2015-06-18T11:37:24-05:00 2015-01-31 470900880 CALIBRE CPA GROUP PLLC 19615 S LAGRANGE ROAD MOKENA IL 60448 990 2014-02-01 362153764 INTERNATIONAL BROTHERHOOD OF TEAMSTERS 710 HEALTH & WELFARE FUND INTE 7732542500 9000 W 187TH STREET MOKENA IL 60448 JOHN T COLI TRUSTEE 7732542500 2015-06-18 1 CHARLES DIGIOVANNI P00284901 7089957180 2014 2016-02-25 16:41:14Z JOHN T COLI 9000 W 187TH STREET MOKENA IL 60448 83389884 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 19 0 0 0 0 0 46700560 49537294 1371358 3453959 105599 7730 48177517 52998983 0 0 44981176 51379256 1489355 1033865 0 0 0 1432875 1311661 47903406 53724782 274111 -725799 86547156 89688233 884458 11217281 85662698 78470952 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 1 936 0 1 19 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 PHILLIP D STANOCH SECRETARY TREASURER 1.00 X 0 59960 0 TOM J VENTURA TRUSTEE 1.00 X 0 0 0 SAMUEL D PILGER TRUSTEE 1.00 X 0 0 0 PATRICK FLYNN EX- TRUSTEE 4.00 45.00 X 0 284556 22071 MICHAEL SWEENEY EX- TRUSTEE 4.00 45.00 X 0 244013 22071 NEAL J LONDON EX- TRUSTEE 5.00 X 0 59960 0 JAMES DAWES EX- TRUSTEE 5.00 X 0 43109 0 HUGH ROBERTS EX- TRUSTEE 1.00 X 0 59960 0 BRIAN O'MALLEY ADMINISTRATOR 25.00 25.00 X 314274 0 40074 314274 751558 84216 1 0 1 0 BLUE CROSS BLUE SHIELD 300 E RANDOLPH CHICAGO IL 60601 BENEFIT CONTRACT ADMINISTRATOR 1559863 PAUL M NEWCOMER 2609 CROOKS ROAD SUITE 106 TROY MI 48084 LEGAL 137493 LEGACY PROFESSIONALS 311 S WACKER DRIVE SUITE 4000 CHICAGO IL 60606 AUDIT & ACCOUNTING 117823 3 EMPLOYER CONTRIBUTIONS 900099 48573324 48573324 RETIREE CONTRIBUTIONS 900099 628198 628198 PARTICIPANT CONTRIBUTI 900099 263280 263280 CLAIMS REFUND 900099 72492 72492 49537294 1643109 1643109 32201751 30390901 1810850 1810850 1810850 MISCELLANEOUS INCOME 900099 7730 7730 7730 52998983 49545024 0 3453959 51379256 282762 528402 20870 154478 47353 294994 210203 101863 34769 172534 137045 186279 12912 7291 153771 53724782 1515879 727001 4585138 3353543 4414430 5242093 439807 728494 401521 381477 148722 20044 75211581 76127928 231599 3489130 86547156 89688233 266413 181597 618045 11035684 884458 11217281 X 0 0 0 0 85662698 78470952 85662698 78470952 86547156 89688233 -725799 914147 -7380094 0 X X 0 1 X 1 0 401521 381477 20044 20044 LIABILITY FOR LOSS ON SECURITIES LENDING 268925 LIABILITY TO RETURN CASH COLLATERAL HELD FOR SECURITIES ON LOAN 3489130 CLAIMS AND INS PREMIUMS PAYABLE 1065400 CLAIMS INCURRED BUT NOT REPORTED 5798737 PRESCRIPTION BENEFITS PAYABLE 410757 DENTAL FEES PAYABLE 2735 11035684 X 53811267 914147 914147 52897120 101863 101863 52998983 53714140 0 53714140 101863 -91221 10642 53724782 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 -313,575. INCREASE IN CLAIMS INCURRED BUT NOT REPORTED 731,270. DECREASE IN PRESCRIPTION BENEFITS PAYABLE -508,926. INCREASE IN DENTAL FEES PAYABLE 10. FORM 990, PART XII, LINE 2D AMOUNT OF RELATED INCOME ON EMPLOYEE TRUST FUND. 1 0 0 0 PATRICK FLYNN EX- TRUSTEE 0 284556 0 0 0 0 0 12630 0 9441 0 306627 0 0 MICHAEL SWEENEY EX- TRUSTEE 0 244013 0 0 0 0 0 12630 0 9441 0 266084 0 0 BRIAN O'MALLEY ADMINISTRATOR 314274 0 0 0 0 0 11427 11427 8610 8610 334311 20037 0 0 DANIELLE DAWES EMPLOYEE 11054 DANIELLE DAWES IS AN EMPLOYEE OF THE PLAN. THE PLAN PAYS DANIELLE DAWES A SALARY AND CONTRIBUTES TO EMPLOYEE BENEFIT PLANS ON HER BEHALF. DANIELLE DAWES IS A FAMILY MEMBER OF AN EX-TRUSTEE. 