STRATEGY STUDIO / PUBLIC DATA EXPLORER

TRI STATE JOINT FUND: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
TRI STATE JOINT FUND (EIN 06-0850110)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-12
IRS object ID
202221329349302997
Schema version
2020v4.2
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)
Return2022-05-12T10:48:40-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN061298465PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SM ESPOSITO & CO PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13013 DIXWELL AVENUEAddressLine1Txt
CityHAMDENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06518ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060850110EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TRI-STATE JOINT FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTRI-BusinessNameControlTxt
Phone2032502601PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVENUE 2ND FLAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDENNIS MCGUIREPersonNm
Person TitleEMPLOYER CO-CHAIRMANPersonTitleTxt
Phone2032502601PhoneNum
Signature2022-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDENNISPersonFirstNm
Person LastMCGUIREPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANA HARVEY CPAPreparerPersonNm
PTINP01452206PTIN
Phone2033877771PhoneNum
Preparation2022-05-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDENNIS MCGUIREPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVENUE 2ND FLAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$130,899,372GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1968FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionSELF-INSURED HEALTH BENEFIT PLANActivityOrMissionDesc
Voting Members Governing Body28VotingMembersGoverningBodyCnt
Voting Members Independent28VotingMembersIndependentCnt
Total Employee10TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$100,819,391PYProgramServiceRevenueAmt
CY Program Service Revenue$111,601,111CYProgramServiceRevenueAmt
PY Investment Income$794,988PYInvestmentIncomeAmt
CY Investment Income$5,136,032CYInvestmentIncomeAmt
PY Other Revenue$63,013PYOtherRevenueAmt
CY Other Revenue$1,048CYOtherRevenueAmt
PY Total Revenue$101,677,392PYTotalRevenueAmt
CY Total Revenue$116,738,191CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$97,605,952PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$108,065,249CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,243,654PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,275,323CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,775,933PYOtherExpensesAmt
CY Other Expenses$1,755,020CYOtherExpensesAmt
PY Total Expenses$100,625,539PYTotalExpensesAmt
CY Total Expenses$111,095,592CYTotalExpensesAmt
PY Revenues Less Expenses$1,051,853PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,642,599CYRevenuesLessExpensesAmt
Total Assets BOY$27,508,191TotalAssetsBOYAmt
Total Assets EOY$32,141,360TotalAssetsEOYAmt
Total Liabilities BOY$9,328,506TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,820,746TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,179,685NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,320,614NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO MEMBERS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS NEGOTIATED BY TEAMSTER LOCALS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE 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 11,609 MEMBERS PLUS THEIR DEPENDENTS.Desc
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 EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee10EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
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 Members28GoverningBodyVotingMembersCnt
Independent Voting Member28IndependentVotingMemberCnt
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 Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
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 Line1SHARON AGNELLOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2032502604PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1609 WEST JOHNSON AVENUE 2ND FLAddressLine1Txt
CityCHESHIRECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06410ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DENNIS MCGUIRE
EMPLOYER CO-CHAIRMAN & TRU4.002.00Yes (X)$0$0$0
THOMAS BAYUSIK
UNION TRUSTEE1.004.00Yes (X)$0$0$0
SALVATORE ABATE
UNION TRUSTEE1.004.00Yes (X)$0$0$0
TIMOTHY CASEY
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
ANTHONY CAPPELLA
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
FORREST HARVEY
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
EDWIN ROONEY
UNION TRUSTEE1.004.00Yes (X)$0$0$0
ROBERT DIGIROLAMO
UNION TRUSTEE1.004.00Yes (X)$0$0$0
FRANK ROSSI
UNION TRUSTEE1.004.00Yes (X)$0$0$0
VICTOR SANTIAGO
UNION TRUSTEE1.004.00Yes (X)$0$0$0
ROBERT SULLIVAN JR
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
LAWRENCE KEEFE
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
BEVAN SWEET
UNION TRUSTEE1.004.00Yes (X)$0$0$0
CRAIG MITCHELL
UNION TRUSTEE1.004.00Yes (X)$0$0$0
NICHOLAS REUT
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
ROARK LEVINE
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
CRAIG TIMPSON
(FORMER) EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
SCOTT BLAIS
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
DONALD SHUBERT
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
DAVID LUCAS
UNION TRUSTEE1.004.00Yes (X)$0$0$0
ANTHONY LEPORE
UNION TRUSTEE1.004.00Yes (X)$0$0$0
JOHN CAPOBIANCO
UNION CO-CHAIRMAN & TRUSTE4.004.00Yes (X)$0$0$0
MICHAEL RINALDI
UNION TRUSTEE1.004.00Yes (X)$0$0$0
HELGA SCHMIDT
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
PAUL AYOUB
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
GLENN BARKSDALE
UNION TRUSTEE1.004.00Yes (X)$0$0$0
PAUL NOVAK
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
JAMES STACK
EMPLOYER TRUSTEE1.002.00Yes (X)$0$0$0
ROBERT ZIOBROWSKI
UNION TRUSTEE1.004.00Yes (X)$0$0$0
SHARON AGNELLO
EXECUTIVE DIRECTOR40.00$144,244$0$49,231Yes (X)
SUSAN KOSTEK
IT DIRECTOR40.00$111,852$0$49,231Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$256,096TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$98,462TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ROBERT M CHEVERIE & ASSOC
333 EAST RIVER DRIVEEAST HARTFORDCT06108LEGAL$313,975
THE SEGAL COMPANY
CHURCH STREET STATION P O BOX 4059NEW YORKNY102614059ACTUARIAL$310,184
SM ESPOSITO & COMPANY PC
3013 DIXWELL AVEHAMDENCT06518ACCOUNTING/AUDITING$284,280
CHANGE HEALTHCARE PAYMENT MGMT
3055 LEBANON PIKENASHVILLETN37214PRINTING/MAILING$153,166
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescCONTRIBUTIONS - HEALTH FUNDSDesc
Business900099BusinessCd
Total Revenue Column$111,601,111TotalRevenueColumnAmt
Related Or Exempt Func Income$111,601,111RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$111,601,111TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$195,244TotalRevenueColumnAmt
Exclusion$195,244ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$19,101,969SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$14,160,585SecuritiesAmt
Other$596OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,941,384SecuritiesAmt
