This report is mandatory under P.L. 86-257, as
amended.
Failure to comply may result in criminal
prosecution, fines,
or
civil penalties as provided by 29 U.S.C.
439 or 440.
For Official Use Only
E
PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE
PREPARING THIS
REPORT.
1. LM-30 File Number
U-69841
2. Fiscal Year Covered: from
01/01/2020
through
12/31/2020
3. Amended Report - If this is an amended report,
check here
4. Your Contact Information
Name (first, middle, last)
Raymond Curry
Street address
8000 E. Jefferson Ave,
City
Detroit
State
MI
ZIP
482143963
Email address (optional)
rcurry@uaw.net
5. Labor Organization Identifying Information
Name
AUTO WORKERS AFL-CIO
Street address
8000 E JEFFERSON,
City
DETROIT
State
MI
ZIP
482143963
File number
000-149
Officer
Employee
Your officer position or job title
President
Complete
PART A, B, or C
if, during the past fiscal year, you or your spouse or minor
child
directly or indirectly had a reportable interest in, transaction
or arrangement with, or received income, payment, or benefit from
the entities described below.
PART A - REPRESENTED EMPLOYER.
An employer whose employees your labor organization represents or is
actively seeking to represent.
No information was reported in PART A.
15. Signature and Verification
The undersigned declares, under penalty of perjury
and other
applicable penalties of law, that
all of the information
submitted in this report (including the
information contained in
any accompanying documents)
has been examined by the signatory and
is, to the best of the
undersigned's knowledge and belief, true,
correct and complete.
Signed
Ray Curry
On
May 11, 2022
Telephone Number
313-926-5392
Form LM-30 (Revised 2011)
PART B - BUSINESS.
A business, such as a vendor or service provider, (1)
a substantial
part of which consists of buying from, selling or
leasing to, or
otherwise dealing with
the business of an employer described in
Part A
or (2) any part of
which consists of buying from or selling
or leasing
directly
or indirectly to, or otherwise dealing with
your labor
organization
or with a trust in which your labor
organization is
interested.
8. Name of business
Blue Cross Blue Shield of Michigan
Contact name
MICHELE A. SAMUELS
Telephone
313-225-0020
Street Address
600 E. Lafayette,
City
Detroit
State
MI
ZIP
48226
9. Business deals with
a. Labor Organization
b. Trust
c. Employer
11.a. Nature of dealings
Blue Cross Blue Shield of Michigan (BCBSM) provides insurance and related administrative services to the International Union, UAW for its active staff and clerical employees under the terms of various service agreements ($11,933,969). The International Union, UAW is also the authorized collective bargaining representative to certain BCBSM customer service representatives($410,973).
11.b. Value of dealings
Total dealings are provided in response 11.a. as form will not ac...
12.a. Nature of interest, benefit, arrangement, or income
Compensation for services as a member of the Board of Directors for Blue Cross Blue Shield of Michigan ($62,500) and insurance premiums for a 24-hour group travel AD&D board policy ($42). The full amount of compensation received from BCBSM - less applicable federal, state and local income tax withholdings was donated to several charities exempt under IRC Section 501(c)(3). Charitable contributions included Gleaners of Michigan, Special Olympics M...
12.b. Amount or value of interest, benefit, arrangement, or
income
$62,542
PART C - OTHER EMPLOYER OR LABOR RELATIONS
CONSULTANT.
An employer (other than an employer or business
covered under Parts
A
and B above) from whom a payment would create an
actual or
potential
conflict between your personal financial
interests
and the
interests of
your labor organization (or your duties to your
labor
organization); or
a labor relations consultant to such an
employer
or to the employer
listed in Part A.