2021-03-02T09:48:44-06:00 2020-06-30 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2019-07-01 060691728 TEAMSTERS LOCAL UNION NO 671 HEALTH SERVICES AND INSURANCE PLAN TEAM 8602430671 18 BRITTON DRIVE BLOOMFIELD CT 06002 DAVID LUCAS TRUSTEE 8602430671 2021-03-02 1 LOUIS VERZELLA CPA P00360279 6106689400 2021-02-12 2019 2022-09-23 18:48:47Z DAVID LUCAS 18 BRITTON DRIVE BLOOMFIELD CT 06002 47110815 0 X HTTPS://ECOMMERCE.ISSISYSTEMS.COM/ISITE160/EREMIT X 1954 CT TO PROVIDE HEALTH AND WELFARE BENEFITS. 4 0 5 0 0 0 0 0 28127161 29176915 1416678 679301 74390 88825 29618229 29945041 0 0 26787582 27739765 634970 648867 0 0 0 1344153 1319880 28766705 29708512 851524 236529 56778985 57629500 4116635 4245598 52662350 53383902 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 TEAMSTERS LOCAL UNION NO. 671 HEALTH SERVICES AND INSURANCE PLAN (THE "PLAN") WAS ESTABLISHED JUNE 24, 1954 BY AN AGREEMENT BETWEEN TEAMSTERS LOCAL UNION NO. 671 OF THE INTERNATIONAL BROTHERHOOD OF TEAMSTERS, CHAUFFEURS, WAREHOUSEMEN AND HELPERS OF AMERICA (THE UNION") AND CERTAIN EMPLOYERS WHO WERE PARTIES TO COLLECTIVE BARGAINING AGREEMENTS WITH THE UNION REQUIRING CONTRIBUTIONS TO THE PLAN (THE "PARTICIPATING EMPLOYERS"). THE PLAN WAS ESTABLISHED TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES OF PARTICIPATING EMPLOYERS AND THEIR ELIGIBLE DEPENDENTS. THE PLAN PROVIDES MEDICAL, VISION, DENTAL, PRESCRIPTION, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY AND LIFE INSURANCE BENEFITS. 0 0 0 0 0 0 0 0 0 1 0 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 1052 0 1 5 1 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 X JANICE L FENLASON 8602430671 18 BRITTON DRIVE BLOOMFIELD CT 06002 ROBERT BOWEN TRUSTEE 2.00 X 0 0 0 DAVID A LUCAS JR TRUSTEE 2.00 60.00 X 0 153124 50402 FRANK MAXWELL TRUSTEE 2.00 X 0 0 0 JEFFREY ISAACS TRUSTEE 2.00 X 0 0 0 JANICE FENLASON EXECUTIVE DIRECTOR 40.00 X 123669 0 50402 123669 153124 100804 1 0 1 0 ANTHEM 108 LEIGUS ROAD WALLINGFORD CT 06492 PPO; CLAIM REPRICING 499961 UBS FINANCIAL 333 EARLE OVINGTON BLVD STE 600 UNIONDALE NY 11553 INVESTMENT MANAGEMENT FEE 141123 INNOVATIVE SOFTWARE SOLUTIONS INC 3000 S LENOLA RD MAPLE SHADE NJ 08052 COMPUTER CONSULTING 103968 3 EMPLOYER CONTRIBUTIONS 480000 28851382 28851382 COBRA CONTRIBUTIONS 480000 234393 234393 RETIREE CONTRIBUTIONS 480000 91140 91140 29176915 972762 972762 16872313 17165774 -293461 -293461 -293461 LIEN RIEMBURSEMENT 480000 88825 88825 88825 29945041 29265740 0 679301 27739765 173225 241569 103906 98412 31755 39600 50012 211559 716908 81673 105685 47360 18544 7091 21177 PCORI FEE 10432 FOREIGN TAXES PAID ON I 6617 SERVICE AND MAINTENANCE 3222 29708512 1793220 1815385 801735 747760 2781584 3415892 246086 239466 264437 236011 28524 28426 51127836 51382571 56778985 57629500 84045 70182 367943 343483 3664647 3831933 4116635 4245598 X 0 0 0 0 52662350 53383902 52662350 53383902 56778985 57629500 236529 485023 0 X X 0 1 X 1 0 264437 236011 28426 28426 BENEFIT OBLIGATIONS CURRENTLY PAYABLE 3553033 EMPLOYER CONTRIBUTION DEPOSIT 190226 DUE TO BROKER FOR SECURITIES PURCHASED 72314 DUE TO ANTHEM 16360 3831933 X 30218505 485023 485023 29733482 211559 211559 29945041 29108295 0 29108295 211559 388658 600217 29708512 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 IT HAS TAKEN AN UNCERTAIN POSITION, THAT MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN OBLIGATION 388,658. X 0 0 0 DAVID A LUCAS JR TRUSTEE 0 153124 0 0 0 0 0 24684 0 25718 0 203526 0 0 JANICE FENLASON EXECUTIVE DIRECTOR 123669 0 0 0 0 0 24684 0 25718 0 174071 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY VIA PAPER COPY OR EMAIL. THE FORM 990 WAS REVIEWED BY THE EXECUTIVE DIRECTOR, TRUSTEE SIGNING THE RETURN AND LEGAL COUNSEL PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, INSTRUMENTS UNDER WHICH THE ORGANIZATION IS OPERATED OR ESTABLISHED, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, TO PARTICIPANTS, EMPLOYERS, AND OTHERS IN ACCORDANCE WITH THE PROVISIONS OF ERISA, BUT ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FORM 990. PART XII, LINE 2C: THE FUNDS MANAGEMENT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. TEAMSTERS LOCAL UNION 671 22 BRITTON DRIVE BLOOMFIELD CT 06002 060400878 UNION OFFICE CT 501 C 5 0 ABF FREIGHT SYSTEM ALLAN S GOODMAN CREC CT TRANSIT DHL CLERICAL DHL EXPRESS FIRST AMERICAN GROUP FIRST TRANSIT UCONN KEYSTONE PAPER & BOX CO LEGERE GROUP LTD MCKESSON MIDDLETOWN TRANSIT DISTRICT PETRO TEAMSTERS LOCAL UNION 671 TOWN OF ENFIELD TRINITY HEALTHST MARY UPS VERITIV (XPEDX) WINTONBURY CARE CENTER YRC WORLDWIDE - ROADWAYYELLOW 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 TEAMSTERS LOCAL UNION 671 K 40424 FMV