Civic Intelligence

Medical Benefits Plan for Retired Non- Physician Salaried Employees

990 • Fiscal year 2019 • EIN 94-3134675

Jan 01, 2019 to Dec 31, 2019 • Filed on Nov 16, 2020

Organization ProfileN/A
c/o State Street Bank PO Box 5100Boston, MA 02206

(510) 271-6903

Siviq Scores

Scores are not available for this record yet.

Balance Sheet

Assets

Flat

$471,505,879

Flat from 2019

Net Assets

Flat

$471,505,879

Flat from 2019

Liabilities

Flat

$0

Flat from 2019

Revenue And Expenses

Revenue

Flat

$18,562,662

Flat from 2019

Expenses

Flat

$44,041,126

Flat from 2019

Net Income

Flat

-$25,478,464

Flat from 2019

Historical Trend

Balance Sheet Trend

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

$600M$400M$200M$0Assets 2011: $497,585,496Liabilities 2011: $0Net Assets 2011: $497,585,4962011Assets 2012: $537,976,888Liabilities 2012: $0Net Assets 2012: $537,976,8882012Assets 2013: $540,499,442Liabilities 2013: $2,354,843Net Assets 2013: $538,144,5992013Assets 2014: $539,830,224Liabilities 2014: $0Net Assets 2014: $539,830,2242014Assets 2015: $513,527,957Liabilities 2015: $0Net Assets 2015: $513,527,9572015Assets 2016: $513,898,804Liabilities 2016: $0Net Assets 2016: $513,898,8042016Assets 2017: $506,304,458Liabilities 2017: $0Net Assets 2017: $506,304,4582017Assets 2018: $451,325,221Liabilities 2018: $0Net Assets 2018: $451,325,2212018Assets 2019: $471,505,879Liabilities 2019: $0Net Assets 2019: $471,505,8792019Assets 2019: $471,505,879Liabilities 2019: $0Net Assets 2019: $471,505,8792019Assets 2020: $471,218,350Liabilities 2020: $0Net Assets 2020: $471,218,3502020Assets 2021: $481,752,947Liabilities 2021: $0Net Assets 2021: $481,752,9472021Assets 2022: $355,868,710Liabilities 2022: $0Net Assets 2022: $355,868,7102022Assets 2023: $334,711,798Liabilities 2023: $0Net Assets 2023: $334,711,7982023Assets 2024: $295,022,769Liabilities 2024: $0Net Assets 2024: $295,022,7692024

Highlighted filing

2019

Assets$471,505,879
Liabilities$0
Net Assets$471,505,879
Open 2019 Filing

Operations Trend

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

$100M$0-$100M-$200MExpenses 2011: $22,821,8722011Expenses 2012: $23,163,9152012Revenue 2013: $37,265,821Expenses 2013: $27,163,322Net Income 2013: $10,102,4992013Revenue 2014: $5,838,336Expenses 2014: $33,034,894Net Income 2014: -$27,196,5582014Revenue 2015: $8,198,539Expenses 2015: $33,557,637Net Income 2015: -$25,359,0982015Revenue 2016: $17,941,313Expenses 2016: $36,292,830Net Income 2016: -$18,351,5172016Revenue 2017: $15,256,489Expenses 2017: $39,212,296Net Income 2017: -$23,955,8072017Revenue 2018: $32,873,495Expenses 2018: $41,231,891Net Income 2018: -$8,358,3962018Revenue 2019: $18,562,662Expenses 2019: $44,041,126Net Income 2019: -$25,478,4642019Revenue 2019: $18,562,662Expenses 2019: $44,041,126Net Income 2019: -$25,478,4642019Revenue 2020: $70,344,635Expenses 2020: $47,159,415Net Income 2020: $23,185,2202020Revenue 2021: $46,602,397Expenses 2021: $46,346,256Net Income 2021: $256,1412021Revenue 2022: -$87,436,366Expenses 2022: $47,152,459Net Income 2022: -$134,588,8252022Revenue 2023: -$17,952,124Expenses 2023: $47,727,593Net Income 2023: -$65,679,7172023Revenue 2024: -$6,852,179Expenses 2024: $55,628,352Net Income 2024: -$62,480,5312024

Highlighted filing

2019

Revenue$18,562,662
Expenses$44,041,126
Net Income-$25,478,464
Open 2019 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2019 to Dec 31, 2019
Signed
Nov 16, 2020
Return Version
2019v5.1
Gross Receipts
$109,780,732
Mission and Program Overview

Mission

To provide medical benefits for retired non-physician employees of the permanente medical group, inc. Covered by the collective bargaining agreement and their eligible dependents.

