PIANY Doc. No. 31363
New York State Workers’ Compensation Board
Group Self-Insured Trusts Summary of
Funding Status as of July 1, 2011
The information contained within
this Resource kit was made available by
the New York State Workers’ Compensation Board
and is provided as a PIANY member service.
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QuickSource document index, contact:
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7/11
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
1
2
Group Self-Insurer
Group Administrator
3
Last Fiscal
Year Level 1
Review Final
4
5
6
Cumulative
Operating Restrictions
Regulatory
Imposed
Deficit
Regulatory Funding Position
Fully
90 - 99% 80 - 89% 70 - 79% 60 - 69%
Funded
Less than
60%
Yes
No
Pending
*A = Active; I = Inactive
(A) Associated Builders & Contractors Compensation Trust
Reller Risk Management, LLC
04/30/10
( X )
(
)
(
)
(
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(
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Charles Reller
Effective Date: 5/1/97
6315 Fly Road
Industry Served: Contractors/Services to Contractors
East Syracuse, NY 13057
end to a calendar year end
Approximate Number of Active Members - 350
315-432-8210
effective 12/31/10.
Remarks: Trust will be changing their year
N/A
Remarks:
charles.reller@rellerrisk.com
(A) Baumann Self-Insurance Trust Fund
Self-Administered
12/31/09
(
)
(
)
( X )
(
)
(
)
(
)
( X )
Edward Keaney
)
Remarks: Closed to
Effective Date: 11/1/92
3355 Veterans Memorial Highway
Industry Served: Passenger Transportation - Bus Operators
Ronkonkoma, NY 11779
enhanced financial
Approximate Number of Active Members - 4
631-471-4600
monitoring; mandatory
$1.2 M
ekeaney@abatransportation.com
(A) Contractors Self-Insurance Trust Fund
NCA Comp Inc.
new members;
scheduled deposits.
09/30/09
( X )
(
)
(
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(
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(
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(
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(
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( X )
(
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( X )
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( X )
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Steven Gidwitz
Effective Date: 8/15/97
14 Lafayette Square
Industry Served: Contractors/Services to Contractors
Buffalo, NY 14203
Approximate Number of Active Members - 160
716-842-0045
N/A
Remarks:
sgidwitz@ncacomp.com
(A) Electrical Employers Self-Insurance Safety Plan
Self-Administered
12/31/09
( X )
(
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(
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(
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(
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(
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(
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Steven Farago
Effective Date: 1/1/67
158-11 Harry Van Arsdale Jr. Avenue
Industry Served: Electrical Workers - IBEW Local #3
Flushing, NY 11365
Approximate Number of Active Members - 430
716-591-2800
N/A
Remarks:
sfarago@jibei.com
(A) ESTRA Self-Insurance Trust
Program Risk Management, Inc.
12/31/09
( X )
(
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(
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(
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(
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(
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(
)
John Conroy
Effective Date: 5/15/95
P. O. Box 12305
Industry Served: Auto/Towing/Recovery/Related Operations
900 Watervliet-Shaker Road
Approximate Number of Active Members - 190
Albany, NY 12212
N/A
Remarks:
518-456-5557
jconroy@prm.com
(A) Healthcare of New York Workers' Compensation Trust
SAFE, LLC
12/31/09
(
)
(
)
( X )
(
)
(
)
(
)
(
)
Gina Emerson
Effective Date: 9/1/01
620 Erie Boulevard West
Industry Served: Health & Social Service Providers
Syracuse, NY 13204
Approximate Number of Active Members - 25
315-701-1600
$4.5 M
Remarks:
gemerson@safetpa.com
Page No. 1 of 10
(
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( X )
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
1
2
Group Self-Insurer
Group Administrator
3
Last Fiscal
Year Level 1
Review Final
4
5
6
Cumulative
Operating Restrictions
Regulatory
Imposed
Deficit
Regulatory Funding Position
Fully
90 - 99% 80 - 89% 70 - 79% 60 - 69%
Funded
Less than
60%
Yes
No
Pending
*A = Active; I = Inactive
(A) Healthcare Underwriters Mutual Risk Management Group
Self Funding, Inc.
