2017-10-31T09:55:33-05:00 2016-12-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2016-01-01 366158494 SUBURBAN TEAMSTERS OF NORTHERN ILLINOIS WELFARE FUND SUBU 6302935218 1171 COMMERCE DR UNIT 1 WEST CHICAGO IL 60185 MARK KENNEDY TRUSTEE 6302935218 2017-10-31 1 COLIN THOMPSON P01460524 3123680500 12.197.118.215 2017-10-31 09:54:28 CD P D56625F7C0621E1EB8BA8C5A7372C18F0F4BC985 C3168D624729577079CA47B99B0ED2C5793BD89E 2016 2018-03-14 21:41:22Z MARK KENNEDY 1171 COMMERCE DR UNIT 1 WEST CHICAGO IL 60185 81633939 0 X WWW.SUBURBANTEAMSTERS.COM X 1951 IL PROVIDE HEALTH BENEFITS 6 0 138 0 0 0 0 0 49950159 57436132 3257683 2395734 304 1323 53208146 59833189 0 0 49993347 56927176 877627 1015564 0 0 0 1124353 1161867 51995327 59104607 1212819 728582 122350388 126492302 149693 227506 122200695 126264796 PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 710 0 1 138 1 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 0 0 X JOSE COLIN - FUND MANAGER 6302930390 1171 COMMERCE DR UNIT 1 WEST CHICAGO IL 60185 X PHILLIP STANOCH TRUSTEE - PAST 1.00 1.00 X 0 0 0 MARK KENNEDY TRUSTEE 2.00 2.00 X 0 0 0 THOMAS FLYNN TRUSTEE 1.00 65.00 X 0 152770 36602 WILLIAM BRACH TRUSTEE 1.00 1.00 X 0 0 0 DOMINIC ROMANAZZI TRUSTEE 2.00 40.00 X 0 143008 44854 TIMOTHY CUSTER TRUSTEE 1.00 65.00 X 0 118796 49933 RITCH DEMBINSKY TRUSTEE - NEW 1.00 1.00 X 0 0 0 JOSE COLIN FUND MANAGER 13.00 27.00 X 0 141029 30654 SUE SELIMOS WELFARE OPERATIONS MANAGER 30.00 10.00 X 0 107603 30654 0 663206 192697 0 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 60601 PPO NETWORK PROVIDER 1718346 METROPOLITAN LIFE INSURANCE COMPANY 501 US HIGHWAY 22 2ND FLOOR BRIDGEWATER NJ 08807 INSURANCE PROVIDER 153847 PRUDENTIAL FINANCIAL 2 GATEWAY CENTER NEWARK NJ 07102 INVESTMENT MANAGER 139606 MED CARE HEALTH MANAGEMENT CORPORATION 1107 S MANNHEIM ROAD WESTCHESTER IL 60154 BENEFIT CONSULTANT 135990 FOSTER & FOSTER 1 OAKBROOK TERRACE SUITE 720 OAKBROOK TERRACE IL 60181 ACTUARY 110391 5 EMPLOYER CONTRIBUTIONS 900099 50730102 50730102 PARTIC & RETIREE CONTRIBUTIONS 900099 4703086 4703086 PRESCRIPTION REBATES 900099 1529005 1529005 RETIREE DRUG SUBSIDY 900099 473939 473939 57436132 1235795 1235795 22960689 21800750 1159939 1159939 1159939 MISCELLANEOUS 900099 1323 1323 1323 59833189 57436132 0 2397057 56927176 55797 547311 131683 189371 91402 153827 111171 258529 110391 157393 107445 168022 2251 14858 16769 43193 PCORI FEES 18018 59104607 4341989 7366065 2054898 171834 4717092 6336094 69403 60860 13110 12983 558190 526380 30507 31810 40931857 42357327 70191532 70155329 122350388 126492302 79615 118250 70078 109256 149693 227506 X 0 0 0 0 122200695 126264796 122200695 126264796 122350388 126492302 728582 3335519 0 X 0 1 X 1 0 558190 526380 31810 31810 IR&M SHORT FUND LLC 9205815 F INSTITUTIONAL STRUCTURED MATURITY BOND FUND 26054202 F INSTITUTIONAL ALL CAP EQUITY FUND 22293478 F CREDOS FLOATING RATE FUND, L.P. 12601834 F 70155329 DUE TO SUBURBAN TEAMSTERS OF NORTHERN ILLINOIS PENSION FUND 109256 109256 X 62910179 3335519 3335519 59574660 258529 258529 59833189 58846078 0 58846078 258529 258529 59104607 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRES. 0 0 0 THOMAS FLYNN TRUSTEE 0 132370 0 0 0 20400 0 19502 0 17100 0 189372 0 0 DOMINIC ROMANAZZI TRUSTEE 0 115530 0 2278 0 25200 0 28525 0 16329 0 187862 0 0 TIMOTHY CUSTER TRUSTEE 0 118796 0 0 0 0 0 32833 0 17100 0 168729 0 0 JOSE COLIN FUND MANAGER 0 141029 0 0 0 0 0 13164 0 17490 0 171683 0 0 SUBURBAN TEAMSTERS OF NORTHERN ILLINOIS PENSION PLAN AFFILIATED PENSION PLAN 112000 RENT EXPENSE 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 IS PROVIDED TO THE CHAIRMAN OF THE BOARD OF TRUSTEES AND THE FUND MANAGER FOR THEIR REVIEW AND APPROVAL PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES AND EMPLOYEES OF THE HEALTH AND WELFARE FUND. THE BOARD OF TRUSTEES MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES APPROVES COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL (OFFICER), THE FUND MANAGER, WHO OVERSEES THE ORGANIZATIONS DAILY OPERATIONS. THE FUND MANAGER IS PAID BY THE RELATED PENSION FUND AND AN AMOUNT IS ALLOCATED TO THE WELFARE FUND AND REIMBURSED BACK TO THE PENSION FUND BASED ON TIME SPENT WORKING FOR THE RESPECTIVE FUNDS. APPROVAL IS DOCUMENTED IN THE ORGANIZATIONS MINUTES. TRUSTEES OF THE ORGANIZATION ARE NOT COMPENSATED. FORM 990, PART VI, SECTION C, LINE 19 THE HEALTH AND WELFARE FUND MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT ITS HOME OFFICE, UPON REQUEST. FORM 990, PART VII, LINE 1A THE ORGANIZATION'S ADMINISTRATOR IS ALSO THE ADMINSITRATOR OF THE RELATED PENSION FUND. REIMBURSEMENTS ARE DISBURSED BETWEEN THE TWO ORGANIZATIONS FOR THEIR ALLOCATED PORTION OF HIS SALARY, FRINGE BENEFITS, AND PAYROLL TAXES. FORM 990, PART V, LINE 2A THE NUMBER OF EMPLOYEES REPORTED ON FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, FILED FOR THE CALENDAR YEAR ENDING WITH OR WITHIN THE YEAR COVERED BY THIS RETURN INCLUDES PARTICIPANTS OF THE FUND THAT HAVE RECEIVED DISABILITY PAYMENTS DURING THE YEAR. 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