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LOCAL 365 UAW WELFARE FUND: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LOCAL 365 UAW WELFARE FUND (EIN 11-6036373)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201323169349305237
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)
Timestamp2013-11-12T16:01:41-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN113266576EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRASSI & CO CPA'S PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line150 JERICHO QUADRANGLEAddressLine1
CityJERICHOCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN116036373EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LOCAL 365 UAW WELFARE FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLOCANameControl
Phone2019478000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1140 SYLVAN AVENUE SUITE 303AddressLine1
CityENGLEWOOD CLIFFSCity
StateNJState
ZIP Code07652ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePETER FULLERTONName
TitlePRESIDENTTitle
Phone2019478000Phone
Date Signed2013-11-05DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameALAN SILVERSTEINName
PTINP00043838PTIN
Phone5162563500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPETER FULLERTONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1140 SYLVAN AVENUE SUITE 303AddressLine1
CityENGLEWOOD CLIFFSCity
StateNJState
ZIP Code07652ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5837334GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1949YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH BENEFITS TO MEMBERSActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
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 Year2951110ProgramServiceRevenuePriorYear
Program Service Revenue CY2536295ProgramServiceRevenueCY
Investment Income Prior Year288147InvestmentIncomePriorYear
Investment Income Current Year311239InvestmentIncomeCurrentYear
Other Revenue Prior Year83871OtherRevenuePriorYear
Other Revenue Current Year278129OtherRevenueCurrentYear
Total Revenue Prior Year3323128TotalRevenuePriorYear
Total Revenue Current Year3125663TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year3805231BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY2405209BenefitsPaidToMembersCY
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 Year291033OtherExpensePriorYear
Other Expenses Current Year189254OtherExpensesCurrentYear
Total Expenses Prior Year4096264TotalExpensesPriorYear
Total Expenses Current Year2594463TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-773136RevenuesLessExpensesPriorYear
Revenues Less Expenses CY531200RevenuesLessExpensesCY
Total Assets BOY5691808TotalAssetsBOY
Total Assets EOY6356451TotalAssetsEOY
Total Liabilities BOY427650TotalLiabilitiesBOY
Total Liabilities EOY369650TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5264158NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5986801NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE ACCIDENT AND SICKNESS, DENTAL, OPTICAL AND MEDICAL BENEFITS TO MEMBERS EMPLOYED BY CONTRIBUTING EMPLOYERSMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTO PROVIDE ACCIDENT AND SICKNESS, DENTAL, OPTICAL AND MEDICAL BENEFITS TO MEMBERS EMPLOYED BY CONTRIBUTING EMPLOYERSDescription
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 Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Required0ScheduleJRequired
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 With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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 Line1LOCAL 365 UAW WELFARE FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2019478000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1140 SYLVAN AVENUE SUITE 303AddressLine1
CityENGLEWOOD CLIFFSCity
StateNJState
ZIP Code07652ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (3 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
PETER FULLERTON
PRESIDENT1.00X000
ALFRED SCHNEIERJR
TRUSTEE1.00X889700
JEFFREY ISAACS
TRUSTEE1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org8897TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1EXPRESS SCRIPTS INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line121653 NETWORK PLACEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60673ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPROVIDE PRESCRIPTION DRUG BENEFITS FOR MDescriptionOfServices
Compensation420381Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYERS CONTRIBUTIONS90009922180612218061
EMPLOYEES COBRA CONTRIBUTIONS900099318234318234
FieldValueIRS element (for citing)
Total Program Service Revenue2536295TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column207392TotalRevenueColumn
Exclusion$207,392ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2815518Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2711671Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities103847Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column103847TotalRevenueColumn
Exclusion$103,847ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column278129TotalRevenueColumn
Related Or Exempt Function Income278129RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue278129TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3125663TotalRevenueColumn
Related Or Exempt Function Income2814424RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$311,239ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total2405209Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total91975Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total32562Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total23750Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total26800Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1775Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total8897Total

Insurance Insurance

FieldValueIRS element (for citing)
Total3495Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2594463Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY230132BOY
EOY569203EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY159975BOY
EOY114255EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY276BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5275440BOY
EOY5641877EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY25985BOY
EOY31116EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5691808BOY
EOY6356451EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY427650BOY
EOY369650EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY427650BOY
EOY369650EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5264158BOY
EOY5986801EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5264158BOY
EOY5986801EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5691808BOY
EOY6356451EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses531200ReconcilationRevenueExpenses
Reconciliation Unrealized Invest191444ReconciliationUnrealizedInvest
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 Committee0AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCLAIMS PAYABLEDescription
Amount$369,650Amount
FieldValueIRS element (for citing)
Total Of Amounts369650TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt3317106TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments191444NetUnrealizedGainsInvestments
Revenue Not Rptd F990191444RevenueNotRptdF990
Revenue Subtotal3125662RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9903125662TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2533215TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal2533215ExpensesSubtotal
Investment Expenses Not Included226800InvestmentExpensesNotIncluded2
Other Expenses Not Included34448OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt61248ExpensesNotRptdOnFinStmt
Total Expenses Per Form9902594463TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
PART XII, LINE 4B - OTHER ADJUSTMENTS:CLAIMS PAYABLE 34,448.
CLAIMS PAYABLE IS THE DIFFERENCE IN THE CHANGE IN PLANS TOTAL BENEFIT OBLIGATION AT THE END OF THE YEAR.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO THIRD PARTY ADMINISTRATOR - BENEFIT SERVICES,INC.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS 3 VOTING MEMBERS OF THE GOVERNING BOARD AND THE MEMBERS ARE INDEPENDENT.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION HAS MEMBERS WHO MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7BTHE BOARD HAS THE RIGHT TO MAKE DECISIONS ON BEHALF OF THE MEMBERS WITHOUT APPROVAL.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION REVIEWS THE 990 AT BOARD MEETINGS BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS AT THE FUND OFFICE ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C ( PAGE 12 )THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1LOCAL 365 UAW PENSION FUNDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1140 SYLVAN AVENUE SUITE 303AddressLine1
CityENGLEWOOD CLIFFSCity
StateNJState
ZIP Code07652ZIPCode
FieldValueIRS element (for citing)
EIN116045281EIN
Primary ActivitiesTO PROVIDE PENSION BENEFITS TO PARTICIPANTSPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section401(A)ExemptCodeSection
Controlled Org0ControlledOrg
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 Org0OtherTransferFromOtherOrg