2022-10-24T08:57:41-05:00 2021-12-31 061386456 T M BYXBEE COMPANY PC P O BOX 187169 HAMDEN CT 06518 990 2021-01-01 060681161 CONNECTICUT LABORERS' HEALTH FUND CONN 2039347991 435 CAPTAIN THOMAS BOULEVARD WEST HAVEN CT 06516 DIANE KLOBUKOWSKI EXECUTIVE DIRECTOR 2039347991 2022-10-22 1 DIANE KLOBUKOWSKI 999009999 PAMELA J MATOCHA P00572001 2032814933 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DIANE KLOBUKOWSKI 435 CAPTAIN THOMAS BOULEVARD WEST HAVEN CT 06516 65768265 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 8 18 0 0 0 0 0 54617182 54824590 311629 1777947 54972 62636 54983783 56665173 0 0 50831587 59671562 907379 929156 0 0 0 694574 668920 52433540 61269638 2550243 -4604465 81385051 80160453 1153753 1378257 80231298 78782196 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 1 1 0 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 0 0 18 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DIANE KLOBUKOWSKI 2039347991 435 CAPTAIN THOMAS BOULEVARD WEST HAVEN CT 06516 JOHN MASTRIANO TRUSTEE 0.50 X 0 0 0 STEVEN JENKINS TRUSTEE 0.50 X 0 0 0 THADDEUS GRABOWSKI TRUSTEE 0.50 X 0 0 0 KEITH BROTHERS TRUSTEE 0.50 X 0 0 0 JOHN BRUNALLI TRUSTEE 0.50 X 0 0 0 VINCENT DECROSTA TRUSTEE 0.50 X 0 0 0 SHAWN GASKA TRUSTEE 0.50 X 0 0 0 VINCENT GIORDANO III TRUSTEE 0.50 X 0 0 0 DIANE KLOBUKOWSKI EXEC. DIR. 40.00 X 215899 0 79775 CRAIG TAYLOR FORMER IT MANAGER 40.00 X 123328 0 57975 339227 0 137750 2 0 1 0 0 CONTRIBUTIONS - EMPLOYERS 900099 46229345 46229345 CONTRIBUTIONS - SELF-PAY 900099 8595245 8595245 54824590 1375642 1375642 9505397 9103092 402305 402305 402305 ADMINISTRATIVE INCOME 900099 62636 62636 62636 56665173 54887226 0 1777947 59671562 536318 128369 222285 42184 88267 59339 37436 135528 142189 67132 21082 47966 REPAIRS AND MAINTENANCE 48245 PROPERTY TAXES 17143 AUTO 4593 61269638 9508357 6372179 22583 50383 530373 252569 301242 277804 9218123 12080214 56926945 54997051 5407801 6382822 81385051 80160453 494825 585179 658928 793078 1153753 1378257 X 0 0 0 0 80231298 78782196 80231298 78782196 81385051 80160453 -4604465 3155363 0 X 0 1 X 1 0 530373 252569 277804 277804 MACKAY SHIELDS CORE FIXED INCOME FUND LIMITED PARTNERSHIP 39483010 F STATE STREET S&P 500 INDEX NL COLLECTIVE TRUST 15514041 F 54997051 CONTRIBUTION RECEIVABLE 4679818 OTHER RECEIVABLES 1703004 6382822 DUE TO AFFILIATED FUNDS 793078 793078 59820536 3155363 3155363 56665173 0 56665173 61269638 0 61269638 0 61269638 1 X X X 0 0 0 DIANE KLOBUKOWSKI EXEC. DIR. 215899 0 0 0 0 0 58734 0 21041 0 295674 0 0 0 CRAIG TAYLOR FORMER IT MANAGER 123328 0 0 0 0 0 36934 0 21041 0 181303 0 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 AVAILABLE UPON REQUEST. HOWEVER, INFORMATION IS NOT AVAILABLE TO THE PUBLIC. INFORMATION IS ONLY AVAILABLE TO PLAN PARTICIPANTS AND SIGNATORY EMPLOYERS UPON REQUEST. 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