ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT FUND: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT FUND (EIN 84-6044454)
- Tax period
- 2011-05-01 to 2012-04-30
- Filed
- 2013-03-14
- IRS object ID
- 201320739349300537
- Schema version
- 2011v1.5
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-03-14T15:05:01-05:00 | Timestamp |
| Tax Period End Date | 2012-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320043599 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEGACY PROFESSIONALS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 S WACKER DRIVE SUITE 4000 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 846044454 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS | BusinessNameLine1 |
| Business Name Line2 | HEALTH BENEFIT FUND | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROCK | NameControl |
| Phone | 3034301118 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5511 W 56TH AVE NO 250 | AddressLine1 |
| City | ARVADA | City |
| State | CO | State |
| ZIP Code | 800022815 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVE DICROCE | Name |
| Title | TRUSTEE | Title |
| Phone | 3034301118 | Phone |
| Date Signed | 2013-03-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRUCE A PAVLIK | Name |
| PTIN | P00748405 | PTIN |
| Phone | 3123680500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEVE DICROCE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5511 W 56TH AVE NO 250 | AddressLine1 |
| City | ARVADA | City |
| State | CO | State |
| ZIP Code | 800022815 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 130316654 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1965 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE HEALTH BENEFITS | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 74317857 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 107382714 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1182657 | InvestmentIncomePriorYear |
| Investment Income Current Year | 140074 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 75500514 | TotalRevenuePriorYear |
| Total Revenue Current Year | 107522788 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 107770238 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 106777417 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7433375 | OtherExpensePriorYear |
| Other Expenses Current Year | 7957791 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 115203613 | TotalExpensesPriorYear |
| Total Expenses Current Year | 114735208 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -39703099 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -7212420 | RevenuesLessExpensesCY |
| Total Assets BOY | 38237248 | TotalAssetsBOY |
| Total Assets EOY | 30934447 | TotalAssetsEOY |
| Total Liabilities BOY | 1022624 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 990853 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 37214624 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 29943594 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE HEALTH BENEFITS TO THE ELIGIBLE PARTICIPANTS AND DEPENDENTS OF ROCKY MOUNTAIN UFCW & EMPLOYERS HEALTH BENEFIT PLAN. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Description | TO PROVIDE HEALTH, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DENTAL, VISION, PRESCRIPTION AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. | Description |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ZENITH AMERICAN SOLUTIONS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3034301118 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5511 W 56TH AVE NO 250 | AddressLine1 |
| City | ARVADA | City |
| State | CO | State |
| ZIP Code | 80002 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| STEVE DICROCE | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| JAMES V MORGAN | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| DANNY MA | |||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 |
| KIM CORDOVA | |||||
| TRUSTEE | 1.00 | X | 0 | 155864 | 9681 |
| KEVIN SCHNEIDER | |||||
| TRUSTEE | 1.00 | X | 0 | 128496 | 9681 |
| STEVE PARDEE | |||||
| TRUSTEE - PAST | 1.00 | X | 0 | 0 | 0 |
| NATE BERNSTEIN | |||||
| TRUSTEE | 1.00 | X | 0 | 132582 | 9681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 416942 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 29043 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CIGNA | |||||
| 900 COTTAGE GROVE ROAD | HARTFORD | CT | 06152 | PPO ACCESS AND ADMIN FEES | 3950662 |
| ZENITH AMERICAN SOLUTIONS | |||||
| 5511 W 56TH AVE STE 250 | ARVADA | CO | 80002 | THIRD PARTY ADMINISTRATOR | 1374812 |
| THE SEGAL COMPANY | |||||
| 101 N WACKER DRIVE STE 500 | CHICAGO | IL | 60606 | ACTUARIAL SERVICES | 546681 |
| DELTA DENTAL | |||||
| 4582 S ULSTER STREET STE 800 | DENVER | CO | 80237 | BENEFIT ADMIN FEES | 355384 |
| REINHART BOERNER VAN DEURAN SC | |||||
| 1000 WATER STREET STE 1700 | MILWAUKEE | WI | 53202 | LEGAL SERVICES | 350636 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | 92423941 | 92423941 |
| RETIREE CONTRIBUTIONS | 900099 | 6955260 | 6955260 |
| PARTICIPANT CONTRIBUTI | 900099 | 5448768 | 5448768 |
| PRESCRIPTION REBATES | 900099 | 1591730 | 1591730 |
| MEDICARE RETIREE DRUG | 900099 | 813296 | 813296 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 149719 | TotalRevenueColumn |
| Related Or Exempt Function Income | 149719 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 107382714 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 244928 | TotalRevenueColumn |
| Exclusion | $244,928 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 22689012 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 22793866 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -104854 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -104854 | TotalRevenueColumn |
| Exclusion | -$104,854 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107522788 | TotalRevenueColumn |
| Related Or Exempt Function Income | 107382714 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $140,074 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106777417 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4009167 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 644986 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76753 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19651 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2886914 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 246522 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30866 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42177 | Total |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEMBERSHIP DUES | Description |
| Total | 755 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114735208 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3670327 | BOY |
| EOY | 6150896 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1315545 | BOY |
| EOY | 1433250 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7876644 | BOY |
| EOY | 18505763 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17122 | BOY |
| EOY | 57973 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25357610 | BOY |
| EOY | 4786565 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38237248 | BOY |
| EOY | 30934447 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 272624 | BOY |
| EOY | 653148 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 750000 | BOY |
| EOY | 337705 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1022624 | BOY |
| EOY | 990853 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37214624 | BOY |
| EOY | 29943594 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37214624 | BOY |
| EOY | 29943594 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38237248 | BOY |
| EOY | 30934447 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -7212420 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -58610 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED EMPLOYER CONTRIBUTION CREDIT | Description |
| Amount | $337,705 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 337705 | TotalOfAmounts |
| Total Revenue | 107522788 | TotalRevenue |
| Total Expenses | 114735208 | TotalExpenses |
| Excess Or Deficit For Year | -7212420 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -58610 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -58610 | TotalAdjustments |
| Excess Or Deficit Per FS | -7271030 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 96108126 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 96108126 | RevenueSubtotal |
| Investment Expenses Not Included | 11011 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 11403651 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 11414662 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 107522788 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 102079768 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 102079768 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 11011 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 12644429 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 12655440 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 114735208 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | 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 XII, LINE 4B - OTHER ADJUSTMENTS: | RETIREE PLAN EMPLOYER CONTRIBUTIONS 2,960,226. RETIREE PLAN INVESTMENT INTEREST 112,433. RETIREE PLAN RETIREE CONTRIBUTIONS 6,955,260. RETIREE PLAN PRESCRIPTION REBATES 503,147. RETIREE PLAN ERRP SUBSIDY 80,346. RETIREE PLAN MEDICARE RETIREE DRUG SUBSIDY 813,296. RETIREE PLAN REALIZED LOSS ON INVESTMENT SOLD -21,057. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | RETIREE PLAN MEDICAL AND LOST TIME 3,958,830. RETIREE PLAN PRESCRIPTION 5,386,062. RETIREE PLAN PREMIUMS 2,696,775. RETIREE PLAN PPO FEES & PROVIDER FEES 136,548. ADMINISTRATIVE EXPENSES 457,574. RETIREE PLAN INVESTMENT FEES 8,640. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KIM CORDOVA | NamePerson |
