TEAMSTERS LOCAL 1035 HEALTH SERVICES & INSURANCES FUND: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: TEAMSTERS LOCAL 1035 HEALTH SERVICES & INSURANCES FUND (EIN 06-0997832)
Tax period: 2022-07-01 to 2023-06-30
Filed: 2024-05-09
IRS object ID: 202441309349301609
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
Form 990
Schedule D
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-05-09T08:38:00-05:00	ReturnTs
Tax Period End	2023-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	061298465	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	SM ESPOSITO & CO PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	3013 DIXWELL AVENUE	AddressLine1Txt
City	HAMDEN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06518	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	060997832	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LOCAL 1035 HEALTH SERVICE AND	BusinessNameLine1Txt
Business Name Line2	INSURANCE PLAN	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	LOCA	BusinessNameControlTxt
Phone	8605284159	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 CHAPEL STREET UNIT 2-B	AddressLine1Txt
City	SOUTH WINDSOR	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06074	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ROBERT ZIOBROWSKI	PersonNm
Person Title	UNION TRUSTEE	PersonTitleTxt
Phone	8605284159	PhoneNum
Signature	2024-05-08	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	ROBERT	PersonFirstNm
Person Last	ZIOBROWSKI	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DANA HARVEY	PreparerPersonNm
PTIN	P01452206	PTIN
Phone	2033877771	PhoneNum
Preparation	2024-05-07	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	ROBERT ZIOBROWSKI	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 CHAPEL ROAD UNIT 2-B	AddressLine1Txt
City	SOUTH WINDSOR	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06074	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$19,920,460	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c	Yes (X)	Organization501cInd
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Trust	Yes (X)	TypeOfOrganizationTrustInd
Formation	1969	FormationYr
Legal Domicile State	CT	LegalDomicileStateCd
Activity Or Mission	SELF-INSURED HEALTH BENEFIT PLAN	ActivityOrMissionDesc
Voting Members Governing Body	4	VotingMembersGoverningBodyCnt
Voting Members Independent	4	VotingMembersIndependentCnt
Total Employee	4	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$8,242,452	PYProgramServiceRevenueAmt
CY Program Service Revenue	$13,253,619	CYProgramServiceRevenueAmt
PY Investment Income	$2,673,038	PYInvestmentIncomeAmt
CY Investment Income	$1,185,217	CYInvestmentIncomeAmt
PY Other Revenue	$3,495	PYOtherRevenueAmt
CY Other Revenue	$330	CYOtherRevenueAmt
PY Total Revenue	$10,918,985	PYTotalRevenueAmt
CY Total Revenue	$14,439,166	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$9,063,308	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$14,634,643	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$359,872	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$449,498	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$586,437	PYOtherExpensesAmt
CY Other Expenses	$756,799	CYOtherExpensesAmt
PY Total Expenses	$10,009,617	PYTotalExpensesAmt
CY Total Expenses	$15,840,940	CYTotalExpensesAmt
PY Revenues Less Expenses	$909,368	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,401,774	CYRevenuesLessExpensesAmt
Total Assets BOY	$43,786,361	TotalAssetsBOYAmt
Total Assets EOY	$57,318,573	TotalAssetsEOYAmt
Total Liabilities BOY	$1,794,845	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$3,291,638	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$41,991,516	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$54,026,935	NetAssetsOrFundBalancesEOYAmt
Mission	PROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTER LOCAL 1035 UNION.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Desc	PROVIDES INSURED AND SELF-INSURED MEDICAL, DEATH & LIFEINSURANCE BENEFITS TO 1,175 ACTIVE AND RETIRED MEMBERS PLUS THEIR DEPENDENTS.	Desc
Described In Section501c3	0	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	4	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	4	GoverningBodyVotingMembersCnt
Independent Voting Member	4	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROBERT ZIOBROWSKI	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8605284159	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 CHAPEL STREET UNIT 2-B	AddressLine1Txt
City	SOUTH WINDSOR	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06074	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
GLENN BARKSDALE
UNION TRUSTEE	4.00	4.00	Yes (X)	$3,181	$3,036	$0
PAUL NOVAK
(FORMER) EMPLOYER TRUSTEE	2.00		Yes (X)	$0	$0	$0
JAMES STACK
EMPLOYER TRUSTEE	2.00		Yes (X)	$0	$0	$0
ROBERT ZIOBROWSKI
UNION TRUSTEE	4.00	50.00	Yes (X)	$0	$129,836	$50,421
PAUL AYOUB
EMPLOYER TRUSTEE	2.00		Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,181	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$132,872	TotReportableCompRltdOrgAmt
Total Other Compensation	$50,421	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ANTHEM BLUE CROSS BLUE SHIELD	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3075 VANDERCAR WAY	AddressLine1Txt
City	CINCINNATI	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45209	ZIPCd

