TEAMSTERS HEALTH SERVICES AND INSURANCE PLAN OF LOCAL UNION 404: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
TEAMSTERS HEALTH SERVICES AND INSURANCE PLAN OF LOCAL UNION 404 (EIN 04-2174518)
Tax period
2024-07-01 to 2025-06-30
Filed
2026-05-11
IRS object ID
202641319349301049
Schema version
2024v5.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2026-05-11T08:09:34-05:00ReturnTs
Tax Period End2025-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN061298465PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SM ESPOSITO & CO PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13013 DIXWELL AVENUEAddressLine1Txt
CityHAMDENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06518ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN042174518EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TEAMSTERS HEALTH SERVICES & INSURANCEBusinessNameLine1Txt
Business Name Line2PLAN OF LOCAL UNION 404BusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlTEAMBusinessNameControlTxt
Phone4137332191PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 PROGRESS AVENUEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01104ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTANLEY OSOWSKIPersonNm
Person TitleUNION TRUSTEEPersonTitleTxt
Phone4137332191PhoneNum
Signature2026-04-24SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANA HARVEY CPAPreparerPersonNm
PTINP01452206PTIN
Phone2033877771PhoneNum
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTANLEY OSOWSKIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 PROGRESS AVENUEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01104ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$61,353,927GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1954FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionSELF-INSURED HEALTH BENEFIT PLANActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$14,308,023PYProgramServiceRevenueAmt
CY Program Service Revenue$14,543,890CYProgramServiceRevenueAmt
PY Investment Income$8,144,306PYInvestmentIncomeAmt
CY Investment Income$10,673,098CYInvestmentIncomeAmt
PY Other Revenue$17,824PYOtherRevenueAmt
CY Other Revenue$75,368CYOtherRevenueAmt
PY Total Revenue$22,470,153PYTotalRevenueAmt
CY Total Revenue$25,292,356CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$10,082,421PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$11,121,896CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$305,427PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$433,172CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,037,960PYOtherExpensesAmt
CY Other Expenses$1,088,217CYOtherExpensesAmt
PY Total Expenses$11,425,808PYTotalExpensesAmt
CY Total Expenses$12,643,285CYTotalExpensesAmt
PY Revenues Less Expenses$11,044,345PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$12,649,071CYRevenuesLessExpensesAmt
Total Assets BOY$188,572,381TotalAssetsBOYAmt
Total Assets EOY$213,728,475TotalAssetsEOYAmt
Total Liabilities BOY$1,391,396TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,304,364TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$187,180,985NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$212,424,111NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTERS LOCAL 404 UNION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescPROVIDES INSURED AND SELF-INSURED MEDICAL, DEATH & LIFEINSURANCE BENEFITS TO 1,200 ACTIVE AND RETIRED MEMBERS PLUS THEIR DEPENDENTS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STANLEY OSOWSKIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4137332191PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 PROGRESS AVENUEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01104ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
FRANK ROSSI
UNION TRUSTEE4.00Yes (X)$9,800$0$0
ROBERT SULLIVAN JR
EMPLOYER TRUSTEE2.00Yes (X)$9,800$0$0
LAWRENCE KEEFE
EMPLOYER TRUSTEE2.00Yes (X)$9,800$0$0
BRYAN DONOVAN
(FORMER) UNION TRUSTEE4.00Yes (X)$0$122,055$65,53055.00
STANLEY OSOWSKI
UNION TRUSTEE4.00Yes (X)$0$120,198$65,53055.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$29,400TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$242,253TotReportableCompRltdOrgAmt
Total Other Compensation$131,060TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANTHEM BLUE CROSS BLUE SHIELDBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11351 WM HOWARD TAFT RDAddressLine1Txt
CityCINCINNATICityNm
State AbbreviationOHStateAbbreviationCd
ZIP45206ZIPCd
FieldValueIRS element (for citing)
ServicesREPRICING & ADMIN FEESServicesDesc
Compensation$230,374CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$14,121,549$14,121,549
SPECIAL RETIREE CONTRIBUTIONS900099$339,079$339,079
AFFILIATED RENTAL INCOME900099$63,463$63,463
COBRA CONTRIBUTIONS900099$16,749$16,749
PAYROLL AUDIT CONTRIBUTIONS900099$3,050$3,050
FieldValueIRS element (for citing)
Total Program Service Revenue$14,543,890TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,530,195TotalRevenueColumnAmt
Exclusion$5,530,195ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$41,204,474SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$36,061,571SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,142,903SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,142,903TotalRevenueColumnAmt
Exclusion$5,142,903ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescREFUNDS & REIMBURSMENTSDesc
Business900099BusinessCd
Total Revenue Column$75,368TotalRevenueColumnAmt
Related Or Exempt Func Income$75,368RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$75,368OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,292,356TotalRevenueColumnAmt
Related Or Exempt Func Income$14,619,258RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$10,673,098ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$11,121,896TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$29,400TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$177,743TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$109,668TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$100,980TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,381TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$116,093TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$708,067TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$19,647TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$129,107TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$29,596TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$18,828TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$26,013TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescUNCOLLECTABLE PAYROLL ADesc
