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ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT FUND: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT FUND (EIN 84-6044454)
Tax period
2012-05-01 to 2013-04-30
Filed
2014-02-20
IRS object ID
201430519349300408
Schema version
2012v2.1
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)
Timestamp2014-02-20T10:03:41-06:00Timestamp
Tax Period End Date2013-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN320043599EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LEGACY PROFESSIONALS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1311 S WACKER DRIVE STE 4000AddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN846044454EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERSBusinessNameLine1
Business Name Line2HEALTH BENEFIT FUNDBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlROCKNameControl
Phone3034301118Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15511 W 56TH AVE NO 250AddressLine1
CityARVADACity
StateCOState
ZIP Code800022815ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN SCHNEIDERName
TitleTRUSTEETitle
Phone3034301118Phone
Date Signed2014-02-20DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTIMOTHY CIBULKAName
PTINP00841100PTIN
Phone3123680500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEVIN SCHNEIDERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15511 W 56TH AVE NO 250AddressLine1
CityARVADACity
StateCOState
ZIP Code800022815ZIPCode
FieldValueIRS element (for citing)
Gross Receipts125240447GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1965YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH BENEFITSActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year107382714ProgramServiceRevenuePriorYear
Program Service Revenue CY122193821ProgramServiceRevenueCY
Investment Income Prior Year140074InvestmentIncomePriorYear
Investment Income Current Year29911InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year107522788TotalRevenuePriorYear
Total Revenue Current Year122223732TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year106777417BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY113897145BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7957791OtherExpensePriorYear
Other Expenses Current Year7754594OtherExpensesCurrentYear
Total Expenses Prior Year114735208TotalExpensesPriorYear
Total Expenses Current Year121651739TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7212420RevenuesLessExpensesPriorYear
Revenues Less Expenses CY571993RevenuesLessExpensesCY
Total Assets BOY30934447TotalAssetsBOY
Total Assets EOY30871530TotalAssetsEOY
Total Liabilities BOY990853TotalLiabilitiesBOY
Total Liabilities EOY359830TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY29943594NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30511700NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH BENEFITS TO THE ELIGIBLE PARTICIPANTS AND DEPENDENTS OF ROCKY MOUNTAIN UFCW & EMPLOYERS HEALTH BENEFIT PLAN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTO PROVIDE HEALTH, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DENTAL, VISION, PRESCRIPTION AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ZENITH AMERICAN SOLUTIONSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3034301118TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15511 W 56TH AVE NO 250AddressLine1
CityARVADACity
StateCOState
ZIP Code80002ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelated
STEVE DICROCE
TRUSTEE1.00X000
BRYAN SMITH - NEW
TRUSTEE1.00X000
DANNY MA
TRUSTEE1.00X000
KIM CORDOVA
TRUSTEE1.00X01640591284445.00
KEVIN SCHNEIDER
TRUSTEE1.00X01322381284445.00
NATHAN BERNSTEIN
TRUSTEE1.00X01361721284445.00
JAMES MORGAN
TRUSTEE - PAST1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs432469TotalReportableCompFrmRltdOrgs
Total Other Compensation38532TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CIGNA
900 COTTAGE GROVE ROADHARTFORDCT06152PPO ACCESS AND ADMIN FEES4162533
ZENITH AMERICAN SOLUTIONS
5511 W 56TH AVE STE 250ARVADACO80002THIRD PARTY ADMINISTRATOR1421253
THE SEGAL COMPANY
101 N WACKER DRIVE STE 500CHICAGOIL60606ACTUARIAL SERVICES453090
REINHART BOERNER VAN DEURAN SC
1000 WATER STREET STE 1700MILWAUKEEWI53202LEGAL SERVICES324726
DELTA DENTAL
4582 S ULSTER STREET STE 800DENVERCO80237BENEFIT ADMIN FEES272887
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS900099108016351108016351
RETIREE CONTRIBUTIONS90009966579376657937
PARTICIPANT CONTRIBUTIONS90009961142596114259
MEDICARE RETIREE DRUG SUBSIDY900099747693747693
PRESCRIPTION REBATES900099641748641748

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column15833TotalRevenueColumn
Related Or Exempt Function Income15833RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue122193821TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column46626TotalRevenueColumn
Exclusion$46,626ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3000000Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3016715Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-16715Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-16715TotalRevenueColumn
Exclusion-$16,715ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column122223732TotalRevenueColumn
Related Or Exempt Function Income122193821RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$29,911ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total113897145Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1358013Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total597048Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total78701Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total19437Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5424096Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total194722Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total33511Total

