FURP.ORG / PUBLIC DATA EXPLORER

IBT LOCAL 191 HEALTH SERVICES & INSURANCE PLAN: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
IBT LOCAL 191 HEALTH SERVICES & INSURANCE PLAN (EIN 06-0689974)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-04-02
IRS object ID
201840929349300739
Schema version
2016v3.0
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)
Return2018-04-02T15:06:11-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

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 Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060689974EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LOCAL 191 HEALTH SERVICE ANDBusinessNameLine1Txt
Business Name Line2INSURANCE PLANBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlLOCABusinessNameControlTxt
Phone2033665849PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11139 FAIRFIELD AVENUEAddressLine1Txt
CityBRIDGEPORTCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06605ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEDWIN ROONEYPersonNm
Person TitleUNION TRUSTEEPersonTitleTxt
Phone2303665849PhoneNum
Signature2018-04-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANA HARVEYPreparerPersonNm
PTINP01452206PTIN
Phone2033877771PhoneNum
Preparation2018-04-02PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address173.162.209.9IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-04-02IPDt
IP Tm16:08:11IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1C6F0C719B2506D6AB68CA1B53DCFF7D12CB5036AtSubmissionCreationDeviceId
At Submission Filing Device Id1C6F0C719B2506D6AB68CA1B53DCFF7D12CB5036AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEDWIN ROONEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11139 FAIRFIELD AVENUEAddressLine1Txt
CityBRIDGEPORTCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06605ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$39,399,974GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1954FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionSELF-INSURED HEALTH BENEFIT PLANActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$21,265,903PYProgramServiceRevenueAmt
CY Program Service Revenue$21,065,335CYProgramServiceRevenueAmt
PY Investment Income$1,173,519PYInvestmentIncomeAmt
CY Investment Income$3,514,006CYInvestmentIncomeAmt
PY Other Revenue$264PYOtherRevenueAmt
CY Other Revenue$8,615CYOtherRevenueAmt
PY Total Revenue$22,439,686PYTotalRevenueAmt
CY Total Revenue$24,587,956CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$20,082,640PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$19,421,865CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$447,650PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$494,976CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,166,377PYOtherExpensesAmt
CY Other Expenses$1,846,954CYOtherExpensesAmt
PY Total Expenses$21,696,667PYTotalExpensesAmt
CY Total Expenses$21,763,795CYTotalExpensesAmt
PY Revenues Less Expenses$743,019PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,824,161CYRevenuesLessExpensesAmt
Total Assets BOY$62,708,324TotalAssetsBOYAmt
Total Assets EOY$68,451,822TotalAssetsEOYAmt
Total Liabilities BOY$2,816,790TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,740,189TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$59,891,534NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$65,711,633NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTERS LOCAL 191 UNION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescPROVIDES INSURED AND SELF-INSURED MEDICAL, DEATH & LIFEINSURANCE BENEFITS TO 2,264 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 Assets0ReportOtherAssetsInd
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 Mem0BusinessRlnWithFamMemInd
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 Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee5EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
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 Committees0MinutesOfCommitteesInd
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 CEO0CompensationProcessCEOInd
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 Line1EDWIN ROONEYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2033665849PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11139 FAIRFIELD AVENUEAddressLine1Txt
CityBRIDGEPORTCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06605ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
ANTHONY CAPPELLA
EMPLOYER TRUSTEE2.00Yes (X)$0$0$0
ED ROONEY
UNION TRUSTEE4.00Yes (X)$0$141,582$44,20555.00
ROBERT FLYNN
UNION TRUSTEE4.00Yes (X)$0$149,757$44,20355.00
FOREST HARVEY
EMPLOYER TRUSTEE2.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$291,339TotReportableCompRltdOrgAmt
Total Other Compensation$88,408TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ANTHEM BLUE CROSS BLUE SHEILD
1351 WM HOWARD TAFT RDCINCINNATIOH45206REPRICING AND ADMIN FEES$420,941
UBS FINANCIAL SERVICES
333 EARLE OVINGTON BLVDUNIONDALENY11553INVESTMENT CONSULTING$271,481
PREFERRED ACCESS NETWORK
1510 WEST 75TH STREETDARIENIL60561REPRICING AND ADMIN FEES$149,406
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$20,521,684$20,521,684
SPECIAL RETIREE CONTRIBUTION900099$251,512$251,512
PAYROLL AUDIT900099$128,534$128,534
COBRA CONTRIBUTIONS900099$113,955$113,955
AFFILIATED RENTAL INCOME900099$49,650$49,650
FieldValueIRS element (for citing)
Total Program Service Revenue$21,065,335TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$868,349TotalRevenueColumnAmt
Exclusion$868,349ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$17,457,675SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$14,812,018SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,645,657SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,645,657TotalRevenueColumnAmt
Exclusion$2,645,657ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SERVERANCE PLAN RECOVERY900099$7,001$7,001
SECURITY LITIGATION PROCEEDS900099$1,614$1,614
FieldValueIRS element (for citing)
Other Revenue Total$8,615OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,587,956TotalRevenueColumnAmt
Related Or Exempt Func Income$21,073,950RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,514,006ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$19,421,865TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$272,806TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$103,314TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$96,243TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$22,613TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,775TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$271,481TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,345,917TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$38,943TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$84,998TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$17,328TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$19,498TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$17,550TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmt
REPAIRS & MAINTENANCE$27,959
SEVERANCE BENEFIT$1,505

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,763,795TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$174,430BOYAmt
EOY$172,704EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$17,186,172BOYAmt
EOY$16,184,126EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,082,404BOYAmt
EOY$1,706,094EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$11,139EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,397,995LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,169,912LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$240,186BOYAmt
EOY$228,083EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$42,793,831BOYAmt
EOY$50,082,023EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$231,301BOYAmt
EOY$67,653EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$62,708,324BOYAmt
EOY$68,451,822EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$32,213BOYAmt
EOY$24,733EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,784,577BOYAmt
EOY$2,715,456EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,816,790BOYAmt
EOY$2,740,189EOYAmt
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$59,891,534BOYAmt
EOY$65,711,633EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,891,534BOYAmt
EOY$65,711,633EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$62,708,324BOYAmt
EOY$68,451,822EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,824,161ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,995,938NetUnrlzdGainsLossesInvstAmt
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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,000OtherCostOrOtherBasisAmt
Book Value$40,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,975,999OtherCostOrOtherBasisAmt
Depreciation$2,841,430DepreciationAmt
Book Value$134,569BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$381,996OtherCostOrOtherBasisAmt
Depreciation$328,482DepreciationAmt
Book Value$53,514BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$228,083TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
HEALTH CLAIMS PAYABLE; HEALTH CLAIMS INCURRED BUT UNREPORTED$2,010,400
DUE TO PARTICIPATING HEALTH SERVICE$239,595
ACCUMULATED ELIGIBILITY CREDITS$444,650
SEVERANCE PAYABLE$20,811
FieldValueIRS element (for citing)
Total Liability$2,715,456TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$27,312,413TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,995,938NetUnrealizedGainsInvstAmt
Revenue Not Reported$2,995,938RevenueNotReportedAmt
Revenue Subtotal$24,316,475RevenueSubtotalAmt
Investment Expenses Not Incld$271,481InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$271,481RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$24,587,956TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$21,523,062TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$30,748OtherExpensesIncludedAmt
Expenses Not Reported$30,748ExpensesNotReportedAmt
Expenses Subtotal$21,492,314ExpensesSubtotalAmt
Investment Expenses Not Incld2$271,481InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$271,481ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,763,795TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 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 ORGANIZATION FILES ITS FORM 990 IN THE U.S. FEDERAL JURISDICTION. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2013 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS.
FORM 990, SCH D, PART XII, LINE 4CCHANGE IN BENEFIT OBLIGATIONS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ED ROONEY
UNION TRUSTEE$0$137,980$0$0$0$3,602$0$22,396$0$21,809$0$185,787$0$0
ROBERT FLYNN
UNION TRUSTEE$0$134,425$0$0$0$15,332$0$22,396$0$21,807$0$193,960$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4AFormAndLineReferenceDesc
ExplanationRELATED PARTY TEAMSTERS LOCAL 191 PAID ROBERT FLYNN SEVERANCE PAY UPON RETIREMENT TOTALING - $9,400.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8BTHERE 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 11BFORM 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 19THE 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 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 (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
IBT LOCAL UNION 191
1139 FAIRFIELD AVENUEBRIDGEPORTCT06605060453477REPRESENTATION OF UNION MEMBERSCT501C-5N/A0
TRI STATE JOINT FUND
25 RESEARCH DRIVEMILFORDCT064600608501103RD PARTY ADMINISTRATOR FOR AFFILIATED ENTITIESCT501C-9N/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (31 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BURNS CONSTRUCTION
300 SPERRY AVESTRATFORDCT06615CTC0
CITY CARTING
PO BOX 17250STAMFORDCT06907CTC0
DEERING CONSTRUCTION INC
20 SHEEHAN AVENORWALKCT06854CTC0
FGB CONSTRUCTION
150 BOUTON STREETNORWALKCT06854CTC0
FIRST STUDENT
600 VINE STREETCINCINNATIOH45202OHC0
GROCERY HAULERS
581 MAIN STREETWOODBRIDGENJ07095NJC0
HI-HO CONN COKE & FUEL CO
39 SALT STREETBRIDGEPORTCT06605CTC0
INTERSTATE & LAKELAND LUMBER CORP
247 MILL STREETGREENWICHCT06830CTC0
JULIAN RAILROAD CONSTRUCTION
488 GRAND STBRIDGEPORTCT06604CTC0
MARK IV CONSTRUCTION
1137 SEAVIEW AVEBRIDGEPORTCT06607CTC0
MARSHALLS EXPRESS INC
80 SOUTHFIELD AVESTAMFORDCT06902CTS0
NATIONWIDE JANITORIAL SERV INC
11624 PAGE SERVICE DRIVEST LOUISMO63146MOC0
O&G INDUSTRIES
112 WALL STREETTORRINGTONCT06790CTC0
PETROLEUM HEAT & POWER
PO BOX 288TIVERTONRI02878RIC0
PETRO-HOME OIL
55 DAY STREETSOUTH NORWALKCT06854CTC0
STANDARD WRECKING CO
30 NUTMEG DRIVETRUMBULLCT06611CTC0
STONY BROOK GARDENS
55 SINGER COURTSTRATFORDCT06614CTC0
STUDENT TRANS OF AMERICA
3349 HIGHWAY 138WALLNJ07719NJC0
TEAMSTERS LOCAL UNION 1150
150 GARFIELD AVESTRATFORDCT06615CTT0
UNITED PARCEL SERVICE
100 EAST CAMPUS VIEW BLVDCOLUMBUSOH43235OHC0
WATERS CONSTRUCTION CO INC
300 BOSTWICK AVEBRIDGEPORTCT06605CTC0
WE TRANSPORT
75 COMMERCIAL STREETPLAINVIEWNY11803CTC0
YRC INC
10990 ROE AVEOVERLAND PARKKS66211KSC0
SPORTECH ENTERPRISES
255 KOSSUTH STREETBRIDGEPORTCT06608CTC0
MEYER RIGGING
LONG BEACH BLVDSTRATFORDCT06615CTC0
TILCON
301 HARTFORD AVENEWINGTONCT06131CTC0
DEL-VA CORPORATION
414 NEW BRITIAN AVENEUEPLAINVILLECT06062CTC0
CJ FUCCI CONSTRUCTION
63 RUSSELL STREETNEW HAVENCT06513CTC0
MICHAEL INFANTE & SONS
29 VINTAGE ROADTRUMBULLCT06611CTC0
RONDANDO M
49 EAST AVENORWALKCT06851CTC0
ARKANSAS BEST FREIGHT
PO BOX 10048FORT SMITHAR72917CT
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1TRISTATE JOINT FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$646,360InvolvedAmt