﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2013v3.1" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2014-11-13T12:43:17-08:00</ReturnTs>
    <TaxPeriodEndDt>2013-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmName>
        <BusinessNameLine1>Robinson &amp; Gordon CPAS PC</BusinessNameLine1>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1>95 Allens Creek Rd Bldg 1 202</AddressLine1>
        <City>Rochester</City>
        <State>NY</State>
        <ZIPCode>14618</ZIPCode>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2013-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>160973194</EIN>
      <BusinessName>
        <BusinessNameLine1>MONROE PLAN FOR MEDICAL CARE INC</BusinessNameLine1>
      </BusinessName>
      <BusinessNameControlTxt>MONR</BusinessNameControlTxt>
      <PhoneNum>5852568462</PhoneNum>
      <USAddress>
        <AddressLine1>1120 PITTSFORD-VICTOR ROAD</AddressLine1>
        <City>PITTSFORD</City>
        <State>NY</State>
        <ZIPCode>14534</ZIPCode>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MICHAEL MESSIER</PersonNm>
      <PersonTitleTxt>CFO\EVP</PersonTitleTxt>
      <SignatureDt>2014-11-13</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Mark J Robinson</PreparerPersonNm>
      <PTIN>P00189672</PTIN>
      <PhoneNum>5852449590</PhoneNum>
    </PreparerPersonGrp>
    <TaxYr>2013</TaxYr>
    <BuildTS>2015-11-30 17:44:51Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="4">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO" softwareId="13000170" softwareVersion="2013v3.1">
      <GrossReceiptsAmt>243474488</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <AllAffiliatesIncludedInd>false</AllAffiliatesIncludedInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>www.monroeplan.com</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1970</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>PROVIDE HEALTH CARE TO GOVERNMENT PROGRAM ELIGIBLES</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>16</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>16</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>221</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>96000</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>802518941</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>170344654</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>5288173</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3470478</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>2864684</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>10896690</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>810767798</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>184711822</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>15391856</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>13601429</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>833385675</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>157668666</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>848777531</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>171270095</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-38009733</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>13441727</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>135396394</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>94091541</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>80952451</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>28937371</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>54443943</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>65154170</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>PROVIDE HEALTH CARE TO GOVERNMENT PROGRAM ELIGIBLES</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <Desc>TO PROVIDE MEDICAL AND MENTAL HEALTH MANAGED CARE TO GOVERNMENT PROGRAM ELIGIBLES ADULTS AND CHILDREN</Desc>
      <DescribedInSection501c3Ind>false</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD">false</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="IRS990ScheduleD">false</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>false</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd>false</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>32</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>221</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>false</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <ExcessBusinessHoldingsInd>false</ExcessBusinessHoldingsInd>
      <TaxableDistributionsInd>false</TaxableDistributionsInd>
      <DistributionToDonorInd>false</DistributionToDonorInd>
      <OrgFiledInLieuOfForm1041Ind>false</OrgFiledInLieuOfForm1041Ind>
      <LicensedMoreThanOneStateInd>false</LicensedMoreThanOneStateInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>16</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>16</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>false</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>MICHAEL MESSIER</PersonNm>
        <PhoneNum>5852568462</PhoneNum>
        <USAddress>
          <AddressLine1>1120 PITTSFORD-VICTOR ROAD</AddressLine1>
          <City>PITTSFORD</City>
          <State>NY</State>
          <ZIPCode>14534</ZIPCode>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN H MCDANIEL PHD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM H BAYER MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENNIS GRAZIANO</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>411362</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>83487</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARILYN R BROWN MD</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM A DOLAN MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA HARRIS MD</PersonNm>
        <TitleTxt>Vice CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ARTHUR D PELLITTIERI MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES NORMAN</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARDY SANDLER LMSW</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AARON SATLOFF MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LARRY DENK MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LEON N ZOGHLIN MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELIZABETH NAUMBURG MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PETER SZILAGYI MD MPH</PersonNm>
        <TitleTxt>Chairman</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRENDAN BRADY MD</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALEXANDER STRASSER MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH STANKAITIS</PersonNm>
        <TitleTxt>Chief Med Off.</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>503719</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>122621</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIM HESS</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>283792</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>58894</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL MESSIER</PersonNm>
        <TitleTxt>CFO/EVP</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>423664</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>119255</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HOWARD BRILL</PersonNm>
        <TitleTxt>DIRECTOR OF INFORMATICS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>241825</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44539</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GEORGE HUGHES</PersonNm>
        <TitleTxt>DIRECTOR OF BENEFITS &amp; PR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>212512</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44339</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA O'DONNELL</PersonNm>
        <TitleTxt>DIR. CLINICAL MANAGEMENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>130413</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33101</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANA BESAW</PersonNm>
        <TitleTxt>PROCESS IMPROV MGR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>114303</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32154</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT FERRIS</PersonNm>
        <TitleTxt>MANAGER I.T.</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>106501</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19973</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIO MACIAS</PersonNm>
        <TitleTxt>MGR PROV. RELATION</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>99076</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12974</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH HENDERSON</PersonNm>
        <TitleTxt>ENT. ARCHITECT MGR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>113185</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25812</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY JOAN MUSCOLINO</PersonNm>
        <TitleTxt>MANAGER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>103205</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19179</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2743557</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>616328</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>11</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>SUNGARD AVAILABILITY SERVICES LP</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>PO BOX 91233</AddressLine1>
            <City>CHICAGO</City>
            <State>IL</State>
            <ZIPCode>60693</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>COMPUTER CONSULTING</ServicesDesc>
        <CompensationAmt>176664</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>MANATT PHELPS &amp; PHILLIPS LLP</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>7 TIMES SQUARE 23RD FLOOR</AddressLine1>
            <City>NEW YORK</City>
            <State>NY</State>
            <ZIPCode>10036</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL</ServicesDesc>
        <CompensationAmt>283632</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>2</CntrctRcvdGreaterThan100KCnt>
      <TotalContributionsAmt>0</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PROGRAM REVENUES</Desc>
        <TotalRevenueColumnAmt>170344654</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>170344654</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>170344654</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2883892</TotalRevenueColumnAmt>
        <ExclusionAmt>2883892</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>59349252</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>58762666</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>586586</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>586586</TotalRevenueColumnAmt>
        <ExclusionAmt>586586</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>EQUITY ERNGS JNT VENTURE</Desc>
        <TotalRevenueColumnAmt>1799764</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1799764</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PRIOR PERIOD ADJUSTMENTS</Desc>
        <TotalRevenueColumnAmt>9096926</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9096926</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>10896690</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>184711822</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>181241344</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>3470478</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2713523</TotalAmt>
        <ManagementAndGeneralAmt>1664108</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>9277167</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>693667</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>0</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>917072</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>92633</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>62564</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2136067</TotalAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>216228</TotalAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>0</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>112601</TotalAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>66719</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>203874</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>2230354</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PROGRAM SERVICES</Desc>
        <TotalAmt>147929696</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TEMPORARY HELP</Desc>
        <TotalAmt>2676121</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS PRINCIPALLY RENT</Desc>
        <TotalAmt>548941</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Postage and Shipping</Desc>
        <TotalAmt>403423</TotalAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>989445</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>171270095</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1664108</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <EOYAmt>0</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>17948940</BOYAmt>
        <EOYAmt>14557026</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>25707806</BOYAmt>
        <EOYAmt>2205016</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>80000</BOYAmt>
        <EOYAmt>70000</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>302672</BOYAmt>
        <EOYAmt>857114</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>3941339</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1281848</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2716960</BOYAmt>
        <EOYAmt>2659491</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>45449285</BOYAmt>
        <EOYAmt>56045316</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>43190731</BOYAmt>
        <EOYAmt>17697578</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>135396394</BOYAmt>
        <EOYAmt>94091541</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4227397</BOYAmt>
        <EOYAmt>3175253</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>76725054</BOYAmt>
        <EOYAmt>25762118</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>80952451</BOYAmt>
        <EOYAmt>28937371</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>54443943</BOYAmt>
        <EOYAmt>65154170</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>54443943</BOYAmt>
