2011-02-07T21:39:23-06:00 2010-03-31 HEMMING MORSE CPA'S AND CONSULTANTS 160 SPEAR STREET SUITE 1900 SAN FRANCISCO CA 94105 990 2009-04-01 952301788 UNITED FOOD & COMMERCIAL WORKERS UNIONS & FOOD EMPLOYERS BEN FUND UNIT 7142202297 6425 KATELLA AVENUE CYPRESS CA 90630 JOEL MELTZ 7142202297 2011-02-07 1 4158364000 2009 2016-02-24 21:20:13Z JOEL MELTZ 6425 KATELLA AVENUE CYPRESS CA 90630 1626457637 0 X N/A X 1964 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 10 10 0 0 0 0 0 316863919 321364408 11058740 3016997 3648121 9320747 331570780 333702152 0 411080632 471658321 3451275 0 0 0 21966804 27161781 436498711 498820102 -104927931 -165117950 527994239 338114217 175855396 147937233 352138843 190176984 0 0 THE PLAN IS A MULTI-EMPLOYER WELFARE BENEFIT PLAN PROVIDING HOSPITAL, MEDICAL, PSYCHIATRIC, PREVENTIVE MEDICINE, DENTAL ORTHODONTIA, PRESCRIPTION DRUG, DEATH, INDUSTRY VACATION AND VISION CARE BENEFITS 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 16472 0 0 0 0 0 0 0 0 0 10 10 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X joel meltz 7142202297 6425 KATELLA AVENUE CYPRESS CA 90630 X GREG CONGER 5.00 X 0 0 0 RICARDO ICAZA 5.00 X 0 0 0 BILL LATHROP 5.00 X 0 0 0 CONNIE LEYVA 5.00 X 0 0 0 michael kasparian 5.00 X 0 0 0 MICHAEL STRAETER 5.00 X 0 0 0 KATHLEEN A FINAZZO 5.00 X 0 0 0 FRANK JORGENSEN 5.00 X 0 0 0 BRENT BOHN 5.00 X 0 0 0 leroy westmoreland 5.00 X 0 0 0 0 0 0 0 0 0 0 SC UFCW ADMINISTRATION LLC 6425 KATELLA AVE CYPRESS CA 90630 CONTRACT ADMINISTRATOR 15296891 ufcw union local 770 630 shatto place LOS ANGELES CA 90005 administration 1070428 SEYFARTH SHAW LLP ONE CENTURY PLAZA SUITE 3500 LOS ANGELES CA 900673021 LEGAL COUNSEL 527039 SCHWARTZ STEINSAPIR DOHRMANN & SOMMERS 6300 WILSHIRE BOULEVARD SUITE 2000 LOS ANGELES CA 900485268 LEGAL COUNSEL 513017 THE SEGAL COMPANY 100 MONTGOMERY STREET SUITE 500 SAN FRANCISCO CA 94104 CONSULTANT 483254 14 EMPLOYER CONTRIBUTIONS 900099 291533455 291533455 PARTICIPANT CONT. 900099 29745504 29745504 COBRA SUBSIDY 900099 85449 85449 321364408 2830288 2830288 1292942194 1292755485 186709 186709 186709 MEDICARE PART D SUBSID 900099 8442393 8442393 MHNS SETTLEMENT 900099 875000 875000 OTHER INCOME 900099 3354 3354 9320747 333702152 330871864 0 2830288 471658321 15296891 1040056 57248 130818 602 233435 COST CONTAINMENT FEES 5793253 UNION ADMIN SUPPORT 2644973 ACTUARIAL CONSULTANTS 1654679 BANK FEES 256040 MISCELLANEOUS 30761 23025 498820102 118289560 101345515 26614213 33687432 193131 204818 382496017 199420315 401318 3456137 527994239 338114217 1007242 829824 174848154 147107409 175855396 147937233 X 0 0 0 0 352138843 190176984 352138843 190176984 527994239 338114217 X 0 1 1 X 0 0 GROUP INSURANCE PREMIUMS AND CLAIMS PAYABLE 73062228 CLAIMS INCURRED BUT NOT REPORTED 39315000 DUE TO OTHER TRUSTS 713944 ANCILLARY AWARDS AND GRANTS NOT USED 274000 CASH - OPERATING ACCOUNTS (OVERDRAFT) 8229737 LIABILITY TO RETURN COLLATERAL FOR SECURITY ON LOAN 25512500 147107409 333702152 498820102 -165117950 3156091 3156091 -161961859 336858243 3156091 3156091 333702152 0 333702152 498820102 0 498820102 0 498820102 Form 990, Part VI, Section B, line 11 THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND VIA 5500 FILING. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. SO CA UFCW UNIONS & FOOD EMPLOYERS JOINT PENSION TRUST FUND 6425 KATELLA AVENUE CYPRESS CA 90630 951939092 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401a SO CA UNITED FOOD & COMM WORKERS UNIONS & FOOD EMPOYERS INDIV ACCT 6425 KATELLA AVENUE CYPRESS CA 90630 330548757 TO PROVIDE ANNUITY PENSION BENEFITS TO ELIGBLE PARTICIPANTS CA 401a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0