IBEW LOCAL 102 WELFARE FUND: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- IBEW LOCAL 102 WELFARE FUND (EIN 22-6487222)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-09
- IRS object ID
- 201743139349300209
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-09T05:24:08-08:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHAUGHNESSY GIELLA CPA PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 ROUTE 46 EAST SUITE 4 | AddressLine1Txt |
| City | FAIRFIELD | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 226487222 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IBEW LOCAL 102 WELFARE FUND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IBEW | BusinessNameControlTxt |
| Phone | 9738871718 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5355 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07054 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BERNARD CORRIGAN | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 9738871718 | PhoneNum |
| Signature | 2017-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL GIELLA | PreparerPersonNm |
| Phone | 9738820228 | PhoneNum |
| Preparation | 2017-11-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.204.130.199 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-09 | IPDt |
| IP Tm | 05:23:57 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 25A691A3715C98EFBD7860BDF5D35C5E571D9CB2 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 25A691A3715C98EFBD7860BDF5D35C5E571D9CB2 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BERNARD CORRIGAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5355 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $68,556,742 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | WELFARE FUND - HEALTH/MEDICAL BENEFITS | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $45,145,526 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,651,327 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,671,807 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,324,583 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,847,383 | PYOtherRevenueAmt |
| CY Other Revenue | $670,045 | CYOtherRevenueAmt |
| PY Total Revenue | $45,969,950 | PYTotalRevenueAmt |
| CY Total Revenue | $49,645,955 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $39,372,239 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $43,260,915 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,431,620 | PYOtherExpensesAmt |
| CY Other Expenses | $3,000,497 | CYOtherExpensesAmt |
| PY Total Expenses | $42,803,859 | PYTotalExpensesAmt |
| CY Total Expenses | $46,261,412 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,166,091 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,384,543 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $110,129,034 | TotalAssetsBOYAmt |
| Total Assets EOY | $117,196,704 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,540,701 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,223,828 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $107,588,333 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $110,972,876 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WELFARE FUND - HEALTH/MEDICAL BENEFITS | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Desc | PROVIDING HEALTH & MEDICAL BENEFITS TO THE PARTICIPANTS | Desc |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 74 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IE SHAFFER PLAN ADMINISTRATORS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6098836688 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 830 BEAR TAVERN ROAD | AddressLine1Txt |
| City | WEST TRENTON | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 08628 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|
| JAMES ESTABROOK | ||
| TRUSTEE | 1.00 | Yes (X) |
| BERNIE CORRIGAN | ||
| TRUSTEE | 1.00 | Yes (X) |
| GARY PFARR | ||
| TRUSTEE | 1.00 | Yes (X) |
| DAVID FIORE | ||
| TRUSTEE | 1.00 | Yes (X) |
| LOUIS VITO | ||
| TRUSTEE | 1.00 | Yes (X) |
| BILL ROSSI | ||
| TRUSTEE | 1.00 | Yes (X) |
| ROBERT WILLIAMSON III | ||
| TRUSTEE | 1.00 | Yes (X) |
| ROBERT RENALDI | ||
| TRUSTEE | 1.00 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HORIZON BC BS | |||||
| 3 PENN PLAZA EAST | NEWARK | NJ | 07105 | CONTRACT ADMINISTRATOR | $786,519 |
| GLOBAL PHARMACEUTICAL BENEFITS LLC | |||||
| 222 LAFAYETTE STREET | NEWARK | NJ | 07105 | CONTRACT ADMINISTRATOR | $620,677 |
| FABIAN & BYRN LLC | |||||
| 204 EAGLE ROCK AVE | ROSELAND | NJ | 07068 | CLAIMS PROCESSING | $484,577 |
| IE SHAFFER CO | |||||
| 830 BEAR TAVERN ROAD | WEST TRENTON | NJ | 08628 | THIRD PARTY ADMINISTRATOR | $375,065 |
| ZELIS HEALTHCAREINC | |||||
| 2 CROSSROADS DRIVE | BEDMINSTER | NJ | 07921 | CLAIMS REVIEW | $155,477 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt |
|---|---|---|
| EMPLOYER & PARTICIPANT CONTRIBUTIONS | 525100 | $45,015,496 |
| MEDICARE DRUG SUBSIDY | 525100 | $634,365 |
| OTHER | 525100 | $1,466 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,651,327 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,809,495 | TotalRevenueColumnAmt |
