACH CEILING &			N/A					No
(209) RESCO PRODUCTS INC			N/A					No
(210) REWOLD FRANK & SONS			N/A					No
(211) RIC MAN DETROIT			N/A					No
(212) RIC-MANN CONSTRUCTION INC			N/A					No
(213) RIVER CONTRACTING INC			N/A					No
(214) RK HYDRO-VAC INC			N/A					No
(215) ROHRSCHEIB SONS CAISSONS INC			N/A					No
(216) RONCELLI ELC3 LLC			N/A					No
(217) ROSATI MASONRY COMPANY INC			N/A					No
(218) ROYAL OAK MILLWORK CO LLC			N/A					No
(219) ROYAL RESTORATION & WATERPROOF			N/A					No
(220) RUDOLPHLIBBE INC			N/A					No
(221) S C ENVIRONMENTAL SERVICES			N/A					No
(222) SSS INC			N/A					No
(223) SAFEWAY SERVICES LLC 89			N/A					No
(224) SAK CONSTRUCTION LLC			N/A					No
(225) SALVATORE EXEC CO INC			N/A					No
(226) SAYLOR'S INC			N/A					No
(227) SCAFFOLD DESIGN & ERECTION			N/A					No
(228) SCAFFOLDING INC			N/A					No
(229) SCHAD BOILER SETTING COMPANY			N/A					No
(230) SCHENA ROOFING AND SHEET METAL			N/A					No
(231) SCHIFFER MASON CONTRACTORS INC			N/A					No
(232) SCHNITZER STEEL			N/A					No
(233) SERES-CASTLE MASONRY INC			N/A					No
(234) SERVICE CONSTRUCTION LLC			N/A					No
(235) SET CONSTRUCTION INC			N/A					No
(236) SHARED SYSTEMS TECHNOLOGY			N/A					No
(237) SHEKELL RL INC			N/A					No
(238) SHMINA AZ INC			N/A					No
(239) SIMONE CONTRACTING CORP			N/A					No
(240) SINELLI & SONS CHARLES			N/A					No
(241) SITE DEVELOPMENT INC			N/A					No
(242) SIWEK CONSTRUCTION COMPANY			N/A					No
(243) SKANSKA USA BUILDING INC			N/A					No
(244) SOLE CONSTRUCTION INC			N/A					No
(245) SORENSON GROSS			N/A					No
(246) SPENCE BROTHERS			N/A					No
(247) STANTE EXCAVATING CO INC			N/A					No
(248) SUPERIOR EXCAVATING INC			N/A					No
(249) TAYLOR BROTHERS CONSTRUCTION			N/A					No
(250) TEAM INDUSTRIAL SERVICES			N/A					No
(251) TEERA CONSTR CO INC			N/A					No
(252) THE STATE GROUP IND(USA)LIMIT			N/A					No
(253) TIMMER CONSTRUCTION COMPANY			N/A					No
(254) TOOLES CONTRACTING GROUP INC			N/A					No
(255) TRI-CITY GOUNDBREAKERS INC			N/A					No
(256) TROELSEN EXCAVATING CO			N/A					No
(257) TURNER CONSTRUCTION CO			N/A					No
(258) TURNER-BROOKS INC			N/A					No
(259) TWENTY-FIRST CENTURY SALVAGE			N/A					No
(260) URS WASHINGTON DIVISION			N/A					No
(261) US BUILDERS GROUP INC			N/A					No
(262) V & O CONTRACTING COMPANY			N/A					No
(263) V I L CONSTRUCTION INC			N/A					No
(264) VIG J S CONSTRUCTION CO			N/A					No
(265) W & G LLC			N/A					No
(266) W C CONSTRUCTORS INC			N/A					No
(267) WPM INC			N/A					No
(268) W-3 CONSTRUCTION COMPANY			N/A					No
(269) WALBRIDGE ALDINGER			N/A					No
(270) WALBRIDGE EAST			N/A					No
(271) WALBRIDGE EQUIPMENT INSTALLATION			N/A					No
(272) WALBRIDGE TOOLING SERVICES			N/A					No
(273) WALSH CONSTRUCTION COMPANY			N/A					No
(274) WASHINGTON GROUP			N/A					No
(275) WAYNE STATE UNIVERSITY			N/A					No
(276) WCI CONSTRUCTION INC			N/A					No
(277) WEISS CONSTRUCTION CO LLC			N/A					No
(278) WHITE CONSTRUCTION CO			N/A					No
(279) WICKERSHAM HOMES INC			N/A					No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE HEALTH AND WELFARE BENEFITS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		0
9	Program service revenue (Part VIII, line 2g) .........	18,100,473	20,868,578
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,324,786	1,442,631
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	23,191	304,951
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	19,448,450	22,616,160
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	21,296,220	23,013,835
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)		0
16a	Professional fundraising fees (Part IX, column (A), line 11e).....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,284,910	1,097,441
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	22,581,130	24,111,276
19	Revenue less expenses. Subtract line 18 from line 12.......	-3,132,680	-1,495,116
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	38,412,825	40,505,056
21	Total liabilities (Part X, line 26).............	6,356,181	8,929,514
22	Net assets or fund balances. Subtract line 21 from line 20.....	32,056,644	31,575,542

