2016-11-11T16:26:54-06:00 2015-12-31 KPMG LLP 345 Park Avenue New York NY 101540102 990 2015-01-01 134129368 1199SEIU NBF FOR HOME CARE EMPLOYEES % MARIA ACOSTA CFO 1199 6464736365 PO BOX 842 NEW YORK NY 10108 MARIA ACOSTA CFO 6464736336 2016-11-11 true DAVID M HIGHFILL P01517891 2127589700 2016-11-11 2015 2017-02-10 21:41:12Z MITRA BEHROOZI 330 WEST 42ND STREET ST FLOOR NEW YORK NY 10036 294836030 false X HTTP://1199SEIUBENEFITS.ORG X 1949 NY TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS UNDER ELIGIBLE PARTICIPANTS UNDER THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT AND TRUST DOCUMENT. 13 13 0 13 0 0 0 198868260 294764644 13890 71386 0 0 198882150 294836030 0 0 160679182 183633256 5500842 6687509 0 0 0 4801721 6162447 170981745 196483212 27900405 98352818 134018220 220030407 37290931 24950300 96727289 195080107 X TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS UNDER THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT AND TRUST DOCUMENT. false false TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS UNDER THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENT AND TRUST DOCUMENT. IN 2015, 33,152 MEMBERS/PARTICIPANTS RECEIVED HEALTH AND WELFARE BENEFITS. false false false false false false false false true false false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 5400 0 true 0 false false false false false false X 13 13 true false false false false true false true true false false false true true true true true true true false X MARIA ACOSTA CFO 6464736336 PO BOX 842 NEW YORK NY 10108 X JAMES CAREY EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 KWAI DAVID HO UNION TRUSTEE 1.0 0.0 X 0 0 0 GLADYS CONFIDENT EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 BRUCE MCIVER EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 LING MA EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 RONA SHAPIRO UNION TRUSTEE 1.0 0.0 X 0 0 0 DORIS SPENCER EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 VLADIMIR FORTUNNY UNION TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL ELSAS EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 JUAN HERNANDEZ EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 ANDREA THOMAS-RANDALL EMPLOYER TRUSTEE 1.0 0.0 X 0 0 0 GUADALUPE ASTACIO UNION TRUSTEE 1.0 0.0 X 0 0 0 KEITH JOSEPH UNION TRUSTEE 1.0 0.0 X 0 0 0 MARIA ACOSTA CFO 1.74 0.0 X 15591 0 5872 MITRA BEHROOZI EXECUTIVE OFFICER 1.56 0.0 X 26936 0 10099 FREDERICK HAGEN CHIEF BENEFITS OFFICER 1.56 0.0 X 22060 0 8767 LORRAINE MONCHAK CHIEF INVESTMENTS OFFICER 1.56 0.0 X 35358 0 13493 DONNA REY CHIEF OPERATING OFFICER 1.74 0.0 X 21427 0 8209 KATHERINE M FALLON BENEFITS CHIEF OF STAFF 1.56 0.0 X 19857 0 7516 GLENN L DI BIASI CHIEF TECHNOLOGY OFFICER 1.74 0.0 X 15736 0 5974 BRANDY D SHILOH CHIEF OF STAFF-STRATEGIC OPS 1.74 0.0 X 18408 0 7198 BARBARA SOLDANO CHIEF INFORMATION SECURITY OFF 1.74 0.0 X 15801 0 5760 JOSHUA SORENSEN NBF-INVESTMENT ANALYST 0.0 0.0 X 29 0 11 JEFFREY STEIN FUND COUNSEL 1.56 0.0 X 25874 0 9709 217077 0 82608 0 false false false CARE ALLIES PRE-CERT 5144 COLLECTION CENTER DRIVE CHICAGO IL 60693 CONSULTING (GENERAL) 773220 STEP VISUAL COMMUNICATIONS 38 LAWRIDGE DRIVE RYE BROOK NY 10573 COPYING/DUPLICATING 733235 MEDCO HEALTH ADMIN FEE 100 PARSONS POND DRIVE FRANKLIN LAKES NJ 07417 CONSULTING (GENERAL) 471529 MILLIMAN INC 1 PENN PLAZA 38TH FLOOR NEW YORK NY 10119 ACTUARIAL 347261 EBS MASTER LLC DBA EMDEON ABF 3055 LEBANON PIKE SUITE 1000 NASHVILLE TN 37214 COPYING/DUPLICATING 291096 7 0 EMPLOYER CONTRIBUTIONS 900099 277821781 COBRA PAYMENTS 900099 100622 MEMBER PREMIUMS 900099 16652791 INTEREST & CHARGES - EMPLOYER DELINQUENCIES 900099 189450 294764644 71386 71386 0 0 0 0 0 0 0 0 0 0 294836030 71386 X 0 0 0 183633256 195184 0 4356071 1776381 5068 354805 0 0 0 0 0 0 883739 0 1631337 154773 0 2129522 0 0 0 0 0 0 113830 MANAGED CARE PRECERTIFICATION 777717 THIRD PARTY ADMIN CHARGES 471529 196483212 0 0 36183653 145110307 0 0 93664427 66509306 0 0 0 0 