U F C W UNIONS & EMPLOYERS MIDWEST HEALTH BENEFITS FUND: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
U F C W UNIONS & EMPLOYERS MIDWEST HEALTH BENEFITS FUND (EIN 36-2440523)
Tax period
2013-12-01 to 2014-11-30
Filed
2015-05-13
IRS object ID
201541339349302539
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-13T12:09:05-05:00ReturnTs
Tax Period End2014-11-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN320043599PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LEGACY PROFESSIONALS LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1311 S WACKER DRIVE STE 4000AddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-12-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362440523EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1U F C W UNIONS & EMPLOYERS MIDWESTBusinessNameLine1
Business Name Line2HEALTH BENEFITS FUNDBusinessNameLine2
FieldValueIRS element (for citing)
Business Name ControlUFCWBusinessNameControlTxt
Phone8473847000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WEST HIGGINS ROAD NO 500AddressLine1
CityROSEMONTCity
StateILState
ZIP Code60018ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROBERT NIKSAPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone8473847000PhoneNum
Signature2015-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCRAIG RESCHPreparerPersonNm
PTINP00844633PTIN
Phone3123680500PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROBERT NIKSAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WEST HIGGINS ROAD NO 500AddressLine1
CityROSEMONTCity
StateILState
ZIP Code60018ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$72,627,546GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.UFCWMIDWEST.ORGWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1960FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH BENEFITSActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee84TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$69,837,397PYProgramServiceRevenueAmt
CY Program Service Revenue$41,415,320CYProgramServiceRevenueAmt
PY Investment Income$599,464PYInvestmentIncomeAmt
CY Investment Income$385,370CYInvestmentIncomeAmt
PY Other Revenue$24,937PYOtherRevenueAmt
CY Other Revenue$71,309CYOtherRevenueAmt
PY Total Revenue$70,461,798PYTotalRevenueAmt
CY Total Revenue$41,871,999CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$59,533,791PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$45,306,432CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,695,256PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,880,988CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,717,145PYOtherExpensesAmt
CY Other Expenses$2,293,076CYOtherExpensesAmt
PY Total Expenses$68,946,192PYTotalExpensesAmt
CY Total Expenses$53,480,496CYTotalExpensesAmt
PY Revenues Less Expenses$1,515,606PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$11,608,497CYRevenuesLessExpensesAmt
Total Assets BOY$44,988,980TotalAssetsBOYAmt
Total Assets EOY$33,395,682TotalAssetsEOYAmt
Total Liabilities BOY$2,048,890TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,245,184TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$42,940,090NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$32,150,498NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE HEALTH BENEFITSMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE HEALTH CARE, DEATH AND DISABILITY BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1206IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee84EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID MINEAUBusinessNameLine1
FieldValueIRS element (for citing)
Phone8473847000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WEST HIGGINS ROAD SUITE 500AddressLine1
CityROSEMONTCity
StateILState
ZIP Code60018ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRIAN JORDAN
TRUSTEE3.00Yes (X)$0$0$0
KEVIN J BECKERLE
TRUSTEE3.00Yes (X)$0$0$0
KENNETH R BOYD
TRUSTEE3.00Yes (X)$0$172,687$22,17855.00
STEVEN M POWELL
TRUSTEE3.00Yes (X)$0$202,999$20,76740.00
DONALD SCHAPER
TRUSTEE3.00Yes (X)$0$0$00.00
KENNETH URZEDOWSKI
TRUSTEE3.00Yes (X)$0$111,130$18,75140.00
TERRY KRAMER
TRUSTEE - PAST3.00Yes (X)$0$152,701$19,58245.00
BRYAN SMITH
TRUSTEE - PAST3.00Yes (X)$0$0$0
ROBERT NIKSA
ADMINISTRATOR40.00$0$0$0Yes (X)
DANIEL W RYAN
ASSISTANT ADMINISTRATOR40.00$165,461$0$156,532Yes (X)
JOSEPH R CALI
FINANCIAL DIRECTOR - PAST40.00$137,968$0$26,200Yes (X)
MICHAEL T WILCHER
ASSISTANT ADMINISTRATOR - PAST40.00$116,553$0$11,502Yes (X)
ANNETTE DIFINO
CLAIMS SUPERVISOR - PAST40.00$102,130$0$82,479Yes (X)
CHRISTINE KLUK CAPONIGRI
HEALTH SERVICES SUPERVISOR40.00$101,853$0$34,551Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$623,965TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$639,517TotReportableCompRltdOrgAmt
Total Other Compensation$392,542TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
BLUE CROSS BLUE SHIELD
300 EAST RANDOLPH STCHICAGOIL60601PPO PROVIDER$2,672,998
LEGACY PROFESSIONALS LLP
311 SOUTH WACKER STE 4000CHICAGOIL60606AUDITOR$249,312
THE SEGAL COMPANY
PO BOX 4092 CHURCH STREET STATIONNEW YORKNY10261ACTUARY$231,498
MEDICAL INSURANCE CONSULTING GROUP INC
4949 N WESTERN AVENUECHICAGOIL60625MEDICAL CONSULTANT$180,022
CATAMARAN
1600 MCCONNOR PARKWAYSCHAUMBURGIL60173PHARMACY BENEFIT MANAGER$147,108
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$36,311,547$36,311,547
REIMB EXP UFCW MW PENSION900099$2,480,387$2,480,387
PARTICIPANT CONTRIBUTIONS900099$1,666,400$1,666,400
PRESCRIPTION DRUG REBATES900099$569,282$569,282
REIMB EXPS UFCW CALUMET FUND900099$338,204$338,204

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,500TotalRevenueColumnAmt
Related Or Exempt Func Income$49,500RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$41,415,320TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$673,648TotalRevenueColumnAmt
Exclusion$673,648ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$30,467,269SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$30,755,547SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$288,278SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$288,278TotalRevenueColumnAmt
Exclusion-$288,278ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CLASS ACTION RECOVERY900099$61,580$61,580
MISCELLANEOUS INCOME900099$9,729$9,729
FieldValueIRS element (for citing)
Other Revenue Total$71,309OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$41,871,999TotalRevenueColumnAmt
Related Or Exempt Func Income$41,415,320RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$456,679ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$45,306,432TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$208,307TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,940,071TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$721,259TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$694,967TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$316,384TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$84,802TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$110,966TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$100,958TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$312,421TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$250,359TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$148,941TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$385,147TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$399TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$36,840TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$212,843TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$119,390TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
FEES MANDATED BY ACA$368,257
OTHER PERSONNEL COSTS$71,329
WEB CLAIMS SERVICE FEE$47,628
STORAGE OF DOCUMENTS$42,796

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$53,480,496TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$306,170BOYAmt
EOY$392,082EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,384,405BOYAmt
EOY$1,668,687EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,089,310BOYAmt
EOY$2,902,330EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$76,511BOYAmt
EOY$84,109EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$669,634LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$351,840LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$343,277BOYAmt
EOY$317,794EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$32,558,259BOYAmt
EOY$28,030,680EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$231,048BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$44,988,980BOYAmt
EOY$33,395,682EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$331,801BOYAmt
EOY$753,516EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,717,089BOYAmt
EOY$491,668EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,048,890BOYAmt
EOY$1,245,184EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$42,940,090BOYAmt
EOY$32,150,498EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$42,940,090BOYAmt
EOY$32,150,498EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$44,988,980BOYAmt
EOY$33,395,682EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$11,608,497ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$818,905NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$669,634OtherCostOrOtherBasisAmt
Depreciation$351,840DepreciationAmt
Book Value$317,794BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$317,794TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DUE TO PARTICIPANTS OF DEFERRED COMPENSATION PLANS$281,924
MAINTENANCE OF RESERVE POLICY REFUNDS$25,582
DUE TO BROKER$25,851
DEFERRED LEASE INCENTIVE$158,311
FieldValueIRS element (for citing)
Total Liability$491,668TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$40,109,559TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$818,905NetUnrealizedGainsInvstAmt
Revenue Not Reported$818,905RevenueNotReportedAmt
Revenue Subtotal$39,290,654RevenueSubtotalAmt
Investment Expenses Not Incld$100,958InvestmentExpensesNotIncldAmt
Other Revenues Not Included$2,480,387OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,581,345RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$41,871,999TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$50,899,151TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$50,899,151ExpensesSubtotalAmt
Investment Expenses Not Incld2$100,958InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$2,480,387OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,581,345ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$53,480,496TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:REIMBURSED ADMIN EXPENSE - UFCW PENSION FUND 2,480,387.
PART XII, LINE 4B - OTHER ADJUSTMENTS:REIMBURSED ADMIN EXPENSE - UFCW PENSION FUND 2,480,387.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KENNETH R BOYD
TRUSTEE$0$172,687$0$0$0$0$0$6,586$0$15,592$0$194,865$0$0
STEVEN M POWELL
TRUSTEE$0$195,568$0$7,431$0$0$0$6,970$0$13,797$0$223,766$0$0
TERRY KRAMER
TRUSTEE - PAST$0$152,701$0$0$0$0$0$6,186$0$13,396$0$172,283$0$0
DANIEL W RYAN
ASSISTANT ADMINISTRATOR$165,461$0$0$0$0$0$147,128$0$9,404$0$321,993$0$0$0
JOSEPH R CALI
FINANCIAL DIRECTOR - PAST$137,968$0$0$0$0$0$16,796$0$9,404$0$164,168$0$0$0
ANNETTE DIFINO
CLAIMS SUPERVISOR - PAST$102,130$0$0$0$0$0$73,075$0$9,404$0$184,609$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINES 4A-BANNETTE DIFINO RECEIVED A SEVERANCE PACKAGE AT THE TIME OF HER RETIREMENT FROM THE UFCW UNIONS & EMPLOYERS MIDWEST HEALTH BENEFITS FUND. THE PACKAGE INCLUDED 15 WEEKS OF REGULAR PAY ALONG WITH CONTINUING HEALTH BENEFITS. THE SEVERANCE BENEFITS PAID IN 2014 TOTALED $27,958.65.
PART I, LINES 4A-BDAN W. RYAN ELECTED TO DEFER A PORTION OF HIS SALARY TO THE DEFERRED COMPENSATION PLAN ESTABLISHED UNDER SECTION 457(F) OF THE IRS CODE.
FORM 990, SCHEDULE J, PART II, COLUMN C:RETIREMENT AND OTHER DEFERRED COMPENSATION INCLUDES THE INCREASE IN THE PRESENT VALUE OF A DEFINED BENEFIT PENSION PLAN FOR DANIEL W. RYAN, JOSEPH R. CALI, AND ANNETTE DIFINO AS DETERMINED BY THE FUND'S ACTUARY.
FORM 990, SCHEDULE J, PART II, COLUMN D:NON-TAXABLE BENEFITS INCLUDE THE VALUE OF HEALTH AND WELFARE PREMIUMS PAID ON BEHALF OF THE INDIVIDUALS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8BTHE PLAN DOES NOT HAVE ANY SEPARATE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL BEFORE IT IS SIGNED AND FILED.
FORM 990, PART VI, SECTION B, LINE 15ASALARIES ARE ANNUALLY REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE FUND OFFICE.
