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IBEW LOCAL UNION NO 212 HEALTH & WELFARE FUND: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
IBEW LOCAL UNION NO 212 HEALTH & WELFARE FUND (EIN 31-0782819)
Tax period
2010-05-01 to 2011-04-30
Filed
2012-03-05
IRS object ID
201230659349300788
Schema version
2010v3.2
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)
Timestamp2012-03-05T08:30:35-08:00Timestamp
Tax Period End Date2011-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KELLEY GALLOWAY & COMPANY PSCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12186 VICTORY PARKWAYAddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45206ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310782819EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LOCAL 212 IBEW HEALTH & WELFARE TRUST FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLOCANameControl
Phone5138614800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15179 FISHWICK DRIVEAddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45216ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRITA MCLUCASName
TitlePLAN ADMINISTRATORTitle
Phone5138614800Phone
Date Signed2012-02-23DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN C LAYNEName
Phone5138611686Phone
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRITA MCLUCASNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15179 FISHWICK DR 103AddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45216ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13614556GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1973YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION IS TO PROVIDE BENEFITS TO ELIGIBLE PARTICIPANTS OF LOCAL 212, IBEW HEALTH AND WELFARE TRUST FUND.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees34TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10526548ProgramServiceRevenuePriorYear
Program Service Revenue CY10982453ProgramServiceRevenueCY
Investment Income Prior Year892263InvestmentIncomePriorYear
Investment Income Current Year961356InvestmentIncomeCurrentYear
Other Revenue Prior Year3199713OtherRevenuePriorYear
Other Revenue Current Year792187OtherRevenueCurrentYear
Total Revenue Prior Year14618524TotalRevenuePriorYear
Total Revenue Current Year12735996TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year10793497BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY8294404BenefitsPaidToMembersCY
Salaries Etc Prior Year88SalariesEtcPriorYear
Salaries Etc Current Year2570SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1514502OtherExpensePriorYear
Other Expenses Current Year1447313OtherExpensesCurrentYear
Total Expenses Prior Year12308087TotalExpensesPriorYear
Total Expenses Current Year9744287TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2310437RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2991709RevenuesLessExpensesCY
Total Assets BOY20375599TotalAssetsBOY
Total Assets EOY22838442TotalAssetsEOY
Total Liabilities BOY4426650TotalLiabilitiesBOY
Total Liabilities EOY3897784TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY15948949NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY18940658NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION IS TO PROVIDE BENEFITS TO ELIGIBLE PARTICIPANTSMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionTHE ORGANIZATION PROVIDED MEDICAL, PRESCRIPTION DRUG AND DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS OF LOCAL UNION 212 IBEW.Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
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
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
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 With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees34NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
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 CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRITA MCLUCAS CEBSNamePerson
Telephone Number5138614800TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15179 FISHWICK DR SUITE 103AddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45216ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
HOWARD MAYERS
TRUSTEE1.00X000
TOM LOTT
TRUSTEE1.00X000
KEVIN BROXTERMAN
TRUSTEE1.00X000
KURT KUBE
TRUSTEE1.00X000
RANDY ROTHERT
TRUSTEE1.00X000
RICHARD MCDONALD
TRUSTEE1.00X025700
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs2570TotalReportableCompFrmRltdOrgs
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HUMANA HEALTH PLAN INC
PO BOX 528CAROL STREAMIL60132BENEFIT ADMINISTRATION565183
HUMANA HEALTH PLAN INC
PO BOX 528CAROL STREAMIL60132STOP LOSS INSURANCE337473
LOCAL 212 IBEW BENEFIT OFFICE
5179 FISHWICK DR SUITE 103CINCINNATIOH45216ADMINISTRATION139594
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumn
CONTRACTOR CONTRIBUTIONS9000998505980
SELF PAYMENTS9000992476473
FieldValueIRS element (for citing)
Total Program Service Revenue10982453TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column939916TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities900000Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities878560Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities21440Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column21440TotalRevenueColumn
Related Or Exempt Function Income21440RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
SUBROGATION CLAIMS9000991246712467
UNREALIZED APPRECIATION900099740498740498
STOP LOSS PROCEEDS9000993495434954

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column4268TotalRevenueColumn
Related Or Exempt Function Income4268RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue792187TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12735996TotalRevenueColumn
Related Or Exempt Function Income12735996RelatedOrExemptFunctionIncome

