Civic Intelligence

Provider Services Benefits Trust

990 • Fiscal year 2013 • EIN 26-6672281

Jan 01, 2013 to Dec 31, 2013 • Filed on Oct 08, 2014

Organization ProfileN/A
25000 Country Club Blvd No 25544070

(440) 793-2247

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

18th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2013 filings • 501(c)9 • $25M-$50M nonprofits • Source year 2013

Liabilities / Revenue

22nd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2013 filings • 501(c)9 • $25M-$50M nonprofits • Source year 2013

Net Margin

5th percentile

-47%

Higher net margin than 5% of similar nonprofits.

2013 filings • 501(c)9 • $25M-$50M nonprofits • Source year 2013

Top Officer Pay

44th percentile

$0

Higher top officer pay than 44% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2013 filings • 501(c)9 • $25M-$50M nonprofits • Source year 2013

Asset Growth

2nd percentile

-70%

Faster asset growth than 2% of similar nonprofits.

2013 filings • 501(c)9 • $25M-$50M nonprofits • Annualized from 2012 to 2013

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2013

Balance Sheet
Liabilities / Assets18th percentile

Assets

Down

$4,010,615

Down $9,396,572 (-70%) from 2012

Net Assets

Down

$4,010,615

Down $9,396,572 (-70%) from 2012

Liabilities

Flat

$0

Flat from 2012

Revenue And Expenses
Liabilities / Revenue22nd percentileNet Margin5th percentile

Revenue

$19,710,275

No earlier filing loaded for comparison.

Expenses

Up

$28,885,298

Up $2,463,699 (+9.3%) from 2012

Net Income

-$9,175,023

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

Asset Growth2nd percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$15M$10M$5.0M$0Assets 2010: $3,000,676Liabilities 2010: $0Net Assets 2010: $3,000,6762010Assets 2011: $6,250,395Liabilities 2011: $0Net Assets 2011: $6,250,3952011Assets 2012: $13,407,187Liabilities 2012: $0Net Assets 2012: $13,407,1872012Assets 2013: $4,010,615Liabilities 2013: $0Net Assets 2013: $4,010,6152013Assets 2014: $13,801Liabilities 2014: $0Net Assets 2014: $13,8012014Assets 2015: $3,137,743Liabilities 2015: $921,679Net Assets 2015: $2,216,0642015Assets 2016: $2,013,658Liabilities 2016: $44,615Net Assets 2016: $1,969,0432016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017

Highlighted filing

2013

Assets$4,010,615
Liabilities$0
Net Assets$4,010,615
Open 2013 Filing

Operations Trend

Revenue GrowthScore unavailable

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$30M$20M$10M$0-$10MExpenses 2010: $15,987,1422010Expenses 2011: $17,854,5322011Expenses 2012: $26,421,5992012Revenue 2013: $19,710,275Expenses 2013: $28,885,298Net Income 2013: -$9,175,0232013Revenue 2014: $17,699,952Expenses 2014: $21,696,766Net Income 2014: -$3,996,8142014Revenue 2015: $3,130,942Expenses 2015: $928,679Net Income 2015: $2,202,2632015Revenue 2016: $37Expenses 2016: $247,058Net Income 2016: -$247,0212016Revenue 2017: $5,139Expenses 2017: $1,974,182Net Income 2017: -$1,969,0432017

Highlighted filing

2013

Revenue$19,710,275
Expenses$28,885,298
Net Income-$9,175,023
Open 2013 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2013 to Dec 31, 2013
Signed
Oct 8, 2014
Return Version
2013v3.0
Gross Receipts
$40,683,481
Mission and Program Overview

Mission

To fund health care and workers' compensation benefits to the eligible employees of the provider services companies.

