2024-11-05T10:24:17-06:00 2023-12-31 320043599 LEGACY PROFESSIONALS LLP 4 WESTBROOK CORPORATE CTR STE 700 WESTCHESTER IL 60154 990 2023-01-01 756232408 UFCW LOCAL 1625 AND EMPLOYERS HEALTH AND WELFARE FUND UFCW 9542666322 2010 NW 150TH AVENUE 200 PEMBROKE PINES FL 33028 EDWARD K CHAMBERS JR CHAIRMAN 9542666322 2024-11-05 1 0 ADAM SIMAGA P01649025 3123680500 2024-11-05 2023 2024-10-15 13:58:12Z EDWARD K CHAMBERS JR 2010 NW 150TH AVENUE 200 PEMBROKE PINES FL 33028 13460975 0 X N/A X 1962 FL PROVIDE HEALTH BENEFITS 6 6 0 0 0 0 0 0 8742755 7676712 27220 161229 0 0 8769975 7837941 0 0 7037261 6858952 0 0 0 0 0 347243 365042 7384504 7223994 1385471 613947 5414517 6107964 0 25000 5414517 6082964 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO FUND PARTICIPANTS. 0 0 0 0 0 0 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 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X NATIONAL EMPLOYEE BENEFIT ADMINISTRATORS 9542666322 2010 NW 150TH AVENUE SUITE 200 PEMBROKE PINES FL 33028 X EDWARD K CHAMBERS JR TRUSTEE 1.00 X 0 0 0 GARY PARODY JR TRUSTEE 1.00 X 0 0 0 WILLIAM R BARRY TRUSTEE 1.00 X 0 0 0 ELIZABETH TROLLER TRUSTEE - ALTERNATE 1.00 X 0 0 0 TRACY SURDYK TRUSTEE 1.00 X 0 0 0 DAVID ARMSTRONG TRUSTEE 1.00 X 0 0 0 JANET CANNON TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 NATIONAL EMPLOYEE BENEFITS ADMINISTRATOR 2010 NW 150TH AVENUE SUITE 200 PEMBROKE PINES FL 33028 THIRD PARTY ADMINISTRATOR 185699 1 EMPLOYER CONTRIBUTIONS 900099 7475960 7475960 PRESCRIPTION DRUG REBATES 900099 197834 197834 PARTICIPANT CONTRIBUTIONS 900099 2918 2918 7676712 134031 134031 5650232 5623034 27198 27198 27198 7837941 7676712 0 161229 6858952 181559 50033 25000 23044 11937 23051 13439 BENEFIT COORDINATOR EXP 34621 PCORI FEES 2358 7223994 1747349 1199868 1508692 1514478 125178 156552 7336 7454 2025962 3229612 5414517 6107964 25000 0 25000 X 0 0 0 0 5414517 6082964 5414517 6082964 5414517 6107964 613947 54500 0 X 0 1 X 1 0 0 X 7892441 54500 54500 7837941 0 7837941 7223994 0 7223994 0 7223994 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THEY HAVE DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO NATIONAL EMPLOYEE BENEFITS ADMINISTRATORS, AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. AFTER THE BOARD'S THOROUGH REVIEW, THE FORM IS APPROVED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES REVIEWS ANNUALLY AND UPDATES AS NECESSARY OR UPON CHANGE IN TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. A & W ELECTRIC CONTRIBUTING EMPLOYER 0 ABBEY REHAB & NURSING CTR CONTRIBUTING EMPLOYER 0 ALPINE HEALTH & REHAB CTR CONTRIBUTING EMPLOYER 0 ALPINE LAUNDRY CONTRIBUTING EMPLOYER 0 AMERICAN FINANCIAL CORP CONTRIBUTING EMPLOYER 0 AUSTEN ELECTRIC INC CONTRIBUTING EMPLOYER 0 BAJA ELECTRIC SERVICES INC CONTRIBUTING EMPLOYER 0 BARTOW CTR CONTRIBUTING EMPLOYER 0 BAY POINTE NURSING PAVILION CONTRIBUTING EMPLOYER 0 BOCA CIEGA CTR CONTRIBUTING EMPLOYER 0 BOCA RATON REHAB CTR CONTRIBUTING EMPLOYER 0 BONDED LIGHTING PRO CONTRIBUTING EMPLOYER 0 BOYD BROTHERS SERVICES INC CONTRIBUTING EMPLOYER 0 CARROLLWOOD CARE CTR CONTRIBUTING EMPLOYER 0 CASA MORA REHAB & EXT CARE CONTRIBUTING EMPLOYER 0 CLEARWATER CTR CONTRIBUTING EMPLOYER 0 CLERMONT HEALTH & REHAB CTR CONTRIBUTING EMPLOYER 0 COGBURN BROTHERS INC CONTRIBUTING EMPLOYER 0 COMMUNITY CONVALESCENT CTR CONTRIBUTING EMPLOYER 0 CONCORDIA MANOR CONTRIBUTING EMPLOYER 0 CONTI LLC CONTRIBUTING EMPLOYER 0 COUNTY WIDE ELECTRIC CONTRIBUTING EMPLOYER 0 DEERFIELD BEACH HEALTH & REHAB CONTRIBUTING EMPLOYER 0 DEERWOOD PLACE CONTRIBUTING EMPLOYER 0 DELANEY HEALTH AND REHAB CONTRIBUTING EMPLOYER 0 DYNALECTRIC COMPANY CONTRIBUTING EMPLOYER 0 EDD HELMS ELECTRICAL CONT CONTRIBUTING EMPLOYER 0 EGRET COVE CTR CONTRIBUTING EMPLOYER 0 EMERALD COAST CTR CONTRIBUTING EMPLOYER 0 ENERGIZE ELECTRICAL CONTRIBUTING EMPLOYER 0 E-TECH ELECTRIC CONTRIBUTING EMPLOYER 0 EVERGREEN WOODS HEALTH & REHAB CONTRIBUTING EMPLOYER 0 FIRST COAST HEALTH & REHAB CTR CONTRIBUTING EMPLOYER 0 FISK ELECTRIC CONTRIBUTING EMPLOYER 0 GULF STATES INC CONTRIBUTING EMPLOYER 0 HEALTHCARE & REHAB OF SANFORD CONTRIBUTING EMPLOYER 0 HIGHLAND PINES REHAB CTR CONTRIBUTING EMPLOYER 0 HILSCHER-CLARKE ELECTRIC INC CONTRIBUTING EMPLOYER 0 JEFF HALL ELECTRIC CONTRIBUTING EMPLOYER 0 KEEGAN ELECTRIC LLC CONTRIBUTING EMPLOYER 0 LAKELAND HILLS CTR CONTRIBUTING EMPLOYER 0 LAR-KEN ELECTRIC INC CONTRIBUTING EMPLOYER 0 MARDANT ELEC CONST CO INC CONTRIBUTING EMPLOYER 0 MASTER VOLT ELECTRIC CORP CONTRIBUTING EMPLOYER 0 MILLER ELECTRIC CONTRIBUTING EMPLOYER 0 NEBA INC (JAX) CONTRIBUTING EMPLOYER 0 NEBA INC (PEMBROKE) CONTRIBUTING EMPLOYER 0 NEBA INC (WPB) CONTRIBUTING EMPLOYER 0 NAUTI ELECTRIC INC CONTRIBUTING EMPLOYER 0 ORLANDO HEALTH & REHAB CTR CONTRIBUTING EMPLOYER 0 PHOENIX ELECTRIC INC CONTRIBUTING EMPLOYER 0 POMPANO HEALTH & REHAB CTR CONTRIBUTING EMPLOYER 0 RAGOLTA JR EDUARDO CONTRIBUTING EMPLOYER 0 REGENTS PARK OF JACKSONVILLE CONTRIBUTING EMPLOYER 0 REGENTS PARK OF SUNRISE CONTRIBUTING EMPLOYER 0 REGENTS PARK OF WINTER PARK CONTRIBUTING EMPLOYER 0 REHAB & HEALTHCARE CTR TAMPA CONTRIBUTING EMPLOYER 0 REHAB & HLTHCARE CTR-C CORAL CONTRIBUTING EMPLOYER 0 REHAB CENTER OF PALM BEACHES CONTRIBUTING EMPLOYER 0 SAN MARCO ELECTRIC CONTRIBUTING EMPLOYER 0 SARASOTA HEALTH & REHAB CTR CONTRIBUTING EMPLOYER 0 SELF-PAY - COBRA CONTRIBUTING EMPLOYER 0 SOUNDELECTRIC LLC CONTRIBUTING EMPLOYER 0 SOUTH HERITAGE HEALTH & REHAB CONTRIBUTING EMPLOYER 0 STRIANO ELECTRIC CO CONTRIBUTING EMPLOYER 0 SUGARMAN & SUSSKIND PA CONTRIBUTING EMPLOYER 0 SUNCOAST POWER LLC CONTRIBUTING EMPLOYER 0 SWANSON'S ELECTRIC CONTRIBUTING EMPLOYER 0 TARPON BAYOU CTR CONTRIBUTING EMPLOYER 0 TECHNICAL MANAGEMENT ASSOC CONTRIBUTING EMPLOYER 0 THE GROVES CENTER CONTRIBUTING EMPLOYER 0 THE OAKS AT AVON PARK CONTRIBUTING EMPLOYER 0 TIRONE ELECTRIC INC CONTRIBUTING EMPLOYER 0 TITUSVILLE REHAB & NURSING CTR CONTRIBUTING EMPLOYER 0 TREASURE ISLE CARE CTR CONTRIBUTING EMPLOYER 0 WESTCHESTER OF SUNRISE CONTRIBUTING EMPLOYER 0 WESTCHESTER OF WINTER PARK CONTRIBUTING EMPLOYER 0 WHISPERING OAKS CONTRIBUTING EMPLOYER 0 WINDSOR WOODS REHAB & HLTHCARE CONTRIBUTING EMPLOYER 0 WINKLER COURT CONTRIBUTING EMPLOYER 0 WINTER HAVEN REHAB CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1