| Base Compensation Filing Org | 0 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 155864 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 2995 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 6686 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 0 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 165545 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE 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 11 | THE 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 12C | THE BOARD OF TRUSTEES ARE REQUIRED TO DISCLOSE ANY NONADHERANCE TO THE ADOPTED POLICY. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE PLAN OFFICE. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -58,610. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2D: | EFFECTIVE MAY 1, 2011, THE TRUSTEES APPROVED A RESOLUTION TO ESTABLISH A SEPARATE PLAN FOR RETIRED PARTICIPANTS. THE ROCKY MOUNTAIN UFCW UNIONS AND EMPLOYERS HEALTH BENEFIT FUND - ACTIVES AND ROCKY MOUNTAIN UFCW UNIONS AND EMPLOYERS HEALTH BENEFIT FUND - RETIREE OPERATES UNDER ONE TRUST AGREEMENT AND EACH PLAN ISSUES SEPARATE AUDITED FINANCIAL STATEMENTS. BOTH PLANS ARE REPORTED ON THIS FORM 990 ON A CONSOLIDATED BASIS. | FINANCIAL STATEMENTS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| ROCKY MOUNTAIN UFCW UNIONS AND EMPLOYERS PENSION PLAN | |||||||||
| 5511 W 56TH AVE SUITE 250 | ARVADA | CO | 80002 | 846045986 | PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIES | CO | 401(A) | N/A | 0 |
| DENVER AREA MEAT CUTTERS AND EMPLOYERS PENSION PLAN | |||||||||
| 5511 W 56TH AVE SUITE 250 | ARVADA | CO | 80002 | 846097461 | PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS AND BENEFICIARIES | CO | 401(A) | N/A | 0 |
| UNITED FOOD AND COMMERICAL WORKERS INTERNATIONAL UNION 7R LOCAL | |||||||||
| 7760 W 38TH AVE | WHEAT RIDGE | CO | 80033 | CONTRIBUTING EMPLOYER | CO | 501(C)(5) | N/A | 0 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|
| ALBERTSONS | ||||||
| 400 S 99TH AVE 200 | TELLSON | AZ | 85353 | CONTRIBUTING EMPLOYER | AZ | N/A |
| ALMAGNO FREELANCE | ||||||
| 10447 E DORADO PL | ENGLEWOOD | CO | 80111 | CONTRIBUTING EMPLOYER | CO | N/A |
| DARLING INTERNATIONAL | ||||||
| PO BOX 16372 | DENVER | CO | 80216 | CONTRIBUTING EMPLOYER | CO | N/A |
| D'CARLO HAIR SALON | ||||||
| 4783 SOUTH NEWTON | LITTLETON | CO | 80123 | CONTRIBUTING EMPLOYER | CO | N/A |
| DEBONAIRE HAIR | ||||||
| 11004 MANET WAY | NORTHGLENN | CO | 80234 | CONTRIBUTING EMPLOYER | CO | N/A |
| GARRISON STREET STYLISTS | ||||||
| 1990 S GARRISON | LAKEWOOD | CO | 80227 | CONTRIBUTING EMPLOYER | CO | N/A |
| GARY & CORI LEETE | ||||||
| 9546 BROOK HILL DRIVE | LONE TREE | CO | 80124 | CONTRIBUTING EMPLOYER | CO | N/A |
| GARY MONTANA SALON INC | ||||||
| 8101 E BELLEVIEW AVEUNIT 1 | DENVER | CO | 80237 | CONTRIBUTING EMPLOYER | CO | N/A |
| IMAGES - A LIZZI | ||||||
| 13851 PINE VALLEY ROAD | PINE | CO | 80470 | CONTRIBUTING EMPLOYER | CO | N/A |
| KING SOOPERS | ||||||
| 65 TEJON STREET | DENVER | CO | 80223 | CONTRIBUTING EMPLOYER | CO | N/A |
| MOSHO'S BARBER SERVICE | ||||||
| 1155 S HAVANA UNIT 33 | AURORA | CO | 80012 | CONTRIBUTING EMPLOYER | CO | N/A |
| THE PERFECT TOUCH | ||||||
| 832 FRANCES STREET | LONGMONT | CO | 80501 | CONTRIBUTING EMPLOYER | CO | N/A |
| ROYBAL'S BARBER SHOP | ||||||
| 6443 EAST 72ND PLACE | COMMERCE CITY | CO | 80022 | CONTRIBUTING EMPLOYER | CO | N/A |
| SAFEWAY | ||||||
| 6900 S YOSEMITE STREET | CENTENNIAL | CO | 801121412 | CONTRIBUTING EMPLOYER | CO | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ROCKY MOUNTAIN UFCW UNIONS AND EMPLOYERS PENSION PLAN | ||
| R | 3883555 | COST |
| DENVER AREA MEAT CUTTERS AND EMPLOYERS PENSION PLAN | ||
| R | 1501875 | COST |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | FORM 990, SCHEDULE R, PART IV, SECTION A: | ReturnReference |
| Explanation | CERTAIN INFORMATION REQUIRED ON SCHEDULE R, PART IV IS NOT MAINTAINED BY THE FUND OFFICE. THE PLAN HAS ENDEAVORED TO OBTAIN ALL REQUIRED INFORMATION RELATED TO ITS CONTRIBUTING EMPLOYERS. AT THIS FILIING DATE HOWEVER, NOT ALL INFORMATION HAS BEEN RECEIVED. WHAT IS AVAILABLE HAS BEEN INCLUDED IN THIS FILING. IT IS THE INTENT OF THE BOARD OF TRUSTEES TO FULLY COMPLY WITH THE INSTRUCTIONS TO THIS FORM WHICH MAY REQUIRE AMENDING THIS FILING UPON RECEIPT OF SUCH INFORMATION AS CONSIDERED NECESSARY. THE EMPLOYER IDENTIFICATION NUMBERS OF THE CONTRIBUTING EMPLOYERS, WHEN AVAILABLE, WHICH ARE REQUIRED TO BE REPORTED IN PARTS IV HAVE NOT BEEN INCLUDED IN THIS FILING DUE TO THE SENSITIVE NATURE OF THE INFORMATION. THE INFORMATION MAY BE AVAILABLE AT THE PLAN OFFICE. | Explanation |