2013-11-14T18:03:09-06:00 2012-12-31 KPMG LLP 345 Park Avenue New York NY 101540102 990 2012-01-01 134129368 1199SEIU NBF FOR HOME CARE EMPLOYEES % MARIA ACOSTA CFO 1199 6464736365 PO BOX 842 Suite NEW YORK NY 10108 MARIA ACOSTA 6464736365 2013-11-13 true KPMG LLP 2127589700 2012 2016-02-25 16:41:14Z MITRA BEHROOZI 330 WEST 42ND STREET ST FLOOR NEW YORK NY 10036 195343297 false X HTTP://1199SEIUBENEFITS.ORG X 1949 NY TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS UNDER THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT AND TRUST DOCUMENT. 10 10 0 10 0 0 0 192062754 195327100 11589 16197 0 0 192074343 195343297 0 0 179467295 157540237 6128363 6016725 0 0 0 5187796 4723466 190783454 168280428 1290889 27062869 78694420 73835931 63393339 31471981 15301081 42363950 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS UNDER THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT AND TRUST DOCUMENT. false false TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS UNDER THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT AND TRUST DOCUMENT. false false false false false false false false true false false true true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 5313 0 true 0 false false false false false false X 10 10 true false false false false true false true true false false false true true true true true false false false X MARIA ACOSTA CFO 6464736365 330 WEST 42ND STREET 28TH FLOOR NEW YORK NY 10036 JAMES CAREY 1.0 1.0 X BRUCE MCIVER 1.0 5.0 X HAROLD MOORER 1.0 0.0 X DORIS SPENCER 1.0 0.0 X LOUISE WEATHERS 1.0 0.0 X AIDA GARCIA 1.0 1.0 X RONA SHAPIRO 1.0 0.0 X CAROLYN BROOKS 1.0 3.0 X KWAI DAVID HO 1.0 0.0 X MINERVA PENA 1.0 0.0 X MITRA BEHROOZI 2.0 21.0 X 20849 0 7879 LORRAINE MONCHAK 2.0 22.0 X 31118 0 11521 FREDERICK HAGEN 2.0 3.0 X 15224 0 5541 DONNA REY 2.0 22.0 X 18050 0 6485 MARIA ACOSTA 2.0 22.0 X 13015 4731 98256 0 36157 0 false false false CARE ALLIES PRE-CERT 5144 COLLECTION CENTER DRIVE CHICAGO IL 60693 CONSULTING (GENERAL) 666104 MEDCO HEALTH ADMIN FEE 100 PARSONS POND DRIVE FRANKLIN LAKES NJ 07417 CONSULTING (GENERAL) 630661 EBS MASTER LLC DBA EMDEON ABF 3055 LEBANON PIKE SUITE 1000 NASHVILLE TN 37214 COPYING/DUPLICATING 230843 MILLIMAN INC 1 PENN PLAZA 38TH FLOOR NEW YORK NY 10119 ACTUARIAL 229223 STEP VISUAL COMMUNICATIONS 38 LAWRIDGE DRIVE RYE BROOK NY 10573 COPYING/DUPLICATING 182509 5 0 EMPLOYER CONTRIBUTIONS 900099 142750867 142750867 COBRA PAYMENTS 900099 137843 137843 NYC PERSONAL CARE PROVIDERS RATE ADJUSTMENT 900099 45442893 45442893 MEMBER PREMIUMS 900099 6953069 6953069 INTEREST & CHARGES - EMPLOYER DELINQUENCIES 900099 42428 42428 195327100 16197 16197 0 0 0 0 0 0 0 0 0 0 195343297 195327100 16197 0 0 0 157540237 134413 0 3995122 1534390 14352 338448 0 81758 117020 0 0 0 447088 0 805556 138517 0 1664090 0 0 0 88944 0 0 83727 MANAGED CARE PRECERTIFICATION 666104 THIRD PARTY ADMIN CHARGES 630662 168280428 0 0 9373763 4670922 0 0 22954959 34181124 0 0 0 0 0 0 0 0 0 0 3100008 3100008 0 0 0 0 0 0 0 0 46365698 34983885 78694420 73835931 1516066 1646745 0 0 0 0 0 0 0 0 0 0 18500000 0 0 0 43377273 29825236 63393339 31471981 X 15301081 42363950 0 0 0 0 15301081 42363950 78694420 73835931 27062869 X false true X true false 2456334 2456334 153910 153910 0 489764 489764 0 NYC PERS. CARE PROV. RATE ADJ 33118804 DUE FROM PHAR BENE MANAGER 1787968 DUE FROM RELATED ENTITIES 62515 PREPAID EXPENSES AND OTHER 14598 34983885 0 DUE TO RELATED ENTITIES 1689166 BENEFIT OBLIGATIONS CURRENTLY PAYABLE 28136070 29825236 X 195343297 195343297 195343297 169682904 1402476 1402476 168280428 168280428 RECONCILIATION OF EXPENSE FORM 990, SCHEDULE D, PART XII, LINE 2D CHANGE IN ACTURIAL RESERVE FOR IBNR:.......................