TY 2019 Form 990

- 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

AFSCME HEALTH AND WELFARE FUND

Employer identification number

23-7360639

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

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

Term 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
d	Equipment ....	13,727	9,612	4,115
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				4,115

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2019

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	9,467,730
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	1,841,401
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	1,841,401
3	Subtract line 2e from line 1..................			3	7,626,329
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	83,278
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	83,278
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	7,709,607

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	6,287,416
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	6,287,416
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	83,278
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	83,278
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	6,370,694

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 FUND AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2019, 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. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS FOR THE PLAN.

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 FUND AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2019, 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. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS FOR THE PLAN.

Schedule D (Form 990) 2019

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

AFSCME HEALTH AND WELFARE FUND

Employer identification number

23-7360639

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE TRUSTEES HAVE BEEN PROVIDED A COPY OF THE FORM 990. IN ADDITION, THE ADMINISTRATOR, AT THE REQUEST OF THE BOARD OF TRUSTEES, REVIEWS THE FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION C, LINE 19	NO GOVERNING DOCUMENTS OR POLICIES ARE MADE AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE FUND'S 5500 FILINGS.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

AFSCME HEALTH AND WELFARE FUND

Employer identification number

23-7360639

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)ALTOONA AREA SCHOOL DISTRICT 1415 6TH AVENUE ALTOONA,PA166020000 25-1157777	LOCAL EDUCATION	PA			N/A		No
(2)ALTOONA WATER AUTHORITY 900 CHESTNUT AVENUE ALTOONA,PA166010000 23-6268625	PUBLIC SECTOR WATER & SEWER	PA			N/A		No
