2012-10-11T08:17:05-05:00 2011-11-30 BST ADVISORS LLC 28 WEST 44TH STREET NEW YORK NY 10036 990 2010-12-01 237042767 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL 1262 & EMPLOYERS HEALTH & WELFARE UNIT 9737785800 1389 BROAD ST CLIFTON NJ 07013 MATTHEW MOLINARO 9737785800 2012-10-10 1 DAVID C LEE 2126618640 2010 2016-02-24 21:20:13Z MATTHEW MOLINARO 1389 BROAD ST CLIFTON NJ 07013 29640577 0 X WWW.UFCW1262.ORG X 1968 NJ TO PROVIDE HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 6 6 0 0 0 0 0 0 21339170 24556355 592638 607432 473193 715934 22405001 25879721 0 0 20957412 24493462 457788 481569 0 0 0 544000 564662 21959200 25539693 445801 340028 13709298 14041490 706616 995206 13002682 13046284 TO PROVIDE HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 25539693 25556355 TO PROVIDE HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO APPROXIMATELY 4,600 ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 25539693 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 0 1 7 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X THE ORGANIZATION 9737785800 1389 BROAD ST CLIFTON NJ 07013 JASON PARADIS 0.50 X 0 0 0 HARVEY WHILLE 0.50 X 0 303018 14352 WILLIAM ROVENSKY 0.50 X 0 135683 14352 MATTHEW MOLINARO 0.50 X 0 274243 14352 KATHY RUSSELLO 0.50 X 0 0 0 DAVID GILLIS 0.50 X 0 0 0 0 712944 43056 0 0 1 0 HORIZON BCBS OF NJ 3 PONY LANE FLEMINGTON NJ 08822 CLAIMS ADMINISTRATOR 1094908 1 EMPLOYER CONTRIBUTIONS 900099 23633666 23633666 RETIREE CO-PAY CONTRIB 900099 710271 710271 COBRA CONTRIBUTIONS 900099 212418 212418 24556355 435682 435682 3932606 3760856 171750 171750 171750 MEDICAL REBATES 900099 712192 712192 INTEREST ON DELINQUENT 900099 3742 3742 715934 25879721 25272289 0 607432 24493462 24493462 365554 365554 17931 17931 65938 65938 32146 32146 92260 92260 59422 59422 31911 31911 4641 4641 18342 18342 3363 3363 622 622 COMPUTER SERVICES 142870 142870 ACTUARY & CONSULTING 72753 72753 THIRD PARTY ADMINISTRAT 69313 69313 MISCELLANEOUS 50075 50075 COMMUNICATION TO PARTIC 19090 19090 25539693 25539693 0 0 112146 201889 1889928 839210 1419860 1848434 1645 6687 53011 52133 1086 878 10256312 11115761 28321 28631 13709298 14041490 153130 199161 553486 796045 706616 995206 X 0 0 0 0 13002682 13046284 13002682 13046284 13709298 14041490 X 340028 -296426 X X 0 1 1 X 0 2528 2054 474 50483 50079 404 878 CORPORATE BONDS -VAR 4843514 F STATE & LOCAL OBLIGATIONS 648966 F MORTGAGE-BACKED SECURITIES 3238560 F U.S. TREASURIES 2384721 F 11115761 STOP-LOSS INSURANCE RESERVE 349751 SERP LIABILITY 37050 DUE TO RELATED PARTIES 353252 DUE TO BROKER 55992 796045 25879721 25539693 340028 -149955 -146471 -296426 43602 24985663 -149955 -149955 25135618 31911 712192 744103 25879721 24942061 0 24942061 31911 565721 597632 25539693 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE PLAN'S MANAGEMENT EVALUATES TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZES A TAX LIABILITY OR ASSET IF AN UNCERTAIN TAX POSITION WAS TAKEN AND IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2007. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATION -146,471. PART XII, LINE 4B - OTHER ADJUSTMENTS: MEDICAL REBATES 712,192. PART XIII, LINE 4B - OTHER ADJUSTMENTS: MEDICAL REBATES 712,192. CHANGE IN BENEFIT OBLIGATIONS -146,471. 0 0 0 HARVEY WHILLE 0 303018 0 0 0 0 0 3456 0 10896 0 317370 0 0 WILLIAM ROVENSKY 0 135683 0 0 0 0 0 3456 0 10896 0 150035 0 0 MATTHEW MOLINARO 0 274243 0 0 0 0 0 3456 0 10896 0 288595 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FUND'S 990 IS PREPARED BY ITS OUTSIDE AUDITOR AND IS SUBMITTED AND REVIEWED WITH THE ADMINISTRATOR, WHO THEN REVIEWS IT WITH THE CHAIRPERSON OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AND MAY BE VIEWED AT THE FUND OFFICE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -149,955. CHANGE IN BENEFIT OBLIGATION -146,471. TOTAL TO FORM 990, PART XI, LINE 5: -296,426. FORM 990, PART XI, LINE 2C THE PROCESS FOR OVERSEEING THE AUDIT AND FOR SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. UFCW LOCAL 1262 & EMPLOYERS PENSION FUND 1389 BROAD STREET CLIFTON NJ 07013 226074414 TO PROVIDE PENSION BENEFITS TO ELIGIBLE MEMBERS AND THEIR BENEFICIARIES NJ 501(A) 0 UFCW LOCAL 1262 & EMPLOYERS LEGAL SERVICES FUND 1389 BROAD STREET CLIFTON NJ 07013 222238707 TO PROVIDE LEGAL BENEFITS TO ELIGIBLE MEMBERS NJ 501(C)(9) 0 UFCW LOCAL 1262 & EMPLOYERS WELFARE FUND 1389 BROAD STREET CLIFTON NJ 07013 226137317 TO PROVIDE HEALTH, MEDICAL & OTHER BENEFITS TO ELIGIBLE MEMBERS NJ 501(C)(9) 0 UFCW LOCAL 1262 1389 BROAD STREET CLIFTON NJ 07013 221339607 REPRESENTS MEMBERS IN COLLECTIVE BARGAINING MATTERS WITH EMPLOYERS NJ 501(C)(5) 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 UFCW LOCAL 1262 & EMPLOYERS PENSION FUND O 205831 CASH UFCW LOCAL 1262 O 139770 CASH UFCW LOCAL 1262 & EMPLOYERS WELFARE FUND E 144531 CASH UFCW LOCAL 1262 E 102466 CASH UFCW LOCAL 1262 & EMPLOYERS PENSION FUND N 397700 CASH