2012-11-15T13:08:11-06:00 2011-12-31 132550103 D'ARCANGELO & CO LLP 800 WESTCHESTER AVE SUITE N-400 RYE BROOK NY 105731301 990 2011-01-01 135542693 CEMENT & CONCRETE WORKERS DC-WELFARE FUND CEME 7187626133 35-30 FRANCIS LEWIS BOULEVARD NO 201 FLUSHING NY 11358 SILVANA BALDO 7187626133 2012-11-02 1 ALFRED F THOBEN P00836295 9146944600 2011 2016-02-24 21:20:13Z SILVANA BALDO 35-30 FRANCIS LEWIS BOULEVARD NO 201 FLUSHING NY 11358 29419668 0 X WWW.CCWBF.ORG X 1949 NY MULTI-EMPLOYER COLLECTIVELY BARGAINED HEALTH AND WELFARE FUND PROVIDING HEALTH (MEDICAL, HOSPITAL, SURGICAL, PRESCRIPTION DRUG AND DENTAL), TEMPORARY DISABILITY AND LIFE INSURANCE BENEFITS TO PARTICIPANTS MEETING ELIGIBILITY REQUIREMENTS, AND MEDICAL AND OTHER BENEFITS TO ELIGIBILE RETIRED MEMBERS. 6 6 29 0 0 0 0 0 14791993 19212555 2074200 3354951 201863 36709 17068056 22604215 0 0 17785860 18244276 716267 700006 0 0 0 1998412 1946779 20500539 20891061 -3432483 1713154 74503223 77899935 1936009 2748273 72567214 75151662 MULTI-EMPLOYER TAFT-HARTLEY HEALTH AND WELFARE PLAN COVERING THE MEMBERS OF THE CEMENT AND CONCRETE WORKERS DISTRICT COUNCIL, COMPRISED OF LOCALS 6-A, 18-A AND 20S. 0 0 20891061 19249264 OPERATE A SELF-ADMINISTERED HEALTH BENEFIT PLAN AND ALSO PROVIDE DEATH BENEFITS AND DISABILITY BENEFITS. 20891061 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 0 1 13 0 1 29 1 0 0 0 0 0 0 X 6 6 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 1 1 0 X FUND OFFICE 7187626133 35-30 FRANCIS LEWIS BLVD FLUSHING NY 11358 ALEXANDER CASTALDI 3.00 X X 0 0 0 ANGELO ANGELONE 3.00 X 0 0 0 CARMINE DATEELLO 3.00 X 0 0 0 BRIAN WINTER 3.00 X 0 0 0 JACK BRUNETTI 3.00 X 0 0 0 KIERAN O'SULLIVAN 1.00 X 0 0 0 MICHAEL A CAHILL 3.00 X X 0 0 0 SILVANA BALDO 35.00 X 112959 80928 29956 112959 80928 29956 1 0 1 0 AUDIT ASSOCIATES INC 14 ST ANDREWS COURT OLD WESTBURY NY 11568 EMPLOYER CONTRIBUTION AUDITOR 147980 MULTIPLAN INC 115 FIFTH AVENUE NEW YORK NY 10003 CLAIM PROCESSING 136902 KAMING & KAMING 156 E 65TH STREET NEW YORK NY 10021 LEGAL AND CONTRIBUTION COLLECTIONS 100802 3 EMPLOYERS CONTRIBUTION 230000 18727913 18727913 MEMBER CONTRIBUTIONS ( 230000 275846 275846 ADMINISTRATIVE RECOVER 230000 188737 188737 EMPLOYERS INTEREST CHA 230000 20059 20059 19212555 2996085 2996085 7174319 6815453 358866 358866 358866 OTHER INCOME 900099 18615 18615 MEDICARE RETIREE DRUG 230000 18094 18094 36709 22604215 19249264 0 3354951 18244276 528714 133413 37879 143552 48744 204420 83542 52888 111684 1935 4450 12971 NYS GRADUATE MED ED SUR 949163 MEDICAL ADMINISTRATION 154564 PAYROLL AUDIT FEES 120311 ACTUARY FEES 53000 5555 20891061 1933719 1917461 1456402 2259377 2436948 2458889 2042 7253 235497 184653 31293 50844 52635423 53868135 15897494 17327893 109902 10083 74503223 77899935 432533 479763 1503476 2268510 1936009 2748273 X 72567214 75151662 0 0 0 0 72567214 75151662 74503223 77899935 X 1713154 871294 X X 0 1 1 X 0 235497 184653 50844 50844 GUARANTEED DEPOSIT CONTRACTS WITH INSURANCE COMPANY 17327893 F 17327893 DUE TO C.C.W.D.C. ANNUITY FUND 491013 DUE TO C.C.W.D.C. PENSION FUND 935263 DUE TO OTHER EMPLOYER SUPPORTED INDUSTRY ORGANIZATIONS 842234 2268510 22604215 20891061 1713154 871294 871294 2584448 23073608 871294 871294 22202314 195070 206831 401901 22604215 20489160 0 20489160 195070 206831 401901 20891061 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: TAX STATUS THE WELFARE FUND IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AS A TAX EXEMPT ORGANIZATION. THE WELFARE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE AND THE BOARD OF TRUSTEES AND PLAN ADMINISTRATOR BELIEVE THAT THE WELFARE PLAN CONTINUES TO QUALIFY AND TO OPERATE AS DESIGNED. THE WELFARE FUND'S ACCOUNTING POLICY IS TO PROVIDE LIABILITIES FOR UNCERTAIN TAX POSITIONS WHEN A LIABILITY IS PROBABLE AND ESTIMABLE. THE BOARD OF TRUSTEES AND THE PLAN ADMINISTRATOR BELIEVE THAT THE WELFARE FUND IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE TAX EXEMPT PROVISIONS OF THE INTERNAL REVENUE CODE. FEDERAL FORM 5500 AND FORM 990 INFORMATION RETURNS FOR THE YEARS 2008 THROUGH 2011 ARE SUBJECT TO AUDIT BY THE APPLICABLE GOVERNMENT JURISDICTIONS. PART XII, LINE 4B - OTHER ADJUSTMENTS: ADMINISTRATIVE COST RECOVERY FEE REPORTED NET OF RELATED EXPENSES 188,737. MEDICARE RETIREE DRUG SUBSIDY REPORTED NET OF BENEFIT COSTS 18,094. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ADMINISTRATIVE COST RECOVERY FEE REPORTED NET OF RELATED EXPENSES 188,737. MEDICARE RETIREE DRUG SUBSIDY REPORTED NET OF BENEFIT COSTS 18,094. X 0 0 0 SILVANA BALDO 112959 80928 0 0 0 0 0 0 17453 12503 130412 93431 0 0 FORM 990, PART VI, SECTION A, LINE 7A AS A TAFT-HARTLEY INDUSTRY/UNION BENEFIT FUND, THE BOARD OF TRUSTEES IS MADE UP OF AN EQUAL NUMBER OF VOTING INDUSTRY MANAGEMENT AND UNION TRUSTEES. INDUSTRY MANAGEMENT PROPOSE INDUSTRY TRUSTEES, AND UNION TRUSTEES PROPOSE UNION TRUSTEES FOR MEMBERSHIP ON THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF TRUSTEES IS ACTIVELY INVOLVED IN ALL ASPECTS OF THE WELFARE FUND'S GOVERNANCE AND MANAGEMENT OF FRINGE BENEFITS. THE BOARD HAS NOT APPOINTED OR DELEGATED AUTHORITY TO ANY SUBCOMMITTEE. FORM 990, PART VI, SECTION B, LINE 11 CEMENT AND CONCRETE WORKERS DC WELFARE FUND ID# 13-5542693 MAINTAINS AN OFFICE TO CONDUCT ADMINISTRATIVE FUNCTIONS. THE OFFICE IS OPEN DURING REGULAR BUSINESS HOURS. CONTRACTORS AND UNION MEMBERS MAY REQUEST INFORMATION AND REVIEW THAT INFORMATION AT THE FUND OFFICE. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES CONSIST OF MANAGMENT AND UNION OFFICIALS THAT ARE REQUIED TO REPORT ANNUALLY TO THE U.S. DEPARTMENT OF LABOR ANY TRANSACTIONS WITH THE FUND. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES INCLUDES MEMBERS THAT ALSO SIT ON OTHER FRINGE BENEFIT FUND BOARDS. THE MEMBERS OF THE BOARD OF TRUSTEES DELIBERATE USING INFORMATION ABOUT FUND ADMINISTRATOR AND OTHER TOP FUND MANAGER COMPENSATION PACKAGES AND THE LATEST TRENDS IN COMPENSATING PEOPLE IN THOSE POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE FUND MAINTAINS AN OFFICE WHERE ITS RECORDS AND GOVERNING DOCUMENTS ARE AVAILABLE TO ITS EMPLOYER CONTRACTORS, UNION MEMBERS AND PUBLIC INQUIRIES. PERSONAL INFORMATION RELATED TO ITS MEMBERS IS NOT AVAILABLE UNLESS AUTHORIZED IN WRITING BY THE MEMBER. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 871,294. OVERSIGHT OF AUDIT OF FINANCIAL STATEMENTS AND SELECTION OF AUDITOR: FORM 990, PART XII FINANCIAL STATEMENTS AND REPORTING,LINE 2C THE BOARD OF TRUSTEES AND PLAN ADMINISTRATOR REVIEW THE AUDITED FINANCIAL STATEMENTS AND PRESENTATION BY THE AUDITOR OF FINANCIAL STATEMENTS. THE MEMBERS OF THE GROUP DISCUSS MATTERS OF INTEREST AND OBTAIN ANSWERS TO ANY QUESTIONS ON THE FINANCIAL STATEMENT PRESENTATION AND AUDITOR AUDIT PROCEDURES AND FINDINGS. CEMENT AND CONCRETE WORKERS DC ANNUITY FUND 35-30 FRANCIS LEWIS BOULEVARD FLUSHING NY 11358 112942389 MULTI-EMPLOYER ANNUITY RETIREMENT BENEFIT TRUST NY 501(C)5 0 CEMENT AND CONCRETE WORKERS DC PENSION FUND 35-30 FRANCIS LEWIS BOULEVARD FLUSHING NY 11358 135629824 MULTI-EMPLOYER PENSION RETIREMENT BENEFIT TRUST NY 501(C)5 0 CEMENT AND CONCRETE WORKERS DC SCHOLARSHIP FUND 35-30 FRANCIS LEWIS BOULEVARD FLUSHING NY 11358 306082178 MULTI-EMPLOYER SCHOLARSHIP TRUST NY 501(C)3 LINE 7 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 CEMENT AND CONCRETE WORKERS DISTRICT COUNCIL ANNUITY FUND M 117326 WORK STUDY ALLOCATION CEMENT AND CONCRETE WORKERS DISTRICT COUNCIL PENSION FUND M 337275 WORK STUDY ALLOCATION CEMENT AND CONCRETE WORKERS DISTRICT COUNCIL ANNUITY FUND N 110403 WORK STUDY ALLOCATION CEMENT AND CONCRETE WORKERS DISTRICT COUNCIL PENSION FUND N 161478 WORK STUDY ALLOCATION