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IBEW LOCAL 915 HEALTH AND WELFARE FUND: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
IBEW LOCAL 915 HEALTH AND WELFARE FUND (EIN 59-6169977)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-31
IRS object ID
201322439349300302
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-31T15:01:42-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN650140643EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1STEVEN D EISENBERG CPA PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line113790 NW 4 STREET 100AddressLine1
CitySUNRISECity
StateFLState
ZIP Code33325ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN596169977EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INTERNATIONAL BROTHERHOOD OF ELECTRICALBusinessNameLine1
Business Name Line2WORKERS LOCAL 915 WELFARE FUNDBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlINTENameControl
Phone6158590131Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1449AddressLine1
CityGoodlettsvilleCity
StateTNState
ZIP Code37070ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANK CARPENTERName
TitleCHAIRMANTitle
Phone6158590131Phone
Date Signed2013-08-19DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEVEN D EISENBERGName
PTINP00175252PTIN
Phone9548469490Phone
Date Prepared2013-08-17DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonFRANK CARPENTERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 1449AddressLine1
CityGoodlettsvilleCity
StateTNState
ZIP Code37070ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5183532GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteNAWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1969YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTo provide health benefits to its members.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5068847ProgramServiceRevenuePriorYear
Program Service Revenue CY4723813ProgramServiceRevenueCY
Investment Income Prior Year424057InvestmentIncomePriorYear
Investment Income Current Year459719InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5492904TotalRevenuePriorYear
Total Revenue Current Year5183532TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year4549276BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY5221523BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year645755OtherExpensePriorYear
Other Expenses Current Year655901OtherExpensesCurrentYear
Total Expenses Prior Year5195031TotalExpensesPriorYear
Total Expenses Current Year5877424TotalExpensesCurrentYear
Revenues Less Expenses Prior Year297873RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-693892RevenuesLessExpensesCY
Total Assets BOY11442707TotalAssetsBOY
Total Assets EOY11286968TotalAssetsEOY
Total Liabilities BOY60348TotalLiabilitiesBOY
Total Liabilities EOY91329TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11382359NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11195639NetAssetsOrFundBalancesEOY
Mission DescriptionThe Organization mission to is provide health benefits to eligible participantsMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionHEALTH BENEFIT COVERAGE PROVIDED ON BEHALF OF ELIGLIBLE MEMBERS OF LOCAL # 915Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN BENEFIT ADMINISTRATORS INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6158590131TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1449AddressLine1
CityGOODLETTSVILLECity
StateTNState
ZIP Code37070ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
FRANK CARPENTER
CHAIRMAN10.00X000
WILLIAM L DEVER JR
TRUSTEE10.00X000
ROBERTO ROSA
TRUSTEE10.00X000
ROBERT COPPERSMITH
TRUSTEE10.00X000
LEON WARD
TRUSTEE10.00X000
VANCE ANDERSON
TRUSTEE10.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BLUE CROSS BLUE SHIELD OF FLORIDA
8400 NE 33RD STREETMIAMIFL33122CLAIMS BENEFIT ADMINISTRATION461932
SOUTHERN BENEFIT ADMINISTRATORS
PO BOX 1449GOODLETTSVILLETN37070CONTRACT ADMINISTRATION126316
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionCONTRIBUTIONSDescription
Business Code230000BusinessCode
Total Revenue Column4723813TotalRevenueColumn
Related Or Exempt Function Income4723813RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue4723813TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column459719TotalRevenueColumn
Exclusion$459,719ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5183532TotalRevenueColumn
Related Or Exempt Function Income4723813RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$459,719ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total5221523Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total9732Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total4680Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4746Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2180Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1955Total

Insurance Insurance

FieldValueIRS element (for citing)
Total9551Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
CLAIMS ADMINISTRATION F461932
FUND AMINISTRATION FEES126316
CONSULTING FEE23043
ACTUARIAL11766

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5877424Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY203415BOY
EOY366600EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY409389BOY
EOY373574EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY222125BOY
EOY222125EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY10607778BOY
EOY10324669EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11442707BOY
EOY11286968EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY60348BOY
EOY91329EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY60348BOY
EOY91329EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11382359BOY
EOY11195639EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11382359BOY
EOY11195639EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11442707BOY
EOY11286968EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-693892ReconcilationRevenueExpenses
Reconciliation Unrealized Invest507172ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt5690704TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments507172NetUnrealizedGainsInvestments
Revenue Not Rptd F990507172RevenueNotRptdF990
Revenue Subtotal5183532RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9905183532TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5877424TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal5877424ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905877424TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section A, line 8bThe Organization is operated by a joint Board of Trustees. There are no sub committees or similar type of group.
Form 990, Part VI, Section B, line 11Form 990 is presented to the Board of Trustees for review. The return is reviewed and accepted. Any changes are made prior to filing.
Form 990, Part VI, Section B, line 12cThe Organization reviews it's conflict of interest policy on a regular basis, and requires Trustees to acknowledge their adherence to policy guidlines.
Form 990, Part VI, Section C, line 19The Organization makes its financial statements and governing documents available to the public upon written request.
The Board of Trustees is responsible for the oversight of the audit. There has been no change in this process.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS #915 PENSION FUND
c/o SBAI PO BOX 1449GOODLETTSVILLETN37070596518568Provide pension benefits to eligible participantsFL401(a)0
INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS #915 VACATION FUND
c/o SBAI PO BOX 1449GOODLETTSVILLETN37070596134658Provide vacation benefits to eligible participantsFL501(c)0
INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS Local Union #915
5621 Harney RoadTampaFL33610Act as collective bargaining agent on behalf of membershipFL501(c)0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg