TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) KEVIN CONNORS...................................................................... TRUSTEE	1.00 .................	X			0	148,003	90,678
(2) JEAMES CUIFFO...................................................................... TRUSTEE	1.00 .................	X			0	122,767	82,189
(3) THOMAS LUERSSEN...................................................................... TRUSTEE - PAST	1.00 .................	X			0	0	0
(4) BRIAN MCBREARTY...................................................................... TRUSTEE - PAST	1.00 .................	X			0	39,840	33,642
(5) FRANK NARCISO...................................................................... TRUSTEE	1.00 .................	X			0	0	0
(6) MAUREEN O'CONNOR...................................................................... TRUSTEE	1.00 .................	X			0	0	0
(7) WILLIAM ROTHBERG...................................................................... TRUSTEE	1.00 .................	X			0	0	0
(8) ROBERT DIORIO...................................................................... TRUSTEE - PAST	1.00 .................	X			0	178,266	51,514
(9) FRANK GREER...................................................................... TRUSTEE - PAST	1.00 .................	X			0	178,266	51,514
(10) RAYMOND MINIERI...................................................................... TRUSTEE	1.00 .................	X			0	155,332	111,067
(11) FRANK NITTO...................................................................... TRUSTEE	1.00 .................	X			0	150,076	110,174
(12) ROBERT SOTO...................................................................... TRUSTEE - PAST	1.00 .................	X			0	151,123	110,607
(13) RALPH TORTORA...................................................................... TRUSTEE	1.00 .................	X			0	150,969	110,326
(14) AL LABELLA...................................................................... TRUSTEE	1.00 .................	X			0	0	0
(15) RANDY BUCHTER...................................................................... TRUSTEE	1.00 .................	X			0	0	0
(16) GLEN CAMISA...................................................................... EXECUTIVE DIRECTOR	40.00 .................		X		167,145	0	88,762
(17) JENNIFER BLAKE...................................................................... OFFICE MANAGER	40.00 .................			X	116,477	0	22,652

(A) Name and business address	(B) Description of services	(C) Compensation
DICKINSON GROUP LLC 50 CHARLES LINDBERGH BLVD SUITE 2 INDIANAPOLIS,IN46240	ACTUARY/CLAIMS PROCESSING	633,395
PROSKAUER ROSE LLP 11 TIMES SQUARE NEW YORK,NJ10038	LEGAL SERVICES	260,135
DJ O'GRADY CONSULTANTS LTD 90 JOHN STREET 305 NEW YORK,NY11501	CONSULTING SERVICES	190,806
CALIBRE CPA GROUP PLLC 7501 WISCONSIN AVE SUITE 1200 WES BETHESDA,MD20814	AUDIT AND COMPLIANCE SERVICES	150,657
BARNES IACCARINO & SHEPHERD LLP 3 SURREY LANE HEMPSTEAD,NY11550	LEGAL SERVICES	125,632
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 5

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

BOARD OF TRUSTEES OF SMWIA LU NO 28
WELFARE FUND

Employer identification number

13-5530847

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...
b	Buildings
c	Leasehold improvements	1,282,140	234,776	1,047,364
d	Equipment ...	3,380,077	2,914,650	465,427
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,512,791

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
EMPLOYER SECURITY DEPOSITS PAYABLE	748,100
DUE TO AFFILIATED PLANS	1,581,488
DUE TO ORGANIZATIONS	99,732
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	2,429,320
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	63,752,547
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-2,306,890
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	-2,306,890
3	Subtract line 2e from line 1..................			3	66,059,437
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	123,982
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	123,982
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	66,183,419

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	64,607,270
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	64,607,270
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	123,982
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	123,982
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	64,731,252

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2:	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE AND DEPARTMENT OF LABOR. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN'S INCOME TAX RETURNS FOR THE YEARS 2012 THROUGH 2014 REMAIN SUBJECT TO EXAMINATION, BASED ON THE NORMAL STATUTORY PERIODS SUBJECT TO AUDIT, NOTWITHSTANDING ANY EVENTS OR CIRCUMSTANCES THAT MAY EXIST WHICH COULD EXPAND THE OPEN PERIOD.

