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U F C W UNIONS & EMPLOYERS MIDWEST HEALTH BENEFITS FUND: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
U F C W UNIONS & EMPLOYERS MIDWEST HEALTH BENEFITS FUND (EIN 36-2440523)
Tax period
2014-12-01 to 2015-11-30
Filed
2016-06-06
IRS object ID
201621589349300772
Schema version
2014v6.0
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)
Return2016-06-06T11:26:34-05:00ReturnTs
Tax Period End2015-11-30TaxPeriodEndDt

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 Line1311 S WACKER DRIVE STE 4000AddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-12-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362440523EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1U F C W UNIONS & EMPLOYERS MIDWESTBusinessNameLine1Txt
Business Name Line2HEALTH BENEFITS FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlUFCWBusinessNameControlTxt
Phone8473847000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WEST HIGGINS ROAD NO 500AddressLine1Txt
CityROSEMONTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60018ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROBERT NIKSAPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone8473847000PhoneNum
Signature2016-06-06SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCRAIG RESCHPreparerPersonNm
PTINP00844633PTIN
Phone3123680500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROBERT NIKSAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WEST HIGGINS ROAD NO 500AddressLine1Txt
CityROSEMONTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60018ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$59,369,489GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.UFCWMIDWEST.ORGWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1960FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH BENEFITSActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee77TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$41,415,320PYProgramServiceRevenueAmt
CY Program Service Revenue$27,449,089CYProgramServiceRevenueAmt
PY Investment Income$385,370PYInvestmentIncomeAmt
CY Investment Income$725,589CYInvestmentIncomeAmt
PY Other Revenue$71,309PYOtherRevenueAmt
CY Other Revenue$50,109CYOtherRevenueAmt
PY Total Revenue$41,871,999PYTotalRevenueAmt
CY Total Revenue$28,224,787CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$45,306,432PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$31,120,908CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,880,988PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,726,283CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,293,076PYOtherExpensesAmt
CY Other Expenses$2,002,676CYOtherExpensesAmt
PY Total Expenses$53,480,496PYTotalExpensesAmt
CY Total Expenses$37,849,867CYTotalExpensesAmt
PY Revenues Less Expenses-$11,608,497PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$9,625,080CYRevenuesLessExpensesAmt
Total Assets BOY$33,395,682TotalAssetsBOYAmt
Total Assets EOY$23,592,511TotalAssetsEOYAmt
Total Liabilities BOY$1,245,184TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,140,701TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$32,150,498NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,451,810NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE HEALTH BENEFITSMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE HEALTH CARE, DEATH AND DISABILITY BENEFITS FOR 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 EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
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 Document1236IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee77EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
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 Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
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 Line1DAVID MINEAUBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8473847000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WEST HIGGINS ROAD SUITE 500AddressLine1Txt
CityROSEMONTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60018ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRIAN JORDAN
TRUSTEE3.00Yes (X)$0$0$0
KEVIN J BECKERLE
TRUSTEE3.00Yes (X)$0$0$0
DEREK KINNEY
TRUSTEE3.00Yes (X)$0$0$0
DANIEL RYAN
ASSISTANT ADMINISTRATOR40.00$115,398$0$69,165Yes (X)
KENNETH R BOYD
TRUSTEE3.00Yes (X)$0$174,133$21,95355.00
STEVEN M POWELL
TRUSTEE3.00Yes (X)$0$247,318$20,89940.00
NANCY MAIZE
PENSION DIRECTOR40.00$104,006$0$24,264Yes (X)
KENNETH URZEDOWSKI
TRUSTEE3.00Yes (X)$0$128,204$19,20240.00
DONALD SCHAPER
TRUSTEE - PAST3.00Yes (X)$0$0$0
ROBERT NIKSA
ADMINISTRATOR40.00$77,699$0$25,527Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$297,103TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$549,655TotReportableCompRltdOrgAmt
Total Other Compensation$181,010TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
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
BLUE CROSS BLUE SHIELD
300 EAST RANDOLPH STCHICAGOIL60601PPO PROVIDER$1,727,898
THE SEGAL COMPANY
PO BOX 4092 CHURCH STREET STATIONNEW YORKNY10261ACTUARY$182,276
MEDICAL INSURANCE CONSULTING GROUP INC
4949 N WESTERN AVENUECHICAGOIL60625MEDICAL CONSULTANT$167,295
LEGACY PROFESSIONALS LLP
