2011-11-28T13:23:35-06:00 2010-10-31 Bonadio & Co LLP 115 Solar Street Syracuse NY 13204 990 2009-11-01 150613682 Service Employees Benefit Fund SERV 3154241754 1153 West Fayette Street Syracuse NY 13204 tammy mcmanus 3154241754 2011-11-28 1 Thomas Kamide 3152147575 2009 2016-02-24 21:20:13Z X TAMMY MCMANUS 1153 West Fayette Street Syracuse NY 13204 20315837 0 X N/A X Benefit Fund 1961 NY to provide health and welfare services to members. 6 6 10 0 0 19128 0 21735489 20179401 6184 23547 18157 112889 21759830 20315837 0 19287285 15662945 563730 575928 0 0 291711 309801 20142726 16548674 1617104 3767163 7400920 10965042 1064080 971811 6336840 9993231 TO PROVIDE HEALTH AND WELFARE SERVICES TO MEMBERS. 0 0 provided coverage for participants for medical, dental, accidental death & dismemberment and life insurance. Total number of participants served was 13,346. 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 560 0 1 10 1 1 1 0 0 0 0 0 0 6 6 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TAMMY McMANUS 3154241754 1153 WEST FAYETTE STREET SYRACUSE NY 13204 JEREMIAH DENNIS 1.00 X X 0 0 0 ELIZABETH GOLEMBESKI 1.00 X 0 0 0 George Kennedy 1.00 X 0 0 0 KATHY TUCKER 1.00 X 0 0 0 Kevin Brogan 1.00 X 0 0 0 Robert Wood 1.00 X 0 0 0 Tammy McManus 40.00 X 74605 0 27202 VICKI SCHNEIDER 40.00 X 47736 0 22847 122341 0 50049 0 0 0 0 0 employer contributions 525100 19959753 19959753 separated employee con 525100 219648 219648 20179401 23547 23547 MISCELLANEOUS INCOME 900099 112889 112889 112889 20315837 20292290 0 23547 15662945 143513 341818 51222 39375 52908 29300 67872 35925 30113 15088 24783 EQUIPMENT RENTAL AND MA 48870 MISCELLANEOUS EXPENSES 4942 16548674 4495050 8666028 1852742 2083993 31106 31075 488057 439440 25360 48617 944141 74943 52521 60386 7400920 10965042 120092 180854 943988 790957 1064080 971811 X 6336840 9993231 0 0 0 0 6336840 9993231 7400920 10965042 X 0 1 1 X 0 103466 74435 29031 384591 365005 19586 48617 DUE TO AFFILIATES 357 DUE TO AETNA, INC. 790600 790957 20315837 16548674 3767163 -110772 -110772 3656391 20205065 -110772 -110772 20315837 0 20315837 16548674 0 16548674 0 16548674 In June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation No. 48, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109, Accounting for Income Taxes (FIN 48). FIN 48 is now known as ASC Section 740. This interpretation addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. For benefit plans, their tax-exempt status itself is deemed to be an uncertainty, since events could potentially occur to jeopardize their exempt status. ASC Section 740 provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, disclosures, and transition. The Plan adopted the provisions of ASC Section 740 on November 1, 2009 and there was no impact on the Plans financial statements. At the date of adoption and as of October 31, 2010, the Plan does not have a liability for unrecognized tax benefits. The Plan files the Annual Return/Report of Employee Benefit Plan (Form 5500) in the U.S. federal jurisdiction. The Plan is no longer subject to U.S. federal informational tax examinations by tax authorities for years through 2006. JERRY DENNIS BOARD MEMBER 2979 PREMIUM 0 ELIZABETH GOLEMBESKI BOARD MEMBER 2979 PREMIUM 0 ROBERT WOOD BOARD MEMBER 529011 PREMIUM 0 KEVIN BROGAN BOARD MEMBER 5800286 PREMIUM 0 Form 990, Part VI, Section A, line 6 THE ORGANIZATION CONTAINS UNION MEMBERS. Form 990, Part VI, Section B, line 11 The form 990 will be reviewed by the Board of Trustees prior to filing with the IRS. Form 990, Part VI, Section B, line 12c EACH YEAR BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. STATEMENTS ARE REVIEWED ANNUALLY BY THE PRESIDENT, CEO & CHAIRPERSON. Form 990, Part VI, Section B, line 15 THE FUND MANAGER'S SALARY IS APPROVED BY THE BOARD OF TRUSTEES THROUGH THE BUDGET. Form 990, Part VI, Section C, line 19 IRS FORM 990 WILL BE PROVIDED TO ANY INDIVIDUAL UPON WRITTEN OR IN PERSON REQUEST WITHOUT CHARGE OTHER THAN REASONABLE FEES FOR COPYING AND POSTAGE. RESPONSIBILITY FOR AUDIT THE board of trustees IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THE board of trustees REVIEWS RESULTS OF THE AUDIT and HAs FINAL APPROVAL OF THE AUDITED FINANCIAL STATEMENTS AS WELL AS APPOINTING OUTSIDE ACCOUNTANTS. SERVICE EMPLOYEES PENSION FUND OF UPSTATE NEW YORK RAISE THE STANDARD OF LIVING OF ITS MEMBERS NY 7 SEIU LOCAL 200UNITED SEIU LOCAL 1199 131510821 PROTECT AND IMPROVE THE LIVES OF THEIR MEMBERS AND FAMILIES NY 5 1199 SEIU UNITED HEALTHCARE WORKERS EAST SEIU 1199 PENSION FUND 131510821 PROVIDING PENSION AND RETIREMENT BENEFITS TO ITS MEMBERS NY 7 1199 SEIU UNITED HEALTHCARE WORKERS EAST SERVICE EMPLOYEES OF WESTERN NEW YORK RAISE THE STANDARD OF LIVING OF ITS MEMBERS NY 7 seiu local 200united PROTECT AND IMPROVE THE LIVES OF THEIR MEMBERS AND FAMILIES NY 5 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0