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INDIANA AREA UFCW HEALTH AND WELFARE PLAN: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
INDIANA AREA UFCW HEALTH AND WELFARE PLAN (EIN 35-6045880)
Tax period
2014-01-01 to 2014-06-30
Filed
2015-04-13
IRS object ID
201511039349301156
Schema version
2014v5.0
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)
Return2015-04-13T19:05:50-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

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 Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN356045880EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA AREA UFCW HEALTH AND WELFARE PLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlINDIBusinessNameControlTxt
Phone3172477381PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15420 WEST SOUTHERN AVENUE NO 407AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46241ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOE CHORPENNINGPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone3172477381PhoneNum
Signature2015-04-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonVICTOR ANCICHPreparerPersonNm
PTINP00201493PTIN
Phone3123680500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Final ReturnYes (X)FinalReturnInd
Principal OfficerJOE CHORPENNINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15420 WEST SOUTHERN AVENUE NO 407AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46241ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$19,641,869GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1968FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH BENEFITSActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body0VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
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$40,422,005PYProgramServiceRevenueAmt
CY Program Service Revenue$16,686,565CYProgramServiceRevenueAmt
PY Investment Income$27,297PYInvestmentIncomeAmt
CY Investment Income$41,253CYInvestmentIncomeAmt
PY Other Revenue$3,929PYOtherRevenueAmt
CY Other Revenue$1,791CYOtherRevenueAmt
PY Total Revenue$40,453,231PYTotalRevenueAmt
CY Total Revenue$16,729,609CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$43,865,035PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$19,488,599CYBenefitsPaidToMembersAmt
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$2,176,270PYOtherExpensesAmt
CY Other Expenses$1,155,590CYOtherExpensesAmt
PY Total Expenses$46,041,305PYTotalExpensesAmt
CY Total Expenses$20,644,189CYTotalExpensesAmt
PY Revenues Less Expenses-$5,588,074PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,914,580CYRevenuesLessExpensesAmt
Total Assets BOY$7,495,347TotalAssetsBOYAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities BOY$279,347TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,216,000NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPROVIDE HEALTH BENEFITSMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
DescTO PROVIDE ACCIDENT, HEALTH, DENTAL, VISION, PRESCRIPTION DRUG, LIFE & LOSS OF TIME BENEFITS FOR ELIGIBLE PARTICIPANTS AND/OR THEIR DEPENDENTS IN ACCORDANCE WITH THE PLAN DOCUMENT AND THE SCHEDULE OF BENEFITS.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 Required0ScheduleJRequiredInd
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 OperationsYes (1)TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members0GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
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 Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEARTLAND HEALTH AND WELLNESS FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9376651900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17250 POE AVENUE SUITE 300AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP454142547ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOE CHORPENNING
TRUSTEE - PAST1.00Yes (X)$0$0$0
CINDY BONDAR
TRUSTEE - PAST1.00Yes (X)$0$0$0
SCOTT BARNETT
TRUSTEE - PAST1.00Yes (X)$0$0$0
MICHAEL MURDOCK
TRUSTEE - PAST1.00Yes (X)$0$0$0
MICHAEL MERRELL
TRUSTEE - PAST1.00Yes (X)$0$0$0
THOMAS CEBULKO
TRUSTEE - PAST1.00Yes (X)$0$0$0
RICHARD FITZGERALD
TRUSTEE - PAST1.00Yes (X)$0$0$0
NORA BAMMANN
TRUSTEE -PAST1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ANTHEM
220 VIRGINIA AVENUEINDIANAPOLISIN46204BENEFIT CLAIMS ADMINISTRATOR$685,772
ZENITH AMERICAN SOLUTIONS
5420 WEST SOUTHERN AVENUE SUITE 407INDIANAPOLISIN46241ADMINISTRATIVE SERVICES$559,060
CONIFER VALUE-BASED CARE LLC
1596 WHITEHALL ROADANNAPOLISMD21409CARE MANAGEMENT SERVICES$232,707
MILLIMAN
111 MONUMENT CIRCLE SUITE 601INDIANAPOLISIN46204BENEFIT AND ACTUARIAL SERVICES$207,703
REINHART BOERNER VAN DEUREN
100 NORTH WATER STREET SUITE 1700MILWAUKEEWI53202LEGAL SERVICES$147,343
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$16,426,363$16,426,363
PRESCRIPTION DRUG REBATES900099$130,926$130,926
PARTICIPANT CONTRIB.900099$129,276$129,276
FieldValueIRS element (for citing)
Total Program Service Revenue$16,686,565TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,100TotalRevenueColumnAmt
Exclusion$4,100ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,949,413SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,912,260SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$37,153SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,153TotalRevenueColumnAmt
Exclusion$37,153ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$1,791TotalRevenueColumnAmt
Exclusion$1,791ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,791OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,729,609TotalRevenueColumnAmt
Related Or Exempt Func Income$16,686,565RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$43,044ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$19,488,599TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$258,628TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$78,593TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$741,114TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$48,416TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$15,737TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,309TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,335TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMEMBERSHIP DUESDesc
Total$458TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,644,189TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,071,724BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,225,165BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,172BOYAmt
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,912,260BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$279,026BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,495,347BOYAmt
EOY$0EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$279,347BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$279,347BOYAmt
EOY$0EOYAmt
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$7,216,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,216,000BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,495,347BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,914,580ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$3,301,420OtherChangesInNetAssetsAmt
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$16,729,609TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$16,729,609RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,729,609TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,644,189TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$20,644,189ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$20,644,189TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE PLAN IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE, EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. FOR THE PERIOD ENDED JUNE 30, 2014, THE PLAN HAS DETERMINED THAT NO INCOME TAXES ARE DUE FROM ITS ACTIVITIES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED IN THE FINANCIAL STATEMENTS. 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 STATUE OF LIMITATION EXPIRES.ExplanationTxt

