2024-08-07T14:07:44-05:00 2023-09-30 WITHUMSMITHBROWNPC 4600 EAST WEST HWY STE 900 BETHESDA MD 20814 990 2022-10-01 942848389 Teamsters Benefit Trust % TITAN INSURANCE ADMINISTRATO TEAM 5107964676 POST OFFICE BOX 5820 FREMONT CA 94537 KEITH FLEMING TRUSTEE 5107964676 2024-08-02 true RICHARD L RUVELSON P00234075 3012726000 2022 2024-08-08 14:25:15Z KEITH FLEMING POST OFFICE BOX 5820 FREMONT CA 94537 366749635 false X www.teamstersbenefittrust.com X 1982 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO MULTIEMPLOYER PLAN PARTICIPANTS. 12 0 2 0 2942702 294093 0 0 349092236 344688094 14302977 21252131 4039810 809410 367435023 366749635 0 0 286711844 291013657 0 0 0 0 0 13411258 15589050 300123102 306602707 67311921 60146928 622468881 739157796 40468503 41063604 582000378 698094192 TO PROVIDE HEALTH AND WELFARE BENEFITS TO MULTIEMPLOYER PLAN PARTICIPANTS. false false PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS IN THIS COLLECTIVELY BARGAINED MULTIEMPLOYER TRUST. false false false false false false false false false false true false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 1368 0 true 2 true true true false false false false false false false X 12 0 false true false false false false false true false false false true true true true true true false false false CA X TITAN INSURANCE ADMINISTRATO 5107964676 39420 LIBERTY ST STE 260 FREMONT CA 94538 X William Albanese Trustee 1.0 0.0 X 0 0 0 Keith Fleming Trustee 1.0 0.0 X 0 0 0 John Bouchard Trustee 1.0 0.0 X 0 0 0 Richard Jordan Trustee 1.0 0.0 X 0 0 0 Dennis Hart Trustee (THRU 12/2022) 1.0 0.0 X 0 0 0 Richard Murphy Trustee 1.0 0.0 X 0 0 0 Bill Rossi Trustee 1.0 0.0 X 0 0 0 Ron Paredes Trustee (THRU 01/2023) 1.0 0.0 X 0 0 0 Carlos Borba Trustee 1.0 0.0 X 0 0 0 Alberto Ruiz Trustee 1.0 0.0 X 0 0 0 JESSE CASQUEIRO TRUSTEE (THRU 01/2023) 1.0 0.0 X 0 0 0 GERALD COLEMAN TRUSTEE 1.0 0.0 X 0 0 0 STEPHEN BECK TRUSTEE (EFF 01/2023) 1.0 0.0 X 0 0 0 SAL LOMELI TRUSTEE (EFF 01/2023) 1.0 0.0 X 0 0 0 STEVEN LUA TRUSTEE (EFF 01/2023) 1.0 0.0 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.0 0.0 X 0 0 0 0 0 0 0 false false false LIPMAN INSURANCE ADMINISTRATORS IN 39420 LIBERTY STREET SUITE 260 FREMONT CA 94538 ADMINISTRATOR 7845317 ANTHEM BLUE CROSS 11030 white rock road RANCHO CORDOVA CA 95670 ADMINISTRATIVE 869894 WITHUMSMITHBROWN PC 5000 Executive Parkway Suite 400 SAN RAMON CA 94583 Audit Services 634615 Beeson Tayer Bodine ROss House 483 Ninth St 2nd Floor OAKLAND CA 94607 Legal Services 326956 INGENIORX 450 HEADQUARTERS PLAZA7TH FL EAST MORRISTOWN NJ 07960 ADMINISTRATIVE 360375 11 0 EMPLOYER CONTRIBUTIONS 900099 337183453 337183453 MEMBER AND RETIREE CONTRIBUTIONS 900099 7252100 7252100 LIQUIDATED DAMAGES 900099 163089 163089 MEDICARE PART D SUBSIDY 900099 19665 19665 STOP LOSS REFUNDS 900099 69787 69787 344688094 21252131 2942702 18309429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OTHER INCOME 900099 809410 