2018-11-14T10:57:46-06:00 2017-12-31 132688836 ROGOFF & COMPANY PC 355 LEXINGTON AVENUE 6TH FLOOR NEW YORK NY 100176603 990 2017-01-01 133029280 VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN VOLU 2123568180 520 EIGHTH AVENUE NEW YORK NY 10018 RHONDA MURRAY ASSISTANT BENEFIT PLAN MANAGER 2123568180 2018-11-13 1 HARRY WHITE P00646563 2125575666 24.136.113.242 2018-11-13 08:31:57 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D244D65BEBDE8FEA372D7314011873D6B2A69DFF 2017 2019-02-21 02:37:17Z RHONDA MURRAY 520 EIGHTH AVENUE NEW YORK NY 10018 45136836 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. 6 6 0 0 0 0 0 0 30410772 32716021 2325167 1994795 459 14131 32736398 34724947 0 0 31940460 32563612 0 0 0 0 0 2721759 2583874 34662219 35147486 -1925821 -422539 42202256 43914212 3363177 3777222 38839079 40136990 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 11 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X VOLUNTARY HOSPITALS HOUSE STAFF BENEFIT PLAN 2123568180 520 EIGHTH AVENUE NEW YORK NY 10018 X ERIC SCHERZER TRUSTEE 1.00 X 0 0 0 DENNIS BUCHANAN 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 0 0 0 0 0 0 0 EMPIRE BLUE CROSS 15 METRO TECH CENTER BROOKLYN NY 11201 BENEFIT ADMINISTRATOR 1802294 HOUSE STAFF BENEFITS PLAN OF CIR 520 EIGTH AVENUE NEW YORK NY 10018 ALLOCATED PAYROLL 253223 2 EMPLOYER CONTRIBUTIONS 525100 31821710 31821710 PARTICIPANT CONTRIBUTIONS 525100 894311 894311 32716021 896442 896442 11510242 10411889 1098353 1098353 1098353 OTHER INCOME 524298 14131 14131 14131 34724947 32716021 0 2008926 32563612 17160 31900 167364 51390 16412 8536 2329 9458 23580 EMPIRE BLUE CROSS 1802294 ALLOCATED PAYROLL EXPEN 255551 ALLOCATED COMMON EXPENS 64219 KEENAN 32254 101427 35147486 2333009 1124527 1982663 1413992 2689029 3537898 1253 15853 423516 174017 135326 249499 34475366 37101220 585610 471223 42202256 43914212 246957 71077 3116220 3706145 3363177 3777222 X 0 0 0 0 38839079 40136990 38839079 40136990 42202256 43914212 -422539 1720450 0 X 0 1 X 1 0 80474 47601 32873 343042 126416 216626 249499 DUE TO AFILLIATES 134835 CLAIMS INCURRED BUT NOT REPORTED 3551730 PREPAID CONTRIBUTIONS 19580 3706145 36278033 1720450 1720450 34557583 167364 167364 34724947 34980122 0 34980122 167364 167364 35147486 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