2025-01-15T11:28:57-06:00 2024-02-29 510435869 Needles & Associates LLC 9737 Wadsworth Pkwy STE 50 Westminster CO 80021 990 2023-03-01 846030963 Teamsters Local No455 Health and Welfare Fund TEAM 3034301118 5511 W 56th Avenue 250 Arvada CO 80002 Dana Rutz Trustee 3034301118 2024-01-09 1 0 Kurt Needles CPA P00850236 3034304225 2025-01-10 2023 2024-10-15 13:58:12Z X Dana Rutz 5511 W 56th Avenue 250 Arvada CO 80002 6130419 0 X N/A X 1956 CO To provide health and welfare benefits to eligible participants. 4 0 0 0 321067 0 0 0 5180654 5407855 323622 401497 155698 321067 5659974 6130419 0 0 4051218 4340781 0 0 0 0 0 601024 598531 4652242 4939312 1007732 1191107 9079160 11022558 646586 974132 8432574 10048426 Provide health and welfare benefits to eligible participants. 0 0 Provide health and welfare benefits to eligible participants. 0 0 0 0 0 0 0 0 0 0 0 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 1 5 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Board of Trustees 3034301118 5511 W 56th Ave Arvada CO 80002 X Dana Rutz Trustee 1.00 X 0 0 0 Kim Iszkun Trustee 1.00 X 0 0 0 Jason Abbott Trustee 1.00 X 0 0 0 Herb Whitaker Chairman 1.00 X 0 0 0 0 0 0 0 0 0 0 Zenith American Solutions 5511 W 56th Ave STE 250 Arvada CO 80002 Administrative 183992 CIGNA 5445 DTC Pkwy 400 Greenwood Village CO 80111 Administrative 116511 2 Employer Contributions 525100 5406418 5406418 Cobra Contributions 525100 1437 1437 5407855 401497 401497 Prescription rebate & 525100 321067 321067 321067 6130419 5407855 321067 401497 4340781 183992 93108 24331 88742 171477 19860 2157 14864 4939312 -46264 -63891 1814994 2810971 709151 167421 10123 8050 6591156 8100007 9079160 11022558 29586 5132 617000 969000 646586 974132 X 8432574 10048426 8432574 10048426 9079160 11022558 1191107 424745 0 X 0 0 0 0 Claims incurred but not reported 921248 Claims Payable 47752 969000 X 6555164 424745 424745 6130419 0 6130419 4587312 -352000 -352000 4939312 0 4939312 Part X, Line 2: The trust funding benefits of the Plan received an exemption letter from the Internal Revenue Service stating that the trust is tax-exempt under the provision of Section 501(c)9 of the Internal Revenue Code. The Plan and the trust are required to operate in conformity with the Internal Revenue Code to maintain the tax-exempt status of the trust. Plan management believes that the Plan is being operated in compliance with the applicable requirements of the Internal Revenue Code. 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 it has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Plan management has evaluated the Plan's tax positions and concluded that the Plan has taken no uncertain tax positions that would require financial statement recognition or disclosure for the year ended February 29, 2024 and February 28, 2023. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. With few exceptions, the Plan is no longer subject to tax examinations by tax authorities for years preceding February 28, 2020. Part XII, Line 2d - Other Adjustments: Change in claims payable -360,173. Change in IBNR 8,173. Form 990, Part VI, Section B, line 11b Form 990 was provided to the organization prior to filing. Form 990, Part VI, Section B, line 12c Board ot Trustees monitor the policies on a regular basis at board meetings. Form 990, Part VI, Section C, line 18 Form 990 is made available for public inspection upon request. Form 990, Part VI, Section C, line 19 The organization makes its governing documents available to the public upon request. International Brotherhood of Teamsters Local Union 455 10 Lakeside Lane Suite 3A Denver CO 80212 840186875 Represent its membership. 501c 0 Contributing Employers - obtain info from administrator N/A NA CO 80002 000000000 N/A N/A 0 0 Contributing Employers - obtain info from administrator N/A NA CO 80002 000000000 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0