2013-11-13T11:16:05-06:00 2012-12-31 132688836 ROGOFF & COMPANY PC 355 LEXINGTON AVENUE NEW YORK NY 100176603 990 2012-01-01 133029280 VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN OF CIR VOLU 2123568180 520 EIGHTH AVENUE NEW YORK NY 10018 EARL MATHURIN 2123568180 2013-11-01 1 HARRY WHITE P00646563 2125575666 2012 2016-02-24 21:20:13Z EARL MATHURIN 520 EIGHTH AVENUE NEW YORK NY 10018 37398828 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, SHORT AND LONG-TERM DISABILITY, LIFE INSURANCE, AND OTHERS. 4 4 0 0 0 0 0 0 21964768 22064492 2305637 1917096 0 0 24270405 23981588 0 0 19975298 21444177 0 0 0 0 0 3168164 3998087 23143462 25442264 1126943 -1460676 46288476 45543343 2642749 2920603 43645727 42622740 TO PROVIDE 501(C)(9) BENEFITS TO VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN PARTICIPANTS. BENEFITS INCLUDE MEDICAL, DENTAL, SHORT AND LONG-TERM DISABILITY, LIFE INSURANCE, AND OTHERS. 0 0 TO PROVIDE 501(C)(9) BENEFITS TO VOLUNTARY HOSPITALS HOUSE STAFF BENEFITS PLAN PARTICIPANTS. BENEFITS INCLUDE MEDICAL, DENTAL, SHORT AND LONG-TERM DISABILITY, LIFE INSURANCE, 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 13 0 1 0 0 0 0 0 0 0 0 0 X 4 4 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 1.00 X 0 0 0 RALPH STAULCUP 1.00 X 0 0 0 DENNIS BUCHANAN 1.00 X 0 0 0 MICHAEL PHELAN 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 3203964 HOUSE STAFF BENEFITS PLAN OF CIR 520 EIGTH AVENUE NEW YORK NY 10018 ALLOCATED PR 217964 STEPHEN M PERLITSH 110 WEST 34TH STREET NEW YORK NY 10001 LEGAL 112145 3 EMPLOYER CONTRIBUTIONS 525120 21237233 21237233 PARTICIPANT CONTRIBUTIONS 525120 827259 827259 22064492 1053048 1053048 14281288 13417240 864048 864048 864048 23981588 22064492 0 1917096 21444177 31506 29000 221132 77190 21645 2679 1518 26920 26393 EMPIRE BLUE CROSS 3203964 ALLOCATED PAYROLL EXPEN 223892 ALLOCATED COMMON EXPENS 73513 COMPUTER NETWORK EXPENS 25083 33652 25442264 2371336 1310071 1540503 556779 1547398 1728935 18978 224234 203413 76822 81088 126591 40464246 41336006 264927 260727 46288476 45543343 40885 105475 2601864 2815128 2642749 2920603 X 0 0 0 0 43645727 42622740 43645727 42622740 46288476 45543343 -1460676 437689 0 X 0 1 X 1 0 73664 7366 66298 129749 69456 60293 126591 DUE TO AFILLIATES 96938 PREPAID CONTRIBUTIONS 267190 CLAIMS INCURRED BUT NOT REPORTED 2451000 2815128 24198145 437689 437689 23760456 221132 221132 23981588 25221132 0 25221132 221132 221132 25442264 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 EMAILED 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