UFCW NATIONAL HEALTH AND WELFARE FUND: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
UFCW NATIONAL HEALTH AND WELFARE FUND (EIN 22-1458594)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-06-19
IRS object ID
201431709349300833
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-06-19T13:27:57-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN611436956EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1NOVAK FRANCELLA LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE PRESIDENTIAL BLVD SUITE 330AddressLine1
CityBALA CYNWYDCity
StatePAState
ZIP Code19004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN221458594EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UFCW NATIONAL HEALTH AND WELFARE FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUFCWNameControl
Phone2015698801Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 GRAND AVENUEAddressLine1
CityENGLEWOODCity
StateNJState
ZIP Code07631ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGEORGE J ORLANDOName
TitleTRUSTEETitle
Phone2015698801Phone
Date Signed2014-06-17DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameLOUIS VERZELLA CPAName
PTINP00360279PTIN
Phone6106689400Phone
Date Prepared2014-06-17DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGEORGE J ORLANDONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line166 GRAND AVENUEAddressLine1
CityENGLEWOODCity
StateNJState
ZIP Code07631ZIPCode
FieldValueIRS element (for citing)
Gross Receipts147663547GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1947YearFormation
State Legal DomicileNJStateLegalDomicile
Activity Or Mission DescriptionTHE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG AND DEATH BENEFITS ARE SELF-FUNDED.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees27TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year83049217ProgramServiceRevenuePriorYear
Program Service Revenue CY100107286ProgramServiceRevenueCY
Investment Income Prior Year1234939InvestmentIncomePriorYear
Investment Income Current Year1127040InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year84284156TotalRevenuePriorYear
Total Revenue Current Year101234326TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year77471317BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY83468056BenefitsPaidToMembersCY
Salaries Etc Prior Year2309691SalariesEtcPriorYear
Salaries Etc Current Year2655382SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1672681OtherExpensePriorYear
Other Expenses Current Year1805058OtherExpensesCurrentYear
Total Expenses Prior Year81453689TotalExpensesPriorYear
Total Expenses Current Year87928496TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2830467RevenuesLessExpensesPriorYear
Revenues Less Expenses CY13305830RevenuesLessExpensesCY
Total Assets BOY34847441TotalAssetsBOY
Total Assets EOY49490374TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY34847441NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY49490374NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PLAN PROVIDES HOSPITAL, MAJOR MEDICAL, SURGICAL, DISABILITY, PRESCRIPTION DRUG, DEATH AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL HEALTH, DISABILITY, PRESCRIPTION DRUG AND DEATH BENEFITS ARE SELF-FUNDED.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTHE FUND PROVIDES MEDICAL, HOSPITAL, PRESCRIPTION DRUGS, DEATH AND VISION BENEFITS FOR MEMBERS AND THEIR DEPENDENTS.Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10968NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees27NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BOARD OF TRUSTEESBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2015698801TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line166 GRAND AVENUEAddressLine1
CityENGLEWOODCity
StateNJState
ZIP Code07631ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
GEORGE J ORLANDO
TRUSTEE-CHAIRMAN5.00X000
TOM R BALLARD
TRUSTEE1.00X000
FRANK J RUNEY
TRUSTEE2.00X000
GERALDINE SENACK
TRUSTEE5.00X000
MICHELLE LEWIS
TRUSTEE1.00X000
JOHN PEPE
TRUSTEE2.00X000
ALIA SAMAD-SALAMEH
TRUSTEE (P)1.00X000
BRIAN FITZSIMMONS
TRUSTEE2.00X000
CHARLES RADER
TRUSTEE2.00X000
MAURICE HODOS
ADMINISTRATOR40.00164063021422X
FieldValueIRS element (for citing)
Total Reportable Comp From Org164063TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation21422TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HORIZON BLUE CROSS BLUE SHIELD
3 PENN PLAZA EAST PP-04KNEWARKNJ07105CLAIMS ADMINISTRATION1901862
INFORMED LLC
1596 WHITEHALL RDANNAPOLISMD21409CLAIMS ADMINISTRATION560454
THE SEGAL COMPANY
333 WEST 34TH STREETNEW YORKNY10001CONSULTING/ACTUARIAL FEES300385
KENNEDY JENNIK & MURRAY PC
113 UNIVERSITY PLACENEW YORKNY10003LEGAL SERVICES188383
INNOVATIVE SOFTWARE SOLUTIONS
3000 SOUTH LENOLA ROADMAPLE SHADENJ08052COMPUTER SERVICES115998
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS5251009939453199394531
PARTICIPANT AND RETIREE CONTRIBUT525100507725507725
MEDICARE PART D REIMB.525100205030205030
FieldValueIRS element (for citing)
Total Program Service Revenue100107286TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column780976TotalRevenueColumn
Exclusion$780,976ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities46775285Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities46429221Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities346064Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column346064TotalRevenueColumn
Exclusion$346,064ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column101234326TotalRevenueColumn
Related Or Exempt Function Income100107286RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,127,040ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total83468056Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total190419Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1359458Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total623385Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total355185Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total126935Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total204572Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total111565Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total181500Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total456403Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total409370Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total101587Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total208410Total

