agendapacket - Atlantic County Municipal Joint Insurance Fund

Transcription

AGENDA PACKET
Wednesday, April 15, 2015 at 3:00 PM
Atlantic County Library
40 Farragut Ave
Mays Landing, NJ
WWW.ACMJIF.ORG
ATLANTIC COUNTY MUNICIPAL JOINT INSURANCE FUND
40 Farragut Ave
Mays Landing, NJ
April 15, 2015 – 3:00 PM
AGENDA
I.
Meeting called to order by Chairman
II.
Flag Salute
III.
Statement of Compliance with Open Public Meetings Act
A.
Notice of this meeting was given by:
1.
Sending sufficient notice herewith to:
a. The Press of Atlantic City (Atlantic and Cape May editions)
b. Courier Post, Cherry Hill, New Jersey; and
2.
Filing advance written notice of this meeting with the Clerks/Administrators of all member
municipalities; and
3.
Posting notice on the public bulletin boards of all member municipalities.
IV.
Roll Call
A.
Fund Commissioners
B.
Fund Professionals
C.
Risk Management Consultants
V.
Approval of Minutes .................................................................................................................Pages 1- 19
A.
Adoption of the March 18, 2015 minutes – Motion – All in Favor
B.
Approval of the March 18, 2015 Closed Session minutes – Motion – All in Favor
The Closed Session Minutes shall not be released to the public until the reason(s) for their
remaining closed is no longer applicable and the Fund Solicitor has an opportunity to review
them.
VI.
Closed Session – Resolution 2015- ______ Authorizing a Closed Session of the Atlantic County Municipal
Joint Insurance Fund to discuss matters affecting the protection of safety and property of the public and to
discuss pending or anticipated litigation and/or contract negotiations – Motion -Roll Call
A.
B.
Claims Review Committee Report – Closed Session Items
Professionals’ Reports
1.
Claims Administrator’s Report
2.
Executive Director’s Report
3.
Safety Director’s Report
4.
Solicitor’s Report
VII.
Reopen Public Portion of Meeting – Motion – All in Favor
VIII.
Authorization of Claims Payments – Motion - Roll Call
IX.
Authorization to Abandon Subrogation (if necessary) – Motion - Roll Call
X.
Claims Review Committee Report – Open Session Items
XI.
Claims Administrator’s Report
A. Lessons Learned from Losses – April 2015…….........................................Page 20-23
XII.
Managed Health Care Report
A. Managed Care Summary………………………………………….…………..…..Page 24
April, 2015
Agenda
Page 2
B.
C.
D.
E.
F.
G.
Average Days to Report……………………………………….……...…….....…Page 25
Transitional Duty Summary……………..…………………………………...…..Page 26
Nurse Case Management Assignment Report ……………….………………......Page 27
PPO Savings and Penetration Reports…….………………………….………......Page 28
Paid Provider by Specialty………………………………………..................…....Page 29
Top 5 Providers….……………………………………………….....................….Page 30
XIII.
Solicitor’s Report
A. Closed Cases Report …………………….…………………………….………..Page 31
XIV.
Committee Reports
A.
Safety Committee Meeting Minutes – March 25, 2015…………………………..Pages 32-70
1. Approval ACMJIF Wellness Policy Program Statement – Roll Call…………Page 71
2. Approval Wellness Incentive Program – Roll Call……………………….Pages 72-74
XV.
Wellness Report…………………………………………………………………………Verbal
XVI.
Executive Director’s Report ..................................................................................................Pages 75-106
A.
Lost Time Accident Frequency Reports ....................................................................Pages 79-80
B.
Certificates of Insurance.............................................................................................Pages 81-85
C.
2014 Safety Incentive Program Awards. ..........................................................................Page 86
D.
2015 Optional Safety Budget............................................................................................Page 87
E.
Employment Practices Liability Coverage Update .........................................................Page 88
F.
EPL Allowance..................................................................................................................Page 89
G.
EPL Helpline – Authorized Contact List...................................................................Pages 90-91
H.
Financial Fast Track Report. .............................................................................................Page 92
I.
Regulatory Filing Checklists......................................................................................Pages 93-94
J.
Monthly Activity Calendar ........................................................................................Pages 95-96
K.
Skateboard Park Approval Status. ....................................................................................Page 97
L.
Capehart & Scatchard Updates ................................................................................Pages 98-102
M.
Statutory Bonds ...............................................................................................................Page 103
N.
New Fund Commissioner Orientation
O.
Financial Disclosure Form
P.
2015 2nd Assessment Billing
Q.
Claims Coordinator Training
R.
Quarterly Attendance Report…………………………………………………….Pages 104-106
S.
Revenue and Appropriations
T.
Payroll Audits
U.
Property Appraisals
V.
New Member Activity
XVII. MEL and/or RCF Reports
A. Super Storm Sandy Memo: Status Update………………………………………….Page 107
XVIII. Safety Director’s Report
A.
Activity Report - March 2015…………………………………….……….…Pages 108-115
MEL Media Library…………………………………………………….…….Pages 116-117
B.
Camp Counselor Training/Log In information……………………………….Pages 118-119
C.
Crossing Guard Training……………………………………………..………Page 120
D.
Bulletin: Collecting Brush in Roadways…………………………...………..Pages 121-122
E.
April, 2015
Agenda
Page 3
XIX.
Treasurer’s Report as of March 31, 2015……………………………………..……Pages 123-182
A.
Fund Status
B.
Investment Report
C.
Payment Register – Motion - Roll Call
D.
Bill List – Motion - Roll Call………………………………………….…….Page 179
F.
Reconciliation
E.
Analysis of Non-Assessment Receipts
XX.
Miscellaneous Business
The Next Meeting will be held on Wednesday, May 20, 2015 at 3:00 PM,
Atlantic County Library, Mays Landing Branch, 40 Farragut Avenue, Mays Landing, NJ
XXI.
Public Comment
A.
B.
XXII.
Motion to Open Meeting to Public Comment – Motion - All in Favor
Motion to Close Meeting to Public Comment – Motion – All in Favor
Motion to Adjourn Meeting – All in Favor
ATLANTIC COUNTY PUBLIC LIBRARY
40 Farragut Ave
Mays Landing, New Jersey
March 18, 2015 – 3:00PM
OPEN SESSION MINUTES
The regular meeting of the Atlantic County Municipal Joint Insurance Fund (ACM JIF) was held on
March 18, 2015, at Atlantic County Library – Mays Landing Branch, 40 Farragut Ave, Mays Landing,
New Jersey at 3PM, prevailing time. Chair Beck, City of Linwood, presiding. The meeting was called to
order at 3:00 PM.
FLAG SALUTE
STATEMENT OF COMPLIANCE WITH OPEN PUBLIC MEETING ACT
Notice of this meeting was given by: (1) sending sufficient notice herewith to The Press of Atlantic City
(Atlantic and Cape May editions) and the Courier Post, Cherry Hill, New Jersey; (2) filing advance
written notice of this meeting with the Clerks/Administrators of all member municipalities of the Atlantic
County Municipal Joint Insurance Fund; and (3) posting notice on the public bulletin boards of all
member municipalities of the Atlantic County Municipal Joint Insurance Fund.
ROLL CALL
Those in attendance were:
Jessica Thompson, Alternate, Absecon
Scott Wahl, Avalon
Karen Blowers, Brigantine
Joseph Santagata, Buena Borough
Bob Smith, Cape May City
Kim Hodsdon, Cape May Point
Heather Sparks, Commercial
Rose Turner, Corbin City
Karen Seifrit, Deerfield
Peter Miller, Egg Harbor Twp
Byron Gummoe, Folsom
Ingrid Perez, Hamilton
Ed Beck, Linwood
Rich Hirsch, Longport
Julie Picard, Lower
Lisa McLaughlin, Margate
Connie Mahon, Middle
Dawn Stollenwerk, Mullica
Scott Jett, North Wildwood
Jim Dickinson, Northfield
MINUTES.docx
1
ACM JIF Executive Committee Meeting Minutes
March 18, 2015
Page 2
Liz Woods, Ocean City
Lucy Samuelsen, Somers Point
Jim Craft, Stone Harbor (arrived 3:02pm)
Teri Smuz, Upper Twp
Roy Spoltore, Upper Deerfield
James Goos, Ventnor
Bill Richardson, Waterford
Lauren Vitelli, West Cape May
Bonnie Yearsley, Weymouth
Chris Wood, Wildwood City (arrived 3:02pm)
Janelle Holzmer, Wildwood Crest
Absent were:
Glenn Clarke, Dennis Twp
Bob Campbell, Downe Twp
Linda Kent, Estell Manor
Susan Jacobucci, Galloway
Susan Robostello, Millville
Sam Barbagli, Newfield
Stephen Wilkins, Pleasantville
George Savastano, Sea Isle City
Chris Ridings, West Wildwood
Lisa Garrison, Woodbine
Also present were:
Paul Forlenza, Deputy Executive Director, AJG Risk Management Services, Inc.
John Hansen, Treasurer
Tim Sheehan, Safety Director, J.A. Montgomery Risk Control
Kathie Tyler-Schohl, Claims Administrator, Qual-Lynx
Karen Beatty, Managed Care Provider, QualCare
Also present were the Risk Management Consultants from the following agencies:
C. J. Adams Company
Atlantic Associates
Conner Strong & Buckelew
Fairview Insurance Agency
R. T. Gerber Insurance
Glenn Insurance
Marsh & McLennan Agency
McMahon Agency, Inc.
Siracusa-Kauffman Insurance
William R. Mints Agency
Absent RMCs were:
Alamo Insurance
BCA Insurance
J. Byrne Agency, Inc.
Hardenberg Insurance
Thomas Heist Insurance Agency
2
March 18, 2015
Page 3
Insurance Agencies Management Inc.
These minutes do not necessarily reflect the order in which some items were discussed.
MOVE UP ALTERNATE
In absence of George Savastano, Sea Isle City and Susan Robostello, Millville City, Chair Beck entertained a
motion to move Alternates Connie Mahon, Middle Twp and Joe Santagata, Buena Borough to the Executive
Committee for voting purposes.
Motion by Ms. Smuz, seconded by Mr. Smith, to move up Alternates Connie Mahon, Middle Twp and Joe
Santagata, Buena Borough to the Executive Committee for voting purposes.
APPROVAL OF MINUTES – OPEN SESSION
Chair Beck entertained a motion to approve the meeting minutes of the February 18, 2015 Executive
Committee Meeting as presented.
Motion by Mr. Smith, seconded by Ms. Smuz, to approve the meeting minutes of the February 18, 2015
Executive Committee Meeting. All in favor. Motion carried.
APPROVAL OF MINUTES – CLOSED SESSION
Confidential Closed Session Meeting Minutes were distributed to the Executive Committee Members.
Chair Beck entertained a motion to adopt the Closed Session Meeting Minutes of the February 18, 2015
Meeting of the Fund as presented.
Motion by Mr. Smith, seconded by Ms. Smuz, to approve the Closed Session minutes of the February 18,
2015 Executive Committee Meeting as presented. All in favor. Motion carried.
The Closed Session meeting minutes of the February 18, 2015 meeting shall not be released to the public
until the reason(s) for their remaining closed is no longer applicable and the Fund Solicitor has had the
opportunity to review them.
Confidential Closed Session Meeting Minutes were collected.
CLOSED SESSION - RESOLUTION #2015-24
Be it moved by the Atlantic County Municipal Joint Insurance Fund that the public be excluded from this
portion of the meeting to permit the Executive Committee to consider in closed session matters affecting
the safety and property of the public and to discuss pending or anticipated litigation and/or contract
negotiations and that the minutes covering these matters and the results of closed session will be released
to the public when the reasons for discussing and acting on them in closed session no longer exists as
required by the Open Public Meeting Act.
Chair Beck entertained a motion to adopt Closed Session Resolution 2015-24 as presented.
Motion by Mr. Smith, seconded by Ms. Smuz to adopt Resolution 2015-24.
3
March 18, 2015
Page 4
ROLL CALL
Joe Santagata, Buena Borough
Ed Beck, Chair, Linwood City
Connie Mahon, Middle Twp
Lucy Samuelsen, Somers Pt City
Teri Smuz, Sec, Upper Twp
Yeas:
Nays:
None
Abstained:
None
Motion carried by unanimous vote.
REOPEN PUBLIC PORTION OF THE MEETING
Chair Beck entertained a motion to reopen the public portion of the meeting.
Motion by Mr. Smith, seconded by Ms. Smuz, to reopen the public portion of the meeting. All in favor.
Motion carried.
AUTHORIZATION OF CLAIMS PAYMENTS
Chair Beck presented the claims for payment as discussed in Closed Session.
Chair Beck asked if there were any questions at this time. No questions were entertained.
Chair Beck entertained a motion to approve the claims for payment as discussed in Closed Session.
Motion by Ms. Hodsdon, seconded by Ms. Mahon to approve the claims for payment as discussed in
Closed Session. They are as follows:
February 2015 PARs:
Workers’
Compensation
General
Liability
Property
Z09891 (01-02)
X52140
W98372
X89365
Z08071
Z07103
X70873
W57075
X72324
X50931
Z10681
X79074
X61925
X64896 (01-02)
4
March 18, 2015
Page 5
ROLL CALL
Yeas:
Nays:
None
Abstain:
None
APPROVAL TO ABANDON SUBROGATION
Chair Beck entertained a motion for authorization to abandon subrogation attempts as discussed in Closed
Session.
Motion by Ms. Smuz, seconded by Mr. Smith to abandon subrogation attempts as discussed in Closed
Session. There were three (3) claims for Abandonment of Subrogation.
Qual-Lynx File #
X64896 (01-02)
X79074
X78970
ROLL CALL
Yeas:
Nays:
None
Abstain:
None
All in favor. Motion carried by unanimous vote.
CLAIMS REVIEW COMMITTEE REPORT – OPEN SESSION ITEMS
Ms. Perez, Hamilton Township, reported on the Claims Review Committee meeting minutes of March 12,
2015. She noted they are a handout to the membership and are self- explanatory.
She highlighted the following items:
PARs
The Committee reviewed Fourteen (14) claims at the March 12, 2015 meeting. Of the claims reviewed,
Nine (9) Workers’ Compensation (5 Police, 3 Fire, and 1 Other); Three (3) General Liability; and two (2)
Property PARs were approved for settlement or continuing defense.
5
March 18, 2015
Page 6
Ms. Perez commented that the Committee discussed transitional duty and all members received a a copy
of the new Transitional Duty Policy at the Safety Breakfast.
Ms. Perez noted that there was a correction to the closed cases listed in the agenda packet which is a
handout this evening. She stated that case #4 on pg 28 should read “v. West Wildwood” and not “v. West
Cape May”.
Ms. Perez asked if there were any questions. No questions were entertained.
The next meeting is April 9, 2015 at the Hamilton Twp Municipal Building, Mays Landing.
CLAIMS ADMINISTRATOR’S REPORT
Lessons Learned from Losses – March
Ms. Tyler-Schohl reported on the Lessons Learned from Losses which in now included in the agenda
packet.
Ms. Tyler-Schohl noted that 2014-2015 had several cases relating to the weather, including potholes. She
cited a recent case that was found in favor of the Plaintiff. She explained that in 2010 a pothole claim
filed against a member was initially denied citing Title 59 immunities. The total damage to the plaintiff’s
vehicle was approximately $500. The claim eventually went to trial. The Jury found in favor of the
Plaintiff finding “the actions of the municipality were palpably unreasonable” awarding him $150,000.
She asked that members review the suggestions regarding potholes listed on her Lessons Learned from
Losses. She also asked that municipalities check with their Public Works departments and make sure
there is a written policy for taking complaints regarding potholes and documenting their repair. Also, if
the pothole is on a county road, that the municipality report it to the county as well. She reminded them
to keep records and to set cones around very bad potholes until they can be fixed.
Claims Coordinator Seminar
Ms. Tyler-Schohl announced that the Claims Coordinator Seminar will be held at Merighi’s on April 30,
2015 from 9AM-12PM. She noted that her office will send emails to all the claims coordinators
announcing these dates.
The remainder of the Claims Administrator’s report was provided in Closed Session.
MANAGED HEALTH CARE REPORT
Ms. Beatty reviewed the Managed Care Report for February 2015.
Lost Time v. Medical Only Cases
Ms. Beatty presented the ACM JIF Lost Time v. Medical Only Cases (Intake Report).
Lost Time
Medical Only
6
Feb
4
YTD
13
36
85
March 18, 2015
Page 7
Report Only
37
60
Total Intakes(New Claims)
77
159
Report Only % of Total
48.1%
37.7%
Medical Only/Lost Time Ratio
90:10
86:14
0.8
1.1
Average Days to Report
Transitional Duty Report
Ms. Beatty presented the Transitional Duty Report.
Transitional Duty Summary Report
Transitional Duty Days Available
Transitional Duty Days Worked
% of Transitional Duty Days Worked
Transitional Duty Days Not Accommodated
% of Transitional Duty Days Not Accommodated
YTD
1,359
868
63.9%
491
36.1%
Nurse Case Assignment Report:
Nurse Case Summary Report (Inclusive of 3 JIFs)
Total Open Cases in current month
Total Cases Closed
Total New Cases Open
Feb
229
70
73
PPO Penetration Report:
Ms. Beatty presented the self-explanatory PPO Penetration Rate Report.
PPO Penetration Rate
Bill Count
Original Provider Charges
Re-priced Bill Amount
Savings
% of Savings
Participating Provider Penetration Rate- Bill count
Participating Provider Penetration Rate-Provider Charges
EPO Penetration Rate – Bill Count
EPO Penetration Rate –Provider Charges
Feb
496
$686,149
$239,049
$432,980
63.1%
92.9%
97.1%
73.9%
82.7%
Ms. Beatty asked if there were any questions at this time. No questions were entertained.
SOLICITOR’S REPORT
In Mr. DeWeese’s absence, Mr. Forlenza presented the following report:
7
YTD
1,028
$1,394,404
$492,615
$882,403
63.3%
93.4%
96.9%
78.9%
76.5%
March 18, 2015
Page 8
New Cases
Mr. Forlenza noted that there were four (4) new cases reported as discussed during Closed Session.
Closed Claims
Mr. Forlenza noted that there were four (4) closed cases. He noted that synopsis of these cases can now
be found in the agenda packet; however, a corrected page is a handout this evening.
Closed Case
Description
Guthrie v. Township of Middle
Assault/resisting arrest. Assigned Defense Counsel,
A. Michael Barker, Esquire negotiated settlement to
the Plaintiffs for $5,000 and $45,000 on behalf of
all the Township of Middle and all Police Officer
Defendants.
Auld Estate v. Township of Middle
Death during medical transit (pre-suit). Defense
Counsel, A. Michael Barker, Esquire, was assigned
pre-suit for monitoring. To date, the insured has not
been served with a Notice of Claim so the file has
been closed.
Marchesano Estate v. City of Ocean City
Trip and Fall in wheelchair. Assigned Defense
Counsel filed Stipulation of Dismissal as to the
insured. The Plaintiff’s counsel filed an Offer of
Judgment with the co-defendants settling for
$20,000 with no contribution from the City of
Ocean City.
Perloff v. Borough of West Wildwood (this was a
corrected handout from one in agenda packet
naming West Cape May)
Constitutional rights/injunctive relief. Assigned
Defense Counsel, Robert Merenich, Esquire filed a
Motion for Summary Judgment which was denied.
With approval of the RCF, Mr. Merenich negotiated
settlement of this matter for the payment to the
Plaintiffs of $350,000.
General Liability File Status Report
Mr. Forlenza reported that there are 68 active General Liability claims.
Subrogation Collection
Mr. Forlenza reported that the subrogation efforts are listed in Mr. DeWeese’s report in the Claims
Review Committee minutes and will be detailed in the Treasurer’s report.
BULLETIN – SPORTS COMMITTEES
Mr. Forlenza noted that on pg 31 is a bulletin regarding potential liability issues for actions of members of
sports and recreation boards, associations, commissions or committees from a case in the TRICO JIF. He
noted that in this case, the members of the Recreation Commission that were appointed by Governing
Body approved the actions and appointments to the boards of the sports group that they oversaw. In
doing so, the Recreation Commission took over control of these groups making them responsible for the
actions of these groups; essentially extending coverage liability coverage to their actions. Mr. Forlenza
8
March 18, 2015
Page 9
asked the members to review how they handle these organizations, noting to look at appointment process,
and make sure the sports committees are not endorsing the individual actions of the sports groups they are
overseeing. He stated that anyone with questions, can contact their RMC, the Fund Solicitor or his office.
COMMITTEE REPORTS
Nothing to report.
EXECUTIVE DIRECTOR’S REPORT
Mr. Forlenza reviewed the Executive Director’s Report found in the agenda packet with the membership.
He highlighted the following items.
2014 Safety Incentive Program Awards – Mr. Forlenza noted that awards letters from his office
were issued after the Safety Breakfast. He stated that the deadline to claim or encumber these
funds is December 31, 2015. All encumbered funds must be claimed by February 1, 2016.
He encouraged members to submit reimbursement requests as soon as you make the purchases and
not wait until the deadline.
2015 Optional Safety Budget - Mr. Forlenza noted that letters from his office were issued via
email detailing how to collect your Optional Safety Budget money. He stated that the deadline
to claim or encumber these funds is December 31, 2015. All encumbered funds must be
claimed by February 1, 2016. He encouraged members to submit reimbursement requests as soon
as you make the purchases and not wait until the deadline.
EPL Helpline – Mr. Forlenza asked members to review the authorized contact list in the agenda
packet to be sure the correct individual is listed.
Financial Fast Track – Mr. Forlenza commented that the JIF has a strong surplus position right
now.
Elected Officials Training – Mr. Forlenza stated that the last Elected Officials training session
was held March 11, 2015 and all were well received. He noted all sign in sheets, including those
from the League of Municipalities, are on the JIF website for your review. Mr. Forlenza stated
that there is an online program that may still be available if any elected officials missed these
sessions.
Financial Disclosure Form – Mr. Forlenza stated that on March 3, 2015 an email was sent to all
Fund Commissioners and included a copy of the Local Finance Notice 2015-5. He stressed that
all forms can be filed after April 1, 2015 and need to be filed with the State by April 30, 2015 to
avoid penalty fees. He reported that the State is currently fining the individuals $100 that did not
file for 2014. In addition, they are still required to complete the 2014 form. He stressed that this
fine cannot be paid by the town or the JIF, it is tied directly to the individual. Ms. Hodsdon also
stressed to remind everyone to print your confirmation receipt to show proof of your filing.
Payroll Audits – Mr. Forlenza reported that the workers’ compensation exposure verification
audits have begun.
9
March 18, 2015
Page 10
Property Appraisals – Mr. Forlenza urged members to update their property schedules in Exigis
as soon as possible so as to not delay the renewal process.
State Auditors – Mr. Forlenza reported to the members that representatives from the DOBI are
currently auditing all three of the municipal JIFs administered in his office. He explained that
every 6-7 years, the Department sends examiners to review the Funds’ operations inclusive of
financial audits, risk management plans, actuarial opinions, committee meeting minutes, meeting
notices, etc. He believes they will provide a written report once it is complete. He noted that
AJG has been able to supply all their requested items thus far and he will keep the members up to
date. He further noted that all of the MEL affiliated JIFs statewide are currently undergoing this
review.
RESOLUTION 2015-25 Appointing Valerie Smith as Wellness Director
Chair Beck noted that the Scope of Services for Ms. Smith in her role as Wellness Director were a
handout this evening. He then entertained a motion to approve Resolution 2015-25 Appointing Valerie
Smith as Wellness Director from March 19, 2015 through December 31, 2015 with a cost not to exceed
$49,479 as presented.
Motion by Mr. Smith, seconded by Ms. Smuz to approve Resolution 2015-25 Appointing Valerie Smith as
Wellness Director from March 19, 2015 through December 31, 2015 with a cost not to exceed $49,479.
Discussion
Prior to Roll Call, Ms. Samuelsen asked to comment on the process for selecting Ms. Smith for this
position noting that she believes several procedures have been missed. She stated that the Fund should
have undergone a RFP or RFQ process; there was not authorization to advertise for this position from
Finance Committee. She commented that her opposition has nothing to do with Ms. Smith and her
qualifications, just purely procedural. She would like to ensure that the Finance Committee has reviewed
the contract and that the contract cost is final. In other words, there are no additional charges set forth for
travel expenses, etc. She also commented that she would have preferred to have seen the top three (3)
candidates instead of having one (1) candidate put before the JIF for approval.
Ms. Hodsdon commented that she shares Ms. Samuelsen’s concerns. She noted that when the Fund
considers positions, a Committee makes a recommendation to the Executive Committee whereas the
Safety Committee did not in this case. She does appreciate the time that AJG put in to finding Ms. Smith,
but feels that the top three (3) candidates should have been presented to the membership for
consideration. Ms. Hodsdon asked for a Motion to Table the Resolutions. Mr. Forlenza noted that in
accordance with Robert’s Rules, there is currently an open Motion on the floor from Mr. Smith and that
must be withdrawn before this Motion can be made. Ms. Hodsdon respectfully requested that his Motion
be withdrawn.
Mr. Miller requested that prior to roll call the members be given an opportunity to be heard. He noted
that he “missed” this new position when the budget was discussed. His concern is the amount of money
that will be saved in WC premium dollars for investing in Wellness. He has not seen any data to prove
the savings will be recognized. He stated that since Burlco and Trico JIFs have had this program for 2+
years, what percentage of savings has been recognized. He also commented that he feels the job
description is repetitive of the State Health Benefits program in which his municipality already
10
March 18, 2015
Page 11
participates. He further asked why the JIF is getting into health systems management rather than staying
with loss control. He noted that if the Fund is hiring someone at $62,500, why would this person need a
consultant to help them do their job. Mr. Miller requested that the Executive Committee honor the
request of Ms. Hodsdon for Mr. Smith to rescind his Motion approving Resolution #2015-25 and to allow
the Motion to table this resolution.
Ms. Samuelsen noted that she is also opposed to the consultant since Ms. Smith’s qualifications are
exceptional.
Ms. Hodsdon commented that she was also disappointed that the job was only advertised on
Monsters.com and Craigslist.com and not local newspapers where we may have missed some local talent.
Ms. Stollenwerk stated that the Safety Committee approached the Finance Committee and requested this
Wellness position. She noted that it was discussed at the Finance Committee and noted that some felt it
could be used as a potential area of funding for local wellness programs. She also stated that she is not in
favor of hiring a consultant either.
Ms. McLaughlin also commented that when she saw this in the budget she too thought it was going to be
another area where the members could receive funds to assist in local wellness items and activities. She
asked that if this position remains, will there be other money available to support member wellness
activities or just to pay the Wellness Director.
Mr. Forlenza addressed the members. He noted that his office advertised on internet job sites for this
position. He commented that his office learned a lesson when advertising for Burlco and Trico’s wellness
position. He noted that the position being advertised for is unique. He reported that 57 resumes were
received in total which he indicated he had with him and offered anyone an opportunity to review if they
desired. He also noted that more than half of the resumes received were from individuals living in the
Southern part of NJ which he felt addressed Ms. Hodsdon concern regarding local talent. He also noted
that the other finalist for the position is from Pleasantville and after an extensive interview; all felt that
Ms. Smith was more qualified and had a better background to meet the needs of this position.
Mr. Forlenza stated that procedurally his office did everything correctly. He noted that the Local Public
Contracts law indicated that you must do an advertisement – which was done. He noted that a RFP
process was not undertaken because they did not want a firm in this position; they wanted a sole
proprietor. He stated that there are only a few firms that do this and their personnel are very expensive
due to high overhead and administrative costs. He estimated the JIF would spend in excess of $100,000
for one person if they were to engage a firm. He reported that he, Mr. Miola and Ms. Schiffer, the
Wellness Director in Burlco and Trico JIFs, reviewed all the resumes and narrowed them down to six
candidates. He stated that a notice was sent to those six individuals asking them to provide additional
information in regards to their background and review the proposed scope of services noting how they
would address the services under the contract, and their compensation requirements.
Mr. Forlenza noted that of the six candidates, one (1) responded they no longer were interested; two (2)
did not respond; and final three (3) responded with the requested information. He commented that the
final three (3) were reviewed by himself, Mr. Miola and Ms. Schiffer. He reported that they decided to
interview the two (2) that were clearly more qualified for the position. He commented that they spent
over an hour discussing each individual and Ms. Smith was the best candidate of the two. He stated that
she currently works for Coaches USA and does provides onsite wellness for Prudential Insurance.
11
March 18, 2015
Page 12
Mr. Forlenza commented that the reason he and Mr. Miola felt that bringing Ms. Schiffer on board to
work with Ms. Smith was so she would get the best opportunity to hit the ground running. Ms. Schiffer
has worked for over two (2) years in Burlco and Trico. He invited the members to contact any member in
either of those JIFs and discuss Ms. Schiffer with them. She is very well liked, energetic and has
developed contacts in the medical field and county health systems. It would be a huge benefit if Ms.
Smith would learn from Ms. Schiffer and not have to start from scratch.
Mr. Forlenza stated that $100,000 has been budgeted. He noted that the contract amount for Ms. Smith is
$62,500 inclusive of expenses and her contract is pro-rated.
Mr. Forlenza noted that all members were aware that the $100,000 was placed into the budget. He
reported that there were extensive discussions of the wellness funding in the Finance Committee minutes,
the 2015 Budget message, and Safety Committee minutes. He commented that at the December 4, 2015
Safety Committee meeting there was discussions on hiring a Wellness Director and hiring Ms. Schiffer as
the consultant whom those present felt was a good idea. Mr. Forlenza noted that he has copies of all of
these items and from discussions over the last six month period if anyone would like to review. He noted
that there was an in depth discussion in addition to a presentation at the ACM JIF Retreat. At the Retreat,
there was also a discussion about hiring a Wellness Director which was incorporated into the slide
presentation. Ms. Schiffer was also a presenter at the Retreat and discussed how she started, her
programs, and her initial difficulties getting the program started. Ms. Schiffer along with Dr. Sigafoos
highlighted the National studies showing the connection between healthy employees and reduction of
workers compensation claims costs. He reiterated that these studies show that healthy employees are less
likely to become injured and if they do get injured, they recover quicker.
Mr. Forlenza stated that he did not feel it would be in the best interest of the JIF to take a step back and
restart this process. Ms. Hodsdon asked if Ms. Smith was promised anything. Mr. Forlenza noted that
she was extended an offer of contract contingent upon approval by the JIF governing body.
Mr. Miller asked about the amount of savings in claims paid from WC’s data available from Burlco and
Trico JIFs. Mr. Forlenza noted that similar to safety programs, you don’t know how much money you
save because you do not know how many accidents you prevented by having a strong safety program. He
commented that the Claims Committee and the adjustors see it when there are delayed surgeries because
the individual is a smoker, or has diabetes, or has to lose weight prior to the surgical procedure. This puts
that individual out of work for a longer time period and costs add up. He reiterated that anything that can
be done, regardless of the source, to improve the health of our workforce, will benefit everyone in the
long run. He also added that Burlco and Trico had these same apprehensions in the beginning and now all
members are engaged. He offered that some towns have Biggest Loser Contests, wear pedometers,
purchase fresh fruit for employees, took out junk food vending machines and are undertaking all kinds of
wellness activities.
Mr. Miller inquired about how many hours Ms. Smith will be working a week. Mr. Forlenza noted he
expects her to work a full 40 hour week inclusive of travel time. He stated that she will be out visiting
members to see what you are doing and how; sitting in on Safety Committee meetings; speak about
appointing a local wellness coordinator and expanding your safety program to be a Safety and Wellness
Committee. He commented that she will be going with Ms. Schiffer to meet with County organizations
and finding out about resources available so she can bring that information to the members. She can
assist in health fairs, smoking cessation, biggest loser contests; lunch and learns, etc. and help develop a
stronger wellness program.
12
March 18, 2015
Page 13
Mr. Miller asked that if a member choses to not participate, will they receive a credit. Mr. Forlenza noted
that money was allocated across the membership based on employee counts. Ms. Hodsdon agreed with
Mr. Miller noting that as an extra small member, she can’t see what the Wellness Director would do for
her town. Ms. Mahon disagreed with that option. She stated that she is a town that does everything that
Mr. Forlenza mentioned including having a Wellness Committee, adding healthy choices to the vending
machine, helping smokers quit, etc. and she has seen a difference in her employees. She reported that it
has a ripple effect on job performance as well in any size municipality noting that reducing smokers also
reduces the number of smoke breaks. Ms. Mahon added that wellness helps everyone’s well-being also
and although she has a strong program, she believes the JIF should move forward and try this program for
at least a year. She has seen it grow in her town from one person to a life of its own with more employees
wanting to participate and she wants to share that with Ms. Smith and the other members. She reminded
everyone that it is not just about wellness, but also about mental wellness of the employees.
Mr. Forlenza also commented that the City of Vineland in the Trico JIF has a very elaborate program and
has amazing WC results.
Mr. Bob Smith, Cape May, also noted that they have had their program for over eight years and it is the
one program that reaches out to the employees AND the community. Every year they have a health fair
with over 16 different vendors/services and it is very successful. He commented that moral increases and
they have participation from the majority of the employees. Mr. Bob Smith also noted that the Executive
Director’s office has done a very thorough job in this interview process and he feels they should move
forward with the wellness program.
Ms. Smuz stated that as a Finance Committee member, she recalled being shocked at the introduction of
the $100,000 line item for wellness. She noted that Upper Township already has a wellness program and
does these activities as well; however, she realizes that it is not just for her town, but for those that do not
have this activity. She reported that they had over a 100 participants at her health fair this year which
incorporated the public and surrounding towns as well. She further noted that at this year’s health fair,
one of her employees found out his sugar was very high, followed up with the doctor and found he was a
diabetic, potentially saving his life. She said with that alone, and without any other statistics, is enough
for her to have a wellness program. She also noted that Ms. Schiffer should assist her initially because
the JIF is not the easiest group to handle.
Ms. Samuelsen reiterated that she still felt communication was lacking and moving forward feels the
Executive Committee should be more involved in these processes. She is looking forward to the wellness
program, but just wants to be part of the process. She also asked Mr. Forlenza if there will be any added
costs. She was also hoping for more “seed” money to help the municipalities get going in wellness. He
noted Ms. Smith’s contract indicates that it covers all costs and that all Fund Professionals contracts are
written with that standard language. Mr. Forlenza commented that he would need to discuss any potential
funding/incentives with the Safety Committee, but the first step is getting the program implemented.
Ms. Stollenwerk again reiterated that she is not in favor of the consultant with Ms. Smith’s glowing
resume. Mr. Forlenza stated that it is a learning curve just like when bringing on a new administrator.
At this time, Chair Beck asked if Mr. Smith would care to withdraw his Motion and Ms. Smuz withdraw
her second for Resolution 2015-25.
13
March 18, 2015
Page 14
Mr. Smith noted that he will not withdraw his Motion nor would Ms. Smuz withdraw her second. Chair
Beck then entertained a roll call on the Motion to approve Resolution 2015-25.
ROLL CALL
Yeas:
Nays:
Abstained:
None
No other questions were entertained.
Motion carried by majority vote.
RESOLUTION 2015-26
Chair Beck entertained a motion to approve Resolution 2015-26 Appointing Debby Schiffer as Wellness
Consultant from March 19, 2015 through December 31, 2015 with a cost not to exceed $15,833 as
presented.
Motion by Mr. Smith, seconded by Ms. Smuz to approve Resolution 2015-26 Appointing Debby Schiffer
as Wellness Consultant from March 19, 2015 through December 31, 2015 with a cost not to exceed
$15,833.
Chair Beck asked if there were any questions at this time. Ms. Samuelsen stated that she vehemently
opposes the appointment of a wellness consultant as she does not believe it is necessary with such a
higher qualified Wellness Director.
Mr. Miller noted that Mr. Forlenza stated that Ms. Schiffer participated in the interview process and he
inquired when she knew she would be asked to be a consultant. Mr. Forlenza stated that is was discussed
at the Safety Committee meeting in early December. He noted no matter whom was hired; they would
need Ms. Schiffer’s initial assistance. He saw no conflict with Ms. Schiffer assisting in the interview
process. He noted that they didn’t recommend hiring a less qualified person to justify a contract for Ms.
Schiffer.
Chair Beck then entertained a roll call on the Motion to approve Resolution 2015-26.
ROLL CALL
Yeas:
Nays:
Abstained:
None
14
March 18, 2015
Page 15
No other questions were entertained.
Motion carried by majority vote.
MEL REPORTS
Mr. Hirsch noted that a written report is included in the agenda. He highlighted the following:
MEL Commissioner Retreat– Mr. Hirsch reported that the MEL Board of Commissioners held a one day
Retreat on February 26, 2015. The Board adopted a Resolution accepting recommendations to combine
the Strategic Planning Committee, Membership & Marketing and Rules/Contracts into the Management
Committee. He noted that in addition they disbanded the Police Accreditation Committee.
2015 MEL & MRHIF Educational Seminar – Mr. Hirsch informed the members of an upcoming
educational seminar hosted by the MEL & MRHIF. He stated it will be on April 17, 2015 from 9am-4pm
at the National Conference Center in East Windsor, NJ.
Professional Service Agreement - Mr. Hirsch reported that the MEL adopted standard contract language
for the professional service agreements.
MEL Coverage Bulletins – Mr. Hirsch noted that coverage bulletins can be found on the MEL website.
Super Storm Sandy Scheduling Order - Mr. Hirsch noted that Judge Carver set a date of July 31, 2015 to
complete the mediation process.
RCF REPORTS
Professional Service Agreement - Mr. Hirsch reported that the RCF adopted the same standard contract
language for the professional service agreements.
Mr. Hirsch asked if there were any questions at this time. No questions were entertained.
SAFETY DIRECTOR'S REPORT
Mr. Sheehan stated that the Safety Director's Report is self-explanatory. He highlighted the following
items and reminded the members of the upcoming training sessions:
Safety Bulletin – Mr. Sheehan commented that the bulletin “First Responders – Safe Lifting and
Moving of Patients” was issued in February. He asked members to read and share it with the
appropriate Departments, your governing bodies, and post it in your municipality.
Safety Director’s Message – Mr. Sheehan noted that there was also a Safety Director’s message sent
out regarding using spotters for backing up vehicles.
S:ERVE – Mr. Sheehan noted that the Safety Emergency Responders Vehicle Education notice was
emailed on January 27, 2015.
15
March 18, 2015
Page 16
MSI Training – Mr. Sheehan reported that the report contains a list of all programs for March, April
and May.
Police Adhoc Minutes – Mr. Sheehan stated that the minutes from the January meeting are in his
report.
Camp Counselor Training – Mr. Sheehan noted that this will be available online by April 1, 2015.
This training covers, Child Sexual Abuse Prevention at camp, Bullying Prevention at camp,
Playground Safety for camp counselors, Trip and Transportation safety and Aquatic safety for
counselors and Professional Lifeguard safety training.
Safety Contracts – Mr. Sheehan reminded members that their Safety Contracts are due by March 31.
2015. He stated that there are 5 members still outstanding and this is a mandatory element of the
Safety program.
Mr. Sheehan asked if there were any questions at this time. No questions were entertained.
TREASURER’S REPORT
Mr. Hansen presented the Treasurer’s Report for the period ending February 28, 2015. The report was
made part of the agenda packet for members’ review.
Investment Interest
Net interest received for the current month totaled $2,472.02 and a coupon payment of $4,500, accrued
interest of $17,375.00. After including an unrealized net loss of $19,200 in the asset portfolio, the yield
was adjusted to positive .02 % for this period. The total overview of the asset portfolio for the Fund
shows an overall unrealized gain of $69,910.38 as it relates to market value vs. the amount invested.
Our asset portfolio with TD Wealth Management has a current market value, at month end, of
$22,055,580 and consists of one (1) with maturity of less than one year; five (5) obligation with maturity
of 1- 2 years and three (3) obligations with maturities greater than two (2) years. He noted that he will be
investing another $5 million at the end of March and an additional $5 million at the end of April.
Redeemed:
Called:
Purchased:
Coupon Payment/Asset Income:
$0
$0
$0
$4,500
Receipt Activity for the Period
Monthly
YTD
Subrogation Receipts
$3,569.63*(corrected
verbally at meeting)
$202,458.31
Reimbursement & Salvage
$2,545.73*(corrected
verbally at meeting)
$8,896.89
$0
$100.00
Closed Year
2015 Assessment Collected
4,959,913.75
16
March 18, 2015
Page 17
Retrospective Program
$0
$7,573.00
1st Quarter Assessments – Mr. Hansen noted that all assessments were collected.
Claim Activity for the Period
Claim activity for the month for claims paid by the Fund and claims payable by the Fund at month end
are in the amount of $744,707.76. A total of 536 checks were issued to vendors.
The claims detail is as follows:
Direct Loss Payments
$672,391.64
Claim Expenses
$37,690.99
Legal Defense Costs
$34,625.13
Void 10 payments
<$299.67>
Cash Activity for the Period
During the reporting month, the Fund’s “Cash Position” changed from an opening balance of
$45,595,905.31 to a closing balance of $48,403,741.36 showing an increase in the Fund of
$2,807,836.05.
A.E.L.C.F. PARTICIPANT YEAR-END BALANCES
02/28/15
Unaudited
Member
Hamilton Township
$15,000
Hammonton Town
$46,089
Middle Township
$22,986
Mullica Township
$6,706
Pleasantville City
$31,825
Upper Deerfield Township
$11,394
Waterford Township
$25,667
Upper Township
$9,606
Stone Harbor
$8,665
Total
$178,027*
*Note – Unaudited interest has been allocated for 2014 and 2015 elections have been added.
17
March 18, 2015
Page 18
Payment Register
Chair Beck entertained a motion to approve the February 2015 Payment Register (Claims Activity) as
presented.
Chair Beck asked if there were any questions at this time. No questions were entertained.
Motion by Mr. Smith, seconded by Ms. Smuz to approve the February 2015 Payment Register (Claims
Activity) as submitted by Mr. Hansen.
ROLL CALL
Yeas:
Nays:
Abstained:
None
None
Bill List – March
For the Executive Committee’s consideration, Mr. Hansen presented the March 2015 Bill List in the
amount of $217,379.17 as presented.
Chair Beck entertained a motion to approve the March 2015 Bill List as presented.
Chair Beck asked if there were any questions at this time. Mr. Miller inquired about a payment for
funeral flowers. Mr. Forlenza noted that a member’s son passed away. Ms. Hodsdon offered condolences
to the member from the Executive Committee. No other questions were entertained.
Motion by Mr. Smith, seconded by Ms. Smuz, to approve the March 2015 Bill List as presented.
ROLL CALL
Yeas:
Nays:
Abstained:
None
None
18
March 18, 2015
Page 19
MISCELLANEOUS BUSINESS
Next Meeting
The next regular meeting will be held on Wednesday, April 15, 2015 at 3:00 PM, at the Atlantic
County Library, 40 Farragut Ave, Mays Landing, NJ.
PUBLIC COMMENT
Chair Beck entertained a motion to open the meeting to the public for comment.
Motion by Mr. Smith, seconded by Ms. Smuz, to open the meeting to the public. All in favor. Motion
carried.
Ms. Samuelsen requested that in the event that Mr. DeWeese will not be present at future meetings that he
send his partner or replacement to the meeting. Mr. Forlenza will address this request with him.
Ms. Turner inquired as to the date of the Claims Coordinator meetings. Ms. Tyler-Schohl noted that
ACM is April 30th at Merighi’s 9am-12pm; BURLCO is April 14th at Indian Springs Country Club 912pm; and TRICO is April 16th at Nicolosi’s 1-4pm.
Mr. Forlenza noted that anyone can attend any one of the trainings if it works better for them since they
are so similar.
Chair Beck entertained a motion to close the meeting to the public for comment.
Motion by Mr. Smith, seconded by Ms. Smuz, to close the meeting to the public. All in favor. Motion
carried.
MOTION TO ADJOURN
Motion by Mr. Smith, seconded by Ms. Smuz, to adjourn the March 18, 2015 meeting of the ACM JIF.
Motion carried.
The meeting was adjourned at 4:06 PM.
_________________________________
__________________________________________
Tracy Forlenza, Recording Secretary for
Teri Smuz, Secretary
19
LESSONS LEARNED FROM LOSSES
APRIL 2015
INJURIES CAUSED BY LIFTING
Last month’s Safety Director Bulletin stressed the importance of safe lifting for First
Responders, which I attach for your reference. Many of the same “safe lifting” pointers
apply to all of the municipal workers. Many employees lift when they shouldn’t.
Examples of recent claims:
 A police officer injured his elbow and shoulder requiring surgery from lifting
equipment from his trunk
 A police officer injured his elbow and shoulder moving cases of ammunition
 A police officer injured his neck while lifting a large traffic sign to turn it.
 A laborer injured his back loading large branches and a tree trunk into a chipper
 A laborer injured his knee lifting heavy recycling cans
 An EMT injured his low back and aggravated a prior back injury lifting a jump bag
containing equipment and supplies used to perform his work
 A truck driver sustained a significant shoulder injury requiring three surgeries
while loading a 100 gallon drum filled with leaves onto a truck by himself. (Almost
$200,000 will be paid on this claim!)
 A 17-year old female lifeguard (5’5” weighing 135 lbs) was lifting a lifeguard
stand into the sand at the end of the day. Another co-worker held the top half of
the stand while the claimant had the bottom half resting on her back. She lost
footing and the lifeguard stand fell on top of her, injuring not only her back but
fractured her left femur. She required emergency surgery to her femur with a rod
placed from her hip to her knee. Her medical alone was over $48,000!
20
Most of these claimants required surgery and had significant time lost from work.
In some of these cases the employees have had ongoing treatment for 5+ years!
Could these injuries have been avoided?
What should have been done?
While we cannot eliminate these claims entirely, there are things that should be
stressed with employees regarding lifting.
 Lift with your legs, not with your back
 Lift without twisting
 Ensure good footing
 Employees need to ask for assistance when lifting heavy items
 Supervisors should also consider whether the task requires more than one
employee
 Take into consideration whether the employee had a prior back or similar injury
As the Safety Director noted in last month’s Safety Bulletin:
“Studies show that a department-wide fitness and wellness program coupled with
training on proper body mechanics and lifting techniques result in fewer injuries.”
Kathie Tyler Schohl
Qual-Lynx
21
22
23
Atlantic County Municipal JIF
Managed Care Summary Report
2015
Intake
# of New Claims Reported
# of Report Only
% Report Only
# of Medical Only
# of Lost Time
Medical Only to Lost Time Ratio
Average # of Days to Report a Claim
March-15 March-14 2015 YTD 2014 Year End
233
77
233
921
87
33
87
324
37.3%
42.9%
37.3%
35.2%
125
40
125
532
21
4
13
65
86:14
91:09
86:14
89:11
1.7
3.0
1.1
2.4
Nurse Case Management
# of Cases Assigned to Case Management
# of Cases >90 days
March-15 March-14
97
97
67
67
Savings
Bill Count
Provider Charges
Repriced Amount
Savings $
% of Savings
March-15
588
$747,694
$245,282
$502,412
67.2%
Participating Provider Penetration Rate
Bill Count
Provider Charges
92.0%
93.2%
92.9%
92.7%
95.1%
96.6%
96.2%
97.2%
EPO Penetration Rate
Bill Count
Provider Charges
70.5%
87.6%
75.5%
86.3%
82.5%
96.2%
75.6%
87.6%
Transitional Duty Summary
% of Transitional Duty Days Worked
% of Transitional Duty Days Not Accommodated
March-14 2015 YTD 2014 Year End
351
1616
6146
$648,924 $2,142,099
$8,715,640
$208,537 $737,897
$2,970,417
$441,071 $1,384,816
$5,731,417
68.0%
64.6%
65.8%
2015 YTD 2014 Year End
68.6%
74.5%
31.4%
25.5%
24
Average Days To Report By JIF Member
March 2015
# Of Claims Reported
Absecon City
Avalon Borough
Brigantine City
Buena Borough
Cape May City
Egg Harbor Township
Galloway Township
Hamilton Township
Lower Township
Margate City
Middle Township
Millville City
Newfield Borough
North Wildwood City
Northfield City
Ocean City
Pleasantville City
Sea Isle City
Somers Point City
Stone Harbor Borough
Upper Township
Ventnor City
Waterford Township
West Cape :May Borough
Wildwood City
Wildwood Crest Borough
Grand Total
Valued as of 4/1/2015
1
1
2
1
2
1
3
2
6
1
2
11
1
2
2
7
5
1
3
2
1
3
2
3
1
7
1
74
25
Average Days To Report
0.0
5.0
0.5
3.0
0.5
0.0
0.0
3.0
1.7
0.0
1.5
1.1
2.0
0.0
1.0
4.9
1.2
0.0
2.3
1.0
0.0
2.7
0.0
1.3
0.0
2.9
1.0
1.7
Transitional Duty Summary Report
January 1, 2015 - March 31, 2015
AVALON BOROUGH
BRIGANTINE CITY
EGG HARBOR TOWNSHIP
GALLOWAY TOWNSHIP
HAMILTON TOWNSHIP
HAMMONTON TOWN
LONGPORT BOROUGH
LOWER TOWNSHIP
MIDDLE TOWNSHIP
MILLVILLE CITY
MULLICA TOWNSHIP
NORTH WILDWOOD CITY
NORTHFIELD CITY
OCEAN CITY
PLEASANTVILLE CITY
SEA ISLE CITY
SOMERS POINT CITY
STONE HARBOR BOROUGH
UPPER TOWNSHIP
VENTNOR CITY
WATERFORD TOWNSHIP
WILDWOOD CITY
WILDWOOD CREST BOROUGH
Grand Total
Transitional Duty Transitional Duty % Of Transitional
Transitional Duty Days % Of Transitional Duty Days
Days Available
Days Worked
Duty Days Worked Not Accommodated
Not Accommodated
90
90
100.0%
0
0.0%
156
67
42.9%
89
57.1%
222
133
59.9%
89
40.1%
151
151
100.0%
0
0.0%
231
45
19.5%
186
80.5%
4
0
0.0%
4
100.0%
7
0
0.0%
7
100.0%
55
55
100.0%
0
0.0%
134
134
100.0%
0
0.0%
42
42
100.0%
0
0.0%
8
8
100.0%
0
0.0%
13
13
100.0%
0
0.0%
189
71
37.6%
118
62.4%
230
162
70.4%
68
29.6%
158
158
100.0%
0
0.0%
97
97
100.0%
0
0.0%
151
66
43.7%
85
56.3%
76
76
100.0%
0
0.0%
73
73
100.0%
0
0.0%
71
71
100.0%
0
0.0%
89
57
64.0%
32
36.0%
111
68
61.3%
43
38.7%
40
7
17.5%
33
82.5%
2398
1644
68.6%
754
31.4%
26
Nurse Case Management Assignment Report
March 2015
Russel Bayer
Lida Feinstein
Kim Gallo
Peggy Holmes
Patricia Henchy
Sharon Maurer
Catherine Betham
Total
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15
63
68
65
60
68
66
61
66
64
28
27
18
47
54
63
38
53
70
19
212
229
213
0
0
0
93 Cases were Closed to Nurse Case Management in March.
72 Cases were Opened to Nurse Case Management in March.
27
Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
0
0
0
0
0
0
PPO Savings And Penetration Report
March 2015
Participating Provider
Facility
Physical Therapy
Ortho/Neuro
MRI/Radiology
Pain Management
Anesthesia
Occ Med/Primary Care
Other
Physician Fees
Out Of Network
Ortho/Neuro
Anesthesia
Physician Fees
Other
Physical Therapy
Pain Management
Grand Total
Bill Count Provider Charges Repriced Amount $ Savings % Of Savings
541
$710,895
$222,330 $488,565
68.7%
34
$426,776
$121,611 $305,165
71.5%
244
$85,454
$17,654
$67,800
79.3%
110
$69,204
$29,001
$40,204
58.1%
44
$41,843
$14,657
$27,186
65.0%
14
$31,549
$12,546
$19,003
60.2%
13
$28,500
$12,647
$15,853
55.6%
53
$13,593
$7,063
$6,530
48.0%
8
$8,119
$4,181
$3,938
48.5%
21
$5,856
$2,970
$2,886
49.3%
47
7
4
17
9
8
2
$36,799
$12,845
$11,770
$5,628
$3,083
$2,963
$511
$22,952
$6,660
$4,931
$5,224
$3,007
$2,749
$382
$13,847
$6,185
$6,839
$405
$76
$214
$129
37.6%
48.2%
58.1%
7.2%
2.4%
7.2%
25.2%
588
$747,694
$245,282
$502,412
67.2%
Participating Provider Penetration Rate
Bill Count
92.0%
Provider Charges
95.1%
EPO Penetration Rate
Bill Count
Provider Charges
70.5%
82.5%
28
Specialty
Facility
Ortho/Neuro
Physical Therapy
Physician Fees
Anesthesia
MRI/Radiology
Pain Management
Other
Grand Total
Repriced Amount
$325,400
$145,726
$61,644
$52,241
$45,464
$38,306
$31,827
$19,076
$18,212
$737,897
Paid Provider By Specialty
January 1, 2015 - March 31, 2015
Occ Med/Primary
Care
Other
3%
3%
Pain Management
4%
MRI/Radiology
5%
Anesthesia
6%
Physician Fees
7%
Facility
44%
Physical Therapy
8%
Ortho/Neuro
20%
29
Top 5 Providers By Specialty
January 1, 2015 - March 31, 2015
Bill Count
Anesthesia
MEDIKINE GROUP, LLC
GLOBAL ANESTHESIA ASSOCIATES
ADVANCED ANESTHESIA ASSOCIATES, PC
ATLANTICARE REGIONAL MEDICAL CENTER
CAPE ANESTHESIA & PAIN MGMT. ASSC.
Facility
SHORE MEDICAL CENTER
SHORE AMBULATORY SURGICAL CTR, LLC
ATLANTICARE REGIONAL MEDICAL CENTER
CAPE REGIONAL MEDICAL CENTER
ATLANTICARE SURGERY CENTER
MRI/Radiology
ONE CALL MEDICAL, INC.
ADVANCED RADIOLOGY SOLUTIONS
DOSHI DIAGNOSTIC IMAGING SERVICES
OCM FN, LLC,
ATLANTIC RADIOLOGISTS PROFESSIONAL ASSOCIATION, LLC
ATLANTICARE URGENT CARE & OCCUPATIONAL HEALTH
CAPE URGENT CARE
CAPE REGIONAL URGENT CARE
MEDEXPRESS URGENT CARE-NEW JERSEY INC.
SHORE URGENT CARE
Ortho/Neuro
SHORE ORTHOPAEDIC UNIVERSITY ASSOC.
COASTAL PHYSICIANS & SURGEONS, P.C.
EAST COAST ORTHO. & SPORTS MED. LLC
ROTHMAN INSTITUTE OF NEW JERSEY
PREMIER ORTHOPAEDIC ASSOC
Other
QUEST DIAGNOSTICS
DJO LLC
MDS MEDICAL DEVICE SPECIALTY
SURGICAL MONITORING SERVICES
HOLY REDEEMER HOME CARE, NJ SHORE
Pain Management
DELAWARE VALLEY PAIN INSTITUTE
PROFESSIONAL PAIN MANAGEMENT ASSOC.
RELIEVUS
PAIN SPECIALISTS, PA
COMPREHENSIVE PAIN MANAGEMENT
Physical Therapy
TWIN BORO PHYSICAL THERAPY
NOVACARE REHABILITATION
FOX OUTPATIENT REHABILITATION
BACHARACH INSTITUTE FOR REHABILATION
STRIVE PHYSICAL THERAPY
Physician Fees
THE PLASTIC SURGERY CENTER
ATLANTICARE PHYSICIAN GROUP, PA
ATLANTIC EMERGENCY ASSOCIATES
SHORE ORTHOPAEDIC UNIVERSITY ASSOC.
CAPE EMERGENCY PHYSICIANS, PA
30
30
12
4
5
5
4
74
17
13
13
20
11
98
73
17
2
1
5
143
44
50
26
17
6
216
110
32
46
26
2
24
15
1
3
1
4
53
22
24
2
4
1
593
311
87
148
17
30
58
2
16
11
22
7
Provider Charges
$75,000
$21,755
$17,770
$15,105
$12,950
$7,420
$865,325
$399,610
$156,196
$121,230
$101,769
$86,521
$108,041
$103,036
$2,298
$1,147
$866
$694
$34,070
$9,975
$9,282
$7,417
$6,113
$1,282
$359,939
$126,531
$109,843
$42,389
$40,916
$40,260
$18,993
$5,889
$5,250
$3,579
$2,425
$1,850
$74,747
$48,315
$25,371
$511
$425
$125
$226,303
$131,379
$29,580
$29,165
$28,024
$8,155
$76,191
$56,140
$6,602
$5,851
$5,210
$2,388
ATLANTIC COUNTY MUNICIPAL JOINT
INSURANCE FUND
APRIL 2015
CLOSED CASES
1)
Thomas v. Borough of Longport – This matter involved the Plaintiff’s
allegations in a Superior Court of New Jersey, Atlantic County Complaint that on
May 17, 2012, the Defendant, Sergeant Frank Culmone, swore out certain Criminal
Complaints against the Plaintiff which alleged that she violated N.J.S.A. 2C:28-4A,
N.J.S.A. 2C:12-1B(5)(A) and N.J.S.A. 2C:29-2A(1). On September 4, 2013 all three
Criminal Complaints were dismissed. The Plaintiff alleged that she suffered
permanent emotional and physical injuries as a result of the arrest, that she was
maliciously prosecuted and that her civil rights were violated as a result of the
Complaints being filed. Our Assigned Defense Counsel, Thomas B. Reynolds,
Esquire and A. Michael Barker, Esquire, attended Mediation which was
unsuccessful in resolving the matter. The Plaintiff’s Demand was for a payment in
the amount of $195,000.00. Mr. Barker and Mr. Reynolds were ultimately able to
negotiate the settlement of this matter for a payment to the Plaintiff in the amount
of $35,000.00 and the payment to the Plaintiff’s attorney in the amount of
$15,000.00 for a total settlement in the amount of $50,000.00.
2)
Finch v. Bigham Easy Lift, LLC v. City of Millville – This matter involved
the Plaintiff’s allegations in a Superior Court of New Jersey, Cumberland County
Complaint that on April 17, 2009, while the Plaintiff, Christopher Finch, was
working for the Third Party Defendant, City of Millville, he was injured while using
a tool which was manufactured and distributed by the Defendant/Third Party
Plaintiff, Bigham Easy Lift, LLC. The tool was designed to remove manhole covers.
The Plaintiff alleged that he sustained serious and permanent injuries as a result of
the accident. Defendant/Third Party Plaintiff, Bigham Easy Lift, LLC filed a Third
Party Complaint which alleged that Third Party Defendant, City of Millville, failed
to properly perform its duty to train and supervise Christopher Finch with respect
to his use of the product that was the subject of this lawsuit, and they sought
contribution and indemnification from the City of Millville. Our Assigned Defense
Counsel, L. Patricia Sampoli, Esquire, was able to convince the Plaintiff’s Counsel
to dismiss the Complaint based upon the substantial Workers’ Compensation lien
and the risk that the case had a substantial potential for a “no cause” verdict.
31
1
EXECUTIVE SAFETY COMMITTEE MEETING MINUTES
SEA ISLE CITY PROVISIONAL CITY HALL (OLD PUBLIC SCHOOL)
4501 PARK ROAD
SEA ISLE CITY, NJ
March 25, 2015 AT 11:30AM
An Executive Safety Committee meeting of the Atlantic County Municipal Joint Insurance Fund
(“ACMJIF”) was held at Sea Isle City’s – Provisional City Hall, Sea Isle, NJ on Wednesday, March 25,
2015 at 11:30am. The meeting was called to order at 11:45am.
Those in attendance were:
George Savastano, Chair, Sea Isle City
James Dickenson, Northfield City
Lucy Samuelsen, Somers Point
Julie Picard, Lower Township
Teri Smuz, Fund Secretary, Upper Township
James Goos, Ventnor City
Joe Byrne, J. Byrne Agency
Dennis Brown, Glenn Insurance
Eugene Siracusa, Siracusa-Kaufmann Insurance Agency
Mike Thomas, Glenn Insurance
Bill McMahon, McMahon Agency
Dave Miller, CJ Adams
Lou Carey, Lead Consultant, J. A. Montgomery Risk Control
Tim Sheehan, Public Sector Assistant Director, J. A. Montgomery Risk Control
Paul J. Miola, Executive Director, Arthur J. Gallagher & Co.
Paul A. Forlenza, Deputy Executive Director, Arthur J. Gallagher & Co.
Sheila Ortiz, Account Representative, Arthur J. Gallagher & Co.
Debby Schiffer, Wellness Director (BURLCO / TRICO JIFs)
Valerie Smith, Wellness Director (ACM JIF)
Those not in attendance were:
Chris Ridings, West Wildwood City
Robert Smith, Cape May City
Robert Campbell, Downe Township
William Richardson, Waterford Township
Charles Pessagno / Jen Modica, Marsh & McLennan
Mike Avalone / Ilene Laursen, Conner Strong & Buckelew
Larry Graham, Fairview Insurance
Tom Heist, Thomas Heist Insurance
Joanne Hall, Safety Director, J. A. Montgomery Risk Control
Donald Ruprecht, Consultant, J. A. Montgomery Risk Control
These minutes may not represent the order in which some items were discussed.
32
ACMJIF
Executive Safety Committee Meeting Minutes
March 25, 2015
Page 2
I.
MINUTES OF DECEMBER 3, 2014 (e-mailed 03/12/2015)
Mr. Savastano stated the December 3, 2014 Executive Safety Committee Meeting minutes were
e-mailed to the Committee on 3/12/15.
II.
SAFETY COMMITTEE CHARTER – E-mailed 03/12/2015
Mr. Forlenza stated it has been the Executive Director’s practice to add the Charter to the first
Safety Committee agenda of the year for review to make sure that it is still accurately depicts
the role and responsibility of the Committee. He asked if there are any suggested changes to
please contact him or Mr. Savastano.
Mr. Forlenza asked the Committee if there were any questions. No questions were entertained.
III.
ANNUAL SAFETY DIRECTOR’S LOSS CONTROL REPORT (e-mailed 03/24/2015)
The Safety Director’s Annual Report was e-mailed to the Committee on March 24, 2015. Mr.
Sheehan handed out an abridged version for the Committee’s review. He briefly reviewed the
report with the Committee.
Mr. Sheehan highlighted the Annual Loss Analysis Summary & the 2015 Service Initiatives
with the Committee. He indicated that his office will be focusing on the Accident Investigation
process in 2015. Mr. Sheehan noted that Accident Investigations are one of the key components
in preventing future incidents. The key element will be to identify the members that have the
highest workers compensation frequency rates, and to work with these members on their
Accident Investigation programs.
Mr. Sheehan asked if there were any questions. No questions were entertained at this time.
Mr. Miola asked that J. A. Montgomery follow-up with the towns that have not designated a
training administrator. Mr. Sheehan responded that his office will follow-up with those towns.
He also noted that an updated training administrator list will be included in his monthly report at
least once a quarter.
Mr. Miola indicated that a few years ago there was an initiative to drive down the number of
claims that fall into the NOC “Not Otherwise Classified” category. He noted that the number of
claims falling into this category appear to be increasing. He stated that he and Mr. Forlenza will
be meeting with Qual-Lynx in a few weeks and will discuss this issue with them.
(The Annual Safety Director’s Loss Control Report is attached to the minutes of today’s
meeting.)
IV.
SAFETY INTERVENTION / MONITORING
Mr. Forlenza referred the Committee to an excerpt from the last Safety Committee Meeting on
page three (3) of the agenda packet. Mr. Sheehan reported that no towns are currently on Safety
Monitoring; however, a number of towns are on his “watch list”. He then stated that the
following towns have been removed from his “watch list” due to their improvement in certain
areas: Corbin City, Pleasantville, Sea Isle City and West Wildwood. He stated that it is his
recommendation to keep Millville on the “watch list” due to their high metrics. Mr. Carey will
conduct a renewal visit in Millville prior to the June Executive Safety Committee Meeting and
will report back to this Committee.
Mr. Forlenza asked if there were any questions at this time. No questions were entertained.
33
F:\DATA\Risk\WINWORD\ACMJIF\SAFETY\2015\Meetings\March\MIN 032515_GS.doc
ACMJIF
March 25, 2015
Page 3
V.
MEMBERSHIP RENEWALS
Mr. Forlenza stated that there are 11 member municipalities up for renewal effective January 1,
2016. They are Brigantine, Lower, Margate, Middle, Millville, North Wildwood, Sea Isle City,
Stone Harbor, West Cape May, Wildwood Crest and Woodbine.
Mr. Forlenza then reviewed with the Committee the Renewing Members ACMJIF Six-Year
Average Loss Ratio Reports for Fund Years 2008-2013 valued as of 12/31/2014 that was
included in the agenda packet. Close attention was paid to members with six-year average loss
ratio over 100% with a review of specific years and lines of coverage that created the loss ratio
in excess of 100%
Mr. Forlenza mentioned that only Millville, Sea Isle City and Woodbine have a high loss ratio
as of 12/31/2014. The Safety Director will complete each Renewal Survey on each member for
presentation at the June 2015 Executive Safety Committee Meeting.
VI.
ACMJIF LOSS RATIO REPORTS – December 31, 2014
Mr. Forlenza directed the Committee to a copy of the ACM JIF Six Year Average Loss Ratio
reports valued as of December 31, 2014 included in the agenda packet. Mr. Forlenza noted that
the six-year average loss ratio for the ACM JIF is 86.5%. These are incurred losses, which is
money paid on known claims, and money set aside in reserve to pay those known claims within
the JIFs self-insured retention. Mr. Forlenza briefly reviewed the following report included in
the agenda packet with the Committee.
Loss Ratio Summary FY 2008 – FY 2013 – Incurred v. Loss Funds as of December 31, 2014
Incurred v. Loss Funds as of 12/31/14 – Fund Year 2008 – 2013 – By Town, By LOC
Incurred v. Loss Funds as of 12/31/14 – Fund Year 2013 – By Town, By LOC
Mr. Forlenza stated that this data is used to create the Loss Ratio Snapshots, which were
distributed to the membership at the February Executive Committee Meeting.
VII.
MEL LOSS RATIO REPORTS – December 31, 2014
Mr. Forlenza directed the Committee to a copy of the MEL Six Year Average Loss Ratio reports
valued as of December 31, 2014 included in the agenda packet. The six year average MEL Loss
Ratio for the ACMJIF is 132.6%. The report reflects a six-year period for Fund Years 2008 –
2013. He indicated that this is money that the MEL uses to fund their self insured retention for
Workers Compensation, Property and Liability losses. Mr. Forlenza noted that this report
represents incurred losses which are funds that have been paid by the MEL on known claims or
set aside in reserve to be paid on known claims. Mr. Forlenza briefly reviewed the following
MEL Reports included in the agenda packet with the Committee.
34
ACMJIF
March 25, 2015
Page 4
Loss Ratio Summary FY 2008 – FY 2013 – Incurred v. Loss Funds as of December 31, 2014
Incurred v. Loss Funds as of 12/31/14 – Fund Year 2008 – 2013 – By Town, By LOC
He also noted that the MEL snapshots were provided to the membership at the February
Executive Committee Meeting.
Mr. Forlenza asked if there were any questions. No questions were entertained.
VIII. REGIONAL TRAINING SCHEDULE
Mr. Sheehan reviewed the Regional Training Schedule for 2015 included in the Agenda Packet
beginning on page 28.
•
Safety Coordinators’ Roundtable: Training took place on February 19, 2015
immediately following the Safety Breakfast with good member representation.
•
Summer Seasonal for Supervisors: Mr. Sheehan mentioned that this training will take
place on April 30, 2015 from 9:00am – 12:00pm. The training will take place at the
North Wildwood Recreation Center. Mr. Carey will confirm. The target audience is
Safety Coordinators, Recreation Department personnel, and Summer Seasonal
Coordinators.
•
Public Works Department Roundtable: Mr. Sheehan mentioned that this training will
take place on September 30, 2015, time TBD. He noted that Mr. Carey will follow-up
with Galloway to see if they can accommodate this date. The target audience is Public
Works Superintendents, Supervisors, Safety Coordinators and other interested persons.
•
Career Survival for Police Officers / Guest Speaker: Mr. Sheehan mentioned that this
training is scheduled on September 17, 2015 from 9:00am-12:00pm at the Ocean City
Library. Mr. Forlenza indicated that there is a fee to secure the guest speaker retired
Police Chief Keith F. Hummel. The fee is $500 for this session. Mr. Forlenza asked the
Committee if they are okay with this expenditure. The Committee approved.
Mr. Forlenza stated that the SLEO Training is listed as a “Police Topic” for the 2015 Regional
Training schedule; however, this training is not really a Regional Training session.
Police Topics – SLEO Training: Mr. Forlenza indicated that retired Police Chief Connell has
conducted this training for the members the last two years. He indicated that Chief Connell
charges the Fund $800 per session. Mr. Forlenza asked the Committee for authorization for this
expenditure. The Committee approved the funding for this training. The trainings are scheduled
on Wednesday, May 13, 2015 from 6:00pm – 10:00pm at the Atlantic County Police Academy
and a second session will be held on Wednesday, May 20, 2015 from 6:00pm – 10:00pm at the
Cape May Police Academy.
Mr. Sheehan indicated that Howard Spencer, Consultant for the TRICO JIF, and Joanne Hall can
offer an additional Regional Training session on “Sensitivity / Dealing with Difficult People”.
He stated that Mr. Spencer and Ms. Hall do a great job with this training. After a brief
35
ACMJIF
March 25, 2015
Page 5
discussion, the Committee approved adding this training to the 2015 Regional Training schedule.
Mr. Forlenza stated that this training will likely be popular as many office workers have to deal
with angry or upset residents. He asked Mr. Sheehan to be sure the facility reserved can
accommodate a large number of attendees.
IX.
SAFETY DIRECTOR’S BULLETIN
Mr. Sheehan referred the Committee to a series of Safety Director Bulletins that have been
distributed to the members since the Committee’s last meeting. He noted that they are located
on pages 29-38 of the agenda packet. The following bulletins were issued:
•
•
•
•
•
Best Practices – Snow Emergencies
Annual Reminder – MVR Checks
Annual Reminder – Posting of OSHA Summary Log
First Responders – Safe Lifting
Brush Collection
Mr. Sheehan indicated that Mr. Ruprecht is working on a few new Safety Bulletins that will be
sent to the members. Mr. Forlenza asked if a Safety Bulletin can be created that would remind
towns to inspect their playgrounds. Mr. Sheehan responded that Mr. Ruprecht is currently
working on a Safety Bulletin regarding playgrounds.
X.
SUPERVISOR’S INCIDENT INVESTIGATION REPORT
Mr. Forlenza indicated that the new form is on the ACM JIF website for use by the members. He
noted that a mobile application of the Supervisor’s Incident Investigation Report is in
development.
XI.
TRANSITIONAL DUTY PROGRAM – REVISIONS
Mr. Forlenza indicated that the new Transitional Duty Program was e-mailed to all of the
Claims Coordinators following the Safety Breakfast. He stated that the Transitional Duty
Program will not be posted to the website due to competing JIF’s stealing their Policies. Mr.
Forlenza noted that he will e-mail the RMC’s the program as they have been requesting a copy
of the document.
XII.
MEL SAFETY INSTITUTE
Mr. Forlenza asked if a Training Administrator has been appointed in each town. Mr. Sheehan
responded that everyone has appointed a Training Administrator with the exception of two
towns. He noted that his office will continue to include this report in the Safety Director’s
monthly report at least once a quarter.
MEL Leadership Institute
Mr. Sheehan indicated that the first MEL Leadership Institute for the year has already started in
Galloway Township. He noted that the class is filled to capacity and he had to turn
approximately 50 people away due to accommodations. Mr. Sheehan indicated that Ms. Hall is
36
ACMJIF
March 25, 2015
Page 6
hoping to offer more MEL Leadership Institute sessions in the South Jersey area. He noted that
Ms. Hall will work with the MEL to search for funding to support additional courses.
Online Training
Mr. Sheehan referred the Committee to page 39 of the agenda packet to a flyer for a “Summer
Camp Counselor” training course. He indicated that this online course will be available to the
members on April 1st via the MSI Learning Management System.
XIII. S:ERVE
Mr. Sheehan reported that the program reminder was e-mailed to the members on January 27,
2015 and the program continues to be utilized. He indicated that last year Safety National added
the Distracted Driver Module as a standalone module for all municipal employees that drive
municipal vehicles.
XIV. POLICE TOPICS
Accreditation Update
Mr. Forlenza indicated that his office recently sent out the annual reminder memorandum
outlining incentives offered by the JIF & MEL to assist member Police Departments in becoming
accredited. He then referred the Committee to the memo on pages 45-46.
Mr. Sheehan indicated that Wildwood City is preparing to begin the accreditation process.
Police Ad Hoc Committee Meeting
Mr. Forlenza stated that the last Police Ad Hoc Committee meeting was held on January 30,
2015. He mentioned that the minutes from the meeting begin on page 47 of the agenda packet.
Mr. Forlenza stated the next Police Ad Hoc Committee Meeting is scheduled for April 10, 2015.
Narcan
Mr. Forlenza reminded the Committee that Mr. DeWeese had raised concerns regarding the
potential liability for municipalities over the administration or non-administration of Narcan. He
indicated that the Governor initially signed an Executive Order providing immunity to First
Responders and EMS regarding the use of Narcan; however, the Executive Order did not provide
immunity for Police Officers. Mr. Forlenza stated that recently the Governor signed Chapter 10
of P.L. 2015 that appears to extend immunity to Police Officers for the use of Narcan.
Penns State Study
Mr. Forlenza asked Mr. Sheehan for an update on the Penn State Study. Mr. Sheehan stated that
there is no update at this time.
Police Safety in and Around Your Vehicle
Mr. Sheehan referred the Committee to page 61 of the agenda packet. He noted that this notice
was sent to all Fund Commissioners. Mr. Sheehan indicated that he reached out to the State
Chiefs of Police Association to secure an updated e-mail group for all Police Chiefs to send out
the memo to all of the JIFs.
SLEO Training – Two Sessions (2)
This discussion took place during the Regional Training section of the agenda.
37
ACMJIF
March 25, 2015
Page 7
XV. MEL SAFETY & EDUCATION MEETING
Mr. Forlenza indicated that the MEL Safety & Education Committee met on December 19, 2014
and the minutes are included in the agenda packet beginning on page 62. He mentioned that the
next meeting is scheduled for March 27, 2015.
XVI. PEOSHA ADVISORY COMMITTEE UPDATES
Mr. Forlenza directed the Committee to page 66 to a notice that was sent from the New Jersey
Department of Labor and Workforce Development. Mr. Carey reviewed the Most Frequently
Cited Standard for the period of October 1, 2014 through December 31, 2014 with the
Committee. He noted that PEOSH is focusing on overhead doors, vehicle lifts, and the annual
posting of the 300 logs.
Mr. Carey indicated that PEOSH has posted a new requirement effective January 5, 2015:
•
Employers must report all work-related fatalities to PEOSH within eight hours
•
Employers must report all work-related in-patient hospitalizations, amputations, or losses
of an eye to PEOSH within twenty-four hours.
Mr. Sheehan commented that Mr. Saville indicated that PEOSH is also focusing their attention to
DPW and Water & Sewer Departments. Mr. Carey noted that Mr. Saville will distribute the
Most Frequently Cited Standard in the next couple of weeks.
Right to Know
Mr. Sheehan reported that all members were required to complete their 2013 data entry into the
State portal by the end of last year. He is awaiting direction from the State on how the 2014 data
entry will be handled.
XVII. SMALL MUNICIPALITIES – REGIONAL SAFETY COMMITTEE MEETINGS
Mr. Forlenza asked if the Small Municipalities Regional Safety Committee Meetings are still
taking place. Mr. Carey responded that these meetings are still taking place. He indicated that
Folsom, Weymouth, Corbin City and Woodbine have been conducting their meetings.
Mr. Carey stated that Downe Township & Commercial Township have a joint program. He
noted that Downe Township’s attendance has not been so great. Therefore, he recently sent a
note to Downe Township asking them that they reassert their efforts in attending the Joint Safety
Committee Meetings.
XVIII. WELLNESS INITIATIVE
Mr. Forlenza indicated that last week the Fund appointed Wellness Director, Valerie Smith for
the ACM JIF. He stated that Ms. Schiffer was appointed last week as a Wellness Consultant to
assist Ms. Smith through the end of the year. Mr. Forlenza mentioned that for the past three
years Debby Schiffer has been the Wellness Director for both the BURLCO and TRICO JIFs.
Ms. Schiffer introduced herself to the Committee and briefed the Committee on her goals when
she started as Wellness Director for the BURLCO and TRICO JIFs. She thanked the members
for the opportunity to begin Wellness in the Atlantic JIF and to assist Ms. Smith.
Ms. Schiffer noted that she initially located some free or low cost wellness activities for the
employees that could easily be implemented. She has utilized local resources including
38
ACMJIF
March 25, 2015
Page 8
hospitals and health departments. Many of them offer free speaker bureaus, where a
professional will come out to the municipality and discuss various topics that may be
appropriate for the employees that are interested.
Ms. Schiffer mentioned a few group activities that she helped organize in the other JIFs:
• Weight loss challenges (“Biggest Loser Challenge”)
• Improve exercises that will help the employee become healthier
• Arrange Speakers: example; Heart Disease / Healthier Heart that can help the
employee’s live a healthier lifestyle.
Mr. Miola stated that the number one goal in the Fund is to lower Workers Competition claims.
Ms. Schiffer agreed with Mr. Miola.
Ms. Schiffer indicated that most municipalities will start the process by sending a survey to their
employees regarding Wellness requesting their feedback. Mr. Miola asked Ms. Schiffer what
the surveys have uncovered. Ms. Schiffer stated that most of the survey responses request
information on how to handle stress. She indicated that yoga, chair massages and overall
lifestyle changes can help with stress. Ms. Schiffer indicated that when employees are healthier,
there will be a lower number of injuries. She commented that Safety and Wellness go “hand in
hand” with one another.
Ms. Schiffer stated that wellness is a voluntarily activity; but she strongly encourages
participation by the municipality & employees. She indicated that some towns have added
healthier choices to their vending machines for their employees. Ms. Schiffer noted that some
of the smaller municipalities have opened up their Community Days to the residents and
adjoining towns.
Ms. Smith then introduced herself to the members. She stated that she began her career in
Cardiac Rehabilitation; working with individuals that suffered “heart” issues. Ms. Smith also
taught in the Health and Wellness Department at Camden County Community College, and then
she became a Wellness Coach for Horizon Blue Cross in North Jersey along with being a
Personal Trainer. Ms. Smith indicated that insurance carriers have incentive programs
available; but the employees are not aware of these incentives.
Ms. Smith reported that she met with Kelli Seib; Safety Coordinator from Sea Isle City prior to
today’s meeting to discuss their Wellness Program. She indicated that Ms. Seib has already
initiated the scheduling of wellness events such as: healthy “potlucks”, monthly exercise
sessions and a walking program. Ms. Smith noted that Ms. Seib also sent out a questionnaire to
the employees requesting feedback and suggestions on their program. She noted that Sea Isle
City is well on their way to a successful wellness program.
Mr. Miola indicated that Ms. Schiffer and Ms. Smith will also research incentives that health
carriers have to offer employees. For example: certain insurance carriers may offer a gift card
for completing certain medical procedures.
Mr. Miola suggested that the Ms. Schiffer and Ms. Smith reach out to the towns that have
already indicated their interest as a starting point. He indicated that by contacting those towns
that are interested it will “spark” interest in other members. Mr. Miola mentioned that Ms.
Smith will provide an update of her activities at the monthly Executive JIF meeting.
Mr. Thomas suggested that an RMC accompany the Wellness Director during the initial visit to
the municipality. Ms. Schiffer commented that she has found having the RMC involved very
helpful during her Wellness visits.
39
ACMJIF
March 25, 2015
Page 9
Mr. Miola indicated his office will meet with Ms. Smith and Ms. Schiffer on Monday to discuss
the announcement to the members. He noted that once the announcement is released the
“Wellness Corner” with all of Ms. Smith’s contact information will be placed on the ACM JIF
website.
Mr. Miola referred the Committee to page 69 of the agenda packet to a JIF Wellness Policy
Program Statement that he would like to see the Fund adopt. Discussion Ensued.
After a brief discussion, Mr. Byrne indicated after reading the program statement the
employee’s and the fund would benefit from a Wellness Program. This would include lower
Workers Compensation costs to the fund. He suggested adding verbiage that employees lives
would benefit from the program by staying healthier and creating a safer workplace. Mr. Byrne
also noted that the Fund would benefit by keeping workers compensation costs down.
Mr. Miola suggested adding verbiage after sentence three on page 70 that would benefit the
employee’s “quality of life”. The Committee Agreed. He then asked the Committee if they
were okay removing “full” from the last sentence. The Committee agreed that the word “full”
was a little demanding.
Mr. Miola stated that once the document is finalized he will circulate it to this Committee for
approval and will be attached to the minutes of today’s meeting. The Committee Agreed.
Mr. Miola noted that a copy of a proposed municipal wellness statement is also located in the
agenda packet. He noted that he would make the same language changes to this document for
potential adoption by the individual members.
Mr. Forlenza indicated that at last week’s Executive JIF meeting there was a discussion
regarding the creation of a Wellness Incentive Program. He indicated that the program would be
used to support existing wellness initiatives that are occurring in a lot of the towns. Mr.
Forlenza stated that following the payments to the Wellness Director and Wellness Advisor
approximately $34,000 is remaining in the budget. He stated that at last week’s JIF meeting Ms.
McLaughlin asked if the remaining balance could be utilized to help support existing wellness
programs.
Mr. Forlenza then referred the Committee to a handout that displays two different Wellness
Incentive options based on the member’s size:
• Wellness Incentive “A” - for 41 towns $ 33,500
o
o
o
o
o
XS - $275
SM - $600
MD - $800
LG - $1,000
XL - $1,500
• Wellness Incentive “A” – for 41 towns $30,500
o
o
o
o
o
XS - $250
SM - $500
MD - $750
LG - $1,000
XL - $1,250
Mr. Forlenza stated that this program would be similar to the Optional Safety Budget Program
and the Safety Incentive Program. He then referred the Committee to a “draft” copy of the
Wellness Incentive Program – Reimbursement Procedure letter. Following a review of the letter,
40
ACMJIF
March 25, 2015
Page 10
Mr. Forlenza asked the Committee if they would like to recommend moving forward with the
Wellness Incentive Program. Discussion ensued.
Mr. McMahon asked if this program would be optional; where the towns could opt out of the
program. Mr. Forlenza responded not for the first year; but for next year this discussion would
have to take place in Committee.
After a brief discussion, the Committee authorized the Executive Director’s office to move
forward with the Wellness Incentive Program funding with Wellness Incentive “A”. Mr.
Forlenza stated that this program will have to be approved at the next Executive JIF meeting in
April. He noted that once the program is approved, the letters will be e-mailed to the members.
Mr. Forlenza asked if there were any questions. No questions were entertained.
XIX. OPTIONAL SAFETY BUDGET
Mr. Forlenza stated that notices regarding available balances for the 2015 Program were sent to
the members on February 11, 2015. The deadline to encumber or claim funds is December 31,
2015. The final date to claim encumbered funds is February 1, 2016.
XX. SAFETY INCENTIVE PROGRAM
2014 Program
Mr. Forlenza directed the Committee to page 72 of the agenda packet to the available balances.
He added that the congratulatory letter was sent out to the governing body on February 25, 2015
and the award letter with reimbursement procedures were sent to Safety Coordinators on
February 25, 2015.
The deadline to encumber or claim funds is December 31, 2015. The final date to claim
encumbered funds is February 1, 2016.
Special Recognition Letters
Mr. Forlenza stated the Special Recognition Award letters will be going out shortly.
XXI. 2015 SAFETY KICKOFF BREAKFAST
Mr. Forlenza mentioned that the Safety Kickoff Breakfast was held at Merighi’s Savoy Inn in
Vineland, NJ on February 19, 2015. He then referred the Committee to page 73 of the agenda
packet to review the survey results following the Safety Kickoff Breakfast. Generally, the
feedback was positive; however, those involved in the planning of this event each year feel some
changes might be needed.
Mr. Forlenza indicated that his office and J. A. Montgomery have a meeting scheduled on April
8, 2015 to discuss the feedback from this year’s survey to revamp the 2016 program. He stated
that a report will be provided at the June meeting.
XXII. MISCELLANEOUS ITEMS
Coordination of Lessons Learned from Losses & Recent Claims
41
ACMJIF
March 25, 2015
Page 11
Mr. Sheehan indicated that the Lessons Learned from Losses is developed each month by QualLynx. He noted that he will be coordinating a meeting with Qual-Lynx to discuss having the
subject covered in the Lessons connected to recent claims. He is hopeful that this will continue
going forward.
Mr. McMahon commented that some of his towns show a few second video on Lessons
Learned. He stated that employees learn more from videos. Mr. Miola commented that it
would be a great idea to send out small clips of video in lieu of a safety bulletin.
Claims Reports & Loss Control Reps.
Mr. Sheehan will coordinate a meeting between J. A. Montgomery and Qual-Lynx to discuss
real claims and resources.
OCEAN CITY SKATEBOARD PARK
Mr. Forlenza stated that he failed to add this discussion to today’s meeting agenda. He indicated
that he had a visit with Ocean City on March 4th to discuss their new skateboard facility. Mr.
Forlenza noted that Ocean City has funding in place and location. The preliminary layout of the
park was reviewed and Mr. Forlenza asked for a scaled drawing to be provided to the Executive
Directors office along with the Safety Director.
Mr. Forlenza stated that once these are received, he will re-issue the standard letter “skateboard”
to Ocean City. He stated that the layout of the park is different from what his office has
generally seen. The elements of the park in Ocean City exist in other parks, but are not all in the
same facility.
Mr. Forlenza stated that once the various steps are completed, approval of coverage would need
to be recommended by this Committee. Once this Committee approves the logistics of the
Ocean City Skateboard park facility, the Executive Committee would then approve. Mr.
McMahon indicated that Ocean City is looking to open the facility this summer.
Mr. Sheehan commented that Mr. Ruprecht conducted a very thorough Loss Control Report for
the skateboard facility. Mr. Forlenza indicated that the next Executive Safety Committee is
scheduled for June 24th a week after the JIF meeting. Therefore, he would like to have the
Executive Committee grant approval of the facility contingent upon a recommendation by the
Safety Committee at the June Executive Safety Committee meeting. The Committee agreed.
XXIII. 2015 MEETING DATES
Mr. Forlenza noted the next meeting date is June 24, 2015 at Sea Isle City at 11:30 AM. The
Committee Agreed.
Mr. Forlenza stated that last year the Committee invited a few Safety Coordinators to attend the
Safety Committee Meeting. He asked the Committee if they would like to continue with this
process. The Committee agreed to invite 2 – 3 Safety Coordinator’s to the next round of safety
meetings. Mr. Sheehan indicated that he would suggest a few candidates.
There being no further business, the meeting adjourned at 1:45 pm.
File:
ACM/2015/Safety Committee Meetings
ACM/GEN/Safety Committee
Tab: March 25, 2015
Tab: March 25, 2015
42
Atlantic County Municipal Joint Insurance Fund
2014 Annual Safety Director’s Report
Table of Contents
EXECUTIVE SUMMARY ................................................................................................ 2
2014 Contract Status ................................................................................. 2
COMMITMENT AND ACCOUNTABILITY .................................................. 2
• SUMMARY OF MEMBER PARTICIPATION ........................................ 2
• Special Recognition Awards ................................................................. 3
CONTROLLING HAZARDS ....................................................................... 6
• Police Activities..................................................................................... 6
• Renewal Surveys .................................................................................. 6
CONTINUING EDUCATION AND TRAINING ............................................ 7
• Regional Training ................................................................................. 8
COMMUNICATION .................................................................................... 8
COACHING ................................................................................................ 9
ANNUAL LOSS ANALYSIS SUMMARY & SERVICE INITIATIVES............................ 10
TRENDS BY LINE OF COVERAGE: ....................................................... 10
TRENDS BY MEMBER ............................................................................ 13
TRENDS BY CAUSE ............................................................................... 16
TRENDS BY DEPARTMENT ................................................................... 21
PLANNED SERVICE ACTIVITIES FOR Q1 ................................................................. 22
APPENDIX A TRAINING ADMINISTRATOR LIST .................................. 24
APPENDIX B: 2014 REGIONAL TRAINING ATTENDANCE ................... 27
APPENDIX C: 2015 MANAGEMENT REPORT ....................................... 28
43
EXECUTIVE SUMMARY
2014 Contract Status
The 2014 Safety Director’s contract calls for a minimum of 126 loss control visits
to the 42 members of the Atlantic County Municipal Joint Insurance Fund. As of
December 31, 2014, 123 all of the proposed visits have been completed, and
many of the visits involved multiple service objectives. All of the special
boardwalk surveys were completed, and renewal surveys have been completed
for the 15 members that will be renewing in 2015. The Safety Director’s service
team consists of Tim Sheehan, Safety Director, and service consultants Louis
Carey, Don Ruprecht and Paul Shatkvich. The team is administratively
supported by Karen LaSala. Training support is administered by the MSI
Learning Management System staff, including Susan Kopec, Andrea Felip and
Natalie Dougherty.
