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UFCW UNIONS & EMPLOYERS HEALTH & WELFARE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
UFCW UNIONS & EMPLOYERS HEALTH & WELFARE (EIN 31-0656412)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201323189349304202
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)
Timestamp2013-11-14T13:18:25-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN391531945EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FREYBERG HINKLE ASHLAND POWERS & STOWELLBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line115420 W CAPITOL DRAddressLine1
CityBROOKFIELDCity
StateWIState
ZIP Code530052621ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310656412EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UFCW UNIONS & EMPLOYERS HEALTH & WELFAREBusinessNameLine1
Business Name Line2PLAN OF CENTRAL OHIOBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlUFCWNameControl
Phone6142377618Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14150 EAST MAIN STREETAddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43213ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRANDY QUICKELName
TitleCHAIRMANTitle
Phone6142377618Phone
Date Signed2013-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS M POWERS CPAName
PTINP00241729PTIN
Phone2627846210Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRANDY QUICKELNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14150 EAST MAIN STREETAddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43213ZIPCode
FieldValueIRS element (for citing)
Gross Receipts88538244GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.UFCWCENTRALOHIOHW.COMWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1956YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionPROVIDE INSURANCE BENEFITS FOR MEMBERSActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees16TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year42194943ProgramServiceRevenuePriorYear
Program Service Revenue CY56602259ProgramServiceRevenueCY
Investment Income Prior Year997174InvestmentIncomePriorYear
Investment Income Current Year587444InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year43192117TotalRevenuePriorYear
Total Revenue Current Year57189703TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year47106150BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY48212915BenefitsPaidToMembersCY
Salaries Etc Prior Year847218SalariesEtcPriorYear
Salaries Etc Current Year793026SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3146121OtherExpensePriorYear
Other Expenses Current Year2926939OtherExpensesCurrentYear
Total Expenses Prior Year51099489TotalExpensesPriorYear
Total Expenses Current Year51932880TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7907372RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5256823RevenuesLessExpensesCY
Total Assets BOY28682609TotalAssetsBOY
Total Assets EOY33651156TotalAssetsEOY
Total Liabilities BOY2513312TotalLiabilitiesBOY
Total Liabilities EOY1740538TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY26169297NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY31910618NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE FOR A UNIFORM HEALTH AND WELFARE PROGRAM FOR EMPLOYEES EMPLOYED UNDER CERTAIN COLLECTIVE BARGAINING AGREEMENTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense50230272Expense
DescriptionBENEFITS PAID TO OR FOR MEMBERS CONSIST OF ACCIDENT, HEALTH, DENTAL, LOSS OF TIME, VISION CARE, PRESCRIPTION DRUG AND LIFE. ALSO INCLUDED ARE THE RELATED ADMINISTRATION FEES CHARGED BY THE BENEFIT PROVIDERS AND COST CONTROLS.Description
Total Program Service Expense50230272TotalProgramServiceExpense
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 Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
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 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 With109678NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees16NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
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 Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
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 Line1DAVE MCALLISTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6142377618TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14150 E MAIN STAddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43213ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
RANDY QUICKEL
CHAIRMAN2.00XX01350100
STEVE LOEFFLER
SECRETARY2.00XX000
JESSICA MILES
TRUSTEE2.00X000
DOUG WHITNEY
TRUSTEE2.00X000
PAUL SMITHBERGER
TRUSTEE2.00X01018590
SUE VANDERSALL
TRUSTEE2.00X000
MARK FLUHARTY
TRUSTEE2.00X01229240
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs359793TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTH SERVICE REVIEW OF OHIO INC
6730 ROOSEVELTFRANKLINOH45005MEDICAL CASE MANAGEMENT216216
REINHART BOERNER VAN DEUREN SC
PO BOX 2965MILWAUKEEWI532012965ATTORNEY172092
BENESYS INC
700 TOWER DRIVE SUITE 300TROYMI480982808IT138999
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS9000995615585456155854
SELF-PAYMENT CONTRIBUTI900099446405446405
FieldValueIRS element (for citing)
Total Program Service Revenue56602259TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column571626TotalRevenueColumn
Exclusion$571,626ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities31364359Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities31348541Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities15818Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column15818TotalRevenueColumn
Exclusion$15,818ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column57189703TotalRevenueColumn
Related Or Exempt Function Income56602259RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$587,444ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total48212915Total
Program Services48212915ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total523477Total
Management And General523477ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total29098Total
Management And General29098ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total197286Total
Management And General197286ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total43165Total
Management And General43165ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total205278Total
Management And General205278ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total36600Total
Management And General36600ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total26817Total
Management And General26817ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total114756Total
Management And General114756ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total271613Total
Management And General271613ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total109555Total
Management And General109555ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total37576Total
Management And General37576ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total14283Total
Management And General14283ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18714Total
Management And General18714ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total21144Total
Management And General21144ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
ACCIDENT, HEALTH AND DE17770501777050
MEDICAL REVIEW SERVICES195328195328
VISION CARE FEES4497944979
TEMPORARY HELP3783637836

