2013-05-06T12:07:00-05:00 2012-12-31 990 2012-01-01 521074154 SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION SPEC 3019841440 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852 KATHRYN DIEM 3019844110 2013-04-23 2012 2016-02-25 16:41:14Z SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION KATHRYN DIEM 11301 OLD GEORGETOWN RD ROCKVILLE MD 20852 260509087 false true X WWW.SAMBAPLANS.COM X 1976 DC TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN FOR ITS MEMBERSHIP. 6 6 73 0 0 261904440 257499146 3446579 3007980 2444 1961 265353463 260509087 6010 221345458 226919529 6439117 6445671 0 0 13845089 19528780 241629664 252899990 23723799 7609097 127930694 140138959 34317330 36202190 93613364 103936769 TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN (THE PLAN) FOR ITS MEMBERSHIP IN ACCORDANCE WITH ERISA. THE SAMBA BENEFIT PLAN INCLUDES HEALTH LIFE SICK ACCIDENT DENTAL VISION AND RELATED COVERAGES. false false SPONSORED HEALTH GROUP TERM LIFE DISABILITY ACCIDENT DENTAL AND VISION BENEFITS FOR APPROXIMATELY 120000 MEMBERS. false false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false false true 18 0 true 73 true false false false false false false X 6 6 false false false false true true false true true false false false true true true false true true false false X JOHN R MARTUCCI 3019844110 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852 WALTER E WILSON 40 X 418642 0 22870 WILLIAM P O'HANLON 4 X X 46000 0 0 DAVID R LOESCH 1 X X 3000 0 0 KATHRYN DIEM 1 X X 3000 0 0 DAVID ERMER 1 X 0 0 0 JOSEPH R DAVIS 1 X 3000 0 0 CHARLENE B THORNTON 1 X 3000 0 0 ANGELA ZENTZ 1 X 0 0 0 PAMELA CUMMINGS 40 X 183434 0 23558 JOHN R MARTUCCI 40 X 159110 0 15265 M TODD SCHOENIAN 40 X 143197 0 14518 MARY K LIVINGSTON 40 X 112774 0 17424 LYNN K CHANG 40 X 111038 0 21208 1186195 114843 6 false true false CGLICIGNA HEALTHCARE 900 COTTAGE GROVE ROAD HARTFORD CT 06152 NETWORK ADMINISTRATOR 6775691 EXPRESS SCRIPTS INC 100 PARSON POND DR FRANKLIN LAKES NJ 07417 PHARMACY BENEFIT MANAGER 5963418 RAM TECHNOLOGIES INC 275 COMMERCE DRIVE SUITE 100 FORT WASHINGTON PA 19034 COMPUTER SOFTWARE SERVICE 921916 MULTIPLAN INC 115 FIFTH AVENUE NEW YORK NY 10003 NETWORK ADMINISTRATOR 688102 EBS MASTER LLC 3055 LEBANON PK NASHVILLE TN 37214 PRINTINGMAILING 617305 17 PREMIUMS 525100 253990137 253990137 ADMINISTRATION FEES 525100 3701598 3701598 EXPERIENCE RATING ADJUSTMENT 525100 -192589 -192589 257499146 1607738 1607738 50286247 48886005 1400242 1400242 1400242 MISCELLANEOUS 524290 1961 1961 1961 260509087 257499146 0 3009941 6010 226919529 880878 3717847 692215 810363 344368 12077513 110898 155048 242847 1565401 1093431 133523 41391 1392763 115814 REINSURANCE EXPENSE 2050428 TAXES - PROPERTY 82998 CLEARINGHOUSE 13391 453334 252899990 0 0 0 500 500 53433442 54387851 19517561 