2019-07-30T09:08:17-07:00 2018-12-31 131577780 Schultheis & Panettieri LLP 210 Marcus Boulevard Hauppauge NY 117883740 990 2018-01-01 132832806 UFCW LOCAL 2013 HEALTH AND WELFARE FUND UFCW 7187453487 9235 4TH AVENUE BROOKLYN NY 11209 LOUIS M CAROTENUTO UNION TRUSTEE 2019-07-30 true CAROL WESTFALL P00539069 6312734778 2018 2019-02-21 02:37:17Z LOUIS M CAROTENUTO 9235 4TH AVENUE BROOKLYN NY 11209 34034956 false false X N/A X 1975 NY THE PURPOSE OF THE PLAN IS TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. 2 2 0 0 0 34604012 33716999 144071 317957 0 34748083 34034956 0 24452815 26359699 0 0 0 2241040 2171430 26693855 28531129 8054228 5503827 35250069 40575632 2542178 2363914 32707891 38211718 THE PURPOSE OF THE PLAN IS TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. false false THE PURPOSE OF THE PLAN IS TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. false false false false false false false false false true false false false true false true false false false false false false false false false false false false false false false false false false false false false false false false false false false true false false true 244 0 true 0 false false false false false false false false false false false false false false false X 2 2 false true false false false false false true true false false true true true true true true false false false X louis m carotenuto 7187453487 9235 4TH AVENUE BROOKLYN NY 11209 X LOUIS M CAROTENUTO UNION TRUSTEE 1.00 0.00 X 0 0 0 STANLEY FLEISHMAN EMPLYR TRUSTEE 1.00 0.00 X 0 0 0 0 false false false EMPIRE HEALTHCHOICE ASSURANCE INC PO BOX 951254 CLEVELAND OH 44193 MEDICAL MGT & FEES 1648294 TRI-STATE ADMINISTRATORS INC 27 ROLAND AVESTE 200 MT LAUREL NJ 08054 THIRD PARTY ADMIN. 1762063 HEALTHPLEX 333 EARLE OVINGTON BLVD UNIONDALE NY 11533 DENTAL ADMIN. 349294 AMER HEALTH HLDING INC 7400 WEST CAMPUS RD NEW ALBANY OH 43054 MEDICAL MGMT 179803 express scripts 100 PARSONS POND DRIVE FRANKLIN LAKES NJ 07417 prescription 138263 5 0 EMPLOYERS CONTRIBUTIONS 900099 31864338 31864338 PARTICIPANTS CONTRIBUTION 900099 1852661 1852661 33716999 317957 317957 0 0 0 0 0 0 0 0 34034956 33716999 317957 0 0 0 26359699 0 0 0 0 0 0 0 68992 64800 0 0 13242 30552 0 298992 74339 0 181933 0 0 0 0 0 35356 12819 THIRD PARTY ADMIN 1390837 NET REIMBURSED EXPENSES -432 0 28531129 0 0 0 3874304 3124661 28062874 33364310 0 3226906 4029342 0 0 0 0 21417 23631 250421 216733 64568 33688 0 0 0 0 0 35250069 40575632 182568 143914 2359610 2220000 2542178 2363914 X 32707891 38211718 32707891 38211718 35250069 40575632 5503827 X false true X true false 250421 216733 33688 33688 BENEFITS CURRENTLY PAYABLE 2220000 2220000 34021714 34021714 13242 13242 34034956 28635887 28635887 13242 -118000 -104758 28531129 Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company the ufcw local 2013 health and welfare fund retains tri-state administrators, inc. to administer the plan in accordance with the governing plan documents, the provisions of erisa, the internal revenue code, and other applicable laws. services performed include but are not limited to, accounting and financial reporting, required communications, claims processing and related services, vendor management, and trustee related services. Form 990, Part VI, Line 11b: Form 990 Review Process THE FORM 990 WAS PREPARED IN COORDINATION WITH THE FUND ADMINISTRATOR AND WAS REVIEWED WITH THE ORGANIZATION'S BOARD OF TRUSTEES PRIOR TO SUBMISSION. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Each Trustee or interested person is required to disclose annually their understanding and compliance with the Conflict of Interest Policy. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO ALL PARTICIPANTS UPON REQUEST. NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. UFCW LOCAL 2013 PENSION FUND 9235 4TH AVENUE BROOKLYN NY 11209 131975910 PROVIDE RETIREMENT BENEFITS TO PARTICIPA NY 501(A) N/A NA false UFCW LOCAL 2013 ANNUITY FUND 9235 4TH AVENUE BROOKLYN NY 11209 112457157 PROVIDE RETIREMENT BENEFITS TO PARTICIPA NY 501(A) N/A NA false UFCW LCL 2013 REALTY HOLDING CORP 9235 4TH AVENUE BROOKLYN NY 11209 010784004 TO HOLD TITLE TO REAL PROPERTY NY 501(C)2 N/A NA false UFCW LOCAL 2013 9235 4TH AVENUE BROOKLYN NY 11209 131995772 LABOR UNION NY 501(C)5 N/A NA false false false false false false false false false false false true false false true true true true false false SCHEDULE R, PART II AND IV: CERTAIN TRUSTEES LISTED ON PART VII, SECTION A, SERVE AS VOLUNTEERS AND DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION OR ANY RELATED ORGANIZATION IN THEIR CAPACITY AS TRUSTEES OF THIS ORGANIZATION.CERTAIN TRUSTEES LISTED ON PART VII, SECTION A, DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION, BUT DO RECEIVE COMPENSATION FROM UFCW LOCAL 2013,(THE "UNION") IN THEIR CAPACITY AS EMPLOYEES/OFFICERS OF THE UNION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED ON THE FORM 990 OF THE UNION.The information disclosed in the attached schedules of related parties is that which was available to this organization at the time of this filing.