2022-11-15T13:20:10-06:00 2021-12-31 131578842 BUCHBINDER TUNICK & CO LLP 150 CLOVE ROAD 5TH FLOOR LITTLE FALLS NJ 07424 990 2021-01-01 136115078 UAW - LOCAL 259 SOCIAL SECURITY DEPT UAW- 2019478000 140 SYLVAN AVENUE 303 ENGLEWOOD CLIFFS NJ 07632 JEFFREY C ISAACS TRUSTEE 2019478000 2022-11-04 1 JEFFREY ISAACS 999009999 TED KIRSHENBAUM CPA P01260796 2126955003 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JEFFREY C ISAACS 140 SYLVAN AVENUE 303 ENGLEWOOD CLIFFS NJ 07632 26023164 0 X N/A X EMPLOYEE BENEFIT PLAN 1949 NY THE PLAN PROVIDES DEATH, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY INCOME, HOSPITAL, SURGICAL, MEDICAL, DENTAL, OPTICAL AND PRESCRIPTION DRUG BENEFITS FOR APPROXIMATELY 1,300 ELIGIBLE ACTIVE AND RETIRED MEMBERS AND THEIR DEPENDENTS. THE PLAN ALSO PROVIDES SUPPLEMENTAL BENEFITS TO ELIBIGLE RETIREES FOR WHOM MEDICARE IS THE PRIMARY CARRIER. 4 4 0 0 0 0 0 0 19785532 21845413 166865 467265 2538223 1870682 22490620 24183360 0 0 23357286 23538148 0 0 0 0 0 1443662 1613115 24800948 25151263 -2310328 -967903 15310673 19912655 216827 113756 15093846 19798899 X FORMULATE, ADOPT AND ADMINISTER A PROGRAM OF BENEFITS FOR THE EXCLUSIVE BENEFIT OF THE FUND'S PARTICIPANTS AND THEIR DEPENDENTS OR OTHER SPECIFIED BENEFICIARIES IN ORDER TO PROVIDE HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND DEPENDENTS OR OTHER SPECIFIED BENEFICIARIES OF SUCH PARTICIPANTS. 0 0 TO PROVIDE HEALTH BENEFITS TO APPROXIMATELY 1,300 ACTIVE AND RETIRED PARTICIPANTS AND DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 1 1 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 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS 2019478000 140 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 07632 X JEFFREY ISAACS EMPLOYER TRUSTEE 5.00 X 0 0 0 BRIAN SCHNECK UNION TRUSTEE 5.00 X 0 0 0 SCOTT TYRELL UNION TRUSTEE 5.00 X 0 0 0 JOE CHALOM EMPLOYER TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 302 KNIGHTS RUN AVE TAMPA FL 33602 CONTRACT ADMINISTRATOR 785163 EMPIRE HEALTH CHOICE ASSURANCE INC 3075 VANDERCAR WAY CINCINNATI OH 45209 CLAIMS ADJUDICATION 410172 2 EMPLOYER CONTRIBUTIONS 900099 21780102 21780102 COBRA CONTRIBUTIONS 900099 64988 64988 RETIREES CONTRIBUTIONS 900099 323 323 21845413 486134 486134 1820935 1839804 -18869 -18869 -18869 PRESCRIPTION DRUG REBATES 900099 884672 884672 STOP LOSS INSURANCE REIMBURSEMENT 900099 883930 883930 SETTLEMENT OF SUBROGATION CLAIMS 900099 59721 59721 42359 42359 1870682 24183360 23716095 0 467265 23538148 123345 84069 20336 61000 23773 2590 19635 BENEFIT ADMINISTRATION 410637 PPO ACCESS FEES 410172 CONTRACT ADMINISTRATOR' 374526 UTILIZATION REVIEW-MED 50540 32492 25151263 742911 434388 9047311 8414339 753622 1156185 11125 4458 3461316 5055138 0 3486081 1294388 1362066 15310673 19912655 32832 82843 183995 30913 216827 113756 X 0 0 0 0 15093846 19798899 15093846 19798899 15310673 19912655 X -967903 -23801 5696757 X X 0 1 X 1 0 0 GUARANTEED RATE FUND 3486081 F 3486081 INTEREST RECEIVABLE 12076 OTHER RECEIVABLE 12645 SECURITY DEPOSITS 74000 STOP LOSS REIMBURSEMENTS RECEIVABLE 718313 PRESCRIPTION DRUG REBATES RECEIVABLE 545032 1362066 CONTRIBUTIONS RECEIVED IN ADVANCE 30913 30913 X 24139223 -23801 -23801 24163024 20336 20336 24183360 25130927 0 25130927 20336 20336 25151263 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS FOR THE PLAN. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONG SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2018. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES RECEIVE A COPY OF THE FORM 990 FOR THEIR REVIEW, PRIOR TO ITS FILING. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO PARTICIPANTS FOR PUBLIC INSPECTION UPON WRITTEN REQUEST. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC JEFFREY ISAACS - 16 ROVEN ROAD, WESLEY HILLS, NY 10952. BRIAN SCHNECK - 80 JERUSALEM AVENUE, HICKSVILLE, NY 11801. SCOTT TYRELL - 80 JERUSALEM AVENUE, HICKSVILLE, NY 11801. JOE CHALOM - 5001 GLENWOOD ROAD, BROOKLYN, NY 11234. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS FROM LOCAL 365 UAW WELFARE FUND 5,696,757. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. UAW LOCAL 259 PENSION FUND 140 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 07632 136115077 TO PROVIDE PENSION BENEFITS TO PARTICIPANTS AND BENEFICIARIES NJ 401(A) N/A 0 1632 HYLAND BLVD AUTO LLC 676 WEST MERRICK ROAD LLC ABC BODY AND TRAILER CO AUDI LYNBROOK AUTO MALL HYUNDAI LTD B&Z AUTO ENTERPRISE-EAST CHESTER JEEP BARON BROTHERS AUTO GROUP BAYRIDGE CHEVROLET BAYRIDGE LEXUS BAYRIDGE TOYOTA BAYSHORE NISSAN LLC BIBENDUM HOLDINGS LLC BICAL CHEVROLET BIENER AUTO GROUP INC BMW OF MANHATTAN INC CHARLES ROSS & SON INC CHAUMONT MOTORS LLC COBHAM LONG ISLAND INC COUNTRY LINCOLN & MERCURY WEST EAST HILLS CHEVROLET OF FREEPORT EAST HILLS CHRY JEEP & DODGE INC FULLERTON CHRYSLER-JEEP-DODGE INC FULLERTON FORD GJM OPCO LLC GREGORIS MOTORS INC IAG NISSAN OF WESTBURY INFINITI OF MASSAPEQUA LTD J & C AUTO WOLC DBA ADVANTAGE TOYOTA JJM ATLANTIC AUTOMOTIVE LLC JM HUNTINGTON MOTORS LLC JS BABYLON CHRYSLER PLYMOUTH JS HYUNDAI OF VALLEY STREAM LLC KRISTAL AUTO MALL CORP LEGEND NISSAN LEXUS OF MANHATTAN LEXUS OF QUEENS MANFREDI CHEVROLET MADISON ACQUISITION GROUP LLC MC MAHON FORD METRO CHRYSLER-PLYMOUTH INC NEWINS BAY SHORE FORD INC NIELSEN CHEVROLET NISSAN OF WESTBURY LLC NYSLI INC OPEN ROAD OF MANHATTAN LLC PATCHOGUE 112 MOTORS LLC PAUL CONTE CADILLAC INC PLANTE CONSULTING LLC PLATINUM VOLKSWAGEN LLC POTDEVIN MACHINE CO PREMIER FORD ROCKAWAY CARS LLC ROCKVILLE CENTRE GMC LLC ROSS METAL FABRICATORS S & H ASSOCIATES LLC SC AUTO SARANT CADILLAC CORP SKYLINE AUTOMOBILE INC SMG AUTOMOTIVE HOLDINGS LLC SOUTH SHORE MTRS ANA SAYVILLE FORD SOUTH SHORE NISSAN LLC STAMFORD LINCOLN MERCURY LLC STOLER AUTOMOTIVE NEW YORK INC STORMS FORD LINCMERC INC SUN PONTIAC GMC INC TOWN MOTORS TRUCK KING INTERNATIONAL VALLEY STREAM FOREIGN CARS INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0