SPECIAL AGENTS MUTUAL BENEFIT: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: SPECIAL AGENTS MUTUAL BENEFIT (EIN 52-1074154)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-05-06
IRS object ID: 201301279349300400
Schema version: 2012v2.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule D
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-06T12:07:00-05:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	521074154	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SPEC	NameControl
Phone	3019841440	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	11301 OLD GEORGETOWN ROAD	AddressLine1
City	ROCKVILLE	City
State	MD	State
ZIP Code	20852	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	KATHRYN DIEM	Name
Title	TREASURER	Title
Phone	3019844110	Phone
Date Signed	2013-04-23	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	KATHRYN DIEM	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	11301 OLD GEORGETOWN RD	AddressLine1
City	ROCKVILLE	City
State	MD	State
ZIP Code	20852	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	260509087	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	true	AllAffiliatesIncluded
Organization501c	X	Organization501c
Web Site	WWW.SAMBAPLANS.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1976	YearFormation
State Legal Domicile	DC	StateLegalDomicile
Activity Or Mission Description	TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN FOR ITS MEMBERSHIP.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	73	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	261904440	ProgramServiceRevenuePriorYear
Program Service Revenue CY	257499146	ProgramServiceRevenueCY
Investment Income Prior Year	3446579	InvestmentIncomePriorYear
Investment Income Current Year	3007980	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2444	OtherRevenuePriorYear
Other Revenue Current Year	1961	OtherRevenueCurrentYear
Total Revenue Prior Year	265353463	TotalRevenuePriorYear
Total Revenue Current Year	260509087	TotalRevenueCurrentYear
Grants And Similar Amnts CY	6010	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	221345458	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	226919529	BenefitsPaidToMembersCY
Salaries Etc Prior Year	6439117	SalariesEtcPriorYear
Salaries Etc Current Year	6445671	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	13845089	OtherExpensePriorYear
Other Expenses Current Year	19528780	OtherExpensesCurrentYear
Total Expenses Prior Year	241629664	TotalExpensesPriorYear
Total Expenses Current Year	252899990	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	23723799	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	7609097	RevenuesLessExpensesCY
Total Assets BOY	127930694	TotalAssetsBOY
Total Assets EOY	140138959	TotalAssetsEOY
Total Liabilities BOY	34317330	TotalLiabilitiesBOY
Total Liabilities EOY	36202190	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	93613364	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	103936769	NetAssetsOrFundBalancesEOY
Mission Description	TO SPONSOR AND ADMINISTER THE SAMBA BENEFIT PLAN (THE PLAN) FOR ITS MEMBERSHIP IN ACCORDANCE WITH ERISA. THE SAMBA BENEFIT PLAN INCLUDES HEALTH LIFE SICK ACCIDENT DENTAL VISION AND RELATED COVERAGES.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Description	SPONSORED HEALTH GROUP TERM LIFE DISABILITY ACCIDENT DENTAL AND VISION BENEFITS FOR APPROXIMATELY 120000 MEMBERS.	Description
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	18	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	73	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	JOHN R MARTUCCI	NamePerson
Telephone Number	3019844110	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	11301 OLD GEORGETOWN ROAD	AddressLine1
City	ROCKVILLE	City
State	MD	State
ZIP Code	20852	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
WALTER E WILSON
EXECUTIVE DIRECTOR	40	X	418642	0	22870
WILLIAM P O'HANLON
PRESIDENTBOARD MEMBER	4	X	46000	0	0	X
DAVID R LOESCH
VICE PRESIDENTBOARD MEMBER	1	X	3000	0	0	X
KATHRYN DIEM
TREASURER BOARD MEMBER	1	X	3000	0	0	X
DAVID ERMER
SECRETARY	1	X	0	0	0
JOSEPH R DAVIS
BOARD MEMBER	1		3000	0	0	X
CHARLENE B THORNTON
BOARD MEMBER	1		3000	0	0	X
ANGELA ZENTZ
BOARD MEMBER	1		0	0	0	X
PAMELA CUMMINGS
DEPUTY EXECUTIVE DIRECTOR	40		183434	0	23558		X
JOHN R MARTUCCI
CONTROLLER	40		159110	0	15265		X
M TODD SCHOENIAN
SENIOR PROGRAM ADMINISTRATOR	40		143197	0	14518			X
MARY K LIVINGSTON
MANAGER HEALTH PLANS	40		112774	0	17424			X
LYNN K CHANG
MANAGER INFORMATION TECHNOLOGY	40		111038	0	21208			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1186195	TotalReportableCompFromOrg
Total Other Compensation	114843	TotalOtherCompensation
Number Individuals GT100 K	6	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation	Address Line2AddressOfContractor/AddressUS/AddressLine2
CGLICIGNA HEALTHCARE
900 COTTAGE GROVE ROAD	HARTFORD	CT	06152	NETWORK ADMINISTRATOR	6775691
EXPRESS SCRIPTS INC
100 PARSON POND DR	FRANKLIN LAKES	NJ	07417	PHARMACY BENEFIT MANAGER	5963418
RAM TECHNOLOGIES INC
275 COMMERCE DRIVE	FORT WASHINGTON	PA	19034	COMPUTER SOFTWARE SERVICE	921916	SUITE 100
MULTIPLAN INC
115 FIFTH AVENUE	NEW YORK	NY	10003	NETWORK ADMINISTRATOR	688102
EBS MASTER LLC
3055 LEBANON PK	NASHVILLE	TN	37214	PRINTINGMAILING	617305

