FURP.ORG / PUBLIC DATA EXPLORER

CHRISTIAN REFORMED CHURCH-N AMER VOLUNTARY PARTICIPANT BENE PL TR: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHRISTIAN REFORMED CHURCH-N AMER VOLUNTARY PARTICIPANT BENE PL TR (EIN 38-2425582)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-06
IRS object ID
201302189349300810
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-06T09:41:12-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382425582EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHRISTIAN REFORMED CHURCH-N AMER VOLUNTARY PARTICIPANT BENE PL TRBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHRINameControl
Phone6162240745Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12850 Kalamazoo Ave SEAddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code49560ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameChris CokName
TitleControllerTitle
Phone6162240745Phone
Date Signed2013-08-06DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJohn BoltNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12850 Kalamazoo Ave SEAddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code49560ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12451562GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.crcna.orgWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1982YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionVoluntary employee plan for health, dental, and life insuranceActivityOrMissionDescription
Nbr Voting Members Governing Body30NbrVotingMembersGoverningBody
Nbr Independent Voting Members30NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10531150ProgramServiceRevenuePriorYear
Program Service Revenue CY10851501ProgramServiceRevenueCY
Investment Income Prior Year91154InvestmentIncomePriorYear
Investment Income Current Year89563InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year10622304TotalRevenuePriorYear
Total Revenue Current Year10941064TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year8678922BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY7911623BenefitsPaidToMembersCY
Salaries Etc Prior Year180366SalariesEtcPriorYear
Salaries Etc Current Year190018SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2058476OtherExpensePriorYear
Other Expenses Current Year2049703OtherExpensesCurrentYear
Total Expenses Prior Year10917764TotalExpensesPriorYear
Total Expenses Current Year10151344TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-295460RevenuesLessExpensesPriorYear
Revenues Less Expenses CY789720RevenuesLessExpensesCY
Total Assets BOY2751986TotalAssetsBOY
Total Assets EOY3594640TotalAssetsEOY
Total Liabilities BOY105204TotalLiabilitiesBOY
Total Liabilities EOY185966TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2646782NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3408674NetAssetsOrFundBalancesEOY
Mission DescriptionMutual membership benefits organization. This is a voluntary employee plan for health, dental, and life insuranceMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9806460Expense
Grants0Grants
Revenue10941064Revenue
DescriptionVoluntary benefits including health, dental, and life insurance serving 892 members, their beneficiaries and dependantsDescription
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense9806460TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members30NbrVotingGoverningBodyMembers
Number Independent Voting Members30NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonChris CokNamePerson
Telephone Number6162240745TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12850 Kalamazoo Ave SEAddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code49560ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Mr Mark Charles
CRCNA Trustee00X000
Rev Peter De Vries
CRCNA Trustee00X000
Ms Joan Flikkema
CRCNA Trustee00X000
Dr R Scott Greenway
CRCNA Trustee Exec Committee00X000
Rev Sheila Holmes
CRCNA Trustee Vice-All00X000
Rev Christian Y Oh
CRCNA Trustee00X000
Rev Angela Taylor-Perry
CRCNA Trustee00X000
Rev John Terpstra
CRCNA Trustee President00X000
Rev Gary Van Engelenhoven
CRCNA Trustee00X000
Mr Loren Veldhuizen
CRCNA Trustee00X000
Mr Wybe Bylsma
CRCNA Trustee00X000
Mr Bruce Dykstra
CRCNA Trustee00X000
Rev Dale Melenberg
CRCNA Trustee00X000
Ms Grace Miedema
CRCNA Trustee Exec Committee00X000
Mr Peter Noteboom
CRCNA Trustee00X000
Ms Katherine Vandergrift
CRCNA Trustee Vice President00X000
Rev Trevor Vanderveen
CRCNA Trustee00X000
Rev William C Veenstra
CRCNA Trustee Exec Committee00X000
Rev Kenneth Baker
CRCNA Trustee00X000
Mr Kyu Paek
CRCNA Trustee00X000
Dr Peter Szto
CRCNA Trustee00X000
Dr Steven Timmermans
CRCNA Trustee00X000
Mr Chris Van Spronsen
CRCNA Trustee00X000
Rev Harold de Jong
CRCNA Trustee00X000
Ms Elaine Dee
CRCNA Trustee00X000
Rev Darren Roorda
CRCNA Trustee00X000
Ms Gavy Tran
CRCNA Trustee00X000
Mr Michael Wevers
CRCNA Trustee00X000
Mr Bert Witvoet
CRCNA Trustee00X000
Rev Robert A Lyzenga
CRCNA Trustee00X000
Rev Eleanor M Rietkerk
CRCNA Trustee00X000
Joel Boot
CRCNA Executive Director00000X
John Bolt
CFO6.100228925723X
Michelle DeBie
Benefits Director1800472507104X
Chris Cok
Controller3.40097212288X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs79863TotalReportableCompFrmRltdOrgs
Total Other Compensation15115TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Blue Cross Blue Shield of MichiganBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 4407AddressLine1
CityDetroitCity
StateMIState
ZIP Code48277ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesManage medical health planDescriptionOfServices
Compensation227671Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionParticipant premiumsDescription
Business Code525100BusinessCode
Total Revenue Column10851501TotalRevenueColumn
Related Or Exempt Function Income10851501RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue10851501TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column112276TotalRevenueColumn
Related Or Exempt Function Income112276RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1487785Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1510498Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-22713Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-22713TotalRevenueColumn
Related Or Exempt Function Income-22713RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10941064TotalRevenueColumn
Related Or Exempt Function Income10941064RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total7911623Total
Program Services7911623ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total79863Total
Program Services0ProgramServices
Management And General79863ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total67116Total
Program Services0ProgramServices
Management And General67116ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total11827Total
Program Services0ProgramServices
Management And General11827ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total23878Total
Program Services0ProgramServices
Management And General23878ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7334Total
Program Services0ProgramServices
Management And General7334ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total238924Total
Program Services238924ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3282Total
Program Services0ProgramServices
Management And General3282ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5300Total
Program Services0ProgramServices
Management And General5300ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total13606Total
Program Services0ProgramServices
Management And General13606ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total71616Total
Program Services0ProgramServices
Management And General71616ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total49235Total
Program Services0ProgramServices
Management And General49235ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total11656Total
Program Services0ProgramServices
Management And General11656ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1656084Total
Program Services1655913ProgramServices
Management And General171ManagementAndGeneral
Fundraising0Fundraising

