Carpenters Welfare Fund 2007
Carpenters Welfare Fund 2007
Carpenters Welfare Fund 2007
B This return/report is: (1) the first return/report filed for the plan; (3) the final return/report filed for the plan;
(2) the amended return/report; (4) a short plan year return/report (less than 12
months).
C If the plan is a collectively-bargained plan, check here
D If you filed for an extension of time to file, check the box and attach a copy of the extension application
Part II Basic Plan Information – enter all requested information.
1a Name of plan 1b Three-digit
501
plan number (PN)
NEW YORK CITY DISTRICT COUNCIL OF CARPENTERS WELFARE FUND 1c Effective date of plan (mo., day, yr.)
July 01, 1950
2a Plan sponsor's name and address (employer, if for a single-employer plan) 2b Employer Identification Number (EIN)
(Address should include room or suite no.) 13-5615576
2c Sponsor's telephone number
BOARD OF TRUSTEES OF NYCDCC WELFARE FUND 212-366-7300
395 HUDSON ST 2d Business code (see instructions)
NEW YORK NY 10014-3669 236200
Caution: A penalty for the late or incomplete filing of this return/report will be assessed unless reasonable cause is established.
Under penalties of perjury and other penalties set forth in the instructions, I declare that I have examined this return/report, including
accompanying schedules, statements and attachments, and to the best of my knowledge and belief, it is true, correct, and complete.
Signature of plan administrator Date Typed or printed name of individual signing as plan administrator
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3a Plan administrator's name and address (if same as plan sponsor, enter"Same") 3b Administrator's EIN
4 If the name and/or EIN of the plan sponsor has changed since the last return/report filed for this plan, enter the b EIN
name, EIN and the plan number from the last return/report below:
c PN
a Sponsor's name
5 Preparer information (optional) a Name (including firm name, if applicable) and address b EIN
61-1436956
NOVAK FRANCELLA LLC c Telephone no.
450 SEVENTH AVENUE, SUITE 3500 212-279-4262
NEW YORK NY 10123
6 Total number of participants at the beginning of the plan year 6 27,070
7 Number of participants as of the end of the plan year (welfare plans complete only lines 7a, 7b, 7c, and 7d)
a Active participants a 20,326
b Retired or separated participants receiving benefits b 7,530
c Other retired or separated participants entitled to future benefits c
d Subtotal. Add lines 7a, 7b, and 7c d 27,856
e Deceased participants whose beneficiaries are receiving or are entitled to receive benefits e
f Total. Add lines 7d and 7e f
g Number of participants with account balances as of the end of the plan year (only defined contribution plans g
complete this item)
h Number of participants that terminated employment during the plan year with accrued benefits that were less h
than 100% vested
i If any participant(s) separated from service with a deferred vested benefit, enter the number of separated i
participants required to be reported on a Schedule SSA (Form 5500)
8 Benefits provided under the plan (complete 8a through 8c, as applicable)
a Pension benefits (check this box if the plan provides pension benefits and enter the applicable pension feature codes from the List
of Plan Characteristics Codes (printed in the instructions)):
b Welfare benefits (check this box if the plan provides welfare benefits and enter the applicable welfare feature codes from the List of
Plan Characteristics Codes (printed in the instructions)):
4A 4B 4D 4E 4F 4K 4L 4Q 4U
9a Plan funding arrangement (check all that apply) 9b Plan benefit arrangement (check all that apply)