COMMITMENT AND ACCOUNTABILITY
• SUMMARY OF MEMBER PARTICIPATION
The Safety Director’s team evaluated participation by all members in the Safety
Incentive Program during service visits. 100 % of the members qualified for
Safety Incentive Program Awards.
Safety Monitoring and Intervention Activity. The Safety Director reviews loss
metrics (LTAF Rate, Loss Ratio Reports), training participation and SIP
involvement on a quarterly basis. Members who show any deterioration in their
results are brought to the attention of the Executive Safety Committee.
2
44
Controlling Hazards
Claims
Management
Health &
Wellness
Y
Accident
Review
Y
Transitional
Duty
N/A
N - No/SIP documentation not available
JSO
Y
Y
Y = YES SIP documentation available
Coaching
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Daily Contact
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NW
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Safety
Committee
Hazard
Correction SFI
Y
Y
Y
Y
Y
N/A
N/A
N/A
N/A
N/A
N/A
Y
N/A
N/A
UK
Y
Y
Y
Y
Y
UK
Y
Y
Y
Y
Y
Y
UK
Y
Y
Y
N/A
N/A
Y
Y
N/A
Y
N/A
Y
Y
Claims Management
Tool Box Talks
Inspections
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NW
NW
Y
NW
NW
NW
Y
NW
Y
Y
Y
NW
Y
NW
NW
Y
Y
NW
NW
Y
Y
Y
Y
Y
NW
Y
Y
Y
NW
Y
Y
NW
Y
Y
Y
Y
Y
Y
NO
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NO
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NW
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NW
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NW
NO
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
UK - Unknown
Training
Admin
Assigned
Police
Participation in
SIP
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
ABSECON
AVALON
BRIGANTINE
BUENA
CAPE MAY
CAPE MAY POINT
COMMERCIAL
CORBIN CITY
DEERFIELD
DENNIS
DOWNE
EGG HARBOR TWP
ESTELL MANOR
FOLSOM
GALLOWAY
HAMILTON
LINWOOD
LONGPORT
LOWER
MARGATE
MIDDLE
MILLVILLE
MULLICA
NEWFIELD
NORTHFIELD
NORTH WILDWOOD
OCEAN CITY
PLEASANTVILLE
SEA ISLE CITY
SOMERS POINT
STONE HARBOR
UPPER DEERFIELD
UPPER TWP
VENTNOR
WATERFORD
WEST CAPE MAY
WEST WILDWOOD
WEYMOUTH
WILDWOOD CITY
WILDWOOD CREST
WOODBINE
Coaching
Communication
Continuing Education
MSI or other
major Training
SAFETY
CONTRACT
ATLANTIC JIF MEMBERS
Safety on the
Agenda
Commitment & Accountability
Roadway Sign
& walkway
SIP Elements
NW - Area Needs work
• Special Recognition Awards
Members were encouraged to nominate individuals or departments for their
efforts to go “above and beyond” in their safety program. Throughout the year
we encouraged more nominations for the Special Recognition Awards. There
were thirteen nominations in 2014. We believe that the nominations all
represented good ideas and we appreciate those individuals that took time to
nominate their co-workers and employees. The special recognition award
program was administered and “winners” were chosen by committee and
recognized at the annual safety kick off breakfast. Winners are awarded a plaque
and a celebratory luncheon for their department co-workers. The Special
recognition Awards winners and honorable mentions are as follows:
3
45
Honorable Mention: Joe Maltese, Waterford Twp. - Submitted by: Larry
Rucco: Noticed a fellow employee choking and successfully administered the
Heimlich Maneuver.
Honorable Mention: Charles Rice, Waterford Twp. - Submitted by Larry
Rucco: In the course of his duties, Charles noticed an elderly gentleman had
flipped his power wheelchair and stopped to assist.
Honorable Mention: James P. Leeds Sr., Longport. - Submitted by E.R.
Strawder: Commissioner Leeds has attended every Safety Committee Meeting
in 2014, and demonstrates a genuine concern for welfare of employees and
citizens.
Winner: Tom Heist Risk Manager for Upper Twp. - Submitted by Terri Smuz:
Attends Township Safety Committee, Proposed and created safety awareness
posters, and gave safety presentation at public works department
Honorable Mention: Michael Rutledge -Submitted by Mary Romano:
Mike suggested magnetic sign which reduce tailgating and associated hazards
for slow moving meter reader truck.
Winner: Wildwood Fire Department- Submitted by Daniel Dunn: Updated
standard SOP’S, Mandated captain Buscio program, Created Wellness Program,
attended National Training Program.
Honorable Mention: Joseph Giannattasio Middle Twp. - Submitted by Vera
Kalish: Innovative Communication Coordinated an environmental awareness
class, recognition for promoting and improving communities.
Honorable Mention: Patricia Feketics Safety Coordinator, Wildwood CrestPatricia is very conscientious, detailed, and a total team player. She takes
ownership, no matter the assignment, and Organizes Safety Committee
meetings with impressive agenda. Patricia has made the safety program
interesting.
Honorable Mention: Ocean City Health and Safety Committee- Submitted
by: Joanne Ciotta- Started in 2000 to recognize employees for safe work
practices. Held in local places of interest, with food from local restaurant, flowers
from local florist, and gifts / prizes.
Honorable Mention: Middle Twp. Wellness Committee-Submitted by Sean
McDevitt- Established a fitness center in the Municipal Building. Contracted with
vendors to sell organic produce at Township locations. Healthy vending machines
in municipal buildings. Negotiated discounted gym memberships, Held several
health seminars.
Winner: Pleasantville Recreation Dept. Wellness Program-Submitted by
Debbie Washington- Created numerous programs throughout year, March
Madness weight loss challenge, Walking Club, Health Fair5K Walk / Run.
Winner: Egg Harbor Police Injury review Board- Submitted by Chief Mike
Morris-IRB created by Departmental General Order. Four member panel reviews
all Supervisor’s Injury Reports. Fact-find: root & contributing causes and identify
lessons to be learned. To date more than 50 lessons & suggestions have been
generated.
4
46
Director’s Award Winner: Joanne Cioeta, Fund Commissioner Ocean CityOutstanding service & support. Role model and mentor to other members.
Innovative ideas. Active in JIF committee’s long record of participation. Past
Chair & active member of the Executive Safety Committee. Fund Commissioner
& Past Safety Coordinator. Strong supporter of JIF loss control efforts. Generous
with time and talents.
5
47
CONTROLLING HAZARDS
We encouraged greater emphasis on Workers’ Compensation issues during
survey visits.
Member visit objectives were expanded to include more
comprehensive job site observations, noise surveys, reviews of special
operations, accident investigations, attendance at safety committee meetings,
right to know surveys and other special projects as requested by the members.
• Police Activities
The Police Chief Ad Hoc Committee met on January 31st , 2014, April 25th,
2014, and August 15th , 2014. Tim Sheehan has taken the responsibility of
organizing and facilitating the meetings. The purpose of the meetings is to review
Accreditation, training, and other risk management issues related to law
enforcement. There where numerous Police Chief’s from the ACM JIF who
attended the meetings throughout the year. Regular attendance by the following
ACM JIF members is recognized: North Wildwood, Egg Harbor Twp. and,
Millville. Also Glenn Prince and Tim Sheehan have developed a uniform
consulting plan for law enforcement agencies to address specific risks that are
exclusive to the law enforcement community. Consultative surveys have been
made to numerous Police Departments by our law enforcement specialist. In
addition, Tim Sheehan and Glenn Prince facilitated Training for Special Officers
offered at the Atlantic and Cape May County Police Academies, which was open
to all JIF members. Course was taught by Ret. Chief Denis Connell from Clark,
NJ.
• Renewal Surveys
Fifteen members were reviewed for renewal: Absecon, Cape May City, Cape
May Point, Corbin City, Deerfield, Egg Harbor Twp., Estell Manor, Folsom,
Linwood, Mullica, Ocean City, Upper Twp., West Wildwood, and Wildwood City.
During the surveys all municipal operations were reviewed, buildings more than
50 + years old were visited and the following elements were reviewed: SIP
participation, progress on Suggestions for Improvement, any unusual exposures
and comments on their loss metrics. Results were summarized and reported at
the June Executive Safety Committee meeting. Although there were some
unique exposures identified, none of the conditions found presented concerns
with the desirability of these members for renewal.
6
48
CONTINUING EDUCATION AND TRAINING
Training administrators have been appointed by the member towns to oversee
the registration and reports for MSI Learning events. An updated list of training
administrators is included in the Appendix “A”, and members are encouraged to
make sure their assigned administrator is current. Administrators are able to
access the Learning Management System, register for classes, order videos,
record external (non-MSI) learning events, run training reports and take
advantage of the on-line learning platform. All but two members have training
administrators assigned. We will work with Buena Borough and Newfield to
encourage them to assign someone to this role.
Training participation was very good in 2014. 2,351 instructor led classes were
completed, which is up from 2,239 MSI Learning events during the previous year.
On line learning was rolled out through the Learning Management System during
2014. 758 course completions were recorded for members of the Atlantic JIF.
We will continue to encourage participation in this learning format during the
coming year. Currently, there are 12 on line programs offered through the MSI
Learning Management System with several more in production, Currently,
available courses are:
•
•
•
•
•
•
•
•
•
•
•
Avoid Back Pain
Bloodborne Pathogens
Crossing Guard Training
Crush Zone
Ethics in Local Government
Fire Safety
Hazard Communications Training
New Employee Safety Orientation Part 1 and Part 2
Office Safety - Perils and Pitfalls
Survival Driving - Emergencies and Natural Disasters
Survival Driving - Urban Driving
Atlantic JIF members borrowed more than 80 DVDs from the MEL Media Library
to supplement instructor led training.
Members with outstanding training participation include:
Stone Harbor,
Commercial, Pleasantville and Upper Twp. Many of the smaller towns had
proportionately high numbers of employees trained.
7
49
• Regional Training
Six Regional Training programs have been held this year:
•
•
•
•
•
•
The Safety Coordinator Round Table was held on February 20, 2014
Back to Basics-Investigating Sprains/ Strain Injuries –Date: April 3rd, 2014,
9:00 am – 3:00 PM.
Police Stress Management Workshops: May 7th & May 28th, 2014
Lifeguard Symposium: June 18th, 2014.
DPW Round Table: October 15th , 9:00am-12:00pm
ACMJIF Retreat was held on 10/22/14 and 10/23/14.
COMMUNICATION
Regulatory Compliance has been added as a standing topic on the Executive
Safety Committee Agendas. John Saville regularly attends the PEOSH Advisory
Committee as a representative from J.A. Montgomery Risk Control. He attends
as an ”interested party” and provides members with updates on focused
enforcement activity, changes in regulations and summaries of the most
frequently cited violations.
Safety Director Bulletins, Tool Box Topics, customized hazard inspection
checklists, and “Frequently Asked Questions” were distributed throughout the
year on a wide range of topics. The use of e-mail distribution has allowed us to
increase the frequency and efficiency of our communications throughout the
year. Some of the topics addressed during the year by bulletins, included:
•
•
•
•
•
•
•
•
•
•
•
•
Safety Director's Bulletin- MVR Checks
Safety Director's Bulletin Posting OSHA Summary Logs – Annual
Reminder
Safety Director's Bulletin - Winter Ice Activities
Safety Director's Bulletin - Managing of Special Events
Safety Director's Bulletin - Soliciting Donations on Roadways
Safety Director Bulletin - Exiting Large Vehicles
Safety Director's Bulletin - Training Summer Seasonal Employees
Safety Director's Bulletin - Preventing Heat-Related Illnesses
Safety Director's Bulletin - Annual School Crossing Guard Training
Safety Director's Bulletin - Best Practices for Backing Fire Apparatus into
the Station
Safety Director's Bulletin - Leaf Collection
Safety Director's Bulletin -Mobile Work Zone SD Bulletin November 2014
8
50
COACHING
There was a concerted effort on the part of the lead safety consultant to
encourage members to use a “narrative” version of the Job Site Observation
report and move away from “Checklists.” Risk control consultants met with
members and mentored safety coordinators in the observation process. More
constructive feedback was given to workers and supervisors reported that the
narrative format was also useful as a training document.
Included in the 2014 Safety Incentive Program, there was an emphasis on more
complete Supervisors Incident investigations. Our consultants provided guidance
and reviewed incidents with supervisor providing suggestions for follow up and
more detailed investigation and remediation. Overall there is an improvement in
the number of towns doing investigations and the level of detail provided.
During on site record checks, all elements of the program were reviewed.
Members make written documentation available for review, such as Safety
Committee Minutes, hazard inspections, training records, job site observations,
etc. Consultants work with members to secure a commitment of participation for
any areas that are found to be lacking during the review. All safety elements are
scored equally and full participation requires that there be activity and significant
demonstration of commitment in all aspects of the program to qualify for a Safety
Incentive Award.
9
51
ANNUAL LOSS ANALYSIS SUMMARY & SERVICE
INITIATIVES
TRENDS BY LINE OF COVERAGE:
Workers Compensation Claims:
For the five year period (2010 - 2014), WC accounted for (45%) of the claim
frequency and (70 %) of the incurred costs. The average cost per WC claim is
$11,102.
• The number of WC claims has declined steadily since 2012
• Payroll declined since 2012, as did the number of F/T employees.
• WC Claim frequency (number of claims per million dollars payroll) has dropped
steadily since 2011
• Total WC Claim frequency per 100 F/T employees has dropped steadily since
2012 and coincides with other frequency measures
• The LTAF rate is the lowest it has been in years.
• Claim cost as a per cent of payroll showed a blip in 2013.
10
52
Workers' Compensation Metrics
Claim Frequency
Total Number of Claims
Payroll (Millions)
# of Claims per Million $ of Payroll
Number of FTE Employees
Total Claim Frequency / 100 FTE
LTA Claim Frequency / 100 FTE
Claim Cost as a % of Payroll
2010
848
$265.5
3.19
7,183
11.81
2011
642
$260.5
2.46
6,806
9.43
4.52%
2.88%
2012
721
$263.2
2.74
6,495
11.1
2.77
2.40%
2013
650
$258.0
2.52
6,305
10.31
2.62
2.64%
2014
612
$247.0
2.48
6,237
9.81
2.47
2.39%
The LTAF still remains higher than the MEL average for the entire period
reported, but the Atlantic JIF rate continues to decline.
2014 LOST TIME ACCIDENT FREQUENCY ALL JIFs
Decemb er 31, 2014
FUND
BURLINGTON
SUBURBAN MUNICIPAL
TRI-COUNTY
MORRIS
CAMDEN
PROF MUN MGMT
CENTRAL
SUBURBAN ESSEX
BERGEN
MONMOUTH
OCEAN
SOUTH BERGEN
NJ PUBLIC HOUSING
ATLANTIC
N.J.U.A.
AVERAGE
2014
LOST TIME
FREQUENCY
1.47
1.58
1.65
1.72
1.82
1.92
2.02
2.06
2.09
2.17
2.22
2.35
2.47
2.47
2.62
2013
LOST TIME
FREQUENCY
1.59
1.91
1.99
1.50
1.95
2.88
2.44
2.49
1.85
1.42
2.24
2.56
2.34
2.62
2.25
2012
LOST TIME
FREQUENCY
1.88
1.74
2.35
1.78
2.90
1.81
2.69
2.35
2.02
1.86
2.94
2.47
2.70
2.77
1.95
TOTAL
RATE *
2014 - 2012
1.64
1.75
2.00
1.67
2.22
2.20
2.37
2.30
1.99
1.82
2.46
2.46
2.51
2.62
2.26
2.04
2.14
2.28
2.15
Service Initiative #1: The thrust of our service efforts are directed at Workers’
Compensation exposures. We continue to support claims mitigation and
reduction efforts, especially focusing on Accident Investigation and promoting the
transitional duty initiatives of the JIF.
11
53
General Liability Claims:
For the five year period (2010 - 2014), General Liability accounted for (26%) of
the claim frequency and (18 %) of the incurred costs. The average cost per GL
claim is $5,143.
• 2014 YTD shows decrease in the number of GL claims.
• Annual appropriations have increased.
• GL Claims per appropriations have declined.
General Liability Metrics
Claim Frequency
Annual Appropriations
# of Claims per Million $ of Appropriations
2010
445
$500,941,456
0.89
2011
389
$503,406,679
0.77
2012
435
$485,607,543
0.90
2013
2014
368
338
$489,619,323 $645,365,805
0.75
0.52
Auto Claims:
Auto Liability claims comprise 9% of the claim frequency and 3 % of the incurred
costs.
•
•
•
2014 claims frequency was relatively flat with 2013, but shows an overall
downward trend for the past 5 years.
Number of vehicles decreased in 2014 comparison to prior year
Number of Auto Claims per 100 vehicles was flat compared to 2013.
Auto Liability Metrics
Claim Frequency
Number of Vehicles
# of Claims per 100 Vehicles
2010
218
2,923
7.46
2011
135
2,852
4.73
2012
117
2,729
4.29
2013
103
2,712
3.80
2014
100
2,598
3.85
Property Claims:
Property claims represent 21% of the claim frequency and 9 % of the incurred
costs.
•
•
Property claims showed a slight upturn in 2014.
Generally, the number of property claims track with Auto liability
frequency. .
Property Metrics
Claim Frequency
2010
429
12
54
2011
309
2012
361
2013
239
2014
263
TRENDS BY MEMBER
The two tables below shows the LTAF rate (2012 – 2014), valued as of
12/31/2014 and claim count by member. Eleven members had no lost time
incidents in 2014 and the LTAF rate has declined steadily over the past few
years. The LTAF rate is higher than the MEL average
Atlantic County JIF
2014 LOST TIME ACCIDENT FREQUENCY
December 31, 2014
MEMBER
2014
LOST TIME
2013
LOST TIME
FREQUENCY
FREQUENCY
2012
LOST TIME
TOTAL
RATE
FREQUENCY 2014 - 2012
BUENA
0.00
2.41
5.03
COMMERCIAL
0.00
0.00
5.88
1.75
DEERFIELD
0.00
0.00
3.13
0.84
ESTELL MANOR
0.00
0.00
0.00
0.00
NEWFIELD
0.00
3.13
0.00
0.97
WEST CAPE MAY
0.00
0.00
0.00
0.00
WOODBINE
0.00
4.17
0.00
1.41
CORBIN CITY
0.00
16.67
0.00
5.56
CAPE MAY POINT
0.00
0.00
1.80
0.63
ABSECON
0.00
1.02
0.00
0.35
DOWNE TOWNSHIP
0.00
0.00
0.00
0.00
WILDWOOD CREST
0.90
0.95
0.45
0.76
STONE HARBOR
1.02
1.99
3.55
2.12
NORTHFIELD
1.02
2.13
3.00
2.05
DENNIS
1.08
1.01
3.00
1.71
UPPER DEERFIELD
1.08
1.12
0.99
1.06
WILDWOOD CITY
1.09
3.96
1.19
2.02
SEA ISLE CITY
1.10
1.57
4.58
2.46
MULLICA
1.32
3.90
0.00
1.71
CAPE MAY
1.53
3.23
1.51
2.07
AVALON
1.74
1.13
1.10
1.32
LONGPORT
1.86
0.00
3.46
1.83
GALLOWAY
1.96
1.20
2.50
1.94
NORTH WILDWOOD
2.04
0.45
1.30
1.29
MARGATE
2.15
1.20
1.49
1.60
OCEAN CITY
2.46
2.48
2.64
2.53
WEYMOUTH
2.50
0.00
0.00
0.92
VENTNOR
3.02
2.98
3.80
3.24
MIDDLE
3.26
2.27
4.39
3.27
HAMILTON
3.42
2.10
3.14
2.87
UPPER
3.43
2.14
3.17
2.90
MILLVILLE
3.49
2.76
6.29
4.23
LINWOOD
EGG HARBOR TOWNSHIP
3.54
3.57
2.74
5.02
7.50
3.32
4.51
3.95
WATERFORD
3.68
1.81
4.72
3.36
BRIGANTINE
3.70
2.64
2.36
2.93
LOWER
4.40
4.47
2.40
3.71
PLEASANTVILLE
5.34
10.24
8.44
7.99
SOMERS POINT
6.82
2.91
0.74
3.47
FOLSOM
7.41
5.26
0.00
4.21
10.34
10.53
2.62
0.00
2.77
7.30
WEST WILDWOOD
2.47
13
55
2.41
2.62
ATLANTIC MUNICIPAL JOINT INSURANCE FUND
ERS' COMPENSATION LOSSES BY MEMBER : FUND YEARS 2010
Claims by Member
Member Name
ABSECON
AVALON
BRIGANTINE
BUENA
CAPE MAY
CAPE MAY POINT
COMMERCIAL
CORBIN CITY
DEERFIELD
DENNIS
DOWNE TOWNSHIP
EGG HARBOR TOWNSHIP
ESTELL MANOR
FOLSOM
GALLOWAY
HAMILTON
LINWOOD
LONGPORT
LOWER
MARGATE
MIDDLE
MILLVILLE
MULLICA
MULLICA
NEWFIELD
NORTH WILDWOOD
NORTHFIELD
OCEAN CITY
PLEASANTVILLE
SEA ISLE CITY
SOMERS POINT
STONE HARBOR
UPPER
UPPER DEERFIELD
VENTNOR
WATERFORD
WEST CAPE MAY
WEST WILDWOOD
WEYMOUTH
WILDWOOD CITY
WILDWOOD CREST
WOODBINE
Total All Members
Total Fund Years 2010 - 2014
Average
% of
Cost per
# Claims Total Incurred Total
33 $
608,643
1.57% $ 18,444
101 $
487,603
1.26% $ 4,828
113 $ 1,574,275
4.06% $ 13,932
27 $
265,532
0.69% $ 9,835
158 $ 1,209,816
3.12% $ 7,657
7 $
29,765
0.08% $ 4,252
1 $
1,733
0.00% $ 1,733
1 $
79,455
0.21% $ 79,455
5 $
53,302
0.14% $ 10,660
28 $
93,904
0.24% $ 3,354
4 $
3,822
0.01% $
955
234 $ 3,588,622
9.26% $ 15,336
5 $
79,579
0.21% $ 15,916
5 $
87,460
0.23% $ 17,492
114 $ 2,518,753
6.50% $ 22,094
148 $ 2,146,369
5.54% $ 14,502
40 $
748,476
1.93% $ 18,712
28 $
249,579
0.64% $ 8,914
193 $ 1,801,637
4.65% $ 9,335
83 $
685,546
1.77% $ 8,260
156 $ 1,199,726
3.10% $ 7,691
183 $ 2,881,790
7.44% $ 15,747
20 $
193,592
0.50% $ 9,680
20 $
193,592
0.50% $ 9,680
5 $
248,455
0.64% $ 49,691
141 $
622,337
1.61% $ 4,414
44 $
511,322
1.32% $ 11,621
429 $ 3,509,826
9.06% $ 8,181
198 $ 3,556,939
9.18% $ 17,964
169 $ 2,052,570
5.30% $ 12,145
84 $
730,237
1.88% $ 8,693
81 $
453,082
1.17% $ 5,594
95 $
821,286
2.12% $ 8,645
16 $
54,974
0.14% $ 3,436
116 $ 1,505,075
3.88% $ 12,975
60 $
689,543
1.78% $ 11,492
10 $
11,823
0.03% $ 1,182
23 $
82,474
0.21% $ 3,586
10 $
84,213
0.22% $ 8,421
164 $ 1,194,770
3.08% $ 7,285
63 $
562,067
1.45% $ 8,922
5 $
43,850
0.11% $ 8,770
3493 $ 38,749,235 100.00% $ 11,093
14
56
Service Initiative #2:
•
We continue to monitor the WC metrics through the “Watch List” to
identify members that may show deteriorating loss experience.
Members that appear to be trending in the wrong direction may be
placed on Safety Monitoring, which initiates greater attention from the
Safety Director office. Members that show significant deterioration or
unwillingness to address exposures may be placed on Safety
Intervention, and calling in the efforts of other JIF Professionals.
•
The Safety Director’s office identifies and reviews members on “Watch,”
“Monitoring,” and “Intervention” during every Executive Safety
Committee meeting.
•
Part of this review includes the LTAF rate, which gives an indication of
overall performance, along with loss ratios and participation in the
Safety Incentive Program. There are many components that go into
reducing the LTAF rate, including 1) not having claims in the first place;
2) medical management of injuries to reduce lost time; 3) incident
investigation to reduce future incidents; and 4) availability of
transitional duty. We will continue to monitor the Atlantic JIF LTAF rate
– both among the members and in comparison with other JIFs to
identify trends and service initiatives
• Accident Investigation is one of the key components in preventing
future incidents. One of our key elements in 2015 will be to identify the
members that have the highest WC frequency rates, and to work with
these members on their accident investigation programs. We have
identified the top 20% of the members in terms of frequency for special
emphasis in 2015:
•
Each of these members will receive a focused survey visit to address
WC accident experience. We will review 5 years of loss experience,
identify departments with the highest frequency rates, review recent
investigation reports and review procedures, and conduct at least one
on-site investigation with the safety coordinator. If needed, we will meet
with the safety committee and conduct an accident investigation
workshop
•
Our goal from this process will be to see 1) increased utilization of the
accident investigation program; 2) more meaningful and substantive
accident investigation findings; 3) clearer understanding on the part of
the member towns on how to use the JIF accident investigation
resources, including on-line reports, root cause analysis worksheet and
the expertise of Loss Control consultants.
15
57
TRENDS BY CAUSE
Workers Compensation Trends:
The Chart and table below shows the Workers Compensation experience (2010
– 2014 YTD) by Cause. The most significant loss sources in terms of frequency/
severity were: strains, motor vehicle incidents, slip falls and assaults.
16
58
CLAIMS BY CAUSE : FUND YEARS 2010 - 2014
Claims by Loss Cause
Loss Cause/
Workers Compensation
# Claims
Burn or Scald / Heat or Cold Exposure
Subtotal Caught In or Between (10, 12-13, 20)
Subtotal Cut, Puncture, Scrape (15 - 19)
Subtotal Fall or Slip From (25 -33)
121
78
205
475
Motor Vehicle Causes
Subtotal Strains (53 - 60)
Subtotal Striking Against or Stepping On (65 - 70)
Subtotal Struck By (75 - 81, 87)
Subtotal Miscellaneous Causes
Robbery or Criminal Assault
Workers Compensation NOC
79
1,159
138
373
574
196
75
Total Workers Compensation Loss Causes
Average Cost
per Claim
Total Incurred
% of
Total
$
$
$
$
563,499
443,620
540,617
7,278,275
1.46%
1.15%
1.40%
18.88%
$
$
$
$
4,657
5,687
2,637
15,323
$ 2,658,589
$ 15,849,451
$
946,926
$ 2,275,834
$ 3,826,622
$ 3,266,816
$
905,395
6.90%
41.11%
2.46%
5.90%
9.92%
8.47%
2.35%
$
$
$
$
$
$
$
33,653
13,675
6,862
6,101
6,667
16,667
12,072
100.00% $
11,102
3473 $ 38,555,644
Service Initiative #4: Focus on most frequent injury types: strains, falls and motor
vehicle incidents. Several actions could be taken to improve this experience:
•
•
•
•
•
•
•
Reinforce during daily safety briefings between employees and
supervisors.
Evaluate every lift. Is there a method to lift / move the material to eliminate
or limit manual handling? Is there a mechanical aid to lessen
musculoskeletal strain potential? Can workers be added or re-positioned
to promote better body mechanics?
Encourage workers to engage in pre-lift stretches. Promote wellness
initiatives.
Prevent winter slips and falls: Snow removal and salting on walkways and
parking lots should be thorough, and repeated as necessary to account for
melting-refreezing cycles
Personnel in the field should be encouraged to take additional precautions
during winter months. Evaluate providing removable shoe cleats for
certain tasks.
Effective self-inspections can identify snow removal and housekeeping
concerns. They should be done frequently, and especially during
inclement weather.
Provide adequate (3-step length), walk off mats at entrances and clean or
replace regularly, to minimize carryover of moisture into the building.
17
59
•
•
•
Provide boot/shoe cleaner brushes at entrances frequented by field
personnel.
Reinforce three-points-of-contact when using ladders, stairs, and entering
/ exiting vehicles.
Defensive driving habits must be consistently emphasized. Offer
Defensive Driving Course, Driver Awareness, S:ERVE or CEVO
presentation.
General Liability Trends:
The table below shows the General Liability experience (2010 – 2014 YTD) by
Cause. The most significant loss sources in terms of frequency and incurred
cost were: Police Professional (7% Frequency and 30.5% cost), Damaged or
Injured (36% frequency and 18.8% cost), Falling Down (23 % frequency and 32%
cost) and Motor Vehicle (19 % frequency and 15 % cost.
Loss Cause/
General Liability
Subtotal Falling Down (10 - 15)
Subtotal Damaged or Injured By (18 - 39)
Subtotal Police Professional (40 - 46)
Subtotal Public Officials (47 - 53)
Subtotal Motor Vehicle (61 - 71)
General Liabilty NOC
Total General Liability Loss Causes
# Claims
456
717
146
211
377
68
1975
Total Incurred
$ 3,310,484
$ 1,909,639
$ 3,096,912
$
148,816
$ 1,553,595
$
138,765
$ 10,158,213
% of
Total
32.59%
18.80%
30.49%
1.47%
15.29%
1.37%
100.00%
Average Cost
per Claim
$
$
$
$
$
$
$
Service Initiative #5: GL
• Focus on most frequent Claim types. Several actions could be taken to
improve this experience:
• Motor vehicle incidents and fall related claims can be mitigated with strong
Roadway Sign and Walkway programs.
• Falls can also be mitigated with some of the same strategies noted under
Workers Comp above.
• Finally, there is a correlation between Police accreditation and reduced Police
Professional Liability claims. Police accreditation is encouraged.
18
60
7,260
2,663
21,212
705
4,121
2,041
5,143
Auto Liability Trends:
The table below shows the Auto Liability experience (2010 – 2014 YTD) by
Cause. The most significant loss sources in terms of frequency and incurred
cost were: Intersection (10% Frequency and 29% cost), Pedestrian (2.5%
frequency and 16% cost), Collision with fixed object (32 % frequency and 9%
cost) and Backing incidents (22 % frequency and 7% cost).
Auto Liability
Rear Ended
Pass, Turn, Lane Change
Backing Up
Intersection
Collision With Fixed Object
Hit Pedestrian
Auto Liability NOC
Total Auto Liability Loss Causes
45
20
146
67
217
17
161
673
$
$
$
$
$
$
$
$
71,989
16,166
103,697
447,854
142,810
254,986
520,417
1,557,921
4.62%
1.04%
6.66%
28.75%
9.17%
16.37%
33.40%
100.01%
$
$
$
$
$
$
$
$
1,600
808
710
6,684
658
14,999
3,232
2,315
Focus on most costly types of claims, especially intersection pedestrian, backing
and collision with fixed objects. Several actions could be taken to improve this
experience:
• Backing incidents - Encourage the use of spotters and new technologies like
cameras and alarm sensors.
• Intersection claims are a concern, especially to first responders. Fire, Police
and EMS Departments are encouraged to take part in the on-line training
offered by S:ERVE on avoiding intersection accidents. These types of claims
tend to be frequent and costly.
• Collision with fixed objects and Rear-end accidents – Emphasize the
importance of maintaining proper following distance, 3 -second rule. Always
wear seat belts and avoid cell phone use while driving. Develop a cell phone
policy and train all employees on its major requirements. Encourage the new
Driver Safety Awareness program as remedial training for anyone involved in
accidents.
19
61
Property Trends:
Loss Cause/
Property
Damaged or Injured By
Wind Damage
Lightening
Flooding
Fire/Explosion
Vandalism
Theft
Total Incurred
% of
Total
$
$
$
$
$
$
$
49,947
187,495
524,207
102,249
217,957
112,028
295,350
0.97%
3.62%
10.13%
1.98%
4.21%
2.17%
5.71%
1,029 $
388 $
# Claims
34
18
41
20
12
34
25
Motor Vehicle All
Property NOC
Total Property Loss Causes
1601
$
Average Cost
per Claim
$
$
$
$
$
$
$
1,469
10,416
12,786
5,112
18,163
3,295
11,814
1,700,079
1,984,251
32.86% $
38.35% $
1,652
5,114
5,173,562
100.00% $
3,231
The most significant property losses arise from physical damage / motor vehicle
claims, which represent 64% of the property claims and 33% of the incurred
losses. . Traditional perils (wind, lightning, flood, fire & explosion, vandalism and
theft represent (11%) of the claim frequency.
The same service intiatives
identified under auto losses apply to the physical damage componets of these
claims.
20
62
TRENDS BY DEPARTMENT
WORKERS' COMPENSATION CLAIMS : FUND YEARS 2010 - 2014
Claims by Department
Department Name
Administration
Subtotal EMS
Subtotal Fire
Lifeguards
Subtotal Police
Subtotal Public Works
NOC
Total All Departments
# Claims
127
80
443
323
1,044
1,425
18
3473
21
63
% of Average Cost
per Claim
Total Incurred
Total
$ 1,287,431
3.34% $
10,137
15,112
3.14% $
$ 1,208,942
11.76% $
10,235
$ 4,534,039
$ 1,267,835
3.29% $
3,925
14,978
40.56% $
$ 15,637,209
10,064
37.19% $
$ 14,340,498
0.66% $
14,206
$
255,699
11,102
$ 38,555,644 100.00% $
Continue to promote the Safety Incentive Program as best practices for a
successful safety program. Encourage all members to show significant
demonstration of participation in each of the areas: 1) Commitment and
Accountability; 2) Controlling hazards; 3) Continuing Education and Training; 4)
Communication; 5) Coaching; and 6) Claims Management.
Service Initiative# 8 – Police:
•
•
Police Ad Hoc Committee - The purpose of the meetings is to review
Accreditation, training, and other risk management issues related to law
enforcement.
Uniform consulting plan for law enforcement agencies to address specific
risks that are exclusive to the law enforcement community.
Service Initiative #9 - Public Works
•
•
•
Encourage more meaningful Job Site Observations and daily crew meetings
for the DPW
Continue to develop Tool-Box-Talk outlines for MSI classes to assist
supervisors in providing specific safety refresher in the years between
mandated MSI training.
Encourage the use of training resources, including MSI, online and regional
training workshops.
PLANNED SERVICE ACTIVITIES FOR Q1
•
•
•
•
•
•
•
Write and distribute the 2015 safety incentive program
Identify Special Recognition award winners and present safety award
breakfast.
Make a concerted effort to identify training opportunities within Atlantic JIF
members, including traditional and on-line formats.
Include “written program review” for members during surveys. Assist in
personalizing programs to meet individual member needs.
Continue to encourage members to utilize the Job Site Observations.
Review recent submitted Supervisor incident reports for completeness and
thorough investigation, and provide constructive feedback to Safety
Coordinators and Supervisors.
Continued emphasis on law enforcement through the uniform consulting
plan.
22
64
•
•
•
•
•
•
•
•
•
•
•
Continue to notify RMC’s and FC’ on a timely basis of any unusual or
unique exposures identified during member visits. Seek their input in
identifying the best approach to take to resolve or present the findings.
Work closely with members with above average frequency / LTAF rates.
Facilitate Police Chief Ad Hoc Committee meeting.
Provide feedback on Safety Incentive Program progress
Encourage disposal of excess or no longer needed chemicals prior to the
Right-to-Know inventories to facilitate accuracy and minimize survey time.
Complete the renewal surveys for 2015 by June 1st
Participate in joint risk control / claims review process
Continue to participate in quarterly Executive Safety Committee meetings
and provide analysis of issues or share insights gained during member
visits. Alert members to issues or incident trends, PEOSH citations and
solicit guidance on proposed activities in response to same.
Distribution of Safety Director Bulletins and notices.
Continue to develop Tool-Box-Talk outlines for MSI classes to assist
supervisors in providing specific safety refresher in the years between
mandated MSI training.
Participate in the fund commissioner meetings and all JIF related activities
23
65
APPENDIX A TRAINING ADMINISTRATOR LIST
MSI ADMINISTRATORS AS OF FEBRUARY 27, 2015
MUNICIPALITY
LAST NAME
FIRST NAME
ABSECON
DOLAN
TERENCE
ABSECON
JONES
LLOYD
AVALON
DEAN
EDWARD, R.
AVALON
JUZAITIS
BRIAN
AVALON
MACOMBER
WILLIAM
AVALON
MCCLINTOCK
ELISABETH
AVALON
PATRO
ROBERT
AVALON
SCARPA
KEVIN
AVALON
WHILDIN JR
WAYNE
BRIGANTINE
DORING
JOHN
BRIGANTINE
MUSUMECI
LISA
BUENA
NONE
CAPE MAY
SMITH
ROBERT
CAPE MAY POINT
MAHON
CONSTANCE
COMMERCIAL
SPARKS
HEATHER
CORBIN CITY
SIEDLECKI
JOANNE
DEERFIELD
SEIFRIT
KAREN
DENNIS
CHAMPION
VERNON
DOWNE TOWNSHIP
LOCKLEY
NADINE
BURGER
DONNA
LINCOLN
ROBERT
SLUSARSKI
STEPHEN
ESTELL MANOR
HENRY
JOE
ESTELL MANOR
KENT
LINDA
FOLSOM
GATTO
PATRICIA
FOLSOM
LAPOLLO
JOHN
GALLOWAY
AYERS
MATT
GALLOWAY
FARRELL
RAYMOND
GALLOWAY
GUERRA
RAY
GALLOWAY
MCDOWELL
KEVIN
HAMILTON
MARCOLONGO
LISA
LINWOOD
BECK
EDWARD
LINWOOD
KOLAKOWSKI
HENRY
LONGPORT
HIRSCH
RICHARD
LONGPORT
SIMMONS
JUERGEN
EGG HARBOR
TOWNSHIP
EGG HARBOR
TOWNSHIP
EGG HARBOR
TOWNSHIP
24
66
MUNICIPALITY
LAST NAME
FIRST NAME
LOWER
BEEBY
THOMAS
LOWER
BIERSBACH
MARTIN
LOWER
CRIPPEN
COLLEEN
LOWER
DILWORTH
JASON
LOWER
GALESTOK
WILLIAM
LOWER
LEPOR
DAVE
LOWER
PLENN
MITCHELL
MARGATE
ADAMS
DANIEL
MIDDLE
KALISH
VERA
MIDDLE
KEATING
KAYTIE
MIDDLE
KRAUSS
KIMBERLY
MILLVILLE
CAMPISI
FRANK
MILLVILLE
HESS
KURT
MILLVILLE
KILEY
TONYA
MILLVILLE
LIPPINCOTT
MICHAEL
MILLVILLE
ROBOSTELLO
SUSAN
MILLVILLE
TONETTA
CHRISTINE
MILLVILLE
WILSON
DOUGLAS
MULLICA
CRITELLI
JERRY
MULLICA
STOLLENWERK
DAWN M.
MULLICA
THOMPSON
JOHN
MULLICA
SPERLAK
STEPHEN
NEWFIELD
NONE
NONE
NORTH WILDWOOD
FORD
DOUGLAS
NORTH WILDWOOD
OSTRANDER
LEWIS
NORTH WILDWOOD
VANSANT
JENNIFER
NORTH WILDWOOD
GALLAGHER
MATTHEW
NORTH WILDWOOD
MCGRAW
ADAM
NORTH WILDWOOD
OKANE
BONNIE
NORTHFIELD
RUFFO
CINDY
OCEAN CITY
BIRCH
DIANE
OCEAN CITY
CIOETA
JOANN
OCEAN CITY
MOYER
CHARLOTTE
PLEASANTVILLE
PAGE-SCOTT
DENISE
SEA ISLE CITY
GLYNN
PAUL
SEA ISLE CITY
SEIB
KELLIE
SOMERS POINT
MOLLENKOPF
SHELBY
SOMERS POINT
VENAFRO
TOM
STONE HARBOR
RUSS
GRANT
25
67
MUNICIPALITY
LAST NAME
FIRST NAME
UPPER
SMUZ
TERI
UPPER
POTTER
JAY
UPPER
MORGAN
SCOTT
UPPER
SHARP
RHONDA
UPPER
SPIEGEL
BARBARA
UPPER DEERFIELD
VAGNARELLI
VICKI
VENTNOR
GOOS
JAMES
WATERFORD
MICKLASAVAGE
MICHAEL
WATERFORD
GARDNER
BETTY ANNE
WATERFORD
CHIUMENTO
DANIEL
WATERFORD
CORMANEY
DANIEL
WATERFORD
LAURSEN
ILENE
WEST CAPE MAY
BASILE
GREGORY
WEST CAPE MAY
RUTHERFORD
DIANNE
WEST CAPE MAY
WALLACE
ELAINE
WEST WILDWOOD
SWEENEY
RUTH
WEYMOUTH
CARROLL
RONALD
WILDWOOD CITY
DUNN
DAN
WILDWOOD CITY
SPEIGEL
DANIEL
WILDWOOD CITY
PINTO
HOPE
WILDWOOD CITY
HODSON
KIM
WILDWOOD CITY
WARD
SENA
WILDWOOD CREST
SHEARER
STEVEN
WILDWOOD CREST
FEKETICS
PATRICIA
WILDWOOD CREST
GRASSI
RALPH
WILDWOOD CREST
HOLZMER
JANELLE
WOODBINE
GURDGIEL
JAMES
26
68
APPENDIX B: 2014 REGIONAL TRAINING ATTENDANCE
Absecon City
Avalon Borough
Brigantine City
Buena Borough
Cape May City
Cape May Point
Commercial Township
Corbin City
Deerfield Township
Dennis Township
Downe Township
Egg Harbor Township
Estell Manor City
Folsom Borough
Galloway Township
Hamilton Township
Linwood
Longport Borough
Lower Township
Margate City
Middle Township
Millville City
Mullica Township
Newfield Borough
North Wildwood City
Northfield City
Ocean City
Pleasantville City
Sea Isle City
Somers Point City
Stone Harbor
Upper Township
Ventnor City
Waterford Township
West Cape May
West Wildwood
Weymouth Township
Wildwood City
Woodbine Borough
XX Total
M
M
L
S
M
XS
XS
XS
XS
S
XS
XL
XS
XS
L
L
M
S
L
L
L
XL
S
XS
L
M
XL
XL
L
M
M
S
M
L
M
XS
XS
XS
XL
M
XS
SC Round
Table
2/20/14
x
Back to Basics Police Stress Police Stress Lifeguard
Strains/Sprains
Mgt.
Mgt.
Symposium
4-3-14
5/7/14
5/28/14
6/18/14
1
1
0
1
1
1
1
1
1
1
DPW RT
10-15-14
1
Police Stress Planning
Mgt.