Total$40,866TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,643,285TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$134,740BOYAmt
EOY$117,406EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$888,036BOYAmt
EOY$19,043,545EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,303,011BOYAmt
EOY$1,150,489EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$46,734BOYAmt
EOY$32,016EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,120,547LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$758,200LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$344,565BOYAmt
EOY$362,347EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$184,685,552BOYAmt
EOY$192,111,208EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,169,743BOYAmt
EOY$911,464EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$188,572,381BOYAmt
EOY$213,728,475EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$43,907BOYAmt
EOY$17,548EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,347,489BOYAmt
EOY$1,286,816EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,391,396BOYAmt
EOY$1,304,364EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$187,180,985BOYAmt
EOY$212,424,111EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$187,180,985BOYAmt
EOY$212,424,111EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$188,572,381BOYAmt
EOY$213,728,475EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$12,649,071ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$12,594,055NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$130,000OtherCostOrOtherBasisAmt
Book Value$130,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$774,849OtherCostOrOtherBasisAmt
Depreciation$661,865DepreciationAmt
Book Value$112,984BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,702OtherCostOrOtherBasisAmt
Depreciation$1,700DepreciationAmt
Book Value$2BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$213,996OtherCostOrOtherBasisAmt
Depreciation$94,635DepreciationAmt
Book Value$119,361BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$362,347TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
HEALTH CLAIMS PAYABLE; INCURRED BUT NOT REPORTED$955,000
ACCUMULATED ELIGIBILITY CREDITS$331,816
FieldValueIRS element (for citing)
Total Liability$1,286,816TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$37,800,318TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$12,594,055NetUnrealizedGainsInvstAmt
Revenue Not Reported$12,594,055RevenueNotReportedAmt
Revenue Subtotal$25,206,263RevenueSubtotalAmt
Investment Expenses Not Incld$86,093InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$86,093RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$25,292,356TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,617,867TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$12,617,867ExpensesSubtotalAmt
Investment Expenses Not Incld2$86,093InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$60,675OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$25,418ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$12,643,285TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND TO RECOGNIZE A TAX LIABILITY FOR ANY UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAX AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.THE PLAN FILES ITS FORM 990 IN THE U.S. FEDERAL JURISDICTION. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2021 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATION -60,673. ROUNDING -2.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRYAN DONOVAN
(FORMER) UNION TRUSTEE$0$121,392$0$0$0$663$0$34,632$0$30,898$0$187,585$0$0
STANLEY OSOWSKI
UNION TRUSTEE$0$118,792$0$0$0$1,406$0$34,632$0$30,898$0$185,728$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE UNION TRUSTEES RECEIVE WAGES FROM RELATED PARTY TEAMSTERS LOCAL UNION 404 FOR THERE POSITION OF UNION OFFICERS. SALARIES ARE DETERMINED BY THE UNION BYLAWS AND APPROVED BY THE UNION EXECUTIVE BOARD.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8BTHERE IS NO APPLICABLE COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE EXECUTIVE BOARD FOR WHICH MINUTES WOULD NEED TO BE RECORDED.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED IN PERSON WITH CERTAIN MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING OF THE RETURN.
FORM 990, PART VI, SECTION C, LINE 19THE HEALTH SERVICE & INSURANCE PLAN DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLIC ANY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS.
FORM 990, PART IX, LINE 11GCLAIM ADMINSTRATION 392,450. REPRICING & ADMIN FEES 315,617.
FORM 990, PART X11, LINE 2COVERSIGHT RESPONSIBILITY THERE HAS BEEN NO CHANGE IN THE OVERSIGHT RESPONSIBILITY. THE TRUSTEE'S ASSUME RESPONSIBILITY FOR THE AUDIT PROCESS INCLUDING SELECTION OF THE INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
TEAMSTERS LOCAL UNION 404
115 PROGRESS AVENUESPRINGFIELDMA01104041171377REPRESENTATION OF UNION MEMBERSMA501C-5N/A0
TRI STATE JOINT FUND
609 WEST JOHNSON AVE 2ND FLOORCHESHIRECT064100608501103RD PARTY ADMINISTRATOR FOR AFFILIATED ENTITIESCT501C-9N/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BERKSHIRE CONCRETE CORP
550 CHESHIRE ROADPITTSFIELDMA01201MAC0
BERKSHIRE TRANS MGT CO
67 DOWNING PARKWAYPITTSFIELDMA01201MAC0
YRC INC
10990 ROE AVEOVERLAND PARKKS66211KSC0
SULLIVAN TRANSPORT INC
PO BOX 90155SPRINGFIELDMA01139MAC0
TITAN ROOFING
165 HARING STREETWORCESTERMA01604MAC0
UNITED PARCEL SERVICE
100 EAST CAMPUS VIEW BLVDCOLUMBUSOH43235OHC0
WILLIAMS DISTRUBUTING
PO BOX 98CHICOPEEMA01021MAC0
CONSTRUCTION SERVICE
2420 BOSTON ROADWILBRAHAMMA01095MAC0
ET & L CONSTRUCTION
873 GREAT ROADSTOWMA01775MAC0
NEW PENN MOTOR EXPRESS
625 S 5TH AVELEBANONPA17042PAC0
ASHLAND INC
1111 GRATTAN STREETCHICOPEEMA01013MAC0
ARKANSAS BEST FREIGHT
PO BOX 10048FORT SMITHAR72917ARC0
AMERICAN ENVIRONMENTAL GROUP LTD
3600 BRECKSVILLE RDRICHFIELDOH44286OHC0
CASELLA WASTE CO
415 NORTH RDWESTFIELDMA01085MAC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
TRISTATE JOINT FUND
M$392,450CASH VALUE
TEAMSTERS LOCAL UNION 404
J$63,463CASH VALUE

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