Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
BAKERY AND CONFECTIONERY UNION AND
INDUSTRY INTERNATIONAL HEALTH BENEFITS FUND
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
10401 CONNECTICUT AVE
 
Room/suite
City or town, state or country, and ZIP + 4
KENSINGTON, MD208953960
D Employer identification number

53-0227042
E Telephone number

G Gross receipts $ 250,914,163
F Name and address of principal officer:
ROBERT J BERGIN
10401 CONNECTICUT AVENUE
KENSINGTON,MD208953960
I
Tax-exempt status: ( 9 ) LeftBullet (insert no.) or
J
Website:MediumBullet
BCTRUSTFUNDS.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1953
M State of legal domicile: NY
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE FUND OPERATES AS A TRUST TO PROVIDE CERTAIN HEALTH BENEFITS TO LOCAL UNION EMPLOYEES, FUND OFFICE EMPLOYEES AND COVERED EMPLOYEES OF PARTICIPATING EMPLOYERS UNDER COLLECTIVELY BARGAINED AGREEMENTS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 0
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 50
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 39,144,339 38,344,489
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 22,051,817 9,994,622
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 61,196,156 48,339,111
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 38,963,950 39,024,800
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 2,269,135 2,475,483
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 2,889,014 2,526,019
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 44,122,099 44,026,302
19 Revenue less expenses. Subtract line 18 from line 12....... 17,074,057 4,312,809
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 242,065,608 243,373,508
21 Total liabilities (Part X, line 26)............. 3,962,636 2,786,991
22 Net assets or fund balances. Subtract line 21 from line 20..... 238,102,972 240,586,517
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: THE ORGANIZATION IS THE TRUST FOR THE BAKERY AND CONFECTIONERY UNION AND INDUSTRY INTERNATIONAL HEALTH BENEFITS PLAN, A COLLECTIVELY BARGAINED WELFARE BENEFIT PLAN SERVING THE UNION MEMBERS OF THE BAKERY AND CONFECTIONERY INDUSTRY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
FUNDED HEALTH, DISABILITY, AND DEATH BENEFITS FOR MEMBERS, WHICH NUMBERED approximately 22,215 AS OF DECEMBER 31, 2011.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$  
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
.........................
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
 
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
 
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
.........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
4,728
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
50
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
 
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
12
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
 
No
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
 
No
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
 
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
 
 
13
Did the organization have a written whistleblower policy? ...............
13
 
No
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
ROBERT J BERGIN
10401 CONNECTICUT AVE
KENSINGTON,MD208953960
(301) 468-3720
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) FRANK HURT
CHAIRMAN/UNION TRUSTEE
1.0 X   X       0 251,549 11,225
(2) DAVID B DURKEE
UNION TRUSTEE
1.0 X           0 237,065 74,544
(3) STEVEN V BERTELLI
UNION TRUSTEE
1.0 X           0 158,880 62,735
(4) ANTHONY L JOHNSON
UNION TRUSTEE
1.0 X           0 158,867 63,294
(5) ART MONTMINY
UNION TRUSTEE
1.0 X           0 158,165 62,845
(6) ROBERT OAKLEY
UNION TRUSTEE
1.0 X           0 163,160 65,434
(7) RANDY D ROARK
UNION TRUSTEE
1.0 X           0 159,183 62,955
(8) JOSEPH THIBODEAU
UNION TRUSTEE (RESIGNED)
1.0 X           0 214,710 11,559
(9) RICHARD B COOK
SECRETARY/TRUSTEE (RESIGNED)
1.0 X   X       0 0 0
(10) THOMAS G KIRCHNER
EMPLOYER TRUSTEE
1.0 X           0 0 0
(11) LOU MINELLA
SECRETARY/EMPLOYER TRUSTEE
1.0 X   X       0 0 0
(12) JON MCPHERSON
EMPLOYER TRUSTEE
1.0 X           0 0 0
(13) JOHN WAGNER
EMPLOYER TRUSTEE
1.0 X           0 0 0
(14) DAN CRAIG
EMPLOYER TRUSTEE
1.0 X           0 0 0
(15) ROBERT J BERGIN
EXECUTIVE DIRECTOR
8.0     X       44,396 177,584 11,030
(16) STEVEN BROCK
MANAGER OF ADMIN SERVICES
8.0     X       25,003 100,011 48,007
(17) HILTON BRAKE
MANAGER OF INFORMATION TECH
14.0         X   46,921 87,139 62,025
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) MICHAEL KIDD
OPERATIONS & DATA CNTRL SUPER.
14.0         X   40,964 76,076 61,093
























