UFCW TRI STATE HEALTH & WELFARE FUND: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- UFCW TRI STATE HEALTH & WELFARE FUND (EIN 23-6449794)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201413169349302221
- Schema version
- 2013v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-12T11:09:37-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 222212404 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARATZ & ASSOCIATES PA | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7 EVES DRIVE SUITE 100 | AddressLine1 |
| City | MARLTON | City |
| State | NJ | State |
| ZIP Code | 080533196 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 236449794 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UFCW UNION & PARTICIPATING FOOD IND | BusinessNameLine1 |
| Business Name Line2 | EMPLOYERS TRI-STATE HEALTH-WELFARE | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UFCW | BusinessNameControlTxt |
| Phone | 8567932500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 ROLAND AVENUE | AddressLine1 |
| City | MT LAUREL | City |
| State | NJ | State |
| ZIP Code | 08054 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN STRING | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 8567932500 | PhoneNum |
| Signature | 2014-09-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN FEKETE CPA | PreparerPersonNm |
| PTIN | P00956964 | PTIN |
| Phone | 8569855688 | PhoneNum |
| Preparation | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FRANK VACCARO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 ROLAND AVE | AddressLine1 |
| City | MT LAUREL | City |
| State | NJ | State |
| ZIP Code | 08054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,824,989 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | HEALTH FUND | OtherOrganizationDsc |
| Formation | 1967 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH BENEFITS TO PARTICIPANTS WHOSE EMPLOYERS HAVE ENTERED INTO COLLECTIVE BARGAINING AGREEMENTS WITH VARIOUS LOCAL AFFILIATES OF THE UNITED FOOD AND COMMERCIAL WORKERS UNION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,929,687 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,412,235 | CYProgramServiceRevenueAmt |
| PY Investment Income | $215,210 | PYInvestmentIncomeAmt |
| CY Investment Income | $215,940 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,448 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $36,149,345 | PYTotalRevenueAmt |
| CY Total Revenue | $35,628,175 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $33,851,467 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $35,489,642 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,464,178 | PYOtherExpensesAmt |
| CY Other Expenses | $2,491,956 | CYOtherExpensesAmt |
| PY Total Expenses | $36,315,645 | PYTotalExpensesAmt |
| CY Total Expenses | $37,981,598 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$166,300 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,353,423 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,339,299 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,100,008 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,160,708 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,112,228 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,178,591 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,987,780 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HEALTH BENEFITS TO PARTICIPANTS WHOSE EMPLOYERS HAVE ENTERED INTO COLLECTIVE BARGAINING AGREEMENTS WITH VARIOUS LOCAL AFFILIATES OF THE UNITED FOOD AND COMMERCIAL WORKERS UNION. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Desc | PROVIDED HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TO PROVIDE HEALTH AND RELATED BENEFITS FOR ELIGIBLE PARTICIPANTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 530 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FUND ADMINISTRATOR | PersonNm |
| Phone | 8567932500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 ROLAND AVENUE | AddressLine1 |
| City | MT LAUREL | City |
| State | NJ | State |
| ZIP Code | 08054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| Business Name Line2BusinessName/BusinessNameLine2 | TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DANIEL DOSENBACH | ||||||
| DANIEL DOSENBACH | TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| GREGORY QUAGLIATO | ||||||
| GREGORY QUAGLIATO | TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| DANIEL KONCZYK | ||||||
| DANIEL KONCZYK | TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| BRIAN STRING | ||||||
| BRIAN STRING | TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| TIM TERIFAY | ||||||
| TIM TERIFAY | TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| MITCHELL SCHAFER | ||||||
| MITCHELL SCHAFER | TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| DANA GENTILE | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | Address Line2ContractorAddress/USAddress/AddressLine2 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| TRI-STATE ADMINISTRATORS INC | ||||||
