2011-07-21T13:26:44-05:00 2010-09-30 CUNNINGHAM & ASSOCIATES 60 EAGLE VALLEY COURT BROADVIEW HEIGHTS OH 44147 990 2009-10-01 346726563 UNITED FOOD & COMMERCIAL WORKERS UNION- EMPLOYER HEALTH & WELFARE FUND UNIT 2162412828 9199 MARKET ST BROADVIEW HTS OH 44147 thomas robertson 2162412828 2011-07-15 1 4407171350 2011-07-13 2009 2016-02-24 21:20:13Z THOMAS H ROBERTSON 9199 MARKET ST BROADVIEW HTS OH 44147 141747678 0 X N/A X 1952 OH PROVIDE HEALTH AND WELFARE BENEFITS TO PARTICIPANTS. 9 9 46 0 0 0 0 91935210 89203645 -4062890 1670121 1425590 1327390 89297910 92201156 0 91747540 97002381 2162158 2089137 0 0 1883408 2075836 95793106 101167354 -6495196 -8966198 57175835 50461650 15751173 15173464 41424662 35288186 PROVIDE HEALTH AND WELFARE BENEFITS TO PARTICIPANTS 0 0 MEDICAL,DENTAL AND DISABILITY BENEFITS- THE FUND INCONJUNTION WITH FORT DEARBORNLIFE INSURANCE COMPANY,KAISER COMMUNITY HEALTH FOUNDATION,AND MEDICAL MUTUAL OFOHIO PROVIDES VARIOUS HOSPITAL, SURGICAL, MEDICAL,ACCIDENT,AND SICKNESS WEEKLY IDEMNITY, AND LIFE INSURANCE BENEFITSTO APPROXIMATELY 23,500 MEMBERS. PAID PRESCRIPTION PROGRAM- THE FUND HAS CONTRACTED WITHCAREMARK TO PROVIDE A PROGRAM FOR PRESCRIPTION DRUGS. THEPROGRAM REQUIRES MEMBERS PAY 20-30% TOWARDS EACHPRESCRIPTION. ALSO SOME MEMBERS RECEIVE REIMBURSEMENTSTHROUGH MAJOR MEDICAL. APPROXIMATELY 22,300 MEMBERS ARECOVERED UNDER THIS PLAN. EYE CARE PROGRAM - THE FUND HAS CONTRACTED WITH SPECTERAINC. AND CERTAIN OTHER OPTOMETRISTS TO PROVIDE A FULLY-PAIDEYE CARE PROGRAM TO APPROXIMATELY 22,700 MEMBERS. THISPROGRAM PROVIDES FOR A FREE EYE EXAMINATION AND A PAIROF GLASSES EVERY 24 MONTHS FOR ADULTS AND EVERY 12 MONTHS FORCHILDREN. 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 1 46 1 0 0 0 0 0 0 0 0 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JEFFREY W WERNER 2162412828 9199 MARKET ST BROADVIEW HTS OH 44147 X THOMAS H ROBERTSON 1.00 X 0 0 0 JEAN M COLARIK 1.00 X 0 0 0 MICHAEL A KRZYS 1.00 X 0 0 0 ROBERT W GRAUVOGL 1.00 X 0 0 0 DAVID HICKS 1.00 X 0 0 0 THOMAS HEINEN 1.00 X 0 0 0 RAY HUBER 1.00 X 0 0 0 JILL ADAM 1.00 X 0 0 0 CARL IVKA 1.00 X 0 0 0 0 0 0 0 0 0 0 LITTLER MENDELSON 1100 SUPERIOR AVE CLEVELAND OH 44114 LEGAL SERVICES 168538 CUNNINGHAM & ASSOCIATES 60 EAGLE VALLEY CT BROADVIEW HTS OH 44147 AUDITING AND ACCOUNTING SERVICES 155771 2 employer contributions 525100 80807464 80807464 employee contributions 525100 6130110 6130110 2266071 2266071 89203645 1198118 1198118 50018525 49546522 472003 472003 472003 formulary rebates 525100 1327390 1327390 1327390 92201156 91003038 0 1198118 97002381 1507014 222379 236974 122770 211076 148422 233122 29644 74841 236174 242661 1975 76386 6769 POSTAGE 345949 bank charges 98815 PRINTING 93998 fiduciary liability ins 61680 retirement plan service 39915 174409 101167354 4801919 4679714 3741521 3553556 49870 40790 2084219 1981017 149693 103202 48007832 41659388 425000 425000 57175835 50461650 605365 276938 15145808 14896526 15751173 15173464 X 0 0 0 0 41424662 35288186 41424662 35288186 57175835 50461650 X 0 1 1 X 0 786014 778645 7369 1298205 1202372 95833 103202 INSURANCE PREMIUMS & CLAIMS PAYABLE 1675826 ESTIMATED LIABILITY FOR IBNR 13220700 14896526 92201156 101167354 -8966198 2829722 2829722 -6136476 94797756 2829722 2829722 91968034 233122 233122 92201156 101183514 0 101183514 233122 -249282 -16160 101167354 Part XIII, Line 4b - Other Adjustments: CHANGE IN BENEFIT OBLIGATIONS CURRENTLY PAYABLE: -249282. Form 990, Part VI, Section B, line 11 THE RETURN IS PREPARED BY THE FUND'S INDEPENDENT QUALIFIED PUBLIC ACCOUNTANTS WHICH ALSO PERFORM AN AUDIT OF THE FUND'S BOOKS AND RECORDS. THE RETURN IS THEN PROVIDED TO THE TRUSTEES FOR REVIEW AND SIGNATURE. Form 990, Part VI, Section B, line 12c THE FUND IS SUBJECT TO ERISA AND THE TRUSTEES CONFORM TO ITS REGULATIONS.SECTION 404 AND 406 CONTAIN STRICT FIDUCIARY RULES AND CONFLICTS OF INTEREST PROHIBITIONS.THE TRUSTEES MONITOR AND ENFORCE THE FUND'S COMPLIANCE WITH THE ERISA WITH ASSISTANCE OF THE FUNDS PROFESSIONALS. Form 990, Part VI, Section C, line 19 ALL THE FUND'S GOVERNING DOCUMENTS,POLICIES FINANCIAL STATEMENTS AND TAX RETURNS ARE AVAILABLE UPON REQUEST BY WRITING THE FUND'S ADMINISTRATOR AND REQUESTING A COPY. FORM 990, PART VI, SECTION B, LINE 12C - THE FUND IS SUBJECT TO ERISA AND THE TRUSTEES CONFORM TO ITS REGULATIONS. SECTION 404 AND 406 OF ERISA CONTAIN STRICT FIDUCIARY RULES AND CONFLICTS OF INTEREST PROHIBITIONS. THE TRUSTEES MONITOR AND ENFORCE THE FUND'S COMPLIANCE WITH ERISA WITH THE ASSISTANCE OF THE FUND'S PROFESSIONALS.