2016-10-13T15:48:54-05:00 2015-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2015-01-01 232627429 District 1199C Benefit Fund DIST 2157355720 1319 Locust Street Philadelphia PA 19107 HENRY NICHOLAS TRUSTEE 2157355720 2016-10-13 1 Louis Verzella CPA P00360279 6106689400 2016-10-11 2015 2017-02-10 21:41:12Z HENRY NICHOLAS 1319 Locust Street Philadelphia PA 19107 85467152 0 X N/A X 1991 PA TO PROVIDE HEALTH AND WELFARE BENEFITS TO DISTRICT 1199C MEMBERS AND THEIR DEPENDENTS. 10 6 0 0 0 0 0 0 44575447 47210402 591337 436489 124701 99774 45291485 47746665 0 0 42904030 46043394 715319 680485 0 0 0 800891 948266 44420240 47672145 871245 74520 23450973 22664056 1391823 910489 22059150 21753567 TO PROVIDE HEALTH AND WELFARE BENEFITS TO DISTRICT 1199C MEMBERS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO DISTRICT 1199C MEMBERS AND THEIR DEPENDENTS. BENEFITS PAID INCLUDE CLAIMS FOR HEALTH, DISABILITY, PRESCRIPTIONS, VISION CARE AND DENTAL. 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 0 0 0 0 0 0 0 X 10 6 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 X LAVERNE DEVALIA 2157355720 1319 LOCUST STREET PHILADELPHIA PA 19107 HENRY NICHOLAS UNION TRUSTEE 2.00 40.00 X 0 142094 0 PETER GOULD UNION TRUSTEE 2.00 40.00 X 0 0 0 MARGUERITE STANFORD UNION TRUSTEE 2.00 40.00 X 0 106990 0 John Hundzynski UNION TRUSTEE 2.00 40.00 X 0 108784 0 Chris Woods UNION TRUSTEE 2.00 40.00 X 0 114513 0 Paul A Csigi EMPLOYER TRUSTEE 2.00 X 0 0 0 Kevin S Kelly EMPLOYER TRUSTEE 2.00 X 0 0 0 Steven S Simmons EMPLOYER TRUSTEE (P) 2.00 X 0 0 0 ELIZABETH BILOTTA EMPLOYER TRUSTEE 2.00 X 0 0 0 DEBRA PACKEL EMPLOYER TRUSTEE (P) 2.00 X 0 0 0 HAKIM BERRY EMPLOYER TRUSTEE 2.00 X 0 0 0 ALFRED J D'ANGELO EMPLOYER TRUSTEE 2.00 X 0 0 0 LAVERNE DEVALIA EXECUTIVE DIRECTOR 20.00 20.00 X 49387 49386 51264 49387 521767 51264 0 0 1 0 AETNA LIFE INSURANCE COMPANY 151 FARMINGTON AVENUE HARTFORD CT 06156 CONTRACT ADMINISTRATOR/CLAIMS PROCESSING 2219693 EXPRESS SCRIPTS ONE EXPRESS WAY ST LOUIS MO 63121 CLAIMS PROCESSING 108827 2 Employer contributions 525100 46501540 46501540 Participants co-pay 525100 681170 681170 COBRA and self-pay 525100 27692 27692 47210402 235383 235383 37921593 37720487 201106 201106 201106 Other income 900099 66579 66579 Interest/liquidation payments 900099 33195 33195 99774 47746665 47210402 0 536263 46043394 75018 384184 59548 123359 38376 88844 41000 20367 223897 135417 51586 40680 384 48273 10808 35780 AFFORDABLE CARE ACT ASS 239515 LEASHOLD IMPROVEMENTS 8159 BIOMETRIC SCREENING EXP 3556 47672145 2869686 1980199 3341087 4043195 5066554 5375947 67233 73752 428940 374293 68442 54647 10756791 9449537 1106079 1511601 175101 175178 23450973 22664056 50484 35588 521095 832274 820244 42627 1391823 910489 X 22059150 21753567 22059150 21753567 23450973 22664056 74520 -380103 0 X X 0 1 X 1 0 67655 43511 24144 361285 330782 30503 54647 COMMON TRUST 1511601 C 1511601 DUE TO RELATED TRAINING FUND 42627 42627 X 47346195 -380103 -380103 47726298 20367 20367 47746665 47651778 0 47651778 20367 20367 47672145 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 years will remain open for three years; however, this may differ depending upon the circumstances of the Plan. X 0 0 0 LAVERNE DEVALIA EXECUTIVE DIRECTOR 49387 49386 0 0 0 