2017-07-26T12:35:38-05:00 2016-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2016-01-01 236263170 CENTRAL PENNSYLVANIA TEAMSTERS HEALTH and welfare fund CENT 6103205500 1055 SPRING STREET WYOMISSING PA 19610 joseph samolewicz authorized signer 6103205500 2017-03-21 1 Louis Verzella CPA P00360279 6106689400 2017-07-25 162.211.205.39 2017-07-26 12:33:48 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A96940F3BC1CB41A42F1C40DCB182A9E8131B64B 2016 2021-01-29 14:40:06Z William m Shappell 1055 SPRING STREET WYOMISSING PA 19610 129461974 0 X www.CENTRALPATEAMSTERS.COM X 1952 PA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS OF COLLECTIVELY BARGAINED EMPLOYERS. 9 9 0 0 -129164 -233050 0 0 100094222 106661633 11588795 2345248 -180481 -126694 111502536 108880187 0 0 98960550 105645766 3153073 3217300 0 0 0 2922204 2908673 105035827 111771739 6466709 -2891552 102087480 102882373 623883 982947 101463597 101899426 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS OF COLLECTIVELY BARGAINED EMPLOYERS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 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 2437 0 0 1 1 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X JOSEPH J SAMOLEWICZ 6103205500 1055 SPRING ST WYOMISSING PA 19610 X WILLIAM SHAPPELL UNION TRUSTEE 2.00 50.00 X 0 98623 62712 THOMAS J VENTURA EMPLOYER TRUSTEE 2.00 X 0 0 0 DANIEL SCHMIDT EMPLOYER TRUSTEE 2.00 X 0 0 0 HOWARD W RHINIER UNION TRUSTEE 2.00 40.00 X 0 94218 40354 Ken Ross EMPLOYER TRUSTEE 2.00 X 0 0 0 CHARLES SHAFER UNION TRUSTEE 2.00 40.00 X 0 93410 61518 JEFFREY STRAUSE UNION TRUSTEE 2.00 50.00 X 0 78311 58015 ERIC BUCHEIT EMPLOYER TRUSTEE 2.00 X 0 0 0 Kevin Bolig Union Trustee 2.00 50.00 X 0 85419 50818 JOSEPH J SAMOLEWICZ FUND ADMINISTRATOR 22.50 22.50 X 0 157261 83227 MARTIN L CULLEN ASST FUND ADMINISTRATOR 22.50 22.50 X 0 115433 74125 JAMES STRICKER INFORMATION TECHNOLOGY 22.50 22.50 X 0 103723 71581 0 826398 502350 0 0 1 0 HEALTHAMERICA OF PENNSYLVANIA INC 3721 TecPort Drive HARRISBURG PA 17106 CLAIMS PROCESSING 1934510 BASYS INC 3700 KOPPERS ST STE 400 BALTIMORE MD 21227 COMPUTER SERVICES 253021 Multiplan 115 Fifth Ave 7th Floor New York NY 10003 CLAIMS PROCESSING 241798 DELTA DENTAL OF PENNSYLVANIA One Delta Drive MECHANICSBURG PA 17055 CLAIMS PROCESSING 231510 GENERAL PRESCRIPTION PROGRAMS INC 305 MADISON AVENUE - SUITE 1166B NEW York NY 10165 CLAIMS PROCESSING 228731 11 EMPLOYER CONTRIBUTIONS 525100 100350725 100350725 PARTICIPANT CONTRIBUTIONS 525100 5357106 