809410 809410 366749635 345497504 2942702 18309429 0 0 0 291013657 0 0 0 0 0 0 8295612 274274 643684 0 0 2220161 2653811 0 701471 0 0 0 0 0 52878 0 0 0 229085 MISCELLANEOUS EXPENSE 518074 306602707 X 2804262 0 11266209 9404248 0 0 39582204 38318288 0 0 0 0 0 0 0 0 956925 1000746 0 0 384707706 472456273 182690375 217517041 0 0 0 0 461200 461200 622468881 739157796 19887913 18974334 0 0 23190 115770 0 0 0 0 0 0 0 0 0 0 20557400 21973500 40468503 41063604 X 0 0 0 0 582000378 698094192 582000378 698094192 622468881 739157796 60146928 55946886 X X false true X true false LIMITED PARTNERSHIPS 80114965 F LIMITED LIABILITY COMPANY 11716467 F 103-12 INVESTMENT ENTITIES 125685609 F 217517041 0 ACCUMULATED ELIGIBILITY CREDITS 21973500 21973500 X 420476360 55946886 55946886 364529474 2220161 2220161 366749635 304999496 304999496 2220161 -616950 1603211 306602707 PART XII, LINE 4B - OTHER ADJUSTMENTS: change in benefit obligations PART X, LINE 2 THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF SEPTEMBER 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS CONTRACTED WITH TITAN INSURANCE ADMINISTRATORS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B: THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B: A COPY OF FORM 990 WAS PROVIDED TO EACH MEMBER OF THE GOVERNING BODY FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C: AT LEAST ONCE A YEAR, TRUSTEES AND OTHER FIDUCIARIES SUBJECT TO THE CONFLICT-OF-INTEREST POLICY WILL BE ASKED TO DISCLOSE IN WRITING ANY RELATIONSHIP OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. SHOULD ANY INDIVIDUAL COVERED BY THE POLICY DETERMINE OR SUSPECT THAT HE OR SHE POSSESSES AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, SUCH INDIVIDUAL MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST OR RELATIONSHIP GIVING RISE TO THE CONFLICT AND DISCLOSE ALL RELEVANT FACTS PRIOR TO ANY DECISION TO ENTER INTO ANY PROPOSED TRANSACTION OR ARRANGEMENT OR, IF LATER, AS SOON AS THE ACTUAL OR POTENTIAL CONFLICT IS RECOGNIZED. THE TRUSTEE OR OTHER FIDUCIARY WITH THE CONFLICT OF INTEREST MUST BE EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION AND THE CONFLICTED INDIVIDUAL IS NOT ALLOWED TO INFLUENCE THE BOARD'S DECISION IN ANY WAY. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, LIPMAN INSURANCE ADMINISTRATORS. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. FORM 990, PART V, LINE 2A: THE PLAN DOES NOT HAVE EMPLOYEES. HOWEVER, CERTAIN PARTICIPANTS OF THE PLAN RECEIVED A FORM W-2 FOR TAXABLE DOMESTIC PARTNER BENEFITS. See explanation at Part VII Various CA NA true false false false false false false false false false false false false false false false false false false false SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF SEPTEMBER 30, 2023, THERE ARE APPROXIMATELY 269 TRIBUTING EMPLOYERS AND SPONSORING ORGANIZATIONS. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS AND SPONSORING ORGANIZATIONS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. A. TEICHERT & SON, INC. AAK USA RICHMOND CORP ABERCROMBIE PIPELINE SERVICES, LLC ABF FREIGHT SYSTEM, INC ACCO ENGINEERED SYSTEMS ACTION SWEEPING SERVICES, INC ADVANCED CONCRETE ALL MODULAR SYSTEMS ALLIANCE GRAPHICS/MECA ALLIANCE READY MIX, INC ALLIED WASTE ALPHA PRESS, INC. ALSCO AMENTUM SERVICES ANDREINI BROTHERS, INC. APRO INTERNATIONAL ARAMARK UNIFORM SERV ARB - LOCAL 431 ARGENT MATERIALS ARGONAUT CONSTRUCTORS B K MILL & FIXTURE BAKEMARK USA LLC BAUMAN LANDSCAPE, INC. BAY AREA PAVING CO. BAY CITIES PAVING & GRADI BAY CITIES REFUSE SERVICE BAY COUNTIES WASTE SERV BAY VIEW REFUSE & RECYCLI BERONIO LUMBER CO BFI NEWBY ISLAND RECYCLERY BFI-OX MOUNTAIN LANDFILL BLACK POINT PRODUCTIONS BRAGG INVESTMENT CO INC/BRAGG CRANE BROSAMER & WALL-TUTOR PERINI, INC BUBBA'S WATER TRUCK SERVICE, INC C.F. ARCHIBALD PAVING, IN C2G LTD CO CALIF LABOR FED, AFL-CIO CALIF WASTE SOLUTIONS CALIFORNIA TRADE BINDERY CALMAT CO DBA SHAMROCK CARONE & COMPANY, INC CARPENTER RIGGING LO2785 CEMEX CEN CAL SERVICES CENTRAL CONCRETE SUPPLY C CERUTTI & SONS TRANSPORT CHALLENGE DAIRY PRODUCTS CHANNEL LUMBER CO CHAUFFEURS, TMSTRS & HELP CHERNE CONSTRUCTION CORP CHUCK MACK AND ASSOCIATE CITY OF YAKIMA CONCEPT SERVICES, INC. CONCORD DISPOSAL SERVICE CONSOLIDATED PRINTING CO CONTRA COSTA BUILDING CT COUNTRY HEARTS TOO TRUCKING CURTIN CONVENTION CURTIN THEATRICAL MOVING CZARNOWSKI EXHIBIT D.A.V.E. TRUCKING & SWEEP DALY CITY SCAVENGER CO, INC DARLING INTERNATIONAL, INC DELTA SAND GRAVEL & RECYCLING DHL DINWIDDIE CONSTRUCTION CO DONALD MIRANDA TRUCKING, INC. DRAGADOS FLAT IRON JV DRILL TECH DRILLING & SHORING, INC. DUMBARTON QUARRY ASSOCIAT DW GENERAL ENGINEERING CONTRACTOR EAGLE DISTRIBUTION EARLE M JORGENSEN CO EAST BAY FORKLIFT EAST BAY RESTAURANT SUPPL EAST BAY SANITARY COMPANY ECONOMY LUMBER CO EMPLOYCO SERVICES, INC. EVENT PRODUCTIONS, INC. FERMA CORPORATION FERMA GREENBOX, INC. FLOYD JOHNSTON CONST. CO. FOREFRONT DEEP FOUNDATIONS FOUR M CONTRACTING, INC. FREEMAN EXPOSITIONS, LLC FREMONT UNIVERSAL TRANS G & J HEAVY HAUL G&B WATER TRUCKS, INC. G. BORTOLOTTO & COMPANY GARDEN CITY SAN GES, INC. GHILOTTI BROTHERS, INC. GHILOTTI CONSTRUCTION CO GILLIG CORPORATION GILLIS & LANE, INC GLOBE - BAY AREA FORKLIFT GOLDEN GATE APPAREL ASSOC GOLDEN GATE DISPOS & RECY GOODFELLOW BROS. CA, LLC. GOODLAND LANDSCAPE CONSTRUCTION INC. GR4 TRUCKING SERVICE LLC GRANITE CONSTRUCTION CO GRANITE ROCK GREEN TEAM OF SAN JOSE GREGORY CONSTRUCTION EQUIPMENT LLC GREIF BROTHERS CORP GRIFFITH COMPANY GUITTARD CHOCOLATE COMPANY H20 TRANSPORT LLC HALF MOON BAY GRADING & P HENKEL CORPORATION HENKELS & MCCOY, INC. HILL BROTHERS CHEMICAL CO. IBT IEDA IN TERMINAL SERV INSIGHT EXHIBITS INTERSTATE GRADING & PAVI IOX, LLC J & M, INC. J F C INTERNATIONAL, INC. JBS BAKESERVICE KATCH ENVIRONMENTAL KIEWIT INFRA WEST CO. KIEWIT SHEA TRAYLOR KNIFE RIVER CONSTRUCTION KODIAK TRUCKING, INC. LARSEN BROS, INC. LIPMAN INSURANCE ADMIN LITHOTYPE COMPANY, INC. LUND CONSTRUCTION MAGGIORA & GHILOTTI INC. MARIN SANITARY SERVICE MARTIN BROWER COMPANY MARTIN MARIETTA INC. MATERIAL RECOVERY SYSTEMS MATHESON TRI-GAS MAXUM EXPO SERVICES MCGUIRE AND HESTER MICHELS PACIFIC ENERGY MISSION TRAIL MON ROC ADMINISTRATORS MONDELEZ MONTEREY MECHANICAL CO. MOUNTAIN CASCADE INC. MV TRANSPORTATION NAPA RECYCLING & WASTE NATIONAL CONVENTION SERVICES NO CA TEAMSTERS APP TRAIN NUVISTA EVENT MANAGEMENT SERVICES O C JONES & SONS, INC. ODIN CONSTRUCTION O'GRADY PAVING, INC. ON POINT DECORATING, LLC OPERATING ENGIN. INTERNAT OSBORNE LUMBER CO INC. PACIFIC RACING ASSOCIATIO PALMISANO DELIVERY PENINSULA CRANE & RIGGING PINE CONE LUMBER PLANT RECLAMATION PLEASANTON READY MIX POTRERO HILLS LANDFILL PRECISION PIPELINE, LLC PRECISION SWEEPING PREMIUM POWER PRICE STAGE LINE LLC PRODUCTION PAYROLL PYRAMID PAINTING Q & D CONSTRUCTION QLM, INC. RANSOME COMPANY RE MASON ENGINEERING INC. RECOLOGY - SAN BRUNO GARB RECOLOGY HAY RD LANDFILL RECOLOGY OF S.M. RECOLOGY OF THE COAST RECOLOGY S.F. RECOLOGY SOUTH BAY RECOLOGY SOUTH VALLEY RECOLOGY VALLEJO REED & GRAHAM REEVE TRUCKING CO. RELIANCE SHEET & STRIP CO. RELIANCE STEEL & ALUMINUM RENAISSANCE MANAGEMENT REPUBLIC SERVICES (CRP) REYES COCA COLA BOTTLING RICH READIMIX CONCRETE, INC. RICHMOND SANITARY ROMANAZZI GENERAL ENGINEERING ROSSI EXPOSITIONS, INC. SA SVG CONTRACTORS SAFEWAY STORES, INC. SAN MATEO LUMBER SAN RAFAEL ROCK QUARRY, INC. SANTA CLARA CHMBR OF COMM SCHAWK, INC. SECURITY PAVING CO, INC. SERVICE WEST SHEEDY DRAYAGE CO. SHELDON GAS SHEPARD EXPOSITION SERV SIERRA MOUNTAIN CONSTR SIERRA POINT LUMBER SIMSMETAL USA SIZEMORE & SON CONSTRUCTION SNELSON COMPANIES, INC. SO SAN FRANCISCO SCAVENGE SOLANO GARBAGE SOUTH BAY REC SOUTH CITY LUMBER & SUPP SOUTHERN WINE SPECIALTY SLD WSTE/CLERIC SPER CONTRACTING CORP STATE BUILD & CON TRADE STATEWIDE CONTRACTING OF AMERICA STEVE P RADOS, INC SUKUT CONSTRUCTION LLC SUNSET SCAV CO. SYAR SYSCO SAN FRANCISCO INC. T3 EXPO LLC TDW CONSTRUCTION, INC. TEAM GHILOTTI INC. TEAM SAN JOSE-CON & TRADE TEAMSTERS ASSISTANCE PROG TEAMSTERS LO 2010 TEAMSTERS LO 2785 B/A'S TEAMSTERS LO 315 TEAMSTERS LO 350 TEAMSTERS LO 665 TEAMSTERS LO 760 TEAMSTERS LO 853 TEAMSTERS LO 890 TEICHERT AGGREGATES LO150 THE HDD COMPANY, INC. TITAN INSURANCE ADMINISTRATORS TOMMY'S WATER TRUCK RENTL TRAHAN ENTERPRISES TRI-VALLEY WATER TRUCKS TROJAN WARRIOR TRUCKING INC. TRUITT & WHITE LUMBER CO. TRUNXAI CONSTRUCTION TUTOR-PERINI ZACHARY PARS UNION PAYROLL AGENCY INC. UNION PLAZA APARTMENTS UNITED PARCEL SERV. L.315 URBAN ART LITHOGRAPHY VACAVILLE SANITARY SERV VALVERDE CONSTRUCTION VANGUARD CONSTRUCTION VERITIV OPERATING CO VULCAN MATERIALS COMPANY W A RASIC CONSTRUCTION W R FORDE ASSOCIATES WELLS SWEEPING WEST CC SANITARY LANDFILL WEST COUNTY RESOURCE RECO WEST VALLEY COLLECTION WEST VALLEY CONSTRUCTION WESTROCK WESTSIDE BUILDING MATERIA WHITE BROTHERS WILLWORK, INC EXHIBIT SER YOUNG'S MARKET CO. YRC FREIGHT