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 157,284 1,942,389 596,746
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
PNC - FINANCIAL SERVICES
TWO HOPKINS PLAZA
BALTIMORE,MD21203
CUSTODIAL SERVICES 290,141
BOND BEEBE
4600 EAST-WEST HWY SUITE 900
BETHESDA,MD208143423
ACCOUNTING SERVICES 223,354
THE SEGAL COMPANY
ONE PARK AVENUE 8TH FLOOR
NEW YORK,NY100165895
ACTUARY SERVICES 244,489
CAPARIO
4415 SOLUTIONS CENTER
CHICAGO,IL606774404
MEDICAL REIMBURSEMNT 191,426
VISION SERVICE PLAN
PO BOX 997100
SACRAMENTO,CA95899
MEDICAL REIMBURSEMNT 112,439
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet5
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 0
 Program Service Revenue Business Code
2a EMPLOYERS CONTRIBUTIONS 525,100 24,745,160 24,745,160    
b PARTICIPANTS COBRA CONTRIBUTIONS 525,100 123,241 123,241    
c RETIREES CONTRIBUTIONS 525,100 13,476,088 13,476,088    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 38,344,489
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 7,897,284     7,897,284
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 204,672,390  
b Less: cost or other basis and sales expenses 202,575,052  
c Gain or (loss) 2,097,338  
d Net gain or (loss)..........MediumBullet 2,097,338     2,097,338
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 48,339,111 38,344,489   9,994,622
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 39,024,800  
5 Compensation of current officers, directors, trustees, and key employees .... 73,811      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 1,379,388      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 598,730      
9 Other employee benefits ....... 307,324      
10 Payroll taxes ........... 116,230      
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 107,229      
c Accounting ........... 223,354      
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 290,141      
g Other .......... 245,259      
12 Advertising and promotion .... 0      
13 Office expenses ....... 575,034      
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 347,802      
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 23,509      
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 272,713      
23 Insurance .............. 36,782      
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL CLAIMS PROCESS/REVIEW 217,086      
b ALLOCATED ADMINISTRATION 149,400      
c MEMBERSHIP FEES 12,515      
d HEALTH CARE AUDITING 7,938      
e
f All other expenses 17,257      
25 Total functional expenses. Add lines 1 through 24f 44,026,302      
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... -377,481 1 219,948
2 Savings and temporary cash investments ....... 7,890,599 2 7,187,053
3 Pledges and grants receivable, net ......... 0 3 0
4 Accounts receivable, net ......... 2,355,964 4 2,401,133
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges ............ 75,799 9 102,835
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 6,980,378
b Less: accumulated depreciation. ..... 10b 6,410,561 551,115 10c 569,817
11 Investments—publicly traded securities .......... 228,944,245 11 231,341,177
12 Investments—other securities. See Part IV, line 11 ...... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 2,625,367 15 1,551,545
16 Total assets. Add lines 1 through 15 (must equal line 34)... 242,065,608 16 243,373,508
Liabilities 17 Accounts payable and accrued expenses . 334,929 17 285,245
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 668,759 19 678,666
20 Tax-exempt bond liabilities .......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 2,958,948 25 1,823,080
26 Total liabilities. Add lines 17 through 25..... 3,962,636 26 2,786,991
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .....   27  
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 0 30 0
31 Paid-in or capital surplus, or land, building or equipment fund ..... 0 31 0
32 Retained earnings, endowment, accumulated income, or other funds 238,102,972 32 240,586,517
33 Total net assets or fund balances ..... 238,102,972 33 240,586,517
34 Total liabilities and net assets/fund balances ..... 242,065,608 34 243,373,508
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
48,339,111
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
44,026,302
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
4,312,809
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
238,102,972
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-1,829,264
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
240,586,517
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
BAKERY AND CONFECTIONERY UNION AND
INDUSTRY INTERNATIONAL HEALTH BENEFITS FUND
Employer identification number

53-0227042
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....        
b Contributions ........        
c Net investment earnings, gains, and losses ...        
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........
       
