2025-05-09T11:36:16-05:00 2024-06-30 061298465 SM ESPOSITO & CO PC 3013 DIXWELL AVENUE HAMDEN CT 06518 990 2023-07-01 060850110 TRI-STATE JOINT FUND TRI- 2032502601 609 WEST JOHNSON AVENUE 2ND FL CHESHIRE CT 06410 BEVAN SWEET UNION CO-CHAIRMAN 2032502601 2025-05-06 1 0 DANA HARVEY CPA P01452206 2033877771 2025-05-06 2023 2025-03-06 01:10:19Z BEVAN SWEET 609 WEST JOHNSON AVENUE 2ND FL CHESHIRE CT 06410 144979188 0 X N/A X 1968 CT SELF-INSURED HEALTH BENEFIT PLAN 23 23 12 0 0 0 0 0 125171732 142255887 -953275 638486 35770 94344 124254227 142988717 0 0 121338642 139412410 1484970 1711007 0 0 0 2503759 3259211 125327371 144382628 -1073144 -1393911 32248972 37915677 11145732 16872525 21103240 21043152 PROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO MEMBERS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS NEGOTIATED BY TEAMSTER LOCALS. 0 0 THE FUND OPERATES UNDER A TRUST AGREEMENT FOR THE PURPOSEOF MAKING BENEFIT PAYMENTS TO MEMBERS OF THE TRI-STATETEAMSTERS HEALTH SERVICES & INSURANCE PLAN, THESE BENEFITS COVER HOSPITAL,SURGICAL, PRESCRIPTION DRUG, HOME HEALTH CARE AND DEATH BENEFITS FOR 11,238 ACTIVE AND RETIRED MEMBERS PLUS THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1458 0 1 12 1 0 0 0 0 0 0 0 0 X 23 23 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 1 0 0 X SHARON AGNELLO 2032502604 609 WEST JOHNSON AVENUE 2ND FL CHESHIRE CT 06410 DENNIS MCGUIRE EMPLOYER CO-CHAIRMAN & TRU 4.00 2.00 X 24000 2100 0 THOMAS BAYUSIK UNION TRUSTEE 1.00 4.00 X 0 0 0 SALVATORE ABATE UNION TRUSTEE 1.00 4.00 X 0 0 0 TIMOTHY CASEY EMPLOYER TRUSTEE 1.00 2.00 X 0 13300 0 FORREST HARVEY EMPLOYER TRUSTEE 1.00 2.00 X 0 7700 0 EDWIN ROONEY UNION TRUSTEE 1.00 4.00 X 0 9100 0 ROBERT DIGIROLAMO UNION TRUSTEE 1.00 4.00 X 0 0 0 GEORGE WIESENDANGER EMPLOYER TRUSTEE 1.00 4.00 X 0 0 0 FRANK ROSSI UNION TRUSTEE 1.00 4.00 X 0 9800 0 BRYAN DONOVAN JR UNION TRUSTEE 1.00 4.00 X 0 0 0 ROBERT SULLIVAN JR EMPLOYER TRUSTEE 1.00 2.00 X 0 4900 0 LAWRENCE KEEFE EMPLOYER TRUSTEE 1.00 2.00 X 0 9800 0 BEVAN SWEET UNION CO-CHAIRMAN 1.00 4.00 X 0 0 0 CRAIG MITCHELL UNION TRUSTEE 1.00 4.00 X 0 0 0 NICHOLAS REUT EMPLOYER TRUSTEE 1.00 2.00 X 0 13300 0 ROARK LEVINE EMPLOYER TRUSTEE 1.00 2.00 X 0 0 0 SCOTT BLAIS EMPLOYER TRUSTEE 1.00 2.00 X 0 0 0 ANTHONY LEPORE UNION TRUSTEE 1.00 4.00 X 0 0 0 PAUL AYOUB EMPLOYER TRUSTEE 1.00 2.00 X 0 0 0 GLENN BARKSDALE UNION TRUSTEE 1.00 4.00 X 0 6794 0 JAMES STACK EMPLOYER TRUSTEE 1.00 2.00 X 0 0 0 ROBERT ZIOBROWSKI UNION TRUSTEE 1.00 4.00 X 0 0 0 ARTHUR BELL UNION TRUSTEE 1.00 4.00 X 0 0 0 JOE SAMOLIS (FORMER) EMPLOYER TRUSTEE 1.00 1.00 X 0 0 0 SHARON AGNELLO EXECUTIVE DIRECTOR 40.00 X 175695 0 52884 SUSAN KOSTEK (FORMER) IT DIRECTOR 40.00 X 115395 0 52884 ERIN FLAVIN CLAIMS ADMINISTRATOR 40.00 X 117259 0 52884 432349 76794 158652 3 0 1 0 THE SEGAL COMPANY CHURCH STREET STATION P O BOX 4059 NEW YORK NY 102614059 ACTUARIAL & CONSULTING 752729 SOFTWARE SYSTEM SOLUTIONS LLC 270 FRAMINGTON AVE FARMINGTON CT 06032 COMPUTER & TECHNOLOGY SUPPORT 658010 SM ESPOSITO & COMPANY PC 3013 DIXWELL AVE HAMDEN CT 06518 ACCOUNTING/AUDITING 334505 ROBERT M CHEVERIE & ASSOC 333 EAST RIVER DRIVE EAST HARTFORD CT 06108 LEGAL 321491 CHANGE HEALTHCARE PAYMENT MGMT 3055 LEBANON PIKE NASHVILLE TN 37214 PRINTING/MAILING 181444 5 CONTRIBUTIONS - HEALTH FUNDS 900099 142253361 142253361 RENTAL INCOME - AFFILIATE 900099 2526 2526 142255887 677483 677483 1951474 1990471 -38997 -38997 -38997 REFUNDS & REIMBURSEMENTS 900099 94344 94344 94344 142988717 142350231 0 638486 139412410 204497 805049 272349 343844 85268 321491 229004 38138 892224 308819 904224 183903 53371 83031 26719 40492 OUTSIDE SERVICES - PAYM 177795 144382628 161953 79952 2371837 848715 80785 