UNITED FOOD & COMMERCIAL WORKERS & EMPS ARIZONA HEALTH & WELFARE TR: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
UNITED FOOD & COMMERCIAL WORKERS & EMPS ARIZONA HEALTH & WELFARE TR (EIN 23-7244353)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-17
IRS object ID
201202919349300240
Schema version
2011v1.3
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)
Timestamp2012-10-17T17:36:59-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MILLER KAPLAN ARASE & CO LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14123 LANKERSHIM BLVDAddressLine1
CityNORTH HOLLYWOODCity
StateCAState
ZIP Code916022828ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237244353EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNITED FOOD AND COMMERCIAL WORKERS ANDBusinessNameLine1
Business Name Line2EMPLOYERS ARIZONA HEALTH & WELFARE TRUSTBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% BARBARA RAYInCareOfName
Name ControlUNITNameControl
Phone6022493582Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12400 W DUNLAP AVEAddressLine1
CityPHOENIXCity
StateAZState
ZIP Code850212811ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARTIN HERNANDEZName
TitleTRUSTEETitle
Date Signed2012-10-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMILLER KAPLAN ARASE LLPName
Phone8187692010Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES MCLAUGHLINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12400 W DUNLAP AVE STE 250AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code850212811ZIPCode
FieldValueIRS element (for citing)
Gross Receipts161200180GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1968YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Termination Or ContractionXTerminationOrContraction
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees1201TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year123183519ProgramServiceRevenuePriorYear
Program Service Revenue CY132774314ProgramServiceRevenueCY
Investment Income Prior Year-134241InvestmentIncomePriorYear
Investment Income Current Year-143663InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year123049278TotalRevenuePriorYear
Total Revenue Current Year132630651TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year116373762BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY131905940BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9233477OtherExpensePriorYear
Other Expenses Current Year9621190OtherExpensesCurrentYear
Total Expenses Prior Year125607239TotalExpensesPriorYear
Total Expenses Current Year141527130TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2557961RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-8896479RevenuesLessExpensesCY
Total Assets BOY38778590TotalAssetsBOY
Total Assets EOY33935264TotalAssetsEOY
Total Liabilities BOY35749053TotalLiabilitiesBOY
Total Liabilities EOY39700791TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3029537NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-5765527NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionTHE UNITED FOOD AND COMMERCIAL WORKERS AND EMPLOYERS ARIZONA HEALTH AND WELFARE TRUST IS A MULTIEMPLOYER WELFARE BENEFIT PLAN PROVIDING MEDICAL-HOSPITAL, DENTAL, PRESCRIPTION, VISION, DISABILITY, DEATH AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO PARTICIPANTS.Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
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 LiquidationtruePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965982NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1201NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
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 Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
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 CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBARBARA RAYNamePerson
Telephone Number6022493582TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12400 W DUNLAP AVE STE 250AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code850212811ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
PETER BARTH
EMPLOYER TRUSTEE4.0X000
STUART MARCUS
EMPLOYER TRUSTEE4.0X000
JAMES NYGREN
EMPLOYER TRUSTEE4.0X000
FRANK STEGMAN
EMPLOYER TRUSTEE4.0X000
MARTIN HERNANDEZ
UNION TRUSTEE4.0X000
JAMES MCLAUGHLIN
UNION TRUSTEE4.0X000
PAUL RUBIN
UNION TRUSTEE4.0X000
JACOB SEDILLO
UNION TRUSTEE4.0X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
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 (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SOUTHWEST SERVICE ADMINISTRATORS IN
2400 W DUNLAP AVE STE 250PHOENIXAZ850212811ADMIN. SERVICES5208711
BLUECROSS BLUESHIELD OF ARIZONA
2444 W LAS PALMARITAS DRPHOENIXAZ850214860COST CONTAINMENT1677935
PATIENT CARE PARTNERSHIP
2400 W DUNLAP AVE STE 250PHOENIXAZ850212811MEDICAL BILLING REV.812572
NAT'L MEDICAL HEALTH CARD SYSTEMS
23 BRITISH AMERICAN BLVDLATHANNY121101435PHARMACY BENEFIT MGM346952
RAEL LETSON
35 N LAKE AVE STE 810PASADENACA911011892ACTUARIAL SERVICES175506
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS900099129965467129965467
EMPLOYEE CONTRIBUTIONS900099349655349655
EARLY RETIREE REINSURANCE PROGRAM REIMB.900099597139597139
RETIREE SELF-PAYMENTS90009912459761245976
SUPPLEMENTAL EMPLOYER CONTRIBUTIONS900099504537504537

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column111540TotalRevenueColumn
Related Or Exempt Function Income111540RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue132774314TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column170325TotalRevenueColumn
Exclusion$170,325ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities28255541Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities28569529Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-313988Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-313988TotalRevenueColumn
Exclusion-$313,988ExclusionAmount

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 Column132630651TotalRevenueColumn
Related Or Exempt Function Income132774314RelatedOrExemptFunctionIncome
Exclusion-$143,663ExclusionAmount

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)
Total131905940Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

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)
Total4503962Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total116837Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total109020Total

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)
Total35643Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total781956Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total701090Total

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)
Total37355Total

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)
Total44525Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
MEDICAL NETWORK ACCESS FEES1677935
MAYO HEALTH NW PPO FEES812572
CASE MANAGEMENT FEES330131
PRESCRIPTION ADMIN FEES346952

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total123212Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total141527130Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6498368BOY
EOY5975980EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9533875BOY
EOY18860729EOY

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)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY22746341BOY
EOY9098555EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY38778590BOY
EOY33935264EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY539953BOY
EOY473619EOY

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)
BOY35209100BOY
EOY39227172EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY35749053BOY
EOY39700791EOY
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)
BOY3029537BOY
EOY-5765527EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3029537BOY
EOY-5765527EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY38778590BOY
EOY33935264EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-8896479ReconcilationRevenueExpenses
Reconcilation Other Changes101415ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionBENEFIT OBLIGATIONSDescription
Amount$39,227,172Amount
FieldValueIRS element (for citing)
Total Of Amounts39227172TotalOfAmounts
Total Revenue132630651TotalRevenue
Total Expenses141527130TotalExpenses
Excess Or Deficit For Year-8896479ExcessOrDeficitForYear
Net Unrealized GL On Investments101415NetUnrealizedGLOnInvestments
Total Adjustments101415TotalAdjustments
Excess Or Deficit Per FS-8795064ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt132732066TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments101415NetUnrealizedGainsInvestments
Revenue Not Rptd F990101415RevenueNotRptdF990
Revenue Subtotal132630651RevenueSubtotal
Total Revenue Per Form990132630651TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt141527130TotExpensesEtcAuditedFinclStmt
Expenses Subtotal141527130ExpensesSubtotal
Total Expenses Per Form990141527130TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPART X, LINE 2:Identifier
Return ReferenceThe Plan has adopted guidance on accounting for uncertainty in incomeReturnReference
Explanationtaxes issued by the Financial Accounting Standards Board. The Plan administrator believes that the Plan has taken no uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. Certain prior years information returns filed by the Plan are subject to examination by authorities for statutory periods.Explanation

Schedule N IRS990ScheduleN

FieldValueIRS element (for citing)
Liquidation TableLiquidationTable
Director Of SuccessorfalseDirectorOfSuccessor
Employee Of SuccessorfalseEmployeeOfSuccessor
Owner Of SuccessorfalseOwnerOfSuccessor
Receive CompensationfalseReceiveCompensation

Disposition Table DispositionTable (4 entries)

Description Of AssetDescriptionOfAssetDate Of DistributionDateOfDistributionFMV Of AssetFMVOfAssetMethod Of FMV DeterminationMethodOfFMVDeterminationEINEINAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeIRC SectionIRCSection
BLUE ROCK CAPITAL FUND LP
BLUE ROCK CAPITAL FUND, L.P.2011-12-307536801SEE FINANCIAL STATEMENTS411657049445 E LAKE ST STE 120WayzataMN55391INVESTMENT MANAGER
PACIFIC INCOME ADVISORS
MONTEREY PIA SHORT-TERM SECURITIES FUND2011-07-037574878SEE FINANCIAL STATEMENTS9540679741299 Ocean Ave Fl 2SANTA MONICACA90401INVESTMENT MANAGER
MELLON INSTITUTIONAL ASSET MANAGEME
MELLON CF GLOBAL ALPHA II FUND2011-06-307627375SEE FINANCIAL STATEMENTS251442864ONE BOSTON PL FL 24BOSTONMA02108INVESTMENT MANAGER
PIMCO
PIMCO ALL ASSET FUND INST. CL2011-08-085000000SEE FINANCIAL STATEMENTS010721718840 NEWPORT CTRNEWPORT BEACHCA92660INVESTMENT MANAGER
FieldValueIRS element (for citing)
Director Of Successor2falseDirectorOfSuccessor2
Employee Of Successor2falseEmployeeOfSuccessor2
Owner Of Successor2falseOwnerOfSuccessor2
Receive Compensation2falseReceiveCompensation2

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierPART I AND III, LINE 1 - ORGANIZATION'S MISSION:Identifier
Return ReferenceTHE UNITED FOOD AND COMMERCIAL WORKERS AND EMPLOYERS ARIZONA HEALTH ANDReturnReference
ExplanationWELFARE TRUST IS A MULTIEMPLOYER WELFARE BENEFIT PLAN PROVIDING MEDICAL-HOSPITAL, DENTAL, PRESCRIPTION, VISION, DISABILITY, DEATH AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO PARTICIPANTS. PART VI, QUESTION 11B: FORM 990 IS PRESENTED FOR REVIEW AND SIGNATURE AT BOARD OF TRUSTEE MEETINGS. PART VI, QUESTIONS 15A AND 15B: THE BOARD OF TRUSTEES DO NOT RECEIVE COMPENSATION. THE ORGANIZATION DOES NOT HAVE OTHER OFFICERS OR "KEY EMPLOYEES", AS DEFINED. PART VI, QUESTION 19: GOVERNING DOCUMENTS - NO DOCUMENTS AVAILABLE TO THE PUPLIC. FINANCIAL STATEMENTS - AUDITED STATEMENTS ARE ONLY AVAILABLE UPON REQUEST. PART XI, LINE 5: NET UNREALIZED APPRECIATION IN FAIR VALUE OF INVESTMENTS $101,415Explanation

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