2025-02-11T16:10:08-06:00 2024-04-30 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2023-05-01 251417264 EMPLOYER TEAMSTERS LOCAL 205 WELFARE FUND EMPL 4127517988 1184 LONG RUN ROAD WHITE OAK PA 15131 CARL A BAILEY CHAIRMAN TRUSTEE 4127517988 2025-02-11 1 0 LOUIS VERZELLA CPA P00360279 6106689400 2025-02-11 2023 2025-03-06 01:10:19Z CARL A BAILEY 1184 LONG RUN ROAD WHITE OAK PA 15131 3914906 0 X N/A X 1982 PA PROVIDE HEALTH, DENTAL, VISION, TEMPORARY DISABILITY, AND LEGAL BENEFITS TO MEMBERS. 4 2 0 0 0 0 0 0 4126137 3826266 32361 37359 37296 37008 4195794 3900633 0 0 3927601 4228641 0 0 0 0 0 408037 391147 4335638 4619788 -139844 -719155 2224765 1508124 385977 354300 1838788 1153824 PROVIDE HEALTH, LIFE, DENTAL, VISION, TEMPORARY DISABILITY, AND LEGAL BENEFITS TO MEMBERS. 0 0 PROVIDE HEALTH, LIFE, DENTAL, VISION, TEMPORARY DISABILITY, AND LEGAL BENEFITS TO MEMBERS. 0 0 0 0 0 0 0 0 0 1 1 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 1 0 0 1 310 0 0 0 0 0 0 0 0 0 0 0 0 X 4 2 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X CARL A BAILEY 4127517988 1184 LONG RUN ROAD WHITE OAK PA 15131 CARL A BAILEY CHAIRMAN TRUSTEE 1.00 X X 0 124821 61058 EDWARD BOEHM TRUSTEE 1.00 X 0 101823 61058 DAVE SCHNEIDER TRUSTEE 1.00 X 0 0 0 MICHAEL CHEREPKO TRUSTEE 1.00 X 0 0 0 0 226644 122116 0 0 1 0 HIGHMARK BLUESHIELD 120 FIFTH AVE PITSSBURGH PA 15222 CLAIMS ADMINISTRATION 325547 1 EMPLOYER CONTRIBUTIONS 900099 3791468 3791468 PARTICIPANT CONTRIBUTI 900099 34798 34798 3826266 36266 36266 36948 0 36948 36948 36948 15366 14273 1093 1093 1093 OTHER INCOME 900099 60 60 60 3900633 3826266 0 74367 4228641 20272 26000 2637 40900 26589 4868 57283 11274 8499 ADMINISTRATION EXPENSES 192472 MISCELLANEOUS 353 4619788 50025 123577 4677 7485 21216 18654 577565 394463 189646 183102 353041 373528 1606160 801778 2224765 1508124 40918 3318 345059 350982 385977 354300 X 0 0 0 0 1838788 1153824 1838788 1153824 2224765 1508124 -719155 34191 0 X X 0 1 X 1 0 100000 100000 388379 310669 77710 89186 83794 5392 183102 ANNUITIES 801778 F 801778 X 3932187 34191 34191 3897996 2637 2637 3900633 4617151 0 4617151 2637 2637 4619788 PART X, LINE 2: US GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND TO RECOGNIZE A TAX LIABILITY IF THE FUND HAS TAKEN AN UNCERTAIN TAX POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE TRUSTEES HAVE ANALYZED THE TAX POSITIONS TAKEN BY THE FUND AND HAVE CONCLUDED THAT, AS OF APRIL 30, 2024 AND 2023, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FUND'S TRUSTEES BELIEVE THE FUND IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2019. 0 0 0 CARL A BAILEY CHAIRMAN TRUSTEE 0 124821 0 0 0 0 0 33206 0 27852 0 185879 0 0 EDWARD BOEHM TRUSTEE 0 101823 0 0 0 0 0 33206 0 27852 0 162881 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE PLAN'S TRUSTEES REVIEW THE FORM 990 AT THE TRUSTEE MEETING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE DURING REGULAR OFFICE HOURS, OR ARE MAILED, IF REQUESTED. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED. SERVICE PERSONNEL & EMPLOYEES DAIRY INDUSTRY TEAMSTERS LOCAL 205 1184 LONG RUN ROAD WHITE OAK PA 15131 250664925 LABOR UNION PA 501(C)(5) N/A 0 ALBERTS ANDERSON DUBOSE BENTLEYVILLE BETHEL PARK BRENTWOOD CANONSBURG CANONSBURG HOUSTON CHARLEROI POL CHARLTON CHARTIERS CITY MCK CLAIRTON POL CLEARFIELD CLEARFIELD POL CRAIG CROTHALL CURWENSVILLE CURWENSVILLE POL DONORA DUQUESNE ELIZ BORO ELIZABETH POL ELIZABETH TWP FIRST STUDENT FORBES FRANKLIN SCH GATEWAY SCHOOL GLASSPORT GLASSPORT POL GREENBERG HARMAR HOMESTEAD POL INDIANA TWP JEFFERSON POL JOHNSON KUSTRA LAWRENCE TWP LINCOLN POL LOCAL 205 LOGO LTD PREMIUM MANOR POL MCK HOUSING MONESSEN MONG'S MONONGAHELA POL MORRISON MUNHALL HOMESTEAD NEW EAGLE SEW NORTH FRANKLIN NORTH VERSAILLES POL NUTRITION PITCAIRN PLUM BORO PLUM MUN PORT VUE REPUBLIC LTD REPUBLIC SERVICES RICHLAND TWP RIVERSIDE SCHNEIDER CL SCHNEIDERS SERVICEMASTER SHALER SCHOOL SILVIS SOUTH PARK STAGE-KERN STOWE TWP SWISSVALE THOMPSON TITUSVILLE DAIRY TOMOSKY TRAFFORD POL UNION RD UPPER ST CLAIR WEST DEER WEST NEWTON POL WINTERS WOODLING ZIPAY 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 SERVICE PERSONNEL & EMPLOYEES DAIRY INDUSTRY TEAMSTERS LOCAL 205 K 36948 ACTUAL AMOUNT SERVICE PERSONNEL & EMPLOYEES DAIRY INDUSTRY TEAMSTERS LOCAL 205 O 207648 ACTUAL AMOUNT