2024-11-04T15:04:42-06:00 2023-12-31 112478817 SAMUEL GOLDSTEIN & CO PC 150 GREAT NECK ROAD GREAT NECK NY 110213309 990 2023-01-01 205003549 TEAMSTERS LOCAL 210 AFFILIATED HEALTH & INSURANCE FUND TEAM 7189668200 1441 SOUTH AVENUE SUITE 702 STATEN ISLAND NY 10314 ROBERT BELLACH CHAIRMAN 2127573463 2024-11-04 1 0 P00832641 5164663388 2023 2024-10-15 13:58:12Z ROBERT BELLACH 55 BROAD STREET - 11TH FLOOR NEW YORK NY 10004 63848549 0 X N/A X 2006 NY TO PROVIDE HEALTH AND VACATION AND OTHER FRINGE BENEFITS TO ELIGIBLE MEMBERS OF LOCAL 210 INTERNATIONAL BROTHERHOOD OF TEAMSTERS AND THEIR FAMILIES. 6 3 0 0 0 0 0 0 56367926 59582087 -87483 557261 0 0 56280443 60139348 0 0 54440935 50702175 0 0 0 0 0 4313260 4370567 58754195 55072742 -2473752 5066606 15833272 22345277 0 0 15833272 22345277 TO PROVIDE HEALTH AND VACATION AND OTHER FRINGE BENEFITS TO ELIGIBLE MEMBERS OF LOCAL 210 INTERNATIONAL BROTHERHOOD OF TEAMSTERS AND THEIR FAMILIES. 0 0 50702175 PROVIDE & MAINTAIN HEALTH BENEFITS (MAJOR MEDICAL, HOSPITAL,SURGICAL & DENTAL), DISABILITY BENEFITS, DEATH BENEFITS AND VACATION AND OTHER FRINGE BENEFITS TO ELIGIBLE MEMBERS AND THEIR ELIGIBLE DEPENDENTS. 50702175 0 0 0 0 0 0 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 0 0 0 1 280 0 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 X CROSSROADS HEALTHCARE MANAGEMENT LLC 7189668200 1441 SOUTH AVENUE SUITE 702 STATEN ISLAND NY 10314 FRANK FOLISE EMPLOYER TRUSTEE 0.00 X 0 0 0 ROBERT BELLACH UNION TRUSTEE 1.00 39.00 X 0 217286 0 ROY KOHN EMPLOYER TRUSTEE 0.00 X 0 0 0 RALPH NATALE UNION TRUSTEE 0.00 X 0 0 0 PEDRO CARDI UNION TRUSTEE 1.00 39.00 X 0 164105 0 KIRK CONAWAY EMPLOYER TRUSTEE 0.00 X 0 0 0 0 381391 0 0 0 1 0 0 EMPLOYER CONTRIBUTIONS 525100 59582087 59582087 59582087 357448 357448 3909014 3709201 199813 199813 199813 60139348 60139348 0 0 50702175 50702175 222925 222925 89646 89646 20643 20643 88000 88000 13694 13694 THIRD-PARTY ADMINISTRAT 3866382 3866382 AFFORDABLE CARE ACT FEE 37309 37309 PRINTING, POSTAGE & MIS 31968 31968 55072742 50702175 4370567 0 1350004 4870771 117435 75607 14365833 17398899 15833272 22345277 0 0 X 0 0 0 0 15833272 22345277 15833272 22345277 15833272 22345277 5066606 1445399 0 X X 0 1 X 1 0 0 X 61564104 1445399 1445399 60118705 20643 20643 60139348 55052099 0 55052099 20643 20643 55072742 PART X, LINE 2: U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 0 0 ROBERT BELLACH UNION TRUSTEE 0 217286 0 0 0 0 0 0 0 0 0 217286 0 0 PEDRO CARDI UNION TRUSTEE 0 164105 0 0 0 0 0 0 0 0 0 164105 0 0 FORM 990, PART VI, SECTION A, LINE 8B NOT APPLICABLE FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND FOR INSPECTION AT THEIR GENERAL OFFICES. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FRANK FOLISE - 2200 SECAUCUS ROAD, NORTH BERGEN, NJ 07047. ROBERT BELLACH - 1911 RICHMOND AVE, STATEN ISLAND, NY 10314. ROY KOHN - 313 UNDERHILL BLVD, P.O. BOX 9034, SYOSSET, NY 11791. RALPH NATALE - 24 NORTH TYSON AVENUE, FLORAL PARK, NY 11001. PEDRO CARDI - 1911 RICHMOND AVE, STATEN ISLAND, NY 10314. FORM 990 - SCHEDULE O MODIFIED CASH BASIS FORM 990 - SCHEDULE O PART XII - LINE 2C: NO CHANGE IN PROCESS FROM THE PRIOR YEAR REGARDING RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNTANT.