2022-12-15T13:42:24-06:00 2022-01-31 470900880 CALIBRE CPA GROUP PLLC 7501 WISCONSIN AVENUE SUITE 1200 WEST BETHESDA MD 20814 990 2021-02-01 550393244 UNITED FOOD & COMMERICIAL WORKERS LOCAL 400 AND EMPLOYERS HEALTH & WELFARE FUND UNIT 3043437682 600 D STREET 250 SOUTH CHARLESTON WV 25302 MARK FEDERICI TRUSTEE 3043437682 2022-12-15 1 MARK FEDERICI 999009999 KRISTIN A JACQUELIN CPA P01325865 2023319880 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MARK FEDERICI 600 D STREET 250 SOUTH CHARLESTON WV 25302 49944995 0 X N/A X 1959 WV TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 6 0 9 0 0 0 0 0 44560317 49862786 6738 267 48362 81942 44615417 49944995 0 0 42693348 50127352 449129 398103 0 0 0 1367317 1177673 44509794 51703128 105623 -1758133 4238911 2344306 259000 122528 3979911 2221778 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 18 0 1 9 1 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BETH DUFF 3043437682 600 D STREET SOUTH CHARLESTON WV 25302 BRYAN BOND TRUSTEE 1.00 40.00 X 0 129630 0 MARK FEDERICI TRUSTEE 1.00 40.00 X 0 211188 0 CHRISTOPHER HOFFMAN TRUSTEE 1.00 40.00 X 0 163163 0 MICHAEL PALMER TRUSTEE 1.00 40.00 X 0 0 0 STEVEN SPRINGER TRUSTEE 1.00 40.00 X 0 0 0 JENNIFER MANCINI TRUSTEE 1.00 40.00 X 0 0 0 0 503981 0 0 0 1 0 ANTHEM HEALTH PLANS INC 220 VIRGINIA AVENUE INDIANAPOLIS IN 46204 PPO ACCESS FEES 1674746 CONIFER VALUE-BASED CARE LLC 1596 WHITEHALL ROAD ANNAPOLIS MD 21409 MANAGED CARE 352627 MILLIMAN 1301 FIFTH AVENUE STE 3800 SEATTLE WA 98101 CONSULTANT 313777 REINHART BOERNER VAN DEUREN 1000 NORTH WATER STREET STE 1700 MILWAUKEE WI 53202 LEGAL 164329 SLEVIN & HART PC 1625 MASSACHUSETTS AVE NW SUITE 45 WASHINGTON DC 20036 LEGAL 151563 7 EMPLOYER CONTRIBUTIONS 525100 48473795 48473795 PARTICIPANT AND RETIREE CONTRIBUT 525100 1388991 1388991 49862786 267 267 SETTLEMENT INCOME 525100 68248 68248 DRUG PROGRAM REBATES 525100 13694 13694 81942 49944995 49944728 0 267 50127352 268585 15110 77736 36672 71947 316024 63886 295587 40981 151635 34956 1268 3699 28115 POSTAGE 130915 BANK FEES 26868 TELEPHONE 11792 51703128 2958251 1610172 1249309 707319 21845 19635 68711 61531 9506 7180 4238911 2344306 259000 122528 259000 122528 X 0 0 0 0 3979911 2221778 3979911 2221778 4238911 2344306 -1758133 0 X X 0 1 X 1 0 68711 61531 7180 7180 49944995 0 49944995 0 49944995 51703128 0 51703128 0 51703128 0 0 0 MARK FEDERICI TRUSTEE 0 211188 0 0 0 0 0 0 0 0 0 211188 0 0 CHRISTOPHER HOFFMAN TRUSTEE 0 163163 0 0 0 0 0 0 0 0 0 163163 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FUND'S INDEPENDENT ACCOUNTANT, IN CONSULATION WITH THE FUND'S ADMINISTRATIVE STAFF AND INDEPENDENT ATTORNEYS, PREPARES A DRAFT OF THE FUND'S 990 FOR PRESENTATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE FUND REQUIRES TRUSTEES AND THOSE PROVIDING SERVICES TO THE FUND TO DISCLOSE ANY RELATIONSHIPS THAT COULD GIVE RISE TO A CONFLICT OF INTEREST UNDER THE "CONFLICT OF INTEREST POLICY" REGARDING THE FUND. ANY IDENTIFIED POTENTIAL CONFLICTS ARE ADDRESSED BY THE BOARD OF TRUSTEES, INCLUDING WHEN APPROPRIATE, THAT PERSON RECUSING HIMSELF OR HERSELF FROM ANY INVOLVEMENT REGARDING THE AFFECTED ENTITY OF TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 ALL TRUSTEES ARE UNCOMPENSATED AND EACH TRUSTEE IS APPOINTED BY THE PARTICIPATING UNION(S) AND EMPLOYER(S) IN ACCORDANCE WITH THE FUND'S TRUST AGREEMENT. THE BOARD OF TRUSTEES DETERMINES THE SALARY AND BENEFITS FOR THE OFFICE STAFF AND CONSULTS WITH THE FUND'S INDEPENDENT PROFESSIONALS TO DETERMINE COMPENSATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). THE DECISION OF THE BOARD IS REFLECTED IN THE MEETINGS AND MINUTES OF THE FUND. FORM 990, PART VI, SECTION C, LINE 19 THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO ERISA. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. NO DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE TO THE GENERAL PUBLIC OTHER THAN THOSE FINANCIAL STATEMENTS MADE PART OF AND REQUIRED TO BE DISCLOSED IN GOVERNMENTAL FILINGS. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. BOARD OF TRUSTEES 600 D STREET SUITE 250 SOUTH CHARLESTON WV 25302 550393244 PLAN SPONSOR WV 501(C)(9) 0 BELPRE POLICE DEPARTMENT UFCW LOCAL UNION 400 THE KROGER COMPANY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1