2017-08-26T10:43:10-05:00 2017-01-31 470900880 CALIBRE CPA GROUP PLLC 19615 S LAGRANGE ROAD MOKENA IL 60448 990 2016-02-01 362153764 INTERNATIONAL BROTHERHOOD OF TEAMSTERS 710 HEALTH & WELFARE FUND INTE 7732542500 9000 W 187TH STREET MOKENA IL 60448 SAMUEL PILGER TRUSTEE 7732542500 2017-08-26 1 CHARLES DIGIOVANNI P00284901 7089957180 38.100.43.100 2017-08-26 10:43:00 CD P DD2F5A6855584BEFBC68452237D9336111CE352F DD2F5A6855584BEFBC68452237D9336111CE352F 2016 2021-01-29 14:40:06Z SAMUEL PILGER 9000 W 187TH STREET MOKENA IL 60448 257023569 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. 5 5 15 0 0 0 0 0 49359353 50248221 1463183 11146420 11905 24474 50834441 61419115 0 0 47415654 51125691 1670923 1183699 0 0 0 1044876 546382 50131453 52855772 702988 8563343 88420231 89617832 11461374 9884345 76958857 79733487 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 0 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 1 895 0 1 15 1 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 X BRIAN O'MALLEY 7732542500 9000 W 187TH STREET MOKENA IL 60448 JOHN T COLI CHAIRMAN/TRUSTEE 1.00 X 0 0 0 STEPHANIE K BRINSON TRUSTEE 1.00 X 0 0 0 SAMUEL D PILGER SECRETARY TREASURER/TRUSTE 1.00 X 0 0 0 GARY CALDWELL TRUSTEE 1.00 X 0 0 0 BERNARD T SHERLOCK FORMER TRUSTEE 1.00 45.00 X 0 140492 44034 DANIEL HOYER TRUSTEE 1.00 X 0 0 0 BRIAN O'MALLEY ADMINISTRATOR 25.00 25.00 X 329988 0 43456 329988 140492 87490 1 0 1 0 BLUE CROSS BLUE SHIELD 300 E RANDOLPH CHICAGO IL 60601 BENEFIT CONTRACT ADMINISTRATOR 1345014 WILLIG WILLIAMS & DAVIDSON 1845 WALNUT ST 24TH FL PHILADELPHIA PA 19103 LEGAL 133921 2 EMPLOYER CONTRIBUTIONS 900099 49323444 49323444 RETIREE CONTRIBUTIONS 900099 401004 401004 PARTICIPANT CONTRIBUTI 900099 302321 302321 CLAIMS REFUNDS AND SET 900099 221452 221452 50248221 1555110 1555110 205195764 195604454 9591310 9591310 9591310 MISCELLANEOUS INCOME 900099 24474 24474 24474 61419115 50272695 0 11146420 51125691 186722 435761 383858 137561 39797 223943 98880 118418 69212 126392 149009 139754 6982 133264 221206 83675 PENSION - DEFINED BENEF -824353 52855772 867486 1231385 4861805 3612999 5379565 5128436 252539 1065445 647974 599544 22203 48430 73883080 76040733 3153553 2490404 88420231 89617832 50596 118435 11410778 9765910 11461374 9884345 X 0 0 0 0 76958857 79733487 76958857 79733487 88420231 89617832 8563343 -5788713 0 X X 0 1 X 1 0 118313 87178 31135 529661 512366 17295 48430 LIABILITY FOR LOSS ON SECURITIES LENDING 259383 LIABILITY TO RETURN CASH COLLATERAL HELD FOR SECURITIES ON LOAN 2490404 CLAIMS AND INS PREMIUMS PAYABLE 822914 CLAIMS INCURRED BUT NOT REPORTED 5685708 PRESCRIPTION BENEFITS PAYABLE 320326 DENTAL FEES PAYABLE 2332 DUE TO RELATED FUND 56911 DUE TO BROKER 127932 9765910 X 55511984 -5788713 -5788713 61300697 118418 118418 61419115 53749616 0 53749616 118418 -1012262 -893844 52855772 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 AND PREMIUMS PAYABLE -1,270,050. INCREASE IN CLAIMS INCURRED BUT NOT REPORTED 265,286. DECREASE IN PRESCRIPTION BENEFITS PAYABLE -4,772. DECREASE IN DENTAL FEES PAYABLE -2,726. 