| A | B | C | D | E | F | G | H | I | J |
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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, 2012 |
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4 | | | | | | | | | | |
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5 | | | | | | | | | | |
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6 | | | | | | |
Current Month | |
2011-2012 | |
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7 |
REVENUES: | | | | | |
(March) | | | |
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8 |
Employer Contributions | | | | |
$ |
1,391,448 |
$ |
12,503,477 | |
---|
9 |
Employee Contributions | | | | | |
318,761 | |
2,667,155 | |
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10 |
Dividend Income | | | | | |
295 | |
2,266 | |
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11 |
Interest Income | | | | | |
15,112 | |
138,236 | |
---|
12 |
Corporate/Govt Obligations - market value adj | | | | | |
(6,015) | |
12,828 | |
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13 | | | | | | |
_ | |
_ | |
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14 |
Total Revenues | | | | | |
1,719,601 | |
15,323,962 | |
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15 | | | | | | |
_ | |
_ | |
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16 |
COST OF BENEFITS PROVIDED: | | | |
| | | |
| |
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17 |
HMA Premium | | | | | |
0 | |
179,667 | |
---|
18 |
HMA Claims | | | | | |
92,667 | |
5,302,718 | |
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19 |
SunLife | | | | | |
55,169 | |
(244,978) | |
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20 |
ESI Prescriptions Paid | | | | | |
(36,693) | |
1,333,916 | |
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21 |
Pacific Care Premium | | | | | |
0 | |
2,333,408 | |
---|
22 |
Group Health Premium | | | | | |
462,567 | |
3,543,778 | |
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23 |
WEA/APA Insurance | | | | | |
1,195,315 | |
3,587,155 | |
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24 |
Washington Dental Service Premium | | | |
| |
0 | |
804,538 | |
---|
25 |
Williamette Dental | | | | | |
35,949 | |
282,521 | |
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26 |
Metropolitan Life ($50M) Premium | | | | | |
9,593 | |
93,501 | |
---|
27 |
Metropolitan Life (VOL) Premium | | | |
| |
15,159 | |
144,406 | |
---|
28 |
Standard Insurance | | | | | |
35,428 | |
317,703 | |
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29 |
UNUM LTC | | | | | |
950 | |
6,662 | |
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30 |
Alere Wellbeing | | | | | |
0 | |
4,445 | |
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31 |
Magellan Behavior | | | | | |
0 | |
37,889 | |
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32 |
Carena | | | | | |
0 | |
0 | |
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33 |
HealthForce | | | | | |
9,866 | |
36,344 | |
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34 | | | | | | |
_ | |
_ | |
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35 | |
Cost of Benefits Provided | | | | |
1,875,970 | |
17,763,672 | |
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36 | | | | | | |
_ | |
_ | |
---|
37 |
Excess (Deficiency) of Revenues over Cost of Benefits | | | | |
|
(156,369) | |
(2,439,710) | |
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38 | |
| | | | |
_ | |
_ | |
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39 |
ADMINISTRATIVE EXPENSES: | | | | | | | |
| |
---|
40 |
Administration | | | | | |
4,851 | |
18,424 | |
---|
41 |
Wellness Program Salaries | | | | | |
7,751 | |
79,633 | |
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42 |
Wellness Program Expenses | | | | | |
2,367 | |
85,365 | |
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43 |
Audit Fee | | | | | |
0 | |
10,470 | |
---|
44 |
Regulatory Fees | | | | | |
0 | |
2,075 | |
---|
45 |
Bank Fees | | | | | |
0 | |
3,884 | |
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46 |
Investment Fees | | | | | |
0 | |
12,995 | |
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47 |
Legal Fees | | | | | |
2,294 | |
31,888 | |
---|
48 |
Liability Insurance | | | | | |
0 | |
4,051 | |
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49 |
Misc. Expense | | | | | |
0 | |
99 | |
---|
50 |
Office & Printing | | | | | |
9 | |
4,693 | |
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51 |
Consultant Fee | | | | | |
0 | |
68,733 | |
---|
52 |
Investment Consultant Fee | | | | | |
4,375 | |
17,500 | |
---|