2014-10-09T13:15:49-05:00 2013-12-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2013-01-01 135521921 LAUNDRY DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND WORKERS UNITED AMAL 9143675559 333 WESTCHESTER AVENUE WHITE PLAINS NY 106042910 MICHAEL POTACK TRUSTEE 9143675559 2014-10-09 1 LOUIS VERZELLA CPA P00360279 6106689400 2014-10-06 2013 2015-11-30 17:44:51Z MICHAEL POTACK 275 7TH AVENUE NEW YORK NY 10001 48635270 0 X N/A X 1946 NY VEBA HEALTH FUND PROVIDING HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 3 6 0 0 0 0 0 18613550 14912656 151469 109123 167530 0 18932549 15021779 0 0 13149208 12339435 250164 244453 0 0 0 2580690 2436966 15980062 15020854 2952487 925 12130473 13395048 380420 411044 11750053 12984004 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 68 0 6 1 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X FUND OFFICE 9143675559 333 WESTCHESTER AVENUE WHITE PLAINS NY 106042910 ALBERTO ARROYO TRUSTEE 1.00 X 0 76204 0 MICHAEL POTACK TRUSTEE 1.00 X 0 0 0 STANLEY ISRAEL ESQ TRUSTEE 1.00 X 0 0 0 BRIAN SANTONNELLO TRUSTEE 1.00 X 0 0 0 WILFREDO LARANCUENT TRUSTEE 1.00 X 0 130796 0 CHRISTINE KERBER TRUSTEE 1.00 X 0 165420 0 0 372420 0 0 0 1 0 ALICARE INC 333 WESTCHESTER AVENUE WHITE PLAINS NY 10604 ADMINISTRATIVE SERVICES 1835789 ANTHEM BLUE CROSS BLUE SHIELD ONE LIBERTY PLAZA NEW YORK NY 10006 CLAIM PROCESSING FEE 661450 SCHULTE ROTH & ZABEL LLP 919 THIRD AVENUE NEW YORK NY 10022 LEGAL 187210 BUCK CONSULTANTS LLC 500 PLAZA DRIVE 8TH FLR SECAUCUS NJ 07096 ACTUARY 141826 DELTA DENTAL OF NY ONE DELTA DRIVE MECHANICSBURG PA 17055 CLAIM PROCESSING FEE 103009 5 EMPLOYER CONTRIBUTIONS 525100 14717536 14717536 MEMBER CONTRIBUTIONS 525100 167520 167520 SHARED EXPENSE REIMBURSEMENTS 525100 27600 27600 14912656 52553 52553 33670061 33613491 56570 56570 56570 15021779 14912656 0 109123 X 12339435 146354 27978 53467 16654 199797 34837 28442 1968615 43051 88163 11111 63 2175 20048 ALLOCATED PAYROLL AND C 31200 PATIENT CENTERED OUTCOM 9464 15020854 250 250 988498 787054 2591184 1399624 1222 77109 16880 16251 2804 629 2454883 3037835 4547996 7686114 1543636 406433 12130473 13395048 169878 216380 210542 194664 380420 411044 X 0 0 0 0 11750053 12984004 11750053 12984004 12130473 13395048 925 1233026 0 X X 0 1 X 1 0 16880 16251 629 629 COMMINGLED FUND 3746022 F COMMON COLLECTIVE TRUST 3940092 F 7686114 DUE TO RELATED ENTITIES 106000 CASH OVERDRAFT 67397 DUE TO ALICO 80 OBLIGATION TO DISTRIBUTE CONTRIBUTIONS TO RELATED PARTIES 19959 DUE TO OTHER 1228 194664 X 16198763 1233026 1233026 14965737 28442 27600 56042 15021779 14964812 0 14964812 28442 27600 56042 15020854 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 27,600. PART XII, LINE 4B - OTHER ADJUSTMENTS: SHARED REIMBURSED EXPENSES 27,600. 0 0 0 CHRISTINE KERBER TRUSTEE 0 165420 0 0 0 0 0 0 0 0 0 165420 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 - 275 7TH AVENUE, NEW YORK, NY 10001. MICHAEL POTACK - 401 SOUTH MACQUESTEN PARKWAY, MOUNT VERNON, NY 10550. STANLEY ISRAEL, ESQ - 50-35 56TH ROAD, MASPETH, NY 11378. BRIAN SANTONNELLO - 1100 6TH AVENUE, NEPTUNE, NJ 07753. WILFREDO LARANCUENT - 275 7TH AVENUE, NEW YORK, NY 10001. CHRISTINE KERBER - 18 WASHINGTON PLACE, 3RD FLR, NEWARK, NJ 07102. FORM 990, PART IX, LINE 11G ACTUARY 141,826. ADMINISTRATIVE FEES 1,826,789. 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. LAUNDRY DRY CLEANING WORKERS & ALLIED IND RETIREMENT FUNDWORKERS UNITED 333 WESTCHESTER AVENUE WHITE PLAINS NY 10604 135521921 PENSION FUND NY 401(A)/501(A) 0 LAUNDRY DRY CLEANING WORKERS EDUCATION & LEGAL ASSISTANCE FUND WORKERS UNI 333 WESTCHESTER AVENUE WHITE PLAINS NY 10604 201072118 EDUCATION AND LEGAL ASSISTANCE FUND NY 501(C)(9) 0 LAUNDRY DRY CLEAINING & ALLIED WKRS JT BD 18 WASHINGTON PLACE 2ND FLR NEWARK NJ 07102 135197381 LABOR UNION NJ 501(C)(5) 0 A & P COAT & APRON SUPPLY NY ACLS NEW ENGLAND INC CT ALLEN LINEN SUPPLY NJ AMER DRIVE IN CLNRS OF HEWLETT NY AMERTEX SERVICES NY ANGELICA TEXTILE SERVICES NY APPAREL PLUS TEXTILE RENTAL LLC NY ARAMARK INC CA ARROW LINEN SUPPLY CO NY BEST METROPOLITAN NY CENTRAL LAUNDRY SERVICE CORP (SEACREST) NY ELITE AIRLINE LAUNDRY SVC NY ERNEST WINZER CLEANERS LLC NY FDR OF PATTERSON NJ NY HCSC LAUNDRY-ASBURY PARK NJ PA HIGHLAND LIGHT STEAM LAUNDRY INC NY HOME LAUNDRY SERVICE INC NJ JET OVERALL UNIFORM NY KEUM LIMITED NY MSJ INC NY MARVAL INDUSTRIES INC NY MED APPAREL SERVICES (CT) CT MERITEX (HILTON) LLC NJ MERLIN INDUSTRIES NY MIRON & SONS LAUNDRY NY MRS ROLES PRIVATE LAUNDRY INC NY NU CLEAR DRIVE IN CLEANERS NY OCEANSIDE INSTINDUSTRIES NY PAUL DYEING CO NJ POLO LINEN SERVICE INC NY QUALITY LINENSINC NY RIDDELL INCALL AMERICAN SPORT OH ROSE TOWEL & LINEN SUPPLY NY SANITARY COAT APRON & TOWEL SUPPLY NJ SHARED TEXTILES -MIDDLETOWN NY STAIN-LESS INC NY STAR CLEANERS ROCKVILLE NY WH CHRISTIAN NY WH LINEN SUPPLY NJ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 LAUNDRY DRY CLEANING WORKERS & ALLIED IND RETIREMENT FUNDWORKERS UNITED Q 18700 FMV LAUNDRY DRY CLEANING WORKERS & UNITE EDUCATION & LEGAL ASSISTANCE FUND Q 8900 FMV