2011-02-14T10:14:08-06:00 2010-06-30 SM ESPOSITO & CO PC 3013 DIXWELL AVENUE HAMDEN CT 06518 990 2009-07-01 060850110 TRI-STATE JOINT FUND TRI- 2038763110 25 RESEARCH DRIVE MILFORD CT 06460 DENNIS E RAYMOND 2038763103 2011-02-14 1 2033877771 2011-02-11 2009 2016-02-24 21:20:13Z DENNIS E RAYMOND 25 RESEARCH DRIVE MILFORD CT 06460 86995694 0 X N/A X 1968 CT SELF-INSURED HEALTH BENEFIT PLAN 28 28 18 0 1050 0 0 75160949 77954859 -704891 247589 12521 7238 74468579 78209686 0 72636605 75537041 1352828 1344508 0 0 1773076 1647632 75762509 78529181 -1293930 -319495 14089226 15821854 2628140 3761926 11461086 12059928 PROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO MEMBERS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS NEGOTIATED BY TEAMSTER LOCALS. 0 0 78529181 THE FUND OPERATES UNDER A TRUST AGREEMENT FOR THE PURPOSEOF MAKING BENEFIT PAYMENTS TO MEMBERS OF THE TRI-STATETEAMSTERS HEALTH SERVICES & INSURANCE PLAN, THESE BENEFITS COVER HOSPITAL,SURGICAL, PRESCRIPTION DRUG, HOME HEALTH CARE AND DEATH BENEFITS FOR 11,705 MEMBERS PLUS THEIR DEPENDENTS. 78529181 0 0 0 0 0 0 0 0 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 18 0 18 1 0 0 0 0 0 0 0 28 28 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 1 0 X PATRICIA SANDILLO 2038763103 25 RESEARCH DRIVE MILFORD CT 06460 DENNIS RAYMOND 4.00 X 0 0 0 JOSEPH ESPOSITO 1.00 X 0 0 0 EDWIN ROONEY 1.00 X 0 0 0 ANTHONY CAPPELLA 1.00 X 0 0 0 RAYMOND ONEGLIA 1.00 X 0 0 0 FRANK ROSSI 1.00 X 0 0 0 VICTOR SANTIAGO 1.00 X 0 0 0 ROBERT SULLIVAN JR 1.00 X 0 0 0 ROBERT PAQUETTE 1.00 X 0 0 0 ROBERT BAYUSIK 1.00 X 0 0 0 LINDA BUNNELL 1.00 X 0 0 0 DENNIS MCGUIRE 4.00 X 0 0 0 THOMAS SCHLINK 1.00 X 0 0 0 BEVAN SWEET 1.00 X 0 0 0 NICHOLAS REUT 1.00 X 0 0 0 BLAIR HEAGY 1.00 X 0 0 0 THOMAS GILMARTIN 1.00 X 0 0 0 ROY SULLIVAN 1.00 X 0 0 0 TIMOTHY MCAVOY 1.00 X 0 0 0 JOHN LEAHY 1.00 X 0 0 0 GEORGE BRIER 1.00 X 0 0 0 ALAN FREOHLICH 1.00 X 0 0 0 CHRISTOPHER ROOS 1.00 X 0 0 0 GLENN BARKSDALE 1.00 X 0 0 0 PAUL NOVAK 1.00 X 0 0 0 JAMES STACK 1.00 X 0 0 0 TIMOTHY CASEY 1.00 X 0 0 0 HELGA SCHMIDT 1.00 X 0 0 0 PATRICIA SANDILLO 40.00 X X 128984 0 33349 128984 0 33349 1 0 1 0 ROBERT M CHEVERIE & ASSOC 333 EAST RIVER DRIVE EAST HARTFORD CT 06108 LEGAL 280150 THE SEGAL COMPANY CHURCH STREET STATION P O BOX 4059 NEW YORK NY 102614059 ACTUARIAL 244119 EMDEONABF 3183 RIDER TRAIL SOUTH EARTH CITY MO 63045 PRINTING/MAILING 143184 SOFTWARE SYSTEMS SOLUTION LLC 212-E NEW LONDON TURNPIKE GLASTONBURY CT 06033 COMPUTER CONSULTING 103468 4 CONTRIBUTIONS - HEALTH 900099 77954859 77954859 77954859 259780 259780 1050 1050 1050 1050 8773817 8786008 -12191 -12191 -12191 SECURITY LITIGATION