2022-11-04T14:41:15-05:00 2021-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE COURT SUITE 500 AUBURN HILLS MI 48362 990 2021-01-01 813021883 UAW RETIREES OF THE BUDD COMPANY HEALTH AND WELFARE TRUST UAWR 2028570620 1701 PENNSYLVANIA AVE NW 1200 WASHINGTON DC 20006 GARY PETRONI CHAIRPERSON 2028570620 2022-10-26 1 GARY PETRONI 999009999 TINA PETERS P00904574 2483757100 2022-10-26 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z X 167908092 0 X WWW.OURBENEFITOFFICE.COM/BUDDRETIREEBENEFITS/ X 2016 MI THE TRUST WAS ESTABLISHED AND IS CONTINUED FOR THE PURPOSE OF PROVIDING HEALTH AND WELFARE BENEFITS TO HELP FUND CERTAIN BENEFITS PROVIDED TO ELIGIBLE RETIRED EMPLOYEES OF THE BUDD COMPANY, INC. WHO ENDED THEIR EMPLOYMENT AT THE BUDD COMPANY IN THE UAW REPRESENTED BARGAINING UNIT, AND SURVIVING SPOUSES, SPOUSES AND DEPENDENTS WHO MAY BE ENTITLED TO SUCH BENEFITS THROUGH THEIR RELATIONSHIP WITH SUCH RETIREES. 5 5 0 1 0 0 0 0 6468680 6603694 8951843 25689426 0 0 15420523 32293120 0 0 21759986 20984109 80000 80000 0 0 0 2731735 2579132 24571721 23643241 -9151198 8649879 494153594 502021542 102246 81383 494051348 501940159 TO HELP FUND CERTAIN BENEFITS PROVIDED TO ELIGIBLE RETIRED EMPLOYEES OF THE BUDD COMPANY AND OTHER ELIGIBLE INDIVIDUALS. 0 0 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 0 0 1 5 0 1 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X GROOM LAW GROUP CHARTERED 2028570620 1701 PENNSYLVANIA AVE NW SUITE 1200 WASHINGTON DC 20006 GARY PETRONI CHAIRPERSON 1.00 5.00 X 23000 36360 0 SUZANNE DANIELS PHD COMMITTEE MEMBER 1.00 10.00 X 19000 43430 0 FRANCINE PARKER COMMITTEE MEMBER 1.00 5.00 X 19000 36360 0 GEORGE HARDY COMMITTEE MEMBER 1.00 5.00 X 0 0 0 RICK ISAACSON COMMITTEE MEMBER 1.00 5.00 X 19000 36360 0 COMERICA INSTITUTIONAL TRUSTEE 1.00 5.00 X 5980 0 0 85980 152510 0 0 0 0 0 BLUE CROSS BLUE SHIELD OF MICHIGAN 205000 CIVIC CENTER DRIVE SOUTHFIELD MI 48076 ADMINISTRATIVE SERVICES 1061510 BENESYS INC 700 TOWER DR SUITE 300 TROY MI 48098 ADMINISTRATIVE AND IT SERVICES 424579 SILVER SCRIPT PO BOX 30001 PITTSBURGH PA 152220330 ADMINISTRATIVE SERVICES 305118 PRUDENTIAL TRUST COMPANY 30 SCRANTON OFFICE PARK SCRANTON PA 18507 INVESTMENT MANAGEMENT FEES 169262 UNICARE LIFE & HEALTH INSURANCE CO 3200 GREENFIELD RD DEARBORN MI 48120 ADMINISTRATIVE SERVICES 134250 6 CMS SUBSIDIES 900099 6603694 6603694 6603694 4135136 4135136 157169262 135614972 21554290 21554290 21554290 32293120 6603694 0 25689426 20984109 80000 382778 37545 57459 93310 13751 49865 ADMINISTRATIVE FEE 1924271 PCORI FEE 11397 BANK FEE 7833 OTHER EXPENSES 923 23643241 8045897 3046792 519682 7520448 125356391 87660958 125021156 171464502 234972295 232287186 238173 41656 494153594 502021542 102246 81383 102246 81383 X 0 0 0 0 494051348 501940159 494051348 501940159 494153594 502021542 8649879 -761068 0 X 0 1 X 1 0 0 COMMON COLLECTIVE TRUST FUNDS 211361034 F PARTNERSHIP INVESTMENTS 20926152 F 232287186 31532052 -761068 -761068 32293120 0 32293120 23643241 0 23643241 0 23643241 FORM 990, PART VI, SECTION A, LINE 7A THERE ARE 2 MEMBERS OF THE COMMITTEE SERVING AT THE DISCRETION OF THE UAW INTERNATIONAL PRESIDENT WHO MAY BE REMOVED OR REPLACED AND A SUCCESSOR DESIGNATED AT ANY TIME BY WRITTEN NOTICE FROM THE UAW INTERNATIONAL PRESIDENT TO THE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE, LEGAL COUNSEL, AND ADMINISTRATOR REVIEW THE 990 PRIOR TO FILING. THE ENTIRE BOARD IS PROVIDED A COPY OF THE 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUST WAS ESTABLISHED BY COURT APPROVED BANKRUPTCY PLAN. THE COURT-APPROVED TRUST AGREEMENT INCLUDES A CODE OF ETHICS BY WHICH EACH COMMITTEE MEMBER AGREES TO ABIDE. IT IS REGULARLY REVIEWED WITH THE COMMITTEE. IN ADDITION, EACH COMMITTEE MEMBER MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONNAIRE WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. IF SUCH A CONFLICT IS PRESENT THE INVOLVED MEMBER(S) DO NOT PARTICIPATE IN THE DISCUSSION OR VOTING. FORM 990, PART VI, SECTION C, LINE 19 THE TRUST IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 OF ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. UAW RETIREES OF THE DANA CORPORATION AND WELFARE TRUST 1701 PENNSYLVANIA AVE NW SUITE 1200 WASHINGTON DC 20006 261851652 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW ST JOSEPH RETIREES HEALTH AND WELFARE TRUST 1701 PENNSYLVANIA AVE NW SUITE 1200 WASHINGTON DC 20006 271401289 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW RETIREES OF ACC BENEFIT TRUST 1701 PENNSYLVANIA AVE NW SUITE 1200 WASHINGTON DC 20006 276927927 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 THYSSENKRUPP NORTH AMERICA INC 111 W JACKSON BLVD SUITE 2400 CHICAGO IL 60604 ENGINEERING IL C 0 THYSSENKRUPP FINANCE USA INC 3155 W BIG BEAVER RD TROY MI 48084 MANAGEMENT SERVICES MI C 0 THE BUDD COMPANY INC 111 W JACKSON BLVD SUITE 2400 CHICAGO IL 60604 AUTOMOTIVE IL C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1