Return Reference

Explanation

PART X, LINE 2:

ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE AND DEPARTMENT OF LABOR. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN'S INCOME TAX RETURNS FOR THE YEARS 2012 THROUGH 2014 REMAIN SUBJECT TO EXAMINATION, BASED ON THE NORMAL STATUTORY PERIODS SUBJECT TO AUDIT, NOTWITHSTANDING ANY EVENTS OR CIRCUMSTANCES THAT MAY EXIST WHICH COULD EXPAND THE OPEN PERIOD.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

BOARD OF TRUSTEES OF SMWIA LU NO 28
WELFARE FUND

Employer identification number

13-5530847

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KEVIN CONNORSTRUSTEE	(i) (ii)	0 ------------- 117,652	0 ------------- 0	0 ------------- 30,351	0 ------------- 68,634	0 ------------- 22,044	0 ------------- 238,681	0 ------------- 0
2JEAMES CUIFFOTRUSTEE	(i) (ii)	0 ------------- 98,044	0 ------------- 0	0 ------------- 24,723	0 ------------- 60,509	0 ------------- 21,680	0 ------------- 204,956	0 ------------- 0
3ROBERT DIORIOTRUSTEE - PAST	(i) (ii)	0 ------------- 134,226	0 ------------- 0	0 ------------- 44,040	0 ------------- 29,176	0 ------------- 22,338	0 ------------- 229,780	0 ------------- 0
4FRANK GREERTRUSTEE - PAST	(i) (ii)	0 ------------- 134,226	0 ------------- 0	0 ------------- 44,040	0 ------------- 29,176	0 ------------- 22,338	0 ------------- 229,780	0 ------------- 0
5RAYMOND MINIERITRUSTEE	(i) (ii)	0 ------------- 126,320	0 ------------- 0	0 ------------- 29,012	0 ------------- 80,228	0 ------------- 30,839	0 ------------- 266,399	0 ------------- 0
6FRANK NITTOTRUSTEE	(i) (ii)	0 ------------- 126,320	0 ------------- 0	0 ------------- 23,756	0 ------------- 79,335	0 ------------- 30,839	0 ------------- 260,250	0 ------------- 0
7ROBERT SOTOTRUSTEE - PAST	(i) (ii)	0 ------------- 120,747	0 ------------- 0	0 ------------- 30,376	0 ------------- 78,432	0 ------------- 32,175	0 ------------- 261,730	0 ------------- 0
8RALPH TORTORATRUSTEE	(i) (ii)	0 ------------- 126,320	0 ------------- 0	0 ------------- 24,649	0 ------------- 79,487	0 ------------- 30,839	0 ------------- 261,295	0 ------------- 0
9GLEN CAMISAEXECUTIVE DIRECTOR	(i) (ii)	167,145 ------------- 0	0 ------------- 0	0 ------------- 0	73,099 ------------- 0	15,663 ------------- 0	255,907 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

BOARD OF TRUSTEES OF SMWIA LU NO 28
WELFARE FUND

Employer identification number

13-5530847

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 WAS SENT TO THE TRUSTEES FOR REVIEW. UPON APPROVAL, A WAVER IS SIGNED AUTHORIZING THE ELECTRONIC SUBMISSION OF THE FORM.
FORM 990, PART VI, SECTION B, LINE 12C	COMPLIANCE IS REVIEWED AT ANNUAL MEETING.
FORM 990, PART VI, SECTION B, LINE 15	INCREASES IN COMPENSATION ARE APPROVED BY THE BOARD AND ARE COMPARED TO INDUSTRY STANDARDS.
FORM 990, PART VI, SECTION C, LINE 19	UPON REQUEST GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XII, LINE 2C:	THIS PROCESS HAS NOT CHANGED.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