f Administrative expenses ....        
g End of year balance ......        
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   1,183,508 1,134,827 48,681
d Equipment ................   5,587,397 5,075,763 511,634
e Other .................   209,473 199,971 9,502
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 569,817
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
CASH COLLATERAL OBLIGATION 616,250
NET UNFUNDED PENSION LIABILITY 1,206,830







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,823,080
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 48,339,111
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 44,026,302
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 4,312,809
4 Net unrealized gains (losses) on investments .......................... 4 -1,267,465
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 -561,799
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 -1,829,264
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 2,483,545
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 46,781,505
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -1,267,465
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e -1,267,465
3 Subtract line 2e from line 1..................... 3 48,048,970
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a 290,141
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c 290,141
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 48,339,111
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 43,736,161
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 43,736,161
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a 290,141
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c 290,141
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 44,026,302
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
FIN 48 FOOTNOTE PART X, LINE 2 Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Fund and accrue an income tax liability if the Fund has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has evaluated the income tax positions taken and concluded that as of December 31, 2011, there are no uncertain positions taken or expected to be taken that would require accrual of a liability in the consolidated financial statements. The Fund is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Management believes that the Fund is no longer subject to income tax examinations for years prior to 2008.
OTHER CHANGE IN NET ASSETS RECONCILIATION PART XI, LINE 8 $(561,799) NET PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
BAKERY AND CONFECTIONERY UNION AND
INDUSTRY INTERNATIONAL HEALTH BENEFITS FUND
Employer identification number

53-0227042
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
 
b
Any related organization? .........................
5b
 
 
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
 
b
Any related organization? .........................
6b
 
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
 
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) ROBERT J BERGIN (i)
(ii)
40,730
162,919
 
 
3,666
14,665
0
0
2,206
8,824
46,602
186,408
0
0
(2) FRANK HURT (i)
(ii)
0
210,672
0
0
0
40,877
0
-418
0
11,643
0
262,774
0
0
(3) DAVID B DURKEE (i)
(ii)
0
196,627
0
0
0
40,438
0
63,050
0
11,494
0
311,609
0
0
(4) STEVEN V BERTELLI (i)
(ii)
0
137,638
0
0
0
21,242
0
51,241
0
11,494
0
221,615
0
0
(5) ANTHONY L JOHNSON (i)
(ii)
0
137,638
0
0
0
21,229
0
51,710
0
11,584
0
222,161
0
0
(6) ART MONTMINY (i)
(ii)
0
137,638
0
0
0
20,527
0
51,351
0
11,494
0
221,010
0
0
(7) ROBERT OAKLEY (i)
(ii)
0
142,638
0
0
0
20,522
0
53,940
0
11,494
0
228,594
0
0
(8) RANDY D ROARK (i)
(ii)
0
137,638
0
0
0
21,545
0
51,461
0
11,494
0
222,138
0
0
(9) JOSEPH THIBODEAU (i)
(ii)
0
182,582
0
0
0
32,128
0
-84
0
11,643
0
226,269
0
0
(10) HILTON BRAKE (i)
(ii)
44,671
82,960
 
 
2,250
4,179
14,125
36,869
3,861
7,170
64,907
131,178
0
0
(11) STEVEN BROCK (i)
(ii)
23,743
94,972
 
 
1,260
5,039
10,243
26,734
2,206
8,824
37,452
135,569
0
0
(12) MICHAEL KIDD (i)
(ii)
40,964
76,076
 
 
 
 
13,867
36,195
3,861
7,170
58,692
119,441
0
0




Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
DEFERRED COMPENSATION PART II, COLUMN C THE AMOUNTS IN THIS COLUMN ONLY REPRESENT THE ANNUAL INCREASE (DECREASE) IN ACTUARIAL VALUE OF A QUALIFIED DEFINED BENEFIT PLAN, AS CALCULATED BY THE PLAN ACTUARY.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
BAKERY AND CONFECTIONERY UNION AND
INDUSTRY INTERNATIONAL HEALTH BENEFITS FUND
Employer identification number

