2021-05-14T07:40:27-05:00 2020-06-30 061298465 SM ESPOSITO & CO PC 3013 DIXWELL AVENUE HAMDEN CT 06518 990 2019-07-01 060689500 LOCAL 493 HEALTH SERVICE AND INSURANCE PLAN LOCA 8608481459 P O BOX 485 UNCASVILLE CT 06382 BEVAN SWEET UNION TRUSTEE 8608481259 2021-05-05 1 DANA HARVEY CPA P01452206 2033877771 2021-05-05 2019 2022-09-23 18:48:47Z BEVAN SWEET 18 CRESENT STREET UNCASVILLE CT 06382 14791480 0 X N/A X 1954 CT SELF-INSURED HEALTH BENEFIT PLAN 4 4 3 0 0 0 0 0 9411148 10190380 1063966 2007744 148 963 10475262 12199087 0 0 8894596 7013457 229621 323882 0 0 0 754835 753256 9879052 8090595 596210 4108492 49600761 53922319 1534800 955386 48065961 52966933 PROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTER LOCAL 493 UNION. 0 0 PROVIDES INSURED AND SELF-INSURED MEDICAL, DEATH & LIFE INSURANCE BENEFITS TO 1,021 MEMBERS AND THEIR DEPENDENTS. 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 0 0 3 1 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 X BEVAN SWEET 8608481259 18 CRESENT STREET UNCASVILLE CT 06382 BEVAN SWEET UNION TRUSTEE 4.00 55.00 X 0 144096 51604 NICHOLAS REUT EMPLOYER TRUSTEE 2.00 X 0 0 0 CRAIG MITCHELL UNION TRUSTEE 4.00 55.00 X 0 127970 46055 ROARKE LEVINE EMPLOYER TRUSTEE 2.00 X 0 0 0 THOMAS SCHLINK (FORMER) UNION TRUSTEE 4.00 55.00 X 0 64005 27738 0 336071 125397 0 1 1 0 ANTHEM BLUE CROSS BLUE SHEILD 1351 WM HOWARD TAFT RD CINCINNATI OH 45206 REPRICING & AMINISTRATION 169119 UBS FINANCIAL SERVICES 333 EARLE OVINGTON BLVD UNIONDALE NY 11553 INVESTMENT CONSULTING 124309 2 EMPLOYER CONTRIBUTIONS 900099 9994156 9994156 SPECIAL RETIREE CONTRIBUTIONS 900099 161155 161155 PAYROLL AUDIT CONTRIBUTIONS 900099 30629 30629 COBRA CONTRIBUTIONS 900099 4440 4440 10190380 904773 904773 3695364 2592393 1102971 1102971 1102971 MISCELLANEOUS REFUNDS 900099 963 963 963 12199087 10191343 0 2007744 7013457 151916 89447 69763 12756 20987 161817 478124 18469 29440 17762 3900 931 21826 8090595 816784 1777351 12040464 12529130 765557 850993 3533 8814 17170 12504 844 4666 35874772 38026484 98807 724881 49600761 53922319 52457 60186 1482343 895200 1534800 955386 X 0 0 0 0 48065961 52966933 48065961 52966933 49600761 53922319 4108492 792480 0 X X 0 1 X 1 0 17170 12504 4666 4666 HEALTH CLAIMS PAYABLE IBNR 709900 ACCUMULATED ELIGIBILTIY CREDITS 177920 SEVERANCE PAYABLE 7380 895200 X 12829750 792480 792480 12037270 161817 161817 12199087 8076508 0 8076508 161817 -147730 14087 8090595 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 PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2016 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS -147,731. ROUNDING ADJUSTMENT 1. 0 0 0 BEVAN SWEET UNION TRUSTEE 0 140950 0 0 0 3146 0 28228 0 23376 0 195700 0 0 CRAIG MITCHELL UNION TRUSTEE 0 126708 0 0 0 1262 0 25127 0 20928 0 174025 0 0 THOMAS SCHLINK (FORMER) UNION TRUSTEE 0 61620 0 0 0 2385 0 14275 0 13463 0 91743 0 0 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 XII, LINE 2C THERE HAS BEEN NO CHANGE IN THE BOARD OVERSIGHT RESPONSIBILITY AND APPROVAL PROCESS. THE TRUSTEE'S ASSUME RESPONSIBILITY FOR THE AUDIT PROCESS INCLUDING SELECTION OF THE INDEPENDENT AUDITOR. TEAMSTERS LOCAL 493 UNION 18 CRESENT STREET UNCASVILLE CT 06382 060601240 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 YRC WORLDWIDE INC 10990 ROE AVENUE OVERLAND KS 66211 KS C 0 TOWN OF WOODSTOCK HGHWY DEPT 415 ROUTE 169 WOODSTOCK CT 06281 CT C 0 WESCON CORP OF CONN PO BOX 296 WESTERLY RI 02891 RI C 0 ARBORIO CORPORATION 231 SHUNPIKE ROAD CROMWELL CT 06416 CT C 0 DAY & ZIMMERMAN NPS INC 1827 FREEDOM ROAD LANCASTER PA 17601 PA C 0 TILCON-RYAN PO BOX 310903 NEWINGTON CT 06131 CT C 0 MONTVILLE BOARD OF ED BUS DRIVERS 800 OLD COLCHESTER RD OAKDALE CT 06370 CT C 0 TOWN OF LEDYARD HWY 741 COLONEL LEDYARD HWY LEDYARD CT 06339 CT C 0 TOWN OF WINDHAM HWY DEPT 322 PROSPECT STREET WILLIMANTIC CT 06226 CT C 0 UNITED PARCEL SERVICE 100 EAST CAMPUS VIEW BLVD COLUMBUS OH 43235 OH C 0 ABF FREIGHT SYSTEM INC 3100 SPRINGHILL NLITTLE ROCK AR 72117 AR C 0 LEVINE DISTRIBUTING CO INC 15 STOTT AVE NORWICH CT 06360 CT C 0 WINDHAM PEPSICOLA BOTLG CO 135 LOUISA VIENS DR DAYVILLE CT 06241 CT C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 TRISTATE JOINT FUND M 252000 CASH VALUE