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 23,013,835 including grants of $ ) (Revenue $ 22,062,112 )
	TO PROVIDE HOSPITALIZATION, MEDICAL, DEATH, SURGICAL AND OTHER RELATED HEALTH CARE BENEFITS TO ELIGIBLE PLAN PARTICIPANTS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses23,013,835

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) MICHAEL AARON........................................................................ TRUSTEE	1.00 .......................40.00	X	0	132,863	46,124
(2) MARK PULICE........................................................................ TRUSTEE	1.00 .......................40.00	X	0	132,623	46,124
(3) BILL BASS........................................................................ CHAIRMAN	1.00 .......................40.00	X	0	131,624	35,608
(4) PAUL GASSEL........................................................................ TRUSTEE	1.00 .......................40.00	X	0	131,623	35,608
(5) JASON CHWALEK........................................................................ TRUSTEE	1.00 .......................40.00	X	0	103,229	35,608
(6) CHARLES WILSON........................................................................ SECRETARY	1.00 .......................	X	0	0	0
(7) ROBERT COPPERSMITH........................................................................ TRUSTEE	1.00 .......................	X	0	0	0
(8) WILLIAM GRUEBNAU........................................................................ TRUSTEE	1.00 .......................	X	0	0	0
(9) DAVID KRUSE........................................................................ TRUSTEE	1.00 .......................	X	0	0	0
(10) SCOTT FISHER........................................................................ TRUSTEE	1.00 .......................	X	0	0	0
(11) MICHAEL P SMITH........................................................................ TRUSTEE	1.00 .......................	X	0	0	0
(12) ALEX ZUREK........................................................................ TRUSTEE	1.00 .......................	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	631,962	199,072

(A) Name and business address	(B) Description of services	(C) Compensation
BLUE CROSS BLUE SHIELD OF MICHIGAN27000 WEST 11 MILE ROAD B494SOUTHFIELDMI48034	HEALTH ADMIN	1,304,059
TIC INTERNATIONAL CORPORATION6525 CENTURION DRIVELANSINGMI48917	TPA	442,230



2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 2

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......
			Business Code
2a	EMPLOYER CONTRIBUTIONS			16,539,540	16,539,540
b	PARTICIPANT SELF-PAYMENTS			4,329,038	4,329,038
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			20,868,578
3	Investment income (including dividends, interest, and other similar amounts).......			695,662	141,614		554,048
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	12,144,918
b	Less: cost or other basis and sales expenses	11,397,949
c	Gain or (loss)	746,969
d	Net gain or (loss)..........			746,969	746,969
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	MEDICARE PART D SUBSIDY			253,694	253,694
b	LIQUIDATED DAMAGES			46,283	46,283
c	COBRA ASSISTANCE PROGRAM			4,974	4,974
d	All other revenue ....
e	Total. Add lines 11a–11d ......			304,951
12	Total revenue. See Instructions......			22,616,160	22,062,112		554,048

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members	23,013,835	23,013,835
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	442,230		442,230
b	Legal .........	28,986		28,986
c	Accounting ...........	21,500		21,500
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	199,853		199,853
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	234,215		234,215
12	Advertising and promotion ....
13	Office expenses .......	88,237		88,237
14	Information technology ......
15	Royalties ..
16	Occupancy ...........
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	1,753		1,753
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....
23	Insurance ..............	14,560		14,560
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	SAFETY DUES	52,354		52,354
b	ERISA REPORTING COSTS	12,493		12,493
c	EDUCATIONAL FOUNDATION	1,260		1,260
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	24,111,276	23,013,835	1,097,441	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).


			(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			1	3,098,875
2	Savings and temporary cash investments .........		3,678,600	2	994,750
3	Pledges and grants receivable, net ...........			3
4	Accounts receivable, net .............		1,677,293	4	2,480,361
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				6
7	Notes and loans receivable, net .............			7
8	Inventories for sale or use ..............			8
9	Prepaid expenses and deferred charges ..........		706,351	9	864,476
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation .....	10b		10c
11	Investments—publicly traded securities ..........		32,350,581	11	33,066,594
12	Investments—other securities. See Part IV, line 11 .....			12
13	Investments—program-related. See Part IV, line 11 .....			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........			15
16	Total assets. Add lines 1 through 15 (must equal line 34)......		38,412,825	16	40,505,056
17	Accounts payable and accrued expenses .........		926,181	17	1,377,514
18	Grants payable .................			18
19	Deferred revenue ................			19
20	Tax-exempt bond liabilities .............			20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			22
23	Secured mortgages and notes payable to unrelated third parties ..			23
24	Unsecured notes and loans payable to unrelated third parties ....			24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................		5,430,000	25	7,552,000
26	Total liabilities. Add lines 17 through 25.........		6,356,181	26	8,929,514
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			27
28	Temporarily restricted net assets ...........			28
29	Permanently restricted net assets ...........			29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........			30
31	Paid-in or capital surplus, or land, building or equipment fund .....			31
32	Retained earnings, endowment, accumulated income, or other funds		32,056,644	32	31,575,542
33	Total net assets or fund balances ...........		32,056,644	33	31,575,542
34	Total liabilities and net assets/fund balances ........		38,412,825	34	40,505,056