12/31/09
(
)
(
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(
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(
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( X )
(
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(
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(
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( X )
John Berger
Effective Date: 4/1/96
5687 Main Street
Industry Served: Health & Social Service Providers
Williamsville, NY 14221
Approximate Number of Active Members - 4
716-634-2876
$3.2M
Remarks:
jberger@selffundinginc.com
(A) Human Services Self-Insurance Trust Fund
FCS Administrators, Inc.
12/31/09
( X )
(
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(
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(
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(
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(
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(
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( X )
(
)
(
(
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Bryan Bingel
Effective Date: 12/29/95
P. O. Box 1248
Industry Served: Health & Social Service Providers
Williamsville, NY 14231
Approximate Number of Active Members - 60
716-631-5001
N/A
Remarks:
bbingel@fcsadministrators.com
(A) McGuire Group Trust
Self-Administered
12/31/09
(
)
(
)
( X )
(
)
(
)
(
)
( X )
Daniel Cronmiller
)
Remarks: Closed to new
Effective Date: 1/1/94
560 Delaware Avenue
Industry Served: Health & Social Service Providers
Buffalo, NY 14202
financial monitoring;
Approximate Number of Active Members - 8
716-826-2010
additional security deposit
$1.0 M
dcronmiller@mcguiregroup.com
(A) New York Bus Operators Compensation Trust
Arthur J. Gallagher Risk Management Services Inc.
members; enhanced
for entire deficit posted.
12/31/09
(
)
( X )
(
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(
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(
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(
)
(X )
(
)
(
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Lynn Cagnetta
Effective Date: 1/1/93
40 Richards Avenue 6th floor
Industry Served: Passenger Transportation - Bus Operators
Norwalk, CT 06854
Approximate Number of Active Members - 40
203-642-0500
$1.9 M
Remarks: Enhanced
financial monitoring.
lynn_cagnetta@ajg.com
(A) New York Choice Self-Insurance Trust
FCS Administrators, Inc.
09/30/09
( X )
(
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(
)
(
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(
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(
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(
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( X )
(
)
Pauline Salay
Effective Date: 9/1/97
P. O. Box 1248
Industry Served: Gas/Petroleum/Fuel Oils - Sale of
Williamsville, NY 14231
end to a calendar year end
Approximate Number of Active Members - 60
716-631-5001
effective 12/31/10.
Remarks: Trust will be changing their year
N/A
Remarks:
psalay@fcsadministrators.com
(A) New York College & University Risk Management Group
Marsh USA, Inc.
12/31/09
(
)
( X )
(
)
(
)
(
)
(
)
(
)
Annette Borodzik
Effective Date: 6/30/94
665 Main Street
Industry Served: Schools (Elementary, Colleges, Universities)
Buffalo, NY 14203
Approximate Number of Active Members - 35
716-843-4504
$2.5 M
Remarks:
annette.m.borodzik@marsh.com
Page No. 2 of 10
(
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( X )
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
1
2
Group Self-Insurer
Group Administrator
3
Last Fiscal
Year Level 1
Review Final
5
6
Cumulative
Operating Restrictions
Regulatory
Imposed
Deficit
4
Regulatory Funding Position
Fully
90 - 99% 80 - 89% 70 - 79% 60 - 69%
Funded
Less than
60%
Yes
No
Pending
*A = Active; I = Inactive
(A) New York Lumbermen's Insurance Trust Fund
W. J. Cox Associates, Inc.
12/31/09
( X )
(
)
(
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(
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(
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(
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(
)
( X )
(
)
Roxanne Dungan
Effective Date: 4/1/81
9600 Main Street
Industry Served: New York Lumbermen
Clarence, NY 14031
Approximate Number of Active Members - 300
716-759-9606
N/A
Remarks:
rdungan@wjcox.com
(A) New York Operators Self-Insurance Trust
Arthur J. Gallagher Risk Management Services Inc.
12/31/09
(
)
(
)
( X )
(
)
(
)
(
)
(
)
(
)
( X )
(
)
( X )
Lynn Cagnetta
Effective Date: 12/31/95
40 Richards Avenue 6th floor
Industry Served: Eating and Drinking Establishments
Norwalk, CT 06854
Approximate Number of Active Members - 265
203-642-0500
$600 K
Remarks:
lynn_cagnetta@ajg.com
(A) New York State Motor Truck Association Compensation Trust
First Niagara Risk Management, Inc.