Field	Value	IRS element (for citing)
Services	REPRICING & ADMINISTRATION	ServicesDesc
Compensation	$221,615	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS	900099	$13,142,940	$13,142,940
SPECIAL RETIREE CONTRIBUTIONS	900099	$91,619	$91,619
COBRA CONTRIBUTIONS	900099	$16,758	$16,758
PAYROLL AUDIT CONTRIBUTIONS	900099	$2,302	$2,302

Field	Value	IRS element (for citing)
Total Program Service Revenue	$13,253,619	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,146,455	TotalRevenueColumnAmt
Exclusion	$1,146,455	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$5,520,056	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$5,481,294	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$38,762	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$38,762	TotalRevenueColumnAmt
Exclusion	$38,762	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	REFUNDS & REIMBURSEMENTS	Desc
Business	900099	BusinessCd
Total Revenue Column	$330	TotalRevenueColumnAmt
Related Or Exempt Func Income	$330	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$330	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,439,166	TotalRevenueColumnAmt
Related Or Exempt Func Income	$13,253,949	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,185,217	ExclusionAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$14,634,643	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$6,269	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$238,418	TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$87,343	TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$97,170	TotalAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$20,298	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$76,131	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$590,572	TotalAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$30,871	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$12,889	TotalAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$20,825	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,050	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,337	TotalAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$22,124	TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$15,840,940	TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$45,883	BOYAmt
EOY	$85,305	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,750,266	BOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$756,925	BOYAmt
EOY	$1,443,350	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,569	BOYAmt
EOY	$19,876	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$56,954	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$29,809	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$9,686	BOYAmt
EOY	$27,145	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$34,727,450	BOYAmt
EOY	$55,302,171	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$494,582	BOYAmt
EOY	$440,726	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$43,786,361	BOYAmt
EOY	$57,318,573	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$17,143	BOYAmt
EOY	$23,522	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,777,702	BOYAmt
EOY	$3,268,116	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,794,845	BOYAmt
EOY	$3,291,638	EOYAmt

Field	Value	IRS element (for citing)
Org Does Not Follow FASB117	Yes (X)	OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$41,991,516	BOYAmt
EOY	$54,026,935	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$41,991,516	BOYAmt
EOY	$54,026,935	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$43,786,361	BOYAmt
EOY	$57,318,573	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,401,774	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$2,338,329	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$11,098,864	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$17,921	OtherCostOrOtherBasisAmt
Depreciation	$1,017	DepreciationAmt
Book Value	$16,904	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,351	OtherCostOrOtherBasisAmt
Depreciation	$1,992	DepreciationAmt
Book Value	$359	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$36,682	OtherCostOrOtherBasisAmt
Depreciation	$26,800	DepreciationAmt
Book Value	$9,882	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$27,145	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
HEALTH CLAIMS PAYABLE; INCURRED BUT NOT REPORTED	$2,891,600
ACCUMULATED ELIGIBILITY CREDITS	$358,634
RIGHT OF USE LIABILITY - OPERATING LEASE	$17,882

Field	Value	IRS element (for citing)
Total Liability	$3,268,116	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$16,701,364	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$2,338,329	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$2,338,329	RevenueNotReportedAmt
Revenue Subtotal	$14,363,035	RevenueSubtotalAmt
Investment Expenses Not Incld	$76,131	InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt	$76,131	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$14,439,166	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$13,742,511	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$13,742,511	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$76,131	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$2,022,298	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$2,098,429	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$15,840,940	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 ORGANIZATION FILES ITS FORM 990 IN THE U.S. FEDERAL JURISDICTION. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2019 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS.

