2020-11-16T08:33:17-06:00 2019-12-31 470900880 CALIBRE CPA GROUP PLLC 7501 WISCONSIN AVENUE BETHESDA MD 20814 990 2019-01-01 237351551 NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND NATI 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 JOHN EGER ADMINISTRATOR 3015771700 2020-11-16 1 PETER P OSMAN CPA P00366693 2023319880 2020-11-12 X 38.100.43.98 2020-11-16 09:31:59 ES P 2A1264631413402ED07D1720FD2C9A4C172C9560 2A1264631413402ED07D1720FD2C9A4C172C9560 2019 2022-01-07 14:23:13Z JOHN EGER 8000 CORPORATE DRIVE LANDOVER MD 20785 6275723 0 X NASIFUND.ORG X 1973 MD TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES UNDER COLLECTIVE BARGAINED AGREEMENTS AND PARTICIPATION AGREEMENTS. 6 3 28 0 0 0 0 0 5278353 5909255 306862 366468 0 0 5585215 6275723 0 0 3887266 4998003 126098 108721 0 0 0 269840 274835 4283204 5381559 1302011 894164 12945940 14934831 249045 168366 12696895 14766465 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES UNDER COLLECTIVE BARGAINED AGREEMENTS AND PARTICIPATION AGREEMENT. 0 0 PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES UNDER COLLECTIVE BARGAINED AGREEMENTS AND PARTICIPATION AGREEMENT. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 217 0 1 28 1 0 0 0 0 0 0 0 0 0 0 X 6 3 1 0 0 0 0 1 0 1 1 1 0 1 0 0 1 1 0 0 X JOHN EGER ADMINISTRATOR 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 BRIAN DUNN TRUSTEE, CHAIRMAN 1.00 39.00 X 0 173258 90128 FRED BARALL TRUSTEE, SECRETARY 1.00 39.00 X 0 0 0 ROBERT J COOPER TRUSTEE 1.00 39.00 X 0 170262 89230 SHANE RAY TRUSTEE 1.00 39.00 X 0 0 0 THOMAS LYDON TRUSTEE 1.00 39.00 X 0 0 0 BRIAN E FISHER TRUSTEE 1.00 39.00 X 0 169264 88930 MICHAEL W JACOBSON ADMINISTRATOR 1.00 39.00 X 3695 254951 127200 JOHN EGER ASSISTANT ADMINISTRATOR 1.00 39.00 X 3367 232359 142204 DAN CURRY IT MANAGER 1.00 34.00 X 2043 130775 40552 NIA PADMORE CLAIMS MANAGER 1.00 34.00 X 2974 118676 38993 ROBERT KAUFMAN COMPUTER ANALYST 0.00 35.00 X 0 116700 38300 12079 1366245 655537 0 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 60601 CLAIMS PROCESSING 193467 SEGAL CONSULTING 1800 M STREET NW SUITE 900 S WASHINGTON DC 20036 ACTUARY 102800 2 EMPLOYER CONTRIBUTIONS 525100 5854052 5854052 PARTICIPANT CONTR. 525100 46260 46260 LIQUIDATED DAMAGES 525100 8943 8943 5909255 366468 366468 6275723 5909255 0 366468 4998003 12079 50817 19104 21426 5295 26102 41483 20860 102800 8411 2339 CLAIMS COST MANAGEMENT 23832 DATA PROCESSING EXPENSE 14631 MAINTENANCE 8199 PRINTING,STATIONARY & O 5754 20424 5381559 1248960 502962 492329 764390 1537 1675 11203114 13665804 12945940 14934831 249045 168366 249045 168366 X 12696895 14766465 0 0 0 0 12696895 14766465 12945940 14934831 894164 1175406 0 X X 0 1 X 1 0 0 X 7430269 1175406 1175406 6254863 20860 20860 6275723 5360699 0 5360699 20860 20860 5381559 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 INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X 1 1 X 0 1 0 BRIAN DUNN TRUSTEE, CHAIRMAN 0 173258 0 0 0 0 0 69348 0 20780 0 263386 0 0 ROBERT J COOPER TRUSTEE 0 170262 0 0 0 0 0 68450 0 20780 0 259492 0 0 BRIAN E FISHER TRUSTEE 0 169264 0 0 0 0 0 68150 0 20780 0 258194 0 0 MICHAEL W JACOBSON ADMINISTRATOR 3388 233775 0 0 307 21176 1557 107458 260 17925 5512 380334 0 0 JOHN EGER ASSISTANT ADMINISTRATOR 3096 213650 0 0 271 18709 1984 136864 260 3096 5611 372319 0 0 DAN CURRY IT MANAGER 2043 130775 0 0 0 0 280 22023 344 17905 2667 170703 0 0 NIA PADMORE CLAIMS MANAGER 2974 118676 0 0 0 0 509 20299 445 17740 3928 156715 0 0 ROBERT KAUFMAN COMPUTER ANALYST 0 116700 0 0 0 0 0 20116 0 18184 0 155000 0 0 PART I, LINE 1A ANY AMOUNT OF THE PRESENT VALUE ACCRUAL IN EXCESS OF THE IRC SECTION 457 DEFERRED COMPENSATION IS REQUIRED TO BE INCLUDED IN A PARTICIPANT'S W-2. THE DEFERRED COMPENSATION AGREEMENTS REQUIRE ANY SUCH AMOUNT INCLUDED IN THE W-2 TO BE GROSSED UP FOR FEDERAL, STATE AND LOCAL TAXES. PART I, LINE 4B MICHAEL JACOBSON PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $585,223. JOHN EGER PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $432,230. FORM 990, PART VI, SECTION A, LINE 2 LOCAL 669 OFFICERS ARE TRUSTEES FOR THE NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND. FORM 990, PART VI, SECTION A, LINE 7A THE NATIONAL FIRE SPRINKLER ASSOCIATION APPOINTS MANAGEMENT TRUSTEES. OFFICERS OF LOCAL 669, ELECTED BY MEMBERS OF LOCAL 669, WHICH INCLUDE PARTICIPANTS IN THIS PLAN, ARE TRUSTEES OF THE NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND. FORM 990, PART VI, SECTION B, LINE 11B JOINT BOARD OF TRUSTEES REVIEWS FILING THROUGH AN EMAILED DRAFT BEFORE SUBMITTING. FUND ADMINISTRATOR HAS BEEN DESIGNATED BY THE JOINT BOARD OF TRUSTEES TO REVIEW AND SIGN THE FORM 990 FILING. FORM 990, PART VI, SECTION B, LINE 12 THE TRUST IS GOVERNED BY ERISA AND THE BOARD OF TRUSTEES COMPLY WITH THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA. FORM 990, PART VI, SECTION B, LINE 15A THE INDEPENDENT BOARD OF TRUSTEES REVIEWS AND APPROVES THE ADMINISTRATORS SALARY ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST AND THROUGH THE FORM 5500 FILING WITH THE DEPARTMENT OF LABOR. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC BRIAN DUNN - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. FRED BARALL - 514 PROGRESS DRIVE SUITE A, LINTHICUM HEIGHTS, MD 21090. ROBERT J. COOPER - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. SHANE RAY - 514 PROGRESS DRIVE SUITE A, LINTHICUM HEIGHTS, MD 21090. THOMAS LYDON - 514 PROGRESS DRIVE SUITE A, LINTHICUM HEIGHTS, MD 21090. BRIAN E. FISHER - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. 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