Retreat
10-22-14
10/22-23/14
1
x
1
1
1
1
1
1
1
0
1
1
1
1
1
1
1
0
1
1
0
0
1
0
1
1
0
1
1
0
1
1
1
0
1
1
x
1
0
1
1
1
0
1
1
0
1
0
1
0
1
1
1
1
x
1
0
1
1
1
1
1
1
1
1
0
1
1
1
1
1
1
1
1
0
1
1
1
1
0
1
x
0
0
x
1
1
1
0
0
0
0
0
1
1
1
1
1
1
1
0
1
1
1
1
1
0
1
1
1
1
1
1
1
1
1
1
1
1
1
x
1
1
1
1
1
1
1
1
1
1
1
1
1
0
1
1
1
1
1
1
1
x
1
1
0
1
1
1
1
1
1
1
1
1
1
0
1
1
0
1
1
0
1
1
1
1
1
x
1
1
x
1
1
1
23
12
0
11
1
35
1
27
69
4
1
21
1
1
6
1
39
Total
Attended
4
5
5
4
6
3
2
1
2
2
1
5
2
2
3
2
2
4
6
4
3
4
1
2
6
4
6
6
5
3
6
4
4
4
5
4
3
4
5
5
1
150
APPENDIX C: 2015 MANAGEMENT REPORT
Loss Control Management Report - Contract Period 1/1/2015 to 12/31/2015
2015 Visit Schedule
Size REN
Absecon City
Avalon
Brigantine City
Buena Borough
Cape May City
Cape May Point
Commercial Township
Corbin City
Deerfield Township
Dennis Township
Downe Township
Egg Harbor Township
Estell Manor City
Folsom Borough
Galloway Township
Hamilton Township
Linwood
Longport Borough
Lower Township
Margate City
Middle Township
Millville City
Mullica Township
Newfield Borough
North Wildwood City
Northfield City
Ocean City
Pleasantville City
Sea Isle City
Somers Point City
Stone Harbor
Upper Township
Ventnor City
Waterford Township
West Cape May
West Wildwood
Weymouth Township
Wildwood City
Woodbine Borough
XXXTotal
M
M
L REN
S
M
XS
XS
SERV PROJ
CONS VISITS BW
PS
LC
LC
LC
DR
LC
LC
3
3
3
2
3
2
2
XS
XS
S
XS
XL
XS
XS
LC
LC
LC
LC
PS
LC
LC
2
2
2
2
4
2
2
L
L
M
S
L REN
L REN
L REN
PS
DR
LC
LC
PS
LC
DR
2
3
3
2
4
4
4
XL REN
S
XS
L REN
M
XL
XL
LC
LC
LC
DR
DR
DR
DR
3
2
2
4
2
4
4
L
M
M
S
M
L
M
XS
XS
XS
XL
M
XS
DR
LC
DR
LC
LC
LC
LC
LC
LC
LC
DR
PS
LC
28
4
3
3
2
3
3
3
2
2
2
4
3
2
REN
REN
REN
REN
REN
70
113
Special
Focus
LAW
ENFOR
Safety Contract
received
3/2/2015
1
3/23/2015 (2nd page)
1
3/19/2015
3/23/2015
1
Acc review
1/22/2015
1/23/2015
2/3/15 (no signatures
on 2nd page)
1/30/2015
3/4/2015
2/18/2015
Acc review
1/28/2015
3/16/2015
1
Acc review
3/2/2015
1/29/2015, second
page only
2/12/2015
1/22/2015
Acc review
2/2/2015
Acc review
1/30/2015
2/23/15, second
page only
2/5/2015
Acc review
1
1
2/2/2015
3/4/2015
1
Acc review
1
Acc review
Acc review
1/29/2015
Acc review
1/28/2015
2/4/2015
1
1
2/3/2015
3/6/2015
2/5/2015
3/3/2015
2/13/2015
1
1/8/2015
3/3/2015
1/28/2015
1/29/2015
2/9/2015
1
Acc review
3/10/2015
1/29/2015
1/28/2015
7
0
5
ATLANTIC
A
C COUNT
TY MUNIICIPAL JO
OINT INS
SURANCE
E FUND
WE
ELLNESS
S POLICY
Y PROGRA
RAM STAT
TEMENT
T
It is thee policy off the Atlanttic County
y Municipaal Joint Inssurance Fuund to prom
mote
the heallth and saffety of mun
nicipal em
mployees. O
Our membeers’ successs in achieeving
a high degree off freedom from acccidents annd injuriess has beenn due to their
committment to saafety. Num
merous stu
udies have demonstraated that thhere is a sttrong
link between
b
workplace
w
e wellnesss and lower W
Workers’ Compensaation
Costs. Wellness Programs also contrribute to eemployee morale, w
well-being, and
quality of life bo
oth in and outside off the workkplace. T
Therefore, iin an effoort to
benefit our employees an
nd to addrress ever rising coosts, we, the Execuutive
Committtee of the Atlantic County
C
Mu
unicipal Joiint Insurannce Fund, hhereby suppport
the im
mplementatiion of a Workplaace Wellnness Proggram in each mem
mber
municip
pality that will utilizee a proactiv
ve approacch to prom
mote emplooyee healthh and
wellness. In furth
herance of this objecttive, the E
Executive C
Committeee has appoiinted
a Welln
ness Direcctor to wo
ork with members’
m
Wellness Committeees to proovide
guidancce and sup
pport for member
m
pro
ograms wiith the goaal of creatiing a healthier
and mo
ore producctive work
kplace. Every
E
mem
mber standds to bennefit from this
program
m. We en
ncourage cooperation
c
n from alll memberss of the A
Atlantic Coounty
Municip
pal Joint In
nsurance Fund.
The ressults of ou
ur compreh
hensive Wellness
W
Proogram willl certainlyy be worthh the
effort.
__
__________
___________________
Fu
und Chair
______
__________
________________________
Fun
nd Secretary
__________
_
__________________
DATE
f:\\data\risk\winworrd\acmjif\wellnesss\wellness policy sstatement ‐ final.docx 71
TO:
Fund Commissioner
FROM:
Executive Safety Committee
DATE:
April 15, 2015
RE:
Wellness Incentive Program - Reimbursement Procedures
Please note that $______ has been allocated for your municipality’s Wellness Incentive
Program for the 2015 Fund Year.
Purpose
The Wellness Incentive Program is designed to assist members in meeting their own
Wellness objectives by providing financial reimbursement for wellness and health related
items or programs purchased by the member municipality.
Suggested Uses
Some suggestions for eligible items are as follows:
•
•
•
•
•
•
Pedometers & Other Activity Monitoring devices
Employee Incentives
Health Fairs & Community Outreach Programs
Promotional Items
Guest Speakers
Nutritionists
Your JIF Wellness Director can help you with additional ideas, if needed.
Inadmissible Reimbursements
Please note that purchases made routinely within a municipality, if a Wellness Incentive
Program were not in place, are not eligible for reimbursement. These items include such
things as healthcare premiums, deductible reimbursements, etc.
Requests for
reimbursement items that are not clearly wellness related will be submitted to the Executive
Safety Committee for approval.
72
Reimbursement Instructions
Payments will be processed on a monthly basis as individual reimbursement requests are
made by members. Instructions for reimbursement are as follows:
1. After you have completed your purchase, you must forward supporting documentation
(purchase orders, vouchers, invoices, course outlines, descriptions, etc.) along with a
copy of the enclosed voucher with an original signature to:
Attention: Sheila Ortiz, Account Representative
PO Box 488
Marlton, NJ 08053
Fax: (856) 446-9149
E-mail: [email protected]
2. Upon receipt of the above documentation, a check will be issued after the next
monthly JIF Executive Committee meeting.
In order to avoid accounting problems for your vendors and the JIF, we want
to again emphasize that all purchases must be made by and paid for by the
municipality. The JIF cannot pay vendors directly on your behalf.
Deadline for Reimbursement Requests
Please plan your expenditures so that your requests for reimbursement are submitted no
later than December 31, 2015. The Executive Safety Committee enforces this cutoff
date. If you are planning to purchase reimbursable items after the December 31, 2015
cutoff date; you may encumber your money by sending a letter to the Executive Director’s
office announcing your intent by the December 31, 2015 deadline.
All encumbered Funds must be claimed by February 1, 2016. The JIF will strictly
adhere to the program cutoff date.
cc:
«F4», Wellness Coordinator
«F5», Risk Management Consultant
Valerie Smith, Wellness Director,
File:
ACMJIF/2015/Wellness Incentive program Tab: Reimbursement Procedures
F:\DATA\Risk\WINWORD\ACMJIF\WELLNESS\draft Wellness Incentive Program.doc
73
2015 WELLNESS INCENTIVE PROGRAM
Member
Corbin City
Downe Township
Estell Manor City
Folsom Borough
Woodbine Borough
Weymouth Township
West Cape May Borough
Deerfield Township
Cape May Point Borough
Commercial Township
Newfield Borough
West Wildwood Borough
Dennis Township
Buena Borough
Mullica Township
Longport Borough
Linwood City
Waterford Township
Absecon City
Upper Township
Northfield City
Somers Point City
Avalon Borough
North Wildwood City
Middle Township
Cape May City
Sea Isle City
Galloway Township
Hamilton Township
Lower Township
Wildwood City
Margate City
Ventnor City
Pleasantville City
Brigantine City
Millville City
Egg Harbor Township
Ocean City
ACM JIF TOTALS
Size
Category
XS
XS
XS
XS
XS
XS
XS
XS
XS
XS
XS
XS
SM
SM
SM
SM
MD
MD
MD
MD
MD
MD
LG
LG
LG
LG
LG
LG
LG
LG
LG
LG
LG
XL
XL
XL
XL
XL
XL
XL
XL
74
Wellness
Incentive
275
275
275
275
275
275
275
275
275
275
275
275
600
600
600
600
800
800
800
800
800
800
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,500
1,500
1,500
1,500
1,500
1,500
1,500
1,500
33,500
To:
Fund Commissioners
From:
Paul J. Miola, CPCU, ARM, Executive Director
Date:
April 15, 2015
Re:
A.
Lost Time Accident Frequency Report (pgs. 79-80)
The March 2015 Lost Time Accident Frequency Summary and the Statewide Recap for March 2015
are enclosed for your review.
B.
Certificates of Insurance (pgs. 81-85)
Summaries of the Certificates of Insurance issued during March 2015 are attached for your review.
C.
2014 Safety Incentive Program Awards (pg. 86)
A letter from our office describing how to collect your 2014 Safety Incentive Awards money was
e-mailed on or about February 27, 2015. A report detailing the available balances for each
member is attached for your review. Please note that the deadline to claim or encumber these
funds is December 31, 2015. All encumbered funds had to be claimed by February 1, 2016.
D.
2015 Optional Safety Budget (pg. 87)
A reporting detailing the available balance for each member participating in the 2015 Optional
Safety Budget is attached for your review. Instructions on claiming these funds were e-mailed to
participating members on or about February 11, 2015. If you have any questions on how to
collect your 2015 Optional Safety Budget funding, please contact our office. Please note that the
deadline for claiming or encumbering these funds is December 31, 2015. All encumbered
funds must be claimed by February 1, 2016.
E.
Employment Practices Liability Coverage – (pgs. 88)
A compliance status report regarding the Employment Practices Liability Coverage is attached for
your review. Each member should review this report carefully to insure its accuracy. If you
believe the report to be inaccurate regarding your town, please contact PERMA directly.
F.
EPL Allowance (pg. 89)
The JIF has provided each member with $725 of funding that can be used by each member for
employment practices related expenses. These expenses include employment related training that
the member would like to arrange for its personnel. Additional employee training can be
effective mechanisms for members looking to manage their employment liability risks. If you
need additional information regarding this program, please contact our office.
C:\Users\Kkristie\Documents\Agenda Packets\ACM JIF\Executive Dir Reports\ED April 2015.doc
75
Page 2
G.
EPL Helpline – Authorized Contact List (pgs. 90-91)
With the placement of the member’s EPL/POL coverage in the commercial insurance market, the
insurance company XL has implemented an EPL Helpline for the member’s use. There is no
restriction on the number of calls or amount of time that members can contact this service.
Members can appoint two representatives to use this service. Appointments must be made by
Resolution of the Governing Body. Please note that Municipal Solicitors can not be
appointed as Helpline Contacts. Enclosed, please find the most recent list of authorized contacts
for the EPL Helpline. These are the only representatives authorized to access this service. Please
contact the Executive Director’s Office with any questions.
H.
Financial Fast Track Report (pg. 92)
The Financial Fast Track Report as of February 28, 2015 is attached for your review. The report
is generated by PERMA and provides a “snapshot” of the JIF’s financial status. The JIF’s surplus
position as of February 28, 2015 was $27,220,088
I.
Regulatory Filing Checklists (pgs. 93-94)
Enclosed please find two regulatory filing checklists that we provide each month as part of our
due diligence reporting on behalf of the JIF. These checklists provide an outline of required
reporting to the Departments of Banking and Insurance and Community Affairs on an annual and
a monthly basis, and the status of the items listed.
J.
Monthly Activity Calendar (pgs. 95-96)
Attached for your review is the monthly activity calendar for the months of April/May.
K.
Skateboard Park Approval Status (pg. 97)
Enclosed, pleased find a spreadsheet depicting the current status of all approved skateboard parks
or those currently under construction by a member municipality. The MEL has established a
process, outlined in MEL Coverage Bulletin 15-09, that must be followed by all members who
wish to construct a skateboard park and have the Atlantic JIF and MEL provide said facility with
coverage. Any member with a park currently under construction or in the review process should
review the enclosed spreadsheet to be sure that it accurately depicts the current status of your
facility. All members considering construction of a skateboard park should contact the Executive
Director’s office prior to moving forward.
L.
Capehart & Scatchard Updates (pgs. 98-102)
John Geaney, Esq. of the law firm of Capehart & Scatchard periodically provides updates on
court cases dealing with workers’ compensation, ADA and FMLA issues. Copies of his latest
updates are included for your information.
M.
Statutory Bond Status (pg. 103)
Attached for your review is the latest listing of Statutory Bonds issued by the MEL for JIF
members. This list should be reviewed for accuracy. Any questions on the status of an
application or a listed bond should be directed to Cate Kiernan at PERMA. Cate can be reached
at 201-518-7031.
N.
New Fund Commissioner Orientation
76
Page 3
For the last several years, the Executive Director’s office has held the New Fund Commissioner
Orientation via webinar. In preparation for the 2015 sessions, the Executive Director’s office is
questioning the effectiveness of holding these sessions via webinar and will be discussing
alternatives to the current process with the Strategic Planning Committee. Additional
information on these sessions will be forthcoming.
O.
Financial Disclosure Form
As you are aware, last year the Division of Local Government Services had changed the on line
process for completion and submission of Financial Disclosure forms. In accordance with the new
program the Executive Directors office created a Local Government Officials roster for the JIF
and last year emailed Pin #’s to each individual required to file the Financial Disclosure Form for
their position with the JIF. This year, a reminder email was sent on March 3, 2015 and March 30,
2015 to all Fund Commissioners and Clerks and included a copy of the Local Finance Notice
2015-5 and 2015-6, respectively, so the online filing may be completed in a timely manner. Any
new Fund Commissioners, who did not receive a Pin # to file the Financial Disclosure Form for
their position with the JIF previously, received their PIN # this year in a separate email sent from
our office on March 2, 2015. Please note all Financial Disclosure Forms are required to be filed
with the State by April 30, 2015 in order to avoid penalty fees. You could start filing your
Financial Disclosure Form as of April 1, 2015. If you have any questions, please contact the
Executive Director’s office.
P.
2015 2nd Assessment Billing
Second installment bills were emailed to member Municipal Clerks, with a copy to the Fund
Commissioner and Risk Management Consultant, on or about March 15, 2015. Please note that
the second installment is due by May 17, 2015. If you have any questions, please contact Tracy
Forlenza at (856) 446-9143.
Q.
Claims Coordinator Training
An email invitation was sent out from Sandy Eaton of Qual-Lynx on March 24, 2015 to all
Claims Coordinators in regards to Claims Coordinator Training scheduled for April 30, 2015
from 9:00 am – 12 noon at Merighi’s Savory Inn, Vineland. It was requested that those that wish
to participate respond via the invitation no later than April 17, 2015
R.
Quarterly Attendance Report (pgs. 104-106)
A report detailing attendance records through the first quarter of the 2015 Fund Year is attached
for your review.
S.
Revenue & Appropriations
This information will not be collected manually this year as in years past, as it is now being
collected in the EXIGIS system.
T.
Payroll Audits
On or about February 6, 2015, a letter was e-mailed to all Municipal Clerks, with a copy to Fund
Commissioners, advising that Bowman & Company will be performing workers’ compensation
exposure verification audits of members’ year 2014 payrolls. These payrolls will serve as the
basis for your 2016 workers compensation renewal data. Attached to the e-mail was a
spreadsheet that included employee counts by payroll classification as reported during last year’s
payroll audit. As employee counts have a tendency to be the most time consuming part of the
payroll audit process, members were asked to review and update this spreadsheet prior to the
actual audit. In addition, beginning this year, members are invited to send the required payroll
77
Page 4
data to the auditors for processing prior to the auditor visiting the member town. Details on how
the data can be sent were included in the February 6, 2015 correspondence. Members not
wishing to send their data to the auditors ahead of time will be contacted by a representative
from Bowman to set up a mutually convenient date and time for the audit.
U.
Property Appraisals
On February 9, 2015 each member and their RMC’s received a notification from our office
asking that they review and update their property schedule located in the Exigis Exposure Data
Management System. Once a member responds, those that are going to receive a physical
appraisal this year will be contacted by the Fund Property Appraiser, ASSETWORKS. Those
that are not receiving a physical inspection in 2015 will have their building & contents values
trended accordingly. All members were asked to complete this process no later than March 20,
2015
V.
New Member Activity
There is no new member activity at this time.
78
79
80
Certificate Of Insurance Monthly Report
From 2/19/2015
Tuesday, March 24, 2015
To 3/23/2015
Holder (H) / Insured Name (I)
Holder
Code
Holder / Insured Address
Description of
Operations
Issue
Date
Coverage
ATLANTIC JIF
H- US Coast Guard Training Center
Cape May 1 Munro Avenue Cape May, NJ 08204
153
Evidence of insurance as respects to Water Rescue Classes.
I- North Wildwood City
P.O. Box 499 North Wildwood, NJ
H- Borough of Longport
I- Longport Borough
2305 Atlantic Avenue Longport, NJ 08403
2305 Atlantic Avenue Longport, NJ
08403
231
Evidence of insurance as respects Statutory Bond Coverage for 2/26/2015 BOND
Donna O'Brien, Tax Collector, Effective 02/05/15.
H- The Flagship Condo Assoc.
I- City of Ocean City
831 Atlantic Avenue Ocean City, NJ 08226
861 Asbury Avenue Ocean City, NJ
08226
310
Certificate Holder is amended to be included as “additional
3/6/2015 GL AU EX WC
insured” the person(s) or organization(s) as shown in the
description section of this certificate of insurance for General
Liability & Excess Liability pursuant to the terms, conditions,
limitations, and exclusions of the JIF Casualty Insurance Policy
(but only with respect to liability caused in whole or in part by the
acts or omissions of the named insured) rental of office space and
right of way at 831 Atlantic Avenue, Ocean City, NJ from April 1,
2015 to October 31, 2015.
H- Cumberland County Emergency 911
Communications & Training Center 637 Bridgeton
384
Avenue Bridgeton, NJ 08302
P.O. Box 609
12 S High Street 12 S. High Street Millville, NJ
08332
3/23/2015 GL EX AU WC
acts or omissions of the named insured) use of all fire training
facilities and grounds.
H- City of Ocean City
861 Asbury Avenue Ocean City, NJ 08226
08226
568
Evidence of insurance as respects to Statutory Bond coverage for 3/11/2015
Terence Graff, Tax Collector, Effective 02/23/15.
H- NJ Department of Health & Senior Services
Office of EMS PO Box 360 Trenton, NJ 08625-0360
1685
Evidence of insurance as respects to Re-licensure with
Department of Health, Office of EMS.
I- City of Millville
2/20/2015 GL EX AU WC
08260
08226
81
3/19/2015 ALL
BOND
H-Rutgers University
I- Township of Upper Deerfield
The State University of New Jersey 335 George Street 2028
Liberty Plaza New Brunswick, NJ 08903
1325 Hwy 77 Seabrook, NJ
08302
Rutgers University, The State University of New Jersey are
3/12/2015 GL EX AU WC
amended to be included as “additional insured” the person(s) or
organization(s) as shown in the description section of this
certificate of insurance for General Liability & Excess Liability
pursuant to the terms, conditions, limitations, and exclusions of the
JIF Casualty Insurance Policy (but only with respect to liability
caused in whole or in part by the acts or omissions of the named
insured) NJDOC Ambulance Services.
H- New Jersey Historic Trust
PO Box 457, S. Broad St. Trenton, NJ 08625-0457
2388
I- City of Ventnor
6201 Atlantic Avenue Ventnor City, NJ
Evidence of Property for Flood on 6201 Atlantic Ave Ventnor NJ 2/25/2015 PR
08406 for Ventnor City Hall Grant Project #2014.SO25. Building
locations wholly or partially within Special Flood Hazard Areas of
100 year flooding as defined by the Federal Emergency
Management Agency (Flood Zones A &V) are subject to the
following limits and deductible: (1) $2,500,000 per location for
loss or damage arising from Flood and/or Surface Water and (2)
Separate deductibles of $500,000 each building for municipality
buildings, $500,000 each building for municipality contents.
Primary flood insurance must be purchased by the Named Insured
separately through National Flood Insurance Plan’s (NFIP).
H- New Jersey Historic Trust
PO Box 457, S. Broad St. Trenton, NJ 08625-0457
2388
Evidence of Property for Flood on 6201 Atlantic Ave Ventnor NJ 2/25/2015 PR
08406 for Ventnor City Hall Grant Project #2014.SO25.
I- City of Ventnor
H- Commerce Bank &/or Assigns
8000 Forsyth Blvd., Suite 510 St. Louis, MO 63105
I- Borough of Buena_
Minotola Fire Company District #2 616 Central Ave.
Minotola, NJ 08341
H- USDA Rural Development
8000 Midlantic Dr., Ste. 500N Mt. Laurel, NJ
I- Folsom Borough
1700 12th Street, Route 54 Folsom, NJ
H- State of NJ
Motor Vehicle Commission 225 East State St., 5th Floor
West PO Box 167 Trenton,NJ 08666-0167
08406
08406
2563
08054
3753
2/19/2015 GL EX AU OTH
Liability & Excess Liability & as “Mortgagee/Loss Payee" ATIMA,
for Property pursuant to the terms, conditions, limitations, and
exclusions of the JIF Casualty and Property Insurance Policies
acts or omissions of the named insured) 2014 Kenworth T370
Rescue Vehicle #2NKHHJ8X9EM408850 values at $333,547.00
Evidence of Insurance.
3/4/2015 GL AU EX CRIME
08037
08302
82
4254 Evidence of insurance.
3/12/2015 GL EX AU WC
H- HUNTERDON COUNTY EMERGENCY
SERVICES TRAINING CENTER
I- City of Wildwood
59 PETTICOAT LANE ANNANDALE, NJ 08801
H- Yamaha Motor Corp., U.S.A.
Attn: Commercial Customer Finance 6555 Katella
5640
Avenue Cypress, CA 90630
1417 West Brigantine Avenue Brigantine, NJ
08203
3/23/2015 GL EX PR
acts or omissions of the named insured) lease of 80 Yamaha Golf
carts, 3 Yamaha Maintenance carts & 1 Yamaha Beverage cart
total lease value of $290,000.
H- Cumberland County
Board of Chosen Freeholders Administration Building 5707
790 E. Commerce St. Bridgeton NJ 08302
Certificate holder is amended to be included as “additional
3/12/2015 GL EX AU WC
acts or omissions of the named insured) use of the Fire and EMS
Training Center located at 637 Bridgeton Ave., Bridgeton, NJ
08302.
H- State of New Jersey
Dept. of Treasury Contract Compliance & Audit Dept. 33 6223 Evidence of insurance.
W. State St., 9th Flr. PO Box 236 Trenton, NJ 08625
08302
3/12/2015 GL EX AU WC
Evidence of insurance as respects to relicensure.
3/12/2015 GL EX AU WC
NJ Dept. of Health & Senior Svcs P O Box 360 Trenton, 6931
NJ 08625
08302
H- Township of Upper Deerfield
Highway 77 PO Box 5098 Seabrook, NJ 08302
08302
Evidence of insurance as respects to Statutory Bond coverage for 3/19/2015
Andrea A. Penny-Tax Collector and Amy L. Colaneri-Treasurer,
effective 01/01/15.
I- Brigantine City
H- Emergency Medical Services - Relicensure
4501
4400 New Jersey Avenue Wildwood, NJ 08260
08302
9515
83
Certificate holder is amended to be included as “additional
3/19/2015 GL EX AU WC
acts or omissions of the named insured) Greg Neill
from the Wildwood Fire Company taking a class at the Hunterdon
County Emergency Services Training Center.
BOND
H- Cape May City
I- City of Cape May
H- Garden State Highway Products, Inc.
I- City of Millville
H- Atlantic County Police
Elementary School District 921 Lafayette Street Cape 12131
May, NJ 08204
643 Washington Street Cape May, NJ
08204
3/6/2015 GL EX AU WC
acts or omissions of the named insured) leased premises located
and known as the Lafayette Street Park
1740 East Oak Road Vineland, NJ 08361
P.O. Box 609
12 S High Street 12 S. High Street Millville, NJ
2/27/2015 GL EX AU OTH
acts or omissions of the named insured) rented/leased contractors
equipment (2006 Sterling Acterra 6500, Vin #
2FZACFDC76AV65977, Valued at $65,000).
14840
08332
Evidence of Insurance as respects to police recruits attending the 3/6/2015 GL EX AU WC
Atlantic County Police Training Center
I- City of Ventnor
Training Center 5033 English Creek Ave. Egg Harbor 17672
Township, NJ 08234
08406
H- Logisticare Solutions & DMAHS
200 Metroplex Drive Suite 200 Edison, NJ 08817
18292
I- Township of Waterford
2131 Auburn Avenue Atco, NJ 08004
REPLACES PRIOR CERTIFICATE -Logisticare Solutions &
2/25/2015 GL EX AU WC
DMAHS are amended to be included as “additional insured” the
person(s) or organization(s) as shown in the description section
of this certificate of insurance for General Liability & Excess
Liability pursuant to the terms, conditions, limitations, and
exclusions of the JIF Casualty Insurance Policy (but only with
respect to liability caused in whole or in part by the acts or
omissions of the named insured) transportation brokerage
services. Sexual Abuse & Molestation is not excluded in the
General Liability coverage.
H- Pine Valley Golf Club
I- Township of Waterford
1 Domey Drive Pine Valley, NJ 08021
2131 Auburn Avenue Atco, NJ 08004
18590
acts or omissions of the named insured) use of facilities by the
Waterford Township Fire Department for a training drill on 3/10/15.
84
H- Jewish Community Center
I- Longport Borough
501 North Jerome Ave Margate, NJ 08402
2305 Atlantic Avenue Longport, NJ
08403
H- County of Salem
Fire Academy 135 Cemetery Rd. Woodstown, NJ 08098 19554 Evidence of insurance with respects to Fire District to the Salem 3/11/2015 GL EX AU WC
County Fire Academy.
08302
18654
acts or omissions of the named insured) Use of swimming pool for
recertification of life guards for the beach patrol
H- Salem County Improvement Authority
I- Borough of Buena
52 McKillip Road Alloway, NJ 08001
19905
Landisville Fire District #1 616 Central Ave. Minotola,
NJ 08341
H- School District of Philadelphia
Office of Risk Management 440 N. Broad Street – Suite 19960 Evidence of insurance with regards to Students from Masterman 3/18/2015 GL EX AU WC
325 Philadelphia, PA 19130
School, 1699 Spring Garden Street, Philadelphia, PA 19130, who
08226
will be performing on Tuesday, April 28, 2015, at the Music Pier in
Ocean City, NJ.
H- PRC Development Group, LLC
I- Buena Borough
40 Monmouth Park Highway West Long Branch,
NJ07764
616 Central Avenue Minotola, NJ
08341
21064
Total # of Holders = 28
85
Evidence of insurance as respects to waste disposal in the Salem 2/24/2015
County landfill.
AU WC
2/26/2015 GL EX WC
Liability, Excess Liability & Property pursuant to the terms,
conditions, limitations, and exclusions of the JIF Casualty
Insurance Policy (but only with respect to liability caused in whole
or in part by the acts or omissions of the named insured) Assisting
Lowys Moving with the relocation of 50 residents. Overall
Management company for the entire project for the John Knox
Property,19 Davis Ave., Neptune, NJ 07753, & Almerth Battle
Homes, 2100 Wells Ave., Neptune, NJ 07753, 56 N. Taylor Ave.,
Neptune, NJ 07753 from 2/27/15 - 03/27/15.
2014 SIP Qualifiers Award
Member
Opening
January
February
March
April
May
June
July
August
September
October
November
December
Paid in
Total YTD
Ending
Encumbered
Municipality
Balance
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2016
Expenses
Balance
Funds
Absecon
1,250.00
0.00
1,250.00
Avalon
1,250.00
0.00
1,250.00
Brigantine
1,500.00
0.00
1,500.00
Buena
1,000.00
Cape May
1,250.00
1,000.00
0.00
0.00
1,250.00
Cape May Point
750.00
750.00
0.00
Commercial
750.00
0.00
750.00
Corbin City
750.00
0.00
750.00
Deerfield
750.00
0.00
750.00
1,000.00
0.00
1,000.00
750.00
0.00
750.00
1,750.00
0.00
1,750.00
0.00
750.00
Dennis
Downe
Egg Harbor Twp.
Estell Manor
750.00
Folsom
750.00
750.00
1,000.00
750.00
750.00
0.00
Galloway
1,500.00
0.00
1,500.00
Hamilton
1,500.00
0.00
1,500.00
Linwood
1,250.00
0.00
1,250.00
Longport
1,000.00
Lower
1,000.00
0.00
1,500.00
0.00
1,500.00
Margate
1,500.00
0.00
1,500.00
Middle
1,500.00
0.00
1,500.00
Millville
1,750.00
0.00
1,750.00
Mullica
1,000.00
Newfield
1,000.00
1,000.00
750.00
North Wildwood
1,500.00
Northfield
1,250.00
Ocean City
1,750.00
1,250.00
1,000.00
0.00
0.00
750.00
0.00
1,500.00
1,250.00
0.00
0.00
1,750.00
Pleasantville
1,750.00
0.00
1,750.00
Sea Isle City
1,500.00
0.00
1,500.00
Somers Point
1,250.00
Stone Harbor
1,250.00
Upper Twp.
1,250.00
Upper Deerfield
1,000.00
Ventnor
Waterford
1,250.00
1,000.00
1,250.00
0.00
0.00
1,250.00
0.00
1,250.00
1,000.00
0.00
1,500.00
0.00
1,500.00
1,250.00
0.00
1,250.00
West Cape May
750.00
0.00
750.00
West Wildwood
750.00
0.00
750.00
Weymouth
750.00
0.00
750.00
Wildwood
1,750.00
1,750.00
1,750.00
0.00
Wildwood Crest
1,250.00
1,250.00
1,250.00
0.00
0.00
750.00
11,000.00
37,750.00
Woodbine
Total By Line
750.00
$48,750.00
0.00
0.00
7,250.00
3,750.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Must be Claimed or Encumbered by December 31, 2015. All Encumbered Funds Must be Claimed by February 1, 2016
ACMJIF
86
Last Revision: 4/8/2015
2015 Optional Safety Budget
Member
Opening
January
February
March
April
May
June
July
August
September
October
November
December
Paid
Total YTD
Ending
Encumb.
Municipality
Balance
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2016
Expenses
Balance
Funds
Absecon City
Avalon Borough
$1,500.00
$0.00
$1,500.00
$2,000.00
$0.00
$2,000.00
Brigantine City
Buena Borough
Cape May City
Cape May Point
Commercial Township
Corbin City
Deerfield Township
$1,000.00
$0.00
$1,000.00
Dennis Township
$1,250.00
$0.00
$1,250.00
Downe Township
Egg Harbor Township
Estell Manor City
Folsom Borough
Galloway Township
Hamilton Township
$2,000.00
$0.00
$2,000.00
Linwood
$1,500.00
$0.00
$1,500.00
$2,000.00
$0.00
$2,000.00
$1,000.00
$0.00
$1,000.00
Northfield City
$1,500.00
$0.00
$1,500.00
Ocean City
$2,500.00
$0.00
$2,500.00
Pleasantville City
$2,500.00
$0.00
$2,500.00
Sea Isle City
$2,000.00
$722.82
$1,277.18
$0.00
$1,500.00
Longport Borough
Lower Township
Margate City
Middle Township
Millville City
Mullica Township
Newfield Borough
North Wildwood City
$722.82
Somers Point City
Stone Harbor
$1,500.00
Upper Township
Ventnor City
Waterford Township
$1,500.00
$0.00
$1,500.00
West Cape May
$1,000.00
$0.00
$1,000.00
West Wildwood
Weymouth Township
$1,000.00
$0.00
$1,000.00
Wildwood City
$2,500.00
$0.00
$2,500.00
$722.82
$27,527.18
Woodbine Borough
Total By Line
$28,250.00
$0.00
$0.00
$0.00
$722.82
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Must be Claimed of Encumbered by December 31, 2014. All Encumbered Funds Must be Claimed by February 1, 2015
ACMJIF
87
Updated as of 4/8/2015
88
2015 JIF EPL ALLOWANCE
Member
Opening
January
February
March
April
May
June
July
August
Sept.
October
November
December
Total YTD
Municipality
Balance
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
Expenses
Encumbered
Paid in
Ending
2016
Balance
Absecon
725.00
0.00
$725.00
Avalon
725.00
0.00
$725.00
Brigantine
725.00
0.00
$725.00
Buena
725.00
0.00
$725.00
Cape May City
725.00
0.00
$725.00
Cape May Point
725.00
0.00
$725.00
Commercial
725.00
0.00
$725.00
Corbin City
725.00
0.00
$725.00
Deerfield
725.00
0.00
$725.00
Dennis
725.00
0.00
$725.00
Downe Township
725.00
0.00
$725.00
Egg Harbor Twp.
725.00
0.00
$725.00
Estell Manor
725.00
0.00
$725.00
Folsom
725.00
0.00
$725.00
Galloway
725.00
0.00
$725.00
Hamilton
725.00
0.00
$725.00
Linwood
725.00
0.00
$725.00
Longport
725.00
0.00
$725.00
Lower
725.00
0.00
$725.00
Margate
725.00
0.00
$725.00
Middle
725.00
0.00
$725.00
Millville
725.00
0.00
$725.00
Mullica
725.00
0.00
$725.00
Newfield
725.00
0.00
$725.00
North Wildwood
725.00
0.00
$725.00
Northfield
725.00
Ocean City
725.00
Pleasantville
0.00
$725.00
340.00
$385.00
725.00
0.00
$725.00
Sea Isle City
725.00
0.00
$725.00
Somers Point
725.00
0.00
$725.00
Stone Harbor
725.00
0.00
$725.00
Upper Deerfield
725.00
0.00
$725.00
Upper Twp.
725.00
0.00
$725.00
Ventnor
725.00
0.00
$725.00
Waterford
725.00
0.00
$725.00
West Cape May
725.00
0.00
$725.00
West Wildwood
725.00
0.00
$725.00
Weymouth
725.00
0.00
$725.00
Wildwood
725.00
0.00
$725.00
Wildwood Crest
725.00
0.00
$725.00
Woodbine
725.00
0.00
Total By Line
$29,725.00
130.00
$0.00
$130.00
210.00
$210.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$340.00
$725.00
$0.00
$29,385.00
Must be used by December 31, 2015
89
Updated as of 4/8/2015
EPL Helpline
Authorized Contact Person(s)
TOWN Absecon City Avalon Borough Brigantine City Buena Borough Cape May City Cape May Point Borough Commercial Township Corbin City Deerfield Township Dennis Township Downe Township Egg Harbor Township Estell Manor City Folsom Borough Galloway Township Hamilton Township Linwood City Longport Borough Lower Township Margate City Middle Township Millville City Mullica Township Newfield Borough Northfield City North Wildwood City Ocean City Pleasantville City Sea Isle City AUTHORIZED CONTACT PERSON Jessica Thompson Scott Wahl Diane Eafrati, Dir. of Personnel Joseph Baruffi, Mayor Bruce MacLeod, City Mgr Kim Hodsdon, Clerk ADDITIONAL CONTACT PERSON(s) John Armstrong, Mayor James Waldron Eleanor Derrickson Joseph Santagata, FC Louise Cummiskey Anita Vanhesswyk Hannah E. Nichols N/A Kelly Camp Karen Seifrit, Clerk Glenn O. Clarke, CFO/FC Robert Campbell Peter Miller, Administrator Joanne Siedlecki N/A Michele Heim, tax Collector Dennis Cook Jennifer McIver Fern Brown Patricia Gatto Susan Jacobucci Michael Jacobs, Administrator Leigh Ann Napoli, Clerk Jenna Kelly/CFO James Ridgway Rosemarie Freed, Acting Clerk Kim Krauss Susan G. Robostello, Clerk/Admin. Dawn Stollenwerk, CFO Toni Van Camp, Clerk/Administrator Mary Canesi, Clerk Scott Jett, Clerk Linda Kent Louis DeStefano Patrick Moran Mary Kelly, HR Dir. N/A Amelia Strawder Julie Picard, Asst Clerk Lisa McLaughlin, CFO Vera Kalish, Personnel Officer N/A Kim Johnson, Clerk N/A Jim Dickinson, Fund Commissioner Todd Burkey, CFO Elizabeth Wood, Asst Dir of HR Linda Peyton, Administrator George Savastano, Administrator Joann Cioeta, Director of HR Davinna King, Personnel Officer Kellie Seib, Alt. FC Atlantic County Municipal Joint Insurance Fund
P.O. Box 488, Marlton, New Jersey 08053 · P: 856-446-9100 · F: 856-446-9149 · www.acmjif.org
Date of Last Revision: 04/08/15
C:\Users\Kkristie\Documents\Agenda Packets\ACM JIF\Executive Dir Reports\EPL Contacts.doc
90
EPL Helpline
Authorized Contact Person(s)
TOWN Somers Point City Stone Harbor Borough AUTHORIZED CONTACT PERSON Wes Swain, City Administrator Jill Gougher ADDITIONAL CONTACT PERSON(s) Carol L. Degrassi, City Clerk N/A Upper Deerfield Township Upper Township Ventnor City Waterford Township West Cape May Borough West Wildwood Borough Weymouth Township Wildwood City Wildwood Crest Borough Woodbine Borough Roy Spoltore, Clerk Vicki Vagnarelli, HR Barbara Spiegel Janice Callaghan William Richardson Rhonda Sharp James Goos Susan Danson Elaine Wallace Pamela Kaithem, Mayor Chris Ridings, Administrator Donna Frederick, Clerk Bonnie S. Yearsley, RMC, Clerk Ken Haeser Chris Wood, FC Janelle Holzmer, Clerk N/A Patricia Feketics Lisa Garrison, Clerk William Pikolycky Atlantic County Municipal Joint Insurance Fund
P.O. Box 488, Marlton, New Jersey 08053 · P: 856-446-9100 · F: 856-446-9149 · www.acmjif.org
Date of Last Revision: 04/08/15
C:\Users\Kkristie\Documents\Agenda Packets\ACM JIF\Executive Dir Reports\EPL Contacts.doc
91
ATLANTIC COUNTY MUNICIPAL FUND
FINANCIAL FAST TRACK REPORT
AS OF
February 28, 2015
THIS
MONTH
1. UNDERWRITING INCOME
2. CLAIM EXPENSES Paid Claims
Case Reserves
IBNR
Recoveries
TOTAL CLAIMS
3.
TOTAL EXPENSES
7.
UNDERWRITING PROFIT (1‐2‐3)
INVESTMENT INCOME
DIVIDEND INCOME
STATUTORY PROFIT (4+5+6)
8.
DIVIDEND
5.
6.
1,987,074
729,937
410,914
(183,521)
‐
PRIOR
YEAR END
3,974,148
1,273,324
356,201
43,995
‐
FUND
BALANCE
340,053,350
344,027,498
166,148,590
13,744,329
6,519,436
(411,505)
167,421,913
14,100,531
6,563,431
(411,505)
957,330
1,673,521
186,000,850
187,674,371
486,371
227,890
972,742
461,653
66,501,099
57,967,786
67,473,841
58,429,439
714,262
1,434,395
124,468,885
125,903,280
315,482
647
0
866,232
65,122
0
29,583,615
18,794,792
2,749,272
30,449,847
18,859,914
2,749,272
316,129
931,354
51,127,679
52,059,033
EXPENSES
Excess Premiums
Administrative
4.
YTD
CHANGE
9. STATUTORY SURPLUS (7‐8)
0
0
24,838,945
24,838,945
316,129
931,354
26,288,734
27,220,088
SURPLUS (DEFICITS) BY FUND YEAR
Closed
2011
2012
2013
2014
2015
TOTAL SURPLUS (DEFICITS)
TOTAL CASH
132
476
108,424
44,105
55,828
107,164
14,526
13,334
260,011
187,891
214,537
241,056
8,506,285
4,239,756
4,946,778
4,947,193
3,648,722
8,520,811
4,253,090
5,206,789
5,135,084
3,863,259
241,056
316,129
931,354
26,288,734
27,220,088
48,403,739
141,226,159
141,226,050
CLAIM ANALYSIS BY FUND YEAR
TOTAL CLOSED YEAR CLAIMS
FUND YEAR 2011
Paid Claims
Case Reserves
IBNR
Recoveries
TOTAL FY 2011 CLAIMS
FUND YEAR 2012
Paid Claims
Case Reserves
IBNR
Recoveries
FUND YEAR 2013
Paid Claims
Case Reserves
IBNR
Recoveries
FUND YEAR 2014
Paid Claims
Case Reserves
IBNR
Recoveries
FUND YEAR 2015
Paid Claims
Case Reserves
IBNR
Recoveries
COMBINED TOTAL CLAIMS
(9)
(109)
72,548
(60,291)
(12,650)
0
(393)
155,777
(64,667)
(96,682)
0
(5,572)
9,131,080
1,881,816
116,906
(70,052)
11,059,750
9,286,857
1,817,149
20,224
(70,052)
11,054,178
120,853
(98,453)
(130,701)
0
(108,301)
30,691
(285,245)
5,957
0
(248,597)
7,086,901
3,369,239
615,255
(341,453)
10,729,942
7,117,592
3,083,994
621,212
(341,453)
10,481,345
149,817
142,022
(335,799)
0
(43,960)
297,269
45,247
(516,643)
0
(174,127)
5,336,588
4,123,507
1,594,904
0
11,054,999
5,633,857
4,168,754
1,078,261
0
10,880,872
291,923
154,638
(502,222)
0
(55,661)
647,119
100,444
(944,341)
0
(196,778)
3,367,861
4,369,768
4,192,371
0
11,930,000
4,014,980
4,470,212
3,248,030
0
11,733,222
94,805
272,997
797,852
0
1,165,654
142,577
560,423
1,595,703
0
2,298,703
957,330
1,673,521
142,577
560,423
1,595,703
0
2,298,703
186,000,850
187,674,371
This report is based upon information which has not been audited nor certified by an actuary and as such may not truly represent the condition of the fund.
4/2/2015
Per Executive Director, professional fees other than RMC Fees reflect paid amounts.
92
ATLFFT_02
Monthly Regulatory Filing Check List
Fund Year 2015 for Month of March
ITEM
Meeting Minutes
Bylaws Amendments
Risk Management Program Changes
New Member Filings
Supplemental Assessments/Contributions
Budget Amendments (transfers, etc.)
Surplus Distribution (refunds/dividends)
Changes/Amendments/Additions to Service Providers
Executive Committee Changes
FILING STATUS
4/16/15
N/A
N/A
N/A
N/A
NA
NA
4/6/15
N/A
C:\Users\Kkristie\Documents\Agenda Packets\ACM JIF\Executive Dir Reports\Reg Filing Month.doc
93
Annual Regulatory Filing Check List
Year: January 1, 2015 – December 31, 2015
ITEM
Ethics Filings (Notification emailed to FC’s and Prof’s)
Renewal Resolutions and Indemnity & Trust Agreements
Budget and Actuarial Certification/Opinion Letter
Annual Assessments/Contributions
Supplemental Assessments/Contributions
Risk Management Program
Annual Certified Audit
List of Fund Commissioners & Executive Committee
Identity of Administrator
Identity of Treasurer
Excess Insurance /Group Purchase Insurance/Reinsurance Policies
Withdrawals
Exhibit A – Certification of JIF Fund Professionals
Exhibit B - Certification of JIF Data Forms
Exhibit D - New Member Filings
New Service Providers
Annual Reorganization Resolutions, including Cash Management Plan
Professionals
Actuary – Actuarial Advantage
Administrative Consultant
PERMA
Administrator - AJG
Asset Manager – TD Bank
Attorney - DeWeese
Attorney (Subrogation) - DeWeese
Attorney (Conflict)-Lou Greco
Auditor- Holman Frenia Allison
Claims Administrator – Qual-Lynx
Exposure Database Manger - Exigis
Managed Care - QualCare
Payroll Auditor - Bowman
Property Appraiser - Assetworks
Safety Director – JA Montgomery
Underwriting Manager – Hrubash,
Website – Joyce Media
Treasurer – J. Hansen
Recording Secretary - T. Forlenza
Wellness Director – Valerie Smith
Contract
FILING STATUS
3/30/15
12/23/14
12/23/14
1/29/15
1/29/15
1/29/15
1/29/15
MEL
1/29/15
N/A
N/A
1/29/15
1/29/15
Gen Ins.
