2022-10-02T10:26:40-05:00 2021-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2021-01-01 236424575 IBEW LOCAL UNION 375 ELECTRICIANS WELFARE FUND IBEW 6104329762 101 S 7TH STREET ALLENTOWN PA 18101 PAUL ANTHONY BUSINESS MGR/TRUSTEE 6104321033 2022-10-02 1 PAUL ANTHONY 999009999 LOUIS VERZELLA P00360279 6106689400 2022-10-02 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z PAUL ANTHONY 101 S 7TH STREET ALLENTOWN PA 18101 13290931 0 X IBEW375.ORG X 1962 PA PROVIDE HEALTH BENEFITS TO MEMBERS 6 6 10 0 0 0 0 0 11962618 12916271 90874 186556 6680 0 12060172 13102827 0 0 11125096 10997313 0 0 0 0 0 552641 640863 11677737 11638176 382435 1464651 9817010 11255547 153164 152318 9663846 11103229 PROVIDE HEALTH BENEFITS TO MEMBERS. 0 0 THE PLAN PROVIDES LIFE, VISION, ACCIDENTAL DEATH, DISABILITY, DENTAL, HOSPITALIZATION, MEDICAL AND OTHER RELATED MEMBER BENEFITS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 5 0 10 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X PAUL ANTHONY 6104321033 101 S 7TH STREET ALLENTOWN PA 18101 X PAUL ANTHONY UNION TRUSTEE 5.00 X 0 0 0 ALAN REX UNION TRUSTEE 2.00 X 0 0 0 PATRICK FALENWOLFE UNION TRUSTEE 2.00 X 0 0 0 MICHAEL ALABOVITZ EMPLOYER TRUSTEE 2.00 X 0 0 0 ALEX MAGGITTI EMPLOYER TRUSTEE 2.00 X 0 0 0 MEAGAN CUNNINGHAM EMPLOYER TRUSTEE 2.00 X 0 0 0 0 0 0 0 0 0 0 CAPITAL BLUE CROSS 1221 WEST HAMILTON STREET ALLENTOWN PA 18102 CLAIMS PROCESSING 266626 THE SEGAL COMPANY 101 NORTH WACKER DRIVE SUITE 500 CHICAGP IL 60606 CONSULTING 141990 2 EMPLOYER AND RECIPROCAL CONTRIBUT 900099 12486178 12486178 SELF PAY AND COBRA ASSISTANCE CON 900099 430093 430093 12916271 103823 103823 270837 188104 82733 82733 82733 13102827 12916271 0 186556 10997313 32400 65360 8485 500323 3994 9685 15115 FEES MANDATED BY THE AC 5501 11638176 3095998 3040527 3810414 3074592 1665807 1712761 11567 47334 1233224 3380333 9817010 11255547 21936 22451 131228 129867 153164 152318 X 0 0 0 0 9663846 11103229 9663846 11103229 9817010 11255547 1464651 -25268 0 X X 0 1 X 1 0 0 AMOUNTS DUE TO OTHER BENEFIT PLANS UNDER RECIPROCAL AGREEMENT 129867 129867 X 13069074 -25268 -25268 13094342 8485 8485 13102827 11629691 0 11629691 8485 8485 11638176 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 IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. FORM 990, PART VI, SECTION B, LINE 11B AFTER COMPLETION OF FORM 990 BY THE PLAN'S ACCOUNTANT, THE GOVERNING BOARD OF TRUSTEES HAVE THE RESPONSIBILITY TO REVIEW AND APPROVE THE FORM 990 PRIOR TO ITS REMITTANCE TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO SIGN AND ACKNOWLEDGE ANY CONFLICT OF INTEREST ASSOCIATED WITH THE ORGANIZATION. THE TRUSTEES ARE REQUIRED TO RENDER AN ORGINAL CONFLICT OF INTEREST DISCLOSURE FORM TO THE ORGANIZATION UPON ACTIVE PARTICIPATION WITH THE ORGANIZATION. THIS CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND IS STRICTLY ENFORCED. FORM 990, PART VI, SECTION C, LINE 19 THE FUND MAKES AVAILABLE TO THE PUBLICE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS UPON WRITTEN REQUEST TO THE WELFARE BENEFITS OFFICE. FORM 990, PART XII, LINE 2C: THE TRUSTEES ARE RESPONSIBLE FOR THE COMPLETE FINANCIAL AFFAIRS OF THE PLAN, WHICH INCLUDES THE OVERSIGHT OF THE AUDIT AND ITS FINANCIAL STATEMENTS AND ELECTION OF THE INDEPENDENT ACCOUNTANT. FORM 990, PART V, LINE 2A: IBEW LOCAL UNION 375 ELECTRICIANS WELFARE FUND DOES NOT HAVE EMPLOYEES. THE FUND ISSUES W-2'S TO PARTICIPANTS FOR TAXABLE BENEFITS. 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