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LOCAL 677 HEALTH SERVICE AND: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
LOCAL 677 HEALTH SERVICE AND (EIN 06-0691862)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-15
IRS object ID
202401369349303450
Schema version
2022v5.0
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)
Return2024-05-15T08:37:28-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

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 Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060691862EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LOCAL 677 HEALTH SERVICE ANDBusinessNameLine1Txt
Business Name Line2INSURANCE PLANBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlLOCABusinessNameControlTxt
Phone2037552906PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVEAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN MURPHYPersonNm
Person TitleUNION TRUSTEEPersonTitleTxt
Phone2037552906PhoneNum
Signature2024-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastMURPHYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANA HARVEY CPAPreparerPersonNm
PTINP01452206PTIN
Phone2033877771PhoneNum
Preparation2024-05-13PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN MURPHYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11871 BALDWIN STREETAddressLine1Txt
CityWATERBURYCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06706ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$81,852,698GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1958FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionSELF-INSURED HEALTH BENEFIT PLANActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body1VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee6TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$41,390,428PYProgramServiceRevenueAmt
CY Program Service Revenue$13,809,656CYProgramServiceRevenueAmt
PY Investment Income$3,767,192PYInvestmentIncomeAmt
CY Investment Income$15,022,516CYInvestmentIncomeAmt
PY Other Revenue$2,145PYOtherRevenueAmt
CY Other Revenue$4,150CYOtherRevenueAmt
PY Total Revenue$45,159,765PYTotalRevenueAmt
CY Total Revenue$28,836,322CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$48,184,601PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$15,783,439CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$789,416PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$330,541CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,173,850PYOtherExpensesAmt
CY Other Expenses$1,174,882CYOtherExpensesAmt
PY Total Expenses$51,147,867PYTotalExpensesAmt
CY Total Expenses$17,288,862CYTotalExpensesAmt
PY Revenues Less Expenses-$5,988,102PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,547,460CYRevenuesLessExpensesAmt
Total Assets BOY$95,770,287TotalAssetsBOYAmt
Total Assets EOY$1,841,420TotalAssetsEOYAmt
Total Liabilities BOY$8,657,932TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,307TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$87,112,355NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,829,113NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTER LOCAL 677 UNION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescPROVIDED INSURED AND SELF-INSURED MEDICAL, DEATH & LIFEINSURANCE BENEFITS TO APPROXIMATELY 3,000 MEMBERS PLUS THEIR DEPENDENTS UP UNTIL DECEMEBER 31, 2022.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 Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
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 Required0ScheduleJRequiredInd
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 OperationsYes (1)TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee6EmployeeCnt
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 Members1GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
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 Line1JOHN MURPHYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2037552906PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVEAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
PAUL AYOUB
(FORMER) EMPLOYER TRUSTEE2.00Yes (X)$0$0$0
HELGA SCHMIDT
(FORMER) EMPLOYER TRUSTEE2.00Yes (X)$2,800$0$0
MICHAEL RINALDI
(FORMER) UNION TRUSTEE4.00Yes (X)$0$0$050.00
JOHN MURPHY
UNION TRUSTEE4.00Yes (X)$0$0$020.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,800TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
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$351,185CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$13,761,032$13,761,032
COBRA CONTRIBUTIONS900099$42,966$42,966
SPECIAL RETIREE CONTRIBUTIONS900099$5,658$5,658
FieldValueIRS element (for citing)
Total Program Service Revenue$13,809,656TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,321,576TotalRevenueColumnAmt
Exclusion$1,321,576ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$66,717,316SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$52,993,920SecuritiesAmt
Other$22,456OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$13,723,396SecuritiesAmt
Other-$22,456OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,700,940TotalRevenueColumnAmt
Exclusion$13,700,940ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescREFUNDS & REIMBURSEMENTSDesc
Business900099BusinessCd
Total Revenue Column$4,150TotalRevenueColumnAmt
Related Or Exempt Func Income$4,150RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$4,150OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,836,322TotalRevenueColumnAmt
Related Or Exempt Func Income$13,813,806RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$15,022,516ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$15,783,439TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,800TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$187,795TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$54,993TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$69,518TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,435TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$60,493TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$98,792TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$879,356TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$17,972TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$17,115TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,180TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,444TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$90,530TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,288,862TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$368,680BOYAmt
EOY$649,389EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,552,663BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,636,259BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,918BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$24,900BOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$86,931,028BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$253,839BOYAmt
EOY$1,192,031EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$95,770,287BOYAmt
EOY$1,841,420EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$89,337BOYAmt
EOY$12,307EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,568,595BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,657,932BOYAmt
EOY$12,307EOYAmt
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$87,112,355BOYAmt
EOY$1,829,113EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$87,112,355BOYAmt
EOY$1,829,113EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$95,770,287BOYAmt
EOY$1,841,420EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$11,547,460ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$8,135,225NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$88,695,477OtherChangesInNetAssetsAmt
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

