2024-02-02T10:07:14-06:00 2023-03-31 221750854 I E Shaffer & Co 830 Bear Tavern Road West Trenton NJ 08628 990 2022-04-01 222236617 TRUSTEES LOCAL 400 IBEW WELFARE FUND C/O IE SHAFFER & CO TRUS 6097181323 830 BEAR TAVERN ROAD WEST TRENTON NJ 08628 JONATHAN D LEVINE ADMINISTRATOR 6097181323 2024-02-02 JONATHAN LEVINE 999009999 0 P01068910 6097181323 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JONATHAN D LEVINE 830 BEAR TAVERN ROAD WEST TRENTON NJ 08628 16501948 0 X N/A X 1978 NJ Provide group health benefits to eligible participants 7 7 0 0 0 0 0 0 14013858 15394881 271175 168402 0 0 14285033 15563283 0 0 14640193 14491500 0 0 0 0 0 527594 629477 15167787 15120977 -882754 442306 9192722 12337395 1505748 1664617 7686974 10672778 Provide group health benefits to eligible participants 0 0 14491500 15563283 Provide group health benefits to eligible participants 14491500 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 1 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 X IE SHAFFER & CO 6097181323 830 BEAR TAVERN ROAD WEST TRENTON NJ 08628 ROBERT SHIMKO TRUSTEE 1.00 40.00 X 0 199311 141511 Robert Ingman TRUSTEE 1.00 2.00 X 0 0 0 EDWARD WELLS TRUSTEE 1.00 X 0 0 0 MICHAEL TOMASIELLO TRUSTEE 1.00 X 0 0 0 WILLIAM JONES TRUSTEE 1.00 X 0 0 0 THOMAS O JOHNSTON ESQ TRUSTEE 1.00 X 0 0 0 ELIZABETH MANZO ESQ TRUSTEE 1.00 X 0 0 0 Michael Ricca TRUSTEE 1.00 40.00 X 0 180041 127830 0 379352 269341 0 0 1 0 IE Shaffer & Co 830 Bear Tavern Rd PO Box 1028 West Trenton NJ 08628 Third Party Administrator 413066 Horizon Healthcare Services Inc 3 Penn Plaza East PP-04V Newark NJ 07105 Claims Processing 292887 Capital RX Inc 228 Park Avenue South Suite 87234 New York NY 10003 Pharmacy Benefits Management 157783 3 EMPLOYER CONTRIBUTIONS 230000 14300432 14300432 COBRA CONTRIBUTIONS 230000 1036070 1036070 OTHER INCOME 230000 58379 58379 15394881 196700 196700 910367 938665 -28298 -28298 -28298 15563283 15563283 0 0 14491500 14491500 413066 413066 78692 78692 61978 61978 16712 16712 23165 23165 16615 16615 13223 13223 1861 1861 PCORI Fee 4165 4165 15120977 14491500 629477 0 879700 1587815 1482811 1807973 3367 3240 2884953 2849805 3941891 6088562 9192722 12337395 259748 316617 1246000 1348000 1505748 1664617 X 7686974 10672778 0 0 0 0 7686974 10672778 9192722 12337395 X 442306 -443967 2987465 X 0 1 X 0 0 0 Guaranteed Investment Contract 6088562 F 6088562 BENEFIT CLAIMS PAYABLE 1348000 1348000 X 15102604 -443967 -443967 15546571 16712 16712 15563283 15002265 0 15002265 16712 102000 118712 15120977 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 Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Services. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Part XII, Line 4b - Other Adjustments: CHANGE IN BENEFIT CLAIMS PAYABLE 102000. 0 0 0 ROBERT SHIMKO TRUSTEE 0 199311 0 0 0 0 0 75738 0 65773 0 340822 0 0 Michael Ricca TRUSTEE 0 180041 0 0 0 0 0 68416 0 59414 0 307871 0 0 Form 990, Part VI, Section A, line 2 ROBERT SHIMKO AND MICHAEL RICCA ARE EMPLOYEES AND OFFICERS OF IBEW LOCAL UNION 400 Form 990, Part VI, Section A, line 7a UNION TRUSTEES ARE APPOINTED BY IBEW LOCAL UNION 400 AND EMPLOYER TRUSTEES ARE APPOINTED BY THE NORTHERN NEW JERSEY CHAPTER, INC. NATIONAL ELECTRICAL CONTRACTORS ASSOCIATION WHO REPRESENTS THE EMPLOYERS HAVING A CONTRACTUAL RELATIONSHIP WITH THE UNION Form 990, Part VI, Section A, line 8b NO SUCH COMMITTEES EXISTED Form 990, Part VI, Section B, line 11b A COPY OF THE RETURN HAS BEEN PROVIDED TO THE TRUSTEES FOR THEIR REVIEW AND COMMENT PRIOR TO ITS SUBMISSION Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST OR MAY BE EXAMINED AT THE ADDRESS OF THE PLAN Form 990, Part XI, line 9: Transfer of Assets from IBEW 400 Supplemental Fund 2987465. LOCAL UNION 400 IBEW PENSION PLAN 830 BEAR TAVERN ROAD WEST TRENTON NJ 08628 226257847 PENSION FUND NJ 401(A) N/A 0 LOCAL UNION 400 IBEW SUPPLEMENTAL BENEFIT PLAN 830 BEAR TAVERN ROAD WEST TRENTON NJ 08628 260181078 PROVIDE HEALTHCARE REIMBURSEMENT BENEFITS TO PARTICIPANTS NJ 501(c)(9) N/A 0 LOCAL UNION 400 IBEW JOINT ANNUITY FUND 830 BEAR TAVERN ROAD WEST TRENTON NJ 08628 222160644 PROVIDE ANNUITY BENEFITS TO PARTICIPANTS NJ 401(A) N/A 0 IBEW 400 LOCAL UNION PO BOX 1256 Wall NJ 07719 210482995 REPRESENT UNION MEMBERS FOR THE PURPOSE OF COLLECTIVE BARGAINING NJ 501(c)(5) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0