2017-11-15T12:39:15-06:00 2016-12-31 113266576 GRASSI & CO CPA'S PC 50 JERICHO QUADRANGLE JERICHO NY 11753 990 2016-01-01 116036373 LOCAL 365 UAW WELFARE FUND LOCA 2019478000 140 SYLVAN AVENUE SUITE 303 ENGLEWOOD CLIFFS NJ 07652 PETER FULLERTON TRUSTEE 2019478000 2017-10-27 1 ALAN SILVERSTEIN P00043838 5162563500 2017-10-27 24.38.5.2 2017-10-27 15:29:39 ED P C7AD96754DCBCDFC6E5A9FA57FCA199BF852563A C7AD96754DCBCDFC6E5A9FA57FCA199BF852563A 2016 2017-02-10 21:41:12Z PETER FULLERTON 140 SYLVAN AVENUE SUITE 303 ENGLEWOOD CLIFFS NJ 07652 10511625 0 X N/A X 1949 NY TO PROVIDE HEALTH BENEFITS TO MEMBERS 2 2 0 0 0 0 0 0 2468283 2316353 163772 177881 138993 67072 2771048 2561306 0 0 2517403 2947027 935 922 0 0 0 231231 221410 2749569 3169359 21479 -608053 6700347 6211399 495777 653476 6204570 5557923 TO PROVIDE ACCIDENT AND SICKNESS, DENTAL, OPTICAL AND MEDICAL BENEFITS TO MEMBERS EMPLOYED BY CONTRIBUTING EMPLOYERS 0 0 TO PROVIDE ACCIDENT AND SICKNESS, DENTAL, OPTICAL AND MEDICAL BENEFITS TO MEMBERS EMPLOYED BY CONTRIBUTING EMPLOYERS 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 4 0 0 0 0 0 0 0 0 0 0 X 2 2 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X LOCAL 365 UAW WELFARE FUND 2019478000 140 SYLVAN AVENUE SUITE 303 ENGLEWOOD CLIFFS NJ 07652 X PETER FULLERTON UNION TRUSTEE 1.00 X 0 0 0 JEFFREY ISAACS EMPLOYER TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 60673 PROVIDE PRESCRIPTION DRUG BENEFITS FOR M 390939 1 EMPLOYERS CONTRIBUTIONS 900099 2296396 2296396 EMPLOYEES COBRA CONTRIBUTIONS 900099 19957 19957 2316353 120649 120649 8007551 7950319 57232 57232 57232 MISCELLANEOUS REVENUE 900099 67072 67072 67072 2561306 2440657 0 120649 2947027 922 105074 29775 25438 37967 593 4549 REINSURANCE FEE 17116 BANK FEES 898 3169359 410885 388918 102745 196249 6168974 5614542 17743 11690 6700347 6211399 495777 653476 495777 653476 X 6204570 5557923 6204570 5557923 6700347 6211399 -608053 -38594 0 X X 0 1 X 0 0 0 CLAIMS PAYABLE 653476 653476 X 2484745 -38594 -38594 2523339 37967 37967 2561306 2973693 0 2973693 37967 157699 195666 3169359 PART X, LINE 2: THE PLAN ADOPTED THE PROVISIONS PERTAINING TO UNCERTAIN TAX PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARDS CODIFICATION ("ASC") TOPIC 740, INCOME TAXES, AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FOUNDATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO 2013. PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS PAYABLE 157,699. FORM 990, PART XII, LINE 4B CLAIMS PAYABLE IS THE DIFFERENCE IN THE CHANGE IN PLANS TOTAL BENEFIT OBLIGATION AT THE END OF THE YEAR. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO THIRD PARTY ADMINISTRATOR - BENSERCO, INC. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 3 VOTING MEMBERS OF THE GOVERNING BOARD AND THE MEMBERS ARE INDEPENDENT. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS WHO MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD HAS THE RIGHT TO MAKE DECISIONS ON BEHALF OF THE MEMBERS WITHOUT APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION REVIEWS THE 990 AT BOARD MEETINGS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AT THE FUND OFFICE ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C ( PAGE 12 ) THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. LOCAL 365 UAW PENSION FUND 140 SYLVAN AVENUE SUITE 303 ENGLEWOOD CLIFFS NJ 07652 116045281 TO PROVIDE PENSION BENEFITS TO PARTICIPANTS NY 401(A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0