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UFCW UNIONS & EMPLOYERS HEALTH & WELFARE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
UFCW UNIONS & EMPLOYERS HEALTH & WELFARE (EIN 31-0656412)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201103199349307955
Schema version
2010v3.4
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)
Timestamp2011-11-15T14:52:52-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2010-01-01TaxPeriodBeginDate

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 Signed2011-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS M POWERS CPAName
Phone2627846210Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

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 Receipts104774301GrossReceipts
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 Employees19TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year47113371ProgramServiceRevenuePriorYear
Program Service Revenue CY47899794ProgramServiceRevenueCY
Investment Income Prior Year1287236InvestmentIncomePriorYear
Investment Income Current Year1356639InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year708204OtherRevenueCurrentYear
Total Revenue Prior Year48400607TotalRevenuePriorYear
Total Revenue Current Year49964637TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year45299268BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY41526733BenefitsPaidToMembersCY
Salaries Etc Prior Year664227SalariesEtcPriorYear
Salaries Etc Current Year799723SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3190880OtherExpensePriorYear
Other Expenses Current Year3533259OtherExpensesCurrentYear
Total Expenses Prior Year49154375TotalExpensesPriorYear
Total Expenses Current Year45859715TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-753768RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4104922RevenuesLessExpensesCY
Total Assets BOY32147439TotalAssetsBOY
Total Assets EOY36588742TotalAssetsEOY
Total Liabilities BOY2305864TotalLiabilitiesBOY
Total Liabilities EOY2513305TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY29841575NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34075437NetAssetsOrFundBalancesEOY
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
Expense44066836Expense
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 Expense44066836TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109686NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees19NumberOfEmployees
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
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
GREGORY BEHNKE
CHAIRMAN2.00XX000
STEVE LOEFFLER
SECRETARY2.00XX000
LANCE CAMPBELL
TRUSTEE2.00X000
REBECCA A BERROYER
TRUSTEE2.00X000
SUE VANDERSALL
TRUSTEE2.00X000
RANDY QUICKEL
TRUSTEE2.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
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 (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ANTHEM INSURANCE COMPANY INC
PO BOX 182361COLUMBUSOH432182361CLAIMS PROCESSING1604994
ALERE HEALTH IMPROVEMENT CO
PO BOX 403393ATLANTAGA303843393DISEASE MANAGEMENT429838
REINHART BOERNER VAN DEUREN SC
PO BOX 2965MILWAUKEEWI532012965ATTORNEY268502
HEALTH SERVICE REVIEW INC
6730 ROOSEVELTFRANKLINOH45005MEDICAL CASE MANAGEMENT235524
DELTA DENTAL
1300 EAST 9TH STREETCLEVELANDOH44114CLAIMS PROCESSING170860
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS9000994742157847421578
SELF-PAYMENT CONTRIBUT900099478216478216
FieldValueIRS element (for citing)
Total Program Service Revenue47899794TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column983535TotalRevenueColumn
Exclusion$983,535ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities55182768Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities54809664Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities373104Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column373104TotalRevenueColumn
Exclusion$373,104ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionGOVERNMENT REIMBURSEMEDescription
Business Code900099BusinessCode
Total Revenue Column708204TotalRevenueColumn
Related Or Exempt Function Income708204RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue708204TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column49964637TotalRevenueColumn
Related Or Exempt Function Income48607998RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,356,639ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total41526733Total
Program Services41526733ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total513884Total
Management And General513884ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total30796Total
Management And General30796ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total212587Total
Management And General212587ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total42456Total
Management And General42456ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total261319Total
Management And General261319ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total30549Total
Management And General30549ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total39142Total
Management And General39142ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total163705Total
Management And General163705ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total220701Total
Management And General220701ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total159786Total
Management And General159786ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total37467Total
Management And General37467ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total31960Total
Management And General31960ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14081Total
Management And General14081ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total15116Total
Management And General15116ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
ACCIDENT, HEALTH AND DE17763971776397
DISEASE MANAGEMENT398249398249
MEDICAL REVIEW SERVICES316235316235
VISION CARE FEES4922249222
ELECTRONIC ENROLLMENT S1850018500

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total830Total
Management And General830ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total45859715Total
Program Services44066836ProgramServices
Management And General1792879ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY6960955EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4147662BOY
EOY940216EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY918673BOY
EOY1290849EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY21890BOY
EOY21016EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis461958LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec384985LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY29211BOY
EOY76973EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY27030003BOY
EOY27298733EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32147439BOY
EOY36588742EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1415864BOY
EOY1697305EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY890000BOY
EOY816000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2305864BOY
EOY2513305EOY
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)
BOY29841575BOY
EOY34075437EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29841575BOY
EOY34075437EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32147439BOY
EOY36588742EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4104922ReconcilationRevenueExpenses
Reconcilation Other Changes128940ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis461958OtherCostOrOtherBasis
Depreciation384985Depreciation
Book Value76973BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings76973TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCLAIMS PAYABLEDescription
Amount$816,000Amount
FieldValueIRS element (for citing)
Total Of Amounts816000TotalOfAmounts
Total Revenue49964637TotalRevenue
Total Expenses45859715TotalExpenses
Excess Or Deficit For Year4104922ExcessOrDeficitForYear
Net Unrealized GL On Investments128940NetUnrealizedGLOnInvestments
Total Adjustments128940TotalAdjustments
Excess Or Deficit Per FS4233862ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt50054435TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments128940NetUnrealizedGainsInvestments
Revenue Not Rptd F990128940RevenueNotRptdF990
Revenue Subtotal49925495RevenueSubtotal
Investment Expenses Not Included39142InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt39142RevenueNotRptdOnFinStmt
Total Revenue Per Form99049964637TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt45894573TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal45894573ExpensesSubtotal
Investment Expenses Not Included239142InvestmentExpensesNotIncluded2
Other Expenses Not Included-74000OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-34858ExpensesNotRptdOnFinStmt
Total Expenses Per Form99045859715TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X: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 MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2010 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 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 2007.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:CURRENT YEAR DECREASE IN CLAIMS PAYABLE -74,000.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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.
TRUSTEES 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 12C
THE CHAIRMAN OF THE BOARD OF TRUSTEES EVALUATES THE ADMINISTRATIVE MANAGER AND DETERMINES COMPENSATION.FORM 990, PART VI, SECTION B, LINE 15A
THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 128,940.FORM 990, PART XI, LINE 5:
THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS.FORM 990, PART XII, LINE 2C
THE $4,233,862 REPORTED HERE DOES NOT AGREE WITH THE NET INCREASE IN NET ASSETS AVAILABLE FOR BENEFITS PER THE AUDITED FINANCIAL STATEMENTS AMOUNT OF $4,159,862. THE DIFFERENCE OF $74,000 IS THE CHANGE IN BENEFITS PAYABLE. THE BENEFITS PAYABLE ARE INCLUDED IN THE FORM 990, BUT ARE ONLY DISCLOSED IN THE NOTES TO THE AUDITED FINANCIAL STATEMENTS.FORM 990, SCHEDULE D, PART XI, LINE 10: