2013-02-12T10:18:47-06:00 2012-06-30 231551315 TROUT EBERSOLE & GROFF LLP 1705 OREGON PIKE LANCASTER PA 17601 990 2011-07-01 263118644 SHARED SERVICES HEALTH PLAN TRUST SHAR 7177962200 C/O BENECON GROUP 147 W AIRPORT RD LITITZ PA 17543 MICHAEL COYNE 7177962200 2013-01-17 1 KRISTA SHOWERS P00326894 7175692900 2011 2016-03-07 17:11:31Z MICHAEL COYNE C/O BENECON GROUP 147 W AIRPORT RD LITITZ PA 17543 16803040 0 X N/A X 2008 PA PROVIDE HEALTH, VISION, AND PRESCRIPTION BENEFITS TO COVERED PARTICIPANTS. 4 0 0 0 0 0 0 0 7366901 16794840 3979 8200 0 0 7370880 16803040 0 0 0 14345421 6135392 0 0 0 0 422762 1019805 6558154 15365226 812726 1437814 3480473 4918287 0 0 3480473 4918287 THE SHARED SERVICES HEALTH PLAN PROVIDES HEALTH, VISION, AND PRESCRIPTION BENEFITS TO EMPLOYEES AND CERTAIN FORMER EMPLOYEES OF PARTICIPATING EMPLOYERS - ALL OF WHICH ARE NON-PROFIT COLLEGES AND UNIVERSITIES LOCATED IN THE COMMONWEALTH OF PENNSYLVANIA. 0 0 15127237 EMPLOYER AND PARTICIPANT CONTRIBUTIONS AS WELL AS REIMBURSEMENTS FROM A REINSURANCE POLICY ARE USED FOR THE PAYMENT OF HEALTH, VISION, AND PRESCRIPTION CLAIMS, AS WELL AS ADMINISTRATIVE EXPENSES. 15127237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 1 0 0 1 1 0 1 0 0 0 1 0 0 0 0 0 0 X BENECON 7177234661 147 W AIRPORT ROAD LITITZ PA 17543 X X MICHAEL COYNE 2.00 X X 0 0 0 GREG FULMER 1.00 X X 0 0 0 RANDY ELDRIDGE 1.00 X X 0 0 0 RICHARD BAILEY 1.00 X X 0 0 0 0 0 0 0 0 0 0 HIGHMARK BLUE SHIELD 1800 CENTER STREET SP/6-W CAMP HILL PA 17089 CLAIMS ADMINISTRATOR 587319 THE BENECON GROUP INC 147 WEST AIRPORT RD LITITZ PA 17549 CONTRACT ADMINISTRATOR 202582 CAPITAL BLUE CROSS 2500 ELMERTON AVENUE HARRISBURG PA 17110 CLAIMS ADMINISTRATOR 120653 3 EMPLOYER CONTRIBUTIONS 525100 12627405 12627405 EMPLOYEE CONTRIBUTIONS 525100 2730627 2730627 RETIREE CONTRIBUTIONS 525100 271766 271766 COBRA DEPOSITS 525100 150121 150121 1014921 1014921 16794840 8200 8200 16803040 16803040 0 0 14345421 14345421 202582 202582 8538 8538 20700 20700 781816 781816 884 884 5285 5285 15365226 15127237 237989 0 165834 372684 2762213 4056207 552426 489396 3480473 4918287 0 0 X 0 0 0 0 3480473 4918287 3480473 4918287 3480473 4918287 1437814 0 X X 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S TRUSTEES HAVE ENGAGED A THIRD-PARTY ADMINISTRATOR (TPA) TO PERFORM THE DAY-TO-DAY MANAGEMENT FUNCTIONS OF THE TRUST AND THE UNDERLYING EMPLOYEE BENEFIT PLAN. THE TRUSTEES MONITOR THE ACTIVITIES OF THE TPA AS PART OF THREE (MINIMUM) BOARD MEETINGS PER YEAR AND ALSO THROUGH FINANCIAL REPORTING IN THE INTERIM. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A TRUST FOR FEDERAL INCOME TAX PURPOSES. ITS APPLICATION FOR TAX EXEMPT STATUS UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE WAS APPROVED ON MAY 17, 2011, EFFECTIVE NOVEMBER 1, 2008. THE TRUST WAS ESTABLISHED BY THREE PARTICIPATING MEMBER COLLEGES (MEMBERS) AND SHARED SERVICES CONSORTIUM, LLC (SSC), AN EMPLOYER ORGANIZATION. THE RIGHTS AND OBLIGATIONS OF EACH MEMBER AND SSC ARE OUTLINED IN THE SHARED SERVICES HELATH PLAN TRUST AGREEMENT. EFFECTIVE JANUARY 1, 2012 A FOURTH MEMBER COLLEGE JOINED. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS COMPRISED OF ONE REPRESENTATIVE FOR EACH PARTICIPATING EMPLOYER. THE PARTICIPATING EMPLOYERS APPOINT THEIR RESPECTIVE BOARD MEMBER. FORM 990, PART VI, SECTION A, LINE 8B THE BOARD CURRENTLY DOES NOT HAVE ANY COMMITTEES, THEREFORE, NO MINUTES WERE PREPARED. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF THE FORM 990 WAS EMAILED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 PLAN PARTICIPANTS ARE INSTRUCTED VIA THE SHARED SERVICES HEALTH PLAN'S SUMMARY ANNUAL REPORT TO REQUEST INFORMATION BY CONTACTING THEIR RESPECTIVE EMPLOYER'S HUMAN RESOURCE OFFICE OR THE OFFICES OF THE TPA. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII MICHAEL COYNE - C/O BENECON GROUP, 147 W AIRPORT RD, LITITZ, PA 17543. GREG FULMER - C/O BENECON GROUP, 147 W AIRPORT RD, LITITZ, PA 17543. RANDY ELDRIDGE - C/O BENECON GROUP, 147 W AIRPORT RD, LITITZ, PA 17543. RICHARD BAILEY - C/O BENECON GROUP, 147 W AIRPORT RD, LITITZ, PA 17543. FORM 990, PART VII: THE SHARED SERVICE HEALTH PLAN TRUST (SSHPT) TRUSTEES ARE EMPLOYEES OF THE ORGANIZATIONS PARTICIPATING IN THE SHARED SERVICES HEALTH PLAN. THE TRUSTEES' COMPENSATION PAID BY THE RELATED ORGANIZATIONS IS ATTRIBUTABLE TO THEIR EMPLOYMENT AT THESE ORGANIZATIONS. NO ADDITIONAL COMPENSATION IS RECEIVED FOR THEIR SSHPT TRUSTEE FUNCTION. NO REASONABLE ESTIMATE CAN BE MADE OF WHAT PORTION OF THE COMPENSATION PAID BY THE RELATED ORGANIZATIONS, IF ANY, WOULD BE REFLECTIVE OF THEIR ROLE AS SSHP TRUSTEES WHICH IS LIMITED TO ONE OR TWO HOURS PER WEEK. THE FULL COMPENSATION OF THE TRUSTEES IS THEREFORE CONSIDERED FOR THE FORM 990 REPORTING OF THE PARTICIPATING EMPLOYERS AND IS NOT REFLECTED ON THE SHARED SERVICES HEALTH PLAN TRUST'S FORM 990. FORM 990, PART XII: THE MODIFIED CASH BASIS OF ACCOUNTING IS A COMPREHENSIVE BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. UNDER THE MODIFIED CASH BASIS OF ACCOUNTING, ONLY REVENUES COLLECTED, COSTS AND EXPENSES PAID, AND ASSETS AND LIABILITIES ARISING AS A RESULT OF CASH TRANSACTIONS OR FROM THE RECOGNITION OF INCOME DUE FROM INSURANCE COMPANIES FOR CLAIMS ARE RECOGNIZED. FRANKLIN & MARSHALL COLLEGE PO BOX 3003 LANCASTER PA 176043003 231352635 EDUCATION PA 501(C)(3) SCHOOL N/A 0 ROSEMONT COLLEGE OF THE HOLY CHILD JESUS 1400 MONTGOMERY AVE ROSEMONT PA 190101631 231365966 EDUCATION PA 501(C)(3) SCHOOL N/A 0 SUSQUEHANNA UNIVERSITY 514 UNIVERSITY AVE SELINSGROVE PA 178701164 231353385 EDUCATION PA 501(C)(3) SCHOOL N/A 0 ELIZABETHTOWN COLLEGE ONE ALPHA DRIVE ELIZABETHTOWN PA 170222298 231352632 EDUCATION PA 501(C)(3) SCHOOL N/A 0 SHARED SERVICES CONSORTIUM LLC 147 W AIRPORT RD LITITZ PA 17543 251882792 PLAN SPONSOR PA N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 SCHEDULE R, PART V, LINE 1K AND R: THE TRUST RECEIVES CONTRIBUTIONS FROM PARTICIPATING EMPLOYERS AS LISTED IN SCHEDULE R, PART II) AND THEIR CURRENT AND/OR FORMER EMPLOYEES FOR THE PURPOSE OF PAYING SELF-INSURED EMPLOYEE BENEFITS AS WELL AS THE COSTS ASSOCIATED WITH ADMINISTERING THOSE BENEFITS.