2015-07-02T13:00:21-05:00 2014-08-31 131578842 BUCHBINDER TUNICK & COMPANY LLP 6720-A ROCKLEDGE DRIVE SUITE 510 BETHESDA MD 20817 990 2013-09-01 222480854 TRUSTEES OF NEW YORK STATE UNITED TEACHERS MEMBER BENEFITS TRUST NEWY 5182136000 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 MARTIN MESSNER TRUSTEE 5182136000 2015-07-02 1 JOHN ZIMMERMAN P01049106 2402001400 2015-05-30 2013 2016-03-07 17:11:31Z MARTIN MESSNER 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 62063912 0 X HTTP://MEMBERBENEFITS.NYSUT.ORG X 1983 NY TO BE FIRST AND FOREMOST IN MINDS OF MEMBERS WHEN IT COMES TO INSURANCE, FINANCIAL, LEGAL AND OTHER SERVICES. THIS WILL OCCUR BY ENDORSING QUALITY PROGRAMS THAT ARE COMPETITIVELY PRICED AND ARE DESIGNED TO PROVIDE FINANCIAL EDUCATION AND SECURITY FOR MEMBERS AND THEIR FAMILIES. 10 7 0 0 0 0 0 0 4496253 32528836 1119057 1044814 6047971 5848958 11663281 39422608 0 0 3257052 3168882 4519167 3998114 0 0 0 2306155 4167179 10082374 11334175 1580907 28088433 41253324 72338477 30166798 31167541 11086526 41170936 X ENDORSING QUALITY PROGRAMS THAT ARE COMPETITIVELY PRICED AND ARE DESIGNED TO PROVIDE FINANCIAL EDUCATION AND SECURITY FOR MEMBERS AND THEIR FAMILIES. 0 1 CATASTROPHE MAJOR MEDICALSUPPLEMENTS BASIC HOSPITALIZATION AND MAJOR MEDICAL INSURANCE AND LONG TERM CARE. FOR THE YEAR ENDING 8/31/14, THERE WERE, ON AVERAGE, 79,809 PARTICIPANTS, AND 54,336 POLICIES. LIFE INSURANCEPROVIDES LIFE INSURANCE FOR MEMBERS AND THEIR FAMILIES. FOR THE YEAR ENDING 8/31/14, THERE WERE, ON AVERAGE, 75,178 PARTICIPANTS, AND 75,178 POLICIES. NYSUT AND GROUP LEGAL SERVICE PLANPROVIDES LEGAL ASSISTANCE FOR LEGAL MATTERS. FOR THE YEAR ENDING 8/31/14, THERE WERE, ON AVERAGE, 92,342 PARTICIPANTS. 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 7 0 1 0 0 0 0 0 0 0 X 10 7 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JEFFREY LOCKWOOD 5182136000 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 LEE CUTLER TRUSTEE-CHAIR 3.00 X X 0 232709 90329 RODERICK SHERMAN TRUSTEE-SECRETARY 2.00 X X 0 26335 0 KATHLEEN DONAHUE TRUSTEE 2.00 X 0 236536 77546 ROBERT LESNIEWSKI TRUSTEE 3.00 X 0 212896 88196 ARTHUR PEPPER TRUSTEE 2.00 X 0 14724 0 ELLEN SCHULER MAUK TRUSTEE 2.00 X 0 26335 0 JOSEPH MCLAUGHLIN TRUSTEE 2.00 X 0 14724 0 LORETTA DONLON TRUSTEE 2.00 X 0 14724 0 CARLA MCLAUD TRUSTEE 2.00 X 0 14724 0 MATTHEW HILL TRUSTEE 2.00 X 0 14724 0 MARTIN MESSNER TRUSTEE-CHAIR 3.00 X X 0 0 0 PAUL PECORALE TRUSTEE 2.00 X 0 14724 0 KEVIN PETERMAN TRUSTEE 2.00 X 0 4000 0 KEVIN RUSTOWICZ TRUSTEE 2.00 X 0 0 0 FLORENCE MCCUE TRUSTEE 2.00 X 0 4000 0 LYNETTE METZ FUND DIRECTOR 35.00 X 0 186092 84151 MICHAEL TRAVINSKI ASSOC SPECIAL COUNSEL 9.00 X 0 162517 68130 JEFFREY LOCKWOOD MGR. ACCOUNTING/REPORTING 5.00 X 0 154242 78006 BETSY PORTER MANAGER, MEMBER BENEFITS 35.00 X 0 131785 68655 VERNELL STOKES ASSISTANT IN MEMBER BENEFITS 35.00 X 0 137798 56921 DONALD COLLIGAN ASSISTANT IN MEMBER BENEFITS 35.00 X 0 131500 69437 0 1735089 681371 0 0 1 0 THE SEGAL COMPANY PO BOX 4058 CHURCH STREET STATION NEW YORK NY 102614058 CONSULTING 128658 1 PARTICIPANT CONTRIBS 524292 24522842 24522842 DIVIDENDS FROM PRIOR INSURED PROG 525100 7393928 7393928 SERVICE FEE 561000 612066 612066 32528836 713843 114062 599781 22972275 22641304 330971 330971 330971 EXP. REIMB./ENDORSEMENT FEES 900099 6604294 6604294 EQUIPMENT RENTAL 532420 1715 1715 NET EARNINGS/(LOSS) OF SUBSIDIARY 900099 -757051 -757051 5848958 39422608 38822827 0 599781 X 3168882 2154519 779134 882972 181489 153929 86882 198121 1583286 682078 35177 753774 358828 30168 29150 11820 100240 ADMINISTRATIVE SERVICE 109233 SOCIAL SERVICE SUPPORT 25000 SECURITY SERVICES 3607 STAFF TRAINING 3461 2425 11334175 100 100 9230778 12410503 856594 2168278 29828 68136 1264787 1213849 45358 50938 17814754 43500989 12872621 13674949 403291 464584 41253324 72338477 9761618 7592557 78408 2268006 20326772 21306978 30166798 31167541 X 0 0 0 0 11086526 41170936 11086526 41170936 41253324 72338477 28088433 1995977 0 X 0 1 X 0 0 20326772 992206 12000 21306978 19719796 965355 176000 182379 20326772 19306491 539123 125818 19719796 19155355 315279 164143 19306491 18466643 729645 40933 19155355 1.00000 0 0 591050 591050 0 287667 287667 0 386070 335132 50938 50938 WELLINGTON TRUST CORE BOND FUND 13674949 F 13674949 PREMIUM STABILIZATION AND OTHER RESERVES 21306978 21306978 PART V, LINE 4: PREMIUM STABILIZATION RESERVES HAVE BEEN ESTABLISHED BY THE TRUST AND INSURANCE PROVIDERS FOR CERTAIN GROUP INSURANCE ARRANGEMENTS. THESE ARRANGEMENTS PROVIDE FOR THE RETURN TO THE NEW YORK STATE UNITED TEACHERS MEMBER BENEFITS TRUST OF A PORTION OF EARNED PREMIUMS WHEN BENEFIT EXPERIENCE IN A POLICY YEAR IS FAVORABLE. THE AMOUNTS RETURNED ARE HELD IN RESERVE BY THE TRUST FOR THE EXCLUSIVE BENEFIT OF THE TRUST'S PARTICIPANTS. THE BENEFIT PROGRAMS WHICH HAVE PREMIUM STABILIZATION RESERVES INCLUDE THE FOLLOWING INSURANCES: TERM LIFE, DISABILITY, GROUP DENTAL AND INDIVIDUAL DENTAL. SOME RESERVES MAY BE USED TO OFFSET PROGRAM LOSSES OR CERTAIN EXPENSES RELATED DIRECTLY TO THAT PROGRAM. OTHER RESERVES HAVE BEEN ESTABLISHED TO SET ASIDE FUNDS EARMARKED FOR SPECIFIC BENEFIT PURPOSES. THOSE BENEFITS INCLUDE HOMEOWNERS INSURANCE AND LEGAL SERVICE PLAN CONFLICT RESOLUTION. 0 0 0 LEE CUTLER TRUSTEE-CHAIR 0 232282 0 0 0 427 0 57270 0 33059 0 323038 0 0 KATHLEEN DONAHUE TRUSTEE 0 219036 0 0 0 17500 0 57270 0 20276 0 314082 0 0 ROBERT LESNIEWSKI TRUSTEE 0 205096 0 0 0 7800 0 54604 0 33592 0 301092 0 0 LYNETTE METZ FUND DIRECTOR 0 185690 0 0 0 402 0 49933 0 34218 0 270243 0 0 MICHAEL TRAVINSKI ASSOC SPECIAL COUNSEL 0 162517 0 0 0 0 0 41725 0 26405 0 230647 0 0 JEFFREY LOCKWOOD MGR. ACCOUNTING/REPORTING 0 154242 0 0 0 0 0 42172 0 35834 0 232248 0 0 BETSY PORTER MANAGER, MEMBER BENEFITS 0 131785 0 0 0 0 0 35923 0 32732 0 200440 0 0 VERNELL STOKES ASSISTANT IN MEMBER BENEFITS 0 132962 0 0 0 4836 0 37217 0 19704 0 194719 0 0 DONALD COLLIGAN ASSISTANT IN MEMBER BENEFITS 0 127345 0 0 0 4155 0 37217 0 32220 0 200937 0 0 FORM 990, PART III, LINE 3 EFFECTIVE JANUARY 1, 2014, THE TRUST BEGAN SELF-FUNDING THE CATASTROPHE MAJOR MEDICAL PLAN (PROGRAM), PREVIOUSLY UNDERWRITTEN BY U.S. LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (US LIFE), PROVIDING THE TRUST MORE FLEXIBILITY AND CONTROL IN PROTECTING THE PROGRAM FOR PROGRAM PARTICIPANTS. US LIFE WILL BE RESPONSIBLE FOR PAYING CLAIMS WITH BENEFIT PERIOD STARTING DATES OF DECEMBER 31, 2013 OR PRIOR. THESE CLAIMS WILL BE PAID FROM THE PROGRAM'S CLAIM RESERVES HELD BY US LIFE. CLAIMS WITH EFFECTIVE BENEFIT PERIODS ON OR AFTER JANUARY 