TY 2015 Form 990

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MINNESOTA CEMENT MASONS HEALTH AND
WELFARE FUND

Employer identification number

41-6023462

Part I

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

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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)

Revenue included on 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:

Revenue included on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability?

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(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 on 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" on 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' on 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).)..		0

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	11,537,021
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-418,868
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	-418,868
3	Subtract line 2e from line 1..................			3	11,955,889
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	50,202
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	50,202
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	12,006,091

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	9,479,249
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	0
3	Subtract line 2e from line 1...................			3	9,479,249
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	50,202
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	50,202
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	9,529,451

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
PART X, LINE 2:	THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRE.

Schedule D (Form 990) 2015

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MINNESOTA CEMENT MASONS HEALTH AND
WELFARE FUND

Employer identification number

41-6023462

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 on 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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on 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 on 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" on 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) 2015

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 on 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 in column(B) reported as deferred on 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)
1GREG MASSEYTRUSTEE - SECRETARY	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 97,065	0 ------------- 39,828	0 ------------- 17,999	0 ------------- 154,892	0 ------------- 0
2GREG JOHNSONTRUSTEE	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 97,828	0 ------------- 38,073	0 ------------- 17,220	0 ------------- 153,121	0 ------------- 0

Schedule J (Form 990) 2015

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) 2015

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 990-EZ 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

2015

Open to Public
Inspection

Name of the organization

MINNESOTA CEMENT MASONS HEALTH AND
WELFARE FUND

Employer identification number

41-6023462

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 3	ALTHOUGH THE BOARD OF TRUSTEES RETAINS ULTIMATE RESPONSIBILITY, THE TRUSTEES HAVE DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO ZENITH AMERICAN SOLUTIONS AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN.
FORM 990, PART VI, SECTION A, LINE 7A	THE PLAN IS GOVERNED BY EIGHT TRUSTEES, FOUR OF WHOM ARE APPOINTED BY THE RELATED LOCAL UNION, TWO OF WHOM ARE APPOINTED BY MINNESOTA CONCRETE AND MASONRY CONTRACTORS ASSOCIATION AND TWO OF WHOM ARE APPOINTED BY ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA.
FORM 990, PART VI, SECTION A, LINE 8B	THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE TRUSTEES EVALUATE ANY POSSIBLE CONFLICTS OF INTEREST ANNUALLY WITH THE PLAN'S ATTORNEY. IN ADDITION, TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH NONPROFIT 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 TO PARTICIPANTS UPON REQUEST.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MINNESOTA CEMENT MASONS HEALTH AND
WELFARE FUND

Employer identification number

41-6023462

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)CITY OF ST PAUL	CONTRIBUTING EMPLOYER						No
(2)ST PAUL PUBLIC SCHOOLS	CONTRIBUTING EMPLOYER						No
(3)UNIVERSITY OF MINNESOTA	CONTRIBUTING EMPLOYER						No
(4)CITY OF MINNEAPOLIS	CONTRIBUTING EMPLOYER						No
(5)CEMENT MASONS LOCAL 633	CONTRIBUTING EMPLOYER						No
(6)MINNESOTA CEMENT MASONS AND PLASTERERS PENSION FUND 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HEIGHTS,MN55120 51-6096906	TO PROVIDE RETIREMENT BENEFITS TO MEMBERS	MN	501(A)				No
(7)MN CEMENT MASONS PLAST SHOPHANDS JOURNEYMAN AND APPRENTICE TRAINING TRUST F	CONTRIBUTING EMPLOYER						No