311 SOUTH WACKER STE 4000CHICAGOIL60606AUDITOR$162,997
CATAMARAN
1600 MCCONNOR PARKWAYSCHAUMBURGIL60173PHARMACY BENEFIT MANAGER$118,021
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$23,368,013$23,368,013
REIMB EXP UFCW MW PENSION900099$2,328,174$2,328,174
PARTICIPANT CONTRIBUTIONS900099$1,178,614$1,178,614
REIMB EXPS UFCW CALUMET FUND900099$354,943$354,943
PRESCRIPTION DRUG REBATES900099$219,345$219,345
FieldValueIRS element (for citing)
Total Program Service Revenue$27,449,089TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$513,978TotalRevenueColumnAmt
Exclusion$513,978ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$31,356,313SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$31,144,702SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$211,611SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$211,611TotalRevenueColumnAmt
Exclusion$211,611ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$50,109TotalRevenueColumnAmt
Exclusion$50,109ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$50,109OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,224,787TotalRevenueColumnAmt
Related Or Exempt Func Income$27,449,089RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$775,698ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$31,120,908TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$182,571TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,034,515TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$710,929TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$539,176TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$259,092TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$79,765TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$123,272TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$74,633TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$301,298TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$277,326TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$77,943TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$402,280TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$348TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$35,465TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$208,712TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$258,622TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
WEB CLAIMS SERVICE FEE$47,628
FEES MANDATED BY ACA$43,173
OTHER PERSONNEL COSTS$36,233
STORAGE OF DOCUMENTS$35,978

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$37,849,867TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$392,082BOYAmt
EOY$350,482EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,668,687BOYAmt
EOY$1,365,561EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,902,330BOYAmt
EOY$2,253,666EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$84,109BOYAmt
EOY$97,361EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$506,171LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$249,488LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$317,794BOYAmt
EOY$256,683EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$28,030,680BOYAmt
EOY$19,268,758EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,395,682BOYAmt
EOY$23,592,511EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$753,516BOYAmt
EOY$622,238EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$491,668BOYAmt
EOY$518,463EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,245,184BOYAmt
EOY$1,140,701EOYAmt
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$32,150,498BOYAmt
EOY$22,451,810EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$32,150,498BOYAmt
EOY$22,451,810EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,395,682BOYAmt
EOY$23,592,511EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$9,625,080ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$73,608NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$506,171OtherCostOrOtherBasisAmt
Depreciation$249,488DepreciationAmt
Book Value$256,683BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$256,683TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO PARTICIPANTS OF DEFERRED COMPENSATION PLANS$206,750
MAINTENANCE OF RESERVE POLICY REFUNDS$25,582
DEFERRED LEASE INCENTIVE$286,131
FieldValueIRS element (for citing)
Total Liability$518,463TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$25,748,372TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$73,608NetUnrealizedGainsInvstAmt
Revenue Not Reported-$73,608RevenueNotReportedAmt
Revenue Subtotal$25,821,980RevenueSubtotalAmt
Investment Expenses Not Incld$74,633InvestmentExpensesNotIncldAmt
Other Revenues Not Included$2,328,174OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,402,807RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,224,787TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$35,447,060TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$35,447,060ExpensesSubtotalAmt
Investment Expenses Not Incld2$74,633InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$2,328,174OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,402,807ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$37,849,867TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:REIMBURSED ADMIN EXPENSE - UFCW PENSION FUND 2,328,174.
