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TEAMSTERS LOCAL 922 EMPLOYERS HEALTH TRUST: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
TEAMSTERS LOCAL 922 EMPLOYERS HEALTH TRUST (EIN 52-1158708)
Tax period
2022-10-01 to 2023-09-30
Filed
2024-07-26
IRS object ID
202442089349300504
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-07-26T07:53:32-05:00ReturnTs
Tax Period End2023-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470900880PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CALIBRE CPA GROUP PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17501 WISCONSIN AVENUE STE 1200WAddressLine1Txt
CityBETHESDACityNm
State AbbreviationMDStateAbbreviationCd
ZIP20814ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521158708EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TEAMSTERS LOCAL 922 - EMPLOYERS HEALTHBusinessNameLine1Txt
Business Name Line2TRUSTBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlTEAMBusinessNameControlTxt
Phone4108729500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17130 COLUMBIA GATEWAY DRIVE AAddressLine1Txt
CityCOLUMBIACityNm
State AbbreviationMDStateAbbreviationCd
ZIP21046ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRUDOLPH GARDNERPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone4108729500PhoneNum
Signature2024-07-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOSEPH M HERISHEN CPAPreparerPersonNm
PTINP00361968PTIN
Phone2023319880PhoneNum
Preparation2024-07-26PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2024-08-08 14:25:15ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRUDOLPH GARDNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line17130 COLUMBIA GATEWAY DRIVEAddressLine1Txt
CityCOLUMBIACityNm
State AbbreviationMDStateAbbreviationCd
ZIP21046ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,700,208GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1979FormationYr
Legal Domicile StateMDLegalDomicileStateCd
Activity Or MissionTHE FUND PROVIDES MEDICAL,SURGICAL,HOSPITALIZATION, VISION CARE AND DENTAL BENEFITS PURSUANT TO CERTAIN COLLECTIVE BARGAINING AGREEMENTS.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$140,646TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$7,711,762PYProgramServiceRevenueAmt
CY Program Service Revenue$8,346,290CYProgramServiceRevenueAmt
PY Investment Income-$28,117PYInvestmentIncomeAmt
CY Investment Income$140,646CYInvestmentIncomeAmt
PY Other Revenue$1,704,341PYOtherRevenueAmt
CY Other Revenue$477,549CYOtherRevenueAmt
PY Total Revenue$9,387,986PYTotalRevenueAmt
CY Total Revenue$8,964,485CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$8,483,623PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$7,825,727CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$344,050PYOtherExpensesAmt
CY Other Expenses$415,256CYOtherExpensesAmt
PY Total Expenses$8,827,673PYTotalExpensesAmt
CY Total Expenses$8,240,983CYTotalExpensesAmt
PY Revenues Less Expenses$560,313PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$723,502CYRevenuesLessExpensesAmt
Total Assets BOY$5,590,724TotalAssetsBOYAmt
Total Assets EOY$6,346,437TotalAssetsEOYAmt
Total Liabilities BOY$91,465TotalLiabilitiesBOYAmt
Total Liabilities EOY$113,547TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,499,259NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,232,890NetAssetsOrFundBalancesEOYAmt
MissionNONEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,240,983ExpenseAmt
DescTHE FUND PROVIDED GROUP LIFE, DISABILITY, HOSPITALIZATION, SURGICAL ,MEDICAL, VISION AND DENTAL BENEFITS TO ELIGIBLE PARTICIPANTS UNDER VARIOUS COLLECTIVE BARGAINING AGREEMENTS.Desc
Total Program Service Expenses$8,240,983TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CARDAY ASSOCIATES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4108729500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17130 COLUMBIA GATEWAY DRIVE STE AAddressLine1Txt
CityCOLUMBIACityNm
State AbbreviationMDStateAbbreviationCd
ZIP21046ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
RUDOLPH GARDNER
UNION TRUSTEE2.00Yes (X)$0$0$0
SHERRI DICKERSON
EMPLOYER TRUSTEE2.00Yes (X)$0$0$0
TIMOTHY BROWN
UNION TRUSTEE2.00Yes (X)$0$0$0
MICHAEL GOBLE
EMPLOYER TRUSTEE2.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENESYS INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line17130 COLUMBIA GATEWAY DR SUITE AAddressLine1Txt
CityCOLUMBIACityNm
State AbbreviationMDStateAbbreviationCd
ZIP21046ZIPCd
FieldValueIRS element (for citing)
ServicesADMINISTRATIVEServicesDesc
Compensation$221,560CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS525100$6,105,263$6,105,263
PARTICIPANT CONTRIBUTIONS525100$2,241,027$2,241,027
FieldValueIRS element (for citing)
Total Program Service Revenue$8,346,290TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$136,369TotalRevenueColumnAmt
Unrelated Business Revenue$136,369UnrelatedBusinessRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,740,000SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,735,723SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,277SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,277TotalRevenueColumnAmt
Unrelated Business Revenue$4,277UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PRESCRIPTION REBATE525100$294,659$294,659
STOP LOSS REIMBURSEMENT525100$159,499$159,499
SUBROGATION525100$22,822$22,822

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$569TotalRevenueColumnAmt
Related Or Exempt Func Income$569RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$477,549OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,964,485TotalRevenueColumnAmt
Related Or Exempt Func Income$8,823,839RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$140,646UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$7,825,727TotalAmt
Program Services$7,825,727ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$221,560TotalAmt
Program Services$221,560ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$33,841TotalAmt
Program Services$33,841ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,979TotalAmt
Program Services$21,979ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$13,201TotalAmt
Program Services$13,201ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$7,479TotalAmt
Program Services$7,479ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$838TotalAmt
Program Services$838ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
ACTUARIAL$43,750$43,750
PPO FEES$28,109$28,109
CASE MANAGEMENT EXPENSE$20,791$20,791
BANK CHARGES$11,856$11,856

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$11,852TotalAmt
Program Services$11,852ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,240,983TotalAmt
Program Services$8,240,983ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,155,529BOYAmt
EOY$2,626,893EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,891,670BOYAmt
EOY$2,989,169EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$542,450BOYAmt
EOY$722,965EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,075BOYAmt
EOY$7,410EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,590,724BOYAmt
EOY$6,346,437EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$91,465BOYAmt
EOY$113,547EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$91,465BOYAmt
EOY$113,547EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,499,259BOYAmt
EOY$6,232,890EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,499,259BOYAmt
EOY$6,232,890EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,590,724BOYAmt
EOY$6,346,437EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$723,502ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$10,129NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE TPA PROVIDES A COPY OF THE 990 TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE FINAL FILING.
FORM 990, PART VI, SECTION C, LINE 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.