TY 2015 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
ELITE ADMINISTRATION GROUP INC 1211 W 22ND STREET OAK BROOK,IL60523	CLAIMS ADMINISTRATION	316,502
Anthony Pinelli, 53 West Jackson Blvd Suite 1460 Chicago,IL60604	Legal services	137,689
Healthcare Strategies Inc PO Box 37039 Baltimore,MD21297	Healthcare case management	148,729


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 3

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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

BUILDING MATERIAL CHAUFFEURS TMSTRS & HELPERS WELFARE FUND OF CHICAGO

Employer identification number

36-6057110

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 ...	0	0		0
b	Buildings	0	0	0	0
c	Leasehold improvements	0	0	0	0
d	Equipment ...	0	235,158	231,418	3,740
e	Other ...	0	0	0	0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					3,740

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	21,109,046
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	2,448,065
b	Donated services and use of facilities .........	2b	0
c	Recoveries of prior year grants ...........	2c	0
d	Other (Describe in Part XIII.) ............	2d	0
e	Add lines 2a through 2d .....................			2e	2,448,065
3	Subtract line 2e from line 1..................			3	18,660,981
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	70,185
b	Other (Describe in Part XIII.) ...........	4b	0
c	Add lines 4a and 4b....................			4c	70,185
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	18,731,166

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	22,599,267
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	0
b	Prior year adjustments ............	2b	0
c	Other losses ................	2c	0
d	Other (Describe in Part XIII.) ............	2d	0
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	22,599,267
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	70,185
b	Other (Describe in Part XIII.) ............	4b	0
c	Add lines 4a and 4b.....................			4c	70,185
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	22,669,452

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) 2015

Additional Data

Software ID:	15000352
Software Version:	v1.00

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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

BUILDING MATERIAL CHAUFFEURS TMSTRS & HELPERS WELFARE FUND OF CHICAGO

Employer identification number

36-6057110

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)
1JEFFREY HOFFADMINISTRATOR	(i) (ii)	0 ------------- 205,844	0 ------------- 0	0 ------------- 18,000	6,732 ------------- 6,732	5,108 ------------- 15,893	11,840 ------------- 246,469	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:	15000352
Software Version:	v1.00

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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

BUILDING MATERIAL CHAUFFEURS TMSTRS & HELPERS WELFARE FUND OF CHICAGO

Employer identification number

36-6057110

Return Reference	Explanation
Form 990, Part VI, Section B, Line 11b	Form 990 is reviewed by the Plan Administrator and forwarded to the chairman and co-chairman for their review. Upon review and approval, Form 990 is filed. Copies of the filed Form 990 are provided to all Trustees of the Fund.
Form 990, Part VI, Section B, Line 12c	Trustees are required to disclose potential conflicts as they arise.
Form 990, Part VI, Section B, Line 15	THE BOARD OF TRUSTEES REVIEWS THE PERFORMANCE OF THE ADMINISTRATOR ANNUALLY. AT THAT TIME, COMPENSATION IS DETERMINED BY USING COMPARATIVE DATA FROM SIMILAR SIZED TAFT-HARTLEY FUNDS AND VARIOUS MARKET PLACE DATA.
Form 990, Part VI, Section C, Line 19	The Fund makes its governing documents, conflict of interest policy and financial statements available to the participants upon written 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:	15000352
Software Version:	v1.00

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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

BUILDING MATERIAL CHAUFFEURS TMSTRS & HELPERS WELFARE FUND OF CHICAGO

Employer identification number

36-6057110

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)LOCAL UNION 786 BUILDING PENSION FUND 300 S ASHLAND AVE SUITE 500 CHICAGO,IL60607 51-6167400	PENSION BENEFITS	IL	501(a)		N/A		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

