2021-10-29T10:51:59-05:00 2020-12-31 131578842 BUCHBINDER TUNICK & COMPANY LLP 6720-A ROCKLEDGE DRIVE SUITE 510 BETHESDA MD 20817 990 2020-01-01 477358956 NYSUT MEMBER BENEFITS CATASTROPHE MAJOR MEDICAL INSURANCE TRUST NEWY 5182136000 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 J PHILIPPE ABRAHAM TRUSTEE 5182136000 2021-10-28 1 J PHILIPPE ABRAHAM 999009999 GARY BRUNICK P01715767 2402001400 2021-10-28 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z J PHILIPPE ABRAHAM 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 62362924 0 X N/A X 2015 NY THE CATASTROPHE MAJOR MEDICAL PLAN ("CMM PLAN") WAS FORMED UNDER TRUST TO PROVIDE SUPPLEMENTAL (EXCESS MAJOR MEDICAL BENEFITS) HEALTH INSURANCE TO THE NYSUT MEMBERSHIP WHO VOLUNTARILY PARTICIPATE. 5 5 0 0 0 0 0 0 39829848 38467663 2581400 3192382 0 0 42411248 41660045 0 0 24503478 22612441 0 0 0 0 0 10514679 8685562 35018157 31298003 7393091 10362042 121800286 141605758 2477386 2364408 119322900 139241350 THE CATASTROPHE MAJOR MEDICAL PLAN ("CMM PLAN") WAS FORMED UNDER TRUST TO PROVIDE SUPPLEMENTAL (EXCESS MAJOR MEDICAL BENEFITS) HEALTH INSURANCE TO THE NYSUT MEMBERSHIP WHO VOLUNTARILY PARTICIPATE. 0 0 SUPPLEMENTED BASIC HOSPITALIZATION AND MAJOR MEDICAL INSURANCE AND LONG TERM CARE. FOR THE YEAR ENDING 12/31/20, THERE WERE, ON AVERAGE, 98,149 COVERED LIVES, AND 58,658 POLICIES. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 5 0 1 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JACLYN FERRUCCI 5182136000 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 DONALD CARLISTO TRUSTEE 1.00 X 0 23554 0 RODERICK SHERMAN TRUSTEE 1.00 X 0 2500 0 EMILY SAMUELS SECRETARY 1.00 X X 0 143515 91602 SANDRA CARNER-SHAFRAN TRUSTEE 1.00 X 0 24764 0 J PHILIPPE ABRAHAM CHAIRPERSON 1.00 X X 0 168923 92257 LAURA FRANZ TRUSTEE 1.00 X 0 7890 0 JEFFREY S HARTNETT PLAN ADMINISTRATOR 2.00 X 0 200751 114924 BETSY L PORTER MANAGER, MEMBER BENEFITS 35.00 X 0 150773 100788 DEREK S CLEMENT ASSISTANT IN MEMBER BENEFITS 35.00 X 0 160239 106072 JACLYN L FERRUCCI DEPUTY DIRECTOR OF FINANCE 9.00 X 0 178139 103662 JEFFREY J LOCKWOOD CFO, DIRECTOR OF FINANCE 2.00 X 0 209884 119281 DONALD COLLIGAN ASSISTANT IN MEMBER BENEFITS 35.00 X 0 150954 102781 MICHAEL S TRAVINSKI ASSOCIATE GENERAL COUNSEL 7.00 X 0 203605 104287 0 1625491 935654 0 0 1 1 MERCER HEALTH & BENEFITS ADMINISTRATION 12421 MEREDITH DRIVE URBANDALE IA 50398 CLAIMS PROCESSOR, RECORDKEEPER & INFORMA 3675523 HEALTHSMART BENEFIT SOLUTIONS 222 WEST LAS COLINAS BLVD STE 500N IRVING TX 75039 CLAIMS PROCESSOR 2613418 STACEY BRAUN ASSOCIATES INC 377 BROADWAY STREET 8TH FLOOR NEW YORK NY 10013 INVESTMENT MANAGEMENT 417014 3 PARTICIPANT CONTRIBUTIONS 524292 38453206 38453206 DIVIDENDS FROM PRIOR INSURED PROG 525100 14457 14457 38467663 2306497 2306497 21588764 20702879 885885 885885 885885 41660045 38467663 0 3192382 X 22612441 63730 43000 434483 5855733 374575 65 37668 ADMINISTRATIVE SERVICE 1613240 PCORI FEE 261645 REIMBURSED EXPENSES 1423 31298003 155969 10450 5290648 9731818 7294027 5067499 109059642 126795991 121800286 141605758 1116234 964068 1361152 1400340 2477386 2364408 X 0 0 0 0 119322900 139241350 119322900 139241350 121800286 141605758 10362042 9556408 0 X 0 1 X 0 0 0 X 50781970 9556408 9556408 41225562 434483 434483 41660045 30863520 0 30863520 434483 434483 31298003 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. EMPLOYEE BENEFIT PLANS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR TAX PERIODS IN PROGRESS FOR THE TRUST. 