| 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, 2011 | |
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4 | | | | | | | | | | | | |
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5 | | | | | | | | | | | | |
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6 | | | | | | |
Current Month | |
2010-2011 | | | |
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7 |
REVENUES: | | | | | |
(March) | | | | | |
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8 |
Employer Contributions | | | | |
$ |
1,419,480 |
$ |
12,652,262 | | | |
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9 |
Employee Contributions | | | | | |
285,804 | |
2,270,825 | | | |
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10 |
Dividend Income | | | | | |
124 | |
4,974 | | | |
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11 |
Interest Income | | | | | |
35,621 | |
194,917 | | | |
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12 |
Corporate/Govt Obligations - market value adj | | | | | |
(19,370) | |
(112,441) | | | |
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13 | | | | | | |
_ | |
_ | | | |
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14 |
Total Revenues | | | | | |
1,721,659 | |
15,010,536 | | | |
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15 | | | | | | |
_ | |
_ | | | |
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16 |
COST OF BENEFITS PROVIDED: | | | |
| | | |
| | | |
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17 |
HMA Premium | | | | | |
23,569 | |
218,122 | | | |
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18 |
HMA Claims | | | | | |
621,114 | |
6,793,061 | | | |
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19 |
SunLife | | | | | |
45,071 | |
(401,797) | | | |
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20 |
ESI Prescriptions Paid | | | | | |
177,424 | |
1,795,944 | | | |
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21 |
Pacific Care Premium | | | | | |
396,994 | |
3,313,848 | | | |
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22 |
Group Health Premium | | | | | |
363,811 | |
2,910,438 | | |
|
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23 |
Washington Dental Service Premium | | | |
| |
139,109 | |
1,254,460 | | |
|
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24 |
Williamette Dental | | | | | |
28,928 | |
259,985 | | | |
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25 |
Metropolitan Life ($50M) Premium | | | | | |
10,849 | |
97,705 | | | |
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26 |
Metropolitan Life (VOL) Premium | | | |
| |
15,939 | |
140,895 | | | |
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27 |
Standard Insurance | | | | | |
36,045 | |
324,875 | | | |
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28 |
UNUM LTC | | | | | |
713 | |
5,459 | | | |
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29 |
Free & Clear | | | | | |
12,465 | |
41,065 | | | |
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30 |
Magellan Behavior | | | | | |
14,082 | |
56,328 | | | |
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31 |
Carena | | | | | |
0 | |
1,800 | | | |
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32 |
HealthForce | | | | | |
0 | |
9,662 | | | |
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33 |
Wellsource Health Solutions | | | | | |
0 | |
0 | | | |
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34 | | | | | | |
_ | |
_ | | | |
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35 | |
Cost of Benefits Provided | | | | |
1,886,112 | |
16,821,849 | | | |
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36 | | | | | | |
_ | |
_ | | | |
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37 |
Excess (Deficiency) of Revenues over Cost of Benefits | | | | |
|
(164,453) | |
(1,811,313) | | | |
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38 | |
| | | | |
_ | |
_ | | | |
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39 |
ADMINISTRATIVE EXPENSES: | | | | | | | |
| | | |
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40 |
Administration | | | | | |
1,674 | |
15,003 | | | |
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41 |
Wellness Program Salaries | | | | | |
9,888 | |
85,416 | | | |
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42 |
Wellness Program Expenses | | | | | |
2,017 | |
41,502 | | | |
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43 |
Audit Fee | | | | | |
0 | |
9,142 | | | |
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44 |
Regulatory Fees | | | | | |
0 | |
4,150 | | | |
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45 |
Bank Fees | | | | | |
202 | |
5,815 | | | |
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46 |
Investment Fees | | | | | |
0 | |
15,619 | | | |
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47 |
Legal Fees | | | | | |
4,681 | |
38,281 | | | |
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48 |
Liability Insurance | | | | | |
0 | |
5,582 | | |
|
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49 |
Misc. Expense | | | | | |
101 | |
298 | | |
|
---|
50 |
Office & Printing | | | | | |
84 | |
300 | | |
|
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51 |
Consultant Fee | | | | | |
0 | |
25,613 | | | |
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52 |
Investment Consultant Fee | | | | | |
4,375 | |
13,125 | | | |
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