7/9/15
12/10/15
Fidelity
N/A
N/A
E&O
7/16/15
12/10/15
Surety
N/A
N/A
X
X
X
X
X
X
X
X
X
X
X
X
X
10/1/15
6/30/15
9/1/15
9/1/15
10/15/14
7/1/15
3/31/15
7/1/15
8/1/15
9/27/15
12/10/15
12/10/15
JIF
10/1/09
N/A
N/A
N/A
N/A
5/1/12
NA
N/A
N/A
N/A
N/A
N/A
9/1/15
10/1/15
9/1/15
9/1/15
10/15/14
N/A
9/16/15
3/31/15
9/16/15
8/1/15
9/27/15
12/10/15
12/10/15
N/A
N/A
N/A
N/A
N/A
N/A
12/31/11
N/A
N/A
N/A
N/A
N/A
N/A
X
X
X
X
N/A
N/A
N/A
N/A
N/A
JIF
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
X
X
C:\Users\Kkristie\Documents\Agenda Packets\ACM JIF\Executive Dir Reports\Reg Filing Yr.doc
Date of last revision: 04/08/15
94
Atlantic County
Municipal Joint
Insurance
Fund
April 2015
Monthly Planner
Monday
Tuesday
Mar 2015
M
T W
T
F
May 2015
S
S
M
T W
T
1
2
3
4
5
6
Wednesday
7
8
4
5
6
7
F
S
S
1
2
3
8
9 10
9 10 11 12 13 14 15
11 12 13 14 15 16 17
16 17 18 19 20 21 22
18 19 20 21 22 23 24
23 24 25 26 27 28 29
30 31
25 26 27 28 29 30 31
6
Thursday
1
2
3
8
9
10
April Fool's Day
7
10:00 AM MEL Special Corp
Claims Conf Call
13
9:00 AM ACM Claims
Review Comm Mtg @
Hamilton Muni Bldg
14
9:00 AM Claims Coordinator
Training @ Indian Springs
Country Club, Marlton
20
Friday
15
9:30 AM Police Ad-Hoc Mtg
@ Conner Strong, Marlton
16
1:30 PM ACM EPL/POL
Claims Review Comm Mtg @
10:00 AM ACM Strat
Planning Mtg @ Weymouth
Muni Bldg
3:00 PM ACMJIF Exec
Comm Mtg @ Atlantic
County Library
1:00 PM Claims Coordintor
Training @ Nicolosi Caterers,
West Deptford
21
22
23
9:00 AM Joint Coverage
Committee Meeting @
Renault Winery, Egg Harbor
City
27
28
29
30
9:00 AM Claims Coordinator
Training @ Merighi's,
Vineland
95
Printed by Calendar Creator for Windows on 4/1/2015
17
MEL ED Seminar - Location:
TBD (all day)
24
Atlantic County
Municipal Joint
Insurance
Fund
May 2015
Monthly Planner
Monday
Tuesday
Wednesday
Apr 2015
M
T
Thursday
1
Jun 2015
W
T
F
S
S
M
T
W
T
F
S
S
1
2
3
4
5
1
2
3
4
5
6
7
6
7
8
9
10
11
12
8
9
10
11
12
13
14
13
14
15
16
17
18
19
15
16
17
18
19
20
21
20
21
22
23
24
25
26
22
23
24
25
26
27
28
27
28
29
30
29
30
4
Friday
5
6
7
8
9:00 AM RCF Claims Conf
Call
10:30 AM MEL Claims
Conference Call
11
12
13
14
9:00 AM ACM Claims Comm
Mtg @ Hamilton Twp Muni
Bldg
18
19
20
15
9:00 AM ACM Finance
Comm Mtg @ Mullica Twp
Court Rm
21
22
28
29
3:00 PM ACM Exec Comm
Mtg @ Atlantic County
Library
25
26
27
10:00 AM MEL Leg Comm
Conference Call
Memorial Day (Observed)
Office Closed
96
Printed by Calendar Creator for Windows on 4/8/2015
Skateboard Park Approval Status
Member
Stage
Status
Notes
Municipality
Absecon
Avalon
Approved
Complete
Brigantine
Approved
Complete
Buena
General Inquiry
Inactive
Approved
Complete
Galloway
Approved
Complete
Hamilton
Removed
Removed
The Executive Director/Safety Director are unaware of any ongoing activity
Cape May
Cape May Point
Corbin City
Commercial
Deerfield
Dennis
Downe
Egg Harbor Twp.
Estell Manor
Folsom
Park Equipment Removed as of 11/1/08
Linwood
Longport
Lower
Removed
Removed
Park Equipment removed as of 4/26/07
Margate
Planning
Inactive
The Executive Director/Safety Director are unaware of any ongoing activity
Middle
Approved
Complete
Millville
Mullica
Removed
Park Equipment removed as of 11/5/09
Newfield
North Wildwood
Approved
Complete
Planning
Pending
Approved
Complete
Approved
Complete
Approved
Complete
Northfield
Ocean City
A letter explaining the Approval Process was sent to the City on 8/27/2013
Pleasantville
Sea Isle City
Somers Point
Stone Harbor
Upper Deerfield
Upper Twp.
Ventnor
Waterford
West Cape May
West Wildwood
Weymouth
Wildwood
Wildwood Crest
Woodbine
F:\DATA\Risk\EXCEL\ACMJIF\2015\[2015 Skateboard status.xls]ACM
Last Update: 4/1/2015
97
98
99
100
101
102
MEL STATUTORY BONDS as of 3/23/2015
Member ID
1
1
1
2
3
3
5
5
377
377
377
6
7
7
8
8
595
10
10
11
11
12
13
13
14
15
465
16
17
17
530
18
19
20
21
21
22
22
23
23
23
24
24
24
25
25
26
27
27
28
28
375
375
29
29
30
30
31
31
32
32
32
33
33
33
34
475
475
475
35
35
36
36
Member Name
AVALON
AVALON
AVALON
BRIGANTINE
BUENA
BUENA
CAPE MAY
CAPE MAY
CAPE MAY POINT
CAPE MAY POINT
CAPE MAY POINT
COMMERCIAL
DEERFIELD
DEERFIELD
DENNIS
DENNIS
DOWNE TOWNSHIP
EGG HARBOR TOWNSHIP
EGG HARBOR TOWNSHIP
ESTELL MANOR
ESTELL MANOR
FOLSOM
GALLOWAY
GALLOWAY
HAMILTON
HAMMONTON
LINWOOD
LONGPORT
LOWER
LOWER
MARGATE
MIDDLE
MILLVILLE
MULLICA
NEWFIELD
NEWFIELD
NORTH WILDWOOD
NORTH WILDWOOD
NORTHFIELD
NORTHFIELD
NORTHFIELD
OCEAN CITY
OCEAN CITY
OCEAN CITY
PLEASANTVILLE
PLEASANTVILLE
SEA ISLE CITY
SOMERS POINT
SOMERS POINT
STONE HARBOR
STONE HARBOR
UPPER
UPPER
UPPER DEERFIELD
UPPER DEERFIELD
VENTNOR
VENTNOR
WATERFORD
WATERFORD
WEST CAPE MAY
WEST CAPE MAY
WEST CAPE MAY
WEST WILDWOOD
WEST WILDWOOD
WEST WILDWOOD
WEYMOUTH
WILDWOOD CITY
WILDWOOD CITY
WILDWOOD CITY
WILDWOOD CREST
WILDWOOD CREST
WOODBINE
WOODBINE
Fund ID
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
DELET
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
ATL
Applicant
Connie L. DiCola
James A. Thatcher
James V. Craft
Dana Wineland
Maryann Coraluzzo
Cynthia LoGuidice
Bruce A. MacLeod
Neil Young
James Craft
Susan jackson
David Carrick
Leslie A. Kraus
Lorraine Boyer
Maria Schiano Branson
Michele Thomas Heim
Glenn Clarke
Jennafer Hernandez
Sharon D. Riley
Jennifer Lynn McIver
Terrence Graff
Judson Moore
Bertha Cappuccio
Christian Johansen
Marilyn Dolcy
Renee DeSalvo
Rosemarie F. Jacobs
Albert Stanley
Donna O'Brien
Lauren Read
Susan Jackson
Linda A. Morgan
Sandra Beasley
Sherri J. Ball
Bertha Cappuccio
Robert E. Scharle
Lawrence J. Nightlinger Jr.
Todd N. Burkey
Todd N. Burkey
Dawn Stollenwerk
Cindy A. Ruffo
Elaine Meglathery
Jon D. Batastini
Frank Donato III
Terence S Graff
Barry Ludy
Flor Roman
Paula G. Doll
William E. Swain
Lisa King
Deborah Candelore
James Craft
Barbara A. Spiegel
Rhonda L. Sharp
Andrea A. Penny
Amy L. Colaneri
Adetoro O. Aboderin
Julie Harron
Anita M. Wilson
Brian Pollock
David S. Carrick
Todd N. Burkey
Frank Donato III
Terence S Graff
Maureen Mitchell
Elaine Brunkel-Crowley
Debra A. D'Amore
Lori J. Rosensteel
Donna Dennis
Jeanette J Powers
Terence S Graff
Alicia Belansen
Lisa Garrison
John H. Miller
103
Position
Tax Collector
Library Treasurer
Treasurer (CFO-Crime)
Tax Collector
Tax Collector
Treasurer
Tax Collector
Treasurer
Treasurer
Tax Collector
Utilities Collector
Tax Collector
Treasurer / CFO Crime
Tax Collector
Tax Collector
Treasurer (CFO Crime)
Tax Collector
Tax Collector
Treasurer
Tax Collector
Treasurer
Tax Collector
Tax Collector
Treasurer
Tax Collector
Tax Collector / Treasurer
Tax Collector
Tax Collector
Treasurer (CFO Crime)
Tax Collector
Tax Collector
Tax Collector
Tax Collector / Utility Collector
Tax Collector
Treasurer ( CFO crime)
Tax Collector
Treasurer CFO / CRIME
Tax Collector
Tax Collector
Library Treasurer
Library Treasurer
Treasurer
Tax Collector
Treasurer
Tax Collector
Tax Collector / Treasurer (CFO-CRIME)
Treasurer( CFO-crime)
Tax Collector / Utility Collector
Tax Collector
Treasurer
Treasurer
Tax Collector
Tax Collector
Treasurer
Treasurer
Tax Collector
Tax Collector
Library Treasurer
water/sewer collector
Tax Collector
Treasurer (CFO-crime)
Tax Collector
Tax Collector / Utilities Collector
Tax Collector
Tax Collector
Utilities Collector
Tax Collector / Utilities Collector
Tax Collector
Eff Date
01/01/07
11/14/07
12/06/07
01/13/07
01/01/07
10/01/13
08/20/07
09/30/13
01/01/13
12/31/07
02/25/14
09/01/10
02/19/14
06/01/09
04/01/07
01/01/07
01/01/09
01/01/07
01/01/10
04/04/12
01/01/08
01/01/07
07/01/14
10/31/11
01/01/07
01/01/07
06/02/14
02/02/15
11/01/07
11/01/07
01/01/15
06/30/07
07/01/10
01/01/07
01/01/07
01/01/08
01/01/13
08/16/07
02/15/12
05/10/07
11/08/07
01/14/13
01/01/10
02/23/15
03/04/13
01/01/07
01/01/07
03/22/14
01/01/15
04/01/11
05/05/14
06/23/08
07/01/09
01/01/07
07/01/09
01/01/09
04/01/08
01/01/09
06/24/09
01/01/07
01/01/09
06/01/09
07/01/12
03/04/11
03/04/11
01/01/07
09/01/12
06/28/11
01/27/07
03/29/10
10/07/13
07/01/07
01/01/14
2015 Combined Member Attendance
Jun-15
Jul-15
Absecon City
Municipality
Jan-15
-
Feb-15
-
Mar-15
1
Apr-15
-
May-15
-
-
-
Aug-15
-
Sep-15
-
Oct-15
-
Nov-15
-
Dec-15
-
# Attended
1
# Meetings
3
% Attended
33%
Avalon Borough
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Brigantine City
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
Buena Borough
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Cape May City
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Cape May Point
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
Commercial Township
-
1
1
-
-
-
-
-
-
-
-
-
2
3
67%
Corbin City
-
1
1
-
-
-
-
-
-
-
-
-
2
3
67%
Deerfield Township
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
Dennis Township
-
-
-
-
-
-
-
-
-
-
-
-
-
3
0%
Downe Township
-
-
-
-
-
-
-
-
-
-
-
-
-
3
0%
Egg Harbor Township
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Estell Manor City
1
-
-
-
-
-
-
-
-
-
-
-
1
3
33%
Folsom Borough
-
1
1
-
-
-
-
-
-
-
-
-
2
3
67%
Galloway Township
-
-
-
-
-
-
-
-
-
-
-
-
-
3
0%
Hamilton Township
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Linwood
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Longport Borough
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Lower Township
-
-
1
-
-
-
-
-
-
-
-
-
1
3
33%
Margate City
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
Middle Township
-
1
1
-
-
-
-
-
-
-
-
-
2
3
67%
Millville City
1
1
-
-
-
-
-
-
-
-
-
-
2
3
67%
Mullica Township
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Newfield Borough
1
1
-
-
-
-
-
-
-
-
-
-
2
3
67%
North Wildwood City
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Northfield City
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
Ocean City
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Pleasantville City
Sea Isle City
1
1
1
1
-
-
-
-
-
-
-
-
-
-
2
2
3
3
67%
67%
Somers Point City
-
1
1
-
-
-
-
-
-
-
-
-
2
3
67%
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Upper Township
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Ventnor City
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Waterford Township
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
West Cape May
-
1
1
-
-
-
-
-
-
-
-
-
2
3
67%
West Wildwood
-
1
-
-
-
-
-
-
-
-
-
-
1
3
33%
Weymouth Township
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Wildwood City
1
1
1
-
-
-
-
-
-
-
-
-
3
3
100%
Wildwood Crest
1
-
1
-
-
-
-
-
-
-
-
-
2
3
67%
28
68%
27
66%
31
76%
-
-
-
-
-
-
-
-
-
86
3
123
0%
70%
Woodbine Borough
41
Total # Municipalities
0%
0%
0%
0%
0%
104
0%
0%
0%
0%
.
Last Update 4/8/2015
2015 ACM Fund Commissioner Attendance
Municipality
FC Last Name
FC First Name
Jan-15
Feb-15
Absecon
Armstrong
John
Avalon
Wahl
Scott
Brigantine
Blowers
Karen
P
Buena Boro
Santagata
Joseph
P
P
P
P
Cape May
Smith
Robert
P
Cape May Point
Hodsdon
Kim
P
P
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
# Attended
# Meetings
0
3
% Attended
0%
P
3
3
100%
P
2
3
67%
P
3
3
100%
P
3
3
100%
P
2
3
67%
Commercial Township Sparks
Heather
P
P
2
3
67%
Corbin City
Turner
Rose
P
P
2
3
67%
Deerfield
Seifrit
Karen
P
2
3
67%
Dennis
Clarke
Glenn
0
3
0%
Downe
Campbell
Robert
0
3
0%
Egg Harbor Twp.
Miller
Peter
P
3
3
100%
Estell Manor
Kent
Linda
P
1
3
33%
Folsom
Gummoe
Bryon
2
3
67%
Galloway
Jacobucci
Susan
0
3
0%
Hamilton
Perez
Ingrid
3
3
100%
Linwood
Beck
Longport
Hirsch
Lower
Picard
Julie
Margate
McLaughlin
Lisa
Middle
Mahon
Constance
Millville
Robostello
Susan
P
P
Mullica
Stollenwerk
Dawn
P
P
Newfield
Barbagli
Sam
P
P
North Wildwood
Jett
William Scott
P
P
P
P
P
P
P
P
P
P
Edward
P
P
P
3
3
100%
Richard
P
P
P
3
3
100%
P
1
3
33%
P
2
3
67%
P
2
3
67%
2
3
67%
3
3
100%
2
3
67%
3
3
100%
P
2
3
67%
P
3
3
100%
P
P
P
P
Northfield
Dickinson
James
P
Ocean City
Woods
Elizabeth
P
P
Pleasantville
Wilkins
Steve
P
P
2
3
67%
Sea Isle
Savastano
George
P
P
2
3
67%
Somers Point
Samuelson
Lucy
Stone Harbor
Craft
Jim
P
P
2
3
67%
P
P
P
3
3
100%
Upper Deerfield
Spoltore
Roy
P
P
P
3
3
100%
Upper Township
Smuz
Teri
P
P
P
3
3
100%
Ventnor
Goos
James
P
P
P
3
3
100%
Waterford
Richardson
Mayor Bill
P
1
3
33%
West Cape May
Vitelli
Lauren
P
P
2
3
67%
West Wildwood
Ridings
Christopher
P
1
3
33%
Weymouth
Yearsley
Bonnie
3
3
100%
P
P
P
Wildwood City
Wood
Chris
P
Wildwood Crest
Holzmer
Janelle
P
Woodbine
Garrison
Lisa
P
P
3
3
100%
P
2
3
67%
0
3
0%
84
123
68%
41
0
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
No representation for this municipality
Alt. Fund Commissioner in attendance
Denotes attendance of a representative, not "officially" a Fund Commissioner at the time.
105
Last Update 4/8/2015
2015 Alternate Fund Commissioner Attendance
Municipality
Alt. Last Name
Alt. First Name
# Attended
# Meetings
% Attended
1
3
33%
James
0
3
0%
Derrickson
Ellie
0
3
0%
Buena Borough
Santagata
Valerie
0
3
0%
Cape May
Cummiskey
Louise
0
3
0%
Cape May Point
vanHeeswyk
Anita
0
3
0%
Commercial Township
Humphries
Pam
0
3
0%
Corbin City
Camp
Kelly
0
3
0%
Deerfield
Closser
Brenda
0
3
0%
Dennis
Justice
Jacqueline
0
3
0%
Downe Township
Bart
Edward
0
3
0%
Egg Harbor Twp.
Burger
Donna
0
3
0%
Estell Manor
Seelman
Teresa
0
3
0%
Folsom
Jantz
Kenneth
0
3
0%
Galloway
Krause
Dennis
0
3
0%
Hamilton
Jacobs
Michael
0
3
0%
Linwood
Napoli
LeighAnn
0
3
0%
Longport
Clayton
Levon
0
3
0%
Lower
Ridgway
James
0
3
0%
Margate
Adams
Daniel
0
3
0%
Middle
Taverner
Tracey
0
3
0%
Millville
Campisi
Frank
0
3
0%
Mullica
none
Newfield
Sullivan
Donald
0
3
0%
North Wildwood
Burkey
Todd
0
3
0%
Northfield
Canesi
Mary
0
3
0%
Ocean City
Cioeta
Joanne
0
3
0%
Pleasantville
Ludy
Barry
0
3
0%
Sea Isle
Seib
Kellie
0
3
0%
Somers Point
Dill
Howard
0
3
0%
Stone Harbor
Bosacco
Carrie
0
3
0%
Upper Deerfield
Vagnareli
Vicki
0
3
0%
Upper Township
Young
Barbara
0
3
0%
Waterford
Danson
Susan
1
3
33%
West Cape May
Kaithern
Pamela
0
3
0%
West Wildwood
Brunkel-Crowley Elaine
0
3
0%
Weymouth
Carroll
Ronald C.
0
3
0%
0%
Absecon
Thompson
Jessica
Avalon
Waldron
Brigantine
Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15 Jul-15 Aug-15 Sep-15 Oct-15
Nov-15
Dec-15
P
Ventnor
P
Wildwood City
Wildwood Crest
Graff
Terence
0
3
Woodbine
Gurdgiel
James
0
3
0%
2
114
2%
41
1
0
1
0
0
0
0
0
0
0
0
0
3%
0%
3%
0%
0%
0%
0%
0%
0%
0%
0%
0%
No representation for this municipality
F:\DATA\Risk\EXCEL\ACMJIF\2015\[ATTEND ACM15.xls]Alternates
Last Update on 4/8/2015 at 3:47 PM
Fund Commissioner in attendance
Denotes attendance of a representative, not "officially" a Fund Commissioner at the time.
106
Alternates
Municipal Excess Liability Joint Insurance Fund
Office of the Fund Attorney
714 Main Street
P.O. Box 228
Boonton, New Jersey 07005
Tel (973) 334-1900
[email protected]
MEMORANDUM
TO:
Member Municipalities and Housing Authorities
DATED:
March 17, 2015
FROM:
Fred Semrau, Esq., General Counsel
RE:
Super Storm Sandy - Flood Claims
Dear Member:
As you know, we continue to pursue progress and move to the final phase of the Super
Storm Sandy Flood Claim process. As you may recall, the MEL and Zurich Insurance have
appointed Alexander H. Carver, III, J.S.C. (Retired) as the Special Mediation Master for
outstanding property damage flood claims relating to this event.
This a reminder that all demands for Arbitration of unresolved claims shall be submitted
to the Special Mediation Master with notice to the NJ Municipal Excess Liability Fund on or
before April 20, 2015. Thereafter, the Special Mediation Master will bring all claims for a
resolve determination no later than July 31, 2015.
All demands for Arbitration shall be submitted to the Special Mediation Master with a
copy of such request to the MEL. Judge Carver’s information is as follows:
Alexander H. Carver, III, Esq.
Harwood Lloyd
130 Main Street
P.O. Box 1788
Hackensack, NJ 07601
With copies to:
David Grubb, Executive Director
PERMA
9 Campus Drive
Parsippany, NJ 07054
If you have any questions, please do not hesitate to contact me.
FCS:sdj
Cc:
David Grubb, Executive Director
Super Storm Sandy Sub-Committee
107
SAFETY DIRECTOR’S REPORT
TO:
Municipal Fund Commissioners, Safety Coordinators, Risk Managers
FROM:
Timothy Sheehan, Associate Public Sector Director
DATE:
March 30, 2015 ______________________________________________________________________________
Service Team:
Timothy Sheehan,
Associate Public Sector Director
[email protected]
Office: 856-552-6862
Cell: 609-352-6378
Paul Shatkyvich
[email protected]
Office: 732-660-5037
Cell: 203-859-4073
Don Ruprecht, Consultant
[email protected]
Office: 732-660-5051
Louis Carey, Consultant
[email protected]
Office: 732-736-5224
Cell: 856-905-2950
Karen La Sala
Executive Assistant
[email protected]
Office: 732-660-5006
Fax: 856-830-1496
Mailing Address: 231 Main Street,
P. O. Box 2017, Toms River
New Jersey 08754
Toll Free: 877-398-3046
MARCH ACTIVITIES
LOSS CONTROL SERVICES
















Borough of Avalon – Conducted a Boardwalk Survey on March 26
City of Brigantine – Conducted a Renewal Survey on March 10
Township of Commercial/Township of Downe – Attended joint Safety Committee meeting on March
11
City of Corbin – Conducted a Loss Control Survey on March 12
City of Corbin, Borough of Folsom, City of Estell Manor and Township of Weymouth – Attended
joint Safety Committee meeting on March 13
Township of Dennis – Attended a Safety Committee meeting on March 27
Township of Deerfield – Conducted a Loss Control Survey on March 20
Township of Downe – Conducted a Loss Control Survey on March 11
Township of Egg Harbor – Conducted a Loss Control Survey on March 13
City of Linwood – Attended Safety Committee meeting and conducted Accident Review on March 18
Township of Lower – Introductory meeting by new consultant, Paul Shatkyvich, on March 10
City of Margate – Conducted a Loss Control Survey on March 10
City of Northfield – Conducted a Loss Control Survey on March 12
City of Ocean City – Conducted two Loss Control Surveys on March 4
City of Somers Point – Attended a Safety Committee meeting on March 13
Township of Upper – Conducted a Loss Control Survey on March 25
108




Borough of West Cape May – Attended Safety Committee meeting and conducted a Renewal
Survey on March 26
City of Wildwood – Conducted a Loss Control Survey on March 23
Borough of Wildwood Crest – Conducted a Renewal Survey on March 10
Supervisor Incident Reports Received – 25
JIF MEETINGS ATTENDED



Claims Review – March 12
Executive Committee – March 18
Executive Safety Committee – March 25
MEL VIDEO LIBRARY
The following members used the MEL Video Library during March. Please note the new e-mail address:
[email protected] and telephone number: 856-552-4900.
To either view the full video catalog or rent videos, use the above website or NJMEL.org.
Municipality
# of Videos
Borough of Buena
City of Margate
Township of Commercial
Township of Egg Harbor
Borough of Stone Harbor
Township of Upper
Borough of West Cape May
Borough of Wildwood Crest
4
5
2
1
2
2
1
1
MEL MEDIA CATALOG 2015
We are excited to announce an updated MEL Media Catalog with 100 new DVD titles! Attached is a list
of the new additions. To view the entire updated catalog go to NJMEL.org, click on the Video button at
the top of the page, then choose ‘Order Conventional Videos’.
NEW SAFETY DIRECTOR’S BULLETINS AND NOTICES
Regional training announcements and Bulletins are distributed by e-mail to Fund Commissioners, Safety
Coordinators and Risk Consultants. Please access the Atlantic JIF (http://www.acmjif.org) to verify Fund
Commissioners, Safety Coordinators and Risk Managers contact information is correct. If you find a
discrepancy, please let us know.
The following Safety Director Bulletins and alerts were distributed by e-mail during March. If you are not
receiving updates or would like to add other names to the distribution list, please let us know. A copy of the
Safety Director’s Bulletin is attached.






Atlantic JIF - Atlantic JIF Fast Track Announcement – Revised
Atlantic JIF - Safety Director's Message - Police Safety In and Around Your Patrol Vehicle
Atlantic JIF MSI Class Notices
Atlantic JIF - MEL Media Library Updated for 2015!
Atlantic JIF - Safety Director's Bulletin - Brush Collection
Atlantic JIF - New Online Camp Counselor Training Programs - Available April 1st
109
UPCOMING EVENTS


Executive Committee – April 15
Rutgers University Crossing Guard Training and Resources Train-the-Trainer – Notices included
MSI TRAINING PROGRAMS
A Summer Camp announcement is attached which outlines online courses to aid in counselor training.
Please note the start date of April 1st.
Listed below are upcoming MSI training programs scheduled for April, May and June. Enrollment is
required for all MSI classes. MSI classes are subject to cancellation or rescheduling at any time.
Members are reminded to log on to the www.njmel.org website, then click on the MSI logo to access
the Learning Management System where you can enroll your employees and verify classes.
Enrolling your staff ensures you will be notified of any schedule changes.
If you need assistance using the MSI Learning Management System, please call the MSI helpline at 866661-5120.
Date
4/1/15
4/8/15
4/9/15
4/9/15
4/13/15
Territory
6
6
6
6
6
Location
City of Margate #2
City of Pleasantville #1
City of Wildwood #3
City of North Wildwood
Township of Egg Harbor #5
Topic
Heavy Equipment Safety
Playground Safety Inspections
Playground Safety Inspections
BBP
Office Safety
Time
8:30 - 11:30 am
8:30 - 10:30 am
8:30 - 10:30 am
11:30 - 12:30 pm
9:00 - 11:00 am
4/13/15
4/15/15
4/16/15
4/16/15
4/17/15
4/17/15
6
6
6
6
6
6
Township of Upper
Township of Galloway
City of Brigantine #3
City of Vineland #1
City of Northfield #1
City of Ocean City #1
1:00 - 3:00 pm
8:00 - 12:00 pm
8:00 - 2:00 pm w/lunch brk
8:30 - 12:30 pm
8:30 - 11:30 am
1:00 - 2:30 pm
4/20/15
4/21/15
4/21/15
4/22/15
4/23/15
4/24/15
4/24/15
4/24/15
4/27/15
4/27/15
4/27/15
4/29/15
4/29/15
5/4/15
6
6
6
6
6
6
6
6
6
6
6
6
6
6
Borough of Longport #1
Township of Hamilton #2
City of Sea Isle City #2
Township of Carneys Point #2
Borough of Woodstown #1
Borough of Woodstown #1
Township of Middle #3
5/4/15
5/7/15
5/8/15
5/8/15
5/14/15
5/14/15
5/15/15
5/15/15
6
6
6
6
6
6
6
6
Township of Upper Deerfield
Hazard ID: Making Your Observation Count
CMVO
Fast Track to Safety
Flagger / Work Zone Safety
Landscape Safety
Employee Conduct & Violence Prevention
Traffic Control for Emergency RespondersEvening
Jetter / Vacuum Safety
PPE
CSE-Permit Required w/Classroom Demo
HazMat Awareness w/HazCom GHS
Forklift Operator Evaluation Train-the-Trainer
Confined Space Awareness
Safety Coordinator Skills Training
Fire Extinguisher
Accident Investigation
Safety Committee Best Practices
Traffic Control for Emergency RespondersEvening
CSE-Permit Required w/Classroom Demo
HazMat Awareness w/HazCom GHS
Hearing Conservation
Special Events Management
Fire Extinguisher
Landscape Safety
Excavation/Trenching/Shoring
110
7:00 - 9:00 pm
8:00 - 10:00 am
10:15 - 12:15 pm
8:30 - 12:30 pm
8:30 - 11:30 am
10:00 - 1:00 pm
8:30 - 10:00 am
10:15 - 11:15 am
8:00 - 11:00 am
11:15 - 12:15 pm
8:00 - 9:00 am
9:15 - 11:15 am
8:30 - 10:30 am
7:00 - 9:00 pm
8:30 - 12:30 pm
8:00 - 11:00 am
11:15 - 12:15 pm
8:30 - 10:30 am
10:45 - 11:45 am
8:30 - 11:30 am
8:00 - 12:00 pm
Date
5/18/15
5/20/15
5/20/15
5/21/15
6/8/15
6/8/15
6/10/15
6/10/15
6/11/15
6/16/15
6/16/15
6/23/15
6/23/15
6/26/15
6/26/15
Territory
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
Location
Borough of Stone Harbor #1
Topic
Flagger / Work Zone Safety
Fall Protection Awareness
Back Safety / Material Handling
Excavation/Trenching/Shoring
PPE
Jetter / Vacuum Safety
Shop & Tool Safety
BBP
CDL-Drivers Safety Regulations
CDL-Supervisors Reasonable Suspicion
Seasonal (Summer) Employee Orientation
BBP
MSI Administrators are listed below.
MSI ADMINISTRATORS AS OF MARCH 31, 2015
MUNICIPALITY
LAST NAME
FIRST NAME
ABSECON
JONES
LLOYD
AVALON
DEAN
EDWARD, R.
AVALON
JUZAITIS
BRIAN
AVALON
MACOMBER
WILLIAM
AVALON
MCCLINTOCK
ELISABETH
AVALON
PATRO
ROBERT
AVALON
SCARPA
KEVIN
AVALON
WHILDIN JR
WAYNE
BRIGANTINE
DORING
JOHN
BRIGANTINE
MUSUMECI
LISA
BUENA
DAN
CAREGNATO
CAPE MAY
SMITH
ROBERT
CAPE MAY POINT
HODSDON
KIMBERLEY
COMMERCIAL
SPARKS
HEATHER
CORBIN CITY
SIEDLECKI
JOANNE
DEERFIELD
SEIFRIT
KAREN
DENNIS
CHAMPION
VERNON
DOWNE TOWNSHIP
LOCKLEY
NADINE
BURGER
DONNA
LINCOLN
ROBERT
SLUSARSKI
STEPHEN
ESTELL MANOR
HENRY
JOE
ESTELL MANOR
KENT
LINDA
FOLSOM
GATTO
PATRICIA
FOLSOM
LAPOLLO
JOHN
GALLOWAY
AYERS
MATT
EGG HARBOR
TOWNSHIP
EGG HARBOR
TOWNSHIP
EGG HARBOR
TOWNSHIP
111
Time
8:30 - 12:30 pm
9:00 - 11:00 am
11:15 - 12:15 pm
8:30 - 12:30 pm
8:30 - 10:30 am
10:45 - 12:15 pm
8:00 - 10:00 am
10:15 - 11:15 am
8:30 - 10:30 am
10:45 - 11:45 am
8:00 - 10:00 am
10:00 - 12:00 pm
8:30 - 12:30 pm
1:00 - 2:00 pm
GALLOWAY
FARRELL
RAYMOND
GALLOWAY
GUERRA
RAY
GALLOWAY
MCDOWELL
KEVIN
HAMILTON
MARCOLONGO
LISA
LINWOOD
BECK
EDWARD
LINWOOD
KOLAKOWSKI
HENRY
LONGPORT
HIRSCH
RICHARD
LONGPORT
SIMMONS
JUERGEN
LOWER
BEEBY
THOMAS
LOWER
BIERSBACH
MARTIN
LOWER
CRIPPEN
COLLEEN
LOWER
DILWORTH
JASON
LOWER
GALESTOK
WILLIAM
LOWER
LEPOR
DAVE
LOWER
PLENN
MITCHELL
MARGATE
ADAMS
DANIEL
MIDDLE
KALISH
VERA
MIDDLE
KEATING
KAYTIE
MIDDLE
KRAUSS
KIMBERLY
MILLVILLE
HESS
KURT
MILLVILLE
KILEY
TONYA
MILLVILLE
LIPPINCOTT
MICHAEL
MILLVILLE
ROBOSTELLO
SUSAN
MILLVILLE
TONETTA
CHRISTINE
MILLVILLE
WILSON
DOUGLAS
MULLICA
CRITELLI
JERRY
MULLICA
STOLLENWERK
DAWN M.
MULLICA
THOMPSON
JOHN
MULLICA
SPERLAK
STEPHEN
NEWFIELD
NONE
NONE
NORTH WILDWOOD
FORD
DOUGLAS
NORTH WILDWOOD
OSTRANDER
LEWIS
NORTH WILDWOOD
VANSANT
JENNIFER
NORTH WILDWOOD
GALLAGHER
MATTHEW
NORTH WILDWOOD
MCGRAW
ADAM
NORTH WILDWOOD
OKANE
BONNIE
NORTHFIELD
RUFFO
CINDY
OCEAN CITY
BIRCH
DIANE
OCEAN CITY
CIOETA
JOANN
OCEAN CITY
MOYER
CHARLOTTE
PLEASANTVILLE
PAGE-SCOTT
DENISE
SEA ISLE CITY
GLYNN
PAUL
SEA ISLE CITY
SEIB
KELLIE
112
SOMERS POINT
MOLLENKOPF
SHELBY
SOMERS POINT
VENAFRO
TOM
STONE HARBOR
RUSS
GRANT
UPPER
SMUZ
TERI
UPPER
POTTER
JAY
UPPER
MORGAN
SCOTT
UPPER
SHARP
RHONDA
UPPER
SPIEGEL
BARBARA
UPPER DEERFIELD
VAGNARELLI
VICKI
VENTNOR
GOOS
JAMES
WATERFORD
MICKLASAVAGE
MICHAEL
WATERFORD
GARDNER
BETTY ANNE
WATERFORD
CHIUMENTO
DANIEL
WATERFORD
CORMANEY
DANIEL
WATERFORD
LAURSEN
ILENE
WEST CAPE MAY
BASILE
GREGORY
WEST CAPE MAY
RUTHERFORD
DIANNE
WEST CAPE MAY
WALLACE
ELAINE
WEST WILDWOOD
SWEENEY
RUTH
WEYMOUTH
CARROLL
RONALD
WILDWOOD CITY
DUNN
DAN
WILDWOOD CITY
SPEIGEL
DANIEL
WILDWOOD CITY
PINTO
HOPE
WILDWOOD CITY
HODSON
KIM
WILDWOOD CITY
WARD
SENA
WILDWOOD CREST
SHEARER
STEVEN
WILDWOOD CREST
FEKETICS
PATRICIA
WILDWOOD CREST
GRASSI
RALPH
WILDWOOD CREST
HOLZMER
JANELLE
WOODBINE
GURDGIEL
JAMES
113
2015 “Fast Track to Safety” Training Scheduled Dates & Open Enrollment Available On‐Line Registration is now available to all individuals who would like to attend one of the scheduled 2015 “Fast Track to Safety” venues listed below. The MEL Safety Institute encourages you taking advantage of one of these full days of regulatory training. To attend one of the scheduled dates, log onto NJMEL.org and access the Learning Management System by clicking on the MSI Logo followed by MSI Login to enroll your employees. If assistance is needed, contact the MSI Help Line at 866‐661‐5120. Full Day Sessions Includes:  Hazard Communication w/GHS  Bloodborne Pathogens  Fire Safety  Personal Protective Equipment  Driving Safety Awareness Venues & Dates Fast Track run time is 5 hours plus a 1 hour lunch break Check website for times & locations June  Deal (Monmouth) – 1/16/15  Upper Deerfield (Atlantic) – 1/23/15 



February  Mahwah (Bergen) – 2/13/15  Pemberton BOE (SAIF) – 2/25/15 March  Barnegat (Ocean) – 3/10/15  Lower Township (Atlantic) – 3/13/15  Wharton (Morris) – 3/19/14  Collingswood (Camden) – 3/20/15  Bergenfield (Bergen) – 3/25/15 April  Union Beach (Monmouth) – 4/9/15  Brigantine (Atlantic) – 4/16/15  Clementon (Camden) – 4/17/15  Pitman (TRICO) – 4/22/15 May  Elmwood Park (S. Bergen) – 5/8/15  Westampton (BURLCO) – 5/12/15  Jackson (Ocean) – 5/22/15 Robbinsville (Mid‐Jersey) – 6/10/15 Stone Harbor (Atlantic) – 6/11/15 Lincoln Park (Morris) – 6/12/15 Manalapan (Monmouth) – 6/26/15 August  Hanover (Morris) – 8/28/15 September  Ocean City (Atlantic) – 9/11/15  Ridgefield (PAIC) – 9/18/15  Perth Amboy H.A. (NJPHA) – 9/22/15  Washington Twp. (TRICO) – 9/24/15 October  Sparta (Morris) – 10/2/15  Hillsborough (Central) – 10/15/15  Middletown (Monmouth) – 10/28/15 November  Beach Haven (Ocean) – 11/4/15 114
CEU's for Certified Publics Works Managers
MSI Course
Advanced Safety Leadership
Asbestos, Lead & Silica Industrial Health Overview
Bloodborne Pathogens Training
Bloodborne Pathogens Train- the- Trainer
BOE Safety Awareness
CDL – Supervisors Reasonable Suspicion
CDL - Drivers' Safety Regulations
Coaching the Maintenance Vehicle Operator
Confined Space Entry – Permit Required
Driving Safety Awareness
Employee Conduct and Violence in the Work Place
Excavation Trenching & Shoring
Flagger / Workzone Safety
HazCom with Globally Harmonized System
CEU's/Cat.
2/M
10 / M
1 /T,G
1/T
1/G
1/T
3/T
2/M
2/G
2 /T,M
3.5 / T
1 /T,G
1.5 / T
1.5 / E
2 /T,M
4/T
2 /T,M
1 /T,G
MSI Course
Hazardous Materials Awareness w/ HazCom & GHS
Hazard Identification - Making Your Observations Count
Housing Authority Safety Awareness
Jetter Safety
Landscape Safety
Leaf Vac Safety Awareness
Lockout Tagout
Personal Protective Equipment (PPE)
Playground Safety
Sanitation and Recycling Safety
Safety Coordinator's Skills Training
Shop and Tool Safety
Seasonal Public Works Operations
Special Events Management
Toolbox Talk Essentials
CEU's/Cat.
3/T
1 /T,M
1 /T,G
1 / G- 2 / T
3/T
2/T
2/T
2/T
2/T
2/T
2/T
2/T
1.5 / M
3 / M,G
1/T
3/T
2/M
1/M
CEU's/Cat.
1/P
1/P
1.5 / E
MSI Course
Hazard Identification - Making your Observations Count
Safety Coordinator's Skills Training
Special Event Management
CEU's/Cat.
2/P
1.5/ P
6/P
2/P
TCH's/Cat.
1.5 / S
10 / S
1/S
1/S
1/S
2.5 / S
3/S
1.5 / S
2/S
1 /S
3.5 / S
5.5 / S
4/S
2/S
5/S
1/S
1/S
2/S
1.5/ S
MSI Course
Hazardous Materials Awareness w/ HazCom & GHS
Housing Authority Safety Awareness
Hazard Identification - Making your Observations Count
Jetter Safety
Ladder Safety/Walking Working Surfaces
Landscape Safety
Leaf Vac Safety
Lockout Tagout
Shop and Tool Safety
Office Safety
Personal Protective Equipment (PPE)
Seasonal Public Works Operations
Snow Plow Safety
Special Event Management
Toolbox Talk Essentials
TCH's/Cat.
3/S
3/S
3/S
1.5 / S
1/S
2/S
2/S
2/S
2/S
2/S
1/S
2/S
2/S
1.5 / S
3/S
2/S
2/S
1/S
CEU's/Cat.
1.5 / E
MSI Course
CEU's for Registered Municipal Clerks
MSI Course
TCH's For Water/ Wastewater
MSI Course
Advanced Safety Leadership
Bloodborne Pathogens Train- the- Trainer
BOE Safety Awareness
CDL – Supervisors Reasonable Suspicion
CDL - Drivers' Safety Regulations
Confined Space Entry - Permit Required
Defensive Driving-6-Hour
Excavation Trenching & Shoring
Fall Protection Awareness
Fire Extinguisher
Fire Safety
Flagger / Workzone Safety
HazCom with Globally Harmonized System
CEU's for Tax Collectors
MSI Course
CEU's for County/Municipal Finance Officers
CEU's for Qualified Purchasing Agents
1.5 / E
***Category
E- Ethics
T- Technical
G- Governmental
S- Safety
P- Professional Development
M- Management
115
CEU's/Cat.
1.5 / E
MEL Media Library
New DVD Additions for 2015
See Catalog For Descriptions
Category
Accident Awareness
Accident Awareness
Back Safety / Lifting
Back Safety / Lifting
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Driving Safety
Electrical / LOTO / Arc-Flash
Electrical / LOTO / Arc-Flash
Emergency Preparedness
Employee Conduct / Harassment &
Violence
Violence in the Workplace
Fall Protection
Fall Protection
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Department
Fire Extinguisher / Fire Safety
Fire Extinguisher / Fire Safety
Forklift (PIT) / Cranes / Aerial
General Job Safety
Hand Safety
Hazard Communications (RTK)
Number
107
108
504
505
1009
1010
1111
1112
1113
1114
1115
1116
1117
1118
1208
1209
1409
1410
1411
1509
Title
Close Calls, Near Misses
Making Safety Work: An Overview of Workplace Safety
Back Injury Prevention
Preventing & Managing Back Pain
Texting & Driving
Five Minute Fundamentals
Driving Safety
Safety Shorts (3 programs)
Winter Driving; When the Rules Change
Safety Winter Driving Considerations
Winter Driving Fundamentals...Including Skid Recovery
Low Visibility Driving
Road Rage: How to Protect Yourself
School Bus Safety
Safe Electrical Work Practices NFPA 70E 2015
Lock Out/Tag Out: When Everyone Knows
First Aid
First Aid: Until Help Arrives
CPE/AED Awareness Training
Preventing Harassment: Creating a Positive Office
1510
Bullying and Respect in the Workplace
1511
1512
Active Shooter Awareness for Business: Helping Prevent
Tragedy
Active Shooter & Workplace Violence
1805
1806
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
2004
2005
2309
2404
2504
2608
Fall Protection (Aurora)
ABC’s of Your Personal Fall Arrest System
Tactical Perspectives – Command
Tactical Perspectives – Fire Attack
Tactical Perspectives – Ventilation
Tactical Perspectives – Search
Tactical Perspectives – Mayday
Tactical Perspectives – Dispatch
Bread & Butter Operations: Car Fires
Bread & Butter Operations: Fire Streams
Bread & Butter Operations: Ground Ladders
Bread & Butter Operations: Initial Attach Lines
Bread & Butter Operations: SCBA
Bread & Butter Operations: Search & Rescue
Bread & Butter Operations: Ventilation
Pride & Ownership: A Firefighter’s Love of the Job
Using Fire Extinguishers
Fire Extinguisher Basic Training
Scissor Lift
Back to Work, Back to Safety
Hand, Wrist & Finger Safety
How to Comply with the New GHS
116
Hazard Communications (RTK)
2609
Hazard Materials & Chemicals
Heavy Equipment / Snow Plow
Heavy Equipment / Snow Plow
Landscape Safety
Landscape Safety
Lifeguard Operations
Office & Ergonomics Safety
Outdoor Exposure
Outdoor Exposure
Outdoor Exposure
Playground Safety / Field Maint.
