2025-04-23T11:33:32-05:00 2024-08-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2023-09-01 042226511 TEAMSTERS UNION LOCAL 25 HEALTH SERVICES & INSURANCE PLAN TEAM 6172419220 529 MAIN STREET 209 CHARLESTOWN MA 02129 THOMAS G MARI UNION TRUSTEE CO-CHAIRMAN 6172419220 2025-04-23 1 0 LOUIS VERZELLA CPA P00360279 6106689400 2025-04-23 2023 2025-03-06 01:10:19Z THOMAS G MARI 529 MAIN STREET 209 CHARLESTOWN MA 02129 306812566 0 X WWW.TEAMSTERSCARE.COM X 1955 MA THE PLAN PROVIDES MEDICAL, HOSPITALIZATION, DENTAL, VISION, HEARING, LIFE INSURANCE, COUNSELING, WEEKLY DISABILITY, AND PRESCRIPTION DRUG BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. THE PLAN ALSO PROVIDES A PROGRAM OF BENEFITS FOR ELIGIBLE RETIREES. 8 4 71 0 0 0 0 0 185860312 184121586 11956521 18480278 1869759 233286 199686592 202835150 0 0 152108206 157580326 8803902 8921288 0 0 0 2889121 2826954 163801229 169328568 35885363 33506582 354814661 410298187 4253591 3604043 350561070 406694144 THE PLAN PROVIDES MEDICAL, HOSPITALIZATION, DENTAL, VISION, HEARING, LIFE INSURANCE, COUNSELING, WEEKLY DISABILITY, AND PRESCRIPTION DRUG BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. THE PLAN ALSO PROVIDES A PROGRAM OF BENEFITS FOR ELIGIBLE RETIREES. 0 0 PLAN PROVIDES MEDICAL, HOSPITAL, DENTAL, PRESCRIPTION, DISABILITY, MENTAL HEALTH, AUDIOLOGY, WELLNESS, AND LIFE AND ACCIDENTAL DEATH INSURANCE BENEFITS TO ELIGIBLE MEMBERS 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 25 0 71 1 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MARIA GNERRE 6172419220 529 MAIN STREET SUITE 209 CHARLESTOWN MA 02129 THOMAS G MARI UNION TRUSTEE, CO-CHAIRMAN 2.00 45.00 X 0 194620 54873 MICHAEL SHAUGHNESSY EMPLOYER TRUSTEE, CO-CHAIR 2.00 X 0 0 0 STEVEN J SOUTH UNION TRUSTEE 2.00 45.00 X 0 183178 54873 JASON LOPES UNION TRUSTEE 2.00 45.00 X 0 144217 54873 ANDREW P WALSH UNION TRUSTEE 2.00 45.00 X 0 143123 54873 JASON PARADIS EMPLOYER TRUSTEE 2.00 X 0 0 0 JOHN WHITE EMPLOYER TRUSTEE 2.00 X 0 0 0 MATTHEW LOUGHLIN EMPLOYER TRUSTEE 2.00 X 0 0 0 MARIA GNERRE EXECUTIVE DIRECTOR 40.00 X 204912 0 54755 LAURIE MURPHY DENTAL DIRECTOR 40.00 X 167720 0 51582 MARK C ANTIDORMI PHARMACY DIRECTOR 40.00 X 163271 0 54755 ANISSA DERROUCHE DENTAL MANAGER 40.00 X 167778 0 54755 JOANNE SCHULTZ DENTIST 40.00 X 154531 0 54755 AZITA NEGAHBAN DENTIST 40.00 X 141006 0 54755 999218 665138 544849 6 0 1 0 MIDWEST INSTITUTIONAL TRUST COMPANY 5901 COLLEGE BLVD SUITE 100 OVERLAND PARK KS 66211 CUSTODIAL AND INVESTMENT MGT 320513 BLUECROSS BLUESHIELD OF MASSACHUSETTS 25 TECHNOLOGY PLACE HINGHAM MA 02013 CLAIMS ADMINISTRATION 274064 SEA CHANGE SYSTEMS INC 83 PINE ST PEABODY MA 01960 IT 135353 MANZI & ASSOCIATES LLC 1855 TURNPIKE STREET NORTH ANDOVER MA 01845 PAYROLL AUDITORS/ACCOUNTING 122110 EXPRESS SCRIPTSMEDCO N19 W24130 RIVERWOOD DR WAUKESHA WI 53188 CLAIMS ADMINISTRATION 118502 7 EMPLOYER CONTRIBUTION 525100 170556871 170556871 REIMBURSEMENTS AND CO-PAYS 525100 7295984 7295984 PARTICIPANT CONTRIBUTION 525100 6268731 6268731 184121586 5944406 5944406 