2021-01-25T14:50:25-06:00 2020-04-30 131578842 BUCHBINDER TUNICK & CO LLP ONE PENN PLAZA - SUITE 3500 NEW YORK NY 101193601 990 2019-05-01 111774226 HEALTH & WELFARE PLAN LOCAL 854 IBT HEAL 5168339300 50 CHARLES LINDBERGH BLVD NO 207 UNIONDALE NY 11553 DEMOS P DEMOPOULOS TRUSTEE 5168339300 2021-01-25 1 P01366109 2126955003 2019 2022-09-23 18:48:47Z DEMOS P DEMOPOULOS 50 CHARLES LINDBERGH BLVD NO 207 UNIONDALE NY 11553 11908437 0 X N/A X EMPLOYEE BENEFIT PLAN 1950 NY TO PROVIDE MEDICAL, PRESCRIPTION DRUG, OPTICAL, LIFE INSURANCE, AND DENTALBENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 6 0 0 0 0 0 0 12309388 9310505 525287 473924 426751 15876 13261426 9800305 0 0 15399133 9720333 0 0 0 0 0 1982531 1343199 17381664 11063532 -4120238 -1263227 4721647 3054681 177408 184499 4544239 2870182 TO PROVIDE HEALTH AND RELATED BENEFITS TO QUALIFIED PARTICIPANTS AND THEIR DEPENDENTS IN THE AMOUNTS AND UNDER THE CONDITIONS AS SPECIFIED IN THE AGREEMENT AND PLAN, IN ACCORDACE WITH APPLICABLE LAW. 0 0 THE PLAN PROVIDES MEDICAL, PRESCRIPTION DRUG, OPTICAL, LIFE INSURANCE AND DENTAL BENEFITS TO 1,022 PARTICIPANTS AND THEIR DEPENDENTS. 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 1 101 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X LOCAL 854 HEALTH AND WELFARE FUND 5168339300 50 CHARLES LINDBERGH BOULEVARD UNIONDALE NY 11553 X DEMOS DEMOPOULOS TRUSTEE 3.00 X 0 0 0 JOHN CURCIO TRUSTEE 0.50 X 0 0 0 KENNETH BARRETT TRUSTEE 0.50 X 0 0 0 WILLIAM CASSESE TRUSTEE 0.50 X 0 0 0 MICHAEL SPINELLI TRUSTEE 0.50 X 0 0 0 STEPHEN MALONE TRUSTEE 0.50 X 0 0 0 DANIEL GATTO FORMER TRUSTEE 0.50 X 0 0 0 0 0 0 0 0 0 0 DICKINSON GROUP LLC 50 CHARLES LINDBERGH BLVD SUITE 20 UNIONDALE NY 11553 CLAIMS PROCESSING & ADMINISTRATIVE SERV. 657264 PAYER MATRIX 405 ELMWOOD AVENUE SHARON HILLS PA 19709 CLAIMS CONSULTING 158608 FRIEDMAN & ANSPACH 1500 BROADWAY SUITE 2300 NEW YORK NY 10036 LEGAL 120080 BUCHBINDER TUNICK & CO LLP ONE PENN PLAZA SUITE 3500 NEW YORK NY 10119 ACCOUNTING 105685 4 CONTRIBUTIONS FROM EMPLOYERS 900099 9122526 9122526 CONTRIBUTIONS FROM PARTICIPANTS 900099 187979 187979 9310505 45440 45440 2536616 2108132 428484 428484 428484 STOP LOSS REIMBURSEMENTS 900099 15876 15876 15876 9800305 9326381 0 473924 9720333 193339 146707 4542 21600 22188 13897 BENEFIT ADMINISTRATIVE 536751 ADMINISTRATIVE SERVICE 215432 CLAIMS REVIEW 174391 RETIREE BENEFIT EXPENSE 14352 11063532 19916 9333 979537 861819 1235926 137418 11251 8344 580632 2037767 1894385 0 4721647 3054681 63810 146591 50750 0 62848 37908 177408 184499 X 0 0 0 0 4544239 2870182 4544239 2870182 4721647 3054681 -1263227 -410830 0 X X 0 1 X 1 0 0 UNCLAIMED BENEFITS LIABILITY 27190 DUE TO LOCAL 854 PENSION FUND 10718 37908 X 9384933 -410830 -410830 9795763 4542 4542 9800305 11058990 0 11058990 4542 4542 11063532 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 BBY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINSTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF APRIL 30, 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 FIANANCIAL STATEMENTS. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS OF THE PLAN. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR PERIOD PRIOR TO PLAN YEAR 2017. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S BOARD OF TRUSTEES REVIEWS THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THIS ORGANIZATION IS AN EMPLOYEE BENEFIT PLAN GOVERNED BY THE EMPLOYEE RETIREMENT INCOME SECURITY ACT (ERISA) OF 1974. UNDER ERISA, THE TRUSTEES HAVE A STATUTORY DUTY TO AVOID CONFLICTS OF INTEREST AND REPORT THEM AS THEY OCCUR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO ITS PARTICIPANTS FOR PUBLIC INSPECTION UPON WRITTEN REQUEST. FORM 990, PART XII, ITEM 2C THE ORGANIZATION'S PROCEDURES FOR OVERSEEING THE AUDIT OF ITS FINANCIAL STATEMENTS OR ITS SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PREVIOUS YEAR. 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