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
PAYROLL AUDITS RECEIVABLE$122,832
DUE FROM HEALTH BENEFIT RECONCILIATION$1,069,199
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,192,031TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$20,633,808TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$8,135,225NetUnrealizedGainsInvstAmt
Revenue Not Reported-$8,135,225RevenueNotReportedAmt
Revenue Subtotal$28,769,033RevenueSubtotalAmt
Investment Expenses Not Incld$89,745InvestmentExpensesNotIncldAmt
Other Revenues Not Included-$22,456OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$67,289RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,836,322TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$23,756,940TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$22,456OtherExpensesIncludedAmt
Expenses Not Reported$22,456ExpensesNotReportedAmt
Expenses Subtotal$23,734,484ExpensesSubtotalAmt
Investment Expenses Not Incld2$89,745InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$6,535,367OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$6,445,622ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,288,862TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 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 TAX 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 PERIODS IN PROGRESS. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2019 AND PRIOR ARE CLOSED YEARS AND ARE NOT SUBJECT TO THE AUDIT PROCESS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:LOSS ON DISPOSITON OF OFFICE EQUIPMENT -22,456.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON DISPOSITION OF OFFICE EQUIPMENT 22,456.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATION -6,535,368. ROUNDING ADJUSTMENT 1.

Schedule N IRS990ScheduleN

Liquidation Of Assets Table LiquidationOfAssetsTableGrp

Liquidation Of Assets Detail LiquidationOfAssetsDetail (5 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
LOCAL 191 HEALTH SERVICE AND INSURANCE PLAN
CASH AND SECURITIES (STOCKS, BONDS AND REGISTERED INVESTMENT COMPANIES)2023-04-30$30,140,135CASH VALUE AND QUOTED MARKET PRICES FOR SECURITIES.0606899741139 FARIFIELD AVENUEBRIDGEPORTCT06605501(C)(9)
LOCAL 443 HEALTH SERVICE & INSURANCE PLAN