BOARD OF TRUSTEES OF SMWIA LU NO 28
WELFARE FUND

Employer identification number

13-5530847

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)SMW LOCAL 28 ANNUITY FUND 195 MINEOLA BLVD MINEOLA,NY11501 13-3073165	PROVIDE RETIREMENT BENEFITS FOR LU 28 MEMBERS		401 (A)				No
(2)SMW LOCAL 28 PENSION FUND 195 MINEOLA BLVD MINEOLA,NY11501 11-2480671	PROVIDE RETIREMENT BENEFITS FOR LU 28 MEMBERS		401 (A)				No
(3)SMW LOCAL 28 500 GREENWICH STREET SUITE 502 NEW YORK,NY10013 13-5388240	ORGANIZE SHEET METAL WORKERS IN THE NYC AREA		501(C)(5)				No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) 4SL U CONTRACTING	CONTRIBUTING EMPLOYER							No
(2) A LISS & CO INC	CONTRIBUTING EMPLOYER							No
(3) AJ MCNULTY & CO INC	CONTRIBUTING EMPLOYER							No
(4) AABCO SHEET METAL CO	CONTRIBUTING EMPLOYER							No
(5) ACCURATE SHEET METAL	CONTRIBUTING EMPLOYER							No
(6) ACCURATE SPECIALTY DAMPER	CONTRIBUTING EMPLOYER							No
(7) ACS SYSTEM ASSOCIATES INC	CONTRIBUTING EMPLOYER							No
(8) ACTION CHUTES	CONTRIBUTING EMPLOYER							No
(9) ADAMS EUROPEAN CONTRACTING	CONTRIBUTING EMPLOYER							No
(10) ADMIRAL CONSTRUCTION LLC	CONTRIBUTING EMPLOYER							No
(11) ADVANCED T&B & ENERGY CONSULT	CONTRIBUTING EMPLOYER							No
(12) AIR EXPERTS	CONTRIBUTING EMPLOYER							No
(13) AIR LOUVER & DAMPER INC	CONTRIBUTING EMPLOYER							No
(14) AIR PERFECT T & B	CONTRIBUTING EMPLOYER							No
(15) AIR WISE HEATING & COOLING INC	CONTRIBUTING EMPLOYER							No
(16) AIRFLEX CORPORATION	CONTRIBUTING EMPLOYER							No
(17) AIRPATH TESTING SERVICES INC	CONTRIBUTING EMPLOYER							No
(18) AIRTECH SYSTEMS INC	CONTRIBUTING EMPLOYER							No
(19) AIRTIGHT LLC	CONTRIBUTING EMPLOYER							No
(20) ALL CITY TESTING & BALANC	CONTRIBUTING EMPLOYER							No
(21) ALLIANCE TRI-STATE CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(22) AMH MECHANICAL CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(23) ANRON AIR SYSTEMS INC	CONTRIBUTING EMPLOYER							No
(24) ANRON SHEET METAL	CONTRIBUTING EMPLOYER							No
(25) APPLE SHEET METAL	CONTRIBUTING EMPLOYER							No
(26) ARC ELECTRICAL & MECHANICAL CONTRACTORS CORP	CONTRIBUTING EMPLOYER							No
(27) ARCHITECTURAL PANEL SYS LLC	CONTRIBUTING EMPLOYER							No
(28) ARISTA PLUMBING HEATING & PIPING COPR	CONTRIBUTING EMPLOYER							No
(29) ARLAN DAMPER	CONTRIBUTING EMPLOYER							No
(30) ARMSTRONG ROOFING CORP	CONTRIBUTING EMPLOYER							No
(31) ARMY CONSTRUCTION LLC	CONTRIBUTING EMPLOYER							No
(32) ASSOCIATED TESTING & BALANCING	CONTRIBUTING EMPLOYER							No
(33) ATLANTIC FABRICATION & COATINGS LLC	CONTRIBUTING EMPLOYER							No
(34) AWL SHEET METAL CORP	CONTRIBUTING EMPLOYER							No
(35) BAMCOINC	CONTRIBUTING EMPLOYER							No
(36) BENINATI ROOFING & SM	CONTRIBUTING EMPLOYER							No
(37) BENSON INDUSTRIES LLC	CONTRIBUTING EMPLOYER							No
(38) BERJEN METAL IND	CONTRIBUTING EMPLOYER							No
(39) BERJEN METAL INDUSTRIES	CONTRIBUTING EMPLOYER							No
(40) BLUE DIAMOND SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(41) BURGESS STEEL PROD CORP	CONTRIBUTING EMPLOYER							No
(42) C & F FABRICATORS INC	CONTRIBUTING EMPLOYER							No
(43) CALLAHAN PIPING LLC	CONTRIBUTING EMPLOYER							No
(44) CELTIC SHEET METAL	CONTRIBUTING EMPLOYER							No
(45) CENTER SHEET METAL	CONTRIBUTING EMPLOYER							No
(46) CENTRAL MECHANICAL SYSTEMS INC	CONTRIBUTING EMPLOYER							No
(47) CHAMPION METAL & GLASS INC	CONTRIBUTING EMPLOYER							No