Schedule N IRS990ScheduleN

Liquidation Of Assets Table LiquidationOfAssetsTableGrp

Liquidation Of Assets Detail LiquidationOfAssetsDetail (4 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
HEARTLAND HEALTH AND WELLNESS FUND
CASH2014-06-30$861,597ACTUAL3160411077250 POE AVENUE SUITE 300DAYTONOH45414501(C)9
HEARTLAND HEALTH AND WELLNESS FUND
RECEIVABLES2014-06-30$2,557,019ACTUAL3160411077250 POE AVENUE SUITE 300DAYTONOH45414501(C)9
HEARTLAND HEALTH AND WELLNESS FUND
PREPAID EXPENSES2014-06-30$8,625ACTUAL3160411077250 POE AVENUE SUITE 300DAYTONOH45414501(C)9
HEARTLAND HEALTH AND WELLNESS FUND
ACCOUNTS PAYABLE AND ACCRUED EXPENSES2014-06-30-$125,821ACTUAL3160411077250 POE AVENUE SUITE 300DAYTONOH45414501(C)9
FieldValueIRS element (for citing)
Director Of SuccessorYes (1)DirectorOfSuccessorInd
Employee Of Successor0EmployeeOfSuccessorInd
Owner Of Successor0OwnerOfSuccessorInd
Receive Compensation0ReceiveCompensationInd
Assets DistributedYes (1)AssetsDistributedInd
Required To Notify AG0RequiredToNotifyAGInd
Attorney General Notified0AttorneyGeneralNotifiedInd
Liabilities PaidYes (1)LiabilitiesPaidInd
Bonds Outstanding0BondsOutstandingInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2E:PERSON(S) INVOLVED: JOE CHORPENNING BECAME A TRUSTEE OF THE HEARTLAND HEALTH AND WELLNESS FUND SUBSEQUENT TO THE MERGER.
SCHEDULE N PART I LIQUIDATION, TERMINATION OR DISSOLUTIONINDIANA AREA UFCW HEALTH AND WELFARE PLAN CEASED OPERATIONS AT THE CLOSE OF BUSINESS ON JUNE 30, 2014, PURSUANT TO A MERGER AGREEMENT BETWEEN THE BOARD OF TRUSTEES OF THE INDIANA AREA UFCW HEALTH AND WELFARE PLAN AND THE BOARD OF TRUSTEES OF HEARTLAND HEALTH AND WELLNESS FUND EFFECTIVE JULY 1, 2014.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 3INDIANA AREA UFCW HEALTH AND WELFARE PLAN CEASED OPERATIONS AT THE CLOSE OF BUSINESS ON JUNE 30, 2014, PURSUANT TO A MERGER AGREEMENT BETWEEN THE BOARD OF TRUSTEES OF THE INDIANA AREA UFCW HEALTH AND WELFARE PLAN AND THE BOARD OF TRUSTEES OF HEARTLAND HEALTH AND WELLNESS FUND EFFECTIVE JULY 1, 2014.
FORM 990, PART VI, SECTION A, LINE 3WHILE THE BOARD OF TRUSTEES RETAINS ULTIMATE RESPONSIBILITY, THEY HAVE DELEGATED THE DAY TO DAY MANAGEMENT OF THE FUND TO A THIRD PARTY ADMINISTRATOR, ZENITH AMERICAN SOLUTIONS.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES FOR THEIR REVIEW AND APPROVAL PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES THE INFORMATION IN QUESTION 19 AVAILABLE UPON REQUEST THROUGH THE PLAN'S THIRD PARTY ADMINISTRATOR - ZENITH AMERICAN SOLUTIONS.
FORM 990, PART XI, LINE 9:TRANSFER OF NET ASSETS DUE TO MERGER -3,301,420.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Primary ActivitiesPrimaryActivitiesTxtControlled OrganizationControlledOrganizationInd
BOROWIAKS IGA
CONTRIBUTING EMPLOYER0
SALEM IGA
CONTRIBUTING EMPLOYER0
PERRY COUNTY MARKET PLACE
CONTRIBUTING EMPLOYER0
ROZIER'S CHESTER MARKET PLACE
CONTRIBUTING EMPLOYER0
NORRENBERNS FOODS INC
CONTRIBUTING EMPLOYER0
KROGER CENTRAL DIVISION
CONTRIBUTING EMPLOYER0
KROGER CINCINNATI DIVISION
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