| Exclusion | $2,809,495 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $19,425,875 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,910,787 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $515,088 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $515,088 | TotalRevenueColumnAmt |
| Exclusion | $515,088 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | UNREALIZED APPRECIATION OF INVESTMENTS | Desc |
| Business | 525100 | BusinessCd |
| Total Revenue Column | $670,045 | TotalRevenueColumnAmt |
| Exclusion | $670,045 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $670,045 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,645,955 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,651,327 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $3,994,628 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,260,915 | TotalAmt |
| Program Services | $43,260,915 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,533 | TotalAmt |
| Program Services | $21,533 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,350 | TotalAmt |
| Program Services | $28,350 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,994 | TotalAmt |
| Program Services | $210,994 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $893 | TotalAmt |
| Program Services | $893 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| ACTUARY | $4,000 | $4,000 |
| OFFICE, PRINTING & POSTAGE | $29,611 | $29,611 |
| CONTRACT ADMINISTRATOR FEES | $2,422,315 | $2,422,315 |
| INSURANCE | $8,972 | $8,972 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,829 | TotalAmt |
| Program Services | $273,829 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,261,412 | TotalAmt |
| Program Services | $46,261,412 | ProgramServicesAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,380,660 | BOYAmt |
| EOY | $7,105,937 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,933,167 | BOYAmt |
| EOY | $5,777,999 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,909,981 | BOYAmt |
| EOY | $103,391,368 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $905,226 | BOYAmt |
| EOY | $921,400 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,129,034 | BOYAmt |
| EOY | $117,196,704 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,540,701 | BOYAmt |
| EOY | $6,223,828 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,540,701 | BOYAmt |
| EOY | $6,223,828 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,588,333 | BOYAmt |
| EOY | $110,972,876 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,588,333 | BOYAmt |
| EOY | $110,972,876 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,129,034 | BOYAmt |
| EOY | $117,196,704 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,384,543 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Rev Etc Audited Fincl Stmt | $49,434,961 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $49,434,961 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $210,994 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $210,994 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,645,955 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $42,295,119 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,142,105 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,142,105 | ExpensesNotReportedAmt |
| Expenses Subtotal | $40,153,014 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $210,994 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $5,897,404 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $6,108,398 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $46,261,412 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt XII, Line 2d | ACCRUED HEALTH CLAIMS 12/31/15 INCLUDED IN BENEFIT OBLIGATIONS STATEMENT. |
| Pt XII, Line 4b | ACCRUED HEALTH CLAIMS 12/31/16 INCLUDED IN BENEFIT OBLIGATIONS STATEMENT |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 3 | THE ORGANIZATION UTILIZES THE SERVICES OF I.E. SHAFFER, A THIRD PARTY ADMINISTRATOR, AND FABIAN & BYRN, LLC A CLAIMS ADMINISTRATOR. |
| Pt VI, Line 11b | A COPY OF THE FORM 990 IS PROVIDED TO EACH TRUSTEE AT A |
| Pt VI, Line 11b | MEETING PRIOR TO THE FILING DATE, WHERE QUESTIONS THAT A |
| Pt VI, Line 11b | TRUSTEE MAY HAVE ARE ADDRESSED. |
| Pt VI, Line 12c | THE ORGANIZATION HAS A REGULARLY SCHEDULED QUARTERLY |
| Pt VI, Line 12c | MEETING WHERE IT MONITORS COMPLIANCE WITH THE POLICY. |
| Pt VI, Line 15a | NO COMPENSATION - EMPLOYEE BENEFIT PLAN. |
| Pt VI, Line 19 | THE DOCUMENTS ARE AVAILABLE TO PARTICIPANTS AND THE PUBLIC |
| Pt VI, Line 19 | UPON REQUEST. |
| Form 990, Part IX, Line 24e | COLLECTION FEES - LEGAL 35374. 35374. |
| Form 990, Part IX, Line 24e | COLLECTION FEES REIMB-102 PENSION/SURETY 22021. 22021. |
| Form 990, Part IX, Line 24e | DISCOUNT CLAIM FEES 27703. 27703. |
| Form 990, Part IX, Line 24e | PATIENT CENTERED OUTCOME FEE 14310. 14310. |
| Form 990, Part IX, Line 24e | PAYROLL AUDIT FEES 36037. 36037. |
| Form 990, Part IX, Line 24e | TRANSITIONAL REINSURANCE FEES 128301. 128301. |
| Form 990, Part IX, Line 24e | RDS SERVICE FEES 10083. 10083. |
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