(3)AMED ALTOONA-LOGAN TOWNSHIP MOBILE MEDICAL EMERGENCY DEPT 1012 7TH AVENUE ALTOONA,PA166020000 25-1413314	MUNICIPAL AMBULANCE AUTHORITY	PA			N/A		No
(4)AMBRIDGE BOROUGH 600 ELEVENTH STREET AMBRIDGE,PA150030000 23-6794450	LOCAL GOVERNMENT	PA			N/A		No
(5)BETHLEHEM TOWNSHIP 4225 EASTON AVENUE BETHLEHEM,PA180200000 24-6001363	LOCAL GOVERNMENT (POLITICAL SUBDIVISION)	PA			N/A		No
(6)BLAIR COUNTY PRISON 419 MARKET SQUARE ALLEY HOLLIDAYSBURG,PA166480000 23-6003045	CORRECTIONAL FACILITY	PA			N/A		No
(7)BOROUGH OF DANVILLE 239 MILL STREET DANVILLE,PA178210000 24-6000579	LOCAL GOVERNMENT	PA			N/A		No
(8)BOROUGH OF IRWIN 424 MAIN ST IRWIN,PA156420000 25-6000389	MUNICIPAL OFFICE	PA			N/A		No
(9)BOROUGH OF LEMOYNE 510 HERMAN AVENUE LEMOYNE,PA170430000 23-6005021	LOCAL GOVERNMENT	PA			N/A		No
(10)BOROUGH OF LEWISTOWN 2 EAST THIRD STREET LEWISTOWN,PA170440000 23-6002883	GOVERNMENT	PA			N/A		No
(11)BOROUGH OF SHIPPENSBURG 111 N FAYETTE ST PO BOX 129 SHIPPENSBURG,PA172570000 23-6003094	MUNICIPAL ACTIVITIES	PA			N/A		No
(12)BOROUGH OF TULLYTOWN 500 MAIN STREET ROAD TULLYTOWN,PA190070000 23-6005389	MUNICIPAL GOVERNMENT	PA			N/A		No
(13)BRACKENRIDGE BOROUGH 1000 BRACKENRIDGE AVENUE BRACKENRIDGE,PA150140000 25-6000285	MUNICIPALITY	PA			N/A		No
(14)BROOKMONT HEALTHCARE CENTER LLC 510 BROOKMONT DR PO BOX 50 EFFORT,PA183300000 77-0616109	SKILLED NURSING SERVICES	PA			N/A		No
(15)BUTLER TOWNSHIP 290 SOUTH DUFFY RD BUTLER,PA160010000 25-6000686	MUNICIPALITY	PA			N/A		No
(16)CENTER TOWNSHIP 1212 NEAL RD HOMER CITY,PA157480000 25-6000762	LOCAL GOVERNMENT	PA			N/A		No
(17)BOROUGH OF LEHIGHTON 1 CONSTITUTION AVENUE LEHIGHTON,PA182352088 24-6000615	MUNICIPAL ACTIVITIES	PA			N/A		No
(18)CITY OF CARBONDALE 1 NORTH MAIN STREET CARBONDALE,PA184070000 24-6000692	MUNICIPALITY	PA			N/A		No
(19)CITY OF FARRELL 500 ROEMER BLVD FARRELL,PA161210000 25-6000858	MUNICIPALITY	PA			N/A		No
(20)CITY OF MEADVILLE 894 DIAMOND PARK MEADVILLE,PA163350000 25-6000867	LOCAL GOVERNMENT	PA			N/A		No
(21)CITY OF MONESSEN ONE WENDELL RAMEY LANE SUITE 423 MONESSEN,PA150620000 25-6000871	LOCAL GOVERNMENT	PA			N/A		No
(22)CITY OF POTTSVILLE 401 NORTHCENTRE STREET POTTSVILLE,PA179010000 23-6001906	MUNICIPALITY	PA			N/A		No
(23)CITY OF SAINT MARYS 11 LAFAYETTE STREET SAINT MARYS,PA158570000 25-1699421	LOCAL GOVERNMENT	PA			N/A		No
(24)CITY OF SHARON 155 W CONNELLY BLVD SUITE 5 SHARON,PA161460000 25-6000883	MUNICIPALITY	PA			N/A		No
(25)CITY OF TITUSVILLE 107 N FRANKLIN ST TITUSVILLE,PA163540000 25-6000884	LOCAL GOVERNMENT	PA			N/A		No
(26)CLARVIEW NURSING AND REHABILITATION 14663 ROUTE 68 SLIGO,PA162530000 23-7435274	SKILLED NURSING AND REHAB LTC	PA			N/A		No
(27)CORNPLANTER TOWNSHIP 136 PETROLEUM CENTER ROAD OIL CITY,PA163010000 25-6001003	GOVERNMENT LOCAL	PA			N/A		No