Balance Sheet Detail
LineBeginningEndChange
Assets
Rtn Earn Endowment Incm Other Fnds$13,407,187$4,010,615▼ $9,396,572
Savings and Temporary Cash Investments$9,779,773$4,010,543▼ $5,769,230
Investments Other Securities$3,615,046$0▼ $3,615,046
Cash and Non-Interest-Bearing Accounts$4,193$72▼ $4,121
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Cap Stk Tr Prin Current Funds$0$0→ $0
Total Assets$13,407,187$4,010,615▼ $9,396,572
Other Assets Total$8,175$0▼ $8,175
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$13,407,187$4,010,615▼ $9,396,572
Total Liabilities and Net Assets / Fund Balance$13,407,187$4,010,615▼ $9,396,572
Compensation and Service Providers
Top Officer Pay44th percentile

Board Members and Trustees

NameTitle
Merrill Lynchbank of AmericaTrustee
Wells FargoTrustee
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$19,305,070
Investment Income
$405,205
Other Revenue
$0
Change in Net Assets
$-9,175,023

Audited Revenue Reconciliation

Revenue per Audited Statements
$19,710,275
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$0
Total Revenue per Audited Statements
$19,710,275
Total Revenue per Form 990
$19,710,275
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$11,027
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members---$28,874,271
Fees for Services Other---$7,980
Fees for Service Investment Mgmnt Fees---$3,047
Total Functional Expenses$0$0$0$28,885,298

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$28,885,298
Total Expenses per Audited Statements$28,885,298
Total Expenses per Form 990$28,885,298
Expenses Not Reported on Financial Statements$0
Expenses Not Reported on Form 990$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Audit committee
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
No
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11

“All members of the governing body review and approve the 990 before it is filed.”

Form 990, Part VI, Section C, Line 19

“The 990 is available upon request.”

Filing and Contact Details

Filer

EIN
26-6672281
Phone
4407932247

Signing Officer

Name
John Krystowski
Title
Officer
Phone
4407932247
Signed
2014-10-08
Discuss with paid preparer
Yes

Organization Details

Principal Officer
John Krystowski
Formed
2008
Legal Domicile
Oh
Voting Board Members
1
Independent Board Members
1
Employees
0
Volunteers
0

Preparer

Preparer
Thomas L Harrison CPA
Phone
4404710800
Raw XML Appendix292 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

