401k Plan data: RI PAINTERS HEALTH PLAN plan

RI PAINTERS HEALTH PLAN 401k Plan overview

Plan Name	RI PAINTERS HEALTH PLAN
Plan identification number	501

RI PAINTERS HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

JOINT BOARD OF TRUSTEES RI PAINTERS has sponsored the creation of one or more 401k plans.

Company Name: JOINT BOARD OF TRUSTEES RI PAINTERS

Employer identification number (EIN): 050269677

NAIC Classification: 238300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RI PAINTERS HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 SCOTT DUHAMEL WILLIAM CLAVIN 2016-03-30
501 2014-01-01 SCOTT DUHAMEL(UNION TRUSTEE) WILLIAM CLAVIN(EMPLOYER TRUSTEE) 2015-09-09
501 2014-01-01 SCOTT DUHAMEL(UNION TRUSTEE) WILLIAM CLAVIN(EMPLOYER TRUSTEE) 2015-09-02
501 2012-01-01 SCOTT DUHAMEL(UNION TRUSTEE) WILLIAM CLAVIN(EMPLOYER TRUSTEE) 2013-07-25
501 2011-01-01 SCOTT DUHAMELUNION TRUSTEE WILLIAM CLAVINEMPLOYER TRUSTEE 2012-07-30
501 2010-01-01 SCOTT DUHAMELUNION TRUSTEE WILLIAM CLAVINEMPLOYER TRUSTEE 2011-08-03
501 2009-01-01 SCOTT DUHAMELUNION TRUSTEE WILLIAM CLAVINEMPLOYER TRUSTEE 2010-06-30
501 2009-01-01 SCOTT DUHAMELUNION TRUSTEE WILLIAM CLAVINEMPLOYER TRUSTEE 2010-06-30

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-01-01	SCOTT DUHAMEL	WILLIAM CLAVIN	2016-03-30
501	2014-01-01	SCOTT DUHAMEL(UNION TRUSTEE)	WILLIAM CLAVIN(EMPLOYER TRUSTEE)	2015-09-09
501	2014-01-01	SCOTT DUHAMEL(UNION TRUSTEE)	WILLIAM CLAVIN(EMPLOYER TRUSTEE)	2015-09-02
501	2012-01-01	SCOTT DUHAMEL(UNION TRUSTEE)	WILLIAM CLAVIN(EMPLOYER TRUSTEE)	2013-07-25
501	2011-01-01	SCOTT DUHAMELUNION TRUSTEE	WILLIAM CLAVINEMPLOYER TRUSTEE	2012-07-30
501	2010-01-01	SCOTT DUHAMELUNION TRUSTEE	WILLIAM CLAVINEMPLOYER TRUSTEE	2011-08-03
501	2009-01-01	SCOTT DUHAMELUNION TRUSTEE	WILLIAM CLAVINEMPLOYER TRUSTEE	2010-06-30
501	2009-01-01	SCOTT DUHAMELUNION TRUSTEE	WILLIAM CLAVINEMPLOYER TRUSTEE	2010-06-30

Plan Statistics for RI PAINTERS HEALTH PLAN

401k plan membership statisitcs for RI PAINTERS HEALTH PLAN

Measure Date Value
2015: RI PAINTERS HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Total participants 2015-01-01 0
2014: RI PAINTERS HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 104
Total of all active and inactive participants 2014-01-01 104
Total participants 2014-01-01 0
Number of employers contributing to the scheme 2014-01-01 21
2012: RI PAINTERS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 117
Total of all active and inactive participants 2012-01-01 117
Total participants 2012-01-01 0
Number of employers contributing to the scheme 2012-01-01 30
2011: RI PAINTERS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 164
Total of all active and inactive participants 2011-01-01 164
Total participants 2011-01-01 164
Number of employers contributing to the scheme 2011-01-01 30
2010: RI PAINTERS HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 228
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 145
Total of all active and inactive participants 2010-01-01 145
Total participants 2010-01-01 145
2009: RI PAINTERS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 228
Total of all active and inactive participants 2009-01-01 228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 229

