2025-07-08T09:47:05-05:00 2024-09-30 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2023-10-01 221458594 UFCW NATIONAL HEALTH AND WELFARE FUND UFCW 2015698801 66 GRAND AVENUE ENGLEWOOD NJ 07631 MILTON JONES TRUSTEE 2015698801 2025-07-08 1 0 LOUIS VERZELLA CPA P00360279 6106689400 2025-07-07 2023 2025-03-06 01:10:19Z MILTON JONES 66 GRAND AVENUE ENGLEWOOD NJ 07631 160854413 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 7 30 0 0 0 0 0 146488263 147539434 4528020 5894289 0 0 151016283 153433723 0 0 121973719 132838552 3241212 3626184 0 0 0 2321551 2774121 127536482 139238857 23479801 14194866 141621766 170703935 3075311 4262110 138546455 166441825 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 10 0 30 1 0 0 0 0 0 0 0 0 X 8 7 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 BOB BLAIR TRUSTEE 2.00 X 0 0 0 FRANK J RUNEY TRUSTEE 2.00 40.00 X 0 130418 0 GEORGE J ORLANDO TRUSTEE-CHAIRMAN (P) 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 REBECCA REED TRUSTEE 2.00 X 0 0 0 MILTON JONES TRUSTEE-CHAIRMAN 5.00 X 0 0 0 GLENN DIBIASI FUND ADMINISTRATOR 40.00 X 295811 0 86074 BRENDA GARMA ASSOCIATE EXECUTIVE DIRECT 40.00 X 125289 0 49175 421100 130418 135249 2 0 1 0 HORIZON BLUE CROSS BLUE SHIELD 3 PENN PLAZA EAST PP-04K NEWARK NJ 07105 CLAIMS ADMINISTRATION 3031793 EMPIRX HEALTH LLC 155 CHESTNUT RIDGE RD SUITE 103 MONTVALE NJ 07645 CLAIMS ADMINISTRATION 1898847 THE SEGAL COMPANY 333 WEST 34TH STREET NEW YORK NY 10001 CONSULTING/ACTUARIAL FEES 378187 GREEN LIGHT COST MANAGEMENT 17015 N SCOTTSDALE RD SUITE 350 SCOTTSDALE AZ 85255 COST MANAGEMENT 367087 CONIFER VALUE BASED CARE LLC 15821 VENTURA BLVD STE 600 ENCINO CA 91436 COST CONTAINMENT 326354 14 EMPLOYER CONTRIBUTIONS 525100 146821321 146821321 PARTICIPANT AND RETIREE CONTRIBUT 525100 441802 441802 MEDICARE PART D REIMB. 525100 276311 276311 147539434 5590769 5590769 7724210 7420690 303520 303520 303520 153433723 147539434 0 5894289 132838552 381885 1902873 231906 932984 176536 316952 139056 242905 736560 395734 392621 246075 72226 72756 59563 TEMPORARY STAFF 99673 139238857 992584 1677033 41444951 54345930 4143272 2610540 35218 36466 549500 190419 371607 359081 88307287 105361091 1430841 1303978 4896006 5009816 141621766 170703935 806760 836421 830494 2073670 1438057 1352019 3075311 4262110 X 0 0 0 0 138546455 166441825 138546455 166441825 141621766 170703935 X 14194866 13636084 64420 X X 0 1 X 1 0 473339 130716 342623 76161 59703 16458 359081 LEASE LIABILITY 1331291 PENDING INVESTMENT TRADES 20728 1352019 X 166826902 13636084 13636084 153190818 242905 242905 153433723 138995952 0 138995952 242905 242905 139238857 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 295811 0 0 0 0 0 63511 0 22563 0 381885 0 0 0 BRENDA GARMA ASSOCIATE EXECUTIVE DIRECT 125289 0 0 0 0 0 26612 0 22563 0 174464 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 XI, LINE 9: COMPENSATION - RETIREMENT BENEFITS ADJUSTMENT 64,420. 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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