CASH AND SECURITIES (STOCKS, BONDS AND REGISTERED INVESTMENT COMPANIES)2023-04-30$26,445,478CASH VALUE AND QUOTED MARKET PRICES FOR SECURITIES.060690083PO BOX 1710NEW HAVENCT06507501(C)(9)
LOCAL 493 HEALTH SERVICE & INSURANCE PLAN
CASH AND SECURITIES (STOCKS, BONDS AND REGISTERED INVESTMENT COMPANIES)2023-04-30$6,830,201CASH VALUE AND QUOTED MARKET PRICES FOR SECURITIES.060689500PO BOX 485UNCASVILLECT06382501(C)(9)
LOCAL 671A HEALTH SERVICE & INSURANCE PLAN
CASH AND SECURITIES (STOCKS, BONDS AND REGISTERED INVESTMENT COMPANIES)2023-04-30$14,180,799CASH VALUE AND QUOTED MARKET PRICES FOR SECURITIES.06068366318 BRITTON DRIVEBLOOMFIELDCT06002501(C)(9)
LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN
CASH AND SECURITIES (STOCKS, BONDS AND REGISTERED INVESTMENT COMPANIES)2023-04-30$11,098,864CASH VALUE AND QUOTED MARKET PRICES FOR SECURITIES.060997832400 CHAPEL STREETSOUTH WINDSORCT06074501(C)(9)
FieldValueIRS element (for citing)
Director Of SuccessorYes (1)DirectorOfSuccessorInd
Employee Of Successor0EmployeeOfSuccessorInd
Owner Of Successor0OwnerOfSuccessorInd
Receive Compensation0ReceiveCompensationInd
Assets DistributedYes (1)AssetsDistributedInd
Required To Notify AG0RequiredToNotifyAGInd
Attorney General Notified0AttorneyGeneralNotifiedInd
Liabilities PaidYes (1)LiabilitiesPaidInd
Bonds Outstanding0BondsOutstandingInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2E:PERSON(S) INVOLVED: PAUL AYOUB
PART I, LINE 2E:EXPLANATION OF INVOLVEMENT: PAUL AYOUB WAS FROMERLY AN EMPLOYER TRUSTEE OF THIS PLAN AND HAS NOW ASSUMED THE ROLE OF AN EMPLOYER TRUSTEE ON LOCAL 1035 HEALTH SERVICE AND INSURANCE PLAN.
FORM 990, SCHEDULE N, PART IDURING THE PLAN YEAR LOCAL 677 HEALTH SERVICE AND INSURANCE PLAN CEASED ITS OPERATIONS AS A RESULT OF THE CLOSING OF SPONSORING UNION TEAMSTERS LOCAL 677. AS OF JANUARY 1 2023 ALL CONTRIBUTING EMPLOYERS AND PLAN PARTICIPANTS WERE TRANSFERRED TO OTHER UNION SPONSORED PLANS WITHIN THE STATE OF CONNECTICUT. THE RECEIVING PLANS WERE AFFILIATES OF TRISTATE (RELATED ORGANIZATION) AND MAINTAINED THE SAME PLAN OF BENEFITS. ASSETS WERE TRANSFERRED TO THE OTHER PLANS ON A PER CAPITA BASIS BASED ON WHICH UNION RECEIVED THE EMPLOYER AND THE RELATED UNION MEMBERS WORKING UNDER A CBA. THE FINAL TRANSFER WILL BE MADE ONCE ALL RECONCILING ITEMS SUCH AS BENEFIT PAYMENTS, REBATES AND GUARANTEES ARE COMPLETED.

