USW RETIREES OF THE DANA CORPORATION HEALTH CARE TR: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
USW RETIREES OF THE DANA CORPORATION HEALTH CARE TR (EIN 26-1860594)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-06
IRS object ID
201323109349300547
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)
Timestamp2013-11-06T13:38:44-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN208078757EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SALTER & COMPANY LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14600 EAST-WEST HIGHWAY SUITE 300AddressLine1
CityBETHESDACity
StateMDState
ZIP Code208143415ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN261860594EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1USW RETIREES OF THE DANA CORPORATIONBusinessNameLine1
Business Name Line2HEALTH CARE TRUSTBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlUSWRNameControl
Phone4122102233Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line160 BLVD OF THE ALLIES 5TH FLOORAddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHARVEY NATHANName
TitleCOMMITTEE MEMBERTitle
Phone4122102233Phone
Date Signed2013-11-06DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameJOSEPH M HERISHEN CPAName
PTINP00361968PTIN
Phone3018307400Phone
Date Prepared2013-11-06DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonHARVEY NATHANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15 GATEWAY CENTERAddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode
FieldValueIRS element (for citing)
Gross Receipts55593866GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation2008YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH AND OTHER WELFARE BENEFITS.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6214016ProgramServiceRevenuePriorYear
Program Service Revenue CY5990301ProgramServiceRevenueCY
Investment Income Prior Year6569083InvestmentIncomePriorYear
Investment Income Current Year9534598InvestmentIncomeCurrentYear
Other Revenue Prior Year1867986OtherRevenuePriorYear
Other Revenue Current Year19150OtherRevenueCurrentYear
Total Revenue Prior Year14651085TotalRevenuePriorYear
Total Revenue Current Year15544049TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year22472004BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY22441111BenefitsPaidToMembersCY
Salaries Etc Prior Year129320SalariesEtcPriorYear
Salaries Etc Current Year132294SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1006826OtherExpensePriorYear
Other Expenses Current Year1086651OtherExpensesCurrentYear
Total Expenses Prior Year23608150TotalExpensesPriorYear
Total Expenses Current Year23660056TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-8957065RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-8116007RevenuesLessExpensesCY
Total Assets BOY243729868TotalAssetsBOY
Total Assets EOY248015302TotalAssetsEOY
Total Liabilities BOY383559TotalLiabilitiesBOY
Total Liabilities EOY540085TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY243346309NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY247475217NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE USW RETIREES OF THE DANA CORPORATION HEALTH CARE TRUST IS ESTABLISHED FOR THE PURPOSE OF (I) PROVIDING HEALTH AND OTHER WELFARE BENEFITS TO PARTICIPANTS IN ACCORDANCE WITH THE USW RETIREES OF THE DANA CORPORATION HEALTH CARE PLAN AND AS ARE PERMISSIBLE UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AS SET FORTH HEREIN; AND (II) TO PROVIDE HEALTH AND WELFARE BENEFITS TO THE RUN-OUT PARTICIPANTS IN ACCORDANCE WITH THE DANA CORPORATION'S ORIGINAL PLAN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTHE TRUST PROVIDED HEALTH AND OTHER WELFARE BENEFITS THROUGH THE USW RETIREES OF THE DANA CORPORATION PLAN TO 5,083 PARTICIPANTS AND SURVIVING SPOUSES.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 Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Required0ScheduleJRequired
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109654NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
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 Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
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 CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CDS ADMINISTRATORSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4122012242TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15 GATEWAY CENTER SUITE 620AddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
HARVEY NATHAN
COMMITTEE MEMBER2.00XX2857500
CHARLES PIPER
COMMITTEE MEMBER2.00X2328400
JAMES DWORKIN
COMMITTEE MEMBER2.00X2328400
JAMES COLE
COMMITTEE MEMBER2.00X635000
THOMAS HAYHURST
COMMITTEE MEMBER2.00X2328400
THOMAS BRAUN
COMMITTEE MEMBER2.00X2328400
ANNE BLANTON
COMMITTEE MEMBER2.00X423300
MIKE O'BRIEN
COMMITTEE MEMBER1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org132294TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HIGHMARK
120 5TH AVE 2015PITTSBURGHPA15222CLAIMS ADMINISTRATION & ACCESS FEE274598
WELLINGTON TRUST COMPANY
280 CONGRESS STBOSTONMA02210INVESTMENT MANAGEMENT246743
CDS ADMINISTRATORS
5 GATEWAY CENTER STE 620 60 BLVDPITTSBURGHPA152221219THIRD PARTY ADMINISTRATOR170292
GALLAGHER FIDUCIARY ADVISORS
805 15TH ST NWWASHINGTONDC20005FIDUCIARY SERVICES100077
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPARTICIPANT CONTRIBUTIDescription
Business Code525100BusinessCode
Total Revenue Column5990301TotalRevenueColumn
Related Or Exempt Function Income5990301RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue5990301TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6932735TotalRevenueColumn
Exclusion$6,932,735ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities42651680Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities40049817Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2601863Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2601863TotalRevenueColumn
Related Or Exempt Function Income2601863RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMEDICARE PART D SUBSIDYDescription
Business Code525100BusinessCode
Total Revenue Column19150TotalRevenueColumn
Related Or Exempt Function Income19150RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue19150TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15544049TotalRevenueColumn
Related Or Exempt Function Income8611314RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$6,932,735ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total22441111Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total132294Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total434722Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total27410Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total31831Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total348469Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total219Total

