2015-10-15T13:20:37-05:00 2014-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2014-01-01 581910292 SOUTHERN PAINTERS WELFARE FUND SOUT 4124321125 5 HOT METAL STREET NO 200 PITTSBURGH PA 15203 HERBERT SANTOS TRUSTEE 4124321125 2015-10-15 1 LOUIS VERZELLA CPA P00360279 6106689400 2015-10-08 2014 2016-02-25 16:41:14Z HERBERT SANTOS 5 HOT METAL STREET NO 200 PITTSBURGH PA 15203 15132951 0 X N/A X 1990 GA THIS IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN WHICH HAS BEEN ESTABLISHED TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE PARTICIPANTS. 6 3 22 0 0 0 0 0 9666631 11920828 306464 363253 0 0 9973095 12284081 0 0 8734268 11225316 0 0 0 0 0 501800 1371015 9236068 12596331 737027 -312250 9709266 9740576 73372 268835 9635894 9471741 THIS IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN WHICH HAS BEEN ESTABLISHED TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE PARTICIPANTS 0 0 THE PLAN PROVIDES DEATH, LIFE, AND HEALTH BENEFITS (MEDICAL, SURGICAL, MAJOR MEDICAL, SHORT-TERM DISABILITY, DENTAL, PRESCRIPTION, AND VISION) FOR 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 X 272 0 22 1 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X CDS ADMINISTRATORS 4124321125 5 HOT METAL STREET NO 200 PITTSBURGH PA 15203 HERBERT SANTOS TRUSTEE 2.00 X 0 114673 0 DAVID WENNINGER TRUSTEE 2.00 X 0 99986 0 CHUCK HILL TRUSTEE 2.00 X 0 94957 0 GAROLD MAY TRUSTEE 2.00 X 0 0 0 DARRYL TRAYLOR TRUSTEE 2.00 X 0 0 0 WALDO EMERSON TRUSTEE 2.00 X 0 0 0 0 309616 0 0 0 0 0 CIGNA 540 WEST MADISON STREET CHICAGO IL 60661 CLAIMS PROCESSOR 575137 ZENITH AMERICAN SOLUTIONS INC 100 CRESCENT CENTRE PKWY - STE 400 TUCKER GA 30084 BENEFIT ADMINISTRATION 253378 2 EMPLOYER CONTRIBUTIONS 525100 11749149 11749149 EMPLOYEE CONTRIBUTIONS 525100 117436 117436 RETIREE CONTRIBUTIONS 525100 54243 54243 11920828 209245 209245 3002878 2848870 154008 154008 154008 12284081 11920828 0 363253 11225316 253378 49136 13200 49174 767818 65306 22630 1645 4794 FEES MANDATED BY ACA 143934 12596331 916294 721208 1092719 2935093 1282245 1420547 2264 1451 6415744 4662277 9709266 9740576 73372 129187 0 139648 73372 268835 X 0 0 0 0 9635894 9471741 9635894 9471741 9709266 9740576 -312250 75664 72433 0 X X 0 1 X 1 0 0 THE AFFORDABLE CARE ACT FEE LIABILITY 139648 139648 X 12310571 75664 75664 12234907 49174 49174 12284081 12547157 0 12547157 49174 49174 12596331 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. FORM 990, PART V, LINE 2A AND 2B: SOME WELFARE BENEFITS PAID BY SOUTHERN PAINTERS WELFARE FUND ARE TAXABLE TO PARTICIPANTS AND MUST BE REPORTED ON FORM W-2. 22 FORMS WERE ISSUED FOR THE 2014 PLAN YEAR. FORM 990, PART VI, SECTION B, LINE 11 SOUTHERN PAINTERS' WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT WHO THEN FORWARDS THE COMPLETED RETURN TO THE FUND'S GOVERNING BODY FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS IT'S CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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