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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Irene Rodriguez Martin</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James R Phaneuf</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John A Egelhofer MD</PersonNm>
        <TitleTxt>Trustee (through 12/31/18)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathleen B Scoble</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kevin P Moriarty MD</PersonNm>
        <TitleTxt>Trustee/ Chief Ped Surgery</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>49.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>702493</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31882</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maria P Goncalves</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Melissa D Cragg</PersonNm>
        <TitleTxt>Trustee (as of 1/1/19)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Paul R Murphy</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert L Pura PhD</PersonNm>
        <TitleTxt>Trustee (through 4/9/19)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Timothy F Farrell</PersonNm>
        <TitleTxt>Trustee (through 4/9/19)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>William R Webber</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dennis Chalke</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>18.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>947658</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>90444</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kristin R Delaney</PersonNm>
        <TitleTxt>Clerk</TitleTxt>
        <AverageHoursPerWeekRt>34.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>16.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>145051</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37639</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Nancy Remillard</PersonNm>
        <TitleTxt>Assistant Clerk (as of 11/13/18)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>51003</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8248</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>702493</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>3171218</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>208255</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>1</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Workday Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6110 Stoneridge Mall Road</AddressLine1Txt>
            <CityNm>Pleasanton</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>94588</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HR/Payroll Software Consulting Services</ServicesDesc>
        <CompensationAmt>3270087</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Baystate Administrative Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
            <CityNm>Springfield</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>011990001</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Management Services</ServicesDesc>
        <CompensationAmt>1972245</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Birdsall Voss &amp; Associates Inc dba</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>250 W Coventry Ct Ste 300</AddressLine1Txt>
            <CityNm>Milwaukee</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53217</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consulting / Advertising Services</ServicesDesc>
        <CompensationAmt>594852</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Premier Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>13034 Ballantyne Corporate Place</AddressLine1Txt>
            <CityNm>Charlotte</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>28277</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT Consulting Services</ServicesDesc>
        <CompensationAmt>526466</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>VLink Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>701 John Fitch Blvd</AddressLine1Txt>
            <CityNm>South Windsor</CityNm>
            <StateAbbreviationCd>CT</StateAbbreviationCd>
            <ZIPCd>06074</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT Consulting Services</ServicesDesc>
        <CompensationAmt>480526</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>14</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>18937475</RelatedOrganizationsAmt>
      <AllOtherContributionsAmt>180459</AllOtherContributionsAmt>
      <TotalContributionsAmt>19117934</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Subpart F Inc-Captive</Desc>
        <BusinessCd>525990</BusinessCd>
        <TotalRevenueColumnAmt>3765879</TotalRevenueColumnAmt>
        <ExclusionAmt>3765879</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Premier Invest Inc</Desc>
        <BusinessCd>525990</BusinessCd>
        <TotalRevenueColumnAmt>1171292</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1036670</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>134622</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MD Dues / Fees</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>686911</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>686911</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>BHIC E&amp;P UBIT</Desc>
        <BusinessCd>525990</BusinessCd>
        <TotalRevenueColumnAmt>322063</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>322063</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CPIP admin revenue</Desc>
        <BusinessCd>524298</BusinessCd>
        <TotalRevenueColumnAmt>305000</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>305000</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>288822</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>288822</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>6539967</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1626591</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>-43000</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1669591</ExclusionAmt>
      </InvestmentIncomeGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>992</TotalRevenueColumnAmt>
        <ExclusionAmt>992</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>31564917</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>31456181</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>108736</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>108736</TotalRevenueColumnAmt>
        <ExclusionAmt>108736</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>Loans-Principal Pmts</Desc>
        <BusinessCd>561499</BusinessCd>
        <TotalRevenueColumnAmt>1413819</TotalRevenueColumnAmt>
        <ExclusionAmt>1413819</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MA state Tax Refund</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>50240</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>50240</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Class Action Stlmnt.</Desc>
        <BusinessCd>523000</BusinessCd>
        <TotalRevenueColumnAmt>4173</TotalRevenueColumnAmt>