PR 900099 6188 6188 6188 78209686 78208636 1050 0 75537041 75537041 823266 823266 217431 217431 232025 232025 71786 71786 329926 329926 55090 55090 64136 64136 52000 52000 498496 498496 58232 58232 94782 94782 60871 60871 CONSULTING FEE (ACTUARI 222936 222936 OUTSIDE SERVICES 142342 142342 PROPERTY TAXES 37302 37302 UTILITIES 31519 31519 78529181 78529181 0 0 752587 2424741 176656 52447 103049 4883561 4297066 576484 586495 10250633 11368909 2280419 1338660 14089226 15821854 1088880 742224 1539260 3019702 2628140 3761926 X 0 0 0 0 11461086 12059928 11461086 12059928 14089226 15821854 X 0 1 1 X 0 152788 152788 3652520 3368406 284114 1078253 928660 149593 586495 INTEREST RECEIVABLE 40791 MISCELLANEOUS RECEIVABLE 537380 HEALTH BENEFIT RECONCILIATION 760489 1338660 DUE TO ANTHEM 3010481 DUE TO AFFILIATES 9221 3019702 78209686 78529181 -319495 918337 918337 598842 78209686 0 78209686 0 78209686 78529181 0 78529181 0 78529181 0 0 0 PATRICIA SANDILLO 114884 0 9700 0 4400 0 0 0 33349 0 162333 0 0 0 Form 990, Part VI, Section B, line 11 FORM 990 IS REVIEWED IN PERSON WITH THE CO-CHAIRMEN AND THE EXECUTIVE DIRECTOR PRIOR TO FILING OF THE RETURN. Form 990, Part VI, Section B, line 15b THE CO-CHAIRMEN REVIEW AND ADJUST THE COMPENSATION OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS. Form 990, Part VI, Section C, line 19 TRI-STATE JOINT FUND DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLICANY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS. IBT TEAMSTERS LOCAL 191 HEALTH SERVICE & INSURANCE PLAN 1139 FAIRFIELD AVENUE BRIDGEPORT CT 06605 060689974 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A TEAMSTERS LOCAL 404 HEALTH SERVICE & INSURANCE PLAN 115 PROGRESS AVENUE SPRINGFIELD MA 01104 042174518 AFFILIATED SELF INSURED HEALTH PLAN MA 501C-9 N/A TRANSPORTATION LOCAL 443 HEALTH SERVICE & INSURANCE PLAN 200 WALLACE STREET NEW HAVEN CT 06511 060690083 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A GENERAL TEAMSTERS LOCAL 493 HEALTH SERVICE & INSURANCE PLAN 18 CRESENT STREET UNCASVILLE CT 06382 060689500 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A TEAMSTERS LOCAL 559 HEALTH SERVICE & INSURANCE PLAN 400 CHAPEL ROAD UNIT 2-B SOUTH WINDSOR CT 06074 060683663 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A TEAMSTERS LOCAL 677 HEALTH SERVICE & INSURANCE PLAN 1871 BALDWIN STREET WATERBURY CT 06706 060691862 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A TEAMSTERS LOCAL 1035 HEALTH SERVICE & INSURANCE PLAN 400 CHAPEL ROAD UNIT 2-A SOUTH WINDSOR CT 06074 060997832 AFFILIATED SELF INSURED HEALTH PLAN CT 501C-9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0