IBEW LOCAL UNION NO 212 HEALTH & WELFARE FUND: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: IBEW LOCAL UNION NO 212 HEALTH & WELFARE FUND (EIN 31-0782819)
Tax period: 2009-05-01 to 2010-04-30
Filed: 2011-03-04
IRS object ID: 201110639349300011
Schema version: 2009v1.3
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
Form 990
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-03-04T11:16:10-08:00	Timestamp
Tax Period End Date	2010-04-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RAFALSKE & LAYNE LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2186 VICTORY PARKWAY	AddressLine1
City	CINCINNATI	City
State	OH	State
ZIP Code	45206	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-05-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	310782819	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	LOCAL 212 IBEW HEALTH & WELFARE TRUST FUND	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	LOCA	NameControl
Phone	5138614800	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5179 FISHWICK DRIVE	AddressLine1
City	CINCINNATI	City
State	OH	State
ZIP Code	45216	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RITA MCLUCAS	Name
Title	PLAN ADMINISTRATOR	Title
Phone	5138614800	Phone
Date Signed	2011-03-04	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	RAFALSKE LAYNE	Name
Phone	5138611686	Phone
Self Employed	X	SelfEmployed

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RITA MCLUCAS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	5179 FISHWICK DR 103	AddressLine1
City	CINCINNATI	City
State	OH	State
ZIP Code	45216	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	17521799	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1973	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	THE MISSION IS TO PROVIDE BENEFITS TO ELIGIBLE PARTICIPANTS OF LOCAL 212, IBEW HEALTH AND WELFARE TRUST FUND.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	52	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	12675339	ProgramServiceRevenuePriorYear
Program Service Revenue CY	10526548	ProgramServiceRevenueCY
Investment Income Prior Year	891002	InvestmentIncomePriorYear
Investment Income Current Year	892263	InvestmentIncomeCurrentYear
Other Revenue Prior Year	-2253921	OtherRevenuePriorYear
Other Revenue Current Year	3199713	OtherRevenueCurrentYear
Total Revenue Prior Year	11312420	TotalRevenuePriorYear
Total Revenue Current Year	14618524	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	10688959	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	10793497	BenefitsPaidToMembersCY
Salaries Etc Prior Year	921	SalariesEtcPriorYear
Salaries Etc Current Year	88	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1629153	OtherExpensePriorYear
Other Expenses Current Year	1514502	OtherExpensesCurrentYear
Total Expenses Prior Year	12319033	TotalExpensesPriorYear
Total Expenses Current Year	12308087	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-1006613	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2310437	RevenuesLessExpensesCY
Total Assets BOY	18922933	TotalAssetsBOY
Total Assets EOY	20375599	TotalAssetsEOY
Total Liabilities BOY	5284420	TotalLiabilitiesBOY
Total Liabilities EOY	4426650	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	13638513	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	15948949	NetAssetsOrFundBalancesEOY
Mission Description	THE MISSION IS TO PROVIDE BENEFITS	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	12308087	Expense
Description	THE ORGANIZATION PROVIDED MEDICAL, PRESCRIPTION DRUG AND DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS OF LOCAL UNION 212 IBEW.	Description
Total Program Service Expense	12308087	TotalProgramServiceExpense
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Balance Sheet Amounts Reported	true	BalanceSheetAmountsReported
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	52	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	RITA MCLUCAS CEBS	NamePerson
Telephone Number	5138614800	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	5179 FISHWICK DR SUITE 103	AddressLine1
City	CINCINNATI	City
State	OH	State
ZIP Code	45216	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
HOWARD MAYERS
TRUSTEE	1.00	X	0	0	0
TOM LOTT
TRUSTEE	1.00	X	0	0	0
KEVIN BROXTERMAN
TRUSTEE	1.00	X	0	0	0
KURT KUBE
TRUSTEE	1.00	X	0	0	0
RANDY ROTHERT
TRUSTEE	1.00	X	0	0	0
RICHARD MCDONALD
TRUSTEE	1.00	X	0	0	0
JAMES WOLFE
TRUSTEE	1.00	X	0	439	0

Field	Value	IRS element (for citing)
Total Reportable Comp Frm Rltd Orgs	439	TotalReportableCompFrmRltdOrgs
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
HUMANA HELATH PLAN INC
PO BOX 528	CAROL STREAM	IL	60132	BENEFIT ADMINISTRATION	637955
CANADA LIFE ASSURANCE CO
PO BOX 843141	BOSTON	MA	02284	STOP LOSS INSURANCE	337345