Travel Travel

FieldValueIRS element (for citing)
Total16285Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total16977Total

Insurance Insurance

FieldValueIRS element (for citing)
Total50127Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
INVESTMENT CONSULTING100077
ACTUARY & CONSULTING44863
BANK FEES11468
POSTAGE & MAILING4203

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total23660056Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY925251BOY
EOY780232EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14674241BOY
EOY8962750EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY22240BOY
EOY19919EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY224942065BOY
EOY233496522EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY3166071BOY
EOY3255879EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY1500000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY243729868BOY
EOY248015302EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY383559BOY
EOY540085EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY383559BOY
EOY540085EOY
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)
BOY243346309BOY
EOY247475217EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY243346309BOY
EOY247475217EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY243729868BOY
EOY248015302EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-8116007ReconcilationRevenueExpenses
Reconciliation Unrealized Invest12244915ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
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

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt27440495TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments12244915NetUnrealizedGainsInvestments
Revenue Not Rptd F99012244915RevenueNotRptdF990
Revenue Subtotal15195580RevenueSubtotal
Investment Expenses Not Included348469InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt348469RevenueNotRptdOnFinStmt
Total Revenue Per Form99015544049TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt23311587TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal23311587ExpensesSubtotal
Investment Expenses Not Included2348469InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt348469ExpensesNotRptdOnFinStmt
Total Expenses Per Form99023660056TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WAS PROVIDED TO THE TRUST'S ADMINISTRATOR TO BE DISTRIBUTED TO THE COMMITTEE MEMBERS FOR THEIR REVIEW PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12CCOMMIITTEE MEMBERS MONITOR THE CONFLICT OF INTEREST POLICY ANNUALLY FOR ANY POTENTIAL CONFLICTS.
FORM 990, PART VI, SECTION C, LINE 19ANY DOCUMENTS THAT THE TRUST WOULD BE REQUIRED TO MAKE AVAILABLE TO THE PUBLIC WOULD BE AVAILABLE BY CONTACTING THE TRUST'S THIRD PARTY ADMINISTRATOR, CDS ADMINISTRATORS.
PART XII - LINE 2(C)NO CHANGE HAS BEEN MADE BY THE COMMITTEE MEMBERS TO THE OVERSIGHT PROCESS FROM THE PRIOR YEAR.

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