PART XII, LINE 4B - OTHER ADJUSTMENTS:REIMBURSED ADMIN EXPENSE - UFCW PENSION FUND 2,328,174.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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
DANIEL RYAN
ASSISTANT ADMINISTRATOR$115,398$0$0$0$0$0$59,572$0$9,593$0$184,563$0$0$0
KENNETH R BOYD
TRUSTEE$0$174,133$0$0$0$0$0$6,381$0$15,572$0$196,086$0$0
STEVEN M POWELL
TRUSTEE$0$195,302$0$7,431$0$44,585$0$2,498$0$18,401$0$268,217$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BDAN RYAN, THE PRIOR ADMINISTRATOR AND CURRENT ASSISTANT ADMINISTRATOR, PARTICIPATES IN A DEFERRED COMPENSATION PLAN ESTABLISHED UNDER SECTION 457(F) OF THE IRS CODE.
FORM 990, SCHEDULE J, PART II, COLUMN CRETIREMENT AND OTHER DEFERRED COMPENSATION INCLUDES THE INCREASE IN THE PRESENT VALUE OF A DEFINED BENEFIT PENSION PLAN FOR ROBERT NIKSA, DANIEL RYAN AND NANCY MAIZE AS DETERMINED BY THE FUND'S ACTUARY.
FORM 990, SCHEDULE J, PART II, COLUMN DNON-TAXABLE BENEFITS INCLUDE THE VALUE OF HEALTH AND WELFARE PREMIUMS PAID ON BEHALF OF THE INDIVIDUAL.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8BTHE PLAN DOES NOT HAVE ANY SEPARATE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL BEFORE IT IS SIGNED AND FILED.
FORM 990, PART VI, SECTION B, LINE 15ASALARIES ARE ANNUALLY REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE FUND OFFICE.
FORM 990, PART VII, SECTION AIN JUNE 2014, ROBERT NIKSA WAS HIRED AS THE FULL TIME ADMINISTRATOR AND DANIEL RYAN WAS NAMED AS THE ASSISTANT ADMINISTRATOR. THE COMPENSATION REPORTED IN PART VII, AS DEFINED BY THE INSTRUCTIONS, IS THE CALENDAR YEAR 2014 COMPENSATION WHICH IS THE CALENDAR YEAR WHICH ENDED DURING THE PLAN'S FISCAL YEAR ENDED NOVEMBER 30, 2015.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
UNITED FOOD & COMMERICAL WORKERS & EMPRS MIDWEST PENSION FUND
9801 WEST HIGGINS ROADROSEMONTIL60018366508328RETIREMENT BENEFITS FOR ELIGIBLE PARTICIPANTSIL501(A)N/A0
UNITED FOOD & COMMERICAL WORKERS LOCAL 881
CONTRIBUTING EMPLOYER0
UNITED FOOD & COMMERICAL WORKERS LOCAL 1546
CONTRIBUTING EMPLOYER0
UNITED FOOD & COMMERCIAL WORKERS LOCAL 536
CONTRIBUTING EMPLOYER0
UNITED STEEL WORKERS OF AMERICA LOCAL 6787
CONTRIBUTING EMPLOYER0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (109 entries)

Primary ActivitiesPrimaryActivitiesTxtControlled OrganizationControlledOrganizationInd
A & G LAUNDROMAT
CONTRIBUTING EMPLOYER0
ANICHINI BROS INC
CONTRIBUTING EMPLOYER0
