SPECIAL AGENTS MUTUAL BENEFIT: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SPECIAL AGENTS MUTUAL BENEFIT (EIN 52-1074154)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-05-04
- IRS object ID
- 201231259349300103
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-04T08:56:00-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521074154 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION | BusinessNameLine1 |
| Business Name Line2 | SAMBA FEDERAL EMPLOYEE BENEFIT ASSOCIATION | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SPEC | NameControl |
| Phone | 3019841440 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11301 OLD GEORGETOWN ROAD | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20852 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KATHRYN DIEM | Name |
| Title | TREASURER | Title |
| Phone | 3019841440 | Phone |
| Date Signed | 2012-05-02 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KATHRYN DIEM | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11301 OLD GEORGETOWN ROAD | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20852 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 265353463 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.SAMBAPLANS.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1976 | YearFormation |
| State Legal Domicile | DC | StateLegalDomicile |
| Activity Or Mission Description | TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN FOR ITS MEMBERSHIP. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 77 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 239025348 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 261904440 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4387563 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3446579 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 287897 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2444 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 243700808 | TotalRevenuePriorYear |
| Total Revenue Current Year | 265353463 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 218089286 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 221345458 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5566506 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6439117 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 12732988 | OtherExpensePriorYear |
| Other Expenses Current Year | 13845089 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 236388780 | TotalExpensesPriorYear |
| Total Expenses Current Year | 241629664 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7312028 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 23723799 | RevenuesLessExpensesCY |
| Total Assets BOY | 104309394 | TotalAssetsBOY |
| Total Assets EOY | 127930694 | TotalAssetsEOY |
| Total Liabilities BOY | 33451313 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 34317330 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 70858081 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 93613364 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN (THE PLAN) FOR ITS MEMBERSHIP IN ACCORDANCE WITH ERISA. THE SAMBA BENEFIT PLAN INCLUDES HEALTH LIFE SICK ACCIDENT DENTAL VISION AND RELATED COVERAGES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Activity Code | 525100 | ActivityCode |
| Description | SPONSORED HEALTH GROUP TERM LIFE DISABILITY ACCIDENT DENTAL AND VISION BENEFITS FOR APPROXIMATELTY 120000 MEMBERS. | Description |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 19 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 77 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN R MARTUCCI | NamePerson |
| Telephone Number | 3019844110 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11301 OLD GEORGETOWN ROAD | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20852 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| WALTER E WILSON | ||||||||
| EXECUTIVE DIRECTOR | 40 | X | 388447 | 0 | 17025 | |||
| WILLIAM P O'HANLON | ||||||||
| PRESIDENTBOARD MEMBER | 4 | X | 46000 | 0 | 0 | X | ||
| DAVID R LOESCH | ||||||||
| VICE PRESIDENTBOARD MEMBER | 1 | X | 2000 | 0 | 0 | X | ||
| KATHRYN DIEM | ||||||||
| TREASURERBOARD MEMBER | 1 | X | 2000 | 0 | 0 | X | ||
| DAVID ERMER | ||||||||
| SECRETARY | 1 | X | 0 | 0 | 0 | |||
| JOSEPH R DAVIS | ||||||||
| BOARD MEMBER | 1 | 2000 | 0 | 0 | X | |||
| CHARLENE B THORNTON | ||||||||
| BOARD MEMBER | 1 | 2000 | 0 | 0 | X | |||
| ANGELA ZENTZ | ||||||||
| BOARD MEMBER | 1 | 0 | 0 | 0 | X | |||
| PAMELA CUMMINGS | ||||||||
| DEPUTY EXECUTIVE DIRECTOR | 40 | 170823 | 0 | 16376 | X | |||
| JOHN R MARTUCCI | ||||||||
| CONTROLLER | 40 | 150648 | 0 | 8876 | X | |||
| M TODD SCHOENIAN | ||||||||
| SENIOR PROGRAM ADMINISTRATOR | 40 | 131959 | 0 | 11513 | X | |||
| MARY K LIVINGSTON | ||||||||
| MANAGER HEALTH PLANS | 40 | 105061 | 0 | 14040 | X | |||
| LYNN K CHANG | ||||||||
| MANAGER IT | 40 | 101372 | 0 | 16035 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1102310 | TotalReportableCompFromOrg |
| Total Other Compensation | 83865 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CGLICIGNA HEALTHCARE | |||||
| 900 COTTAGE GROVE ROAD | HARTFORD | CT | 06152 | NETWORK ADMINISTRATOR | 6769285 |
| MEDCO HEALTH SOLUTIONS | |||||
