2019-10-15T08:14:23-05:00 2018-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2018-01-01 581910292 SOUTHERN PAINTERS WELFARE FUND SOUT 4124321125 5 HOT METAL STREET NO 200 PITTSBURGH PA 15203 CHARLES HILL TRUSTEE 4124321125 2019-10-15 1 LOUIS VERZELLA CPA P00360279 6106689400 2019-10-04 162.211.205.39 2019-10-15 07:57:28 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A96940F3BC1CB41A42F1C40DCB182A9E8131B64B 2018 2019-02-21 02:37:17Z CHARLES HILL 5 HOT METAL STREET NO 200 PITTSBURGH PA 15203 35744444 0 X N/A X 1990 GA THIS IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN WHICH HAS BEEN ESTABLISHED TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE PARTICIPANTS. 8 4 0 0 0 0 0 0 22850025 22002169 927105 559857 13259 510903 23790389 23072929 0 0 23337644 24259354 0 0 0 0 0 2355734 2413457 25693378 26672811 -1902989 -3599882 21014572 16861379 2180617 2281012 18833955 14580367 THIS IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN WHICH HAS BEEN ESTABLISHED TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE PARTICIPANTS 0 0 THE PLAN PROVIDES DEATH, LIFE, AND HEALTH BENEFITS (MEDICAL, SURGICAL, MAJOR MEDICAL, SHORT-TERM DISABILITY, DENTAL, PRESCRIPTION, AND VISION) FOR ELIGIBLE 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 X 134 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X CDS ADMINISTRATORS 4124321125 5 HOT METAL STREET NO 200 PITTSBURGH PA 15203 HERBERT SANTOS JR UNION TRUSTEE/CHAIRMAN 2.00 X 0 117260 0 CHUCK HILL UNION TRUSTEE 2.00 X 0 118053 57054 GAROLD MAY EMPLOYER TRUSTEE/SECRETARY 2.00 X 0 0 0 DARRYL TRAYLOR EMPLOYER TRUSTEE 2.00 X 0 0 0 WALDO EMERSON EMPLOYER TRUSTEE 2.00 X 0 0 0 ERIC PORTER UNION TRUSTEE 2.00 X 0 107207 30441 WALTER ILCZYSZYN UNION TRUSTEE 2.00 X 0 92679 54009 NIKITAS MANIAS EMPLOYER TRUSTEE 2.00 X 0 0 0 0 435199 141504 0 0 1 0 HIGHMARK 120 FIFTH AVE SUITE P2307 PITTSBURGH PA 15222 CLAIMS PROCESSOR 1090180 CENTRAL DATA SERVICES INC 5 HOT METAL ST STE 200 PITTSBURGH PA 15203 BENEFIT ADMINISTRATION 347583 ENVISION RX 2181 E AURORA RD - STE 201 TWINSBURG OH 44087 CLAIMS PROCESSOR 256540 ROBEIN URANN SPENCER PICARD & CANGEMI 2540 SEVERN AVE STE 400 METAIRIE LA 700096768 LEGAL 131412 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD STE 330 BALA CYNWYD PA 19004 ACCOUNTING 118118 6 EMPLOYER CONTRIBUTIONS 525100 21524662 21524662 RETIREE CONTRIBUTIONS 525100 477507 477507 22002169 357293 357293 12874079 12671515 202564 202564 202564 OTHER INCOME 900099 510903 510903 510903 23072929 22002169 0 1070760 24259354 347583 282935 113093 57366 1459409 98002 37370 7098 FEES MANDATED BY ACA 10601 26672811 2687652 1985394 2305741 1869081 2380170 2215388 13553 14272 13627456 10777244 21014572 16861379 316432 401209 1864185 1879803 2180617 2281012 X 0 0 0 0 18833955 14580367 18833955 14580367 21014572 16861379 -3599882 -653706 0 X X 0 1 X 1 0 0 THE AFFORDABLE CARE ACT FEE LIABILITY 10601 DUE TO RELATED PARTIES 1869202 1879803 X 22361857 -653706 -653706 23015563 57366 57366 23072929 26615445 0 26615445 57366 57366 26672811 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, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. 0 0 0 CHUCK HILL UNION TRUSTEE 0 118053 0 0 0 0 0 41610 0 15444 0 175107 0 0 FORM 990, PART V, LINE 2A AND 2B: SOME WELFARE BENEFITS PAID BY SOUTHERN PAINTERS WELFARE FUND ARE TAXABLE TO PARTICIPANTS AND MUST BE REPORTED ON FORM W-2. 2966 FORMS WERE ISSUED FOR THE 2017 PLAN YEAR. FORM 990, PART VI, SECTION B, LINE 11B SOUTHERN PAINTERS' WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT WHO THEN FORWARDS THE COMPLETED RETURN TO THE FUND'S GOVERNING BODY FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS IT'S CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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