ANTON'S FRUIT RANCH &
CONTRIBUTING EMPLOYER0
APPLE MARKET
CONTRIBUTING EMPLOYER0
ARAMARK UNIFORM SERVICES
CONTRIBUTING EMPLOYER0
ARLINGTON GOURMET MKT
CONTRIBUTING EMPLOYER0
ASCOT MEATS INC
CONTRIBUTING EMPLOYER0
ASHMANN PRESCRIPTIONS
CONTRIBUTING EMPLOYER0
ATHENA SCHOOL - CO
CONTRIBUTING EMPLOYER0
BAJA SERVICES
CONTRIBUTING EMPLOYER0
BASIC HARDWARE CENTER
CONTRIBUTING EMPLOYER0
BLUE GOOSE STORE
CONTRIBUTING EMPLOYER0
BUEDEL'S FOOD PRODUCTS
CONTRIBUTING EMPLOYER0
BUNGE FOODS
CONTRIBUTING EMPLOYER0
C & F PACKING CO
CONTRIBUTING EMPLOYER0
CP MEAT MARKET
CONTRIBUTING EMPLOYER0
CENTRAL MARKET OF INDIANA INC
CONTRIBUTING EMPLOYER0
CERTIFIED WAREHOUSE FOODS
CONTRIBUTING EMPLOYER0
CHASE UNIVERSAL SRVCS INC
CONTRIBUTING EMPLOYER0
CHIPAIN'S FINER FOODS
CONTRIBUTING EMPLOYER0
CONSUMER'S PACKING
CONTRIBUTING EMPLOYER0
D & D FINER FOODS
CONTRIBUTING EMPLOYER0
D & S INC
CONTRIBUTING EMPLOYER0
D & S MEAT MARKET
CONTRIBUTING EMPLOYER0
DARLING INTERNATIONAL INC
CONTRIBUTING EMPLOYER0
DE VRIES MEAT MARKET
CONTRIBUTING EMPLOYER0
DISCOUNT MEATS
CONTRIBUTING EMPLOYER0
DOMANI CNSTRCTN & DVLPMNT INC
CONTRIBUTING EMPLOYER0
ER SMITH ENTERPRISESINC
CONTRIBUTING EMPLOYER0
EGYPTIAN STATIONERS INC
CONTRIBUTING EMPLOYER0
ELEGANCE IN MEATS INC
CONTRIBUTING EMPLOYER0
EX-CEL CORNED BEEF INC
CONTRIBUTING EMPLOYER0
FARMER'S MARKET INC
CONTRIBUTING EMPLOYER0
FELICIA'S
CONTRIBUTING EMPLOYER0
FRESH LINE FOODS
CONTRIBUTING EMPLOYER0
GENE'S TIRE SERVICE INC
CONTRIBUTING EMPLOYER0
GEPPERTH'S MARKET
CONTRIBUTING EMPLOYER0
GILLMORES CORNER MARKET
CONTRIBUTING EMPLOYER0
GLENVIEW GOURMET MEATS
CONTRIBUTING EMPLOYER0
GREAT WESTERN BEEF
CONTRIBUTING EMPLOYER0
HADDAD'S MARKET
CONTRIBUTING EMPLOYER0
HAPPY FOODS INC
CONTRIBUTING EMPLOYER0
HARI LLC
CONTRIBUTING EMPLOYER0
HARMON'S FOODS
CONTRIBUTING EMPLOYER0
HOLZKOPF'S MEAT
CONTRIBUTING EMPLOYER0
HOME FURNITURE LLC
CONTRIBUTING EMPLOYER0
HONEY BAKED HAM
CONTRIBUTING EMPLOYER0
ILLINOIS FOOD RETAILERS ASSOCIATION
CONTRIBUTING EMPLOYER0
INTERNATIONAL MEAT CO INC
CONTRIBUTING EMPLOYER0
JT AMUSEMENTS LTD
CONTRIBUTING EMPLOYER0
JACK & PAT'S CERT INC
CONTRIBUTING EMPLOYER0
JERRY'S QUALITY MEATS
CONTRIBUTING EMPLOYER0
JOHNNY G'S QUALITY MEATS
CONTRIBUTING EMPLOYER0
JONDEB CORP
CONTRIBUTING EMPLOYER0
K & S WHOLESALE MEATS INC
CONTRIBUTING EMPLOYER0
KINGDOM FARMS
CONTRIBUTING EMPLOYER0
KRAMER FOODS
CONTRIBUTING EMPLOYER0
LAKE AREA UNITED WAY
CONTRIBUTING EMPLOYER0