To provide medical benefits for retired non-physician employees of permanente medical group, inc. Covered by the collective bargaining agreement and their eligible dependents.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cap Stk Tr Prin Current Funds$451,325,221$471,505,879▲ $20,180,658
Investments in Publicly Traded Securities$340,919,642$364,286,320▲ $23,366,678
Accounts Receivable$0$56,493,776▲ $56,493,776
Investments Other Securities$104,292,862$41,800,509▼ $62,492,353
Savings and Temporary Cash Investments$5,844,604$8,749,772▲ $2,905,168
Cash and Non-Interest-Bearing Accounts$268,113$175,502▼ $92,611
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Program Related$0$0→ $0
Land, Buildings, and Equipment, Net$0$0→ $0
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Rtn Earn Endowment Incm Other Fnds$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$451,325,221$471,505,879▲ $20,180,658
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$0$0→ $0
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$451,325,221$471,505,879▲ $20,180,658
Total Liabilities and Net Assets / Fund Balance$451,325,221$471,505,879▲ $20,180,658

Asset Categories

AssetBook ValueDepreciationBasis
Other Securities$41,800,509--
Compensation and Service Providers

Employees

NameTitleBaseTotal
State Street Bank TrTrustee$58,322$58,322
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$13,119,109
Other Revenue
$5,443,553
Change in Net Assets
$-25,478,464

Audited Revenue Reconciliation

Revenue per Audited Statements
$18,562,662
Revenue Not Reported on Form 990
$45,659,122
Total Revenue per Audited Statements
$64,221,784
Total Revenue per Form 990
$18,562,662
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$1,390,637
Salaries, Compensation, and Employee Benefits$61,510
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members---$42,588,979
Fees for Service Investment Mgmnt Fees---$1,173,776
Other Expenses---$215,111
Current Officers, Directors, Trustees, and Key Employees---$58,322
Other Salaries and Wages---$3,188
Fees for Services Legal---$582
Total Functional Expenses$0$0$0$44,041,126

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$44,041,126
Total Expenses per Audited Statements$44,041,126
Total Expenses per Form 990$44,041,126
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Audit committee
Yes
Business relationship with 35% controlled entity
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 A, Lines 1A & 1B & Part VII

“The plan sponsor is the permanente medical group, inc. The trust is administered by the plan sponsor in accordance with the terms of the trust agreement. As such, the veba does not have a governing body that exercises discretion.”

Form 990, Part VI, Sections A & B, Lines 8, 12-15

“These questions are not applicable to this trust. Additionally, the trust does not have any employees, therefore no processes related to employee compensation are in place.”

Form 990, Part VI, Section B, Line 11B

“A complete electronic copy of the organization's form 990 was provided to the trustee for review prior to filing with the irs.”

Filing and Contact Details

Filer

Filer Name
Medical Benefits Plan for Retired Non-
EIN
94-3134675
In Care Of
% STATE STREET BANK
Phone
5102716903
Address
c/o State Street Bank PO Box 5100, BOSTON, MA 02206

Signing Officer

Name
Janice K Murphy
Title
VP - Pension & Inv.
Phone
5102716903
Signed
2020-11-16
Discuss with paid preparer
Yes

Organization Details

Principal Officer
State Street Bank
Formed
1990
Legal Domicile
CA
Voting Board Members
1
Independent Board Members
1
Employees
0
Volunteers
0

Preparer

Firm
PricewaterhouseCoopers LLP
Address
101 SEAPORT BLVD SUITE 500, BOSTON, MA 02210
Preparer
Gwen Spencer
Phone
6175305000
Supplemental Narrative

Additional Explanations

Form 990, Part XII, Line 1

“The trust uses a modified cash method of accounting.”

Raw XML Appendix373 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.

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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE PLAN SPONSOR IS THE PERMANENTE MEDICAL GROUP, INC. THE TRUST IS ADMINISTERED BY THE PLAN SPONSOR IN ACCORDANCE WITH THE TERMS OF THE TRUST AGREEMENT. AS SUCH, THE VEBA DOES NOT HAVE A GOVERNING BODY THAT EXERCISES DISCRETION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THESE QUESTIONS ARE NOT APPLICABLE TO THIS TRUST. ADDITIONALLY, THE TRUST DOES NOT HAVE ANY EMPLOYEES, THEREFORE NO PROCESSES RELATED TO EMPLOYEE COMPENSATION ARE IN PLACE.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2A COMPLETE ELECTRONIC COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO THE TRUSTEE FOR REVIEW PRIOR TO FILING WITH THE IRS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE TRUST USES A MODIFIED CASH METHOD OF ACCOUNTING.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINES 1A & 1B & PART VII
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTIONS A & B, LINES 8, 12-15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART XII, LINE 1
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IRS990ScheduleR/AssetPurchaseFromOtherOrgInd0false
IRS990ScheduleR/AssetSaleToOtherOrgInd0false
IRS990ScheduleR/DivRelatedOrganizationInd0false
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd0false
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd0false
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/ControlledOrganizationInd0false
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingEntityName/BusinessNameLine1Txt0NA
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EIN0942728480
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EntityTypeTxt0C CORP
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd0CA
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/PrimaryActivitiesTxt0MEDICAL
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt0THE PERMANENTE MEDICAL GROUP INC
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/AddressLine1Txt01800 HARRISON ST 7TH FLOOR
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/CityNm0OAKLAND
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/StateAbbreviationCd0CA
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/ZIPCd094612
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd0false
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd0false
IRS990ScheduleR/PaidEmployeesSharingInd0false
IRS990ScheduleR/PerformOfServicesByOtherOrgInd0false
IRS990ScheduleR/PerformOfServicesForOthOrgInd0false
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd0false
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd0false
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd0false
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd0false
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd0false
IRS990ScheduleR/SharingOfFacilitiesInd0false
IRS990ScheduleR/TransferFromOtherOrgInd0false
IRS990ScheduleR/TransferToOtherOrgInd0false
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0CA
IRS990/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondLiabilitiesGrp/BOYAmt00
IRS990/TaxExemptBondLiabilitiesGrp/EOYAmt00
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt0451325221
IRS990/TotalAssetsEOYAmt0471505879
IRS990/TotalAssetsGrp/BOYAmt0451325221
IRS990/TotalAssetsGrp/EOYAmt0471505879
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt00
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/TotalAmt044041126
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0451325221
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0471505879
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceRevenueAmt00
IRS990/TotalReportableCompFromOrgAmt058322
IRS990/TotalRevenueGrp/ExclusionAmt018562662
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt018562662
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0451325221
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0471505879
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TravelGrp/TotalAmt00
IRS990/TypeOfOrganizationTrustInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnsecuredNotesLoansPayableGrp/BOYAmt00
IRS990/UnsecuredNotesLoansPayableGrp/EOYAmt00
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0PO BOX 5100
IRS990/USAddress/CityNm0BOSTON
IRS990/USAddress/StateAbbreviationCd0MA
IRS990/USAddress/ZIPCd002206
IRS990/VotingMembersGoverningBodyCnt01
IRS990/VotingMembersIndependentCnt01
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02022-01-07 14:23:13Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0JANICE K MURPHY
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0VP - PENSION & INV.
ReturnHeader/BusinessOfficerGrp/PhoneNum05102716903
ReturnHeader/BusinessOfficerGrp/SignatureDt02020-11-16
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0MEDICAL BENEFITS PLAN FOR RETIRED NON-
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0PHYSICIAN SALARIED EMPLOYEES
ReturnHeader/Filer/BusinessNameControlTxt0MEDI
ReturnHeader/Filer/EIN0943134675
ReturnHeader/Filer/InCareOfNm0% STATE STREET BANK
ReturnHeader/Filer/PhoneNum05102716903
ReturnHeader/Filer/USAddress/AddressLine1Txt0c/o State Street Bank PO Box 5100
ReturnHeader/Filer/USAddress/CityNm0BOSTON
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MA
ReturnHeader/Filer/USAddress/ZIPCd002206
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0B47CCF04BD3B2E015E6960197D502E2208D5D56B
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0EDFCDED6C29CE812AB3851FCA2CAA65AFF7F79DA
ReturnHeader/FilingSecurityInformation/FederalOriginalSubmissionId004363820203185000062
ReturnHeader/FilingSecurityInformation/FederalOriginalSubmissionIdDt02020-11-13
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0155.201.35.69
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0PricewaterhouseCoopers LLP
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0101 SEAPORT BLVD SUITE 500
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0BOSTON
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd002210
ReturnHeader/PreparerPersonGrp/PhoneNum06175305000
ReturnHeader/PreparerPersonGrp/PreparationDt02020-11-16
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0GWEN SPENCER
ReturnHeader/ReturnTs02020-11-16T17:11:09-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02019-01-01
ReturnHeader/TaxPeriodEndDt02019-12-31
ReturnHeader/TaxYr02019

Document Assets

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Filings

Displayed year

2019 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$471,505,879
Liabilities
$0
Net assets
$471,505,879
Revenue
$18,562,662
Expenses
$44,041,126
Net income
-$25,478,464
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$295$0.00$295$6.85$55.6$62.5
2023Detailed filing. Detailed filing data is available for this year.$335$0.00$335$18.0$47.7$65.7
2022Detailed filing. Detailed filing data is available for this year.$356$0.00$356$87.4$47.2$135
2021Detailed filing. Detailed filing data is available for this year.$482$0.00$482$46.6$46.3$0.26
2020Detailed filing. Detailed filing data is available for this year.$471$0.00$471$70.3$47.2$23.2
2019Detailed filing. Detailed filing data is available for this year.$472$0.00$472$18.6$44.0$25.5
2019Detailed filing. Detailed filing data is available for this year.$472$0.00$472$18.6$44.0$25.5
2018Detailed filing. Detailed filing data is available for this year.$451$0.00$451$32.9$41.2$8.36
2017Summary only. Only limited summary data is available for this year.$506$0.00$506$15.3$39.2$24.0
2016Summary only. Only limited summary data is available for this year.$514$0.00$514$17.9$36.3$18.4
2015Summary only. Only limited summary data is available for this year.$514$0.00$514$8.20$33.6$25.4
2014Summary only. Only limited summary data is available for this year.$540$0.00$540$5.84$33.0$27.2
2013Summary only. Only limited summary data is available for this year.$540$2.35$538$37.3$27.2$10.1
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$538$0.00$538$23.2
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$498$0.00$498$22.8