Measure	Date	Value
2015: RI PAINTERS HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Total participants	2015-01-01	0
2014: RI PAINTERS HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	104
Total of all active and inactive participants	2014-01-01	104
Total participants	2014-01-01	0
Number of employers contributing to the scheme	2014-01-01	21
2012: RI PAINTERS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	117
Total of all active and inactive participants	2012-01-01	117
Total participants	2012-01-01	0
Number of employers contributing to the scheme	2012-01-01	30
2011: RI PAINTERS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	164
Total of all active and inactive participants	2011-01-01	164
Total participants	2011-01-01	164
Number of employers contributing to the scheme	2011-01-01	30
2010: RI PAINTERS HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	228
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	145
Total of all active and inactive participants	2010-01-01	145
Total participants	2010-01-01	145
2009: RI PAINTERS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	228
Total of all active and inactive participants	2009-01-01	228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	229

Financial Data on RI PAINTERS HEALTH PLAN

Measure	Date	Value
2015 : RI PAINTERS HEALTH PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-06-01	$57,265
Total unrealized appreciation/depreciation of assets	2015-06-01	$57,265
Total transfer of assets from this plan	2015-06-01	$3,185,078
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-01	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-01	$44,383
Total income from all sources (including contributions)	2015-06-01	$728,124
Total loss/gain on sale of assets	2015-06-01	$0
Total of all expenses incurred	2015-06-01	$853,106
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-01	$701,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-01	$656,284
Value of total assets at end of year	2015-06-01	$0
Value of total assets at beginning of year	2015-06-01	$3,354,443
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-01	$151,162
Total interest from all sources	2015-06-01	$14,575
Total dividends received (eg from common stock, registered investment company shares)	2015-06-01	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-01	No
Administrative expenses professional fees incurred	2015-06-01	$32,487
Was this plan covered by a fidelity bond	2015-06-01	Yes
Value of fidelity bond cover	2015-06-01	$500,000
If this is an individual account plan, was there a blackout period	2015-06-01	No
Were there any nonexempt tranactions with any party-in-interest	2015-06-01	No
Contributions received from participants	2015-06-01	$61,896
Assets. Other investments not covered elsewhere at beginning of year	2015-06-01	$6,644
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-06-01	$44,605
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-06-01	$34,208
Administrative expenses (other) incurred	2015-06-01	$103,231
Total non interest bearing cash at beginning of year	2015-06-01	$160,761
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-01	No
Value of net income/loss	2015-06-01	$-124,982
Value of net assets at end of year (total assets less liabilities)	2015-06-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-06-01	$3,310,060
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-01	No
Were any leases to which the plan was party in default or uncollectible	2015-06-01	No
Investment advisory and management fees	2015-06-01	$7,283
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-01	$1,127,760
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-01	$363,837
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-01	$363,837
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-01	$14,575
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-01	$701,944
Asset value of US Government securities at beginning of year	2015-06-01	$1,274,635
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-01	No
Was there a failure to transmit to the plan any participant contributions	2015-06-01	No
Has the plan failed to provide any benefit when due under the plan	2015-06-01	No
Contributions received in cash from employer	2015-06-01	$594,388
Employer contributions (assets) at beginning of year	2015-06-01	$376,201
Contract administrator fees	2015-06-01	$8,161
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-06-01	No
Liabilities. Value of benefit claims payable at beginning of year	2015-06-01	$10,175
Did the plan have assets held for investment	2015-06-01	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-01	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-01	No
Opinion of an independent qualified public accountant for this plan	2015-06-01	Unqualified
Accountancy firm name	2015-06-01	WARD, FISHER & COMPANY, LLP
Accountancy firm EIN	2015-06-01	050234540
2014 : RI PAINTERS HEALTH PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$176,576
Total unrealized appreciation/depreciation of assets	2014-12-31	$176,576
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$44,383
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$21,376
Total income from all sources (including contributions)	2014-12-31	$1,919,557
Total of all expenses incurred	2014-12-31	$1,836,225
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,692,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,700,775
Value of total assets at end of year	2014-12-31	$3,354,443
Value of total assets at beginning of year	2014-12-31	$3,248,104
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$104,673
Total interest from all sources	2014-12-31	$42,206
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$55,945
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$160,490
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$6,644
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$810
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$44,605
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$43,476
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$34,208
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$8,656
Administrative expenses (other) incurred	2014-12-31	$12,994
Liabilities. Value of operating payables at end of year	2014-12-31	$10,175
Liabilities. Value of operating payables at beginning of year	2014-12-31	$12,720
Total non interest bearing cash at end of year	2014-12-31	$160,761
Total non interest bearing cash at beginning of year	2014-12-31	$293,430
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$83,332
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,310,060
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,226,728
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$16,874
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,127,760
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,008,195
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$363,837
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$338,213
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$338,213
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$42,206
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$1,692,650
Asset value of US Government securities at end of year	2014-12-31	$1,274,635
Asset value of US Government securities at beginning of year	2014-12-31	$1,218,068
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$1,540,285
Employer contributions (assets) at end of year	2014-12-31	$376,201
Employer contributions (assets) at beginning of year	2014-12-31	$345,912
Contract administrator fees	2014-12-31	$18,860
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	WARD,FISHER & COMPANY,LLP
Accountancy firm EIN	2014-12-31	050234540
2012 : RI PAINTERS HEALTH PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$90,838
Total unrealized appreciation/depreciation of assets	2012-12-31	$90,838
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$29,150
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$42,415
Total income from all sources (including contributions)	2012-12-31	$2,208,864
Total of all expenses incurred	2012-12-31	$1,758,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,645,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,077,412
Value of total assets at end of year	2012-12-31	$3,259,956