53-0227042
Identifier Return Reference Explanation
REVIEW PROCESS OF FORM 990 PART VI, SECTION B, LINE 11B THE BOARD OF TRUSTEES HAS DELEGATED THE RESPONSIBILITY TO REVIEW THE FORM 990 PRIOR TO FILING TO THE MANAGER OF ADMINISTRATIVE SERVICES AND THE EXECUTIVE DIRECTOR.
SELECTION OF TRUSTEES PART VI, SECTION A, LINE 7A THE TRUSTEES ARE APPOINTED BY THE UNION AND EMPLOYERS, WHO PARTICIPATE IN THE HEALTH BENEFIT PLAN. EACH GROUP HAS THE RIGHT TO SELECT UP TO EIGHT TRUSTEES TO SERVE ON THE BOARD.
PUBLIC AVAILABILITY OF GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS PART VI, SECTION C, LINE 19 THE BENEFIT PLAN DOES MAKE ITS PLAN DOCUMENT, TRUST DOCUMENT AND SUMMARY PLAN DESCRIPTION AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
OTHER COMMITTEES PART VI, SECTION A, LINE 8B THE BENEFIT PLAN HAS NO OTHER COMMITTEE THAT CAN ACT ON THE BEHALF OF THE GOVERNING BODY.
MAILING ADDRESSES FOR TRUSTEES DIFFERENT FROM FUND ADDRESS PART VI, SECTION A, LINE 11 LIST OF TRUSTEES THAT ARE REACHED AT AN ADDRESS DIFFERENT FROM THE TRUST: ------------------------------------------------------------------------- Steven V. Bertelli International Vice President, BCTGM International Union PO Box 199, Loami, IL 62661-0199 Anthony L. Johnson International Vice President, BCTGM International Union 8415 King William Street, Cordova, TN 38016 Art Montminy International Vice President, BCTGM International Union PO Box 628, Douglas, MA 01516 Robert Oakley International Vice President, BCTGM International Union 706 Stelwood Road, Philadelphia, PA 19115 Randy D. Roark International Vice President, BCTGM International Union 12506 37th Ave Court, N.W., Gig Harbor, WA 98332 Dan Craig Vice President, Labor & Employee Relations, Bimbo Bakeries USA 3500 Lacey Road, Downers Grove, IL 60515 Thomas G. Kirchner Sr. Director of Labor Relations, Kraft Foods 3 Lakes Drive, Northfield, IL 60093 Jon McPherson Vice President, Labor Relations, Kellogg Company One Kellogg Square, Battle Creek, MI 49017 Lou Minella Vice President, Labor Relations, Bimbo Bakeries USA 255 Business Center Drive, #200, Horsham, PA 19044 John Wagner Vice President of Labor Relations, The Kroger Company 1014 Vine Street, Cincinnati, OH 45202-1100
NONCASH OUTLAYS INCLUDED IN COMPENSATION PART VII, SECTION A, COLUMN E & F $460,284 OF COLUMN F REPRESENT AMOUNTS CALCULATED BY THE PLAN ACTUARY AS TO THE INCREASE IN ACTUARIAL VALUE IN DEFINED BENEFITS. THESE AMOUNTS REPORTED ARE NOT ACTUAL OUTLAYS OF COMPENSATION TO THE OFFICERs AND HIGHLY COMPENSATED EMPLOYEES.
OTHER CHANGE IN NET ASSETS PART XI, LINE 5 $(1,267,465) UNREALIZED LOSSES FROM INVESTMENTS PENSION-RELATED CHANGES OTHER Than Net Periodic Pension $ (561,799) COST ------------ $(1,829,264) ============
CONTRIBUTING EMPLOYER RECEIVABLES AT YEAR-END PART X Contributions receivable outstanding at the plan's year-end from contributing employers represent amounts due for the last month of the fiscal year. These contributions are requirements, as stipulated under terms of written agreements and, approved by the governing board, with the employers that must be remitted to the plan on a timely basis. These amounts constitute receivables that were created in the ordinary course of the plan's business.
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FRANK HURT TITLE:CHAIRMAN/UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID B DURKEE TITLE:UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVEN V BERTELLI TITLE:UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANTHONY L JOHNSON TITLE:UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ART MONTMINY TITLE:UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT OAKLEY TITLE:UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RANDY D ROARK TITLE:UNION TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOSEPH THIBODEAU TITLE:UNION TRUSTEE (RESIGNED) HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD B COOK TITLE:SECRETARY/TRUSTEE (RESIGNED) HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:THOMAS G KIRCHNER TITLE:EMPLOYER TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LOU MINELLA TITLE:SECRETARY/EMPLOYER TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JON MCPHERSON TITLE:EMPLOYER TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN WAGNER TITLE:EMPLOYER TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAN CRAIG TITLE:EMPLOYER TRUSTEE HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT J BERGIN TITLE:EXECUTIVE DIRECTOR HOURS:32
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVEN BROCK TITLE:MANAGER OF ADMIN SERVICES HOURS:32
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HILTON BRAKE TITLE:MANAGER OF INFORMATION TECH HOURS:26
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL KIDD TITLE:OPERATIONS & DATA CNTRL SUPER. HOURS:26
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
BAKERY AND CONFECTIONERY UNION AND
INDUSTRY INTERNATIONAL HEALTH BENEFITS FUND
Employer identification number

53-0227042
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) b&c union & industry intl pension

10401 CONNECTICUT AVE

KENSINGTON,MD20895
52-6118572
PENSION FUND MD 401(A)   NA
 
 
No
(2) BCTGM Local Union 25

3922 Volunteer Drive

Chattanooga,TN37416
labor org TN 501(C)(5)   N/A
 
No
(3) BCTGM Local Union 26

2201 West 52nd Av

Denver,CO80221
84-0621307
LABOR ORG CO 501(C)(5)   N/A
 
No
(4) BCTGM Local Union 50

145 Talmadge Rd Ste 17

Edison,NJ08817
13-4939915
labor org NJ 501(C)(5)   N/A
 
No
(5) BCTGM Local Union 1

7310 39th Street 200

Lyons,IL60534
36-2376965
labor org IL 501(C)(5)   N/A
 
No
(6) BCTGM Local Union 53

41-07 Crescent Street

Long Island City,NY11101
labor org NY 501(C)(5)   N/A
 
No
(7) BCTGM Local Union 3 h&w fund

41-07 Crescent Street

Long Island City,NY11101
11-1782177
BENEFIT PLAN NY 501(C)(9)   N/A
 
No
(8) BCTGM Local Union 4

2615 Winnebago Street

Saint Louis,MO63118
labor org MO 501(C)(5)   N/A
 
No
(9) BCTGM Local Union 6

5416 Rising Sun Ave

Philadelphia,PA19120
23-0381215
labor org PA 501(C)(5)   N/A
 
No
(10) BCTGM Local Union 9

5950 6th Ave S Suite 201

Seattle,WA98108
91-0135325
labor org WA 501(C)(5)   N/A
 
No
(11) BCTGM Local Union 22

312 Central Ave Ste 590

Minneapolis,MN55414
41-0137360
labor org MN 501(C)(5)   N/A
 
No
(12) BCTGM Local Union 36

736 Federal St Ste 1205

Davenport,IA52803
labor org IA 501(C)(5)   N/A
 
No
(13) BCTGM Local Union 42

1030 Dill Ave S W

Atlanta,GA30310
58-0246792
labor org GA 501(C)(5)   N/A
 
No
(14) BCTGM Local Union 57

555 East Rich Street

Columbus,OH43215
31-4353538
labor org OH 501(C)(5)   N/A
 
No
(15) BCTGM Local Union 65

1414 N Memorial Dr

Tulsa,OK74115
labor org OK 501(C)(5)   N/A
 
No
(16) BCTGM Local Union 83

6275 Auto Center Drive

Buena Park,CA90621
labor org CA 501(C)(5)   N/A
 
No
(17) BCTGM Local Union 68

2701 W Patapsco Av

Baltimore,MD21230
52-0392505
labor org MD 501(C)(5)   N/A
 
No
(18) BCTGM Local Union 85

7125 Governors Circle

Sacramento,CA95823
94-0302193
labor org CA 501(C)(5)   N/A
 
No
(19) BCTGM Local Union 102

108-15 Crossbay Blvd

Ozone Park,NY11471
11-6252961
labor org NY 501(C)(5)   N/A
 
No
(20) BCTGM Local Union 103

605 Waltham Avenue

Orlando,FL62809
59-1199426
labor org FL 501(C)(5)   N/A
 
No
(21) BCTGM Local Union 111

1720 Ocala Street

Dallas,TX75218
75-1215844
labor org TX 501(C)(5)   N/A
 
No
(22) BCTGM Local Union 116

66 Genesee Street

Auburn,NY13021
15-0405443
labor org NY 501(C)(5)   N/A
 
No
(23) BCTGM Local Union 118

9602 B Martin L King Hwy

Lanham,MD20706
53-0031270
labor org MD 501(C)(5)   N/A
 
No
(24) BCTGM Local Union 132

431 S Mapleton St

Columbus,IN47201
labor org IN 501(C)(5)   N/A
 
No
(25) BCTGM Local Union 149

3305 DIRECTORS ROW

