2016-11-14T15:45:06-06:00 2015-12-31 132688836 ROGOFF & COMPANY PC 355 LEXINGTON AVENUE NEW YORK NY 100176603 990 2015-01-01 133029280 VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN VOLU 2123568180 520 EIGHTH AVENUE NEW YORK NY 10018 EARL MATHURIN BENEFIT PLAN MANAGER 2123568180 2016-11-03 1 HARRY WHITE P00646563 2125575666 2015 2017-02-10 21:41:12Z EARL MATHURIN 520 EIGHTH AVENUE NEW YORK NY 10018 52971673 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 23822317 25841377 3414038 3489864 0 1021 27236355 29332262 0 0 25339168 29100855 0 0 0 0 0 3362774 2818943 28701942 31919798 -1465587 -2587536 51090318 45913444 3893297 4035094 47197021 41878350 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 14 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 LAURA MCSPEDON 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 TAMARA ROBINSON 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 1737383 HOUSE STAFF BENEFITS PLAN OF CIR 520 EIGTH AVENUE NEW YORK NY 10018 ALLOCATED PAYROLL 595778 2 EMPLOYER CONTRIBUTIONS 525120 24886385 24886385 PARTICIPANT CONTRIBUTIONS 525120 954992 954992 25841377 1002566 1002566 26126709 23639411 2487298 2487298 2487298 OTHER INCOME 525120 1021 1021 1021 29332262 25841377 0 3490885 29100855 25552 31900 214956 342893 24732 3674 5690 22563 27297 EMPIRE BLUE CROSS 1737383 ALLOCATED PAYROLL EXPEN 251394 ALLOCATED COMMON EXPENS 64069 COMPUTER NETWORK EXPENS 38390 28450 31919798 622114 671421 639766 495492 1784270 1529537 16765 212794 155101 80256 57693 47696992 42893640 266920 248896 51090318 45913444 505161 294844 3388136 3740250 3893297 4035094 X 0 0 0 0 47197021 41878350 47197021 41878350 51090318 45913444 -2587536 -2731135 0 X X 0 1 X 1 0 80474 31507 48967 132320 123594 8726 57693 DUE TO AFILLIATES 324111 CLAIMS INCURRED BUT NOT REPORTED 3100500 PREPAID CONTRIBUTIONS 315639 3740250 26386171 -2731135 -2731135 29117306 214956 214956 29332262 31704842 0 31704842 214956 214956 31919798 FORM 990, PART VI, SECTION B, LINE 11 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 XII, LINE 2C: THERE WERE NO CHANGES TO THE OVERSIGHT PROCESS.