2013-07-22T10:14:20-05:00 2012-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2012-01-01 236263170 CENTRAL PENNSYLVANIA TEAMSTERS HEALTH AND WELFARE FUND CENT 6103205500 1055 SPRING STREET WYOMISSING PA 19610 WILLIAM SHAPPELL 6103205500 2013-07-22 1 LOUIS VERZELLA CPA P00360279 6106689400 2013-07-22 2012 2016-02-24 21:20:13Z JOE SAMOLEWICZ 1055 SPRING STREET WYOMISSING PA 19610 122241929 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 -314063 -314063 0 0 101788151 101778981 1482226 3995563 -119848 -310998 103150529 105463546 0 0 104284758 98623425 2990075 3119961 0 0 0 2691211 2655250 109966044 104398636 -6815515 1064910 85581799 93169368 413859 439904 85167940 92729464 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 2913 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 2.00 40.00 X 0 87891 51119 THOMAS J VENTURA 2.00 X 0 0 0 KEITH L NOLL 2.00 X 0 0 0 DANIEL SCHMIDT 2.00 X 0 0 0 HOWARD W RHINIER 2.00 40.00 X 0 93660 32577 TOMM FORREST 2.00 X 0 0 0 J CHRISTOPHER MICHAEL 2.00 X 0 0 0 KEITH YOUST 2.00 40.00 X 0 83468 49819 KEN ROSS 2.00 X 0 0 0 CHARLES SHAFER 2.00 40.00 X 0 84977 52790 JEFFREY STRAUSE 2.00 40.00 X 0 69789 47001 JOSEPH J SAMOLEWICZ 22.50 22.50 X 74280 74279 74051 MARTIN L CULLEN 22.50 22.50 X 53080 53079 64067 127360 547143 371424 0 0 1 0 HEALTHAMERICA OF PENNSYLVANIA INC 3721 TECPORT DRIVE HARRISBURG PA 17106 CLAIMS PROCESSING 2345982 WILLIG WILLIAMS & DAVIDSON 1845 WALNUT STREET - 24TH FLOOR PHILADELPHIA PA 19103 LEGAL SERVICES 254879 GENERAL PRESCRIPTION PROGRAM INC 222 LAFAYETTE STREET NEWARK NJ 07105 CLAIMS PROCESSING 252837 DELTA DENTAL OF PENNSYLVANIA ONE DELTA DRIVE MECHANICSBURG PA 17055 CLAIMS PROCESSING 246058 BASYS INC 857 ELKRIDGE LANDING ROAD SUITE 70 LINTHICUM MD 21090 COMPUTER ADMIN SVCS 157083 8 EMPLOYER CONTRIBUTIONS 525100 88120281 88120281 PARTICIPANT CONTRIBUTIONS 525100 12204803 12204803 RETIREE DRUG SUBSIDY-MEDICARE PAR 525100 1453897 1453897 101778981 2440784 2440784 18333162 16778383 1554779 1554779 1554779 MISCELLANEOUS INCOME 900099 3065 3065 PASS THROUGH INCOME FROM PARTNERS 900099 -314063 -314063 -310998 105463546 101778981 -314063 3998628 98623425 1538087 827137 622487 132250 466105 84623 211689 706577 613892 226076 161180 33686 748 34293 82018 ALLOCATED DEPRECIATION 23474 PAYROLL AUDIT EXPENSE 7234 COBRA SUBSIDY 2477 INVESTMENT TAXES 1178 104398636 1795331 2568828 1699544 1284769 7931560 8019545 90375 83767 2207310 2132421 64626 74889 53763006 60149733 19696231 20501553 541126 486284 85581799 93169368 388087 388705 25772 51199 413859 439904 X 0 0 0 0 85167940 92729464 85167940 92729464 85581799 93169368 X 1064910 6182551 314063 X X 0 1 X 1 0 1574 1574 0 1828390 1753501 74889 377346 377346 0 74889 103-12 INVESTMENT ENTITY 9721367 F LIMITED PARTNERSHIP 6907264 F MASTER LIMITED PARTNERSHIP 3872922 F 20501553 DUE TO RELATED PARTIES 24408 DUE TO BROKER FOR PURCHASES OF SECURITIES 26791 51199 X 111745994 6182551 6182551 105563443 211689 -311586 -99897 105463546 104184470 0 104184470 211689 2477 214166 104398636 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: MANAGEMENT EVALUATED THE FUND'S TAX POSITIONS AND CONCLUDED THAT THE FUND HAD MAINTAINED ITS TAX EXEMPT STATUS AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. AT THE PRESENT TIME, THE FUND IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2009. PART XI, LINE 4B - OTHER ADJUSTMENTS: PASS THROUGH INCOME FROM PARTNERSHIP K-1'S -314,063. COBRA SUBSIDY 2,477. PART XII, LINE 4B - OTHER ADJUSTMENTS: COBRA SUBSIDY 2,477. X 0 0 0 JOSEPH J SAMOLEWICZ 74280 74279 0 0 0 0 20130 20131 16895 16895 111305 111305 0 0 MARTIN L CULLEN 53080 53079 0 0 0 0 17010 17011 15023 15023 85113 85113 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PASS THROUGH INCOME FROM PARTNERSHIP K-1'S 314,063. 