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

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
(1) 3-D CONCRETE & CONSTRUCTION	CONTRIBUTING EMPLOYER						No			No
(2) A-PLUS LANDSCAPINGLLC	CONTRIBUTING EMPLOYER						No			No
(3) BULACH CUSTOM ROCK	CONTRIBUTING EMPLOYER						No			No
(4) CMS LLC	CONTRIBUTING EMPLOYER						No			No
(5) COMMERCIAL SHOTBLAST SER LLC	CONTRIBUTING EMPLOYER						No			No
(6) COMPLETE INGROUND SERVICESLLC	CONTRIBUTING EMPLOYER						No			No
(7) CONCRETE UNLIMITEDLLC	CONTRIBUTING EMPLOYER						No			No
(8) CREATE CONSTRUCTION LLC	CONTRIBUTING EMPLOYER						No			No
(9) CREATIVE CURB LLC	CONTRIBUTING EMPLOYER						No			No
(10) D R FRANTZ CONCRETE CONST INC	CONTRIBUTING EMPLOYER						No			No
(11) HANSON MASONRY & CONCRETE LLC	CONTRIBUTING EMPLOYER						No			No
(12) KRAEMER NORTH AMERICA LLC	CONTRIBUTING EMPLOYER						No			No
(13) LARSON MASONRY CONSTLLC	CONTRIBUTING EMPLOYER						No			No
(14) NORTHLAND CONCRETE & MAS LLC	CONTRIBUTING EMPLOYER						No			No
(15) NORTHLAND CONSTRUCTION	CONTRIBUTING EMPLOYER						No			No
(16) OPUS DESIGN BUILDERSLLC	CONTRIBUTING EMPLOYER						No			No
(17) PCI ROADS LLC	CONTRIBUTING EMPLOYER						No			No
(18) PULLMAN POWER LLC	CONTRIBUTING EMPLOYER						No			No
(19) QUALITY COATINGS LLC	CONTRIBUTING EMPLOYER						No			No
(20) RAM CONSTRUCTION SER OF MI INC	CONTRIBUTING EMPLOYER						No			No
(21) REDSTONE CONSTRUCTION LLC	CONTRIBUTING EMPLOYER						No			No
(22) STEENBERG-WATRUD CONST INC	CONTRIBUTING EMPLOYER						No			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) ACME CONCRETE PAVING INC	CONTRIBUTING EMPLOYER							No
(2) ADB CONST	CONTRIBUTING EMPLOYER							No
(3) ADOLFSON & PETERSON CONST SERV	CONTRIBUTING EMPLOYER							No
(4) AMENDOLA BUILDERS INC	CONTRIBUTING EMPLOYER							No
(5) AMES CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(6) ANCHOR BLOCK COMPANY	CONTRIBUTING EMPLOYER							No
(7) ANDERSON MSRY & CONCRETE INC	CONTRIBUTING EMPLOYER							No
(8) A-PLUS LANDSCAPINGLLC	CONTRIBUTING EMPLOYER							No
(9) ARNIE MACKEY CONST INC	CONTRIBUTING EMPLOYER							No
(10) AXEL H OHMAN INC	CONTRIBUTING EMPLOYER							No
(11) BIGELOW BROTHERS PLASTERING	CONTRIBUTING EMPLOYER							No
(12) BOOKER CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(13) BOUGALIS INC	CONTRIBUTING EMPLOYER							No
(14) BRUCES CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(15) C AND C WINGER INC	CONTRIBUTING EMPLOYER							No
(16) C R CONCRETE INC	CONTRIBUTING EMPLOYER							No
(17) C R FISCHER AND SONS INC	CONTRIBUTING EMPLOYER							No
(18) C R MEYER AND SONS COMPANY	CONTRIBUTING EMPLOYER							No
(19) C S MCCROSSAN CONST INC	CONTRIBUTING EMPLOYER							No
(20) CAPITAL CONCRETE INC	CONTRIBUTING EMPLOYER							No
(21) CARLSON LA VINE INC	CONTRIBUTING EMPLOYER							No
(22) CBI SERVICES INC	CONTRIBUTING EMPLOYER							No
(23) CENTURY CONST COMPANY INC	CONTRIBUTING EMPLOYER							No
(24) CHARD TILING & EXC INC	CONTRIBUTING EMPLOYER							No
