2016-07-27T09:26:41-05:00 2015-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2015-01-01 236263170 CENTRAL PENNSYLVANIA TEAMSTERS HEALTH and welfare fund CENT 6103205500 1055 SPRING STREET WYOMISSING PA 19610 william shappell trustee 6103205500 2016-07-27 1 Louis Verzella CPA P00360279 6106689400 2016-07-26 2015 2016-12-15 16:53:06Z JOE SAMOLEWICZ 1055 SPRING STREET WYOMISSING PA 19610 163803630 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 -183071 -183071 0 0 101129811 100094222 2220491 11588795 -182767 -180481 103167535 111502536 0 0 97928613 98960550 3099186 3153073 0 0 0 3599506 2922204 104627305 105035827 -1459770 6466709 109027822 102087480 693251 623883 108334571 101463597 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 2398 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 KEITH YOUST UNION TRUSTEE (P) 2.00 50.00 X 0 46660 35752 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 78005 78005 83300 MARTIN L CULLEN ASST FUND ADMINISTRATOR 22.50 22.50 X 57261 57261 73530 JAMES STRICKER INFORMATION TECHNOLOGY 22.50 22.50 X 50851 50851 70506 186117 682758 536505 0 0 1 0 HEALTHAMERICA OF PENNSYLVANIA INC 3721 TecPort Drive HARRISBURG PA 17106 CLAIMS PROCESSING 2002615 Multiplan 115 Fifth Ave 7th Floor New York NY 10003 CLAIMS PROCESSING 264492 BASYS INC 3700 KOPPERS ST STE 400 BALTIMORE MD 21227 COMPUTER SERVICES 253816 Stevens & Lee 1818 Market Street 29th floor PHILADELPHIA PA 19103 LEGAL SERVICES 227150 DELTA DENTAL OF PENNSYLVANIA One Delta Drive MECHANICSBURG PA 17055 CLAIMS PROCESSING 225534 10 EMPLOYER CONTRIBUTIONS 525100 94036998 94036998 PARTICIPANT CONTRIBUTIONS 525100 5017094 5017094 RETIREE DRUG SUBSIDY-MEDICARE PAR 525100 1040130 1040130 100094222 2472358 2472358 61417531 52301094 9116437 9116437 9116437 MISCELLANEOUS INCOME 900099 2634 2634 FOREIGN CURRENCY 900099 -44 -44 PASS THROUGH INCOME FROM PARTNERS 900099 -183071 -183071 -180481 111502536 109210659 -183071 2474948 98960550 1500242 781871 746210 124750 577743 80965 321120 639486 550108 356264 149101 39817 2745 54067 112963 FEES MANDATED BY ACA 28193 ALLOCATED DEPRECIATION 4213 PAYROLL AUDIT EXPENSE 3530 INVESTMENT TAXES 1889 105035827 3637046 2760093 1425569 2103656 7341436 7752818 125015 130636 2395291 2261125 67620 134166 75262084 79525812 20709169 9256357 459883 423942 109027822 102087480 562827 408649 130424 215234 693251 623883 X 0 0 0 0 108334571 101463597 108334571 101463597 109027822 102087480 X 6466709 -13520754 183071 X X 0 1 X 1 0 6459 6459 0 2002710 1880874 121836 386122 373792 12330 134166 LIMITED PARTNERSHIP 9256357 F 9256357 DUE TO RELATED PARTIES 15448 DUE TO BROKER FOR PURCHASES OF SECURITIES 121738 Obligation under capital lease 78048 215234 X 97843154 -13520754 -13520754 111363908 321699 -183071 138628 111502536 104714128 0 104714128 321699 321699 105035827 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 -183,071. 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 78005 78005 0 0 0 0 22925 22925 18725 18725 119655 119655 0 0 MARTIN L CULLEN ASST FUND ADMINISTRATOR 57261 57261 0 0 0 0 19872 19872 16893 16893 94026 94026 0 0 JAMES STRICKER INFORMATION TECHNOLOGY 50851 50851 0 0 0 0 18927 18927 16326 16326 86104 86104 0 0 Form 990, Part VI, Section B, line 11 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 183,071. 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 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 PA ABM INDUSTRIES JANITORIAL PA AIRGAS SPECIALTY PRODUCTS GA ANTHRACITE INDUSTRIES INC PA ARAMARK COFFEE PA ARKANSAS BEST FREIGHT SYS AR ARKEMA INC PA BERKS PACKING COMPANY INC PA BRENNTAG NORTHEAST INC PA CANTEEN VENDING SERVICES NC CARL R BIEBER INC PA CEMPORT INC NJ CENTRAL BUILDERS SUPPLY C PA CENTRE CONCRETE COMPANY PA CPC TANKER LLC MO DBA ALL STAR DISTRIBUTG PA DAIRY FARMERS OF AMERICA PA E J BRENEMAN L P PA EJB PAVING AND MATERIALS PA ELCO HAUSMAN DIV OF PA EMPIRE WRECKNG CO OF RDG PA ENERFAB POWER & INDUSTRIAL PA GOODMAN VENDING SERVICE PA GROCERY HAULERS INC NJ HENKELS & MCCOY INC PA HESS TRUCKING COMPANY PA INT SCRAP IRON & METAL CO PA J D M MATERIALS CO INC PA JONES MOTOR CO INC PA KUNZLER & COMPANY INC PA LEHIGH VALLEY DAIRIES TX LEHIGH VALLEY DAIRIES INC TX LENTZ MILLING COMPANY PA MILLER ROBESONIA TRUCK SV NJ NEW PENN MOTOR EXPRESS IN PA PENNSY SUPPLY INC PA PETRO OIL NY POLLOCK-READING INC PA PRECISION PIPELINE LLC WI RABBIT TRANSIT PA READING FOUNDRY & SUPPLY PA SAVOR STREET FOODS INC PA SHEEHAN PIPE LINE CONSTR OK SINGER EQUIPMENT CO INC PA SUPERVALU INC AZ THE HILLIS GROUP LLC PA UNITED PARCEL SERVICE OH UPS CARTAGE SERVICES INC OH US PIPELINE INC TX WALTER W ZEIGLER & SONS PA WEINER IRON & METAL CORP PA WELDED CONSTRUCTION OH WINDSOR SERVICE TRUCKING PA WOOD-MODE INCORPORATED PA YEAGER SUPPLY INC PA YORK CONCRETE CO PA YORK GROUP INC PA YRC FREIGHT KS 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 2506925 FMV TEAMSTERS LOCAL UNION NO 429 K 134727 FMV