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LOCAL 475 HEALTH PLAN: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
LOCAL 475 HEALTH PLAN (EIN 13-6179467)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-08
IRS object ID
201933129349302653
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-08T11:33:00-08:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN112836481PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Wagner & Zwerman LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 Old Country Road Ste 202AddressLine1Txt
CityMelvilleCityNm
State AbbreviationNYStateAbbreviationCd
ZIP117472731ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN136179467EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LOCAL 475 HEALTH PLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLOCABusinessNameControlTxt
Phone9147386555PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1629 FIFTH AVENUEAddressLine1Txt
CityPELHAMCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10803ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPETER VAUPELPersonNm
Person TitleFUND ADMINISTRATORPersonTitleTxt
Signature2019-11-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANDREW M ZWERMAN CPAPreparerPersonNm
PTINP00641815PTIN
Phone6317771000PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

US Address USAddress

FieldValueIRS element (for citing)
Address Line1629 FIFTH AVENUEAddressLine1Txt
CityPELHAMCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10803ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,052,939GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1965FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionEMPLOYER CONTRIBUTIONS PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPANTS IN THE PLAN.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$5,537,653PYProgramServiceRevenueAmt
CY Program Service Revenue$5,779,111CYProgramServiceRevenueAmt
PY Investment Income$49,325PYInvestmentIncomeAmt
CY Investment Income$71,779CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$5,586,978PYTotalRevenueAmt
CY Total Revenue$5,850,890CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$3,528,653PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$3,860,088CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$155,333PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$161,400CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$778,995PYOtherExpensesAmt
CY Other Expenses$769,290CYOtherExpensesAmt
PY Total Expenses$4,462,981PYTotalExpensesAmt
CY Total Expenses$4,790,778CYTotalExpensesAmt
PY Revenues Less Expenses$1,123,997PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,060,112CYRevenuesLessExpensesAmt
Total Assets BOY$6,356,195TotalAssetsBOYAmt
Total Assets EOY$7,257,900TotalAssetsEOYAmt
Total Liabilities BOY$625,267TotalLiabilitiesBOYAmt
Total Liabilities EOY$676,506TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,730,928NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,581,394NetAssetsOrFundBalancesEOYAmt
MissionEMPLOYER CONTRIBUTIONS PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPANTS IN THE PLAN.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
DescEMPLOYER CONTRIBUTIONS PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPANTS IN THE PLAN.Desc
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSILVIA PEREZPersonNm
Phone9147386555PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1629 FIFTH AVEAddressLine1Txt
CityPELHAMCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10803ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
PETER VAUPEL
FUND ADMIN17.0023.00Yes (X)$61,786$83,695$12,333
RICHARD THOMA
TRUSTEE0.000.00Yes (X)$0$0$0
EDUARDO MELENDEZ
Trustee15.0025.00Yes (X)$32,474$52,403$12,640
FieldValueIRS element (for citing)
Total Reportable Comp From Org$94,260TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$136,098TotReportableCompRltdOrgAmt
Total Other Compensation$24,973TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANTHEM INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 951254AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44193ZIPCd
FieldValueIRS element (for citing)
ServicesADMINISTRATIVE FEESServicesDesc
Compensation$107,804CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
COBRA CONTRIBUTIONS900099$27,101$27,101
EMPLOYER CONTRIBUTIONS900099$5,752,010$5,752,010
FieldValueIRS element (for citing)
Total Program Service Revenue$5,779,111TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$71,260TotalRevenueColumnAmt
Related Or Exempt Func Income$71,260RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,202,568SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,202,049SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$519SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$519TotalRevenueColumnAmt
Related Or Exempt Func Income$519RelatedOrExemptFuncIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,850,890TotalRevenueColumnAmt
Related Or Exempt Func Income$5,850,890RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$3,860,088TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$94,260TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$25,949TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$14,789TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,498TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$9,904TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21,600TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$30,363TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$6,200TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$19,000TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,723TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$28,713TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,532TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$351,269TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescCLAIMS PROCESSING FEESDesc
Total$292,890TotalAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,790,778TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,754,240BOYAmt
EOY$1,124,662EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,924BOYAmt
EOY$10,271EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$439,662EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$2,298EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,427,932BOYAmt
EOY$3,051,393EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,168,859BOYAmt
EOY$2,606,530EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,240BOYAmt
EOY$23,084EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,356,195BOYAmt
EOY$7,257,900EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$625,267BOYAmt
EOY$676,506EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$625,267BOYAmt
EOY$676,506EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$5,730,928BOYAmt
EOY$6,581,394EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,730,928BOYAmt
EOY$6,581,394EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,356,195BOYAmt
EOY$7,257,900EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,060,112ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$209,646NetUnrlzdGainsLossesInvstAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting OtherYes (X)MethodOfAccountingOtherInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Securities$2,606,530TotalBookValueSecuritiesAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$5,635,044TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$209,646NetUnrealizedGainsInvstAmt
Revenue Not Reported-$209,646RevenueNotReportedAmt
Revenue Subtotal$5,844,690RevenueSubtotalAmt
Investment Expenses Not Incld$6,200InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$6,200RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$5,850,890TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,912,578TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$4,912,578ExpensesSubtotalAmt
Investment Expenses Not Incld2$6,200InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$128,000OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$121,800ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$4,790,778TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X : FIN48 FootnoteFormAndLineReferenceDesc
ExplanationThe Plan administrator has analyzed the tax positions taken by the Plan, and has concluded that as of December 31, 2018 and 2017, 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, 2015 are no longer open to examination, notwithstanding any information not yet known which could expand the open period.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonPETER VAUPELPersonNm
TitleFUND ADMINTitleTxt
Base Compensation Filing Org$61,786BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$83,695CompensationBasedOnRltdOrgsAmt
Nontaxable Benefits Filing Org$5,061NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$7,272NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$66,847TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$90,967TotalCompensationRltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessFORM 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 ConflictsANNUALLY AT THE BOARD OF TRUSTEE MEETINGS.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesINCREASES IN COMPENSATION ARE APPROVED BY THE BOARD AND ARE COMPARED TO INDUSTRY STANDARDS.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableUPON REQUEST, GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
LOCAL 475 PENSION PLAN
629 FIFTH AVENUEPELHAMNY10803132571151TO PROVIDE PENSION BENEFITS TO MEMBERSNY401- (a)N/Afalse
STAFF RETIREMENT PLAN OF LOCAL 475
629 FIFTH AVENUEPELHAMNY10803132996854TO PROVIDE SUPPLEMENTAL RETIREMENT BENEFITSNY401- (a)N/Afalse
IUEW LOCAL 475
629 FIFTH AVENUEPELHAMNY10803131654293BETTERMENT OF WAGES AND WORKING CONDITIONSNY501 (c) 5N/Afalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
DELTA DENTAL OF NEW JERSEY
1639 ROUTE 10PARSIPPANYNJ07054CONTRIBUTING EMPLOYERNJN/Afalse
CHROMALLOY NEW YORK
330 BLAISDELL ROADORANGEBURGNY10962CONTRIBUTING EMPLOYERNYN/Afalse
C W BRABENDER INSTRUMENTS INC
50 E WESLEY STREETS HACKENSACKNJ07604CONTRIBUTING EMPLOYERNJN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd