2020-10-15T09:25:09-05:00 2019-11-30 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2018-12-01 390979166 UNITED FOOD & COMMERCIAL WORKERS UNIONS & EMPLOYERS HEALTH PLAN UNIT 4144762523 2001 NORTH MAYFAIR ROAD MILWAUKEE WI 53226 JOHN EIDEN CHAIRMAN 4144762523 2020-10-14 1 JAMES B BOUTELLE CPA P01794129 2627549400 2020-10-09 24.209.117.46 2020-10-14 18:40:49 CD P 5036B7683FD1B3126D579BE48C37A71E8ADD2876 934FC65FEE8495E85B690041CFEAE27130F8D972 2018 2021-09-10 13:11:23Z JOHN EIDEN 2001 NORTH MAYFAIR ROAD MILWAUKEE WI 53226 2163902 0 X N/A X 1960 WI HEALTH PLAN 9 4 0 4 0 0 0 0 2298093 2153823 0 7579 1205 2500 2299298 2163902 0 0 1882631 1930004 0 0 0 0 0 374781 426879 2257412 2356883 41886 -192981 3119438 2963942 367911 387781 2751527 2576161 TO PROVIDE ELIGIBLE PARTICIPANTS ACCIDENT, HEALTH, VISION, DENTAL, PRESCRIPTION DRUG, LIFE INSURANCE, LOSS OF TIME, AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS. 0 0 ACCIDENT, HEALTH, LOSS-OF-TIME, DENTAL, LIFE, VISION CARE BENEFIT PAYMENTS TO PARTICIPANTS. PRESCRIPTION DRUG PROGRAM BENEFITS PAID ON BEHALF OF PARTICIPANTS. LIFE INSURANCE BENEFITS PAID ON BEHALF OF 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 1 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 9 4 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS 4144761220 2001 NORTH MAYFAIR ROAD MILWAUKEE WI 53226 JOHN EIDEN CHAIRMAN/UNION TRUSTEE 1.00 40.00 X X 0 135273 18275 GRANT WITHERS UNION TRUSTEE 1.00 40.00 X 0 123756 18275 JACOB BAILEY ALTERNATE UNION TRUSTEE 1.00 40.00 X 0 104466 18275 CHAD WHITESIDE ALTERNATE UNION TRUSTEE 1.00 40.00 X 0 103943 18275 MELANIE BARTHOLF ALTERNATE UNION TRUSTEE 1.00 40.00 X 0 64429 18275 DARREN HORNDASCH SECRETARY/EMPLOYER TRUSTEE 1.00 X X 0 0 0 PAUL BUTERA SR EMPLOYER TRUSTEE 1.00 X 0 0 0 PAUL BUTERA JR ALTERNATE EMPLOYER TRUSTEE 1.00 X 0 0 0 JUDITH BUTERA ALTERNATE EMPLOYER TRUSTEE 1.00 X 0 0 0 0 531867 91375 0 0 1 0 0 EMPLOYER CONTRIBUTIONS 525100 2135063 2135063 SELF PAY CONTRIBUTIONS 525100 18760 18760 2153823 7579 7579 CLASS ACTION LITIGATIO 525100 2500 2500 2500 2163902 2156323 0 7579 1930004 100000 50601 80888 5991 617 7790 STOP LOSS PREMIUMS 83299 ACCIDENT & HEALTH FEES 61059 BANK SERVICE FEES 15576 PROGRAM EXPENSE 11849 9209 2356883 3100095 918954 2922 11376 11220 7967 6074 2024772 3119438 2963942 97240 136240 63671 61541 207000 190000 367911 387781 X 0 0 0 0 2751527 2576161 2751527 2576161 3119438 2963942 -192981 17615 0 X 0 1 X 1 0 0 CLAIMS PAYABLE 190000 190000 X 2181517 17615 17615 2163902 0 2163902 2373883 17000 17000 2356883 0 2356883 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)9 OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE, AND THE PLAN SPONSOR BELIEVES THAT THE TRUST AND THE PLAN, AS AMENDED, CONTINUE TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE INTERNAL REVENUE CODE. U.S. GAAP 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 TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 2D - OTHER ADJUSTMENTS: DECREASE IN CURRENT YEAR CLAIMS PAYABLE 17,000. 