2023-09-27T14:06:01-05:00 2022-11-30 043508036 MANZI & ASSOCIATES LLC 855 TURNPIKE STREET NORTH ANDOVER MA 01845 990 2021-12-01 042088633 SHEET METAL WORKERS LOCAL UNION NO 17 INSURANCE FUND SHEE 6174265646 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 RICHARD KEOGH FUND ADMINISTRATOR 6174265646 2023-09-27 1 RICHARD KEOGH 999009999 JEANNIE MICKEL P01058630 9789751099 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z RICHARD KEOGH 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 51530062 0 X N/A X 1950 MA TO PROVIDE HEALTH BENEFITS FOR ELIGIBLE PARTICIPANTS 6 6 31 0 0 0 0 0 45795761 48300772 600216 898780 893185 815802 47289162 50015354 0 0 37141786 40659507 911429 854617 0 0 0 715600 755464 38768815 42269588 8520347 7745766 86646775 88739286 5554005 6259818 81092770 82479468 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 0 0 TO PROVIDE HEALTH AND OTHER SPECIFIED BENEFITS TO ELIGIBLE MEMBERS/DEPENDENTS THROUGH A COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 31 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 1 0 X RICHARD KEOGH 6174265646 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 X JAMES WOOL TRUSTEE 10.00 X X 0 0 0 KEVIN GILL TRUSTEE 10.00 X X 0 0 0 JOSEPH CULLEN TRUSTEE 10.00 X X 0 0 0 JACK DESMOND TRUSTEE 10.00 X X 0 0 0 RICHARD KEOGH TRUSTEE 10.00 X 0 0 0 ROBERT BUTLER TRUSTEE 10.00 X 0 0 0 RICHARD B KEOGH ADMINISTRATOR 40.00 X 138305 0 115045 ROBERT KEOGH FORMER ADMINISTRATOR 40.00 X 222392 0 69854 360697 0 184899 2 1 1 0 BLUE CROSS BLUE SHIELD 401 PARK DRIVE BOSTON MA 02215 HEALTH CLAIMS ADMINISTRATION 1227473 DELTA DENTAL 465 MEDOFRD STREET BOSTON MA 02129 DENTAL CLAIMS ADMINISTRATION 115533 ELIXIR SOLUTIONS 2181 E AURORA ROAD TWINSBURG OH 44087 PRESCRIPTION CLAIMS ADMINSTRATION 103444 3 EMPLOYER CONTRIBUTIONS 561000 46491564 46491564 MEMBER CONTRIBUTIONS 561000 1450711 1450711 SASMI CONTRIBUTIONS 561000 358497 358497 48300772 901393 901393 1512095 1514708 -2613 -2613 -2613 ADMIN ASSESSMENTS 900099 691583 691583 STOP LOSS REIMBURSEMENT 900099 98721 98721 DELINQUENT CONTRACTOR INTEREST 900099 25498 25498 815802 50015354 49113961 0 901393 40659507 187194 234353 244183 146744 42143 45924 47745 155388 198410 16537 70175 45813 12018 38791 37523 STOPLOSS INSURANCE 20953 PRINTING 18404 POSTAGE 17330 TELEPHONE 14687 15766 42269588 1780773 3444844 7765561 7389454 58943 98794 1253138 710889 569829 542249 73643169 74532145 2828500 2731800 86646775 88739286 416000 159911 5138005 6099907 5554005 6259818 X 0 0 0 0 81092770 82479468 81092770 82479468 86646775 88739286 7745766 -6359068 0 X X 0 1 X 1 0 810927 314522 496405 442211 396367 45844 542249 LONGVIEW LARGECAP 500 24824230 F INSTITUTIONAL SENIOR LOAN FUND 5016026 F BAIRD INTERMEDIATE BOND 23039514 F NHIT CORE PLUS DISCRETION TRUST 14812926 F US REAL ESTATE INVEST FUND 6839449 F 74532145 INCURRED BUT NOT REPORTED CLAIMS 5590500 BENEFITS PAYABLE 495460 DUE TO AFFILIATES 13947 6099907 X 43500898 -6359068 -6359068 49859966 155388 155388 50015354 41135921 0 41135921 155388 978279 1133667 42269588 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE DEPARTMENT OF LABOR AND INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF NOVEMBER 30, 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS: NET CHANGE IN BENEFIT OBLIGATIONS 978,279. X 0 0 0 ROBERT KEOGH FORMER ADMINISTRATOR 222392 0 0 0 0 0 64776 0 5078 0 292246 0 0 0 RICHARD B KEOGH ADMINISTRATOR 138305 0 0 0 0 0 85696 0 29349 0 253350 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN FOR MEMBERS AND RETIREES OF LOCAL 17 SMW FORM 990, PART VI, SECTION B, LINE 11B BOARD OF TRUSTEES HAS GIVEN AUTHORITY TO THE FUND ADMINISTRATOR TO REVIEW ALL TAX DOCUMENTATION BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12 AS AN EMPLOYEE BENEFIT PLAN WE ARE SUBJECT TO THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C: NO CHANGE IN OVERSIGHT PROCESS OR SELECTION OF INDEPENDENT ACCOUNTANT. 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