2015-10-15T12:18:11-05:00 2014-11-30 464001827 SAXBST LLP 28 WEST 44TH STREET NEW YORK NY 10036 990 2013-12-01 237042767 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL 1262 & EMPLOYERS HEALTH & WELFARE UNIT 9737785800 1389 BROAD ST CLIFTON NJ 07013 MATTHEW MOLINARO TRUSTEE 9737785800 2015-10-15 1 DAVID C LEE P00178190 2126618640 2013 2016-03-07 17:11:31Z MATTHEW MOLINARO 1389 BROAD ST CLIFTON NJ 07013 35606195 0 X WWW.UFCW1262.ORG X 1968 NJ TO PROVIDE HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND MEDICAL BENEFITS TO APPROXIMATELY 5,000 ELIGIBLE PARTICIPANTS. 6 0 0 0 0 0 0 0 28655376 31152413 525726 387524 0 0 29181102 31539937 0 0 27228345 29992959 449062 454766 0 0 0 537776 486645 28215183 30934370 965919 605567 15086335 15937271 744608 1068273 14341727 14868998 TO PROVIDE HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO APPROXIMATELY 5,000 ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 8 0 1 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 X THE ORGANIZATION 9737785800 1389 BROAD ST CLIFTON NJ 07013 JASON PARADIS TRUSTEE 0.50 40.00 X 0 0 0 HARVEY WHILLE TRUSTEE 0.50 40.00 X 0 334188 23159 JOHN COLELLA TRUSTEE 0.50 40.00 X 0 206834 22055 MATTHEW MOLINARO TRUSTEE 0.50 40.00 X 0 299800 23159 DAVID GILLIS TRUSTEE 0.50 40.00 X 0 0 0 ROBERT SPINELLA TRUSTEE 0.50 40.00 X 0 0 0 FRANK VACCARO OFFICER 5.00 X 177635 232437 0 177635 1073259 68373 1 0 1 0 HORIZON BCBS OF NJ 3 PONY LANE FLEMINGTON NJ 08822 CLAIMS ADMINISTRATOR 1216633 EXPRESS SCRIPTS 528 EDITH RD LANDING NJ 07850 CLAIMS ADMINISTRATOR 298108 VALUE OPTIONS THREE PENN PLAZA NEWARK NJ 07105 CLAIMS ADMINISTRATOR 174906 FRANK M VACCARO & ASSOCIATES INC 27 ROLAND AVE SUITE 200 MOUNT LAUREL NJ 08054 THIRD PARTY ADMINISTRATOR 113683 4 EMPLOYER CONTRIBUTIONS 900099 30187662 30187662 RETIREE CO-PAY CONTRIBUTIONS 900099 614431 614431 LEGAL CONTRIBUTIONS 900099 177661 177661 COBRA CONTRIBUTIONS 900099 172659 172659 31152413 403172 403172 4050610 4066258 -15648 -15648 -15648 31539937 31152413 0 387524 29992959 327001 19691 79935 28139 82740 50000 35826 6132 21723 3246 710 8388 THIRD PARTY ADMINISTRAT 113684 COMPUTER SERVICES 54876 MISCELLANEOUS 50000 ACTUARY & CONSULTING 48633 10687 30934370 X 180367 154350 2522028 1729235 2111890 3661450 4821 4003 54624 53668 346 956 10240409 10377303 26474 9974 15086335 15937271 232114 514097 512494 554176 744608 1068273 X 0 0 0 0 14341727 14868998 14341727 14868998 15086335 15937271 605567 -78296 0 X X 0 1 X 1 0 2528 2528 0 52096 51140 956 956 CORPORATE BONDS -VAR 6635289 F STATE & LOCAL OBLIGATIONS 487712 F MORTGAGE-BACKED SECURITIES 1589715 F U.S. TREASURIES 1664587 F 10377303 STOP-LOSS INSURANCE RESERVE 349751 SERP LIABILITY 41054 DUE TO RELATED PARTIES 151168 DUE TO BROKER FOR PENDING TRADES 12203 554176 X 31425815 -78296 -78296 31504111 35826 35826 31539937 30898544 0 30898544 35826 35826 30934370 PART X, LINE 2: THE PLAN RECEIVED ITS LATEST DETERMINATION LETTER ON MAY 8, 1970, IN WHICH THE INTERNAL REVENUE SERVICE (IRS) ADVISED THAT THE PLAN QUALIFIES UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC) AND IS, THEREFORE, EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(A). THE PLAN HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE PLAN'S TRUSTEES AND THE PLAN'S COUNSEL BELIEVE THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THE PLAN'S MANAGEMENT EVALUATES TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZES A TAX LIABILITY OR ASSET IF AN UNCERTAIN TAX POSITION WAS TAKEN AND IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. 