2015-08-07T15:45:44-05:00 2014-12-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2014-01-01 362365968 UFCW L1546 FOOD HANDLERS WELFARE FUND C/O ZENITH AMERICAN SOLUTIONS UFCW 3126491200 18861 90TH AVENUE NO A MOKENA IL 60448 KENNETH BOYD BOARD CHAIRMAN 3126491200 2015-08-07 1 BRUCE A PAVLIK P00748405 3123680500 2014 2016-04-25 22:37:26Z KENNETH BOYD 18861 90TH AVENUE NO A MOKENA IL 60448 81050510 0 X N/A X 1956 IL PROVIDE HEALTH BENEFITS. 6 6 0 0 0 0 0 0 12696871 14828664 308651 979220 0 0 13005522 15807884 0 0 14057288 13477324 0 0 0 0 0 1347603 1618527 15404891 15095851 -2399369 712033 25015359 26092499 108273 393694 24907086 25698805 PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND ACCIDENTAL DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 3126491200 18861 90TH AVENUE SUITE A MOKENA IL 60448 X KENNETH BOYD TRUSTEE 1.00 X 0 0 0 GERALD M KOLB TRUSTEE 1.00 X 0 0 0 CHRISTINE BARTHOLMEY TRUSTEE 0.50 X 0 0 0 WAYNE CLAVIO ALTERNATE TRUSTEE 0.50 X 0 0 0 DAVID KALUZNY II TRUSTEE 0.50 X 0 0 0 JAMES GOW TRUSTEE 0.50 X 0 0 0 BOB O'TOOLE TRUSTEE 0.50 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH ST CHICAGO IL 60601 PPO PROVIDER 544090 ZENITH AMERICAN SOLUTIONS 18861 90TH AVE SUITE A MOKENA IL 60448 CONTRACT ADMINISTRATOR 504809 2 EMPLOYER CONTRIBUTIONS 900099 14697459 14697459 PRESCRIPTION DRUG REBATES 900099 110876 110876 PARTICIPANTS CONTRIB. 900099 18110 18110 SUBROGATION REFUNDS 900099 2219 2219 14828664 656595 656595 65565251 65242626 322625 322625 322625 15807884 14828664 0 979220 13477324 388155 61623 37679 107498 613951 52491 5894 18427 16549 FEES MANDATED BY ACA 186023 FIELD REPRESENTATIVE EX 87724 COST CONTAINMENT FEES 42513 15095851 227470 307382 769886 410653 79492 17294 50970 51425 23689187 25119183 198354 186562 25015359 26092499 107475 122651 798 17483 0 253560 108273 393694 X 0 0 0 0 24907086 25698805 24907086 25698805 25015359 26092499 712033 79686 0 X 0 1 X 1 0 0 DUE TO BROKER 74953 FEES MANDATED BY ACA 178607 253560 X 15780072 79686 79686 15700386 107498 107498 15807884 14988353 0 14988353 107498 107498 15095851 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 PLANS RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRE. FORM 990, PART VI, SECTION A, LINE 3 EVEN THOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THE PLAN IS ADMINISTERED AND MANAGED ON A DAY TO DAY BASIS BY ZENITH AMERICAN SOLUTIONS, A THIRD PARTY ADMINISTRATOR AS DIRECTED BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. AFTER THE BOARDS' THOROUGH REVIEW, THE FORM IS APPROVED, SIGNED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C A FIDUCIARY TO THE FUND IS REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST TO BOTH THE FUND ADMINISTRATOR AND THE TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE INFORMATION IN QUESTION 19 AVAILABLE UPON REQUEST THROUGH THE FUND'S THIRD PARTY