2020-08-06T09:16:30-05:00 2019-10-31 611436956 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2018-11-01 222507311 UFCW LOCAL 1459 & CONTRIBUTING EMPLOYERS HEALTH & WELFARE UND UNIT 4137331197 33 EASTLAND STREET SPRINGFIELD MA 011092348 TYRONE C HOUSEY TRUSTEE 4137331197 2020-08-06 1 LOUIS VERZELLA CPA P00360279 6106689400 2020-07-08 162.211.205.39 2020-08-06 09:15:31 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 214E2DE4754F8F73DD572B34B07E6CCBC316F7C9 2018 2020-09-23 17:36:50Z TYRONE C HOUSEY 33 EASTLAND STREET SPRINGFIELD MA 011092348 10420183 0 X N/A X 1983 MA PROVIDING ELIGIBLE PARTICIPANTS WITH VARIOUS HEALTH & WELFARE BENEFITS 4 2 0 0 0 0 0 0 6638542 7977277 98787 2121 513400 467785 7250729 8447183 0 0 7487281 6500062 0 0 0 0 0 834254 877851 8321535 7377913 -1070806 1069270 2875866 3836926 722541 602835 2153325 3234091 PROVIDING ELIGIBLE PARTICIPANTS WITH VARIOUS EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, PRESCRIPTION, DISABILITY AND LIFE. 0 0 TO OBTAIN AND ADMINISTER THE HEALTH AND WELFARE PROGRAM FOR ALL ELIGIBLE PARTICIPANTS. 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 0 0 0 0 0 0 0 0 0 0 0 X 4 2 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 4137331197 33 EASTLAND STREET SPRINGFIELD MA 01109 TYRONE C HOUSEY CHAIRMAN/UNION TRUSTEE 2.00 40.00 X X 0 126391 11015 GENEROSO DEL ROSARIO SECRETARY/MANAGEMENT TRUST 2.00 X 0 0 0 JEFFERY W JONES UNION TRUSTEE 2.00 40.00 X 0 93868 11015 CHRISTA KRAMER MANAGEMENT TRUSTEE 2.00 X 0 0 0 JASON PARADIS MANAGEMENT TRUSTEE (P) 2.00 X 0 0 0 0 220259 22030 0 0 0 0 ZENITH AMERICAN SOLUTIONS 33 EASTLAND STREET SPRINGFIELD CT 01109 THIRD PARTY ADMINISTRATOR 463304 CIGNA HEALTH AND LIFE INSURANCE COMPANY 44 WHIPPANY ROAD MORRISTOWN NJ 07072 ASO CONTRACT ADMINISTRATOR 178829 2 PARTICIPATING EMPLOYERS 900099 7631356 7631356 PARTICIPANTS 900099 345921 345921 7977277 7942 7942 1967179 1973000 -5821 -5821 -5821 STOP LOSS REIMBURSEMENT 900099 383676 383676 PRESCRIPTION REBATES 900099 74065 74065 DUES REIMBURSEMENTS 900099 7042 7042 3002 3002 467785 8447183 8445062 0 2121 6500062 463304 56393 22500 1066 286715 9628 16111 1000 18613 PCORI 2521 7377913 1360699 3655113 511563 1515 8546 14026 610010 383533 167787 2875866 3836926 42441 70935 680100 531900 722541 602835 X 2153325 3234091 0 0 0 0 2153325 3234091 2875866 3836926 1069270 11496 0 X X 0 1 X 1 0 0 HEALTH CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 531900 531900 X 8450571 11496 11496 8439075 1066 7042 8108 8447183 7518005 141158 141158 7376847 1066 1066 7377913 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE FUND MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND RECOGNIZE A TAX LIABILITY IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. PART XI, LINE 4B - OTHER ADJUSTMENTS: DUES REIMBURSEMENT 7,042. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN BENEFIT OBLIGATIONS 148,200. DUES -7,042. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES ARE APPOINTED HALF BY THE UNION SPONSORING ORGANIZATIONS AND HALF BY THE EMPLOYER SPONSORING ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATIONS FORM 990 IS PREPARED BY THE INDEPENDENT ACCOUNTANT WHO FORWARDS IT TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REQUIRES ALL TRUSTEES TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY. ANY POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO THE BOARD FOR DISCUSSION AND RESOLUTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, TAX RETURNS AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE BENEFIT OFFICE. FORM 990. PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED. UFCW LOCAL 1459 AND CONTRIBUTING EMPLOYERS LEGAL BENEFIT FUND 33 EASTLAND STREET SPRINGFIELD MA 01109 222507618 MULTIEMPLOYER LEGAL BENEFIT FUND MA 501(C)(9) N/A 0 UFCW LOCAL 1459 EDUCATION SAFETY & INDUSTRY TRUST FUND 33 EASTLAND STREET SPRINGFIELD MA 01109 522331090 MULTIEMPLOYER EDUCATION & SAFETY FUND MA 501(C)(9) N/A 0 UFCW LOCAL 1459 33 EASTLAND STREET SPRINGFIELD MA 01109 042220774 LABOR UNION MA 501(C)(5) 0 THE STOP & SHOP SUPERMARKET CO INC FIRST STUDENT INC VETERANS FACILITY SERVICES WORK OPPORTUNITY CENTER INC DURHAM SCHOOL SERVICES FIVE STAR TRANSPORTATION VALLEY AREA TRANSIT AFCO SPORTS MANAGEMENT LLC PHOENIX MANAGEMENT INC TRIAD LOGISTICS SERVICES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0