0 0 0 JOHN EIDEN CHAIRMAN/UNION TRUSTEE 0 135273 0 0 0 0 0 0 0 18275 0 153548 0 0 FORM 990, PART VI, SECTION A, LINE 2 PAUL BUTERA SR., PAUL BUTERA JR., AND JUDITH BUTERA HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE FUND'S RECORDKEEPER. THEY REVIEW IT AND APPROVE IT, THEN PRESENT THE FORM 990 TO THE BOARD OF TRUSTEES FOR REVIEW AND FILING APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THEY ARE AVAILABLE UPON REQUEST. UNITED FOOD AND COMMERCIAL WORKERS LOCAL 1473 2001 NORTH MAYFAIR ROAD MILWAUKEE WI 53226 562585698 LABOR UNION WI 501(C)(5) N/A 0 BOARD OF TRUSTEES OF WI UFCW UNIONS AND EMPLOYERS HEALTH PLAN 2001 NORTH MAYFAIR ROAD MILWAUKEE WI 53226 390979166 PLAN SPONSOR AND PLAN ADMINISTRATOR WI 501(C)(9) N/A 0 OFFICE SOLUTIONS - USA INC UNION FIRST LASER TECHNOLOGIES INC PIGGLY WIGGLY MIDWEST SUPERIOR NATIONAL BANK & TRUST COMPANY STINEBRINK'S PIGGLY WIGGLY WISCONSIN VISION 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 THE TAXPAYER FAILED TO FILE AN EXTENSION AND IS THUS LATE IN FILING FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX.AS WILL BE FURTHER EXPLAINED BELOW, WE DO NOT BELIEVE THAT ANY PENALTY SHOULD BE ASSESSED TO THE TAXPAYER AS THE LATE FILING WAS NOT A RESULT OF WILLFUL NEGLECT, AND ASSESSING THIS PENALTY WOULD IMPOSE UNDUE HARDSHIP ON "UNITED FOOD & COMMERCIAL WORKERS UNIONS & EMPLOYERS HEALTH PLAN". AS PROVIDED UNDER IRC SECTION 6652(C)(4), NO PENALTY WILL BE IMPOSED FOR LATE FILING IF THE TAXPAYER CAN DEMONSTRATE REASONABLE CAUSE AS TO HOW THE LATE FILING OCCURRED. THE FOLLOWING STATEMENT OF REASONABLE CAUSE IS PRESENTED TO JUSTIFY THE POSITION THAT NO PENALTIES SHOULD BE ASSESSED IN THIS SITUATION FOR THE LATE FILING OF THE FORM 990.UNITED FOOD & COMMERCIAL WORKERS UNIONS & EMPLOYERS HEALTH PLAN IS A SMALL NONPROFIT CORPORATION (TAX EXEMPT UNDER IRC SECTION 501(C)(9)) WHOSE PRIMARY PURPOSE IS TO PROVIDE ELIGIBLE PARTICIPANTS ACCIDENT, HEALTH, VISION, DENTAL AND DISMEMBERMENT BENEFITS.DURING 2019, UNITED FOOD & COMMERCIAL WORKERS UNIONS & EMPLOYERS HEALTH PLAN WAS IN THE PROCESS OF CHANGING ACCOUNTANTS. WITH THIS CHANGE, THERE WAS CONFUSION IN REGARDS TO THE FILING OF EXTENSION. THE BOARD OF TRUSTEES OF UNITED FOOD & COMMERCIAL WORKERS UNIONS & EMPLOYERS HEALTH PLAN TOOK IMMEDIATE ACTION UPON DISCOVERING THIS LATE FILING. ONCE INFORMED, THE EXECUTIVE DIRECTOR TOOK CORRECTIVE MEASURES AND REQUESTED IMMEDIATE ASSISTANCE TO FILE ALL REQUIRED FORMS AS SOON AS POSSIBLE, THEREBY DEMONSTRATING THAT IT ACTED RESPONSIBLY AND IN GOOD FAITH.AS MENTIONED ABOVE, THE LATE FILING WAS CAUSED BY AN ADMINISTRATIVE OVERSIGHT WITH THE CHANGE OF ACCOUNTANT. THE PLAN HAS TIMELY FILED ALL PRIOR RETURNS. WE RESPECTFULLY REQUEST THAT YOU REMOVE THE LATE FILING PENALTY AS IT WOULD BE AGAINST EQUITY AND GOOD CONSCIENCE TO IMPOSE A PENALTY ON THIS SMALL TAX EXEMPT ORGANIZATION. FURTHERMORE, IT WAS NOT AN ACT OF DELIBERATE LATE FILING BUT WAS A MERE ADMINISTRATIVE OVERSIGHT.