2017-01-16T00:00:00-06:00 2016-08-31 131578842 BUCHBINDER TUNICK & COMPANY LLP 6720-A ROCKLEDGE DRIVE SUITE 510 BETHESDA MD 20817 990 2015-09-01 222480854 NEW YORK STATE UNITED TEACHERS MEMBER BENEFITS TRUST NEWY 5182136000 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 MARTIN MESSNER TRUSTEE 5182136000 2017-01-17 1 JOHN ZIMMERMAN P01049106 2402001400 2017-01-13 2015 2021-01-29 14:40:06Z MARTIN MESSNER 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 18825987 0 X HTTP://MEMBERBENEFITS.NYSUT.ORG X 1983 NY TO BE FIRST AND FOREMOST IN MINDS OF MEMBERS WHEN IT COMES TO INSURANCE, FINANCIAL, LEGAL AND OTHER SERVICES. THIS WILL OCCUR BY ENDORSING QUALITY PROGRAMS THAT ARE COMPETITIVELY PRICED AND ARE DESIGNED TO PROVIDE FINANCIAL EDUCATION AND SECURITY FOR MEMBERS AND THEIR FAMILIES. X 10 8 0 0 0 0 0 0 37660696 4274190 1616733 1155228 5743943 7217494 45021372 12646912 0 0 5313276 3159575 4199064 3663667 0 0 0 6451222 2488173 15963562 9311415 29057810 3335497 101968721 54828180 32157612 31854358 69811109 22973822 X ENDORSING QUALITY PROGRAMS THAT ARE COMPETITIVELY PRICED AND ARE DESIGNED TO PROVIDE FINANCIAL EDUCATION AND SECURITY FOR MEMBERS AND THEIR FAMILIES. 0 1 NYSUT AND GROUP LEGAL SERVICE PLANPROVIDES LEGAL ASSISTANCE FOR LEGAL MATTERS. FOR THE YEAR ENDING 8/31/16, THERE WERE, ON AVERAGE, 95,425 PARTICIPANTS. VOLUNTARY TERM LIFEPROVIDES TERM LIFE INSURANCE COVERAGE TO MEMBERS AND SPOUSES OR DOMESTIC PARTNERS. FOR THE YEAR ENDING 8/31/16, THERE WERE, ON AVERAGE, 77,825 PARTICIPANTS. GROUP TERM LIFEPROVIDES TERM LIFE INSURANCE COVERAGE TO MEMBERS AND SPOUSES OR DOMESTIC PARTNERS. FOR THE YEAR ENDING 8/31/16, THERE WERE, ON AVERAGE, 59,500 PARTICIPANTS. 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 7 0 1 0 0 0 0 0 0 0 X 10 8 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JACLYN FERRUCCI 5182136000 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 X RODERICK SHERMAN TRUSTEE-SECRETARY 2.00 X X 0 0 0 ROBERT LESNIEWSKI TRUSTEE 2.00 X 0 239287 101563 ARTHUR PEPPER TRUSTEE 2.00 X 0 14871 0 LORETTA DONLON TRUSTEE 2.00 X 0 15171 0 MATTHEW HILL TRUSTEE 2.00 X 0 14871 0 MARTIN MESSNER TRUSTEE-CHAIR 7.00 X X 0 253362 100558 PAUL PECORALE TRUSTEE 2.00 X 0 112063 67946 KEVIN PETERMAN TRUSTEE 2.00 X 0 14871 0 FLORENCE MCCUE TRUSTEE 2.00 X 0 14871 0 THOMAS MCMAHON TRUSTEE 2.00 X 0 0 0 JEFFREY HARTNETT TRUSTEE 2.00 X 0 181401 88767 LYNETTE METZ DIRECTOR OF MEMBER BENEFITS 35.00 X 0 211382 95618 MICHAEL TRAVINSKI ASSOC GENERAL COUNSEL 11.00 X 0 179106 80600 JEFFREY LOCKWOOD DIRECTOR OF FINANCE 2.00 X 0 169477 86571 KATHYRN MAGUIRE ASSISTANT IN MEMBER BENEFITS 35.00 X 0 145617 59770 DEREK CLEMENT ASSISTANT IN MEMBER BENEFITS 35.00 X 0 148870 79194 DONALD COLLIGAN ASSISTANT IN MEMBER BENEFITS 35.00 X 0 145335 60294 0 1860555 820881 0 0 1 1 MERCER CONSUMER 12421 MEREDITH DRIVE URBANDALE IA 50398 CLAIMS PROCESSOR; RECORDKEEPER & INFORMA 475570 HEALTH ADVOCATE INC 3043 WALTON RD STE 150 PLYMOUTH MEETING PA 19462 CONSULTING 338788 STACEY BRAUN ASSOCIATES INC 377 BROADWAY NEW YORK NY 100133934 INVESTMENT ADVISER 222854 BENCHEMARK PRINTING INC PO BOX 1031 SCHENECTADY NY 12301 PRINTING 115887 4 PARTICIPANT CONTRIBS 