FURP.ORG / PUBLIC DATA EXPLORER

TRI STATE JOINT FUND: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
TRI STATE JOINT FUND (EIN 06-0850110)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-12
IRS object ID
202021339349302512
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-05-12T15:06:12-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN061298465PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SM ESPOSITO & CO PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13013 DIXWELL AVENUEAddressLine1Txt
CityHAMDENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06518ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060850110EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TRI-STATE JOINT FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTRI-BusinessNameControlTxt
Phone2032502601PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVENUE 2ND FLAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN CAPOBIANCOPersonNm
Person TitleUNION CO-CHAIRMANPersonTitleTxt
Phone2032502601PhoneNum
Signature2020-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANA HARVEY CPAPreparerPersonNm
PTINP01452206PTIN
Phone2033877771PhoneNum
Preparation2020-04-23PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address173.162.209.9IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-12IPDt
IP Tm16:01:39IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id01A18352793CBBCD4AE184237F5074D4C4A8D035AtSubmissionCreationDeviceId
At Submission Filing Device Id01A18352793CBBCD4AE184237F5074D4C4A8D035AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-09-10 13:11:23ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN CAPOBIANCOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVENUE 2ND FLAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$110,764,446GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1968FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionSELF-INSURED HEALTH BENEFIT PLANActivityOrMissionDesc
Voting Members Governing Body28VotingMembersGoverningBodyCnt
Voting Members Independent28VotingMembersIndependentCnt
Total Employee13TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$93,412,067PYProgramServiceRevenueAmt
CY Program Service Revenue$104,657,138CYProgramServiceRevenueAmt
PY Investment Income$1,209,213PYInvestmentIncomeAmt
CY Investment Income$1,293,800CYInvestmentIncomeAmt
PY Other Revenue$2,977PYOtherRevenueAmt
CY Other Revenue$197CYOtherRevenueAmt
PY Total Revenue$94,624,257PYTotalRevenueAmt
CY Total Revenue$105,951,135CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$90,304,897PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$101,639,636CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,180,917PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,247,140CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,739,249PYOtherExpensesAmt
CY Other Expenses$1,759,675CYOtherExpensesAmt
PY Total Expenses$93,225,063PYTotalExpensesAmt
CY Total Expenses$104,646,451CYTotalExpensesAmt
PY Revenues Less Expenses$1,399,194PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,304,684CYRevenuesLessExpensesAmt
Total Assets BOY$22,626,447TotalAssetsBOYAmt
Total Assets EOY$25,624,574TotalAssetsEOYAmt
Total Liabilities BOY$7,210,459TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,727,852TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,415,988NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,896,722NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO MEMBERS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS NEGOTIATED BY TEAMSTER LOCALS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE FUND OPERATES UNDER A TRUST AGREEMENT FOR THE PURPOSEOF MAKING BENEFIT PAYMENTS TO MEMBERS OF THE TRI-STATETEAMSTERS HEALTH SERVICES & INSURANCE PLAN, THESE BENEFITS COVER HOSPITAL,SURGICAL, PRESCRIPTION DRUG, HOME HEALTH CARE AND DEATH BENEFITS FOR 11,507 MEMBERS PLUS THEIR DEPENDENTS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee13EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members28GoverningBodyVotingMembersCnt
Independent Voting Member28IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHARON AGNELLOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2032502604PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVENUE 2ND FLAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DENNIS MCGUIRE
EMPLOYER CO-CHAIRMAN & TRU4.002.00Yes (X)$0$0$0
THOMAS BAYUSIK
UNION TRUSTEE1.004.00Yes (X)$0$0$0
SALVATORE ABATE
UNION TRUSTEE1.004.00Yes (X)$0$0$0
TIMOTHY CASEY
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
ANTHONY CAPPELLA
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
FORREST HARVEY
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
EDWIN ROONEY
UNION TRUSTEE1.004.00Yes (X)$0$0$0
ROBERT FLYNN
(FORMER) UNION TRUSTEE1.004.00Yes (X)$0$0$0
ROBERT DIGIROLAMO
UNION TRUSTEE1.004.00Yes (X)$0$0$0
FRANK ROSSI
UNION TRUSTEE1.004.00Yes (X)$0$0$0
VICTOR SANTIAGO
UNION TRUSTEE1.004.00Yes (X)$0$0$0
ROBERT SULLIVAN JR
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
LAWRENCE KEEFE
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
THOMAS SCHLINK
(FORMER) UNION TRUSTEE1.004.00Yes (X)$0$0$0
BEVAN SWEET
UNION TRUSTEE1.004.00Yes (X)$0$0$0
CRAIG MITCHELL
UNION TRUSTEE1.004.00Yes (X)$0$0$0
NICHOLAS REUT
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
JON HENDEL
(FORMER) EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
ROARK LEVINE
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
ROBERT RANDALL
(FORMER) UNION TRUSTEE1.004.00Yes (X)$0$0$0
PEDRO DEPARA
(FORMER) UNION TRUSTEE1.004.00Yes (X)$0$0$0
CRAIG TIMPSON
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
DONALD SHUBERT
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
DAVID LUCAS
UNION TRUSTEE1.004.00Yes (X)$0$0$0
THOMAS CONELIAS
(FORMER) UNION TRUSTEE1.002.00Yes (X)$0$0$0
ANTHONY LEPORE
UNION TRUSTEE1.004.00Yes (X)$0$0$0
JOHN CAPOBIANCO
UNION CO-CHARIMAN & TRUSTE4.004.00Yes (X)$0$0$0
MICHAEL RINALDI
UNION TRUSTEE1.004.00Yes (X)$0$0$0
HELGA SCHMIDT
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
PAUL AYOUB
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
CHRISTOPHER ROOS
UNION TRUSTEE1.004.00Yes (X)$0$0$0
GLENN BARKSDALE
UNION TRUSTEE1.004.00Yes (X)$0$0$0
PAUL NOVAK
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
JAMES STACK
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
SHARON AGNELLO
EXECUTIVE DIRECTOR40.00Yes (X)$121,467$0$46,000
SUSAN KOSTEK
IT DIRECTOR40.00$102,839$0$46,000Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$224,306TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$92,000TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ROBERT M CHEVERIE & ASSOC
333 EAST RIVER DRIVEEAST HARTFORDCT06108LEGAL$328,725
THE SEGAL COMPANY
CHURCH STREET STATION P O BOX 4059NEW YORKNY102614059ACTUARIAL$291,825
SM ESPOSITO & COMPANY PC
3013 DIXWELL AVEHAMDENCT06763ACCOUNTING/AUDITING$180,760
CHANGE HEALTHCARE PAYMENT MGMT
3055 LEBANON PIKENASHVILLETN37214PRINTING/MAILING$142,516
SOFTWARE SYSTEM SOLUTIONS
212 NEW LONDON TPKEGLASTONBURYCT06033SOFTWARE SUPPORT$104,032
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CONTRIBUTIONS - HEALTH FUNDS900099$104,655,788$104,655,788
RENTAL INCOME -AFFILIATE900099$1,350$1,350
FieldValueIRS element (for citing)
Total Program Service Revenue$104,657,138TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$316,378TotalRevenueColumnAmt
Exclusion$316,378ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,740,733SecuritiesAmt
Other$1,050,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,356,155SecuritiesAmt
Other$457,156OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$384,578SecuritiesAmt
Other$592,844OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$977,422TotalRevenueColumnAmt
Related Or Exempt Func Income$592,844RelatedOrExemptFuncIncomeAmt
Exclusion$384,578ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC REFUNDSDesc
Business900099BusinessCd
Total Revenue Column$197TotalRevenueColumnAmt
Related Or Exempt Func Income$197RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$197OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$105,951,135TotalRevenueColumnAmt
Related Or Exempt Func Income$105,250,179RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$700,956ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$101,639,636TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$123,814TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$573,594TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$251,877TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$238,080TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$59,775TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$328,725TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$72,760TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$60,826TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$413,970TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$267,292TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$138,845TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$139,887TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$34,622TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$92,492TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$18,501TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$46,169TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmt
OUTSIDE SERVICES$142,516
MEDICAL EQUIPMENT$3,070

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$104,646,451TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$84,373BOYAmt
EOY$105,258EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,887,846BOYAmt
EOY$3,606,676EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$136,512BOYAmt
EOY$52,317EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$497,315LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$358,251LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$414,743BOYAmt
EOY$139,064EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,487,149BOYAmt
EOY$14,011,047EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,615,824BOYAmt
EOY$7,710,212EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$22,626,447BOYAmt
EOY$25,624,574EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,115,314BOYAmt
