2023-04-06T14:12:34-05:00 2022-06-30 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2021-07-01 237097998 ASBESTOS WORKERS PHILADELPHIA HEALTH AND WELFARE PLAN ASBE 2152894303 2014 HORNIG ROAD PHILADELPHIA PA 19116 STEPHEN PETTIT TRUSTEE 2152894303 2023-04-06 1 STEPHEN PETTIT 999009999 LOUIS VERZELLA CPA P00360279 6106689400 2023-04-06 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z STEPHEN PETTIT 2014 HORNIG ROAD PHILADELPHIA PA 19116 29426247 0 X N/A X 1950 PA THE PLAN IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN COVERING MEMBERS OF INSULATORS AND ASBESTOS WORKERS LOCAL UNION NOS. 14 AND 89 AND ALL EMPLOYEES WHOSE EMPLOYMENT IS IN A CAPACITY WHICH PROVIDES FOR CONTRIBUTIONS TO THE TRUST OF THE PLAN. 6 3 3 0 0 0 46697 0 14227764 14363001 747290 -430596 0 0 15021751 13932405 0 0 12211774 13436223 271872 408690 0 0 0 658062 602250 13141708 14447163 1880043 -514758 31470862 28943140 156528 79965 31314334 28863175 X THE PLAN PROVIDES THE FOLLOWING BENEFITS FOR ELIGIBLE ACTIVE AND RETIRED EMPLOYEES AND THEIR DEPENDENTS:DEATH BENEFITS,OUT-PATIENT DIAGNOSTIC,ACCIDENTAL DEATH AND DISMEMBERMENT,X-RAY AND LABORATORY,MATERNITY,HOSPITAL,MAJOR MEDICAL,SURGICAL,DENTAL CARE,VISION CARE,EXTENDED BENEFITS AFTER TERMINATION OF ELIGIBILITY,PRESCRIPTION DRUGS,VACATION BENEFITS AND ALCOHOL AND DRUG ABUSE TREATMENT.THE HOSPITAL, MEDICAL AND SURGICAL BENEFITS ARE BEING PAID THROUGH AN INSURANCE ARRANGEMENT WITH INDEPENDENCE BLUE CROSS/BLUE SHIELD OF PENNSYLVANIA. THE DEATH AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS ARE BEING PAID THROUGH AN INSURANCE ARRANGEMENT WITH UNION LABOR LIFE INSURANCE COMPANY. SELF-INSURED BENEFITS PAID DIRECTLY TO PARTICIPANTS CONSIST PRIMARILY OF PRESCRIPTION DRUGS, VISION, DENTAL, MAJOR MEDICAL, MEDICARE, SICKNESS AND ACCIDENT, EXTENDED BENEFITS AND ALCOHOL AND DRUG ABUSE TREATMENT. 0 0 TO PROVIDE MEDICAL, HOSPITAL, DENTAL, VISION, PRESCRIPTION, WEEKLY DISABILITY INCOME, AND DEATH BENEFITS. 0 0 0 0 0 0 0 0 0 1 0 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 1 X 451 0 3 1 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 X ADMINISTRATOR 2152894303 2014 HORNIG ROAD PHILADELPHIA PA 19116 JERRY MCCAFFREY MANAGEMENT TRUSTEE CO-CHAI 1.00 X 0 0 0 STEPHEN PETTIT LABOR TRUSTEE CO-CHAIRMAN 1.00 40.00 X 0 173727 121153 MICHAEL FORMICA MANAGEMENT TRUSTEE 1.00 X 0 0 0 ROBERT CELLUCCI LABOR TRUSTEE 1.00 40.00 X 0 159254 118386 ARTHUR SWEENEY MANAGEMENT TRUSTEE 1.00 X 0 0 0 STEPHEN ROBERTS JR LABOR TRUSTEE 1.00 40.00 X 0 159254 118486 MICHAEL BURNS FUND ADMINISTRATOR 16.00 29.00 X 56072 104133 92516 56072 596368 450541 0 0 1 0 AETNA 9 ENTIN ROAD STE 203 PARSIPPANY NJ 07054 CLAIMS PROCESSING 321691 1 EMPLOYER CONTRIBUTIONS 525100 11086042 11086042 PARTICIPANT VACATION CONTRIBUTION 525100 1669343 1669343 RETIREE CONTRIBUTIONS 525100 1545681 1545681 COBRA CONTRIBUTION 525100 61935 61935 14363001 495974 495974 14567272 15493842 -926570 -926570 -926570 13932405 14363001 0 -430596 13436223 88453 152131 97596 54754 15756 59000 79994 79936 153893 53041 69531 52807 8010 11510 3438 27395 PCORI FEES 3695 14447163 949920 1240455 6505769 7044787 1171289 1509110 72330 46312 150085 148080 5443 2005 21371249 17827332 1394862 1273139 31470862 28943140 58268 60897 98260 19068 156528 79965 X 0 0 0 0 31314334 28863175 31314334 28863175 31470862 28943140 -514758 -1936401 0 X X 0 1 X 1 0 90364 90364 0 50083 48078 2005 9638 9638 0 2005 DUE TO LOCAL UNION 14 2499 RECIPROCAL CONTRIBUTIONS PAYABLE 752 DUE TO ASBESTOS WORKERS