2020-11-05T05:25:33-08:00 2019-12-31 112836481 Wagner & Zwerman LLP 201 Old Country Road Ste 202 Melville NY 117472731 990 2019-01-01 136179467 Local 475 Health Plan LOCA 9147386555 629 FIFTH AVENUE PELHAM NY 10803 PETER VAUPEL FUND ADMINISTRATOR 2020-11-05 true ANDREW M ZWERMAN CPA P00641815 6317771000 2019 2021-04-22 16:20:28Z 629 FIFTH AVENUE PELHAM NY 10803 10249039 false X N/A X 1965 NY EMPLOYER CONTRIBUTIONS PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPANTS IN THE PLAN. 3 1 5 0 0 5779111 6288266 71779 1149529 0 5850890 7437795 0 3860088 4327526 161400 188113 0 0 769290 807426 4790778 5323065 1060112 2114730 7257900 9276731 676506 667834 6581394 8608897 EMPLOYER CONTRIBUTIONS PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPANTS IN THE PLAN. false false EMPLOYER CONTRIBUTIONS PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPANTS IN THE PLAN. false false false false false false false false false false false false false false true true false false false false false false false false false false false false true false false false false false false false false false false false true false false true 4 0 true 5 true false false false false false false false false X 3 1 false false false false false false false true true false false true true true true true true true true false X SILVIA PEREZ 9147386555 629 FIFTH AVE PELHAM NY 10803 X PETER VAUPEL FUND ADMIN 19.00 21.00 X 76750 83413 12392 EDUARDO MELENDEZ Trustee 17.00 23.00 X 36141 48736 12723 Ronald Kowalski Jr TRUSTEE 0.00 0.00 X 0 0 0 112891 132149 25115 0 false true false ANTHEM INC PO BOX 951254 CLEVELAND OH 44193 ADMINISTRATIVE FEES 122457 1 0 COBRA CONTRIBUTIONS 900099 34771 34771 EMPLOYER CONTRIBUTIONS 900099 6253495 6253495 6288266 111813 111813 0 0 0 3848960 2811244 1037716 1037716 1037716 0 0 0 0 7437795 7437795 0 0 0 4327526 112891 0 26360 7007 31357 10498 0 21600 24600 0 0 5615 20000 0 11573 0 0 29574 4298 0 0 0 0 0 374688 CLAIMS PROCESSING FEES 315478 0 5323065 0 0 0 1124662 972428 10271 9788 0 439662 457276 0 0 0 0 2298 0 0 3051393 7722000 2606530 0 0 0 23084 115239 7257900 9276731 676506 667834 676506 667834 X 6581394 8608897 6581394 8608897 7257900 9276731 2114730 -87227 X X false true X true false X 7344953 -87227 -87227 7432180 5615 5615 7437795 5300450 5300450 5615 17000 22615 5323065 Part X : FIN48 Footnote The Plan administrator has analyzed the tax positions taken by the Plan, and has concluded that as of December 31, 2019 and 2018, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in process. Based on the normal statutory period for audits, the Plan administrator believes that the tax returns of the Plan for the years prior to the year ended December 31, 2016 are no longer open to examination, notwithstanding any information not yet known which could expand the open period. Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S change in future benefit obligation $17000 false false false PETER VAUPEL FUND ADMIN 76750 83413 5500 6892 82250 90305 Form 990, Part VI, Line 11b: Form 990 Review Process FORM 990 WAS SENT TO THE TRUSTEES FOR REVIEW. UPON APPROVAL, A WAIVER IS SIGNED AUTHORIZING THE ELECTRONIC SUBMISSION OF THE FORM. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts ANNUALLY AT THE BOARD OF TRUSTEE MEETINGS. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees INCREASES IN COMPENSATION ARE APPROVED BY THE BOARD AND ARE COMPARED TO INDUSTRY STANDARDS. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available UPON REQUEST, GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC. LOCAL 475 PENSION PLAN 629 FIFTH AVENUE PELHAM NY 10803 132571151 TO PROVIDE PENSION BENEFITS TO MEMBERS NY 401- (a) N/A false STAFF RETIREMENT PLAN OF LOCAL 475 629 FIFTH AVENUE PELHAM NY 10803 132996854 TO PROVIDE SUPPLEMENTAL RETIREMENT BENEFITS NY 401- (a) N/A false IUEW LOCAL 475 629 FIFTH AVENUE PELHAM NY 10803 131654293 BETTERMENT OF WAGES AND WORKING CONDITIONS NY 501 (c) 5 N/A false DELTA DENTAL OF NEW JERSEY 1639 Route 10 PARSIPPANY NJ 07054 CONTRIBUTING EMPLOYER NJ N/A false CHROMALLOY NEW YORK 330 Blaisdell Road ORANGEBURG NY 10962 CONTRIBUTING EMPLOYER NY N/A false C W BRABENDER INSTRUMENTS INC 50 E Wesley Street S HACKENSACK NJ 07604 CONTRIBUTING EMPLOYER NJ N/A false false false false false false false false false false false false false false true true true true false false