2018-04-13T17:59:22-05:00 2017-06-30 542189926 HENNINGFIELD & ASSOCIATES INC 27913 SMYTH DRIVE VALENCIA CA 91355 990 2016-07-01 956134346 FOOD EMPLOYERS & BAKERY & CONFECTIONERY WORKERS BENEFIT FUND OF SOUTHERN CALIF FOOD 6267324500 1325 NORTH GRAND AVENUE COVINA CA 91724 DOYLE TOWNSON TRUSTEE 6267324500 2018-03-30 1 RANDY D HENNINGFIELD P01364367 6612953363 108.89.97.154 2018-04-13 15:58:32 PD P B174AE6F88008EEA395284392A0091C0770EC910 B174AE6F88008EEA395284392A0091C0770EC910 2016 2021-01-29 14:40:06Z DOYLE TOWNSON 450 CARSON PLAZA CARSON CA 90746 13987287 0 X N/A X 1965 CA HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 5 5 0 0 0 0 0 0 13551020 13546116 3279 33029 116675 408142 13670974 13987287 0 0 11625768 11368700 0 0 0 0 0 693676 658938 12319444 12027638 1351530 1959649 5787722 7439949 2707512 2406088 3080210 5033861 HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 0 0 12027638 HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 12027638 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 7 0 1 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 CA X X MS CHIEMI WATANABE 6267322502 1325 NORTH GRAND AVENUE COVINA CA 91724 X KATHLEEN FINAZZO TRUSTEE 5.00 X 0 0 0 STEFANIE GUSHA TRUSTEE 5.00 X 0 0 0 DOYLE TOWNSON TRUSTEE 5.00 X 0 0 0 FELIPE J LOPEZ TRUSTEE 5.00 X 0 0 0 LEROY WESTMORELAND TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 1325 N GRAND AVE COVINA CA 91724 ADMINISTRATOR 235956 1 EMPLOYER CONTRIBUTIONS 445100 12860817 12860817 RETIREE CONTRIBUTIONS 445100 685299 685299 13546116 33029 33029 STOP LOSS RECOVERIES 445100 318999 318999 RETIREE PRESCRIPTIONS 445100 43258 43258 PRESCRIPTION REBATES 445100 32139 32139 13746 13746 408142 13987287 13954258 0 33029 11368700 235956 91495 24635 37018 995 8731 COST CONTAINMENT FEES 112020 CONSULTANTS FEES 85267 REINSURANCE FEES 30429 ADMINISTRATION FEES - V 9128 23264 12027638 121586 207969 4009175 2501097 1070434 1081582 75673 110931 6557 7104 504297 3531266 5787722 7439949 51464 30956 2656048 2375132 2707512 2406088 X 0 0 0 0 3080210 5033861 3080210 5033861 5787722 7439949 1959649 -5998 0 X 0 1 X 1 0 0 IBNR & ACCUM. ELIGIBILITY 2771000 PREMIUMS PAYABLE (RECEIVABLE) -395868 2375132 13981289 -5998 -5998 13987287 0 13987287 12308554 0 12308554 -280916 -280916 12027638 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN ACCUMULATED ELIGIBILITY AND IBNR AND PREMIUMS PAYABLE FORM 990, PART VI, SECTION A, LINE 3 THE TRUSTEES HAVE CONTRACTED WITH A THIRD PARTY ADMINISTRATOR TO PERFORM THE EVERYDAY ADMINISTRATION OF THE FUND. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS PRESENTED TO THE TRUSTEES FOR REVIEW AND SIGNATURES. FORM 990, PART VI, SECTION C, LINE 19 SUMMARY ANNUAL REPORTS ARE PROVIDED TO ALL PARTICIPANTS ANNUALLY AND SPDS ARE AVAILABLE FROM THE ADMINISTRATOR UPON REQUEST. AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST OF THE DOL OR THE ADMINISTRATION AS WELL AS THE DOL WEBSITE. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC KATHLEEN FINAZZO - 301 S. TIPPECANOE, SAN BERNARDINO, CA 92408. STEFANIE GUSHA - 1421 S. MANHATTAN AVE., FULLERTON, CA 92831. DOYLE TOWNSON - 450 CARSON PLAZA, CARSON, CA 90746. FELIPE J. LOPEZ - 6801 E. WASHINGTON BLVD., COMMERCE, CA 90040. LEROY WESTMORELAND - 1100 W ARTESIA BLVD, COMPTON, CA 90220. ALBERTSON'S 1421 S MANHATTAN AVE FULLERTON CA 92831 204057706 RETAIL GROCERS CA C 0 VONS SAFEWAY 618 MICHILLINDA AVE ARCADIA CA 91007 381623900 RETAIL GROCERS CA C 0 RALPHS 1100 W ARTESIA BLVD COMPTON CA 90220 870258768 RETAIL GROCERS CA C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0