2015-02-11T12:36:55-06:00 2014-07-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2013-08-01 596152618 PLUMBERS & PIPEFITTERS LOCAL UNION NO 803 HEALTH AND WELFARE FUND PLUM 9045380100 8657 BAYPINE ROAD BUILDING 5 NO 200 JACKSONVILLE FL 32256 BERNARD HORNE TRUSTEE 9045380100 2015-02-11 1 GREG WALLENBECKER P01451145 3123680500 2013 2016-03-07 17:11:31Z BERNARD HORNE 8657 BAYPINE ROAD BUILDING 5 NO 200 JACKSONVILLE FL 32256 6687174 0 X N/A X 1965 FL PROVIDE HEALTH BENEFITS 7 6 0 0 0 0 0 0 2579865 2479258 183736 45665 0 0 2763601 2524923 0 0 2803533 4168737 0 0 0 0 0 325001 400787 3128534 4569524 -364933 -2044601 4945390 2830172 122133 52977 4823257 2777195 PROVIDE HEALTH BENEFITS 0 0 THE FUND PROVIDES HEALTH, VISION, AND DEATH BENEFITS TO 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 303 0 1 0 0 0 0 0 0 0 0 0 X 7 6 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 0 0 0 X NATIONAL EMPLOYEE BENEFIT ADMINISTR 9045380100 8657 BAYPINE ROAD BUILDING 5 SUITE JACKSONVILLE FL 32256 BERNARD HORNE TRUSTEE 1.00 X 0 0 0 DAVID GARLINGTON TRUSTEE 1.00 X 0 0 0 TIM MILES TRUSTEE 1.00 X 0 0 0 GARY MONSON TRUSTEE 1.00 X 0 0 0 PAUL V JONES TRUSTEE 1.00 X 0 0 0 BRAD GRABILL TRUSTEE 1.00 40.00 X 0 92746 0 CHARLES V NEWARK TRUSTEE 1.00 X 0 0 0 0 92746 0 0 0 0 0 CATAMARAN PO BOX 27275 NEW YORK NY 100877275 PRESCRIPTION BENEFIT PROVIDER 739781 FLORIDA HOSPITAL MEDICAL CENTER PO BOX 862304 ORLANDO FL 328862304 HEALTHCARE PROVIDER 693412 SHANDS HOSPITAL ACUTE PO BOX 100005 ATLANTA GA 303840384 HEALTHCARE PROVIDER 210471 DR P PHILLIPS HOSPITAL PO BOX 62000 STOP 9936 ORLANDO FL 328919936 HEALTHCARE PROVIDER 187060 CIGNA HEALTH CARE 1111 MARKET STREET CHATTANOOGA TN 37402 BENEFIT ADMINISTRATION FEES 116721 7 EMPLOYER CONTRIBUTIONS 900099 2307400 2307400 PARTICIPANT & RETIREE CONTRIBUTIO 900099 171858 171858 2479258 140001 140001 4067915 4162251 -94336 -94336 -94336 2524923 2479258 0 45665 4168737 61386 50914 14500 22932 191657 21339 4976 3005 FEES MANDATED BY ACA 30078 4569524 443557 656473 154832 25526 327619 303693 2579 9735 4016803 1834745 4945390 2830172 29623 23687 92510 29290 122133 52977 X 0 0 0 0 4823257 2777195 4823257 2777195 4945390 2830172 -2044601 -1461 0 X 0 1 X 1 0 0 ACA REINSURANCE FEE LIABILITY 29290 29290 X 2500530 -1461 -1461 2501991 22932 22932 2524923 4546592 0 4546592 22932 22932 4569524 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES. FORM 990, PART VI, SECTION A, LINE 3 WHILE THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THEY HAVE DELEGATED CONTROL OVER DAY-TO-DAY MANAGEMENT DUTIES TO NATIONAL EMPLOYEE BENEFITS ADMINISTRATORS, INC., A THIRD PARTY ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE FUND DOES NOT HAVE A SEGREGATED COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED, THROUGHLY REVIEWED AND APPROVED BY THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FUND IS REQUIRED BY THE EMPLOYEE RETIREMENT INCOME SECURITY ACT TO DISCLOSE ANY CONFLICTS OF INTEREST. THE TRUSTEES MONITOR AND ENFORCE THE FUND'S COMPLIANCE WITH ERISA WITH ASSISTANCE FROM THE FUND'S PROFESSIONALS FORM 990, PART VI, SECTION C, LINE 19 THE FUND MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PLUMBERS & PIPEFITTERS LOCAL 803 PENSION FUND 8657 BAYPINE ROAD BUILDING 5 STE 20 JACKSONVILLE FL 32256 596228172 PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS FL 401(A) N/A 0 UA LOCAL 803 CONTRIBUTING EMPLOYER 0 ADLER MECHANICAL INC CONTRIBUTING EMPLOYER 0 AIRSTRON INC CONTRIBUTING EMPLOYER 0 CARRIER CORPORATION CONTRIBUTING EMPLOYER 0 CELSIUS CONTRACTORS INC CONTRIBUTING EMPLOYER 0 FLORIDA MECHANICAL CONTRIBUTING EMPLOYER 0 HILL YORK SERVICE CORP CONTRIBUTING EMPLOYER 0 HONEYWELL INTL INC CONTRIBUTING EMPLOYER 0 IRVINE MECHANICAL INC CONTRIBUTING EMPLOYER 0 JOHN J KIRLIN CONTRIBUTING EMPLOYER 0 JOHNSON CONTROLS INC CONTRIBUTING EMPLOYER 0 JPI MECHANICAL SERVICES CONTRIBUTING EMPLOYER 0 KINETICS SYSTEMS INC CONTRIBUTING EMPLOYER 0 KIRLIN FLORIDA LLC CONTRIBUTING EMPLOYER 0 MDI SERVICES LLC CONTRIBUTING EMPLOYER 0 MECHANICAL SERVICES INC CONTRIBUTING EMPLOYER 0 PAGE PIPING INC CONTRIBUTING EMPLOYER 0 SAUER GROUP INC CONTRIBUTING EMPLOYER 0 SHAW MECHANICAL SERVICES CONTRIBUTING EMPLOYER 0 SHUMATE MECHANICAL CONTRIBUTING EMPLOYER 0 SIEMENS BUILDING TECH IN CONTRIBUTING EMPLOYER 0 THERMETRICS CORP CONTRIBUTING EMPLOYER 0 TRANSLOGIC CORP CONTRIBUTING EMPLOYER 0 WALT DISNEY WORLD CONTRIBUTING EMPLOYER 0 WW GAY MECHANICAL CONTR CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 PLUMBERS & PIPEFITTERS LOCAL 803 PENSION FUND S 110190 COST