524292 3658598 3658598 SERVICE FEE 561000 615592 615592 4274190 979193 143810 835383 6355110 6179075 176035 176035 176035 EXP. REIMB./ENDORSEMENT FEES 900099 7589567 7589567 EQUIPMENT RENTAL 532420 2400 2400 NET EARNINGS/(LOSS) OF SUBSIDIARY 900099 -374473 -374473 7217494 12646912 11811529 0 835383 3159575 2305301 828572 349353 180441 73939 49782 160305 89469 690061 60662 732289 388517 31020 20152 14560 66405 ADMINISTRATIVE SERVICE 105858 SECURITY SERVICES 3508 STAFF TRAINING 1387 MISCELLANEOUS 259 9311415 100 100 12995764 11309676 2798969 1874027 50046 19758 1269787 1242468 41879 27319 71703144 25989552 13836823 14815263 541996 792485 101968721 54828180 7727038 8987171 2319799 74700 22110775 22792487 32157612 31854358 X 0 0 0 0 69811109 22973822 69811109 22973822 101968721 54828180 X 3335497 1401315 -51574099 X 0 1 X 0 0 22110775 694212 500 12000 22792487 21306978 815797 12000 22110775 20326772 992206 12000 21306978 19719796 965355 176000 182379 20326772 19306491 539123 125818 19719796 1.00000 0 0 591050 591050 0 287667 287667 0 391070 363751 27319 27319 WELLINGTON TRUST CORE BOND FUND 14815263 F 14815263 PREMIUM STABILIZATION AND OTHER RESERVES 22792487 22792487 PART V, LINE 4: PREMIUM STABILIZATION RESERVES HAVE BEEN ESTABLISHED BY THE TRUST AND INSURANCE PROVIDERS FOR CERTAIN GROUP INSURANCE ARRANGEMENTS. THESE ARRANGEMENTS PROVIDE FOR THE RETURN TO THE NEW YORK STATE UNITED TEACHERS MEMBER BENEFITS TRUST OF A PORTION OF EARNED PREMIUMS WHEN BENEFIT EXPERIENCE IN A POLICY YEAR IS FAVORABLE. THE AMOUNTS RETURNED ARE HELD IN RESERVE BY THE TRUST FOR THE EXCLUSIVE BENEFIT OF THE TRUST'S PARTICIPANTS. THE BENEFIT PROGRAMS WHICH HAVE PREMIUM STABILIZATION RESERVES INCLUDE THE FOLLOWING INSURANCES: TERM LIFE, DISABILITY, GROUP DENTAL AND INDIVIDUAL DENTAL. SOME RESERVES MAY BE USED TO OFFSET PROGRAM LOSSES OR CERTAIN EXPENSES RELATED DIRECTLY TO THAT PROGRAM. OTHER RESERVES HAVE BEEN ESTABLISHED TO SET ASIDE FUNDS EARMARKED FOR SPECIFIC BENEFIT PURPOSES. THOSE BENEFITS INCLUDE HOMEOWNERS INSURANCE AND LEGAL SERVICE PLAN CONFLICT RESOLUTION. 0 0 0 ROBERT LESNIEWSKI TRUSTEE 0 226837 0 0 0 12450 0 61452 0 40111 0 340850 0 0 MARTIN MESSNER TRUSTEE-CHAIR 0 253362 0 0 0 0 0 61093 0 39465 0 353920 0 0 PAUL PECORALE TRUSTEE 0 94063 0 0 0 18000 0 25693 0 42253 0 180009 0 0 JEFFREY HARTNETT TRUSTEE 0 181401 0 0 0 0 0 47164 0 41603 0 270168 0 0 LYNETTE METZ DIRECTOR OF MEMBER BENEFITS 0 211382 0 0 0 0 0 54865 0 40753 0 307000 0 0 MICHAEL TRAVINSKI ASSOC GENERAL COUNSEL 0 179106 0 0 0 0 0 45367 0 35233 0 259706 0 0 JEFFREY LOCKWOOD DIRECTOR OF FINANCE 0 169477 0 0 0 0 0 44979 0 41592 0 256048 0 0 KATHYRN MAGUIRE ASSISTANT IN MEMBER BENEFITS 0 145617 0 0 0 0 0 37225 0 22545 0 205387 0 0 DEREK CLEMENT ASSISTANT IN MEMBER BENEFITS 0 148870 0 0 0 0 0 38565 0 40629 0 228064 0 0 DONALD COLLIGAN ASSISTANT IN MEMBER BENEFITS 0 141963 0 0 0 3372 0 37225 0 23069 0 205629 0 0 PART II, PAUL PECORALE THIS OFFICER IS CURRENTLY UNDER A COMPENSATION ARRANGEMENT WHERE A RELATED ORGANIZATION TO THE FILING ORGANIZATION PAYS SOME OF THIS OFFICER'S COMPENSATION AND AN UNRELATED ORGANIZATION (PATCHOGUE-MEDFORD SCHOOL DISTRICT) PAYS THE REMAINDER OF THE