PART XII, LINE 4B - OTHER ADJUSTMENTS:

CHANGE IN BENEFIT OBLIGATION 2,022,298.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	ROBERT ZIOBROWSKI	PersonNm
Title	UNION TRUSTEE	TitleTxt
Base Compensation Filing Org	$0	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$128,320	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$1,516	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$0	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$24,684	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$0	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$25,737	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$0	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$180,257	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 3	FormAndLineReferenceDesc
Explanation	ONE UNION TRUSTEE IS PAID BY THE LOCAL UNION FOR THEIR POSITION AS UNION PRINCIPAL OFFICER OF TEAMSTERS LOCAL 1035. SALARIES ARE DETERMINED BY THE UNION BYLAWS AND ARE APPROVED BY THE UNION EXECUTIVE BOARD.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8B	THERE 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 11B	FORM 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 19	THE 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 XI, LINE 9:	PLAN ASSET TRANSFER FROM AFFILIATE DUE TO DISSOLUTION 11,098,864.
FORM 990, PART X11, LINE 2C	OVERSIGHT 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/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd
IBT LOCAL UNION 1035
400 CHAPEL ROAD UNIT 2-B	SOUTH WINDSOR	CT	06074	060915620	REPRESENTATION OF UNION MEMBERS	CT	501C-5	N/A	0
TRI STATE JOINT FUND
609 WEST JOHNSON AVE 2ND FLOOR	CHESHIRE	CT	06410	060850110	3RD PARTY ADMINISTRATOR FOR AFFILIATED ENTITIES	CT	501C-9	N/A	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Legal Domicile StateLegalDomicileStateCd
HARTFORD DISTRIBUTORS
131 CHAPEL ROAD	MANCHESTER	CT	06040	CT
COCA-COLA OF NEW ENGLAND
451 MAIN STREET	EAST HARTFORD	CT	06108	CT
ROGO DISTRIBUTORS
65 ROBERTS STREET	EAST HARTFORD	CT	06108	CT
DEAN FOODS
3600 RIVER ROAD	FRANKLIN	IL	61031	IL
TOWN OF TOLLAND
TOWN GREEN	TOLLAND	CT	06084	CT
COCA-COLA BEVERAGE NORTHEAST
80 RADO DR	NAUGATUCK	CT	06670	CT
MJ DALY LLC
110 MATTATUCK HEIGHTS	WATERBURY	CT	06705	CT
A FIORILLO & CO
396 CLARK STREET	MILLDALE	CT	06487	CT
CONSOLIDATED INDUSTRIES INC
677 MIXVILLE RD	CHESHIRE	CT	06410	CT
NORTHEAST TRANSPORTATION CO
761 FROST BRIDGE RD	WATERTOWN	CT	06795	CT
METALLON INC
1415 WATERBURY RD	THOMASTON	CT	06787	CT
MONDELEZ INT
40 LEONARDS DR	MONTGOMERY	NY	12549	NY
PETRO
125 COMMERCE DR	BROOKFIELD	CT	06804	CT
DRAWN METAL TUBE COMPANY
PO BOX 218	MIDDLE VILLAGE	NY	11379	NY

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	TRISTATE JOINT FUND	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	M	TransactionTypeTxt
Involved	$344,722	InvolvedAmt
Method Of Amount Determination	CASH VALUE	MethodOfAmountDeterminationTxt