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CONTRACTOR CONTRIBUTIONS	900099	8351640	8351640
SELF PAYMENTS	900099	2174908	2174908

Field	Value	IRS element (for citing)
Total Program Service Revenue	10526548	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	809055	TotalRevenueColumn
Related Or Exempt Function Income	809055	RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	2986483	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	2903275	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	83208	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	83208	TotalRevenueColumn
Related Or Exempt Function Income	83208	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
SUBROGATION CLAIMS	900099	53700	53700
UNREALIZED APPRECIATION	900099	2571811	2571811
STOP LOSS PROCEEDS	900099	569484	569484

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	4718	TotalRevenueColumn
Related Or Exempt Function Income	4718	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	3199713	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	14618524	TotalRevenueColumn
Related Or Exempt Function Income	14618524	RelatedOrExemptFunctionIncome

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	10793497	Total
Program Services	10793497	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	88	Total
Program Services	88	ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
PPO ADMINSTRATIVE FEES	637955	637955
ADMINISTRATIVE EXPENSES	457357	457357
INSURANCE-STOP LOSS	337345	337345
CLAIMS REVIEW EXPENSES	50958	50958
FED TAX ON DISABILITY	17443	17443

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	13444	Total
Program Services	13444	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	12308087	Total
Program Services	12308087	ProgramServices

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1211486	BOY
EOY	1010553	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	869773	BOY
EOY	593230	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	16243018	BOY
EOY	17185960	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	598656	BOY
EOY	1585856	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	18922933	BOY
EOY	20375599	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	5282524	BOY
EOY	4426650	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1896	BOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	5284420	BOY
EOY	4426650	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13638513	BOY
EOY	15948949	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	13638513	BOY
EOY	15948949	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	18922933	BOY
EOY	20375599	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Other Assets OtherAssets (4 entries)

DescriptionDescription	Book ValueBookValue
ACCRUED INTEREST INCOME	24966
RECEIVABLES FROM OTHER FUNDS	1148010
OTHER	345910
PREPAID EXPENSES	66970

Field	Value	IRS element (for citing)
Total Book Value Other Assets	1585856	TotalBookValueOtherAssets
Total Revenue	14618524	TotalRevenue
Total Expenses	12308087	TotalExpenses
Excess Or Deficit For Year	2310437	ExcessOrDeficitForYear
Other	-$820,129	OtherAmount
Total Adjustments	-820129	TotalAdjustments
Excess Or Deficit Per FS	1490308	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	14618524	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	14618524	RevenueSubtotal
Total Revenue Per Form990	14618524	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	13128216	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	13128216	ExpensesSubtotal
Other Expenses Not Included	-820129	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	-820129	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	12308087	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifier	ExplanationExplanation
Pt X	THE PLAN HAS NOT TAKEN ANY UNCERTAIN TAX POSITIONS THAT ARE REQUIRE TO BE DISCLOSED IN THE FINANCIAL STATEMENTS.
Pt XI Line 8	CHANGE IN CLAIMS PAYABLE CLAIMS PAYABLE AT 4/30/09 $(4,314,526) CLAIMS PAYABLE AT 4/30/10 3,494,397 REDUCTION IN BENEFITS EXPENSE (820,129)
Pt XIII Line 4b	CLAIMS PAYABLE AT 4/30/09 $(4,314,526) CLAIMS PAYABLE AT 4/30/10 3,494,397
Pt XIII Line 4b	REDUCTION IN BENEFITS EXPENSE (820,129)

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (18 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI-A, Line 7a	THE UNION MEMBERS ELECT THREE GOVERNING BODY MEMBERS.
	THREE OF THE GOVERNING BODY MEMBERS ARE APPOINTED BY THE
	LOCAL CHAPTER OF NECA.
Pt VI-B, Line 11A	THE FORM 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 12c	THE ORGANIZATION INFORMALLY MONITORS ITS CONFLICTS OF INTEREST
	POLICY UNDER DIRECTION OF THE GOVERNING BOARD AND THE PLAN
	ADMINISTRATOR.
Pt VI-B, Line 15	NO COMPENSATION IS PAID DIRECTLY BY THE PLAN. ALL COMPENSATION
	IS PAID THROUGH THE LOCAL UNION NO 212 BENEFIT OFFICE
	(TIN 23-7345993). THE HEALTH AND 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.