        <ExclusionAmt>4173</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>1468232</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>28862452</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2062643</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>718685</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>6963190</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>493843</TotalAmt>
        <ProgramServicesAmt>493843</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1735932</TotalAmt>
        <ProgramServicesAmt>1735932</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>852539</TotalAmt>
        <ProgramServicesAmt>852539</ProgramServicesAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>641623</TotalAmt>
        <ManagementAndGeneralAmt>641623</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>50106</TotalAmt>
        <ManagementAndGeneralAmt>50106</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>414000</TotalAmt>
        <ProgramServicesAmt>414000</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>49799</TotalAmt>
        <ManagementAndGeneralAmt>49799</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3234086</TotalAmt>
        <ProgramServicesAmt>3234086</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>8742</TotalAmt>
        <ProgramServicesAmt>8742</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>78289</TotalAmt>
        <ProgramServicesAmt>6131</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72158</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>71346</TotalAmt>
        <ProgramServicesAmt>27531</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43815</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <TravelGrp>
        <TotalAmt>44869</TotalAmt>
        <ProgramServicesAmt>44869</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>249924</TotalAmt>
        <ProgramServicesAmt>206994</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42930</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>1268530</TotalAmt>
        <ManagementAndGeneralAmt>1268530</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>2449621</TotalAmt>
        <ProgramServicesAmt>1827995</ProgramServicesAmt>
        <ManagementAndGeneralAmt>621626</ManagementAndGeneralAmt>
      </PaymentsToAffiliatesGrp>
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        <TotalAmt>8115</TotalAmt>
        <ManagementAndGeneralAmt>8115</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>28207</TotalAmt>
        <ManagementAndGeneralAmt>28207</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>STRATEGIC INITIATIVES</Desc>
        <TotalAmt>14694329</TotalAmt>
        <ProgramServicesAmt>14694329</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>457b PENSION PLAN EXP</Desc>
        <TotalAmt>2033860</TotalAmt>
        <ManagementAndGeneralAmt>2033860</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEMBERSHIP DUES/FEES</Desc>
        <TotalAmt>266369</TotalAmt>
        <ManagementAndGeneralAmt>266369</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>RESEARCH INITIATIVES</Desc>
        <TotalAmt>223617</TotalAmt>
        <ProgramServicesAmt>223617</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>462528</TotalAmt>
        <ProgramServicesAmt>218061</ProgramServicesAmt>
        <ManagementAndGeneralAmt>244467</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>29360274</TotalAmt>
        <ProgramServicesAmt>23988669</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5371605</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>19048564</BOYAmt>
        <EOYAmt>11229799</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>381384</BOYAmt>
        <EOYAmt>1306335</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>20813035</BOYAmt>
        <EOYAmt>21391474</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>348445</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>278122</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>78438</BOYAmt>
        <EOYAmt>70323</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>18795339</BOYAmt>
        <EOYAmt>19813176</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>119145761</BOYAmt>
        <EOYAmt>125594094</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>4132000</BOYAmt>
        <EOYAmt>4132000</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>53629705</BOYAmt>
        <EOYAmt>54399336</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>236024226</BOYAmt>
        <EOYAmt>237936537</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2246472</BOYAmt>
        <EOYAmt>2926884</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>305000</BOYAmt>
        <EOYAmt>305000</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>40800655</BOYAmt>
        <EOYAmt>39487166</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>85901002</BOYAmt>
        <EOYAmt>94483391</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>129253129</BOYAmt>
        <EOYAmt>137202441</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
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        <BOYAmt>76382445</BOYAmt>
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        <EOYAmt>237936537</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-497822</ReconcilationRevenueExpnssAmt>
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        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
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        <CurrentTaxYearAmt>19117934</CurrentTaxYearAmt>
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      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>BH paid Rauschenbach Associates for lobbying activities related to healthcare policy, bills and appropriations-related activities. BH paid HospitalMax Associates, Inc., Philip W. Johnston Associates, Capitol Counsel, LLC, Buoniconti &amp; McCary, LLC and Brian P. Lees for technical and strategic advisory services including public advocacy and interpretation of proposed and actual program and legislative changes.</ExplanationTxt>
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        <EndYearBalanceAmt>21660762</EndYearBalanceAmt>
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      <EquipmentGrp>
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        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>Investments - Other Securities</Desc>
        <BookValueAmt>7244196</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Investment in Unconsolidated Affiliate</Desc>
        <BookValueAmt>2960018</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Investment in Subsidiaries (Ingraham, Wing and Noble)</Desc>
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        <MethodValuationCd>C</MethodValuationCd>
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      <OtherAssetsOrgGrp>
        <Desc>Due from Affiliated Companies</Desc>
        <BookValueAmt>3473461</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>Affiliate Line of Credit</Desc>
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      <OtherAssetsOrgGrp>
