PENNSYLVANIA EMPLOYEES BENEFIT: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PENNSYLVANIA EMPLOYEES BENEFIT (EIN 52-1588740)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-04
IRS object ID
201310359349300201
Schema version
2011v1.2
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)
Timestamp2013-02-04T08:50:55-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN521588740EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PENNSYLVANIA EMPLOYEES BENEFIT TRUST FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPENNNameControl
Phone7175614750Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 SOUTH 43RD STREET SUITE 1AddressLine1
CityHARRISBURGCity
StatePAState
ZIP Code171115700ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert BickfordName
TitleChief Financial OfficerTitle
Phone7175657318Phone
Date Signed2013-02-01DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKathryn FarleyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1150 S 43rd Street Suite 1AddressLine1
CityHarrisburgCity
StatePAState
ZIP Code171115700ZIPCode
FieldValueIRS element (for citing)
Gross Receipts934583150GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitepebtf.orgWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other DescriptionNon-profitTypeOfOrgOtherDescription
Year Formation1988YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTrust for the provision of medical, surgical, hospital and supplemental benefits to employees of the Commonwealth of Pennsylvania as well as other participants.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees146TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year815142623ProgramServiceRevenuePriorYear
Program Service Revenue CY894904809ProgramServiceRevenueCY
Investment Income Prior Year588913InvestmentIncomePriorYear
Investment Income Current Year320463InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year815731536TotalRevenuePriorYear
Total Revenue Current Year895225272TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year833508987BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY878653108BenefitsPaidToMembersCY
Salaries Etc Prior Year4694140SalariesEtcPriorYear
Salaries Etc Current Year4350450SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year42073179OtherExpensePriorYear
Other Expenses Current Year41835715OtherExpensesCurrentYear
Total Expenses Prior Year880276306TotalExpensesPriorYear
Total Expenses Current Year924839273TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-64544770RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-29614001RevenuesLessExpensesCY
Total Assets BOY430262647TotalAssetsBOY
Total Assets EOY427582297TotalAssetsEOY
Total Liabilities BOY84173367TotalLiabilitiesBOY
Total Liabilities EOY111055748TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY346089280NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY316526549NetAssetsOrFundBalancesEOY
Mission DescriptionTrust for the provision of medical, surgical, hospital and supplemental benefits to employees of the Commonwealth of Pennsylvania as well as other participants.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense0Expense
Grants0Grants
Revenue0Revenue
DescriptionTo provide medical, surgical, hospital and supplemental benefits to employoees of the Commonwealth of Pennsylvania as well as other participants. Benefits provided to approximately 77,000 contracts or 185,000 covered lives.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense0TotalProgramServiceExpense
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 Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
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 Required1ScheduleJRequired
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096353NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees146NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
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 Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
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 Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLorraine BarringerNamePerson
Telephone Number7175614750TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1150 S 43rd Street Suite 1AddressLine1
CityHarrisburgCity
StatePAState
ZIP Code171115700ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
David Fillman
Secretary0X000
Richard Caponi
Board Member0X000
Michael Fox
Board Member0X000
Neal Bisno
Board Member0X000
Marc Kornfeld
Board Member0X000
Kathy Jellison
Board Member0X000
Wendell Young IV
Board Member0X000
Dominic Sgro
Board Member0X000
William Einhorn
Board Member0X000
Kelly Powell Logan
Chairman0X000
James A Honchar
Board Member0X000
Matt Waneck
Board Member0X000
David Donley
Board Member0X000
Charlene Couch
Board Member0X000
Ann Spishock
Board Member0X000
Jay Gasdaska
Board Member0X000
Charles Zogby
Board Member0X000
Todd Shamash
Board Member0X000
Kathryn Farley
Exec Director/CEO40250531022647X
Robert Bickford
CFO40140866017772X
Nancy Murphy
Chief Operating Officer40135952015581X
Joseph Sassano
Chief Information Officer40129756017169X
Philip Witters
Associate Executive Director40109477015781X
Gerald Anastasio
Director of Human Resources40110157016229X
Christy Leo
Communications Director40102072015754X
FieldValueIRS element (for citing)
Total Reportable Comp From Org978811TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation120933TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1Address Line2AddressOfContractor/AddressUS/AddressLine2CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
OptumHealth
SDS 12-2834PO Box 86MinneapolisMN554862837Consulting Services348920
Kirschner & Gartrell PC
4910 Massachusetts AveNW Suite 215WashingtonDC20016Legal services314665
Buchanan Ingersoll & Rooney
One Oxford Centre 20th Floor301 Grant StreetPittsburghPA15219Legal Services268529
Aon Consulting
555 East Lancaster Avenue Suite 300PO Box 7300RadnorPA190877300Actuarial services260114
Towers Watson Pennsylvania Inc
1500 Market StreetCentre Square EastPhiladelphiaPA19102Actuarial Services120587
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Employer contributions5242928035774418035774410$0
Participants contributions52429290517336905173360$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column810032TotalRevenueColumn
Related Or Exempt Function Income810032RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue894904809TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column321918TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$321,918ExclusionAmount

