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SOUTHEAST LABORERS HEALTH FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SOUTHEAST LABORERS HEALTH FUND (EIN 23-7100845)
Tax period
2011-04-01 to 2012-03-31
Filed
2013-01-14
IRS object ID
201330149349300328
Schema version
2011v1.2
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)
Timestamp2013-01-14T13:08:08-06:00Timestamp
Tax Period End Date2012-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DANIELS IRWIN & AYLORBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1223 MADISON STREET SUITE 112AddressLine1
CityMADISONCity
StateTNState
ZIP Code371153660ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237100845EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHEAST LABORERS HEALTH FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone6158590131Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1449AddressLine1
CityGOODLETTSVILLECity
StateTNState
ZIP Code370701449ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTEPHEN E FARNERName
TitleCHAIRMANTitle
Phone6158590131Phone
Date Signed2012-08-27DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDOUGLAS A IRWINName
Phone6158686008Phone
Date Prepared2013-01-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts23646421GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1968YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionPROVISION OF BENEFITS TO PARTICIPANTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees60TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14869868ProgramServiceRevenuePriorYear
Program Service Revenue CY15659235ProgramServiceRevenueCY
Investment Income Prior Year737274InvestmentIncomePriorYear
Investment Income Current Year632023InvestmentIncomeCurrentYear
Other Revenue Prior Year364147OtherRevenuePriorYear
Other Revenue Current Year313778OtherRevenueCurrentYear
Total Revenue Prior Year15971289TotalRevenuePriorYear
Total Revenue Current Year16605036TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year13926835BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY15477716BenefitsPaidToMembersCY
Salaries Etc Prior Year11016SalariesEtcPriorYear
Salaries Etc Current Year9902SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1543673OtherExpensePriorYear
Other Expenses Current Year1536230OtherExpensesCurrentYear
Total Expenses Prior Year15481524TotalExpensesPriorYear
Total Expenses Current Year17023848TotalExpensesCurrentYear
Revenues Less Expenses Prior Year489765RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-418812RevenuesLessExpensesCY
Total Assets BOY16364253TotalAssetsBOY
Total Assets EOY16835599TotalAssetsEOY
Total Liabilities BOY8024537TotalLiabilitiesBOY
Total Liabilities EOY8914695TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8339716NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7920904NetAssetsOrFundBalancesEOY
Mission DescriptionPROVISION OF BENEFITS TO PARTICIPANTS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionTHE PROVISION OF HEALTH, TEMPORARY DISABILITY AND DEATH BENEFITS TO PLAN PARTICIPANTS.Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961303NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees60NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSOUTHERN BENEFIT ADMINISTRATORSNamePerson
Telephone Number6158590131TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12001 CALDWELL DRIVEAddressLine1
CityGOODVETTSVILLECity
StateTNState
ZIP Code37072ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
STEPHEN E FARNER
CHAIRMAN2.00X000
MICHAEL B PFIEFFER
SECRETARY2.00X000
J DAVID BECKLER
TRUSTEE2.00X000
KERRY HALE
TRUSTEE2.00X000
F DOUGLASS STEIN
TRUSTEE2.00X000
GLENN FARNER
TRUSTEE2.00X000
DANNY C MACMILLAN
TRUSTEE2.00X000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CIGNA
TWO LIBERTY PLACE 1601 CHESTNUT STPHILADELPHIAPA19192PPO705555
SOUTHERN BENEFIT ADMINISTRATORS INC
PO BOX 1449GOODLETTSVILLETN370701449ADMINISTRATION567575
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS1542606515426065
EMPLOYEE CONTRIBUTIONS233170233170
FieldValueIRS element (for citing)
Total Program Service Revenue15659235TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column560878TotalRevenueColumn
Exclusion$560,878ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities7112530Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7041385Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities71145Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column71145TotalRevenueColumn
Exclusion$71,145ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
FORMULARY REBATES130759130759
SUBROGATION REFUNDS9645596455
CLAIMS REFUNDS6852468524

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column18040TotalRevenueColumn
Related Or Exempt Function Income18040RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue313778TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16605036TotalRevenueColumn
Related Or Exempt Function Income15973013RelatedOrExemptFunctionIncome
Exclusion$632,023ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total15477716Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9902Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total528000Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total20113Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total17982Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total36041Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total747690Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5074Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
CONTRIBUTIONS TO LHSFNA140327
PRINTING & MAILING20356
FIDUCIARY LIABILITY INSUR12147
BANK CHARGES8500

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17023848Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY533010BOY
EOY173624EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3008619BOY
EOY3306170EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1623659BOY
EOY1458030EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY11198965BOY
EOY11897775EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY16364253BOY
EOY16835599EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8024537BOY
EOY8914695EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8024537BOY
EOY8914695EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8339716BOY
EOY7920904EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8339716BOY
EOY7920904EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16364253BOY
EOY16835599EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-418812ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR
Total Revenue16605036TotalRevenue
Total Expenses17023848TotalExpenses
Excess Or Deficit For Year-418812ExcessOrDeficitForYear
Excess Or Deficit Per FS-418812ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt16605036TotRevenueEtcAuditedFinclStmt
Revenue Subtotal16605036RevenueSubtotal
Total Revenue Per Form99016605036TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt17023848TotExpensesEtcAuditedFinclStmt
Expenses Subtotal17023848ExpensesSubtotal
Total Expenses Per Form99017023848TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2OHIO VALLEY & SOUTHERN STATES REGIO OHIO VALLEY & SOUTHERN STATES REGIO CHAIRMAN TRUSTEE WORK IN SAME UNION OFFICE SOUTHEAST LABORERS' DISTRICT COUNCI OHIO VALLEY & SOUTHERN STATES REGIO TRUSTEE CHAIRMAN BROTHERS
MANAGEMENT DELEGATEDFORM 990, PAGE 6, PART VI, LINE 3SOUTHERN BENEFIT ADMINISTRATORS, INC.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE UNION TRUSTEES ARE SELECTED BY THE LABOR ORGANIZATIONS PARTY TO THE AGREEMENT AND DECLARATION OF TRUST WHILE THE EMPLOYER TRUSTEES ARE SELECTED BY THE EMPLOYER ORGANIZTIONS PARTY TO THE AGREEMENT AND DECLARATION OF TRUST.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 IS REVIEWED AND APPROVED BY THE ENTIRE BOARD OF TRUSTEES. IT IS THEN SIGNED AND FILED.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICTS OF INTEREST ARE REVIEWED CONTINUALLY AND ANY ISSUES THAT ARISE ARE HANDLED AT REGULAR BOARD MEETINGS.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE MEMBERS OF THE BOARD OF TRUSTEES ARE NOT COMPENSATED IN ANY WAY. A THIRD PARTY ADMINISTRATOR WAS HIRED BY THE BOARD OF TRUSTEES TO MANAGE THE FUND AND WAS SELECTED, HAD ITS QUALIFICATIONS REVIEWED AND COMPENSATION DETERMINED BY COMPETITIVE COMPARISON BY THE ENTIRE BOARD OF TRUSTEES.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE MEMBERS OF THE BOARD OF TRUSTEES ARE NOT COMPENSATED IN ANY WAY. A THIRD PARTY ADMINISTRATOR WAS HIRED BY THE BOARD OF TRUSTEES TO MANAGE THE FUND AND WAS SELECTED, HAD ITS QUALIFICATIONS REVIEWED AND COMPENSATION DETERMINED BY COMPETITIVE COMPARISON BY THE ENTIRE BOARD OF TRUSTEES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19AVAILABLE UPON REQUEST. ALL MAILOUTS AND COMMUNICATIONS INCLUDE REFERENCE TO DOCUMENTS BEING AVAILABLE UPON REQUEST.