1 0 0 0 BERNARD T SHERLOCK FORMER TRUSTEE 0 140492 0 0 0 0 0 24834 0 19200 0 184526 0 0 BRIAN O'MALLEY ADMINISTRATOR 329988 0 0 0 0 0 12246 12246 9482 9482 351716 21728 0 0 MICHAEL O'MALLEY EMPLOYEE 125411 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 ILLINOIS ADVOCATES LAW FIRM OWNED BY SON OF A TRUSTEE OF THE PLAN 34518 CO-COUNSEL WITH WILLIG, WILLIAMS AND DAVIDSON RECEIVES LEGAL FEES 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 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 EMPLOYEES PENSION PLAN OF IB OF T UNION LOCAL 710 H&W FUND 9000 W 187TH STREET MOKENA IL 60448 362153764 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 CONTIRBUTING EMPLOYER IL 501(C)(5) N/A 0 AIRGAS INC CONTRIBUTING EMPLOYER 0 ANICHINI BROS INC CONTRIBUTING EMPLOYER 0 ARKANSAS BEST FRT-GE CONTRIBUTING EMPLOYER 0 AURORA PACKING CO D CONTRIBUTING EMPLOYER 0 BREAKTHRU BEVERAGE G CONTRIBUTING EMPLOYER 0 CASSENS TRANSPORT CO CONTRIBUTING EMPLOYER 0 CITY FOODS CONTRIBUTING EMPLOYER 0 CND TRANSPORTATION CONTRIBUTING EMPLOYER 0 CPC LOGISTICS INC CONTRIBUTING EMPLOYER 0 DAILY MEAT SUPPLY I CONTRIBUTING EMPLOYER 0 FOUR STAR FOODS INC CONTRIBUTING EMPLOYER 0 GOLDEN STATE FOODS CONTRIBUTING EMPLOYER 0 GUARINO WHOLESALE I CONTRIBUTING EMPLOYER 0 H & M INTERNATIONAL CONTRIBUTING EMPLOYER 0 HEBDING TRANSPORT I CONTRIBUTING EMPLOYER 0 HOFMEISTER JOHN AND CONTRIBUTING EMPLOYER 0 JACK COOPER TRANSPOR CONTRIBUTING EMPLOYER 0 KALUZNY BROTHERS IN CONTRIBUTING EMPLOYER 0 L AND L PROVISION CONTRIBUTING EMPLOYER 0 LINCOLN PROVISIONS I CONTRIBUTING EMPLOYER 0 MAHONEY ENVIRONMENTA CONTRIBUTING EMPLOYER 0 MONDELEZ GLOBAL LLC CONTRIBUTING EMPLOYER 0 MORREALE JOHN R I CONTRIBUTING EMPLOYER 0 NEALEY FOODS CONTRIBUTING EMPLOYER 0 PACIFIC RAIL SERVICE CONTRIBUTING EMPLOYER 0 RANDOLPH PACKING CO CONTRIBUTING EMPLOYER 0 ROSE PACKING COMPANY CONTRIBUTING EMPLOYER 0 SOUTHERN WINE & SPIR CONTRIBUTING EMPLOYER 0 STEINBACH PROVISION CONTRIBUTING EMPLOYER 0 STOCK YARDS CHICAGO CONTRIBUTING EMPLOYER 0 SYSCO CHICAGO INC CONTRIBUTING EMPLOYER 0 USF HOLLAND INC CONTRIBUTING EMPLOYER 0 VANEK INC CONTRIBUTING EMPLOYER 0 WHITE CASTLE SYSTEM CONTRIBUTING EMPLOYER 0 WICHITA PACKING COMP CONTRIBUTING EMPLOYER 0 YRC WORLDWIDE CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1