FORM 990, PART VII, SECTION A:IN JUNE OF 2014, ROBERT NIKSA WAS HIRED AS THE FULL TIME FUND ADMINISTRATOR AND DANIEL RYAN WAS NAMED AS THE ASSISTANT ADMINISTRATOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
UNITED FOOD & COMMERICAL WORKERS & EMPRS MIDWEST PENSION FUND
9801 WEST HIGGINS ROADROSEMONTIL60018366508328RETIREMENT BENEFITS FOR ELIGIBLE PARTICIPANTSIL501(A)N/A0
UNITED FOOD & COMMERCIAL WORKERS & EMPLOYERS MIDWEST HEALTH BENEFITS FUND
CONTRIBUTING EMPLOYER0
UNITED FOOD & COMMERICAL WORKERS LOCAL 881
CONTRIBUTING EMPLOYER0
UNITED FOOD & COMMERICAL WORKERS LOCAL 1546
CONTRIBUTING EMPLOYER0
UNITED FOOD & COMMERCIAL WORKERS LOCAL 536
CONTRIBUTING EMPLOYER0
UNITED STEEL WORKERS OF AMERICA LOCAL 6787
CONTRIBUTING EMPLOYER0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (122 entries)

Primary ActivitiesPrimaryActivitiesTxtControlled OrganizationControlledOrganizationInd
A & G LAUNDROMAT
CONTRIBUTING EMPLOYER0
A & J MEATS
CONTRIBUTING EMPLOYER0
ANICHINI BROS INC
CONTRIBUTING EMPLOYER0
ANTON'S FRUIT RANCH & THE BRANCH INC
CONTRIBUTING EMPLOYER0
APPLE MARKET
CONTRIBUTING EMPLOYER0
ARAMARK UNIFORM SERVICES
CONTRIBUTING EMPLOYER0
ARLINGTON GOURMET MARKET (DBA -THURINGER MEATS)
CONTRIBUTING EMPLOYER0
ASCOT MEATS INC
CONTRIBUTING EMPLOYER0
ASHMANN PRESCRIPTIONS PHARMACY INC
CONTRIBUTING EMPLOYER0
ATHENA SCHOOL
CONTRIBUTING EMPLOYER0
AURORA PAC LLC
CONTRIBUTING EMPLOYER0
AURORA REHABILITATON & LIVING CENTER
CONTRIBUTING EMPLOYER0
BAJA SERVICES (DBA - FUN SERVICES)
CONTRIBUTING EMPLOYER0
BASIC HARDWARE CENTER
CONTRIBUTING EMPLOYER0
BAYSIDE TERRACE
CONTRIBUTING EMPLOYER0
BLUE GOOSE STORE
CONTRIBUTING EMPLOYER0
BRIICK MEATS INC
CONTRIBUTING EMPLOYER0
BUEDEL'S FOOD PRODUCTS
CONTRIBUTING EMPLOYER0
BUNGE FOODS
CONTRIBUTING EMPLOYER0
BURGESS SQUARE HEALTHCARE & REHAB CENTRE LLC
CONTRIBUTING EMPLOYER0
C & F PACKING COMPANY
CONTRIBUTING EMPLOYER0
CP MEAT MARKET
CONTRIBUTING EMPLOYER0
CENTRAL MARKET
CONTRIBUTING EMPLOYER0
CERTIFIED WAREHOUSE FOODS
CONTRIBUTING EMPLOYER0
CHASE UNIVERSAL SERVICE INC
CONTRIBUTING EMPLOYER0
CHIPAIN'S FINER FOODS
CONTRIBUTING EMPLOYER0
CONSUMER'S PACKING
CONTRIBUTING EMPLOYER0
D & D FINER FOODS
CONTRIBUTING EMPLOYER0
D & S INC
CONTRIBUTING EMPLOYER0
D & S MEAT MARKET
CONTRIBUTING EMPLOYER0
DARLING INTERNATIONAL INC
CONTRIBUTING EMPLOYER0
DE VRIES MEAT MARKET
CONTRIBUTING EMPLOYER0
DISCOUNT MEATS
CONTRIBUTING EMPLOYER0
DOMANI CONSTRUCTION & DEVELOPMENT INC
CONTRIBUTING EMPLOYER0
ER SMITH ENTERPRISESINC
CONTRIBUTING EMPLOYER0
EGYPTIAN STATIONERS INC
CONTRIBUTING EMPLOYER0
ELEGANCE IN MEATS INC
CONTRIBUTING EMPLOYER0
EX-CEL CORNED BEEF INC
CONTRIBUTING EMPLOYER0
FARMER'S MARKET INC
CONTRIBUTING EMPLOYER0
FELICIA'S MEAT MARKET DELI & CATERING
CONTRIBUTING EMPLOYER0
FRESH LINE FOODS
CONTRIBUTING EMPLOYER0
GENE'S TIRE SERVICE INC
CONTRIBUTING EMPLOYER0
GEPPERTH'S MARKET
CONTRIBUTING EMPLOYER0
GILLMORES CORNER MARKET
CONTRIBUTING EMPLOYER0
GLENVIEW GOURMET MEATS (DBA - REAGAN MEATS)
CONTRIBUTING EMPLOYER0
GREAT WESTERN BEEF
CONTRIBUTING EMPLOYER0
HADDAD'S MARKET
CONTRIBUTING EMPLOYER0
HAPPY FOODS INC
CONTRIBUTING EMPLOYER0
HARI LLC (DBA - ILLINOIS VALLEY FOODS)
CONTRIBUTING EMPLOYER0
HARMON'S FOODS
CONTRIBUTING EMPLOYER0
HOLZKOPF'S MEAT MARKET LLC
CONTRIBUTING EMPLOYER0
HOME FURNITURE LLC
CONTRIBUTING EMPLOYER0
HONEY BAKED HAM
CONTRIBUTING EMPLOYER0
ILLINOIS FOOD RETAILERS ASSOCIATION
CONTRIBUTING EMPLOYER0
INTERNATIONAL MEAT COMPANY INC
CONTRIBUTING EMPLOYER0
JT AMUSEMENTS LTD
CONTRIBUTING EMPLOYER0
JACK & PAT'S CERTIFIED INC
CONTRIBUTING EMPLOYER0
JERRY'S QUALITY MEATS
CONTRIBUTING EMPLOYER0
JOHNNY G'S QUALITY MEATS
CONTRIBUTING EMPLOYER0
JONDEB CORPORATION (DBA - PAN'S FOOD CENTER)
CONTRIBUTING EMPLOYER0
K & S WHOLESALE MEATS INC
CONTRIBUTING EMPLOYER0
KINGDOM FARMS WHOLESALE MEATS INC
CONTRIBUTING EMPLOYER0
KRAMER FOODS
CONTRIBUTING EMPLOYER0
LAKE AREA UNITED WAY
CONTRIBUTING EMPLOYER0
LUESSE GROCERIES INC (DBA - LEROY'S A & J MARKET)
CONTRIBUTING EMPLOYER0
M & K FOODS (DBA - SEVEN ELEVEN)
CONTRIBUTING EMPLOYER0
MARCO CONSULTING GROUP
CONTRIBUTING EMPLOYER0
MARIO'S BUTCHER SHOP
CONTRIBUTING EMPLOYER0
MAXON SHOOTERS SUPPLIES INC
CONTRIBUTING EMPLOYER0
MC CHESNEY & MILLER
CONTRIBUTING EMPLOYER0
MIKE'S MEAT MARKET (DBA - CASEY'S FOODS & MARKET)
CONTRIBUTING EMPLOYER0
MILLER GROCERY MARKET LLC (DBA - MILLER K MARKETS)
CONTRIBUTING EMPLOYER0
MINELLI DELI & MEATS
CONTRIBUTING EMPLOYER0
MR BEEF
CONTRIBUTING EMPLOYER0
MR CKG INC
CONTRIBUTING EMPLOYER0
MURPHY & ASSOCIATES LTD
CONTRIBUTING EMPLOYER0
NORTHWESTERN INDIANA BUILDING & TRADES COUNCIL
CONTRIBUTING EMPLOYER0
ONE STOP FOOD & LIQUORS
CONTRIBUTING EMPLOYER0
ONE STOP PACEMAKER
CONTRIBUTING EMPLOYER0
ORCHARD PRIME MEATS OF CARY INC