PHILADELPHIA PENSION FUND 15817 19068 X 11916068 -1936401 -1936401 13852469 79936 79936 13932405 14367227 0 14367227 79936 79936 14447163 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. X 0 0 0 STEPHEN PETTIT LABOR TRUSTEE CO-CHAIRMAN 0 173727 0 0 0 0 0 86239 0 34914 0 294880 0 0 STEPHEN ROBERTS JR LABOR TRUSTEE 0 159254 0 0 0 0 0 83572 0 34914 0 277740 0 0 ROBERT CELLUCCI LABOR TRUSTEE 0 159254 0 0 0 0 0 83472 0 34914 0 277640 0 0 MICHAEL BURNS FUND ADMINISTRATOR 56072 104133 0 0 0 0 21713 40323 10668 19812 88453 164268 0 0 FORM 990, PART V, LINE 2A: ASBESTOS WORKERS PHILADELPHIA HEALTH AND WELFARE FUND PAYS TAXABABLE DISABILITY BENEFITS TO PARTICIPANTS. THE FUND ISSUED FORMS W-2 FOR DISABILITY BENEFITS AND 3 FOR EMPLOYEES IN CALENDAR YEAR 2021. FORM 990, PART VI, SECTION B, LINE 11B ASBESTOS WORKERS PHILADELPHIA HEALTH AND WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT. THE COMPLETED RETURN IS FORWARDED TO THE FUND ADMINISTRATOR FOR INITIAL REVIEW. THE RETURN IS THEN PRESENTED TO THE TRUSTEES FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12 ASBESTOS WORKERS PHILADELPHIA HEALTH AND WELFARE PLAN MONITORS ITS CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 ASBESTOS WORKERS PHILADELPHIA HEALTH AND WELFARE FUND'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: ASBESTOS WORKERS PHILADELPHIA HEALTH AND WELFARE FUND'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPEDENT PUBLIC ACCOUNTANT THAT PERFORMS THE AUDIT. NO CHNAGE FROM THE PRIOR YEAR. INTERNATIONAL ASSOC OF HEAT & FROST INSULATORS AND ALLIED WORKERS LOCAL 89 1502 SOUTH OLDEN AVENUE TRENTON NJ 08610 221732686 LOCAL UNION NJ 501(C)(5) N/A 0 ASBESTOS WORKERS PHILADELPHIA PENSION FUND 2014 HORNIG ROAD PHILADELPHIA PA 19116 236406511 PENSION FUND PA 401(A)/501(A) N/A 0 ASBESTOS WORKERS LOCAL NO 14 SCHOLARSHIP FUND 2014 HORNIG ROAD PHILADELPHIA PA 19116 311729117 SCHOLARSHIP FUND PA 501(C)(3) 509(A)(2) 0 JOINT APPRENTICE TRAINING FUND 2014 HORNIG ROAD PHILADELPHIA PA 19116 231711170 EDUCATION AND TRAINING FUND PA 501(C)(3) 170(B)(1)(A)(II) 0 INTERNATIONAL ASSOC OF HEAT & FROST INSULATORS AND ALLIED WORKERS LOCAL 14 2014 HORNIG ROAD PHILADELPHIA PA 19116 230724510 LOCAL UNION PA 501(C)(5) N/A 0 ASBESTOS WORKERS PHILADELPHIA FUNDS 2014 HORNIG ROAD PHILADELPHIA PA 19116 231899244 LOCAL UNION PA 501(C)(5) N/A 0 JAC LOCAL #14 2014 HORNIG ROAD PHILADELPHIA PA 19116 LOCAL UNION PA 501(C)(5) N/A 0 LOCAL 14 MARKETING FUND 2014 HORNIG ROAD PHILADELPHIA PA 19116 230724510 LOCAL UNION PA 501(C)(5) N/A 0 ACCURATE INSULATION ADVANCED SPECIALTY CONTRACTORS ALLIED POWER LLC APACHE INDUSTRIAL UNITED APEX INSULATION INC BRANDSAFWAY INDUSTRIES BRASS ROOTS INSULATION BROCK INDUSTRIAL SERVICES DELTABJDS INC DIAMOND HUNTBACH CONST CORP ED-O INSULATION CO INC EII INC EWP CONTRACTING INC FOLEY INSULATION INC INDEPENDENCE INSULATION INSULATION INDUSTRY INTERNATIONAL INSULTECH INC K FACTOR INSULATION K GULLER LLC M&R INSULATION SYSTEMS MAXIMUM MECHANICAL MECHANICAL INSULATION MID-ATLANTIC INSULATION MJM INDUSTRIES MPF INSULATION NORRIS INSULATION CO PHILADELPHIA D&M PRIME GROUP INSULATION SELVEY GOLDEN INCORP STAR INSULATION INC STEFANOW INSULATION INC TANDEM ASSOCIATES INC TEMPERED INSULATION INC THERMAL PIPING DIV OF GBI THERMAL SOLUTIONS CONTRACTING VIERLING INSULATION WOOLSULATE CORPORATION Z-TECH INSULATION 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 1 ASBESTOS WORKERS PHILADELPHIA PENSION FUND Q 221768 FMV ASBESTOS LOCAL 14 L 51443 FMV LOCAL 14 BUILDING FUND N 83688 FMV