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 OR FINANCIAL STATEMENTS.
FORM 990, PART XI, LINE 9:TRANSFER OF PLAN ASSETS TO AFFILIATES DUE TO DISSOLUTION -88,695,477.
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
IBT LOCAL UNION 677
1871 BALDWIN STREETWATERBURYCT06706060389865REPRESENTATION OF UNION MEMBERSCT501C-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 (47 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BRUNALI CONSTRUCTION CO
PO BOX 112SOUTHINGTONCT06489CTC0
CITY OF DANBURY
155 DEER HILL AVEDANBURYCT06810CTC0
DALY & SONS INC
110 MATTATUCK HEIGHTSWATERBURYCT06705CTC0
THE DRAWN METAL TUBE COMPANY
PO BOX 218MIDDLE VILLAGENY11379NYC0
A FIORILLO & COMAPNY
396 CLARK STREETMILLDALECT06467CTC0
TOWN OF NEW MILFORD
10 MAIN STREETNEW MILFORDCT06776CTC0
NEW PENN MOTOR EXPRESS
625 SO FIFTH STREETLEBANONPA17042PAC0
NORTHEAST TRANS CO
1717 THOMASTON AVEWATERBURYCT06704CTC0
O&G INDUSTRIES INC
PO BOX 907TORRINGTONCT06790CTC0
POMPERAUG REGIONAL SCHOOL 15
PO BOX 395MIDDLEBURYCT06762CTC0
YRC INC
10990 ROE AVEOVERLAND PARKKS66211KSC0
UNITED PARCEL SERVICE
100 EAST CAMPUS VIEW BLVDCOLUMBUSOH43235OHC0
SUZIO CONSTRUCTION CO
WESTFIELD ROADMERIDENCT06450CTC0
TOWN OF MIDDLEBURY
1212 WHITTEMORE ROADMIDDLEBURYCT06762CTC0
TOWN OF OXFORD
426 OXFORD ROADOXFORDCT06483CTC0
WACO SCAFFOLDING CO INC
1247 HIGHLAND AVENUECHESHIRECT06410CTC0
YORK TRAP ROCK QUARRY CO
WESTFIELD ROADMERIDENCT06450CTC0
J IAPALUCCIO INC
425 FEDERAL ROADBROOKFIELDCT06804CTC0
THE QUAKER CORPORATION
PO BOX 368CHESHIRECT06410CTC0
CORESLAB STRUCTURES INC
PO BOX 279THOMASTONCT06787CTC0
VEOLIA WATER SEYMOUR
VWNA EAST 723 DERBY AVESEYMOURCT06483CTC0
VEOLIA WATER DANBURY
NEWTOWN ROADDANBURYCT06810CTC0
TOWN OF ROXBURY
29 NORTH STREETROXBURYCT06783CTC0
CONSOLIDATED INDUSTRIES
677 MIXVILLE ROADCHESHIRECT06410CTC0
GRIFFIN HOSPITAL
130 DIVISION STREETDEBRYCT06518CTC0
INTERSTATE & LAKELAND LUMBER
247 MILL STREETGREEWICHCT06830CTC0
PETRO HOLDINGS
PO BOX 283TIVERTONRI02878RIC0
TOWN OF NEW FAIRFIELD
4 BRUSH HILL ROADNEW FAIRFIELDCT06812CTC0
TOWN OF SHERMAN
PO BOX 39 MALLERYSHERMANCT06784CTC0
ANSONIA BOARD OF EDUCATION
42 GROVE STREETANSONIACT06401CTC0
TOWN OF BRIDGEWATER
PO BOX 216BRIDGEWATERCT06752CTC0
TOWN OF SOUTHBURY
501 MAIN STREETSOUTHBURYCT06488CTC0
REGIONAL SCHOOL DISTRICT NO 14
5 MINORTOWN RAODWOODBURYCT06798CTC0
METALLON INC
1415 WATERBURY ROADTHOMASTONCT06787CTC0
DANBURY BOARD OF EDUCATION
63 BEAVER BROOK ROADDANBURYCT06810CTC0
TOWN OF SHARON
PO BOX 385SHARONCT06069CTC0
THE COCA-COLA COMPANY
1 COCA-COLA PLZ NWATLANTAGA30313GAC0
CITY OF ANSONIA
1 NORTH DIVISION STREETANSONIACT06401CTC0
BORGGAARD CONSTRUCTION CORP
70 CREEPER HILL RDNORTH GRAFTONMA01536MAC0
I-84 CONSTRUCTORS
130 SCOTT RDWATERBURYCT06705CTC0
PAGANELLI CONSTRUCTION
51 LAWNACRE RDWINDSOR LOCKSCT06096CTC0
SUPREME INDUSTRIES INC
216 LOWER BOGUE RDHARWINTONCT06791CTC0
WALSH CONSTRUCTION
100 RIVER RIDGE DRNORWOODMA02062MAC0
EMPIRE PAVING INC
30 BERNHARD RDNORTH HAVENCT06473CTC0
TOWN OF PLYMOUTH
80 S MAIN STREETTERRYVILLECT06786CTC0
HERITAGE VILLAGE
450 HERITAGE VILLAGESOUTHBURYCT06488CTC0
SOMERS THIN STRIP
215 PIEDMONT STREETWATERBURYCT06706CTC0
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 Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1TRISTATE JOINT FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$519,675InvolvedAmt
Method Of Amount DeterminationCASH VALUEMethodOfAmountDeterminationTxt

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