2019-11-14T14:55:31-06:00 2018-12-31 132688836 ROGOFF & COMPANY PC 355 LEXINGTON AVENUE 6TH FLOOR NEW YORK NY 100176603 990 2018-01-01 133029280 VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN VOLU 2123568180 10-27 46TH AVENUE LONG ISLAND CITY NY 11101 RHONDA MURRAY PLAN ADMINISTRATOR 2123568180 2019-11-14 1 HARRY WHITE P00646563 2125575666 24.136.113.242 2019-11-14 14:43:47 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 61170FE31941E600C2581A3323EB1F0B1792CA49 2018 2020-03-31 21:24:44Z RHONDA MURRAY 10-27 46TH AVENUE LONG ISLAND CITY NY 11101 49898475 0 X WWW.CIRSEIU.ORG/BENEFITS X 1980 NY TO PROVIDE 501(C)(9) BENEFITS TO VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN PARTICIPANTS. BENEFITS INCLUDE MEDICAL, DENTAL, LEGAL, SHORT AND LONG-TERM DISABILITY, LIFE INSURANCE, TRAINING, EDUCATION AND OTHERS. 4 4 0 0 0 0 0 0 32716021 35370920 1994795 2593738 14131 7551 34724947 37972209 0 0 32563612 35455722 0 0 0 0 0 2583874 2688128 35147486 38143850 -422539 -171641 43914212 42569857 3777222 4291031 40136990 38278826 TO PROVIDE 501(C)(9) BENEFITS TO VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN PARTICIPANTS. BENEFITS INCLUDE MEDICAL, DENTAL, LEGAL,SHORT AND LONG-TERM DISABILITY, LIFE INSURANCE, TRAINING, EDUCATION AND OTHERS. 0 0 TO PROVIDE 501(C)(9) BENEFITS TO VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN PARTICIPANTS. BENEFITS INCLUDE MEDICAL, DENTAL, LEGAL, SHORT AND LONG-TERM DISABILITY, LIFE INSURANCE, TRAINING, EDUCATION AND OTHERS. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 2123568180 10-27 46TH AVENUE LONG ISLAND CITY NY 11101 X ERIC SCHERZER EX TRUSTEE 1.00 X 0 0 0 SELENA GRIFFIN-MAHON TRUSTEE 1.00 X 0 0 0 THOMAS DOHERTY TRUSTEE 1.00 X 0 0 0 JED TYRPAK TRUSTEE 1.00 X 0 0 0 MARGO RIPHAGEN TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 EMPIRE BLUE CROSS 15 METRO TECH CENTER BROOKLYN NY 11201 BENEFIT ADMINISTRATOR 1863366 HOUSE STAFF BENEFITS PLAN OF CIR 520 EIGTH AVENUE NEW YORK NY 10018 ALLOCATED PAYROLL 233506 2 EMPLOYER CONTRIBUTIONS 525100 34569388 34569388 PARTICIPANT CONTRIBUTIONS 525100 801532 801532 35370920 895999 895999 13624005 11926266 1697739 1697739 1697739 OTHER INCOME 524298 7551 7551 7551 37972209 35370920 0 2601289 35455722 17450 31900 168528 85880 27172 10168 2687 9458 24234 EMPIRE BLUE CROSS 1863366 ALLOCATED PAYROLL EXPEN 238516 KEENAN 56178 ALLOCATED COMMON EXPENS 55368 97223 38143850 1124527 1408016 1413992 835781 3537898 3827841 15853 16638 444448 183474 249499 260974 37101220 35119395 471223 1101212 43914212 42569857 71077 158996 3706145 4132035 3777222 4291031 X 0 0 0 0 40136990 38278826 40136990 38278826 43914212 42569857 X -171641 -2873790 1187267 X 0 1 X 1 0 80474 55648 24826 363974 127826 236148 260974 DUE TO AFILLIATES 206535 CLAIMS INCURRED BUT NOT REPORTED 3925500 4132035 34929890 -2873790 -2873790 37803680 168528 168528 37972208 37601552 0 37601552 168528 168528 37770080 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 EMAILED AND PRESENTED TO TRUSTEES PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C WRITTEN STATEMENT FROM OFFICERS, TRUSTEES, AND KEY EMPLOYEES REQUIRED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THERE ARE NO EMPLOYEES FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE DISCLOSED UPON REQUEST FORM 990, PART XI, LINE 9: PRIOR PERIOD ADJUSTMENT TO FUND BALANCE 1,187,267.