12/31/09
(
)
( X )
(
)
(
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(
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(
)
(
)
Robert Fortenbaugh
Effective Date: 7/1/94
726 Exchange Street - Suite 900
Industry Served: Transportation
Buffalo, NY 14210
Approximate Number of Active Members - 70
716-819-5640
$566 K
Remarks:
robert.fortenbaugh@fnrm.com
(A) Niagara Business Trust
FCS Administrators, Inc.
12/31/09
(
)
( X )
(
)
(
)
(
)
(
)
(
)
( X )
(
)
Pauline Salay
Effective Date: 2/1/98
P. O. Box 1248
Industry Served: Manufacturers - Various Types
Williamsville, NY 14231
additional $160,000 for
Approximate Number of Active Members - 40
716-631-5001
2009 and has collected
$157 K
psalay@fcsadministrators.com
(A) NYAHSA Services, Inc. Self-Insurance Trust
Cool Insurance Agency
Remarks: Trust Billed an
75%.
12/31/09
(
)
(
)
( X )
(
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(
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(
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(
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(
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( X )
(
)
(
John Snow
Effective Date: 10/2/95
784 Troy-Schenectady Road
Industry Served: Health & Social Service Providers
Latham, NY 12110
Approximate Number of Active Members - 110
518-783-2665
$15.1M
Remarks:
jfsnow@coolins.com
(A) Rochester General Health System Workers' Compensation Trust
Self-Administered
12/31/09
(
)
(
)
( X )
(
)
(
)
(
)
( X )
Mary Tribuzzi
Effective Date: 10/1/96 as ViaHealth Workers' Compensation Trust
1425 Portland Avenue
Industry Served: Health & Social Service Providers
Rochester, NY 14621
Approximate Number of Active Members - 9
585-922-3978
)
Remarks: Closed to new
Remarks: Trust Changed Name effective 10/25/10.
Previous name was ViaHealth.
$2.9 M
members; enhanced
financial monitoring.
mary.tribuzzi@viahealth.org
Page No. 3 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
1
2
Group Self-Insurer
Group Administrator
3
Last Fiscal
Year Level 1
Review Final
4
5
6
Cumulative
Operating Restrictions
Regulatory
Imposed
Deficit
Regulatory Funding Position
Fully
90 - 99% 80 - 89% 70 - 79% 60 - 69%
Funded
Less than
60%
Yes
No
Pending
*A = Active; I = Inactive
(A) Special Trades, Contracting and Construction Trust
USA TPA - Prior to 2011- New York Compensation Managers, Inc.
09/30/09
( X )
(
)
(
)
(
)
(
)
(
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(
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( X )
(
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Christoher R. Mason
Effective Date: 10/1/95
P. O. Box 3580
Industry Served: Contractors/Services to Contractors
6250 South Bay Road
end to a calendar year end
Approximate Number of Active Members - 600
Syracuse, NY 13220
effective 12/31/10.
Remarks: Trust will be changing their year
N/A
Remarks: Membership
limited to 966 per
legislation
315-699-8475
cmason@workerscomp.com
(A) Western New York Hospital Risk Management Group
Marsh USA, Inc.
12/31/09
(
)
(
)
( X )
(
)
(
)
(
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(
)
(
)
( X )
Annette Borodzik
Effective Date: 7/1/94
665 Main Street
Industry Served: Health & Social Service Providers
Buffalo, NY 14203
Approximate Number of Active Members - 15
716-843-4504
$3.1 M
Remarks:
annette.m.borodzik@marsh.com
INACTIVE GROUP SELF-INSURERS
Status
(I) Automobile Dealers Workers' Compensation Self-Insurance Trust
FCS Administrators, Inc.
Bryan Bingel
Industry Served: Retailers/Wholesalers - Automobiles
Run Off
P. O. Box 1248
Remarks: Trust voluntarily terminated effective 12/31/10.
Trustees monitoring run off.
Williamsville, NY 14231
Total Members from 12/29/95-12/31/10 - 292
(I) Automotive Service and Repair Self-Insurance Trust
Industry Served: Auto Service and Repair
Total Members from 1/1/05 - 1/31/10 - 453
716-631-5001
bbingel@fcsadministrators.com
New York Compensation Managers, Inc.
Anthony D'Amato
P. O. Box 3580
6250 South Bay Road
Syracuse, NY 13220
315-699-8475
Run Off
Remarks: Trust voluntarily terminated effective 1/31/10. Forensic accounting review
completed and member deficit reconstruction bills issued on 6/15/11.
Run Off
Remarks: Trust voluntarily terminated effective 12/31/10.
As of 10/15/10 Trust transferred to State contracted group
administrator.
(I) Beer Wholesalers Compensation Trust of New York
EBS-RMSCO, Inc.
Theodore Strobeck
Industry Served: Retailers/Wholesalers - Malt & Carbonated
557 Lanceshire Lane
Trustees monitoring run off.
State College, PA 16803
Total Members from 2/1/00 - 12/31/10 - 50
315-247-7094
Ted.Strobeck@ebsrmsco.com
Page No. 4 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
Status
(I) Builders Self-Insurance Trust Fund
Industry Served: Contractors/Services to Contractors
Total Members from 10/1/98 - 9/30/07 - 311
(I) Business Council WC Manufacturers Group Self-Insurance Trust
Industry Served: Manufacturers - Various Types
Total Members from 1/1/96 - 1/1/09 - 1,264
(I) Contractors Compensation Trust
Industry Served: Contractors/Services to Contractors
Total Members from 11/1/99 - 1/1/09 - 2,865
(I) Cooperative Association of Food Enterprises WC Trust
Industry Served: Eating and Drinking Establishments
Total Members from 6/13/95 - 1/1/09 - 3,986
(I) Community Residence Insurance Saving Plan SI Trust
Industry Served: Health & Social Service Providers
Total Members from 12/15/95 - 12/31/10 - 457
(I) Elderwood Senior Care Self-Insurance Trust
Industry Served: Health & Social Service Providers
Total Members from 11/1/05 - 1/1/09 - 14
(I) ELEC-CON Trust
Industry Served: Electrical Contractors and Supplies
Total Members from 7/1/01 - 1/1/09 - 536
(I) Elite Contractors Trust of New York
Industry Served: Contractors/Services to Contractors
Total Members from 8/27/99 - 7/16/08 - 2,676
Marsh USA, Inc.
Robert Bossert
665 Main Street
Buffalo, NY 14203
716-843-4500
As of 5/1/09 Trust transferred to State contracted group
administrator.
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
Program Risk Management, Inc.
Edward Sorenson
P. O. Box 12305
900 Watervliet-Shaker Road
Albany, NY 12212
518-456-5557
esorenson@prm.com
Self-Administered
Richard Courtney
7 Limestone Drive
Williamsville, NY 14221
716-633-3900
rcourtney@elderwood.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
FCS Administrators, Inc.
Bryan Bingel
P. O. Box 1248
Williamsville, NY 14231
716-631-5001
Insolvent
Remarks: Trust terminated effective 9/30/07.
Forensic accounting review completed
and member deficit reconstruction bills issued on 8/4/10.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 12/31/10.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Insolvent
Remarks: Trust terminated effective 7/16/08.
Forensic accounting review completed
and member deficit reconstruction bills issued on 1/31/11.
As of 4/1/10 Trust transferred to State contracted group
administrator.
Page No. 5 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
Status
(I) Empire State Agricultural Compensation Trust
Industry Served: Agriculture and Related Services
Total Members from 12/31/97 - 1/1/09 - 1,801
(I) Empire State Education Trust
Industry Served: Schools (Elementary, Colleges, Universities)
Total Members from 6/30/00 - 1/1/09 - 112
(I) Empire State Hospitality WC Trust
Industry Served: Lodging/Amusement/Recreation Services
Total Members from 3/1/96 - 1/1/09 - 731
(I) Empire State Transportation WC Trust
Industry Served: Passenger Transportation - Bus Operators
Total Members from 1/1/95 - 1/1/09 - 935
(I) First Automotive Services Trust
Industry Served: Auto Service and Repair
Total Members from 1/1/05 - 1/1/09 - 1,007
(I) Health Care Providers Self-Insurance Trust
Industry Served: Health & Social Service Providers
Total Members from 4/19/93 - 7/1/09 - 333
(I) Healthcare Industry Trust of New York
Industry Served: Health & Social Service Providers
Total Members from 9/12/99 - 12/31/07 - 468
Agri-Services Agency, LLC
Janice Klodowski
P. O. Box 4910
Syracuse, NY 13221
866-826-0207
jan.klodowski@agri-servicesagency.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-223-1900
cgeoffroy@firstcardinal.com
Program Risk Management, Inc.