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 PRISON LOCAL GOVERNMENT PA 0 BIRDSBORO BOROUGH LOCAL GOVERNMENT PA 0 BOROUGH OF BERWICK LOCAL GOVERNMENT PA 0 LOYALSOCK TOWNSHIP LOCAL GOVERNMENT PA 0 MAHANOY CITY BOROUGH LOCAL GOVERNMENT PA 0 MILTON REGIONAL SEWER AUTHORITY LOCAL GOVERNMENT PA 0 MUHLENBERG TOWNSHIP LOCAL GOVERNMENT PA 0 MUHLENBERG TOWNSHIP AUTH LOCAL GOVERNMENT PA 0 NESCOPECK BOROUGH LOCAL GOVERNMENT PA 0 NEWBERRY TOWNSHIP LOCAL GOVERNMENT PA 0 NORTHUMBERLAND COUNTY LOCAL GOVERNMENT PA 0 PA CONFERENCE OF TEAMSTERS 814 N 2ND ST HARRISBURG PA 17102 232311355 LABOR UNION PA 501(C)(5) 0 READING REGIONAL AIRPORT AUTH LOCAL GOVERNMENT PA 0 SCHUYLKILL COUNTY PRISON LOCAL GOVERNMENT PA 0 SMITHFIELD TOWNSHIP LOCAL GOVERNMENT PA 0 SNYDER COUNTY LOCAL GOVERNMENT PA 0 SPRING GARDEN TOWNSHIP LOCAL GOVERNMENT PA 0 SPRINGETTSBURY TOWNSHIP LOCAL GOVERNMENT PA 0 SUMMIT HILL BOROUGH LOCAL GOVERNMENT PA 0 TEAMSTERS LOCAL UNION NO 229 3104 N MAIN STREET SCRANTON PA 18508 240565465 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 312 1 EAST 15TH STREET CHESTER PA 19013 231154457 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 401 260 SOUTH WASHINGTON STREET WILKESBARRE PA 18701 240740310 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 429 1055 SPRING STREET WYOMISSING PA 19610 230724625 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 764 450 BEAVER STREET MILTON PA 17847 240773584 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 771 1025 N DUKE STREET LANCASTER PA 17602 231071860 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 773 1345 HAMILTON STREET ALLENTOWN PA 18102 230724667 LABOR UNION PA 501(C)(5) 0 TEAMSTERS LOCAL UNION NO 776 2552 JEFFERSON STREET HARRISBURG PA 17110 231147664 LABOR UNION PA 501(C)(5) 0 TOWNSHIP OF BERN LOCAL GOVERNMENT PA 0 UPPER MT BETHEL TOWNSHIP LOCAL GOVERNMENT PA 0 WEST PENN TOWNSHIP LOCAL GOVERNMENT PA 0 WEST YORK BOROUGH LOCAL GOVERNMENT PA 0 WEST YORK BOROUGH FIREFIGHTERS LOCAL GOVERNMENT PA 0 YORK COUNTY TRANSIT AUTH LOCAL GOVERNMENT PA 0 ACME MARKETSALBERTSONS AZ 0 AIRGAS SPECIALTY PRODUCTS GA 0 AMERICAN STEEL & ALUMINUM PA 0 ANTHRACITE INDUSTRIES INC NJ 0 ARAMARK COFFEE PA 0 ARKANSAS BEST FREIGHT SYS INC AR 0 ARKEMA INC PA 0 ASSOCIATED WHOLESALERS IN PA 0 AYCOCK DIVISION OF ENERFAB OH 0 BERKS PACKING COMPANY INC PA 0 BLANSKI INC PA 0 BRENNTAG NORTHEAST INC PA 0 CANTEEN VENDING SERVICE NC 0 CARL R BIEBER INC PA 0 CEMPORT INC NJ 0 CENTRE CONCRETE COMPANY PA 0 DAIRY FARMERS OF AMERICA PA 0 E J BRENEMAN LP PA 0 EJB PAVING AND MATERIALS PA 0 ELCO HAUSMAN DIV OF NEW ENTERPRISES PA 0 EMPIRE WRECKING CO OF READING PA 0 EXETER TOWNSHIP BOARD OF SUPERVISORS PA 0 GOODMAN VENDING SERVICE PA 0 HESS TRUCKING COMPANY PA 0 INT SCRAP IRON & METAL CO PA 0 JDM MATERIALS CO INC PA 0 JONES MOTOR CO INC PA 0 KUNZLER & COMPANY INC PA 0 LEHIGH VALLEY DAIRIES INC PA 0 LENTZ MILLING COMPANY PA 0 METALS USA PA 0 MORRIS KREITZ & SONS INC PA 0 NEW PENN MOTOR EXPRESS PA 0 NEW PENN MOTOR EXPRESS PA 0 OROGRAIN BAKERIES SALES INC PA 0 PENNSY SUPPLY PA 0 PENSKE TRUCK LEASING CO PA 0 PETRO OIL NY 0 POLLOCK-READING INC PA 0 READING EAGLE COMPANY PA 0 READING FOUNDRY & SUPPLY PA 0 RGC GROUP INC PA 0 SCHNEIDER VALLEY FARMS PA 0 SINGER EQUIPMENT CO INC PA 0 SAVOR STREET FOODS INC PA 0 UNITED PARCEL SERVICE INC OH 0 WALTER W ZIEGLER & SONS PA 0 WEINER IRON & METAL CORP PA 0 WINDSOR SERVICE TRUCKING PA 0 WOOD-MODE INCORPORATED PA 0 YEAGER SUPPLY INC PA 0 YORK CONCRETE CO PA 0 YORK GROUP INC PA 0 YRC FREIGHT KS 0 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 2609549 FMV TEAMSTERS LOCAL UNION NO 429 K 150421 FMV