0 0 0 JEFFREY J LOCKWOOD CFO, DIRECTOR OF FINANCE 0 209884 0 0 0 0 0 55214 0 64067 0 329165 0 0 JEFFREY S HARTNETT PLAN ADMINISTRATOR 0 200751 0 0 0 0 0 52444 0 62480 0 315675 0 0 MICHAEL S TRAVINSKI ASSOCIATE GENERAL COUNSEL 0 203605 0 0 0 0 0 56834 0 47453 0 307892 0 0 JACLYN L FERRUCCI DEPUTY DIRECTOR OF FINANCE 0 178139 0 0 0 0 0 46381 0 57281 0 281801 0 0 DEREK S CLEMENT ASSISTANT IN MEMBER BENEFITS 0 160239 0 0 0 0 0 42348 0 63724 0 266311 0 0 J PHILIPPE ABRAHAM CHAIRPERSON 0 149423 0 0 0 19500 0 43598 0 48659 0 261180 0 0 DONALD COLLIGAN ASSISTANT IN MEMBER BENEFITS 0 146152 0 0 0 4802 0 39606 0 63175 0 253735 0 0 BETSY L PORTER MANAGER, MEMBER BENEFITS 0 150773 0 0 0 0 0 42536 0 58252 0 251561 0 0 EMILY SAMUELS SECRETARY 0 143515 0 0 0 0 0 37553 0 54049 0 235117 0 0 990 SCHEDULE J, PART II, J. PHILIPPE ABRAHAM THIS OFFICER WAS UNDER A COMPENSATION ARRANGEMENT FOR 2020 WHERE A RELATED ORGANIZATION TO THE FILING ORGANIZATION PAYS SOME OF THIS OFFICER'S COMPENSATION AND AN UNRELATED ORGANIZATION (UNITED UNIVERSITY PROFESSIONS) PAYS THE REMAINDER OF THE COMPENSATION. FOR 2020, THE AMOUNT PAID TO J. PHILIPPE ABRAHAM BY UNITED UNIVERSITY PROFESSIONS TOTALED $159,320, WHICH INCLUDES WAGES, RETIREMENT AND NONTAXABLE BENEFITS. FORM 990, PART VI, SECTION B, LINE 11B THE FINAL DRAFT OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPOINTS A CONFLICT OF INTEREST OFFICER. THE CONFLICT OF INTEREST OFFICER'S RESPONSIBILITIES ARE TO MONITOR THE IMPLEMENTATION OF THE CONFLICT OF INTEREST POLICY AND, RECOMMEND TO THE OVERSIGHT COMMITTEE, SUCH MODIFICATIONS IN THE POLICY AS THEY MAY FROM TIME TO TIME DEEM APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 THIS ORGANIZATION, AND ALL ITS RELATED ORGANIZATIONS, DETERMINES COMPENSATION OF ALL ITS OFFICERS AND KEY EMPLOYEES ANNUALLY EITHER BY A) COMPLIANCE WITH COLLECTIVE BARGAINING AGREEMENTS FOR INDIVIDUALS COVERED BY THE CBAS OR B) THE BOARD OF DIRECTORS OF THE PARENT ORGANIZATION, NEW YORK STATE UNITED TEACHERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE FORM 5500 FILED WITH THE EMPLOYEE BENEFIT SECURITY ADMINISTRATION (US DEPARTMENT OF LABOR) IS MADE AVAILABLE TO PLAN PARTICIPANTS. FORM 990, PART IX, LINE 11G ADMINISTRATIVE FEES 1,926,248. CLAIMS FEES 3,832,436. CONSULTING 97,049. NEW YORK STATE UNITED TEACHERS 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 141584772 LABOR ORGANIZATION NY 501(C)(5) N/A 0 NYSUT BUILDING CORP 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 141700200 BUILDING CORPORATION NY 501(C)(2) NEW YORK STATE UNITED TEACHERS 0 NYSUT MEMBER BENEFITS TRUST 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 222480854 BENEFIT PLAN NY 501(C)(5) N/A 0 NYSUT RETIREE VEBA HEALTH FUND 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 146204878 BENEFIT PLAN NY 501(C)(9) N/A 0 NYSUT EDUCATION AND LEARNING TRUST 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 166460576 OFFERS COURSES TO PROMOTE EFFECTIVE TEACHING NY 501(C)(3) LINE 7 N/A 0 MARY MULDOON FUND 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 146030191 PRIVATE FOUNDATION NY 501(C)(3) PF N/A 0 NYSUT EMPLOYEES RETIREMENT FUND PLAN #001 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE BENEFIT PLAN NY 501(A) N/A 0 NYSUT STAFF 401K PLAN #002 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE BENEFIT PLAN NY 501(A) N/A 0 NYSUT DISASTER RELIEF AND SCHOLARSHIP FUND 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 113761261 PROVIDES DISASTER RELIEF AND SCHOLARSHIPS NY 501(C)(3) LINE 7 N/A 0 NYSUT VOTECOPE STATE 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 141565672 POLITICAL COMMITTEE NY 527 N/A 0 NYSUT VOTECOPE FEDERAL 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 264047277 POLITICAL COMMITTEE NY 527 N/A 0 NYSUT MEMBER BENEFITS CORPORATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 263989358 MEMBER PROGRAM DISCOUNTS NY N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0