(1) Insurance (1) Insurance
(2) Section 412(i) insurance contracts (2) Section 412(i) insurance contracts
(3) Trust (3) Trust
(4) General assets of the sponsor (4) General assets of the sponsor
10 Schedules attached (Check all applicable boxes and, where indicated, enter the number attached. See instructions.)
a Pension Benefit Schedules b Financial Schedules
(1) R (Retirement Plan Information) (1) H (Financial Information)
(2) I (Financial Information – Small Plan)
(2) T (Qualified Pension Plan Coverage Information)
(3) 2 A (Insurance Information)
If a Schedule T is not attached because the plan is (4) C (Service Provider Information)
relying on coverage testing information for a prior (5) D (DFE/Participating Plan Information)
year, enter the year (6) G (Financial Transaction Schedules)
(3) B (Actuarial Information)
(4) E (ESOP Annual Information)
(5) SSA (Separated Vested participant Information)
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C Plan sponsor's name as shown on line 2a of Form 5500 D Employer Identification Number
13-5615576
BOARD OF TRUSTEES OF NYCDCC WELFARE FUND
1 Coverage
(a) Name of insurance carrier
06/30/2007
06-0838648 70815 GVL-303004 21944 08/01/2006
2 Insurance fees and commissions paid to agents, brokers, and other persons:
Totals
Amount of commissions paid Fees paid / Amount
$62,500
For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form Schedule A (Form 5500)
5500. v2.3 2006
(a) Name and address of the agents, brokers or other
persons to whom commissions or fees were paid
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3 Current value of plan's interest under this contract in the general account at year end
4 Current value of plan's interest under this contract in separate accounts at year end
5 Contracts With Allocated Funds
a State the basis of premium rates
b Premiums paid to carrier
c Premiums due but unpaid at the end of the year
d If the carrier, service, or other organization incurred any specific costs in connection with the acquision or
retention of the contract or policy, enter amount
Specify nature of costs
e Type of contract (1) individual policies (2) group deferred annuity (3) other (specify)
f If contract purchased, in whole or in part, to distribute benefits from a terminating plan check here
6 Contracts With Unallocated Funds (Do not include portions of these contracts maintained in separate accounts)
a Type of contract (1) deposit administration (2) immediate participation guarantee
(3) guaranteed investment (4)
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C Plan sponsor's name as shown on line 2a of Form 5500 D Employer Identification Number
13-5615576
BOARD OF TRUSTEES OF NYCDCC WELFARE FUND
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1 Coverage
(a) Name of insurance carrier
08/31/2006
06-6033492 60054 880782-ERG 0 07/01/2006
2 Insurance fees and commissions paid to agents, brokers, and other persons:
Totals
Amount of commissions paid Fees paid / Amount
For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form Schedule A (Form 5500)
5500. v2.3 2006
(a) Name and address of the agents, brokers or other
persons to whom commissions or fees were paid
3 Current value of plan's interest under this contract in the general account at year end
4 Current value of plan's interest under this contract in separate accounts at year end
5 Contracts With Allocated Funds
a State the basis of premium rates
b Premiums paid to carrier
c Premiums due but unpaid at the end of the year
d If the carrier, service, or other organization incurred any specific costs in connection with the acquision or
retention of the contract or policy, enter amount
Specify nature of costs
e Type of contract (1) individual policies (2) group deferred annuity (3) other (specify)
f If contract purchased, in whole or in part, to distribute benefits from a terminating plan check here
6 Contracts With Unallocated Funds (Do not include portions of these contracts maintained in separate accounts)
a Type of contract (1) deposit administration (2) immediate participation guarantee
(3) guaranteed investment (4)
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e Deductions:
(1) Disbursed from fund to pay benefits or purchase annuities during year
(2) Administration charge made by carrier
(3) Transferred to separate account
(4) Other (specify below)
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NONE $7,172,727
99
EMPLOYEE $3,684,202
99
NONE $1,059,392
22
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NONE $1,002,549
9917
NONE $952,914
10
NONE $894,452
10
NONE $751,491
16
SIDS 11-2995970
DENTAL CLAIMS ADMINISTRAT
(d) Relationship to employer, employee organization, (e) Gross salary or (f) Fees and commissions (g) Nature of service code(s)
or person known to be a party-in-interest allowances paid by plan paid by plan (see instructions)
NONE $647,679
99
NONE $292,809
22
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NONE $240,215
99
NONE $169,711
16
NONE $168,000
17
NONE $159,125
21
NONE $94,667
10
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NONE $77,133
10
NONE $68,926
20
NONE $64,879
21
NONE $36,695
10
EMPLOYEE $63,465
13
EMPLOYEE $42,941
13
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EMPLOYEE $53,939
13
EMPLOYEE $71,238
13
EMPLOYEE $53,460
13
EMPLOYEE $54,204
13
EMPLOYEE $137,128
13
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EMPLOYEE $42,195
13
EMPLOYEE $48,312
13
EMPLOYEE $35,402
13
EMPLOYEE $58,407
13
EMPLOYEE $35,904
13
EMPLOYEE $131,046
13
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EMPLOYEE $50,361
13
EMPLOYEE $100,225
13
EMPLOYEE $49,597
13
EMPLOYEE $49,365
13
EMPLOYEE $42,208
13
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EMPLOYEE $65,736
13
CONTRACT ADMINISTRATOR
(d) Relationship to employer, employee organization, (e) Gross salary or (f) Fees and commissions (g) Nature of service code(s)
or person known to be a party-in-interest allowances paid by plan paid by plan (see instructions)
12
EMPLOYEE $50,462
13
EMPLOYEE $42,181
13
EMPLOYEE $45,055
13
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Department of the Treasury This schedule is required to be filed under section 104 of the Employee 2006
Internal Revenue Service Retirement Income Security Act of 1974 (ERISA) and section 6058(a) of the This Form is Open to
Department of Labor Internal Revenue Code (the Code). Public Inspection
Employee Benefits Security
Administration File as an attachment to Form 5500.
Pension Benefit
Guaranty Corporation
For the calendar plan year 2006 or fiscal plan year beginning July 01, 2006, and ending June 30, 2007
A Name of plan B Three digit
501
NEW YORK CITY DISTRICT COUNCIL OF CARPENTERS WELFARE FUND plan number
C Plan sponsor's name as shown on line 2a of Form 5500 or 5500-EZ D Employer Identification
BOARD OF TRUSTEES OF NYCDCC WELFARE FUND Number
13-5615576
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5a Has a resolution to terminate the plan been adopted during the plan year or any prior plan year? If yes, enter the amount of any plan
assets that reverted to the employer this year Yes No Amount
5b If, during this plan year, any assets or liabilities were transferred from this plan to another plan(s), identify the plan(s) to which assets or
liabilities were transferred. (See instructions).
5b(1) Name of plan(s) 5b(2) EIN(s) 5b(3) PN(s)
For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form Schedule H (Form 5500)
5500. v2.3 2006
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