2012-03-22T15:21:41-05:00 2011-06-30 SM ESPOSITO & CO PC 3013 DIXWELL AVENUE HAMDEN CT 06518 990 2010-07-01 060850110 TRI-STATE JOINT FUND TRI- 2038763110 25 RESEARCH DRIVE MILFORD CT 06460 DENNIS E RAYMOND 2038763103 2012-03-22 1 2033877771 2012-03-22 2010 2016-02-24 21:20:13Z DENNIS E RAYMOND 25 RESEARCH DRIVE MILFORD CT 06460 83719800 0 X N/A X 1968 CT SELF-INSURED HEALTH BENEFIT PLAN 28 28 17 0 0 0 0 0 77954859 77241528 247589 417179 7238 30181 78209686 77688888 0 0 75537041 75123997 1344508 1362300 0 0 0 1647632 1605556 78529181 78091853 -319495 -402965 15821854 16206546 3761926 3595688 12059928 12610858 PROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO MEMBERS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS NEGOTIATED BY TEAMSTER LOCALS. 0 0 78091853 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 11,473 MEMBERS PLUS THEIR DEPENDENTS. 78091853 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 0 1 19 0 17 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 0 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 EDWIN ROONEY 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 BLAIR HEAGY 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 GEORGE BRIER 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 X 134880 0 36357 RONALD DEFILIPPO 1.00 X 0 0 0 134880 0 36357 1 0 1 0 ROBERT M CHEVERIE & ASSOC 333 EAST RIVER DRIVE EAST HARTFORD CT 06108 LEGAL 297043 THE SEGAL COMPANY CHURCH STREET STATION P O BOX 4059 NEW YORK NY 102614059 ACTUARIAL 240678 EMDEONABF 3183 RIDER TRAIL SOUTH EARTH CITY MO 63045 PRINTING/MAILING 137692 SOFTWARE SYSTEMS SOLUTION LLC 212-E NEW LONDON TURNPIKE GLASTONBURY CT 06033 COMPUTER CONSULTING 109645 4 CONTRIBUTIONS - HEALTH 900099 77241528 77241528 77241528 218685 218685 1350 1350 1350 1350 6229406 6030912 198494 198494 198494 SECURITY LITIGATION PR 900099 28831 28831 28831 77688888 77688888 0 0 75123997 75123997 808098 808098 227752 227752 258101 258101 68349 68349 347761 347761 57500 57500 58337 58337 38800 38800 476806 476806 65218 65218 74104 74104 54551 54551 CONSULTING FEE (ACTUARI 243399 243399 OUTSIDE SERVICES 117990 117990 UTILITIES 35711 35711 PROPERTY TAXES 35379 35379 78091853 78091853 0 0 2424741 3659613 103049 80158 4855131 4294710 586495 560421 11368909 9490601 1338660 2415753 15821854 16206546 742224 837098 3019702 2758590 3761926 3595688 X 0 0 0 0 12059928 12610858 12059928 12610858 15821854 16206546 X -402965 953895 X 0 1 1 X 0 152788 152788 3652520 3399232 253289 1049823 895478 154344 560421 INTEREST RECEIVABLE 25460 MISCELLANEOUS RECEIVABLE 487459 HEALTH BENEFIT RECONCILIATION 24920 DUE FROM AFFILIATES 495314 DUE FROM AFFILIATES - CONTRIBUTIONS 1382600 2415753 DUE TO ANTHEM 2758590 2758590 77688888 78091853 -402965 953895 953895 550930 78642783 953895 953895 77688888 0 77688888 78091853 0 78091853 0 78091853 0 0 0 PATRICIA SANDILLO 121269 0 9758 0 3853 0 0 0 36357 0 171237 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 953,895. 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