2020-10-26T13:42:46-05:00 2019-12-31 131578842 BUCHBINDER TUNICK & COMPANY LLP 6720-A ROCKLEDGE DRIVE SUITE 510 BETHESDA MD 20817 990 2019-01-01 477358956 NYSUT MEMBER BENEFITS CATASTROPHE MAJOR MEDICAL INSURANCE TRUST NEWY 5182136000 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 J PHILIPPE ABRAHAM TRUSTEE 5182136000 2020-10-21 1 GARY BRUNICK P01715767 2402001400 2020-10-21 207.99.80.132 2020-10-21 16:23:00 ED P 5524639FBF68C09EE315A92609141BE2B23F1C15 084952EAFC4395C88C697A4D0F2EDC949E67DA35 2019 2021-04-22 16:20:28Z J PHILIPPE ABRAHAM 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 67459334 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 37861500 39829848 4069627 2581400 0 0 41931127 42411248 0 0 19585141 24503478 0 0 0 0 0 11729479 10514679 31314620 35018157 10616507 7393091 105026629 121800286 3120620 2477386 101906009 119322900 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 12/31/19, THERE WERE, ON AVERAGE, 103,010 MEMBERS, AND 61,227 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 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 0 0 0 X JACLYN FERRUCCI 5182136000 800 TROY-SCHENECTADY ROAD LATHAM NY 121102455 X DONALD CARLISTO TRUSTEE 1.00 X 0 0 0 ARTHUR PEPPER TRUSTEE 1.00 X 0 0 0 RODERICK SHERMAN TRUSTEE 1.00 X 0 0 0 EMILY SAMUELS SECRETARY 1.00 X X 0 0 0 SANDRA CARNER-SHAFRAN TRUSTEE 1.00 X 0 0 0 J PHILIPPE ABRAHAM CHAIRPERSON 1.00 X X 0 0 0 0 0 0 0 0 0 0 MERCER CONSUMER 12421 MEREDITH DRIVE URBANDALE IA 50398 CLAIMS PROCESSOR, RECORDKEEPER & INFORMA 4975096 HEALTHSMART BENEFIT SOLUTIONS 222 WEST LAS COLINAS BLVD STE 500N IRVING TX 75039 CLAIMS PROCESSOR 3219352 STACEY BRAUN ASSOCIATES INC 377 BROADWAY STREET NEW YORK NY 10013 INVESTMENT MANAGEMENT 404012 THE SEGAL COMPANY 333 WEST 34TH STREET NEW YORK NY 10001 ACTUARIAL AND BENEFIT CONSULTING SERVICE 140494 4 PARTICIPANT CONTRIBUTIONS 524292 37420338 37420338 DIVIDENDS FROM PRIOR INSURED PROG 525100 2409510 2409510 39829848 2149172 2149172 25480314 25048086 432228 432228 432228 42411248 39829848 0 2581400 X 24503478 86999 38000 395354 8031764 76789 35878 ADMINISTRATIVE SERVICE 1601097 PCORI FEE 248538 OTHER FEES 260 35018157 25412 155969 4474898 5290648 5795703 7294027 94730616 109059642 105026629 121800286 1934128 1116234 1186492 1361152 3120620 2477386 X 0 0 0 0 101906009 119322900 101906009 119322900 105026629 121800286 7393091 10023800 0 X 0 1 X 0 0 0 X 52039694 10023800 10023800 42015894 395354 395354 42411248 34622803 0 34622803 395354 395354 35018157 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, 2019, 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. 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 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 2,037,663. CLAIMS FEES 5,889,324. CONSULTING 104,777.