2021-06-03T15:10:07-05:00 2021-01-31 470900880 CALIBRE CPA GROUP PLLC 19615 S LAGRANGE ROAD MOKENA IL 60448 990 2020-02-01 362153764 INTERNATIONAL BROTHERHOOD OF TEAMSTERS 710 HEALTH & WELFARE FUND INTE 7732542500 9000 W 187TH STREET MOKENA IL 60448 SAMUEL PILGER TRUSTEE 7732542500 2021-06-03 1 SAMUEL PILGER 999009999 CHARLES DIGIOVANNI P00284901 7089957180 2021-06-03 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SAMUEL PILGER 9000 W 187TH STREET MOKENA IL 60448 114061198 0 X N/A X 1950 IL TO PROVIDE HEALTH BENEFITS TO THE ELIGIBLE PARTICIPANTS AND DEPENDENTS OF INTERNATIONAL BROTHERHOOD OF TEAMSTERS 710 HEALTH & WELFARE FUND. 6 6 14 0 0 0 0 0 55244023 50297633 2559242 3374948 2138 104921 57805403 53777502 0 0 49245509 41002716 2055137 1114788 0 0 0 1123492 996790 52424138 43114294 5381265 10663208 105183558 121648374 8685577 8259673 96497981 113388701 TO PROVIDE HEALTH BENEFITS TO THE ELIGIBLE PARTICIPANTS AND DEPENDENTS OF INTERNATIONAL BROTHERHOOD OF TEAMSTERS 710 HEALTH & WELFARE FUND. 0 0 TO PROVIDE HEALTH, LIFE, TEMPORARY DISABILITY, ACCIDENTAL DEATH AND DISMEMBERMENT, PRESCRIPTION DRUGS, DENTAL AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS 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 1 0 0 0 0 0 0 1 0 0 1 888 0 1 14 1 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X BRIAN O'MALLEY 7732542500 9000 W 187TH STREET MOKENA IL 60448 SAMUEL D PILGER SECRETARY TREASURER/TRUSTE 1.00 X 0 0 0 GARY CALDWELL TRUSTEE 1.00 X 0 0 0 BERNARD T SHERLOCK TRUSTEE 1.00 45.00 X 0 124900 53425 DELMAR SCHAEFER TRUSTEE 1.00 45.00 X 0 148589 53658 MICHAEL J CALES CHAIRMAN/TRUSTEE 1.00 45.00 X 0 157308 53658 RYAN THIBODEAU TRUSTEE 1.00 X 0 0 0 BRIAN O'MALLEY ADMINISTRATOR 25.00 25.00 X 329988 0 52332 MICHAEL O'MALLEY ASST ADMINISTRATOR 25.00 25.00 X 112163 0 52332 442151 430797 265405 2 0 1 0 BLUE CROSS BLUE SHIELD 300 E RANDOLPH CHICAGO IL 60601 BENEFIT CONTRACT ADMINISTRATOR 1388188 MORGAN LEWIS BOCKUS LLP PO BOX 8500 S-6050 PHILADELPHIA PA 19178 LEGAL 135506 UNITED ACTUARIAL SERVICES INC 11590 N MERIDIAN ST 610 CARMEL IN 46032 ACTUARIAL 104000 3 EMPLOYER CONTRIBUTIONS 900099 49362040 49362040 PARTICIPANT CONTRIBUTI 900099 358907 358907 RETIREE CONTRIBUTIONS 900099 294940 294940 CLAIMS REFUNDS AND SET 900099 281746 281746 50297633 1358410 1358410 62300234 60283696 2016538 2016538 2016538 MISCELLANEOUS INCOME 900099 104921 104921 104921 53777502 50402554 0 3374948 41002716 191759 508009 204441 164486 46093 206761 94330 133440 104000 118348 141445 116396 13577 6928 61565 43114294 3577356 4064379 5502074 3416398 4824305 5462324 41064 32671 655766 622177 20719 33589 61861246 68820993 29301794 39640970 55000 177050 105183558 121648374 21137 101703 8664440 8157970 8685577 8259673 X 0 0 0 0 96497981 113388701 96497981 113388701 105183558 121648374 10663208 6227512 0 X X 0 1 X 1 0 123441 118827 4614 532325 503350 28975 33589 COMMON COLLECTIVE TRUSTS 39640970 F 39640970 LIABILITY FOR LOSS ON SECURITIES LENDING 252069 LIABILITY TO RETURN COLLATERAL HELD FOR SECURITIES ON LOAN 177050 INSURANCE PREMIUMS PAYABLE 47810 DUE TO BROKER 441851 CLAIMS PAYABLE/IBNR 7239190 8157970 X 59871574 6227512 6227512 53644062 133440 133440 53777502 43762854 0 43762854 133440 -782000 -648560 43114294 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEES BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES. PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN CLAIMS, IBNR AND PREMIUMS PAYABLE -782,000. 1 0 0 0 BRIAN O'MALLEY ADMINISTRATOR 329988 0 0 0 0 0 14507 14507 11659 11659 356154 26166 0 0 MICHAEL J CALES CHAIRMAN/TRUSTEE 0 150000 0 2500 0 4808 0 29014 0 24644 0 210966 0 0 DELMAR SCHAEFER TRUSTEE 0 138000 0 2500 0 8089 0 29014 0 24644 0 202247 0 0 BERNARD T SHERLOCK TRUSTEE 0 104000 0 2500 0 18400 0 29014 0 24411 0 178325 0 0 MICHAEL O'MALLEY ASST ADMINISTRATOR 108163 0 4000 0 0 0 14507 14507 11659 11659 138329 26166 0 0 MICHAEL O'MALLEY EMPLOYEE 167437 MICHAEL O'MALLEY IS AN EMPLOYEE OF THE PLAN. THE PLAN PAYS MICHAEL O'MALLEY A SALARY AND CONTRIBUTES TO EMPLOYEE BENEFIT PLANS ON HIS BEHALF. MICHAEL O'MALLEY IS A FAMILY MEMBER OF A CURRENT KEY EMPLOYEE OF THE PLAN. 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE ADMINISTRATOR AND IS MADE AVAILABLE TO THE TRUSTEES PRIOR TO FILING. THE FORM IS SIGNED AND FILED AFTER THIS REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY DURING BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 15 SALARIES ARE REVIEWED PERIODICALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. FORM 990 PART XII LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. IB OF T LOCAL NO 710 PENSION FUND 9000 W 187TH STREET MOKENA IL 60448 362377656 PROVIDE RETIREMENT, DISABILITY AND DEATH BENEFITS IL 501(A) N/A 0 IB OF T LOCAL UNION NO 710 9000 W 187TH STREET MOKENA IL 60448 361460890 LABOR ORGANIZATION IL 501(C)(5) N/A 0 ARKANSAS BEST FRT-GE AURORA PACKING CO D BREAKTHRU BEVERAGE G CASSENS TRANSPORT CO CITY FOODS CND TRANSPORTATION CPC HOME PRODUCTS L DAILY MEAT SUPPLY I FOUR STAR FOODS INC GUARINO WHOLESALE I HEBDING TRANSPORT I HOFMEISTER JOHN AND JACK COOPER TRANSPOR KALUZNY BROTHERS IN L AND L PROVISION LINCOLN PROVISIONS I MAHONEY ENVIRONMENTA MARTIN BROWERGSF MONDELEZ GLOBAL LLC MORREALE JOHN R I NEALEY FOODS OFFICE OF THE TRUSTE PACIFIC RAIL SERVICE RANDOLPH PACKING CO ROSE PACKING COMPANY SOUTHERN GLAZIERS WI STOCK YARDS CHICAGO SYSCO CHICAGO INC USF HOLLAND INC VANEK INC VANEK INC - FLATBED WHITE CASTLE SYSTEM WICHITA PACKING COMP YRC WORLDWIDE IB OF T LOCAL UNION 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1