CONTRIBUTING EMPLOYER0
P & V CATERING
CONTRIBUTING EMPLOYER0
PARAMOUNT TRUCK BODY
CONTRIBUTING EMPLOYER0
PARKSHORE MARKET LTD
CONTRIBUTING EMPLOYER0
PAULINA MARKET
CONTRIBUTING EMPLOYER0
PERSONAL CHEF SERVICES
CONTRIBUTING EMPLOYER0
PIATAK MEATS
CONTRIBUTING EMPLOYER0
POTASH BROTHERS
CONTRIBUTING EMPLOYER0
PRIME'N TENDER MEATS
CONTRIBUTING EMPLOYER0
RABER PACKING COMPANY
CONTRIBUTING EMPLOYER0
RIVERSIDE FOODS
CONTRIBUTING EMPLOYER0
RUSSO OF ITALY
CONTRIBUTING EMPLOYER0
RUSSO WHOLESALE
CONTRIBUTING EMPLOYER0
SNN INC (DBA - HOWARD & SONS QUALITY MEATS)
CONTRIBUTING EMPLOYER0
SAFEWAY INC
CONTRIBUTING EMPLOYER0
SALEM VILLAGE NURSING HOME
CONTRIBUTING EMPLOYER0
SAURO & ASSOCIATES INC
CONTRIBUTING EMPLOYER0
SCHWEGEL'S MARKET
CONTRIBUTING EMPLOYER0
SHOELESS JOE'S
CONTRIBUTING EMPLOYER0
SODEXO INC
CONTRIBUTING EMPLOYER0
STEINBACH MEATS
CONTRIBUTING EMPLOYER0
STRACK & VAN TIL
CONTRIBUTING EMPLOYER0
SUNSET FOOD MARTS
CONTRIBUTING EMPLOYER0
SUPERVALUE FOODS
CONTRIBUTING EMPLOYER0
SV CARE LLC (DBA - SOUTHVIEW MANOR NURSING CENTER)
CONTRIBUTING EMPLOYER0
SYMPHONY HEALTHCARE
CONTRIBUTING EMPLOYER0
TED'S AUTO CLINIC INC
CONTRIBUTING EMPLOYER0
TERRACE NURSING HOME
CONTRIBUTING EMPLOYER0
THE CALUMET PROJECT FOR INDUSTRIAL JOBS
CONTRIBUTING EMPLOYER0
THE KROGER COMPANY
CONTRIBUTING EMPLOYER0
THORNTON HEIGHTS TERRACE
CONTRIBUTING EMPLOYER0
TRANSPORT PRODUCTION SYSTEMS (DBA - PTO SERVICES INC)
CONTRIBUTING EMPLOYER0
TREASURE ISLAND
CONTRIBUTING EMPLOYER0
TRISTATE SECURITY OF AMERICA (DBA - HICKORY POINT MALL)
CONTRIBUTING EMPLOYER0
US FOODS (DBA - NEW CITY PACKING COMPANY)
CONTRIBUTING EMPLOYER0
WATSON'S OFFICE SUPPLY
CONTRIBUTING EMPLOYER0
WELCH'S STOP & SHOP
CONTRIBUTING EMPLOYER0
WHEATON MEAT COMPANY
CONTRIBUTING EMPLOYER0
WINSTON'S SAUSAGE
CONTRIBUTING EMPLOYER0
WISE WAY SUPER CENTERS
CONTRIBUTING EMPLOYER0
YESTER YEARS MEAT SHOPPE
CONTRIBUTING EMPLOYER0
ZENITH AMERICAN SOLUTIONS
CONTRIBUTING EMPLOYER0
ZVI FISHBANE INC
CONTRIBUTING EMPLOYER0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
UNITED FOOD AND COMMERICAL WORKERS UNIONS & EMPLOYERS MIDWEST PENSION FUND
N$287,552
UNITED FOOD AND COMMERICAL WORKERS UNIONS & EMPLOYERS MIDWEST PENSION FUND
O$2,192,835
UNITED FOOD AND COMMERICAL WORKERS UNIONS & EMPLOYERS MIDWEST PENSION FUND
Q$2,709,036

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