2015-04-13T09:12:12-05:00 2014-06-30 542189926 HENNINGFIELD & ASSOCIATES INC 27913 SMYTH DRIVE VALENCIA CA 91355 990 2013-07-01 956134346 FOOD EMPLOYERS & BAKERY & CONFECTIONERY WORKERS BENEFIT FUND OF SOUTHERN CALIF FOOD 6267324500 1325 NORTH GRAND AVENUE COVINA CA 91724 DOYLE TOWNSON TRUSTEE 6267324500 2015-04-13 1 RANDY D HENNINGFIELD P01364367 6612953363 2013 2016-02-25 16:41:14Z DOYLE TOWNSON 450 CARSON PLAZA CARSON CA 90746 12240731 0 X N/A X 1965 CA HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 6 6 0 0 0 0 0 0 11248587 11764147 11399 12012 45392 66621 11305378 11842780 0 0 11625998 11935482 0 0 0 0 0 662311 712981 12288309 12648463 -982931 -805683 3803558 3117175 2599069 2717241 1204489 399934 HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 0 0 12648463 HEALTH & WELFARE BENEFITS PROVIDED TO MEMBERS WHO ARE COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN UNION AND EMPLOYERS. 12648463 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 18 0 1 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 CA X X MS CHIEMI WATANABE 6267322502 1325 NORTH GRAND AVENUE COVINA CA 91724 X DAVID GOODALL TRUSTEE 5.00 X 0 0 0 STEFANIE GUSHA TRUSTEE 5.00 X 0 0 0 DOYLE TOWNSON TRUSTEE 5.00 X 0 0 0 FELIPE J LOPEZ TRUSTEE 5.00 X 0 0 0 LEROY WESTMORELAND TRUSTEE 5.00 X 0 0 0 KATHLEEN FINAZZO TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 1325 N GRAND AVE COVINA CA 91724 ADMINISTRATOR 275918 BLUE CROSS 3350 PEACHTREE ROAD ATLANTA GA 30326 COST CONTAINMENT FEES 103698 2 EMPLOYER CONTRIBUTIONS 445100 10888368 10888368 RETIREE CONTRIBUTIONS 445100 863375 863375 COBRA CONTRIBUTIONS 445100 12404 12404 11764147 9963 9963 400000 397951 2049 2049 2049 RETIREE PRESCRIPTIONS 445100 66621 66621 66621 11842780 11830768 0 12012 11935482 275918 73815 23156 59652 915 22239 COST CONTAINMENT FEES 145658 CONSULTANTS FEES 83956 ADMINISTRATION FEES - V 10970 CLAIMS CONSULTANT 8480 8222 12648463 -178278 -199631 3093969 2374892 874067 923998 3130 10942 20098 6974 -9428 0 3803558 3117175 30069 30241 2569000 2687000 2599069 2717241 X 0 0 0 0 1204489 399934 1204489 399934 3803558 3117175 -805683 1128 0 X 0 1 X 1 0 0 IBNR & ACCUM. ELIGIBILITY 2687000 2687000 11843908 1128 1128 11842780 0 11842780 12539891 0 12539891 108572 108572 12648463 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN ACCUMULATED ELIGIBILITY AND IBNR AND PREMIUMS PAYABLE FORM 990, PART VI, SECTION A, LINE 3 THE TRUSTEES HAVE CONTRACTED WITH A THIRD PARTY ADMINISTRATOR TO PERFORM THE EVERYDAY ADMINISTRATION OF THE FUND. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 WAS PRESENTED TO THE TRUSTEES FOR REVIEW AND SIGNATURES. FORM 990, PART VI, SECTION C, LINE 19 SUMMARY ANNUAL REPORTS ARE PROVIDED TO ALL PARTICIPANTS ANNUALLY AND SPDS ARE AVAILABLE FROM THE ADMINISTRATOR UPON REQUEST. AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST OF THE DOL OR THE ADMINISTRATION AS WELL AS THE DOL WEBSITE. FORM 990, PART VII DAVID GOODALL - 618 MICHELLINDA AVE, ARCADIA, CA 91007. STEFANIE GUSHA - 1421 S. MANHATTAN AVE., FULLERTON, CA 92831. DOYLE TOWNSON - 450 CARSON PLAZA, CARSON, CA 90746. FELIPE J. LOPEZ - 6801 E. WASHINGTON BLVD., COMMERCE, CA 90040. LEROY WESTMORELAND - 1100 W ARTESIA BLVD, COMPTON, CA 90220. KATHLEEN FINAZZO - 301 S. TIPPECANOE, SAN BERNARDINO, CA 92408. ALBERTSON'S 1421 S MANHATTAN AVE FULLERTON CA 92831 204057706 RETAIL GROCERS CA C 0 VONS SAFEWAY 618 MICHILLINDA AVE ARCADIA CA 91007 381623900 RETAIL GROCERS CA C 0 RALPHS 1100 W ARTESIA BLVD COMPTON CA 90220 870258768 RETAIL GROCERS CA C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0