| 100 PARSON POND DR | FRANKLIN LAKES | NJ | 07417 | PRESCRIPTION BENEFIT MANAGER | 649120 |
| EMDEON BUSINESS SERVICES LLC | |||||
| 3055 LEBANON PK | NASHVILLE | TN | 37214 | PRINTINGMAILING | 627596 |
| MULTIPLAN INC | |||||
| 115 FIFTH AVENUE | NEW YORK | NY | 10003 | NETWORK ADMINISTRATOR | 470289 |
| AETNA US HEALTHCARE | |||||
| 151 FARMINGTON AVENUE | HARTFORD | CT | 06156 | NETWORK ADMINISTRATOR | 439174 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PREMIUMS | 525100 | 251034686 | 251034686 |
| ADMINISTRATION FESS | 525100 | 3356348 | 3356348 |
| CONTINGENCY RESERVE TRANSFER | 525100 | 7100333 | 7100333 |
| EXPERIENCE RATING ADJUSTMENT | 525100 | 413073 | 413073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 261904440 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1624748 | TotalRevenueColumn |
| Exclusion | $1,624,748 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 39600951 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 37779120 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1821831 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1821831 | TotalRevenueColumn |
| Exclusion | $1,821,831 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Business Code | 524290 | BusinessCode |
| Total Revenue Column | 2444 | TotalRevenueColumn |
| Exclusion | $2,444 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2444 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 265353463 | TotalRevenueColumn |
| Related Or Exempt Function Income | 261904440 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $3,449,023 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221345458 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 806195 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3673670 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 979010 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 641816 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338426 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6432302 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65918 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161174 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189708 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1599367 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1136515 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154351 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17518 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6010 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1015239 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134933 | Total |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| CLEARINGHOUSE EXPENSE | 13057 |
| FASB 158 EFFECT | 750900 |
| REINSURANCE EXPENSE | 1828097 |
| TAXES - PROPERTY | 84084 |
| MISCELLANEOUS | 255916 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241629664 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500 | BOY |
| EOY | 500 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31932282 | BOY |
| EOY | 53433442 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18662534 | BOY |
| EOY | 19517561 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 397208 | BOY |
| EOY | 387827 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10713707 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7269027 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3686001 | BOY |
| EOY | 3444680 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48907202 | BOY |
| EOY | 50222999 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 723667 | BOY |
| EOY | 923685 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104309394 | BOY |
| EOY | 127930694 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 753575 | BOY |
| EOY | 787312 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1974747 | BOY |
| EOY | 2427740 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30722991 | BOY |
| EOY | 31102278 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33451313 | BOY |
| EOY | 34317330 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70858081 | BOY |
| EOY | 93613364 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70858081 | BOY |
| EOY | 93613364 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104309394 | BOY |
| EOY | 127930694 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 23723799 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -968516 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 600000 | OtherCostOrOtherBasis |
| Book Value | 600000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4301095 | OtherCostOrOtherBasis |
| Depreciation | 3668914 | Depreciation |
| Book Value | 632181 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5531275 | OtherCostOrOtherBasis |
| Depreciation | 3410494 | Depreciation |
| Book Value | 2120781 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 281337 | OtherCostOrOtherBasis |
| Depreciation | 189619 | Depreciation |
| Book Value | 91718 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3444680 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| FUNDS IN EXCESS OF RESERVE - FSL | 538760 |
| REINSURANCE RECOVERABLE ON PAID CLAIMS | 384925 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 923685 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| GROUP INSURANCE PREMIUM PAYABLE | $760,299 |
