| A | B | C | D | E | F | G | H | I | J | K | L |
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1 |
EVERETT SCHOOL EMPLOYEE BENEFIT TRUST | |
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2 |
STATEMENT OF OPERATIONS AND FUND BALANCE | |
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3 |
For the Year Ended June 30, 2010 | |
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4 | | | | | | | | | | | | |
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5 | | | | | | | | | | | | |
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6 | | | | | | |
Current Month | |
2009-2010 | | | |
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7 |
REVENUES: | | | | | |
(January) | | | | | |
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8 |
Employer Contributions | | | | |
$ |
1,391,606 |
$ |
9,696,042 | | | |
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9 |
Employee Contributions | | | | | |
225,056 | |
1,528,910 | | | |
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10 |
Investment Earnings | | | | | |
5,695 | |
57,349 | | | |
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11 |
Net Appreciation (Depreciation) of market value | | | | | |
72,643 | |
228,693 | | | |
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12 | | | | | | |
_ | |
_ | | | |
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13 |
Total Revenues | | | | | |
1,695,000 | |
11,510,994 | | | |
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14 | | | | | | |
_ | |
_ | | | |
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15 |
COST OF BENEFITS PROVIDED: | | | |
| | | |
| | | |
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16 |
HMA Premium | | | | | |
24,730 | |
170,533 | | | |
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17 |
HMA Claims | | | | | |
880,068 | |
4,452,602 | | | |
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18 |
SunLife | | | | | |
27,696 | |
160,220 | | | |
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19 |
Other Benefits | | | | | |
0 | |
(553) | | | |
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20 |
ESI Prescriptions Paid | | | | | |
186,076 | |
1,060,523 | | | |
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21 |
Pacific Care Premium | | | | | |
356,650 | |
2,224,088 | | | |
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22 |
Group Health Premium | | | | | |
295,488 | |
1,857,329 | | |
|
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23 |
Washington Dental Service Premium | | | |
| |
140,857 | |
961,106 | | |
|
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24 |
Williamette Dental | | | | | |
28,416 | |
201,729 | | | |
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25 |
Metropolitan Life ($50M) Premium | | | | | |
11,031 | |
77,474 | | | |
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26 |
Metropolitan Life (VOL) Premium | | | |
| |
14,434 | |
102,049 | | | |
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27 |
Standard Insurance | | | | | |
36,558 | |
256,937 | | | |
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28 |
UNUM LTC | | | | | |
670 | |
4,687 | | | |
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29 |
Free & Clear | | | | | |
1,637 | |
1,637 | | | |
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30 |
Magellan Behavior | | | | | |
14,082 | |
28,164 | | | |
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31 |
Carena | | | | | |
2,109 | |
3,933 | | | |
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32 |
Sound Health Solutions | | | | | |
1,063 | |
35,063 | | | |
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33 |
Wellsource Health Solutions | | | | | |
9,000 | |
59,085 | | | |
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34 | | | | | | |
_ | |
_ | | | |
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35 | |
Cost of Benefits Provided | | | | |
2,030,565 | |
11,656,605 | | | |
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36 | | | | | | |
_ | |
_ | | | |
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37 |
Excess (Deficiency) of Revenues over Cost of Benefits | | | | |
|
(335,565) | |
(145,610) | | | |
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38 | |
| | | | |
_ | |
_ | | | |
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39 |
ADMINISTRATIVE EXPENSES: | | | | | | | |
| | | |
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40 |
Administration | | | | | |
1,440 | |
11,735 | | | |
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41 |
Wellness Coordinator Salary | | | | | |
8,091 | |
54,873 | | | |
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42 |
Wellness Program Expenses | | | | | |
2,762 | |
31,990 | | | |
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43 |
Audit Fee | | | | | |
0 | |
8,950 | | | |
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44 |
Regulatory Fees | | | | | |
2,075 | |
4,150 | | | |
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45 |
Bank Fees | | | | | |
5 | |
748 | | | |
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46 |
Investment Fees | | | | | |
0 | |
10,520 | | | |
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47 |
Legal Fees | | | | | |
5,915 | |
44,039 | | | |
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48 |
Liability Insurance | | | | | |
8,700 | |
9,150 | | |
|
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49 |
Misc. Expense | | | | | |
42 | |
207 | | |
|
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50 |
Office & Printing | | | | | |
22 | |
544 | | |
|
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51 |
Consultant Fee | | | | | |
0 | |
0 | | | |
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52 |
Investment Consultant Fee | | | | | |
0 | |
13,125 | | | |
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