2013-11-08T16:17:28-06:00 2012-12-31 470900880 CALIBRE CPA GROUP PPLC 7501 WISCONSIN AVENUE BETHESDA MD 20814 990 2012-01-01 203804404 SHEET METAL WORKERS' HEALTH PLAN SHEE 7037397250 8403 ARLINGTON BLVD NO 300 FAIRFAX VA 22031 KENNETH COLOMBO 7037397250 2013-11-08 1 SCOTT E HALLBERG P01081188 2023319880 2012 2016-03-07 17:11:31Z KENNETH COLOMBO 601 NORTH FAIRFAX ST SUITE 500 ALEXANDRIA VA 22314 7561199 0 X N/A X 2006 TN SEE SCHEDULE O.THE PLAN'S MISSION IS TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIES. 4 4 0 0 0 0 0 0 7424373 7466390 78518 80331 0 14478 7502891 7561199 0 0 5509037 6023440 0 0 0 0 0 627334 492598 6136371 6516038 1366520 1045161 7742105 9027736 35158 36147 7706947 8991589 THE PLAN'S PRIMARY MISSION IS TO PROVIDE AND MAINTAIN MEDICAL, LIFE, ACCIDENT, SICKNESS, AND RELATED BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES IN THE AMOUNTS AND UNDER THE CONDITIONS AS SPECIFIED IN THE PLAN. 0 0 THE PLAN PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIES OF SHEET METAL WORKERS' INTERNATIONAL ASSOCIATION AND OTHER CLASSES OF EMPLOYEES WHO ARE EMPLOYED BY A CONTRIBUTING EMPLOYER, BUT NOT REPRESENTED IN COLLECTIVE BARGAINING BY THE SHEET METAL WORKERS' INTERNATIONAL ASSOCIATION. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 1 0 0 0 X SOUTHERN BENEFIT ADMINISTRATORS 6158590131 PO BOX 1449 GOODLETTSVILLE TN 370701449 KENNETH COLOMBO 1.00 X 162829 0 74827 JAMES SHOULDERS 1.00 X 0 227887 73791 JOSEPH SELLERS JR 1.00 X 0 382475 65681 MARC LEBLANC 1.00 X 0 249667 73381 162829 860029 287680 1 0 1 0 SOUTHERN BENEFIT ADMINISTRATORS PO BOX 1449 GOODLETTSVILLE TN 370701449 PLAN ADMINISTRATOR 156508 CIGNA 3500 PIEDMONT ROAD ATLANTA GA 30305 PPO PROVIDER 103564 2 EMPLOYER CONTRIBUTIONS 525100 7345651 7345651 MEDICARE RETIREE DRUG 525100 120739 120739 7466390 80331 80331 SUBROGATION INCOME 900099 14478 14478 14478 7561199 7480868 0 80331 6023440 132000 12572 15121 7405 11275 10373 4589 2734 MEDICARE RETIREE DRUG P 120533 CLAIMS BENEFIT MANAGEME 103564 DENTAL CLAIMS MANAGEMEN 44630 PRESCRIPTION DRUG MANAG 13511 14291 6516038 147144 389805 6125248 6956595 149456 168292 1302565 1489323 17692 23721 7742105 9027736 17466 12426 17692 23721 35158 36147 X 0 0 0 0 7706947 8991589 7706947 8991589 7742105 9027736 X 1045161 239481 X 0 1 X 1 0 0 MEDICARE DRUG RETIREE SUBSIDY PAYABLE 23721 23721 7793275 239481 239481 7553794 7405 7405 7561199 6508633 0 6508633 7405 7405 6516038 0 0 0 KENNETH COLOMBO 162829 0 0 0 0 0 51577 0 23250 0 237656 0 0 0 JAMES SHOULDERS 0 188378 0 0 0 39509 0 47989 0 25802 0 301678 0 0 JOSEPH SELLERS JR 0 253487 0 0 0 128988 0 42905 0 22776 0 448156 0 0 MARC LEBLANC 0 249667 0 0 0 0 0 42216 0 31165 0 323048 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE FULL GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTSEES REVIEW AND MONITOR THE CONFLICT OF INTEREST POLICY AS NEEDED AT THEIR QUARTERLY MEETINGS. FORM 990, PART VI, SECTION C, LINE 18 FORMS 990 AND 1023 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 FORMS 990 AND 1023 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: UNREALIZED GAIN (LOSS) ON INVESTMENTS 239,481. SHEET METAL WORKERS NATIONAL PENSION 8403 ARLINGTON BOULEVARD FAIRFAX VA 22031 526112463 401 0 INTERNATIONAL TRAINING INSTITUTE FOR THE SHEET METAL & AIR CONDITIONING IND 8403 ARLINGTON BOULEVARD FAIRFAX VA 22031 520914827 501(C)(3) 0 NATIONAL ENERGY MANAGEMENT INSTITUTE COMMITTEE 8403 ARLINGTON BOULEVARD FAIRFAX VA 22031 521311294 501(C)(6) 0 SHEET METAL WORKERS LOCAL UNION & COUNCIL 8403 ARLINGTON BOULEVARD FAIRFAX VA 22031 CA 401 INTERNATIONAL ASSOCIATION OF SHEET METAL AIR RAIL AND TRANSPORTATION WORKER 1750 NEW YORK AVENUE NW WASHINGTON DC 20006 536001972 501(C)(5) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0