Path#Value
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IRS990/AuditCommitteeInd00
IRS990/BenefitsToMembersGrp/TotalAmt028874271
IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine10JOHN KRYSTOWSKI
IRS990/BooksInCareOfDetail/PhoneNum04407932247
IRS990/BooksInCareOfDetail/USAddress/AddressLine1025000 COUNTRY CLUB BLVD 255
IRS990/BooksInCareOfDetail/USAddress/City0NORTH OLMSTED
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IRS990/GoverningBodyVotingMembersCnt01
IRS990/GrantsToIndividualsInd00
IRS990/GrantsToOrganizationsInd00
IRS990/GrantToRelatedPersonInd00
IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt021370981
IRS990/GrossReceiptsAmt040683481
IRS990/GroupReturnForAffiliatesInd00
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IRS990/IndependentAuditFinclStmtInd01
IRS990/IndependentVotingMemberCnt01
IRS990/IndivRcvdGreaterThan100KCnt00
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InvestmentIncomeGrp/ExclusionAmt07430
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt07430
IRS990/InvestmentInJointVentureInd00
IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt03615046
IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt00
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LegalDomicileStateCd0OH
IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt020973206
IRS990/LoanOutstandingInd00
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IRS990/NetUnrelatedBusTxblIncmAmt00
IRS990/NetUnrlzdGainsLossesInvstAmt0-221549
IRS990/NoListedPersonsCompensatedInd0X
IRS990/NondeductibleContributionsInd00
IRS990/OfficerMailingAddressInd00
IRS990/OperateHospitalInd00
IRS990/Organization501cInd0X
IRS990/OrgDoesNotFollowSFAS117Ind0X
IRS990/OtherAssetsTotalGrp/BOYAmt08175
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IRS990/OtherChangesInNetAssetsAmt00
IRS990/PartialLiquidationInd00
IRS990/PayPremiumsPrsnlBnftCntrctInd00
IRS990/PdInCapSrplsLandBldgEqpFundGrp/BOYAmt00
IRS990/PdInCapSrplsLandBldgEqpFundGrp/EOYAmt00
IRS990/PoliticalCampaignActyInd00
IRS990/PrincipalOfficerNm0JOHN KRYSTOWSKI
IRS990/ProfessionalFundraisingInd00
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IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt019305070
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IRS990/ProhibitedTaxShelterTransInd00
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IRS990/PYInvestmentIncomeAmt0202152
IRS990/PYOtherExpensesAmt024420
IRS990/PYOtherRevenueAmt00
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IRS990/PYRevenuesLessExpensesAmt06972631
IRS990/PYSalariesCompEmpBnftPaidAmt00
IRS990/PYTotalExpensesAmt026421599
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IRS990/PYTotalRevenueAmt033394230
IRS990/QuidProQuoContributionsInd00
IRS990/RcvFndsToPayPrsnlBnftCntrctInd00
IRS990/ReconcilationRevenueExpnssAmt0-9175023
IRS990/RelatedEntityInd01
IRS990/RelatedOrganizationCtrlEntInd00
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IRS990/ReportOtherLiabilitiesInd00
IRS990/ReportProgramRelatedInvstInd00
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IRS990/RtnEarnEndowmentIncmOthFndsGrp/BOYAmt013407187
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IRS990ScheduleD/ExpensesSubtotalAmt028885298
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IRS990/ScheduleJRequiredInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0ALL MEMBERS OF THE GOVERNING BODY REVIEW AND APPROVE THE 990 BEFORE IT IS FILED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE 990 IS AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd00
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd00
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingNACd0N/A
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EIN0810681796
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EntityTypeTxt0C
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd0OH
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IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd00
IRS990ScheduleR/PaidEmployeesSharingInd01
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IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd00
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd00
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd00
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd01
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd00
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IRS990/TotalCompGreaterThan150KInd00
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IRS990/TotalVolunteersCnt00
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IRS990/UponRequestInd0X
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IRS990/USAddress/City0NORTH OLMSTED
IRS990/USAddress/State0OH
IRS990/USAddress/ZIPCode044070
IRS990/VotingMembersGoverningBodyCnt01
IRS990/VotingMembersIndependentCnt01
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02015-11-30 17:44:51Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0JOHN KRYSTOWSKI
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0OFFICER
ReturnHeader/BusinessOfficerGrp/PhoneNum04407932247
ReturnHeader/BusinessOfficerGrp/SignatureDt02014-10-08
ReturnHeader/Filer/BusinessName/BusinessNameLine10PROVIDER SERVICES BENEFITS TRUST
ReturnHeader/Filer/BusinessNameControlTxt0PROV
ReturnHeader/Filer/EIN0266672281
ReturnHeader/Filer/PhoneNum04407932247
ReturnHeader/Filer/USAddress/AddressLine1025000 COUNTRY CLUB BLVD NO 255
ReturnHeader/Filer/USAddress/City0NORTH OLMSTED
ReturnHeader/Filer/USAddress/State0OH
ReturnHeader/Filer/USAddress/ZIPCode044070
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0371574855
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine10CORRIGAN KRAUSE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine102055 CROCKER RD SUITE 300
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/City0WESTLAKE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/State0OH
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCode0441451964
ReturnHeader/PreparerPersonGrp/PhoneNum04404710800
ReturnHeader/PreparerPersonGrp/PreparationDt02014-10-08
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0THOMAS L HARRISON CPA
ReturnHeader/ReturnTs02014-10-09T14:03:22-05:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02013-01-01
ReturnHeader/TaxPeriodEndDt02013-12-31
ReturnHeader/TaxYr02013

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2013 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$4,010,615
Liabilities
$0
Net assets
$4,010,615
Revenue
$19,710,275
Expenses
$28,885,298
Net income
-$9,175,023
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.01$1.97$1.97
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.01$0.04$1.97$0.00$0.25$0.25
2015Detailed filing. Detailed filing data is available for this year.$3.14$0.92$2.22$3.13$0.93$2.20
2014Detailed filing. Detailed filing data is available for this year.$0.01$0.00$0.01$17.7$21.7$4.00
2013Detailed filing. Detailed filing data is available for this year.$4.01$0.00$4.01$19.7$28.9$9.18
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$13.4$0.00$13.4$26.4
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$6.25$0.00$6.25$17.9
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.00$0.00$3.00$16.0
Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2013 filings • 501(c)9 • $25M-$50M nonprofits