2015-11-10T14:13:08-06:00 2014-12-31 580942047 BABUSH NEIMAN KORNMAN & JOHNSON LLP 5909 PEACHTREE DUNWOODY RD SUITE 800 ATLANTA GA 30328 990 2014-01-01 276362820 GEORGIA CANCER SPECIALISTS IPC VOLUNTARY EMPLOYEES BENEFICIARY ASSOC GEOR 7704969400 1835 SAVOY DRIVE SUITE 300 ATLANTA GA 30341 AL SOLTAN MD PRESIDENT 7704969400 2015-11-09 1 HOWARD F NEIMAN P00029525 7702611900 2014 2016-04-25 22:37:26Z X ASSOCIATION TRUST DR AL SOLTAN 1835 SAVOY DRIVE ATLANTA GA 30341 2661616 0 X N/A X 2009 GA TO PROVIDE VARIOUS WELFARE BENEFITS TO ALL EMPLOYEES OF GEORGIA CANCER SPECIALISTS I, P.C. 1 1 0 0 0 0 0 0 2644559 2661616 0 0 0 0 2644559 2661616 0 0 3577250 2705021 0 0 0 0 0 13527 14598 3590777 2719619 -946218 -58003 58003 0 0 0 58003 0 X COLLECTS INSURANCE PREMIUMS FROM EMPLOYEES AND EMPLOYER AND PAYS HEALTH & INSURANCE BENEFITS ON BEHALF OF HEALTH CARE PLAN (GEORGIA CANCER SPECALIST I, P.C. WELFARE BENEFIT PLAN.) 0 1 2719619 2661616 COLLECTION OF INSURANCE PREMIUMS AND PAYMENT OF HEALTH AND INSURANCE BENEFITS FOR GEORGIA CANCER SPECIALISTS I, P.C. WELFARE BENEFIT PLAN. 2719619 0 0 0 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 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 X 1 1 0 0 1 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 GA X WYANE CERSEY 7704969400 1835 SAVOY DRIVE SUITE 300 ATLANTA GA 30341 AL SOLTAN PRESIDENT 1.00 40.00 X 0 663079 0 CHERYL JONES VICE PRESIDENT 1.00 40.00 X 0 806949 0 STEPHEN SZABO SECRETARY 1.00 40.00 X 0 1155614 0 GERALD GOLDKLANG BOARD OF DIRECTOR 1.00 40.00 X 0 731890 0 GENA VOLAS-REDD BOARD OF DIRECTOR 1.00 40.00 X 0 1077206 0 JOHN MANFREDI BOARD OF DIRECTOR 1.00 40.00 X 0 792573 0 JAYANTHI SRINIVASIAH BOARD OF DIRECTOR 1.00 40.00 X 0 1152046 0 LAURA WEAKLAND BOARD OF DIRECTOR 1.00 40.00 X 0 725493 0 NISHAN FERNANDO BOARD OF DIRECTOR 1.00 40.00 X 0 662510 0 PRADEEP JOLLY BOARD OF DIRECTOR 1.00 40.00 X 0 740872 0 RICHARD LOYD BOARD OF DIRECTOR 1.00 40.00 X 0 676286 0 AARON ALIZADEH HIGHEST COMPENSATED EMPLOYEE 1.00 40.00 X 0 880367 0 RAO MORAVINENI HIGHEST COMPENSATED EMPLOYEE 1.00 40.00 X 0 1077076 0 ANTHONY LAGROON FORMER TRUSTEE 0.00 0.00 X 0 199310 22473 0 11341271 22473 0 1 1 0 AETNA 151 FARMINGTON AVENUE HARTFORD CT 06156 ADMINISTRATION OF BENEFIT PLAN 2205526 MUTUAL OF OMAHA MUTUAL OF OMAHA PLAZA OMAHA NE 68175 ADMINISTRATION OF BENEFIT PLAN 196964 AMERITAS 5900 O STREET LINCOLN NE 68510 ADMINISTRATION OF BENEFIT PLAN 178499 3 EMPLOYER CONTRIBUTIONS 900001 2209214 2209214 EMPLOYEE CONTRIBUTIONS 900001 452402 452402 2661616 2661616 0 0 2661616 2705021 2705021 ADMINISTRATIVE EXPENSES 14598 14598 2719619 2719619 0 0 58003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58003 0 0 0 X 0 0 0 0 58003 0 58003 0 58003 0 -58003 0 X X 0 1 X 1 0 0 2661616 0 2661616 0 2661616 2719619 0 2719619 0 2719619 0 0 0 AL SOLTAN PRESIDENT 0 639009 0 0 0 24070 0 0 0 0 0 663079 0 0 CHERYL JONES VICE PRESIDENT 0 782879 0 0 0 24070 0 0 0 0 0 806949 0 0 STEPHEN SZABO SECRETARY 0 1132036 0 0 0 23578 0 0 0 0 0 1155614 0 0 GERALD GOLDKLANG BOARD OF DIRECTOR 0 706584 0 0 0 25306 0 0 0 0 0 731890 0 0 GENA VOLAS-REDD BOARD OF DIRECTOR 0 1053628 0 0 0 23578 0 0 0 0 0 1077206 0 0 JOHN MANFREDI BOARD OF DIRECTOR 0 773711 0 0 0 18862 0 0 0 0 0 792573 0 0 JAYANTHI SRINIVASIAH BOARD OF DIRECTOR 0 1127976 0 0 0 24070 0 0 0 0 0 1152046 0 0 LAURA WEAKLAND BOARD OF DIRECTOR 0 701423 0 0 0 24070 0 0 0 0 0 725493 0 0 NISHAN FERNANDO BOARD OF DIRECTOR 0 638944 0 0 0 23566 0 0 0 0 0 662510 0 0 PRADEEP JOLLY BOARD OF DIRECTOR 0 716070 0 0 0 24802 0 0 0 0 0 740872 0 0 RICHARD LOYD BOARD OF DIRECTOR 0 651937 0 0 0 24349 0 0 0 0 0 676286 0 0 AARON ALIZADEH HIGHEST COMPENSATED EMPLOYEE 0 856789 0 0 0 23578 0 0 0 0 0 880367 0 0 RAO MORAVINENI HIGHEST COMPENSATED EMPLOYEE 0 1053498 0 0 0 23578 0 0 0 0 0 1077076 0 0 ANTHONY LAGROON FORMER TRUSTEE 0 199310 0 0 0 0 0 0 0 22473 0 221783 0 0 EFFECTIVE NOV 6, 2014, PLAN GOVERNANCE ISSUED A RESOLUTION TO TERMINATE AND DISSOLVE VEBA. 0 0 0 0 1 1 1 1 0 FORM 990, PART III, LINE 3 EFEFCTIVE NOVEMBER 6, 2014, PLAN GOVERNANCE ISSUED A RESOLUTION TO TERMINATE AND DISSOLVE VEBA PLAN. FORM 990, PART VI, SECTION A, LINE 4 THE VEBA PLAN TERMINATED AND DISSOLVED ON NOV 6,2014 THEREBY ORGANIZATION MADE SIGNIFICANT CHANGES TO ITS ORGANIZATIONAL DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE AS TO HOW THE AUDITOR WAS SELECTED SINCE THE PLAN WAS CREATED IN 2009. THE PLAN TRUSTEES MAKE SUCH DECISION. GEORGIA CANCER SPECIALISTS I PC 1835 SAVOY DRIVE STE 300 ATLANTA GA 30341 582181189 HEALTH CARE SERVICES GA N/A S 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 GEORGIA CANCER SPECIALISTS I PC S 2661616 FMV