2014-08-12T09:24:47-05:00 2013-12-31 542189926 Henningfield & Associates Inc 27913 Smyth Drive Valencia CA 91355 990 2013-01-01 237100610 UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 711 FOOD EMPLOYERS BENEFIT FUND UNIT 8004534584 4885 SOUTH 900 EAST No 202 SALT LAKE CITY UT 84117 MICHAEL GITTINGS TRUSTEE 8004534584 2014-07-22 1 RANDY D HENNINGFIELD P01364367 6612953363 2013 2015-11-30 17:44:51Z MICHAEL GITTINGS 4885 SOUTH 900 EAST SALT LAKE CITY UT 84117 43748743 0 X N/A X 1970 CA HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS 7 7 0 0 0 0 0 0 37013914 43740039 8678 8704 0 0 37022592 43748743 0 0 34180463 32776121 0 0 0 0 0 3198461 3197669 37378924 35973790 -356332 7774953 13136271 21805926 10788947 11683649 2347324 10122277 HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS 0 0 32776121 HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 32776121 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1103 0 1 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 X X JAS INC 8004534584 4885 SOUTH 900 EAST 202 SALT LAKE CITY UT 84117 X DAVID GOODALL TRUSTEE 10.00 X 0 0 0 WILLIAM HORNBROOK TRUSTEE 10.00 X 0 0 0 DEANNA LEIVAS TRUSTEE 10.00 X 0 0 0 IAN ADAMS TRUSTEE 10.00 X 0 0 0 BRENT BOHN TRUSTEE 10.00 X 0 0 0 TERRY RACHIELE TRUSTEE 10.00 X 0 0 0 MICHAEL GITTINGS TRUSTEE 10.00 X 0 0 0 0 0 0 0 0 0 0 JAS INC 4885 SOUTH 900 EAST SUITE 202 SALT LAKE CITY UT 84117 CONTRACT ADMINISTRATION 901886 BEECH STREETMULTIPLAN 115 FIFTH AVE 7TH FL NEW YORK NY 10003 NETWORK ACCESS FEES 731599 SHPSCAREWISE HEALTH 9305 E VIA DE VENTURA STE 101 SCOTTSDALE AZ 85258 CASE MANAGEMENT AND UTILIZATION REVIEW 192413 MINES & ASSOCIATES 10367 WEST CENTENNIAL RD 100 LITTLETON CO 80127 EAP SERVICES 131337 NEVADA DENTAL BENEFITS 7872 W SAHARA LAS VEGAS NV 89117 CLAIMS PROCESSING 122366 7 EMPLOYER CONTRIBUTIONS 445100 40452427 40452427 PARTICIPANT CONTRIBUTIONS 445100 3287612 3287612 43740039 8704 8704 43748743 43740039 0 8704 32776121 901886 187411 35341 110241 15864 29880 MEDICAL COST CONTAINMEN 1254001 ADMINISTRATION - RX 191947 CONSULTING 173732 ADMINISTRATION - DENTAL 122366 175000 35973790 9707428 14031809 3414477 3754207 14366 13066 4006844 13136271 21805926 249947 320649 10539000 11363000 10788947 11683649 X 0 0 0 0 2347324 10122277 2347324 10122277 13136271 21805926 7774953 0 X 0 1 X 1 0 0 IBNR PAYABLE 5650000 ACCUM ELIG CREDITS PAYABLE 5713000 11363000 43748743 0 43748743 0 43748743 35149790 0 35149790 824000 824000 35973790 Part XII, Line 4b - Other Adjustments: CHANGE IN IBNR & EXTENDED ELIGIBILITY 824,000. Form 990, Part VI, Section A, line 3 The trustees have contracted with a third party administrator to perform the everyday administration of the fund. Form 990, Part VI, Section B, line 11 A copy of Form 990 was presented to the trustees for review and signatures. Form 990, Part VI, Section C, line 19 Summary Annual Reports are provided to all participants annually. SPDs and audited financial statements are available from the administrator upon request, as well as the DOL website. Form 990, Part VII DAVID GOODALL - 618 Michillinda Ave.,, ARCADIA, CA 91007. WILLIAM HORNBROOK - 1201 N. DECATUR,, LAS VEGAS, NV 89108. DEANNA LEIVAS - 1201 N. DECATUR,, LAS VEGAS, NV 89108. IAN ADAMS - 4885 So 900 East,, SALT LAKE CITY, UT 84117. BRENT BOHN - 1421 S. Manhattan Ave.,, FULLERTON, CA 92831. TERRY RACHIELE - 1201 N. DECATUR,, LAS VEGAS, NV 89108. MICHAEL GITTINGS - 1201 N. DECATUR,, LAS VEGAS, NV 89108. ALBERTSON'S 1421 S MANHATTAN AVE FULLERTON CA 92831 204057706 RETAIL GROCERS CA C 0 SMITH' FOOD 4 LESS 4885 S 900 EAST SALT LAKE CITY UT 84117 870258768 RETAIL GROCERS CA C 0 VONS SAFEWAY 618 MICHILLINDA AVE ARCADIA CA 91007 381623900 RETAIL GROCERS CA C 0 UFCW LOCAL 711 1201 NORTH DECATUR LAS VEGAS NV 89108 880057132 LABOR UNION NV C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0