Other-$596OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,940,788TotalRevenueColumnAmt
Related Or Exempt Func Income-$596RelatedOrExemptFuncIncomeAmt
Exclusion$4,941,384ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescREFUNDS & REIMBURSEMENTSDesc
Business900099BusinessCd
Total Revenue Column$1,048TotalRevenueColumnAmt
Related Or Exempt Func Income$1,048RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,048OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$116,738,191TotalRevenueColumnAmt
Related Or Exempt Func Income$111,601,563RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$5,136,628ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$108,065,249TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$259,096TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$471,154TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$241,528TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$243,232TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$60,313TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$313,975TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$176,280TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$40,346TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$428,364TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$253,798TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$157,008TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$140,894TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$12,115TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,710TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$24,885TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$46,548TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmt
OUTSIDE SERVICES$153,166
MEDICAL EQUIPMENT$4,931

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$111,095,592TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$101,752BOYAmt
EOY$1,764,369EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,080,257BOYAmt
EOY$6,457,783EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$77,074BOYAmt
EOY$90,800EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$515,694LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$363,166LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$128,165BOYAmt
EOY$152,528EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$15,014,895BOYAmt
EOY$20,175,268EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,106,048BOYAmt
EOY$3,500,612EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,508,191BOYAmt
EOY$32,141,360EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,066,949BOYAmt
EOY$1,189,699EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,261,557BOYAmt
EOY$8,631,047EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,328,506BOYAmt
EOY$9,820,746EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$18,179,685BOYAmt
EOY$22,320,614EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,179,685BOYAmt
EOY$22,320,614EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,508,191BOYAmt
EOY$32,141,360EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,642,599ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,501,670NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,148OtherCostOrOtherBasisAmt
Depreciation$1,692DepreciationAmt
Book Value$8,456BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$140,445OtherCostOrOtherBasisAmt
Depreciation$63,393DepreciationAmt
Book Value$77,052BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$365,101OtherCostOrOtherBasisAmt
Depreciation$298,081DepreciationAmt
Book Value$67,020BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$152,528TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
MISCELLANEOUS RECEIVABLE$2,115,951
DUE FROM AFFILIATES$1,117,501
SECURITY DEPOSIT$7,583
HEALTH BENEFITS EXPERIENCE RECONCILIATINO$257,796
INTEREST RECEIVABLE$1,781
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,500,612TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO ANTHEM$5,440,029
DUE TO AFFILIATES$3,171,218
CLAIMS INCURRED BUT NOT RECEIVED$19,800
FieldValueIRS element (for citing)
Total Liability$8,631,047TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$115,236,520TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$1,501,670NetUnrealizedGainsInvstAmt
Revenue Not Reported-$1,501,670RevenueNotReportedAmt
Revenue Subtotal$116,738,190RevenueSubtotalAmt
Other Revenues Not Included$1OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$116,738,191TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$111,094,891TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$111,094,891ExpensesSubtotalAmt
Other Expenses Not Included$701OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$701ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$111,095,592TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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, 2017 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FOUNDING ADJUSTMENT 1.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATION 700. ROUNDING ADJUSTMENT 1.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SHARON AGNELLO
EXECUTIVE DIRECTOR$144,244$0$0$0$0$0$24,684$0$24,547$0$193,475$0$0$0
SUSAN KOSTEK
IT DIRECTOR$111,852$0$0$0$0$0$24,684$0$24,547$0$161,083$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonABRINA CAPOBIANCOPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionDAUGHTER IN LAW OF CO-CHAIR JOHN CAPOBIANCORelationshipDescriptionTxt
Transaction$121,670TransactionAmt
TransactionPAYMENT OF WAGES AND BENEFITS AS A RESULT OF EMPLOYMENT WITH THE ORGANIZATION.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED WITH THE CO-CHAIRMEN AND THE EXECUTIVE DIRECTOR PRIOR TO FILING OF THE RETURN.
FORM 990, PART VI, SECTION B, LINE 15ATHE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19TRI-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 2COVERSIGHT 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN
1139 FAIRFIELD AVENUEBRIDGEPORTCT06605060689974AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN
115 PROGRESS AVENUESPRINGFIELDMA01104042174518AFFILIATED SELF INSURED HEALTH PLANMA501C-9N/A0
TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN
200 WALLACE STREETNEW HAVENCT06511060690083AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN
18 CRESCENT STREETUNCASVILLECT06382060689500AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 671A HEALTH SERVICE & INSURANCE PLAN
22 BRITTON DRIVEBLOOMFIELDCT06002060683663AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN
1871 BALDWIN STREETWATERBURYCT06706060691862AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN
400 CHAPEL ROAD UNIT 2-ASOUTH WINDSORCT06074060997832AFFILIATED SELF INSURED HEALTH PLANCT501C-9N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN
L$707,840CASH VALUE
TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN
L$360,240CASH VALUE
TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN
L$498,160CASH VALUE
GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN
L$286,600CASH VALUE
TEAMSTERS LOCAL 671A HEALTH SERVICE & INSURANCE PLAN
L$173,960CASH VALUE
TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN
L$997,400CASH VALUE
TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN
L$240,680CASH VALUE