2023-11-15T12:51:56-06:00 2022-12-31 470900880 CALIBRE CPA GROUP PLLC 7501 WISCONSIN AVENUE SUITE 1200 WEST BETHESDA MD 20814 990 2022-01-01 530209136 JOINT BOARD OF TRUSTEES OF LOCAL 639 EMPLOYERS HEALTH TRUST FUND TEAM 2026368181 3130 AMES PLACE NE WASHINGTON DC 20018 RAY HOWARD SECRETARY 2026368181 2023-11-15 1 RAY HOWARD 999009999 0 SCOTT E HALLBERG CPA P01081188 2023319880 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RAY HOWARD 3130 AMES PLACE NE WASHINGTON DC 20018 91407408 0 X N/A X 1952 DC TO PROVIDE HEALTH & WELFARE INSURANCE BENEFITS TO EMPLOYEES (AND THEIRELIGIBLE DEPENDENTS) OF CONTRIBUTING EMPLOYERS WHO ARE REPRESENTED BYTHE PARTICIPATING LOCAL UNION 8 0 0 0 0 0 0 0 55551712 56014161 9057877 5011500 50071 468144 64659660 61493805 0 0 36402662 35988693 72000 72000 0 0 0 4533014 3966640 41007676 40027333 23651984 21466472 293952419 293933238 988587 1229760 292963832 292703478 TO PROVIDE COVERAGE FOR HOSPITALIZATION, MEDICAL BENEFITS, MENTAL HEALTH BENEFITS, DISABILITY INCOME, DEATH BENEFITS, PRESCRIPTION DRUGS, DISEASE CASE MANAGEMENT, DENTAL, AND VISION CARE BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS 0 0 PAYMENT OF MEDICAL AND OTHER BENEFITS TO OR FOR ITS PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 15 0 1 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 1 0 0 0 X BENESYS 4108739020 7310 COLUMBIA GATEWAY DRIVE SUITE A COLUMBIA MD 21046 ERIC D WEISS TRUSTEE-EMPLOYER 2.00 2.00 X 12000 0 0 MICHAEL BULL TRUSTEE-EMPLOYER 2.00 X 12000 0 0 THOMAS RATLIFF TRUSTEE-UNION 2.00 2.00 X 12000 0 0 FRANK W STEGMAN TRUSTEE-EMPLOYER 2.00 2.00 X 12000 0 0 WILLIAM DAVIS TRUSTEE-UNION 2.00 55.00 X 0 145437 55376 JOHN GIBSON TRUSTEE-UNION 2.00 55.00 X 0 157555 55376 PHILIP GILES TRUSTEE-SECRETARY 2.00 X 12000 0 0 RAYMOND HOWARD TRUSTEE-CHAIRMAN 2.00 X 12000 0 0 72000 302992 110752 0 0 1 0 CVS CAREMARK INC ONE CVS DRIVE WOONSOCKET RI 02895 PRESCRIPTION BENEFIT MANAGEMENT 10796978 DENTAL HEALTH CENTERS & ASSOCIATES 1450 MERCANTILE LN 131 UPPER MARLBORO MD 20774 DENTAL CLINIC 2367057 CIGNA HEALTHCARE 900 COTTAGE GROVE ROAD BLOOMFIELD CT 06002 CLAIMS PROCESSING 1086689 BENESYS 7130 COLUMBIA GATEWAY DR A COLUMBIA MD 21046 THIRD PARTY ADMINISTRATOR 968248 MORGAN LEWIS & BOCKIUS 1111 PENNSYLVANIA AVE WASHINGTON DC 20004 LAW FIRM 298255 8 CONTRIBUTIONS-EMPLOYERS 525100 55693130 55693130 CONTRIBUTIONS-PARTICIPANTS 525100 321031 321031 56014161 6275697 6275697 28649406 29913603 -1264197 -1264197 -1264197 LITIGATION PROCEEDS 525100 468144 468144 468144 61493805 56482305 0 5011500 35988693 72000 945214 560355 118880 693697 136275 99708 875 86107 NETWORK PPO FEES 1087932 OONP EXPENSES 190241 BANK FEES 29645 PCORI FEES 17711 40027333 528274 14511278 15875206 12135422 6021711 6627867 114049430 104870269 154960277 153219417 2517521 2568985 293952419 293933238 326103 740233 662484 489527 988587 1229760 X 292963832 292703478 0 0 0 0 292963832 292703478 293952419 293933238 21466472 -21726826 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 110419924 F HEDGE FUNDS 47779 F COMMON COLLECTIVE TRUST 42751714 F 153219417 PENDING INVESTMENT TRANSACTION 489527 489527 X 39073282 -21726826 -21726826 60800108 693697 693697 61493805 39333636 0 39333636 693697 693697 40027333 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION. THE PLAN ADMINISTRATOR IS NOT AWARE OF ANY UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS AS OF DECEMBER 31, 2022. THE PLAN IS SUBJECT TO ROUTINE AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2019. 