2021-10-12T09:38:04-05:00 2020-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2020-05-01 042433313 UFCW AND PARTICIPATING EMPLOYERS INTERSTATE HEALTH & WELFARE FUND RETA 4014354700 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 RICHARD CHARETTE CHAIRMAN 4014354700 2021-10-12 1 RICHARD CHARETTE 999009999 LOUIS VERZELLA CPA P00360279 6106689400 2021-10-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X RICHARD CHARETTE 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 65800968 0 X N/A X 1967 RI TO PROVIDE MEDICAL, DENTAL, VISION, HEARING, PRESCRIPTION, DISABILITY, LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO ELIGIBLE PARTICIPANTS. X 6 0 0 0 0 0 0 0 69307510 49790136 1032194 864862 85266 92636 70424970 50747634 0 0 66195376 37693782 12000 9000 0 0 0 5844736 4483306 72052112 42186088 -1627142 8561546 48104486 0 6150178 0 41954308 0 TO PROVIDE MEDICAL, DENTAL, VISION, HEARING, PRESCRIPTION, DISABILITY, LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, HEARING, PRESCRIPTION, DISABILITY, LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 0 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 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X SARA COTE CO LONDON HEALTH ADMINISTRATORS 4014354700 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 CYNDIE ESTEVAO UNION - ALTERNATE TRUSTEE 2.00 40.00 X 0 137895 28823 DOMENIC PONTARELLI UNION - ALTERNATE TRUSTEE 2.00 40.00 X 0 149086 28823 GENE DEL ROSARIO EMPLOYER - ALTERNATE TRUST 2.00 X 0 0 0 JAMES RONAYNE UNION TRUSTEE 2.00 40.00 X 0 0 0 JASON PARADIS EMPLOYER TRUSTEE 2.00 X 0 0 0 JEFF BOLLEN UNION TRUSTEE (P) 2.00 40.00 X 0 0 0 SUSAN SANVILLE EMPLOYER TRUSTEE 2.00 X 0 0 0 TIMOTHY MELIA UNION TRUSTEE 2.00 40.00 X 0 186548 28823 TOM BROWN UNION - ALTERNATE TRUSTEE (P) 2.00 40.00 X 0 45000 28823 ROBERT SPINELLA EMPLOYER TRUSTEE 2.00 X 0 0 0 CHRISTA KRAMER EMPLOYER - ALTERNATE TRUST 2.00 X 0 0 0 FERNANDO LEMUS UNION TRUSTEE 2.00 X 0 160300 28823 KEVIN MCGAFFIGAN UNION - ALTERNATE TRUSTEE 2.00 X 0 94445 28823 RICHARD CHARETTE CHAIRMAN/PROFESSIONAL TRUS 10.00 X 9000 0 0 9000 773274 172938 0 0 1 0 BLUE CROSSBLUE SHIELD OF RI 500 EXCHANGE STREET PROVIDENCE RI 029032699 CLAIMS ADMINISTRATOR 1881213 LONDON HEALTH ADMINISTRATORS 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 THIRD PARTY ADMINISTRATOR 1428051 THE SEGAL COMPANY 30 WATERSIDE DRIVE -SUITE 300 FARMINGTON CT 06032 CONSULTANT 420663 3 EMPLOYER CONTRIBUTIONS 900099 45430941 45430941 PARTICIPANT AND RETIREE CONTRIBUT 900099 4359195 4359195 49790136 377002 377002 15541194 15053334 487860 487860 487860 BENEFITS RECOVERED 900099 92636 92636 92636 50747634 49882772 0 864862 X 37693782 9000 1428051 124060 39230 49760 2429295 119386 40164 LONG TERM DISABILITY PR 253360 42186088 2549840 0 28741127 0 0 1455627 0 0 0 0 0 0 0 14405179 0 0 0 0 952713 0 48104486 0 164194 5985984 0 6150178 0 X 41954308 0 0 0 0 0 41954308 0 48104486 0 X 8561546 626974 -51142828 X X 0 1 X 1 0 0 X 51324848 626974 626974 50697874 49760 49760 50747634 42375057 238729 238729 42136328 49760 49760 42186088 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE FUND MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND RECOGNIZE A TAX LIABILITY IF THE FUND 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 FUND 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. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN CURRENTLY PAYABLE BENEFIT OBLIGATIONS 238,729. 0 0 0 TIMOTHY MELIA UNION TRUSTEE 0 186548 0 0 0 0 0 16252 0 12571 0 215371 0 0 FERNANDO LEMUS UNION TRUSTEE 0 160300 0 0 0 0 0 16252 0 12571 0 189123 0 0 DOMENIC PONTARELLI UNION - ALTERNATE TRUSTEE 0 149086 0 0 0 0 0 16252 0 12571 0 177909 0 0 CYNDIE ESTEVAO UNION - ALTERNATE TRUSTEE 0 137895 0 0 0 0 0 16252 0 12571 0 166718 0 0 TRANSFER OF NET ASSETS TO PLAN 502 2021-01-01 51142828 FAIR MARKET VALUE 066069081 UFCW & PARTICIPATING EMPLOYERS NEW ENGLAND HEALTH FUND 290 POST ROAD WEST PO BOX 470 WESTPORT CT 068810470 501(C)(9) 1 0 0 0 0 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: CHRISTA KRAMER, FERNANDO LEMUS, TIM MELIA, JASON PARADIS, ROBERT SPINELLA, SUSAN SANVILLE, DOMENIC PONTARELLI AND GENE DEL ROSARIO. PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: BECOME TRUSTEES AND ALTERNATE TRUSTEES OF THE SUCESSOR ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FUND'S FORM 990 IS PREPARED BY THE INDEPENDENT ACCOUNTANT WHO THEN PROVIDES A COPY TO ALL MEMBERS OF THE GOVERNING BODY FOR THEIR APPROVAL AND SIGNATURE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, TRUSTEES, FUND EMPLOYEES AND OTHER INTERESTED PERSONS MUST DISCLOSE THE EXISTENCE OF A FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OF TRUSTEES AND COMMITTEES WITH BOARD OF TRUSTEES' DELEGATED POWERS. CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT AFTER SUCH DISCLOSURE, AND AFTER DISCUSSION WITH THE INTERESTED PERSON, THE BOARD OF TRUSTEES SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE CHAIRPERSON OF THE BOARD OF TRUSTEES SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. IF THE BOARD OF TRUSTEES HAS REASONABLE CAUSE TO BELIEVE A PERSON HAS FAILED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, IT SHALL AFFORD THE PERSON THE OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE, AND IF WARRANTED, TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. THE MINUTES OF THE BOARD OF TRUSTEES SHALL REFLECT ANY DISCLOSABLE OR DISCOVERED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST, AS WELL AS ACTIONS TAKEN REGARDING SUCH MATTERS. FORM 990, PART VI, SECTION C, LINE 19 THE FUND PROVIDES TO EACH OF ITS PARTICIPANTS ON AN ANNUAL BASIS, A SUMMARY OF THE FUND'S FINANCIAL STATUS, AND MAKES AVAILABLE, UPON REQUEST, ANY OTHER GOVERNING DOCUMENTS OR POLICIES AS REQUIRED BY ERISA AND THE INTERNAL REVENUE SERVICE. FORM 990, PART IX, LINE 11G BENEFITS ADMINISTRATION FEES 2,008,632. BENEFITS CONSULTANT 420,663. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS TO UFCW AND PARTICIPATING EMPLOYERS N.E. HEALTH FUND -51,142,828. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED. UFCW LOCAL UNION NO 1445 30 STERGIS WAY DEDHAM MA 02026 041768085 LABOR UNION MA 501(C)(5) 0 UFCW LOCAL UNION NO 328 278 SILVER SPRING STREET PROVIDENCE RI 02904 050227658 LABOR UNION RI 501(C)(5) 0 UFCW AND PARTICIPATING EMPLOYERS NEW ENGLAND HEALTH FUND 290 POST ROAD WEST PO BOX 470 WESTPORT CT 068800470 066069081 WELFARE BENEFITS CT 501(C)(9) 0 STOP AND SHOP COMPANIES INC GORTON'S SEAFOOD BAKER COMMODITIES INC SPORTS SERVICE MEDICAL AND LIFE ROBBINS BEEF COMPANY INC CITY PACKING 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0