2011-11-15T10:03:55-06:00 2010-12-31 SALTER & COMPANY LLC 4600 EAST-WEST HIGHWAY SUITE 300 BETHESDA MD 208143415 990 2010-01-01 530209136 TEAMSTERS LOCAL 639-EMPLOYERS HEALTH TRUST TEAM 2026368181 3130 AMES PLACE NE WASHINGTON DC 20018 THOMAS RATLIFF 2026368181 2011-11-15 1 JOSEPH M HERISHEN CPA 3018307400 2011-11-15 X 2010 2016-03-07 17:11:31Z THOMAS RATLIFF 3130 AMES PLACE NE WASHINGTON DC 20018 86550018 0 X N/A X 1952 DC TO PROVIDE HEALTH & WELFARE INSURANCE BENEFITS TO EMPLOYEES (AND THEIR ELIGIBLE DEPENDENTS) OF CONTRIBUTING EMPLOYERS WHO ARE REPRESENTED BY THE PARTICIPATING LOCAL UNIONS. 8 0 0 0 0 0 0 0 42087077 43817223 109599 2889012 6660 6551 42203336 46712786 0 0 27448843 31403601 12000 18000 0 0 0 3049497 3102625 30510340 34524226 11692996 12188560 60035697 73259548 168103 115456 59867594 73144092 TO PROVIDE COVERAGE FOR HOSPITALIZATION, MEDICAL BENEFITS, MENTAL HEALTH BENEFITS, DISABILITY INCOME, DEATH BENEFITS, PRESCRIPTION DRUGS, DISEASE CASE MANAGEMENT, DENTAL, AND VISION CARE BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 PAYMENT OF MEDICAL AND OTHER BENEFITS TO OR FOR ITS PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 0 0 1 0 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 0 0 1 0 0 0 0 0 0 0 X 8 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 1 0 0 0 X ABPA INC 2026368181 3130 AMES PLACE NE WASHINGTON DC 20018 ERIC D WEISS 2.00 X 6000 0 0 MICHAEL D BULL 2.00 X 12000 0 0 THOMAS RATLIFF 2.00 X 0 0 0 FRANK W STEGMAN 2.00 X 0 0 0 ANTHONY SMITH 2.00 X 0 0 0 JOHN GIBSON 2.00 X 0 0 0 PHILIP GILES 2.00 X 0 0 0 RAYMOND HOWARD 2.00 X 0 0 0 18000 0 0 0 0 0 0 0 CONTRIBUTIONS - PARTIC 900099 43817223 43817223 43817223 1730868 1730868 40995376 39837232 1158144 1158144 1158144 SECURITY LITIGATION PR 900099 6551 6551 6551 46712786 44981918 0 1730868 31403601 18000 985196 279457 61934 198353 2603 7064 6142 HOSPITAL NETWORK PROGRA 909279 DISEASE CASE MANAGEMENT 224733 MENTAL HEALTH ADMIN. FE 159609 POSTAGE & SHIPPING 88815 ACTUARIAL & CONSULTING 71094 108346 34524226 -394691 -511891 20174242 16392591 4369998 4824759 35886148 52554089 60035697 73259548 123500 101376 44603 14080 168103 115456 X 59867594 73144092 0 0 0 0 59867594 73144092 60035697 73259548 X 12188560 1087938 X X 0 1 1 X 0 0 DUE TO TEAMSTERS PENSION FUND 14080 14080 46712786 34524226 12188560 1087938 1087938 13276498 47602371 1087938 -198353 889585 46712786 0 46712786 34325873 0 34325873 198353 198353 34524226 PART XII, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSE -198,353. FORM 990, PART VI, SECTION A, LINE 2 THE UNION TRUSTEES ARE OFFICERS OF THE SAME RELATED ORGANIZATION, AND POSSIBLY ONE OR MORE OF THE EMPLOYER TRUSTEES ARE OFFICERS OF THE EMPLOYER ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 HAS BEEN PROVIDED TO THE FUND'S ADMINISTRATOR TO BE DISTRIBUTED TO THE FUND'S BOARD OF TRUSTEES PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FUND IS SUBJECT TO THE REQUIREMENTS OF THE EMPLOYEE RETIREMENT SECURITY ACT, AS AMENDED ("ERISA") AND THE FIDUCIARY STANDARDS OF ERISA, INCLUDING THE PROHIBITED TRANSACTION PROVISIONS, WHICH CONSTITUTE THE FUND'S CONFLICT OF INTEREST POLICY AND THE BOARD OF TRUSTEES MONITORS AND ENFORCES COMPLIANCE WITH THOSE PROVISIONS AS REQUIRED BY ERISA AND WITH THE ASSISTANCE OF THE FUND'S PROFESSIONALS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION ANNUAL FINANCIAL DISCLOSURE STATEMENTS FORM 5500 IS AVAILABLE FOR PUBLIC INSPECTION AT THE ERISA WEBSITE. THE FUND MAKES ITS GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS, BENEFICIARIES, THE SPONSORING UNION, AND CONTRIBUTING EMPLOYERS AS REQUIRED BY ERISA. ERISA DOES NOT REQUIRE THE FUND TO MAKE THESE DOCUMENTS AVAILABLE TO THE PUBLIC AND THE FUND DOES NOT DO SO. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII ERIC D. WEISS - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. MICHAEL D. BULL - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. THOMAS RATLIFF - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. FRANK W. STEGMAN - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. ANTHONY SMITH - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. JOHN GIBSON - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. PHILIP GILES - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. RAYMOND HOWARD - 3130 AMES PLACE, N.E., WASHINGTON, DC 20018. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,087,938. FORM 990, PAGE 11, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FUND'S FINANCIAL STATEMENTS AND ITS SELECTION OF AN INDEPENDENT ACCOUNTANT AND NO CHANGE HAS OCCURRED FROM THE PRIOR YEAR. TEAMSTERS LOCAL 639 EMPLOYERS PENSION TRUST FUND 3130 AMES PLACE NE WASHINGTON DC 20018 530237142 PENSION FUND DC 401(A) 0 TEAMSTERS LOCAL 639 LEGAL SERVICES FUND 3130 AMES PLACE NE WASHINGTON DC 20018 521096713 LEGAL SERVICES FUND DC 501(C)(9) 0 UPS 100 E CAMPUS VIEW BLVD COLUMBUS OH 43235 362407381 EMPLOYER OH C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0