(48) COMMERCIAL INSTRUMENTATION SERVICES	CONTRIBUTING EMPLOYER							No
(49) COMPLETE SPIRAL MANUFACT INC	CONTRIBUTING EMPLOYER							No
(50) CONTRACTORS SM LLC	CONTRIBUTING EMPLOYER							No
(51) CRAFTSMAN STORE FRONT	CONTRIBUTING EMPLOYER							No
(52) CRO SHEET METAL	CONTRIBUTING EMPLOYER							No
(53) CUSTOM EXTERIOR SYSTEMS	CONTRIBUTING EMPLOYER							No
(54) CW SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(55) D & G SHEET METAL CO	CONTRIBUTING EMPLOYER							No
(56) DASNY MECHANICAL INC	CONTRIBUTING EMPLOYER							No
(57) DBD TECHNOLOGIES CORP	CONTRIBUTING EMPLOYER							No
(58) DELTA SHEET METAL	CONTRIBUTING EMPLOYER							No
(59) DERR AND ISBELL CONSTRUCTION LLC	CONTRIBUTING EMPLOYER							No
(60) DIAMOND MECHANICAL	CONTRIBUTING EMPLOYER							No
(61) EAGLE ONE ROOFING CONTRS INC	CONTRIBUTING EMPLOYER							No
(62) EAI INC	CONTRIBUTING EMPLOYER							No
(63) EAST BAY MECHANICAL CORP	CONTRIBUTING EMPLOYER							No
(64) EASTERN METAL WORKS	CONTRIBUTING EMPLOYER							No
(65) ECS INSTALLATIONS LLC	CONTRIBUTING EMPLOYER							No
(66) EMPIRE DUCT SYSTEMS LLC	CONTRIBUTING EMPLOYER							No
(67) ENERGY METAL SPECIALTIES INC	CONTRIBUTING EMPLOYER							No
(68) EVEREST MECHANICAL INC	CONTRIBUTING EMPLOYER							No
(69) FIVE STAR KITCHEN INSTALLATIONS INC	CONTRIBUTING EMPLOYER							No
(70) FLUSH METAL PARTITIONS LLC	CONTRIBUTING EMPLOYER							No
(71) FRESH MEADOW MECH	CONTRIBUTING EMPLOYER							No
(72) FRIGIDYNE AIR CONDITIONING CO INC	CONTRIBUTING EMPLOYER							No
(73) FRP SHEET METAL CONT	CONTRIBUTING EMPLOYER							No
(74) GM SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(75) GAMMA INSTALLATIONS INC	CONTRIBUTING EMPLOYER							No
(76) GEM ROOFING & WATER PROOFING	CONTRIBUTING EMPLOYER							No
(77) GENTLEMEN SHEET METAL LTD	CONTRIBUTING EMPLOYER							No
(78) GEOMATRIX SERVICES INC	CONTRIBUTING EMPLOYER							No
(79) H KLEIN & SONS INC	CONTRIBUTING EMPLOYER							No
(80) HERITAGE MECHANICAL SERVICES I	CONTRIBUTING EMPLOYER							No
(81) HI TECH DATA FLOORS INC	CONTRIBUTING EMPLOYER							No
(82) HIGH VELOCITY	CONTRIBUTING EMPLOYER							No
(83) HUDSON VALLEY GLASS & METAL WORKS INC	CONTRIBUTING EMPLOYER							No
(84) IMPERIAL DAMP & LOUV COINC	CONTRIBUTING EMPLOYER							No
(85) IMPERIUM CONSTRUCTION INC	CONTRIBUTING EMPLOYER							No
(86) INDEPENDENT TESTING & BALANCING	CONTRIBUTING EMPLOYER							No
(87) INDOOR AIR TECHNOLOGIES INC	CONTRIBUTING EMPLOYER							No
(88) INSTALLATION 10 INC	CONTRIBUTING EMPLOYER							No
(89) INTERNATIONAL TEST& BAL	CONTRIBUTING EMPLOYER							No
(90) ISLAND ACOUSTICS LLC	CONTRIBUTING EMPLOYER							No
(91) J & A CONTRACTORS CORP	CONTRIBUTING EMPLOYER							No
(92) J KOKOLAKIS CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(93) JC STEEL CORPORTATION	CONTRIBUTING EMPLOYER							No
(94) JANSONS ASSOCIATES INC	CONTRIBUTING EMPLOYER							No
(95) JESLIN LLC	CONTRIBUTING EMPLOYER							No
(96) JGM INC	CONTRIBUTING EMPLOYER							No
(97) JOHN W MCDOUGALL CO INC	CONTRIBUTING EMPLOYER							No
(98) JORDAN PANEL SYSTEMS CORP	CONTRIBUTING EMPLOYER							No
(99) KARO SHEET METAL	CONTRIBUTING EMPLOYER							No
(100) KENNETH J HERMAN	CONTRIBUTING EMPLOYER							No
(101) KIMCO GROUP INC	CONTRIBUTING EMPLOYER							No
(102) KOKO CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(103) L MARTONE & SONS	CONTRIBUTING EMPLOYER							No
(104) LEADER SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(105) LEINSTER ENVIRONMENTAL SOLUT	CONTRIBUTING EMPLOYER							No
