2013-11-11T19:26:46-06:00 2012-12-31 MILLER KAPLAN ARASE LLP 44 MONTGOMERY ST STE 3701 SAN FRANCISCO CA 941044831 990 2012-01-01 680139450 UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH AND WELFARE TRUST FUND % JESSE GLAVES UFCW 9257467530 1277 TREAT BLVD Suite WALNUT CREEK CA 945977975 rick a silva 9257467530 2013-11-11 true miller kaplan arase llp 4159563600 2012 2016-03-07 17:11:31Z esai alday 1277 TREAT BLVD WALNUT CREEK CA 945977975 23072916 false X N/A X 1987 CA The Plan provides various types and levels of health benefits to participants, depending upon the type and level of benefits contained in the participants' collective bargaining agreements. 9 9 0 0 0 0 0 20174779 22785831 1296 0 247809 287085 20423884 23072916 0 0 19772706 21461889 0 0 0 0 0 1693468 1634394 21466174 23096283 -1042290 -23367 3763235 4128530 5543427 5932089 -1780192 -1803559 THE PLAN PROVIDES VARIOUS TYPES AND LEVELS OF HEALTH BENEFITS TO PARTICIPANTS, DEPENDING UPON THE TYPE AND LEVEL OF BENEFITS CONTAINED IN THE PARTICIPANTS' COLLECTIVE BARGAINING AGREEMENTS. false false THE PLAN PROVIDES VARIOUS TYPES AND LEVELS OF HEALTH BENEFITS TO PARTICIPANTS, DEPENDING UPON THE TYPE AND LEVEL OF BENEFITS CONTAINED IN THE PARTICIPANTS' COLLECTIVE BARGAINING AGREEMENTS. false false false false false false false false false false false false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true X 566 0 true 0 false false false false false false X 9 9 false false false false false false false true false false false false true false false true true false X JESSE GLAVES 9257467530 1277 TREAT BLVD WALNUT CREEK CA 945977975 X X BRAD SAPP 1.0 X STEVEN SHIPMAN 1.0 X ADAM LOVEALL 1.0 X ESAI ALDAY 1.0 X PETER DERENALE 1.0 X RICHARD GLAZER 1.0 X PAUL BENNIE 1.0 X JOHN HEISE 1.0 X JONATHAN HUGHES 1.0 X 0 false false false THE SEGAL COMPANY 100 MONTGOMERY ST STE 500 SAN FRANCISCO CA 941044308 ACTUARY 134871 ufcw-emp benefit plans of no ca grp 1277 treat blvd WALNUT CREEK CA 945977975 administrator 981472 JOHN H COHENOUR 2255 WATT AVENUE STE 335 SACRAMENTO CA 95825 LEGAL 128136 3 0 EMPLOYER CONTRIBUTIONS 900099 21645688 21645688 PARTICIPANT CONTRIBUTIONS 900099 1140143 1140143 22785831 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS 900099 107 107 MEDICARE PART D REIMBURSEMENT 900099 273372 273372 STOP-LOSS REIMBURSEMENT 900099 13606 13606 287085 23072916 23072916 0 0 0 21461889 0 0 0 0 0 0 957723 128136 43006 0 0 0 179699 0 29847 138119 0 60972 4135 0 1698 0 0 21525 17862 PRINTING 46489 MISCELLANEOUS 5183 23096283 1587289 2500368 256354 0 0 0 1906095 1626621 0 0 0 0 0 0 0 0 13497 1541 0 0 0 0 0 0 0 0 0 0 0 3763235 4128530 243427 174089 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5300000 5758000 5543427 5932089 X 0 0 0 0 -1780192 -1803559 -1780192 -1803559 3763235 4128530 -23367 X false true X true 0 CLAIMS PAYABLE AND CLAIMS IBNR 2488000 ACCUM. ELIGIBILITY CREDITS 3270000 5758000 X 23072916 23072916 23072916 22638283 5300000 5300000 17338283 5758000 5758000 23096283 PART X, LINE 2: THE PLAN HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. INFORMATION RETURNS FOR YEARS FOR WHICH THE APPLICABLE STATUTES OF LIMITATIONS HAVE NOT EXPIRED ARE SUBJECT TO EXAMINATION BY AUTHORITIES. PART XII, 2D: BENEFIT OBLIGATIONS AT DECEMBER 31, 2011: $5,300,000 PART XII, 4B: BENEFIT OBLIGATIONS AT DECEMBER 31, 2012: $5,758,000 part vi, line 8b: the PLAN does not have a committee with authority to act on behalf of the governing body. PART VI, LINE 11b: THE BOARD VOTES TO GIVE AUTHORITY TO CHAIR AND SECRETARY PRIOR TO SUBMISSION, WITH THEM REVIEWING AFTERWARDS. PART VI, LINE 19: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO PARTICIPANTS UPON REQUEST. THE PLAN FILES A FORM 5500 ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN WITH THE DEPARTMENT OF LABOR. THE FORM 5500 IS AVAILABLE ON THE DOL'S WEBSITE. THE PLAN COMPLIES WITH ERISA. hp heritage plaza associates lp 630 pena dr 400 davis CA 95618 810565212 mutlifamily apt CA na unrelated false false rite aid corporation 30 hunter ln camp hill PA 17011 954391249 sales PA na c corp 0 0 false savco drugs inc 455 oconnor dr 190 san jose CA 95128 361924025 sales CA na c corp 0 0 false redding howell's inc 1426 eureka way redding CA 96001 680424921 sales CA na c corp 0 0 false cascade paint & supply 1220 california st redding CA 96001 942317856 sales & repair CA na c corp 0 0 false ufcw-emp ben plans of no ca grp admin 1277 treat blvd walnut creek CA 94597 260048379 admin svcs CA na c corp 0 0 false false false false false false false false false false false false false true false false false false false true