2015-10-13T11:28:07-05:00 2014-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2014-01-01 236263170 CENTRAL PENNSYLVANIA TEAMSTERS HEALTH AND WELFARE FUND CENT 6103205500 1055 SPRING STREET WYOMISSING PA 19610 WILLIAM SHAPPELL ADMINISTRATOR 6103205500 2015-10-13 1 LOUIS VERZELLA CPA P00360279 6106689400 2015-10-02 2014 2016-03-07 17:11:31Z JOE SAMOLEWICZ 1055 SPRING STREET WYOMISSING PA 19610 129308963 0 X WWW.CENTRALPATEAMSTERS.COM X 1952 PA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE MEMBERS OF COLLECTIVELY BARGAINED EMPLOYERS. 10 10 0 0 -189060 -189060 0 0 98383779 101129811 4944236 2220491 -246319 -182767 103081696 103167535 0 0 92145908 97928613 3159210 3099186 0 0 0 2692566 3599506 97997684 104627305 5084012 -1459770 107750635 109027822 651015 693251 107099620 108334571 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 2573 0 0 1 1 0 0 0 0 0 X 10 10 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 93244 57686 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 93660 36459 J CHRISTOPHER MICHAEL EMPLOYER TRUSTEE 2.00 X 0 0 0 KEITH YOUST UNION TRUSTEE 2.00 50.00 X 0 88551 56596 KEN ROSS EMPLOYER TRUSTEE 2.00 X 0 0 0 CHARLES SHAFER UNION TRUSTEE 2.00 40.00 X 0 92050 56674 JEFFREY STRAUSE UNION TRUSTEE 2.00 50.00 X 0 74039 53313 ERIC BUCHEIT EMPLOYER TRUSTEE 2.00 X 0 0 0 JOSEPH J SAMOLEWICZ FUND ADMINISTRATOR 22.50 22.50 X 75764 75763 79313 MARTIN L CULLEN ASST FUND ADMINISTRATOR 22.50 22.50 X 55624 55623 70332 131388 572930 410373 0 0 1 0 HEALTHAMERICA OF PENNSYLVANIA INC 3721 TECPORT DRIVE HARRISBURG PA 17106 CLAIMS PROCESSING 2189189 GENERAL PRESCRIPTION PROGRAM INC 222 LAFAYETTE STREET NEWARK NJ 07105 CLAIMS PROCESSING 370820 DELTA DENTAL OF PENNSYLVANIA ONE DELTA DRIVE MECHANICSBURG PA 17055 CLAIMS PROCESSING 248711 WILLIG WILLIAMS & DAVIDSON 1845 WALNUT STREET PHILADELPHIA PA 19103 LEGAL SERVICES 244456 BASYS INC 3700 KOPPERS ST STE 400 BALTIMORE MD 21227 COMPUTER SERVICES 216855 8 EMPLOYER CONTRIBUTIONS 525100 94661026 94661026 PARTICIPANT CONTRIBUTIONS 525100 5419461 5419461 RETIREE DRUG SUBSIDY-MEDICARE PAR 525100 1049324 1049324 101129811 2212357 2212357 26149562 26141428 8134 8134 8134 MISCELLANEOUS INCOME 900099 6292 6292 FOREIGN CURRENCY 900099 1 1 PASS THROUGH INCOME FROM PARTNERS 900099 -189060 -189060 -182767 103167535 101129811 -189060 2226784 97928613 1502177 850596 623084 123329 452219 75648 325452 672518 548732 280129 147807 36260 30 40006 85800 FEES MANDATED BY ACA 924495 PAYROLL AUDIT EXPENSE 4862 ALLOCATED DEPRECIATION 4213 INVESTMENT TAXES 1335 104627305 4266950 3637046 1510785 1425569 7888100 7341436 123955 125015 2274678 2207058 72606 67620 72465736 75262084 20752325 20709169 670178 459883 107750635 109027822 426662 562827 224353 130424 651015 693251 X 0 0 0 0 107099620 108334571 107099620 108334571 107750635 109027822 X -1459770 2505661 189060 X X 0 1 X 1 0 2784 2784 0 1883571 1828315 55256 388323 375959 12364 67620 103-12 INVESTMENT ENTITY 13300871 F LIMITED PARTNERSHIP 7408298 F 20709169 DUE TO RELATED PARTIES 13028 DUE TO BROKER FOR PURCHASES OF SECURITIES 117396 130424 X 105536524 2505661 2505661 103030863 325732 -189060 136672 103167535 104301573 0 104301573 325732 325732 104627305 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 -189,060. X 0 0 0 WILLIAM SHAPPELL UNION TRUSTEE 0 93244 0 0 0 0 0 40380 0 17306 0 150930 0 0 JOSEPH J SAMOLEWICZ FUND ADMINISTRATOR 75764 75763 0 0 0 0 21701 21701 17956 17955 115421 115419 0 0 MARTIN L CULLEN ASST FUND ADMINISTRATOR 55624 55623 0 0 0 0 18895 18894 16272 16271 90791 90788 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 189,060. 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 LABOR UNION 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 OLD LYCOMING TOWNSHIP 246001507 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 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 AYCOCK DIVISON OF ENERFAB OH 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 MICHELS CORPORATION NJ MILLER ROBESONIA TRUCK SV NJ MORRIS KREITZ & SONS INC PA NEW PENN MOTOR EXPRESS IN PA PETRO OIL NY POLLOCK-READING INC PA PRECISION PIPELINE LLC WI RABBIT TRANSIT PA READING FOUNDRY & SUPPLY PA SAVOR STREET FOODS INC PA SINGER EQUIPMENT CO INC PA SUPERVALU INC AZ UNITED PARCEL SERVICE OH WALTER W ZEIGLER & SONS PA WEINER IRON & METAL CORP PA 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 2517248 FMV TEAMSTERS LOCAL UNION NO 429 K 133262 FMV