ADMINISTRATOR. NEW HORIZON CHRISTIAN CENTER CONTRIBUTING EMPLOYER 0 GEORGIOU LLC CONTRIBUTING EMPLOYER 0 0 HELLAS MANAGEMENT LLC CONTRIBUTING EMPLOYER 0 0 OSI INDUSTRIES LLC CONTRIBUTING EMPLOYER 0 0 ROUNDEL INC CONTRIBUTING EMPLOYER 0 0 A W R WELDING INC CONTRIBUTING EMPLOYER 0 ADAM & EVE HAIR DESIGN INC DBA ENTOURAGE HAIR SALON AND SPA CONTRIBUTING EMPLOYER 0 ALLFRESH FOOD PRODUCTS INC CONTRIBUTING EMPLOYER 0 ALLIANCE POULTRY FARMS INC CONTRIBUTING EMPLOYER 0 ANTON FINANCIAL SERVICE CORP CONTRIBUTING EMPLOYER 0 ASSOCIATED THIRD PARTY ADMINISTRATORS CONTRIBUTING EMPLOYER 0 BERNARD FOOD INDUSTRY INC CONTRIBUTING EMPLOYER 0 C & N BROTHERS LTD CONTRIBUTING EMPLOYER 0 CARL BUDDIG & CO CONTRIBUTING EMPLOYER 0 CHICAGO SUBURBAN LUMBER SALES INC CONTRIBUTING EMPLOYER 0 CLASSIC TICKETS INC CONTRIBUTING EMPLOYER 0 COLUMBUS MEATS INC CONTRIBUTING EMPLOYER 0 CONSUMER PACKING COMPANY INC CONTRIBUTING EMPLOYER 0 COUGLE COMMISSION COMPANY CONTRIBUTING EMPLOYER 0 COUNTRY SQUIRE FOODS INC CONTRIBUTING EMPLOYER 0 COUNTRYSIDE TROPICAL SNO INC CONTRIBUTING EMPLOYER 0 DANIELSON FOOD PRODUCTS CONTRIBUTING EMPLOYER 0 DEKALB COUNTY PACKING CONTRIBUTING EMPLOYER 0 DEVON AVENUE MEATS CONTRIBUTING EMPLOYER 0 DOULAS PARTNERS CONTRIBUTING EMPLOYER 0 FARM CITY MEAT CONTRIBUTING EMPLOYER 0 FAT SAM'S PUB CONTRIBUTING EMPLOYER 0 FISH KEG CONTRIBUTING EMPLOYER 0 GEORGE'S RESTAURANT CONTRIBUTING EMPLOYER 0 H R R ENTERPRISES CONTRIBUTING EMPLOYER 0 HERRING KING CONTRIBUTING EMPLOYER 0 INDUSTRIAL PLANT EQUIPMENT CONTRIBUTING EMPLOYER 0 JFC INTERNATIONAL INC CONTRIBUTING EMPLOYER 0 KALUZNY BROTHERS INC CONTRIBUTING EMPLOYER 0 KUHNS DELICATESSEN & LIQUORS OF DES PLAINES CONTRIBUTING EMPLOYER 0 L ISAACSON & STEIN FISH CO CONTRIBUTING EMPLOYER 0 LAROCCO BROTHERS INC CONTRIBUTING EMPLOYER 0 LORENZO'S FROZEN FOODS LTD CONTRIBUTING EMPLOYER 0 LUCHA'S BEAUTY SHOP CONTRIBUTING EMPLOYER 0 LYONS POULTRY & EGG COMPANY INC CONTRIBUTING EMPLOYER 0 MIDWAY WHOLESALE PROVISION INC CONTRIBUTING EMPLOYER 0 MIDWEST RECYCLING CO CONTRIBUTING EMPLOYER 0 MOBILE MEATORLAND MARKET & DELI CONTRIBUTING EMPLOYER 0 MOMENCE PACKING COMPANY CONTRIBUTING EMPLOYER 0 NOON HOUR FOOD PRODUCTS INC CONTRIBUTING EMPLOYER 0 ORIGINAL SCOOPS CHICAGO INC CONTRIBUTING EMPLOYER 0 PREMIUM TEST EQUIPMENT CORP CONTRIBUTING EMPLOYER 0 PURPLE ONION RESTAURANT CONTRIBUTING EMPLOYER 0 QUALITY SNACK FOODS INC CONTRIBUTING EMPLOYER 0 RICHELIEU FOODS INC CONTRIBUTING EMPLOYER 0 RIVER PARK MOTEL & SUITES INC CONTRIBUTING EMPLOYER 0 RWB DESIGN INC CONTRIBUTING EMPLOYER 0 RYAN MEAT CO CONTRIBUTING EMPLOYER 0 SUPREME LOBSTER CONTRIBUTING EMPLOYER 0 T T & G INC DBA LONE STAR RESTAURANT CONTRIBUTING EMPLOYER 0 UNITED WHOLESALE GRUB & SUPPLIES CONTRIBUTING EMPLOYER 0 VITA FOOD PRODUCTS INC CONTRIBUTING EMPLOYER 0 WJ POWELL & CO CONTRIBUTING EMPLOYER 0 WEST BEVERLY NEWS CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1