RETIREES OF CTNA HEALTH CARE TRUST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
RETIREES OF CTNA HEALTH CARE TRUST (EIN 26-3625263)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-18
IRS object ID
201232929349300003
Schema version
2011v1.2
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)
Timestamp2012-10-18T07:15:14-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCELHANEY & ASSOCIATES LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11725 WASHINGTON RD STE 602AddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15241ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN263625263EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1VEBA COMMITTEE RETIREES OF CTNA HEALTH CARE TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlVEBANameControl
Phone4122012242Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS DUZAKName
TitleCOMMITTEE MEMBERTitle
Phone4122012242Phone
Date Signed2012-07-24DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameF E MCELHANEY JRName
Phone4128313812Phone
Date Prepared2012-10-18DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS 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 Receipts41352009GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation2008YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH CARE BENEFITSActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16009415ProgramServiceRevenuePriorYear
Program Service Revenue CY16195017ProgramServiceRevenueCY
Investment Income Prior Year1501985InvestmentIncomePriorYear
Investment Income Current Year1623422InvestmentIncomeCurrentYear
Other Revenue Current Year1216937OtherRevenueCurrentYear
Total Revenue Prior Year17511400TotalRevenuePriorYear
Total Revenue Current Year19035376TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year13631842BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY13629233BenefitsPaidToMembersCY
Salaries Etc Prior Year97700SalariesEtcPriorYear
Salaries Etc Current Year100481SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year456518OtherExpensePriorYear
Other Expenses Current Year406523OtherExpensesCurrentYear
Total Expenses Prior Year14186060TotalExpensesPriorYear
Total Expenses Current Year14136237TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3325340RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4899139RevenuesLessExpensesCY
Total Assets BOY51159484TotalAssetsBOY
Total Assets EOY56801691TotalAssetsEOY
Total Liabilities BOY76646TotalLiabilitiesBOY
Total Liabilities EOY75127TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY51082838NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY56726564NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH CARE BENEFITSMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionHEALTH CARE BENEFITS TO PARTICIPANTSDescription
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 FootnotefalseReportFin48Footnote
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
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
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
Transaction Related EntityfalseTransactionRelatedEntity
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
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
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 CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CENTRAL DATA SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4122012242TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
THOMAS DUZAK
COMMITTEE MEMBER1.00X2409600
CLIFTON SHANNON
COMMITTEE MEMBER1.00X477400
HOWARD KLINE
COMMITTEE MEMBER1.00X1909600
JAMES CARNEY
COMMITTEE MEMBER1.00X1909600
WAYNE CHAMBERS
COMMITTEE MEMBER1.00X1909600
JOHN SELLERS
COMMITTEE MEMBER1.00X1432300
FieldValueIRS element (for citing)
Total Reportable Comp From Org100481TotalReportableCompFromOrg
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CENTRAL DATA SERVICES INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line160 BOULEVARD OF THE ALLIES 5TH FLAddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesADMINISTRATORDescriptionOfServices
Compensation115200Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumn
EMPLOYER CONTRIBUTIONS90009911673130
PARTICIPANT CONTRIBUTIONS9000994521887
FieldValueIRS element (for citing)
Total Program Service Revenue16195017TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1827780TotalRevenueColumn
Exclusion$1,827,780ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities22112275Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities22316633Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-204358Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-204358TotalRevenueColumn
Exclusion-$204,358ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionEARLY RETIREE REINSURANCE PROGRAMDescription
Business Code900099BusinessCode
Total Revenue Column1216937TotalRevenueColumn
Exclusion$1,216,937ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1216937TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column19035376TotalRevenueColumn
Related Or Exempt Function Income16195017RelatedOrExemptFunctionIncome
Exclusion$2,840,359ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total13629233Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total100481Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total10067Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total10125Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total153373Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total153573Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total28795Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5671Total

Insurance Insurance

FieldValueIRS element (for citing)
Total44919Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14136237Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY161791BOY
EOY423605EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY22148BOY
EOY6436EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY36593BOY
EOY41633EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY33970849BOY
EOY32473543EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY16652818BOY
EOY23555600EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY315285BOY
EOY300874EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY51159484BOY
EOY56801691EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY50263BOY
EOY47274EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY26383BOY
EOY27853EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY76646BOY
EOY75127EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY51082838BOY
EOY56726564EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY51082838BOY
EOY56726564EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY51159484BOY
EOY56801691EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4899139ReconcilationRevenueExpenses
Reconcilation Other Changes744587ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
US TIPS INDEX MUTUAL FUND9604216F
PIMCO UNCONSTRAINED BOND8246031F
JPM PRIME MM FUND5705353F
FieldValueIRS element (for citing)
Total Of Book Value Securities23555600TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionPARTICIPANT CONTRIBUTIONS IN ADVANCEDescription
Amount$27,853Amount
FieldValueIRS element (for citing)
Total Of Amounts27853TotalOfAmounts
Total Revenue19035376TotalRevenue
Total Expenses14136237TotalExpenses
Excess Or Deficit For Year4899139ExcessOrDeficitForYear
Net Unrealized GL On Investments744587NetUnrealizedGLOnInvestments
Total Adjustments744587TotalAdjustments
Excess Or Deficit Per FS5643726ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt19626590TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments744587NetUnrealizedGainsInvestments
Revenue Not Rptd F990744587RevenueNotRptdF990
Revenue Subtotal18882003RevenueSubtotal
Investment Expenses Not Included153373InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt153373RevenueNotRptdOnFinStmt
Total Revenue Per Form99019035376TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13982864TotExpensesEtcAuditedFinclStmt
Expenses Subtotal13982864ExpensesSubtotal
Investment Expenses Not Included2153373InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt153373ExpensesNotRptdOnFinStmt
Total Expenses Per Form99014136237TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 11aREVIEWED BY PRINCIPAL OFFICERS AND SIGNING COMMITTEE MEMBER
Pt VI, Line 12cAREAS OF POSSIBLE CONFLICT REVIEWED BY COMMITTEE MEMBERS AS NEEDED
Pt VI, Line 15DETERMINED BY THE COMMITTEE MEMBERS
Pt VI, Line 19AVAILABLE UPON REQUEST
Pt XIUNREALIZED INVESTMENT GAIN

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)
EIN341417030EIN
Primary ActivityMANUFACTURE AND SALE OF TIRESPrimaryActivity
Legal Domicile StateSCLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
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
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 OrgfalseOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSCH.R,PART IVIdentifier
ExplanationRELATED ORGANIZATION IS CONTRIBUTING EMPLOYER OF THE VEBA.Explanation

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