0 MICHAEL O'MALLEY EMPLOYEE 121091 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 JENNIFER DRYMILLER EMPLOYEE 90729 JENNIFER DRYMILLER IS AN EMPLOYEE OF THE PLAN. THE PLAN PAYS JENNIFER DRYMILLER A SALARY AND CONTRIBUTES TO EMPLOYEE BENEFIT PLANS ON HER BEHALF. JENNIFER DRYMILLER IS A FAMILY MEMBER OF AN EX-TRUSTEE. 0 FORM 990, PART VI, SECTION B, LINE 11 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 SINCE PRIOR YEAR. PART IX LINE 8 PRIOR PERIOD ADJUSTMENT WRITE OFF LEASEHOLD IMPROVEMENTS (81,900) ACCUM. DEP LEASEHOLD IMPR WRITTEN OFF 28,665 WRITE OFF FURNITURE & EQUIPMENT (108,565) ACCUM. DEP. FURN & EQUIP WRITTEN OFF 37,864 WRITE OFF BUILDOUT LIABILITY 112,692 WRITE OFF NCR COMPUTER EQUIPMENT (4,582) ACCUM. DEP. NCR COMPUTER EQUIPMENT 4,582 ADJUSTMENT FOR EGINNING BENEFITS PAYABLE: CLAIMS AND INSURANCE PREMIUMS (1,378,975) CLAIMS INCURRED AND NOT REPORTED (5,067,467) PRESCRIPTION BENEFITS PAYABLE (919,683) DENTAL FEES PAYABLE (2,725) TOTAL (7,380,094) BEGINNING NET ASSETS AVAILABLE FOR BENEFITS IS BEING REDUCED BY BEGINNING CLAIMS PAYABLE, WHICH HAD NOT BEEN PREVIOUSLY RECORDED AS WELL AS AN ADJUSTMENT FOR CERTAIN TRANSACTIONS RELATED TO THE FUND'S LEASE AGREEMENT. FORM 990, PART XI, LINE 10 THE CURRENT YEAR INCREASE IN THE EXCESS FUNDED STATUS FOR THE SINGLE EMPLOYER PENSION PLAN IN THE AMOUNT OF $304,750 HAS BEEN NETTED AGAINST THE TOTAL PENSION EXPENSE OF $325,620 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 0 AIRGAS INC CONTRIBUTING EMPLOYER 0 JOHN R MORREALE INC CONTRIBUTING EMPLOYER 0 ANICHINI BROS INC CONTRIBUTING EMPLOYER 0 ARKANSAS BEST FREIGHT CONTRIBUTING EMPLOYER 0 AURORA PACKING CO CONTRIBUTING EMPLOYER 0 BROWN PACKING COMPANY CONTRIBUTING EMPLOYER 0 CAPITOL WHOLESALE MEATS CONTRIBUTING EMPLOYER 0 CASSENS TRANSPORT COMPANY CONTRIBUTING EMPLOYER 0 CITY FOODS CONTRIBUTING EMPLOYER 0 CND TRANSPORTATION INC CONTRIBUTING EMPLOYER 0 CPC LOGISTICS INC CONTRIBUTING EMPLOYER 0 DAILY MEAT SUPPLY CONTRIBUTING EMPLOYER 0 DARLING INTERNATIONAL CONTRIBUTING EMPLOYER 0 FOUR STAR FOODS INC CONTRIBUTING EMPLOYER 0 GOLDEN STATE FOOD CONTRIBUTING EMPLOYER 0 GROVE MEAT COMPANY INC CONTRIBUTING EMPLOYER 0 GUARINO WHOLESALE INC CONTRIBUTING EMPLOYER 0 H&M INTERNATIONAL CONTRIBUTING EMPLOYER 0 HEBDING TRANSPORT INC CONTRIBUTING EMPLOYER 0 JOHN HOFMEISTER & SONS CONTRIBUTING EMPLOYER 0 JACK COOPER TRANSPORT CONTRIBUTING EMPLOYER 0 KALUZNY BROTHERS INC CONTRIBUTING EMPLOYER 0 HENRY KAMINSKI CONTRIBUTING EMPLOYER 0 MONDELEZ GLOBAL LLC CONTRIBUTING EMPLOYER 0 L&L PROVISION CONTRIBUTING EMPLOYER 0 LINCOLN PROVISIONS INC CONTRIBUTING EMPLOYER 0 MAHONEY ENVIRONMENTAL INC CONTRIBUTING EMPLOYER 0 MIDWAY AUTO CLINIC CONTRIBUTING EMPLOYER 0 NABISCO BISCUIT AND SNACK CONTRIBUTING EMPLOYER 0 NEALEY FOODS CONTRIBUTING EMPLOYER 0 PACIFIC RAIL SERVICES CONTRIBUTING EMPLOYER 0 RANDOLPH PACKING COMPANY CONTRIBUTING EMPLOYER 0 ROSE PACKING COMPANY INC CONTRIBUTING EMPLOYER 0 RUWALDT PACKING COMPANY CONTRIBUTING EMPLOYER 0 RYDER INTEGRATED LOGISTICS CONTRIBUTING EMPLOYER 0 SOUTHERN WINE & SPIRITS CONTRIBUTING EMPLOYER 0 STANDARD FORWARDING CO INC CONTRIBUTING EMPLOYER 0 STEINBACH PROVISION COMPANY CONTRIBUTING EMPLOYER 0 STOCK YARDS PACKING CONTRIBUTING EMPLOYER 0 SYSCO CHICAGO INC CONTRIBUTING EMPLOYER 0 TOM TOM TAMALES COMPANY CONTRIBUTING EMPLOYER 0 USF HOLLAND INC CONTRIBUTING EMPLOYER 0 VANEK BROS INC CONTRIBUTING EMPLOYER 0 WHITE CASTLE SYSTEM INC CONTRIBUTING EMPLOYER 0 WICHITA PACKING COMPANY CONTRIBUTING EMPLOYER 0 WIRTZ BEVERAGE OF ILLINOIS 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