2014-05-12T08:10:41-05:00 2013-07-31 061533253 SASLOW LUFKIN & BUGGY LLP 10 TOWER LANE AVON CT 06001 990 2012-08-01 060844353 UFCW UNION LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD HEALTH & WELFARE FUND 919 8606778118 6 HYDE ROAD 2ND FLOOR FARMINGTON CT 060322830 MARK A ESPINOSA 8606778118 2014-05-12 1 RICHARD BUGGY P00512316 8606789200 2012 2015-11-30 17:44:51Z ROGER BARRETTE 6 HYDE ROAD 2ND FLOOR FARMINGTON CT 060322830 35499872 0 X N/A X 1967 CT PROVIDING ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH EMPLOYEE HEALTH AND WELFARE BENEFITS. 4 4 0 0 0 0 0 0 32776527 35443581 91109 56291 0 0 32867636 35499872 0 0 32240347 34861339 317257 317748 0 0 0 598806 493096 33156410 35672183 -288774 -172311 6076931 6038431 4083533 4046730 1993398 1991701 PROVIDING ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH VARIOUS EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, DENTAL, PRESCRIPTION, OPTICAL, DISABILITY AND LIFE. 0 0 34861339 35443581 THE FUND PROVIDES ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, DENTAL, OPTICAL, PRESCRIPTION, DISABILITY AND LIFE INSURANCE COVERAGE. 34861339 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 0 0 0 0 0 0 0 X 4 4 1 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X ROGER BARRETTE FUND OFFICE MANAGER 8606778118 6 HYDE ROAD FARMINGTON CT 060322830 MARK A ESPINOSA 3.00 X 0 0 0 JOEL A BOONE 3.00 X X 0 0 0 JAMES R WALLACE JR 3.00 X X 0 0 0 JASON PARADIS 3.00 X 0 0 0 MAUREEN A MAS 1.00 X 0 0 0 ROBERT SPINELLA 1.00 X 0 0 0 ROGER BARRETTE 25.00 X 88307 49672 9875 88307 49672 9875 0 0 0 0 AETNA INC 151 FARMINGTON AVENUE HARTFORD CT 06156 CLAIMS ADMINISTRATION 1188321 S & S HEALTHCARE STRATEGIES 1385 KEMPER MEADOW DRIVE CINCINNATI OH 45240 CLAIMS ADMINISTRATION 1174200 SEGAL CO 30 WATERSIDE DRIVE SUITE 300 FARMINGTON CT 06032 ACTUARIAL SERVICES 180727 EYEMED VISION CARE 4000 LUXOTTICA PLACE MASON OH 45040 VISION CARE 179323 4 EMPLOYER CONTRIBUTIONS 525100 34120946 34120946 EMPLOYEE CONTRIBUTIONS 525100 1322635 1322635 35443581 56291 56291 35499872 35443581 0 56291 34861339 34861339 253919 253919 44129 44129 19700 19700 70015 70015 26757 26757 10200 10200 187972 187972 79340 79340 22425 22425 26880 26880 13213 13213 23229 23229 19657 19657 BANK FEES 7726 7726 UTILITIES 2907 2907 PROPERTY TAXES 1056 1056 REPAIRS & MAINTENANCE 939 939 780 780 35672183 34861339 810844 0 1085183 413543 1864013 2391297 27173 25920 169984 139403 52755 30581 3047807 3177090 6076931 6038431 120050 131947 3963483 3914783 4083533 4046730 X 1993398 1991701 0 0 0 0 1993398 1991701 6076931 6038431 X -172311 74914 95700 X X 0 1 X 1 0 169984 139403 30581 30581 VANGUARD-S&P 500 INDEX FUND 616721 F VANGUARD-SHORT-TERM BOND FUND 2560369 F 3177090 ESTIMATED CLAIMS INCURRED BUT NOT REPORTED 1706305 HEALTH CLAIMS PAYABLE 1959595 DEPOSIT FROM STOP & SHOP 247410 DUE TO AFFILIATES 1473 3914783 X 35572586 74914 74914 35497672 2200 2200 35499872 35669983 0 35669983 2200 2200 35672183 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FUND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH CERTAIN PROVISIONS OF FASB ASC 740, "INCOME TAXES", WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. UNDER FASB ASC 740, THE FUND MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE FUND DID NOT RECORD ANY UNRECOGNIZED TAX BENEFITS FOR THE YEARS ENDED JULY 31, 2013 AND 2012. THEREFORE, FASB ASC 740 HAD NO IMPACT ON THE 2013 AND 2012 FINANCIAL STATEMENTS. THE FUND ANTICIPATES THAT IT WILL NOT HAVE A CHANGE IN UNRECOGNIZED TAX BENEFITS DURING THE NEXT TWELVE MONTHS THAT WOULD HAVE A MATERIAL IMPACT ON THE FUND'S FINANCIAL STATEMENTS. THE FUND'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES RELATED TO INCOME TAXES AS A COMPONENT OF INTEREST AND PENALTY EXPENSE. AS OF AND FOR THE YEARS ENDED JULY 31, 2013 AND 2012, THE FUND DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS. THE FUND'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. X X 0 0 0 PART I, LINE 3 THE COMPENSATION FOR THE FUND OFFICE MANAGER IS REVIEWED ANNUALLY BY THE BOARD, TAKING INTO ACCOUNT SALARY SURVEYS AND OTHER COMPARABLE FUND OFFICE MANAGER SALARY LEVELS, AS PROVIDED BY SEGAL COMPANY. THE BOARD IS REQUIRED TO APPROVE ANY CHANGES TO THE FUND OFFICE MANAGER'S SALARY. FORM 990, PART VI, SECTION A, LINE 2 MARK A. ESPINOSA, JAMES R. WALLACE, JR., AND MAUREEN A. MAS ARE OFFICERS OF THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 919, WHICH IS A SPONSORING ORGANIZATION FOR THE UFCW UNION LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD HEALTH & WELFARE FUND. FORM 990, PART VI, SECTION A, LINE 7A AS A SPONSORING ORGANIZATION, THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 919 HAS THE AUTHORITY TO APPOINT TWO TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. SIMILARLY, AS A SPONSORING ORGANIZATION AND A PARTICIPATING EMPLOYER, THE STOP & SHOP SUPERMARKET COMPANY HAS THE AUTHORITY TO APPOINT TWO TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE FULL BOARD, APPROVED AND ACCEPTED AT THE FIRST BOARD MEETING SUBSEQUENT TO THE PREPARATION AND FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REQUIRES ALL TRUSTEES TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY. ANY POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO THE BOARD FOR DISCUSSION AND RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION FOR THE FUND OFFICE MANAGER IS DETERMINED ANNUALLY BY TAKING INTO ACCOUNT PERFORMANCE AND CONTEMPORANEOUS MARKET DATA FOR SIMILAR POSITIONS AND LEVELS OF RESPONSIBILITY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, TAX RETURNS AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE FUND OFFICE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE ATTRIBUTABLE TO HEALTH BENEFITS OBLIGATIONS 95,700. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS, AND FOR THE SELECTION OF AN INDEPENDENT AUDITING FIRM. THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FOR AUDITOR SELECTION OR FINANCIAL STATEMENT AUDIT OVERSIGHT FROM THE PRIOR YEAR. FORM 990, PART V, LINE 2A: THE ORGANIZATION REIMBURSES A RELATED TAX-EXEMPT PENSION FUND FOR THE SERVICES OF CERTAIN EMPLOYEES WHO PROVIDE SERVICES TO THE ORGANIZATION. THESE EMPLOYEES ARE INCLUDED ON FORMS W-2 AND FORM W-3 ISSUED BY THE RELATED PENSION FUND. ALTHOUGH A PORTION OF THE SALARIES OF THESE EMPLOYEES IS CHARGED TO THE ORGANIZATION, THE ORGANIZATION DOES NOT ISSUE FORMS W-2 TO ANY EMPLOYEE. HOWEVER, THE ORGANIZATION DOES ISSUE FORMS W-2 TO THE RECIPIENTS OF SHORT-TERM (TEMPORARY) DISABILITY INCOME PAYABLE TO ELIGIBLE COLLECTIVELY BARGAINED EMPLOYEES OF PARTICIPATING EMPLOYERS. UFCW LOCAL 919 & CONTRIB EMPLOYERS' FOOD PENSION FUND 6 HYDE ROAD 2ND FLOOR FARMINGTON CT 060322830 061065206 MULTIEMPLOYER PENSION PLAN CT 401(A) & 501(A) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 UFCW LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD PENSION FUND N 42853 ACTUAL CASH PAID UFCW LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD PENSION FUND O 282912 ACTUAL CASH PAID UFCW LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD PENSION FUND P 119888 ACTUAL CASH PAID (SEE PART VII FOR ADDITIONAL DISCLOSURE) SCH. R, PART V: THE ORGANIZATION SHARES CERTAIN ADMINISTRATIVE COSTS SUCH AS PAYROLL, PAYROLL TAXES, ACCOUNTING, LEGAL AND CERTAIN OTHER EXPENSES WITH RELATED TAX-EXEMPT MULTIEMPLOYER PENSION FUND ORGANIZATIONS OCCUPYING THE SAME OFFICE SPACE AND UTILIZING THE SAME OFFICE PERSONNEL. SUCH COSTS ARE ALLOCATED TO EACH ORGANIZATION IN PROPORTION TO ESTIMATED USE AND PERSONNEL TIME EXPENDED. THE TOTAL AMOUNT OF SHARED EXPENSES ALLOCATED TO THE ORGANIZATION FOR THE YEAR ENDED JULY 31, 2013 WAS $445,653.