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FCA US LLC HEALTH CARE BENEFITS PLAN: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FCA US LLC HEALTH CARE BENEFITS PLAN (EIN 38-2968384)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201123199349301717
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)
Timestamp2011-11-15T12:04:17-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12601 CAMBRIDGE CT SUITE 500AddressLine1
CityAUBURN HILLSCity
StateMIState
ZIP Code48326ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382968384EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHRYSLER GROUP LLC HEALTH CARE BENEFITS PLANBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHRYNameControl
Phone2485122263Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O CIMS 485-07-90 1000 CHRYSLERAddressLine1
Address Line2DRIVEAddressLine2
CityAUBURN HILLSCity
StateMIState
ZIP Code483262766ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT P KAISERName
TitleSENIOR MANAGERTitle
Phone2485122263Phone
Date Signed2011-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLYNNE M HUISMANNName
Phone2483757100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT P KAISERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1C/O CIMS 485-07-90 1000 CHRYSLERAddressLine1
Address Line2DRIVEAddressLine2
CityAUBURN HILLSCity
StateMIState
ZIP Code483262766ZIPCode
FieldValueIRS element (for citing)
Gross Receipts211551793GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1991YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionPROVISION OF HOSPITAL, SURGICAL, MEDICAL, DRUGS, VISION, HEARING AND DENTAL BENEFITS FOR APPROXIMATELY 26,653 PARTICIPANTS AT CHRYSLER LLC.ActivityOrMissionDescription
Nbr Voting Members Governing Body0NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year192151243ProgramServiceRevenuePriorYear
Program Service Revenue CY179668014ProgramServiceRevenueCY
Investment Income Prior Year3005450InvestmentIncomePriorYear
Investment Income Current Year4070904InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year195156693TotalRevenuePriorYear
Total Revenue Current Year183738918TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year186250664BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY171416614BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9183960OtherExpensePriorYear
Other Expenses Current Year13506443OtherExpensesCurrentYear
Total Expenses Prior Year195434624TotalExpensesPriorYear
Total Expenses Current Year184923057TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-277931RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1184139RevenuesLessExpensesCY
Total Assets BOY127386215TotalAssetsBOY
Total Assets EOY133706153TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY127386215NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY133706153NetAssetsOrFundBalancesEOY
Mission DescriptionNONEMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionPROVISION OF HOSPITAL, SURGICAL, MEDICAL, DRUGS, VISION, HEARING AND DENTAL BENEFITS FOR APPROXIMATELY 26,653 PARTICIPANTS AT CHRYSLER GROUP LLC.Description
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 Equip0ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
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 Members0NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
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 Body0MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
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 Line1BANK OF AMERICABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9087641238TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1300 DAVIDSON AVENUEAddressLine1
CitySOMMERSETCity
StateNJState
ZIP Code08873ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA

FieldValueIRS element (for citing)
Name PersonBANK OF AMERICANamePerson
TitleTRUSTEETitle
Average Hours Per Week1.00AverageHoursPerWeek
Institutional TrusteeXInstitutionalTrustee
Reportable Comp From Organization0ReportableCompFromOrganization
Reportable Comp From Related Orgs0ReportableCompFromRelatedOrgs
Other Compensation0OtherCompensation
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
BLUE CROSS BLUE SHIELD
600 LAFAYETTE EAST MAILCODE X600DETROITMI48226MEDICAL, HOSPITAL AND SURGICAL SERVICES6844059
AON HEWITT
100 HALF DAY ROADLINCOLNSHIREIL60069CONSULTING AND OUTSOURCING3243863
TOWERS WATSON
335 MADISON AVENUENEW YORKNY10017MANAGEMENT SERVICES AND CONSULTING1279770
STAYWELL HEALTH MANAGEMENT
3000 AMES CROSSING ROAD STE 100ST PAULMN55121MANAGEMENT SERVICES521344
CIGNA
900 COTTAGE GROVE ROADHARTFORDCT06152INSURANCE PROVIDER447975
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS525100157627347157627347
EMPLOYEE CONTRIBUTIONS5251002204066722040667
FieldValueIRS element (for citing)
Total Program Service Revenue179668014TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2604327TotalRevenueColumn
Exclusion$2,604,327ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities29279452Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities27812875Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1466577Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1466577TotalRevenueColumn
Exclusion$1,466,577ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column183738918TotalRevenueColumn
Related Or Exempt Function Income179668014RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,070,904ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total171416614Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total7288885Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionCONTRACT ADMINISTRATIONDescription
Total6217558Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total184923057Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY62313BOY
EOY25534EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1871894BOY
EOY1858183EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10BOY
EOY62EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY814663BOY
EOY990134EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY124283100BOY
EOY130446837EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY354235BOY
EOY385403EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY127386215BOY
EOY133706153EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
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)
BOY127386215BOY
EOY133706153EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY127386215BOY
EOY133706153EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY127386215BOY
EOY133706153EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1184139ReconcilationRevenueExpenses
Reconcilation Other Changes7504077ReconcilationOtherChanges
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

