2021-10-28T14:43:50-05:00 2020-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2020-11-01 222507311 UFCW LOCAL 1459 & CONTRIBUTING EMPLOYERS HEALTH & WELFARE FUND UNIT 4137331197 33 EASTLAND STREET SPRINGFIELD MA 011092348 JEFFREY JONES TRUSTEE 4137331197 2021-10-28 1 JEFFREY JONES 999009999 LOUIS VERZELLA CPA P00360279 6106689400 2021-10-28 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z X JEFFREY JONES 33 EASTLAND STREET SPRINGFIELD MA 011092348 1390170 0 X N/A X 1983 MA PROVIDING ELIGIBLE PARTICIPANTS WITH VARIOUS HEALTH & WELFARE BENEFITS X 4 2 0 0 0 0 0 0 7393235 1331315 6832 6012 191047 52843 7591114 1390170 0 0 5820382 217858 0 0 0 0 0 1210817 208004 7031199 425862 559915 964308 4788614 0 994608 0 3794006 0 PROVIDING ELIGIBLE PARTICIPANTS WITH VARIOUS EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, PRESCRIPTION, DISABILITY AND LIFE. 0 0 TO OBTAIN AND ADMINISTER THE HEALTH AND WELFARE PROGRAM FOR ALL 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 4 2 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 4137331197 33 EASTLAND STREET SPRINGFIELD MA 01109 TYRONE C HOUSEY CHAIRMAN/UNION TRUSTEE 2.00 40.00 X X 0 142703 17850 GENEROSO DEL ROSARIO SECRETARY/MANAGEMENT TRUST 2.00 X 0 0 0 JEFFERY W JONES UNION TRUSTEE 2.00 40.00 X 0 96828 17850 CHRISTA KRAMER MANAGEMENT TRUSTEE 2.00 X 0 0 0 0 239531 35700 0 0 1 0 0 PARTICIPATING EMPLOYER 900099 1266558 1266558 PARTICIPANTS 900099 64757 64757 1331315 6012 6012 PRESCRIPTION REBATES 900099 48119 48119 STOP LOSS REIMBURSEMEN 900099 4724 4724 52843 1390170 1384158 0 6012 X 217858 86771 30724 14673 51025 525 24286 425862 354063 0 4401224 0 0 0 0 0 0 0 8546 0 0 0 0 0 0 24781 0 4788614 0 63808 0 930800 0 994608 0 X 3794006 0 0 0 0 0 3794006 0 4788614 0 X 964308 -4758314 X X 0 1 X 1 0 0 X 1390170 0 1390170 0 1390170 1356662 0 1356662 -930800 -930800 425862 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 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATION -930,800. 0 0 0 TYRONE C HOUSEY CHAIRMAN/UNION TRUSTEE 0 142703 0 0 0 0 0 2915 0 14935 0 160553 0 0 TRANSFER OF NET ASSETS AVAILALABLE FOR BENEFITS DUE TO PLAN MERGER 2020-12-31 4758314 FAIR MARKET VALUE 066069081 UFCW AND PARTICIPATING EMPLOYERS NEW ENGLAND HEALTH FUND 290 POST RD WEST WESTPORT CT 06881 501 C 9 1 0 0 0 0 0 0 0 0 PART I, LINE 2E: PERSON(S) INVOLVED: JEFF JONES PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: TRUSTEE FOR NEW FUND FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATIONS FORM 990 IS PREPARED BY THE INDEPENDENT ACCOUNTANT WHO FORWARDS IT TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REQUIRES ALL TRUSTEES TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY. ANY POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO THE BOARD FOR DISCUSSION AND RESOLUTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, TAX RETURNS AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE BENEFIT OFFICE. FORM 990, PART IX, LINE 11G ACTUARIAL AND CONSULTING 51,025. FORM 990, PART XI, LINE 9: TRANSFER TO UFCW AND PARTICIPATING EMPLOYERS NEW ENGLAND HEALTH FUND -4,758,314. FORM 990. PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED. UFCW LOCAL 1459 AND CONTRIBUTING EMPLOYERS LEGAL BENEFIT FUND 33 EASTLAND STREET SPRINGFIELD MA 01109 222507618 MULTIEMPLOYER LEGAL BENEFIT FUND MA 501(C)(9) N/A 0 UFCW LOCAL 1459 EDUCATION SAFETY & INDUSTRY TRUST FUND 33 EASTLAND STREET SPRINGFIELD MA 01109 522331090 MULTIEMPLOYER EDUCATION & SAFETY FUND MA 501(C)(9) N/A 0 UFCW LOCAL 1459 33 EASTLAND STREET SPRINGFIELD MA 01109 042220774 LABOR UNION MA 501(C)(5) 0 THE STOP & SHOP SUPERMARKET CO INC FIRST STUDENT INC VETERANS FACILITY SERVICES WORK OPPORTUNITY CENTER INC DURHAM SCHOOL SERVICES FIVE STAR TRANSPORTATION VALLEY AREA TRANSIT AFCO SPORTS MANAGEMENT LLC PHOENIX MANAGEMENT INC TRIAD LOGISTICS SERVICES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0