Memphis,TN38131
62-0122516
labor org TN 501(C)(5)   N/A
 
No
(26) BCTGM Local Union 218

1100 Admiral Blvd 202

Kansas City,MO64106
44-0296689
labor org MO 501(C)(5)   N/A
 
No
(27) BCTGM Local Union 253

5725 Dragon Way Ste 201

Cincinnati,OH45227
31-0707947
labor org OH 501(C)(5)   N/A
 
No
(28) BCTGM Local Union 280

210 N Fulton Ave

Evansville,IN47710
labor org IN 501(C)(5)   N/A
 
No
(29) BCTGM Local Union 300

4376 South Archer Ave

Chicago,IL60632
36-2421118
labor org IL 501(C)(5)   N/A
 
No
(30) BCTGM Local Union 315

8316 Clairemont Mesa Blv Ste 201

San Diego,CA92111
91-6056171
labor org CA 501(C)(5)   N/A
 
No
(31) BCTGM Local Union 326

10501 Allen Rd 206

Allen Park,MI48101
38-0322827
labor org MI 501(C)(5)   N/A
 
No
(32) BCTGM Local Union 334

94 Auburn Street 200

Portland,ME04103
01-0229553
labor org ME 501(C)(5)   N/A
 
No
(33) BCTGM Local Union 348

1 Pleasant St

Framingham,MA01701
04-2609835
labor org MA 501(C)(5)   N/A
 
No
(34) BCTGM Local Union 358

1311 East Nine Mile Road

Highland Springs,VA23075
54-0449879
labor org VA 501(C)(5)   N/A
 
No
(35) BCTGM Local Union 364

2205 North Lombard St

Portland,OR97217
labor org OR 501(C)(5)   N/A
 
No
(36) BCTGM Local Union 372B

6433 E Washington St

Indianapolis,IN46219
labor org IN 501(C)(5)   N/A
 
No
(37) BCTGM Local Union 464

16 W Caracas Av

Hershey,PA17033
23-0592894
labor org PA 501(C)(5)   N/A
 
No
(38) BCTGM Local Union 492

7521 Verree Road

Philadelphia,PA19111
labor org PA 501(C)(5)   N/A
 
No
(39) BCTGM Local Union 503

122 Mentor Street

Summerville,SC29483
labor org SC 501(C)(5)   N/A
 
No
(40) BCTGM Local Union 719

P O Box 1133

Clen Rock,NJ07452
22-1687758
labor org NJ 501(C)(5)   N/A
 
No
(41) BCTGM Local Union 70

158 36th Street SE

Grand Rapids,MI49548
labor org MI 501(C)(5)   N/A
 
No
(42) BCTGM Local Union 36G

225 Louisiana Street

Buffalo,NY14204
labor org NY 501(C)(5)   N/A
 
No
(43) BCTGM Local Union 326 H&W FUND

10501 ALLEN ROAD 206

ALLEN PARK,MI48101
38-6114034
BENEFIT PLAN MN 501(C)(9)   N/A
 
No
(44) BCTGM Local Union 102 H&W FUND

108-15 CROSS BAY BLVD

OZONE PARK,NY11417
11-6252961
BENEFIT PLAN NY 501(C)(9)   N/A
 
No
(45) BCTGM INTERNATIONAL UNION

10401 CONNECTICUT AVENUE

KENSINGTON,MD20895
53-0231138
LABOR ORG MD 501(C)(5)   N/A
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) HOSTESS BRANDS INC
12 East Armour Blvd
Kansas City,MO64111
44-0296705
FOOD PROCESSOR MO  
C CORP      
(2) KRAFT FOODS GLOBAL INC
THREE LAKES DRIVE
NORTHFIELD,IL60093
36-3083135
FOOD PROCESSOR VA  
C CORP      
(3) BIMBO BAKERIES USA INC
255 Stewart Road
Wilkes Barre,PA18706
75-2490530
FOOD PROCESSOR DE  
C CORP      
(4) A B Workers Federal credit union
7521 Verree Road
Philadelphia,PA19111
     