116513288 103977416 12535872 12535872 12535872 REPAYMENT OF CLAIMS 900099 197465 197465 OTHER INCOME 900099 35821 35821 233286 202835150 184354872 0 18480278 157580326 267057 5191061 1342832 1670062 450276 104859 179810 754693 5873 191469 282303 811387 2737 164408 284316 FEES MANDATED BY THE AC 45099 169328568 2335 2336 31635659 37011850 17418781 18012786 246905 224034 2775925 1724188 1091467 1051737 118159996 144735205 181425218 204562283 3592772 3192222 1241528 1505734 354814661 410298187 263764 308423 3989827 3295620 4253591 3604043 X 0 0 0 0 350561070 406694144 350561070 406694144 354814661 410298187 33506582 22626492 0 X X 0 1 X 1 0 1510888 702809 808079 277621 203451 74170 987416 817928 169488 1051737 REAL ESTATE INVESTMENT TRUST 12901546 F COMMON COLLECTIVE TRUST FUNDS 124498738 F LIMITED PARTNERSHIP - SECURED FLOATING RATE LOAN FUND 16614039 F COMMINGLED FUND - 103-12IE 14907230 F LIMITED PARTNERSHIP - EMERGING MARKETS 11441235 F LIMITED PARTNERSHIP - INT'L EQUITY 24199495 F 204562283 OPERATING LEASE LIABILITY 3295620 3295620 X 224706949 22626492 22626492 202080457 754693 754693 202835150 168573875 0 168573875 754693 754693 169328568 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 TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. X 0 0 0 MARIA GNERRE EXECUTIVE DIRECTOR 204912 0 0 0 0 0 24690 0 30065 0 259667 0 0 0 THOMAS G MARI UNION TRUSTEE, CO-CHAIRMAN 0 194620 0 0 0 0 0 24690 0 30183 0 249493 0 0 STEVEN J SOUTH UNION TRUSTEE 0 183178 0 0 0 0 0 24690 0 30183 0 238051 0 0 ANISSA DERROUCHE DENTAL MANAGER 167778 0 0 0 0 0 24690 0 30065 0 222533 0 0 0 LAURIE MURPHY DENTAL DIRECTOR 167720 0 0 0 0 0 23259 0 28323 0 219302 0 0 0 MARK C ANTIDORMI PHARMACY DIRECTOR 163271 0 0 0 0 0 24690 0 30065 0 218026 0 0 0 JOANNE SCHULTZ DENTIST 154531 0 0 0 0 0 24690 0 30065 0 209286 0 0 0 JASON LOPES UNION TRUSTEE 0 144217 0 0 0 0 0 24690 0 30183 0 199090 0 0 ANDREW P WALSH UNION TRUSTEE 0 143123 0 0 0 0 0 24690 0 30183 0 197996 0 0 AZITA NEGAHBAN DENTIST 141006 0 0 0 0 0 24690 0 30065 0 195761 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S AUDITOR PREPARES THE FORM 990 AND REVIEWS IT WITH MANAGEMENT AND THE GOVERNING BODY'S CO-CHAIR BEFORE IT IS SIGNED BY THEM. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH CONFLICT OF INTEREST POLICY IS MONITORED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 SALARY INCREASES ARE GRANTED ON AN ACROSS-THE-BOARD PERCENTAGE BASIS FOR ALL EMPLOYEES, INCLUDING THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES. INCREASES ARE VOTED UPON BY THE BOARD OF TRUSTEES AND DOCUMENTED IN THE MINUTES TO THEIR MEETING. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: TEAMSTERS UNION 25 HEALTH SERVICES & INSURANCE PLAN'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR WHO PERFORMS THE AUDIT. FORM 990, PART V, LINE 2A: TEAMSTERS UNION 25 HEALTH SERVICES & INSURANCE PLAN ALSO ISSUES FORMS W-2 FOR THE DISABILITY BENEFIT (THIRD-PARTY SICK PAY) OFFERED BY THE PLAN. 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