2020-02-18T21:40:10-06:00 2019-03-31 450250958 EIDE BAILLY LLP 3130 CROW CANYON PL STE 300 SAN RAMON CA 945831386 990 2018-04-01 952301788 UNITED FOOD & COMMERCIAL WORKERS UNIONS & FOOD EMPLOYERS BENEFIT FUND UNIT 7142202297 6425 KATELLA AVE CYPRESS CA 90630 TRUSTEE TRUSTEE ADMINISTRATOR 7142202297 2020-02-18 1 THERESA MONTGOMERY P00232100 9254804000 2020-02-18 24.5.226.27 2020-02-18 21:39:29 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F52D36390EBCF6BF15030359CEDEDEC3AB6B140A 2018 2020-11-19 02:30:22Z 6425 KATELLA AVE CYPRESS CA 90630 1308197311 0 X N/A X 1964 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 12 12 24 0 0 0 0 0 574875827 584931427 2579961 10117459 3942532 8260874 581398320 603309760 0 0 563671308 551300009 0 0 0 0 0 31310190 33206490 594981498 584506499 -13583178 18803261 325674998 332576630 132706061 120868772 192968937 211707858 NONE 0 0 THE PLAN IS A MULTI-EMPLOYER WELFARE BENEFIT PLAN PROVIDING HOSPITAL, MEDICAL, PSYCHIATRIC, PREVENTIVE MEDICINE, DENTAL ORTHODONTIA, PRESCRIPTION DRUG, DEATH, INDUSTRY VACATION AND VISION CARE BENEFITS 0 0 0 0 0 0 0 0 0 0 1 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 8251 0 1 24 1 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 X RON SCHOEN 7142202297 6425 KATELLA AVE CYPRESS CA 90630 X GREG CONGER TRUSTEE 5.00 X 0 0 0 JOE DUFFLE TRUSTEE 5.00 X 0 0 0 DUANE SNIDER TRUSTEE 5.00 X 0 0 0 MARK RAMOS TRUSTEE 5.00 X 0 0 0 MICHAEL STRAETER TRUSTEE 5.00 X 0 0 0 KATHY FINN TRUSTEE 5.00 X 0 0 0 FRANK JORGENSEN TRUSTEE 5.00 X 0 0 0 BRENT BOHN TRUSTEE 5.00 X 0 0 0 LEROY WESTMORELAND TRUSTEE 5.00 X 0 0 0 TODD WALTERS TRUSTEE 5.00 X 0 0 0 JOHN GRANT TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 SC UFCW ADMINISTRATION LLC 6425 KATELLA AVE CYPRESS CA 90630 CONTRACT ADMINISTRATOR 19246829 BLUE CROSS OF CALIFORNIA DEPT 5812 LOS ANGELES CA 90074 CONSULTANT 4695100 HEALTH MANAGEMENT CONCEPTS 181 COMMODORE DR JUPITER FL 33477 CONSULTANT 2799591 SAFEWAY HEALTH INC PO BOX 742820 LOS ANGELES CA 90074 CONSULTANT 781634 SEYFARTH SHAW ONE CENTURY PLAZA STE 3500 2029 CEN LOS ANGELES CA 90067 LEGAL 666137 15 EMPLOYER CONTRIBUTIONS 900099 523295048 523295048 PARTICIPANT CONT. 900099 61636379 61636379 584931427 4875231 4875231 710129779 704887551 5242228 5242228 5242228 MEDICARE PART D SUBSIDY 900099 4616370 4616370 LEGAL SETTLEMENT INCOME 900099 3644504 3644504 8260874 603309760 603309760 0 0 551300009 19246829 1305095 66137 396412 99668 219001 COST CONTAINMENT FEES 6665107 BENEFIT CONSULTING 1864081 ACTUARIAL CONSULTANTS 1045399 MARKET PRICE DRUG PROGR 781634 1517127 584506499 45554576 43149239 41762280 50622429 207455 207455 148410811 162522747 88190813 68300412 1549063 7774348 325674998 332576630 542390 753610 132163671 120115162 132706061 120868772 X 0 0 0 0 192968937 211707858 192968937 211707858 325674998 332576630 18803261 -64340 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIP 68300412 F 68300412 GROUP INSURANCE PREMIUMS AND CLAIMS PAYABLE 78886446 CLAIMS INCURRED BUT NOT REPORTED 24349000 ANCILLARY AWARDS AND GRANTS NOT USED 334000 CASH - OPERATING ACCOUNTS (OVERDRAFT) 5222059 LIABILITY TO RETURN COLLATERAL FOR SECURITY ON LOAN 8489346 DUE TO OTHER TRUST FUNDS AND LLC 2834311 120115162 X 603245420 -64340 -64340 603309760 0 603309760 584506499 0 584506499 0 584506499 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE ENTITY BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. SO CA UFCW UNIONS & FOOD EMPLOYERS JOINT PENSION TRUST FUND 6425 KATELLA AVENUE CYPRESS CA 90630 951939092 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 SO CA UFCW UNIONS & FOOD EMPLOYERS JOINT PENSION TRUST FUND P 751480 CASH SO CA UFCW UNIONS & FOOD EMPLOYERS JOINT PENSION TRUST FUND Q 40756 CASH PARTS II, III, AND IV- IDENTIFICATION OF RELATED TAX ORGANIZATIONS IN A MULTIEMPLOYER PLAN, A CONTRIBUTING EMPLOYER IS CONSIDERED A RELATED ORGANIZATIONS BECAUSE THEY ARE OBLIGATED TO CONTRIBUTE TO THE PLAN PURSUANT TO THE TERMS IN THE COLLECTIVE BARGAINING OR PARTICIPANTS AGREEMENT. THE ADMINISTRATIVE OFFICE ONLY MAINTAINS THE DATA NECESSARY TO FULFILL THE OBLIGATION TO CONTRIBUTE, IT DOES NOT MAINTAIN SEPECIFIC BUSINESS DATA REGARDING THE EMPLOYERS, SUCH AS ENTITY TYPE OR TAX INFORMATION.