| 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: | | | | | |
(March) | | | | | |
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8 |
Employer Contributions | | | | |
$ |
1,607,668 |
$ |
12,893,456 | | | |
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9 |
Employee Contributions | | | | | |
10,187 | |
1,758,337 | | | |
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10 |
Investment Earnings | | | | | |
(6,995) | |
42,162 | | | |
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11 |
Net Appreciation (Depreciation) of market value | | | | | |
8,216 | |
288,485 | | | |
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12 | | | | | | |
_ | |
_ | | | |
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13 |
Total Revenues | | | | | |
1,619,077 | |
14,982,439 | | | |
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14 | | | | | | |
_ | |
_ | | | |
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15 |
COST OF BENEFITS PROVIDED: | | | |
| | | |
| | | |
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16 |
HMA Premium | | | | | |
24,886 | |
220,151 | | | |
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17 |
HMA Claims | | | | | |
676,250 | |
5,378,353 | | | |
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18 |
SunLife | | | | | |
(186,854) | |
1,174 | | | |
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19 |
Other Benefits | | | | | |
0 | |
(553) | | | |
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20 |
ESI Prescriptions Paid | | | | | |
187,380 | |
1,442,058 | | | |
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21 |
Pacific Care Premium | | | | | |
355,740 | |
2,936,580 | | | |
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22 |
Group Health Premium | | | | | |
298,432 | |
2,452,465 | | |
|
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23 |
Washington Dental Service Premium | | | |
| |
140,494 | |
1,243,001 | | |
|
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24 |
Williamette Dental | | | | | |
28,563 | |
258,854 | | | |
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25 |
Metropolitan Life ($50M) Premium | | | | | |
11,044 | |
99,548 | | | |
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26 |
Metropolitan Life (VOL) Premium | | | |
| |
15,099 | |
131,921 | | | |
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27 |
Standard Insurance | | | | | |
36,600 | |
330,095 | | | |
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28 |
UNUM LTC | | | | | |
670 | |
6,026 | | | |
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29 |
Free & Clear | | | | | |
0 | |
1,637 | | | |
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30 |
Magellan Behavior | | | | | |
0 | |
28,164 | | | |
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31 |
Carena | | | | | |
0 | |
4,383 | | | |
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32 |
Sound Health Solutions | | | | | |
0 | |
35,063 | | | |
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33 |
Wellsource Health Solutions | | | | | |
0 | |
59,085 | | | |
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34 | | | | | | |
_ | |
_ | | | |
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35 | |
Cost of Benefits Provided | | | | |
1,588,303 | |
14,628,003 | | | |
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36 | | | | | | |
_ | |
_ | | | |
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37 |
Excess (Deficiency) of Revenues over Cost of Benefits | | | | |
|
30,775 | |
354,437 | | | |
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38 | |
| | | | |
_ | |
_ | | | |
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39 |
ADMINISTRATIVE EXPENSES: | | | | | | | |
| | | |
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40 |
Administration | | | | | |
1,629 | |
14,967 | | | |
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41 |
Wellness Coordinator Salary | | | | | |
8,059 | |
70,992 | | | |
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42 |
Wellness Program Expenses | | | | | |
4,455 | |
37,035 | | | |
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43 |
Audit Fee | | | | | |
0 | |
8,950 | | | |
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44 |
Regulatory Fees | | | | | |
0 | |
4,150 | | | |
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45 |
Bank Fees | | | | | |
40 | |
2,449 | | | |
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46 |
Investment Fees | | | | | |
0 | |
18,436 | | | |
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47 |
Legal Fees | | | | | |
6,427 | |
50,466 | | | |
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48 |
Liability Insurance | | | | | |
0 | |
9,150 | | |
|
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49 |
Misc. Expense | | | | | |
33 | |
273 | | |
|
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50 |
Office & Printing | | | | | |
0 | |
544 | | |
|
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51 |
Consultant Fee | | | | | |
0 | |
0 | | | |
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52 |
Investment Consultant Fee | | | | | |
4,375 | |
17,500 | | | |
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