(106) LIBERTY DUCTWORK INC	CONTRIBUTING EMPLOYER							No
(107) LIBERTY INSTALLERS LLC	CONTRIBUTING EMPLOYER							No
(108) LIFFEY SHEET METAL	CONTRIBUTING EMPLOYER							No
(109) LITEHOUSE BUILDERS INC	CONTRIBUTING EMPLOYER							No
(110) LYNBROOK GLASS & ARCHIT	CONTRIBUTING EMPLOYER							No
(111) M & A METALS INC	CONTRIBUTING EMPLOYER							No
(112) MACE CONTRACTING CORPORATION	CONTRIBUTING EMPLOYER							No
(113) MELCON CONSULTANT INC	CONTRIBUTING EMPLOYER							No
(114) MERENDINO ASSOCIATES	CONTRIBUTING EMPLOYER							No
(115) MET SALES & INSTALLATIONS	CONTRIBUTING EMPLOYER							No
(116) METAL & ROOF SUPPLIES INC	CONTRIBUTING EMPLOYER							No
(117) METRO CRANE AND RIGGING SERVICE INC	CONTRIBUTING EMPLOYER							No
(118) METROPOLITAN ROOF SYSTEMS	CONTRIBUTING EMPLOYER							No
(119) METROPOLITAN WALTERS LLC	CONTRIBUTING EMPLOYER							No
(120) MG MCGRATH INC	CONTRIBUTING EMPLOYER							No
(121) MIDTOWN HVAC ENTERPRISES LTD	CONTRIBUTING EMPLOYER							No
(122) MILCON CONSTRUCTION CORP	CONTRIBUTING EMPLOYER							No
(123) MILLENNIUM STEEL INC	CONTRIBUTING EMPLOYER							No
(124) MINELLI CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER							No
(125) MIRAGE MECHANICAL	CONTRIBUTING EMPLOYER							No
(126) MTE SOLUTIONS LLC	CONTRIBUTING EMPLOYER							No
(127) NICHOLSON-GALLOWAYIND	CONTRIBUTING EMPLOYER							No
(128) NORTH STAR MECHANICAL CORP	CONTRIBUTING EMPLOYER							No
(129) NY CHUTES LLC	CONTRIBUTING EMPLOYER							No
(130) ORNAMENTAL INSTALLATION SPEC	CONTRIBUTING EMPLOYER							No
(131) P & F SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(132) PC TESTING & BALANCING INC	CONTRIBUTING EMPLOYER							No
(133) PARAGON SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(134) PB VENTILATING SYSTEMS INC	CONTRIBUTING EMPLOYER							No
(135) PEEPELS MECHANICAL	CONTRIBUTING EMPLOYER							No
(136) PERMASTEELISA NORTH AMERICA CORP	CONTRIBUTING EMPLOYER							No
(137) POSILLICO-SKANSKA JOINT VENTURE	CONTRIBUTING EMPLOYER							No
(138) POWER SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(139) PRECISION TEST & BAL OF NY	CONTRIBUTING EMPLOYER							No
(140) PS CONTRACTING OF NJ INC	CONTRIBUTING EMPLOYER							No
(141) RAMS MECHANICAL INC	CONTRIBUTING EMPLOYER							No
(142) RAY INDUSTRIAL SERVICES INC	CONTRIBUTING EMPLOYER							No
(143) RAY'S INSTALLATION	CONTRIBUTING EMPLOYER							No
(144) REARDEN METALWORKS LLC	CONTRIBUTING EMPLOYER							No
(145) RELATED SERVICES LLC	CONTRIBUTING EMPLOYER							No
(146) RG INSTALLERS INC	CONTRIBUTING EMPLOYER							No
(147) RICHARDS PLUMBING & HEATING CO INC	CONTRIBUTING EMPLOYER							No
(148) ROMAR SHEET METAL	CONTRIBUTING EMPLOYER							No
(149) ROTH BROS INC	CONTRIBUTING EMPLOYER							No
(150) S & M MECHANICAL CORP	CONTRIBUTING EMPLOYER							No
(151) SANDHU CONTRACTING INC	CONTRIBUTING EMPLOYER							No
(152) SASMI	CONTRIBUTING EMPLOYER							No
(153) SEABREEZE MECHANICAL CORP	CONTRIBUTING EMPLOYER							No
(154) SEFI FAB DBA P&M LLC	CONTRIBUTING EMPLOYER							No
(155) SHARP MECHANICAL SERVICES INC	CONTRIBUTING EMPLOYER							No
(156) SKY KING SKYLIGHTS INC	CONTRIBUTING EMPLOYER							No
(157) SMS SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(158) SMW LOCAL 10 BENEFIT FUND	CONTRIBUTING EMPLOYER							No
(159) SMW LOCAL 110	CONTRIBUTING EMPLOYER							No
(160) SMW LOCAL 177	CONTRIBUTING EMPLOYER							No
