2022-04-12T15:16:35-05:00 2021-06-30 203920878 BULTYNCK & CO PLLC 15985 CANAL RD CLINTON TOWNSHIP MI 480385021 990 2020-07-01 383544316 PLUMBERS & PIPEFITTERS LOCAL NO 333 HEALTH & WELFARE BENEFIT PLAN PLUM 5173217502 6525 CENTURION DRIVE LANSING MI 48917 PRICE DOBERNICK CHAIRMAN 5173217502 2022-03-10 true PRICE DOBERNICK XXX-XX-XXXX CHRISTOPHER SCOTT CPAPFS MST P00380614 5862867300 2022-03-10 2020 2022-09-23 18:48:47Z PRICE DOBERNICK 5405 S MARTIN LUTHER KING JR BLVD LANSING MI 48911 18207218 false X X 2000 MI TO PROVIDE HEALTH AND WELFARE BENEFITS TO THE MEMBERS OF PLUMBERS AND PIPEFITTERS LOCAL 333, PURSUANT TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT, THROUGH A TAFT-HARTLEY MULTI-EMPLOYER TRUST FUND. 8 4 35 8 0 0 12105775 12936632 343284 655935 584571 879923 13033630 14472490 0 9915821 11650359 0 0 0 876161 933309 10791982 12583668 2241648 1888822 17098782 19954579 6747100 7825063 10351682 12129516 false false TO PROVIDE HEALTH AND WELFARE BENEFITS TO LOCAL 333 MEMBERS UNDER THE COLLECTIVE BARGAINING AGREEMENT, THROUGH A TAFT-HARTLEY MULTI- EMPLOYER TRUST FUND. false false false false false false false false false false false false false true false true false false false false false false false false false false false false false false false false false false false false false false false false false false false true 2 0 35 true false false false false false false false false X 8 4 false false false false false false false true true false false false true true true true true false false false X TIC 5173217502 6525 CENTURION DRIVE LANSING MI 48917 X PRICE DOBERNICK CHAIRMAN 1.00 X X 0 0 0 JOHN GREEN TRUSTEE 1.00 X 0 0 0 KEVIN JONAS TRUSTEE 1.00 X 0 0 0 CHRIS KECK TRUSTEE 1.00 X 0 0 0 JASON KREGER TRUSTEE 1.00 X 0 0 0 JOSEPH MICHILIZZI TRUSTEE 1.00 X 0 0 0 CHAD MYERS SECRETARY 1.00 X X 0 0 0 GEORGE VANCOPPENOLLE TRUSTEE 1.00 X 0 0 0 false false false MET LIFE 200 PARK AVE NEW YORK NY 10017 INSURANCE 571396 BLUE CROSS BLUE SHIELD 600 E LAFAYETTE BLVD DETROIT MI 48226 ADMIN 191790 TIC INTERNATIONAL CORPORATIONS 6525 CENTURION DRIVE LANSING MI 48917 TPA 113357 3 EMPLOYER CONTRIBUTIONS 525100 12395771 12395771 SELF PAYMENT CONTRIBUTIONS 525100 540861 540861 12936632 453656 453537 119 3937007 3734728 202279 202279 202279 STOP LOSS REFUNDS 525100 549611 549611 RX REBATES 525100 323014 323014 LIQUIDATED DAMAGES 525100 7298 7298 879923 14472490 14472371 119 11650359 737061 73996 35156 23425 19094 31114 100 13363 12583668 0 0 0 874808 880104 13803 11805 1171299 1200055 296699 4683 14742165 17857925 8 7 17098782 19954579 1016115 1041897 5730985 6783166 6747100 7825063 X 10351682 12129516 10351682 12129516 17098782 19954579 X 1888822 714952 -825940 X false false FUTURE BENEFITS 3358380 MRA LIABILITY 2888786 CLAIMS INCURRED BUT NOT REPORTED 536000 6783166 14472490 14472490 14472490 12583668 12583668 12583668 FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERS CONSIST OF UNCOMPENSATED BOARD MEMBERS. FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS REVIEWED BY THE BOARD PRIOR TO APPROVAL AND MOTION FOR THE CHAIRMAN TO SIGN THE REQUIRED DOCUMENTS. FORM 990, PAGE 6, PART VI, LINE 12C BOARD MEMBERS ARE RESPONSIBLE FOR DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST AS THEY ARISE THROUGHOUT THE YEAR. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER IS REQUIRED TO ABSTAIN FROM DISCUSSION AND VOTING OF THE MATTER. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 CHANGE IN IBNR -49,000 CHANGE IN ACCUM ELIGIBILITY CREDITS -776,940 TOTAL -825,940