2012-11-08T17:30:49-06:00 2011-12-31 MILLER KAPLAN ARASE LLP 44 MONTGOMERY ST STE 3701 SAN FRANCISCO CA 941044831 990 2011-01-01 680139450 UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH AND WELFARE TRUST FUND % RICK SILVA UFCW 9257467530 1277 TREAT BLVD WALNUT CREEK CA 945977975 rick silva 2012-11-08 true miller kaplan arase llp 4159563600 2011 2016-02-25 16:41:14Z esai alday 1277 TREAT BLVD WALNUT CREEK CA 945977975 20423884 false X N/A X 1987 CA The Plan provides various types and levels of health benefits to participants, depending upon the type and level of benefits contained in the participants' collective bargaining agreements. 9 9 0 0 0 0 0 0 18184996 20174779 516 1296 219007 247809 18404519 20423884 0 0 19189802 19772706 0 0 0 0 0 1484022 1693468 20673824 21466174 -2269305 -1042290 4199573 3763235 4937475 5543427 -737902 -1780192 THE PLAN PROVIDES VARIOUS TYPES AND LEVELS OF HEALTH BENEFITS TO PARTICIPANTS, DEPENDING UPON THE TYPE AND LEVEL OF BENEFITS CONTAINED IN THE PARTICIPANTS' COLLECTIVE BARGAINING AGREEMENTS. false false THE PLAN PROVIDES VARIOUS TYPES AND LEVELS OF HEALTH BENEFITS TO PARTICIPANTS, DEPENDING UPON THE TYPE AND LEVEL OF BENEFITS CONTAINED IN THE PARTICIPANTS' COLLECTIVE BARGAINING AGREEMENTS. false false false false false false false false false false false false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false false true 680 0 true 0 false false false false false false X 9 9 false false false false false false false true false false false true true false false true true false X RICK SILVA 9257467530 1277 TREAT BLVD WALNUT CREEK CA 945977975 X BRAD SAPP 1.0 X 0 0 0 STEVEN SHIPMAN 1.0 X 0 0 0 ADAM LOVEALL 1.0 X 0 0 0 ESAI ALDAY 1.0 X 0 0 0 PETER DERENALE 1.0 X 0 0 0 RICHARD GLAZER 1.0 X 0 0 0 PAUL BENNIE 1.0 X 0 0 0 JOHN HEISE 1.0 X 0 0 0 JONATHAN HUGHES 1.0 X 0 0 0 0 0 0 0 false false false THE SEGAL COMPANY 100 MONTGOMERY ST STE 500 SAN FRANCISCO CA 941044308 ACTUARY 126910 ufcw-emp benefit plans of no ca grp 1277 treat blvd WALNUT CREEK CA 945977975 administrator 1072490 2 0 EMPLOYER CONTRIBUTIONS 900099 20053986 20053986 PARTICIPANT CONTRIBUTIONS 900099 120793 120793 20174779 1296 1296 0 0 0 0 0 0 MEDICARE PART D REIMBURSEMENT 900099 238822 238822 MISCELLANEOUS 900099 8987 8987 247809 20423884 20422588 1296 0 0 0 19772706 0 0 0 0 0 0 975027 108857 48904 0 0 0 181161 0 53402 157465 0 62433 7101 0 5321 0 0 25887 15400 PRINTING 46802 MISCELLANEOUS 5708 21466174 1312805 1587289 1326126 256354 0 0 1544045 1906095 0 0 0 0 0 0 0 0 16597 13497 0 0 0 0 0 0 0 0 0 0 0 4199573 3763235 208475 243427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4729000 5300000 4937475 5543427 X 0 0 0 0 -737902 -1780192 -737902 -1780192 4199573 3763235 -1042290 X false true true X 0 CLAIMS PAYABLE AND CLAIMS IBNR 2275000 ACCUM. ELIGIBILITY CREDITS 2850000 PREMIUMS PAYABLE 175000 5300000 20423884 21466174 -1042290 571000 571000 -471290 20423884 20423884 20423884 20895174 4729000 4729000 16166174 5300000 5300000 21466174 PART XI, 8: CHANGES IN BENEFIT OBLIGATIONS: $571,000 PART XIII, 2D: BENEFIT OBLIGATIONS AT DECEMBER 31, 2010: ($4,729,000) PART XIII, 4B: BENEFIT OBLIGATIONS AT DECEMBER 31, 2011: $5,300,000 PART X, LINE 2: THE PLAN HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES 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. INFORMATION RETURNS FOR YEARS FOR WHICH THE APPLICABLE STATUTES OF LIMITATIONS HAVE NOT EXPIRED ARE SUBJECT TO EXAMINATION BY AUTHORITIES. part vi, line 8b: the organization does not have a committee with authority to act on behalf of the governing body. part vi, line 11a: a copy of form 990 is emailed to all the trustees for review before filing. PART VI, LINE 11b: THE BOARD VOTES TO GIVE AUTHORITY TO CHAIR AND SECRETARY PRIOR TO SUBMISSION, WITH THEM REVIEWING AFTERWARDS. PART VI, LINE 19: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO PARTICIPANTS UPON REQUEST. THE PLAN FILES A FORM 5500 ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN WITH THE DEPARTMENT OF LABOR. THE FORM 5500 IS AVAILABLE ON THE DOL'S WEBSITE. THE PLAN COMPLIES WITH ERISA. hp heritage plaza associates lp 630 pena dr 400 davis CA 95618 810565212 mutlifamily apt CA na unrelated 0 0 false false 0.00000 rite aid corporation 30 hunter ln camp hill PA 17011 954391249 sales PA na c corp 0 0 0.00000 savco drugs inc 455 oconnor dr 190 san jose CA 95128 361924025 sales CA na c corp 0 0 0.00000 redding howell's inc 1426 eureka way redding CA 96001 680424921 sales CA na c corp 0 0 0.00000 cascade paint & supply 1220 california st redding CA 96001 942317856 sales & repair CA na c corp 0 0 0.00000 ufcw-emp ben plans of no ca grp admin 1277 treat blvd walnut creek CA 94597 260048379 admin svcs CA na c corp 0 0 0.00000 false false false false false false false false false false false true false false false false false true rite aid corporation r 19001486 cash received savco drugs inc r 159997 cash received hp heritage plaza associates lp r 59425 cash received cascade paint & supply r 56837 cash received ufcw-employer benefit plans of northern california group administration llc l 1072492 cash