Playground Safety / Field Maint.
Respiratory Protection
Sanitation Safety
Shop & Tool Safety
Shop & Tool Safety
Slips, Trips, Falls
Supervisors / Management
Supervisors / Management
Task Specific
Water / Waste Water
Wellness
Wellness
Wellness
Wellness
Wellness
Wellness
Wellness
Wellness
Wellness
Wellness
Wellness
2710
2915
2916
3009
3010
3106
3107
3108
3109
3110
3111
3205
3308
3309
3310
3506
3507
3701
3911
4111
4112
4206
4308
4309
4402
4504
4721
4722
4723
4724
4725
4726
4727
4728
4729
4730
4731
HazCom & The Global Harmonizing System Employee Training
(Refresher)
Flammable Liquid Safety
Basic Snowplowing Techniques
Skid Steer Loaders in the Snow & Ice Industry
Pesticides Training for Handlers
Pesticide Safety: Worker Protection
Beach Safety Basics (2 programs)
Beach Vehicle Operations
Code X (Search & Recovery)
Components of a Rescue
Water Observation
Safety Chemical Handling for Lifeguards & Pool Operators
Office Safety (Marcom)
The Mosquito - What You Need to Know
Hidden in the Leaves
Summer Sports & Recreation Safety (Off-Job Safety)
Safety Active Play: A Guide to Avoiding Play Area Hazards
Playground Safety Supervision
Respirator Selection And Use
5 Keys to Safety Driving: Sanitation Truck
Machine Guard Safety
Table Saw Safety And Use
Winter Walking: Staying On Your Feet
Responsibilities Of A Supervisor
Safety And The Supervisor
Basic Sidewalk Clearing With Snow Blowers
Motorola EME Awareness for Antenna Site Safety
Nutrition: Restaurants, Fast Foods & Parties
What Is Heart Failure?
Stroke: Reducing Your Risk
Pre-Diabetes: It’s Time To Make Changes
Snoring And Obstructive Sleep Apnea
Sensorineural Loss In Adults
Understanding And Managing Your Allergies
Preventing The Spread of Contagious Illness
Resisting The Flu: How To Minimize Your Risk
Go With Your Own Glow (Skin Cancer)
Workplace Stress
Police Department
In-The-Line-Of-Duty Series
Special Issue Series
Volume 14 – Program 1
Volume 15 - Program 1
Volume 15 - Program 5
5028
5029
5030
5031
6401
6402
6403
6404
6405
6503
6505
6506
Courtroom Testimony
Alabama Officer Stabbed to Death
Rapid Response: Saving Lives In The Golden Hour
Use of Force: The Death of Eric Garner
Violent Ground Fight Erupts: Are You Prepared – Part 1
Violent Ground Fight Erupts: Are You Prepared – Part 2
Terror in Tuscalossa: The Public Safety Response
Shootout in Conroe: What Would You Have Done?
El Segundo Movie Theater Gunfight
Cops and Black Eyes: Ethics Training
Murder Of An Arkansas Officer
What If: Scenarios That Can Save Cops Lives
117
Contacct Us: 866-661-5120
New Online Camp
C
Cou
unselor Trraining Prrograms **Available April 1st
They’
T
reRea
ady for
f Ca
amp! Are Y
You?
Starting April 1st, the
t
MEL Saffety Institute is pleased to
o provide a new suite off online trainiing
programs for camp counselors.

Ch
hild Sexual Abuse
A
Prevention at Cam
mp - This cou
urse will teacch counselorss how to identtify
red
d flags warnin
ng signs of ab
buse and metthods to prote
ect campers from peer-to--peer and adu
ultto--child sexual abuse.
a

Bu
ullying Preve
ention at Camp - This co
ourse will tea
ach counselorrs what bullyiing is, what tthe
consequences could
c
be, and
d how to identtify, stop and prevent bullyying.

Pla
ayground Sa
afety for Ca
amp Counse
elors - This course will tteach counse
elors how mo
ost
pla
ayground injuries happen and
a the strate
egies you can
n use to preve
ent them from
m occurring.

Triip and Transportation Safety
S
- This
s training willl help you pllan and prep
pare for off ssite
adventures to make
m
them me
emorable, saffe and fun.

Aq
quatic Safety
y for Couns
selors - This training will teach non-lifeguard cam
mp staff how to
pro
otect campers
s in the pool and
a natural bo
odies of wate
er.

Th
he Professio
onal Lifegua
ard – Pools - This trraining helpss guards un
nderstand th
heir
res
sponsibilities and the practtical applicatio
on of their skiills on the poo
ol deck.
Camp counselors can complete the
t courses in
ndividually orr as a group.
QUEST
TIONS? Con
ntact the MSI Help Line (8
866) 661-5120
0
118
Summer
Before you start
even one activity,
make the following
online courses part
of your counselor
training:
Camp
 Child Sexual Abuse Prevention at Camp
 Bullying Prevention at Camp
 Playground Safety for Camp Counselors
 Trip and Transportation Safety
 Aquatic Safety for Counselors
 The Professional Lifeguard – Pools
Visit The MEL Safety Institute.
Questions? Contact the MSI Help Line (866) 661-5120.
The MSI Safety Institute can be accessed anytime by
going to www.njmel.org. Look for our logo.
How to Access Online Training Courses:
1. Go to NJMEL.org and click on the MSI logo at the top of the page.
2. Click on "MSI Login"
3. If you have taken MSI classes in the past, enter your username and password.
If you do not know your username/password, check with your Training Administrator or call the MSI Helpline listed below. If you are new, click "I am a new user."
Complete the fields and you’ll receive a confirmation email with your username
and password.
4. Once logged in, click on "MSI On-Line Training Courses."
5. Choose the course you would like to complete
6. Click enroll
7. Choose "Click Here" to go to your authorized course list.
8. Click the program name to launch the course.
9. Click Start to begin.
10. Upon completion of the course and questions you will navigate to the "Student
Center" tab to print your Certificate of Completion. Learning Transcripts are
automatically updated in the MSI Learning Management System.
119
New Jersey
Safe Routes
to School
Resource Center
Crossing Guard
Program
Rutgers University
Crossing Guard Training and Resources
Train-the-Trainer Course
Are you currently working as a Police Traffic Safety Officer supervising
School Crossing Guards?
If YES, please join us for a crossing guard training program.
TRAIN-THE-TRAINER DETAILS
When: Wednesday, April 29, 2015
Time: 8:30 a.m.– 1:00 p.m.
Where: Ocean County Police Academy
659 Ocean Avenue
Lakewood NJ 08701
About the Training:
The training will include crossing guard positioning and procedures, state and
federal law and regulations, and hands-on practice to set up similar training for
crossing guards in your community. .
To attend or for more information, please contact Catherine Bull
at 848-932-2833; [email protected]
Registration is limited, deadline: Wednesday, April 15, 2015
for more information on Safe Routes to School visit saferoutesnj.org
This training is sponsored by NJ Department of Transportation and the
NJ Division of Highway Traffic Safety with funding from the Federal
Highway Administration, and by the New Jersey Excess Liability Joint
Insurance Fund.
120
Safety Director Bulletin
One in a series of safety bulletins from your Joint Insurance Fund
March 2015
Safety when Collecting Brush on Roadways
Spring time means spring cleaning and many agencies begin with branch and brush clean-up operations. Now
is a good time to review your policies and practices for collecting brush along public roads.
There are two common practices for collecting brush; chippers and front-end loaders with a claw attachment.
Each presents hazards, some common, such as working on streets that are open to traffic, and others specific to
the equipment being used.
Traffic Hazards
Collecting brush is considered a Mobile Work Zone. The minimum requirements are high intensity amber
warning lights that can be seen by vehicles approaching from either the front or rear of the crew, and workers
wearing ANSI Class 2 high-visibility outer wear. Be alert for obstructions to the amber lights being visible due
to raised beds, equipment, or damage. Also, due to the changing weather, retro-reflective outerwear can be a
challenge. The temperature change between mornings and afternoon can mean three levels of outwear during
the day. Make sure employees have, leave with, and use options that meet the MUTCD requirements.
New Jersey has the most congested roads in the nation. Look for opportunities to go above the minimum safety
requirements for crews on the street.
• If crews are collecting brush in a development with one or two entrances, consider placing warning
signs at the entrance(s).
• While most brush piles can safely be collected with the crew assigned, consider assigning a trailing
vehicle or flaggers for difficult locations.
• Schedule collections for areas around schools when school is in session and bus / pick-up / drop-off
traffic is minimal. Likewise, schedule collections along commuter routes after and before times of
heavy traffic.
New Jersey public agencies have experienced a significant number of fatalities / injuries and near misses when
a vehicle approaching from behind the crew have been distracted or blinded from the sun and ran into the rear
work vehicle. Workers must be aware that motorists are distracted, blinded, rushed or inexperienced and the
workers must watch their back and the backs of each other.
Do not forget the hazard of the work vehicles moving from stop to stop. Nationally, half of work zone fatalities
are from workers being struck by their own work vehicles. There is a simple rule to avoid these incidents:
Drivers must not move a vehicle unless every worker can be seen, either directly or in mirrors.
Ergonomic Hazards
Regardless of the method of collecting branches and brush, workers will need to handle the vegetation to some
extent. Whether with rakes or bending over to pick-up branches, workers will need to be reminded to protect
their backs, shoulders, and knees. Sprains and strains are the most common injury to employees.
• Evaluate rake handles. Are they the right length and diameter for workers? Are they in good condition?
• Observe workers as they rake, lift, and carry vegetation. Are they using the proper body mechanics?
Take pictures and discuss footing, erect body position when using a rake, locking the lower back in the
natural S-curve when lifting, and other concerns.
This bulletin is intended for general information purposes only. It should not be construed as legal advice or legal opinion
regarding any specific or factual situation. Always follow your organization’s policies and procedures as presented by your
manager or supervisor. For further information regarding this bulletin, contact your Safety Director at 877.398.3046.
© All rights reserved
121
Page 1
Chipper Safety
Review the additional safeguards with crews who will be using chippers:
•
Review the Owners’ Manual and the
safety warnings. Make sure a copy is
available for reference.
•
Review
the
pre-use
inspection
procedure. Best practice is to use a
form from the manufacturer. Take the
crew outside and go through the
inspection process with the chipper.
Explain the criteria for taking the unit
out-of-service for deficiencies.
•
Review the proper personal protective
equipment that is needed. This should
include hardhats, face / eye protection,
hearing protection, and foot protection.
Operational best practices include:
• Do not wear loose-fitting clothing or gloves
• Feed branches with the cut end first. Stand to the side and walk away when the branches catch
• Use a tool or other branches to feed small brush into the chipper – never your hands. Very small
branches and vegetation can be thrown directly onto the pile of chipped material.
• Follow guidelines for clearing jams. Be aware that knives can free spin for minutes after the machine is
turned off. Review Lock Out / Tag Out procedures for various maintenance operations.
Front-end Loader & Claw Safety
For crews using front-end loaders, review the following safeguards:
• There are two significant ‘Crush Zones’
for workers to be aware: 1) between the
truck / container and the loader, and 2)
under the raised claw. It is not enough
just for workers on foot to make eye
contact with the loader operator. There
must a means, such as hand signals, for
more definitive communication on the
intent of the worker and operator.
• The operation entails a lot of movement
within the work zone by the loader.
This places a great responsibility on the
operator to check behind, to the sides
and front of the loader before EVERY
move, checking for people and cars.
Dump-site Safety
Crews must unload the collected vegetation at the end of their assignment. Dump sites can be a dangerous
place. There are typically no designated traffic patterns, multiple vehicles at any one time, and workers on foot.
Discuss site safety, working around raised containers, and the requirement for high-visibility apparel.
© All rights reserved
122
Page 2
April 2, 2015
To the Members of the
Executive Board of the
Atlantic County Municipal
Joint Insurance Fund
I have enclosed for your review and, in some cases consideration, documents of
presentation relating to claims, transfers, and the financial condition of the Fund.
The statements included in this report are prepared on a “modified cash basis” and relate
to financial activity through the one month period ending March 31st, 2015, for Closed
Fund Years 1987 to 2010, and Fund Years 2011, 2012, 2013, 2014, and 2015. The
reports, where required, are presented in a manner prescribed or permitted by the
Department of Insurance and the Division of Local Government Services of the
Department of Community Affairs.
All statements contained in this report are subject to adjustment by annual audit.
A summary of the contents of these statements is presented below.
INVESTMENT INTEREST & INVESTMENTS:
Net interest received of $2,300.89 and a coupon payment of $46,875, accrued interest for
the reporting period totaled $18,104.17 and after including an unrealized net gain of
$17,820 in the asset portfolio, the yield is adjusted to a .95% for this period. The total
overview of the asset portfolio for the fund shows an overall unrealized gain of
$90,550.00 as it relates to current market value vs. the amount we have invested.
Our asset portfolio with TD Wealth Management has a current market value, at month
end, of $27,073,400 and consists of -1- with maturity of less than one year and -9obligation with a maturity of 1-2 years and -0- of greater than 2 years. Portfolio inventory
activity during this period:
Redeemed
$-0-Called
$-0-& Purchased:
$5,000,000
Coupon Payment/Asset Income
$46,875
RECEIPT ACTIVITY FOR THE PERIOD
Subrogation Receipts
Reimbursement & Salvage
2015 Assessment Collected 2nd qtr.
Due Atlantic County
$123,474.37 {YTD=$325,932.68}
$ --0-{YTD=$ 8,996.89}
$233,211.00
$ -0{YTD=$7,573.00
$625.00
123
YTD DEPOSITS
YTD TO
MARCH
CONTROL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
MONTH
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
JANUARY
CONTROL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
ACMJIF
DEPOSIT
DATE
1/8/2015
1/8/2015
1/8/2015
1/8/2015
1/8/2015
1/10/2015
1/10/2015
1/10/2015
1/10/2015
1/10/2015
1/10/2015
1/10/2015
1/13/2015
1/13/2015
1/13/2015
1/15/2015
1/20/2015
1/20/2015
1/22/2015
1/22/2015
1/22/2015
1/22/2015
1/22/2015
1/22/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/30/2015
1/31/2015
GROUP NAME
EGG HARBOR TOWNSHIP
LOWER TOWNSHIP
LOWER TOWNSHIP
LOWER TOWNSHIP
LOWER TOWNSHIP
HAMILTON TOWNSHIP
SOMERS POINT CITY
SOMERS POINT CITY
SOMERS POINT CITY
SOMERS POINT CITY
LONGPORT BOROUGH
VENTNOR CITY
MILLVILLE CITY
GALLOWAY TOWNSHIP
MIDDLE TOWNSHIP
EGG HARBOR TOWNSHIP
GALLOWAY TOWNSHIP
GALLOWAY TOWNSHIP
ABSECON CITY
ABSECON CITY
PLEASANTVILLE CITY
HAMILTON TOWNSHIP
LOWER TOWNSHIP
HAMMONTON TOWN
EGG HARBOR TOWNSHIP
WILDWOOD CITY
LINWOOD CITY
LINWOOD CITY
WILDWOOD CITY
LOWER TOWNSHIP
LOWER TOWNSHIP
EGG HARBOR TOWNSHIP
MILLVILLE CITY
ASSESSMENTS
LOWER TOWNSHIP
CONTROL
POST YR
Closed year
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
RETROSPECTIVE
2015
Closed year
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
$ 6,182,858.32
AMOUNT
50.00
416.88
602.15
1,373.46
1,373.46
10.00
48.00
59.00
59.00
363.73
2,328.00
3,461.80
1,000.00
7,573.00
7,734.47
50.00
157.00
1,553.35
8.50
8.50
28.00
50.00
61.00
400.00
6.00
30.00
50.00
50.00
50.00
74.00
74.00
102.00
178.00
183,333.33
646,606.00
196.21
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
859,518.84
MONTH
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
FEBRUARY
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
MARCH
2/7/2015
2/27/2015
2/25/2014
2/25/2015
2/11/2015
2/11/2015
2/27/2015
2/27/2015
2/27/2015
2/25/2015
2/27/2015
2/27/2015
2/27/2015
2/27/2015
2/27/2015
2/27/2015
2/27/2015
2/27/2015
2/12/2015
2/27/2015
2/25/2015
2/25/2015
2/25/2015
2/27/2015
2/12/2015
2/28/2015
3/5/2015
3/5/2015
3/4/2015
3/14/2015
3/18/2015
3/18/2015
3/21/2015
3/25/2014
3/25/2015
3/26/2015
3/26/2015
3/26/2015
3/26/2015
3/27/2015
3/27/2015
3/30/2015
3/30/2015
3/30/2015
3/30/2015
3/30/2015
3/30/2015
3/30/2015
3/30/2015
3/31/2015
MILLVILLE CITY
WATERFORD TOWNSHIP
HAMILTON TOWNSHIP
HAMILTON TOWNSHIP
HAMILTON TOWNSHIP
HAMILTON TOWNSHIP
SOMERS POINT CITY
SOMERS POINT CITY
LINWOOD CITY
HAMILTON TOWNSHIP
PLEASANTVILLE CITY
HAMILTON TOWNSHIP
LINWOOD CITY
LINWOOD CITY
ABSECON CITY
ABSECON CITY
WILDWOOD CITY
SOMERS POINT CITY
WILDWOOD CITY
PLEASANTVILLE CITY
VENTNOR CITY
MILLVILLE CITY
EGG HAR HARBOR TOWNSHIP
MILLVILLE CITY
ASSESSMENTS
MILLVILLE CITY
EGG HARBOR TOWNSHIP
EGG HARBOR TOWNSHIP
EGG HARBOR TOWNSHIP
UPPER DEERFIELD
MILLVILLE CITY
EGG HARBOR TOWNSHIP
SOMERS POINT
EGG HARBOR TOWNSHIP
LOWER TOWNSHIP
EGG HARBOR TOWNSHIP
SOMERS POINT
GALLOWAY
PLEASANTVILLE
EGG HARBOR TOWNSHIP
HAMILTON TWP
SEA ISLE CITY
WILDWOOD CREST
SOMERS POINT
ABSECON
ATLANTIC COUNTY
LINWOOD
NORTHFIELD
ASSESSMENTS
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015 CLOSED YR
2015
2015
2015
2015
2015
2015 CLOSED YR
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015
2015 2ND QTR
$
100.00
$
2,200.00
$
9.00
$
9.00
$
9.00
$
9.00
$
49.00
$
49.00
$
25.00
$
40.00
$
56.00
$
50.00
$
50.00
$
50.00
$
5.00
$
5.00
$
40.00
$
78.00
$
48.00
$
26.00
$
1,871.90
$
490.73
$
500.00
$
248.00
$
97.73
$ 4,959,913.75
$ 4,966,029.11
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
100.00
71,957.46
431.59
50.00
459.70
200.00
86.60
13,435.90
11,504.60
98.00
1,924.00
13.00
102.00
20,000.00
50.00
40.00
90.73
98.00
98.00
10.00
625.00
101.00
2,623.79
233,211.00
357,310.37
$ 325,932.68
RECOVERY
$
$
$
$
$
$
$
$
$
$
$
$
10.00
48.00
59.00
59.00
363.73
3,461.80
1,000.00
$
7,734.47
$ 8,996.89 $ 8,198.00
ADJUSTMENT
OTHER
$
50.00
$
416.88
$
602.15
$ 1,373.46
$ 1,373.46
$
$ 5,839,730.75
ASSESSMENT
$
-
2,328.00
$ 7,573.00
$
50.00
$
61.00
$
196.21
$ 198,888.68
$
6,451.16
$ 198,888.68
$ 6,451.16
$ 205,339.84
$
157.00
$ 1,553.35
$
8.50
$
8.50
$
28.00
$
50.00
$
$
400.00
$
6.00
$
30.00
$
50.00
$
50.00
$
50.00
$
74.00
$
74.00
$
102.00
$
178.00
$ 183,333.33
-
$
100.00
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
9.00
9.00
9.00
9.00
49.00
49.00
25.00
40.00
56.00
50.00
50.00
50.00
5.00
5.00
40.00
78.00
48.00
26.00
1,871.90
490.73
500.00
$
3,569.63
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
100.00
71,957.46
431.59
50.00
459.70
200.00
86.60
13,435.90
11,504.60
98.00
1,924.00
13.00
102.00
20,000.00
50.00
40.00
90.73
98.00
98.00
10.00
$
$
101.00
2,623.79
$ 123,474.37
124
$
2,200.00
$
$
248.00
97.73
$
$
2,545.73
6,115.36
$
$ 123,474.37
$
646,606.00
$ 7,573.00
$
646,606.00
$ 7,573.00
$
646,606.00
$
-
$ 4,959,913.75
$ 4,959,913.75
$
625.00
$
625.00
$
$
233,211.00
233,211.00
FILE:C:\Users\Kkristie\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\Y0LF9D5A\DEPOSITS YTD MARCH 2015.xlsx\PR _03685_ AJF-ATL.JOINT I__All
4/3/2015
125
SUMMARY OF CASH AND INVESTMENT INSTRUMENTS
ALL FUND YEARS COMBINED
CURRENT MONTH
March
CURRENT FUND YEAR
2015
Description:
ID Number:
Maturity (Yrs)
Purchase Yield:
Opening Cash & Investment Balance
Opening Interest Accrual Balance
1
2
3
4
5
6
7
8
9
10
Interest Accrued and/or Interest Cost
Interest Accrued - discounted Instr.s
(Amortization and/or Interest Cost)
Accretion
Interest Paid - Cash Instr.s
Interest Paid - Term Instr.s
Unrealized Gain (Loss)
Net Investment Income
Deposits - Purchases
(Withdrawals - Sales)
Ending Cash & Investment Balance
Ending Interest Accrual Balance
Plus Outstanding Checks
(Less Deposits in Transit)
Balance per Bank
Instr #2
EXP & CONT
0
0
Instr #3
IMPREST
0
0
Instr #4
TD INVEST
0
0
TOTAL for All
Accts & instruments
$48,403,741.36 $
$69,910.38 $
20,868,110.43
-
$18,104.17
$0.00
$0.00
$0.00
$2,300.89
$46,875.00
$17,820.00
$38,225.06
$11,493,522.83
($12,225,549.92)
$0.00
$0.00
$0.00
$0.00
$3,311.77
$0.00
$0.00
$3,311.77
$357,310.37
($6,089,337.46)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$217,379.17
($217,379.17)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$871,958.29
($871,958.29)
$47,738,710.16
$41,139.55
$214,872.97
($40.00)
$47,953,543.13
$15,139,395.11
$0.00
$0.00
($40.00)
$15,139,355.11
$500.00
$0.00
$55,513.00
$0.00
$56,013.00
$99,729.99
$0.00
$159,359.97
$0.00
$259,089.96
0.95%
0.22%
Annualized Rate of Return This Month
SCII_REPORT PAGE.xlsx
Instr #1
LOSS
SCII_REPORTS
$
$
500.00
-
0.00%
126
Page 1
$
$
99,729.99
-
0.00%
Instr #5
TD CHECK
0
0
$
$
22,055,580.00
69,910.38
$18,104.17
$0.00
$0.00
$0.00
$0.00
$46,875.00
$17,820.00
$35,924.17
$5,000,000.00
($46,875.00)
$27,073,400.00
$41,139.55
$0.00
$0.00
$27,073,400.00
1.75%
Instr #6
0
0
0
$
$
5,379,820.94
-
0
0
$
$
-
$0.00
$0.00
$0.00
$0.00
($1,010.88)
$0.00
$0.00
($1,010.88)
$5,046,875.00
($5,000,000.00)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$5,425,685.06
$0.00
$0.00
$0.00
$5,425,685.06
$0.00
$0.00
$0.00
$0.00
$0.00
-0.22%
4/7/2015
1:31 PM
Investment Income Allocation
2015
1
2
3
4
5
6
7
8
9
Prop
167,813.08
$6.07
Accretion
Realized Gain (Loss)
Interest Accrued - Net Change
2014
1
2
3
4
5
6
7
8
9
2015 CIR_ACM.xls
SCII_REPORTS
Auto
99,364.78
$4.04
WC
1,797,346.99
$67.25
Ded
504,109.92
$21.69
Cont
999.64
$0.37
EJIF
0.00
$0.00
($101.10)
$0.00
$0.00
$0.00
$7.81
$4.07
$60.52
($32.77)
($105.17)
($46.24)
$0.00
$0.00
$0.00
$3.57
$33.25
$27.68
($14.99)
($79.49)
($59.86)
$0.00
$0.00
$0.00
$4.63
$2.71
$35.83
($19.40)
($62.57)
($1,082.82)
$0.00
$0.00
$0.00
$83.69
$45.09
$648.14
($350.98)
($1,127.91)
($303.70)
$0.00
$0.00
$0.00
$23.47
$14.54
$181.79
($98.44)
($318.24)
($0.60)
$0.00
$0.00
$0.00
$0.05
$0.25
$0.36
($0.20)
($0.85)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$139,629.68
($99.10)
$122,303.46
($29.89)
$98,037.72
($58.53)
$1,745,795.69
($1,060.66)
$525,299.74
($296.56)
$1,000.30
($0.48)
$0.00
$0.00
Liab
2,731,460.11
$1,871.52
Auto
379,324.82
$519.19
WC
5,896,240.94
$8,450.14
Ded
2,287,704.01
$2,940.53
0.00
$0.00
Prop
(92,558.56)
$80.68
Accretion
Liab
76,745.01
$49.59
Cont
30,733.96
$11.47
EJIF
MEL
(919,813.43)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
($2,341.02)
$0.00
$0.00
$0.00
$180.93
$106.14
$1,401.27
($758.82)
($2,447.16)
($919,813.43)
$0.00
$1,108,061.66
($743.64)
$2,820,314.82
($2,288.86)
MEL
199,211.72
$74.34
Admin
260,838.53
$3,609.01
($1,645.57)
$0.00
$0.00
$0.00
$127.18
$1,254.86
$984.99
($533.40)
($2,900.43)
($228.52)
$0.00
$0.00
$0.00
$17.66
$348.12
$136.79
($74.07)
($576.64)
($3,552.20)
$0.00
$0.00
$0.00
$274.54
$5,665.83
$2,126.25
($1,151.41)
($9,218.03)
($1,378.23)
$0.00
$0.00
$0.00
$106.52
$1,971.63
$824.97
($446.74)
($3,349.86)
($18.52)
$0.00
$0.00
$0.00
$1.43
$7.69
$11.08
($6.00)
($26.21)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
($120.02)
$0.00
$0.00
$0.00
$9.28
$49.85
$71.84
($38.90)
($169.86)
($93,697.04)
$26.58
$2,726,312.72
($1,028.91)
$379,797.39
($57.45)
$5,701,153.35
($767.89)
$2,290,607.13
($409.33)
$30,754.16
($14.74)
$0.00
$0.00
$199,342.68
($95.52)
127
Total
$2,966,007.01
$158.30
($746.70)
$0.00
$0.00
$0.00
$57.71
$6.22
$446.96
($242.04)
($752.93)
$0.00
$0.00
$0.00
$0.00
$0.00
$54.10
$0.00
$0.00
($54.10)
Page 1
Admin
1,239,441.02
$9.28
($157.14)
$0.00
$0.00
$0.00
$12.15
$2,419.85
$94.06
($50.94)
($2,576.99)
$251,774.28
$1,032.02
4/3/2015
Total
$11,692,955.53
$17,556.89
($7,100.21)
$0.00
$0.00
$0.00
$548.75
$11,771.92
$4,249.99
($2,301.46)
($18,872.13)
$11,486,044.67
($1,315.24)
11:00 AM
2013
1
2
3
4
5
6
7
8
9
Prop
105,440.36
$136.13
Accretion
2012
1
2
3
4
5
6
7
8
9
2015 CIR_ACM.xls
SCII_REPORTS
Auto
322,176.54
$451.12
WC
4,674,504.36
$7,086.23
Ded
2,352,236.31
$3,274.96
Cont
EJIF
0.00
$0.00
0.00
$0.00
MEL
167,131.06
$234.65
Admin
102,535.98
$190.44
($1,546.83)
$0.00
$0.00
$0.00
$119.55
$2,428.21
$925.89
($501.39)
($3,975.04)
($194.10)
$0.00
$0.00
$0.00
$15.00
$302.48
$116.18
($62.91)
($496.57)
($2,816.16)
$0.00
$0.00
$0.00
$217.65
$4,751.33
$1,685.68
($912.83)
($7,567.50)
($1,417.11)
$0.00
$0.00
$0.00
$109.52
$2,195.86
$848.24
($459.34)
($3,612.97)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
($100.69)
$0.00
$0.00
$0.00
$7.78
$157.33
$60.27
($32.64)
($258.02)
$105,574.57
($18.67)
$2,568,957.15
($353.56)
$322,590.20
($45.45)
$4,589,552.61
($481.26)
$2,355,389.94
($338.02)
$0.00
$0.00
$0.00
$0.00
$167,356.45
($23.37)
$101,705.42
$0.98
$10,211,126.34
($1,259.35)
Liab
2,106,449.69
$3,026.24
Auto
268,703.94
$388.37
WC
4,545,602.77
$6,432.16
Ded
1,409,769.84
$2,041.10
0.00
$0.00
0.00
$0.00
MEL
241,180.06
$337.32
Admin
122,022.94
$183.04
Total
$8,759,192.38
$12,432.94
Cont
EJIF
($61.77)
$0.00
$0.00
$0.00
$4.77
$127.69
$36.98
($20.02)
($189.46)
Total
$10,291,589.61
$14,995.02
($63.52)
$0.00
$0.00
$0.00
$4.91
$91.28
$38.02
($20.59)
($154.80)
Prop
65,463.14
$24.71
Accretion
Liab
2,567,565.00
$3,621.48
($6,200.19)
$0.00
$0.00
$0.00
$479.19
$10,054.19
$3,711.26
($2,009.72)
($16,254.37)
($39.44)
$0.00
$0.00
$0.00
$3.05
$16.57
$23.61
($12.78)
($56.01)
($1,269.03)
$0.00
$0.00
$0.00
$98.08
$2,029.10
$759.61
($411.35)
($3,298.13)
($161.88)
$0.00
$0.00
$0.00
$12.51
$260.40
$96.90
($52.47)
($422.28)
($2,738.51)
$0.00
$0.00
$0.00
$211.65
$4,312.77
$1,639.19
($887.66)
($7,051.28)
($849.32)
$0.00
$0.00
$0.00
$65.64
$1,368.56
$508.38
($275.30)
($2,217.88)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
($145.30)
$0.00
$0.00
$0.00
$11.23
$226.17
$86.97
($47.10)
($371.47)
($73.51)
$0.00
$0.00
$0.00
$5.68
$122.73
$44.00
($23.83)
($196.24)
($5,276.99)
$0.00
$0.00
$0.00
$407.84
$8,336.31
$3,158.66
($1,710.49)
($13,613.30)
$72,149.97
($31.30)
$1,915,024.29
($271.89)
$266,619.25
($33.92)
$4,535,269.69
($619.12)
$1,411,712.42
($176.78)
$0.00
$0.00
$0.00
$0.00
$241,504.44
($34.15)
$122,195.35
($13.20)
$8,564,475.41
($1,180.36)
128
Page 1
4/3/2015
11:01 AM
2011
1
2
3
4
5
6
7
8
9
Prop
95,110.31
$131.66
Accretion
1
2
3
4
5
6
7
8
9
Auto
59,423.27
$83.93
WC
2,601,004.57
$3,794.51
Ded
2,123,576.60
$2,952.59
Cont
EJIF
MEL
0.00
$0.00
0.00
$0.00
(0.54)
$0.00
($57.30)
$0.00
$0.00
$0.00
$4.43
$88.28
$34.30
($18.57)
($145.58)
($481.45)
$0.00
$0.00
$0.00
$37.21
$896.41
$288.19
($156.06)
($1,377.86)
($35.80)
$0.00
$0.00
$0.00
$2.77
$56.27
$21.43
($11.60)
($92.07)
($1,566.98)
$0.00
$0.00
$0.00
$121.11
$2,544.23
$937.95
($507.92)
($4,111.21)
($1,279.35)
$0.00
$0.00
$0.00
$98.88
$1,979.72
$765.79
($414.69)
($3,259.07)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$95,059.96
($13.92)
$759,982.13
($40.94)
$59,503.74
($8.15)
$2,577,397.56
($316.69)
$2,126,420.98
($306.48)
$0.00
$0.00
$0.00
$0.00
($0.54)
$0.00
Prop
Closed
Liab
799,158.23
$1,336.92
Liab
Auto
WC
Ded
Cont
EJIF
MEL
108.86
$0.04
0.00
$0.00
0.00
$0.00
0.00
$0.00
0.00
$0.00
0.00
$0.00
0.00
$0.00
0.00
$0.00
Accretion
($0.07)
$0.00
$0.00
$0.00
$0.01
$0.03
$0.04
($0.02)
($0.09)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
($6.00)
($0.05)
$0.00
$0.00
$0.00
$0.00
$8,063.16
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
2015 CIR_ACM.xls
SCII_REPORTS
129
Page 1
Admin
157,313.02
$219.29
Total
$5,835,585.46
$8,518.91
($94.77)
$0.00
$0.00
$0.00
$7.32
$147.03
$56.73
($30.72)
($241.81)
($3,515.66)
$0.00
$0.00
$0.00
$271.71
$5,711.94
$2,104.38
($1,139.56)
($9,227.60)
$157,524.11
($22.52)
$5,775,887.94
($708.69)
Admin
8,858,301.79
$16,248.26
($5,336.70)
$0.00
$0.00
$0.00
$412.46
$10,894.48
$3,194.40
($1,729.84)
($16,231.18)
$8,872,803.13
$17.07
4/3/2015
Total
$8,858,410.65
$16,248.29
($5,336.77)
$0.00
$0.00
$0.00
$412.46
$10,894.51
$3,194.44
($1,729.86)
($16,231.27)
$8,880,860.29
$17.02
11:02 AM
ATLANTIC COUNTY MUNICIPAL JIF
INVESTMENT MANAGEMENT
ACCOUNT NO. 65-P142-01-4
FINANCIAL STATEMENT FOR THE PERIOD
03/01/15 THROUGH 03/31/15
ACCOUNT MANAGER:
JASON J. WALLACH
201-574-4836
PORTFOLIO MANAGER:
JASON WALLACH
JOHN HANSEN
105 SIMPSON AVE
OCEAN CITY NJ 08226
130
TABLE OF CONTENTS
PAGE
STATEMENT OF CHANGES IN NET ASSETS. . . . . . . . .
1
PORTFOLIO SUMMARY . . . . . . . . . . . . . . . . .
2
BOND MATURITY SUMMARY . . . . . . . . . . . . . . .
3
PORTFOLIO APPRAISAL . . . . . . . . . . . . . . . .
4
TRANSACTION LEDGER. . . . . . . . . . . . . . . . .
7
131
STATEMENT OF CHANGES IN NET ASSETS
FOR PERIOD 03/01/15 THRU 03/31/15
PAGE
BEGINNING TOTAL PORTFOLIO AS OF 03/01/15
22,125,490.38
TRANSACTION ACTIVITY
CASH RECEIPTS
5,000,000.00
COUPON PAYMENTS/ASSET INCOME
46,875.00
CASH DISBURSEMENTS
46,875.00-
NON-CASH ASSET CHANGES
.00
CHANGE IN UNREALIZED CAPITAL GAIN/LOSS
UNREALIZED GAIN/LOSS CURRENT PERIOD
90,550.00
UNREALIZED GAIN/LOSS PRIOR PERIOD
72,730.00
----------------17,820.00
NET CHANGE
ACCRUED INCOME RECONCILIATION
ENDING INTEREST ACCRUAL BALANCE
41,139.55
BEGINNING INTEREST ACCRUAL BALANCE
69,910.38
CHANGE IN INCOME ACCRUAL
----------------28,770.83-----------------
TOTAL TRANSACTIONS
4,989,049.17
----------------27,114,539.55
ENDING TOTAL PORTFOLIO AS OF 03/31/15
TOTAL PORTFOLIO VALUE INCLUDES ASSET MARKET VALUE PLUS ACCRUED INCOME
132
1
PORTFOLIO SUMMARY
AS OF 03/31/15
PAGE
FIXED INCOME SECURITIES
GOVERNMENT OBLIGATIONS
CASH AND EQUIVALENTS
TOTAL COST
TOTAL MARKET
26,982,850.00
.00
--------------26,982,850.00
27,073,400.00
.00
--------------27,073,400.00
133
% OF
ESTIMATED PURCH
MKT VAL ANN INCOME
YLD
100.00
-----100.00
282,000
1.0
----1.0
2
PORTFOLIO SUMMARY
AS OF 03/31/15
PAGE
BOND MATURITY SUMMARY
RANGE
DEBT OBLIGATIONS
3 - 6 MONTHS
1 - 2 YEARS
GREATER THAN 2 YEARS
TOTAL DEBT OBLIGATIONS
TOTAL
PAR
VALUE
MARKET
VALUE
5,000,000
5,036,650.00
11,000,000
11,006,950.00
11,000,000
11,029,800.00
---------------- --------------27,000,000
27,073,400.00
---------------- --------------27,000,000
27,073,400.00
134
3
PORTFOLIO APPRAISAL
AS OF 03/31/15
PAR VALUE/
NO. SHARES
CUSIP/
DESCRIPTION
PAGE
4
TOTAL ACCRUED
INTEREST
MARKET VALUE
ACQUISITION COST
UNREALIZED
GAIN/LOSS
MARKET PRICE
CURRENT BOOK
% OF
PURCHASE
PORTFOLIO YIELD
CASH & EQUIVALENTS
CASH
0
.00
INCOME CASH
0
.00
PRINCIPAL CASH
TOTAL CASH
.00
.000
.00
.00
.000
.00
.00
.00
.00
.00
.00
TOTAL CASH & EQUIVALENTS
.00
.00
0.0
.00
0.0
18.60
1.9
18.60
1.9
.00
.00
.00
.00
5,729.16
5,036,650.00
4,987,500.00
49,150.00
5,729.16
5,036,650.00
4,987,500.00
49,150.00
.00
DEBT OBLIGATIONS
3 - 6 MONTHS
5,000,000
3136FP-DY-0
FED NATL MTG ASSN 1.875% 09/09/2015
DTD 09/09/10 CALLABLE 03/09/2011
TOTAL 3 - 6 MONTHS
100.733
4,998,750.00
4,998,750.00
1 - 2 YEARS
2,000,000
3134G4-VK-1
FHLMC .45% 05/27/2016
DTD 02/27/2014 CALLABLE 08/27/2014
3,000,000
3130A3-KC-7
FHLBB
0.700% 12/12/2016
DTD 12/12/14
850.00
1,998,080.00
2,000,000.00
1,920.00-
99.904
2,000,000.00
7.38
.4
1,750.00
3,002,970.00
3,000,000.00
2,970.00
100.099
3,000,000.00
11.09
.7
135
PORTFOLIO APPRAISAL
AS OF 03/31/15
PAGE
PAR VALUE/
NO. SHARES
CUSIP/
DESCRIPTION
5
TOTAL ACCRUED
INTEREST
MARKET VALUE
ACQUISITION COST
UNREALIZED
GAIN/LOSS
MARKET PRICE
CURRENT BOOK
% OF
PURCHASE
PORTFOLIO YIELD
3,000,000
3134G4-QP-6
FHLMC .75% 12/27/2016
DTD 12/27/2013 CALLABLE 12/27/2016
5,875.00
3,003,360.00
2,997,750.00
5,610.00
100.112
2,998,680.00
11.09
.8
1,000,000
313381-KR-5
FEDL HOME LOAN BK .625% 12/28/2016
DTD 12/28/2012 CALLABLE 06/28/2013
1,614.58
1,001,160.00
999,600.00
1,560.00
100.116
999,820.00
3.70
.6
2,000,000
3134G5-A4-7
FHLMC .65% 12/20/2016
DTD 06/30/2014 CALLABLE
3,286.11
2,001,380.00
2,000,000.00
1,380.00
100.069
2,000,000.00
7.39
.6
TOTAL 1 - 2 YEARS
13,375.69
11,006,950.00
10,997,350.00
9,600.00
40.66
0.7
4,555.55
1,000,340.00
1,000,000.00
340.00
100.034
1,000,000.00
3.69
1.0
10,416.66
3,003,450.00
2,999,400.00
4,050.00
100.115
2,999,580.00
11.09
1.0
729.16
5,007,050.00
5,000,000.00
7,050.00
100.141
5,000,000.00
18.49
1.0
6,333.33
2,018,960.00
1,998,600.00
20,360.00
100.948
1,998,900.00
7.46
1.2
22,034.70
11,029,800.00
10,998,000.00
31,800.00
40.74
1.1
27,073,400.00
26,982,850.00
90,550.00
100.00
1.0
10,998,500.00
GREATER THAN 2 YEARS
1,000,000
3130A1-GG-7
FHLB 1% 04/17/2017
3,000,000
3134G4-V4-7
FED HOME LN MTG 1% 05/26/2017
DTD 02/26/2014 CALLABLE 05/26/2014
5,000,000
3134G6-JU-8
FED HOME LN MTG
DTD 03/26/15
2,000,000
1.050% 09/26/2017
3134G5-AU-9
FHLMC 1.2% 12/26/2017
TOTAL GREATER THAN 2 YEARS
TOTAL DEBT OBLIGATIONS
41,139.55
136
10,998,480.00
26,995,730.00
PORTFOLIO APPRAISAL
AS OF 03/31/15
PAR VALUE/
NO. SHARES
CUSIP/
DESCRIPTION
NET ASSETS
PAGE
6
TOTAL ACCRUED
INTEREST
MARKET VALUE
ACQUISITION COST
UNREALIZED
GAIN/LOSS
MARKET PRICE
CURRENT BOOK
------------- --------------- ----------------------------41,139.55
27,073,400.00
90,550.00
26,982,850.00
26,995,730.00
TOTAL SECURITIES CURRENTLY HELD
27,114,539.55
137
% OF
PURCHASE
PORTFOLIO YIELD
-----100.00
----1.0
TRANSACTION LEDGER
FOR PERIOD 03/01/15 THRU 03/31/15
TRANSACTION
PAGE
7
TRADE
DATE
SETTLEMENT
DATE
CUSIP
00/00/00
03/09/15
JIF ATLANTIC COUNTY
DISCRETIONARY DISTRIBUTION
DAILY DISTRIBUTION OF INCOME AND
PRINCIPAL TO TD BANK NA
JIF ATLANTIC COUNTY
ACCT # 7855139650
REP #2805
46,875.00-
.00
.000
00/00/00
03/09/15
INT TO 03/09/15 ON 5,000,000
3136FP-DY-0
FED NATL MTG ASSN 1.875% 09/09/2015
DTD 09/09/10 CALLABLE 03/09/2011
46,875.00
.00
.000
00/00/00
03/26/15
TRANSFER FUNDS FROM
DDA 7855139650
ATLANTIC COUNTY JIF
TO COVER TRADES SETTLING
5,000,000.00
.00
.000
02/27/15
03/26/15
PURCHASED 5000000 02/27/15
FROM JEFFERIES & CO/CUSTODY
@ 100
FED HOME LN MTG 1.050% 09/26/2017
DTD 03/26/15
5,000,000.00
5,000,000.000
3134G6-JU-8
CASH
5,000,000.00-
--------------.00
TOTAL TRANSACTIONS
138
COST
SHARES/
PAR VALUE
--------------5,000,000.00
139
SUMMARY OF CASH TRANSACTIONS - ALL FUND YEARS COMBINED
Current Fund Year:
Month Ending:
OPEN BALANCE
RECEIPTS
Assessments
Refunds
Invest Pymnts
Invest Adj
Subtotal Invest
Other *
TOTAL
2015
March
Prop
341,377.19
Liab
8,281,378.04
Auto
1,128,993.35
WC
19,514,699.63
Ded
8,677,396.68
Cont
31,733.60
8,238.47
28,455.58
431.02
0.00
431.02
186.60
37,311.67
48,221.95
0.00
10,013.78
0.00
10,013.78
0.00
58,235.73
4,397.73
0.00
1,429.68
0.00
1,429.68
0.00
5,827.41
79,109.22
102,895.35
25,265.11
0.00
25,265.11
0.00
207,269.68
20,970.02
0.00
11,063.51
0.00
11,063.51
0.00
32,033.53
0.00
0.00
20.86
0.00
20.86
0.00
20.86
0.00
0.00
0.00
0.00
0.00
0.00
0.00
59,676.19
301.53
0.00
59,977.72
318,711.14
247,034.02
0.00
0.00
247,034.02
8,092,579.75
8,272.46
0.00
0.00
8,272.46
1,126,548.30
564,737.25
0.00
0.00
564,737.25
19,157,232.06
0.00
0.00
0.00
0.00
8,709,430.21
0.00
0.00
0.00
0.00
31,754.46
0.00
0.00
0.00
0.00
0.00
EJIF
0.00
MEL
(312,291.13)
0.00
0.00
680.73
0.00
680.73
0.00
680.73
Admin
10,740,453.28
TOTAL
48,403,740.64
72,273.61
0.00
18,091.23
0.00
18,091.23
625.00
90,989.84
233,211.00
131,350.93
66,995.92
0.00
66,995.92
811.60
432,369.45
0.00
217,379.17
0.00
217,379.17
10,614,063.95
879,719.92
217,680.70
0.00
1,097,400.62
47,738,709.47
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
0.00
0.00
0.00
0.00
(311,610.40)
$47,738,710.16
$0.68
Report Month: March
Opening Balances:
Imprest Transfers:
Investment Balances:
Ending Balances:
Accural Balances:
Opening Balances are equal
Imprest Totals are equal
Investment Payment Balances are equal
Investment Adjustment Balances are equal
Ending Balances are equal
Accural Balances are equal
Differences
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Claims Transaction Status:
Allocation variance 1:
Pre-existing variance:
2015 CIR_ACM.xls
SCT_REPORTS
Daily xactions add to monthly totals
Monthly transactions and allocation totals are equal
Treasurer/TPA net payments NOT equal-reconciliaiton
Max/Min
needed
Prior period unreconciled variance exists
Max/Min
Page 1
140
0.00
0.00
0.00
0.00
/
/
(0.00)
(0.00)
4/3/2015
11:02 AM
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
AJF-ATL.JOINT INS.FUND
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
PHYSICIA
PHYSICIA
URGENT C
PHYSICIA
PHYSICIA
CB002 00100NJ
ATL.CO.MUNICIPAL JIF-CB
IRS#
BATCH#
GRP FILE#
CL
COV
020701782
020701782
020701782
020701782
020701782
0247137
0247137
0247137
0247137
0247137
037
003
042
010
037
Z07109
Z08202
Z08883
Z08662
Z09085
01
01
01
01
01
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MCO00144000.
