HEALTH & WELFARE FUND: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HEALTH & WELFARE FUND (EIN 04-2219623)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-10-14
- IRS object ID
- 202132879349302108
- Schema version
- 2020v4.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-10-14T15:28:56-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 043508036 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MANZI & ASSOCIATES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 855 TURNPIKE STREET | AddressLine1Txt |
| City | NORTH ANDOVER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042219623 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEAMSTERS LOCAL 170 HEALTH AND | BusinessNameLine1Txt |
| Business Name Line2 | WELFARE FUND | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TEAM | BusinessNameControlTxt |
| Phone | 5087913416 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 SOUTHWEST CUTOFF | AddressLine1Txt |
| City | WORCESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01604 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANNON GEORGE | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 5087913416 | PhoneNum |
| Signature | 2021-10-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHANNON | PersonFirstNm |
| Person Last | GEORGE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEANNIE MICKEL | PreparerPersonNm |
| PTIN | P01058630 | PTIN |
| Phone | 9789751099 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHANNON GEORGE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 SOUTHWEST CUTOFF | AddressLine1Txt |
| City | WORCESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,454,081 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.TEAMSTERS170HWF.COM | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | TRUST | OtherOrganizationDsc |
| Formation | 1954 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL, DENTAL, VISION, LIFE, ACCIDENT & SICKNESS BENEFITS TO ELIGIBLE PARTICIPANTS | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 6 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,062,300 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,550,687 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,168,408 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,100,338 | CYInvestmentIncomeAmt |
| PY Other Revenue | $195,738 | PYOtherRevenueAmt |
| CY Other Revenue | $229,510 | CYOtherRevenueAmt |
| PY Total Revenue | $35,426,446 | PYTotalRevenueAmt |
| CY Total Revenue | $37,880,535 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $29,167,948 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $26,583,635 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $834,665 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $806,700 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,369,831 | PYOtherExpensesAmt |
| CY Other Expenses | $1,282,995 | CYOtherExpensesAmt |
| PY Total Expenses | $31,372,444 | PYTotalExpensesAmt |
| CY Total Expenses | $28,673,330 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,054,002 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,207,205 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $64,169,049 | TotalAssetsBOYAmt |
| Total Assets EOY | $78,211,518 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,306,770 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,901,290 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $54,862,279 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $67,310,228 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE MEDICAL, DENTAL, VISION, LIFE, ACCIDENT & SICKNESS BENEFITS TO ELIGIBLE PARTICIPANTS | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | PROVIDE WELFARE BENEFITS TO EMPLOYEES UNDER COLLECTIVE BARGAINING AGREEMENT | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 6 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHANNON GEORGE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5087913416 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 SOUTHWEST CUTOFF | AddressLine1Txt |
| City | WORCESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|
| SHANNON GEORGE | ||||||
| TRUSTEE/CO-CHAIR | 10.00 | Yes (X) | $0 | $0 | $0 | |
| PAUL E DAUPHINAIS | ||||||
| TRUSTEE | 10.00 | Yes (X) | $0 | $0 | $0 | |
| SEAN M FOLEY | ||||||
| TRUSTEE | 10.00 | Yes (X) | $0 | $0 | $0 | |
| RONALD J BEVENS | ||||||
| TRUSTEE | 10.00 | Yes (X) | $0 | $0 | $0 | |
| ELIAS GILLEN | ||||||
| TRUSTEE | 10.00 | Yes (X) | $0 | $0 | $0 | |
| MONICA J CHESTER | ||||||
| TRUSTEE | 10.00 | Yes (X) | $0 | $0 | $0 | |
| RAYMOND REED | ||||||
| EMPLOYEE | 40.00 | $161,649 | $0 | $49,774 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $161,649 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $49,774 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE CROSS BLUE SHIELD | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 TECHNOLOGY PLACE | AddressLine1Txt |
| City | HINGHAM | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02043 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CLAIMS ADMIN | ServicesDesc |
| Compensation | $869,821 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | $35,487,033 | $35,487,033 |
| EMPLOYEE CONTRIBUTIONS | 900099 | $1,063,654 | $1,063,654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,550,687 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,180,086 | TotalRevenueColumnAmt |
| Exclusion | $1,180,086 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $213,471 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $213,471 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,471 | TotalRevenueColumnAmt |
| Exclusion | $213,471 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,493,798 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,573,546 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$79,748 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$79,748 | TotalRevenueColumnAmt |
| Exclusion | -$79,748 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $16,039 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,039 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $16,039 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,880,535 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,566,726 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,313,809 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,583,635 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,649 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,563 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,104 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,540 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,844 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,615 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,309 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,285 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,408 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,851 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,278 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,324 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,511 | TotalAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt |
|---|---|
| STOP LOSS | $230,462 |
| PCORI EXCISE TAX | $9,152 |
| TRANSITIONAL REINSURANC | $1,800 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,673,330 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,292,197 | BOYAmt |
| EOY | $5,594,715 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,788,405 | BOYAmt |
| EOY | $14,954,797 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,068,965 | BOYAmt |
| EOY | $3,871,573 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,907 | BOYAmt |
| EOY | $45,855 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,048,681 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,016,748 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,322,311 | BOYAmt |
| EOY | $3,031,933 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,092,341 | BOYAmt |
| EOY | $32,737,444 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,349,022 | BOYAmt |
| EOY | $17,774,885 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,901 | BOYAmt |
| EOY | $200,316 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,169,049 | BOYAmt |
| EOY | $78,211,518 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,275 | BOYAmt |
| EOY | $142,983 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,181,495 | BOYAmt |
| EOY | $10,758,307 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,306,770 | BOYAmt |
| EOY | $10,901,290 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,862,279 | BOYAmt |
| EOY | $67,310,228 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,862,279 | BOYAmt |
| EOY | $67,310,228 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,169,049 | BOYAmt |
| EOY | $78,211,518 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $9,207,205 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,240,744 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $534,151 | OtherCostOrOtherBasisAmt |
| Book Value | $534,151 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,875,600 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,792,431 | DepreciationAmt |
| Book Value | $2,083,169 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $687,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $461,393 | DepreciationAmt |
| Book Value | $226,378 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $507,654 | OtherCostOrOtherBasisAmt |
| Depreciation | $366,142 | DepreciationAmt |
| Book Value | $141,512 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $443,505 | OtherCostOrOtherBasisAmt |
| Depreciation | $396,782 | DepreciationAmt |
| Book Value | $46,723 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,031,933 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| FIDELITY INFLAT-PROTBOND INDEX | $7,394,305 | F |
| FIDELITY 500 INDEX PREMIUM CLASS | $5,998,792 | F |
| FIDELITY INTL INDEX PREMIUM | $4,381,788 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $17,774,885 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| EST. INCURRED BUT UNREPORTED CLAIMS | $10,747,014 |
| CONTRACTOR DEPOSITS | $11,293 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,758,307 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $41,014,970 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $3,240,744 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $3,240,744 | RevenueNotReportedAmt |
| Revenue Subtotal | $37,774,226 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $106,309 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $106,309 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $37,880,535 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,993,062 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $26,993,062 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $106,309 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $1,573,959 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,680,268 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $28,673,330 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2020, 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RAYMOND REED | PersonNm |
| Title | EMPLOYEE | TitleTxt |
| Base Compensation Filing Org | $161,649 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $25,090 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $24,684 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $211,423 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEAMSTERS UNION LOCAL NO 170 | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 SOUTHWEST CUTOFF STE 201 | AddressLine1Txt |
| City | WORCESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 041106780 | EIN |
| Primary Activities | RENT | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(5) | ExemptCodeSectionTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (34 entries)
| Legal Domicile StateLegalDomicileStateCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|
| 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 | |
| GM WHITE CONSTRUCTION INC | |
| MA | |
| 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 | |
| PARSEC | |
| OH | |
| PJ KEATING DRIVERS | |
| MA | |
| PJ KEATINGMECHANICS | |
| MA | |
| RAND WHITNEY GROUP LLC | |
| MA | |
| ROSENFELD CONCRETE CORP | |
| MA | |
| RYDER TRUCK RENTAL | |
| NH | |
| SPINCRAFT | |
| MA | |
| TEAMSTER UNION LOCAL 170 | |
| MA | |
| TOWN OF MERRIMAC | |
| MA | |
| TOWN OF W NEWBURY POL & HWY | |
| MA | |
| TRANSGAS CO | |
| MA | |
| TRANSGAS CO (MECHANICS) | |
| MA | |
| UNISOURCE | |
| OH | |
| UNITED PARCEL SERVICE | |
| OH | |
| YELLOW FREIGHT SYSTEMS INC | |
| KS | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEAMSTERS LOCAL 170 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | J | TransactionTypeTxt |
| Involved | $75,690 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |