2024-05-09T08:38:00-05:00 2023-06-30 061298465 SM ESPOSITO & CO PC 3013 DIXWELL AVENUE HAMDEN CT 06518 990 2022-07-01 060689500 LOCAL 493 HEALTH SERVICE AND INSURANCE PLAN LOCA 8608481459 P O BOX 485 UNCASVILLE CT 06382 BEVAN SWEET UNION TRUSTEE 8608481259 2024-05-07 1 BEVAN SWEET 999009999 0 DANA HARVEY CPA P01452206 2033877771 2024-05-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BEVAN SWEET 18 CRESENT STREET UNCASVILLE CT 06382 22435786 0 X N/A X 1954 CT SELF-INSURED HEALTH BENEFIT PLAN 4 4 3 0 0 0 0 0 11757681 13695827 3285373 1285827 1866 6761 15044920 14988415 0 0 10042052 13648586 369455 428659 0 0 0 708311 788643 11119818 14865888 3925102 122527 62748886 75094708 1487913 3272359 61260973 71822349 PROVIDE SELF INSURED HEALTH BENEFITS TO MEMBERS COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT NEGOTIATED BY THE TEAMSTER LOCAL 493 UNION. 0 0 PROVIDES INSURED AND SELF-INSURED MEDICAL, DEATH & LIFE INSURANCE BENEFITS TO 1,258 ACTIVE AND RETIRED MEMBERS 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 1 0 1 3 1 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 X BEVAN SWEET 8608481259 18 CRESENT STREET UNCASVILLE CT 06382 BEVAN SWEET UNION TRUSTEE 4.00 55.00 X 0 161460 60940 NICHOLAS REUT EMPLOYER TRUSTEE 2.00 X 14700 0 0 CRAIG MITCHELL UNION TRUSTEE 4.00 55.00 X 0 152463 60484 ROARKE LEVINE EMPLOYER TRUSTEE 2.00 X 0 0 0 14700 313923 121424 0 0 1 0 ANTHEM BLUE CROSS BLUE SHEILD 1351 WM HOWARD TAFT RD CINCINNATI OH 45206 REPRICING & AMINISTRATION 218077 1 EMPLOYER CONTRIBUTIONS 900099 13562615 13562615 SPECIAL RETIREE CONTRIBUTIONS 900099 63796 63796 PAYROLL AUDIT CONTRIBUTIONS 900099 42224 42224 COBRA CONTRIBUTIONS 900099 27192 27192 13695827 1548720 1548720 7184478 7447371 -262893 -262893 -262893 SEVERANCE RECOVERY 900099 3720 3720 REFUNDS AND REIMBURSMENTS 900099 3041 3041 6761 14988415 13702588 0 1285827 13648586 14000 193277 116743 88704 15935 18000 90530 578751 23024 29440 23938 4740 1235 18985 14865888 954500 400 10847450 1810828 1083809 1198149 4515 3459 18662 14303 4472 4359 49368950 71812315 485190 265198 62748886 75094708 23108 36672 1464805 3235687 1487913 3272359 X 0 0 0 0 61260973 71822349 61260973 71822349 62748886 75094708 X 122527 3608648 6830201 X X 0 1 X 1 0 18662 14303 4359 4359 HEALTH CLAIMS PAYABLE IBNR 2334100 ACCUMULATED ELIGIBILTIY CREDITS 319038 SEVERANCE PAYABLE 7360 HEALTH BENEFIT EXPERIANCE PAYABLE 455014 RIGH OF USE LIABILITY - OPERATING LEASES 120175 3235687 X 18502812 3608648 3608648 14894164 90530 3721 94251 14988415 13521505 0 13521505 90530 1253853 1344383 14865888 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND TO RECOGNIZE A TAX LIABILITY FOR ANY UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAX AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN BELIEVES THAT THE INCOME TAX RETURNS FOR YEARS ENDED JUNE 30, 2019 AND PRIOR ARE CLOSED YEARS AND THEREFORE, ARE NOT SUBJECT TO THE AUDIT PROCESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: SERVERANCE RECOVERY 3,720. ROUNDING ADJUSTMENT 1. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS 1,250,132. SEVERANCE RECOVERY 3,720. ROUNDING ADJUSTMENT 1. 0 0 0 BEVAN SWEET UNION TRUSTEE 0 158453 0 0 0 3007 0 34632 0 26308 0 222400 0 0 CRAIG MITCHELL UNION TRUSTEE 0 149989 0 0 0 2474 0 34746 0 25738 0 212947 0 0 PART I, LINE 3 UNION TRUSTEES ARE PAID BY THE LOCAL UNION (RELATED PARTY) FOR THEIR POSITIONS AS UNION OFFICERS OF TEAMSTERS LOCAL 493. SALARIES ARE DETERMINED BY THE UNION BYLAWS AND ARE APPROVED BY THE UNION EXECUTIVE BOARD. KATELYN MITCHELL DAUGHTER OF UNION TRUSTEE CRAIG MITCHELL 18132 THE PLAN PAYS WAGES AND BENEFITS TO THE EMPLOYEE FOR THE ROLE OF CLAIMS PROCESSOR. 0 FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO APPLICABLE COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE EXECUTIVE BOARD FOR WHICH MINUTES WOULD NEED TO BE RECORDED. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED IN PERSON WITH CERTAIN MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING OF THE RETURN. FORM 990, PART VI, SECTION C, LINE 19 THE HEALTH SERVICE & INSURANCE PLAN DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLIC ANY OF ITS GOVERNING DOCUMENTS POLICY OR FINANCIAL STATEMENTS. FORM 990, PART XI, LINE 9: ASSET TRANSFER FROM DISSOLUTION OF AFFILIATED PLAN 6,830,201. FORM 990, PART XII, LINE 2C THERE HAS BEEN NO CHANGE IN THE BOARD OVERSIGHT RESPONSIBILITY AND APPROVAL PROCESS. THE TRUSTEE'S ASSUME RESPONSIBILITY FOR THE AUDIT PROCESS INCLUDING SELECTION OF THE INDEPENDENT AUDITOR. TEAMSTERS LOCAL 493 UNION 18 CRESENT STREET UNCASVILLE CT 06382 060601240 REPRESENTATION OF UNION MEMBERS CT 501C-5 N/A 0 TRI STATE JOINT FUND 609 WEST JOHNSON AVE 2ND FLOOR CHESHIRE CT 06410 060850110 3RD PARTY ADMINISTRATOR FOR AFFILIATED ENTITIES CT 501C-9 N/A 0 YRC WORLDWIDE INC 10990 ROE AVENUE OVERLAND KS 66211 KS C 0 TOWN OF WOODSTOCK HGHWY DEPT 415 ROUTE 169 WOODSTOCK CT 06281 CT C 0 WESCON CORP OF CONN PO BOX 296 WESTERLY RI 02891 RI C 0 ARBORIO CORPORATION 231 SHUNPIKE ROAD CROMWELL CT 06416 CT C 0 DAY & ZIMMERMAN NPS INC 1827 FREEDOM ROAD LANCASTER PA 17601 PA C 0 TILCON-RYAN PO BOX 310903 NEWINGTON CT 06131 CT C 0 MONTVILLE BOARD OF ED BUS DRIVERS 800 OLD COLCHESTER RD OAKDALE CT 06370 CT C 0 TOWN OF LEDYARD HWY 741 COLONEL LEDYARD HWY LEDYARD CT 06339 CT C 0 TOWN OF WINDHAM HWY DEPT 322 PROSPECT STREET WILLIMANTIC CT 06226 CT C 0 UNITED PARCEL SERVICE 100 EAST CAMPUS VIEW BLVD COLUMBUS OH 43235 OH C 0 ABF FREIGHT SYSTEM INC 3100 SPRINGHILL NLITTLE ROCK AR 72117 AR C 0 LEVINE DISTRIBUTING CO INC 15 STOTT AVE NORWICH CT 06360 CT C 0 WINDHAM PEPSICOLA BOTLG CO 135 LOUISA VIENS DR DAYVILLE CT 06241 CT C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 TRISTATE JOINT FUND M 337741 CASH VALUE