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      <FederalIncomeTaxLiabilityAmt>76392</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Affiliated Companies</Desc>
        <Amt>6373611</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Board-Designated Funds</Desc>
        <Amt>1095413</Amt>
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        <Desc>Insurance Reserves</Desc>
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        <Desc>Deferred Compensation Obligations</Desc>
        <Amt>66973184</Amt>
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        <FormAndLineReferenceDesc>Part V, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Endowment assets are to provide funding to support programs that further Baystate Health's mission.</ExplanationTxt>
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    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="RetDoc1040500001">
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        <EmployeeCnt>0</EmployeeCnt>
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      <AccountActivitiesOutsideUSGrp>
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      <AccountActivitiesOutsideUSGrp>
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        <EmployeeCnt>0</EmployeeCnt>
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      <InterestInForeignTrustInd>0</InterestInForeignTrustInd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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        </USAddress>
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        <PurposeOfGrantTxt>To assist the Public Health Institute of Western Massachusetts, formerly Partners for a Healthier Community, in narrowing the gap in health disparities for some of Springfield's most vulnerable citizens, and to be a source of support for building civic leaders, creating strategies for change, and promoting policy actions to create healthier communities.</PurposeOfGrantTxt>
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      <RecipientTable>
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          <BusinessNameLine1Txt>Develop Springfield</BusinessNameLine1Txt>
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          <AddressLine1Txt>83 Maple Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
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        <PurposeOfGrantTxt>To promote development and redevelopment projects that stimulate and support economic growth and expedite City of Springfield revitalization.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Massachusetts Health Policy Forum</BusinessNameLine1Txt>
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          <AddressLine1Txt>415 South Street MS 035</AddressLine1Txt>
          <CityNm>Waltham</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
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        <PurposeOfGrantTxt>To improve health and the health care system in the Commonwealth of MA by convening forums and presenting the highest quality research to legislators, stakeholders and the public.</PurposeOfGrantTxt>
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      <RecipientTable>
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          <BusinessNameLine1Txt>Health Resources in Action Inc</BusinessNameLine1Txt>
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          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02116</ZIPCd>
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        <PurposeOfGrantTxt>To advance public health and medical research by developing programs. The organization collaborates with others to resolve public health issues through policy, research, prevention and health promotion.</PurposeOfGrantTxt>
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      <RecipientTable>
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          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
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        <PurposeOfGrantTxt>To support the Health Science Library and wellness of practicing MDs and other medical staff.</PurposeOfGrantTxt>
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      <RecipientTable>
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        <PurposeOfGrantTxt>To advance community health through education.</PurposeOfGrantTxt>
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        <ExplanationTxt>Grantees are selected that promote or support healthcare advancement objectives and community revitalization. Proposed candidates go through a management approval process.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, line 1, Column (h):</FormAndLineReferenceDesc>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationRltdOrgsAmt>2067548</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
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        <PersonNm>Kevin P Moriarty MD</PersonNm>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
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        <PersonNm>Dennis Chalke</PersonNm>
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        <OtherCompensationRltdOrgsAmt>205523</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>59898</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>30546</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1038102</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kristin R Delaney</PersonNm>
        <TitleTxt>Clerk</TitleTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Dennis W. Chalke - Supplemental Retirement of $151,701 is included in column B. This amount was earned and paid in 2018. Mark A. Keroack, MD Supplemental Retirement of $351,037 is included in column B. This amount was earned in 2018. Kevin P. Moriarty, MD - Supplemental Retirement of $22,859 is included in column B. This amount was earned and paid in 2018.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Anne M. Paradis, Paul R. Murphy and Robert L. Pura, PhD, (2) John F. Maybury and Mark A. Keroack, MD, (3) Hector F. Toledo and Timothy F. Farrell.