2021-01-18T15:46:40-06:00 2020-04-30 410746749 CLIFTONLARSONALLEN LLP 2210 EAST ROUTE 66 GLENDORA CA 91740 990 2019-05-01 916049498 UNITED FOOD AND COMMERCIAL WORKERS WELFARE TRUST UNIT 5095340600 1322 N POST SPOKANE WA 99201 ERIC RENNER CHAIRMAN 5095340600 2021-01-14 1 TINA HENTON P00630282 6268577300 2021-01-14 2019 2022-09-23 18:48:47Z 1322 N POST SPOKANE WA 99201 160834011 0 1 X N/A X 1963 WA PROVIDE A HEALTH AND WELFARE PLAN TO THE UNITED FOOD AND COMMERCIAL WORKERS UNION PURSUANT TO A COLLECTIVE BARGAINING AGREEMENT. 8 8 0 8 0 0 0 0 43560787 44175398 545581 1640587 0 0 44106368 45815985 0 0 39540844 38575449 0 0 0 0 0 1345121 1351438 40885965 39926887 3220403 5889098 29971596 36277515 4666115 4293874 25305481 31983641 X PROVIDE A HEALTH AND WELFARE PLAN TO THE UNITED FOOD AND COMMERCIAL WORKERS UNION PERSUANT TO A COLLECTIVE BARGAINING AGREEMENT. 0 0 THE PLAN PROVIDES HEALTH AND WELFARE BENEFITS TO PARTICIPANTS AND THEIR DEPENDENTS. PREMIUMS TO UNDERWRITERS FOR HEALTH AND WELFARE BENEFITS. PAYMENTS OF MEDICAL AND DENTAL PRESCRIPTION DRUGS, DENTAL, AND TIME LOSS CLAIMS. 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 484 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X AW REHN & ASSOCIATES 5095340600 1322 N POST SPOKANE WA 99201 X ERIC RENNER CHAIRMAN 2.00 X X 0 0 0 SCOTT POWERS SECRETARY 2.00 X X 0 0 0 BRENT BOHN TRUSTEE 2.00 X 0 0 0 ALEX GARCIA TRUSTEE 2.00 X 0 0 0 SCOTT HABENICHT TRUSTEE 2.00 X 0 0 0 CAROL HAWKINS TRUSTEE 2.00 X 0 0 0 SANDRA HUGGINS TRUSTEE 2.00 X 0 0 0 ROBERT MCLAUCHLIN TRUSTEE 2.00 X 0 0 0 0 0 0 0 0 0 0 A W REHN & ASSOCIATES INC 1322 N POST ST SPOKANE WA 99201 ADMIN AND CLAIMS FEES 795152 AETNA 151 FARMINGTON AVENUE HARTFORD CT 06156 PPO NETWORK 793417 UNITED CLAIM SOLUTIONS 23048 N 15TH AVENUE PHOENIX AZ 85027 CLAIMS ADMINISTRATOR 136918 3 EMPLOYER CONTRIBUTIONS 900099 40934660 40934660 PARTICIPANT CONTRIBUTIONS 900099 3240738 3240738 44175398 711542 711542 115947071 115018026 929045 929045 929045 45815985 44175398 0 1640587 38575449 926169 29400 26187 120080 84684 108017 17885 19568 PCORI TAXES 12701 CYBER LIABILITY 2822 FIDELITY BOND 2660 IFEBP DUES 1265 39926887 53321 35957 1952867 3068466 3632949 3774316 24332459 29398776 29971596 36277515 12315 14174 4653800 4279700 4666115 4293874 X 0 0 0 0 25305481 31983641 25305481 31983641 29971596 36277515 X 5889098 414962 374100 X X 0 1 X 1 0 0 CLAIMS INCURRED BUT NOT REPORTED 4279700 4279700 X 46114368 414962 414962 45699406 116579 116579 45815985 39810308 0 39810308 116579 116579 39926887 PART X, LINE 2: THE VEBA TRUST FUNDING CERTAIN BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE IRS DATED DECEMBER 18, 1989, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, AS A RESULT OF THE PLANS FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2020 AND 2019 FOR UNRELATED BUSINESS TAXABLE INCOME. FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR REVIEWED THE COMPLETED 990 AND TOOK THE FORM TO THE CHAIRMAN FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION C, LINE 18 NO GOVERNMENT DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC; ONLY TO THOSE REQUIRED BY ERISA. FORM 990, PART VI, SECTION C, LINE 19 NO GOVERNMENT DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC; ONLY TO THOSE REQUIRED BY ERISA. FORM 990, PART XI, LINE 9: CHANGE IN INCURRED BUT NOT REPORTED CLAIMS 374,100. PART XII, LINE 2C: THE OVERSIGHT PROCESS AND METHOD OF SELECTING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM THE PRIOR YEAR. UFCW LOCAL 1439 UNITED WAY OF SPOKANE ACTION PROCESS SERVICE LLC AW REHN & ASSOCIATES BLUE OAK LLC REDSERGE VENTURES VICKI'S HAIRKRAFTERS A & B MORTGAGE CROWN FOODS DEER PARK COUNTRY CLUB DUZAN E & D DISTRIBUTORS FRED MEYERKROGER GENE'S JOHN STERK KENNETH KATO MARK'S GOLF MS MAURA GIBSON RAY'S MEATS RIVERLINKS GOLF INC RON'S THRIFT ROSAUERSURM SAFEWAY SAFEWAY PORTLAND ABS SAFEWAY PORTLAND DIVISION SAFEWAY SEATTLE ABS SAV MART SIGN WORKS CUSTOM CONCEPTS LLC SPOKANE RENDERING THE MARKETS LLC WINCO FOODS LLC WRAY'S 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0