2013-03-22T08:14:43-05:00 2012-06-30 310800053 CLARK SCHAEFER HACKETT & CO 10100 INNOVATION DRIVE SUITE 400 DAYTON OH 45342 990 2011-07-01 316084151 IBEW LOCAL 82 HEALTH AND WELFARE FUND IBEW 3047813921 609 THIRD AVE PO BOX 487 CHESAPEAKE OH 45619 NICHOLAS COMSTOCK 3047813921 2013-03-19 1 KEVIN T DAVIS CPA P00039883 9372260070 2013-03-19 2011 2016-02-25 16:41:14Z NICHOLAS COMSTOCK 6650 POE AVE DAYTON OH 454142527 12903123 0 X N/A X 1967 OH TO PROVIDE HEALTH, PRESCRIPTION & DEATH BENEFITS TO COVERED MEMBERS, RETIREES & DEPENDENTS. 6 6 0 0 126893 0 0 0 9073994 8952406 302377 126893 0 0 9376371 9079299 0 0 8836483 7435418 0 0 0 0 0 792059 731865 9628542 8167283 -252171 912016 10200122 11143834 67074 45609 10133048 11098225 TO PROVIDE HEALTH, PRESCRIPTION, AND DEATH BENEFITS TO COVERED MEMBERS, RETIREES, AND DEPENDENTS. 0 0 PROVIDED SELF FUNDED HEALTH INSURANCE BENEFITS TO ELIGIBLE PARTICIPANTS, DEPENDANTS, AND RETIREES OF INTERNATIONAL BROTHERHOOD OF ELECTICAL WORKERS LOCAL 82. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X X RYAN JONES 3047813921 609 THIRD AVE PO BOX 487 CHESAPEAKE OH 45619 X DANAL NEAL 2.00 X 0 0 0 SCOTT RAIRDEN 2.00 X 0 0 0 NICHOLAS COMSTOCK 2.00 X 0 0 0 MICHAEL GEBHART 2.00 X 0 0 0 JACK LOHBECK 2.00 X X 0 0 0 JIM FORTKAMP 2.00 X 0 0 0 WILLIAM MELKE 2.00 X X 0 0 0 0 0 0 0 0 0 0 AMERICAN BENEFIT CORPORATION 3150 US ROUTE 60 ONA WV 255459507 PLAN MANAGEMENT AND OPERATION 268166 ANTHEM (WELL POINT) 120 MONUMENT CIRCLE INDIANAPOLIS IN 26204 MEDICAL NETWORK FEES 258583 2 EMPLOYER CONTRIB 525100 7596079 7596079 PARTICIPANT CONTRIB 525100 1172051 1172051 RETIREE DRUG SUBSIDY 525100 184276 184276 8952406 334974 334974 3615743 3823824 -208081 -208081 -208081 9079299 8952406 126893 0 7435418 38948 24651 22124 59908 6413 12203 10200 CLAIMS ADMIN FEES 526749 OTHER 26134 DATA PROCESSING 2180 FIDELITY BOND 1500 855 8167283 1103286 1399628 821204 684190 47843 51016 8227789 9009000 10200122 11143834 67074 45609 67074 45609 X 0 0 0 0 10133048 11098225 10133048 11098225 10200122 11143834 X 912016 53161 X X 0 1 1 X 0 0 9079299 8167283 912016 53161 53161 965177 9110336 53161 53161 9057175 22124 22124 9079299 8145159 0 8145159 22124 22124 8167283 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JUNE 30, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED PRIOR TO JUNE 30, 2009. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES TO REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15: THE TRUSTEES HAVE RETAINED A THIRD PARTY ADMINISTRATOR (TPA) TO MANAGE THE DAILY OPERATIONS OF THE PLAN. THE TPA WAS SELECTED THROUGH A PROPOSAL PROCESS WHICH INCLUDED OTHER QUALIFIED PROVIDERS OF SUCH SERVICES. THE TRUSTEES CONTINUALLY MONITOR THE SERVICE LEVELS AND FEES OF THE CONTRACT ADMINISTRATOR. AS A CONTRACT ADMINISTRATOR IS UTILIZED, THE PLAN DOES NOT HAVE ANY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST ARE DETAILED IN PROHIBITED TRANSACTIONS UNDER ERISA. IN