2020-06-29T10:43:37-05:00 2019-07-31 470900880 CALIBRE CPA GROUP PLLC 462 SEVENTH AVENUE 16TH FLOOR NEW YORK NY 10018 990 2018-08-01 226062063 LOCAL 522 WELFARE FUND OF NEW YORK AND NEW JERSEY LOCA 7188592326 2137 UTICA AVENUE BROOKLYN NY 11234 JAMES KANE TRUSTEE 7188592326 2020-06-29 1 JOSEPH MORELLO P02146706 2126951300 2020-06-29 38.100.43.98 2020-06-29 11:43:26 ED P 099BB351ED5C43DB8E4A0DD96B056B1430213725 2A1264631413402ED07D1720FD2C9A4C172C9560 2018 2021-09-10 13:11:23Z 33553646 0 X N/A X 1954 NY TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 4 2 0 0 0 0 0 0 17173040 19165134 465389 376143 0 0 17638429 19541277 0 0 19230759 18211247 0 0 0 0 0 700805 687993 19931564 18899240 -2293135 642037 23467016 24739604 2422308 2421459 21044708 22318145 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 THE PLAN PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 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 58 0 1 0 0 0 0 0 0 0 0 0 X 4 2 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X THE ORGANIZATION 7188592326 2137 UTICA AVENUE BROOKLYN NY 11234 JAMES KANE TRUSTEE 2.00 40.00 X 0 120736 43937 ANDREW SOMMER TRUSTEE 2.00 X 0 0 0 DANIEL KANE SR TRUSTEE 2.00 X 0 0 0 JEFFREY KELLY TRUSTEE 2.00 X 0 0 0 0 120736 43937 0 0 1 0 AETNA LIFE INSURANCE CO 151 FARMINGTON AVENUE HARTFORD CT 06156 MEDICAL ADMINISTRATOR 825395 UNITED TEAMSTER FUND 2137 UTICA AVENUE BROOKLYN NY 11234 THIRD PARTY ADMINISTRATOR 463744 DJ O'GRADY CONSULTANT 3219 E TREMONT AVENUE BRONX NY 10461 CONSULTING 156342 HEALTH MANAGEMENT CONCEPTS 140 INTRACOASTAL POINTE DR JUPITER FL 33477 WELLNESS PROGRAM 116798 4 EMPLOYER CONTRIBUTIONS 525100 19087758 19087758 PARTICIPANT CONTRIBUTIONS 525100 77376 77376 19165134 359042 359042 14029470 14012369 17101 17101 17101 19541277 19165134 0 376143 18211247 46723 46276 50740 487744 9925 16149 5277 25159 18899240 648040 1338869 5550769 5492394 833817 1586962 76613 97349 16357777 16224030 23467016 24739604 82308 101459 2340000 2320000 2422308 2421459 X 0 0 0 0 21044708 22318145 21044708 22318145 23467016 24739604 642037 631400 0 X 0 1 X 0 0 0 BENEFIT OBLIGATIONS 2320000 2320000 X 20121937 631400 631400 19490537 50740 50740 19541277 18868500 0 18868500 50740 -20000 30740 18899240 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRES THE PLAN TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JULY 31, 2019, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN BENEFIT OBLIGATIONS 0 0 0 JAMES KANE TRUSTEE 0 120736 0 0 0 0 0 33367 0 10570 0 164673 0 0 FORM 990, PART VI, SECTION A, LINE 2 LINE 2 EXPLANATION - JAMES KANE AND DANIEL KANE, SR. - FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - THE RETURN PREPARER E-MAILS A COPY OF THE FORM 990 TO THE PLAN ADMINISTRATOR AND TRUSTEES FOR THEIR REVIEW AND APPROVAL. INQUIRES ARE MADE TO THE PREPARER AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH ITS ANNUAL FORM 5500 FILING. NO OTHER DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC. 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