2018-09-11T06:50:02-05:00 2017-10-31 350921680 CROWE LLP 175 POWDER FOREST DR SIMSBURY CT 06089 990 2016-11-01 222507311 UFCW LOCAL 1459 & CONTRIBUTING EMPLOYERS HEALTH & WELFARE FUND UNIT 4137331197 33 EASTLAND STREET SPRINGFIELD MA 011092348 Tyrone C Housey TRUSTEE 4137331197 2018-09-09 1 Kristin Anderson P01231300 8606789200 71.235.41.73 2018-09-09 10:29:31 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AA421F75DA49A5AC9284B7DC027BEC2634D2411D 2016 2018-06-14 16:35:46Z Tyrone C Housey 33 EASTLAND STREET SPRINGFIELD MA 011092348 11584027 0 X N/A X 1983 MA PROVIDING ELIGIBLE PARTICIPANTS WITH VARIOUS HEALTH AND WELFARE BENEFITS. 4 0 0 4 0 0 0 0 4612159 5165889 72567 173516 0 0 4684726 5339405 0 0 5573878 5874192 0 0 0 0 0 875739 933022 6449617 6807214 -1764891 -1467809 5677753 4369522 1131539 1271952 4546214 3097570 PROVIDING ELIGIBLE PARTICIPANTS WITH VARIOUS EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, PRESCRIPTION, DISABILITY AND LIFE. 0 0 6559696 0 5165889 TO OBTAIN AND ADMINISTER THE HEALTH AND WELFARE PROGRAM FOR ALL ELIGIBLE PARTICIPANTS. 6559696 0 0 0 0 0 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0 X 4 0 1 1 0 0 0 1 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 JOEL A BOONE SECRETARY(ENDING 10/31/17)/TRUSTEE 2.00 40.00 X X 0 0 0 DANIEL P CLIFFORD CHAIRMAN(ENDING 10/31/17)/TRUSTEE 2.00 40.00 X X 0 148956 16599 SUSAN SANVILLE TRUSTEE 2.00 40.00 X 0 0 0 TYRONE C HOUSEY TRUSTEE 2.00 40.00 X 0 106141 15174 0 255097 31773 0 0 1 0 ZENITH AMERICAN SOLUTIONS 33 EASTLAND STREET SPRINGFIELD CT 01109 THIRD PARTY CONTRACT ADMINISTRATOR 438575 CONNECTICUT GENERAL LIFE INSURANCE COTTAGE GROVE ROAD BLOOMFIELD CT 06002 ASO CONTRACT ADMINISTRATOR 151034 2 EMPLOYER CONTRIBUTIONS 525100 4993781 4993781 EMPLOYEE CONTRIBUTIONS 525100 172108 172108 5165889 70828 70828 6347310 6244622 102688 102688 102688 5339405 5165889 0 173516 5874192 5874192 56700 56700 22000 22000 16049 16049 239691 151034 88657 28911 28911 13546 13546 16242 16242 CONTRACT ADMINISTRATOR 438575 438575 MASS. UNCOMPENSATED CAR 57261 57261 WELLNESS PROGRAM 32494 32494 DUES & REGISTRATIONS (I 6140 6140 5413 5413 6807214 6559696 247518 0 630536 1212398 5444 5502 39070 56564 4863191 2751458 139512 343600 5677753 4369522 152373 159042 979166 1112910 1131539 1271952 X 4546214 3097570 0 0 0 0 4546214 3097570 5677753 4369522 -1467809 19165 0 X 0 1 X 1 0 0 STOP LOSS RECOVERABLE 343600 343600 HEALTH CLAIMS PAYABLE 199010 ESTIMATED CLAIMS INCURRED BUT NOT REPORTED 913900 1112910 X 5358570 19165 19165 5339405 0 5339405 6807214 0 6807214 0 6807214 Part X, Line 2: GAAP requires management to evaluate uncertain tax positions taken by the Fund. The financial statement effects of a tax position are recognized when the position is more likely than not, based on the technical merits, to be sustained upon examination by the IRS. The plan administrator has analyzed the tax positions taken by the Fund and has concluded that as of October 31, 2017 and 2016, there are no uncertain positions taken or expected to be taken. The Fund has recognized no interest or penalties related to uncertain tax positions. The Fund is subject to routine audits by taxing jurisdictions. However, there are currently no audits for any tax periods in progress. The plan administrator believes it is no longer subject to tax examinations for years prior to 2014. 0 0 0 DANIEL P CLIFFORD CHAIRMAN(ENDING 10/31/17)/TRUSTEE 0 148956 0 0 0 0 0 0 0 16599 0 165555 0 0 Form 990, Part VI, Section A, line 2 DANIEL CLIFFORD AND TYRONE HOUSEY ARE OFFICERS OF THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 1459, WHICH IS A SPONSORING ORGANIZATION FOR THE UFCW UNION LOCAL 1459 & CONTRIBUTING EMPLOYERS' HEALTH & WELFARE FUND. Form 990, Part VI, Section A, line 3 THE ORGANIZATION CONTRACTS WITH ZENITH AMERICAN SOLUTIONS, AN INDEPENDENT THIRD PARTY ADMINISTRATOR, TO CONDUCT THE DAY-TO-DAY OPERATIONS OF THE FUND. ZENITH AMERICAN SOLUTIONS IS ENGAGED BY AND REPORTS DIRECTLY TO THE BOARD OF TRUSTEES. Form 990, Part VI, Section A, line 7a AS A SPONSORING ORGANIZATION, THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 1459 HAS THE AUTHORITY TO APPOINT TWO TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. SIMILARLY, AS A SPONSORING ORGANIZATION AND A PARTICIPATING EMPLOYER, THE STOP & SHOP SUPERMARKET COMPANY HAS THE AUTHORITY TO APPOINT TWO TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. Form 990, Part VI, Section B, line 11b THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AND APPROVED AT THE FIRST BOARD MEETING SUBSEQUENT TO THE PREPARATION OF THE RETURN. 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 B, line 15 DAY-TO-DAY MANAGEMENT OF THE FUND IS CONTRACTED TO ZENITH AMERICAN SOLUTIONS, A THIRD PARTY CONTRACT ADMINISTRATOR. CONTRACTUAL TERMS AND CONDITIONS ARE EVALUATED AND NEGOTIATED BY THE BOARD ON AN ANNUAL BASIS. 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 BENEFITS OFFICE. 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 and Contributing Employers' HEALTH AND WELFARE FUND 33 EASTLAND STREET SPRINGFIELD MA 01109 222507311 MULTIEMPLOYER HEALTH AND WELFARE FUND MA 501(c)(9) N/A 0 UFCW Local 1459 The Stop & Shop Supermarket Co Inc Veterans Facility Services First Student Inc Work Opportunity Center Inc Valley Area Transit Five Star Transportation Durham School Services AFCO Sports Management LLC Whitsons 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 FORM 990, SCHEDULE R, PART V THE FILING ORGANIZATION SHARES OFFICE SPACE WITH TWO RELATED BUT INDEPENDENT MULTIEMPLOYER BENEFIT FUNDS, AND UTILIZES THE SAME THIRD PARTY ADMINISTRATOR. EACH ORGANIZATION IS CHARGED FOR AND PAYS ALL OF ITS OWN COSTS. IN ADDITION, THE FILING ORGANIZATION HAS LISTED EACH OF THE CONTRIBUTING EMPLOYERS IN PARTS II AND IV. PER THE IRS INSTRUCTIONS, ONLY THE NAME OF THE CONTRIBUTING EMPLOYER IS REQUIRED TO BE REPORTED.