COMPENSATION. FOR 2015, THE AMOUNT PAID TO PAUL PECORALE BY PATCHOGUE-MEDFORD SCHOOL DISTRICT TOTALED $160,473 WHICH INCLUDES WAGES AND RETIREMENT. THE ASSETS AND LIABILITIES THAT RESULTED FROM THE TRUST'S CATASTROPHE MAJOR MEDICAL PLAN. 2015-09-01 51574099 ACTUAL COSTS AND/OR FMV 477358956 NYSUT MEMBER BENEFITS CATASTROPHE MAJOR MEDICAL INSURANCE TRUST 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 501(C)(5) 1 0 0 0 PART II, LINE 2E: PERSON(S) INVOLVED: RODERICK SHERMAN, ARTHUR PEPPER, AND JEFFREY HARTNETT. PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: ALSO TRUSTEES OF NYSUT MEMBER BENEFITS CATASTROPHE MAJOR MEDICAL INSURANCE TRUST. FORM 990, PART III, LINE 3 THE CATASTROPHE MAJOR MEDICAL PLAN (PROGRAM) WAS SPONSORED AND ADMINISTERED BY NEW YORK STATE UNITED TEACHERS MEMBER BENEFITS TRUST (TRUST) PRIOR TO SEPTEMBER 1, 2015. EFFECTIVE SEPTEMBER 1, 2015, THE NEW YORK STATE UNITED TEACHERS (NYSUT) MEMBER BENEFITS CATASTROPHE MAJOR MEDICAL INSURANCE TRUST BECAME THE SOLE PLAN SPONSOR AND PLAN ADMINISTRATOR OF THE PROGRAM. FORM 990, PART VI, SECTION A, LINE 2 NAME RELATIONSHIP ORGANIZATION RODERICK SHERMAN BUSINESS NYSUT MEMBER BENEFITS CORPORATION LYNETTE METZ BUSINESS NYSUT MEMBER BENEFITS CORPORATION ARTHUR PEPPER BUSINESS NYSUT MEMBER BENEFITS CORPORATION ROBERT LESNIEWSKI BUSINESS NYSUT MEMBER BENEFITS CORPORATION PAUL PECORALE BUSINESS NYSUT MEMBER BENEFITS CORPORATION JEFFREY HARTNETT BUSINESS NYSUT MEMBER BENEFITS CORPORATION FORM 990, PART VI, SECTION B, LINE 11 THE FINAL DRAFT OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES AND TRUST EMPLOYEES ARE COVERED UNDER THE POLICY/CODE OF ETHICS, WHICH APPOINTS AN ETHICS COMPLIANCE OFFICER, WHO IS RESPONSIBLE FOR ADMINISTERING, IMPLEMENTING, INTERPRETING AND ENFORCING THE POLICY. EACH TRUSTEE AND TRUST EMPLOYEE MUST SIGN AND SUBMIT WRITTEN ACKNOWLEDGMENT STATING THAT HE OR SHE HAS RECEIVED THE POLICY. IN ADDITION, EACH TRUSTEE SHALL BE REQUIRED TO SUBMIT ANNUALLY AN ETHICS COMPLIANCE FORM. TRUSTEES AND TRUST EMPLOYEES WHO BECOME AWARE OF, OR REASONABLY SHOULD HAVE BECOME AWARE, THAT THEY HAVE A CONFLICT OF INTEREST, HAVE A DUTY NOT ONLY TO DISCLOSE THAT CONFLICT, BUT TO CURE IT (NORMALLY BY PROMPTLY ELIMINATING THE CONFLICT OR REFRAINING FROM TAKING ACTION ON A PARTICULAR TRUST MATTER AS TO WHICH A CONFLICT EXISTS), IF A CURE IS REQUIRED. A CONFLICT OF INTEREST ARISES WHENEVER A TRUSTEE OR TRUST EMPLOYEE HAS AN INTEREST WITH AN INDIVIDUAL OR ORGANIZATION WHICH HAS OR IS SEEKING TO ENTER INTO A TRANSACTION, ARRANGEMENT, OR OTHER RELATIONSHIP WITH THE TRUST, INCLUDING, WITHOUT LIMITATION, AN ENDORSEMENT ARRANGEMENT, OR STANDS TO OBTAIN A BENEFIT THEREFROM. A CONFLICT OF INTEREST MAY ALSO ARISE AS A RESULT OF A PERSONAL OR PROFESSIONAL RELATIONSHIP BETWEEN A TRUSTEE OR TRUST EMPLOYEE AND THIRD PARTIES, COMMONLY REFERRED TO AS A "RELATED-PARTY TRANSACTION." FORM 990, PART VI, SECTION B, LINE 15 THIS ORGANIZATION, AND ALL ITS RELATED ORGANIZATIONS, DETERMINES COMPENSATION OF ALL ITS OFFICERS AND KEY EMPLOYEES ANNUALLY EITHER BY A) COMPLIANCE WITH COLLECTIVE BARGAINING AGREEMENTS FOR INDIVIDUALS COVERED BY THE CBAS OR B) THE BOARD OF DIRECTORS OF THE PARENT ORGANIZATION, NEW YORK STATE UNITED TEACHERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE FORM 5500 FILED WITH THE EMPLOYEE BENEFIT SECURITY ADMINISTRATION (US DEPARTMENT OF LABOR) IS MADE AVAILABLE TO PLAN PARTICIPANTS. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B HOURS FOR RELATED ORGANIZATIONS SOME OF THE OFFICERS AND DIRECTORS LISTED IN PART VII, SECTION A, LINE 1A ALSO SERVE IN SIMILAR ROLES FOR RELATED ORGANIZATIONS. THE HOURS LISTED IN PART VII COLUMN B REFLECT THE AVERAGE HOURS PER WEEK FOR THIS ORGANIZATION ONLY. THE HOURS WORKED FOR RELATED ORGANIZATIONS ARE REFLECTED ON THE RESPECTIVE ORGANIZATIONS' FORM 990. CERTAIN KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A, LINE 1A ALSO PERFORM WORK IN VARYING CAPACITIES FOR RELATED ORGANIZATIONS. THE TOTAL HOURS THAT THESE EMPLOYEES WORK ON AVERAGE IS BETWEEN 35 AND 40 HOURS PER WEEK FOR THIS AND RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS AVAILABLE FOR BENEFITS TO NYSUT MB CMM INS TRUST -51,574,099. NEW YORK STATE UNITED TEACHERS 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 LABOR ORGANIZATION NY 501(C)(5) N/A 0 NYSUT BUILDING CORPORATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141700200 BUILDING CORPORATION NY 501(C)(2) N/A 0 NYSUT RETIREE VEBA HEALTH FUND 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 146204878 BENEFIT PLAN NY 501(C)(9) N/A 0 VOICE OF TEACHERS FOR EDUCATIONCOMMITTEE ON POLICAL EDUCATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141565672 POLICAL ACTION COMMITTEE NY 527 N/A 0 NYSUT EMPLOYEES RETIREMENT PLAN 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE BENEFIT PLAN NY 501(A) N/A 0 NYSUT STAFF 401(K) PLAN 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE ELECTIVE BENEFIT PLAN NY 501(A) N/A 0 NYSUT EDUCATION AND LEARNING TRUST 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 166460576 OFFERS COURSES TO PROMOTE EFFECTIVE TEACHING NY 501(C)(3) 170(B)(1)(A)(II) N/A 0 NYSUT DISASTER RELIEF AND SCHOLARSHIP TRUST 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 113761261 PROVIDES DISASTER RELIEF AND SCHOLARSHIPS NY 501(C)(3) 170(B)(1)(A)(IV) N/A 0 MARY MULDOON FUND 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 146030191 PRIVATE FOUNDATION NY 501(C)(3) PF N/A 0 NYSUT PLAN FOR FORMER EMPLOYEES OF NEA NY PLAN #006 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE BENEFIT PLAN NY 501(A) N/A 0 NEW YORKERS FOR A BRIGHTER FUTURE 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 273442678 POLICAL ACTION COMMITTEE NY 527 N/A 0 VOICE OF TEACHERS FOR EDUCATIONCOMMITTEE ON POLICAL EDUCATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 264047272 POLICAL ACTION COMMITTEE NY 527 N/A 0 NYSUT MEMBER BENEFITS CORPORATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 263989358 MEMBER PROGRAM DISCOUNTS NY N/A C -374473 809892 1.00000 1 1 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 NYSUT MEMBER BENEFITS CORPORATION A 143810 ACTUAL COSTS AND/OR FMV NYSUT MEMBER BENEFITS CORPORATION Q 220000 ACTUAL COSTS AND/OR FMV NYSUT MEMBER BENEFITS CORPORATION P 1732011 ACTUAL COSTS AND/OR FMV NYSUT MEMBER BENEFITS CORPORATION D 7230292 ACTUAL COSTS AND/OR FMV