2012-11-13T09:55:04-06:00 2011-12-31 990 2011-01-01 226058341 TEAMSTERS INDUSTRIAL EMPLOYEES WELFARE FUND TEAM 2018673553 707 SUMMIT AVENUE UNION CITY NJ 07087 ROBERT BLUMENFELD 2018671477 2012-11-13 2011 2016-02-24 21:20:13Z ROBERT BLUMENFELD 707 SUMMIT AVENUE UNION CITY NJ 07087 15570795 0 X WWW.560BENEFITFUNDS.COM X 1948 NJ TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 5 4 0 0 0 0 0 0 11137531 12204525 482862 486173 55182 140943 11675575 12831641 0 0 9282854 13576361 0 2881 0 0 0 817480 810136 10100334 14389378 1575241 -1557737 11770645 11037914 1632060 2221169 10138585 8816745 TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 238 0 1 0 0 0 0 0 0 0 X 5 4 1 0 0 0 1 0 0 1 0 0 0 1 1 1 1 0 1 0 0 0 X ROBERT BLUMENFELD 2018671477 707 SUMMIT AVENUE UNION CITY NJ 07087 EDWIN H STIER 1.00 X 2881 5314 0 ANTHONY VALDNER 2.00 X 0 0 0 CHARLES T CONNORS 1.00 X 0 0 0 CHARLES D'ANGELO 1.00 X 0 0 0 LOUIS RODRIGUEZ 1.00 X 0 0 0 JEFFREY BRUNNER 1.00 X 0 0 0 ROBERT BLUMENFELD 10.00 X 0 0 0 2881 5314 0 0 0 0 0 HORIZON BLUE CROSS BLUE SHIELD PO BOX 15306 NEWARK NJ 07105 HEALTH CARE PROVIDER 315597 TC3 HEALTH INC 19732 MACARTHUR BLVD SUITE 100 IRVINE CA 92612 CLAIMS REPRICING AGENT 166281 2 EMPLOYER CONTRIBUTIONS 525100 12105606 12105606 COBRA 525100 98919 98919 12204525 361018 361018 2864309 2739154 125155 125155 125155 PRESCRIPTION REBATE IN 525100 132324 132324 OTHER INCOME 525100 8619 8619 140943 12831641 12345468 0 486173 13576361 2881 43796 22700 48261 85848 56547 59607 44092 288 4031 10607 ADMINISTRATIVE EXPENSE 433593 DUES AND SUBSCRIPTIONS 766 14389378 357759 198984 418463 0 1299028 1358052 612 7157 53870 31214 5140 22656 9463866 9183428 225777 267637 11770645 11037914 90874 166377 1541186 2054792 1632060 2221169 X 0 0 0 0 10138585 8816745 10138585 8816745 11770645 11037914 X -1557737 235897 X X 0 1 1 X 0 4019 4019 0 49081 26425 22656 770 770 0 22656 COMMON COLLECTIVE TRUSTS 7510760 F LIMITED PARTNERSHIPS 1672668 F 9183428 CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED 1998700 OTHER LIABILITIES 46525 DUE TO AFFILIATES, NET 9567 2054792 12831641 14389378 -1557737 235897 235897 -1321840 13019277 235897 235897 12783380 48261 48261 12831641 13844517 -496600 -496600 14341117 48261 48261 14389378 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITION TAKEN BY THE PLAN, AND HAS CALULATED THAT AS OF DECEMBER 31, 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XIII, LINE 2D - CHANGE IN BENEFIT OBLIGATIONS (496,600). FORM 990, PART VI, SECTION A, LINE 2 JEFFREY BRUNNER EMPLOYER TRUSTEE DIVISION PRESIDENT INERGY PROPANE, LLC HAS A BUSINESS RELATIONSHIP WITH CHARLES T. CONNORS, PRESIDENT OF H&M INTERNATIONAL COMPANY. FORM 990, PART VI, SECTION A, LINE 6 THE PLAN HAS PARTICIPANTS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD DURING 2011. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PREPARES THE FORM 990. THE INDEPENDENT AUDITOR REVIEWS THE FORM 990. A COPY OF THE FORM 990 WAS PROVIDED TO THE TRUSTEES OF THE ORGANIZATION BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE PLAN IS BOUND BY ERISA PROHIBITED TRANSACTION RULES WHICH PRECLUDE THE PLAN FROM ENGAGING IN ANY NON-EXEMPT PARTY IN INTEREST TRANSACTIONS. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS ARE PROVIDED TO PARTICIPANTS AND OTHER INTERESTED PARTIES UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 235,897. FORM 990, PART XII, LINE 2C. THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR. TEAMSTERS INDUSTRIAL EMPLOYEES PENSION FUND 707 SUMMIT AVENUE UNION CITY NJ 07087 226099363 TO PROVIDE RETIREMENT NJ 401 (A) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0