2023-09-08T10:42:27-05:00 2022-12-31 043508036 MANZI & ASSOCIATES LLC 855 TURNPIKE STREET NORTH ANDOVER MA 01845 990 2022-01-01 042219623 TEAMSTERS LOCAL 170 HEALTH AND WELFARE FUND TEAM 5087913416 330 SOUTHWEST CUTOFF WORCESTER MA 01604 SHANNON GEORGE TRUSTEE 5087913416 2023-09-06 1 SHANNON GEORGE 999009999 0 JEANNIE MICKEL P01058630 9789751099 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SHANNON GEORGE 330 SOUTHWEST CUTOFF WORCESTER MA 01604 51853129 0 X WWW.TEAMSTERS170HWF.COM X TRUST 1954 MA TO PROVIDE MEDICAL, DENTAL, VISION, LIFE, ACCIDENT & SICKNESS BENEFITS TO ELIGIBLE PARTICIPANTS 6 6 6 0 0 0 0 0 37801171 38837781 2674834 2623710 213087 216796 40689092 41678287 0 0 32735212 32585634 844479 862854 0 0 0 1363208 1590649 34942899 35039137 5746193 6639150 84073039 82271369 10379406 10528515 73693633 71742854 TO PROVIDE MEDICAL, DENTAL, VISION, LIFE, ACCIDENT & SICKNESS BENEFITS TO ELIGIBLE PARTICIPANTS 0 0 PROVIDE WELFARE BENEFITS TO EMPLOYEES UNDER COLLECTIVE BARGAINING AGREEMENT 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 2 0 1 6 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 0 0 1 1 0 0 1 0 1 1 0 1 0 X SHANNON GEORGE 5087913416 330 SOUTHWEST CUTOFF WORCESTER MA 01604 X SHANNON GEORGE TRUSTEE/CO-CHAIR 10.00 X 0 0 0 PAUL E DAUPHINAIS TRUSTEE 10.00 X 0 0 0 ROBERT ROBINSON TRUSTEE 10.00 X 0 0 0 RONALD J BEVENS TRUSTEE 10.00 X 0 0 0 ELIAS GILLEN TRUSTEE 10.00 X 0 0 0 MONICA J CHESTER TRUSTEE 10.00 X 0 0 0 RAYMOND REED EMPLOYEE 40.00 X 170649 0 51546 170649 0 51546 1 0 1 0 BLUE CROSS BLUE SHIELD 25 TECHNOLOGY PLACE HINGHAM MA 02043 CLAIMS ADMIN 1191606 1 EMPLOYER CONTRIBUTIONS 900099 37937577 37937577 EMPLOYEE CONTRIBUTIONS 900099 900204 900204 38837781 1763592 1763592 216796 0 216796 216796 216796 11034960 10174842 860118 860118 860118 41678287 38837781 0 2840506 32585634 170649 339437 148104 161772 42892 61539 123001 142035 132433 365683 39417 285398 52688 STOP LOSS 282082 SPD 96357 PCORI EXCISE TAX 10016 35039137 5469596 6556816 10357140 13998991 3862042 3334931 64662 52344 8132074 5591330 2762837 2540744 37901653 34616837 23416009 20960390 239100 210316 84073039 82271369 172332 142955 10207074 10385560 10379406 10528515 X 0 0 0 0 73693633 71742854 73693633 71742854 84073039 82271369 6639150 -8589929 0 X X 0 1 X 0 0 534151 534151 5875600 4219747 1655853 759446 506286 253160 507654 439680 67974 455223 425617 29606 2540744 FIDELITY 500 INDEX PREMIUM CLASS 6320567 F FIDELITY INTL INDEX PREMIUM 4621416 F VANGUARD SHT TERM INFL PROTECT 10018407 F 20960390 EST. INCURRED BUT UNREPORTED CLAIMS 10374268 CONTRACTOR DEPOSITS 11292 10385560 X 32965357 -8589929 -8589929 41555286 123001 123001 41678287 34737650 0 34737650 123001 178486 301487 35039137 PART X, LINE 2: 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 THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE DEPARTMENT OF LABOR AND INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFITS PAYABLE PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFITS PAYABLE X 0 0 0 RAYMOND REED EMPLOYEE 170649 0 0 0 0 0 24684 0 26862 0 222195 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN FOR MEMBERS OF TEAMSTERS LOCAL 170 HEALTH AND WELFARE FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF TRUSTEES HAS GRANTED THE FUND ADMINSTRATOR AUTHORITY TO REVIEW AND FILE ALL TAX DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 12 AS AN EMPLOYEE BENEFIT PLAN, THE ORGANIZATION IS SUBJECT TO THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA FORM 990, PART VI, SECTION B, LINE 15B BOARD OF TRUSTEES REVIEWS KEY EMPLOYEES COMPENSATION WITH COMPARABILITY DATA ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION ARE AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C: NO CHANGE IN OVERSIGHT PROCESS OR SELECTION OF INDEPENDANT ACCOUNTANT. TEAMSTERS UNION LOCAL NO 170 330 SOUTHWEST CUTOFF STE 201 WORCESTER MA 01604 041106780 RENT MA 501(C)(5) 0 ABF FREIGHT SYSTEMS INC AR AGGREGATE SHREWSBURY CA AGGREGATEASHLAND CA BAKER COMMODITIES MA BORGGAARD CONSTRUCTION MA CPC HOME PRODUCTS LLC MO DAUPHINAIS CONCRETE MA DURHAM SCHOOL SERVICES IL FIRST STUDENT (FITCHBURG MECH) OH FIRST STUDENT DUDLEY OH GRANGER-LYNCH INC RI J G MACLELLAN CONCRETE CO MA LAWRENCE HOUSING AUTHORITY MA MACLELLANGRAFTON MA MACLELLANLUNENNBURG MA MAROIS BROTHERS INC MA MERRIMACK VALLEY DISTRIB CO MA MVRTA MA PJ KEATING DRIVERS MA PJ KEATINGMECHANICS MA RAND WHITNEY GROUP LLC MA ROSENFELD CONCRETE CORP MA RYDER TRUCK RENTAL NH SPINCRAFT MA TOWN OF W NEWBURY POL & HWY MA TRANSGAS CO MA TRANSGAS CO (MECHANICS) MA UNITED PARCEL SERVICE OH YELLOW FREIGHT SYSTEMS INC KS 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 TEAMSTERS LOCAL 170 J 77664 CASH