(25) CHRIS JENSEN & SON COMPANY INC	CONTRIBUTING EMPLOYER							No
(26) CLAUSEN CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(27) COMMERCIAL SHOTBLAST SER LLC	CONTRIBUTING EMPLOYER							No
(28) CONCRETE IDEA INC	CONTRIBUTING EMPLOYER							No
(29) CONCRETE SAWING SERVICES	CONTRIBUTING EMPLOYER							No
(30) CONCRETE UNLIMITEDLLC	CONTRIBUTING EMPLOYER							No
(31) CONE CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(32) CONSTRUCTION RESULTS CORP	CONTRIBUTING EMPLOYER							No
(33) CORVAL CONSTRUCTORS INC	CONTRIBUTING EMPLOYER							No
(34) CORVAL GROUP CONSTRUCTORS	CONTRIBUTING EMPLOYER							No
(35) CROSSTOWN MASONRY INC	CONTRIBUTING EMPLOYER							No
(36) CURB MASTERS INC	CONTRIBUTING EMPLOYER							No
(37) CURRY CONCRETE CONST INC	CONTRIBUTING EMPLOYER							No
(38) CUSTOM DRYWALLINC	CONTRIBUTING EMPLOYER							No
(39) DJ KRANZ CO INC	CONTRIBUTING EMPLOYER							No
(40) DALLCO INC	CONTRIBUTING EMPLOYER							No
(41) DAVIS DRYWALL INC	CONTRIBUTING EMPLOYER							No
(42) DAYCO CONCRETE COMPANY INC	CONTRIBUTING EMPLOYER							No
(43) DINGMAN CONCRETE & SCREED SERV	CONTRIBUTING EMPLOYER							No
(44) DIVERSIFIED COATINGS INC	CONTRIBUTING EMPLOYER							No
(45) DONLAR CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(46) DOYLE CONNER CO	CONTRIBUTING EMPLOYER							No
(47) DUNCAN CONCRETE INC	CONTRIBUTING EMPLOYER							No
(48) EDDE CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(49) FITOL-HINTZ CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(50) FLOOR TECHNOLOGIESINC	CONTRIBUTING EMPLOYER							No
(51) FRENCH LAKE CURB COMPANY	CONTRIBUTING EMPLOYER							No
(52) GAGE BROS CAULKING INC	CONTRIBUTING EMPLOYER							No
(53) GEORGE SIEGFRIED	CONTRIBUTING EMPLOYER							No
(54) GERALD DAVIDSON CONST INC	CONTRIBUTING EMPLOYER							No
(55) GLOBAL SPECIALTY	CONTRIBUTING EMPLOYER							No
(56) GOEBEL CONSTR CO INC	CONTRIBUTING EMPLOYER							No
(57) GRAHAM CONSTRUCTION SER INC	CONTRIBUTING EMPLOYER							No
(58) GRAYCOR	CONTRIBUTING EMPLOYER							No
(59) GRESSER COMPANIES INC	CONTRIBUTING EMPLOYER							No
(60) GREYSTONE CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(61) GRIDOR CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(62) GROVE-JOHNSON COMPANY	CONTRIBUTING EMPLOYER							No
(63) GUSTAFSON & GOUDGE INC	CONTRIBUTING EMPLOYER							No
(64) HAMMERLUND CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(65) HANSON MASONRY & CONCRETE LLC	CONTRIBUTING EMPLOYER							No
(66) HELMKAMP CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(67) HIBBING EXCAVATING INC	CONTRIBUTING EMPLOYER							No
(68) HMI (HOME MENDERS INC)	CONTRIBUTING EMPLOYER							No
(69) HOLLENBACK & NELSON INC	CONTRIBUTING EMPLOYER							No
(70) HOVLAND INC	CONTRIBUTING EMPLOYER							No
(71) IACARELLA CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(72) INDUSTRIAL CONSTRUCTION SPECIA	CONTRIBUTING EMPLOYER							No
(73) INDUSTRIAL CONTRACTORS	CONTRIBUTING EMPLOYER							No
