2018-11-15T09:14:39-06:00 2017-12-31 131578842 BUCHBINDER TUNICK & CO LLP ONE PENN PLAZA NEW YORK NY 101190219 990 2017-01-01 135598021 INTERNATIONAL ASSOCIATION OF MACHINISTS DISTRICT 15 HEALTH FUND INTE 2019478000 140 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 07632 DOMINIC TAIBBI TRUSTEE 2019478000 2018-11-13 1 P01366109 2126955003 38.142.119.26 2018-11-13 16:23:50 ES P 803B78696D3F74D3C5A1CDD03CFE1365F176BEFA 803B78696D3F74D3C5A1CDD03CFE1365F176BEFA 2017 2019-02-21 02:37:17Z DOMINIC TAIBBI 140 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 07632 41764361 0 X N/A X EMPLOYEE BENEFIT PLAN 1950 NY THE PLAN PROVIDES HOSPITAL, SURGICAL, MEDICAL, DENTAL, OPTICAL AND PRESCRIPTION DRUG BENEFITS FOR APPROXIMATELY 1,330 ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES. 6 6 0 0 0 0 0 0 23626332 23388775 1085288 712451 988796 2033620 25700416 26134846 0 0 18132159 19317608 0 0 0 0 0 1856031 1748848 19988190 21066456 5712226 5068390 47205977 52302175 394033 91611 46811944 52210564 THE ORGANIZATION SHALL PROVIDE HEALTH BENEFITS FOR ITS ELIGIBLE PARTICIPANTS AND THEIR FAMILIES AS DEFINED BY THE TRUSTEES. 0 0 TO PROVIDE HEALTH BENEFITS TO APPROXIMATELY 1,330 ACTIVE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 77 0 1 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 0 0 0 0 X ZENITH AMERICAN SOLUTIONS 2019478000 140 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 07632 X JEFFREY ISAACS EMPLOYER TRUSTEE 2.00 X 0 0 0 JANE GOODMAN EMPLOYER TRUSTEE 2.00 X 0 0 0 DENNIS SCHNEIDER EMPLOYER TRUSTEE 2.00 X 0 0 0 DOMINIC TAIBBI CHAIRMAN/UNION TRUSTEE 2.00 X 0 0 0 ROBERT MOTISI UNION TRUSTEE 2.00 X 0 0 0 ROBERT PAESE UNION TRUSTEE 2.00 X 0 0 0 JUAN NEGRAON FORMER UNION TRUSTEE 2.00 X 0 0 0 JAMES CONIGLIARO JR FORMER UNION TRUSTEE 2.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 140 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 07632 CLAIMS ADMINISTRATION 955978 ZENITH AMERICAN SOLUTIONS 2 PENN CENTER PHILADELPHIA PA 19102 CLAIMS PROCESSING 418547 2 EMPLOYER CONTRIBUTIONS 900099 23284277 23284277 COBRA CONTRIBUTIONS 900099 104498 104498 23388775 737824 737824 15604142 15629515 -25373 -25373 -25373 STOP LOSS REIMBURSEMENTS 900099 1435455 1435455 PRESCRIPTION DRUG REBATES 900099 583767 583767 OTHER INCOME 900099 14398 14398 2033620 26134846 26160219 0 -25373 19317608 81629 47968 127763 52425 16580 795 42268 CONTRACT ADMINISTRATOR' 955978 BENEFIT ADMINISTRATION 418547 COMMUNICATIONS TO PARTI 4895 21066456 -372597 -298071 17025581 19481751 2173404 2641949 11612 9986 28367977 18793071 11673489 47205977 52302175 170995 81989 223038 9622 394033 91611 X 0 0 0 0 46811944 52210564 46811944 52210564 47205977 52302175 5068390 330230 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIP 11673489 F 11673489 CONTRIBUTIONS RECEIVED IN ADVANCE 9622 9622 X 26337313 330230 330230 26007083 127763 127763 26134846 20938693 0 20938693 127763 127763 21066456 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 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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 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. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS FOR THE PLAN. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2014. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES WERE MAILED A COPY OF THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES WILL ANNUALLY DISCLOSE TO THE FUND INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST. EACH TRUSTEE SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; B. HAS READ AND UNDERSTANDS THE POLICY; C. HAS AGREED TO COMPLY WITH THE POLICY; D. UNDERSTANDS THAT THE FUND IS A TAX-EXEMPT ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S PROCESS FOR OVERSEEING THE AUDIT OF ITS FINANCIAL STATEMENTS AND FOR ITS SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. 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