FURP.ORG / PUBLIC DATA EXPLORER

CHRISTIAN REFORMED CHURCH-N AMER VOLUNTARY PARTICIPANT BENE PL TR: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CHRISTIAN REFORMED CHURCH-N AMER VOLUNTARY PARTICIPANT BENE PL TR (EIN 38-2425582)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-10
IRS object ID
201222239349301007
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)
Timestamp2012-08-10T10:24:03-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

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 Signed2012-08-10DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
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 Receipts11619883GrossReceipts
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 Year10395210ProgramServiceRevenuePriorYear
Program Service Revenue CY10531150ProgramServiceRevenueCY
Investment Income Prior Year212418InvestmentIncomePriorYear
Investment Income Current Year91154InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year10607628TotalRevenuePriorYear
Total Revenue Current Year10622304TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year10358900BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY8678922BenefitsPaidToMembersCY
Salaries Etc Prior Year163508SalariesEtcPriorYear
Salaries Etc Current Year180366SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1539014OtherExpensePriorYear
Other Expenses Current Year2058476OtherExpensesCurrentYear
Total Expenses Prior Year12061422TotalExpensesPriorYear
Total Expenses Current Year10917764TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1453794RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-295460RevenuesLessExpensesCY
Total Assets BOY3093479TotalAssetsBOY
Total Assets EOY2751986TotalAssetsEOY
Total Liabilities BOY130349TotalLiabilitiesBOY
Total Liabilities EOY105204TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2963130NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2646782NetAssetsOrFundBalancesEOY
Mission DescriptionMutual membership benefits organization. This is a voluntary employee plan for health, dental, and life insuranceMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense10608837Expense
Revenue10622304Revenue
DescriptionVoluntary employee benefits including health, dental, and life insurance serving 965 members, their beneficiaries and dependentsDescription
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense10608837TotalProgramServiceExpense
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
Transaction Related Entity0TransactionRelatedEntity
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 (44 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Mr Mark Charles
CRCNA Trustee0X000
Rev Peter De Vries
CRCNA Trustee0X000
Ms Joan Flikkema
CRCNA Trustee0X000
Dr R Scott Greenway
CRCNA Trustee Exec Committee0X000
Rev Sheila Holmes
CRCNA Trustee Vice-All0X000
Rev Christian Y Oh
CRCNA Trustee0X000
Rev Angela Taylor-Perry
CRCNA Trustee0X000
Rev John Terpstra
CRCNA Trustee President0X000
Rev Gary Van Engelenhoven
CRCNA Trustee0X000
Mr Loren Veldhuizen
CRCNA Trustee0X000
Mr Wybe Bylsma
CRCNA Trustee0X000
Mr Bruce Dykstra
CRCNA Trustee0X000
Rev Dale Melenberg
CRCNA Trustee0X000
Ms Grace Miedema
CRCNA Trustee Exec Committee0X000
Mr Peter Noteboom
CRCNA Trustee0X000
Ms Katherine Vandergrift
CRCNA Trustee Vice President0X000
Rev Trevor Vanderveen
CRCNA Trustee0X000
Rev William C Veenstra
CRCNA Trustee Exec Committee0X000
Rev Kenneth Baker
CRCNA Trustee0X000
Mr Kyu Paek
CRCNA Trustee0X000
Dr Peter Szto
CRCNA Trustee0X000
Dr Steven Timmermans
CRCNA Trustee0X000
Mr Chris Van Spronsen
CRCNA Trustee0X000
Rev Harold de Jong
CRCNA Trustee0X000
Ms Elaine Dee
CRCNA Trustee0X000
Rev Darren Roorda
CRCNA Trustee0X000
Ms Gavy Tran
CRCNA Trustee0X000
Mr Michael Wevers
CRCNA Trustee0X000
Mr Bert Witvoet
CRCNA Trustee0X000
Rev Bruce Adema
CRCNA Acting Executive Director (outgoing 2011)0X000
Ms Janette Bax
CRCNA Trustee (outgoing in 2011)0X000
Rev Kenneth D Boonstra
CRCNA Trustee Vice President (outgoing 2011)0X000
Ms Gayle Monsma
CRCNA Trustee (outgoing 2011)0X000
Mr Gary VanArragon
CRCNA Trustee Exec Committee (outgoing 2011)0X000
Rev Robert A Lyzenga
CRCNA Trustee Exec Committee (outgoing 2011)0X000
Rev Eleanor M Rietkerk
CRCNA Trustee (outgoing 2011)0X000
Rev John Rop Jr
CRCNA Trustee (outgoing 2011)0X000
Mr Roy Stallworth
CRCNA Trustee (outgoing 2011)0X000
Rev Mark D Vermaire
CRCNA Trustee President (outgoing 2011)0X000
Mrs Irene Bakker
CRCNA Trustee (outgoing 2011)0X000
Joel Boot
CRCNA Executive Director0000X
John Bolt
CFO60226005384X
Michelle DeBie
Benefits Director180463506492X
Chris Cok
Controller3096003109X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs78550TotalReportableCompFrmRltdOrgs
Total Other Compensation14985TotalOtherCompensation
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
Compensation433278Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column10531150TotalRevenueColumn
Related Or Exempt Function Income10531150RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue10531150TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column90579TotalRevenueColumn
Related Or Exempt Function Income90579RelatedOrExemptFunctionIncome
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)
Securities998154Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities997579Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities575Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column575TotalRevenueColumn
Related Or Exempt Function Income575RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10622304TotalRevenueColumn
Related Or Exempt Function Income10622304RelatedOrExemptFunctionIncome
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)
Total8678922Total
Program Services8678922ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total78550Total
Program Services0ProgramServices
Management And General78550ManagementAndGeneral
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)
Total61345Total
Program Services0ProgramServices
Management And General61345ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total12246Total
Program Services0ProgramServices
Management And General12246ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total23462Total
Program Services0ProgramServices
Management And General23462ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4763Total
Program Services0ProgramServices
Management And General4763ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total448195Total
Program Services448195ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5550Total
Program Services0ProgramServices
Management And General5550ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5150Total
Program Services0ProgramServices
Management And General5150ManagementAndGeneral
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)
Total13667Total
Program Services0ProgramServices
Management And General13667ManagementAndGeneral
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)
Total47319Total
Program Services0ProgramServices
Management And General47319ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total44894Total
Program Services0ProgramServices
Management And General44894ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

