2022-10-06T14:23:40-05:00 2021-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2021-01-01 016196051 TRUSTEES OF INTERNATIONAL BROTHERHOOD TEAMSTERS VOLUNTARY EMPLOYEE BENEFITS INTE 2026246800 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 CHUCK WHOBREY CHAIRMAN TRUSTEE 2026246800 2022-10-06 1 CHUCK WHOBREY CHAIRMAN XXX-XX-XXXX LOUIS VERZELLA CPA P00360279 6106689400 2022-10-06 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z FRED ZUCKERMAN 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 51398884 0 X WWW.TEAMSTER.ORG X 2002 DC TO SERVE AS A VEHICLE FOR THE COORDINATION AND FUNDING OF NUMEROUS IBT HEALTH AND WELFARE PROGRAMS. 5 0 0 0 0 0 0 0 50855555 51363960 43266 34924 0 0 50898821 51398884 0 0 42422992 46066801 0 0 0 0 0 4347591 4587622 46770583 50654423 4128238 744461 24507611 25157658 3493423 3457359 21014188 21700299 TO SERVE AS A VEHICLE FOR THE COORDINATION AND FUNDING OF NUMEROUS HEALTH INSURANCE WELFARE AND EDUCATIONAL PROGRAMS FOR THE BENEFIT OF MEMBERS OF THE INTERNATIONAL BROTHERHOOD OF TEAMSTERS AND THEIR FAMILIES. 0 0 TO SERVE AS A VEHICLE FOR THE COORDINATION AND FUNDING OF NUMEROUS HEALTH INSURANCE WELFARE AND EDUCATIONAL PROGRAMS FOR THE BENEFIT OF MEMBERS OF THE INTERNATIONAL BROTHERHOOD OF TEAMSTERS AND THEIR FAMILIES. 0 0 0 0 0 0 0 0 0 0 0 0 1 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 4 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X FRED ZUCKERMAN TRUSTEE 2026246800 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 JOHN F MURPHY TRUSTEE 2.00 40.00 X 0 217993 46707 KEN HALL CHAIRMAN 2.00 40.00 X 0 249643 53848 WILLIAM HAMILTON TRUSTEE 2.00 40.00 X 0 155788 39521 DENIS TAYLOR TRUSTEE 2.00 40.00 X 0 170743 41786 THOMAS CONELIAS TRUSTEE 2.00 40.00 X 0 159582 41549 0 953749 223411 0 0 1 0 UNITED AMERICAN INSURANCE COMPANY 3700 S STONEBRIDGE DRIVE MCKINNEY TX 75070 CLAIMS ADMINISTRATION 2011128 MEDIMPACT HEALTHCARE SYSTEMS INC 10181 SCRIPPS GATEWAY CT SAN DIEGO CA 92131 CLAIMS ADMINISTRATION 1816999 PILLAR RX CONSULTING LLC 10400 W INNOVATION DR STE 105 MILWAUKEE WI 53226 ACTUARIAL/CONSULTING 325000 3 PARTICIPANT CONTRIBUTION 900099 21488887 21488887 MEDICARE REINSURANCE REVENUE 900099 10754748 10754748 PRESCRIPTION DRUG REBATES 900099 10257203 10257203 COVERAGE GAP DISCOUNT PROGRAM 900099 6566228 6566228 INSURANCE REVENUE 900099 1936538 1936538 360356 360356 51363960 28367 28367 6557 0 6557 6557 6557 51398884 51363960 0 34924 46066801 68438 36547 18000 4165457 29700 16881 REIMBURSED ADMINISTRATI 249001 BANK FEES 3598 50654423 4747579 2766820 32165 32165 2422869 2399443 17304998 19959230 24507611 25157658 213230 194359 193 0 3000000 3000000 280000 263000 3493423 3457359 X 21014188 21700299 21014188 21700299 24507611 25157658 744461 -58350 0 X X 0 1 X 1 0 0 FEE FOR SUPPORT SERVICES RECEIVABLE 424255 MEDICARE REINSURANCE RECEIVABLE 5789847 PRESCRIPTION DRUG REBATES 8463178 PARTICIPANT CONTRIBUTIONS 1020300 COVERAGE GAP DISCOUNT 4255756 OTHER RECEIVEABLES 5894 19959230 DUE TO INTERNATIONAL UNION 263000 263000 X 41061733 -58350 -58350 41120083 21598 10257203 10278801 51398884 40375622 -10257203 -10257203 50632825 