0 0 0 HARVEY WHILLE TRUSTEE 0 334188 0 0 0 0 0 8663 0 14496 0 357347 0 0 JOHN COLELLA TRUSTEE 0 206834 0 0 0 0 0 7559 0 14496 0 228889 0 0 MATTHEW MOLINARO TRUSTEE 0 299800 0 0 0 0 0 8663 0 14496 0 322959 0 0 FRANK VACCARO OFFICER 177635 232437 0 0 0 0 0 0 0 0 177635 232437 0 0 FRANK VACCARO OWNER 113683 THIRD PARTY ADMINISTRATOR 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENGAGES A MANAGEMENT COMPANY TO PERFORM ADMINISTRATIVE SERVICES INCLUDING OVERSIGHT OF CERTAIN PERSONNEL AND EXECUTING FINANCIAL OPERATIONS ON A LIMITED BASIS. THE SERVICES ARE PERFORMED UNDER THE TERMS OF A WRITTEN CONTRACT. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO SUBCOMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FUND'S 990 IS PREPARED BY ITS OUTSIDE AUDITOR AND IS SUBMITTED AND REVIEWED WITH THE ADMINISTRATOR. THE ADMINISTRATOR THEN REVIEWS IT WITH THE CHAIRPERSON OF THE BOARD OF TRUSTEES. A COPY OF THE RETURN IS AVAILABLE TO THE EXECUTIVE BOARD MEMBERS UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AND MAY BE VIEWED AT THE FUND OFFICE. FORM 990, PART X, LINE 33: GENERALLY ACCEPTED ACCOUNTING PRINCIPLES ALLOW FOR PRESENTATION OF ESTIMATED CURRENT CLAIMS OBLIGATIONS ON A SEPARATE STATEMENT IN THE FUND'S AUDITED FINANCIAL STATEMENTS. FOR CONSISTENCY, THE BALANCE SHEET FOR FORM 990 WILL ALSO NOT INCLUDE LIABILITIES FOR ESTIMATED CURRENT CLAIMS OBLIGATIONS. NET ASSETS PER THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE ESTIMATED CURRENT CLAIMS OBLIGATIONS OF $5,651,034 AND ESTIMATED POST RETIREMENT OBLIGATIONS OF $6,142,075. FORM 990, PART XI, LINE 2C THE PROCESS FOR OVERSEEING THE AUDIT AND FOR SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. UFCW LOCAL 1262 & EMPLOYERS PENSION FUND 1389 BROAD STREET CLIFTON NJ 07013 226074414 TO PROVIDE PENSION BENEFITS TO ELIGIBLE MEMBERS AND THEIR BENEFICIARIES NJ 501(A) 0 UFCW LOCAL 1262 & EMPLOYERS LEGAL SERVICES FUND 1389 BROAD STREET CLIFTON NJ 07013 222238707 TO PROVIDE LEGAL BENEFITS TO ELIGIBLE MEMBERS NJ 501(C)(9) 0 UFCW LOCAL 1262 & EMPLOYERS WELFARE FUND 1389 BROAD STREET CLIFTON NJ 07013 226137317 TO PROVIDE HEALTH, MEDICAL & OTHER BENEFITS TO ELIGIBLE MEMBERS NJ 501(C)(9) 0 UFCW LOCAL 1262 1389 BROAD STREET CLIFTON NJ 07013 221339607 REPRESENTS MEMBERS IN COLLECTIVE BARGAINING MATTERS WITH EMPLOYERS NJ 501(C)(5) 0 UFCW LOCAL 1262 & EMPLOYERS RETAIL NON-FOOD PENSION FUND 1389 BROAD STREET CLIFTON NJ 07013 226181292 TO PROVIDE PENSION BENEFITS TO ELIGIBLE MEMBERS AND THEIR BENEFICIARIES NJ 501(A) 0 UFCW LOCAL 1262 PATHMARK HEALTH & WELFARE FUND 1389 BROAD STREET CLIFTON NJ 07013 371664252 TO PROVIDE HEALTH, MEDICAL & OTHER BENEFITS TO ELIGIBLE MEMBERS. NJ 501(C)(9) 0 STOP AND SHOP VARIOUS VARIOUS NJ 99999 NJ 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 UFCW LOCAL 1262 & EMPLOYERS PENSION FUND N 58859 CASH UFCW LOCAL 1262 & EMPLOYERS PENSION FUND O 454766 CASH UFCW LOCAL 1262 & EMPLOYERS PENSION FUND Q 591528 CASH UFCW LOCAL 1262 K 17156 CASH UFCW LOCAL 1262 N 3400 CASH UFCW LOCAL 1262 O 57347 CASH