Travel Travel

FieldValueIRS element (for citing)
Total72617Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4467Total

Insurance Insurance

FieldValueIRS element (for citing)
Total34835Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionTEMPORARY STAFF AGENCYDescription
Total19732Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total87928496Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1604557BOY
EOY578288EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9026735BOY
EOY13628404EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis848555LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec842009LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7743BOY
EOY6546EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY23841739BOY
EOY34660469EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY366667BOY
EOY616667EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY34847441BOY
EOY49490374EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY34847441BOY
EOY49490374EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY34847441BOY
EOY49490374EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY34847441BOY
EOY49490374EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses13305830ReconcilationRevenueExpenses
Reconcilation Other Changes1337103ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting OtherXMethodOfAccountingOther
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2394OtherCostOrOtherBasis
Depreciation2394Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis235154OtherCostOrOtherBasis
Depreciation228757Depreciation
Book Value6397BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis611007OtherCostOrOtherBasis
Depreciation610858Depreciation
Book Value149BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6546TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt98576991TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1954531NetUnrealizedGainsInvestments
Revenue Not Rptd F9901954531RevenueNotRptdF990
Revenue Subtotal96622460RevenueSubtotal
Investment Expenses Not Included183909InvestmentExpensesNotIncluded
Other Revenues Not Included4427957OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt4611866RevenueNotRptdOnFinStmt
Total Revenue Per Form990101234326TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt87762692TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal87762692ExpensesSubtotal
Investment Expenses Not Included2183909InvestmentExpensesNotIncluded2
Other Expenses Not Included-18105OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt165804ExpensesNotRptdOnFinStmt
Total Expenses Per Form99087928496TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: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:CHANGE IN RECEIVABLES 4,427,957.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN PAYABLES 16,789. CHANGE IN ACCRUED PENSION COST & FASB 715 ADJ -34,894.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonMAURICE HODOSNamePerson
TitleADMINISTRATORTitle
Base Compensation Filing Org164063BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org11039DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org10383NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org185485TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11UFCW NATIONAL HEALTH AND WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT ACCOUNTANT. THE RETURN IS THEN FORWARDED TO THE FUND ADMINISTRATOR FOR INITIAL REVIEW BEFORE BEING PRESENTED TO THE TRUSTEES FOR REVIEW AND SIGNATURE.
FORM 990, PART VI, SECTION B, LINE 12CUFCW NATIONAL HEALTH & WELFARE FUND MONITORS ITS CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION OF PLAN SERVICE PROVIDERS IS SUBJECT TO APPROVAL OF THE BOARD OF TRUSTEES UNDER THE PLAN'S TRUST AGREEMENTS. PERSONS WITH A CONLFICT OF INTEREST WITH RESPECT TO A COMPENSATION ARRANGEMENT WILL NOT BE INVOLVED. DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS IS USED. CONTEMPORANEOUS DOCUMENTATION AND REORDS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT ARE MADE AND KEPT.
FORM 990, PART VI, SECTION C, LINE 19UFCW NATIONAL HEALTH AND WELFARE FUND MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VIIGEORGE J. ORLANDO - 219 PATERSON AVENUE, LITTLE FALLS, NJ 07424. GERALDINE SENACK - 556 BOCA CIEGA POINT BLVD. SOUTH, MADEIRA BEACH, FL 33708. MICHELLE LEWIS - E & J GALLO WINERY, P.O. BOX 1130, MODESTO, CA 95353. JOHN PEPE - 520 DIVISION ST, GALLO WINE SALES OF NJ, ELIZABETH, NJ 07201. ALIA SAMAD-SALAMEH - P.O. BOX 600, SHAW'S SUPERMARKETS INC, E BRIDGEWATER, MA 02333. BRIAN FITZSIMMONS - P.O. BOX 600, SHAW'S SUPERMARKETS INC, E BRIDGEWATER, MA 02333.CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
FORM 990, PART XI, LINE 9:ADJUSTMENT OF COST BASIS OF INVESTMENTS 1,337,103.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 1:UFCW NATIONAL HEALTH AND WELFARE FUND'S FORM 990 IS PREPARED USING THE MODIFIED CASH BASIS OF ACCOUNTING.
FORM 990, PART XII, LINE 2C:UFCW NATIONAL HEALTH AND WELFARE FUND'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
RETIREMENT PLAN OF THE UFCW NATIONAL HEALTH AND WELFARE FUND
66 GRAND AVENUEENGLEWOODNJ07631221458594PENSION FUNDNJ401(A)/501(A)0
HARRIS COUNTY AFL CIO
2506 SUTHERLAND STHOUSTONTX77023741356044LABOR UNIONTX501(C)(5)0
UFCW LOCAL UNION 540
11041 GARLAND RDDALLASTX75218750953266LABOR UNIONTX501(C)(5)0
UFCW LOCAL UNION 791
55 NORFOLK AVESOUTH EASTONMA02375237281421LABOR UNIONMA501(C)(5)0
METROPOLITAN BALTIMORE COUNCIL
2701 W PATAPSCO AVE 110BALTIMOREMD21230526068046LABOR UNIONMD501(C)(5)0
UFCW LOCAL UNION 18
3163 EAST TREMONT AVEBRONXNY10461130664176LABOR UNIONNY501(C)(5)0
UFCW LOCAL UNION 2D
8402 18TH AVENUEBROOKLYNNY11214131471825LABOR UNIONMO501(C)(5)0
UFCW LOCAL UNION 186
329 DOWNEYMODESTOCA95354941549203LABOR UNIONCA501(C)(5)0
UFCW LOCAL 496
2901 RIDGELAKE DR STE 202METAIRIELA70002720225967LABOR UNIONLA501(C)(5)0

