2018-02-12T11:21:11-06:00 2017-04-30 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2016-05-01 231578380 Cement Masons Union Local No 592 Health and Welfare Fund CEME 2154680237 7821 BARTRAM AVENUE Philadelphia PA 19153 William Ousey Trustee 2154680237 2018-02-12 1 Louis Verzella CPA P00360279 6106689400 2018-02-10 162.211.205.39 2018-02-12 11:19:26 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 19998950A844A1ED5F18EB360E4E9E4F9906FFA9 2016 2021-01-29 14:40:06Z X William Ousey 7821 BARTRAM AVENUE Philadelphia PA 19153 32275838 0 X N/A X 1960 PA The purpose of Cement Masons Union Local 592 Health and Welfare Fund is to provide for the payment of life, sick, accident, or other benefits to its members or their dependents or designated beneficiaries. 6 3 0 0 0 0 0 0 9605520 10248553 65573 133368 0 0 9671093 10381921 0 0 5539761 5811118 269867 238088 0 0 0 495715 730188 6305343 6779394 3365750 3602527 7588124 14957274 57492 183861 7530632 14773413 The purpose of Cement Masons Union Local 592 Health and Welfare Fund is to provide for the payment of life, sick, accident, or other benefits to its members or their dependents or designated beneficiaries. 0 0 Plan provides medical, hospital, surgical, death, weekly disability income, and medicine reimbursements. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 18 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Joseph Diehl 2154680237 7821 BARTRAM AVENUE Philadelphia PA 19153 Bill Ousey Union co-chairman 2.00 38.00 X 0 140227 87928 Jim Dolente Employer Trustee 2.00 X 0 0 0 Francis A Pietrini Employer co-chairman 2.00 X 0 0 0 Mark Wildsmith Union Trustee 2.00 38.00 X 0 136511 87458 Mike Sabatini Union Trustee 2.00 38.00 X 0 137593 87673 BEN CONNORS EMPLOYER TRUSTEE 2.00 X 0 0 0 joe diehl Administrator 20.00 20.00 X 34802 93951 89113 34802 508282 352172 0 0 1 0 AETNA 920 HARVEST DRIVE PO BOX 50092 BLUE BELL PA 19422 CLAIMS PROCESSING 255086 jennings sigmond 1835 market street philadelphia PA 19103 legal services 107839 2 Employer Contributions 525100 9919287 9919287 Retiree Contributions 525100 205295 205295 Medicare Contributions 525100 91550 91550 COBRA Contributions 525100 29353 29353 Self pay contributions 525100 3068 3068 10248553 143139 143139 21884146 21893917 -9771 -9771 -9771 10381921 10238782 0 143139 5811118 133749 47908 39984 16447 147677 64607 34758 344049 23551 21328 6876 6514 6169 1671 889 45747 FEES MANDATED BY THE AC 26352 6779394 319326 687487 1537575 1949987 1625271 1702181 54342 72024 42911 42430 3470 481 4048140 10545114 7588124 14957274 57492 117621 6597 0 59643 57492 183861 X 7530632 14773413 7530632 14773413 7588124 14957274 X 3602527 -51757 3692011 X X 0 1 X 1 0 6000 5519 481 33842 33771 71 3069 3140 -71 481 DUE TO CUSTODIAN 59643 59643 X 10295406 -51757 -51757 10347163 34758 34758 10381921 6744636 0 6744636 34758 34758 6779394 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 U.S. Federal, state, or local taxing authorities. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Typically, plan tax years will remain open for three years, however this may differ depending upon the circumstances of the Plan. 0 0 0 Bill Ousey Union co-chairman 0 140227 0 0 0 0 0 60159 0 27769 0 228155 0 0 Mark Wildsmith Union Trustee 0 136511 0 0 0 0 0 59689 0 27769 0 223969 0 0 Mike Sabatini Union Trustee 0 137593 0 0 0 0 0 59904 0 27769 0 225266 0 0 joe diehl Administrator 34802 93951 0 0 0 0 0 59702 0 29411 34802 183064 0 0 Form 990, Part VI, Section B, line 11b Cement Masons Union Local No. 592 Health and Welfare Fund's Form 990 is prepared by its independent public accountant. The return is forwarded to the fund administrator for initial review. The fund administrator then presents the return to the trustees for signature. Form 990, Part VI, Section B, line 12c The organization's conflict of interest policyis reviewed annually. Form 990, Part VI, Section B, line 15 The fund administrator's salary is approved annually by the board of trustees. Form 990, Part VI, Section C, line 19 Cement Masons Union Local No. 592 Health and Welfare Fund's governing documents and financial statements are made available to the public upon request. Form 990, Part VII Contact Addresses for Officers, Directors, Etc Bill Ousey - 2843 SNYDER AVENUE, PHILADELPHIA, PA 19145. Jim Dolente - 130 Quaker Lane, MALVERN, PA 19355. Francis A. Pietrini - 111 E. CHURCH ROAD, KING OF PRUSSIA, PA 19046. joe diehl - 2315 S. 22nd Street, pHILADELPHIA, PA 19145. Form 990, Part XI, line 9: TRANSFER OF ASSETS PLASTERERS' LOCAL 8 HEALTH & WELFARE FUND DUE TO MERGER 3,692,011. Form 990, Part XII, line 2c: Cement Masons Union Local No. 592 Health and Welfare Fund's board of trustees is responsible for overseeing the financial statement audit and selection of the independent public accountant who performs the audit. 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