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ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT FUND: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT FUND (EIN 84-6044454)
Tax period
2017-05-01 to 2018-04-30
Filed
2019-02-28
IRS object ID
201930599349300943
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-02-28T13:59:12-06:00ReturnTs
Tax Period End2018-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN320043599PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LEGACY PROFESSIONALS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14 WESTBROOK CORPORATE CTR 700AddressLine1Txt
CityWESTCHESTERCityNm
State AbbreviationILStateAbbreviationCd
ZIP60154ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN846044454EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERSBusinessNameLine1Txt
Business Name Line2HEALTH BENEFIT FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlROCKBusinessNameControlTxt
Phone3034301118PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15511 W 56TH AVE NO 250AddressLine1Txt
CityARVADACityNm
State AbbreviationCOStateAbbreviationCd
ZIP800022815ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVE DICROCEPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone3034301118PhoneNum
Signature2019-02-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRUCE PAVLIKPreparerPersonNm
PTINP00748405PTIN
Phone3123680500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address12.235.239.120IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-02-28IPDt
IP Tm13:59:40IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id6880C95823272E60E39D273128B3ACEFC4B4081DAtSubmissionCreationDeviceId
At Submission Filing Device IdDBF743AF1216C3B70D6C9C598EE47CA4DBC4F1E6AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEVE DICROCEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15511 W 56TH AVE NO 250AddressLine1Txt
CityARVADACityNm
State AbbreviationCOStateAbbreviationCd
ZIP800022815ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$123,210,688GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1965FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH BENEFITSActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$121,140,907PYProgramServiceRevenueAmt
CY Program Service Revenue$122,823,204CYProgramServiceRevenueAmt
PY Investment Income$24,474PYInvestmentIncomeAmt
CY Investment Income$325,265CYInvestmentIncomeAmt
PY Other Revenue$101,689PYOtherRevenueAmt
CY Other Revenue$62,219CYOtherRevenueAmt
PY Total Revenue$121,267,070PYTotalRevenueAmt
CY Total Revenue$123,210,688CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$111,406,082PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$111,003,225CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,248,353PYOtherExpensesAmt
CY Other Expenses$8,981,929CYOtherExpensesAmt
PY Total Expenses$120,654,435PYTotalExpensesAmt
CY Total Expenses$119,985,154CYTotalExpensesAmt
PY Revenues Less Expenses$612,635PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,225,534CYRevenuesLessExpensesAmt
Total Assets BOY$47,684,591TotalAssetsBOYAmt
Total Assets EOY$50,511,678TotalAssetsEOYAmt
Total Liabilities BOY$967,876TotalLiabilitiesBOYAmt
Total Liabilities EOY$569,429TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$46,716,715NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$49,942,249NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH BENEFITS TO THE ELIGIBLE PARTICIPANTS AND DEPENDENTS OF ROCKY MOUNTAIN UFCW & EMPLOYERS HEALTH BENEFIT PLAN.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE HEALTH, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DENTAL, VISION, PRESCRIPTION AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ZENITH AMERICAN SOLUTIONSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3034301118PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15511 W 56TH AVE NO 250AddressLine1Txt
CityARVADACityNm
State AbbreviationCOStateAbbreviationCd
ZIP80002ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
STEVE DICROCE
TRUSTEE1.00Yes (X)$0$0$0
BOB MCLAUCHLIN
TRUSTEE - NEW1.00Yes (X)$0$0$0
DANNY MA
TRUSTEE1.00Yes (X)$0$0$0
KIM CORDOVA
TRUSTEE1.00Yes (X)$0$188,852$12,09045.00
KEVIN SCHNEIDER
TRUSTEE1.00Yes (X)$0$167,082$11,63945.00
NATHANIEL BERNSTEIN
TRUSTEE1.00Yes (X)$0$160,375$11,63945.00
LEROY WESTMORELAND
TRUSTEE - NEW1.00Yes (X)$0$0$0
MARTIN GARCIA
TRUSTEE - NEW1.00Yes (X)$0$150,987$11,63945.00
BRYAN SMITH
TRUSTEE - PAST1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$667,296TotReportableCompRltdOrgAmt
Total Other Compensation$47,007TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CIGNA
900 COTTAGE GROVE ROADHARTFORDCT06152PPO ACCESS AND ADMIN FEES$4,476,436
ZENITH AMERICAN SOLUTIONS
5511 W 56TH AVE STE 250ARVADACO80002THIRD PARTY ADMINISTRATOR$2,292,696
DELTA DENTAL
4582 S ULSTER STREET STE 800DENVERCO80237DENTAL BENEFIT ADMIN FEES$313,527
REINHART BOERNER VAN DEURAN SC
1000 N WATER ST STE 1700MILWAUKEEWI53202LEGAL SERVICES$254,682
MINES & ASSOCIATES
10367 CENTENNIAL RD 100LITTLETONCO80127MENTAL HEALTH ADMIN FEES$188,331
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$106,327,818$106,327,818
PARTICIPANT CONTRIBUTIONS900099$12,163,978$12,163,978
PRESCRIPTION REBATES900099$3,854,623$3,854,623
MEDICARE PT. D RETIREE DRUG SUBSI900099$476,785$476,785
FieldValueIRS element (for citing)
Total Program Service Revenue$122,823,204TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$325,265TotalRevenueColumnAmt
