2011-04-12T09:49:20-05:00 2010-06-30 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2009-07-01 050271216 Teamsters Local 251 Health Services And Insurance Plan TEAM 4014673323 1201 Elmwood Avenue Providence RI 029043799 Joseph J Bairos 4014673323 2011-04-08 LOUIS VERZELLA CPA 6106689400 2011-03-31 2009 2016-02-24 21:20:13Z Joseph J Bairos 121 Brightridge Avenue East Providence RI 02914 43925491 0 X N/A X 1954 RI The Plan provides medical, hospitalization, dental, vision, hearing, life insurance, weekly accident and sickness, prepaid legal, employees assistance program, income tax preparation, and prescription drug benefits for eligible participants and their dependents. The Plan also provides a program of benefits for eligible retirees. 8 8 6 0 0 0 0 26554860 29729219 -931651 1106010 172520 100891 25795729 30936120 0 24921770 27371974 635321 789929 0 0 859869 872132 26416960 29034035 -621231 1902085 35507424 38899610 230660 222785 35276764 38676825 The Plan provides medical, hospitalization, dental, vision, hearing, life insurance, weekly accident and sickness, prepaid legal, employees assistance program, income tax preparation, and prescription drug benefits for eligible participants and their dependents. The Plan also provides a program of benefits for eligible retirees. 0 0 THE FUND PROVIDED MEDICAL, HOSPITAL, ACCIDENT, SICKNESS, DENTAL, VISION, HEARING, LIFE INSURANCE BENEFITS, DEATH, AND PREPAID LEGAL BENEFITS FOR APPROXIMATELY 2,382 MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 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 1 42 0 6 1 0 0 0 0 0 0 0 8 8 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 X Executive Director 4014673323 1201 Elmwood Avenue Providence RI 029043799 Joseph J Bairos 2.00 X 0 0 0 Paul M Fradin 2.00 X 0 0 0 Antonio B Cardi 2.00 X 0 0 0 Brian E Carroll 2.00 X 0 0 0 Kevin G Reddy 2.00 X 0 0 0 Steven M Labrie 2.00 X 0 0 0 Frank J Maxwell 2.00 X 0 0 0 LOUIS SPERLING 2.00 X 0 0 0 BARRY S GOLDEN 2.00 X 0 0 0 Tammy Beaudreault 40.00 X 80328 0 42550 0 0 0 0 0 0 0 blue cross & blue shield of ri 444 westminister mall providence RI 02901 claims processing 1545059 Coia & Lepore LTD 226 South Main Street Providence RI 02903 Legal Benefits Provider 414150 gursky law associates 420 scrabbletown rd n kingston RI 02852 legal services 147606 The Harwich Group LLC 48 Harwich Road Providence RI 02906 Consultant 129644 mellon financial corp 1 turks head place providence RI 02903 investment manager 111756 6 Employer Contributions 525100 27964609 27964609 RETIREE CONTRIBUTIONS 515100 1215632 1215632 Participant Contributi 525100 548978 548978 29729219 1043055 1043055 13052326 12989371 62955 62955 62955 MISCELLANEOUS INCOME 900099 100891 100891 100891 30936120 29729219 0 1206901 27371974 343181 133280 138259 175209 147606 40000 133067 312203 76332 14371 65162 37048 26319 8244 SUMMARY PLAN DESCRIPTIO 11780 29034035 4243305 3274250 2206257 2913069 939323 635536 275156 303787 25181389 28417679 3601317 3990825 35507424 38899610 157561 157393 4491 68608 65392 230660 222785 X 35276764 38676825 0 0 0 0 35276764 38676825 35507424 38899610 X 0 1 1 X 0 33602 33602 625461 419034 206427 190784 131790 58994 89476 84712 4764 303787 Common Collective Trust 3990825 F 3990825 Deferrred Retiree and Cobra Contributions 65392 65392 30936120 29034035 1902085 1497976 1497976 3400061 32301029 1497976 1497976 30803053 133067 133067 30936120 28900968 0 28900968 133067 133067 29034035 Form 990, Part VI, Section B, line 11 TEAMSTERS LOCAL 251 HEALTH SERVICES AND INSURANCE PLAN'S FORM 990 IS PREAPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT. THE RETURN IS FORWARDED TO THE FUND'S EXECUTIVE DIRECTOR FOR INTITIAL REVIEW. THE RETURN IS THEN PRESENTED TO THE TRUSTEES FOR REVIEW AND SIGNATURE Form 990, Part VI, Section C, line 19 TEAMSTERS LOCAL 251 HEALTH SERVICES & INSURANCE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. TEAMSTERS LOCAL 251 HEALTH SERVICES AND INSURANCE PLAN'S BOARD OF TRUSTEES IS RESPOSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT. TEAMSTERS LOCAL 251 HEALTH SERVICES AND INSURANCE PLAN ALSO PREPARE FORMS W-2 FOR ALL PARTICIPANTS THAT RECEIVE THE TAXABLE LEGAL, DEPENDENT LIFE INSURANCE AND TAX PREPARATION BENEFITS UNDER THE PLAN. A TOTAL OF 2,439 FROMS W-2 WERE ISSUED FOR THESE BENEFITS FOR THE CALENDAR YEAR 2009. Teamsters Local 251 Health Services and Insurance 401(k) Plan 1201 Elmwood Avenue Providence RI 02907 050271216 Pension Plan RI 401(A)/501(A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0