(74) INDUSTRIAL MAINTENANCE SERVICE	CONTRIBUTING EMPLOYER							No
(75) INTERSTATE IMPROVEMENT INC	CONTRIBUTING EMPLOYER							No
(76) J R JENSEN CONTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(77) JAMAR COMPANY	CONTRIBUTING EMPLOYER							No
(78) JAMES STEELE CONSTRUCTION CO	CONTRIBUTING EMPLOYER							No
(79) JE DUNN NORTH CENTRAL	CONTRIBUTING EMPLOYER							No
(80) JMF CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(81) JOHNNY MASONRY INC	CONTRIBUTING EMPLOYER							No
(82) JOHNSON WILSON CONSTRUCTORS	CONTRIBUTING EMPLOYER							No
(83) JOSEPH CONST OF ST PAUL INC	CONTRIBUTING EMPLOYER							No
(84) KELLEHER CONSTRUCTIONINC	CONTRIBUTING EMPLOYER							No
(85) KELLY STUCCO SYSTEMS	CONTRIBUTING EMPLOYER							No
(86) KIFFMEYER INC	CONTRIBUTING EMPLOYER							No
(87) KMAC INC	CONTRIBUTING EMPLOYER							No
(88) KNIFE LAKE CONCRETE INC	CONTRIBUTING EMPLOYER							No
(89) KNUTSON CONSTRUCTION SERVICES	CONTRIBUTING EMPLOYER							No
(90) KRAUS ANDERSON CONSTRUCTION CO	CONTRIBUTING EMPLOYER							No
(91) KTM PAVING INC	CONTRIBUTING EMPLOYER							No
(92) L S BLACK CONSTRUCTORS INC	CONTRIBUTING EMPLOYER							No
(93) LAKEHEAD CONSTRUCTORS INC	CONTRIBUTING EMPLOYER							No
(94) LANDMARK CONCRETE INC	CONTRIBUTING EMPLOYER							No
(95) LANGER CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(96) LARSON MASONRY CONST	CONTRIBUTING EMPLOYER							No
(97) LENCI ENTERPRISES INC	CONTRIBUTING EMPLOYER							No
(98) LEWIS CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(99) LOEFFEL CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(100) LOUHI & KIVELA MASONRY INC	CONTRIBUTING EMPLOYER							No
(101) LUNDA CONST CO	CONTRIBUTING EMPLOYER							No
(102) M A MORTENSON COMPANY	CONTRIBUTING EMPLOYER							No
(103) MAERTENS-BRENNY CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(104) MAGNEY CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(105) MARCY CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(106) MARKET & JOHNSONINC	CONTRIBUTING EMPLOYER							No
(107) MAXGRAY CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(108) MCGOUGH CONSTRUCTION CO	CONTRIBUTING EMPLOYER							No
(109) MEYER CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(110) MIDWEST CONCRETE SPECIALTIES	CONTRIBUTING EMPLOYER							No
(111) MINNESOTA CONCRETE SPECIALTIES	CONTRIBUTING EMPLOYER							No
(112) MIRON CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER							No
(113) MN STATE CURB & GUTTER CORP	CONTRIBUTING EMPLOYER							No
(114) MORCON CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(115) MULCAHY NICKOLAUS	CONTRIBUTING EMPLOYER							No
(116) NEECK CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(117) NORTH COUNTRY CONCRETE INC	CONTRIBUTING EMPLOYER							No
(118) NORTH METRO ASPHALT & CONTRAC	CONTRIBUTING EMPLOYER							No
(119) NORTHERN INDUSTRIAL ERECTORS	CONTRIBUTING EMPLOYER							No
(120) O'MALLEY CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(121) PARAGON COMPANY INC	CONTRIBUTING EMPLOYER							No