| 27 ROLAND AVE | 27 ROLAND AVE | MT LAUREL | NJ | 08054 | ADMINISTRATIVE | $2,161,974 |
| AMERIHEALTH ADMINISTRATORS | ||||||
| 720 BLAIR MILL RD | 720 BLAIR MILL RD | HORSHAM | PA | 19044 | HEALTH BENEFITS | $437,809 |
| SPEAR WILDERMAN PC | ||||||
| 230 S BROAD ST | 230 S BROAD ST | PHILADELPHIA | PA | 19102 | LEGAL | $196,440 |
| HEALTH MAP INC | ||||||
| 1 CLEMENTS COURT | 1 CLEMENTS COURT | MT LAUREL | NJ | 08054 | STAFFING CO | $188,411 |
| HEALTH PLAN SYSTEMS INC | ||||||
| 1 WOODBRIDGE CENTER STE220 | 1 WOODBRIDGE CENTER STE 220 | WOODBRIDGE TWP | NJ | 07095 | COMPUTER | $170,380 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| EMPLOYER CONTRIBUTIONS | $35,033,857 | $35,033,857 |
| EMPLOYEE CONTRIBUTIONS | $378,378 | $378,378 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,412,235 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $162,754 | TotalRevenueColumnAmt |
| Exclusion | $162,754 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,250,000 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,196,814 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $53,186 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,186 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,186 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,628,175 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,465,421 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $162,754 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,489,642 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,155 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,500 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,951 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,319 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,335 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,795 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt |
|---|---|
| ADMINISTRATOR FEES | $2,087,823 |
| DATA PROCESSING | $123,689 |
| SPECIAL PROJECT FEES | $50,258 |
| NEWSLETTER | $22,881 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,250 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,981,598 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,848,324 | BOYAmt |
| EOY | $3,066,353 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,185,586 | BOYAmt |
| EOY | $2,074,190 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,559 | BOYAmt |
| EOY | $72,264 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $277,543 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $125,853 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,026 | BOYAmt |
| EOY | $151,690 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,777,958 | BOYAmt |
| EOY | $2,906,511 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,266,846 | BOYAmt |
| EOY | $829,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,339,299 | BOYAmt |
| EOY | $9,100,008 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,711 | BOYAmt |
| EOY | $107,106 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,007,997 | BOYAmt |
| EOY | $7,005,122 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,160,708 | BOYAmt |
| EOY | $7,112,228 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,178,591 | BOYAmt |
| EOY | $1,987,780 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,178,591 | BOYAmt |
| EOY | $1,987,780 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,339,299 | BOYAmt |
| EOY | $9,100,008 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,353,423 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $162,612 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $277,543 | OtherCostOrOtherBasisAmt |
| Depreciation | $125,853 | DepreciationAmt |
| Book Value | $151,690 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $151,690 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BLUE CROSS DEPOSIT | Desc |
| Book Value | $829,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $829,000 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCRUED BENEFIT LIABILITIES | Desc |
| Amt | $7,005,122 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,005,122 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $35,782,787 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $162,612 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $162,612 | RevenueNotReportedAmt |
| Revenue Subtotal | $35,620,175 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $8,000 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $8,000 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $35,628,175 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $38,976,473 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $38,976,473 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $8,000 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | -$1,002,875 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$994,875 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $37,981,598 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XII, LINE 4B | FormAndLineReferenceDesc |
