2026-07-10T10:35:23-05:00 2025-09-30 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2024-10-01 221458594 UFCW NATIONAL HEALTH AND WELFARE FUND UFCW 2015698801 66 GRAND AVENUE ENGLEWOOD NJ 07631 MILTON JONES TRUSTEE 2015698801 2026-07-10 1 0 ANTHONY VOGT CPA P01385419 6106689400 2026-07-10 2024 2025-03-06 01:10:19Z MILTON JONES 66 GRAND AVENUE ENGLEWOOD NJ 07631 173515214 0 X N/A X 1947 NJ THE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DENTAL, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG, DENTAL, VISION, AND DEATH BENEFITS ARE SELF-FUNDED. 8 8 34 0 0 0 0 0 147539434 150817303 5894289 6040910 0 799064 153433723 157657277 0 0 132838552 159387432 3626184 3922596 0 0 0 2774121 3027764 139238857 166337792 14194866 -8680515 170703935 169417160 4262110 3844167 166441825 165572993 THE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DENTAL, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG, DENTAL, VISION, AND DEATH BENEFITS ARE SELF-FUNDED. 0 0 THE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DENTAL, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG, DENTAL, VISION, AND DEATH BENEFITS ARE SELF-FUNDED. 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 0 0 0 0 0 0 0 1 0 0 1 9 0 34 1 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BOARD OF TRUSTEES 2015698801 66 GRAND AVENUE ENGLEWOOD NJ 07631 FRANK J RUNEY UNION TRUSTEE (P) 2.00 X 0 135549 0 PETER DEROUEN UNION TRUSTEE 2.00 40.00 X 0 117016 0 MILTON JONES UNION TRUSTEE/CHAIRMAN 5.00 X 0 0 0 GERALDINE SENACK EMPLOYER TRUSTEE/SECRETARY 2.00 X 0 0 0 MICHELLE LEWIS EMPLOYER TRUSTEE (P) 2.00 X 0 0 0 JOHN PEPE EMPLOYER TRUSTEE 2.00 X 0 0 0 DAVID PIERCE EMPLOYER TRUSTEE 2.00 X 0 0 0 JEFF SPARFVEN EMPLOYER TRUSTEE 2.00 X 0 0 0 BOB BLAIR UNION TRUSTEE 2.00 X 0 0 0 JAMES BLAU UNION TRUSTEE 2.00 X 0 0 0 GLENN DIBIASI FUND ADMINISTRATOR 40.00 X 328104 0 46296 BRENDA GARMA ASSOCIATE EXECUTIVE DIRECTOR 40.00 X 132800 0 37099 460904 252565 83395 2 0 1 0 HORIZON BLUE CROSS BLUE SHIELD 3 PENN PLAZA EAST PP-04K NEWARK NJ 07105 CLAIMS ADMINISTRATION 3347443 EMPIRX HEALTH LLC 155 CHESTNUT RIDGE RD SUITE 103 MONTVALE NJ 07645 CLAIMS ADMINISTRATION 1283939 GREEN LIGHT COST MANAGEMENT 17015 N SCOTTSDALE RD SUITE 350 SCOTTSDALE AZ 85255 COST MANAGEMENT 529399 THE SEGAL COMPANY 333 WEST 34TH STREET NEW YORK NY 10001 CONSULTING/ACTUARIAL FEES 438235 CONIFER VALUE BASED CARE LLC 15821 VENTURA BLVD STE 600 ENCINO CA 91436 COST CONTAINMENT 308284 17 EMPLOYER CONTRIBUTIONS 525100 150292510 150292510 PARTICIPANT AND RETIREE CONTRIBUT 525100 332956 332956 MEDICARE PART D REIMB. 525100 191837 191837 150817303 5737189 5737189 16161658 15857937 303721 303721 303721 SETTLEMENT INCOME 525100 799064 799064 799064 157657277 151616367 0 6040910 X 159387432 363091 1965388 353327 1046475 194315 419100 172166 251030 660317 425809 590856 255985 100284 79610 72607 166337792 1677033 1049041 54345930 28589792 2610540 2738749 36466 97731 590816 269527 359081 321289 105361091 128797728 1303978 1173106 5009816 6649724 170703935 169417160 836421 589395 2073670 2038804 1352019 1215968 4262110 3844167 X 0 0 0 0 166441825 165572993 166441825 165572993 170703935 169417160 X -8680515 6466605 1345078 X X 0 1 X 1 0 471362 200357 271005 119454 69170 50284 321289 LEASE LIABILITY 1215968 1215968 X 163872852 6466605 6466605 157406247 251030 251030 157657277 166086762 0 166086762 251030 251030 166337792 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 GLENN DIBIASI FUND ADMINISTRATOR 328104 0 0 0 0 0 21477 0 24819 0 374400 0 0 0 BRENDA GARMA ASSOCIATE EXECUTIVE DIRECTOR 132800 0 0 0 0 0 12280 0 24819 0 169899 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B UFCW NATIONAL HEALTH AND WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT ACCOUNTANT. THE RETURN IS THEN FORWARDED TO THE FUND ADMINISTRATOR FOR INITIAL REVIEW BEFORE BEING PRESENTED TO THE TRUSTEES FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C UFCW NATIONAL HEALTH & WELFARE FUND MONITORS ITS CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF PLAN SERVICE PROVIDERS IS SUBJECT TO APPROVAL OF THE BOARD OF TRUSTEES UNDER THE PLAN'S TRUST AGREEMENTS. PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO A COMPENSATION ARRANGEMENT WILL NOT BE INVOLVED. DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS IS USED. CONTEMPORANEOUS DOCUMENTATION AND RECORDS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT ARE MADE AND KEPT. FORM 990, PART VI, SECTION C, LINE 19 UFCW NATIONAL HEALTH AND WELFARE FUND MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC (MEANING PARTICIPANTS AND BENEFICIARIES OF THE FUND) UPON REQUEST. FORM 990, PART IX, LINE 11G ACTUARY 438,235. OTHER CONSULTING FEES 139,505. MEDICAL ADVISOR 44,000. PAYROLL SERVICE 18,269. TEMP AGENCY 20,308. FORM 990, PART XI, LINE 9: COMPENSATION - RETIREMENT BENEFITS ADJUSTMENT 1,345,078. FORM 990, PART XII, LINE 2C: UFCW NATIONAL HEALTH AND WELFARE FUND'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHO PERFORMS THE AUDIT. 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