EOY$1,184,113EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,095,145BOYAmt
EOY$7,543,739EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,210,459BOYAmt
EOY$8,727,852EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$15,415,988BOYAmt
EOY$16,896,722EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,415,988BOYAmt
EOY$16,896,722EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,626,447BOYAmt
EOY$25,624,574EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,304,684ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$176,050NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,148OtherCostOrOtherBasisAmt
Depreciation$338DepreciationAmt
Book Value$9,810BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$117,440OtherCostOrOtherBasisAmt
Depreciation$70,726DepreciationAmt
Book Value$46,714BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$369,727OtherCostOrOtherBasisAmt
Depreciation$287,187DepreciationAmt
Book Value$82,540BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$139,064TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
INTEREST RECEIVABLE$21,070
MISCELLANEOUS RECEIVABLE$3,379,209
DUE FROM AFFILIATES$2,590,926
HEALTH BENEFIT RECONCILATION$1,711,424
SECURITY DEPOSIT$7,583
FieldValueIRS element (for citing)
Total Book Value Other Assets$7,710,212TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO ANTHEM$3,852,339
DUE TO AFFILIATES$3,667,900
CLAIMS INCURRED BUT NOT RECEIVED$23,500
FieldValueIRS element (for citing)
Total Liability$7,543,739TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$106,127,183TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$176,050NetUnrealizedGainsInvstAmt
Revenue Not Reported$176,050RevenueNotReportedAmt
Revenue Subtotal$105,951,133RevenueSubtotalAmt
Other Revenues Not Included$2OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$105,951,135TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$104,639,149TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$104,639,149ExpensesSubtotalAmt
Other Expenses Not Included$7,302OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$7,302ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$104,646,451TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 FILES ITS FORM 990 IN THE U.S. FEDERAL JURISDICTION. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2015 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FOUNDING ADJUSTMENT 2.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATION 7,300. ROUNDING ADJUSTMENT 2.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonSHARON AGNELLOPersonNm
TitleEXECUTIVE DIRECTORTitleTxt
Base Compensation Filing Org$121,467BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$24,000DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$22,000NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$167,467TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonABRINA CAPOBIANCOPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionDAUGHTER IN LAW OF CO-CHAIR JOHN CAPOBIANCORelationshipDescriptionTxt
Transaction$40,528TransactionAmt
TransactionPAYMENT OF WAGES AND BENEFITS AS A RESULT OF EMPLOYENT WITH THE ORGANIZATION.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED WITH THE CO-CHAIRMEN AND THE EXECUTIVE DIRECTOR PRIOR TO FILING OF THE RETURN.
FORM 990, PART VI, SECTION B, LINE 15ATHE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19TRI-STATE JOINT FUND DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLIC ANY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS.
FORM 990, PART IX, LINE 11GDENTAL CONSULTANT 7,545. ACTUARIAL 291,825. CLAIMS PROCESSING CONSULTANT 6,600. PAYROLL AUDIT FEE 108,000.
FORM 990, PART X11, LINE 2COVERSIGHT RESPONSIBILITY THERE HAS BEEN NO CHANGE IN THE OVERSIGHT RESPONSIBILITY. THE TRUSTEE'S ASSUME RESPONBILBILITY FOR THE AUDIT PROCESS INCLUDING SELECTION OF THE INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN
1139 FAIRFIELD AVENUEBRIDGEPORTCT06605060689974AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN
115 PROGRESS AVENUESPRINGFIELDMA01104042174518AFFILIATED SELF INSURED HEALTH PLANMA501C-9N/A0
TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN
200 WALLACE STREETNEW HAVENCT06511060690083AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN
18 CRESENT STREETUNCASVILLECT06382060689500AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 559 HEALTH SERVICE & INSURANCE PLAN
400 CHAPEL ROAD UNIT 2-BSOUTH WINDSORCT06074060683663AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN
1871 BALDWIN STREETWATERBURYCT06706060691862AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN
400 CHAPEL ROAD UNIT 2-ASOUTH WINDSORCT06074060997832AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN
L$641,960CASH VALUE
TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN
L$345,160CASH VALUE
TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN
L$473,440CASH VALUE
GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN
L$246,360CASH VALUE
TEAMSTERS LOCAL 671A HEALTH SERVICE & INSURANCE PLAN
L$164,880CASH VALUE
TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN
L$937,760CASH VALUE
TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN
L$261,400CASH VALUE