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) A NO 1 EXPRESS 7601 W 79TH STREET BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(2) ACCURATE READYMIX 7601 W 79TH STREET BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(3) ACORN ROOFING SUPPLY 2655 W 48TH ST CHICAGO,IL60632	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(4) ADJUSTABLE FORMS ONE E PROGRESS ROAD LOMBARD,IL60148	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(5) ALAMP CONCRETE CONTRACTORS INC 1900 WRIGHT BLVD SCHAUMBURG,IL60193	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(6) ALLIED BUILDING PRODUCTS CORP 15 E UNION AVENUE EAST RUTHERFORD,NJ07073	CONTRIBUTING EMPLOYER	NJ	N/A	C				No
(7) AMERICAN WILBERT VAULT 7525 99TH PLACE BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(8) ARAMARK SOUTH 2200 BERNICE ROAD LANSING,IL60438	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(9) ARAMARK MIDWEST EQUIP 2200 BERNICE ROAD LANSING,IL60438	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(10) ARROW ROAD CONSTRUCTION BOX 334 3401 S BUSSE MT PROSPECT,IL60056	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(11) BALTAS TRUCKING INC 12900 W BRUNS RD MANHATTAN,IL60442	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(12) BLUE LINX 2101 DRALLE ROAD UNIVERSITY PARK,IL60466	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(13) BROWN R CARTAGE 1020 EAST STATE PARKWAY SCHAUMBURG,IL60173	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(14) BUILDING MATERIAL 300 S ASHLAND CHICAGO,IL60607	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(15) CAPITAL CEMENT 6231 N PULASKI CHICAGO,IL60646	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(16) CERNIGLIA CO 3421 LAKE STREET MELROSE PARK,IL60160	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(17) CHAIN O LAKES SAND GRAVEL 7601 W 79TH ST BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(18) CHAS HORN LUMBER CO PO BOX 53 RIVERSIDE,IL60546	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(19) CHICAGO CEMENT TRANSPORTATION 19001 OLD LAGRANGE ROAD SUITE 300 MOKENA,IL60448	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(20) CHICAGO GYPSUM SUPPLY INC 12630 S HAMLIN ALSIP,IL60803	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(21) CRAWFORD BLDG MATERIAL 3949 W PALMER CHICAGO,IL60647	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(22) ENO INC 191 S GARY CAROL STREAM,IL60188	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(23) FITZER TRUCKING INC 13001 W HALEY RD MANHATTAN,IL60442	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(24) FORTINI AND SON 5685 N LAS CASA AVE CHICAGO,IL606465619	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(25) FOUNDATION BUILDING MATERIALS 1 LEAGUE 60969 IRVINE,CA92602	CONTRIBUTING EMPLOYER	CA	N/A	C				No
(26) FOX HOME CENTER PO BOX 130 WORTH,IL60482	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(27) G AND M TRUCKING AGG 8811 KATHY LANE DES PLAINES,IL60016	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(28) G E KLOOS MATERIAL PO BOX 516 BLUE ISLAND,IL604060516	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(29) G V CONSTRUCTION 371 S EVERGREEN BENSENVILLE,IL60106	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(30) GALLOY AND VANETTEN INC 11756 S HALSTED CHICAGO,IL60628	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(31) GEE KAY MAINTENANCE 5432 S CENTRAL CHICAGO,IL60638	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(32) GEORGE J ROLL AND SONS 2258 W VERMONT ST BLUE ISLAND,IL60406	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(33) GERARDI SEWER AND WATER 4520 N OSAGE NORRIDGE,IL60656	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(34) GRRH INC 11303 W MANHATTAN MONEE RD MONEE,IL60449	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(35) H J MOHR AND SONS CO 915 S MAPLE AVE OAK PARK,IL60304	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(36) HARRYS MOTOR SERVICE BOX 305 WESTERN SPRINGS,IL60558	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(37) HARVEY CEMENT PRODUCTS 16030 S PARK AVE HARVEY,IL60426	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(38) HELLER LUMBER CO 24 N HICKORY ARLINGTON HTS,IL60004	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(39) HENRY