MCO00144632.
MCO00144928.
MCO00144901.
MCO00145087.
MCO00129029.
MCO201101123
MCO201102083
MCO00145922.
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
681915
681916
681917
681918
681918
ATLANTICARE
ATLANTICARE
ATLANTICARE
ATLANTICARE
ATLANTICARE
3/03/15
3/03/15
3/03/15
3/03/15
681919
681920
681920
681920
MATTHEW FANNON
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
0247137 026 X79373
133973142 0247137 015 W81603
133973142 0247137 009 W84056
133973142 0247137 009 Z10520
01
01
01
01
WC
WC
WC
WC
IND
MED
MED
MED
3/03/15
3/03/15
3/03/15
3/03/15
681921
681921
681921
681921
ISO
ISO
ISO
ISO
133973142
133973142
133973142
133973142
01
01
01
01
GL
GL
GL
GL
BI
BI
BI
BI
3/03/15
3/03/15
681922 ISO SERVICES, INC.
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
681923
681924
681925
681926
681927
681928
681929
681930
681931
681932
681932
681932
681932
WILLIAM REED
MARK MENSCH
NICHOLAS PETRUZZI
AARON FINCKE
JESSICA CRACKOVICH
MICHAEL COSTELLO
ERIC BITTMANN
GEORGE BARGER
ATLANTIC EMERGENCY A
STRIVE PHYSICAL THER
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
681933
681934
681935
681936
681937
681938
681938
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
681939
681940
681941
681942
681943
681944
681945
681946
681947
681948
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
0247137
0247137
0247137
0247137
038
005
008
037
Z05135
Z10292
Z10343
Z10346
CLIENT#
133973142 0247137 024 X67720 04 AL BI
133973142 0247137 024 X67720 05 AL BI
200287387
201901714
201901714
201901714
201901714
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
021
021
007
017
011
009
014
024
008
014
014
014
014
X26999
X47412
X63143
X93675
X88077
X35537
X23660
X93459
Z09082
X99960
X99960
X99960
X99960
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
IND
IND
IND
MED
MED
MED
MED
MED
MCO00102474.
MCO00112008.
MCO00120252.
MCO00136979.
MCO00133869.
MCO00107163.
MCO00100457.
MCO00136903.
MCO00145101.
MCO00140045.
MCO00140045.
MCO00140045.
MCO00140045.
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
DOSHI DIAGNOSTIC IMA
EAST COAST ORTHO. &,
202896034
202896034
202896034
202896034
203661505
204484976
204484976
0247137
0247137
0247137
0247137
0247137
0247137
0247137
043
012
022
022
026
017
038
Z09249
Z09581
Z10012
Z10012
Z07929
Z01300
Z05471
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MCO00145152.
MCO00145346.
MCO00145606.
MCO00145606.
MCO00144433.
MCO00140865.
MCO00143263.
ARMC FACULTY PRACTIC
ATLANTICARE REGIONAL
BACHARACH INSTITUTE
BRIGANTINE CITY
BRIGANTINE CITY
STATE OF NEW JERSEY
NORTHFIELD CITY
PLEASANTVILLE CITY
DYLAN YOUNG
SOUTH JERSEY RADIOLO
210634549
210634549
210634964
216000384
216000384
216000928
216000945
216001018
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
221899118 0247137
014
026
023
026
026
009
005
006
012
007
Z07103
Z02843
X00875
Z05819
Z05819
Z04848
X86239
X88172
Z07456
Z08545
01
02
01
01
01
01
01
03
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
IND
IND
MED
IND
IND
IND
MED
MCO00144003.
MCO00141786.
MCO201106024
MCO00143500.
MCO00143500.
MCO00142921.
MCO00132909.
MCO00133944.
MCO00144132.
MCO00144823.
141
RUN DATE: 4/01/2015 PAGE 1
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
63.37
263.00
263.00
263.00
263.00
526.00
880.00
10.00
10.00
10.00
30.00
10.00
10.00
10.00
10.00
40.00
10.00
10.00
20.00
1,620.00
464.00
880.00
815.14
5,512.50
954.84
954.84
900.00
805.00
63.00
63.00
63.00
63.00
252.00
91.36
91.36
128.79
86.87
34.05
93.76
2,227.08
2,320.84
234.00
133.90
198.00
1,686.00
1,686.00
1.81
450.00
1,686.00
805.46
14.88
LOSS 1/03/15
LOSS 1/14/15
LOSS 1/21/15
LOSS 1/20/15
LOSS 1/24/15
TOTAL CHECK#:
LOSS 12/13/13
EXP
1/12/11
EXP
2/08/11
EXP
2/12/15
TOTAL CHECK#:
EXP 11/08/14
EXP
2/09/15
EXP
2/07/15
EXP
1/19/15
TOTAL CHECK#:
EXP
7/05/13
EXP
7/05/13
TOTAL CHECK#:
LOSS 4/23/12
LOSS 11/12/12
LOSS 5/09/13
LOSS 6/14/14
LOSS 3/24/14
LOSS 7/25/12
LOSS 3/27/12
LOSS 6/11/14
LOSS 1/25/15
LOSS 9/12/14
LOSS 9/12/14
LOSS 9/12/14
LOSS 9/12/14
TOTAL CHECK#:
LOSS 1/28/15
LOSS 1/31/15
LOSS 2/06/15
LOSS 2/06/15
LOSS 1/05/15
LOSS 10/01/14
LOSS 12/07/14
TOTAL CHECK#:
LOSS 1/03/15
LOSS 10/24/14
LOSS 6/02/11
LOSS 12/12/14
LOSS 12/12/14
EXP 11/24/14
LOSS 3/04/14
LOSS 3/27/14
LOSS 1/06/15
LOSS 1/17/15
15
15
15
15
15
037-9430NJ
003-7720NJ
042-7720NJ
010-9403NJ
037-7720NJ
681918
13 026-7720NJ
11 015-7720NJ
11 009-5509NJ
15 009-7720NJ
681920
14 038-5509NJ
15 005-5509NJ
15 008-5509NJ
15 037-5509NJ
681921
13 024-7720NJ
13 024-7720NJ
681922
12 021-7720NJ
12 021-7720NJ
13 007-9015NJ
14 017-9053NJ
14 011-9430NJ
12 009-5509NJ
12 014-7720NJ
14 024-5509NJ
15 008-7720NJ
14 014-7720NJ
14 014-7720NJ
14 014-7720NJ
14 014-7720NJ
681932
15 043-7720NJ
15 012-9430NJ
15 022-7580NJ
15 022-7580NJ
15 026-9403NJ
14 017-9430NJ
14 038-9402NJ
681938
15 014-7720NJ
14 026-7720NJ
11 023-5509NJ
14 026-5509NJ
14 026-5509NJ
14 009-7711NJ
14 005-9106NJ
14 006-7720NJ
15 012-7720NJ
15 007-7720NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
TODD
TODD
TODD
TODD
IRS#
BATCH#
GRP FILE#
CL
222046544
222046544
222046544
222046544
0247137
0247137
0247137
0247137
023
009
044
042
X50931
X08781
X13696
X42822
01
01
01
01
GL
GL
GL
GL
PD
BI
BI
BI
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
009
008
008
008
008
021
021
021
021
009
009
009
014
014
014
014
014
X91165
X79964
X79964
X79964
X79964
X98251
X98251
X98251
X98251
Z00080
Z00080
Z00080
Z07103
Z07103
Z07103
Z07103
Z07103
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00135579.
MCO00129514.
MCO00129514.
MCO00129514.
MCO00129514.
MCO00139155.
MCO00139155.
MCO00139155.
MCO00139155.
MCO00140147.
MCO00140147.
MCO00140147.
MCO00144003.
MCO00144003.
MCO00144003.
MCO00144003.
MCO00144003.
UN
UN
UN
UN
222540040
222540040
222540040
222540040
0247137
0247137
0247137
0247137
027
039
027
014
Z06585
Z06101
Z06585
Z07103
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00143911.
MCO00143632.
MCO00143911.
MCO00144003.
MEREN
MEREN
MEREN
MEREN
COV
CLIENT#
3/03/15
3/03/15
3/03/15
3/03/15
681949
681950
681950
681950
GEMMEL,
GEMMEL,
GEMMEL,
GEMMEL,
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
681951
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
681952
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
3/03/15
3/03/15
3/03/15
3/03/15
681953
681954
681954
681954
SHORE
SHORE
SHORE
SHORE
3/03/15
3/03/15
3/03/15
681955 QUALCARE, INC.
3/03/15
3/03/15
3/03/15
3/03/15
681956
681957
681957
681957
ONE
ONE
ONE
ONE
IN
IN
IN
IN
223218521
223218521
223218521
223218521
0247137
0247137
0247137
0247137
006
006
027
037
Z09081
Z05390
Z06585
Z09085
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00145130.
MCO00143236.
MCO00143911.
MCO00145087.
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
681958
681959
681960
681961
681962
681963
681964
681965
681966
681967
681968
681969
681969
ATLANTICARE CLINICAL
PACE ORTHOPEDICS AND
ROTHMAN INSTITUTE OF
SHORE AMBULATORY SUR
FOX OUTPATIENT REHAB
RT ENVIRONMENTAL SER
NOVACARE REHABILITAT
ATLANTIC SECURITY IN
NICOLAPT LLC
CAPE REGIONAL URGENT
223265214
223319594
223700669
223700669
223778333
223822612
223822612
232534548
232736153
233024656
262230453
272584205
272584205
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
0247137
008
023
002
037
006
027
027
023
027
016
003
034
034
X88175
Z04015
X41650
Z09085
Z05390
Z08547
Z08547
X50931
Z05233
W48335
Z05652
Z08882
Z08882
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
GL
WC
PR
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
PD
MED
I/M
MED
MED
MED
MCO00133828.
MCO00142436.
MCO00108313.
MCO00145087.
MCO00143236.
MCO00144830.
MCO00144830.
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
&
&
&
&
CB002 00100NJ
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
CALL
CALL
CALL
CALL
MEDICAL,
MEDICAL,
MEDICAL,
MEDICAL,
223129563 0247137 024 Z11855 01 WC MED MCO00146618.
223129563 0247137 008 Z11985 01 WC MED MCO00146697.
223129563 0247137 009 Z11986 01 WC MED MCO00146605.
142
MCO00143126.
BUENA VISTA
MCO00143378.
MCO00144993.
MCO00144993.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
9,393.33
3,449.01
3,888.25
3,584.37
10,921.63
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
1,008.00
308.95
1,829.16
160.00
84.00
2,073.16
472.00
472.00
472.00
1,416.00
485.00
785.00
427.88
485.00
1,697.88
4.00
91.93
54.32
200.70
5,901.35
63.00
63.00
329.23
80.63
251.50
198.00
119.56
195.51
315.07
LGL 11/08/11
LGL
8/01/11
LGL 10/01/11
LGL
8/02/12
TOTAL CHECK#:
LOSS 5/11/14
LOSS 12/16/13
LOSS 12/16/13
LOSS 12/16/13
LOSS 12/16/13
LOSS 8/18/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 1/03/15
LOSS 1/03/15
LOSS 1/03/15
LOSS 1/03/15
LOSS 1/03/15
TOTAL CHECK#:
LOSS 12/28/14
LOSS 12/16/14
LOSS 12/28/14
LOSS 1/03/15
TOTAL CHECK#:
LOSS 2/24/15
LOSS 3/01/15
LOSS 2/27/15
TOTAL CHECK#:
LOSS 1/10/15
LOSS 12/05/14
LOSS 12/28/14
LOSS 1/24/15
TOTAL CHECK#:
LOSS 3/25/14
LOSS 11/05/14
LOSS 8/25/12
LOSS 1/24/15
LOSS 12/05/14
LOSS 1/15/15
LOSS 1/15/15
EXP 11/08/11
LOSS 12/03/14
EXP
6/02/10
LOSS 12/10/14
LOSS 1/22/15
LOSS 1/22/15
TOTAL CHECK#:
11
11
11
12
023-9410NJ
009-5509NJ
044-5509NJ
042-5509NJ
681950
14 009-7720NJ
13 008-7720NJ
13 008-7720NJ
13 008-7720NJ
13 008-7720NJ
14 021-5509NJ
14 021-5509NJ
14 021-5509NJ
14 021-5509NJ
14 009-7711NJ
14 009-7711NJ
14 009-7711NJ
15 014-7720NJ
15 014-7720NJ
15 014-7720NJ
15 014-7720NJ
15 014-7720NJ
681952
14 027-7720NJ
14 039-5509NJ
14 027-7720NJ
15 014-7720NJ
681954
15 024-7711NJ
15 008-7720NJ
15 009-8810NJ
681955
15 006-7720NJ
14 006-7720NJ
14 027-7720NJ
15 037-7720NJ
681957
14 008-7720NJ
14 023-5509NJ
12 002-7720NJ
15 037-7720NJ
14 006-7720NJ
15 027-7720NJ
15 027-7720NJ
11 023-9410NJ
14 027-5509NJ
10 016-5509NJ
14 003-7720NJ
15 034-5509NJ
15 034-5509NJ
681969
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
IRS#
BATCH#
CB002 00100NJ
GRP FILE#
CL
COV
CLIENT#
3/03/15
3/03/15
681970 AFFANATO MARUT, LLC
681970 AFFANATO MARUT, LLC
463266146 0247137 024 X05966 01 WC IND MCO00081778.
463266146 0247137 021 X26999 01 WC IND MCO00102474.
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/03/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
681971
681972
681973
681974
681975
681976
681977
681978
681979
681979
681979
681979
681979
681979
681979
681979
BIRCHMEIER & POWELL,
ANTHONY VENUTO
IOD INCORPORATED
MULLICA TOWNSHIP
LANCE GREENE
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
472344815 0247137 031 X90949
472344815 0247137 036 X83846
472344815 0247137 043 X69721
0247137 021 X62430
650765287 0247137 027 X17938
999999999 0247137 033 Z06376
0247219 026 X03678
133973142 0247219 009 Z10585
133973142 0247219 008 X07684
133973142 0247219 039 X41407
133973142 0247219 015 X43438
133973142 0247219 024 X47413
133973142 0247219 043 X56666
133973142 0247219 043 Z10521
133973142 0247219 008 Z10717
133973142 0247219 008 Z10788
01
01
01
03
01
01
01
01
01
01
01
01
01
01
01
01
GL
GL
GL
WC
GL
PR
WC
AL
WC
WC
WC
WC
WC
WC
WC
WC
BI
PI
PPPI
IND MCO00119842.
PPBI
COL MULLICA TWP
IND MCO00080569.
PD
MED MCO00082669.
MED MCO00108235.
MED
MED MCO00112074.
MED MCO00116729.
MED MCO00145901.
MED MCO00145996.
MED MCO00146024.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
681980
681980
681980
681980
681980
ISO
ISO
ISO
ISO
ISO
133973142
133973142
133973142
133973142
133973142
0247219
0247219
0247219
0247219
0247219
006
023
038
005
006
X09949
X96683
X98297
X98548
Z10592
02
01
01
01
01
GL
GL
GL
GL
GL
BI
BI
BI
BI
BI
3/06/15
3/06/15
3/06/15
3/06/15
681981
681982
681983
681983
LEA MARIE SACCO
ANDREW MATTERN
PIETRAS, SARACINO, S 141872046
0247219
0247219
0247219
0247219
012
023
006
027
Z05059
X48720
X44747
X87954
01
01
01
01
WC
WC
WC
WC
IND MCO00143022.
IND MCO00112875.
IND MCO00110384.
IND
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
681984
681985
681986
681987
681988
681989
681990
681990
DAMON ORBACH
ALLEN MAGNAVITA
KEVIN OLSON
JOHNATHAN SEIDEL
RICHARD RUTLEDGE
WILLIAM HAMMERSTEIN
LAW OFFICES OF NEIL
LAW OFFICES OF NEIL
0247219
0247219
0247219
0247219
0247219
0247219
161623340 0247219
161623340 0247219
021
024
043
036
023
027
009
010
X70005
X81602
Z10933
X34147
X18919
X41191
X40452
X45008
01
01
01
02
01
01
01
01
WC
WC
WC
WC
WC
WC
GL
GL
IND
IND
IND
IND
IND
IND
BI
BI
MCO00123965.
MCO00130379.
MCO00146053.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
681991
681992
681993
681993
681993
STACY KUSKO
0247219
CAPE URGENT CARE
202896034 0247219
EAST COAST ORTHO. &, 204484976 0247219
EAST COAST ORTHO. &, 204484976 0247219
EAST COAST ORTHO. &, 204484976 0247219
009
043
012
012
038
X94524
Z10933
Z05059
Z05059
Z05471
01
01
01
01
01
WC
WC
WC
WC
WC
IND
MED
MED
MED
MED
MCO00137519.
MCO00146053.
MCO00143022.
MCO00143022.
MCO00143263.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
681994
681995
681996
681997
681998
BRIGANTINE CITY
CAPE MAY CITY
CAPE MAY CITY
EGG HARBOR TOWNSHIP
009
026
038
038
021
Z04848
Z02843
X88710
Z05471
X98251
01
02
01
01
01
WC
WC
WC
WC
WC
MED
IND
IND
IND
IND
MCO00142921.
MCO00141786.
MCO00134236.
MCO00143263.
MCO00139155.
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
210634549
216000384
216000429
216000429
216000547
0247219
0247219
0247219
0247219
0247219
143
MCO00097438.
MCO00108155.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
276.00
163.00
439.00
4,350.25
658.30
517.00
1,984.00
40.20
10,495.82
1,480.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
80.00
10.00
10.00
10.00
10.00
10.00
50.00
1,362.84
697.30
266.50
381.50
648.00
880.00
900.00
759.64
985.44
1,058.80
857.88
2,967.99
2,012.00
4,979.99
535.50
220.80
93.76
93.76
232.66
420.18
824.00
1,686.00
1,070.08
1,686.00
948.94
LGL
8/03/11
LGL
4/23/12
TOTAL CHECK#:
LGL
4/21/12
LGL
1/27/14
LGL
8/05/11
LOSS 4/30/13
EXP 10/11/11
LOSS 12/20/14
LOSS 7/07/11
EXP
2/12/15
EXP
8/25/11
EXP
8/24/12
EXP
6/29/12
EXP 11/13/12
EXP
2/16/13
EXP
2/11/15
EXP
2/09/15
EXP
2/16/15
TOTAL CHECK#:
EXP
6/10/11
EXP
7/01/14
EXP
7/31/14
EXP
6/14/14
EXP 11/17/14
TOTAL CHECK#:
LOSS 11/27/14
LOSS 11/24/12
LGL 10/09/12
LGL
3/10/14
TOTAL CHECK#:
LOSS 8/09/13
LOSS 1/13/14
LOSS 2/16/15
LOSS 7/08/12
LOSS 1/23/12
LOSS 8/21/12
LGL
5/27/12
LGL
7/13/12
TOTAL CHECK#:
LOSS 6/26/14
LOSS 2/16/15
LOSS 11/27/14
LOSS 11/27/14
LOSS 12/07/14
TOTAL CHECK#:
LOSS 11/24/14
LOSS 10/24/14
LOSS 4/03/14
LOSS 12/07/14
LOSS 8/18/14
11 024-8810NJ
12 021-7720NJ
681970
12 031-5509NJ
14 036-7720NJ
11 043-7720NJ
13 021-7720NJ
11 027-7720NJ
14 033-7720NJ
11 026-9403NJ
15 009-7720NJ
11 008-8810NJ
12 039-9403NJ
12 015-8810NJ
12 024-9403NJ
13 043-7711NJ
15 043-5509NJ
15 008-7720NJ
15 008-7720NJ
681979
11 006-5509NJ
14 023-9053NJ
14 038-9053NJ
14 005-5509NJ
14 006-5509NJ
681980
14 012-7715NJ
12 023-5509NJ
12 006-7711NJ
14 027-8810NJ
681983
13 021-5509NJ
14 024-5509NJ
15 043-7520NJ
12 036-7720NJ
12 023-5509NJ
12 027-5509NJ
12 009-5509NJ
12 010-5509NJ
681990
14 009-9053NJ
15 043-7520NJ
14 012-7715NJ
14 012-7715NJ
14 038-9402NJ
681993
14 009-7711NJ
14 026-7720NJ
14 038-5509NJ
14 038-9402NJ
14 021-5509NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
TOWNSHIP
TOWNSHIP
NEW JERSEY
NEW JERSEY
NEW JERSEY
NEW JERSEY
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
216000690
216000690
216000928
216000928
216000928
216000928
0247219
0247219
0247219
0247219
0247219
0247219
014
014
008
023
039
014
X14840
X90115
X87367
X86410
Z06101
Z07103
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
IND
IND
MED
MED
MED
MED
MCO00095253.
MCO00134990.
MCO00133509.
MCO00132983.
MCO00143632.
MCO00144003.
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
009
009
006
006
043
036
024
037
037
037
037
037
037
037
009
026
026
Z00080
Z04848
Z05390
Z09891
Z10933
Z05062
X55550
Z04906
Z04906
Z04906
Z04906
Z04906
Z04906
Z04906
X87368
Z02843
Z02843
01
01
01
02
01
01
01
01
01
01
01
01
01
01
01
02
02
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
MED
IND
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00140147.
MCO00142921.
MCO00143236.
MCO00145535.
MCO00146053.
MCO00143055.
MCO00116184.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00133503.
MCO00141786.
MCO00141786.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
681999
682000
682001
682002
682002
682002
HAMILTON
HAMILTON
STATE OF
STATE OF
STATE OF
STATE OF
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
682003
682004
682005
682006
682007
682008
682009
682010
682011
682012
682013
682014
682015
682016
682017
682017
682017
OCEAN CITY
OCEAN CITY
PLEASANTVILLE CITY
PLEASANTVILLE CITY
WILDWOOD CITY
VINELAND COMMUNITY
LOWER TOWNSHIP
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
TWIN BORO PHYSICAL
T
T
T
T
T
T
T
T
T
T
216000952
216000952
216001018
216001018
216001360
216001670
216005700
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
3/06/15
3/06/15
3/06/15
3/06/15
682018
682019
682020
682020
SHORE ORTHOPAEDIC UN
HAND SURGERY AND REH
222540040
222540040
222545917
222545917
0247219
0247219
0247219
0247219
026
006
036
036
Z07929
Z09891
X90026
X90026
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00144433.
MCO00145535.
MCO00134969.
MCO00134969.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
682021
682022
682022
682022
682022
682022
682022
682022
682022
682022
682022
FERNANDO J. DELASOTT
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
222711719
223129563
223129563
223129563
223129563
223129563
223129563
223129563
223129563
223129563
223129563
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
037
036
014
012
024
024
024
024
005
015
036
Z04906
Z11462
Z11990
Z12161
Z12162
Z12162
Z12162
Z12162
Z12290
Z12291
Z12294
01
01
01
01
01
02
03
04
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00142983.
MCO00146386.
MCO00146699.
MCO00146741.
MCO00146803.
MCO00146803.
MCO00146803.
MCO00146803.
MCO00146904.
MCO00146711.
MCO00146891.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
682023
682024
682025
682026
682027
682028
682029
682030
682031
KINEMATIC CONSULTANT
KINEMATIC CONSULTANT
ONE CALL MEDICAL, IN
PROFESSIONAL PAIN MA
I.C.U. INVESTIGATION
ADVOCARE, LLC
223211494
223211494
223218521
223218521
223218521
223351986
223492387
223537011
223700669
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
024
023
037
037
037
002
006
043
022
X55550
X00875
Z04906
Z04906
Z04906
X79605
X80854
Z04343
X73306
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
GL
WC
MED
MED
MED
MED
MED
MED
MED
BI
MED
MCO00116184.
MCO201106024
MCO00142983.
MCO00142983.
MCO00142983.
MCO00129231.
MCO00129905.
N
144
MCO00125565.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
1,584.00
1,686.00
5.24
8.73
4.44
5.89
19.06
1,083.86
1,686.00
1,686.00
1,710.00
759.64
690.00
1,337.78
63.00
90.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
189.00
1,293.28
247.41
68.00
68.00
136.00
115.00
472.00
472.00
472.00
472.00
472.00
472.00
472.00
472.00
472.00
472.00
4,720.00
720.00
720.00
700.00
485.00
300.00
205.52
150.00
19.00
90.00
LOSS 11/26/11
LOSS 4/25/14
EXP
3/16/14
EXP
2/26/14
EXP 12/16/14
EXP
1/03/15
TOTAL CHECK#:
LOSS 9/14/14
LOSS 11/24/14
LOSS 12/05/14
LOSS 2/04/15
LOSS 2/16/15
LOSS 11/29/14
LOSS 2/05/13
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 3/16/14
LOSS 10/24/14
LOSS 10/24/14
TOTAL CHECK#:
LOSS 1/05/15
LOSS 2/04/15
LOSS 4/16/14
LOSS 4/16/14
TOTAL CHECK#:
LOSS 11/26/14
LOSS 2/20/15
LOSS 3/01/15
LOSS 3/02/15
LOSS 3/02/15
LOSS 3/02/15
LOSS 3/02/15
LOSS 3/02/15
LOSS 3/04/15
LOSS 3/01/15
LOSS 3/01/15
TOTAL CHECK#:
LOSS 2/05/13
LOSS 6/02/11
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 12/08/13
EXP
1/06/14
EXP
9/27/14
LOSS 9/20/13
11
14
14
14
14
15
014-7720NJ
014-7720NJ
008-7720NJ
023-9015NJ
039-5509NJ
014-7720NJ
682002
14 009-7711NJ
14 009-7711NJ
14 006-7720NJ
15 006-7711NJ
15 043-7520NJ
14 036-7711NJ
13 024-9403NJ
14 037-5509NJ
14 037-5509NJ
14 037-5509NJ
14 037-5509NJ
14 037-5509NJ
14 037-5509NJ
14 037-5509NJ
14 009-7720NJ
14 026-7720NJ
14 026-7720NJ
682017
15 026-9403NJ
15 006-7711NJ
14 036-7720NJ
14 036-7720NJ
682020
14 037-5509NJ
15 036-7520NJ
15 014-7720NJ
15 012-7720NJ
15 024-9430NJ
15 024-9430NJ
15 024-9430NJ
15 024-9430NJ
15 005-7711NJ
15 015-7720NJ
15 036-5509NJ
682022
13 024-9403NJ
11 023-5509NJ
14 037-5509NJ
14 037-5509NJ
14 037-5509NJ
13 002-5509NJ
14 006-7720NJ
14 043-5509NJ
13 022-7711NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
IRS#
BATCH#
CB002 00100NJ
GRP FILE#
CL
COV
CLIENT#
3/06/15
682031 ROTHMAN INSTITUTE OF 223700669 0247219 007 Z01712 01 WC MED MCO00141117.
3/06/15
3/06/15
3/06/15
3/06/15
682032
682032
682032
682032
FOX
FOX
FOX
FOX
REHAB
REHAB
REHAB
REHAB
223822612
223822612
223822612
223822612
0247219
0247219
0247219
0247219
024
023
012
012
X99651
Z04088
Z05059
Z05059
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00139832.
MCO00142475.
MCO00143022.
MCO00143022.
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
682033
682034
682034
682034
682034
682034
REHAB CLINICS (SPT)
232736153
232736153
232736153
232736153
232736153
232736153
0247219
0247219
0247219
0247219
0247219
0247219
007
036
036
036
007
007
Z01712
X73094
X73094
X73094
Z01712
Z01712
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO00141117.
MCO00125478.
MCO00125478.
MCO00125478.
MCO00141117.
MCO00141117.
3/06/15
3/06/15
3/06/15
682035 LEO PETETTI, LLC.
270005874 0247219 017 Z10688 01 PR COMP AVALON
270005874 0247219 021 Z09454 01 PR COL EGG HARBOR T
270005874 0247219 014 Z12360 01 PR COL HAMILTON TWP
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
3/06/15
682037
682038
682039
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
682040
455564717
455564717
455564717
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
3/06/15
3/06/15
682041 STONERIVER PHARMACY
682041 STONERIVER PHARMACY
621770924 0247219 021 X77237 02 WC MED MCO00127753.
621770924 0247219 037 Z07931 01 WC MED MCO00144392.
3/06/15
3/06/15
3/10/15
3/10/15
3/10/15
3/10/15
682042
682043
682044
682045
682046
682046
999999999
999999999
020701782
020701782
020701782
020701782
3/10/15
3/10/15
3/10/15
682047 ADMINISTRATIVE CLAIM 043174375 0247271 039 Z08073 01 WC MED MCO00144459.
133973142 0247271 042 X70655 01 GL BI
133973142 0247271 007 Z10900 01 GL PPBI
OUTPATIENT
OUTPATIENT
OUTPATIENT
OUTPATIENT
THE DEWEESE LAW
THE DEWEESE LAW
THE DEWEESE LAW
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
AFFANATO MARUT,
FIRM
FIRM
FIRM
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
LLC
CITY OF MARGATE
HAMILTON TOWNSHIP
ATLANTICARE PHYSICIA
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247219
0247271
0247271
0247271
0247271
036
007
036
006
037
021
023
014
021
027
009
026
014
038
008
009
010
026
026
044
014
014
009
010
010
X16792
X78970
X34147
W81842
W86835
X40541
X48999
X58070
X75966
X81959
X85028
X85860
X90681
X96484
X96684
Z00080
Z02841
Z03327
Z03498
Z08125
Z12360
Z08204
Z08661
Z08662
Z09247
145
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
PR
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
PR
PR
WC
WC
WC
WC
I/M
MED
MED
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
I/M
COL
MED
MED
MED
MED
MILLVILLE
MCO00128787.
MCO201101153
MCO201103101
MCO00107859.
MCO00113320.
MCO00117428.
MCO00127081.
MCO00130576.
MCO00132289.
MCO00132700.
MCO00135294.
MCO00138429.
MCO00140147.
MCO00141784.
MCO00142093.
MARGATE CITY
HAMILTON TWP
MCO00144639.
MCO00144877.
MCO00144901.
MCO00145147.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
73.90
163.90
63.00
90.00
63.00
63.00
279.00
342.00
185.00
185.00
185.00
80.63
80.63
716.26
679.50
160.00
85.00
245.00
157.00
150.00
27,500.00
223.00
186.00
249.00
134.00
304.00
112.00
109.00
132.00
165.00
232.00
333.00
240.00
443.00
193.00
238.00
336.00
3,629.00
183.14
55.27
238.41
1,500.00
3,807.21
63.37
263.00
61.39
263.00
324.39
3.00
10.00
10.00
LOSS 10/08/14
TOTAL CHECK#:
LOSS 9/06/14
LOSS 11/12/14
LOSS 11/27/14
LOSS 11/27/14
TOTAL CHECK#:
LOSS 10/08/14
LOSS 9/19/13
LOSS 9/19/13
LOSS 9/19/13
LOSS 10/08/14
LOSS 10/08/14
TOTAL CHECK#:
EXP
2/13/15
EXP
1/28/15
EXP
3/01/15
TOTAL CHECK#:
LGL 12/01/11
EXP 12/07/13
EXP
7/08/12
LGL
1/15/11
LGL
3/10/11
LGL
8/03/12
LGL 11/30/12
LGL
3/06/13
LGL 10/24/13
LGL
1/03/14
LGL
2/20/14
LGL
2/21/14
LGL
5/04/14
LGL
7/24/14
LGL
7/27/14
LGL
9/14/14
LGL 10/23/14
LGL 10/29/14
LGL 10/27/14
TOTAL CHECK#:
LOSS 11/07/13
LOSS 1/09/15
TOTAL CHECK#:
LOSS 12/22/14
LOSS 3/01/15
LOSS 1/14/15
LOSS 1/20/15
LOSS 1/20/15
LOSS 1/27/15
TOTAL CHECK#:
EXP
1/12/15
EXP 12/19/12
EXP
5/03/13
14 007-5509NJ
682031
14 024-7720NJ
14 023-5509NJ
14 012-7715NJ
14 012-7715NJ
682032
14 007-5509NJ
13 036-7720NJ
13 036-7720NJ
13 036-7720NJ
14 007-5509NJ
14 007-5509NJ
682034
15 017-9430NJ
15 021-9420NJ
15 014-7720NJ
682036
11 036-7520NJ
13 007-7720NJ
12 036-7720NJ
11 006-7720NJ
11 037-8810NJ
12 021-7720NJ
12 023-9403NJ
13 014-7720NJ
13 021-5509NJ
14 027-5509NJ
14 009-5509NJ
14 026-7720NJ
14 014-7720NJ
14 038-7720NJ
14 008-7720NJ
14 009-7711NJ
14 010-7720NJ
14 026-5509NJ
14 026-7720NJ
682040
13 021-7720NJ
15 037-7720NJ
682041
14 044-5509NJ
15 014-7720NJ
15 014-7715NJ
15 009-7720NJ
15 010-9403NJ
15 010-9403NJ
682046
15 039-5509NJ
12 042-7720NJ
13 007-7720NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
036
008
008
010
042
042
021
043
010
009
037
027
039
015
015
024
004
043
006
043
009
021
043
X02818
X04249
X08145
X18291
X21494
X21494
X24064
X34257
X34722
X35537
X40418
X41191
X41407
X43438
X45469
X47413
X70872
X97775
Z08544
Z10933
Z11029
Z11032
Z11033
01
01
01
01
01
02
01
01
01
01
01
01
01
01
02
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00080143.
MCO00080935.
MCO00082819.
MCO00096999.
MCO00098940.
MCO00098940.
MCO00100699.
MCO00106472.
MCO00106754.
MCO00107163.
MCO00107843.
MCO00108155.
MCO00108235.
141867044
141867044
141867044
141867044
141867044
141867044
0247271
0247271
0247271
0247271
0247271
0247271
0247271
021
008
006
007
045
024
006
X07452
X41402
X50121
X63143
X64666
X81602
X82058
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
IND
MED
MED
MED
MED
MED
MED
MCO00082593.
MCO00108236.
MCO00113968.
MCO00120252.
MCO00121114.
MCO00130379.
MCO00130595.
141872046
141872046
141872046
141872046
141872046
0247271
0247271
0247271
0247271
0247271
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
682050
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682051
682052
682053
682053
682053
682053
682053
DANIEL
JERSEY
JERSEY
JERSEY
JERSEY
JERSEY
JERSEY
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682054
682054
682054
682054
682054
PIETRAS,
PIETRAS,
PIETRAS,
PIETRAS,
PIETRAS,
014
038
007
045
042
X14840
X17061
X44748
X64666
X88917
01
01
01
01
01
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
MCO00095253.
MCO00096364.
MCO00110385.
MCO00121114.
MCO00134339.
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682055
682056
682057
682058
682059
682059
MARK SIMON
0247271 009
JOSEPH MARRONE
0247271 045
MARK ALEXANDER
0247271 006
THE SIMONS GROUP, LL 200796890 0247271 023
NEW JERSEY IME ASSOC 202197146 0247271 002
NEW JERSEY IME ASSOC 202197146 0247271 036
X34720
X64666
X08695
Z04088
X79605
X83094
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
IND
IND
IND
MED
MED
MED
MCO00106751.
MCO00121114.
MCO00082985.
MCO00142475.
MCO00129231.
MCO00131187.
3/10/15
3/10/15
3/10/15
682060 O'BRIEN ADJUSTMENT S 202647837 0247271 036 Z08765 01 PR B/C
682061 O'BRIEN ADJUSTMENT S 202647837 0247271 005 Z06609 01 PR I/M NORTHFIELD C
682061 O'BRIEN ADJUSTMENT S 202647837 0247271 036 Z06756 01 PR I/M
3/10/15
3/10/15
682062 CAPE URGENT CARE
682063 CAPE URGENT CARE
LITTLEFIELD
SHORE REPORTI
SHORE REPORTI
SHORE REPORTI
SHORE REPORTI
SHORE REPORTI
SHORE REPORTI
SARACINO,
SARACINO,
SARACINO,
SARACINO,
SARACINO,
S
S
S
S
S
MCO00110918.
MCO00112074.
MCO00124334.
MCO00138943.
MCO00144841.
MCO00146053.
MCO00146115.
MCO00146120.
MCO00146102.
202896034 0247271 012 Z09581 01 WC MED MCO00145346.
202896034 0247271 043 Z10521 01 WC MED MCO00145901.
146
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
230.00
1,480.00
105.28
90.00
90.00
90.00
90.00
90.00
450.00
706.00
675.50
329.50
657.00
175.00
2,543.00
1,512.00
4,014.48
1,035.72
735.00
550.00
550.00
1,100.00
419.65
381.60
412.65
794.25
86.87
134.87
EXP
6/24/11
EXP
7/13/11
EXP
8/30/11
EXP 12/13/11
EXP
2/27/12
EXP
2/27/12
EXP
3/31/12
EXP
7/09/12
EXP
7/16/12
EXP
7/25/12
EXP
8/11/12
EXP
8/21/12
EXP
8/24/12
EXP
6/29/12
EXP
8/17/12
EXP 11/13/12
EXP
8/20/13
EXP
8/07/14
EXP
1/17/15
EXP
2/16/15
EXP
2/18/15
EXP
2/19/15
EXP
2/18/15
TOTAL CHECK#:
LOSS 8/20/11
EXP
8/23/12
EXP 12/10/12
EXP
5/09/13
EXP
5/30/13
EXP
1/13/14
EXP
1/19/14
TOTAL CHECK#:
LGL 11/26/11
LGL 12/29/11
LGL 10/09/12
LGL
5/30/13
LGL
4/05/14
TOTAL CHECK#:
LOSS 7/16/12
LOSS 5/30/13
LOSS 9/03/11
EXP 11/12/14
LOSS 12/08/13
LOSS 1/30/14
TOTAL CHECK#:
EXP
1/06/15
EXP 12/22/14
EXP 12/30/14
TOTAL CHECK#:
LOSS 1/31/15
LOSS 2/11/15
11
11
11
11
12
12
12
12
12
12
12
12
12
12
12
12
13
14
15
15
15
15
15
036-7720NJ
008-7720NJ
008-7720NJ
010-7720NJ
042-7720NJ
042-7720NJ
021-5509NJ
043-7720NJ
010-7720NJ
009-5509NJ
037-7720NJ
027-5509NJ
039-9403NJ
015-8810NJ
015-7720NJ
024-9403NJ
004-7720NJ
043-5509NJ
006-7711NJ
043-7520NJ
009-7711NJ
021-7720NJ
043-7720NJ
682050
11 021-7720NJ
12 008-7720NJ
12 006-7711NJ
13 007-9015NJ
13 045-9430NJ
14 024-5509NJ
14 006-7711NJ
682053
11 014-7720NJ
11 038-5509NJ
12 007-5509NJ
13 045-9430NJ
14 042-7720NJ
682054
12 009-7711NJ
13 045-9430NJ
11 006-7711NJ
14 023-5509NJ
13 002-5509NJ
14 036-5509NJ
682059
15 036-9102NJ
14 005-9102NJ
14 036-5509NJ
682061
15 012-9430NJ
15 043-5509NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
204484976
208761981
210662542
216000928
216001164
216001324
216005700
222540040
222540040
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
027
045
022
037
023
039
024
024
009
01
01
01
01
01
01
01
01
01
Z09374
X64666
Z11459
Z07931
Z11460
Z06101
X55550
X47413
Z10520
COV
CLIENT#
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682064
682065
682066
682067
682068
682069
682070
682071
682071
RALPH G. CATALDO, DO
CAPE REGIONAL MEDICA
STATE OF NEW JERSEY
SEA ISLE CITY
UPPER TOWNSHIP
LOWER TOWNSHIP
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
IND
MED
MED
IND
IND
IND
MED
MED
MCO00145225.
MCO00121114.
MCO00146314.
MCO00144392.
MCO00146296.
MCO00143632.
MCO00116184.
MCO00112074.
MCO00145922.
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682072
682073
682073
682073
682073
682073
682073
HAND SURGERY AND REH 222545917 0247271 036 X90026 01 WC
QUALCARE, INC.
223129563 0247271 005 Z12289 01 WC
QUALCARE, INC.
223129563 0247271 034 Z12392 01 WC
QUALCARE, INC.
223129563 0247271 011 Z12471 01 WC
QUALCARE, INC.
223129563 0247271 023 Z12472 01 WC
QUALCARE, INC.
223129563 0247271 036 Z12474 01 WC
QUALCARE, INC.
223129563 0247271 034 Z12672 01 WC
MED
MED
MED
MED
MED
MED
MED
MCO00134969.
MCO00146848.
MCO00146918.
MCO00146942.
MCO00146947.
MCO00146979.
MCO00147009.
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682074
682075
682076
682077
682078
682079
682080
682081
682082
682083
682084
682085
682086
682086
682086
682086
682086
682086
682086
682086
682086
682086
OCEAN CITY FAMILY PR
DWYER & DUNNIGAN
QUEST COPY SERVICE L
ANDREA BLOCH D.O.