(161) SMW LOCAL 28 EDUCATION FUND	CONTRIBUTING EMPLOYER							No
(162) SMW LOCAL 28 GENERAL FUND	CONTRIBUTING EMPLOYER							No
(163) SMW LOCAL 28 LABOR MANAGEMENT	CONTRIBUTING EMPLOYER							No
(164) SMW LOCAL 28 WELFARE FUND	CONTRIBUTING EMPLOYER							No
(165) SPRINGFIELD SMW INC	CONTRIBUTING EMPLOYER							No
(166) STEEL & DUCT SM FBRS INC	CONTRIBUTING EMPLOYER							No
(167) STERLING INDUSTRIES INC	CONTRIBUTING EMPLOYER							No
(168) STONEBRIDGE STEEL ERECTION	CONTRIBUTING EMPLOYER							No
(169) STRIKER SHEET METAL II CORP	CONTRIBUTING EMPLOYER							No
(170) SUNY AT STONY BROOK	CONTRIBUTING EMPLOYER							No
(171) TECH MECHANICAL INC	CONTRIBUTING EMPLOYER							No
(172) TECHNICAL SYS SOL & MEAS INC	CONTRIBUTING EMPLOYER							No
(173) TECHNICO CONSTRUCTION SERVICES INC	CONTRIBUTING EMPLOYER							No
(174) THE JOBIN ORGANIZATION	CONTRIBUTING EMPLOYER							No
(175) THE URBAN GROUP LTD	CONTRIBUTING EMPLOYER							No
(176) THE WENIG CORP ENCLOSURE	CONTRIBUTING EMPLOYER							No
(177) THEMIS CHIMNEY INC	CONTRIBUTING EMPLOYER							No
(178) THERMAL THINKERS INC	CONTRIBUTING EMPLOYER							No
(179) THERMO HYDRONIC CORP	CONTRIBUTING EMPLOYER							No
(180) TLH PANEL INC	CONTRIBUTING EMPLOYER							No
(181) TOMCO MECHANICAL CORP	CONTRIBUTING EMPLOYER							No
(182) TRIPLE S AIR SYSTEMS INC	CONTRIBUTING EMPLOYER							No
(183) TRI-STATE SKYLIGHTS INC	CONTRIBUTING EMPLOYER							No
(184) TRU SHEET METAL	CONTRIBUTING EMPLOYER							No
(185) U & I MECHANICAL CORP	CONTRIBUTING EMPLOYER							No
(186) UNIQUE DUCT DESIGN CORP	CONTRIBUTING EMPLOYER							No
(187) UNITED SHEET METAL CORP	CONTRIBUTING EMPLOYER							No
(188) UNIVERSAL HEATING & AIR CONDITIONING INC	CONTRIBUTING EMPLOYER							No
(189) US CHUTES CORP	CONTRIBUTING EMPLOYER							No
(190) USA ROOFING CO CORP	CONTRIBUTING EMPLOYER							No
(191) VAMCO MECHANICAL CONT	CONTRIBUTING EMPLOYER							No
(192) W & W STEEL ERECTORS LLC	CONTRIBUTING EMPLOYER							No
(193) WBE SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(194) WDF INC	CONTRIBUTING EMPLOYER							No
(195) WEICKERT INDUSTRIES INC	CONTRIBUTING EMPLOYER							No
(196) WELKIN MECHANICAL LLC	CONTRIBUTING EMPLOYER							No
(197) WOLKOW-BRAKER RFG CORP	CONTRIBUTING EMPLOYER							No
(198) YOUR CHOICE MECHANICAL SHEET METAL INC	CONTRIBUTING EMPLOYER							No
(199) ZHL GROUP INC	CONTRIBUTING EMPLOYER							No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE MEMBERS WITH HEALTH AND WELFARE BENEFITS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	55
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	68,789,703	63,742,434
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,260,294	1,770,384
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	886,393	670,601
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	70,936,390	66,183,419
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	50,865,248	61,336,611
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	934,301	931,177
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,448,483	2,463,464
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	54,248,032	64,731,252
19	Revenue less expenses. Subtract line 18 from line 12.......	16,688,358	1,452,167
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	132,716,351	131,501,040
21	Total liabilities (Part X, line 26).............	5,739,520	4,737,164
22	Net assets or fund balances. Subtract line 21 from line 20.....	126,976,831	126,763,876