BROTHERS 9821 S 78TH AVE HICKORY HILLS,IL60457	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(40) HENRY FRERK SONS INC 3135 W BELMONT CHICAGO,IL60618	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(41) HOLCIM US INC PO BOX 382 SUMMIT,IL60501	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(42) ILLINOIS BRICK 8995 WEST 95TH STREET PALOS HILLS,IL60465	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(43) INDEPENDENT PAVING CO PO BOX 4596 OAK BROOK,IL60522	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(44) J AND A CARTAGE P O BOX 52 LYONS,IL605340052	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(45) J AND J NEWELL CONTRETE CONTRACTORS INC PO BOX 329 CALUMET CITY,IL60409	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(46) JOHN DEYOUNG TRUCKING 527 E 168TH PLACE SO HOLLAND,IL60473	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(47) JOHN PIPIKIOS 802 HERITAGE DR MT PROSPECT,IL60056	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(48) JONES AND CLEARY RFG CO 6838 S CHICAGO AVE CHICAGO,IL60637	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(49) K FIVE CONSTRUCTION 999 OAKMONT PLAZA DRIVE SUITE 200 WESTMONT,IL60559	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(50) KNICKERBOCKER ROOF 16851 S LATHROP STREET HARVEY,IL60426	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(51) L AND S CARTAGE CO INC 7525 W 79TH ST BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(52) L BO LOGISTICS INC PO BOX 2046 FRANKFORT,IL60423	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(53) LAKE COUNTY CARTAGE INC 9385 JULIA DRIVE ST JOHN,IN46373	CONTRIBUTING EMPLOYER	IN	N/A	C				No
(54) LAMPIGNANO AND SONS CONSTRUCTION 501 S ARTHUR ARLINGTON HEIGHTS,IL60005	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(55) LANCE ANDERSON SUPPLY 4225 W OGDEN AVE CHICAGO,IL60623	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(56) LEE LUMBER CO 633 W PERSHING ROAD CHICAGO,IL60609	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(57) LINDON TRUCKING INC 6430 WEST 181 ST STREET TINLEY PARK,IL60477	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(58) LOCAL 786 VENDING EMPLOYEES PENSION FUND 300 S ASHLAND CHICAGO,IL60607	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(59) LOCAL UNION 786 EES 300 S ASHLAND CHICAGO,IL60607	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(60) LORIG CONSTRUCTION CO 250 EAST TOUHY AVE DES PLAINES,IL60018	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(61) LUISE INC 1348 HANNAH AVE FOREST PARK,IL60130	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(62) M W POWELL CO 3445 S LAWNDALE AVE CHICAGO,IL60623	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(63) M TAYLOR CARTAGE INC 3261 LONGFORD DR JOLIET,IL60431	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(64) MARK 1 RESTORATION 1021 MARYLAND AVE DOLTON,IL604192225	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(65) MATERIAL SERVICE CORP 300 E JOHN CARPENTER FREEWAY IRVING,TX75062	CONTRIBUTING EMPLOYER	TX	N/A	C				No
(66) MATTHUIS TRUCKING INC 19314 MICHAEL CT MOKENA,IL60448	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(67) MENINI CARTAGE INC 951B ESTES COURT SCHAUMBURG,IL60193	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(68) METROMEX CONTRACTORS INC 9550 SERGO DR SUITE 100 MCCOOK,IL60525	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(69) MOREHOUSE CARTAGE INC 16635 S CRAWFORD MARKHAM,IL60426	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(70) MR PORCH COMPANY 3076 N ELSTON AVE CHICAGO,IL60618	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(71) N F DEMOLITION 16W050 JEANS ROAD LEMONT,IL60439	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(72) NEXGEN BUILDING SUPPLY 1099 GREENLEAF AVENUE ELK GROVE VILLAGE,IL60007	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(73) NICOMARR TRUCKING INC 409 ALPINE ROUND LAKE,IL60073	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(74) OMNI 1 ELECTRONICS INC 31632 N ELLIS DRIVE UNIT 304 VOLO,IL60073	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(75) ORANGE CRUSH 321 CENTER STREET HILLSIDE,IL60162	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(76) ORIENT EXPRESS 