0 7655 7655 17977 17977 75019 75018 0 0 Form 990, Part VI, Section B, line 11 DISTRICT 1199C BENEFIT FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT WHO THEN FORWARDS THE COMPLETED RETURN TO THE PLAN ADMINISTRATOR. THE PLAN ADMINISTRATOR PRESENTS THE 990 TO THE FUND'S GOVERNING BODY FOR REVIEW AND SIGNATURE. Form 990, Part VI, Section C, line 19 DISTRICT 1199C BENEFIT FUND MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: DISTRICT 1199C BENEFIT FUND'S GOVERNING BODY IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT. PENSION PLAN FOR HOSPITAL & HEALTH CARE EMPLOYEES PHILADELPHA & VICINITY 1319 LOCUST STREET PHILADELPHIA PA 19107 262627428 PENSION FUND PA 401(A)/501(A) 0 DISTRICT 1199C JOB SECURITY FUND 100 SOUTH BROAD STREET PHILADELPHIA PA 19110 232841131 TRAINING AND EDUCATION PA 501(C)(3) 0 PENSION FUND FOR NURSING HOME AND HEALTH CARE EMPLOYEES C/O ONEILL CONSULTING 1560 OLD YORK ABINGTON PA 19001 232774706 PENSION FUND PA 401(A)/501(A) 0 HEALTH AND TECHNOLOGY TRAINING INSTITUTE 1319 LOCUST STREET PHILADELPHIA PA 19107 232854079 TRAINING AND EDUCATION PA 501(C)(3) 0 DISTRICT 1199C LEGAL SERVICES PLAN 1319 LOCUST STREET PHILADELPHIA PA 19107 232188968 LEGAL BENEFIT FUND PA 501(C)(9) 0 DISTRICT 1199C TRAINING AND UPGRADING FUND LAND TITLE BUILDING 10TH FLR PHILADELPHIA PA 19110 237418594 TRAINING AND EDUCATION PA 501(C)(3) 0 1199C NATIONAL UNION OF HOSPITAL AND HEALTH CARE EMPLOYEES AFSCME 1319 LOCUST STREET PHILADELPHIA PA 19107 231922766 LABOR UNION PA 501(C)(5) 0 National Union of Hospital and Health Care Employees 9-25 alling street FLOOR 4 NEWARK NJ 07102 133521368 LABOR UNION NJ 501(C)(5) 0 Temple University 2450 West Hunting Park Avenue Philadelphia PA 191291302 231365971 UNIVERSITY PA 501(C)(3) 0 Temple University Hospital Inc 2450 West Hunting Park Avenue Philadelphia PA 191291302 232825878 HOSPITAL PA 501(C)(3) 0 Temple University Health System Inc 2450 West Hunting Park Avenue Philadelphia PA 191291302 232825881 HOSPITAL PA 501(C)(3) 0 Thomas Jefferson University 833 Chestnut Street Philadelphia PA 191074418 232829095 HOSPITAL PA 501(C)(3) 0 JFK Community MHMR Center 112 North Broad Street Philadelphia PA 191021577 232095511 HOSPITAL PA 501(C)(3) 0 Inglis House 2600 Belmont Avenue Philadelphia PA 191312713 231352284 CHARITY PA 501(C)(3) 0 Crozer Chester Medical Center One Medical Center Blvd Upland PA 190133902 231637191 MEDICAL CENTER PA 501(C)(3) 0 Aramark Corporation 3340 North Broad Street Philadelphia PA 191405102 208482211 FOOD SERVICES PA C 0 Burlington Woods Convalescent Center 115 Sunset Road Burlington NJ 080164153 221948394 CONVALESCENT CENTER NJ C 0 Cooper River West Convalescent Center 5101 North Park Drive Pennsauken NJ 081094643 221948394 COLLEGE BOOK STORE NJ C 0 Crothall Services Group 230 North Broad Street Philadelphia PA 191021121 631053451 HOUSEKEEPING SERVICES PA C 0 Kresson View Center 2601 Evesham Road Voorhees NJ 080439509 042861357 HEALTHCARE SERVICES NJ C 0 Sodexho Inc PO Box 352 Buffalo NY 142400352 520936594 FOOD SERVICES NY C 0 TenetHahnemann University Hospital 230 North Broad Street Philadelphia PA 191021121 752784869 HOSPITAL PA C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 PENSION FUND FOR HOSPITAL AND HEALTHCARE WORKERS P 1804924 FMV