| PROVISION FOR POST RETIREMENT | $769,155 |
| RESERVE IN EXCESS OF FUNDS - ALLIANZ | $622,705 |
| ACCRUED PENSION LIABILITY | $1,865,818 |
| RESERVE FOR UNPAID CLAIMS | $27,084,301 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 31102278 | TotalOfAmounts |
| Total Revenue | 265353463 | TotalRevenue |
| Total Expenses | 241629664 | TotalExpenses |
| Excess Or Deficit For Year | 23723799 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -968516 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -968516 | TotalAdjustments |
| Excess Or Deficit Per FS | 22755283 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 266514297 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -968516 | NetUnrealizedGainsInvestments |
| Other Revenues | 2129350 | OtherRevenues |
| Revenue Not Rptd F990 | 1160834 | RevenueNotRptdF990 |
| Revenue Subtotal | 265353463 | RevenueSubtotal |
| Total Revenue Per Form990 | 265353463 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 243759014 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 2129350 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 2129350 | ExpensesNotRptdF990 |
| Expenses Subtotal | 241629664 | ExpensesSubtotal |
| Total Expenses Per Form990 | 241629664 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART X LINE 2 US GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE MANAGEMENT OF A PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECORD A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER TAXING AUTHORITIES. MANAGEMENT HAS EVALUATED TAX POSITIONSTAKEN BY THE PLAN AND CONCLUDED THAT AS OF DECEMBER 31 2011 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS HOWEVER THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY TAX PERIODS. MANAGEMENT BELIEVES THAT THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2008. PART XII LINE 2D. OTHER REVENUE ON AUDITED FINANCIAL STATEMENTS NOT ON RETURN INTERPLAN ALLOCATIONS - 2129350 PART XIII LINE 2D. OTHER EXPENSES ON AUDITED FINANCIAL STATEMENTS NOT ON RETURN INTERPLAN ALLOCATIONS - 2129350 | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|
| WALTER E WILSON | |||||
| 289475 | 92672 | 6300 | 4381 | 12644 | 405472 |
| PAMELA CUMMINGS | |||||
| 155823 | 15000 | 2357 | 14019 | 187199 | |
| JOHN R MARTUCCI | |||||
| 144648 | 6000 | 2176 | 6700 | 159524 | |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | FORM 990 PART VI SECTION A LINE 6 MEMBERSHIP IN THE CORPORATION SHALL BE OPEN TO INDIVIDUALS WHO ARE ACTIVE EMPLOYEES OF A SAMBA ELIGIBLE EMPLOYING AGENCY OR WHO ARE RETIRED FROM A SAMBA ELIGIBLE EMPLOYING AGENCY UNDER ANY ESTABLISHED RETIREMENT PROGRAM. THE TERM SAMBA ELIGIBLE EMPLOYING AGENCY MEANS ANY BRANCH DEPARTMENT OR AGENCY OF THE UNITED STATES GOVERNMENT INCLUDING WITHOUT LIMITAION THE U.S. POSTAL SERVICE AND U.S. COURTS. MEMBERSHIP IN THE CORPORATION SHALL CONSIST OF TWO CLASSES REGULAR MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT REGULAR MEMBERSHIP BY ENROLLING IN THE HEALTH BENEFIT PLAN. REGULAR MEMBERS ALSO MAY ENROLL IN OTHER PLAN PROGRAMS IN ACCORDANCE WITH AND AS PERMITTED BY THE PLAN DOCUMENTS. REGULAR MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF THE HEALTH BENEFIT PLAN COVERAGE. MEMBERSHIP AT THAT TIME WILL CONVERT TO ASSOCIATE MEMBERSHIP IF THE INDIVIDUAL REMAINS ENROLLED IN ANY OTHER PLAN PROGRAM. ASSOCIATE MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT ASSOCIATE MEMBERSHIP BY ENROLLING IN A PLAN PROGRAM OTHER THAN THE HEALTH BENEFIT PLAN IN ACCORDANCE WITH AND AS PERMITTED BY THE PLAN DOCUMENTS. ASSOCIATE MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF PLAN COVERAGE UNLESS THE INDIVIDUAL TRANSFERS EMPLOYMENT TO ANOTHER AGENCY IN WHICH CASE HE OR SHE MAY CONTINUE HIS OR HER ENROLLMENT AND ASSOCIATE MEMBERSHIP WHILE SO EMPLOYED. FORM 990 PART VI SECTION A LINE 7A REGULAR MEMBERS SHALL HAVE THE RIGHT TO VOTE IN AN ELECTION OF DIRECTORS. EXCEPT AS OTHERWISE EXPRESSLY STATED IN THE BYLAWS OR IN THE ARTICLES OF INCORPORATION MEMBERS INCLUDING REGULAR MEMBERS SHALL NOT HAVE THE RIGHT TO VOTE ON ANY OTHER MATTERS AFFECTING THE CORPORATION INCLUDING BUT NOT LIMITED TO MERGER CONSOLIDATION OR DISSOLUTION. FORM 990 PART VI SECTION B LINE 11B THE FORM 990 IS REVIEWED BY BOTH THE CONTROLLER AND THE ORGANIZATION'S OUTSIDE AUDIT FIRM BEFORE IT IS SUBMITTED TO THE TREASURER FOR FINAL REVIEW AND SIGNATURE. FORM 990 PART VI SECTION B LINE 12C OFFICERS DIRECTORS OR TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST INCLUDING BUT NOT LIMITED TO EMPLOYMENT AND ANY WORK PERFORMED FOR ANOTHER ORGANIZATION PAID OR UNPAID. FORM 990 PART VI SECTION B LINE 15A THE BOARD OF DIRECTORS SETS THE COMPENSATION OF THE EXECUTIVE DIRECTOR BASED UPON OUTSIDERECOMMENDATIONS AND STATISTICAL DATA. THE EXECUTIVE DIRECTOR'S COMPENSATION WAS LAST REVIEWED IN JANUARY OF 2008. FORM 990 PART VI SECTION C LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S BYLAWS ARE AVAILABLE ON ITS WEBSITE TO ANYONE TO VIEW WITH THE LATEST UPDATE AS OF SEPTEMBER 1 2011. FORM 990 PART XI LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCE OF (968516) IS AN UNREALIZED LOSS ON INVESTMENTS. | Explanation |
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