John Conroy
P. O. Box 12305
900 Watervliet-Shaker Road
Albany, NY 12212
518-456-5557
As of 10/13/09 Trust transferred to State contracted group
administrator.
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Insolvent
Remarks: Trust terminated effective 7/1/2009. Forensic accounting review completed
and member deficit reconstruction bills issued on 9/14/10.
Insolvent
Remarks: Trust terminated effective 12/31/07. Forensic accounting review completed
and member deficit reconstruction bills issued on 12/1/09.
As of 2/11/08 Trust transferred to State contracted group
administrator.
(I) Hudson Health Care Workers' Compensation Group Trust
PMA Management Corp. of New England
Joe Gugliotti
Industry Served: Health & Social Service Providers
530 Preston Avenue
Run Off
Remarks: Trust voluntarily terminated effective 12/31/10.
Trustees monitoring run off.
Meriden, CT 06450
Total Members from 1/1/02 - 12/31/10 - 8
203-379-3434
Joseph_Gugliotti@pmagroup.com
Page No. 6 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
Status
(I) Independent Grocers Workers' Compensation Self-Insurance Trust FCS Administrators, Inc.
Pauline Salay
Industry Served: Retailers/Wholesalers - Food
P. O. Box 1248
Williamsville, NY 14231
Total Members from 4/26/96 - 7/1/09 - 68
716-631-5001
psalay@fcsadministrators.com
FCS Administrators, Inc.
(I) Long Term Care Risk Management Group
Bryan Bingel
Industry Served: Health & Social Service Providers
P. O. Box 1248
Williamsville, NY 14231
Total Members from 10/1/92 - 12/31/09 - 69
716-631-5001
(I) Manufacturing Industry WC Self-Insurance Trust
Industry Served: Manufacturers - Various Types
As of 4/14/11 Trust transferred to State contracted group
administrator.
Consolidated Risk Services, Inc.
985 Old Eagle School Road
Wayne, PA 19087
610-975-8257
Run Off
Remarks: Trust voluntarily terminated effective 7/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 12/31/09.
Forensic accounting review in progress.
Insolvent
Remarks: Trust terminated effective 3/31/06. Forensic accounting review
completed and member deficit reconstruction bills issued on 4/15/08.
Insolvent
Remarks: Trust terminated effective 8/31/06. Attorney General issued summons
and complaint for collections under joint and several. Forensic accounting
review completed 11/16/09.
Total Members from 1/1/98 - 3/31/06 - 103
(I) Manufacturing Self-Insurance Trust
Industry Served: Manufacturers - Various Types
Total Members from 12/1/97 - 8/31/06 - 266
(I) Mercantile Self-Insurance Trust
Industry Served: Retailers/Wholesalers - Various Types
Total Members from 10/1/94 - 2/29/08 - 575
(I) New York Healthcare Facilities Workers' Compensation Trust
Industry Served: Health & Social Service Providers
As of 3/31/06 Trust transferred to State contracted group
administrator.
New York Compensation Managers, Inc.
P. O. Box 3580
6250 South Bay Road
Syracuse, NY 13220
315-699-8475
As of 6/1/07 Trust transferred to State contracted group
administrator.
USA TPA
Lew Rumsmoke
P. O. Box 3580
6250 South Bay Road
Syracuse, NY 13220
315-699-8475
lrumsmoke@workerscomp.com
Hamilton Wharton Group, Inc.
110 Wall Street
New York, NY 10005
212-344-6000
Run Off
Insolvent
Remarks: Trust terminated effective 2/29/08. Member deficit assessment
coordinated by group administrator.
