PLUMBER & PIPEFITTERS LOCAL UNION 803 HEALTH & WELFARE FUND: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
PLUMBER & PIPEFITTERS LOCAL UNION 803 HEALTH & WELFARE FUND (EIN 59-6152618)
Tax period
2009-08-01 to 2010-07-31
Filed
2011-03-11
IRS object ID
201100709349300110
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-03-11T12:07:30-06:00Timestamp
Tax Period End Date2010-07-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Legacy Professionals LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1311 S Wacker Drive Ste 4000AddressLine1
CityChicagoCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-08-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN596152618EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PLUMBERS & PIPEFITTERS LOCAL UNION NOBusinessNameLine1
Business Name Line2803 HEALTH AND WELFARE FUNDBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlPLUMNameControl
Phone9045380100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line18875 LIBERTY RIDGE DRIVEAddressLine1
CityJACKSONVILLECity
StateFLState
ZIP Code32256ZIPCode

Officer Officer

FieldValueIRS element (for citing)
Namebernard horneName
TitlechairmanTitle
Phone9045380100Phone
Date Signed2011-03-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3123680500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer Personbernard horneNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line18875 LIBERTY RIDGE DRIVEAddressLine1
CityJACKSONVILLECity
StateFLState
ZIP Code32256ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2875022GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1965YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH BENEFITSActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2137725ProgramServiceRevenuePriorYear
Program Service Revenue CY1955022ProgramServiceRevenueCY
Investment Income Prior Year43429InvestmentIncomePriorYear
Investment Income Current Year44663InvestmentIncomeCurrentYear
Other Revenue Prior Year319OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2181473TotalRevenuePriorYear
Total Revenue Current Year1999685TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year2111334BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY2239844BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year153559OtherExpensePriorYear
Other Expenses Current Year153945OtherExpensesCurrentYear
Total Expenses Prior Year2264893TotalExpensesPriorYear
Total Expenses Current Year2393789TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-83420RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-394104RevenuesLessExpensesCY
Total Assets BOY5192254TotalAssetsBOY
Total Assets EOY5226923TotalAssetsEOY
Total Liabilities BOY18949TotalLiabilitiesBOY
Total Liabilities EOY27814TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5173305NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5199109NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE health benefitsMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTHE FUND PROVIDES HEALTH, VISION, AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTSDescription
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096305NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NATIONAL EMPLOYEE BENEFIT ADMINISTRBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9045380100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18875 LIBERTY RIDGE DRIVE SUITE 101AddressLine1
CityJACKSONVILLECity
StateFLState
ZIP Code32256ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
BERNARD HORNE
TRUSTEE1.00X000
LINTON HARTLEY JR
TRUSTEE1.00X000
DAVID GARLINGTON
TRUSTEE1.00X000
Robert Towe
truSTEE1.00X000
GARY MONSON
TRUSTEE1.00X000
JOSEPH PAGE
TRUSTEE1.00X000
AUDIE BAILEY
TRUSTEE1.00X000
mark rentfrow
tRUSTEE1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ADVENTIST HEALTH SYSTEM SUNBELT
601 EAST ROLLINS STREETORLANDOFL32803HEALTHCARE PROVIDER379582
ORLANDO REGIONAL HEALTHCARE SYSTEM
PO BOX 91-7311ORLANDOFL32891HEALTHCARE PROVIDER143770
cigna health care
1111 Market streetchattanoogaTN37402benefit administration fees118735
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS90009918099241809924
PARTICIPANT AND RETIRE900099122106122106
COBRA SUBSIDY9000992299222992
FieldValueIRS element (for citing)
Total Program Service Revenue1955022TotalProgramServiceRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities920000Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities875337Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities44663Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column44663TotalRevenueColumn
Exclusion$44,663ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1999685TotalRevenueColumn
Related Or Exempt Function Income1955022RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$44,663ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total2239844Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total50004Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8053Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total17481Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total28594Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total26600Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total16432Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2795Total

Insurance Insurance

FieldValueIRS element (for citing)
Total3986Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2393789Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY302904BOY
EOY526521EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY104909BOY
EOY291390EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2054BOY
EOY2054EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4782387BOY
EOY4406958EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5192254BOY
EOY5226923EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY18949BOY
EOY27814EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18949BOY
EOY27814EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY5173305BOY
EOY5199109EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5173305BOY
EOY5199109EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5192254BOY
EOY5226923EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
Descriptionoppenheimer core fixed income sitDescription
Book Value4406958BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities4406958TotalOfBookValueSecurities
Total Revenue1999685TotalRevenue
Total Expenses2393789TotalExpenses
Excess Or Deficit For Year-394104ExcessOrDeficitForYear
Net Unrealized GL On Investments419908NetUnrealizedGLOnInvestments
Total Adjustments419908TotalAdjustments
Excess Or Deficit Per FS25804ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2390999TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments419908NetUnrealizedGainsInvestments
Revenue Not Rptd F990419908RevenueNotRptdF990
Revenue Subtotal1971091RevenueSubtotal
Investment Expenses Not Included28594InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt28594RevenueNotRptdOnFinStmt
Total Revenue Per Form9901999685TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2365195TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal2365195ExpensesSubtotal
Investment Expenses Not Included228594InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt28594ExpensesNotRptdOnFinStmt
Total Expenses Per Form9902393789TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
Explanationthe plan files form 990, return of the organization exempt from income tax and form 5500, annual return/report of employee benefit plan. the plan's returns are subject to examination by the internal revenue service until the applicable statute of limitation expires.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 3The fund delegated control over day-to-day management duties to national employee benefits administrators, inc., a third party administrator.
Form 990, Part VI, Section A, line 8bThe fund does not have a segregated committee with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11the form 990 is provided, reviewed and approved by the board of trustees prior to filing.
Form 990, Part VI, Section B, line 12cTHE FUND IS REQUIRED BY THE EMPLOYEE RETIREMENT INCOME SECURITY ACT TO DISCLOSE ANY CONFLICTS OF INTEREST. THE TRUSTEES MONITOR AND ENFORCE THE FUND'S COMPLIANCE WITH ERISA WITH ASSISTANCE FROM THE FUND'S PROFESSIONALS
Form 990, Part VI, Section C, line 19The fund makes governing documents and financial statements available upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Plumbers & Pipefitters Local 803 Pension FundBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18875 liberty ridge driveAddressLine1
CityjacksonvilleCity
StateFLState
ZIP Code32256ZIPCode
FieldValueIRS element (for citing)
EIN596228172EIN
Primary Activitiesprovide pension benefits to eligible employeesPrimaryActivities
Legal Domicile StateFLLegalDomicileState
Exempt Code Section401(a)ExemptCodeSection
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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