5357106 RETIREE DRUG SUBSIDY-MEDICARE PAR 525100 953802 953802 106661633 2321216 2321216 20605819 20581787 24032 24032 24032 MISCELLANEOUS INCOME 900099 2448 2448 FOREIGN CURRENCY 900099 22 22 PASS THROUGH INCOME FROM PARTNERS 900099 -129164 -129164 -126694 108880187 106685665 -129164 2323686 105645766 1534037 791241 763024 128998 507307 92601 271082 688496 568392 381154 148441 37418 2497 66789 108688 FEES MANDATED BY ACA 28430 ALLOCATED DEPRECIATION 2570 PAYROLL AUDIT EXPENSE 2545 INVESTMENT TAXES 2263 111771739 2760093 3727199 2103656 1500682 7752818 9044597 130636 87337 2458496 2327914 134166 130582 79525812 79256788 9256357 8689695 423942 445493 102087480 102882373 408649 884983 215234 97964 623883 982947 X 0 0 0 0 101463597 101899426 101463597 101899426 102087480 102882373 X -2891552 3198217 129164 X X 0 1 X 1 0 1574 1574 0 52313 7944 44369 2014710 1941346 73364 389899 377050 12849 130582 103-12 INVESTMENT ENTITY 8689695 F 8689695 DUE TO RELATED PARTIES 2570 DUE TO BROKER FOR PURCHASES OF SECURITIES 51173 Obligation under capital lease 44221 97964 X 111935604 3198217 3198217 108737387 271964 -129164 142800 108880187 111499775 0 111499775 271964 271964 111771739 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. Part XI, Line 4b - Other Adjustments: PASS THROUGH LOSS FROM PARTNERSHIP K-1's -129,164. X 0 0 0 WILLIAM SHAPPELL UNION TRUSTEE 0 98623 0 0 0 0 0 31356 0 31356 0 161335 0 0 CHARLES SHAFER UNION TRUSTEE 0 93410 0 0 0 0 0 30759 0 30759 0 154928 0 0 JOSEPH J SAMOLEWICZ FUND ADMINISTRATOR 0 157261 0 0 0 0 0 45227 0 38000 0 240488 0 0 MARTIN L CULLEN ASST FUND ADMINISTRATOR 0 115433 0 0 0 0 0 39539 0 34586 0 189558 0 0 JAMES STRICKER INFORMATION TECHNOLOGY 0 103723 0 0 0 0 0 37949 0 33632 0 175304 0 0 Form 990, Part VI, Section B, line 11b THE INDEPENDENT PUBLIC ACCOUNTANT, NOVAK FRANCELLA LLC, PRESENTS A DRAFT FORM 990 TO THE TRUSTEES AT A MEETING TO BE HELD PRIOR TO THE FILING FOR TRUSTEE REVIEW AS WELL AS LEGAL COUNSEL REVIEW. Form 990, Part VI, Section B, line 12c ONCE A YEAR, THE CONFLICT OF INTEREST POLICY IS LOOKED AT FOR THE INVESTMENT MANAGERS AND INVESTMENT CONSULTANT. THE TRUSTEES AND KEY EMPLOYEES ARE SUPPOSED TO DISCLOSE ANY CONFLICT AS SOON AS THEY KNOW ABOUT IT. Form 990, Part VI, Section B, line 15 THE TRUSTEES REVIEW THE ADMINISTRATOR'S SALARY ON A YEARLY BASIS IN EXECUTIVE SESSION. THE SALARY INCREASES FOR ASSISTANT ADMINISTRATOR, CONTROLLER, HR MANAGER, IT MANAGER AND ALL OTHER EMPLOYEES ARE DISCUSSED AS FOLLOWS: THE CONTROLLER GETS