2015-11-03T07:41:34-06:00 2014-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2014-01-01 135521921 LAUNDRY DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND WORKERS UNITED AMAL 9143675000 333 WESTCHESTER AVENUE WHITE PLAINS NY 106042910 MICHAEL POTACK TRUSTEE 9143675000 2015-11-03 1 LOUIS VERZELLA CPA P00360279 6106689400 2015-10-29 2014 2016-04-25 22:37:26Z MICHAEL POTACK 275 7TH AVENUE NEW YORK NY 10001 18264165 0 X N/A X 1946 NY VEBA HEALTH FUND PROVIDING HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 3 4 0 0 0 0 0 14912656 16846493 109123 50828 0 0 15021779 16897321 0 0 12339435 12243128 244453 224795 0 0 0 2436966 2587729 15020854 15055652 925 1841669 13395048 15955656 411044 534732 12984004 15420924 TO PROVIDE MEDICAL, HOSPITALIZATION, DENTAL, VISION AND PRESCRITION BENEFITS PAID TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 MEDICAL, HOSPITALIZATION, DENTAL, VISION AND PRESCRITION BENEFITS PAID TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 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 1 287 0 4 1 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 0 0 0 X FUND OFFICE 9143675000 333 WESTCHESTER AVENUE WHITE PLAINS NY 106042910 ALBERTO ARROYO TRUSTEE 1.00 X 0 84042 0 MICHAEL POTACK TRUSTEE 1.00 X 0 0 0 STANLEY ISRAEL ESQ TRUSTEE 1.00 X 0 0 0 BRIAN SANTONELLO TRUSTEE 1.00 X 0 0 0 WILFREDO LARANCUENT TRUSTEE 1.00 X 0 134720 0 CHRISTINE KERBER TRUSTEE 1.00 X 0 170373 0 0 389135 0 0 0 1 0 ALICARE INC 333 WESTCHESTER AVENUE WHITE PLAINS NY 10604 ADMINISTRATIVE SERVICES 1809269 ANTHEM BLUE CROSS BLUE SHIELD ONE LIBERTY PLAZA NEW YORK NY 10006 CLAIM PROCESSING FEE 570219 SCHULTE ROTH & ZABEL LLP 919 THIRD AVENUE NEW YORK NY 10022 LEGAL 175074 3 EMPLOYER CONTRIBUTIONS 525100 16809193 16809193 SHARED EXPENSE REIMBURSEMENTS 525100 27700 27700 MEMBER CONTRIBUTIONS 525100 9600 9600 16846493 62743 62743 1354929 1366844 -11915 -11915 -11915 16897321 16834578 0 62743 X 12243128 130197 20831 57983 15784 181288 32626 125059 1803750 64782 62671 6589 415 629 21544 FEES MANDATED BY THE AF 260776 ALLOCATED PAYROLL AND C 27600 15055652 250 250 787054 1342282 1399624 1563396 77109 20925 16880 16880 629 0 3037835 3802588 7686114 8934585 406433 291630 13395048 15955656 216380 133322 194664 401410 411044 534732 X 0 0 0 0 12984004 15420924 12984004 15420924 13395048 15955656 1841669 595251 0 X X 0 1 X 1 0 16880 16880 0 0 HEDGE FUND OF FUNDS - DIVERSIFIED 4298499 F COMMON COLLECTIVE TRUST 4636086 F 8934585 DUE TO RELATED ENTITIES 27600 CASH OVERDRAFT 97973 DUE TO ALICO 300 OBLIGATION TO DISTRIBUTE CONTRIBUTIONS TO RELATED PARTIES 14761 FEES MANDATED BY THE AFFORDABLE CARE ACT 260776 401410 X 17339813 595251 595251 16744562 125059 27700 152759 16897321 14902893 0 14902893 125059 27700 152759 15055652 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN 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 PLAN 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 XI, LINE 4B - OTHER ADJUSTMENTS: SHARED REIMBURSED EXPENSES 27,700. PART XII, LINE 4B - OTHER ADJUSTMENTS: SHARED REIMBURSED EXPENSES 27,700. 0 0 0 CHRISTINE KERBER TRUSTEE 0 170373 0 0 0 0 0 0 0 0 0 170373 0 0 FORM 990, PART VI, SECTION B, LINE 11 LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND, WORKERS UNITED'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT WHO THEN FORWARDS THE COMPLETED RETURN TO THE BOARD OF TRUSTEES FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND, WORKERS UNITED MONITORS ITS CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND, WORKERS UNITED'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII ALBERTO ARROYO - 18 WASHINGTON PLACE, 3RD FLR, NEWARK, NJ 07102. MICHAEL POTACK - 401 SOUTH MACQUESTEN PARKWAY, MOUNT VERNON, NY 10550. STANLEY ISRAEL, ESQ - 50-35 56TH ROAD, MASPETH, NY 11378. BRIAN SANTONELLO - 1100 6TH AVENUE, NEPTUNE, NJ 07753. WILFREDO LARANCUENT - 18 WASHINGTON PLACE, 3RD FLR, NEWARK, NJ 07102. CHRISTINE KERBER - 18 WASHINGTON PLACE, 3RD FLR, NEWARK, NJ 07102. FORM 990, PART IX, LINE 11G ACTUARY 99,505. ADMINISTRATIVE FEES 1,704,245. FORM 990, PART XII, LINE 2C: LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND,WORKERS UNITED BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT WHO PERFORMED THE AUDIT. 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