LEGACY HEALTHCARE
CONTRIBUTING EMPLOYER0
M & K FOODS DBA SEVEN-ELEVEN
CONTRIBUTING EMPLOYER0
MARCO CONSULTING GROUP
CONTRIBUTING EMPLOYER0
MARIO'S BUTCHER SHOP
CONTRIBUTING EMPLOYER0
MAXON SHOOTERS
CONTRIBUTING EMPLOYER0
MIKE'S MEAT MARKET
CONTRIBUTING EMPLOYER0
MILLER GROCERY MARKET LLC
CONTRIBUTING EMPLOYER0
MINELLI DELI & MEATS
CONTRIBUTING EMPLOYER0
MR BEEF
CONTRIBUTING EMPLOYER0
MR CKGK INC
CONTRIBUTING EMPLOYER0
MURPHY & ASSOCIATES LTD
CONTRIBUTING EMPLOYER0
NORTHWESTERN INDIANA
CONTRIBUTING EMPLOYER0
ONE STOP FOOD & LIQUORS
CONTRIBUTING EMPLOYER0
ONE STOP PACEMAKER
CONTRIBUTING EMPLOYER0
ORCHARD PRIME MEATS
CONTRIBUTING EMPLOYER0
P & V CATERING
CONTRIBUTING EMPLOYER0
PARAMOUNT TRUCK BODY
CONTRIBUTING EMPLOYER0
PARKSHORE MARKET LTD
CONTRIBUTING EMPLOYER0
PAULINA MARKET
CONTRIBUTING EMPLOYER0
PERSONAL CHEF SERVICES
CONTRIBUTING EMPLOYER0
PIATAK MEATS
CONTRIBUTING EMPLOYER0
POTASH BROTHERS
CONTRIBUTING EMPLOYER0
PRIME'N TENDER MEATS
CONTRIBUTING EMPLOYER0
RABER PACKING CO
CONTRIBUTING EMPLOYER0
RIVERSIDE FOODS
CONTRIBUTING EMPLOYER0
ROIN'S PRODUCE
CONTRIBUTING EMPLOYER0
RUSSO OF ITALY HAIR DESIGNS
CONTRIBUTING EMPLOYER0
RUSSO WHOLESALE
CONTRIBUTING EMPLOYER0
SNN INC
CONTRIBUTING EMPLOYER0
SALEM VILLAGE NURSING HM
CONTRIBUTING EMPLOYER0
SAURO & ASSOC INC
CONTRIBUTING EMPLOYER0
SCHWEGEL'S MARKET
CONTRIBUTING EMPLOYER0
SHOELESS JOE'S
CONTRIBUTING EMPLOYER0
SODEXO INC
CONTRIBUTING EMPLOYER0
STEINBACH MEATS
CONTRIBUTING EMPLOYER0
STRACK-ULTRA
CONTRIBUTING EMPLOYER0
SUNSET FOOD MART
CONTRIBUTING EMPLOYER0
SUPERVALU
CONTRIBUTING EMPLOYER0
SV CARE SOUTHVIEW
CONTRIBUTING EMPLOYER0
SYMPHONY HEALTHCARE
CONTRIBUTING EMPLOYER0
TED'S AUTO CLINIC
CONTRIBUTING EMPLOYER0
TERRACE NURSING
CONTRIBUTING EMPLOYER0
THE KROGER COMPANY
CONTRIBUTING EMPLOYER0
TRANSPORT PRODUCTION SYSTEMS
CONTRIBUTING EMPLOYER0
TREASURE ISLAND
CONTRIBUTING EMPLOYER0
TRISTATE SECURITY OF AMER
CONTRIBUTING EMPLOYER0
WELCH'S STOP & SHOP
CONTRIBUTING EMPLOYER0
WHEATON MEAT CO
CONTRIBUTING EMPLOYER0
WINSTON'S SAUSAGE
CONTRIBUTING EMPLOYER0
YESTER YEARS MEAT SHOPPE
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 FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
UNITED FOOD AND COMMERICAL WORKERS UNIONS & EMPLOYERS MIDWEST PENSION FUND
N$456,029
UNITED FOOD AND COMMERICAL WORKERS UNIONS & EMPLOYERS MIDWEST PENSION FUND
O$1,872,145
UNITED FOOD AND COMMERICAL WORKERS UNIONS & EMPLOYERS MIDWEST PENSION FUND
Q$2,850,708