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total8294404Total
Program Services8294404ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2570Total
Program Services2570ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PPO ADMINSTRATIVE FEES565183565183
ADMINISTRATIVE EXPENSES484208484208
INSURANCE-STOP LOSS337473337473
CLAIMS REVIEW EXPENSES4513545135
FED TAX ON DISABILITY54165416

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total9898Total
Program Services9898ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9744287Total
Program Services9744287ProgramServices

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1010553BOY
EOY1290989EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY593230BOY
EOY831917EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY17185960BOY
EOY18998609EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1585856BOY
EOY1716927EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY20375599BOY
EOY22838442EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4426650BOY
EOY3897784EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4426650BOY
EOY3897784EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY15948949BOY
EOY18940658EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15948949BOY
EOY18940658EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20375599BOY
EOY22838442EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2991709ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
ACCRUED INTEREST INCOME28144
RECEIVABLES FROM OTHER FUNDS1204264
OTHER284886
PREPAID EXPENSES199633
FieldValueIRS element (for citing)
Total Book Value Other Assets1716927TotalBookValueOtherAssets
Total Revenue12735996TotalRevenue
Total Expenses9744287TotalExpenses
Excess Or Deficit For Year2991709ExcessOrDeficitForYear
Other-$513,431OtherAmount
Total Adjustments-513431TotalAdjustments
Excess Or Deficit Per FS2478278ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12742461TotRevenueEtcAuditedFinclStmt
Other Revenues6465OtherRevenues
Revenue Not Rptd F9906465RevenueNotRptdF990
Revenue Subtotal12735996RevenueSubtotal
Total Revenue Per Form99012735996TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt10264183TotExpensesEtcAuditedFinclStmt
Other Expenses Included6465OtherExpensesIncluded
Expenses Not Rptd F9906465ExpensesNotRptdF990
Expenses Subtotal10257718ExpensesSubtotal
Other Expenses Not Included-513431OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-513431ExpensesNotRptdOnFinStmt
Total Expenses Per Form9909744287TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierExplanationExplanation
Pt XACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES
POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PLAN MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR PERIODS PRIOR TO 2007.
Pt XII Line 2dRECIPROCITY PAYMENTS
Pt XIII Line 2dRECIPROCITY PAYMENTS
Pt XI Line 8CHANGE IN CLAIMS PAYABLE: CLAIMS PAYABLE AT 4/30/10 $(3,494,397) CLAIMS PAYABLE AT 4/30/11 2,980,966 REDUCTION IN BENEFITS EXPENSE (513,431)
Pt XIII Line 4bCLAIMS PAYABLE AT 4/30/10 $(3,494,397) CLAIMS PAYABLE AT 4/30/11 2,980,966 REDUCTION IN BENEFITS EXPENSE (513,431)

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (19 entries)

IdentifierIdentifierExplanationExplanation
Pt VI-A, Line 7aTHE UNION MEMBERS ELECT THREE OF THE GOVERNING BODY MEMBERS,
AND THE OTHER THREE GOVERNING BODY MEMBERS ARE APPOINTED
BY THE LOCAL CHAPTER OF NECA.
Pt VI-B, Line 11aFORM 990 WAS MAILED TO THE ORGANIZATION'S TRUSTEE GOVERNING
BODY FOR REVIEW AND COMMENT. PRIOR TO SUBMITTING THE RETURN
TO THE INTERNAL REVENUE SERVICE, A REVIEW OF FORM 990 WAS
CONDUCTED BY JOHN C. LAYNE, CPA (PREPARER OF THE RETURN)
WITH THE PLAN ADMINISTRATOR.
Pt VI-B, Line 12cTHE ORGANIZATION INFORMALLY MONITORS ITS CONFLICTS OF INTEREST
POLICY UNDER DIRECTION OF THE GOVERNING BOARD AND THE PLAN
ADMINISTRATOR.
Pt VI-B, Line 15NO COMPENSATION IS PAID DIRECTLY BY THE PLAN. ALL COMPENSATION
IS PAID THROUGH THE LOCAL UNION NO. 212 BENEFIT OFFICE
(TIN 23-7345993). THE HEALTH & WELFARE TRUST FUND IS ALLOCATED
ITS RESPECTIVE SHARE OF COMPENSATION AND ADMINISTRATIVE
EXPENSES. ALL COMPENSATION IS REPORTED ON W-2 FORMS ISSUED BY
THE BENEFIT OFFICE. THE BENEFIT OFFICE IS NOT CONSIDERED A
RELATED ORGANIZATION UNDER THE INSTRUCTIONS TO FORM 990.
Form 990, Part IX, Line 24fMISCELLANEOUS 9898. 9898.