26526 N HWY 12 WAUCONDA,IL60084	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(77) OZINGA CHICAGO RMC INC 19001 OLD LAGRANGE ROAD MOKENA,IL60448	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(78) OZINGA ILLINOIS RMC INC 18825 SOUTH OLD LAGRANGE ROAD MOKENA,IL60448	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(79) POINT READY MIX 5435 Bull Valley Road Suite 130 MCHENRY,IL60050	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(80) POWER FORCES LLC 8750 WEST BRYN MAUR CHICAGO,IL60631	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(81) PRAIRIE MATERIAL SALES 7601 W 79TH ST BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(82) PSV TRUCKING CORP P O BOX 731 MIDLOTHIAN,IL604450731	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(83) R & D THIEL 2340 NEWBURG ROAD BELVIDERE,IL61008	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(84) R WAY TRUCKING PO BOX 586 MORRIS,IL60450	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(85) RAE TRANSPORT INC 148 S BLOOMINGDALE ROAD BLOOMINGDALE,IL60108	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(86) REINKE GYPSUM SUPPLY 1400 SHELDON DRIVE ELGIN,IL60120	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(87) RNR CONTRACTORS 1420 WALNUT AVENUE HANOVER PARK,IL60133	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(88) S & H TRANSPORT INC 7575 W 79TH ST BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(89) S S TRANSPORT 21070 COLUMBIA CT HAWTHORNE WDS,IL60047	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(90) SCHROEDER & SCHROEDER INC 7306 CENTRAL PARK SKOKIE,IL60076	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(91) SISSUNG TRUCKING & HAULILNG 427 SE GARFIELD AVE MUNDELEIN,IL60060	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(92) SKOKIE VALLEY MATERIAL 3640 LAKE ST WILMETTE,IL60091	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(93) SODEXO INC P O BOX 352 BUFFALO,NY14240	CONTRIBUTING EMPLOYER	NY	N/A	C				No
(94) STANDARD LUMBER CO 1912 LEHIGH AVENUE GLENVIEW,IL60025	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(95) T & T VENDING BOX 82 OAK LAWN,IL60454	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(96) TERRELL MATERIALS CORP 10600 W HIGGINS ROAD ROSEMONT,IL60018	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(97) TRAFFIC SOLUTIONS 1020 EAST STATE PARKWAY SCHAUMBURG,IL60173	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(98) TRINITY ROOFING SERVICE INC 610 HOMESTEAD ROAD LAGRANGE PARK,IL60526	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(99) TRUCK KING HAULING CONTRACTORS INC 4600 WEST 48TH STREET CHICAGO,IL60632	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(100) UNIQUE PLUMBING 9408 W 47TH STREET BROOKFIELD,IL60513	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(101) UNITED LEASING & LOGISTICS INC 7575 W 79TH ST BRIDGEVIEW,IL60455	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(102) UTILITY TRANSPORT SERVICE INC 2044 W 163RD ST UNIT 2 MARKHAM,IL60428	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(103) V&K MANAGEMENT 19015 S JODI ROAD SUITE F MOKENA,IL60448	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(104) VOLLMAR CLAY PRODUCTS 5835 W TOUHY AVE CHICAGO,IL606461264	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(105) VULCAN MATERIAL CO ATTN PAYROLL SHARED SERVICES BIRMINGHAM,AL352385014	CONTRIBUTING EMPLOYER	AL	N/A	C				No
(106) WALLS TRUCKING INC 3606 N LUNA CHICAGO,IL60641	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(107) WELSCH READY MIX INC 4243 W 166TH STREET OAK FOREST,IL604524608	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(108) WILLE BROS 11303 W MANHATTAN MONEE RD MONEE,IL60449	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(109) WITECH COMPANY INC 25353 STATE STREET CRETE,IL60417	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(110) WONDAAL TRUCKING CO INC 8995 WEST 95TH STREET PALOS HILLS,IL60465	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(111) YESS TRUCKING 17920 S KEDZIE HAZEL CREST,IL60429	CONTRIBUTING EMPLOYER	IL	N/A	C				No
(112) ZECHMAN SUPPLY 550 W ADAMS ST CHICAGO,IL60601	CONTRIBUTING EMPLOYER	IL	N/A	C				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) ...................

Yes

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

Yes

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

Yes

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

Yes

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) 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:	15000352
Software Version:	v1.00

1	Briefly describe the organization’s mission or most significant activities: 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	8
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
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) .........	15,538,289	17,708,415
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,051,141	1,022,751
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)	17,589,430	18,731,166
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).....	17,915,576	21,599,090
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	372,430	441,138
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)....	645,084	629,224
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	18,933,090	22,669,452
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,343,660	-3,938,286
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	48,780,928	47,239,968
21	Total liabilities (Part X, line 26).............	194,729	143,990
22	Net assets or fund balances. Subtract line 21 from line 20.....	48,586,199	47,095,978

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	PROVIDED MEDICAL, DENTAL, VISION, LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses0

(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) MARTIN OZINGA IV...................................................................... TRUSTEE	1 .................	X			0	0	0
(2) EDWARD RIZZO...................................................................... TRUSTEE	1 .................	X			0	0	0
(3) STEVEN FISHER...................................................................... TRUSTEE	1 .................	X			0	0	0
(4) RICKY BLEVINS...................................................................... TRUSTEE	1 .................	X			0	0	0
(5) MICHAEL YAUGHER...................................................................... TRUSTEE	1 .................	X			0	0	0
(6) KEVIN JARCHOW...................................................................... TRUSTEE	1 .................	X			0	0	0
(7) STEVEN WARNKE...................................................................... TRUSTEE	1 .................	X			6,811	6,811	0
(8) DAVID MASHEK...................................................................... TRUSTEE	1 .................	X			0	0	0
(9) JEFFREY HOFF...................................................................... ADMINISTRATOR	40 .................		X		0	223,844	34,464
(10) CHRISTINE FLORENDO...................................................................... ASSISTANT ADMINISTRATOR	40 .................			X	0	135,860	0
(11) ROSANNE LACALAMITA...................................................................... ASSISTANT ADMINISTRATOR	40 .................			X	0	111,717	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,811	478,232	34,464

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.......		0

			Business Code
2a	EMPLOYER CONTRIBUTIONS	525100	16,462,017	16,462,017	0	0
b	PARTICIPANT CONTRIBUTIONS	525100	231,515	231,515	0	0
c	SUBROGATION SETTLEMENTS	525100	138,605	0	0	138,605
d	STOP LOSS REFUND	525100	876,278	876,278	0	0
e
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			17,708,415

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			1,210,325	1,210,325	0	0
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	0	15,996,358
b	Less: cost or other basis and sales expenses	0	16,183,932
c	Gain or (loss)	0	-187,574
d	Net gain or (loss).....			-187,574	-187,574	0	0
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 ......			0
12	Total revenue. See Instructions......			18,731,166	18,592,561	0	138,605

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	21,599,090
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	304,308
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	62,019
9	Other employee benefits .......	53,408
10	Payroll taxes ...........	21,403
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	182,461
c	Accounting ...........	69,459
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	70,188
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,991
12	Advertising and promotion ....	0
13	Office expenses .......	25,294
14	Information technology ......	52,307
15	Royalties ..	0
16	Occupancy ...........	45,561
17	Travel ............	5,747
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	29,625
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	1,496
23	Insurance ...	29,257
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	PCORI fees	5,978
b	Transitional Reinsurance fees	100,860
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	22,669,452	0	0	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).

1	Cash–non-interest-bearing ........			-7,982	1	-80,400
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			2,401,923	4	2,679,068
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
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
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			0	8	0
9	Prepaid expenses and deferred charges ......			8,902	9	10,439
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	235,158
b	Less: accumulated depreciation	10b	231,418	5,236	10c	3,740
11	Investments—publicly traded securities .			45,159,753	11	44,074,178
12	Investments—other securities. See Part IV, line 11 .....			1,111,250	12	476,403
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			101,846	15	76,540
16	Total assets. Add lines 1 through 15 (must equal line 34)...			48,780,928	16	47,239,968

17	Accounts payable and accrued expenses .....	173,960	17	143,990
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	20,769	25
26	Total liabilities. Add lines 17 through 25..	194,729	26	143,990

	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	48,586,199	32	47,095,978
33	Total net assets or fund balances ...........	48,586,199	33	47,095,978
34	Total liabilities and net assets/fund balances ........	48,780,928	34	47,239,968