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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
U F C W UNIONS & EMPLOYERS MIDWEST
HEALTH BENEFITS FUND
Employer identification number

36-2440523
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY SEPARATE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL BEFORE IT IS SIGNED AND FILED.
FORM 990, PART VI, SECTION B, LINE 15A SALARIES ARE ANNUALLY REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE FUND OFFICE.
FORM 990, PART VII, SECTION A IN JUNE 2014, ROBERT NIKSA WAS HIRED AS THE FULL TIME ADMINISTRATOR AND DANIEL RYAN WAS NAMED AS THE ASSISTANT ADMINISTRATOR. THE COMPENSATION REPORTED IN PART VII, AS DEFINED BY THE INSTRUCTIONS, IS THE CALENDAR YEAR 2014 COMPENSATION WHICH IS THE CALENDAR YEAR WHICH ENDED DURING THE PLAN'S FISCAL YEAR ENDED NOVEMBER 30, 2015.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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