PENNSYLVANIA EMPLOYEES BENEFIT: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
PENNSYLVANIA EMPLOYEES BENEFIT (EIN 52-1588740)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-02-07
IRS object ID
201130459349301108
Schema version
2009v1.2
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)
Timestamp2011-02-07T15:09:13-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

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 Signed2011-02-11DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

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 Receipts954255701GrossReceipts
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 Employees160TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year873292064ProgramServiceRevenuePriorYear
Program Service Revenue CY944563710ProgramServiceRevenueCY
Investment Income Prior Year2230679InvestmentIncomePriorYear
Investment Income Current Year289428InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year875522743TotalRevenuePriorYear
Total Revenue Current Year944853138TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year701456980BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY785638028BenefitsPaidToMembersCY
Salaries Etc Prior Year4538943SalariesEtcPriorYear
Salaries Etc Current Year4796085SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year49892460OtherExpensePriorYear
Other Expenses Current Year43381508OtherExpensesCurrentYear
Total Expenses Prior Year755888383TotalExpensesPriorYear
Total Expenses Current Year833815621TotalExpensesCurrentYear
Revenues Less Expenses Prior Year119634360RevenuesLessExpensesPriorYear
Revenues Less Expenses CY111037517RevenuesLessExpensesCY
Total Assets BOY370800830TotalAssetsBOY
Total Assets EOY491048667TotalAssetsEOY
Total Liabilities BOY73050223TotalLiabilitiesBOY
Total Liabilities EOY81377145TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY297750607NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY409671522NetAssetsOrFundBalancesEOY
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 employees of the Commonwealth of Pennsylvania as well as other participants. Benefits provided to approximately 80,000 contracts or 184,000 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
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961123NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees160NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
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
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
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 (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest 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
Percy Poindexter
Board Member0X000
Dominic Sgro
Board Member0X000
Naomi Wyatt
Chairman of Board0X000
James A Honchar
Board Member0X000
Matt Waneck
Board Member0X000
David Donley
Board Member0X000
Mary Soderberg
Board Member0X000
Charlene Couch
Board Member0X000
William Grab
Board Member0X000
Ann Spishock
Board Member0X000
Jay Gasdaska
Board Member0X000
Kathryn Farley
Exec Director/CEO40244638021978X
Robert Bickford
CFO4013092609945X
Nancy Murphy
Chief Operating Officer40158875017966X
Joseph Sassano
Chief Information Officer40122641016127X
Gerald Anastasio
Director of Human Resources40107097015185X
Philip Witters
Associate Executive Director40105714015127X
FieldValueIRS element (for citing)
Total Reportable Comp From Org869891TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation96328TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
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
Kirschner & Gartrell PC
4910 Massachusetts AveNW Suite 215WashingtonDC20016Legal services717962
Ballard Spahr Andrews & Ingersoll
1735 Market St 51st FloorPhiladelphiaPA191037599Legal services494259
Vynamic
1650 Market St 36th FloorPhiladelphiaPA19103Consulting services437810
Aon Consulting
555 East Lancaster Avenue Suite 300PO Box 7300RadnorPA190877300Actuarial services381926
Towers Perrin
1500 Market StCentre Square EastPhiladelphiaPA19102Consulting services217681
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Employer contributions5242928769551428769551420$0
Participants contributions52429266913334669133340$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column695234TotalRevenueColumn
Related Or Exempt Function Income695234RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue944563710TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column283816TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$283,816ExclusionAmount

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)
Securities9408175Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9402563Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities5612Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column5612TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,612ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column944853138TotalRevenueColumn
Related Or Exempt Function Income944563710RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$289,428ExclusionAmount

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)
Total785638028Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total252109Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3296141Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total956775Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total291060Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total653069Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total56061Total

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)
Total898482Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total724358Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total296392Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total282980Total

Travel Travel

FieldValueIRS element (for citing)
Total12429Total

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)
Total169109Total

Insurance Insurance

FieldValueIRS element (for citing)
Total117620Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
Retension expense (administration fees)30981407
Mental health/substance abuse(admin fee)2597991
Disease management6532556
Dues, subscriptions & licenses57006

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2048Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total833815621Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY205526717BOY
EOY175913313EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY92357335BOY
EOY260637947EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY346890BOY
EOY371029EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14837204LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14249310LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY799141BOY
EOY587894EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY71193225BOY
EOY53538484EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY577522BOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY370800830BOY
EOY491048667EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY22803252BOY
EOY27007884EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY50246971BOY
EOY54369261EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY73050223BOY
EOY81377145EOY
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)
BOY297750607BOY
EOY409671522EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY297750607BOY
EOY409671522EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY370800830BOY
EOY491048667EOY
FieldValueIRS element (for citing)
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 Basis358394OtherCostOrOtherBasis
Depreciation328915Depreciation
Book Value29479BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis557960OtherCostOrOtherBasis
Depreciation540601Depreciation
Book Value17359BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis13920850OtherCostOrOtherBasis
Depreciation13379794Depreciation
Book Value541056BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings587894TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionEstimated health claims incurred but not reportedDescription
Amount$54,369,261Amount
FieldValueIRS element (for citing)
Total Of Amounts54369261TotalOfAmounts
Total Revenue944853138TotalRevenue
Total Expenses833815621TotalExpenses
Excess Or Deficit For Year111037517ExcessOrDeficitForYear
Net Unrealized GL On Investments883398NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments883398TotalAdjustments
Excess Or Deficit Per FS111920915ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt945736536TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments883398NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F990883398RevenueNotRptdF990
Revenue Subtotal944853138RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990944853138TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt833815621TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal833815621ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990833815621TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L00Identifier
Return ReferenceSchedule D, Part XReturnReference
ExplanationNot applicable.Explanation

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 (2 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
222952000216860120330126660269337000
Nancy Murphy
1540010004874080210126660179562000

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 $3,055.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11Form 990, Part VI, Section B, Line 11Form 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 PEBTF Corporate 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.

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