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Baystate Health, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Two of the Trustees of the filing organization are required to be members of the Board of Directors of Baystate Wing Hospital Corporation (BWH), an affiliated organization, and their election is subject to approval by the Board of Directors of BWH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Prior to filing the Form 990, appropriate sections were reviewed by the Tax, Finance, and Human Resources areas of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The Form 990 was also reviewed by tax experts from an independent accounting firm and signed-off as a paid preparer. The process, key areas and any new changes were reviewed prior to filing with the Baystate Health Audit and Compliance Committee (ACC), which is composed of trustees of the filing organization. The ACC members had an opportunity to ask questions regarding the tax compliance process and the tax filings in general. The Form 990 was provided to all members of the Baystate Health Board of Trustees prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Baystate Health, Inc. (BH) and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual "conflict of interest" form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit &amp; Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee. The compensation of the Senior Vice President, Finance, CFO and Treasurer is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the Senior Vice President, Finance, CFO and Treasurer and of other officers would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the Senior Vice President, Finance, CFO and Treasurer is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers of the filing organization is determined by the President of the filing organization in accordance with the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President and CEO is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization. Form 990, Part VI, Section B, Line 16b: Baystate Health, Inc. has a joint venture policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII, Section A, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Consulting Fees: Program service expenses 3,157,213. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,157,213. Temporary Help: Program service expenses 23,844. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,844. Accreditation / Licensing: Program service expenses 35,506. Management and general expenses 0. Fundraising expenses 0. Total expenses 35,506. Education: Program service expenses 12,107. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,107. Claim History Fees: Program service expenses 5,416. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,416.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Transfers from/to Affiliated Companies, Net 7,551,082. Property, Plant &amp; Equipment Transfers -10,558,773. Equity Gain / (Loss) in Baycare 409,826. Equity Gain / (Loss) in Ingraham 101,094. Equity Gain / (Loss) in Shields -678,072. BHIC UBTI -322,063. Subpart F Income from Captive Insurance Company -3,765,879. Net Assets Released from Restrictions - BHF -2,613.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
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          <AddressLine1Txt>164 High Street</AddressLine1Txt>
          <CityNm>Greenfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01301</ZIPCd>
        </USAddress>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Wing Hospital Corporation</BusinessNameLine1Txt>
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          <AddressLine1Txt>40 Wright Street</AddressLine1Txt>
          <CityNm>Palmer</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01069</ZIPCd>
        </USAddress>
        <EIN>222519813</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>Visiting Nurse Assn and Hospice of Western New England Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Total Home Care Inc</BusinessNameLine1Txt>
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          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
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        <EIN>203260764</EIN>
        <PrimaryActivitiesTxt>Real Estate and Other</PrimaryActivitiesTxt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Administrative Services Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>222747685</EIN>
        <PrimaryActivitiesTxt>Administrative services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12c, III</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Health Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>043549011</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Noble Hospital Corporation</BusinessNameLine1Txt>
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          <AddressLine1Txt>115 West Silver Street</AddressLine1Txt>
          <CityNm>Westfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>010861634</ZIPCd>
        </USAddress>
        <EIN>222537423</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>Westfield Medical Corporation</BusinessNameLine1Txt>
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          <AddressLine1Txt>115 West Silver Street</AddressLine1Txt>
          <CityNm>Westfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>010861634</ZIPCd>
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        <EIN>043127730</EIN>
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          <BusinessNameLine1Txt>Baystate Noble Hospital Corporation</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Health New England Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
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        <PrimaryActivitiesTxt>HMO/Insurance</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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          <BusinessNameLine1Txt>HNE of Connecticut Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>465190134</EIN>
        <PrimaryActivitiesTxt>HMO/Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CT</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (4)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Health New England</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Baystate Health Systems Inc Health &amp; Welfare Benefits Plan</BusinessNameLine1Txt>
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          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
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          <ZIPCd>01199</ZIPCd>
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        <EIN>222531644</EIN>
        <PrimaryActivitiesTxt>Voluntary Employees' Benefit Association</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (9)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HNE Advisory Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>043012347</EIN>
        <PrimaryActivitiesTxt>Administrative Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HNE Insurance Services Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>043183019</EIN>
        <PrimaryActivitiesTxt>Ancilliary Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Ingraham Corporation</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
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        <PrimaryActivitiesTxt>Health care and other business activities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
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        <ShareOfEOYAssetsAmt>1794156</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
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          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
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          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
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        <EIN>464620480</EIN>
        <PrimaryActivitiesTxt>Holding shares in subsidiary corporations</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Health New England Inc</BusinessNameLine1Txt>
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</Return>