1, 2014 ARE THE RESPONSIBILITY OF THE TRUST. MERCER CONSUMER WILL CONTINUE TO ADMINISTER THE PROGRAM UNDER THE SELF-FUNDED ARRANGEMENT - PROVIDING PREMIUM COLLECTION AND CLAIM PROCESSING SERVICES. FORM 990, PART VI, SECTION A, LINE 2 NAME RELATIONSHIP ORGANIZATION RODERICK SHERMAN BUSINESS NYSUT MEMBER BENEFITS CORPORATION LYNETTE METZ BUSINESS NYSUT MEMBER BENEFITS CORPORATION ARTHUR PEPPER BUSINESS NYSUT MEMBER BENEFITS CORPORATION ROBERT LESNIEWSKI BUSINESS NYSUT MEMBER BENEFITS CORPORATION PAUL PECORALE BUSINESS NYSUT MEMBER BENEFITS CORPORATION FORM 990, PART VI, SECTION B, LINE 11 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 HE OR SHE 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 CONSULTING 130,206. ADMINISTRATIVE AND CLAIMS FEES 1,275,662. HEALTH ADVOCATE FEES 177,418. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B SOME OF THE OFFICERS AND DIRECTORS LISTED IN PART VII, SECTION A, LINE 1A ALSO SERVE IN SIMILAR ROLES FOR RELATED ORGANIZATIONS. THE HOURS LISTED IN PART VII COLUMN B REFLECT THE AVERAGE HOURS PER WEEK FOR THIS ORGANIZATION ONLY. THE HOURS WORKED FOR RELATED ORGANIZATIONS ARE REFLECTED ON THE RESPECTIVE ORGANIZATIONS' FORM 990. CERTAIN KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A, LINE 1A ALSO PERFORM WORK IN VARYING CAPACITIES FOR RELATED ORGANIZATIONS. THE TOTAL HOURS THAT THESE EMPLOYEES WORK ON AVERAGE IS BETWEEN 35 AND 40 HOURS PER WEEK FOR THIS AND RELATED ORGANIZATIONS. NEW YORK STATE UNITED TEACHERS 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 LABOR ORGANIZATION NY 501(C)(5) N/A 0 NYSUT BUILDING CORPORATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141700200 BUILDING CORPORATION NY 501(C)(2) 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 VOICE OF TEACHERS FOR EDUCATIONCOMMITTEE ON POLICAL EDUCATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141565672 POLICAL ACTION COMMITTEE NY 527 N/A 0 NYSUT EMPLOYEES RETIREMENT PLAN 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE BENEFIT PLAN NY 501(A) N/A 0 NYSUT STAFF 401(K) PLAN 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE ELECTIVE BENEFIT PLAN NY 501(A) 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) 170(B)(1)(A)(II) N/A 0 NYSUT DISASTER RELIEF AND SCHOLARSHIP TRUST 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 113761261 PROVIDES DISASTER RELIEF AND SCHOLARSHIPS NY 501(C)(3) 170(B)(1)(A)(IV) 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 PLAN FOR FORMER EMPLOYEES OF NEA NY PLAN #006 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 141584772 NYSUT EMPLOYEE BENEFIT PLAN NY 501(A) N/A 0 NYSUT VOTECOPE UNAUTHORIZED COMMITTEE 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 273442678 POLICAL ACTION COMMITTEE NY 527 N/A 0 VOICE OF TEACHERS FOR EDUCATIONCOMMITTEE ON POLICAL EDUCATION 800 TROY SCHENECTADY ROAD LATHAM NY 121102455 264047272 POLICAL ACTION 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 -757051 478534 1.00000 1 1 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 NYSUT MEMBER BENEFITS CORPORATION A 114062 ACTUAL COSTS AND/OR FMV NYSUT MEMBER BENEFITS CORPORATION Q 220000 ACTUAL COSTS AND/OR FMV NYSUT MEMBER BENEFITS CORPORATION P 1850478 ACTUAL COSTS AND/OR FMV NYSUT MEMBER BENEFITS CORPORATION D 5882078 ACTUAL COSTS AND/OR FMV