2011-08-15T08:54:36-05:00 2010-09-30 BST ADVISORS LLC 28 WEST 44TH STREET NEW YORK NY 10036 990 2009-10-01 226137317 UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 1262 EMPLOYERS WELFARE FUND UNIT 9737785800 1389 BROAD STREET CLIFTON NJ 07013 MATTHEW MOLINARO 9737785800 2011-08-11 1 DAVID C LEE 2126618640 2009 2016-02-24 21:20:13Z MATTHEW MOLINARO 1389 BROAD STREET CLIFTON NJ 07013 84151484 0 X N/A X 1969 NJ TO PROVIDE HOSPITAL, MAJOR MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION, LIFE INSURANCE AND OTHER MEDICAL BENEFITS TO APPROXIMATELY 18,000 ELIGIBLE PARTICIPANTS. 6 6 0 0 0 0 0 79438658 80738154 1133814 719813 357575 73 80930047 81458040 0 80598102 77626178 842756 892825 0 0 1096134 1170127 82536992 79689130 -1606945 1768910 21888276 22977570 2234830 521211 19653446 22456359 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 18,000 ELIGIBLE PARTICIPANTS. 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 11 0 1 0 0 0 0 0 0 0 0 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 X DEWEY CANELLA 5.00 X 0 0 0 HARVEY WHILLE 5.00 X 0 0 0 JOHN DURKIN 5.00 X 0 0 0 MATTHEW MOLINARO 5.00 X 0 0 0 MICHAEL KANTOR 5.00 X 0 0 0 LEONARD COMBENATE 5.00 X 0 0 0 0 0 0 0 0 0 0 HORIZON BCBS OF NJ 3 PONY LANE FLEMINGTON NJ 08822 CLAIMS ADMINISTRATION 4381164 HORIZON HEALTHCARE DENTAL SERVICES PO BOX 1938 NEWARK NJ 07101 CLAIMS ADMINISTRATION 342377 PROSKAUER ROSE LLP 1585 BROADWAY NEW YORK NY 10036 LEGAL SERVICES 313529 FRANK M VACCARO & ASSOCIATES INC 27 ROLAND AVE SUITE 200 MOUNT LAUREL NJ 08054 THIRD-PARTY ADMINISTRATOR 244444 VALUE HEALTH OPTIONS 240 CORPORATE BLVD NORFOLK VA 23502 CLAIMS ADMINISTRATION 154689 6 EMPLOYER'S CONTRIBUTIO 900099 78427979 78427979 RETIREE CO-PAY CONTRIB 900099 1602100 1602100 COBRA CONTRIBUTIONS 900099 708075 708075 80738154 561889 561889 2851368 2693444 157924 157924 157924 INTEREST ON DELINQUENT 900099 73 73 73 81458040 81458040 0 0 77626178 643408 192734 56683 367722 63000 11779 18310 73767 4541 5044 7800 THIRD-PARTY ADMINISTRAT 244443 COMPUTER SERVICES 134584 ALL OTHER EXPENSES 89167 ACTUARIAL AND OTHER CON 66785 COMMUNICATION TO PARTIC 64433 18752 79689130 1165704 2869397 2407568 2474504 3510 5384 170442 165390 8482 5052 17733757 17066830 569255 556403 21888276 22977570 156031 194064 2078799 327147 2234830 521211 X 0 0 0 0 19653446 22456359 19653446 22456359 21888276 22977570 X 0 1 1 X 0 4867 4159 708 160370 156026 4344 5205 5205 0 5052 DUE TO AFFILIATES 254868 SERP LIABILITY 72279 327147 81458040 79689130 1768910 1034002 1034002 2802912 82480263 1034002 1034002 81446261 11779 11779 81458040 79677351 0 79677351 11779 11779 79689130 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 2006 AND PRIOR, AS OF AUGUST 31, 2010. THE ADOPTION OF THIS STANDARD RESULTED IN NO MATERIAL UNCERTAIN TAX BENEFITS OR PROVISIONS IDENTIFIED AND RECORDED AS A LIABILITY OR ASSET. 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. FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBIILTY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. form 990, PART VI, SECTION B, LINE 14 DOCUMENT RETENTION AND DESTRUCTION POLICY THE ORGANIZATION DID NOT HAVE A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY IN PLACE AS OF THE CLOSE OF THE TAX YEAR, HOWEVER, A WRITTEN POLICY WAS UNDER DEVELOPMENT AT THE THE TIME OF FILING OF THIS FORM 990. FORM 990, PART X, LINE 33 GENERALLY ACCEPTED ACCOUNTING PRINCIPLES ALLOW FOR PRESENTATION OF ESTIMATED CURRENT CLAIMS OBLIGATIONS ON A SEPARATE STATEMENT IN THE FUND'S AUDITED FINANCIAL STATEMENTS. FOR CONSISTENCY, THE BALANCE SHEET FOR FORM 990 WILL ALSO NOT INCLUDE LIABILITIES FOR ESTIMATED CURRENT CLAIMS OBLIGATIONS. THE FOLLOWING TABLE DETAILS PRIOR YEAR AMOUNTS WHICH HAVE BEEN RESTATED TO BE IN CONFORMITY WITH CURRENT YEAR'S PRESENTATION: PART X, LINE 25, COLUMN B - OTHER LIABILITIES (PER 2008 FILING) $ 11,597,137 ADJUSTMENT FOR CLAIMS OBLIGATIONS (9,518,338) PART X, LINE 25, COLUMN A - OTHER LIABILITIES, AS RESTATED(PER 2009 FILING) 2,078,799 PART X, LINE 26, COLUMN B - TOTAL LIABILITIES (PER 2008 FILING) $ 11,753,168 ADJUSTMENT FOR CLAIMS OBLIGATIONS (9,518,338) PART X, LINE 25, COLUMN A - TOTAL LIABILITIES, AS RESTATED (PER 2009 FILING) 2,234,830 PART X, LINE 32 & 33, COLUMN B - RETAINED EARNINGS, ENDOWMENT, ACCUMULATED INCOME, OR OTHER FUNDS (PER 2008 FILING) $ 10,135,108 ADJUSTMENT FOR CLAIMS OBLIGATIONS 9,518,338 PART X, LINE 25 COLUMN A - RETAINED EARNINGS, ENDOWMENT, ACCUMULATED INCOME OR OTHER FUNDS, AS RESTATED (PER 2009 FILING) 19,653,447 NET ASSETS PER THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE ESTIMATED CURRENT CLAIMS OBLIGATIONS OF $9,477,561AND ESTIMATED POST RETIREMENT OBLIGATIONS OF $56,237,539. 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) 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 LOCAL 1262 AND EMPLOYERS' PENSION FUND O 1299632