2024-11-13T07:06:58-06:00 2023-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2023-01-01 060681161 CONNECTICUT LABORERS' HEALTH FUND CONN 2039347991 435 CAPTAIN THOMAS BOULEVARD WEST HAVEN CT 06516 SUSAN HENDERSON EXECUTIVE DIRECTOR 2039347991 2024-11-13 1 0 LOUIS VERZELLA CPA P00360279 6106689400 2024-11-12 2023 2024-10-15 13:58:12Z SUSAN HENDERSON 435 CAPTAIN THOMAS BOULEVARD WEST HAVEN CT 06516 62379064 0 X N/A X 1984 CT TO PROVIDE MEDICAL, LIFE AND RELATED BENEFITS TO INDIVIDUALS WORKING UNDER THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT WITH THE LABORERS UNION IN CONNECTICUT 8 0 18 0 0 0 0 0 58640639 60499273 1483366 1078211 58563 57834 60182568 61635318 0 0 57527744 57903121 1061225 1008174 0 0 0 722208 2304945 59311177 61216240 871391 419078 70061054 75675888 1212223 8075491 68848831 67600397 TO PROVIDE MEDICAL, LIFE AND RELATED BENEFITS TO INDIVIDUALS WORKING UNDER THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT WITH THE LABORERS UNION IN CONNECTICUT 0 0 PROVIDE MEDICAL, LIFE, AND OTHER RELATED BENEFITS TO COVERED EMPLOYEES AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 18 1 0 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SUSAN HENDERSON 2039347991 435 CAPTAIN THOMAS BOULEVARD WEST HAVEN CT 06516 THADDEUS GRABOWSKI TRUSTEE 0.50 X 0 20000 5800 KEITH BROTHERS TRUSTEE 0.50 X 0 251508 121513 JOHN BRUNALLI TRUSTEE 0.50 X 0 0 0 VINCENT DECROSTA TRUSTEE (P) 0.50 X 0 6891 1088 SHAWN GASKA TRUSTEE 0.50 X 0 4200 1218 VINCENT GIORDANO III TRUSTEE 0.50 X 0 0 0 MICHAEL ROY TRUSTEE 0.50 X 0 0 0 JOE BURNS TRUSTEE 0.50 X 0 0 0 CHRISTOPHER SNIPES TRUSTEE 0.50 X 0 1250 241 DIANE KLOBUKOWSKI EXEC. DIR. ( P) 40.00 X 24771 39023 34857 SUSAN HENDERSON EXEC. DIR. 40.00 X 103920 74706 34855 LORI FREDETTE CLAIMS SUPERVISOR 40.00 X 100734 0 34855 RICKY FREE COLLECTION SPECIALIST 40.00 X 39907 79826 34855 269332 477404 269282 2 0 1 0 AETNA LIFE INSURANCE CO 151 FARMINGTON AVE RE 11 HARTFORD CT 06156 CONTRACT ADMINISTRATION 1471460 CVS PHARMACY INC ONE CVS DRIVE WOONSOCKET RI 02895 CONTRACT ADMINISTRATION 195393 2 EMPLOYER CONTRIBUTIONS 900099 51294013 51294013 SELF PAY CONTRIBUTIONS 900099 9205260 9205260 60499273 321957 321957 1500000 743746 756254 756254 756254 ADMINISTRATIVE INCOME 900099 57834 57834 57834 61635318 60557107 0 1078211 57903121 562759 133615 252619 59181 86692 59412 35237 1762449 135666 140772 974 27024 52359 MEMBERSHIP DUES 4360 61216240 9846839 11536182 6141283 35062 31057 624479 298597 279422 325882 8419062 9140100 45333281 48501384 6147388 0 70061054 75675888 585316 598130 626907 7477361 1212223 8075491 X 0 0 0 0 68848831 67600397 68848831 67600397 70061054 75675888 419078 4316988 -5984500 0 X X 0 1 X 1 0 624479 298597 325882 325882 CCTS 12664102 F PARTNERSHIPS 35837282 F 48501384 DUE TO RELATED FUNDS 1054461 BENEFIT OBLIGATIONS 6422900 7477361 X 65917069 4316988 4316988 61600081 35237 35237 61635318 60742603 0 60742603 35237 438400 473637 61216240 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN IBNR 438,400. 0 0 0 KEITH BROTHERS TRUSTEE 0 233398 0 4488 0 13622 0 95278 0 26235 0 373021 0 0 SUSAN HENDERSON EXEC. DIR. 103920 74706 0 0 0 0 24945 176 9666 68 138531 74950 0 0 RICKY FREE COLLECTION SPECIALIST 39907 79826 0 0 0 0 8373 16748 3244 6490 51524 103064 0 0 FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE FORM 990 ARE DISTRIBUTED TO BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO EACH TRUSTEE AND KEY EMPLOYEE. ON AN ANNUAL BASIS, EACH TRUSTEE AND KEY EMPLOYEE SIGN A STATEMENT THAT THEY RECEIVED, UNDERSTAND AND WILL ABIDE BY THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS THE COMPENSATION LEVELS FOR EXECUTIVE DIRECTORS OF COMPARABLE FUNDS TO HELP DETERMINE THE COMPENSATION OF ITS OWN EXECUTIVE DIRECTOR. JOB PERFORMANCE IS ALSO EVALUATED AND USED TO DETERMINE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION AVAIABLE UPON REQUEST. HOWEVER, INFORMATION IS NOT AVAILABLE TO THE PUBLIC. INFORMATION IS ONLY AVAILABLE TO PLAN PARTICIPANTS AND SIGNATORY EMPLOYERS UPON REQUESTS. FORM 990. PART XII, LINE 2C. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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