2013-08-19T13:35:02-07:00 2012-09-30 ANASTASI MOORE & MARTIN PLLC 104 S Division Spokane WA 99202 990 2011-10-01 810305103 Montana Retail Store Employees Health & Welfare Trust MONT 2062824100 201 Queen Anne Avenue North Seattle WA 98109 Nicolai Cocergine 2013-08-19 true Paul J Anastasi CPA 5093230272 2011 2016-02-24 21:20:13Z 8147870 false false X N/A X 1968 MT TO PROVIDE HEALTH AND WELFARE BENEFITS FOR COVERED EMPLOYEES IN ACCORDANCE WITH THE PLAN 6 6 0 0 0 7354597 8086410 94036 61460 0 7448633 8147870 0 7562755 6860394 0 0 0 713164 678038 8275919 7538432 -827286 609438 5176743 6498806 2373837 3017493 2802906 3481313 TO PROVIDE HEALTH AND WELFARE BENEFITS FOR COVERED EMPLOYEES IN ACCORDANCE WITH THE PLAN false false TO PROVIDE HEALTH AND WELFARE BENEFITS FOR COVERED EMPLOYEES IN ACCORDANCE WITH THE PLAN false false false false false false false false false false false false false false true false true false false false false false false false false false false false false false false false false false false false false false false false false false false false false true true true true false false true 0 0 false 0 false false false false false false false false false false false false false false false false X 6 6 false true false false false false false true true false false false true true true true false true false false false false X Zenith American Solutions 2062824100 201 Queen Anne Avenue North Seattle WA 98109 X Sara Thody 1.00 X 0 0 0 Brent Bohn 1.00 X 0 0 0 Nicolai Cocergine 1.00 X 0 0 0 Robert McLauchlin 1.00 X 0 0 0 Stefanie Gusha 1.00 X 0 0 0 Ian M Adams 1.00 X 0 0 0 0 false false false Zenith Adminstrators 201 Queen Anne Avenue North 100 Seattle WA 98109 Contract adminstrati 383531 1 0 LIQUIDATED DAMAGES 445100 1404 1404 EMPLOYER CONTRIBUTIONS 445100 7503519 7503519 EMPLOYEE CONTRIBUTIONS 445100 581487 581487 8086410 59721 59721 0 0 0 1739 1739 1739 1739 0 0 0 0 8147870 8088149 59721 0 0 0 6860394 0 0 0 0 0 0 482046 58175 12353 0 0 1403 61122 0 12542 0 0 0 0 0 18004 0 0 0 4540 cobra expense 1076 Printing and Publications 1957 bank & merchant fees 4728 special report 20092 0 7538432 0 0 0 0 1151732 2069666 0 583915 862373 0 0 0 0 2287 237 0 3438809 3566530 0 0 0 0 5176743 6498806 54837 45493 2319000 2972000 2373837 3017493 X 2802906 3481313 2802906 3481313 5176743 6498806 X 609438 68969 X false true false X false false INCURRED CLAIMS & FUTURE ELIIBLES 2972000 2972000 8147870 7538432 609438 68969 660865 729834 1339272 8215436 68969 68969 8146467 1403 1403 8147870 6876164 6876164 1403 660865 662268 7538432 Part XIII, Line 4b Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S total obligation for benefits 12/31/11 $-2356513 total obigation for benefits 12/31/12 $3017378 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Requests for governing documents, financial statements and other documents will be filled as they come in. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Annual letters are mailed and collected from each trustee. Trust counsel asks for any known issues at each trustee meeting. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process A copy of Form 990 was provided to the board and reviewed by the board before its filing. Form 990, Part VI, Line 3 Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company The plan contracts with a third-party administrator to provide all ministerial and daily administrative duties. Pawn Plus 1625 Old Hardin Rd Billings MT 59101 810513423 pawn shop MT N/A UFCW Local 8 PO Box 2925 Great Falls MT 59403 810187215 Labor union DC N/A false UFCW Local 4 P O Box 567 Butte MT 59703 333333333 labor union MT N/A false Vans Thriftway 306 Euclid Ave Helena MT 59601 841371275 retail grocery MT N/A c corp Safeway 5918 Stoneridge Mall Rd Pleasanton CA 94588 943019135 retail grocery CA N/A c corp Rosauers 1815 W Garland spokane WA 99205 910582615 retail grocery WA URM Stores Inc c corp Vans IGA East Great Falls P O Box 1965 Bozeman MT 597711965 205273305 grocery store MT N/A c corp Gary & Leos IGA 730 1st Street Havre MT 59501 810450061 retail grocery MT N/A c corp Vans of Great Falls 2505 6th Ave N Great falls MT 59401 810460169 retail grocery MT N/A s corp Bob Ward & Sons Inc 3015 Paxson Missoula MT 59801 810227028 retail sporting goods store MT Bob Ward & Sons Inc C corp Albertsons LLC 250 E PArkcenter Blvd West Plaza Boise ID 83706 820184434 retail ID N/A C corp see attached -Sch R response Corp 104 S Division Spokane WA 99208 222222222 various WA N/A Corp false false false false false false false false false false false false false false false false false true Vans Thriftway r 353584 cash Safeway r 2162397 cash Rosauers r 676265 cash Vans IGA East Great Falls r 156729 cash Gary & Leos IGA r 255778 cash Vans of Great Falls r 104208 cash Bob Ward & Sons Inc r 98787 cash Albertsons LLC r 3730961 cash