2021-09-24T10:24:06-05:00 2020-12-31 161131146 BONADIO & CO LLP 432 NORTH FRANKLIN STREET SYRACUSE NY 13204 990 2020-01-01 156025162 IBEW LOCAL 1249 INSURANCE FUND IBEW 3156568390 8531 BREWERTON ROAD NO 2 CICERO NY 13039 RYAN YOUNGMAN PLAN ADMINISTRATOR 3156568390 2021-09-23 1 RYAN YOUNGMAN 999009999 KAREN NASONI P00057004 3154227109 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z RYAN YOUNGMAN 8531 BREWERTON ROAD NO 2 CICERO NY 13039 117055633 0 X N/A X 1960 NY TO PROVIDE INSURANCE COVERAGE TO PLAN PARTICIPANTS 6 6 0 0 0 0 0 0 41966924 48151759 1932910 1426486 1176224 1263005 45076058 50841250 0 0 37416997 34648898 0 0 0 0 0 1174285 1107537 38591282 35756435 6484776 15084815 71222895 94840263 1735303 2289663 69487592 92550600 TO PROVIDE INSURANCE COVERAGE TO PLAN PARTICIPANTS 0 0 THE PLAN IS A SELF INSURED WELFARE PLAN PROVIDING: ACCIDENTAL, HOSPITAL, MEDICAL, SURGICAL, OPTICAL, PRESCRIPTION, DEATH, DENTAL, LIFE INSURANCE, HARDSHIP PAY, DISABILITY, EDUCATION, CHILD CARE, VACATION, UNEMPLOYMENT, AND INSURANCE PREMIUMS TO PLAN PARTICIPANTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X RYAN YOUNGMAN 3156568390 8531 BREWERTON ROAD CICERO NY 13039 MARK LAWRENCE TRUSTEE 1.00 X 0 0 0 HENRY H WESTBROOK III TRUSTEE 1.00 X 0 0 0 EDWIN MOREIRA JR TRUSTEE 1.00 X 0 0 0 JAMES C ATKINS TRUSTEE 1.00 X 0 0 0 MICHAEL GILCHRIST TRUSTEE 1.00 X 0 0 0 SCOTT LAMONT TRUSTEE 1.00 X 0 0 0 RYAN YOUNGMAN PLAN ADMINISTRATOR 26.00 19.00 X 0 259293 81442 0 259293 81442 0 0 1 0 UMR INC 2425 JAMES STREET SYRACUSE NY 13206 CLAIMS ADMINISTRATOR 892067 US-RX CARE LLC 707 MIAMASBURG-CENTERVILLE RD 405 DAYTON OH 45459 PRESCRIPTION ADMINISTRATOR 219386 KEENAN & ASSOCIATES PO BOX 4328 TORRANCE CA 90510 INSURANCE BROKER 180946 DELTA DENTAL ONE DELTA DRIVE MECHANICSBURG PA 17055 DENTAL ADMINISTRATOR 143003 4 EMPLOYER CONTRIBUTIONS 525100 47476174 47476174 EMPLOYEE CONTRIBUTIONS 525100 675585 675585 48151759 999307 999307 66641562 66214383 427179 427179 427179 REBATES REVENUE 524298 1141636 1141636 MISCELLANEOUS INCOME 900099 121369 121369 1263005 50841250 49414764 0 1426486 34648898 95563 28200 108371 20740 1841 1000 16656 ADMINISTRATIVE FEES 827965 EQUIPMENT RENTAL 4800 MISCELLANEOUS EXPENSES 2401 35756435 10307760 11973135 804479 13841015 7470870 9025840 16628 15126 52414328 59985147 208830 0 71222895 94840263 1415154 1913829 0 16879 320149 358955 1735303 2289663 X 0 0 0 0 69487592 92550600 69487592 92550600 71222895 94840263 15084815 7978193 0 X 0 1 X 1 0 0 DUE TO RELATED PARTY 358955 358955 X 58711072 7978193 7978193 50732879 108371 108371 50841250 35648064 0 35648064 108371 108371 35756435 PART X, LINE 2: THE PLAN IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE. 0 0 0 RYAN YOUNGMAN PLAN ADMINISTRATOR 0 259293 0 0 0 0 0 48640 0 32802 0 340735 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES OTHER THAN THE GOVERNING BODY (BOARD OF TRUSTEES). FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE PLAN ADMINISTRATOR PRIOR TO BEING FILED. IT IS AVAILABLE AT THE FUND OFFICE FOR ALL THE TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES RECEIVES ANNUALLY A CONFLICT OF INTEREST FORM TO BE COMPLETED AND RETURNED TO THE FUND OFFICE AND TO REPORT ANY CONFLICTS AS THEY ARISE DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES UTILIZE THEIR KNOWLEDGE OF THE INDUSTRY TO DETERMINE RAISES TO THE TOP MANAGEMENT OFFICIAL AND OTHER KEY EMPLOYEES. THEIR DETERMINATION IS MADE ANNUALLY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION HAS THESE DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT CURRENTLY MAKE THE GOVERNING DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. 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