2023 Form 5500 filing — Teamsters Local 210 Affiliated Health & Insurance Fund
Plain-English filing summary
According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20241015182711NAL0015250595001) for Teamsters Local 210 Affiliated Health & Insurance Fund, reported by Teamsters Local 210 Affiliated Health & Insurance Fund under EIN 20-5003549 and plan number 501. It reports 5,442 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015182711NAL0015250595001
- Filing year
- 2023
- Form type
- 1
- Plan sponsor
- Teamsters Local 210 Affiliated Health & Insurance Fund
- EIN
- 20-5003549
- Plan number
- 501
- Location
- Staten Island, NY
- Participants
- 5,442
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $22,345,277
- Net assets (EOY)
- $22,345,277
- Employer contributions
- $59,402,821
- Participant contributions
- $179,266
- Total income / additions
- $61,584,747
- Benefits paid
- $50,702,175
- Administrative expenses
- $4,370,567
- Total expenses
- $55,072,742
- Net increase / (decrease)
- $6,512,005
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Crossroads Healthcare Management Ll | NONE | $3,189,171 | not reported in the loaded dataset |
| Empire Blue Cross Blue Shield | NONE | $1,415,960 | not reported in the loaded dataset |
| Empire Blue Cross Blue Shield | NONE | $940,644 | not reported in the loaded dataset |
| Proscript Pharmacy Management LLC | NONE | $581,178 | not reported in the loaded dataset |
| Law Offices Of Thomas A. Thompson | NONE | $222,925 | not reported in the loaded dataset |
| Davis Vision Inc | NONE | $164,808 | not reported in the loaded dataset |
| Crossroads Healthcare Management Ll | NONE | $96,033 | not reported in the loaded dataset |
| Samuel Goldstein & Co., P.C. | NONE | $89,646 | not reported in the loaded dataset |
| Amalgamated Life Insurance Co | NONE | $77,576 | not reported in the loaded dataset |
| First Unum Life Insurance Co | NONE | $73,681 | not reported in the loaded dataset |
| Mutual Of Omaha | NONE | $68,984 | not reported in the loaded dataset |
| Savasta And Company Inc | NONE | $52,000 | not reported in the loaded dataset |
| Dental Services Inc | NONE | $50,256 | not reported in the loaded dataset |
| David R Pfaff, Md | NONE | $36,000 | not reported in the loaded dataset |
| Vision Screening Inc | NONE | $27,780 | not reported in the loaded dataset |
| Perfect Printing Solutions Inc | NONE | $17,229 | not reported in the loaded dataset |
| General Vision Services LLC | NONE | $15,280 | not reported in the loaded dataset |
| Palmer-Tanno Agency Inc | NONE | $13,694 | not reported in the loaded dataset |
| Ziegler Capital Management LLC | NONE | $8,508 | not reported in the loaded dataset |