THE CPI NUMBER FOR THE YEAR AND THE ASSISTANT ADMINISTRATOR USES THAT PERCENTAGE AS A PROPOSED BASIS FOR SALARY INCREASES. AT THAT POINT THE COMPENSATION COMMITTEE IS GIVEN THE PROPOSED PERCENTAGE AS WELL AS HOW MUCH THAT PERCENTAGE WOULD COST THE FUND. THE COMPENSATION COMMITTEE AND THE TRUSTEES THEN HAVE A MEETING WITH THE ADMINISTRATOR AND INFORM HIM OF THE APPROVED INCREASE AND WHETHER OR NOT THERE WOULD BE ANY MERIT INCREASES ALLOWED. Form 990, Part VI, Section C, line 19 THE FUND SENDS THE GOVERNING DOCUMENTS (SPD) TO ALL MEMBERS WHEN PRINTED AS WELL AS TO ALL NEW MEMBERS. CONFLICT OF INTEREST POLICY - NOT GIVEN TO PARTICIPANTS. ALL PARTICIPANTS ARE SENT SAR'S ANNUALLY AND THE FINANICAL STATEMENT IS MADE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: JOSEPH J. SAMOLEWICZ, FUND ADMINISTRATOR, WORKED 22.50 HOURS FOR RELATED ORGANIZATIONS. MARTIN L. CULLEN, ASST. FUND ADMINISTRATOR, WORKED 22.50 HOURS FOR RELATED ORGANIZATIONS. Form 990, Part XI, line 9: PASS THROUGH LOSS FROM PARTNERSHIP K-1's 129,164. FORM 990, PART XII, LINE 2C: THE GOVERNING BODY (TRUSTEES) OF CENTRAL PENNSYLVANIA TEAMSTERS HEALTH AND WELFARE FUND ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT. CENTRAL PENNSYLVANIA TEAMSTERS DEFINED BENEFIT PLAN 1055 SPRING STREET WYOMISSING PA 19610 236262789 PENSION PLAN PA 401(A) 0 CENTRAL PENNSYLVANIA TEAMSTERS RETIREMENT INCOME PLAN - 1987 1055 SPRING STREET WYOMISSING PA 19610 236262789 PENSION PLAN PA 401(A) 0 BERKS COUNTY JAIL SYSTEM 236003049 locAL GOVERNMENT PA 0 BERN TOWNSHIP 236000249 LOCAL GOVERNMENT PA 0 BIRDSBORO BOROUGH 236003118 LOCAL GOVERNMENT PA 0 BOROUGH OF BERWICK 246000568 LOCAL GOVERNMENT PA 0 CUMRU TOWNSHIP 236000288 locAL GOVERNMENT PA 0 DENVER BOROUGH 236002983 LOcAL GOVERNMENT PA 0 EXETER TWP BD OF SUPV 236000327 LOCAL GOVERNMENT PA 0 LOYALSOCK TOWNSHIP 246001483 LOCAL GOVERNMENT PA 0 MAHANOY CITY BOROUGH 236002892 LOCAL GOVERNMENT PA 0 MILTON REGIONAL SEWER ATH 300093422 LOCAL GOVERNMENT PA 0 MUHLENBERG TOWNSHIP 236000435 LOCAL GOVERNMENT PA 0 MUHLENBERG TOWNSHIP AUTH 256010770 LOCAL GOVERNMENT PA 0 NESCOPECK BOROUGH 246000638 LOCAL GOVERNMENT PA 0 NEWBERRY TWP BD OF SUPV 236000437 loCAL GOVERNMENT PA 0 NORTHUMBERLAND COUNTY 246000742 LOCAL GOVERNMENT PA 0 PA CONFERENCE OF TEAMSTER 232311355 LOCAL GOVERNMENT PA 0 POLK TOWNSHIP SUPERVISORS 246001528 LOCAL GOVERNMENT PA 0 RDG REGIONAL AIRPORT AUTH 236050410 LOCAL GOVERNMENT PA 0 SCHUYLKILL COUNTY PRISON 236003048 LOCAL GOVERNMENT PA 0 SMITHFIELD TOWNSHIP 232089952 LOCAL GOVERNMENT PA 0 SNYDER COUNTY 236003152 loCAL GOVERNMENT PA 0 SPRING GARDEN TWP BOC 236003037 LOCAL GOVERNMENT PA 0 SPRINGETTSBURY TOWNSHIP 236000513 LOCAL GOVERNMENT PA 0 SUMMIT HILL BOROUGH 246000664 LOCAL GOVERNMENT PA 0 TEAMSTERS LOCAL UNION 229 240565465 LABOR UNION PA 501(c)(5) 0 TEAMSTERS LOCAL UNION 429 230724625 LABOR UNION PA 501(c)(5) 0 TEAMSTERS LOCAL UNION 764 240773584 LABOR UNION PA 501(c)(5) 0 TEAMSTERS LOCAL UNION 771 231071860 LABOR UNION PA 501(c)(5) 0 TEAMSTERS LOCAL UNION 773 230724667 LABOR UNION PA 501(c)(5) 0 TEAMSTERS LOCAL UNION 776 231147664 LABOR UNION PA 501(c)(5) 0 UPPER MT BETHEL TOWNSHIP 246001583 LOCAL GOVERNMENT PA 0 WASHINGTON TOWNSHIP 236000563 locAL GOVERNMENT PA 0 WEST READING BOROUGH 236002959 locAL GOVERNMENT PA 0 WEST YORK BOROUGH FIREFIG 236003014 LOCAL GOVERNMENT PA 0 3B SERVICES INC ABM FLOOR SERVICES ABM INDUSTRIES JANITORIAL ABM INDUSTRIES MECHANICAL AIRGAS SPECIALTY PRODUCTS ANTHRACITE INDUSTRIES INC ANTONIO ORIGLIO ARAMARK COFFEE ARKANSAS BEST FREIGHT SYS ARKEMA INC BERKS PACKING COMPANY INC BRENNTAG NORTHEAST INC CANTEEN VENDING SERVICES CARL R BIEBER INC CEMPORT INC CENTRAL BUILDERS SUPPLY C CENTRE CONCRETE COMPANY CPC TANKER LLC CSI DBA MCMINNS ASPHALT CO DAIRY FARMERS OF AMERICA DIVISION OF DEAN TRANS IN E J BRENEMAN L P EJB PAVING AND MATERIALS EMPIRE WRECKNG CO OF RDG ENERFAB POWER & INDUSTRIAL GOODMAN VENDING SERVICE GROCERY HAULERS INC HENKELS & MCCOY INC HESS TRUCKING COMPANY INFRASOURCE INC INT SCRAP IRON & METAL CO J D M MATERIALS CO INC JONES MOTOR CO INC KIEWIT POWER CONSTRUCTORS KUNZLER & COMPANY INC LEHIGH VALLEY DAIRIES INC LENTZ MILLING COMPANY MICHELS CORPORATION MILLER ROBESONIA TRUCK SV NEW ENTERPRISES STONELIM NEW PENN MOTOR EXPRESS IN OZ DIRECTIONAL DRILLING PENN LINE SERVICES PETRO OIL POLLOCK-READING INC PRECISION PIPELINE LLC PRICE GREGORY INT'L INC RABBIT TRANSIT READING FOUNDRY & SUPPLY R-VALUE FOAM INSULATION SAVOR STREET FOODS INC SHEEHAN PIPE LINE CONSTR SINGER EQUIPMENT CO INC SOUTHEAST DIRECT DRILLIN SUPERVALU INC SUPREME INDUSTRIES TG MERCER CONSULTING THE HILLIS GROUP LLC THE NAPP GRECCO CO UNITED PARCEL SERVICE US PIPELINE INC WALTER W ZEIGLER & SONS WEINER IRON & METAL CORP WELDED CONSTRUCTION WINDSOR SERVICE TRUCKING WOOD-MODE INCORPORATED YEAGER SUPPLY INC YORK CONCRETE CO YORK GROUP INC YRC FREIGHT 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 CENTRAL PENNSYLVANIA TEAMSTERS RETIREMENT INCOME PLAN - 1987 P 2642203 FMV TEAMSTERS LOCAL UNION NO 429 K 135080 FMV