$1,402,476 FIN 48 FOOTNOTE FORM 990, SCHEDULE D, PART XIV US GAAP REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION 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 DECEMBER 31, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF LIABILITY (OR ASSET) OR DISCLOSURE IN 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 PRIOR TO 2009. BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 2 ALL OF THE UNION TRUSTEES ARE ALSO EMPLOYEES OF 1199SEIU (THE UNION) AND THEREFORE HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. MEMBERS/STOCKHOLDERS FORM 990, PART VI, LINES 7A LINE 7A: The Union trustees are appointed by 1199SEIU United Healthcare Workers East, and the employer trustees are appointed by the Contributing Employers. REVIEW OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF FINANCIAL OFFICER AND FINANCE TEAM REVIEW THE DRAFT FORM 990 AND CONFER WITH THE ACCOUNTANTS AND LEGAL COUNSEL TO ENSURE THE ACCURACY OF THE RETURN. ANY CONCERNS ARE NOTED AND ADDRESSED AND MANAGEMENT ENSURES THAT THE CHANGES ARE INCORPORATED IN THE FORM 990. THE COMPLETED FORM 990 IS THEN SIGNED BY THE CHIEF FINANCIAL OFFICER. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES AND EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE OR UPDATE TO THE EXECUTIVE DIRECTOR, OR DESIGNEE, THEIR INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTERESTS. FOR EACH INTEREST DISCLOSED BY A TRUSTEE, THE EXECUTIVE DIRECTOR OR DESIGNEE WILL DETERMINE WHETHER TO (A) TAKE NO ACTION (B) ASSURE FULL DISCLOSURE TO THE TRUSTEES (C ) ASK THE TRUSTEE TO BE RECUSED FROM PARTICIPATION IN RELATED DISCUSSIONS OR DECISIONS; AND/OR (D) ASK THE TRUSTEE TO RESIGN. REGARDING EMPLOYEES, COMPLETED CONFLICTS OF INTEREST DISCLOSURE FORMS WILL BE REVIEWED BY THE HUMAN RESOURCES DEPARTMENT AND DISCLOSED CONFLICTS WILL BE REVIEWED BY CHIEF OF HUMAN RESOURCES. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINE 15A AND 15B Compensation for all directors, officers and key employees of the Fund is determined by the Cross Funds Compensation Committee (the "Committee"), comprised of independent members. The Committee utilizes appropriate data as to comparability in its determinations, including information provided by independent compensation consultants. The Committee documents the basis for any compensation determinations contemporaneously in the minutes of the Committee. The Committee determines compensation periodically as it deems appropriate. PUBLIC DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 SUMMARY PLAN DISCRIPTIONS AND FINANCIAL REPORTS ARE MADE PUBLIC PURSUANT TO IRS REQUIREMENTS. WRITTEN REQUESTS FOR OTHER INFORMATION WILL BE FORWARDED TO GENERAL COUNSEL'S OFFICE FOR CONSIDERATION. UNRELATED BUSINESS INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 419A(F)(5)(A), COLLECTIVE BARGAINING AGREEMENTS ARE EXEMPT FROM ACCOUNT LIMIT REQUIREMENTS SET UNDER IRC SECTION 419A(C), AND ARE THEREFORE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX UNDER IRC SECTION 512(A)(3). ALLIANCE HOME CARE SERVICES N/A BETH EMETH HOME ATTENDANT N/A BRONX JEWISH COMMUNITY COUNCIL N/A BRONX JEWISH HOUSEKEEPER N/A BROOKLYN BUREAU OF COMMUNITY SERVICE N/A BUSHWICK STUYVESANT HEIGHTS N/A CARE AT HOME N/A CHINESE-AMERICAN PLANNING N/A FEGS HOME ATTENDANT SERVICES N/A FAMILY CARE SERVICES N/A FAMILY HOME CARE SERVICES N/A FIRST CHINESE PRESBYTERIAN N/A JEWISH COMMUNITY COUNCIL N/A NEW YORK FOUNDATION FOR SENIOR N/A RICHMOND HOME NEEDS SERVICES N/A RIDGEWOOD BUSHWICK SENIOR N/A ROCKAWAY HOME ATTENDANT N/A SAINT NICHOLAS HUMAN SUPPORT N/A SCHOOL SETTLEMENT HOME N/A STELLA ORTON HOME CARE AGENCY N/A SUNNYSIDE N/A UNITED JEWISH FUND N/A ALL CITY CARE ALL METRO HEALTH CARE ALL SEASONS HOME ATTENDANTS BHRAGS HOME CARE CORPORATION CABS HOME ATTENDANT SERVICES CABS HOUSEKEEPER SERVICE CIDNEY INDEPENDENT LIVING COOPERATIVE HOME CARE HOME ATTENDANT SERVICES OF HYDE PARK HOME HEALTH MANAGEMENT SERVICE KIND CARE PSC COMMUNITY SERVICES PEOPLE CARE ASSISTED CARE PEOPLE CARE DFTA RAIN HOME ATTENDANT SERVICES SOCIAL CONCERNS false false false false false false false false false false false false false false false false false false true