2021-05-13T11:42:49-07:00 2020-06-30 990 2019-07-01 521588740 PENNSYLVANIA EMPLOYEES BENEFIT TRUST FUND PENN 7175657318 150 South 43rd Street Harrisburg PA 17111 John Cromer Accounting Manager 7175657307 2021-05-14 2019 2022-09-23 18:48:47Z Kathryn Farley 150 South 43rd Street Harrisburg PA 17111 1211002793 0 X pebtf.org X Non-profit 1988 PA Trust for the provision of employee benefits to employees of the Commonwealth of Pennsylvania. 18 18 127 18 0 0 0 0 1110154402 1117504876 10461359 10699501 0 0 1120615761 1128204377 0 0 984776154 950428776 7034400 6677018 0 0 0 36759342 35274270 1028569896 992380064 92045865 135824313 734797344 872478824 103336935 96711171 631460409 775767653 Trust for the provision of medical, surgical, hospital, and supplemental benefits to employees of the Commonwealth of Pennsylvania and associated agencies, as well as their dependents and retirees. 0 0 To provide medical, surgical, hospital, and supplemental benefits to employees of the Commonwealth of Pennsylvania as well as other participants. Benefits provided to approximately 70,900 contracts or 166,000 covered lives. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 0 0 0 1 8 0 1 127 1 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 1 0 X Kathryn Farley 7175657215 150 South 43rd Street Harrisburg PA 17111 Kathryn Farley Executive Director/CEO 40.0 X 288321 0 28069 Nancy Murphy COO 40.0 X 203660 0 24237 Sharon Young Controller 40.0 X 143907 0 21466 Gerald Anastasio Dir of Human Resources 40.0 X 137310 0 20785 John-Marc Blanche Network Manager 40.0 X 124785 0 20126 Christy Leo Dir of Communications 40.0 X 118493 0 19775 Swapna Dighe Dir of Application Development 40.0 X 114236 0 19493 David Fillman Chairman 0.25 X X 0 0 0 Michael Newsome Secretary 0.25 X X 0 0 0 Teresa Miller Board Member 0.25 X 0 0 0 Dave Henderson Board Member 0.25 X 0 0 0 Dominic Sgro Board Member 0.25 X 0 0 0 Erika Swaney Board Member 0.25 X 0 0 0 Jay Gasdaska Board Member 0.25 X 0 0 0 Jennifer Swails Board Member 0.25 X 0 0 0 Jessica Altman Board Member 0.25 X 0 0 0 Matt Yarnell Board Member 0.25 X 0 0 0 Michael Bodinsky Board Member 0.25 X 0 0 0 Natalie Krug Board Member 0.25 X 0 0 0 Richard Caponi Board Member 0.25 X 0 0 0 Tara Long Board Member 0.25 X 0 0 0 V Reid Walsh Board Member 0.25 X 0 0 0 Stephen Catanese Board Member 0.25 X 0 0 0 Wendell Young IV Board Member 0.25 X 0 0 0 William Einhorn Board Member 0.25 X 0 0 0 1130712 0 153951 13 0 1 0 Willis Towers Watson 1500 Market St Centre Square East Philadelphia PA 19102 Actuarial services 957961 Kennedy Printing Company Inc 5534 Baltimore Avenue Philadelphia PA 19143 Printing and mailing 679667 Standish Mellon Asset Management 500 Grant Street Pittsburgh PA 15258 Investment management 460195 HR Best Practices PO Box 2400 Wayne NJ 07470 1095 form production 260000 Ballard Spahr LLP 1735 Market Street 51st Floor Philadelphia PA 19103 Legal services 251770 9 0 Employer contributions 524292 990150012 990150012 0 0 Participant contributions 524292 127040795 127040795 0 0 314069 314069 0 0 1117504876 9601400 0 0 9601400 0 0 0 0 0 0 0 0 0 0 83896517 0 82798416 0 1098101 0 1098101 0 0 1098101 0 1128204377 1117504876 0 10699501 950428776 524254 4457338 1314243 381183 418007 62054 771649 514593 658944 431428 26048 889119 183483 Retention expense (admin) 25867177 Mental health/substance abuse 4665173 Dues, subscriptions, licenses 669042 Disease management 88330 29223 992380064 0 0 0 403233972 599766310 110375997 104318457 284916 364438 38923075 37514012 1985535 1409063 218916924 166620556 734797344 872478824 28332935 37646171 75004000 59065000 103336935 96711171 X 0 0 0 0 631460409 775767653 631460409 775767653 734797344 872478824 X 135824313 1824739 0 0 0 6658192 X 0 1 X 1 0 0 0 0 0 0 0 0 0 422370 375437 46933 0 567309 563885 3424 0 37933396 36574690 1358706 1409063 Estimated health claims incurred but not reported 59065000 59065000 X 1130029116 1824739 0 0 0 1824739 1128204377 0 0 0 1128204377 992380064 0 0 0 0 0 992380064 0 0 0 992380064 Schedule D, Part X, Line 2 Estimated health claims incurred but not reported. X 1 1 X X X X 0 0 0 Kathryn Farley Executive Director/CEO 246024 0 0 0 42297 0 15433 0 12636 0 316390 0 0 0 Nancy Murphy COO 177597 0 0 0 26063 0 11601 0 12636 0 227897 0 0 0 Sharon Young Controller 143106 0 0 0 801 0 8830 0 12636 0 165373 0 0 0 Gerald Anastasio Dir of Human Resources 126923 0 0 0 10387 0 8149 0 12636 0 158095 0 0 0 Schedule J, Part I, Line 1a Gross-up for Kathryn Farley for the current year totaled $9,524. Form 990, Part VI, Section B, Line 11b The form 990 is reviewed by the Controller and an outside accounting firm before being filed with the IRS. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is monitored and enforced as an integral part of the Pennsylvania Employees Benefit Trust Fund (PEBTF) corporate compliance program. As such, the corporate compliance office, in conjunction with the corporate compliance committee, has the primary responsibility for 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 conflicts of interest. Form 990, Part VI, Section B, Line 15 The process for determining compensation of the CEO is a process that includes the Compensation Committee of the Board of Directors, the Chair of the Finance Committee, and the Chair 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 Chair of the Board comparing performance expectations to the actual performance for the year. (3) A performance increase is recommended by the Compensation Committee for an appropriate increase taking the salary survey range and performance into account. (4) In the event the CEO's salary falls significantly outside the independent salary survey range, either on the high or low side, additional information is sought prior to the development of an increase amount. The process of determining compensation for the other officers and key employees of the organization is performed by the CEO using the steps outlined above. Form 990, Part VI, Section C, Line 19 PEBTF'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 requestor. Form 990, Part XI, Line 9 Change in benefit obligations of $6,658,192. Form 8868 was timely filed providing a six month extension of the due date to May 15, 2021.