2013-11-07T15:24:37-06:00 2012-12-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2012-01-01 366158494 SUBURBAN TEAMSTERS OF NORTHERN ILLINOIS WELFARE FUND SUBU 6302935218 1171 COMMERCE DR UNIT 1 WEST CHICAGO IL 60185 MARK KENNEDY 6302935218 2013-11-07 1 COLIN THOMPSON P01460524 3123680500 2012 2016-02-25 16:41:14Z MARK KENNEDY 1171 COMMERCE DR UNIT 1 WEST CHICAGO IL 60185 105069886 0 X N/A X 1951 IL PROVIDE HEALTH BENEFITS 6 0 119 0 0 0 0 0 45941844 46539049 2053602 3561073 154 7878 47995600 50108000 0 0 42694368 42399517 829165 807948 0 0 0 1022290 1066268 44545823 44273733 3449777 5834267 108408131 116795908 127184 740911 108280947 116054997 PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 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 1 704 0 1 119 1 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X JOSE COLIN - FUND MANAGER 6302930390 1171 COMMERCE DR UNIT 1 WEST CHICAGO IL 60185 X PHILLIP STANOCH 1.00 X 0 0 0 MARK KENNEDY 2.00 X 0 0 0 TOM FLYNN 1.00 65.00 X 0 145600 27985 WILLIAM BRACH 1.00 X 0 0 0 DOMINIC ROMANAZZI 2.00 40.00 X 0 124875 40300 PAUL HAWKINS 1.00 65.00 X 0 115785 43249 JOSE COLIN 40.00 40.00 X 0 120723 20396 0 506983 131930 0 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 60601 PPO NETWORK PROVIDER 1402058 PROVENA HOSPITALS 75 REMITTANCE DRIVE CHICAGO IL 60675 MEDICAL PROVIDER 223852 METROPOLITAN LIFE INSURANCE COMPANY DEPT CH 10579 PALATINE IL 60055 DENTAL NETWORK PROVIDER 129711 PRUDENTIAL FINANCIAL 2 GATEWAY CENTER NEWARK NJ 07102 INVESTMENT MANAGER 121817 MEDCARE MANAGEMENT 2090 PALM BEACH LAKES BLVD 900 WEST PALM BEACH FL 33409 MEDICAL REVIEW 116860 5 EMPLOYER CONTRIBUTIONS 900099 39432549 39432549 PARTIC & RETIREE CONTRIBUTIONS 900099 5236753 5236753 PRESCRIPTION REBATES 900099 1042531 1042531 RETIREE DRUG SUBSIDY 900099 644217 644217 EARLY RETIREE REINS. 900099 182999 182999 46539049 2716616 2716616 55806343 54961886 844457 844457 844457 MISCELLANEOUS 900099 7878 7878 7878 50108000 46539049 0 3568951 42399517 35113 465602 92963 138048 76222 156197 92571 259296 60590 141826 59462 169079 1656 11956 64487 42298 MISCELLANEOUS EXPENSE 6850 44273733 12129095 10721181 0 115387 5741722 5767895 322363 292779 13173 13436 538036 449339 140668 88697 36286471 39519395 53774639 60277138 108408131 116795908 127184 124119 0 616792 127184 740911 X 0 0 0 0 108280947 116054997 108280947 116054997 108408131 116795908 5834267 1939783 0 X 0 1 X 1 0 538036 449339 88697 88697 PRUDENTIAL TRUST COMPANY 39648073 F IR&M SHORT FUND LLC 20629065 F 60277138 DUE TO SUBURBAN TEAMSTERS OF NORTHERN ILLINOIS PENSION FUND 65280 DUE TO BROKER - PENDING INVESTMENT TRADES 551512 616792 X 51788487 1939783 1939783 49848704 259296 259296 50108000 44014437 0 44014437 259296 259296 44273733 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRES. 0 0 0 TOM FLYNN 0 127375 0 0 0 18225 0 13105 0 14880 0 173585 0 0 DOMINIC ROMANAZZI 0 100665 0 0 0 24210 0 24700 0 15600 0 165175 0 0 PAUL HAWKINS 0 115785 0 0 0 0 0 28369 0 14880 0 159034 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES FOR THEIR REVIEW AND APPROVAL PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES AND EMPLOYEES OF THE HEALTH AND WELFARE FUND. THE BOARD OF TRUSTEES MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES APPROVES COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL (OFFICER), THE FUND MANAGER, WHO OVERSEES THE ORGANIZATIONS DAILY OPERATIONS. THE FUND MANAGER IS PAID BY THE RELATED PENSION FUND AND AN AMOUNT IS ALLOCATED TO THE WELFARE FUND AND REIMBURSED BACK TO THE PENSION FUND BASED ON TIME SPENT WORKING FOR THE RESPECTIVE FUNDS. APPROVAL IS DOCUMENTED IN THE ORGANIZATIONS MINUTES. TRUSTEES OF THE ORGANIZATION ARE NOT COMPENSATED. FORM 990, PART VI, SECTION C, LINE 19 THE HEALTH AND WELFARE FUND MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT ITS HOME OFFICE, UPON REQUEST. FORM 990, PART VII, LINE 1A THE ORGANIZATION'S ADMINISTRATOR IS ALSO THE ADMINSITRATOR OF THE RELATED PENSION FUND. REIMBURSEMENTS ARE DISBURSED BETWEEN THE TWO ORGANIZATIONS FOR THEIR ALLOCATED PORTION OF HIS SALARY, FRINGE BENEFITS, AND PAYROLL TAXES. FORM 990, PART V, LINE 2A THE NUMBER OF EMPLOYEES REPORTED ON FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, FILED FOR THE CALENDAR YEAR ENDING WITH OR WITHIN THE YEAR COVERED BY THIS RETURN INCLUDES PARTICIPANTS OF THE FUND THAT HAVE RECEIVED DISABILITY PAYMENTS DURING THE YEAR. 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