2013-11-15T14:52:53-06:00 2012-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT SUITE 500 AUBURN HILLS MI 48326 990 2012-01-01 456488442 UAW RETIREES OF MACK TRUCKS HEALTH BENEFIT FUND UAWR 2488139800 700 TOWER DRIVE SUITE 300 TROY MI 48098 SUZANNE DANIELS 2488139800 2013-11-11 1 LYNNE M HUISMANN P00053811 2483757100 2012 2016-02-25 16:41:14Z SUZANNE DANIELS 700 TOWER DRIVE SUITE 300 TROY MI 48098 20653871 0 X N/A X 2011 MI THE TRUST WAS ESTABLISHED AND IS CONTINUED FOR THE PURPOSE OF PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPEDENTS. 7 7 0 3 0 0 0 0 610615316 19207471 4083 1446400 64028 0 610683427 20653871 0 0 72474798 37454766 33417 119500 0 0 0 93448 1396794 72601663 38971060 538081764 -18317189 538170393 747461873 88629 205353300 538081764 542108573 TO HELP FUND CERTAIN BENEFITS PROVIDED TO CERTAIN MACK RETIREES AND OTHER ELIGIBLE INDIVIDUALS. 0 0 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 7 0 1 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X HEATHER CARMAN 2488139800 700 TOWER DRIVE SUITE 300 TROY MI 48098 SUZANNE DANIELS 2.00 6.00 X X 30000 36625 0 JACK MARTIN 0.50 1.50 X 22500 31323 0 FRANCINE PARKER 0.50 1.50 X 24750 31323 0 GARY PETRONI 0.50 1.50 X 24750 31323 0 WILLARD BECK 0.50 0.00 X 0 0 0 RAYMOND CURRY 0.50 0.00 X 0 0 0 RICHARD SAYLOR 0.50 0.00 X 4500 0 0 106500 130594 0 0 0 0 0 BENESYS INC 700 TOWER DRIVE SUITE 300 TROY MI 48098 PLAN ADMINISTRATION 436241 HIGHMARK INC FIFTH AVENUE PLACE 120 FIFTH AVENU PITTSBURGH PA 15222 CLAIMS ADMINISTRATION 435914 MILLIMAN INC 336 S MAIN STREET ROCHESTER MI 48307 ACTUARY SERVICES 144153 3 EMPLOYER INTEREST CONTRIBUTIONS 900099 13951497 13951497 PARTICIPANT CONTRIBUTIONS 900099 5255974 5255974 19207471 1446400 1446400 20653871 19207471 0 1446400 37454766 119500 54898 4350 56648 1191169 22945 14105 52679 38971060 14961764 210518153 267619290 73934507 255587546 210000000 1451824 251287775 1793 269614 538170393 747461873 88629 205353300 88629 205353300 X 538081764 542108573 0 0 0 0 538081764 542108573 538170393 747461873 -18317189 -2132484 24476482 0 X X 0 1 X 1 0 0 X 11063367 -2132484 -2132484 13195851 7458020 7458020 20653871 31513040 0 31513040 7458020 7458020 38971060 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ACCORDANCE WITH GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, MANAGEMENT EVALUATED THE PLAN'S TAX POSITION AND DOES NOT BELIEVE THE PLAN HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: CLAIMS PAID, REPORTED NET WITH INTEREST CONTRIBUTIONS ON FINANCIALS 7,458,020. PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS PAID, REPORTED NET WITH INTEREST CONTRIBUTIONS ON FINANCIALS 7,458,020. FORM 990, PART VI, SECTION A, LINE 7A THERE ARE 3 MEMBERS OF THE BOARD SERVING AT THE DISCRETION OF THE UAW INTERNATIONAL PRESIDENT AND MAY BE REMOVED OR REPLACED, AND A SUCCESSOR DESIGNATED, AT ANY TIME BY WRITTEN NOTICE FROM THE UAW INTERNATIONAL PRESIDENT TO THE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11 THE CHAIR, LEGAL COUNSEL, AND ADMINISTRATOR REVIEW THE 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUST WAS ESTABLISHED BY COURT SETTLEMENT. THE COURT-APPROVED TRUST AGREEMENT INCLUDES A CODE OF ETHICS BY WHICH EACH COMMITTEE MEMBER AGREES TO ABIDE. IT IS REGULARLY REVIEWED WITH THE COMMITTEE. IN ADDITION, EACH COMMITTEE MEMBER MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONNAIRE WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. IF SUCH A CONFLICT IS PRESENT THE INVOLVED MEMBER(S) DO NOT PARTICIPATE IN THE DISCUSSION OR VOTING. FORM 990, PART VI, SECTION C, LINE 19 THE TRUST IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 OF ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. UAW RETIREES OF THE DANA CORPORATION HEALTH AND WELFARE TRUST 700 TOWER DRIVE SUITE 300 TROY MI 48098 261851652 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW ST JOSEPH RETIREES HEALTH AND WELFARE TRUST 700 TOWER DRIVE SUITE 300 TROY MI 48098 271401289 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW RETIREES OF ACC BENEFIT TRUST 700 TOWER DRIVE SUITE 300 TROY MI 48098 276927927 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 MACK TRUCKS INC 7825 NATIONAL SERVICE ROAD GREENSBORO NC 27409 221582040 TRUCK MANUFACTURING DE N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1