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	17	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PREMIUMS	525100	253990137	253990137
ADMINISTRATION FEES	525100	3701598	3701598
EXPERIENCE RATING ADJUSTMENT	525100	-192589	-192589

Field	Value	IRS element (for citing)
Total Program Service Revenue	257499146	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1607738	TotalRevenueColumn
Exclusion	$1,607,738	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	50286247	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	48886005	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	1400242	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	1400242	TotalRevenueColumn
Exclusion	$1,400,242	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	MISCELLANEOUS	Description
Business Code	524290	BusinessCode
Total Revenue Column	1961	TotalRevenueColumn
Exclusion	$1,961	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1961	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	260509087	TotalRevenueColumn
Related Or Exempt Function Income	257499146	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$3,009,941	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	6010	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	226919529	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	880878	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	3717847	Total

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	692215	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	810363	Total

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	344368	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	12077513	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	110898	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	155048	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	242847	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1565401	Total

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1093431	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	133523	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	41391	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1392763	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	115814	Total

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal
REINSURANCE EXPENSE	2050428
TAXES - PROPERTY	82998
CLEARINGHOUSE	13391

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	453334	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	252899990	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	500	BOY
EOY	500	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	53433442	BOY
EOY	54387851	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	19517561	BOY
EOY	20242721	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	387827	BOY
EOY	384871	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	11828133	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	8397260	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3444680	BOY
EOY	3430873	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	50222999	BOY
EOY	60987717	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	923685	BOY
EOY	704426	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	127930694	BOY
EOY	140138959	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	787312	BOY
EOY	1143126	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	2427740	BOY
EOY	934157	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	31102278	BOY
EOY	34124907	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	34317330	BOY
EOY	36202190	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	93613364	BOY
EOY	103936769	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	93613364	BOY
EOY	103936769	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	127930694	BOY
EOY	140138959	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	7609097	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	1593857	ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment	814359	ReconcilationPriorAdjustment
Reconcilation Other Changes	306092	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	600000	OtherCostOrOtherBasis
Book Value	600000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4318590	OtherCostOrOtherBasis
Depreciation	3885513	Depreciation
Book Value	433077	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6516680	OtherCostOrOtherBasis
Depreciation	4241457	Depreciation
Book Value	2275223	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	392863	OtherCostOrOtherBasis
Depreciation	270290	Depreciation
Book Value	122573	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3430873	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
FUNDS IN EXCESS OF RESERVE - FSL	418570
REINSURANCE RECOVERABLE ON PAID CLAIMS	285856