Exclusion$325,265ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
COMMISSION CREDITS900099$53,138$53,138
MISCELLANEOUS INCOME900099$9,081$9,081
FieldValueIRS element (for citing)
Other Revenue Total$62,219OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$123,210,688TotalRevenueColumnAmt
Related Or Exempt Func Income$122,823,204RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$387,484ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$111,003,225TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,015,195TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$408,800TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$109,139TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,990,526TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$354,261TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$17,531TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$51,303TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescFEES MANDATED BY ACADesc
Total$35,174TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$119,985,154TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,238,465BOYAmt
EOY$1,967,064EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$33,113,517BOYAmt
EOY$38,742,268EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,283,497BOYAmt
EOY$9,751,690EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$49,112BOYAmt
EOY$50,656EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$47,684,591BOYAmt
EOY$50,511,678EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$213,628BOYAmt
EOY$138,499EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$449,495BOYAmt
EOY$430,930EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$304,753BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$967,876BOYAmt
EOY$569,429EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$46,716,715BOYAmt
EOY$49,942,249EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$46,716,715BOYAmt
EOY$49,942,249EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$47,684,591BOYAmt
EOY$50,511,678EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,225,534ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$113,560,313TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$113,560,313RevenueSubtotalAmt
Other Revenues Not Included$9,650,375OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$9,650,375RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$123,210,688TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$110,132,971TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$110,132,971ExpensesSubtotalAmt
Other Expenses Not Included$9,852,183OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$9,852,183ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$119,985,154TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RETIREE PLAN - EMPLOYER CONTRIBUTIONS 2,793,453. RETIREE PLAN - INVESTMENT INTEREST 28,415. RETIREE PLAN - RETIREE CONTRIBUTIONS 5,359,366. RETIREE PLAN - PRESCRIPTION REBATES 939,218. RETIREE PLAN - MEDICARE PT. D RETIREE DRUG SUBSIDIES 476,785. RETIREE PLAN - COMMISSION CREDITS 53,138.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RETIREE PLAN - MEDICAL BENEFITS 2,130,366. RETIREE PLAN - PRESCRIPTION BENEFITS 4,986,466. RETIREE PLAN - MEDICAL PREMIUMS 2,048,909. RETIREE PLAN - HMO PREMIUMS 160,703. RETIREE PLAN - PPO FEES & PROVIDER FEES 246,032. RETIREE PLAN - ADMINISTRATIVE EXPENSES 275,709. RETIREE PLAN - FEES MANDATED BY ACA 3,998.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KIM CORDOVA
TRUSTEE$0$178,767$0$0$0$10,085$0$2,184$0$9,906$0$200,942$0$0
KEVIN SCHNEIDER
TRUSTEE$0$156,997$0$0$0$10,085$0$2,184$0$9,455$0$178,721$0$0
NATHANIEL BERNSTEIN
TRUSTEE$0$150,290$0$0$0$10,085$0$2,184$0$9,455$0$172,014$0$0
MARTIN GARCIA
TRUSTEE - NEW$0$150,987$0$0$0$0$0$2,184$0$9,455$0$162,626$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE BOARD OF TRUSTEES HAS DELEGATED THE RECORD KEEPING AND DAY TO DAY ADMINISRATION OF THE PLAN TO ZENITH AMERICAN SOLUTIONS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES AND PLAN ADMINISTRATOR PRIOR TO FILING. AFTER THE BOARDS' REVIEW, THE FORM IS APPROVED AND FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF TRUSTEES IS REQUIRED TO DISCLOSE ANY NONADHERENCE TO THE ADOPTED POLICY.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE PLAN OFFICE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
ROCKY MTN UFCW UNIONS AND EMPRS RETAIL AND MEAT PENSION PLAN
5511 W 56TH AVE SUITE 250ARVADACO80002846045986PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIESCO401(A)N/A0
UNITED FOOD AND COMMERICAL WORKERS INTERNATIONAL UNION 7R LOCAL
CONTRIBUTING EMPLOYER0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Primary ActivitiesPrimaryActivitiesTxtControlled OrganizationControlledOrganizationInd
ALBERTSONS SAFEWAY
CONTRIBUTING EMPLOYER0
ALMAGNO FREELANCE
CONTRIBUTING EMPLOYER0
DARLING INTERNATIONAL
CONTRIBUTING EMPLOYER0
DEBONAIRE HAIR
CONTRIBUTING EMPLOYER0
DENVER PROCESSING (KS - MEAT PLANT)
CONTRIBUTING EMPLOYER0
IMAGES - A LIZZI
CONTRIBUTING EMPLOYER0
KING SOOPERSCITY MARKETSMITH FOODS
CONTRIBUTING EMPLOYER0
THE PERFECT TOUCH
CONTRIBUTING EMPLOYER0
ZENITH AMERICAN SOLUTIONS
CONTRIBUTING EMPLOYER0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS RETAIL AND MEAT PENSION PLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeSTransactionTypeTxt
Involved$4,136,160InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt