2023-05-11T13:51:59-05:00 2022-06-30 871353108 EISNER ADVISORY GROUP LLC 733 THIRD AVENUE NEW YORK NY 100172703 990 2021-07-01 136157604 HEALTH AND WELFARE FUND OF THE PBA OF THE CITY OF NEW YORK HEAL 2123497560 125 BROAD STREET 11TH FL NEW YORK NY 10004 PATRICK G HENDRY TRUSTEE 2123497560 2023-05-11 1 PATRICK HENDRY 999009999 WILLIAM EPSTEIN P01307171 2129498700 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID NICHOLSON 125 BROAD ST 11TH FL NEW YORK NY 10004 44992404 0 X WWW.NYCPBA.ORG X 1964 NY PROVIDE HEALTH & WELFARE BENEFITS TO ACTIVE POLICE OFFICERS (SEE PAGE 2 PART III, LINE 1). 5 0 51 0 0 0 0 0 44121335 43797050 1154991 1195278 365 76 45276691 44992404 0 0 21197858 23018855 2240402 2098413 0 0 0 6259043 6361314 29697303 31478582 15579388 13513822 118546121 127205831 2765028 2459455 115781093 124746376 THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE HEALTH & WELFARE BENEFITS TO ACTIVE POLICE OFFICERS, THEIR SPOUSES, AND ELIGIBLE DEPENDENTS. 0 0 THE HEALTH AND WELFARE FUND OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK IS A WELFARE BENEFIT PLAN COVERING, AT JUNE 30, 2022, 23,112 ELIGIBLE PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. THE FUND PROVIDES PRESCRIPTION DRUG, DENTAL, OPTICAL, AND SUPPLEMENTAL BENEFITS INCLUDING CATASTROPHIC BENEFIT, OFFICE VISIT CO-PAYMENT BENEFIT, AND LIFE INSURANCE COVERAGE. 0 0 0 0 0 0 0 0 0 1 0 0 1 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 1 1 0 1 1335 0 1 51 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X MONITA WONG 2123947560 125 BROAD STREET 11TH FL NEW YORK NY 10004 X PATRICK J LYNCH TRUSTEE 5.00 55.00 X 0 109912 0 JOHN P PUGLISSI TRUSTEE 5.00 45.00 X 0 95344 0 JOSEPH A ALEJANDRO TRUSTEE 5.00 45.00 X 0 85631 0 PATRICK G HENDRY TRUSTEE 5.00 45.00 X 0 85631 0 DANIEL J TIRELLI TRUSTEE 5.00 45.00 X 0 85631 0 DAVID NICHOLSON FUNDS ADMINISTRATOR 13.50 31.50 X 115520 273484 70057 KEITH OWEN ASST. FUNDS ADMIN. 22.00 23.00 X 76542 79665 57783 MONITA WONG CONTROLLER 16.50 28.50 X 51795 87505 56261 VICKI TRICKETT SQL DBA & DEVELOPER 12.40 32.60 X 38381 101462 27718 GREGORY ARISTILDE IT DIRECTOR 12.40 32.60 X 38367 101461 27708 NIVEEN MANSOUR SENIOR ACCOUNTANT 10.10 34.90 X 27669 96830 26296 348274 1202556 265823 1 0 1 0 MICHAEL T MURRAY & ASSOCIATES PC 10 ESQUIRE ROAD SUITE 11C NEW CITY NY 10956 LEGAL SERVICES 128520 1 CONTRIBUTION FROM NYC 525100 43682784 43682784 COBRA PREMIUM COLLECTED 525100 114266 114266 43797050 1195278 1195278 MISCELLANEOUS INCOME 900099 76 76 76 44992404 43797050 0 1195354 23018855 146998 1172370 92483 584319 102243 5386 128520 70423 39054 67979 106599 312407 20337 45166 BENEFIT EXP REIMBURSEME 4774221 BENEFIT ADMIN. EXPENSE 724989 TEMP HELP 65247 SUBSCRIPTION FEE 986 31478582 2746892 2406054 14523068 26065299 97005 101255 1117956 1033091 140931 84865 90759692 90664199 10278533 7884159 118546121 127205831 2277556 2069478 487472 389977 2765028 2459455 X 115781093 124746376 0 0 0 0 115781093 124746376 118546121 127205831 13513822 -4548539 0 X 0 1 X 1 0 59528 35863 23665 667980 614817 53163 390448 382411 8037 84865 CONTRIBUTION RECEIVABLE FROM NYC 4242676 PRESCRIPTION DRUG BENEFIT 1932626 DUE FROM OTHER AFFILIATED ORG 1552143 MISCELLANEOUS RECEIVABLE 155200 COBRA BENEFIT RECEIVABLE 1635 BENEFIT RECEIVABLE -121 7884159 DEFERRED RENT PAYABLE 389977 389977 X 40443865 -4548539 -4548539 44992404 0 44992404 