        <EOYAmt>65154170</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>135396394</BOYAmt>
        <EOYAmt>94091541</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>13441727</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-2731500</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="13000170" softwareVersion="2013v3.1">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1350538</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>336743</DepreciationAmt>
        <BookValueAmt>1013795</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1207845</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>138389</DepreciationAmt>
        <BookValueAmt>1069456</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>1382956</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>806716</DepreciationAmt>
        <BookValueAmt>576240</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>2659491</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>ADVANCE PAYMENTS</Desc>
        <BookValueAmt>17233</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ASSETS HELD IN TRUST</Desc>
        <BookValueAmt>537500</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DEFERRED COMP ASSET</Desc>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DEPOSITS</Desc>
        <BookValueAmt>250000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RECEIVABLE FROM JOINT VENTURE</Desc>
        <BookValueAmt>1586197</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>17697578</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>BENEFIT CLAIMS PAYABLE</Desc>
        <Amt>9796406</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LIABILITIES HELD IN TRUST</Desc>
        <Amt>537500</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER PAYABLES</Desc>
        <Amt>15428212</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>25762118</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>181980322</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-2731500</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-2731500</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>184711822</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>184711822</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>171270095</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>171270095</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>171270095</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>Management evaluates any significant tax implications that may effect the financial statements and does not believe that it has taken any positions that would affect the audited statements.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="13000170" softwareVersion="2013v3.1">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>true</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DENNIS GRAZIANO</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>317659</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>60200</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>33503</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>60100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23387</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>494849</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GEORGE HUGHES</PersonNm>
        <TitleTxt>DIRECTOR OF BENEFITS &amp; PR</TitleTxt>
        <BaseCompensationFilingOrgAmt>174502</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>35415</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2595</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>17163</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27176</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>256851</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HOWARD BRILL</PersonNm>
        <TitleTxt>DIRECTOR OF INFORMATICS</TitleTxt>
        <BaseCompensationFilingOrgAmt>199046</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>39924</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2855</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18804</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25735</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>286364</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSEPH STANKAITIS</PersonNm>
        <TitleTxt>Chief Med Off.</TitleTxt>
        <BaseCompensationFilingOrgAmt>350211</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>43378</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>110130</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>88200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>34421</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>626340</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>75000</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIM HESS</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>214948</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>38050</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>30794</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>24999</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33895</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>342686</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LINDA O'DONNELL</PersonNm>
        <TitleTxt>DIR. CLINICAL MANAGEMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>111009</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>16951</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2453</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10466</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22635</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>163514</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL MESSIER</PersonNm>
        <TitleTxt>CFO/EVP</TitleTxt>
        <BaseCompensationFilingOrgAmt>274786</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>42373</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>106505</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>88200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>31055</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>542919</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>75000</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="13000170" softwareVersion="2013v3.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO/CFO/COO &amp; CHIEF COMPLIANCE OFFICER REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization requires annual disclosures from Directors, Key Employees and Officers concerning conflicts of interest. The Chief Compliance Officer is responsible for ensuring compliance with this policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPARABILITY DATA AND OTHER OUTSIDE SOURCES ARE USED TO DETERMINE THE CEO SALARY. THE BOARD APPROVES THE SALARY AND MAINTAINS AN EMPLOYMENT AGREEMENT FOR THAT POSITION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>Comparability data and other outside sources are used for the officers and Key employees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL STATEMENTS,TAX RETURNS AND GOVERNING DOCUMENTS are AVAILABLE UPON REQUEST. OTHER policies are available on the organization's website.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>