2020-06-26T08:01:46-05:00 2019-06-30 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2018-07-01 060683942 IUPAT DISTRICT COUNCIL NO 11 HEALTH FUND IUPA 2032697741 PO BOX 5817 WALLINGFORD CT 06492 DOMINICK CIERI TRUSTEE 2032697741 2020-06-26 1 LOUIS VERZELLA CPA P00360279 6106689400 2020-06-26 162.211.205.39 2020-06-26 07:59:52 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 214E2DE4754F8F73DD572B34B07E6CCBC316F7C9 2018 2020-09-22 18:59:49Z DOMINICK CIERI PO BOX 5817 WALLINGFORD CT 06492 26051328 0 X N/A X 1950 CT TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. 7 3 1 0 0 0 0 0 14988997 17265253 1076947 1076051 617991 1289198 16683935 19630502 0 0 13329626 14792712 35873 37256 0 0 0 1426493 1317203 14791992 16147171 1891943 3483331 29683600 34223400 1511307 1701721 28172293 32521679 TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. 0 0 TO PROVIDE VARIOUS FORMS OF HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIES OF THIS FUND. 0 0 0 0 0 0 0 0 0 0 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 0 0 1 1 0 0 0 0 0 0 0 0 X 7 3 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 2032697741 PO BOX 5817 WALLINGFORD CT 06492 DOMINICK CIERI TRUSTEE 2.00 60.00 X 0 193296 77662 MARK VERITY TRUSTEE 2.00 45.00 X 0 142809 61712 JUSTIN KELLEY TRUSTEE 2.00 40.00 X 0 136516 51263 NORBERT OLIVEIRA TRUSTEE 2.00 45.00 X 0 130192 56199 PAUL CARAMANICA TRUSTEE 2.00 X 0 0 0 ANDREW F MELE TRUSTEE 2.00 X 0 0 0 MALCOLM MACKENZIE TRUSTEE 2.00 X 0 0 0 0 602813 246836 0 0 1 0 ANTHEM BCBS 108 LEIGUS ROAD WALLINGFORD CT 06492 PPO 314792 ZENITH AMERICAN SOLUTIONS INC 10 TECHNOLOGY DRIVE WALLINGFORD CT 06492 THIRD PARTY ADMIN. 310038 ANCHOR CAPITAL ADVISORS TWO INTERNATIONAL PLACE BOSTON MA 02110 INVESTMENT MANAGEMENT 110091 RBC WEALTH MANAGEMENT 60 SOUTH 6TH ST MINNEAPOLIS MN 55401 INVESTMENT MANAGEMENT 100521 4 EMPLOYER CONTRIBUTIONS 900099 16472077 16472077 SELF-PAY CONTRIBUTIONS 900099 793176 793176 17265253 620981 620981 6875896 6420826 455070 455070 455070 STOP LOSS REIMBURSEMENT 900099 964162 964162 PRESCRIPTION REBATE 900099 314032 314032 INTEREST ON EMPLOYER CONTRIBUTION 900099 11004 11004 1289198 19630502 18554451 0 1076051 14792712 28259 6673 2324 81106 41826 210612 908542 16767 2370 13961 DUES ASSESSMENT 21004 MEMBERSHIP DUES 12495 FOREIGN TAX ON INVESTME 4798 PCORI FEE 3722 16147171 3269480 3251669 3118716 3068501 19359 24402 23276045 27878828 29683600 34223400 107831 46315 111200 51247 1292276 1604159 1511307 1701721 X 0 0 0 0 28172293 32521679 28172293 32521679 29683600 34223400 3483331 866055 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 1514200 DUE TO OUTSIDE FUNDS 89959 1604159 X 20285945 866055 866055 19419890 210612 210612 19630502 15611559 0 15611559 210612 325000 535612 16147171 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 (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATION 325,000. X 0 0 0 DOMINICK CIERI TRUSTEE 0 193296 0 0 0 0 0 60592 0 17070 0 270958 0 0 MARK VERITY TRUSTEE 0 142809 0 0 0 0 0 44837 0 16875 0 204521 0 0 JUSTIN KELLEY TRUSTEE 0 136516 0 0 0 0 0 43988 0 7275 0 187779 0 0 NORBERT OLIVEIRA TRUSTEE 0 130192 0 0 0 0 0 43134 0 13065 0 186391 0 0 FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - THE FORM 990 WAS REVIEWED BY THE TRUSTEE SIGNING THE RETURN, LEGAL COUNSEL, AND TPA PRIOR TO FILING THE RETURN. FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY VIA PAPER COPY OR EMAIL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, INSTRUMENTS UNDER WHICH THE ORGANIZATION IS OPERATED OR ESTABLISHED, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, TO PARTICIPANTS, EMPLOYERS AND OTHERS IN ACCORDANCE WITH THE PROVISIONS OF ERISA, BUT ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART XI, LINE 2C THE GOVERNING BODY IS RESPONSIBLE FOR OVERSEEING THE AUDIT OF FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNTANT. NO CHANGE FROM PRIOR YEAR. 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