0 0 0 JOHN GIBSON TRUSTEE-UNION 0 157555 0 0 0 0 0 39194 0 16182 0 212931 0 0 WILLIAM DAVIS TRUSTEE-UNION 0 145437 0 0 0 0 0 39194 0 16182 0 200813 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 HAS BEEN PROVIDED TO THE FUND'S ADMINISTRATOR TO BE DISTRIBUTED TO THE FUND'S BOARD OF TRUSTESS PRIOR TO ITS FILING FORM 990, PART VI, SECTION B, LINE 12C THE FUND IS SUBJECT TO THE REQUIREMENTS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT, AS AMENDED 1974 ("ERISA"), INCLUDING THE STATUTE'S FIDUCIARY STANDARDS AND PROHIBITED TRANSACTION PROVISIONS, WHICH TOGETHER CONSTITUTE THE FUND'S CONFLICT OF INTEREST POLICY. THE BOARD OF TRUSTEES, ALONG WITH THE VARIOUS FUND PROFESSIONALS' ASSISTANCE, MONITOR AND ENFORCE THE FUND'S COMPLIANCE WITH ERISA AND ALSO THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S ANNUAL FINANCIAL DISCLOSURE STATEMENT, THE FORM 5500, IS AVAILABLE FOR PUBLIC INSPECTION THROUGH CERTAIN WEBSITES, INCLUDING BUT NOT LIMITED TO, THE UNITED STATES DEPARTMENT OF LABOR'S FORM 5500 FILING SEARCH AND FREEERISA. THE FUND MAKES ITS GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS, BENEFICIARIES, THE SPONSORING UNION, AND CONTRIBUTING EMPLOYERS AS REQUIRED BY ERISA. ERISA DOES NOT REQUIRE THE FUND TO MAKE THESE DOCUMENTS AVAILABLE TO THE PUBLIC AND THE FUND DOES NOT DO SO. FORM 990, PART XII, LINE 2C: THE TRUSTEES EVALUATE AND APPROVE THE INDEPENDENT AUDITOR. TEAMSTERS LOCAL 639 EMPLOYERS PENSION TRUST FUND 3130 AMES PLACE NE WASHINGTON DC 20018 PENSION FUND MD 401(A) 0 TEAMSTERS LOCAL 639 LEGAL SERVICES FUND 3130 AMES PLACE NE WASHINGTON DC 20018 LEGAL FUND MD 501(C)(9) 0 TEAMSTERS LOCAL UNION 639 3130 AMES PLACE NE WASHINGTON DC 20018 LABOR UNION MD 501(C)(5) 0 JOINT BOARD OF TRUSTEES LOCAL 639 EMPLOYERS HEALTH TRUST FUND 3130 AMES PL NE WASHINGTON DC 20018 530209136 0 21ST CENTURY EXPO GROUP ABF FREIGHT SYSTEM INC ADVANTAGE CONF & EXPO LLC ALLIED POWER SERVICES ALUMA SYSTEMS CONCRETE CONSTR ARATA EXPOSTIONS INC ATLANTIC EXPO SERVICES BREAKTHRU BEVERAGE GROUP CAPITAL PAVING OF DC INC CAST & CREW PRODUCTION SERV CLARK CONSTRUCTION GROUP LLC CRANE RENTAL DEANS TRANSPORTATIONINC EMPLOYCO SERVICES LTD ENTERTAINMENT PARTNERS EXPO LABOR PROS LLC FREEMAN EXPOSITIONS INC HARGROVE INC HUTCHINSON INTERNATIONAL CORP JJ TAYLOR INC L B M INC LAMAR & WALLACE LOCAL 639 DRIVERS CHAUFFEURS MARTIN-BROWER CO (DRIVERS) MARTIN-BROWER CO (WAREHOUSE) MARVA MAID MDVA MILK PRODUCERS MERIT CONCRETE CORPORATION METRO MECHANICAL CONTR INC METROPOLITAN POULTRY MICHAELS NEXXTSHOW NOLAND COMPANY REPUBLIC NAT'L DISTRIBUTING CO RUAN LOGISTICS COPORATION S FREEDMAN & SONS SHENANDOAH FLEET MAINTENANCE SHEPARD EXPO (CASUAL) SHEPARD EXPOSITION SERVICES SILVER HILL AGGREGATE LTD STROMBERG SHEET METAL SUPER CONCRETE TRAX INTERNATIONAL CORPORATION UNION PAYROLL UPS 2100 VISTA CONVENTION SERVICES INC WASTE MANAGEMENT (FORMERLY POTOMAC DISPOSAL SERVICES LLC) WILLWORK INC YRC WORLDWIDE ENTERPRISE SERV BOILER & FURNACE CLEANERS BEEHGLY TREE GES EXPO SERVICE CO (CASUAL) GES EXPOSITION SERVICES GIANT FOOD (639 DRIVERS) HAMMER START LLC PRICE GREGORY PARAMOUNT CONVENTION SERVICES INC T3 EXPO LLC THINKFILM INC US PIPELINE INC 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1