31676534 0 31676534 -197952 -197952 31478582 PART X, LINE 2: THE FUND HAS RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS") DATED JULY 1964 (AS CONFIRMED ON MARCH 12, 1987 AND AUGUST 1, 2019), STATING THAT THE FUND IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (THE "CODE") AS A VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION. THE FUND IS REQUIRED TO OPERATE IN CONFORMITY WITH THE CODE TO MAINTAIN ITS TAX-EXEMPT STATUS. THE FUND'S MANAGEMENT BELIEVES THAT THE FUND IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE CODE AND, THEREFORE, BELIEVES THE FUND IS TAX-EXEMPT. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE FUND'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND RECOGNIZE A TAX LIABILITY IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE FUND'S MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF JUNE 30, 2022,THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN. THE FUND IS SUBJECT TO ROUTINE EXAMINATIONS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE NO EXAMINATIONS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: OBLIGATION FOR BENEFITS, CLAIMS INCURRED BUT NOT REPORTED 290,000. BENEFITS CURRENTLY PAYABLE TO OR FOR PARTICIPANTS -487,952. X 0 0 0 DAVID NICHOLSON FUNDS ADMINISTRATOR 115187 262474 0 0 333 11010 7981 18186 13914 31708 137415 323378 0 0 KEITH OWEN ASST. FUNDS ADMIN. 76357 79473 0 0 185 192 6808 7085 23034 23974 106384 110724 0 0 MONITA WONG CONTROLLER 51556 87097 0 0 239 408 4591 7780 17214 29624 73600 124909 0 0 VICKI TRICKETT SQL DBA & DEVELOPER 38098 100716 0 0 283 746 3379 8930 5046 13304 46806 123696 0 0 GREGORY ARISTILDE IT DIRECTOR 38301 101288 0 0 66 173 3376 8923 5045 13304 46788 123688 0 0 NIVEEN MANSOUR SENIOR ACCOUNTANT 27546 96403 0 0 123 427 2424 8463 4097 14119 34190 119412 0 0 PART I, LINE 3 EACH YEAR THE BOARD APPROVES THE SALARIES OF ALL EMPLOYEES OF THE ORGANIZATION. THE APPROVAL PROCESS INCLUDES A DISCUSSION OF PERFORMANCE AND REVIEW OF SALARIES FOR COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS. SALARY ADJUSTMENTS ARE DIRECTED BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THEIR RIGHTS: NEW YORK CITY POLICE OFFICERS WHO ARE ACTIVE MEMBERS OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK HAVE THE RIGHT TO ELECT THE ORGANIZATION'S GOVERNING BODY ONCE EVERY FOUR YEARS. FORM 990, PART VI, SECTION B, LINE 11B ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE 990 IS PREPARED BY THE COMPANY'S INTERNAL ACCOUNTING DEPARTMENT REVIEWED BY A CERTIFIED PUBLIC ACCOUNTANT (EISNER ADVISORY GROUP LLC), THEN A COPY OF THE 990 INCLUDING ALL THE SCHEDULES ARE PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO THE SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ENFORCEMENT OF CONFLICTS OF INTEREST POLICY: THE ORGANIZATION ENFORCES ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL OFFICERS, TRUSTEES, AND EMPLOYEES TO DISCLOSE ANY FINANCIAL INTEREST THEY OR THEIR FAMILY MEMBERS HAVE IN ANY FIRM THAT DOES BUSINESS WITH THE ORGANIZATION. THIS IS A CONTINUING OBLIGATION AND IS REVIEWED ANNUALLY FOR COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION PROCESS FOR TOP OFFICIAL: EACH YEAR THE BOARD APPROVES THE SALARIES OF ALL EMPLOYEES OF ORGANIZATION, INCLUDING THE TOP MANAGEMENT OFFICIAL. THE APPROVAL PROCESS INCLUDES A DISCUSSION OF PERFORMANCE AND REVIEW OF SALARIES FOR COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS. SALARY ADJUSTMENTS ARE DIRECTED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: THE ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENT AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT REQUIRED BY LAW. FORM 990, PART VII - ADDITIONAL INFORMATION SECTION B, LINE 1 EXPENSES SHARED BETWEEN THE RELATED ENTITIES ARE DISBURSED SOLELY BY THE HEALTH AND WELFARE FUND OF THE PBA ("HEALTH AND WELFARE FUND") AND ALLOCATED TO THE HEALTH AND WELFARE FUND AND RELATED ORGANIZATIONS. THE HEALTH AND WELFARE FUND ISSUES THE FORM 1099-NEC. BASED ON THE TOTAL COMPENSATION DISBURSED TO THE RECIPIENT. COMPENSATIONS SHOWN ON PART VII, SECTION B LINE 1 COLUMN C REFLECT THE FILING ORGANIZATION'S SHARE OF THE REPORTED COMPENSATIONS ON THE 1099-NEC, BOX 1. ANNUITY FUND OF THE PBA 125 BROAD STREET 11TH FLOOR NEW YORK NY 10004 136302673 SEE PART VII NY 401A PBA OF NYC 1 LEGAL SERVICES FUND OF THE PBA 125 BROAD STREET 11TH FLOOR NEW YORK NY 10004 132972437 SEE PART VII NY 501(C)(5) PBA OF NYC 1 PBA EMPL & FUND OFFICE STAFF PENSION 125 BROAD STREET 11TH FLOOR NEW YORK NY 10004 133078801 SEE PART VII NY 401A PBA OF NYC 1 PBA OF THE CITY OF NEW YORK INC 125 BROAD STREET 11TH FLOOR NEW YORK NY 10004 135308915 SEE PART VII NY 501(C)(5) N/A 0 PBA WIDOWS & CHILDRENS FUND INC 125 BROAD STREET 11TH FLOOR NEW YORK NY 10004 132949036 SEE PART VII NY 501(C)(3) LINE 7 PBA OF NYC 1 RETIREE H&W FUND OF THE PBA 125 BROAD STREET 11TH FLOOR NEW YORK NY 10004 510237976 SEE PART VII NY 501(C)(9) PBA OF NYC 1 THE CITY OF NEW YORK 1 CENTER STREET NEW YORK NY 10007 SEE PART VII NY 115 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 THE CITY OF NEW YORK C 46922244 FMV RETIREE FUND OF THE PBA Q 3044661 FMV LEGAL SERVICES FUND OF THE PBA Q 5119463 FMV ANNUITY FUND OF THE PBA Q 281517 FMV SCHEDULE R - ADDITIONAL INFORMATION SCHEDULE R PART II (B) PRIMARY ACTIVITY: RETIREE HEALTH AND WELFARE FUND OF THE PBA: THE FUND PROVIDES HEALTH AND WELFARE BENEFITS TO RETIRED PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. ANNUITY FUND OF THE PBA: THE FUND IS A DEFINED CONTRIBUTION PLAN PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO ELIGIBLE PARTICIPANTS IN ACCORDANCE WITH THE PLAN'S RULES AND REGULATIONS. LEGAL SERVICES FUND OF THE PBA: THE FUND PROVIDES JOB RELATED LEGAL SERVICES AND CIVIL LEGAL REPRESENTATION TO ACTIVE POLICE OFFICERS THROUGH MULTIPLE PROVIDERS. PBA EMPLOYEE & FUND OFFICE STAFF PENSION PLAN: THE PLAN IS A MONEY PURCHASE PENSION PLAN COVERING ALL ELIGIBLE EMPLOYEES OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK, INC. (THE "PBA"), THE HEALTH & WELFARE FUND OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK, THE RETIREE HEALTH & WELFARE FUND OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK, THE ANNUITY FUND OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK, AND THE LEGAL SERVICES FUND OF THE POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK. POLICE BENEVOLENT ASSOCIATION OF THE CITY OF NEW YORK, INC.: THE PBA IS A LABOR UNION WHOSE MEMBERS ARE ACTIVE AND RETIRED POLICE OFFICERS OF THE CITY OF NEW YORK. PBA WIDOWS AND CHILDREN'S FUND, INC.: THE FUND PROVIDES AID AND ASSISTANCE TO THE WIDOWS, WIDOWERS AND ELIGIBLE DEPENDENTS OF POLICE OFFICERS WHO HAVE LOST THEIR LIVES IN THE LINE OF DUTY. THE CITY OF NEW YORK IS THE CONTRIBUTING EMPLOYER.