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total15410Total
Management And General15410ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total51932880Total
Program Services50230272ProgramServices
Management And General1702608ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4114064BOY
EOY3283186EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1179343BOY
EOY874392EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY798689BOY
EOY532077EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY30469BOY
EOY26137EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis330904LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec304195LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY50349BOY
EOY26709EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY22509695BOY
EOY28908655EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY28682609BOY
EOY33651156EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1593916BOY
EOY801506EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY396BOY
EOY3032EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY919000BOY
EOY936000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2513312BOY
EOY1740538EOY
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)
BOY26169297BOY
EOY31910618EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26169297BOY
EOY31910618EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY28682609BOY
EOY33651156EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses5256823ReconcilationRevenueExpenses
Reconciliation Unrealized Invest484498ReconciliationUnrealizedInvest
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

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis330904OtherCostOrOtherBasis
Depreciation304195Depreciation
Book Value26709BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings26709TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCLAIMS PAYABLEDescription
Amount$936,000Amount
FieldValueIRS element (for citing)
Total Of Amounts936000TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt57647384TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments484498NetUnrealizedGainsInvestments
Revenue Not Rptd F990484498RevenueNotRptdF990
Revenue Subtotal57162886RevenueSubtotal
Investment Expenses Not Included26817InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt26817RevenueNotRptdOnFinStmt
Total Revenue Per Form99057189703TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt51889063TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal51889063ExpensesSubtotal
Investment Expenses Not Included226817InvestmentExpensesNotIncluded2
Other Expenses Not Included17000OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt43817ExpensesNotRptdOnFinStmt
Total Expenses Per Form99051932880TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX YEARS IN PROGRESS. PLAN MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CURRENT YEAR INCREASE IN CLAIMS PAYABLE 17,000.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 GOES THROUGH A PRELIMINARY REVIEW BY THE ADMINISTRATIVE MANAGER AND DIRECTOR OF FINANCE. ONCE THEY APPROVE THE FORM 990 IT IS PRESENTED TO A COMMITTEE OF TRUSTEES FOR APPROVAL PRIOR TO SIGNING AND FILING.
FORM 990, PART VI, SECTION B, LINE 12CTRUSTEES ARE EXPECTED TO FULLY DISCLOSE ANY OWNERSHIP OR OTHER FINANCIAL RELATIONSHIPS THEY HAVE WITH OTHER PARTIES THAT DEAL WITH THE PLAN.
FORM 990, PART VI, SECTION B, LINE 15ATHE CHAIRMAN OF THE BOARD OF TRUSTEES EVALUATES THE ADMINISTRATIVE MANAGER AND DETERMINES COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2CTHE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS.
FORM 990, SCHEDULE R, PARTS II-IV:IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, THE PLAN ALSO HAD 4 SOLE PROPRIETORS AS CONTRIBUTING EMPLOYERS DURING 2012.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 1059
4150 E MAIN STREETCOLUMBUSOH43213314392482LABOR UNIONOH501(C)(5)N/A0
BOARD OF TRUSTEES OF THE UFCW UNIONS AND EMPLOYERS H&W PLAN OF CENTRAL OHIO
4150 E MAIN STREETCOLUMBUSOH43213310656412PLAN SPONSOR AND PLAN ADMINISTRATOROH501(C)(9)N/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

CVSCAREMARK
GREAT SCOT INC
THE KROGER CO
INTERSTATE BRANDS CORP
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 Orgs1RentalOfFacilitiesFrOtherOrgs
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

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 1059BusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeKTransactionType
Amount Involved58368AmountInvolved
Method Of Amt DeterminationFAIR MARKET VALUEMethodOfAmtDetermination