2026-05-15T11:15:08-07:00 2025-06-30 990 2024-07-01 521588740 PENNSYLVANIA EMPLOYEES BENEFIT TRUST FUND PENN 7175657318 150 South 43rd Street Harrisburg PA 17111 Sharon Young CFO 7175657318 2026-05-15 1 2024 2025-03-06 01:10:19Z Don Clair 150 South 43rd Street Harrisburg PA 17111 1754799387 0 X www.PEBTF.org X 1988 PA Trust for the provision of employee benefits to employees of the Commonwealth of Pennsylvania. 18 18 113 18 0 0 0 0 1314022327 1465232620 34695852 47874637 0 0 1348718179 1513107257 0 0 1134318542 1265283071 6698728 7275499 0 0 0 30673140 29129758 1171690410 1301688328 177027769 211418929 1187630384 1417128551 121037571 134481286 1066592813 1282647265 Trust for the provision of medical, surgical, hospital, and supplemental benefits to employees of the Commonwealth of Pennsylvania and associated agencies, as well as their dependents and retirees. 0 0 To provide medical, surgical, hospital, and supplemental benefits to employees of the Commonwealth of Pennsylvania as well as other participants. Benefits provided to approximately 68,200 contracts, or 152,000 covered lives. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 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 0 0 1 8 0 1 113 1 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 1 1 1 0 X Don Clair 7175657215 150 South 43rd Street Harrisburg PA 17111 Lori Donovan COO 40 X 278542 0 40045 Don Clair Executive Director/CEO 40 X 297659 0 17501 Jim Cibak Chief Information Officer 40 X 195723 0 34484 Sharon Young CFO 40 X 183125 0 33531 John-Marc Blanche Network Manager 40 X 159272 0 29811 Amy Spease Director of Support Services / Training 40 X 159018 0 28586 Christy Leo Director of Communications 40 X 146575 0 28547 Dan Wiest Applications Development Manager 40 X 141836 0 20070 John Cromer Accounting Manager 40 X 133020 0 23668 Kathryn Farley Former Executive Director/CEO 0 0 X 140873 0 14102 Tom Tosti Chairman 0.25 X X 0 0 0 James Howell Chairman 0.25 0 X X 0 0 0 Neil Weaver Secretary 0.25 X X 0 0 0 Michael Sukal Secretary 0.25 X X 0 0 0 Valarie Arkoosh Board Member 0.25 X 0 0 0 William Einhorn Board Member 0.25 X 0 0 0 Natalie Krug Board Member 0.25 X 0 0 0 Kerri Gallagher Board Member 0.25 X 0 0 0 Tara Long Board Member 0.25 X 0 0 0 Zollie J Rayner Jr Board Member 0.25 X 0 0 0 H Ben Lukens Board Member 0.25 X 0 0 0 Stephen Catanese Board Member 0.25 X 0 0 0 Uri Monson Board Member 0.25 X 0 0 0 Adam K Weber Board Member 0.25 X 0 0 0 Tracy Sullivan Board Member 0.25 X 0 0 0 Matt Yarnell Board Member 0.25 X 0 0 0 Erika Swaney Board Member 0.25 X 0 0 0 Wendell Young IV Board Member 0.25 X 0 0 0 Jason Swarthout Board Member 0.25 X 0 0 0 Joan Bradbury Board Member 0.25 X 0 0 0 1835643 0 270345 23 1 1 0 Standish Mellon Asset Management 500 Grant Street Pittsburgh PA 15258 Investment Management 769470 Willis Towers Watson 1735 Market Street Philadelphia PA 19103 Actuarial Services 487500 Kennedy Printing Company Inc 5534 Baltimore Avenue Philadelphia PA 19143 Printing and Mailing 348072 HUB International 1007 Mumma Road Suite 200 Wormleysburg PA 19103 Insurance Services 337011 Ballard Spahr LLP 1735 Market Street 51st Floor Philadelphia PA 19103 Legal Services 313961 9 0 Employer contributions 524292 1291723661 1291723661 0 0 Participant contributions 524292 172873423 172873423 0 0 635536 635536 0 0 1465232620 41474321 41474321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248092446 0 241692130 0 6400316 0 6400316 6400316 0 0 0 1513107257 1513107257 0 0 0 0 0 1265283071 659428 0 4783546 253312 1166978 412235 0 418904 99211 0 0 1237052 881589 0 472886 910085 0 178825 32623 0 0 0 0 77975 210562 Retention Expense Admin 17738485 Mental Health/Substance Abuse 6280614 Dues, Subscriptions, Licenses 515864 Disease Management 30660 44423 1301688328 0 0 0 0 0 491674888 544303583 0 0 140940128 153776427 0 0 0 0 0 0 0 0 1676357 493905 39508058 39071963 199881 436095 553006919 718052358 0 0 0 0 0 0 132211 66183 1187630384 1417128551 41337571 46040286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79700000 88441000 