| Explanation | BENEFITS PAYABLE ADJUSTMENT -1,002,875 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | TO PROVIDE HEALTH AND RELATED BENEFITS FOR ELIGIBLE PARTICIPANTS. |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE TRUSTEES HAVE DELEGATED MANAGEMENT AUTHORITY OVER DAY-TO-DAY OPERATIONS TO A THIRD-PARTY ADMINISTRATOR. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 WAS REVIEWED WITH THE FUND'S BOOKKEEPER, BEFORE BEING SENT TO THE TRUSTEES FOR FINAL REVIEW AND SIGNATURE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNMENT FORMS ARE AVAILABLE FOR REVIEW UPON REQUEST. PARTICIPANTS ARE ABLE TO COME INTO THE ADMINISTRATIVE OFFICE AND REQUEST AN OPPORTUNITY TO REVIEW THE FORMS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| WEPCO FEDERAL CREDIT UNION | |||||||||
| PO BOX 157 | BLOOMINGTON | MD | 21523 | 520627367 | FINL SVCS | MD | 501C1 | N/A | false |
| FIRST PEOPLES COMMUNITY FCU | |||||||||
| 153 BALTIMORE ST | CUMBERLAND | MD | 21502 | 520905189 | FINL SVCS | MD | 501C1 | N/A | false |
| CHESSIE FCU | |||||||||
| PO BOX 689 | CUMBERLAND | MD | 215010689 | 520580973 | FINL SVCS | MD | 501C1 | N/A | false |
| HUMAN RESOURCERS DEVELOPMENT COMM | |||||||||
| 125 VIRGINIA AVE | CUMBERLAND | MD | 21502 | 526065754 | CHARITY | MD | 501C3 | N/A | false |
| THE LIONS CENTER FOR REHABILITATION | |||||||||
| 901 SETON DR | CUMBERLAND | MD | 21502 | 520812302 | NURSINGSVC | MD | 115 | N/A | false |
| TOWNSHIP OF WATERFORD | |||||||||
| 2131 AUBURN AVE | ATCO | NJ | 08004 | 216001341 | GOVT AGENC | NJ | 170C1 | N/A | false |
| CAMDEN COUNTY MUA | |||||||||
| 1645 FERRY AVE | CAMDEN | NJ | 08104 | 222003702 | WATERTREAT | NJ | 115 | N/A | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|
| FROSTBURG FACILITY OPERATIONS LLC | ||||||||
| ONE KAYLOR CIRCLE | FROSTBURG | MD | 21532 | 205111843 | MD | N/A | false | false |
| ASSISTED LIVING AT FROSTBURG VILLAG | ||||||||
| 100 VILLAGE PARKWAY | FROSTBURG | MD | 21532 | 205103941 | MD | N/A | false | false |
| AVISTA HEALTHCARE LLC | ||||||||
| 3025 CHAPEL AVE WEST | CHERRY HILL | NJ | 08002 | 205274922 | NJ | N/A | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line2RelatedOrganizationName/BusinessNameLine2 | Direct Controlling NADirectControllingNACd | Address Line2USAddress/AddressLine2 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ACME MARKETS INC | |||||||||||||
| 11840 VALLEY VIEW RD | EDEN PRAIRIE | MN | 55344 | 870440072 | FOOD STORE | MN | SUPERVALUE | C CORP | false | ||||
| ALLEGHANEY COUNTY HUMAN RESOURCES | |||||||||||||
| 125 VIRGINIA AVE | CUMBERLAND | MD | 21502 | 526065754 | MD | C CORP | false | ALLEGHANEY COUNTY HUMAN RESOURCES | N/A | ||||
| ARAMARK CORRECTIONAL SERVICES | |||||||||||||
| PO BOX 34 | TITUSVILLE | NJ | 08560 | 232778485 | FOOD SERV | NJ | C CORP | false | N/A | ||||
| AVON FOODS INC | |||||||||||||
| 1275 HORNBERGER AVE | ROEBLING | NJ | 08554 | 562628476 | GROCERY ST | NJ | S CORP | false | AVON FOODS INC | N/A | |||
| CAPE REGIONAL MEDICAL CENTER | |||||||||||||
| 2 STONE HARBOR BLVD | CAPE MAY CO COURTHOUSE | NJ | 08210 | 210662542 | HEALTHCARE | NJ | C CORP | false | N/A | ||||
| CROTHALL HEALTHCARE | |||||||||||||
| 2 STONE HARBOR BLVD | CAPE MAY CO COURTHOUSE | NJ | 08210 | 510386133 | HEALTHCARE | NJ | C CORP | false | N/A | ||||
| GENESIS HEALTHCARE | |||||||||||||
| 515 FAIRMONT AVE | TOWSON | MD | 21286 | HEALTHCARE | NJ | C CORP | false | N/A | |||||
| HEALTH FACILITIES INC | |||||||||||||
| 2629 TRENTON RD | LEVITTOWN | PA | 19056 | 391406172 | PA | C CORP | false | HEALTH FACILITIES INC | N/A | ||||
| HEALTHCARE SERVICES GROUP INC | |||||||||||||
| 3220 TILLMAN DR | BENSALEM | PA | 19020 | 232018365 | PA | C CORP | false | N/A | SUITE 300 | ||||
| INCOLLINGO'S EGG HARBOR CITY MARKET | |||||||||||||
| 810 WHITE HORSE PK | EGG HARBOR CITY | NJ | 08215 | 205776050 | FOOD STORE | NJ | S CORP | false | N/A | ||||
| INCOLLINGO'S HOLDING CO | |||||||||||||
| 457 CAST BROADWAY | SALEM | NJ | 08079 | 223813956 | NJ | S CORP | false | INCOLLINGO'S HOLDING CO | N/A | ||||
| NURSING HOME BOARD OF ALLEGHANEY | |||||||||||||
| 901 SETON DR | CUMBERLAND | MD | 21502 | 520812302 | HELATHCARE | C CORP | false | NURSING HOME BOARD OF ALLEGHANEY | N/A | ||||
| PATHMARK | |||||||||||||
| 2 PARAGON DR | MONTVALE | NJ | 07645 | 222879612 | GROCERY ST | NJ | GREAT | C CORP | false | ATLANTIC & PACIFIC TEA COMPANY | |||
| VIW-IWCO ENT INC | |||||||||||||
| 1 N VIRGINIA AVE | PENNSGROVE | NJ | 08069 | 222478138 | NJ | S CORP | false | VIW-IWCO ENT INC | N/A | ||||
| WILLSE & ASSOCIATES INC | |||||||||||||
| 1501 S CLINTON ST | BALTIMORE | MD | 21224 | 521187907 | GROCERY ST | MD | C CORP | false | WILLSE & ASSOCIATES INC | N/A | 7TH FLOOR | ||
| SUPER FRESH | |||||||||||||
| 2 PARAGON DR | MONTVALE | NJ | 07645 | 222402491 | GROCERY ST | NJ | GREAT | false | ATLANTIC & PACIFIC TEA COMPANY | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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