2018-05-15T10:41:54-05:00 2017-06-30 161131146 BONADIO & CO LLP 171 SULLYS TRAIL SUITE 201 PITTSFORD NY 14534 990 2016-07-01 201260597 NBPA-NBA SUPPLEMENTAL BENEFIT PLAN NBPA 2018651500 100 PLAZA DRIVE SECAUCUS NJ 07094 ROBERT CRIQUI GARY ARRICK TRUSTEES 2018651500 2018-05-15 1 DAWN MINEMIER P01339753 5853811000 2016 2022-09-23 18:48:47Z R CRIQUI G ARRICK 100 PLAZA DRIVE SECAUCUS NJ 07094 249437573 0 X N/A X 2004 NY THE PLAN PROVIDES SUPPLEMENTAL HEALTH REIMBURSEMENT ACCOUNT ("HRA") (CONTINUED ON SCHEDULE O) (CONTINUATION OF LINE 1) BENEFITS THAT COVER CERTAIN HEALTH-RELATED COSTS OF ELIGIBLE CURRENT AND FORMER NATIONAL BASKETBALL ASSOCIATION ("NBA") PLAYERS AND THEIR SPOUSES AND ELIGIBLE DEPENDENTS. EFFECTIVE JANUARY 1, 2017, THE PLAN WAS AMENDED TO ALSO PROVIDE FULLY INSURED MEDICAL AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE RETIRED NBA PLAYERS AND THEIR SPOUSES AND ELIGIBLE DEPENDENTS. EFFECTIVE JULY 1, 2017 THE PLAN CHANGED ITS NAME FROM THE NBPA-NBA SUPPLEMENTAL BENEFIT PLAN TO THE NBA PLAYERS' HEALTH AND WELFARE BENEFIT PLAN. 6 6 0 0 0 0 0 0 13403226 13692218 4694431 19112647 0 0 18097657 32804865 0 0 4450715 5900597 0 0 0 0 0 862969 696499 5313684 6597096 12783973 26207769 243212310 277465300 273724 817701 242938586 276647599 X THE PLAN PROVIDES SUPPLEMENTAL HRA BENEFITS THAT COVER CERTAIN HEALTH-RELATED COSTS OF ELIGIBLE CURRENT AND FORMER NBA PLAYERS AND THEIR SPOUSES AND ELIGIBLE DEPENDENTS. EFFECTIVE JANUARY 1, 2017, THE PLAN WAS AMENDED TO ALSO PROVIDE FULLY (CONTINUED ON SCHEDULE O) (CONTINUATION OF LINE 1) INSURED MEDICAL AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE RETIRED NBA PLAYERS AND THEIR SPOUSES AND ELIGIBLE DEPENDENTS. 1 0 THE PLAN WAS INITIALLY ESTABLISHED TO PROVIDE ELIGIBLE CURRENT AND FORMER NBA PLAYERS WITH SUPPLEMENTAL HRA BENEFITS THAT COVER HEALTH-RELATED COSTS QUALIFIED UNDER IRS RULES THAT ARE NOT COVERED BY THE PRIMARY INSURANCE CARRIERS. TO THE EXTENT APPLICABLE, COSTS INCURRED IN CONNECTION WITH THE PAYMENT OF PREMIUMS FOR CERTAIN TYPES OF HEALTH INSURANCE MAY ALSO BE COVERED. AS OF JANUARY 1, 2017, THE PLAN ALSO PROVIDES FULLY INSURED MEDICAL AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE RETIRED NBA PLAYERS AND THEIR SPOUSES AND ELIGIBLE DEPENDENTS. THESE BENEFITS ARE CURRENTLY PROVIDED THROUGH INSURANCE POLICIES ADMINISTERED BY UNITEDHEALTHCARE. THE RETIREE MEDICAL PLAN CONSISTS OF INSURED COVERAGE FOR PRE-MEDICARE RETIREES AND A MEDICARE ADVANTAGE PLAN FOR PARTICIPANTS AND DEPENDENTS ELIGIBLE FOR MEDICARE COVERAGE. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 0 0 0 0 0 0 0 X 6 6 1 0 1 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X POMCO 3154329171 2425 JAMES STREET SYRACUSE NY 13206 X ROBERT CRIQUI TRUSTEE 1.00 X 0 0 0 DANIEL RUBE TRUSTEE 1.00 X 0 0 0 RICHARD DELORENZO TRUSTEE - UNTIL 9/30/2016 1.00 X 0 0 0 NEIL AARON TRUSTEE - AS OF 9/30/2016 1.00 X 0 0 0 RONALD KLEMPNER TRUSTEE 1.00 X 0 0 0 GARY ARRICK TRUSTEE 1.00 X 0 0 0 ROGER MASON JR TRUSTEE - UNTIL 12/1/2016 1.00 X 0 0 0 PURVIS SHORT TRUSTEE - AS OF 4/17/2017 1.00 X 0 0 0 0 0 0 0 0 0 0 WELLINGTON TRUST COMPANY NA 280 CONGRESS STREET BOSTON MA 02210 INVESTMENT MANAGEMENT 447307 WELLS FARGO BANK 12 E 49TH STREET NEW YORK NY 10017 CUSTODIAL 184671 GALLIARD CAPITAL MANAGEMENT INC 800 LASALLE AVENUE MINNEAPOLIS MN 55402 INVESTMENT MANAGEMENT 156865 3 NBA TEAMS CONTRIBUTIONS 624100 13692218 13692218 13692218 4983295 4983295 230762060 216632708 14129352 14129352 14129352 32804865 13692218 0 19112647 5900597 696104 395 6597096 505318 762218 1572672 2217245 99112111 130833913 141559406 143222351 462803 429573 243212310 277465300 273724 817701 273724 817701 X 242938586 276647599 242938586 276647599 243212310 277465300 26207769 7501244 0 X 0 1 X 1 0 0 RUSSELL 3000(R) INDEX NL CTF4 70277896 F WTC-CTF INTERNATIONAL RESEARCH EQUITY PORTFOLIO 44160224 F WTC-CTF OPPORTUNISTIC INVESTMENT ALLOCTION 28784231 F 143222351 X 39610005 7501244 7501244 32108761 696104 696104 32804865 5900992 0 5900992 696104 696104 6597096 PART X, LINE 2: IN GENERAL, FOR EMPLOYEE BENEFIT PLANS, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD POTENTIALLY OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. THE PLAN FILES THE RETURN OF EXEMPT ORGANIZATION FROM INCOME TAX (FORM 990) AND THE ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN (FORM 5500) IN THE U.S. FEDERAL JURISDICTION. FORM 990, PART III, LINE 2 EFFECTIVE JANUARY 1, 2017, THE PLAN WAS AMENDED TO INCLUDE A NEWLY ESTABLISHED NBA PLAYERS' RETIREE MEDICAL PLAN PURSUANT TO THE COLLECTIVE BARGAINING AGREEMENT BETWEEN THE NBA AND NATIONAL BASKETBALL PLAYERS ASSOCIATION ("NBPA"). THE RETIREE MEDICAL PLAN PROVIDES FULLY INSURED MEDICAL AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE RETIRED NBA PLAYERS AND THEIR DEPENDENTS. THESE BENEFITS ARE CURRENTLY PROVIDED THROUGH INSURANCE POLICIES ADMINISTERED BY UNITEDHEALTHCARE. IN SOME CASES, ELIGIBLE RETIREES CONTRIBUTE TO THE COST OF THE PREMIUMS FOR THIS COVERAGE. THE RETIREE MEDICAL PLAN CONSISTS OF INSURED COVERAGE FOR PRE-MEDICARE RETIREES AND A MEDICARE ADVANTAGE PLAN FOR PARTICIPANTS AND DEPENDENTS ELIGIBLE FOR MEDICARE COVERAGE. FORM 990, PART VI, SECTION A, LINE 2 BECAUSE THE PLAN IS JOINTLY OPERATED AND ADMINISTERED BY THE NBPA AND THE NBA, (I) THE NBPA TRUSTEES ARE IN A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF GARY ARRICK BEING THE CHIEF FINANCIAL OFFICER OF THE NBPA AND RON KLEMPNER AND PURVIS SHORT BEING EMPLOYEES OF THE NBPA AND (II) THE NBA TRUSTEES ARE IN A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF ALL BEING OFFICERS OF THE NBA. FORM 990, PART VI, SECTION A, LINE 4 THE TRUST AGREEMENT FOR THE PLAN WAS RESTATED EFFECTIVE JULY 1, 2017 AS THE AGREEMENT OF TRUST FOR THE NBA PLAYERS' HEALTH AND WELFARE BENEFIT PLAN. FORM 990, PART VI, SECTION A, LINE 7A THE NBA HAS THE RIGHT TO APPOINT AND REMOVE THREE NBA TRUSTEES, AND THE NBPA HAS THE RIGHT TO APPOINT AND REMOVE THREE NBPA TRUSTEES, EACH PURSUANT TO THE TRUST AGREEMENT ESTABLISHING THE PLAN. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED AND COMMENTED ON BY PLAN COUNSEL AND THE TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE ANNUALLY SIGNS A STATEMENT THAT AFFIRMS SUCH PERSON'S UNDERSTANDING OF THE FUND'S CONFLICT OF INTEREST POLICY; THIS CONFLICT OF INTEREST POLICY WAS PREVIOUSLY AGREED TO BY THE TRUSTEES. PRIOR TO THE SIGNING OF THE MOST RECENT STATEMENT, PLAN COUNSEL ADVISED THE TRUSTEES THAT THEY ARE NOT AWARE OF ANY CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST THAT INVOLVE THE TRUSTEES. THE TRUSTEES ARE REQUIRED TO DISCLOSE ANY CONFLICT OR POSSIBLE CONFLICT IN ACCORDANCE WITH THE TERMS OF THE CONFLICT OF INTEREST POLICY, AND ARE OTHERWISE PRECLUDED FROM ACTING AS A TRUSTEE WITH RESPECT TO ANY MATTER THAT WOULD POSE A CONFLICT OR POSSIBLE CONFLICT WITH THE CONFLICT OF INTEREST POLICY. TO ENSURE THE FUND OPERATES IN A MANNER CONSISTENT WITH ITS TAX EXEMPT STATUS AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX EXEMPT STATUS, PERIODIC REVIEWS ARE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. CHICAGO PROFESSIONAL SPORTS LIMITED PARTNERSHIP DALLAS BASKETBALL LIMITED DENVER NUGGETS LIMITED PARTNERSHIP ROCKET BALL LTD LA CLIPPERS LLC MIAMI HEAT LIMITED PARTNERSHIP MINNESOTA TIMBERWOLVES BASKETBALL LIMITED PARTNERSHIP NEW ORLEANS PELICANS NBA LLC NEW YORK KNICKS LLC ORLANDO MAGIC LTD PHILADELPHIA 76ERS LP SACRAMENTO KINGS LIMITED PARTNERSHIP LP WASHINGTON BULLETS LP ATL INVESTCO LLC BANNER SEVENTEEN LLC BROOKLYN BASEKETBALL HOLDINGS LLC HORNETS BASKETBALL LLC CAVALIERS OPERATING COMPANY LLC GSW SPORTS LLC PACERS BASKETBALL LLC MEMPHIS BASKETBALL LLC MILWAUKEE BUCKS LLC THE PROFESSIONAL BASKETBALL CLUB LLC SUNS LEGACY PARTNERS LLC SAN ANTONIO SPURS LLC DETROIT PISTONS BASKETBALL COMPANY MAPLE LEAF SPORTS AND ENTERTAINMENT PARTNERSHIP THE LOS ANGELES LAKERS INC TRAIL BLAZERS INC JAZZ BASKETBALL INVESTORS INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0