2021-03-15T11:44:36-05:00 2020-08-31 131577780 SCHULTHEIS & PANETTIERI LLP 450 WIRELESS BLVD HAUPPAUGE NY 11788 990 2019-09-01 135548780 LOCAL 807 LABOR-MANAGEMENT HEALTH FUND LOCA 7187262525 32-43 49TH STREET LONG ISLAND CITY NY 11103 ROBERT HOLDEN MGT TRUSTEE 7187262525 2021-03-15 1 CAROL WESTFALL P00539069 6312734778 2019 2022-09-23 18:48:47Z TERESA CASANOVA 32-43 49TH STREET LONG ISLAND CITY NY 11103 37424170 0 X N/A X 1948 NY TO PROVIDE HEALTH & MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 6 13 0 0 0 0 0 12699463 10456077 3656543 1819816 157691 165684 16513697 12441577 0 0 10418744 10320396 1347568 1336420 0 0 0 166374 141748 11932686 11798564 4581011 643013 71817473 73465201 1944240 1973767 69873233 71491434 TO PROVIDE HEALTH & MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HEALTH & MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 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 1 692 0 1 13 1 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 X TERESA CASANOVA 7187262525 32-43 49TH STREET LONG ISLAND CITY NY 11103 ANTHONY STORZ UNION TRUSTEE 1.00 0.00 X 0 0 0 JOHN SULLIVAN UNION TRUSTEE 1.00 0.00 X 0 0 0 LUIS HERRERA UNION TRUSTEE 1.00 0.00 X 0 0 0 SCOTT LITTLE MGT TRUSTEE 1.00 0.00 X 0 0 0 JOHN ZAK MGT TRUSTEE 1.00 0.00 X 0 0 0 ROBERT HOLDEN MGT TRUSTEE 1.00 0.00 X 0 0 0 TERESA CASANOVA FUND ADMIN. 40.00 0.00 X 151670 0 44417 151670 0 44417 1 0 1 0 MAGNACARE ADMIN SERVICES ONE PENN PLAZA NEW YORK NY 10119 NETWORK ACCESS 258420 BLUE CROSS BLUE SHIELD 15 METROTECH CENTER BROOKLYN NY 11201 MED CLAIM ADMIN 247478 2 EMPLOYER CONTRIBUTIONS 900099 10314944 10314944 PARTICIPANTS CONTRIBUTIONS 900099 141133 141133 10456077 1605358 1605358 165684 0 165684 165684 165684 25197051 24982593 214458 214458 214458 12441577 10456077 0 1985500 10320396 201680 605312 266932 201913 60583 69762 100654 117354 134444 66990 25141 105352 721 3401 42428 REIMB PR, TAXES AND BEN -524499 11798564 916075 766078 1776004 3085928 2614555 2041222 95318 104602 6591418 787785 5807034 5803633 56518072 55231037 4090415 6432701 71817473 73465201 65140 275000 1879100 1698767 1944240 1973767 X 0 0 0 0 69873233 71491434 69873233 71491434 71817473 73465201 643013 975188 0 X 0 1 X 1 0 5800000 5800000 173693 173693 0 617725 614092 3633 5803633 SSGA S&P 500 NL QP CTF 1413268 F SSGA S&P 500 SL QP CTF 3569433 F BOYD WATTERSON STATE GOVT FUND LP 1450000 F 6432701 BENEFIT CLAIMS& PREM CURRENTLY PAY 1261200 NET TRADES PENDING SETTLEMENT 437567 1698767 13299411 975188 975188 12324223 117354 117354 12441577 12299110 0 12299110 117354 -617900 -500546 11798564 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFITS PAYABLE -617,900. X 0 0 0 TERESA CASANOVA FUND ADMIN. 151670 0 0 0 0 0 25302 0 19115 0 196087 0 0 0 SCHEDULE J PART II TERESA CASANOVA RECEIVED COMPENSATION AND BENEFITS IN HER CAPACITY AS FUND ADMINISTRATOR OF THIS ENTITY AND THE RELATED ANNUITY AND PENSION FUNDS. COMPENSATION AND BENEFITS ARE PAID BY THE HEALTH FUND WITH REIMBURSEMENTS MADE ACCORDINGLY. THE HEALTH FUND PORTION OF THESE EXPENSES IS 52% OF THE GROSS AMOUNT DETAILED ON THE FORM 990, PART VII, SECTION A. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED IN COORDINATION WITH MANAGEMENT OF THE ORGANIZATION AND WAS REVIEWED BY THE BOARD PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO PARTICIPANTS UPON REQUEST. THE ORGANIZATION DOES NOT MAKE DOCUMENTS AVAILABLE TO THE PUBLIC. LOCAL 807 LABOR-MANAGEMENT PENSION FUND 32-43 49TH STREET LONG ISLAND CITY NY 11103 516099111 PROVIDE RET BENEFITS TO PARTICIPANTS NY 501(A) N/A N/A 0 LOCAL 807 PROFIT-SHARING PLAN 32-43 49TH STREET LONG ISLAND CITY NY 11103 112532544 PROVIDE RET BENEFITS TO PARTICIPANTS NY 501(A) N/A N/A 0 INTL BROTHERHOOD OF TEAMSTERS L807 32-43 49TH STREET LONG ISLAND CITY NY 11103 135157850 LABOR UNION NY 501(C)(5) N/A N/A 0 NYC TRUCKING AUTHORITY (NYCTA) 32-43 49TH STREET LONG ISLAND CITY NY 11103 135614411 LABOR UNION NY 501(C)(5) N/A N/A 0 SEE SCHEDULE R SUPPLEMENTAL INFORMATION 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 FORM 990, PART VII, SECTION A, CERTAIN TRUSTEES LISTED ON FORM 990, PART VII, SECTION A, SERVE AS VOLUNTEERS AND DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION OR ANY RELATED ORGANIZATION IN THEIR CAPACITY AS TRUSTEES OF THIS ORGANIZATION. THE FILING ORGANIZATION IS NOT REQUIRED TO LIST THE COMPENSATION FOR THESE TRUSTEES BECAUSE THE RELATED ORGANIZATION (I) WAS "FOR PROFIT", (II) WAS NOT OWNED OR CONTROLLED DIRECTLY OR INDIRECTLY BY THE FILING ORGANIZATION OR ONE OR MORE RELATED TAX EXEMPT ORGANIZATIONS, AND (III) DID NOT PROVIDE MANAGEMENT SERVICES FOR A FEE TO THE FILING ORGANIZATION. CERTAIN TRUSTEES LISTED ON FORM 990, PART VII, SECTION A, DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION, BUT DO RECEIVE COMPENSATION FROM LOCAL 807 IN THEIR CAPACITY AS EMPLOYEES/OFFICERS OF THE UNION. THE INFORMATION DISCLOSED ON THE ATTACHED SCHEDULE OF RELATED PARTIES IS THAT WHICH WAS AVAILABLE TO THIS ORGANIZATION AT THE TIME OF THIS FILING. PART IV IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS CORP OR TRUST (A) NAME ABC SUPPLY CO INC ACCORD SUPPLY CO, INC. 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