184708 574016 419028 102072 154988 19369335 21279711 10162990 15367603 32248972 37915677 1565690 2133096 9580042 14739429 11145732 16872525 X 0 0 0 0 21103240 21043152 21103240 21043152 32248972 37915677 -1393911 1333823 0 X X 0 1 X 1 0 10148 3723 6425 196555 89223 107332 367313 326082 41231 154988 MISCELLANEOUS RECEIVABLE 7858489 DUE FROM AFFILIATES 6620409 HEALTH BENEFIT EXPERIANCE RECONCILIATION 171470 SECURITY DEPOSIT 7583 RIGHT OF USE ASSET - OPERATING LEASES 697602 INTEREST RECEIVABLE 12050 15367603 DUE TO ANTHEM 5827004 DUE TO AFFILIATES 8166598 CLAIMS INCURRED BUT NOT RECEIVED 34200 RIGHT OF USE LIABILITY - OPERATING LEASES 711627 14739429 X 144322540 1333823 1333823 142988717 0 142988717 144395928 0 144395928 -13300 -13300 144382628 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND TO RECOGNIZE A TAX LIABILITY FOR ANY UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAX AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN FILES ITS FORM 990 IN THE U.S. FEDERAL JURISDICTION. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2020 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: ROUNDING ADJUSTMENT PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATION -13,300. ROUNDING ADJUSTMENT X 0 0 0 SHARON AGNELLO EXECUTIVE DIRECTOR 175695 0 0 0 0 0 24684 0 28200 0 228579 0 0 0 ERIN FLAVIN CLAIMS ADMINISTRATOR 117259 0 0 0 0 0 24684 0 28200 0 170143 0 0 0 SUSAN KOSTEK (FORMER) IT DIRECTOR 115395 0 0 0 0 0 24684 0 28200 0 168279 0 0 0 PART I, LINE 3 THE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND OTHER HIGHLY COMPENSATED EMPLOYEES ON AN ANNUAL BASIS. ABRINA CAPOBIANCO DAUGHTER IN LAW OF (FORMER) CO-CHAIR JOHN CAPOBIANCO 130546 PAYMENT OF WAGES AND BENEFITS AS A RESULT OF EMPLOYMENT WITH THE ORGANIZATION. 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED WITH THE CO-CHAIRMEN AND THE EXECUTIVE DIRECTOR PRIOR TO FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 15A THE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 TRI-STATE JOINT FUND DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLIC ANY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS. FORM 990, PART X11, LINE 2C OVERSIGHT RESPONSIBILITY THERE HAS BEEN NO CHANGE IN THE OVERSIGHT RESPONSIBILITY. THE TRUSTEE'S ASSUME RESPONSIBILITY FOR THE AUDIT PROCESS INCLUDING SELECTION OF THE INDEPENDENT AUDITOR. IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN 1139 FAIRFIELD AVENUE BRIDGEPORT CT 06605 060689974 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN 115 PROGRESS AVENUE SPRINGFIELD MA 01104 042174518 AFFILIATED SELF INSURED HEALTH PLAN MA 501C-9 N/A 0 TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN 200 WALLACE STREET NEW HAVEN CT 06511 060690083 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN 18 CRESCENT STREET UNCASVILLE CT 06382 060689500 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 671A HEALTH SERVICE & INSURANCE PLAN 22 BRITTON DRIVE BLOOMFIELD CT 06002 060683663 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN 609 WEST JOHNSON AVE CHESHIRE CT 06410 060691862 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN 400 CHAPEL ROAD UNIT 2-A SOUTH WINDSOR CT 06074 060997832 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN L 1141965 CASH VALUE TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN L 376650 CASH VALUE TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN L 927540 CASH VALUE GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN L 387180 CASH VALUE TEAMSTERS LOCAL 671A HEALTH SERVICE & INSURANCE PLAN L 249795 CASH VALUE TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN L 0 CASH VALUE TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN L 466110 CASH VALUE