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
MUTUAL FUNDS66914286F
COMMON AND PREFERRED STOCK6943880F
CORPORATE DEBT INSTRUMENTS12667F
GUARANTEED INVESTMENT CONTRACTS56576004F
FieldValueIRS element (for citing)
Total Of Book Value Securities130446837TotalOfBookValueSecurities
Total Revenue183738918TotalRevenue
Total Expenses184923057TotalExpenses
Excess Or Deficit For Year-1184139ExcessOrDeficitForYear
Net Unrealized GL On Investments7504077NetUnrealizedGLOnInvestments
Total Adjustments7504077TotalAdjustments
Excess Or Deficit Per FS6319938ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt191242995TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments7504077NetUnrealizedGainsInvestments
Revenue Not Rptd F9907504077RevenueNotRptdF990
Revenue Subtotal183738918RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990183738918TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt184923057TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal184923057ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990184923057TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 8ACHRYSLER LLC HEALTH CARE BENEFITS PLAN DOES NOT HAVE A GOVERNING BODY AND COMMITTEE WITH AUTHORITY TO ACT ON ITS BEHALF. THE PLAN HAS ONLY AN INSTITUTIONAL TRUSTEE APPOINTED BY THE PLAN AND MEETINGS ARE NOT HELD OR DOCUMENTED.
FORM 990, PART VI, SECTION A, LINE 8BCHRYSLER LLC HEALTH CARE BENEFITS PLAN DOES NOT HAVE A GOVERNING BODY AND COMMITTEE WITH AUTHORITY TO ACT ON ITS BEHALF. THE PLAN HAS ONLY AN INSTITUTIONAL TRUSTEE APPOINTED BY THE PLAN AND MEETINGS ARE NOT HELD OR DOCUMENTED.
FORM 990, PART VI, SECTION B, LINE 11NO REVIEW WAS OR WILL BE CONDUCTED.
NONE OF THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 7,504,077.FORM 990, PART XI, LINE 5:
THERE ARE NO CHANGES TO THE PROCESS OF THE COMMITTEE RESPONSIBLE FOR OVERSEEING THE AUDITED FINANCIAL STATEMENTS.FORM 990, PART XI, LINE 2C:
POLICIES:THE PLAN IS GOVERNED BY A TRUST DOCUMENT. THE PROVISIONS OF THE TRUST CONTROL ITS OPERATIONS AND NONE OF THESE POLICIES ARE DEEMED NECESSARY.FORM 990, PART VI, SECTION:

Schedule R IRS990ScheduleR

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CHRYSLER GROUP LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 CHRYSLER DRIVEAddressLine1
CityAUBURN HILLSCity
StateMIState
ZIP Code483262766ZIPCode
FieldValueIRS element (for citing)
EIN270187394EIN
Primary ActivityAUTOMOTIVEPrimaryActivity
Legal Domicile StateMILegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1CHRYSLER LLCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType
Amount Involved157627347AmountInvolved
Method Of Amt DeterminationCASH RECEIVEDMethodOfAmtDetermination