TEAMSTERS HEALTH SERVICES AND INSURANCE PLAN OF LOCAL UNION 404: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- TEAMSTERS HEALTH SERVICES AND INSURANCE PLAN OF LOCAL UNION 404 (EIN 04-2174518)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-13
- IRS object ID
- 201911339349306781
- Schema version
- 2017v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-13T10:48:49-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 061298465 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SM ESPOSITO & CO PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3013 DIXWELL AVENUE | AddressLine1Txt |
| City | HAMDEN | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06518 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042174518 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEAMSTERS HEALTH SERVICES & INSURANCE | BusinessNameLine1Txt |
| Business Name Line2 | PLAN OF LOCAL UNION 404 | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TEAM | BusinessNameControlTxt |
| Phone | 4137332191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 PROGRESS AVENUE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01104 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRANK A ROSSI | PersonNm |
| Person Title | UNION TRUSTEE | PersonTitleTxt |
| Phone | 4137332191 | PhoneNum |
| Signature | 2019-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANA HARVEY CPA | PreparerPersonNm |
| PTIN | P01452206 | PTIN |
| Phone | 2033877771 | PhoneNum |
| Preparation | 2019-05-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 173.162.209.9 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-13 | IPDt |
| IP Tm | 11:45:41 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 01A18352793CBBCD4AE184237F5074D4C4A8D035 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 01A18352793CBBCD4AE184237F5074D4C4A8D035 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FRANK A ROSSI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 PROGRESS AVENUE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,784,348 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | SELF-INSURED HEALTH BENEFIT PLAN | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,400,210 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,965,083 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,896,058 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,758,146 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,097 | PYOtherRevenueAmt |
| CY Other Revenue | $2,217 | CYOtherRevenueAmt |
| PY Total Revenue | $15,297,365 | PYTotalRevenueAmt |
| CY Total Revenue | $16,725,446 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $8,123,382 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $7,894,599 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $419,928 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $446,103 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,025,001 | PYOtherExpensesAmt |
| CY Other Expenses | $1,075,852 | CYOtherExpensesAmt |
| PY Total Expenses | $9,568,311 | PYTotalExpensesAmt |
| CY Total Expenses | $9,416,554 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,729,054 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,308,892 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $96,261,149 | TotalAssetsBOYAmt |
| Total Assets EOY | $106,774,031 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,072,145 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $995,857 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $95,189,004 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $105,778,174 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTERS LOCAL 404 UNION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | PROVIDES INSURED AND SELF-INSURED MEDICAL, DEATH & LIFEINSURANCE BENEFITS TO 1,387 MEMBERS PLUS THEIR DEPENDENTS. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANK A ROSSI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4137332191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 PROGRESS AVENUE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01104 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| FRANK ROSSI | ||||||
| UNION TRUSTEE | 4.00 | 55.00 | Yes (X) | $0 | $95,370 | $49,239 |
| VICTOR SANTIAGO | ||||||
| UNION TRUSTEE | 4.00 | 55.00 | Yes (X) | $0 | $93,704 | $49,221 |
| ROBERT SULLIVAN JR | ||||||
| EMPLOYER TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LAWRENCE KEEFE | ||||||
| EMPLOYER TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $189,074 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $98,460 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANTHEM BLUE CROSS BLUE SHIELD | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1351 WM HOWARD TAFT RD | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | REPRICING & ADMIN FEES | ServicesDesc |
| Compensation | $226,940 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | $12,618,730 | $12,618,730 |
| SPECIAL RETIREE CONTRIBUTIONS | 900099 | $246,623 | $246,623 |
| AFFILIATED RENTAL INCOME | 900099 | $47,515 | $47,515 |
| PAYROLL AUDIT CONTRIBUIONS | 900099 | $41,006 | $41,006 |
| COBRA CONTRIBUTIONS | 900099 | $11,209 | $11,209 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,965,083 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,736,695 | TotalRevenueColumnAmt |
| Exclusion | $2,736,695 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $17,080,353 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,058,902 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,021,451 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,021,451 | TotalRevenueColumnAmt |
| Exclusion | $1,021,451 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,217 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,217 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,217 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,725,446 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,967,300 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,758,146 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,894,599 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,041 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,787 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,624 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,651 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,095 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,972 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $642,629 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,483 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,611 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,140 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,850 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,458 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,614 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,416,554 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,651 | BOYAmt |