121037571 134481286 X 0 0 0 0 1066592813 1282647265 1066592813 1282647265 1187630384 1417128551 X 211418929 18242704 0 0 0 -13607181 X 0 1 X 1 0 0 0 0 0 0 0 0 0 422370 422370 0 0 571303 570105 1198 0 38514385 38079488 434897 436095 0 Estimated health claims incurred but not reported 88441000 88441000 1531349961 18242704 0 0 0 18242704 1513107257 0 0 0 1513107257 1301688328 0 0 0 0 0 1301688328 0 0 0 1301688328 X 1 1 X X X 0 0 0 Lori Donovan COO 261321 0 15000 0 2221 0 16489 0 23556 0 318587 0 0 0 Don Clair Executive Director/CEO 297142 0 0 0 518 0 0 0 17501 0 315161 0 0 0 Jim Cibak Chief Information Officer 193175 0 0 0 2548 0 11559 0 22925 0 230207 0 0 0 Sharon Young CFO 182435 0 0 0 690 0 10590 0 22941 0 216656 0 0 0 John-Marc Blanche Network Manager 158582 0 0 0 690 0 9368 0 20442 0 189082 0 0 0 Amy Spease Director of Support Services / Training 148328 0 10000 0 690 0 9428 0 19157 0 187603 0 0 0 Christy Leo Director of Communications 137383 0 7000 0 2192 0 8642 0 19906 0 175123 0 0 0 Dan Wiest Applications Development Manager 139949 0 0 0 1887 0 0 0 20070 0 161906 0 0 0 John Cromer Accounting Manager 125497 0 6000 0 1523 0 7561 0 16107 0 156688 0 0 0 Kathryn Farley Former Executive Director/CEO 138662 0 0 0 2211 0 8090 0 6012 0 154975 0 0 0 Schedule J, Part I, Line 1a Gross-up for Don Clair totaled $667. Gross-up for Kathryn Farley totaled $1,528. Form 990, Part VI, Section A, Line 8b The organization does not have any committees that have the authority to act on behalf of the board. Form 990, Part VI, Section B, Line 11b The form 990 is reviewed by the CFO and an outside accounting firm before being filed with the IRS. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is monitored and enforced as an integral part of the Pennsylvania Employees Benefit Trust Fund (PEBTF) corporate compliance program. As such, the corporate compliance office, in conjunction with the corporate compliance committee has the primary responsibility for monitoring and enforcement of this policy. In addition, on an annual basis the Human Resources department requires each employee to sign a conflict of interest statement which provides documentation of any actual or perceived conflict as well as reiterating the PEBTF's policy regarding conflicts of interest. Any noted conflicts of interest would require the employee to recuse themselves from any dealings or decisions related to the party with which they have an actual or perceived conflict. Form 990, Part VI, Section B, Line 15 The process for determining compensation of the CEO includes the Compensation Committee of the Board of Trustees, the Chair of the Finance Committee, and the Chair of the Board. (1) Independent salary survey information is provided to the Compensation Committee by the Director of Human Resources. (2) A formal review of the CEO is performed by the Chair of the Board comparing performance expectations to the actual performance for the year. (3) A performance increase is recommended by the Compensation Committee after taking the salary survey range and performance information into account. (4) In the event the CEO's salary falls significantly outside the independent salary survey range, either on the high or low side, additional information is sought prior to development of an increase amount. The process of determining compensation for the other officers and key employees is led by the CEO and follows the steps outlined above. Salary data obtained from executive search firms is used for comparability while the final compensation amounts require approval from the Board of Trustees. Form 990, Part VI, Section C, Line 19 PEBTF's governing documents, conflict of interest policy, and financial statements are not generally made available to the public. However, if there is a written request for the above information the request is reviewed by the CEO with assistance from corporate counsel, and a determination is made and rendered in writing to the requestor. Form 990, Part XI, Line 9 Increase in benefit obligations of $13,607,181