2025-05-12T14:55:59-05:00 2024-06-30 320043599 LEGACY PROFESSIONALS LLP 4 WESTBROOK CORPORATE CTR STE 700 WESTCHESTER IL 60154 990 2023-07-01 362418276 LOCAL NO 4 SEIU HEALTH AND WELFARE FUND SERV 7733859300 2229 SOUTH HALSTED STREET 122 CHICAGO IL 60608 PAIGE KELLY TRUSTEE 7733859300 2025-05-12 1 0 CHRISTOPHER FRANZ P01456588 3123680500 2025-05-12 2023 2025-03-06 01:10:19Z PAIGE KELLY 2229 SOUTH HALSTED STREET 122 CHICAGO IL 60608 23427691 0 X N/A X 1959 IL PROVIDE HEALTH BENEFITS 6 3 62 0 0 0 0 0 20477072 21786479 279949 142364 0 0 20757021 21928843 0 0 19361866 17121745 1029567 1089478 0 0 0 799137 683180 21190570 18894403 -433549 3034440 10432549 13882303 109786 167725 10322763 13714578 PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH CARE, PRESCRIPTION DRUGS, AD&D BENEFITS, AND LIFE INSURANCE FOR ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 403 0 1 62 1 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ELNALYN COSTA 7733859300 2229 S HALSTED CHICAGO IL 60608 MYRA GLASSMAN TRUSTEE 4.00 40.00 X 0 149824 56041 PAIGE KELLY TRUSTEE 4.00 40.00 X 0 119785 42717 SHABATAYAH ANDRICH TRUSTEE 4.00 40.00 X 0 125565 25431 STEVEN TUROFSKY TRUSTEE 4.00 X 0 0 0 EPHRAIM VILENSKI TRUSTEE 4.00 X 0 0 0 MELISSA A STRECANSKY TRUSTEE 4.00 X 0 0 0 ELNALYN COSTA ADMINISTRATOR 8.00 X 169880 0 41825 CHERYL HARRIS-ARMSTRONG CONTROLLER-PAST 10.00 X 108795 0 38802 278675 395174 204816 2 0 1 0 UNION MEDICAL CENTER 1649 W ADAMS ST FLOOR 3 CHICAGO IL 60612 HMO SERVICES 2831328 OPTUMRX 1600 MCCONNOR PARKWAY SCHAUMBURG IL 60173 RX BENEFITS 1203875 SPECIALTY CARE MANAGEMENT LLC PO BOX 732 LAHASKA PA 18931 MEDICAL REVIEW SERVICES 536588 HINES & ASSOCIATES 115 E HIGHLAND AVE ELGIN IL 60120 MEDICAL CLAIMS REVIEW AND CASE MANAGEMEN 163830 HEALTHLINK INC PO BOX 6501 CAROL STREAM IL 60197 PREFERRED PROVIDER NETWORK 138577 6 EMPLOYER CONTRIBUTIONS 900099 19632428 19632428 PARTICIPANT CONTRIBUTIONS 900099 1544997 1544997 PRESCRIPTION DRUG REBATES 900099 477826 477826 LIQ DAMAGES, INTEREST, AND FEES 900099 88469 88469 CLAIM REFUNDS AND FEES 900099 42759 42759 21786479 290057 290057 1351155 1498848 -147693 -147693 -147693 21928843 21786479 0 142364 17121745 45514 710111 136979 134103 62771 70390 130862 3040 71759 81967 122259 119962 4967 32521 18434 MISCELLANEOUS 13132 ACA FEES 10571 MEMBERSHIP DUES 3316 18894403 1664818 4356001 273104 1325736 1550787 2162919 46838 45262 1157255 887890 341007 269365 5410211 4683643 1145784 1039377 10432549 13882303 109786 167725 109786 167725 X 0 0 0 0 10322763 13714578 10322763 13714578 10432549 13882303 3034440 357375 0 X 0 1 X 1 0 91254 22813 68441 91992 91495 497 974009 773582 200427 269365 COLLECTIVE INVESTMENT FUND 1039377 F 1039377 X 22283178 357375 357375 21925803 3040 3040 21928843 18891363 0 18891363 3040 3040 18894403 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X X X 0 0 0 MYRA GLASSMAN TRUSTEE 0 149824 0 0 0 0 0 31463 0 24578 0 205865 0 0 PAIGE KELLY TRUSTEE 0 119785 0 0 0 0 0 24651 0 18066 0 162502 0 0 SHABATAYAH ANDRICH TRUSTEE 0 125565 0 0 0 0 0 25431 0 0 0 150996 0 0 ELNALYN COSTA ADMINISTRATOR 169880 0 0 0 0 0 38216 0 3609 0 211705 0 0 0 SEIU HEALTHCARE ILLINOIS INDIANA LANDLORD 454437 LOCAL NO 4 SEIU HEALTH AND WELFARE FUND (THE PLAN) SUBLEASES OFFICE SPACE FROM SEIU HEALTHCARE ILLINOIS INDIANA (THE LOCAL). CERTAIN MEMBERS OF THE PLAN'S BOARD OF TRUSTEES ALSO SERVE AS OFFICERS OF THE LOCAL, THESE INCLUDE: MYRA GLASSMAN, PAIGE KELLY AND SHABATAYAH ANDRICH. 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. THE TRUSTEES REVIEW THE FORM AND UPON FULLY UNDERSTANDING THE COMPLETED FORM 990, IT IS APPROVED, SIGNED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES AND THE FUND ADMINISTRATOR SHALL REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THIS POLICY, TAKING ALL STEPS THEY DEEM NECESSARY TO ENSURE SUCH MONITORING AND ENFORCEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, DOCUMENT RETENTION AND DESTRUCTION POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. FORM 990, PART VII, SECTION A / FORM 990, PART IX, LINE 7,8,9,10 THE PLAN SHARES ITS COMPENSATED EMPLOYEES WITH THE SEIU HEALTHCARE HOME CARE AND CHILD CARE FUND AND THE SEIU LOCAL NO. 4 PENSION FUND, BOTH OF WHICH ARE UNRELATED BENEFIT FUNDS. THESE UNRELATED FUNDS REIMBURSE THE PLAN FOR SHARED SALARIES AND SALARY-RELATED EXPENSES AND OTHER ADMINISTRATIVE EXPENSES, WHICH ARE ALLOCATED PURSUANT TO A SHARED ADMINISTRATIVE AGREEMENT AND ESTIMATED USING COST ALLOCATION STUDIES APPROVED BY THE TRUSTEES. THE AMOUNTS REPORTED IN PART VII, COLUMNS D AND F REPRESENT THE GROSS AMOUNTS REPORTED ON FORM W-2 FOR 2023 AND REPRESENT THE ANNUAL SALARY. COLUMN B OF PART VII REPORTS THE TOTAL AVERAGE HOURS WORKED PER WEEK FOR THIS BENEFIT FUND AND DOES NOT INCLUDE THOSE HOURS DEDICATED TO AFFILIATED BUT UNRELATED FUNDS, AS DEFINED BY THIS FORM'S INSTRUCTIONS. THE FUNCTIONAL EXPENSES REPORTED, ON FORM 990, PART IX REPRESENT ONLY THOSE EXPENSES THAT ARE ALLOCATED TO THIS BENEFIT FUND. FORM 990, PART VI, SECTION B, LINE 15 / FORM 990, SCH. J, PART I, LN 3 THE FUND ADMINISTRATOR ENTERED INTO AN EMPLOYMENT AGREEMENT WITH THE FUND THAT HAS EXTENDED INTO THE CURRENT FILING PERIOD. THE COMPENSATION APPROVED BY THE FUND'S BOARD OF TRUSTEES WAS BASED, IN PART, ON AN ANNUAL SURVEY OF THE CHICAGO AREA ADMINISTRATORS GROUP THAT ANALYZED THE COMPENSATION LEVELS OF FUND ADMINISTRATORS WITHIN THE GEOGRAPHIC AREA, ADJUSTED FOR THE SIZE OF THE FUND, AND THE COMPENSATION OF THE PARTICIPANTS. PERIODICALLY, THE ADMINISTRATOR HAS ALSO RECEIVED COST OF LIVING OR OTHER ACROSS-THE-BOARD RAISES THAT WERE PROVIDED TO ALL FUND STAFF. 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