2014-02-10T14:38:04-06:00 2013-06-30 061298465 SM ESPOSITO & CO PC 3013 DIXWELL AVENUE HAMDEN CT 06518 990 2012-07-01 060850110 TRI-STATE JOINT FUND TRI- 2038763110 25 RESEARCH DRIVE MILFORD CT 06460 DENNIS E RAYMOND 2038763103 2014-02-10 1 2033877771 2014-02-10 2012 2015-11-30 17:44:51Z DENNIS E RAYMOND 25 RESEARCH DRIVE MILFORD CT 06460 87669750 0 X N/A X 1968 CT SELF-INSURED HEALTH BENEFIT PLAN 28 28 15 0 0 0 0 0 78773261 79663104 322885 579332 2306 1784 79098452 80244220 0 0 76463341 77421276 1320581 1323716 0 0 0 1603308 1645505 79387230 80390497 -288778 -146277 14997874 15369983 2943996 3064550 12053878 12305433 PROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO MEMBERS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS NEGOTIATED BY TEAMSTER LOCALS. 0 0 80390497 THE 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 11,196 MEMBERS PLUS THEIR DEPENDENTS. 80390497 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 18 0 1 15 1 0 0 0 0 0 0 0 0 X 28 28 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 1 0 X PATRICIA SANDILLO 2038763103 25 RESEARCH DRIVE MILFORD CT 06460 DENNIS RAYMOND 4.00 X 0 0 0 JOSEPH ESPOSITO 1.00 X 0 0 0 DANIEL FLANAGAN 1.00 X 0 0 0 ANTHONY CAPPELLA 1.00 X 0 0 0 RAYMOND ONEGLIA 1.00 X 0 0 0 FRANK ROSSI 1.00 X 0 0 0 VICTOR SANTIAGO 1.00 X 0 0 0 ROBERT SULLIVAN JR 1.00 X 0 0 0 SCOTT THOMSON 1.00 X 0 0 0 ROBERT BAYUSIK 1.00 X 0 0 0 LINDA BUNNELL 1.00 X 0 0 0 DENNIS MCGUIRE 4.00 X 0 0 0 THOMAS SCHLINK 1.00 X 0 0 0 BEVAN SWEET 1.00 X 0 0 0 NICHOLAS REUT 1.00 X 0 0 0 JOHN LUPACCHINO 1.00 X 0 0 0 THOMAS GILMARTIN 1.00 X 0 0 0 ROY SULLIVAN 1.00 X 0 0 0 TIMOTHY MCAVOY 1.00 X 0 0 0 JOHN LEAHY 1.00 X 0 0 0 DANIEL DURSO 1.00 X 0 0 0 ALAN FREOHLICH 1.00 X 0 0 0 CHRISTOPHER ROOS 1.00 X 0 0 0 GLENN BARKSDALE 1.00 X 0 0 0 PAUL NOVAK 1.00 X 0 0 0 JAMES STACK 1.00 X 0 0 0 TIMOTHY CASEY 1.00 X 0 0 0 HELGA SCHMIDT 1.00 X 0 0 0 PATRICIA SANDILLO 40.00 X 133978 0 38342 RONALD DEFILIPPO 1.00 X 0 0 0 KENNETH PAUZE 1.00 X 0 0 0 JOHN CAPOBIANCO 1.00 X 0 0 0 133978 0 38342 1 0 1 0 ROBERT M CHEVERIE & ASSOC 333 EAST RIVER DRIVE EAST HARTFORD CT 06108 LEGAL 323762 THE SEGAL COMPANY CHURCH STREET STATION P O BOX 4059 NEW YORK NY 102614059 ACTUARIAL 243381 EMDEONABF 3183 RIDER TRAIL SOUTH EARTH CITY MO 63045 PRINTING/MAILING 127213 3 CONTRIBUTIONS - HEALTH FUNDS 900099 79663104 79663104 79663104 252744 252744 7752118 7425530 326588 326588 326588 RENTAL INCOME 900099 1350 1350 SECURITY LITIGATION PROCEEDS 900099 434 434 1784 80244220 80244220 0 0 77421276 77421276 759824 759824 259358 259358 239121 239121 65413 65413 368754 368754 155500 155500 67262 67262 41415 41415 439221 439221 61371 61371 57750 57750 51844 51844 CONSULTING FEE (ACTUARI 236863 236863 OUTSIDE SERVICES 98384 98384 PROPERTY TAXES 37109 37109 UTILITIES 30032 30032 80390497 80390497 0 0 5576991 2677430 86428 44995 4827789 4375068 507833 452721 7479634 11378478 1346988 816359 14997874 15369983 783148 1162359 2160848 1902191 2943996 3064550 X 0 0 0 0 12053878 12305433 12053878 12305433 14997874 15369983 -146277 397832 0 X 0 1 X 1 0 152788 152788 3652520 3433553 218967 1022481 941515 80966 452721 INTEREST RECEIVABLE 42403 MISCELLANEOUS RECEIVABLE 670990 DUE FROM AFFILIATES - CONTRIBUTIONS 102966 816359 DUE TO ANTHEM 1632098 DUE TO AFFILIATES 270093 1902191 80642052 397832 397832 80244220 0 80244220 80390497 0 80390497 0 80390497 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED IN PERSON WITH THE CO-CHAIRMEN AND THE EXECUTIVE DIRECTOR PRIOR TO FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 15B THE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 TRI-STATE JOINT FUND DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLICANY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS. IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN 1139 FAIRFIELD AVENUE BRIDGEPORT CT 06605 060689974 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN 115 PROGRESS AVENUE SPRINGFIELD MA 01104 042174518 AFFILIATED SELF INSURED HEALTH PLAN MA 501C-9 N/A 0 TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN 200 WALLACE STREET NEW HAVEN CT 06511 060690083 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN 18 CRESENT STREET UNCASVILLE CT 06382 060689500 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 559 HEALTH SERVICE & INSURANCE PLAN 400 CHAPEL ROAD UNIT 2-B SOUTH WINDSOR CT 06074 060683663 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN 1871 BALDWIN STREET WATERBURY CT 06706 060691862 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN 400 CHAPEL ROAD UNIT 2-A SOUTH WINDSOR CT 06074 060997832 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0