(122) PARK CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(123) PCL CONST SERVICES INC	CONTRIBUTING EMPLOYER							No
(124) PROJECT RESTORATIONINC	CONTRIBUTING EMPLOYER							No
(125) QC COMPANIES	CONTRIBUTING EMPLOYER							No
(126) QUALITY CUTTING & CORING INC	CONTRIBUTING EMPLOYER							No
(127) QUALITY DRYWALL & PLASTERING	CONTRIBUTING EMPLOYER							No
(128) RAILWORKS TRACK SERVICES INC	CONTRIBUTING EMPLOYER							No
(129) RAINBOW INC	CONTRIBUTING EMPLOYER							No
(130) RICE LAKE CONTRACTING CORP	CONTRIBUTING EMPLOYER							No
(131) RIIHILUOMA RAY INC	CONTRIBUTING EMPLOYER							No
(132) ROBERT R SCHROEDER CONST INC	CONTRIBUTING EMPLOYER							No
(133) RON KASSA CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(134) RYAN COMPANIES USINC	CONTRIBUTING EMPLOYER							No
(135) RYAN CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(136) S M HENTGES &SONS INC	CONTRIBUTING EMPLOYER							No
(137) SCHMIDT CURB COMPANY INC	CONTRIBUTING EMPLOYER							No
(138) SCHOCH CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(139) SCT CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(140) SEAL-TREAT INC	CONTRIBUTING EMPLOYER							No
(141) SERICE CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(142) SHAFER CONTRACTING COMPANY INC	CONTRIBUTING EMPLOYER							No
(143) SHAW LUNDQUIST ASSOCIATESINC	CONTRIBUTING EMPLOYER							No
(144) SHEEHY CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER							No
(145) SIG OLSON & SONS PLASTERING	CONTRIBUTING EMPLOYER							No
(146) STANDARD CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(147) STANDARD SIDEWALK INC	CONTRIBUTING EMPLOYER							No
(148) STAPF CONCRETE CONST INC	CONTRIBUTING EMPLOYER							No
(149) STARTING LINE FLOOR COATINGS	CONTRIBUTING EMPLOYER							No
(150) STEENBERG-WATRUD CONST INC	CONTRIBUTING EMPLOYER							No
(151) STONE CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(152) SULLIVAN RIEHM CONSTRUCTION	CONTRIBUTING EMPLOYER							No
(153) SUMMIT CONCRETE & MASONRY CONS	CONTRIBUTING EMPLOYER							No
(154) SURFACE ART & PREP INC	CONTRIBUTING EMPLOYER							No
(155) T L CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(156) TERRAZZO & CONCRETE REST	CONTRIBUTING EMPLOYER							No
(157) TFE INC	CONTRIBUTING EMPLOYER							No
(158) THE BOLDT COMPANY	CONTRIBUTING EMPLOYER							No
(159) THOMAS & SONS CONST INC	CONTRIBUTING EMPLOYER							No
(160) THOR CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(161) TI-ZACK CONCRETE INC	CONTRIBUTING EMPLOYER							No
(162) TOTAL CONSTRUCTION & EQUIPMENT	CONTRIBUTING EMPLOYER							No
(163) TWIN CITIES SPECIALTIES	CONTRIBUTING EMPLOYER							No
(164) WAGNER CONST OF HAMPTON INC	CONTRIBUTING EMPLOYER							No
(165) WEST STAR CURB & CONCRETE	CONTRIBUTING EMPLOYER							No
(166) XCEL ENERGYNSP	CONTRIBUTING EMPLOYER							No
(167) YAW CONSTRUCTION GROUP INC	CONTRIBUTING EMPLOYER							No
(168) YOUNG & DAVIS DRYWALL INC	CONTRIBUTING EMPLOYER							No

