2013-10-15T13:51:58-05:00 2012-12-31 043508036 MANZI & ASSOCIATES LLC 855 TURNPIKE STREET STE 140 NORTH ANDOVER MA 01845 990 2012-01-01 042149479 TEAMSTERS LOCAL 653 WELFARE FUND TEAM 5082307140 4 B HAMPDEN DRIVE SOUTH EASTON MA 02375 MICHAEL CLARK 5082307140 2013-10-15 1 EDWARD MANZI P01058633 9789751099 2012 2016-03-07 17:11:31Z MICHAEL CLARK 4 B HAMPDEN DRIVE SOUTH EASTON MA 023751158 26909534 0 X N/A X 1952 MA PROVIDE HEALTH BENEFITS TO MEMBERS OF SPONSORING ORGANIZATION UNDER CBA 6 6 18 0 0 0 0 0 17900793 18373619 1645102 1659252 0 4750 19545895 20037621 0 0 17121377 17619171 228114 203671 0 0 0 636661 891595 17986152 18714437 1559743 1323184 44967633 48060148 2916479 3079353 42051154 44980795 PROVIDE HEALTH BENEFITS TO MEMBERS OF THE SPONSORING ORGANIZATION UNDER COLLECTIVE BARGAINING AGREEMENT 0 0 PROVIDE WELFARE BENEFITS TO EMPLOYEES UNDER COLLECTIVE BARGAINING AGREEMENT 0 0 0 0 0 0 0 0 0 1 0 0 1 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 0 0 18 1 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 1 1 0 X MICHAEL CLARK 5082307140 4 B HAMPDEN DRIVE SOUTH EASTON MA 02375 X MICHAEL CLARK 10.00 X 0 0 0 BRIAN MCELHINNEY 10.00 X 0 0 0 ROBERT EPSTEIN 10.00 X 0 0 0 MICHAEL EPSTEIN 10.00 X 0 0 0 WILLIAM BURKE 10.00 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD 401 PARK DR 14 BOSTON MA 02129 CLAIMS ADMIN 713638 MORGAN STANLEY SMITH BARNEY 25 RECREATION PK DR HINGHAM MA 02043 INVESTMENT FEES 306604 2 EMPLOYER CONTRIBUTIONS 900099 17944225 17944225 EMPLOYEE CONTRIBUTIONS 900099 429394 429394 18373619 1355810 1355810 7175355 6871913 303442 303442 303442 OTHER INCOME 532420 4750 4750 4750 20037621 18373619 0 1664002 17619171 150884 42138 10649 22801 31825 358590 12909 26826 STOPLOSS 264629 ACTUARY 60000 REPAIRS AND MAINTENANCE 41624 INSURANCE 28402 43989 18714437 1303624 1656836 1993756 1913125 1352276 543197 835905 809079 38173322 41086503 2661026 2594605 44967633 48060148 39517 34040 2876962 3045313 2916479 3079353 X 0 0 0 0 42051154 44980795 42051154 44980795 44967633 48060148 1323184 1606457 0 X X 0 1 X 1 0 115200 115200 1237076 543197 693879 809079 DEPOSITS 2465956 INVESTMENT INCOME RECEIVABLE 128649 2594605 HEALTH CLAIMS PAYABLE 3045313 3045313 X 21285488 1606457 1606457 19679031 358590 358590 20037621 18187496 0 18187496 358590 168351 526941 18714437 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 DEPARTMENT OF LABOR AND INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012, 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. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFITS PAYABLE 168,351. FORM 990, PART VI, SECTION A, LINE 6 COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN FOR MEMBERS OF TEAMSTERS LOCAL 653 FORM 990, PART VI, SECTION B, LINE 11 BOARD OF TRUSTEES HAS GIVEN AUTHORITY TO THE FUND ADMINISTRATOR TO REVIEW TAX DOCUMENTATION BEFORE FILING. FORM 990, PART VI, LINE 15A: BOARD OF TRUSTEES DO NOT RECEIVE COMPENSATION. FORM 990, PART VI, SECTION B, LINE 12 AS AN EMPLOYEE BENEFIT PLAN, THE ORGANIZATION IS SUBJECT TO THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA FORM 990, PART VI, SECTION B, LINE 15 BOARD OF TRUSTEES REVIEWS KEY EMPLOYEES COMPENSATION WITH COMPARABILITY DATA ANNUALLY. 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