2017-11-07T12:13:21-06:00 2016-12-31 WITHUMSMITHBROWNPC 4600 EAST WEST HWY 900 BETHESDA MD 208143423 990 2016-01-01 526044428 UNITED FOOD AND COMMERCIAL WORKERS UNIONS AND PARTICIPATING EMPLOYERS HEALTH & WELFARE FUND % ASSOCIATED ADMINISTRATORS L UNIT 4106836500 8400 Corporate Drive Suite 430 LANDOVER MD 207852361 MARK FEDERICI DONNA GWIN TRUSTEES 4106836500 2017-11-03 true RICHARD L RUVELSON P00234075 3012726000 66.195.210.98 22006220173115000027 2017-11-07 P E4D8CF098BE404CCCB871927F4C0A0A29E91B1BB EFE937D907E9188D51497D9C700ABA7D032A681F 2016 2018-03-14 21:41:22Z X MARK FEDERICI UFCW LC400 8400 CORPORATE DR LANDOVER MD 20785 52511599 false X n/a X 1961 MD established by the ufcw int'l union, ufcw local unions 27 & 400 and participating employers, to receive contributions & hold assets for a multiemployer employee benefit fund. 8 0 0 0 0 0 0 48640754 48926554 161873 117637 24557 22500 48827184 49066691 0 0 45842038 44508241 0 0 0 0 0 4743973 4278673 50586011 48786914 -1758827 279777 8618244 8663224 727935 489521 7890309 8173703 THE TRUST WAS ESTABLISHED BY UNITED FOOD AND COMMERICAL WORKERS LOCAL UNIONS 27 AND 400 AND PARTICIPATING EMPLOYERS TO RECEIVE CONTRIBUTIONS AND HOLD THE ASSETS FOR A MULTIEMPLOYER, COLLECTIVELY BARGAINED EMPLOYEE BENEFIT PLAN. false false SERVED AS THE TRUST FOR A MULTIEMPLOYER WELFARE BENEFIT FUND THAT PROVIDES MEDICAL, HOSPITAL, ACCIDENT AND SICKNESS, MENTAL HEALTH AND SUBSTANCE ABUSE, PRESCRIPTION DRUG, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO PARTICIPANTS AND DEPENDENTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS AND PARTICIPATION AGREEMENTS. false false false false false false false false false false false false false false true true false false false false false false false false false false false false true false false false false false false false false false false false true false false true 1248 0 true 0 false false false false false false X 8 0 true false false false false true false true true false false true true true true true true false false false X ASSOCIATED ADMINISTRATORS L 4106836500 911 RIDGEBROOK ROAD SPARKS MD 21152 X MARK FEDERICI CHAIRMAN/UNION TRUSTEE 1.0 39.0 X X 0 211435 25161 STEVE LOEFFLER SECRETARY/EMPLOYER TRUSTEE 1.0 39.0 X X 0 0 0 ATHAR BILGAMI EMPLOYER TRUSTEE (EFF 9/15/16) 1.0 39.0 X 0 0 0 JON BORN EMPLOYER TRUSTEE 1.0 39.0 X 0 0 0 MICHELLE EUBANK UNION TRUSTEE 1.0 39.0 X 0 116384 22657 DONNA GWIN EMPLOYER TRUSTEE 1.0 39.0 X 0 0 0 ERIN HAITHCOCK EMPLOYER TRUSTEE (THRU 9/15/16 1.0 39.0 X 0 0 0 LAVORIS HARRIS UNION TRUSTEE 1.0 39.0 X 0 170349 23719 THOMAS HIPKINS UNION TRUSTEE (THRU 9/19/16) 1.0 39.0 X 0 143008 22706 GEORGE MURPHY JR UNION TRUSTEE (EFF 9/19/16) 1.0 39.0 X 0 200323 21832 0 841499 116075 0 false true false ASSOCIATED ADMINISTRATORS LLC 911 RIDGEBROOK RD SPARKS MD 211529451 CLAIMS/CONTRACT FEES 1604393 ANTHEM BLUE CROSSBLUE SHIELD 9075 CENTRE POINT DR STE 200 WEST CHESTER OH 45069 CLAIMS ADMIN FEES 1008539 CONIFER VALUE-BASED CARE LLC 1596 WHITEHALL ROAD ANNAPOLIS MD 21401 MEDICAL MANAGEMENT 482342 AETNA 1351 WM HOWARD TAFT ROAD CINCINNATI OH 45206 CLAIMS PROCESSING 337572 SLEVIN HART PC 1625 MASSACHUSETTS AVENUE NW STE 4 WASHINGTON DC 20036 LEGAL SERVICES 297248 7 0 EMPLOYERS CONTRIBUTIONS 525100 48092638 48092638 PARTICIPANTS CONTRIBUTIONS 525100 833916 833916 48926554 90744 90744 0 0 0 0 0 3471801 3444908 26893 26893 26893 0 0 0 0 0 0 0 0 0 EDUCATIONAL FUNDING 900099 22500 22500 22500 49066691 48926554 140137 0 0 0 44508241 0 0 0 0 0 0 0 369698 47700 0 0 9023 3449297 0 83247 0 0 0 0 0 24048 0 0 0 31347 ACA EXCISE FEES 246964 OTHER TAXES 