Value of total assets at beginning of year	2012-12-31	$2,822,606
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$112,483
Total interest from all sources	2012-12-31	$27,083
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$13,531
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$13,531
Administrative expenses professional fees incurred	2012-12-31	$42,450
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$178,384
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$6,155
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$42,084
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$44,458
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$26,171
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$36,136
Administrative expenses (other) incurred	2012-12-31	$55,196
Liabilities. Value of operating payables at end of year	2012-12-31	$2,979
Liabilities. Value of operating payables at beginning of year	2012-12-31	$6,279
Total non interest bearing cash at end of year	2012-12-31	$369,684
Total non interest bearing cash at beginning of year	2012-12-31	$477,379
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$450,615
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,230,806
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,780,191
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$14,837
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$766,250
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$672,111
Income. Interest from US Government securities	2012-12-31	$26,315
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$523,425
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$243,392
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$243,392
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$768
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$1,645,766
Asset value of US Government securities at end of year	2012-12-31	$1,102,034
Asset value of US Government securities at beginning of year	2012-12-31	$1,055,803
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$1,899,028
Employer contributions (assets) at end of year	2012-12-31	$450,324
Employer contributions (assets) at beginning of year	2012-12-31	$329,463
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Aggregate proceeds on sale of assets	2012-12-31	$1,250,000
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$1,250,000
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	WARD,FISHER & COMPANY,LLP
Accountancy firm EIN	2012-12-31	050234540
2011 : RI PAINTERS HEALTH PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$6,426
Total unrealized appreciation/depreciation of assets	2011-12-31	$6,426
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$42,415
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$62,077
Total income from all sources (including contributions)	2011-12-31	$2,022,375
Total loss/gain on sale of assets	2011-12-31	$524
Total of all expenses incurred	2011-12-31	$1,758,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,653,435
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,968,226
Value of total assets at end of year	2011-12-31	$2,822,606
Value of total assets at beginning of year	2011-12-31	$2,578,631
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$105,303
Total interest from all sources	2011-12-31	$35,624
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$11,575
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$11,575
Administrative expenses professional fees incurred	2011-12-31	$36,050
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$252,039
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$36,260
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$44,458
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$114,524
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$36,136
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$57,160
Administrative expenses (other) incurred	2011-12-31	$54,736
Liabilities. Value of operating payables at end of year	2011-12-31	$6,279
Liabilities. Value of operating payables at beginning of year	2011-12-31	$4,917
Total non interest bearing cash at end of year	2011-12-31	$477,379
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$263,637
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,780,191
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,516,554
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$14,517
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$672,111
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$684,161
Income. Interest from US Government securities	2011-12-31	$35,460
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$243,392
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$361,432
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$361,432
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$164
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$1,653,435
Asset value of US Government securities at end of year	2011-12-31	$1,055,803
Asset value of US Government securities at beginning of year	2011-12-31	$1,086,803
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$1,679,927
Employer contributions (assets) at end of year	2011-12-31	$329,463
Employer contributions (assets) at beginning of year	2011-12-31	$331,711
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Aggregate proceeds on sale of assets	2011-12-31	$1,200,000
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$1,199,476
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	WARD,FISHER & COMPANY,LLP
Accountancy firm EIN	2011-12-31	050234540
2010 : RI PAINTERS HEALTH PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$91,156
Total unrealized appreciation/depreciation of assets	2010-12-31	$91,156
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$62,077
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$34,844
Total income from all sources (including contributions)	2010-12-31	$1,934,757
Total of all expenses incurred	2010-12-31	$2,207,273
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$2,099,214
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,785,741
Value of total assets at end of year	2010-12-31	$2,578,631
Value of total assets at beginning of year	2010-12-31	$2,823,914
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$108,059
Total interest from all sources	2010-12-31	$48,191
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$9,669
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$38,243
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$129,414
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$170,070
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$114,524
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$56,555
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$57,160
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$32,664
Administrative expenses (other) incurred	2010-12-31	$55,063
Liabilities. Value of operating payables at end of year	2010-12-31	$4,917
Liabilities. Value of operating payables at beginning of year	2010-12-31	$2,180
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-272,516
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,516,554
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,789,070
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$14,753
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$684,161
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$547,629
Income. Interest from US Government securities	2010-12-31	$42,454
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$361,432
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$414,592
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$414,592
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$5,737
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$2,099,214
Asset value of US Government securities at end of year	2010-12-31	$1,086,803
Asset value of US Government securities at beginning of year	2010-12-31	$1,401,284
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$1,486,257
Employer contributions (assets) at end of year	2010-12-31	$331,711
Employer contributions (assets) at beginning of year	2010-12-31	$403,854
Income. Dividends from common stock	2010-12-31	$9,669
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	WARD,FISHER & COMPANY,LLP
Accountancy firm EIN	2010-12-31	050234540