Form990 Schedule R Part IV Form990ScheduleRPartIV (39 entries)

Legal Domicile StateLegalDomicileState
DIAGEO WINES
CA
BUFFALO TRACE DIST INC
KY
JIM BEAM BRANDS COMPANY
KY
VIVENDI UNIVERSAL (RETIREES)
NY
JOHN JONES SERVICES LLCEC MANAGEMENT INC
IN
BRONCO WINERY
CA
SKYY SPIRITS LLCDBA CAMPARI
CA
PATRICK METALSALTEC ALUMINUM TECHNOLOGIES
IN
DELANO GROWERS CORP
CA
GLEASON CORPORATION
CA
THE WINE GROUP
CA
E&J GALLO WINERY
CA
FOSS MANUFACTURING LLC
NH
GALLO WINE COMPANY
CA
SOUTHERN WINE & SPIRITS OF AMERICA
FL
GALLO WINE SALES OF NJ
NJ
GIBSON WINE COMPANY
CA
GENERAL ALUM NEW ENGLAND CORPORATION
NJ
GLENMORE DISTILLERSSAZERAC NORTH AMERICA INC
KY
GUIMARRA VINEYARDS CORP
CA
JACOB STERN SONS
CA
MAXIMUS COFFEE GROUP
TX
PRIORITY ONE SERVICES
VA
HUHTAMAKI INC
KS
JIM BEAM BRANDS COMPANY
KY
PERNOD RICARDCRAFT DIVISION (RETIREES ONLY)
NY
DIAGEO NORTH AMERICA INC
CT
SHAWSALBERTSONSSUPERVALUE
MA
SEBASTIANI VINEYARDS INC
CA
SUNMAID GROWERS OF CALIF
CA
CONSTELLATION WINES US CANANDAIGUA
NY
VENTURA FOODS LLC
PA
FOUNTAIN INDUSTRIES COMPANY
MN
VIE DEL CO
CA
SB FOOT TANNING COMPANY
MN
WH BAGSHAW CO INC
NH
VISCOFAN USA INC
IL
SUN PRODUCTS CORPORATION
CT
CSL BEHRING
PA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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