8899 FAIR HEALTH COSTS 7322 DUES 1105 23 48786914 -322152 25182 2119520 3237563 0 0 2133421 3358584 0 0 0 0 0 0 0 0 12492 19033 0 0 4131883 1748369 0 0 0 0 0 0 543080 274493 8618244 8663224 727935 489521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727935 489521 X 0 0 0 0 7890309 8173703 7890309 8173703 8618244 8663224 279777 3617 X false true X true false 0 0 X 49061285 3617 3617 49057668 9023 9023 49066691 48777891 48777891 9023 9023 48786914 PART X, LINE 2 - FIN 48 FOOTNOTE: Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken 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 the Internal Revenue Service. Management has evaluated the tax positions taken by the Plan and concluded that as of December 31, 2016 there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the financial statements. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. false false false MARK FEDERICI CHAIRMAN/UNION TRUSTEE 0 190550 20885 0 9889 0 15272 0 236596 0 0 LAVORIS HARRIS UNION TRUSTEE 0 154500 15849 0 8447 0 15272 0 194068 0 0 THOMAS HIPKINS UNION TRUSTEE (THRU 9/19/16) 0 143008 0 2923 0 19783 0 165714 0 0 GEORGE MURPHY JR UNION TRUSTEE (EFF 9/19/16) 0 200323 0 2923 0 18909 0 222155 0 0 PART VI, SECTION A, LINE 2 - BUSINESS RELATIONSHIPS: TRUSTEES MARK FEDERICI AND LAVORIS HARRIS SERVE AS PRESIDENT AND SECRETARY-TREASURER OF UNITED FOOD AND COMMERICAL WORKERS LOCAL NO. 400. MICHELLE EUBANK, THOMAS HIPKINS AND GEORGE MURPHY JR. SERVE AS RECORDER/FIELD ASST. TO THE PRESIDENT, SECRETARY-TREASURER AND PRESIDENT OF UNITED FOOD AND COMMERICAL WORKERS LOCAL 27, AFL-CIO. PART VI, SECTION A, LINE 7A - SELECTION OF TRUSTEES: When a Trustee vacancy arises, the Fund's Trust Agreement provides that the United Food and Commercial Workers, International Union, AFL-CIO, Locals Nos. 27 and 400, have the power to appoint Union Trustees for the Fund, and the covered employers have the power to appoint Employer Trustees to the Fund. PART VI, SECTION B, LINE 11B - REVIEW PROCESS OF FORM 990: The Board of Trustees is provided a draft of the Form 990 for review prior to the submission of the Form 990. PART VI, SECTION B, LINE 12C - CONFLICT OF INTEREST POLICY: The Fund is maintained and administered in accordance with ERISA Sections 404 and 406 and the Fund's conflict of interest policy is set forth in ERISA Sections 404 and 406. The Board of Trustees monitors and enforces the Fund's compliance with ERISA, with the assistance of the Fund's professionals. PART VI, SECTION C, LINE 19-GOVERNING DOCUMENTS, POLICIES & F/S: The Fund makes its governing documents, policies and financial statements available to participants and beneficiaries as required by Employee Retirement Income Security Act of 1974 (ERISA). UFCW LOCAL 27 AFL-CIO 21 WEST ROAD BALTIMORE MD 21204 521265190 LABOR ORG MD 501(C)(5) false UFCW LOCAL NO 400 8400 CORPORATE DRIVE SUITE 200 LANDOVER MD 20785 530241580 LABOR ORG MD 501(C)(5) false BD OF TTEES UFCW UNIONS & PARTICIPATING 4301 GARDEN CITY DRIVE SUITE 201 LANDOVER MD 20785 PLAN SPONSOR MD false DELMARVA UFCW HEALTH & WELFARE FUND KEL-CO FEDERAL CREDIT UNION ASSOCIATED ADMINISTRATORS LLC KROGER FOOD STORES PERKINS MANAGEMENT SERVICES COMPANY INC RETAIL BRAND ALLIANCE SAFEWAY INC SUPERVALU INC (SHOPPERS) false false false false false false false false false false false false true true false false false false true PART IV - RELATED ORGANIZATIONS TAXABLE AS CORPORATIONS: THE ORGANIZATIONS LISTED AS RELATED ARE ALL CONTRIBUTING EMPLOYERS TO THE HEALTH AND WELFARE FUND AND THE INSTRUCTIONS ONLY REQUIRE THE NAME OF THE ORGANIZATIONS ON THIS FORM.