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

Occupancy Occupancy

FieldValueIRS element (for citing)
Total11875Total
Program Services0ProgramServices
Management And General11875ManagementAndGeneral
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)
Total1481826Total
Program Services1481720ProgramServices
Management And General106ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10917764Total
Program Services10608837ProgramServices
Management And General308927ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY216350BOY
EOY94319EOY

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)
BOY141746BOY
EOY131336EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY288261BOY
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)
BOY402506BOY
EOY441499EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2026997BOY
EOY2067336EOY

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)
BOY17619BOY
EOY17496EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3093479BOY
EOY2751986EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY70026BOY
EOY54642EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY60323BOY
EOY50562EOY

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)
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY130349BOY
EOY105204EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2963130BOY
EOY2646782EOY

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)
BOY2963130BOY
EOY2646782EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3093479BOY
EOY2751986EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-295460ReconcilationRevenueExpenses
Reconcilation Other Changes-20888ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited0FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Total Revenue10622304TotalRevenue
Total Expenses10917764TotalExpenses
Excess Or Deficit For Year-295460ExcessOrDeficitForYear
Net Unrealized GL On Investments-20888NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments-20888TotalAdjustments
Excess Or Deficit Per FS-316348ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt10601416TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-20888NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F990-20888RevenueNotRptdF990
Revenue Subtotal10622304RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99010622304TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt10917764TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal10917764ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99010917764TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

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, 2011 and 2010 there are no uncertian positions taken or expected to be taken that would require recognition of a liabiltiy (or asset) or disclosure in the finacial statements.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 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, (1 position is currently vacant), 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 : Rev. John Rop, Jr., 4732 Zunder, Muskegon MI 49441 : Mr. Roy Stallworth, 3364 Brook Hollow Dr NE, Rockford MI 49341 : Rev. Mark D. Vermaire, 3235 Solar Lane, San Marcos CA 92069 : Mrs Irene Bakker, 71 Ingleborough Dr, Whitby ON L1N 8J4 : Ms. Janette Bax, 4292 Masterson Circle, London ON N6P 1T4 : Rev. Kenneth D. Boonstra, 20943 - 51 Avenue, Langley BC V3A 5C2 : Ms. Gayle Monsma, 1613 Robertson Close SW, Edmonton AB T6W 1K1 : Mr. Gary VanArragon, 30 High Park Drive, Guelph ON N1G 2H7 :
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11b990 Process: The 990 form and all required schedules are completed by the Accountant 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 members, 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 15All CRCNA compensated employee positions, including any Officer and Director positions were evaluated by CAC and an outside group (HayGroup) to determine position grades or levels. Each grade was then assigned an Pay Scale based on Internal, Individual, and External Equity. These Pay Grades and Pay Scales are reviewed by CAC, and the revised compensation package is sent to CRCNA Board of Trustees for ratification.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The CRCNA Governing Documents and Conflict of Interest Policy are available on the CRCNA public website (www.crcna.org), Financial statements are available on request.
F990_P11_S00_L05Form 990, Part XI, Line 5Net unrealized loss on investments

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
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 Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Christian Reformed Church in North America
m11875Allocation
Christian Reformed Church in North America
n180366Allocation

Reasonable Cause Explanation ReasonableCauseExplanation

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