2017-02-18T07:17:34-06:00 2016-04-30 350921680 CROWE HORWATH LLP 175 POWDER FOREST DRIVE SIMSBURY CT 06089 990 2015-05-01 042433313 UFCW AND PARTICIPATING EMPLOYERS INTERSTATE HEALTH & WELFARE FUND UNIT 4014354700 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 RICHARD CHARETTE CHAIRMAN 4014354700 2017-02-16 1 Richard Buggy P00512316 8606789200 2015 2021-01-29 14:40:06Z 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 77602383 0 X N/A X 1967 RI TO PROVIDE MEDICAL, DENTAL, LIFE, ACCIDENT AND SICK BENEFITS TO ELIGIBLE PARTCIPANTS. 6 0 0 0 0 0 0 0 66239534 71137790 507250 250191 -31704 0 66715080 71387981 0 0 57872069 59302488 0 0 0 0 0 2771773 5708875 60643842 65011363 6071238 6376618 36985839 44966821 4646759 6334800 32339080 38632021 TO PROVIDE MEDICAL, DENTAL, LIFE, ACCIDENT AND SICK BENEFITS TO ELIGIBLE PARTCIPANTS. 0 0 64661202 71137790 TO OBTAIN AND ADMINISTER THE HEALTH AND WELFARE PROGRAM FOR ALL ELIGIBLE PARTICIPANTS. 64661202 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 X LONDON HEALTH ADMINISTRATORS 4014354700 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 CHRISTINE NICKERSON ALTERNATE TRUSTEE 2.00 X 0 0 0 CYNDIE ESTEVAO ALTERNATE TRUSTEE 2.00 X 0 0 0 DAVID FLEMING RESIGNED 816 TRUSTEE 2.00 X 0 0 0 DOMENIC PONTARELLI ALTERNATE TRUSTEE 2.00 X 0 0 0 GENE DEL ROSARIO ALTERNATE TRUSTEE 2.00 X 0 0 0 JAMES RONAYNE TRUSTEE 2.00 X 0 0 0 JASON PARADIS TRUSTEE 2.00 X 0 0 0 JEFF BOLLEN ALTERNATE TRUSTEE 2.00 X 0 0 0 JOEL BOONE TRUSTEE 2.00 X 0 0 0 RICHARD CHARETTE CHAIRMAN/PROFESSIONAL TRUSTEE 10.00 X 10000 0 0 SUSAN SANVILLE TRUSTEE 2.00 X 0 0 0 TIMOTHY MELIA TRUSTEE 2.00 X 0 0 0 TOM BROWN ALTERNATE TRUSTEE 2.00 X 0 0 0 10000 0 0 0 0 0 0 LONDON HEALTH ADMINISTRATORS 40 COMMERCIAL WAY EAST PROVIDENCE RI 02914 CONTRACT ADMINISTRATOR 2100770 THE SEGAL COMPANY 30 WATERSIDE DRIVE SUITE 300 FARMINGTON CT 06032 ACTUARIAL CONSULTANTS 156286 2 EMPLOYER CONTRIBUTIONS 525100 65438250 65438250 EMPLOYEE CONTRIBUTIONS 525100 5699540 5699540 71137790 353854 353854 6110739 6214402 -103663 -103663 -103663 71387981 71137790 0 250191 59302488 59302488 2100770 2100770 47786 47786 28500 28500 58874 58874 2627376 2627376 45326 45326 REINSURANCE FEE 451968 451968 ACTUARIAL AND CONSULTIN 156286 156286 POSTAGE & PRINTING 127851 127851 INSURANCE 22548 22548 41590 22314 19276 65011363 64661202 350161 0 14517196 22712052 6020076 6034835 333567 329504 14074569 14179217 2040431 1711213 36985839 44966821 172793 115469 14027 4459939 6219331 4646759 6334800 X 0 0 0 0 32339080 38632021 32339080 38632021 36985839 44966821 6376618 -83677 0 X X 0 1 X 1 0 0 U.S. GOVERNMENT SECURITIES 7487917 F MUTUAL FUNDS 3316478 F CORPORATE BONDS 1008713 F MONEY MARKET DEPOSIT ACCOUNT 250000 F COMMON STOCKS 2116109 F 14179217 CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED 5925795 INSURANCE PREMIUMS PAYABLE 293536 6219331 X 71304304 -83677 -83677 71387981 0 71387981 65011363 0 65011363 0 65011363 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. THE FUND ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF APRIL 30, 2016 AND 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FUND ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2013. Form 990, Part VI, Section A, line 3 DAY-TO-DAY MANAGEMENT OF THE FUND IS CONTRACTED TO LONDON HEALTH ADMINISTRATORS, 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 A, line 7a THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 328 AND LOCAL 1445, AS SPONSORING ORGANIZATIONS, HAVE THE AUTHORITY TO APPOINT THREE TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. SIMILARLY, THE STOP & SHOP SUPERMARKET COMPANY, AS A SPONSORING ORGANIZATION AND A PARTICIPATING EMPLOYER, CAN, ON ITS BEHALF AND ON BEHALF OF OTHER CONTRIBUTING EMPLOYERS, APPOINT THREE TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. Form 990, Part VI, Section B, line 11 FORM 990 IS REVIEWED BY THE BOARD AND APPROVED AND ACCEPTED AT THE FIRST BOARD MEETING SUBSEQUENT TO THE PREPARATION AND FILING OF THE RETURN. 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 AS REQUIRED BY ERISA AND MAKES AVAILABLE TO ITS PARTICIPANTS, UPON REQUEST, ANY OTHER GOVERNING DOCUMENTS OR POLICIES AS REQUIRED BY ERISA AND THE INTERNAL REVENUE SERVICE. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT AUDITING FIRM AND IS RESPONSIBLE FOR THE OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT PROCESS. THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR IN HOW THESE RESPONSIBILITIES ARE ADMINISTERED. UFCW LOCAL UNION NO 1445 30 STERGIS WAY DEDHAM MA 02026 041768085 LABOR UNION MA 501(c)(5) NO 0 UFCW LOCAL UNION NO 328 278 SILVER SPRING STREET PROVIDENCE RI 02904 050227658 LABOR UNION RI 501(c)(5) NO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0