Schedule R (Form 990) 2015

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) ............................

Yes

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) 2015

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) 2015

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) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTH BENEFITS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	1
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	12
6	Total number of volunteers (estimate if necessary) .............	6	0
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	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	9,876,352	11,640,633
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	378,757	365,458
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	10,255,109	12,006,091
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	7,853,345	8,797,866
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	656,764	731,585
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	8,510,109	9,529,451
19	Revenue less expenses. Subtract line 18 from line 12.......	1,745,000	2,476,640
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	16,698,419	18,686,304
21	Total liabilities (Part X, line 26).............	176,761	106,874
22	Net assets or fund balances. Subtract line 21 from line 20.....	16,521,658	18,579,430

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	TO PROVIDE HEALTH CARE, DENTAL, DEATH AND DISABILITY BENEFITS FOR ELIGIBLE MEMBERS AND THEIR DEPENDENTS OR BENEFICIARIES ON A SELF-INSURED BASIS.

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 expenses

(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) GREG MASSEY...................................................................... TRUSTEE - SECRETARY	2.00 ................. 46.00	X	0	97,065	57,827
(2) GREG JOHNSON...................................................................... TRUSTEE	2.00 ................. 44.00	X	0	97,828	55,293
(3) DAVE SCHUTTA...................................................................... TRUSTEE	2.00 ................. 40.00	X	0	76,436	45,833
(4) MIKE SYVERSRUD...................................................................... TRUSTEE - NEW / ALT TRUSTEE - PAST	2.00 ................. 44.00	X	0	82,738	55,319
(5) BRIAN GULLICKSON...................................................................... TRUSTEE - PAST / ALT TRUSTEE - NEW	2.00 ................. 27.00	X	0	64,582	36,133
(6) TIM WORKE...................................................................... TRUSTEE - CHAIRMAN	2.00 .................	X	0	0	0
(7) STEVE FRITZ...................................................................... TRUSTEE	2.00 .................	X	0	0	0
(8) STEVE BULACH...................................................................... TRUSTEE	2.00 .................	X	0	0	0
(9) DAVID JOSLIN...................................................................... TRUSTEE	2.00 .................	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	418,649	250,405

(A) Name and business address	(B) Description of services	(C) Compensation
ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD STE 325 MENDOTA HTS,MN55120	THIRD PARTY ADMINISTRATOR	352,321
LEONARD O'BRIEN SPENCER GALE & SAYRE 100 SOUTH FIFTH ST STE 2500 MINNEAPOLIS,MN55402	ATTORNEY	163,509



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

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 above	1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......

		Business Code
2a	EMPLOYER CONTRIBUTIONS	900099	10,007,428	10,007,428
b	HRA EMPLOYER CONTRIBUT	900099	1,051,276	1,051,276
c	PARTICIPANT/RETIREE CO	900099	348,561	348,561
d	STOP-LOSS REFUNDS	900099	110,177	110,177
e	PRESCRIPTION DRUG REBA	900099	65,786	65,786
f	All other program service revenue.			57,405	57,405
g Total.Add lines 2a–2f.....			11,640,633

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			387,952			387,952
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		2,750,110
b	Less: cost or other basis and sales expenses		2,772,604
c	Gain or (loss)		-22,494
d	Net gain or (loss).....			-22,494			-22,494
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..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			12,006,091	11,640,633	0	365,458

1	Grants and other assistance to domestic organizations and domestic governments. 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	8,797,866
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 ......	224,056
b	Legal .........	163,509
c	Accounting ...........	44,670
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	50,202
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	51,960
12	Advertising and promotion ....
13	Office expenses .......	52,115
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 ....	17,612
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	10,790
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	FEES MANDATED BY ACA	113,976
b	DUES & SUBSCRIPTIONS	2,695
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	9,529,451
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).

1	Cash–non-interest-bearing ........		821,959	1	802,864
2	Savings and temporary cash investments .........		3,523,690	2	4,335,222
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............		742,710	4	892,600
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 ......		9,685	9	14,910
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 .		11,600,375	11	12,640,708
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)...		16,698,419	16	18,686,304

17	Accounts payable and accrued expenses .....	168,204	17	98,847
18	Grants payable ...		18
19	Deferred revenue .........	8,557	19	8,027
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		25
26	Total liabilities. Add lines 17 through 25..	176,761	26	106,874

	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 .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	16,521,658	32	18,579,430
33	Total net assets or fund balances ...........	16,521,658	33	18,579,430
34	Total liabilities and net assets/fund balances ........	16,698,419	34	18,686,304