2017-08-30T15:11:15-05:00 2016-11-30 043508036 MANZI & ASSOCIATES LLC 855 TURNPIKE STREET NORTH ANDOVER MA 01845 990 2015-12-01 042088633 SHEET METAL WORKERS LOCAL UNION NO 17 INSURANCE FUND SHEE 6174265646 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 ROBERT KEOGH FUND ADMINISTRATOR 6174265646 2017-08-30 1 JEANNIE MICKEL P01058630 9789751099 2015 2021-01-29 14:40:06Z ROBERT KEOGH 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 48008027 0 X X 1950 MA TO PROVIDE HEALTH BENEFITS FOR ELIGIBLE PARTICIPANTS 6 6 33 0 0 0 0 0 27170183 27829106 4640365 1442604 480827 517425 32291375 29789135 0 0 27729626 31422360 662231 700032 0 0 0 654430 576579 29046287 32698971 3245088 -2909836 53774041 51501653 4632829 5170780 49141212 46330873 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 0 0 TO PROVIDE HEALTH AND OTHER SPECIFIED BENEFITS TO ELIGIBLE MEMBERS/DEPENDENTS THROUGH A COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN. 0 0 0 0 0 0 0 0 0 1 1 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 2 0 1 33 1 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 1 0 X ROBERT KEOGH 6174265646 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 X JAMES WOOL TRUSTEE 10.00 X X 0 0 0 FRED CREAGER TRUSTEE 10.00 X X 0 0 0 KEVIN GILL TRUSTEE 10.00 X X 0 0 0 FESTUS JOYCE TRUSTEE 10.00 X X 0 0 0 JOSEPH CULLEN TRUSTEE 10.00 X X 0 0 0 JACK DESMOND TRUSTEE 10.00 X X 0 0 0 ROBERT KEOGH ADMINISTRATOR 40.00 X 214299 0 101207 214299 0 101207 1 0 1 0 BLUE CROSS BLUE SHIELD 401 PARK DRIVE BOSTON MA 02215 HEALTH CLAIMS ADMINISTRATION 1041560 1 EMPLOYER CONTRIBUTIONS 561000 26504971 26504971 MEMBER CONTRIBUTIONS 561000 984952 984952 SASMI CONTRIBUTIONS 561000 339183 339183 27829106 889921 889921 18771575 18218892 552683 552683 552683 ADMIN ASSESSMENTS 900099 517425 517425 517425 29789135 28346531 0 1442604 31422360 213408 194782 177439 89024 25379 22018 20955 125343 58090 6615 47286 37808 12901 31544 19751 TRANSITIONAL REINSURANC 171908 TELEPHONE 9360 ADMINISTRATIVE EXPENSE 6641 POSTAGE 3211 3148 32698971 547165 -114101 4728138 4985298 21711 21586 1191191 533362 651274 657829 21607616 20771424 24004862 22907929 2213275 2271688 53774041 51501653 308134 350263 4324695 4820517 4632829 5170780 X 0 0 0 0 49141212 46330873 49141212 46330873 53774041 51501653 -2909836 99497 0 X X 0 1 X 1 0 807660 189795 617865 383531 343567 39964 657829 AMALGAMATED LONGVIEW ULTRA 6663775 F INSTITUTIONAL SENIOR LOAN FUND 3514010 F MESIROW MULTISTRATEGY 3830812 F DPT CORE PLUS 8899332 F 22907929 INCURRED BUT NOT REPORTED CLAIMS 4383665 BENEFITS PAYABLE 436852 4820517 X 29763289 99497 99497 29663792 125343 125343 29789135 32077806 0 32077806 125343 495822 621165 32698971 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 DEPARTMENT OF LABOR AND INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF NOVEMBER 30, 2016, 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. PART XII, LINE 4B - OTHER ADJUSTMENTS: NET CHANGE IN BENEFIT OBLIGATIONS 495,822. X 0 0 0 ROBERT KEOGH ADMINISTRATOR 214299 0 0 0 0 0 78951 0 22256 0 315506 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN FOR MEMBERS AND RETIREES OF LOCAL 17 SMW FORM 990, PART VI, SECTION B, LINE 11 BOARD OF TRUSTEES HAS GIVEN AUTHORITY TO THE FUND ADMINISTRATOR TO REVIEW ALL TAX DOCUMENTATION BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12 AS AN EMPLOYEE BENEFIT PLAN WE ARE SUBJECT TO THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C: NO CHANGE IN OVERSIGHT PROCESS OR SELECTION OF INDEPENDENT ACCOUNTANT. 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