0 0 0 0 0 316386 3100008 3100008 0 0 0 0 0 0 0 0 4170140 8094408 134018220 220030407 1111120 1197716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36179811 23752584 37290931 24950300 X 96727289 195080107 0 0 0 0 96727289 195080107 134018220 220030407 98352818 X false true true false 2456334 2456334 0 153910 153910 0 489764 489764 0 0 0 DUE TO RELATED ENTITIES 209727 BENEFIT OBLIGATIONS CURRENTLY 23542857 23752584 X 294836030 294836030 294836030 205723039 205723039 -9239827 -9239827 196483212 RECONCILIATION OF EXPENSE FORM 990, SCHEDULE D, PART XII, LINE 2D Change in Benefits Reported and Paid :..............$(9,239,827). FIN 48 FOOTNOTE Form 990, Schedule D, Part X, Line 2 US GAAP REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION 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, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF LIABILITY (OR ASSET) OR DISCLOSURE IN FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012. BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 2 ALL OF THE UNION TRUSTEES ARE ALSO EMPLOYEES OF 1199SEIU (THE UNION) AND THEREFORE HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. POWER TO ELECT FORM 990, PART VI, LINE 7A The Union trustees are appointed by 1199SEIU United Healthcare Workers East, and the employer trustees are appointed by the Contributing Employers. REVIEW OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF FINANCIAL OFFICER AND FINANCE TEAM REVIEW THE DRAFT FORM 990 AND CONFER WITH THE ACCOUNTANTS AND LEGAL COUNSEL TO ENSURE THE ACCURACY OF THE RETURN. ANY CONCERNS ARE NOTED AND ADDRESSED AND MANAGEMENT ENSURES THAT THE CHANGES ARE INCORPORATED IN THE FORM 990. THE COMPLETED FORM 990 IS THEN SIGNED BY THE CHIEF FINANCIAL OFFICER. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES AND EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE OR UPDATE TO THE EXECUTIVE DIRECTOR, OR DESIGNEE, THEIR INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTERESTS. FOR EACH INTEREST DISCLOSED BY A TRUSTEE, THE EXECUTIVE DIRECTOR OR DESIGNEE WILL DETERMINE WHETHER TO (A) TAKE NO ACTION (B) ASSURE FULL DISCLOSURE TO THE TRUSTEES (C) ASK THE TRUSTEE TO BE RECUSED FROM PARTICIPATION IN RELATED DISCUSSIONS OR DECISIONS; AND/OR (D) ASK THE TRUSTEE TO RESIGN. REGARDING EMPLOYEES, COMPLETED CONFLICTS OF INTEREST DISCLOSURE FORMS WILL BE REVIEWED BY THE HUMAN RESOURCES DEPARTMENT AND DISCLOSED CONFLICTS WILL BE REVIEWED BY CHIEF OF HUMAN RESOURCES. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINE 15A AND 15B Compensation for all directors, officers and key employees of the Fund is determined by the Cross Funds Compensation Committee (the "Committee"), comprised of independent members. The Committee utilizes appropriate data as to comparability in its determinations, including information provided by independent compensation consultants. The Committee documents the basis for any compensation determinations contemporaneously in the minutes of the Committee. The Committee determines compensation periodically as it deems appropriate. PUBLIC DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 SUMMARY PLAN DESCRIPTIONS AND FINANCIAL REPORTS ARE MADE PUBLIC PURSUANT TO IRS REQUIREMENTS. WRITTEN REQUESTS FOR OTHER INFORMATION WILL BE FORWARDED TO GENERAL COUNSEL'S OFFICE FOR CONSIDERATION. UNRELATED BUSINESS INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 419A(F)(5)(A), COLLECTIVE BARGAINING AGREEMENTS ARE EXEMPT FROM ACCOUNT LIMIT REQUIREMENTS SET UNDER IRC SECTION 419A(C), AND ARE THEREFORE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX UNDER IRC SECTION 512(A)(3). RELATED ORGANIZATION COMPENSATION FORM 990, PART VII, SECTION A, LINE 1 THE EMPLOYER TRUSTEES REPORTED ON PART VII MAY HAVE RECEIVED COMPENSATION FROM A RELATED TAX-EXEMPT ORGANIZATION REPORTED IN SCHEDULE R, PART II. WITH VERY LIMITED EXCEPTION, NO ONE RESPONDED TO THE REQUEST MADE FOR COMPENSATION INFORMATION. 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