(28)COUDERSPORT BOROUGH 201 SOUTH WEST ST COUDERSPORT,PA169150000 24-6000576	MUNICIPAL GOVERNMENT	PA			N/A		No
(29)COUNTY OF BUCKS 50 N MAIN ST DOYLESTOWN,PA189010000 23-6003044	GOVERNMENT	PA			N/A		No
(30)CITY OF ERIE 626 STATE STREET ERIE,PA165011128 99-9000176	LOCAL GOVERNMENT	PA			N/A		No
(31)COUNTY OF ERIE COURTHOUSE 140 WEST 6TH STREET ROOM 501 ERIE,PA165010000 25-6001027	GOVERNMENT	PA			N/A		No
(32)LANCASTER CO PRISON 50 N DUKE STREET LANCASTER,PA176032805 23-1352351	CORRECTIONAL FACILITY	PA			N/A		No
(33)COUNTY OF NORTHAMPTON - GRACEDALE 2 GRACEDALE AVE 669 WASHINGTON ST RASTON,PA180420000 24-6000741	NURSING HOME	PA			N/A		No
(34)ERIE MUNICIPAL AIRPORT AUTHORITY 4411 WEST 12TH STREET ERIE,PA165050000 25-6004040	AIRPORT	PA			N/A		No
(35)ERIE WATER WORKS 340 WEST BAYFRONT PARKWAY ERIE,PA165070000 25-1664864	WATER UTILITY	PA			N/A		No
(36)EXTENDICARE HEALTHCARE SERVICES INC MOUNTAIN LAUREL NURSING REHAB CENTER 700 LEONARD ST CLEARFIELD,PA168300000 98-0066268	LONG TERM CARE	PA			N/A		No
(37)HARRISBURG HOUSING AUTHORITY 351 CHESTNUT HARRISBURG,PA171010000 23-6002297	PUBLIC HOUSING	PA			N/A		No
(38)HARRISON TOWNSHIP PO BOX 376 NATRONA HEIGHTS,PA150650000 25-6001675	LOCAL GOVERNMENT	PA			N/A		No
(39)HATFIELD TOWNSHIP MUNICIPAL AUTHORITY 3200 ADVANCE LANE COLMAR,PA189150000 23-1672408	WASTEWATER TREATMENT PLANT	PA			N/A		No
(40)HOLLIDAYSBURG AREA SCHOOL DISTRICT 201 JACKSON STREET HOLLIDAYSBURG,PA166480000 25-1157793	EDUCATION ORGANIZATION	PA			N/A		No
(41)HOLLIDAYSBURG BOROUGH 401 BLAIR STREET HOLLIDAYSBURG,PA166480000 23-6002874	GOVERNMENT	PA			N/A		No
(42)HOUSING AUTHORITY OF THE COUNTY OF ARMSTRONG 350 SOUTH JEFFERSON STREET KITTANNING,PA162010000 25-1115593	LOW INCOME HOUSING	PA			N/A		No
(43)HUMAN SERVICES CENTER 130 W NORTH ST NEW CASTLE,PA161010000 25-1123896	MENTAL HEALTH SERVICES	PA			N/A		No
(44)KITTANNING BOROUGH 300 SOUTH MCKEAN STREET PO BOX 973 KITTANNING,PA162010000 25-6000392	MUNICIPAL GOVERNMENT	PA			N/A		No
(45)LEHIGHTON WATER AUTHORITY PO BOX 29 LEHIGHTON,PA182350000 24-6002307	SUPPLY PUBLIC DRINKING WATER	PA			N/A		No
(46)LIGONIER VALLEY SCHOOL DISTRICT 339 WEST MAIN STREET LIGONIER,PA156580000 25-1157797	K-12 EDUCATION	PA			N/A		No
(47)LOWER PAXTON TOWNSHIP 425 PRINCE STREET HARRISBURG,PA171090000 23-6000401	N/A	PA			N/A		No
(48)LOWER YODER TOWNSHIP 128 J STREET JOHNSTOWN,PA159060000 25-6002023	LOCAL GOVERNMENT	PA			N/A		No
(49)LUTHERAN HOME AT KANE 100 HIGH POINT DRIVE KANE,PA167350000 25-1158827	SKILLED NURSING FACILITY	PA			N/A		No
(50)MCKEAN COUNTY 500 W MAN ST SMETHPORT,PA167490000 25-6001039	COUNTY GOVERNEMENT	PA			N/A		No
(51)NESHANNOCK TOWNSHIP ROAD DEPARTMENT 3131 MERCER ROAD NEW CASTLE,PA161050000 25-6002260	POLITICAL SUBDIVISION OF THE COMMONWEALTH OF PA	PA			N/A		No