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	TO PROVIDE MEMBERS WITH HEALTH AND WELFARE BENEFITS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	384,865	1,274,642	884,863

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) DEBRA FRAZIER........................................................................ EMPLOYEE	40.00 .......................	X	101,243	0	21,738

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......

			Business Code
2a	EMPLOYER CONTRIBUTIONS	230000	61,722,583	61,722,583
b	RETIREE AND COBRA CONTRIBUTIONS	230000	2,019,851	2,019,851
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			63,742,434

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			1,743,773			1,743,773
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		26,486,860
b	Less: cost or other basis and sales expenses		26,460,249
c	Gain or (loss)		26,611
d	Net gain or (loss).....			26,611			26,611
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER INCOME		900099	670,601			670,601
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			670,601
12	Total revenue. See Instructions......			66,183,419	63,742,434	0	2,440,985

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members	61,336,611
5	Compensation of current officers, directors, trustees, and key employees ....	150,781
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	615,316
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	31,973
9	Other employee benefits .......	76,770
10	Payroll taxes ...........	56,337
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	235,250
c	Accounting ...........	117,176
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	123,982
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	49,650
12	Advertising and promotion ....
13	Office expenses .......	179,059
14	Information technology ......	57,957
15	Royalties ..
16	Occupancy ...........	166,781
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	5,543
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	340,183
23	Insurance ...	33,820
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	THIRD PARTY ADMINISTRAT	744,814
b	MEDICAL CONSULTING	409,249
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	64,731,252
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			19,000,171	1	15,848,475
2	Savings and temporary cash investments .........			20,629,735	2	20,096,068
3	Pledges and grants receivable, net ......			6,000	3	0
4	Accounts receivable, net .............			4,724,849	4	4,360,923
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......			6,191	9	2,478
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	4,662,217
b	Less: accumulated depreciation	10b	3,149,426	1,655,416	10c	1,512,791
11	Investments—publicly traded securities .			86,624,048	11	89,594,330
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			69,941	15	85,975
16	Total assets. Add lines 1 through 15 (must equal line 34)...			132,716,351	16	131,501,040

17	Accounts payable and accrued expenses .....	897,043	17	397,248
18	Grants payable ...		18
19	Deferred revenue .........	1,770,574	19	1,910,596
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	3,071,903	25	2,429,320
26	Total liabilities. Add lines 17 through 25..	5,739,520	26	4,737,164

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	126,976,831	32	126,763,876
33	Total net assets or fund balances ...........	126,976,831	33	126,763,876
34	Total liabilities and net assets/fund balances ........	132,716,351	34	131,501,040