21598 21598 50654423 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE TRUST MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE TRUST AND RECOGNIZE A TAX LIABILITY IF THE TRUST HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE TRUST IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, TRUST TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE TRUST. PART XI, LINE 4B - OTHER ADJUSTMENTS: PRESCRITPTION DRUG REBATES 10,257,203. PART XII, LINE 2D - OTHER ADJUSTMENTS: PRESCRIPTION DRUG REBATES -10,257,203. X 0 0 0 KEN HALL CHAIRMAN 0 249643 0 0 0 0 0 31173 0 22675 0 303491 0 0 JOHN F MURPHY TRUSTEE 0 217993 0 0 0 0 0 25772 0 20935 0 264700 0 0 DENIS TAYLOR TRUSTEE 0 170743 0 0 0 0 0 20966 0 20820 0 212529 0 0 THOMAS CONELIAS TRUSTEE 0 159582 0 0 0 0 0 18743 0 22806 0 201131 0 0 WILLIAM HAMILTON TRUSTEE 0 155788 0 0 0 0 0 18941 0 20580 0 195309 0 0 FORM 990, PART VI, SECTION B, LINE 11B INTERNATIONAL BROTHERHOOD OF TEAMSTERS VOLUNTARY EMPLOYEE BENEFITS TRUST'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT. THE FORM IS THEN FORWARDED TO THE BOARD OF TRUSTEES FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C INTERNATIONAL BROTHERHOOD OF TEAMSTERS VOLUNTARY EMPLOYEE BENEFITS TRUST MONITORS ITS CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 INTERNATIONAL BROTHERHOOD OF TEAMSTERS VOLUNTARY EMPLOYEE BENEFITS TRUST MAKES ITS FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII, LINE 2C: INTERNATIONAL BROTHERHOOD OF TEAMSTERS VOLUNTARY EMPLOYEE BENEFITS TRUST'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT WHO PERFORMS THE AUDIT. INTERNATIONAL BROTHERHOOD OF TEAMSTERS 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 530215427 LABOR UNION DC 501(C)(5) 0 TEAMSTER DISASTER RELIEF FUND 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 521790540 CHARITABLE ORANIZATION DC 501(C)(3) 170(B)(1)(A)(VI) 0 COMM FOR DMCRTC REPUB INDP VOTER EDUCATION (DRIVE) 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 530261255 POLITICAL ACTION COMMITTEE DC SECTION 527 0 INTERNATIONAL BROTHERHOOD OF TEAMSTERS SUPP'L BENEFITS TRUST 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 200412571 SUPPLEMENTAL BENEFITS TRUST DC 501(C)(5) 0 TEAMSTERS LEGAL DEFENSE TRUST 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 263361356 LEGAL DEFENSE FUND DC 501(C)(9) 0 TEAMSTERS EDUCATION AND MOBILIZATION FUND 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 262912925 POLITICAL ACTION COMMITTEE DC SECTION 527 0 JLMC TEAMSTERS VOLUNTARY EMPLOYEE BENEFIT TRUST 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 274722755 VEBA TRUST DC 501(C)(4) 0 TEAMSTER AFFILIATES PENSION PLAN 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 526128127 PENSION PLAN DC 401(A)/501(A) 0 INT'L BRTHD OF TMSTRS RETIREMENT & FAMILY PROTECTION 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 530215427 PENSION PLAN DC 401(A)/501(A) 0 TEAMSTERS NATIONAL HEADQUARTERS BUILDING CORPORATION 25 LOUISIANA AVENUE NW WASHINGTON DC 20001 530226398 BUILDING CORPORATION DC C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 INTERNATIONAL BROTHERHOOD OF TEAMSTERS P 249001 FMV