HARMONS EMPLOYEE WELFARE BENEFIT PLAN: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: HARMONS EMPLOYEE WELFARE BENEFIT PLAN (EIN 94-2667827)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-11-14
IRS object ID: 202313189349309806
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-11-14T14:06:28-05:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	870343246	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	SQUIRE & COMPANY PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	215 S STATE ST STE 850	AddressLine1Txt
City	SALT LAKE CITY	CityNm
State Abbreviation	UT	StateAbbreviationCd
ZIP	841112380	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	942667827	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HARMONS EMPLOYEE WELFARE BENEFIT	BusinessNameLine1Txt
Business Name Line2	PLAN TRUST	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	HARM	BusinessNameControlTxt
Phone	8019698261	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3540 SOUTH 4000 WEST	AddressLine1Txt
City	WEST VALLEY CITY	CityNm
State Abbreviation	UT	StateAbbreviationCd
ZIP	84120	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	NICOLE LENGEL	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8019698261	PhoneNum
Signature	2023-11-07	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	NICOLE	PersonFirstNm
Person Last	LENGEL	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (true)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	GREGORY O HYDE CPA	PreparerPersonNm
PTIN	P00641196	PTIN
Phone	8015330409	PhoneNum
Preparation	2023-11-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JUSTIN MANGONE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3540 SOUTH 4000 WEST	AddressLine1Txt
City	WEST VALLEY CITY	CityNm
State Abbreviation	UT	StateAbbreviationCd
ZIP	84120	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$12,259,355	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c	Yes (X)	Organization501cInd
Website Address	HARMONSGROCERY.COM	WebsiteAddressTxt
Type Of Organization Trust	Yes (X)	TypeOfOrganizationTrustInd
Formation	1979	FormationYr
Legal Domicile State	UT	LegalDomicileStateCd
Activity Or Mission	PROVIDE MEDICAL, DENTAL, DISABILITY AND LIFE BENEFITS TO THE EMPLOYEES OF HARMON CITY, INC.	ActivityOrMissionDesc
Voting Members Governing Body	2	VotingMembersGoverningBodyCnt
Voting Members Independent	1	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Gross UBI	$0	TotalGrossUBIAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$11,864,166	PYProgramServiceRevenueAmt
CY Program Service Revenue	$12,253,492	CYProgramServiceRevenueAmt
PY Investment Income	$127	PYInvestmentIncomeAmt
CY Investment Income	$5,863	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$11,864,293	PYTotalRevenueAmt
CY Total Revenue	$12,259,355	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$13,218,788	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$12,840,844	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$12,500	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$12,500	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$802,189	PYOtherExpensesAmt
CY Other Expenses	$810,909	CYOtherExpensesAmt
PY Total Expenses	$14,033,477	PYTotalExpensesAmt
CY Total Expenses	$13,664,253	CYTotalExpensesAmt
PY Revenues Less Expenses	-$2,169,184	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,404,898	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,798,194	TotalAssetsBOYAmt
Total Assets EOY	$1,580,282	TotalAssetsEOYAmt
Total Liabilities BOY	$1,384,635	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,571,621	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,413,559	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,661	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	PROVIDE MEDICAL, DENTAL, DISABILITY AND LIFE BENEFITS TO THE EMPLOYEES OF HARMON CITY, INC.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Desc	PROVIDE MEDICAL, DENTAL, DISABILITY AND LIFE BENEFITS TO THE EMPLOYEES OF HARMON CITY, INC.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Desc	PROVIDE MEDICAL, DENTAL, DISABILITY AND LIFE BENEFITS TO THE EMPLOYEES OF HARMON CITY, INC.	Desc

Field	Value	IRS element (for citing)
Described In Section501c3	false	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	false	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (true)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	false	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	false	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	false	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	2	GoverningBodyVotingMembersCnt
Independent Voting Member	1	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	Yes (true)	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	false	ConflictOfInterestPolicyInd
Whistleblower Policy	false	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HARMON CITY INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8019698261	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3540 S 400 W	AddressLine1Txt
City	WEST VALLEY CITY	CityNm
State Abbreviation	UT	StateAbbreviationCd
ZIP	84120	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Institutional TrusteeInstitutionalTrusteeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
PRINCIPAL GROUP
TRUSTEE	0.10	Yes (X)	$12,500	$0	$0
NICOLE LENGEL
CFO	1.00		$0	$0	$0	Yes (X)
JUSTIN MANGONE
CONTROLLER	1.00		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$12,500	TotalReportableCompFromOrgAmt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SELECTHEALTH
5381 S GREEN STREET	SALT LAKE CITY	UT	84123	ADMIN FEES	$484,642
MERITAIN HEALTH
4246 S RIVERBOAT RD 200	SALT LAKE CITY	UT	84123	ADMIN FEES	$247,974

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	2	CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
EMPLOYER CONTRIBUTIONS	$8,030,681	$8,030,681
EMPLOYEE CONTRIBUTIONS	$4,184,472	$4,184,472
COBRA CONTRIBUTIONS	$38,339	$38,339

Field	Value	IRS element (for citing)
Total Program Service Revenue	$12,253,492	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,863	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,863	RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,259,355	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,863	RelatedOrExemptFuncIncomeAmt
Exclusion	$12,253,492	ExclusionAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$12,840,844	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$12,500	TotalAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Desc	CLAIMS PROCESSING FEES	Desc
Total	$810,909	TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,664,253	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$666,321	BOYAmt
EOY	$219,902	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,131,873	BOYAmt
EOY	$1,335,240	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
EOY	$25,140	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,798,194	BOYAmt
EOY	$1,580,282	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,384,635	BOYAmt
EOY	$1,571,621	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,384,635	BOYAmt
EOY	$1,571,621	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,413,559	BOYAmt
EOY	$8,661	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,413,559	BOYAmt
EOY	$8,661	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,798,194	BOYAmt
EOY	$1,580,282	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$1,404,898	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Total Rev Etc Audited Fincl Stmt	$12,259,355	TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal	$12,259,355	RevenueSubtotalAmt
Total Revenue Per Form990	$12,259,355	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$13,664,253	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$13,664,253	ExpensesSubtotalAmt
Total Expenses Per Form990	$13,664,253	TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4D	PROVIDE MEDICAL, DENTAL, DISABILITY AND LIFE BENEFITS TO THE EMPLOYEES OF HARMON CITY, INC.
FORM 990, PAGE 6, PART VI, LINE 9	PRINCIPAL GROUP 2150 S 1300 E SUITE 300 SALT LAKE CITY, UT 84106
FORM 990, PAGE 6, PART VI, LINE 11B	THE CFO REVIEWS THE FORM 990 AND TIES IT TO THE TRIAL BALANCE. IT IS THEN PRESENTED TO THE GOVERNING BODY FOR APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 19	NO DOCUMENTS AVAILABLE TO THE PUBLIC