       
(5) Alpha Baking Co Inc
5001 W Polk Street
Chicago,IL60644
     
       
(6) Bays Michigan Corp
P O Box 1455
Chicago,IL60690
     
       
(7) Boehms Candies Inc
255 Northeast Gillman
Issaquah,WA98027
     
       
(8) Lewis Bros Bakeries Inc
855 Scott Street
Murfreesboro,TN37129
     
       
(9) Compass Group
7458 Candlewood Road C
Hanover,MD21076
     
       
(10) Cellone Bakery
P O BOX 16288
Pittsburgh,PA15242
     
       
(11) East Balt Commissary Inc
1801 W 31st Place
Chicago,IL60608
     
       
(12) Fuller Market Basket Inc
P O Box 929
Centralia,WA98531
     
       
(13) Giant Food Inc
P O Box 55888
Boston,MA02205
     
       
(14) Gonnella Baking Co
1117 East Wiley Road
Schaumburg,IL60173
     
       
(15) Haggen Inc
P O Box 9704
Bellingham,WA98227
     
       
(16) Herman Seekamp Inc
1120 W Fullerton Ave
Addison,IL60101
     
       
(17) Automatic Rolls of ne
328 Lake Rd
Dayville,CT06241
     
       
(18) Just Born II
7701 State Road
Philadelphia,PA19136
     
       
(19) Klostermans Baking Co
4760 Paddock Rd
Cincinnati,OH45229
     
       
(20) Kroger Co
P O Box 1648
Hutchinson,KS67504
     
       
(21) Mallet & Co Inc
P O Box 474
Carnegie,PA15106
     
       
(22) Kellogg Co
235 Porter St Bldg 91-4
Battle Creek,MI49014
     
       
(23) New Bakery Co of Ohio
3005 Eastpoint Drive
Zanesville,OH43701
     
       
(24) Nickles Bakery Inc
26 Main Street
Navarre,OH44662
     
       
(25) Olson Food
P O Box 3488
Lynnwood,WA98046
     
       
(26) Ottenbergs Bakery Inc
3330 75th Avenue
Hyattsville,MD20785
     
       
(27) Richmond Baking Co
P O Box 698
Richmond,IN47375
     
       
(28) Safeway Stores Inc
P O Box 52035
Phoenix,AZ85072
     
       
(29) Franz Bakeries Inc
P O Box 24327
Seattle,WA98124
     
       
(30) Svenhards Swedish bakery inc
335 Adeline St
Oakland,CA94607
     
       
(31) Virginia Bakery
1690 Shattuck Ave
Berkeley,CA94709
     
       
(32) Nestle USA
2501 Beich Rd
Bloomington,IL61704
     
       
(33) The Bachman Company
P O Box 15053
Reading,PA19612
     
       
(34) Perfection Bakeries Inc
350 Pearl Street
Fort Wayne,IN46802
     
       
(35) Cohens Bakery Inc
1132-1136 Broadway
Buffalo,NY14212
     
       
(36) The Markets LLC
P O Box 9797
Bellingham,WA98227
     
       
(37) B & G Foods Inc
1 Bean Pot Circle
Portland,ME04103
     
       
(38) Sara Lee Corp
3470 Rider Trail South
Earth City,MO63045
     
       
(39) Beech-Nut Nutrition Corp
100 Hero Drive
Amsterdam,NY12010
     
       
(40) Tom Cat Bakery Inc
43-05 10th St
Long Island City,NY11101
     
       
(41) Ralcorp
P O Box 618
Saint Louis,MO63188
     
       
(42) Zeregas Sons Inc
P O Box 241
Fair Lawn,NJ07410
     
       
(43) Del Monte Corporation
243 Urban Street
Buffalo,NY14211
     
       
(44) Supervalu
2501-1 West Grandview Rd
Phoenix,AZ85023
     
       
(45) automatic rolls of nj
one gourmet lane
edison,NJ08837
     
       
(46) hartford bakery inc
500 n fulton avenue
evansville,IN47710
     
       
(47) linette quality chocolate inc
po box 212
womelsdorf,PA19567
     
       
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
(2)

(3)

(4)

(5)

(6)

Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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