| EOY | $66,112 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,019,310 | BOYAmt |
| EOY | $3,078,737 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,077,101 | BOYAmt |
| EOY | $1,111,237 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,733 | BOYAmt |
| EOY | $37,275 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $879,136 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $555,875 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,719 | BOYAmt |
| EOY | $323,261 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,363,876 | BOYAmt |
| EOY | $101,375,258 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,759 | BOYAmt |
| EOY | $782,151 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,261,149 | BOYAmt |
| EOY | $106,774,031 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,350 | BOYAmt |
| EOY | $46,014 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,016,795 | BOYAmt |
| EOY | $949,843 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,072,145 | BOYAmt |
| EOY | $995,857 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,189,004 | BOYAmt |
| EOY | $105,778,174 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,189,004 | BOYAmt |
| EOY | $105,778,174 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,261,149 | BOYAmt |
| EOY | $106,774,031 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,308,892 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,280,278 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $130,000 | OtherCostOrOtherBasisAmt |
| Book Value | $130,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $678,004 | OtherCostOrOtherBasisAmt |
| Depreciation | $489,269 | DepreciationAmt |
| Book Value | $188,735 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $71,132 | OtherCostOrOtherBasisAmt |
| Depreciation | $66,606 | DepreciationAmt |
| Book Value | $4,526 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $323,261 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| HEALTH CLAIMS PAYABLE; INCURRED BUT NOT REPORTED | $734,600 |
| ACCUMULATED ELIGIBILITY CREDITS | $215,243 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $949,843 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $19,786,752 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $3,280,278 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $3,280,278 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,506,474 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $218,972 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $218,972 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,725,446 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,264,534 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,264,534 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $218,972 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | -$66,952 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $152,020 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,416,554 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2014 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS. |
| SCH D PART XII, LINE 4B | CHANGE IN BENEFIT OBLIGATION |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | EUROPE (INCLUDING ICELAND & GREENLAND) - | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $1,536,750 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $1,536,750 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $1,536,750 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 OVERSIGHT RESPONSIBILITY AND APPROVAL PROCESS. THE TRUSTEE'S ASSUME RESPONSIBILITY FOR THE AUDIT PROCESS INCLUDING THE SELECTION OF THE INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| TEAMSTERS LOCAL UNION 404 | |||||||||
| 115 PROGRESS AVENUE | SPRINGFIELD | MA | 01104 | 041171377 | REPRESENTATION OF UNION MEMBERS | MA | 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|
| BERKSHIRE CONCRETE CORP | ||||||
| 550 CHESHIRE ROAD | PITTSFIELD | MA | 01201 | MA | C | 0 |
| BERKSHIRE TRANS MGT CO | ||||||
| 67 DOWNING PARKWAY | PITTSFIELD | MA | 01201 | MA | C | 0 |
| LANE CONSTRUCTION CORP | ||||||
| 953 ODLIN ROAD | BANGOR | ME | 04401 | ME | C | 0 |
| YRC INC | ||||||
| 10990 ROE AVE | OVERLAND PARK | KS | 66211 | KS | C | 0 |
| SULLIVAN TRANSPORT INC | ||||||
| PO BOX 90155 | SPRINGFIELD | MA | 01139 | MA | C | 0 |
| TITAN ROOFING | ||||||
| 165 HARING STREET | WORCESTER | MA | 01604 | MA | C | 0 |
| UNITED PARCEL SERVICE | ||||||
| 100 EAST CAMPUS VIEW BLVD | COLUMBUS | OH | 43235 | OH | C | 0 |
| WILLIAMS DISTRUBUTING | ||||||
| PO BOX 98 | CHICOPEE | MA | 01021 | MA | C | 0 |
| CONSTRUCTION SERVICE | ||||||
| 2420 BOSTON ROAD | WILBRAHAM | MA | 01095 | MA | C | 0 |
| ET & L CONSTRUCTION | ||||||
| 873 GREAT ROAD | STOW | MA | 01775 | MA | C | 0 |
| BORGGAARD CONSTRUCTION GROUP | ||||||
| 70 CREEPER HILL ROAD | NORTH GRAFTON | MA | 01536 | MA | C | 0 |
| NEW PENN MOTOR EXPRESS | ||||||
| 625 S 5TH AVE | LEBANON | PA | 17042 | PA | C | 0 |
| HYDRO CONDUIT CORP | ||||||
| 1501 BELVEDERE ROAD | WEST PALM BEACH | FL | 33406 | FL | C | 0 |
| ASHLAND INC | ||||||
| 1111 GRATTAN STREET | CHICOPEE | MA | 01013 | MA | C | 0 |
| ARKANSAS BEST FREIGHT | ||||||
| PO BOX 10048 | FORT SMITH | AR | 72917 | AR | C | 0 |
| AMERICAN ENVIRONMENTAL GROUP LTD | ||||||
| 3600 BRECKSVILLE RD | RICHFIELD | OH | 44286 | OH | ||
| COMPLETE DISPOSAL CO | ||||||
| 415 NORTH RD | WESTFIELD | MA | 01085 | MA | ||
| TAYLOR OIL NORTHEAST INC | ||||||
| 176 CENTRE STREET | HOLBROOK | MA | 02343 | MA | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRISTATE JOINT FUND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $344,720 | InvolvedAmt |
Comments