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10151344Total
Program Services9806460ProgramServices
Management And General344884ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY94319BOY
EOY678527EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY131336BOY
EOY409505EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY441499BOY
EOY397034EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2067336BOY
EOY2092959EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY17496BOY
EOY16615EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2751986BOY
EOY3594640EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY54642BOY
EOY47911EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY50562BOY
EOY138055EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY105204BOY
EOY185966EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2646782BOY
EOY3408674EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2646782BOY
EOY3408674EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2751986BOY
EOY3594640EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses789720ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-27828ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview

Accountant Compile Or Review Basis AccountantCompileOrReviewBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
FS Audited0FSAudited
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt10913236TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-27828NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F990-27828RevenueNotRptdF990
Revenue Subtotal10941064RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99010941064TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt10151344TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal10151344ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99010151344TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L02Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationFIN 48 Footnote from financials related to uncertian tax positions: Plan management has analyzed the tax positions taken by the Plan and has concluded that as of December 31, 2012 and 2011 there are no uncertian positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P00_S00_L0CForm 990, Header, Line CExplanation of the relationship between the Benefit Trust (or CGI) and the Christian Reformed Church in North America (or CRCNA). -CGI was created to provide health insurance benefits to the CRCNA agency affiliate employees and member church employees. The CRCNA exists to provide administrative support for the church. The management of CGI consists of a Human Resource Committee (or HRC), and all changes to policies or revisions to the insurance plans are submitted from HRC to the CRCNA Board of Trustees for approval. The CRCNA Board of Trustees is comprised of 30 voting members, none of whom are officers, directors, or employees of CRCNA, and one non-voting member -the executive director of CRCNA. For purposes of the 990 form and any completed schedules, questions in reference to the Governing Body, or Trustees are completed based on the current CRCNA Board of Trustees information. Policy questions referencing officers, directors or employees are completed based on CRCNA policies. Questions referencing the organization, and all financial information are based on CGI policies or information.
F990_P06_S0A_L09Form 990, Part VI, Section A, Line 9Mr. Mark Charles, P.O. Box 2672, Fort Defiance AZ 86504 : Rev. Peter De Vries, 8756 Alta Cove Dr, Sandy UT 84093 : Ms. Joan Flikkema, 1060 Cherrywood Lane NE, Grand Rapids MI 49505 : Rev R.Scott Greenway, (Executive Committee), 9957 Cherry Valley, Caledonia MI 49316 : Rev. Sheila Holmes, (Executive Committee), 167 North 7th St, Paterson NJ 07522 : Rev. Christian Y Oh, 1849 Livernois, Rochester Hills MI 48307 : Rev. Angela Taylor-Perry, 306 Candlewyck Dr, Kalamazoo MI 490001 : Rev. John Terpstra, (Executive Committee), 3221 W Prospect Rd, Fort Collins CO 80526 : Rev. Gary Van Engelenhoven, 702 - 2nd Avenue E, Oskaloosa IA 52577 : Mr. Loren Veldhuizen, 105 18th St NW, Orange City IA 51041 : Mr. Wybe Bylsma, 2606 Cap Wilson Rd, Unit 175, Cobourg ON K9A 4J9 : Mr. Bruce Dykstra, 25 Iron Bridge Ct, Caladonia ON N3W 0A4 : Rev. Dale Melenberg, 4822 - 21 Ave NW, Calgary AB T3B 0W9 : Ms. Grace Miedema, (Executive Committee), 75 Water St, Aylmer ON N5H 1H1 : Mr. Peter Noteboom, 147 Springhurst Ave, Toronto ON M6K 1B9 : Ms. Katherine Vandergrift, (Executive Committee), 937 Alpine Ave, Ottawa ON K2B 5R9 : Rev. Trevor Vanderveen, 2181 East 13th Ave., Vancouver BC V5N 2C6 : Rev. William C Veenstra, (Executive Committee), 9800 McNaught Rd, Chilliwack BC V2P 6G2 : Rev. Kenneth Baker, 6379 Old Log Trail, Kalamazoo MI 49009 : Mr. Kyu Paek, 8208 Peppertree Lane, Cypress CA 84093 : Dr. Peter Szto, 3334 N 125th Ave, Omaha NE 68164 : Dr. Steven Timmermans, 6601 West College Dr, Palos Heights IL 60463 : Mr. Chris Van Spronsen, 3517 Bennet Rd, Saranac MI 48881 : Rev. Harold de Jong, 14 Cegar Lane, Rosslyn ON P7K 0M9 : Ms. Elaine Dee, Unit 3 10171 No1 Rd, Richmond BC V7E 1S1 : Rev. Darren Roorda, 386 Townsend Dr, Breslau ON N0B 1M0 : Ms. Gavy Tran, 13 3087 Immel St, Abbotsford BC V2S 6Z6 : Mr. Michael Wevers, 9320 161 St, Edmonton AB T4R 2L4 : Mr. Bert Witvoet, 73 Highland Ave, St Catharines ON L2R 4H9 : Rev. Robert A. Lyzenga, 1818 Whisper Valley Dr, Lafayette IN 47909 : Rev. Eleanor M. Rietkerk, 15229 12th Dr SE, Mill Creek WA 98012 :
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11b990 completion and review process: The 990 form and all required schedules are completed by the Finance Manager and reviewed by the Controller. The completed forms are then forwarded to the current Finance committee of the CRCNA Board of Trustees prior to being submitted to the IRS. The Finance committee is comprised of the CRCNA CFO, selected board memebers, and financial professionals.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cCompliance to the Conflict of Interest Policy procedure: The September CRCNA Annual Board meeting itinerary includes the distribution of an Orientation Package which includes the Conflict of Interest Policy. Any new Board members are required to complete and sign the included policy compliance package. Any existing members are requested to review the Compliance package and resubmit the Compliance form if any changes have occurred.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Compensation review and approval: All CRCNA compensated employee positions, including any officer and director positions were evaluated by HRC and an outside group to determine position grades or levels. Each grade was then assigned a Pay Scale based on Internal, Individual, and External Equity. These Pay Grades and Pay Scales are annually reviewed by HRC and the revised compensation package is sent to the CRCNA Board of Trustees for ratification.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Public document availability: The CRCNA Governing Documents and Conflict of Interest Policy are available on the CRCNA public website (www.crcna.org), Financial statements are available on request

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Christian Reformed Church in North AmericaBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12850 Kalamazoo Ave SEAddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code49560ZIPCode
FieldValueIRS element (for citing)
EIN382051351EIN
Primary ActivitiesReligousPrimaryActivities
Legal Domicile StateMILegalDomicileState
Exempt Code Section501(c)3ExemptCodeSection
Public Charity Status1PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Christian Reformed Church in North America
n11656Allocation
Christian Reformed Church in North America
o190018Allocation
Christian Reformed Church in North America
p68844Allocations

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationExtention request was filed to allow time for completion of financial statement review by auditorsExplanation