Form 5500 Responses for RI PAINTERS HEALTH PLAN

2015: RI PAINTERS HEALTH PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Multi-employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: RI PAINTERS HEALTH PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Multi-employer plan
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2012: RI PAINTERS HEALTH PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Multi-employer plan
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RI PAINTERS HEALTH PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Multi-employer plan
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: RI PAINTERS HEALTH PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Multi-employer plan
2010-01-01	Plan is a collectively bargained plan	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: RI PAINTERS HEALTH PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Multi-employer plan
2009-01-01	Plan is a collectively bargained plan	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175

Policy instance

Insurance contract or identification number	4175
Number of Individuals Covered	310
Insurance policy start date	2015-01-01
Insurance policy end date	2015-05-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $655,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

G31255, C4411

Policy instance

Insurance contract or identification number	G31255, C4411
Number of Individuals Covered	101
Insurance policy start date	2014-07-01
Insurance policy end date	2015-05-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $9,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	CORNERSTONE FINANCIAL GROUP, INC.

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175

Policy instance

Insurance contract or identification number	4175
Number of Individuals Covered	310
Insurance policy start date	2015-01-01
Insurance policy end date	2015-05-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $43,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175

Policy instance

Insurance contract or identification number	4175
Number of Individuals Covered	291
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,587,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175

Policy instance

Insurance contract or identification number	4175
Number of Individuals Covered	290
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $105,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

G3125, C4411

Policy instance

Insurance contract or identification number	G3125, C4411
Number of Individuals Covered	103
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $220
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $11,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $220
Insurance broker organization code?	3
Insurance broker name	CORNERSTONE FINANCIAL GROUP, INC

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

G3125, C4411

Policy instance

Insurance contract or identification number	G3125, C4411
Number of Individuals Covered	125
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $1,020
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $20,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,020
Additional information about fees paid to insurance broker	COMMISSIONS PER AGREEMENT
Insurance broker organization code?	3
Insurance broker name	CORNERSTONE FINANCIAL GROUP, INC

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175

Policy instance

Insurance contract or identification number	4175
Number of Individuals Covered	318
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,286,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175

Policy instance

Insurance contract or identification number	4175
Number of Individuals Covered	318
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $82,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

G-3125,C-4411

Policy instance

Insurance contract or identification number	G-3125,C-4411
Number of Individuals Covered	139
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $1,035
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $20,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175 1

Policy instance

Insurance contract or identification number	4175 1
Number of Individuals Covered	288
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $100,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175 1

Policy instance

Insurance contract or identification number	4175 1
Number of Individuals Covered	288
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,550,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

G-3125,C-4411

Policy instance

Insurance contract or identification number	G-3125,C-4411
Number of Individuals Covered	145
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $1,138
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $22,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,138
Additional information about fees paid to insurance broker	COMMISSIONS PER AGREEMENT
Insurance broker organization code?	3
Insurance broker name	CORNERSTONE FINANCIAL GROUP, INC

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175 1

Policy instance

Insurance contract or identification number	4175 1
Number of Individuals Covered	399
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $126,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )

Policy contract number

4175 1

Policy instance

Insurance contract or identification number	4175 1
Number of Individuals Covered	400
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,943,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	JOINT BOARD OF TRUSTEES RI PAINTERS
Employer identification number (EIN):	050269677
NAIC Classification:	238300