2012-08-14T08:36:11-05:00 2011-09-30 BST ADVISORS LLC 28 WEST 44TH STREET NEW YORK NY 10036 990 2010-10-01 226137317 UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 1262 EMPLOYERS WELFARE FUND UNIT 9737785800 1389 BROAD ST CLIFTON NJ 07013 MATTHEW MOLINARO 9737785800 2012-08-14 1 DAVID C LEE 2126618640 2010 2016-02-24 21:20:13Z MATTHEW MOLINARO 1389 BROAD STREET CLIFTON NJ 07013 88429233 0 X N/A X 1969 NJ TO PROVIDE HOSPITAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO APPROXIMATELY 16,000 ELIGIBLE PARTICIPANTS. 6 6 0 0 0 0 0 0 80738154 87571133 719813 857999 73 101 81458040 88429233 0 0 77626178 83947742 892825 919465 0 0 0 1170127 1062919 79689130 85930126 1768910 2499107 22977570 24670368 521211 667715 22456359 24002653 TO PROVIDE HOSPITAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 TO PROVIDE HOSPITAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO APPROXIMATELY 16,000 ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X MATTHEW MOLINARO TRUSTEE 9737785800 1389 BROAD STREET CLIFTON NJ 07013 DEWEY CANELLA 5.00 X 0 0 0 HARVEY WHILLE 5.00 X 0 303018 14352 JOHN DURKIN 5.00 X 0 0 0 MATTHEW MOLINARO 5.00 X 0 274243 14352 MICHAEL KANTOR 5.00 X 0 182966 13352 ALI RIZVI 5.00 X 0 0 0 0 760227 42056 0 0 1 0 HORIZON BCBS OF NJ 3 PONY LANE FLEMINGTON NJ 08822 CLAIMS ADMINISTRATION 4289597 HORIZON HEALTHCARE DENTAL SERVICES PO BOX 1938 NEWARK NJ 07101 CLAIMS ADMINISTRATION 329137 FRANK M VACCARO & ASSOCIATES INC 27 ROLAND AVE SUITE 200 MOUNT LAUREL NJ 08054 THIRD-PARTY ADMINISTRATOR 174929 EXPRESS SCRIPTS ONE EXPRESS WAY ST LOUIS MO 63121 CLAIMS ADMINISTRATION 155623 VALUE HEALTH OPTIONS 240 CORPORATE BLVD NORFOLK VA 23502 CLAIMS ADMINISTRATION 151047 6 EMPLOYER'S CONTRIBUTIO 900099 85242090 85242090 RETIREE CO-PAY CONTRIB 900099 1604648 1604648 COBRA CONTRIBUTIONS 900099 724395 724395 87571133 857999 857999 INTEREST ON DELINQUENT 900099 101 101 101 88429233 87571234 0 857999 83947742 650206 211190 58069 169201 63000 11802 16121 47371 1131 3992 8850 COMPUTER SERVICES 277535 THIRD-PARTY ADMINISTRAT 174929 ACTUARIAL AND OTHER CON 137352 ALL OTHER EXPENSES 91718 COMMUNICATION TO PARTIC 59917 85930126 185840 2869397 3262362 2474504 3016500 5384 4638 171162 169381 5052 1781 17066830 16971624 556403 1227623 22977570 24670368 194064 138969 327147 528746 521211 667715 X 0 0 0 0 22456359 24002653 22456359 24002653 22977570 24670368 X 2499107 -952813 X 0 1 0 X 0 4867 4393 474 161090 159783 1307 5205 5205 0 1781 DUE TO AFFILIATES 456467 SERP LIABILITY 72279 528746 88429233 85930126 2499107 -952813 -952813 1546294 87464618 -952813 -952813 88417431 11802 11802 88429233 85918324 0 85918324 11802 11802 85930126 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: PART X: ON OCTOBER 1, 2009, THE PLAN ADOPTED ASC 740-10-25, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN ON AN INCOME TAX RETURN. THE BENEFIT OF AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED IN THE FINANCIAL STATEMENTS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED, BASED ON ITS TECHNICAL MERITS, UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. THE PLAN'S TAX YEARS SUBJECT TO REVIEW WERE 2007 AND PRIOR, AS OF AUGUST 31, 2011. THE ADOPTION OF THIS STANDARD RESULTED IN NO MATERIAL UNCERTAIN TAX BENEFITS OR PROVISIONS IDENTIFIED AND RECORDED AS A LIABILITY OR ASSET. 0 0 0 HARVEY WHILLE 0 303018 0 0 0 0 0 3456 0 10896 0 317370 0 0 MATTHEW MOLINARO 0 274243 0 0 0 0 0 3456 0 10896 0 288595 0 0 MICHAEL KANTOR 0 182966 0 0 0 0 0 2456 0 10896 0 196318 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENGAGES A MANAGEMENT COMPANY TO PERFORM ADMINISTRATIVE SERVICES INCLUDING OVERSIGHT OF CERTAIN PERSONNEL AND EXECUTING FINANCIAL OPERATIONS ON A LIMITED BASIS. THE SERVICES ARE PERFORMED UNDER THE TERMS OF A WRITTEN CONTRACT. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO SUBCOMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FUND'S 990 IS PREPARED BY ITS OUTSIDE AUDITOR AND IS SUBMITTED AND REVIEWED WITH THE ADMINISTRATOR. THE ADMINISTRATOR THEN REVIEWS IT WITH THE CHAIRPERSON OF THE BOARD OF TRUSTEES. A COPY OF THE RETURN IS AVAILABLE TO THE EXECUTIVE BOARD MEMBERS UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AND MAY BE EXAMINED AT THE ORGANIZATION'S OFFICE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -952,813. UFCW 1262 AND EMPLOYERS PENSION FUND 1389 BROAD STREET CLIFTON NJ 07013 226074414 TO PROVIDE PENSION BENEFITS TO ELIGIBLE MEMBERS AND THEIR BENEFICIARIES. NJ 501(A) 0 UFCW 1262 AND EMPLOYERS LEGAL FUND 1389 BROAD STREET CLIFTON NJ 07013 222238707 TO PROVIDE LEGAL BENEFITS TO ELIGIBLE MEMBERS. NJ 501(C)9 0 UFCW WORKERS LOCAL 1262 1389 BROAD STREET CLIFTON NJ 07013 221339607 TO REPRESENT UNION MEMBERS IN COLLECTIVE BARGAINING MATTERS WITH EMPLOYERS NJ 501(C)5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 UFCW LOCAL 1262 AND EMPLOYERS' PENSION FUND O 1210674 CASH UFCW LOCAL 1262 N 274667 CASH UFCW LOCAL 1262 O 274667 CASH