2020-11-12T10:13:11-06:00 2019-12-31 131578842 BUCHBINDER TUNICK & CO LLP ONE PENN PLAZA - SUITE 3500 NEW YORK NY 101193601 990 2019-01-01 226058341 TEAMSTERS INDUSTRIAL EMPLOYEES WELFARE FUND TEAM 2018673553 707 SUMMIT AVENUE UNION CITY NJ 07087 ROBERT BLUMENFELD FUND ADMINISTRATOR 2018673553 2020-11-11 1 GREG AUTERI P01366109 2126955003 68.195.67.127 2020-11-11 13:16:58 ES P CB8B4554FF2B0E55EAF1BAEF1CDA56A6BA42187A 42252ED06F80D3588A466467C665D9BA13E91C7E 2019 2021-04-22 16:20:28Z ROBERT BLUMENFELD 707 SUMMIT AVENUE UNION CITY NJ 07087 44064201 0 X WWW.560BENEFITFUNDS.COM X 1948 NJ TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 5 4 0 0 0 0 0 0 20938692 21601823 525567 1019122 593628 561726 22057887 23182671 0 0 17130445 15754722 1073 0 0 0 0 1151581 1243716 18283099 16998438 3774788 6184233 28196470 36082607 3261449 3131778 24935021 32950829 TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS 0 0 TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 163 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 1 0 0 1 0 0 0 1 1 1 1 0 1 0 0 0 X ROBERT BLUMENFELD 2018671447 707 SUMMIT AVE UNION CITY NJ 07087 EDWIN H STIER UNION TRUSTEE 1.00 X 2550 0 0 ANTHONY VALDNER UNION TRUSTEE 2.00 X 0 0 0 CHARLES T CONNORS EMPLOYER TRUSTEE 1.00 X 0 0 0 JOSEPH DIPALMA UNION TRUSTEE ALTERNATE 1.00 X 0 0 0 LOUIS RODRIGUEZ UNION TRUSTEE 1.00 X 0 0 0 RICHARD GOLDBERG EMPLOYER TRUSTEE 1.00 X 0 0 0 ROBERT BLUMENFELD FUND ADMINISTRATOR 11.00 X 0 0 0 2550 0 0 0 0 0 0 HORIZON BLUE CROSS BLUE SHIELD THREE PENN PLAZA EAST NEWARK NJ 07105 HEALTH CARE PROVIDER 543094 CHANGE HEALTHCARE SOLUTIONS LLC 19732 MACARTHUR BLVD SUITE 100 IRVINE CA 92612 CLAIMS REPRICING AGENT 164938 COHEN LEDER MONTALBANO & CONNAUGHTON 669 RIVER DRIVE SUITE 125 ELMWOOD PARK NJ 07407 ATTORNEY 101500 3 EMPLOYER CONTRIBUTIONS 525100 21584396 21584396 COBRA 525100 17427 17427 21601823 818716 818716 21081936 20881530 200406 200406 200406 PRESCRIPTION REBATE INCOME 525100 538164 538164 OTHER INCOME 525100 23562 23562 561726 23182671 22163549 0 1019122 15754722 101500 29200 55217 81363 9318 19319 60 6878 21967 ALLOCATED SALARIES AND 918237 DUES AND SUBSCRIPTIONS 657 16998438 2619865 1459143 443716 6540413 2064724 2128404 13697 13608 88079 77542 17416 10537 22152247 24901694 884805 1028808 28196470 36082607 248330 307878 3013119 2823900 3261449 3131778 X 0 0 0 0 24935021 32950829 24935021 32950829 28196470 36082607 6184233 1831575 0 X X 0 1 X 1 0 10211 10211 0 70922 60385 10537 6946 6946 0 10537 CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED 2823900 2823900 X 24959029 1831575 1831575 23127454 55217 55217 23182671 17131921 0 17131921 55217 -188700 -133483 16998438 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 IRS. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2019, 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. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS FOR THE PLAN. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2016. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGES IN CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED -188,700. FORM 990, PART VI, SECTION A, LINE 6 THE PLAN HAS PARTICIPANTS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO THE TRUSTEES OF THE ORGANIZATION BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE PLAN IS BOUND BY ERISA PROHIBITED TRANSACTION RULES WHICH PRECLUDE THE PLAN FROM ENGAGING IN ANY NON-EXEMPT PARTY IN INTEREST TRANSACTIONS. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS ARE PROVIDED TO PARTICIPANTS AND OTHER INTERESTED PARTIES UPON REQUEST. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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