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)
Securities39356423Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities39357878Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1455Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1455TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$1,455ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column895225272TotalRevenueColumn
Related Or Exempt Function Income894904809RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$320,463ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total878653108Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total215152Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3048627Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total824242Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total262429Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total289605Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total33079Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total320109Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total712736Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total150182Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total301612Total

Travel Travel

FieldValueIRS element (for citing)
Total14879Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total644093Total

Insurance Insurance

FieldValueIRS element (for citing)
Total106054Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
Retention expense (administraation fees)28418276
Mental health/substance abuse (admin fee)2688927
Disease management7581395
Dues, Subscriptions & licenses565026

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total9742Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total924839273Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY258197388BOY
EOY185542487EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY84937224BOY
EOY86028654EOY

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)
BOY390990BOY
EOY368282EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20137306LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec16314048LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2432608BOY
EOY3823258EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY84304437BOY
EOY151819616EOY

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)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY430262647BOY
EOY427582297EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY18673385BOY
EOY33235748EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY65499982BOY
EOY77820000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY84173367BOY
EOY111055748EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY346089280BOY
EOY316526549EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY346089280BOY
EOY316526549EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY430262647BOY
EOY427582297EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-29614001ReconcilationRevenueExpenses
Reconcilation Other Changes51270ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis364019OtherCostOrOtherBasis
Depreciation353119Depreciation
Book Value10900BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis563503OtherCostOrOtherBasis
Depreciation557829Depreciation
Book Value5674BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis19209784OtherCostOrOtherBasis
Depreciation15403100Depreciation
Book Value3806684BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3823258TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionEstimated health claims incurred but not reportedDescription
Amount$77,820,000Amount
FieldValueIRS element (for citing)
Total Of Amounts77820000TotalOfAmounts
Total Revenue895225272TotalRevenue
Total Expenses924839273TotalExpenses
Excess Or Deficit For Year-29614001ExcessOrDeficitForYear
Net Unrealized GL On Investments51270NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments51270TotalAdjustments
Excess Or Deficit Per FS-29562731ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt895276542TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments51270NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F99051270RevenueNotRptdF990
Revenue Subtotal895225272RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990895225272TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt924839273TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal924839273ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990924839273TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Kathryn Farley
218723000318080120520134600276043000
Robert Bickford
12816000012706071770134600161503000
Nancy Murphy
12103000014922068610111080153921000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSchJ_P01_S00_L01aIdentifier
Return ReferenceSchedule J, Part I, Line 1aReturnReference
ExplanationGross up for CEO Kathryn Farley in the amount of $7,579Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bForm 990 is reviewed by the CFO and an outside accounting firm before being filed with the IRS.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe Conflict of Interest Policy is monitored and enforced as an integral part of the PEBTFCorporate Compliance Program. As such, the Corporate Compliance Officer in conjunction with the Corporate Compliance Committee, has the primary responsibility for the monitoring and enforcement of this policy. In addition, on an annual basis, the Human Resources department requires each employee to sign a Conflict of Interest Statement which provides documentation of any actual or perceived conflict as well as reiterating the PEBTF's Policy regarding Conflict of Interest.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The process of determining compensation of the CEO is a process including the Compensation Committee of the Board of Directors, the Chair of the Finance Committee and the Chairman of the Board. (1) Independent Salary Survey information is provided to the Compensation Committee by the Director of Human Resources. (2) A formal review of the CEO is performed by the Chairman of the Board comparing performance expectation to actual performance for the year. (3) A performance increase is recommended by the Compensation Committee for an appropriate increase taking the Salary Survey information and performance into account. (4) In the event that the CEO's salary falls significantly outside of the Independent Salary Survey range, either on the high or low side, additional information, such as alternative Salary Surveys or additional clarifying information is sought prior to the development of the increase amount. The process of determining compensation for the other officers and key employees of the organization is as follows: (1)Independent Salary Survey information is provided to the CEO by the Director of Human Resources. (2) A formal review of the key officer or key employee is performed by the CEO comparing performance expectation to actual performance for the year. (3) A performance increase is recommended by the CEO for an appropriate increase taking the Salary Survey information and performance into account. (4) In the event that the key officer or key employee's salary falls significantly outside of the Independent Salary Survey range, either on the high or low side, additional information, such as alternative Salary Surveys, comparative job responsibilities or additional clarifying information is sought prior to the development of the increase amount.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19PEBTF's governing documents, conflict of interest policy and Financial Statements are not generally made available to the public. However, if there is a written request for the above information, the request is reviewed by the CEO with assistance from Corporate Counsel and a determination is made and rendered in writing to the requester.
F990_P11_S00_L05Form 990, Part XI, Line 5Net unrealized gain.

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