2018-08-20T14:52:18-05:00 2017-12-31 208078757 SALTER & COMPANY LLC 4600 EAST WEST HIGHWAY SUITE 300 BETHESDA MD 20814 990 2017-01-01 237351551 NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND NATI 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 MICHAEL W JACOBSON ADMINISTRATOR 3015771700 2018-08-20 1 CHARLES L UNDERWOOD JR P01259271 3018307400 X 2017 2022-09-23 18:48:47Z MICHAEL W JACOBSON 8000 CORPORATE DRIVE LANDOVER MD 20785 9359249 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 23 0 0 0 0 0 5594767 5440761 287964 245727 0 0 5882731 5686488 0 0 3970484 3632604 140599 135673 0 0 0 257862 235452 4368945 4003729 1513786 1682759 9997451 12252946 271168 308055 9726283 11944891 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES UNDER COLLECTIVE BARGAINED AGREEMENTS AND PARTICIPATION AGREEMENT. 0 0 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 343 0 1 23 1 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 MICHAEL W JACOBSON ADMINISTRATOR 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 BRIAN DUNN TRUSTEE, CHAIRMAN 1.00 39.00 X 0 168105 98251 FRED BARALL TRUSTEE, SECRETARY 1.00 39.00 X 0 0 0 ROBERT J COOPER TRUSTEE 1.00 39.00 X 0 165115 97978 TOR CHRISTENSEN TRUSTEE 1.00 39.00 X 0 0 0 RORY SCHNURR TRUSTEE 1.00 39.00 X 0 0 0 BRIAN E FISHER TRUSTEE 1.00 39.00 X 0 164117 97600 MICHAEL W JACOBSON ADMINISTRATOR 1.00 39.00 X 6319 223469 181724 JOHN EGER ASSISTANT ADMINISTRATOR 1.00 39.00 X 2891 206581 123052 DAN CURRY IT MANAGER 1.00 34.00 X 3475 122903 41562 WILLIAM SAPP COMPUTER PROGRAMMER 6.00 29.00 X 20700 93664 39552 NIA PADMORE CLAIMS MANAGER 2.00 33.00 X 3139 108961 39172 MARY SHAW ACCOUNTANT 1.00 34.00 X 2141 115477 40095 IGOR EPSHTEYN COMPUTER PROGRAMMER 5.00 30.00 X 14779 87570 37541 53444 1455962 796527 0 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 60601 CLAIMS PROCESSING 158120 1 UNDER UNION AGMNT 525100 5219476 5219476 STOP LOSS INCOME 525100 174884 174884 PARTICIPANT CONTR. 525100 43980 43980 LIQUIDATED DAMAGES 525100 2421 2421 5440761 245412 245412 3673076 3672761 315 315 315 5686488 5441076 0 245412 3632604 53444 36234 20500 18927 6568 7003 33956 19448 8552 3233 INSURANCE CONSULT. 96900 CLAIMS COST MANAGEMENT 20036 DATA PROCESSING EXPENSE 19006 PRINTING,STATIONARY & O 5472 21846 4003729 437368 558914 1440639 721992 1198 1262 8118246 10970778 9997451 12252946 271168 308055 271168 308055 X 9726283 11944891 0 0 0 0 9726283 11944891 9997451 12252946 1682759 535849 0 X X 0 1 X 1 0 0 6028005 535849 535849 5492156 19448 174884 194332 5686488 3809397 0 3809397 19448 174884 194332 4003729 PART XI, LINE 4B - OTHER ADJUSTMENTS: STOP LOSS REIMBURSEMENT PART XII, LINE 4B - OTHER ADJUSTMENTS: STOP LOSS REIMBURSEMENT X 1 1 X 0 1 0 BRIAN DUNN TRUSTEE, CHAIRMAN 0 168105 0 0 0 0 0 78200 0 20051 0 266356 0 0 ROBERT J COOPER TRUSTEE 0 165115 0 0 0 0 0 77927 0 20051 0 263093 0 0 BRIAN E FISHER TRUSTEE 0 164117 0 0 0 0 0 77549 0 20051 0 261717 0 0 MICHAEL W JACOBSON ADMINISTRATOR 5749 203320 0 0 570 20149 4679 160272 461 16312 11459 400053 0 0 JOHN EGER ASSISTANT ADMINISTRATOR 2637 188432 0 0 254 18149 1504 104775 231 16542 4626 327898 0 0 DAN CURRY IT MANAGER 3475 122903 0 0 0 0 682 16312 461 24107 4618 163322 0 0 WILLIAM SAPP COMPUTER PROGRAMMER 20700 93664 0 0 0 0 4123 18656 3036 13737 27859 126057 0 0 NIA PADMORE CLAIMS MANAGER 3139 108961 0 0 0 0 627 21772 470 16303 4236 147036 0 0 MARY SHAW ACCOUNTANT 2141 115477 0 0 0 0 424 16468 305 22898 2870 154843 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 - $516,158. JOHN EGER PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $298,828. 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 AT TRUSTEES MEETING. 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. TOR CHRISTENSEN - 514 PROGRESS DRIVE SUITE A, LINTHICUM HEIGHTS, MD 21090. RORY SCHNURR - 514 PROGRESS DRIVE SUITE A, LINTHICUM HEIGHTS, MD 21090. BRIAN E. FISHER - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. FORM 990, PART XII, LINE 2C: NO CHANGES NATIONAL AUTOMATIC SPRINKLER INDUSTRY WELFARE FUND 8000 CORPORATE DRIVE LANDOVER MD 20785 530215881 HEALTH AND WELFARE FUND MD SECTION 501(C)(9) 0 NATIONAL AUTOMATIC SPRINKLER INDUSTRY PENSION FUND 8000 CORPORATE DRIVE LANDOVER MD 20785 526054620 DEFINED BENEFIT PENSION PLAN MD SECTION 401(A)(4) 0 NATIONAL AUTOMATIC SPRINKLER INDUSTRY METAL TRADE PENSION FUND 8000 CORPORATE DRIVE LANDOVER MD 20785 526133856 DEFINED BENEFIT PENSION PLAN MD SECTION 401(A)(4) 0 NATIONAL AUTOMATIC SPRINKLER LOCAL 669 UA EDUCATION FUND 8000 CORPORATE DRIVE LANDOVER MD 20785 526035213 EDUCATION FUND MD SECTION 501(C)(5) 0 SPRINKLER FITTER LOCAL 696 UNEMPLOYMENT COBRA ASSISTANCE PLAN 41-43 E WILLOW ST MILLBURN NJ 07041 223201568 HEALTH AND WELFARE FUND NJ SECTION 501(C)(9) 0 SPRINKLER INDUSTRY SUPPLEMENTAL PENSION FUND 8000 CORPORATE DRIVE LANDOVER MD 20785 141595069 DEFINED CONTRIBUTION PENSION PLAN MD SECTION 401(A)(4) 0 UA INTERNATIONAL TRAINING FUND THREE PARK PLACE 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