Remarks: Trust terminated effective 7/31/06. Forensic accounting review completed
and member deficit reconstruction bills issued on 4/15/08.
Total Members from 1/1/98 - 7/31/06 - 207
(I) New York McDonald's Operators WC Trust
Industry Served: Eating and Drinking Establishments
Total Members from 1/1/99 - 1/1/09 - 155
(I) New York Petroleum Associations Compensation Trust
Industry Served: Gas/Petroleum/Fuel Oils - Sale of
Total Members from 7/1/01 - 1/1/09 - 228
As of 7/31/06 Trust transferred to State contracted group
administrator.
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Page No. 7 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
Status
(I) New York State Cemeteries Trust
Industry Served: Cemeteries
Total Members from 2/1/02 - 3/31/08 - 85
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
Insolvent
Remarks: Trust terminated effective 3/31/08. Forensic accounting review completed
and member deficit reconstruction bills issued on 7/9/10.
As of 7/7/08 Trust transferred to State contracted group
administrator.
(I) New York State Health Providers Workers' Compensation Trust
Self-Administered
Nanci Hurlburt
Industry Served: Health & Social Service Providers
Run Off
201 North Union Street
Remarks: Trust voluntarily terminated effective 12/31/10.
Trustees monitoring run off.
Olean, NY 14760
Total Members from 4/1/02 - 12/31/10 - 18
(I) NY Transportation Workers' Compensation Trust
Industry Served: Transportation
Total Members from 12/1/00 - 1/1/09 - 1,375
(I) Northeast Health Workers' Compensation Plan
716-375-4606
nyshpa@verizon.net
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Run Off
Remarks: Trust voluntarily terminated effective 12/31/10.
Self-Administered
Robert Allen
Industry Served: Health & Social Service Providers
Run Off
600 Northern Boulevard
Trustees monitoring run off.
Albany, NY 12204
Total Members from 1/1/95 - 12/31/10 - 26
518-427-3407
allenb@nehealth.com
(I) NYSARC Workers' Compensation Trust
USA TPA
Christopher R. Mason
Industry Served: Health & Social Service Providers
Run Off
P. O. Box 3580
Remarks: Trust voluntarily terminated effective 12/31/10.
Trustees monitoring run off.
6250 South Bay Road
Total Members from 5/1/99 - 12/31/10 - 33
Syracuse, NY 13220
315-699-8475
(I) OHI Workers' Compensation Trust
Industry Served: Gas/Petroleum/Fuel Oils - Sale of
Total Members from 1/1/98 - 1/1/2010 - 165
cmason@workerscomp.com
Cody Management Services, Inc.
David Harvey
357 Bay Road
Queensbury, NY 12804
518-745-7159
Run Off
Remarks: Trust voluntarily terminated effective 1/1/10.
Run Off
Remarks: Trust voluntarily terminated effective 12/31/10.
As of 7/1/11 Trust transferred to State contracted group
administrator.
(I) PIA Manufacturers Self Insurance Trust Fund
NCA Comp Inc.
Steven Gidwitz
Industry Served: Printing Operations - Commercial
14 Lafayette Square
Trustees monitoring run off.
Buffalo, NY 14203
Total Members from 4/1/96 - 12/31/2010 - 73
716-845-0045
sgidwitz@ncacomp.com
Page No. 8 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
Status
(I) Preferred Manufacturers Insurance Trust Fund
Industry Served: Manufacturers - Various Types
Total Members from 1/1/93 - 9/1/09 - 211
(I) Provider Agency Trust for Human Services
Industry Served: Health & Social Service Providers
NCA Comp, Inc.
Steven Gidwitz
14 Lafayette Square
Buffalo, NY 14203
716-842-0045
As of 9/1/09 Trust transferred to State contracted group
administrator.
Consolidated Risk Services, Inc.
985 Old Eagle School Road
Wayne, PA 19087
610-975-8257
Run Off
Remarks: Trust voluntarily terminated on 9/1/09. Forensic accounting review
completed and member deficit reconstruction bills issued on 11/19/10.