Field	Value	IRS element (for citing)
Total Book Value Other Assets	704426	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescription	AmountAmount
GROUP INSURANCE PREMIUM PAYABLE	$2,197,860
PROVISION FOR POST RETIREMENT	$604,200
RESERVE IN EXCESS OF FUNDS - ALLIANZ	$644,488
ACCRUED PENSION LIABILITY	$2,102,400
RESERVE FOR UNPAID CLAIMS	$28,575,959

Field	Value	IRS element (for citing)
Total Of Amounts	34124907	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	264124766	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	1593857	NetUnrealizedGainsInvestments
Other Revenues	2021822	OtherRevenues
Revenue Not Rptd F990	3615679	RevenueNotRptdF990
Revenue Subtotal	260509087	RevenueSubtotal
Total Revenue Per Form990	260509087	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	254921812	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	2021822	OtherExpensesIncluded
Expenses Not Rptd F990	2021822	ExpensesNotRptdF990
Expenses Subtotal	252899990	ExpensesSubtotal
Total Expenses Per Form990	252899990	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Explanation	PART X LINE 2 U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE MANAGEMENT OF A PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECORD A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER TAXING AUTHORITIES. MANAGEMENT HAS EVALUATED TAX POSITIONS TAKEN BY THE PLAN AND CONCLUDED THAT AS OF DECEMBER 31 2012 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECETED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS HOWEVER THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY TAX PERIODS. MANAGEMENT BELIEVES THAT THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. PART XI LINE 2D OTHER REVENUE ON AUDITED FINANCIAL STATEMENTS NOT ON RETURN INTERPLAN ALLOCATIONS - 2021822 PART XIILINE 2D OTHER EXPENSES ON AUDDITED FINANCIAL STATEMENTS NOT ON RETURN INTERPLAN ALLOCATIONS - 2021822	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg
WALTER E WILSON
308741	102347	7554	9517	13353	441512
PAMELA CUMMINGS
165434	18000		8736	14822	206992
JOHN R MARTUCCI
153110	6000		6833	8433	174376
M TODD SCHOENIAN
136697	6500		6086	8432	157715

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

ExplanationExplanation

FORM 990 PART VI SECTION A LINE 6 MEMBERSHIP IN THE CORPORATION SHALL BE OPEN TO INDIVIDUALS WHO ARE ACTIVE EMPLOYEES OF A SAMBA ELIGIBLE EMPLOYING AGENCY OR WHO ARE RETIRED FROM A SAMBA ELIGIBLE EMPLOYING AGENCY UNDER ANY ESTABLISHED RETIREMENT PROGRAM. THE TERM SAMBA ELIGIBLE EMPLOYING AGENCY MEANS ANY BRANCH DEPARTMENT OR AGENCY OF THE UNITED STATES GOVERNMENT INCLUDING WITHOUT LIMITATION THE U.S. POSTAL SERVICE AND U.S. COURTS. MEMBERSHIP IN THE CORPORATION SHALL CONSIST OF TWO CLASSES REGULAR MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT REGULAR MEMBERSHIP BY ENROLLING IN THE HEALTH BENEFIT PLAN. REGULAR MEMBERS ALSO MAY ENROLL IN OTHER PLAN PROGRAMS IN ACCORDANCE WITH AND AS PERMITTED BY THE PLAN DOCUMENTS. REGULAR MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF THE HEALTH BENEFIT PLAN COVERAGE. MEMBERSHIP AT THAT TIME WILL CONVERT TO ASSOCIATE MEMBERSHIP IF THE INDIVIDUAL REMAINS ENROLLED IN ANY OTHER PLAN PROGRAM. ASSOCIATE MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT ASSOCIATE MEMBERSHIP BY ENROLLING IN A PLAN PROGRAM OTHER THAN THE HEALTH BENEFIT PLAN IN ACCORDANCE WITH AND AS PERMITTED BY THE PLAN DOCUMENTS. ASSOCIATE MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF PLAN COVERAGE UNLESS THE INDIVIDUAL TRANFERS EMPLOYMENT TO ANOTHER AGENCY IN WHICH CASE HE OR SHE MAY CONTINUE HIS OR HER ENROLLMENT AND ASSOCIATE MEMBERSHIP WHILE SO EMPLOYED. FOR PERSONS WHO DO NOT MEET THE CRITERIA FOR REGULAR OR ASSOCIATE MEMBERSHIP THE BOARD OF DIRECTORS MAY IN ITS DISCRETION DEFINE A SPECIAL CLASS OF MEMBERSHIP BY VIRTUE OF (1) EMPLOYMENT OR SERVICE WITH THE CORPORATION (2) PREVIOUS ENROLLMENT IN A PLAN SPONSORED BY THE CORPORATION OR (3) SECTION 409 OF THE INDIAN HEALTHCARE IMPROVEMENT ACT (IHCIA) AS INCORPORATED AND AMMENDED BY SUBSECTION 10221 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) ALLOWING INDIAN TRIBES OR TRIBAL ORGANIZATIONS OR URBAN INDIAN ORGANIZATIONS AND THEIR EMPLOYEES TO PURCHASE COVERAGE UNDER THE FEDERAL EMPLOYEES HEALTH BENEFIT PROGRAM OR ANY OTHER SUCCESSOR PROGRAM AS SUCH TERMS ARE DEFINED THEREIN. PERSONS ADMITTED AS SPECIAL MEMBERS IN THE CORPORATION SHALL HAVE ALL THE RIGHTS ACCORDED ASSOCIATE MEMBERS AND MAY ENROLL IN A PLAN SPONSORED BY THE CORPORATION IF PERMITTED UNDER APPLICABLE LAW. FORM 990 PART VI SECTION A LINE 7A REGULAR MEMBERS SHALL HAVE THE RIGHT TO VOTE IN THE ELECTION OF DIRECTORS. EXCEPT AS OTHERWISE EXPRESSLY STATED IN THE BYLAWS OR IN THE ARTICLES OF INCORPORATION MEMBERS INCLUDING REGULAR MEMBERS SHALL NOT HAVE THE RIGHT TO VOTE ON ANY OTHER MATTERS AFFECTING THE CORPORATION INCLUDING BUT NOT LIMITED TO MERGER CONSOLIDATION AND DISSOLUTION. FORM 990 PART VI SECTION B LINE 11B THE FORM 990 IS REVIEWED BY BOTH THE CONTROLLER AND THE ORGANIZATION'S OUTSIDE AUDIT FIRM BEFORE IT IS SUBMITTED TO THE TREASURER FOR FINAL REVIEW AND SIGNATURE. FORM 990 PART VI SECTION B LINE 12C OFFICERS DIRECTORS OR TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST INCLUDING BUT NOT LIMITED TO EMPLOYMENT AND ANY WORK PERFORMED FOR ANOTHER ORGANIZATION PAID OR UNPAID. FORM 990 PART VI SECTION B LINE 15A THE BOARD OF DIRECTORS SETS THE COMPENSATION OF THE EXECUTIVE DIRECTOR BASED UPON OUTSIDE RECOMMENDATIONS AND STATISICAL DATA. THE EXECUTIVE DIRECTOR'S COMPENSATION WAS LAST REVIEWED IN JANUARY 2012. FORM 990 PART VI SECTION C LINE 19

THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S BYLAWS ARE AVAILABLE ON ITS WEBSITE FOR ANYONE TO VIEW WITH THE LATEST UPDATE AS OF OCTOBER 1 2012. FORM 990 PART XI LINE 8 PRIOR PERIOD ADJUSTMENT OF 814359 IS A CORRECTION OF A PREVIOUS OVERSTATEMENT OF AN OBLIGATION DUE TO A CARRIER. FORM 990 PART XI LINE 9 OTHER CHANGES TO NET ASSETS OR FUND BALANCE OF 306092 CONSISTS OF THE FOLLOWING INCREMENTAL EFFECT OF FASB 158 332418 CONTIGENCY RESERVE PAYMENT (26326)