Insurance Insurance

FieldValueIRS element (for citing)
Total46833Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionMEMBERSHIP DUESDescription
Total2233Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total121651739Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6150896BOY
EOY11545509EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1433250BOY
EOY5512743EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY18505763BOY
EOY10004872EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY57973BOY
EOY41848EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4786565BOY
EOY3766558EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY30934447BOY
EOY30871530EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY653148BOY
EOY235470EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY124360EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY337705BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY990853BOY
EOY359830EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY29943594BOY
EOY30511700EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29943594BOY
EOY30511700EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30934447BOY
EOY30871530EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses571993ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-3887ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt111506658TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal111506658RevenueSubtotal
Investment Expenses Not Included2696InvestmentExpensesNotIncluded
Other Revenues Not Included10714378OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt10717074RevenueNotRptdOnFinStmt
Total Revenue Per Form990122223732TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt108905698TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal108905698ExpensesSubtotal
Investment Expenses Not Included22696InvestmentExpensesNotIncluded2
Other Expenses Not Included12743345OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt12746041ExpensesNotRptdOnFinStmt
Total Expenses Per Form990121651739TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: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 PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RETIREE PLAN EMPLOYER CONTRIBUTIONS 2,977,412. RETIREE PLAN INVESTMENT INTEREST 46,432. RETIREE PLAN RETIREE CONTRIBUTIONS 6,657,937. RETIREE PLAN PRESCRIPTION REBATES 301,619. RETIREE PLAN MEDICARE RETIREE DRUG SUBSIDY 747,693. RETIREE PLAN REALIZED LOSS ON INVESTMENT SOLD -16,715.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RETIREE PLAN MEDICAL 4,758,448. RETIREE PLAN PRESCRIPTION 4,632,346. RETIREE PLAN MEDICAL PREMIUMS 2,757,598. RETIREE PLAN PPO FEES & PROVIDER FEES 241,483. ADMINISTRATIVE EXPENSES 336,729. RETIREE PLAN INVESTMENT FEES 16,741.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonKIM CORDOVANamePerson
TitleTRUSTEETitle
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs164059CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs2938DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs9906NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs176903TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 3THE BOARD OF TRUSTEES HAS DELEGATED THE RECORD KEEPING AND DAY TO DAY ADMINISRATION OF THE PLAN TO ZENITH AMERICAN SOLUTIONS.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES AND PLAN ADMINISTRATOR PRIOR TO FILING. AFTER THE BOARDS REVIEW, THE FORM IS APPROVED AND FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF TRUSTEES ARE REQUIRED TO DISCLOSE ANY NONADHERANCE TO THE ADOPTED POLICY.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE PLAN OFFICE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
ROCKY MOUNTAIN UFCW UNIONS AND EMPLOYERS PENSION PLAN
5511 W 56TH AVE SUITE 250ARVADACO80002846045986PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIESCO401(A)N/A0
DENVER AREA MEAT CUTTERS AND EMPLOYERS PENSION PLAN
5511 W 56TH AVE SUITE 250ARVADACO80002846097461PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIESCO401(A)N/A0
UNITED FOOD AND COMMERICAL WORKERS INTERNATIONAL UNION 7R LOCAL
CONTRIBUTING EMPLOYER0

Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)

Primary ActivityPrimaryActivityControlled OrgControlledOrg
ALBERTSONS
CONTRIBUTING EMPLOYER0
ALMAGNO FREELANCE
CONTRIBUTING EMPLOYER0
DARLING INTERNATIONAL
CONTRIBUTING EMPLOYER0
D'CARLO HAIR SALON
CONTRIBUTING EMPLOYER0
DEBONAIRE HAIR
CONTRIBUTING EMPLOYER0
GARRISON STREET STYLISTS
CONTRIBUTING EMPLOYER0
GARY & CORI LEETE
CONTRIBUTING EMPLOYER0
GARY MONTANA SALON INC
CONTRIBUTING EMPLOYER0
IMAGES - A LIZZI
CONTRIBUTING EMPLOYER0
KING SOOPERS
CONTRIBUTING EMPLOYER0
MOSHO'S BARBER SERVICE
CONTRIBUTING EMPLOYER0
THE PERFECT TOUCH
CONTRIBUTING EMPLOYER0
ROYBAL'S BARBER SHOP
CONTRIBUTING EMPLOYER0
SAFEWAY
CONTRIBUTING EMPLOYER0
ZENITH AMERICAN SOLUTIONS
CONTRIBUTING EMPLOYER0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS PENSION PLAN
S3638165COST
DENVER AREA MEAT CUTTERS & EMPLOYERS PENSION PLAN
S1430695COST