Insolvent
Remarks: Trust terminated effective 3/1/06. Forensic accounting review completed
and member deficit reconstruction bills issued on 4/15/08.
As of 3/1/06 Trust transferred to State contracted group
administrator.
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
Insolvent
Remarks: Trust terminated effective 8/2/07.
Forensic accounting review completed
and member deficit reconstruction bills issued on 5/10/10.
As of 7/7/08 Trust transferred to State contracted group
administrator.
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
Insolvent
Remarks: Trust terminated effective 1/31/08.
Forensic accounting review completed
and member deficit reconstruction bills issued on 6/30/10.
As of 7/7/08 Trust transferred to State contracted group
administrator.
NCA Comp, Inc.
Steven Gidwitz
14 Lafayette Square
Buffalo, NY 14203
716-842-0045
Insolvent
Forensic accounting review completed
Remarks: Trust terminated effective 7/31/06.
and member deficit reconstruction bills issued on 6/28/10.
Total Members from 1/1/97 - 3/1/06 - 46
(I) Public Entity Trust of New York
Industry Served: Public Entity
Total Members from 1/1/02 - 8/2/07 - 14
(I) Real Estate Management Trust of New York
Industry Served: Real Estate and Property Management
Total Members from 1/1/01 - 1/31/08 - 307
(I) Retail and Wholesale Industry WC Self-Insurance Trust
Industry Served: Retailers/Wholesalers - Various Types
Total Members from 7/16/98 - 7/31/06 - 70
(I) Retailers of New York Worker's Compensation Trust
Industry Served: Retailers/Wholesalers - Various Types
Total Members from 9/1/97 - 1/1/09 - 1,421
(I) Selective Safety Trust
Industry Served: Transportation
Total Members from 10/1/95 - 1/1/09 - 159
As of 10/15/08 Trust transferred to State contracted group
administrator.
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
cgeoffroy@firstcardinal.com
First Cardinal, LLC
Cathy Geoffroy
10 British American Boulevard
Latham, NY 12110
518-213-1900
Run Off
Insolvent
Remarks: Trust voluntarily terminated effective 1/1/09.
Trustees monitoring run off.
Remarks: Trust voluntarily terminated effective 1/1/09. Forensic accounting review in
progress. Estimated member deficit bills issued on 6/1/11.
As of 3/18/11 Trust transferred to State contracted group
administrator.
Page No. 9 of 10
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
Report of Group Self-Insurers
As of Month 7/1/2011
Status
(I) Team Transportation Workers' Comp Trust
Program Risk Management, Inc.
John Conroy
Industry Served: Transportation
Run Off
P. O. Box 12305
Remarks: Trust voluntarily terminated effective 12/31/10.
Trustees monitoring run off.
900 Watervliet-Shaker Road
Total Members from 10/15/95 - 12/31/10 - 768
Albany, NY 12212
518-456-5557
(I) Trade Industry Workers' Compensation Trust for Manufacturers
Industry Served: Manufacturers - Various Types
Total Members from 12/27/01 - 1/31/08 - 148
(I) Transportation Industry Workers' Compensation Trust
Industry Served: Transportation
Total Members from 12/27/00 - 1/31/08 - 826
jconroy@prm.com
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
As of 5/16/08 Trust transferred to State contracted group
administrator.
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
Insolvent
Remarks: Trust terminated effective 1/31/08.
Forensic accounting review completed
and member deficit reconstruction bills issued on 6/1/10.
Insolvent
Remarks: Trust terminated effective 1/31/08.
Forensic accounting review completed
and member deficit reconstruction bills issued on 7/29/10.
Insolvent
Remarks: Trust terminated effective 4/29/08.
Forensic accounting review completed
and member deficit reconstruction bills issued on 5/25/10.
As of 9/8/08 Trust transferred to State contracted group
administrator.
(I) Wholesale and Retail Workers' Compensation Trust of New York
Industry Served: Retailers/Wholesalers - Various Types
Total Members from 9/27/99 - 4/29/08 - 905
Compensation Risk Managers, LLC
P. O. Box 1999
2515 South Road
Poughkeepsie, NY 12601
845-452-4100
As of 8/11/08 Trust transferred to State contracted group
administrator.
Page No. 10 of 10