2021-11-09T14:12:21-06:00 2020-12-31 222951202 MSPC CPAS & ADVISORS PC 340 NORTH AVENUE EAST CRANFORD NJ 070162496 990 2020-01-01 221537766 JOINT WELFARE BOARD LOCAL #164 - IBEW INTE 9732284200 425 EAGLE ROCK AVENUE ROSELAND NJ 07068 ROBERT FARINA FUND ADMINISTRATOR 9732284200 2021-11-09 1 ROBERT FARINA 999009999 JON S GAGLIARDI P00528721 9082727000 2021-11-08 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROBERT FARINA 204 EAGLE ROCK AVENUE ROSELAND NJ 07068 217312724 0 X N/A X 1952 NJ TO PROVIDE MEDICAL AND OTHER RELATED TYPE BENEFITS. 8 7 0 0 0 0 0 0 74592899 64055600 14393601 5386634 1267084 1187651 90253584 70629885 0 0 66711283 58775048 0 0 0 0 0 3258610 3400886 69969893 62175934 20283691 8453951 182710178 203164050 1162758 1107587 181547420 202056463 TO PROVIDE HEALTH AND WELFARE BENEFITS TO PARTICIPANTS COVERED UNDER THE COLLECTIVE BARAGAINING AGREEMENT. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO PARTICIPANTS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 763 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X FABIAN & BYRN LLC 9732284200 425 EAGLE ROCK AVE SUITE 105 ROSELAND NJ 07068 CHERYL ADELUNG EMPLOYER TRUSTEE 1.00 X 0 0 0 DAN KELLY EMPLOYER TRUSTEE 1.00 X 0 0 0 VICTOR DAIDONE EMPLOYER TRUSTEE 1.00 X 0 0 0 JAMES ESTABROOK EMPLOYER TRUSTEE 1.00 X 0 0 0 CHRISTOPHER BIOLETTI UNION TRUSTEE 1.00 X 0 0 0 KELLY WHALEN UNION TRUSTEE 1.00 X 0 0 0 STANLEY JAWORSKI UNION TRUSTEE 1.00 X 0 0 0 DANIEL GUMBLE UNION TRUSTEE 1.00 39.00 X 0 241740 137792 0 241740 137792 0 0 1 0 HORIZON BLUE CROSS PO BOX 15306 NEWARK NJ 071055306 MEDICAL CLAIMS CONSULTANT 1174860 FABIAN & BYRN LLC 204 EAGLE ROCK AVENUE ROSELAND NJ 07068 THIRD PARTY ADMINISTRATOR 704254 GLOBAL PHARMACEUTICAL BENEFITS LLC 222 LAFAYETTE STREET NEWARK NJ 07105 MEDICAL CLAIMS CONSULTANT 452760 ZELIS CLAIMS INTEGRITY 2 CROSSROADS DRIVE BEDMINSTER NJ 07921 MEDICAL CLAIMS CONSULTANT 350351 RAMIREZ ASSET MANAGEMENT 61 BROADWAY NEW YORK NY 10006 INVESTMENT MANAGEMENT 151891 5 CONTRACTOR CONTRIBUTION 900099 63010135 63010135 MEMBER SELF-PAYMENTS 900099 1045465 1045465 64055600 4125460 4125460 147944013 146682839 1261174 1261174 1261174 RETIREE DRUG SUBSIDY 900099 1187651 1187651 1187651 70629885 65243251 0 5386634 58775048 704254 79320 41000 309241 2209380 22683 11155 ACA PATIENT - RESEARCH 21453 ERTS FEES 2400 62175934 1642508 5038807 11116725 12976343 161639748 177853156 8311197 7295744 182710178 203164050 257128 239456 905630 868131 1162758 1107587 X 0 0 0 0 181547420 202056463 181547420 202056463 182710178 203164050 8453951 12055092 0 X X 0 1 X 1 0 0 BENEFIT OBLIGATIONS PAYABLE 471300 RECIPROCAL PAYABLE 396831 868131 X 82375736 12055092 12055092 70320644 309241 309241 70629885 61893593 0 61893593 309241 -26900 282341 62175934 PART X, LINE 2: THE PLAN HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE STATING THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(9). 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 INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31,2020, 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. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2017. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN HEALTH CLAIMS PAYABLE -26,900. 0 0 0 DANIEL GUMBLE UNION TRUSTEE 0 241740 0 0 0 0 0 67687 0 70105 0 379532 0 0 FORM 990, PART VI, SECTION B, LINE 11B BOARD MEMBERS ARE PROVIDED A CLIENT COPY FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 18 JOINT WELFARE BOARD'S CONSTITUION AND BYLAWS ARE AVAILABLE ON THE DEPARTMENT OF LABOR WEBSITE IN ADDITION TO BEING FURNISHED UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 JOINT WELFARE BOARD'S CONSTITUION AND BYLAWS ARE AVAILABLE ON THE DEPARTMENT OF LABOR WEBSITE IN ADDITION TO BEING FURNISHED UPON REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE ELECTION OF INDEPENDENT ACCOUNTANTS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. IBEW #164 ANNUITY FUND 204 EAGLE ROCK AVENUE ROSELAND NJ 07068 226031200 PROVIDE ANNUITY BENEFITS FOR LOCAL 164 MEMBERS NJ SECTION 401(A) 0 IBEW #164 PENSION FUND 204 EAGLE ROCK AVENUE ROSELAND NJ 07068 226031199 PROVIDE PENSION BENEFITS FOR LOCAL 164 MEMBERS NJ SECTION 401(A) 0 IBEW #164 APPRENTICESHIP FUND 65 WEST CENTURY ROAD PARAMUS NJ 07652 226029937 PROVIDE ELECTRICAL TRAINING FOR LOCAL 164 MEMBERS NJ SECTION 501(C)(3) SEC 170(B)(1)(A)(II) 0 IBEW #164 LMCC 204 EAGLE ROCK AVENUE ROSELAND NJ 07068 222693287 PROVIDE DRUG TESTING SERVICES FOR LOCAL 164 MEMBERS NJ SECTION 501(C)(5) 0 IBEW LOCAL UNION #164 205 ROBIN ROAD PARAMUS NJ 07652 221010190 PROMOTE THE WELL BEING OF MEMBERS BY PROVIDING A VARIETY OF PROGRAMS/SERVICE NJ SECTION 501(C)(5) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0