2012-08-11T11:00:22-05:00 2011-12-31 650140643 STEVEN D EISENBERG CPA PA 13790 NW 4 STREET 100 SUNRISE FL 33325 990 2011-01-01 596169977 INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS LOCAL 915 WELFARE FUND INTE 6158590131 PO Box 1449 Goodlettsville TN 37070 FRANK CARPENTER 6158590131 2012-08-11 1 STEVEN D EISENBERG P00175252 9548469490 2012-08-11 2011 2016-02-24 21:20:13Z FRANK CARPENTER PO Box 1449 Goodlettsville TN 37070 5492904 0 X NA X 1969 FL To provide health benefits to its members. 6 0 0 0 0 0 0 0 4116212 5068847 605540 424057 165150 0 4886902 5492904 0 0 6506093 4549276 0 0 0 0 0 727220 645755 7233313 5195031 -2346411 297873 11335065 11442707 203798 60348 11131267 11382359 The Organization mission to is provide health benefits to eligible participants 0 0 HEALTH BENEFIT COVERAGE PROVIDED ON BEHALF OF ELIGLIBLE MEMBERS OF LOCAL # 915 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X SOUTHERN BENEFIT ADMINISTRATORS INC 6158590131 PO BOX 1449 GOODLETTSVILLE TN 37070 X FRANK CARPENTER 10.00 X 0 0 0 WILLIAM L DEVER JR 10.00 X 0 0 0 ROBERTO ROSA 10.00 X 0 0 0 ROBERT COPPERSMITH 10.00 X 0 0 0 LEON WARD 10.00 X 0 0 0 VANCE ANDERSON 10.00 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD OF FLORIDA 8400 NE 33RD STREET MIAMI FL 33122 CLAIMS BENEFIT ADMINISTRATION 447143 SOUTHERN BENEFIT ADMINISTRATORS PO BOX 1449 GOODLETTSVILLE TN 37070 CONTRACT ADMINISTRATION 125068 2 CONTRIBUTIONS 230000 5068847 5068847 5068847 424057 424057 5492904 5068847 0 424057 4549276 8978 3880 5344 2180 1470 9627 CLAIMS ADMINISTRATION F 447143 FUND AMINISTRATION FEES 125068 CONSULTING FEE 26350 ACTUARIAL 15705 10 5195031 96448 203415 338336 409389 222125 222125 10580506 10607778 97650 0 11335065 11442707 203798 60348 203798 60348 X 11131267 11382359 11131267 11382359 11335065 11442707 X 297873 -46781 X X 0 1 1 X 0 0 5492904 5195031 297873 -46781 -46781 251092 5446123 -46781 -46781 5492904 0 5492904 5195031 0 5195031 0 5195031 Form 990, Part VI, Section A, line 8b The Organization is operated by a joint Board of Trustees. There are no sub committees or similar type of group. Form 990, Part VI, Section B, line 11 Form 990 is presented to the Board of Trustees for review. The return is reviewed and accepted. Any changes are made prior to filing. Form 990, Part VI, Section B, line 12c The Organization reviews it's conflict of interest policy on a regular basis, and requires Trustees to acknowledge their adherence to policy guidlines. Form 990, Part VI, Section C, line 19 The Organization makes its financial statements and governing documents available to the public upon written request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -46781. The Board of Trustees are responsible for the oversight of the audit. There has been no change in this process. INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS #915 PENSION FUND c/o SBAI PO BOX 1449 GOODLETTSVILLE TN 37070 596518568 Provide pension benefits to eligible participants FL 401(a) 0 INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS #915 VACATION FUND c/o SBAI PO BOX 1449 GOODLETTSVILLE TN 37070 596134658 Provide vacation benefits to eligible participants FL 501(c) 0 INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS Local Union #915 5621 Harney Road Tampa FL 33610 Act as collective bargaining agent on behalf of membership FL 501(c) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0