2012-05-04T08:56:00-05:00 2011-12-31 990 2011-01-01 521074154 SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION SAMBA FEDERAL EMPLOYEE BENEFIT ASSOCIATION SPEC 3019841440 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852 KATHRYN DIEM 3019841440 2012-05-02 2011 2016-02-24 21:20:13Z SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION KATHRYN DIEM 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852 265353463 false X WWW.SAMBAPLANS.COM X 1976 DC TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN FOR ITS MEMBERSHIP. 6 6 77 0 0 239025348 261904440 4387563 3446579 287897 2444 243700808 265353463 0 218089286 221345458 5566506 6439117 0 0 12732988 13845089 236388780 241629664 7312028 23723799 104309394 127930694 33451313 34317330 70858081 93613364 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. false false 525100 SPONSORED HEALTH GROUP TERM LIFE DISABILITY ACCIDENT DENTAL AND VISION BENEFITS FOR APPROXIMATELTY 120000 MEMBERS. false false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false false false true 19 0 true 77 true false false false false false false X 6 6 false false false false true true false true true false false false true true true false true true false false X JOHN R MARTUCCI 3019844110 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852 WALTER E WILSON 40 X 388447 0 17025 WILLIAM P O'HANLON 4 X X 46000 0 0 DAVID R LOESCH 1 X X 2000 0 0 KATHRYN DIEM 1 X X 2000 0 0 DAVID ERMER 1 X 0 0 0 JOSEPH R DAVIS 1 X 2000 0 0 CHARLENE B THORNTON 1 X 2000 0 0 ANGELA ZENTZ 1 X 0 0 0 PAMELA CUMMINGS 40 X 170823 0 16376 JOHN R MARTUCCI 40 X 150648 0 8876 M TODD SCHOENIAN 40 X 131959 0 11513 MARY K LIVINGSTON 40 X 105061 0 14040 LYNN K CHANG 40 X 101372 0 16035 1102310 83865 6 false true false 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 14 PREMIUMS 525100 251034686 251034686 ADMINISTRATION FESS 525100 3356348 3356348 CONTINGENCY RESERVE TRANSFER 525100 7100333 7100333 EXPERIENCE RATING ADJUSTMENT 525100 413073 413073 261904440 1624748 1624748 39600951 37779120 1821831 1821831 1821831 MISCELLANEOUS 524290 2444 2444 2444 265353463 261904440 0 3449023 221345458 806195 3673670 979010 641816 338426 6432302 65918 161174 189708 1599367 1136515 154351 17518 6010 1015239 134933 CLEARINGHOUSE EXPENSE 13057 FASB 158 EFFECT 750900 REINSURANCE EXPENSE 1828097 TAXES - PROPERTY 84084 MISCELLANEOUS 255916 241629664 0 0 0 500 500 31932282 53433442 18662534 19517561 397208 387827 10713707 7269027 3686001 3444680 48907202 50222999 723667 923685 104309394 127930694 753575 787312 1974747 2427740 30722991 31102278 33451313 34317330 X 70858081 93613364 70858081 93613364 104309394 127930694 X 23723799 -968516 X false true true X false false 600000 600000 4301095 3668914 632181 5531275 3410494 2120781 281337 189619 91718 3444680 FUNDS IN EXCESS OF RESERVE - FSL 538760 REINSURANCE RECOVERABLE ON PAID CLAIMS 384925 923685 GROUP INSURANCE PREMIUM PAYABLE 760299 PROVISION FOR POST RETIREMENT 769155 RESERVE IN EXCESS OF FUNDS - ALLIANZ 622705 ACCRUED PENSION LIABILITY 1865818 RESERVE FOR UNPAID CLAIMS 27084301 31102278 265353463 241629664 23723799 -968516 -968516 22755283 266514297 -968516 2129350 1160834 265353463 265353463 243759014 2129350 2129350 241629664 241629664 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 X X X false false false WALTER E WILSON 289475 92672 6300 4381 12644 405472 PAMELA CUMMINGS 155823 15000 2357 14019 187199 JOHN R MARTUCCI 144648 6000 2176 6700 159524 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.