ADDITION, THE PLAN ALSO HAS A SEPARATE POLICY IN PLACE. THE PLAN'S LEGAL COUNSEL CONTINUALLY MONITORS THE PLAN AND ITS TRUSTEES FOR POSSIBLE CONFLICTS OF INTEREST. A MEMBER OF THE PLAN'S LEGAL COUNSEL ATTENDS EACH MEETING OF THE TRUSTEES AND MONITORS ON AN "AS NEEDED" BASIS FOR ACTIVITY THAT COULD GIVE RISE TO POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN'S FORM 990 IS AVAILABLE THROUGH VARIOUS WEBSITES, SUCH AS GUIDESTAR AND THE FORM 5500 IS AVAILABLE TO THE PUBLIC THROUGH FREEERISA. THE PLAN WOULD ALSO PROVIDE SUCH INFORMATION RETURNS UPON WRITTEN REQUEST. GOVERNING DOCUMENTS ARE NOT PROVIDED TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 53,161. FORM 990, PART XI, LINE 2C: THE PLAN'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT OF ITS FINANCIAL STATEMENTS. THERE HAVE BEEN NO CHANGES IN OVERSIGHT PROCEDURES FROM THE PRIOR YEAR. FORM 990, PART I, LINE 5 & PART V, LINE 2A: THE PLAN REPORTS PARTICIPANTS ON FORM W-3 RELATED TO DISABILITY PAYMENTS, WHICH ARE CLASSIFIED AS BENEFITS EXPENSE. THE TRUSTEES UTILIZE A THIRD PARTY ADMINISTRATOR FOR DAILY OPERATIONS OF THE PLAN. AS SUCH, THE PLAN HAS NO EMPLOYEES. IBEW LOCAL 82 DEFINED BENEFIT PLAN 6650 POE AVENUE DAYTON OH 454142527 316127268 PENSION PLAN OH 501(C)(9) N/A N/A 0 IBEW LOCAL 82 DEFINED CONTRIBUTIONS PLAN 6650 POE AVENUE DAYTON OH 454142527 311119203 PENSION PLAN OH 501(C)(9) N/A N/A 0 IBEW LOCAL 82 401(K) PLAN 6650 POE AVENUE DAYTON OH 454142527 310329975 PENSION PLAN OH 501(C)(9) N/A N/A 0 IBEW #505 - NECA OH 0 IBEW #82 OH 0 IBEW #322 OH 0 IBEW #351 OH 0 IBEW #697 OH 0 IBEW #1701 OH 0 IBEW #379 OH 0 IBEW #41 OH 0 IBEW #145 OH 0 IBEW #1516 OH 0 IBEW #153 OH 0 IBEW #1579 OH 0 IBEW #16 OH 0 IBEW #164 OH 0 IBEW #212 OH 0 IBEW #22 OH 0 IBEW #246 OH 0 IBEW #317 OH 0 IBEW #32 OH 0 IBEW #357 OH 0 IBEW #364 OH 0 IBEW #369 OH 0 IBEW #38 OH 0 IBEW #401 OH 0 IBEW #466 OH 0 IBEW #479 OH 0 IBEW #480 OH 0 IBEW #5 OH 0 IBEW #569 OH 0 IBEW #595 OH 0 IBEW #613 OH 0 IBEW #64 OH 0 IBEW #648 OH 0 IBEW #666 OH 0 IBEW #683 OH 0 IBEW #702 OH 0 IBEW #725 OH 0 IBEW #728 OH 0 IBEW #8 OH 0 IBEW #816 OH 0 IBEW #968 OH 0 IBEW #305 OH 0 IBEW #35 NECA OH 0 IBEW #38 OH 0 IBEW #1141 OH 0 IBEW #212 OH 0 IBEW #32 OH 0 IBEW #481 OH 0 IBEW #648 OH 0 IBEW #683 OH 0 IBEW #716 OH 0 AUTOMATED CONTROLS & POWER OH BRIGHT STREET OH CAPITAL ELECTRIC OH CHAPEL ELECTRIC OH COUGAR ELECTRIC OH DEBRA KUEMPEL OH ESI ELECTRICAL CONTRACTORS OH GLENWOOD ELECTRIC OH HIGH VOLTAGE MAINTENANCE OH JATC OH JUSTICE ELECTRIC OH KASTLE ELECTRIC CO OH LAKE ERIE ELECTRIC INC OH MAXWELL LIGHTING PROTECTION OH MAYERS ELECTRIC CO INC OH MUTUAL ELECTRIC COMPANY OH NAMVET OH POWER SERVICES OH PRODUCTIVE ELECTRIC INC OH SIDNEY ELECTRIC CO INC OH SPOURLING ELECTRIC CO INC OH STUDEBAKER ELECTRIC CO OH TRIAD ELECTRICAL CONT OH WAGNER INDUSTRIAL ELEC OH WAVE ELECTRIC SERVICES OH YORK ELECRIC INC OH ZENITH SYSTEMS OH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0