RETIREES OF CTNA HEALTH CARE TRUST: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
RETIREES OF CTNA HEALTH CARE TRUST (EIN 26-3625263)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201313169349304521
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)
Timestamp2013-11-12T13:28:08-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BOND BEEBE PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14600 EAST-WEST HIGHWAY SUITE 900AddressLine1
CityBETHESDACity
StateMDState
ZIP Code208143423ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN263625263EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RETIREES OF CTNA HEALTH CARE TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% CENTRAL DATA SERVICES INCInCareOfName
Name ControlRETINameControl
Phone4122012242Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line160 BOULEVARD OF THE ALLIES 5TH FLAddressLine1
Address Line2SuiteAddressLine2
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS F DUZAKName
TitleCOMMITTEE MEMBERTitle
Phone4122012242Phone
Date Signed2013-09-24DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBRIAN GARSTECKIName
Phone3012726000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS F DUZAKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line160 BOULEVARD OF THE ALLIESAddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode
FieldValueIRS element (for citing)
Gross Receipts37606790GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation2008YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTHE FUND OPERATES AS A TRUST TO PROVIDE CERTAIN HEALTH AND WELFARE BENEFITS TO CURRENT AND FUTURE CONTINENTAL TIRE NORTH AMERICA INC RETIREES FOLLOWING EMPLOYMENT IN USW-REPRESENTED BARGAINING UNITS.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16195017ProgramServiceRevenuePriorYear
Program Service Revenue CY16314297ProgramServiceRevenueCY
Investment Income Prior Year1623422InvestmentIncomePriorYear
Investment Income Current Year1355768InvestmentIncomeCurrentYear
Other Revenue Prior Year1216937OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year19035376TotalRevenuePriorYear
Total Revenue Current Year17670065TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year13629233BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY12192529BenefitsPaidToMembersCY
Salaries Etc Prior Year100481SalariesEtcPriorYear
Salaries Etc Current Year101707SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year406523OtherExpensePriorYear
Other Expenses Current Year1049962OtherExpensesCurrentYear
Total Expenses Prior Year14136237TotalExpensesPriorYear
Total Expenses Current Year13344198TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4899139RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4325867RevenuesLessExpensesCY
Total Assets BOY56801691TotalAssetsBOY
Total Assets EOY63671454TotalAssetsEOY
Total Liabilities BOY75127TotalLiabilitiesBOY
Total Liabilities EOY157770TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY56726564NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY63513684NetAssetsOrFundBalancesEOY
Mission DescriptionTHE FUND OPERATES AS A TRUST TO PROVIDE CERTAIN HEALTH AND WELFARE BENEFITS TO CURRENT AND FUTURE CONTINENTAL TIRE NORTH AMERICA INC RETIREES FOLLOWING EMPLOYMENT IN USW-REPRESENTED BARGAINING UNITS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionMANAGES THE PROVISION OF MEDICAL, HOSPITAL, AND PRESCRIPTION PLAN FOR CURRENT AND FUTURE RETIREES OF CONTINENTAL TIRE NORTH AMERICA INC AND TO THEIR BENEFICIARIES AND COVERED DEPENDENTS.Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCENTRAL DATA SERVICES INCNamePerson
Telephone Number4122012242TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line160 BLVD OF THE ALLIES 5TH FLAddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
THOMAS F DUZAK
COMMITTEE MEMBER, CHAIR1.0X2452600
HOWARD KLINE
COMMITTEE MEMBER1.0X1952600
JAMES CARNEY
COMMITTEE MEMBER1.0X1952600
WAYNE CHAMBERS
COMMITTEE MEMBER1.0X1952600
JOHN SELLERS
COMMITTEE MEMBER1.0X1788700
FieldValueIRS element (for citing)
Total Reportable Comp From Org100991TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CENTRAL DATA SERVICES INC
60 BOULEVARD OF THE ALLIES 5TH FLPITTSBURGHPA15222ADMINISTRATOR115200
HIGHMARK INC
120 FIFTH AVENUEPITTSBURGHPA15222CLAIMS ADMIN FEES653322
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS5251001194056811940568
PARTICIPANT CONTRIBUTIONS52510043737294373729
FieldValueIRS element (for citing)
Total Program Service Revenue16314297TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1399350TotalRevenueColumn
Exclusion$1,399,350ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities19893143Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities19936725Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-43582Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-43582TotalRevenueColumn
Exclusion-$43,582ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17670065TotalRevenueColumn
Related Or Exempt Function Income16314297RelatedOrExemptFunctionIncome
Exclusion$1,355,768ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total12192529Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total101707Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5213Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total10750Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total170628Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total799892Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11757Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2805Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total48917Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13344198Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY423605BOY
EOY153943EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY3654108EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6436BOY
EOY1429EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY41633BOY
EOY38504EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY32473543BOY
EOY41693738EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY23555600BOY
EOY17795946EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY300874BOY
EOY333786EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY56801691BOY
EOY63671454EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY47274BOY
EOY57572EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27853BOY
EOY100198EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY75127BOY
EOY157770EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY56726564BOY
EOY63513684EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY56726564BOY
EOY63513684EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY56801691BOY
EOY63671454EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses4325867ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2461253ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
SSGA US TIPS INDEX NL TRUST FD11857324F
WELLINGTON GLOBAL OPP PORTFOLI5938622F
FieldValueIRS element (for citing)
Total Of Book Value Securities17795946TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PARTICIPANT CONTRIBUTIONS IN ADVANCE$10,226
DUE TO BROKER FOR SECURITIES PURCHASED$89,972
FieldValueIRS element (for citing)
Total Of Amounts100198TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt19960690TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments2461253NetUnrealizedGainsInvestments
Revenue Not Rptd F9902461253RevenueNotRptdF990
Revenue Subtotal17499437RevenueSubtotal
Investment Expenses Not Included170628InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt170628RevenueNotRptdOnFinStmt
Total Revenue Per Form99017670065TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13173570TotExpensesEtcAuditedFinclStmt
Expenses Subtotal13173570ExpensesSubtotal
Investment Expenses Not Included2170628InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt170628ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013344198TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierFIN 48 FOOTNOTEIdentifier
Return ReferencePART X, LINE 2ReturnReference
ExplanationGenerally accepted accounting principles require management to evaluate tax positions taken and recognize a tax liability if the organization has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has evaluated the tax positions taken by the Trust and concluded that as of December 31, 2012 there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the financial statements. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Management believes that all returns filed by the Plan are subject to income tax examinations.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
REVIEW PROCESS FOR FORM 990PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, UPON WHICH A DRAFT IS SENT FOR REVIEW TO THE COMMITTEE MEMBERS. ONCE THE COMMITTEE MEMBERS HAVE APPROVED THE DRAFT, THE E-FILE AUTHORIZATION IS SIGNED BY A COMMITTEE MEMBER (GENERALLY THE CHAIRPERSON) AND SENT TO THE INDEPENDENT ACCOUNTANTING FIRM TO FILE WITH THE INTERNAL REVENUE SERVICE.
PUBLIC AVAILABILITY OF GOVERNING DOCUMENTS, POLICIES AND FINANCIALSPART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS AS REQUIRED UNDER "ERISA".
OTHER COMMITTEES WITH AUTHORITYPART VI, SECTION A, LINE 8BTHERE ARE NO OTHER COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
MONITORING AND COMPLIANCE OF CONFLICT OF INTEREST POLICYPART VI, SECTION B, LINE 12CTHE COMMITTEE HAS DELEGATED THE RESPONSIBILITY FOR MONITORING COMPLIANCE AND ENFORCING ITS CONFLICT OF INTEREST POLICY WITH THE PLAN'S ADMINISTRATOR. A COVERED PERSON UNDER THIS POLICY MEANS ANY MEMBER OF THE COMMITTEE, ANY EMPLOYEE OF THE TRUST, AND ANY OFFICER, DIRECTOR, OR EMPLOYEE OF THE PLAN ADMINISTRATOR. EACH COVERED PERSON IS REQUIRED TO READ THE POLICY AND ACKNOWLEDGE IN WRITING THAT HE/SHE HAD READ IT, UNDERSTANDS IT, AND AGREES TO ABIDE BY IT. THE PLAN ADMINISTRATOR IS GIVEN AUTHORITY TO REQUEST ANY INFORMATION FROM A COVERED PERSON AS NECESSARY TO ASCERTAIN THAT SUCH COVERED PERSON IS IN COMPLIANCE. EACH COVERED PERSON IS REQUIRED TO REPORT ANY ACTUAL OR POTENTIAL VIOLATIONS OF THIS POLICY. ONCE ANY POTENTIAL INTEREST OR VIOLATION IS IDENTIFIED, SUCH DISCLOSURE SHALL BE MADE TO THE COMMITTEE. THE PLAN ADMINISTRATOR IS REQUIRED ON MAKE AN ANNUAL REPORT TO THE COMMITTEE CONCERNING COMPLIANCE WITH THIS POLICY.

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CONTINENTAL TIRE THE AMERICAS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11830 MACMILLAN PARK DRIVEAddressLine1
CityFORT MILLCity
StateSCState
ZIP Code29707ZIPCode
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierIDENTIFICATION OF RELATED ORGANIZATION TAXABLE AS A CORPORATIONIdentifier
Return ReferencePART IV LINE 1ReturnReference
ExplanationTHE RELATED ORGANIZATION IS A CONTRIBUTING EMPLOYER TO THE HEALTH CARE TRUST.Explanation

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