2011-06-25T11:42:05-05:00 2010-12-31 STEVEN D EISENBERG CPA PA 13790 NW 4 STREET 100 SUNRISE FL 33325 990 2010-01-01 596169977 INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS LOCAL 915 WELFARE FUND INTE 6158590131 PO Box 1449 Goodlettsville TN 37070 FRANK CARPENTER 6158590131 2011-06-15 1 STEVEN D EISENBERG 9548469490 2011-06-25 2010 2016-02-24 21:20:13Z FRANK CARPENTER PO Box 1449 Goodlettsville TN 37070 8210922 0 X N/A X 1969 FL To provide health benefits to its members. 6 0 0 0 0 0 0 0 5923520 4116212 506431 605540 0 165150 6429951 4886902 0 0 5504996 6506093 0 0 0 0 0 929132 727220 6434128 7233313 -4177 -2346411 13285412 11335065 185992 203798 13099420 11131267 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 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 2 0 0 1 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 DON CANTY 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 521291 SOUTHERN BENEFIT ADMINISTRATORS PO BOX 1449 GOODLETTSVILLE TN 37070 CONTRACT ADMINISTRATION 120976 2 CONTRIBUTIONS 230000 4116212 4116212 4116212 598109 598109 3331451 3324020 7431 7431 7431 LOSS RECOVERY 230000 165150 165150 165150 4886902 4886902 0 0 6506093 13558 8763 3880 5979 3997 137 9757 CLAIMS ADMINISTRATION F 521291 FUND AMINISTRATION FEES 120976 CONSULTING FEE 21600 ACTUARIAL 12727 COLLECTION COSTS 4555 7233313 306794 96448 595405 338336 222125 222125 11347895 10580506 813193 97650 13285412 11335065 185992 203798 185992 203798 X 13099420 11131267 13099420 11131267 13285412 11335065 X -2346411 378258 X X 0 1 1 X 0 0 4886902 7233313 -2346411 378258 378258 -1968153 5265160 378258 378258 4886902 0 4886902 7233313 0 7233313 0 7233313 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 gains on investments: 378258. The Board of Trustees is 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