2024-05-29T10:42:39-05:00 2023-09-30 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2022-10-01 221458594 UFCW NATIONAL HEALTH AND WELFARE FUND UFCW 2015698801 66 GRAND AVENUE ENGLEWOOD NJ 07631 GEORGE J ORLANDO TRUSTEE 2015698801 2024-05-29 1 GEORGE ORLANDO 999009999 0 LOUIS VERZELLA CPA P00360279 6106689400 2024-05-29 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GEORGE J ORLANDO 66 GRAND AVENUE ENGLEWOOD NJ 07631 163596365 0 X N/A X 1947 NJ THE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG AND DEATH BENEFITS ARE SELF-FUNDED. 8 8 32 0 0 0 0 0 148407271 146488263 2710548 4528020 0 0 151117819 151016283 0 0 142242080 121973719 3109276 3241212 0 0 0 2221108 2321551 147572464 127536482 3545355 23479801 113084722 141621766 3030512 3075311 110054210 138546455 THE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG AND DEATH BENEFITS ARE SELF-FUNDED. 0 0 THE FUND PROVIDES MEDICAL, HOSPITAL, PRESCRIPTION DRUGS, DEATH AND VISION BENEFITS FOR MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 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 1 0 0 1 15 0 32 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 TRUSTEE 2.00 X 0 125891 0 GEORGE J ORLANDO TRUSTEE-CHAIRMAN 5.00 X 0 0 0 GERALDINE SENACK TRUSTEE 2.00 X 0 0 0 JAMES BLAU TRUSTEE 2.00 X 0 0 0 JOHN PEPE TRUSTEE 2.00 X 0 0 0 MICHELLE LEWIS TRUSTEE 2.00 X 0 0 0 BOB BLAIR TRUSTEE 2.00 X 0 0 0 REBECCA REED TRUSTEE 2.00 X 0 0 0 GLENN DIBIASI FUND ADMINISTRATOR 40.00 X 280463 0 42225 BRENDA GARMA ASSOCIATE EXECUTIVE DIRECTOR 40.00 X 120327 0 42188 400790 125891 84413 2 0 1 0 HORIZON BLUE CROSS BLUE SHIELD 3 PENN PLAZA EAST PP-04K NEWARK NJ 07105 CLAIMS ADMINISTRATION 2875596 EMPIRX HEALTH LLC 155 CHESTNUT RIDGE RD SUITE 103 MONTVALE NJ 07645 CLAIMS ADMINISTRATION 2643398 THE SEGAL COMPANY 333 WEST 34TH STREET NEW YORK NY 10001 CONSULTING/ACTUARIAL FEES 364183 CONIFER VALUE BASED CARE LLC 15821 VENTURA BLVD STE 600 ENCINO CA 91436 COST CONTAINMENT 323533 HEALTHSMART CARE MGMT SOLUTION 222 WEST LAS COLINAS BOULEVARD STE IRVING TX 75039 HEALTH CARE MANAGEMENT 211204 12 EMPLOYER CONTRIBUTIONS 525100 145586120 145586120 PARTICIPANT AND RETIREE CONTRIBUT 525100 635174 635174 MEDICARE PART D REIMB. 525100 266969 266969 146488263 4344604 4344604 12763498 12580082 183416 183416 183416 151016283 146488263 0 4528020 121973719 343283 1614857 304617 829215 149240 224078 141051 179955 595409 430200 327661 228960 56032 60945 60966 TEMPORARY STAFF 16294 127536482 2952175 992584 24102495 41444951 940594 4143272 53940 35218 489269 117662 263508 371607 81116133 88307287 1430841 3655877 4896006 113084722 141621766 682083 806760 2317551 830494 30878 1438057 3030512 3075311 X 0 0 0 0 110054210 138546455 110054210 138546455 113084722 141621766 X 23479801 3924250 1088194 X X 0 1 X 1 0 413108 63944 349164 76161 53718 22443 371607 LEASE LIABILITY 1438057 1438057 X 154760578 3924250 3924250 150836328 179955 179955 151016283 127356527 0 127356527 179955 179955 127536482 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 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 280463 0 0 0 0 0 21013 0 21212 0 322688 0 0 0 BRENDA GARMA ASSOCIATE EXECUTIVE DIRECTOR 120327 0 0 0 0 0 20976 0 21212 0 162515 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 CONLFICT 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 REORDS 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, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: COMPENSATION - RETIREMENT BENEFITS ADJUSTMENT 1,088,194. 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 SELECTION OF THE INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT. 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