(52)NEW CASTLE PUBLIC LIBRARY 207 EAST NORTH STREET NEW CASTLE,PA161010000 25-6002274	LIBRARY	PA			N/A		No
(53)NORTH HUNTINGDON TOWNSHIP 11279 CENTER HWY HUNTINGDON,PA156420000 25-6002327	GOVERNMENT	PA			N/A		No
(54)NORTHERN CAMBRIA BOROUGH 1202 PHILADELPHIA AVENUE NORTHERN CAMBRIA,PA157140000 25-1843543	LOCAL GOVERNMENT	PA			N/A		No
(55)NORWIN SCHOOL DISTRICT 281 MCMAHON DR NORTH HUNTINGDON,PA156420000 25-6010564	PUBLIC EDUCATION	PA			N/A		No
(56)PHILIPSBURG BOROUGH 4 NORTH CENTRE STREET PO BOX 631 PHILIPSBURG,PA168660000 24-6000648	LOCAL GOVERNMENT OFFICE	PA			N/A		No
(57)PLEASANT RIDGE MANOR 8300 WEST RIDGE ROAD GIRARD,PA164170000 25-1302760	SKILLED NURSING FACILITY	PA			N/A		No
(58)SHENANGO TOWNSHIP 3439 HUBBARD-MIDDLESEX ROAD WEST MIDDLESEX,PA161590000 25-6002993	LOCAL GOVERNMENT	PA			N/A		No
(59)STATE COLLEGE AREA SCHOOL DISTRICT 131 WEST NITTANY AVE STATE COLLEGE,PA168010000 24-6001247	PA SALES TAX EXEMPTION 76148000	PA			N/A		No
(60)INDIANA STUDENT COOPERATIVE ASSN INC 319 PRATT DRIVE INDIANA,PA157010000 25-6012456	SERVICE ORGANIZATION FOR A STATE UNIVERSITY	PA			N/A		No
(61)SUSQUEHANNA TOWNSHIP BOARD OF COMMISSIONERS 1900 LINGLUTOWN ROAD HARRISBURG,PA171100000 23-6005240	MUNICIPAL GOVERNMENT	PA			N/A		No
(62)TARENTUM BOROUGH 318 EAST 2ND AVE TARENTUM,PA150840000 25-6000482	GOVERNMENT OFFICE	PA			N/A		No
(63)THE CITY OF CORRY 100 SOUTH CENTER STREET CORRY,PA164070000 25-6000854	MUNICIPAL GOVERNMENT	PA			N/A		No
(64)TITUSVILLE AREA HOSPITAL 406 W OAK ST TITUSVILLE,PA163540000 25-0965579	HEALTHCARE	PA			N/A		No
(65)NORTHAMPTON CO PRISON 666 WALNUT STREET EASTON,PA180424481 24-6000741	CORRECTIONAL FACILITY	PA			N/A		No
(66)VALLEY TOWNSHIP PO BOX 467 COATESVILLE,PA193200000 23-6000550	MUNICIPAL GOVERNMENT	PA			N/A		No
(67)WARREN COUNTY COMMISSIONERS (SHERRIF'S OFFICE) 204 FOURTH AVE WARREN,PA163650000 25-6003371	COUNTY GOVERNEMENT	PA			N/A		No
(68)WARREN GENERAL HOSPITAL 2 CRESCENT PARK WEST WARREN,PA163650000 25-0965598	ACUTE CARE HOSPITAL	PA			N/A		No
(69)WEST MEAD TOWNSHIP 1150 MORGAN VILLAGE ROAD MEADVILLE,PA163350000 25-6003453	LOCAL GOVERNMENT TOWNSHIP	PA			N/A		No
(70)WESTMONT BOROUGH 1000 LOZERNE ST JOHNSTOWN,PA159050000 25-6000506	LOCAL GOVERNMENT	PA			N/A		No
(71)ZERBE TOWNSHIP 800 MANHANDY STREET TREVORTON,PA178810000 24-6001602	MUNICIPALITY	PA			N/A		No
(72)UNIVERSITY AREA JOINT AUTHORITY 1576 SPRING VALLEY RD STATE COLLEGE,PA168010000 25-1195933	MUNICIPAL AUTHORITY	PA			N/A		No
(73)SOUTH WILLIAMSPORT BOROUGH 329 W SOUTHERN AVENUE SOUTH WILLIAMSPORT,PA17702 24-6000659	MUNICIPALITY	PA			N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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

Schedule R (Form 990) 2019

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) ......................

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) ...................

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

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

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

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

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

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) 2019

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) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTH AND WELFARE BENEFITS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	0
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 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	6,657,620	6,668,397
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	588,014	517,068
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	524,208	524,142
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	7,769,842	7,709,607
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).....	6,140,986	5,702,188
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
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)....	699,761	668,506
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	6,840,747	6,370,694
19	Revenue less expenses. Subtract line 18 from line 12.......	929,095	1,338,913
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	17,944,724	21,129,121
21	Total liabilities (Part X, line 26).............	51,859	55,942
22	Net assets or fund balances. Subtract line 21 from line 20.....	17,892,865	21,073,179

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	PAY DENTAL CLAIMS FOR APPROXIMATELY 1800 PARTICIPANTS UNDER THE PLAN'S DENTAL PROGRAM.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	PAY PRESCRIPTION DRUG CLAIMS FOR APPROXIMATELY 1,350 PARTICIPANTS UNDER THE PLAN'S PRESCRIPTION DRUG PROGRAM.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	PAY GROUP INSURANCE PREMIUMS FOR APPROXIMATELY 784 PARTICIPANTS UNDER THE PLAN'S DISABILITY INSURANCE PROGRAM.

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

(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)		(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
(1) DAVE FILLMAN...................................................................... TRUSTEE, CHAIRMAN	1.00 .................	X		0	0	0
(2) ZOLLIE RAYNER...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(3) TOM TOSTI...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(4) KERRI GALLAGHER...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(5) ELIZABETH KELLY...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(6) JUSTIN TAYLOR...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(7) SHANNON BERKEY...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(8) ALYCIA KNOLL...................................................................... TRUSTEE	1.00 .................	X		0	0	0
(9) TRAVIS OHM...................................................................... ADMINISTRATOR	1.00 .................		X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

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:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	EMPLOYER CONTRIBUTIONS	900099	6,586,161	6,586,161
b	PARTICIPANT CONTRIBUTIONS	900099	42,632	42,632
c	COBRA PREMIUMS	900099	39,604	39,604
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		6,668,397

3 Investment income (including dividends, interest, and othersimilar amounts) ......			576,548			576,548
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		1,913,429	7a
b	Less: cost or other basis and sales expenses		1,972,909	7b
c	Gain or (loss)		-59,480	7c
d	Net gain or (loss).........			-59,480			-59,480
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	PRESCRIPTION REBATES		900099	524,142	524,142
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			524,142
12	Total revenue. See instructions.....			7,709,607	7,192,539	0	517,068

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	5,702,188
5	Compensation of current officers, directors, trustees, and key employees ...........
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........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	40,000
c	Accounting ...........	40,221
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	83,278
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	158,398
12	Advertising and promotion ....
13	Office expenses .......	40,764
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	22,558
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	984
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,635
23	Insurance ...	10,120
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	ADMINISTRATION FEES	239,891
b	PICORI FEES	27,692
c	PARTICIPATIONS, SUBSCRI	1,965
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	6,370,694
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 ........			366,502	1	66,791
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			513,561	4	476,299
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			20,980	9	1,980
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	13,727
b	Less: accumulated depreciation	10b	9,612	6,750	10c	4,115
11	Investments—publicly traded securities .			17,036,931	11	20,579,936
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 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			17,944,724	16	21,129,121

17	Accounts payable and accrued expenses .....	51,859	17	55,942
18	Grants payable ...		18
19	Deferred revenue .........		19
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			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		25
26	Total liabilities. Add lines 17 through 25..	51,859	26	55,942

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	17,892,865	29	21,073,179
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	0	31	0
32	Total net assets or fund balances ...........	17,892,865	32	21,073,179
33	Total liabilities and net assets/fund balances ........	17,944,724	33	21,129,121