20242721 387827 384871 11828133 8397260 3444680 3430873 50222999 60987717 923685 704426 127930694 140138959 787312 1143126 2427740 934157 31102278 34124907 34317330 36202190 X 93613364 103936769 93613364 103936769 127930694 140138959 X 7609097 1593857 814359 306092 X false true true false 600000 600000 4318590 3885513 433077 6516680 4241457 2275223 392863 270290 122573 3430873 FUNDS IN EXCESS OF RESERVE - FSL 418570 REINSURANCE RECOVERABLE ON PAID CLAIMS 285856 704426 GROUP INSURANCE PREMIUM PAYABLE 2197860 PROVISION FOR POST RETIREMENT 604200 RESERVE IN EXCESS OF FUNDS - ALLIANZ 644488 ACCRUED PENSION LIABILITY 2102400 RESERVE FOR UNPAID CLAIMS 28575959 34124907 X 264124766 1593857 2021822 3615679 260509087 260509087 254921812 2021822 2021822 252899990 252899990 PART X LINE 2 U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE MANAGEMENT OF A PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECORD A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER TAXING AUTHORITIES. MANAGEMENT HAS EVALUATED TAX POSITIONS TAKEN BY THE PLAN AND CONCLUDED THAT AS OF DECEMBER 31 2012 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECETED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS HOWEVER THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY TAX PERIODS. MANAGEMENT BELIEVES THAT THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. PART XI LINE 2D OTHER REVENUE ON AUDITED FINANCIAL STATEMENTS NOT ON RETURN INTERPLAN ALLOCATIONS - 2021822 PART XIILINE 2D OTHER EXPENSES ON AUDDITED FINANCIAL STATEMENTS NOT ON RETURN INTERPLAN ALLOCATIONS - 2021822 X X X false false false WALTER E WILSON 308741 102347 7554 9517 13353 441512 PAMELA CUMMINGS 165434 18000 8736 14822 206992 JOHN R MARTUCCI 153110 6000 6833 8433 174376 M TODD SCHOENIAN 136697 6500 6086 8432 157715 FORM 990 PART VI SECTION A LINE 6 MEMBERSHIP IN THE CORPORATION SHALL BE OPEN TO INDIVIDUALS WHO ARE ACTIVE EMPLOYEES OF A SAMBA ELIGIBLE EMPLOYING AGENCY OR WHO ARE RETIRED FROM A SAMBA ELIGIBLE EMPLOYING AGENCY UNDER ANY ESTABLISHED RETIREMENT PROGRAM. THE TERM SAMBA ELIGIBLE EMPLOYING AGENCY MEANS ANY BRANCH DEPARTMENT OR AGENCY OF THE UNITED STATES GOVERNMENT INCLUDING WITHOUT LIMITATION THE U.S. POSTAL SERVICE AND U.S. COURTS. MEMBERSHIP IN THE CORPORATION SHALL CONSIST OF TWO CLASSES REGULAR MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT REGULAR MEMBERSHIP BY ENROLLING IN THE HEALTH BENEFIT PLAN. REGULAR MEMBERS ALSO MAY ENROLL IN OTHER PLAN PROGRAMS IN ACCORDANCE WITH AND AS PERMITTED BY THE PLAN DOCUMENTS. REGULAR MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF THE HEALTH BENEFIT PLAN COVERAGE. MEMBERSHIP AT THAT TIME WILL CONVERT TO ASSOCIATE MEMBERSHIP IF THE INDIVIDUAL REMAINS ENROLLED IN ANY OTHER PLAN PROGRAM. ASSOCIATE MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT ASSOCIATE MEMBERSHIP BY ENROLLING IN A PLAN PROGRAM OTHER THAN THE HEALTH BENEFIT PLAN IN ACCORDANCE WITH AND AS PERMITTED BY THE PLAN DOCUMENTS. ASSOCIATE MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF PLAN COVERAGE UNLESS THE INDIVIDUAL TRANFERS EMPLOYMENT TO ANOTHER AGENCY IN WHICH CASE HE OR SHE MAY CONTINUE HIS OR HER ENROLLMENT AND ASSOCIATE MEMBERSHIP WHILE SO EMPLOYED. FOR PERSONS WHO DO NOT MEET THE CRITERIA FOR REGULAR OR ASSOCIATE MEMBERSHIP THE BOARD OF DIRECTORS MAY IN ITS DISCRETION DEFINE A SPECIAL CLASS OF MEMBERSHIP BY VIRTUE OF (1) EMPLOYMENT OR SERVICE WITH THE CORPORATION (2) PREVIOUS ENROLLMENT IN A PLAN SPONSORED BY THE CORPORATION OR (3) SECTION 409 OF THE INDIAN HEALTHCARE IMPROVEMENT ACT (IHCIA) AS INCORPORATED AND AMMENDED BY SUBSECTION 10221 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) ALLOWING INDIAN TRIBES OR TRIBAL ORGANIZATIONS OR URBAN INDIAN ORGANIZATIONS AND THEIR EMPLOYEES TO PURCHASE COVERAGE UNDER THE FEDERAL EMPLOYEES HEALTH BENEFIT PROGRAM OR ANY OTHER SUCCESSOR PROGRAM AS SUCH TERMS ARE DEFINED THEREIN. PERSONS ADMITTED AS SPECIAL MEMBERS IN THE CORPORATION SHALL HAVE ALL THE RIGHTS ACCORDED ASSOCIATE MEMBERS AND MAY ENROLL IN A PLAN SPONSORED BY THE CORPORATION IF PERMITTED UNDER APPLICABLE LAW. FORM 990 PART VI SECTION A LINE 7A REGULAR MEMBERS SHALL HAVE THE RIGHT TO VOTE IN THE ELECTION OF DIRECTORS. EXCEPT AS OTHERWISE EXPRESSLY STATED IN THE BYLAWS OR IN THE ARTICLES OF INCORPORATION MEMBERS INCLUDING REGULAR MEMBERS SHALL NOT HAVE THE RIGHT TO VOTE ON ANY OTHER MATTERS AFFECTING THE CORPORATION INCLUDING BUT NOT LIMITED TO MERGER CONSOLIDATION AND DISSOLUTION. FORM 990 PART VI SECTION B LINE 11B THE FORM 990 IS REVIEWED BY BOTH THE CONTROLLER AND THE ORGANIZATION'S OUTSIDE AUDIT FIRM BEFORE IT IS SUBMITTED TO THE TREASURER FOR FINAL REVIEW AND SIGNATURE. FORM 990 PART VI SECTION B LINE 12C OFFICERS DIRECTORS OR TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST INCLUDING BUT NOT LIMITED TO EMPLOYMENT AND ANY WORK PERFORMED FOR ANOTHER ORGANIZATION PAID OR UNPAID. FORM 990 PART VI SECTION B LINE 15A THE BOARD OF DIRECTORS SETS THE COMPENSATION OF THE EXECUTIVE DIRECTOR BASED UPON OUTSIDE RECOMMENDATIONS AND STATISICAL DATA. THE EXECUTIVE DIRECTOR'S COMPENSATION WAS LAST REVIEWED IN JANUARY 2012. FORM 990 PART VI SECTION C LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S BYLAWS ARE AVAILABLE ON ITS WEBSITE FOR ANYONE TO VIEW WITH THE LATEST UPDATE AS OF OCTOBER 1 2012. FORM 990 PART XI LINE 8 PRIOR PERIOD ADJUSTMENT OF 814359 IS A CORRECTION OF A PREVIOUS OVERSTATEMENT OF AN OBLIGATION DUE TO A CARRIER. FORM 990 PART XI LINE 9 OTHER CHANGES TO NET ASSETS OR FUND BALANCE OF 306092 CONSISTS OF THE FOLLOWING INCREMENTAL EFFECT OF FASB 158 332418 CONTIGENCY RESERVE PAYMENT (26326)