PHOTOFAX, INC
COMPREHENSIVE MEDICA
MEDEXPRESS URGENT CA
THE DEWEESE LAW FIRM
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
223218521
223283776
223626977
223636768
223752318
223822612
223822612
272584205
363618907
371558333
455388778
455564717
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
463266146
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
0247271
026
009
045
030
015
005
027
023
021
007
036
021
021
036
008
005
041
036
036
027
006
042
Z06186
Z10294
X64666
X85172
X45469
Z03152
Z08547
Z09083
Z03411
X44748
Z09803
X26999
X24064
X40881
X41402
X45811
X55173
X55993
X73094
X76154
X77067
X93974
01
01
01
01
02
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
IND
MED
MED
MED
MED
MED
MED
MED
MED
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
MCO00143674.
MCO00145721.
MCO00121114.
MCO00132384.
MCO00110918.
MCO00141989.
MCO00144830.
MCO00145091.
MCO00142125.
MCO00110385.
MCO00145481.
MCO00102474.
MCO00100699.
MCO00108016.
MCO00108236.
MCO00111179.
MCO00115876.
MCO00116355.
MCO00125478.
MCO00127172.
MCO00127678.
MCO00137223.
3/10/15
3/10/15
3/10/15
3/10/15
3/10/15
682087
682088
682088
682088
682088
WATERFORD FAMILY PRA
STONERIVER PHARMACY
STONERIVER PHARMACY
STONERIVER PHARMACY
STONERIVER PHARMACY
562354590
621770924
621770924
621770924
621770924
0247271
0247271
0247271
0247271
0247271
030
023
023
022
026
X85172
X48720
X48720
X73306
Z02843
01
01
01
01
02
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MCO00132384.
MCO00112875.
MCO00112875.
MCO00125565.
MCO00141786.
3/10/15
3/13/15
3/13/15
3/13/15
682089
682090
682091
682092
CITY OF NORTHFIELD
ISO SERVICES, INC.
ISO SERVICES, INC.
999999999
020701782
133973142
133973142
0247271
0247365
0247365
0247365
005
037
006
008
Z06609
Z09893
X96633
Z11222
01
01
01
01
PR
WC
AL
AL
I/M NORTHFIELD C
MED MCO00145544.
BI
PD
147
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
260.43
400.00
795.00
3.57
1,043.45
1,418.78
191.12
84.00
132.00
216.00
68.00
472.00
472.00
472.00
472.00
472.00
472.00
2,832.00
485.00
185.00
1,204.52
75.00
275.00
63.00
63.00
239.00
2,234.38
1,200.00
160.00
10,793.62
192.00
168.00
463.00
216.00
108.00
180.00
169.00
192.00
156.00
465.00
2,309.00
100.00
183.14
11.28
58.06
55.27
307.75
1,623.79
59.80
10.00
10.00
LOSS 1/29/15
LOSS 5/30/13
LOSS 2/21/15
EXP
1/09/15
LOSS 2/23/15
LOSS 12/16/14
LOSS 2/05/13
LOSS 11/13/12
LOSS 2/12/15
TOTAL CHECK#:
LOSS 4/16/14
LOSS 3/02/15
LOSS 3/04/15
LOSS 3/06/15
LOSS 3/06/15
LOSS 3/06/15
LOSS 3/07/15
TOTAL CHECK#:
LOSS 12/17/14
LOSS 2/09/15
LOSS 5/30/13
EXP
1/27/14
LOSS 8/17/12
LOSS 10/13/14
LOSS 1/15/15
LOSS 1/26/15
EXP 11/02/14
LOSS 10/09/12
LOSS 2/04/15
LGL
4/23/12
LGL
3/31/12
LGL
8/15/12
LGL
8/23/12
LGL 10/23/12
LGL
1/31/13
LGL
2/07/13
LGL
9/19/13
LGL 10/28/13
LGL 11/07/13
LGL
6/19/14
TOTAL CHECK#:
EXP
1/27/14
LOSS 11/24/12
LOSS 11/24/12
LOSS 9/20/13
LOSS 10/24/14
TOTAL CHECK#:
LOSS 12/22/14
LOSS 2/04/15
EXP
7/08/14
EXP
1/26/15
15
13
15
15
15
14
13
12
15
027-5509NJ
045-9430NJ
022-7711NJ
037-7720NJ
023-9403NJ
039-5509NJ
024-9403NJ
024-9403NJ
009-7720NJ
682071
14 036-7720NJ
15 005-9106NJ
15 034-5509NJ
15 011-9403NJ
15 023-5509NJ
15 036-9102NJ
15 034-7720NJ
682073
14 026-7715NJ
15 009-5509NJ
13 045-9430NJ
14 030-5509NJ
12 015-7720NJ
14 005-7720NJ
15 027-7720NJ
15 023-5509NJ
14 021-7720NJ
12 007-5509NJ
15 036-7520NJ
12 021-7720NJ
12 021-5509NJ
12 036-5509NJ
12 008-7720NJ
12 005-5509NJ
13 041-8810NJ
13 036-7580NJ
13 036-7720NJ
13 027-9403NJ
13 006-7720NJ
14 042-7720NJ
682086
14 030-5509NJ
12 023-5509NJ
12 023-5509NJ
13 022-7711NJ
14 026-7720NJ
682088
14 005-9102NJ
15 037-7720NJ
14 006-5509NJ
15 008-5509NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682093
682093
682093
682093
682093
682093
682093
682093
682093
682093
682093
682093
682093
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
038
021
036
003
021
026
035
045
026
017
022
023
036
X17061
X56219
Z11151
Z11291
Z11294
Z11297
Z11298
Z11302
Z11381
Z11458
Z11459
Z11460
Z11461
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
3/13/15
3/13/15
3/13/15
3/13/15
682094
682094
682094
682094
ISO
ISO
ISO
ISO
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
133973142
133973142
133973142
133973142
0247365
0247365
0247365
0247365
038
038
015
022
X70653
Z09212
Z11340
Z11345
01
01
01
01
GL
GL
GL
GL
BI
BI
BI
BI
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682095
682096
682097
682098
682099
682100
682101
682102
682103
682104
682105
682106
682106
682106
682106
682106
ERIC GRANT
ANDREW MATTERN
GARY SMILEY
FREDERICK PANE
JERSEY SHORE REPORTI
PIETRAS, SARACINO, S
GERALD SUTTS
KEVIN OLSON
RICHARD WILENT
HOWARD SMITH
JEREMY IRELAND
201901714
201901714
201901714
201901714
201901714
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
008
023
037
023
006
037
001
043
009
023
023
014
014
014
014
014
X17667
X48720
X51435
X51540
X70873
X51435
X71376
Z10933
X67311
W87271
X11917
X99960
X99960
X99960
X99960
X99960
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
MED
IND
IND
IND
IND
IND
IND
MED
MED
MED
MED
MED
3/13/15
3/13/15
3/13/15
3/13/15
682107
682107
682107
682107
NEW
NEW
NEW
NEW
202197146
202197146
202197146
202197146
0247365
0247365
0247365
0247365
021
011
014
044
X70005
X88077
X90681
X97658
01
01
01
01
WC
WC
WC
WC
MED MCO00123965.
MED MCO00133869.
MED MCO00135294.
MED
3/13/15
3/13/15
3/13/15
682108 EAST COAST ORTHO. &, 204484976 0247365 024 X99651 01 WC MED MCO00139832.
682108 EAST COAST ORTHO. &, 204484976 0247365 012 Z07456 01 WC MED MCO00144132.
682108 EAST COAST ORTHO. &, 204484976 0247365 037 Z07931 01 WC MED MCO00144392.
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682109
682110
682111
682112
682113
682114
JERSEY
JERSEY
JERSEY
JERSEY
IME
IME
IME
IME
ASSOC
ASSOC
ASSOC
ASSOC
MDS MEDICAL DEVICE S
INSPIRA MEDICAL CENT
NORTH WILDWOOD CITY
LINWOOD CITY
141867044
141872046
204959083
210634484
210634549
210662542
214000944
216000800
0247365
0247365
0247365
0247365
0247365
0247365
008
036
006
038
022
042
X79964
Z07457
Z09891
Z11300
X73306
X52140
148
01
01
02
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
IND
IND
MCO00096364.
MCO00116493.
MCO00146172.
MCO00146249.
MCO00146298.
MCO00146244.
MCO00146247.
MCO00146294.
MCO00146349.
MCO00146314.
MCO00146296.
MCO00146384.
MCO00096693.
MCO00112875.
MCO00114540.
MCO00114613.
MCO00124315.
MCO00114540.
MCO00124565.
MCO00146053.
MCO00122656.
MCO201103168
MCO00093680.
MCO00140045.
MCO00140045.
MCO00140045.
MCO00140045.
MCO00140045.
MCO00129514.
MCO00144168.
MCO00145535.
MCO00146289.
MCO00125565.
MCO00115029.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
130.00
10.00
10.00
10.00
10.00
40.00
1,512.00
697.30
3,550.00
2,366.41
90.00
414.00
972.16
759.64
880.00
1,711.36
1,120.00
63.00
63.00
63.00
63.00
63.00
315.00
550.00
550.00
550.00
750.00
2,400.00
111.62
147.55
936.36
1,195.53
704.92
1,215.10
2,511.00
795.00
1,652.00
1,534.00
EXP 12/29/11
EXP
2/10/13
EXP
2/18/15
EXP
2/22/15
EXP
2/23/15
EXP
2/23/15
EXP
2/21/15
EXP
2/23/15
EXP
7/30/14
EXP
2/24/15
EXP
2/21/15
EXP
2/23/15
EXP
2/20/15
TOTAL CHECK#:
EXP
7/23/13
EXP
1/25/15
EXP
2/23/15
EXP
1/29/15
TOTAL CHECK#:
LOSS 1/08/12
LOSS 11/24/12
LOSS 4/01/12
LOSS 1/07/13
EXP
8/19/13
LGL
4/01/12
LOSS 8/23/13
LOSS 2/16/15
LOSS 7/08/13
LOSS 3/16/11
LOSS 10/17/11
LOSS 9/12/14
LOSS 9/12/14
LOSS 9/12/14
LOSS 9/12/14
LOSS 9/12/14
TOTAL CHECK#:
EXP
8/09/13
EXP
3/24/14
EXP
5/04/14
EXP
8/05/14
TOTAL CHECK#:
LOSS 9/06/14
LOSS 1/06/15
LOSS 1/09/15
TOTAL CHECK#:
LOSS 12/16/13
LOSS 1/06/15
LOSS 2/04/15
LOSS 2/20/15
LOSS 9/20/13
LOSS 1/15/13
11
13
15
15
15
15
15
15
14
15
15
15
15
038-5509NJ
021-9430NJ
036-7720NJ
003-7720NJ
021-9430NJ
026-7711NJ
035-5509NJ
045-7720NJ
026-5509NJ
017-7720NJ
022-7711NJ
023-9403NJ
036-7720NJ
682093
13 038-9053NJ
15 038-9410NJ
15 015-5509NJ
15 022-5509NJ
682094
12 008-7711NJ
12 023-5509NJ
12 037-5509NJ
13 023-9403NJ
13 006-7711NJ
12 037-5509NJ
13 001-5509NJ
15 043-7520NJ
13 009-7720NJ
11 023-5509NJ
11 023-9403NJ
14 014-7720NJ
14 014-7720NJ
14 014-7720NJ
14 014-7720NJ
14 014-7720NJ
682106
13 021-5509NJ
14 011-9430NJ
14 014-7720NJ
14 044-5509NJ
682107
14 024-7720NJ
15 012-7720NJ
15 037-7720NJ
682108
13 008-7720NJ
15 036-9430NJ
15 006-7711NJ
15 038-7720NJ
13 022-7711NJ
13 042-7720NJ
LR0503685
ACCOUNT:002
PERIOD:03/2015
QUAL-LYNX
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682115
682116
682117
682118
682119
682120
682121
682122
682123
682124
682125
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
682126
MARGATE CITY
MILLVILLE CITY
NORTHFIELD CITY
NORTHFIELD CITY
PLEASANTVILLE CITY
SOMERS POINT CITY
UPPER TOWNSHIP
VENTNOR CITY
LOWER TOWNSHIP
GEMMEL, TODD & MEREN
TWIN BORO PHYSICAL T
216000828
216000875
216000945
216000945
216001018
216001196
216001324
216001326
216005700
222046544
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
044
036
005
005
006
010
039
008
024
023
037
008
008
008
037
037
005
005
009
009
021
021
021
021
009
009
009
009
026
026
026
026
Z07817
X73094
X78968
Z03152
X88172
Z02841
Z06101
X79964
Z08071
X48204
Z04906
X79964
X79964
X79964
X81753
X81753
X86239
X86239
X87368
X87368
X98251
X98251
X98251
X98251
Z00080
Z00080
Z00080
Z00080
Z02843
Z05819
Z05819
Z05819
01
01
01
01
03
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
02
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
AL
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
IND
IND
IND
IND
BI
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00144295.
MCO00125478.
MCO00128802.
MCO00141989.
MCO00133944.
MCO00141784.
MCO00143632.
MCO00129514.
MCO00144540.
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682127
682128
682129
682130
682131
682131
682131
682131
682131
682131
ATLANTIC PULMONARY &
ATLANTIC PULMONARY C
BOB'S AUTO BODY
222409225
222409225
222420309
222540040
222540040
222540040
222540040
222540040
222540040
222540040
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
008
014
043
026
008
005
003
027
027
043
X74634
Z07103
Z11939
Z09084
X79964
X86239
Z05652
Z06585
Z06585
Z10933
01
01
01
01
01
01
01
01
01
01
WC
WC
PR
WC
WC
WC
WC
WC
WC
WC
MED
MED
COL
MED
MED
MED
MED
MED
MED
MED
MCO00126325.
MCO00144003.
WILDWOOD CIT
MCO00145118.
MCO00129514.
MCO00132909.
MCO00143378.
MCO00143911.
MCO00143911.
MCO00146053.
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682132
682133
682134
682135
682136
682136
682136
ELLIOT L AMES DO
THE MEDICAL CENTER O
COURTNEY VANDERSLICE
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
222620270
222649838
222711719
222803078
223129563
223129563
223129563
0247365
0247365
0247365
0247365
0247365
0247365
0247365
009
037
009
009
036
009
009
X94524
X51435
Z00080
X44466
Z11993
Z12671
Z12824
01
01
01
01
01
01
01
WC
WC
WC
GL
WC
WC
WC
MED
IND
MED
BI
MED
MED
MED
MCO00137519.
MCO00114540.
MCO00140147.
149
MCO00142983.
MCO00129514.
MCO00129514.
MCO00129514.
MCO00130428.
MCO00130428.
MCO00132909.
MCO00132909.
MCO00133503.
MCO00133503.
MCO00139155.
MCO00139155.
MCO00139155.
MCO00139155.
MCO00140147.
MCO00140147.
MCO00140147.
MCO00140147.
MCO00141786.
MCO00143500.
MCO00143500.
MCO00143500.
MCO00146698.
MCO00146994.
MCO00147024.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
1,710.00
1,652.00
1,652.00
1,686.00
1,686.00
1,686.00
608.04
1,652.00
1,465.71
2,454.50
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
1,323.00
32.00
193.20
1,997.80
373.61
1,347.80
35.75
66.00
259.33
1,234.44
212.52
3,155.84
800.00
400.00
80.00
175,000.00
472.00
472.00
472.00
LOSS 1/09/15
LOSS 9/19/13
LOSS 12/09/13
LOSS 10/13/14
LOSS 3/27/14
LOSS 10/23/14
LOSS 12/16/14
LOSS 12/16/13
LOSS 1/08/15
LGL 11/24/12
LOSS 11/26/14
LOSS 12/16/13
LOSS 12/16/13
LOSS 12/16/13
LOSS 1/13/14
LOSS 1/13/14
LOSS 3/04/14
LOSS 3/04/14
LOSS 3/16/14
LOSS 3/16/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 10/24/14
LOSS 12/12/14
LOSS 12/12/14
LOSS 12/12/14
TOTAL CHECK#:
EXP 10/07/13
LOSS 1/03/15
LOSS 2/25/15
LOSS 1/26/15
LOSS 12/16/13
LOSS 3/04/14
LOSS 12/10/14
LOSS 12/28/14
LOSS 12/28/14
LOSS 2/16/15
TOTAL CHECK#:
LOSS 6/26/14
LOSS 4/01/12
LOSS 9/14/14
LOSS 7/20/12
LOSS 2/27/15
LOSS 3/06/15
LOSS 3/02/15
15
13
13
14
14
14
14
13
15
12
14
13
13
13
14
14
14
14
14
14
14
14
14
14
14
14
14
14
14
14
14
14
044-7720NJ
036-7720NJ
005-7720NJ
005-7720NJ
006-7720NJ
010-7720NJ
039-5509NJ
008-7720NJ
024-7720NJ
023-5509NJ
037-5509NJ
008-7720NJ
008-7720NJ
008-7720NJ
037-5509NJ
037-5509NJ
005-9106NJ
005-9106NJ
009-7720NJ
009-7720NJ
021-5509NJ
021-5509NJ
021-5509NJ
021-5509NJ
009-7711NJ
009-7711NJ
009-7711NJ
009-7711NJ
026-7720NJ
026-5509NJ
026-5509NJ
026-5509NJ
682126
13 008-7720NJ
15 014-7720NJ
15 043-7720NJ
15 026-5509NJ
13 008-7720NJ
14 005-9106NJ
14 003-7720NJ
14 027-7720NJ
14 027-7720NJ
15 043-7520NJ
682131
14 009-9053NJ
12 037-5509NJ
14 009-7711NJ
12 009-5509NJ
15 036-7720NJ
15 009-9102NJ
15 009-8810NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
INC.
INC.
INC.
INC.
INC.
INC.
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
223129563
223129563
223129563
223129563
223129563
223129563
0247365
0247365
0247365
0247365
0247365
0247365
027
008
024
026
036
043
Z12827
Z12986
Z12987
Z12988
Z12990
Z12991
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO00147041.
MCO00147212.
MCO00147232.
MCO00147173.
MCO00147202.
MCO00147238.
223218521
223218521
223265214
223579200
223700669
223752318
223752318
223752318
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
003
037
008
037
005
021
021
033
Z05652
Z07931
X88175
X51435
X78968
X77237
X77237
Z07107
01
01
01
01
01
01
02
01
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
IND
MED
MED
MED
MED
MCO00143378.
MCO00144392.
MCO00133828.
MCO00114540.
MCO00128802.
MCO00127753.
MCO00127753.
MCO00144001.
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682136
682136
682136
682136
682136
682136
QUALCARE,
QUALCARE,
QUALCARE,
QUALCARE,
QUALCARE,
QUALCARE,
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682137
682138
682139
682140
682141
682142
682142
682142
ONE CALL MEDICAL INC
D'ARCY JOHNSON DAY,
ANDREA BLOCH D.O.
ANDREA BLOCH D.O.
ANDREA BLOCH D.O.
3/13/15
3/13/15
3/13/15
682143 FOX OUTPATIENT REHAB 223822612 0247365 017 X93675 01 WC MED MCO00136979.
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682144
682145
682146
682147
682147
DJS ASSOCIATES, INC.
REHAB CLINICS (SPT)
AD PREMIER ORTHO AND
AD PREMIER ORTHO AND
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682148
682149
682150
682150
682150
682150
ADVANCED
RELIEVUS
NICOLAPT
NICOLAPT
NICOLAPT
NICOLAPT
3/13/15
3/13/15
3/13/15
682151 ATLANTIC RADIOLOGIST 264036315 0247365 025 X99652 01 WC MED MCO00139820.
3/13/15
3/13/15
3/13/15
270005874 0247365 006 Z12114 01 PR COL PLEASANTVILL
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
3/13/15
682153
682154
682155
682156
682157
682158
682159
682160
682161
682162
272248055
382084239
382084239
542091537
621770924
710884319
999999999
999999999
999999999
999999999
232208440
232736153
232736153
232866529
232866529
0247365
0247365
0247365
0247365
0247365
043
007
007
009
009
X10123
Z01712
Z01712
X94524
X94524
01
01
01
01
01
GL
WC
WC
WC
WC
BI
MED
MED
MED
MED
MCO00141117.
MCO00141117.
MCO00137519.
MCO00137519.
RADIOLOGY S 261212464
262043323
LLC
262230453
LLC
262230453
LLC
262230453
LLC
262230453
0247365
0247365
0247365
0247365
0247365
0247365
021
027
003
003
003
003
Z07303
X33192
Z05652
Z05652
Z05652
Z05652
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO00144056.
MCO00106060.
MCO00143378.
MCO00143378.
MCO00143378.
MCO00143378.
MEDIKINE GROUP, LLC
QUEST DIAGNOSTICS
QUEST DIAGNOSTICS
GREYSTONE APPRAISALS
STONERIVER PHARMACY
LISA REAGAN
CITY OF PLEASANTVILL
CITY OF VENTNOR
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
0247365
008
023
037
043
027
021
006
006
006
008
X79964
Z04016
Z07931
Z11939
Z06585
X24691
Z12114
Z12116
Z12261
Z08632
150
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
PR
WC
GL
PR
PR
PR
PR
MED
MED
MED
COL
MED
BI
COL
COL
COL
COL
MCO00129514.
MCO00142442.
MCO00144392.
WILDWOOD CIT
MCO00143911.
PLEASANTVILL
PLEASANTVILL
PLEASANTVILL
VENTNOR CITY
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
472.00
472.00
472.00
472.00
472.00
472.00
4,248.00
1,445.00
350.00
55.34
1,050.00
160.90
300.00
600.00
250.00
1,150.00
63.00
63.00
63.00
189.00
6,843.33
80.63
417.00
238.00
308.00
546.00
53.01
90.00
63.00
63.00
63.00
63.00
252.00
15.89
15.89
15.89
47.67
225.00
225.00
225.00
675.00
1,019.93
43.85
23.14
110.00
55.75
68.50
3,199.00
2,383.94
4,218.63
6,554.88
LOSS 3/08/15
LOSS 3/11/15
LOSS 3/10/15
LOSS 3/10/15
LOSS 3/09/15
LOSS 3/10/15
TOTAL CHECK#:
LOSS 12/10/14
LOSS 1/09/15
LOSS 3/25/14
LOSS 4/01/12
LOSS 12/09/13
LOSS 11/07/13
LOSS 11/07/13
LOSS 12/20/14
TOTAL CHECK#:
LOSS 6/14/14
LOSS 6/14/14
LOSS 9/06/14
TOTAL CHECK#:
EXP
6/23/11
LOSS 10/08/14
LOSS 10/08/14
LOSS 6/26/14
LOSS 6/26/14
TOTAL CHECK#:
LOSS 1/06/15
LOSS 6/26/12
LOSS 12/10/14
LOSS 12/10/14
LOSS 12/10/14
LOSS 12/10/14
TOTAL CHECK#:
LOSS 9/06/14
LOSS 9/06/14
LOSS 9/06/14
TOTAL CHECK#:
EXP
2/26/15
EXP
2/16/15
EXP
2/25/15
TOTAL CHECK#:
LOSS 12/16/13
LOSS 11/08/14
LOSS 1/09/15
EXP
2/25/15
LOSS 12/28/14
EXP
1/28/12
LOSS 2/26/15
LOSS 2/16/15
LOSS 2/25/15
LOSS 1/15/15
15
15
15
15
15
15
027-9430NJ
008-7720NJ
024-9430NJ
026-7720NJ
036-7720NJ
043-5509NJ
682136
14 003-7720NJ
15 037-7720NJ
14 008-7720NJ
12 037-5509NJ
13 005-7720NJ
13 021-7720NJ
13 021-7720NJ
14 033-7720NJ
682142
14 017-9053NJ
14 017-9053NJ
14 024-7720NJ
682143
11 043-5509NJ
14 007-5509NJ
14 007-5509NJ
14 009-9053NJ
14 009-9053NJ
682147
15 021-5509NJ
12 027-5509NJ
14 003-7720NJ
14 003-7720NJ
14 003-7720NJ
14 003-7720NJ
682150
14 025-9430NJ
14 025-9430NJ
14 025-9430NJ
682151
15 006-5509NJ
15 006-5509NJ
15 006-5509NJ
682152
13 008-7720NJ
14 023-7720NJ
15 037-7720NJ
15 043-7720NJ
14 027-7720NJ
12 021-5509NJ
15 006-5509NJ
15 006-5509NJ
15 006-5509NJ
15 008-9410NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
OCEAN CITY
SOUTH JERSEY GAS
UPPER DEERFIELD TOWN
BAYFRONT EMERGENCY P
BAYFRONT EMERGENCY P
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
999999999
999999999
999999999
020701782
030436345
030436345
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247365
0247365
0247365
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
009
044
011
008
006
009
006
008
023
042
036
014
043
006
006
008
021
038
001
014
024
043
006
009
043
01
01
01
01
01
01
02
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
682163
682164
682165
682166
682167
682168
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
682169
3/17/15
3/17/15
133973142 0247404 045 Z00830 01 GL BI
133973142 0247404 043 Z10631 01 GL BI
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
682171
682172
682173
682174
682175
682175
REGIONAL OTOLARYNGOL
THOMAS FLICKLINGER
ARTHUR TRAIN
MCMC IIC
134233377 0247404
0247404
0247404
141847542 0247404
141872046 0247404
141872046 0247404
012
026
014
003
006
006
X85030
X74106
X48594
Z05652
X50121
X82058
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
IND
IND
MED
IND
IND
MCO00132269.
MCO00125948.
MCO00112728.
MCO00143378.
MCO00113968.
MCO00130595.
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
682176
682177
682178
682179
682180
682181
682182
682183
682184
682185
682186
682187
682188
682189
682190
JAIME PIRCHIO
RODGER LEEDS
DONNA BROWN
DONALD MABRY
THOMAS WITTLAND
THOMAS WITTLAND
COLLIN MCCLORY
JAMES FREELAND
JOHN BARBIERI
JOSEPH IANNUZZELLI
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
008
009
026
027
006
006
023
006
010
008
014
022
035
024
043
X90114
X82549
X70522
X76154
X50121
X82058
X51756
X69867
X00420
X42161
X99960
Z10012
Z11298
Z11572
Z11573
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
MED
MED
MED
MED
MED
MCO00134997.
MCO00130887.
MCO00124178.
MCO00127172.
MCO00113968.
MCO00130595.
MCO00114803.
MCO00123908.
MCO201105260
MCO00108596.
MCO00140045.
MCO00145606.
MCO00146247.
MCO00146416.
MCO00146463.
151
PR
GL
PR
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
B/C
PD
I/M
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
CLIENT#
3/13/15
3/13/15
3/13/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
201901714
202896034
202896034
202896034
202896034
X98646
Z00825
X97914
Z09082
X96318
Z11029
X19963
X42161
X51756
X52140
X55993
X63049
X63050
X70873
X72846
X86680
X94614
Z11300
Z11570
Z11571
Z11572
Z11573
Z11690
Z11692
Z11697
COV
OCEAN CITY
UPPER DEERFI
MCO00145101.
MCO00138244.
MCO00146115.
MCO00097921.
MCO00108596.
MCO00114803.
MCO00115029.
MCO00116355.
MCO00120171.
MCO00120169.
MCO00124315.
MCO00125284.
MCO00133108.
MCO00137549.
MCO00146289.
MCO00146493.
MCO00146422.
MCO00146416.
MCO00146463.
MCO00146454.
MCO00146563.
MCO00146558.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
1,050.00
871.54
459.70
63.37
819.00
518.00
10.00
10.00
10.00
10.00
10.00
9.20
9.20
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
188.40
10.00
10.00
20.00
1,490.00
972.16
985.44
6.00
943.50
906.00
1,849.50
5,315.63
900.00
880.00
880.00
22,400.00
21,751.77
946.00
880.00
1,480.00
1,513.00
63.00
86.87
164.60
130.52
130.38
LOSS 8/23/14
LOSS 8/14/14
LOSS 8/11/14
LOSS 1/25/15
LOSS 7/22/14
LOSS 2/18/15
EXP
2/06/12
EXP
9/05/12
EXP
1/10/13
EXP
1/15/13
EXP
2/07/13
EXP
5/07/13
EXP
5/06/13
EXP
8/19/13
EXP
9/16/13
EXP
3/05/14
EXP
6/26/14
EXP
2/20/15
EXP
2/23/15
EXP
2/23/15
EXP
2/22/15
EXP
2/22/15
EXP
2/25/15
EXP
2/24/15
EXP
2/25/15
TOTAL CHECK#:
EXP
7/06/14
EXP 12/05/14
TOTAL CHECK#:
LOSS 2/20/14
LOSS 10/01/13
LOSS 11/27/12
EXP 12/10/14
LGL 12/10/12
LGL
1/19/14
TOTAL CHECK#:
LOSS 4/25/14
LOSS 1/25/14
LOSS 8/15/13
LOSS 10/28/13
LOSS 12/10/12
LOSS 1/19/14
LOSS 1/10/13
LOSS 8/08/13
LOSS 5/26/11
LOSS 9/05/12
LOSS 9/12/14
LOSS 2/06/15
LOSS 2/21/15
LOSS 2/22/15
LOSS 2/22/15
14
14
14
15
14
15
12
12
13
13
13
13
13
13
13
14
14
15
15
15
15
15
15
15
15
009-9410NJ
044-5509NJ
011-5509NJ
008-7720NJ
006-5509NJ
009-7711NJ
006-7720NJ
008-7711NJ
023-9403NJ
042-7720NJ
036-7580NJ
014-5509NJ
043-5509NJ
006-7711NJ
006-7720NJ
008-5509NJ
021-7715NJ
038-7720NJ
001-5509NJ
014-7711NJ
024-7720NJ
043-7580NJ
006-7720NJ
009-7720NJ
043-7520NJ
682169
14 045-5509NJ
14 043-5509NJ
682170
14 012-5509NJ
13 026-7520NJ
12 014-7720NJ
14 003-7720NJ
12 006-7711NJ
14 006-7711NJ
682175
14 008-7720NJ
14 009-9403NJ
13 026-8810NJ
13 027-9403NJ
12 006-7711NJ
14 006-7711NJ
13 023-9403NJ
13 006-5509NJ
11 010-7720NJ
12 008-7711NJ
14 014-7720NJ
15 022-7580NJ
15 035-5509NJ
15 024-7720NJ
15 043-7580NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
682191
682192
682193
682194
682195
682196
682197
682198
682199
682200
682201
682202
682203
682204
682205
682206
682207
682208
682209
682209
682209
682209
682209
682209
682209
682209
682209
682209
682209
682209
CAPE URGENT CARE
CAPE URGENT CARE
REGIONAL DIAGNOSTIC,
REGIONAL DIAGNOSTIC,
INSPIRA MEDICAL CENT
BRIGANTINE CITY
BRIGANTINE CITY
202896034
202896034
203232397
203232397
204484976
210634484
210634549
210662542
210662542
210662542
210662542
216000384
216000384
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
043
024
046
036
024
011
027
024
024
024
024
026
026
037
037
037
037
006
014
014
014
037
005
005
009
026
006
008
008
008
Z11697
Z11855
Z00460
Z07108
Z08071
Z08546
Z06585
Z12162
Z12162
Z12162
Z08071
Z02923
Z02923
Z04906
Z04906
Z04906
Z04906
Z08544
X14840
X14840
X14840
X81753
X86239
X86239
X87368
Z02843
Z09891
Z10788
Z10788
Z10788
01
01
01
01
01
01
01
01
02
03
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
02
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
IND
IND
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00146558.
MCO00146618.
MCO00140351.
MCO00144048.
MCO00144540.
MCO00144817.
MCO00143911.
MCO00146803.
MCO00146803.
MCO00146803.
MCO00144540.
MCO00141850.
MCO00141850.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00142983.
MCO00144841.
MCO00095253.
MCO00095253.
MCO00095253.
MCO00130428.
MCO00132909.
MCO00132909.
MCO00133503.
MCO00141786.
MCO00145535.
MCO00146024.
MCO00146024.
MCO00146024.
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
682210
682210
682210
682210
682210
682210
682210
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
222540040
222540040
222540040
222540040
222540040
222540040
222540040
0247404
0247404
0247404
0247404
0247404
0247404
0247404
026
037
021
034
008
008
008
X70522
X81753
Z06724
Z07304
Z10717
Z10717
Z10788
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MCO00124178.
MCO00130428.
MCO00143965.
MCO00144051.
MCO00145996.
MCO00145996.
MCO00146024.
3/17/15
3/17/15
3/17/15
682211 HAND SURGERY AND REH 222545917 0247404 036 X90026 01 WC MED MCO00134969.
3/17/15
3/17/15
3/17/15
3/17/15
682212
682213
682214
682214
3/17/15
3/17/15
3/17/15
682215 MEDICAL ONE MULTISPE 222923985 0247404 026 Z07929 01 WC MED MCO00144433.
223129563 0247404 043 Z13084 01 WC MED MCO00147264.
223129563 0247404 009 Z13208 01 WC MED MCO00147277.
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
CAPE MAY
GALLER &
FERNANDO
FERNANDO
UN
UN
UN
UN
UN
UN
UN
COURT HOUSE
FEINBERG SU
J. DELASOTT
J. DELASOTT
222671500
222696987
222711719
222711719
0247404
0247404
0247404
0247404
043
026
023
009
Z11033
Z02843
Z04088
Z10520
152
01
02
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00146102.
MCO00141786.
MCO00142475.
MCO00145922.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
186.04
249.29
21.80
59.38
1,295.31
920.56
721.00
795.00
795.00
795.00
3,975.00
1,686.00
1,686.00
63.00
63.00
63.00
63.00
63.00
90.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
90.00
63.00
90.00
63.00
837.00
259.00
84.00
84.00
37.42
84.00
132.00
254.17
934.59
68.00
68.00
68.00
204.00
28.00
92.73
115.00
300.00
415.00
118.06
472.00
472.00
LOSS 2/25/15
LOSS 2/24/15
LOSS 9/13/14
LOSS 1/04/15
LOSS 1/08/15
LOSS 1/16/15
LOSS 12/28/14
LOSS 3/02/15
LOSS 3/02/15
LOSS 3/02/15
LOSS 1/08/15
LOSS 10/25/14
LOSS 10/25/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 1/17/15
LOSS 11/26/11
LOSS 11/26/11
LOSS 11/26/11
LOSS 1/13/14
LOSS 3/04/14
LOSS 3/04/14
LOSS 3/16/14
LOSS 10/24/14
LOSS 2/04/15
LOSS 2/16/15
LOSS 2/16/15
LOSS 2/16/15
TOTAL CHECK#:
LOSS 8/15/13
LOSS 1/13/14
LOSS 12/30/14
LOSS 1/05/15
LOSS 2/09/15
LOSS 2/09/15
LOSS 2/16/15
TOTAL CHECK#:
LOSS 4/16/14
LOSS 4/16/14
LOSS 4/16/14
TOTAL CHECK#:
LOSS 2/18/15
LOSS 10/24/14
LOSS 11/12/14
LOSS 2/12/15
TOTAL CHECK#:
LOSS 1/05/15
LOSS 3/11/15
LOSS 2/22/15
15
15
14
15
15
15
14
15
15
15
15
14
14
14
14
14
14
15
11
11
11
14
14
14
14
14
15
15
15
15
043-7520NJ
024-7711NJ
045-5509NJ
036-7711NJ
024-7720NJ
011-8810NJ
027-7720NJ
024-9430NJ
024-9430NJ
024-9430NJ
024-7720NJ
026-7720NJ
026-7720NJ
037-5509NJ
037-5509NJ
037-5509NJ
037-5509NJ
006-7711NJ
014-7720NJ
014-7720NJ
014-7720NJ
037-5509NJ
005-9106NJ
005-9106NJ
009-7720NJ
026-7720NJ
006-7711NJ
008-7720NJ
008-7720NJ
008-7720NJ
682209
13 026-8810NJ
14 037-5509NJ
14 021-9403NJ
15 034-5509NJ
15 008-7720NJ
15 008-7720NJ
15 008-7720NJ
682210
14 036-7720NJ
14 036-7720NJ
14 036-7720NJ
682211
15 043-7720NJ
14 026-7720NJ
14 023-5509NJ
15 009-7720NJ
682214
15 026-9403NJ
15 043-8810NJ
15 009-7711NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
IRS#
BATCH#
CB002 00100NJ
GRP FILE#
CL
COV
CLIENT#
3/17/15
223129563 0247404 007 Z13351 01 WC MED MCO00147451.
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
682217
682218
682219
682220
682221
682222
682223
682224
682225
682226
682227
682228
682229
682229
682229
MCALLISTER, HYBERG,
MCALLISTER, HYBERG,
MCALLISTER, HYBERG,
MCALLISTER, HYBERG,
BARKER, GELFAND & JA
223218521
223218521
223218521
223218521
223319594
223319594
223319594
223476019
223476019
223476019
223476019
223573411
223822612
223822612
223822612
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247404
008
023
026
027
023
006
021
006
006
006
006
027
012
012
009
Z10717
Z04088
Z09084
Z09374
Z04015
Z08544
Z11032
X50121
X82058
X82058
X82058
X91222
Z05059
Z05059
Z10520
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
GL
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
IND
IND
IND
IND
BI
MED
MED
MED
3/17/15
3/17/15
3/17/15
3/17/15
682230
682231
682232
682232
PERCISION REPORTING
REHAB CLINICS (SPT)
232625814
232736153
232736153
232736153
0247404
0247404
0247404
0247404
006
007
036
036
X19262
Z01712
X73094
X73094
01
01
01
01
GL
WC
WC
WC
PPBI
MED MCO00141117.
MED MCO00125478.
MED MCO00125478.
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
682233
682234
682235
682235
682235
682235
682235
SOCRATES, INC.
ADVANCED RADIOLOGY
ADVANCED RADIOLOGY
ADVANCED RADIOLOGY
ADVANCED RADIOLOGY
ADVANCED RADIOLOGY
ADVANCED RADIOLOGY
251886816
261212464
261212464
261212464
261212464
261212464
261212464
0247404
0247404
0247404
0247404
0247404
0247404
0247404
006
044
009
009
009
009
009
X82058
Z07817
Z10520
Z10520
Z10520
Z10520
Z10520
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
IND
MED
MED
MED
MED
MED
MED
3/17/15
3/17/15
3/17/15
682237 DAVID S. DEWEESE
682237 DAVID S. DEWEESE
270005874 0247404 021 X90291 01 PR COL EHT
272802400 0247404 021 X11126 01 PR COL EGG HARBOR T
272802400 0247404 006 X19611 01 PR COL PLEASANTVILL
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/17/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682238
682239
682240
682241
682242
682243
682244
682245
682246
682247
682248
682249
682249
682249
274211365
455388778
455564717
455564717
472344815
999999999
999999999
3/20/15
682250 ADMINISTRATIVE CLAIM 043174375 0247486 012 Z05059 01 WC MED MCO00143022.
S
S
S
S
S
S
SHORE URGENT CARE
LOWER TOWNSHIP
THOMPSON REALTY CO
SUSAN REEVES
MRO CORPORATION
ATLANTICARE URGENT C
ADMINISTRATIVE CLAIM
010661910
020701782
020701782
043174375
043174375
043174375
0247404
0247404
0247404
0247404
0247404
0247404
0247404
0247486
0247486
0247486
0247486
0247486
0247486
0247486
003
036
016
045
009
024
026
036
014
010
037
006
006
043
Z11291
Z11151
W48335
W13735
X64830
Z10475
Z02301
X34147
X34622
Z09247
Z09893
Z09891
Z09891
Z10933
153
01
01
01
01
01
01
01
01
01
01
01
01
02
01
WC
WC
PR
PR
GL
PR
GL
WC
GL
WC
WC
WC
WC
WC
MED
MED
B/C
I/M
BI
COL
PD
IND
BI
MED
MED
MED
MED
MED
MCO00145996.
MCO00142475.
MCO00145118.
MCO00145225.
MCO00142436.
MCO00144841.
MCO00146120.
MCO00113968.
MCO00130595.
MCO00130595.
MCO00130595.
MCO00143022.
MCO00143022.
MCO00145922.
MCO00130595.
MCO00144295.
MCO00145922.
MCO00145922.
MCO00145922.
MCO00145922.
MCO00145922.
MCO00146249.
MCO00146172.
BUENA VISTA
ABSECON CITY
MCO00145147.
MCO00145544.
MCO00145535.
MCO00145535.
MCO00146053.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
472.00
1,416.00
445.00
635.00
485.00
485.00
91.93
240.28
247.70
5,600.00
5,724.00
400.00
209.61
121.50
63.00
63.00
90.00
216.00
853.75
417.00
185.00
80.63
265.63
848.62
70.48
76.63
71.81
53.01
11.40
53.01
265.86
220.00
20.36
30.00
50.36
175.00
160.00
5.35
44.68
1,981.50
2,320.40
2,374.93
3,240.00
57.66
63.37
99.78
3.00
3.00
3.00
9.00
3.00
LOSS 3/14/15
TOTAL CHECK#:
LOSS 2/09/15
LOSS 11/12/14
LOSS 1/26/15
LOSS 1/29/15
LOSS 11/05/14
LOSS 1/17/15
LOSS 2/19/15
LOSS 12/10/12
LOSS 1/19/14
LOSS 1/19/14
LOSS 1/19/14
LGL
5/10/14
LOSS 11/27/14
LOSS 11/27/14
LOSS 2/12/15
TOTAL CHECK#:
EXP 10/18/11
LOSS 10/08/14
LOSS 9/19/13
LOSS 9/19/13
TOTAL CHECK#:
LOSS 1/19/14
LOSS 1/09/15
LOSS 2/12/15
LOSS 2/12/15
LOSS 2/12/15
LOSS 2/12/15
LOSS 2/12/15
TOTAL CHECK#:
EXP
4/21/14
LGL
9/25/11
LGL
1/25/12
TOTAL CHECK#:
LOSS 2/22/15
LOSS 2/18/15
LGL
6/02/10
LGL
1/26/10
LGL
5/04/13
LOSS 2/10/15
LOSS 7/05/14
LOSS 7/08/12
EXP
5/12/12
LOSS 1/27/15
LOSS 2/04/15
EXP
2/04/15
EXP
2/04/15
EXP
2/16/15
TOTAL CHECK#:
EXP 11/27/14
15 007-9420NJ
682216
15 008-7720NJ
14 023-5509NJ
15 026-5509NJ
15 027-5509NJ
14 023-5509NJ
15 006-7711NJ
15 021-7720NJ
12 006-7711NJ
14 006-7711NJ
14 006-7711NJ
14 006-7711NJ
14 027-7715NJ
14 012-7715NJ
14 012-7715NJ
15 009-7720NJ
682229
11 006-7720NJ
14 007-5509NJ
13 036-7720NJ
13 036-7720NJ
682232
14 006-7711NJ
15 044-7720NJ
15 009-7720NJ
15 009-7720NJ
15 009-7720NJ
15 009-7720NJ
15 009-7720NJ
682235
14 021-9430NJ
11 021-7720NJ
12 006-9410NJ
682237
15 003-7720NJ
15 036-7720NJ
10 016-5509NJ
10 045-5509NJ
13 009-5509NJ
15 024-7720NJ
14 026-7580NJ
12 036-7720NJ
12 014-5509NJ
15 010-9403NJ
15 037-7720NJ
15 006-7711NJ
15 006-7711NJ
15 043-7520NJ
682249
14 012-7715NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CLAIM
CLAIM
CLAIM
CLAIM
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
043174375
043174375
043174375
043174375
0247486
0247486
0247486
0247486
027
024
009
008
Z06585
Z08071
Z10520
Z10788
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00143911.
MCO00144540.
MCO00145922.
MCO00146024.
MCO00107859.
MCO00108494.
MCO00124539.
MCO00130946.
MCO00133622.
MCO00138831.
MCO00139832.
MCO00146618.
MCO00146697.
MCO00146605.
MCO00146699.
MCO00146741.
MCO00146803.
MCO00146803.
MCO00146803.
3/20/15
3/20/15
3/20/15
3/20/15
682250
682250
682250
682250
ADMINISTRATIVE
ADMINISTRATIVE
ADMINISTRATIVE
ADMINISTRATIVE
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682251
682252
682252
682252
682252
682252
682252
682252
682252
682252
682252
682252
682252
682252
682252
682252
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
037
021
006
027
009
008
038
024
024
008
009
014
012
024
024
024
X90841
X40541
X42017
X71380
X82698
X87599
X97516
X99651
Z11855
Z11985
Z11986
Z11990
Z12161
Z12162
Z12162
Z12162
02
01
01
01
01
01
03
01
01
01
01
01
01
01
02
03
AL
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
BI
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682253
682253
682253
682253
682253
ISO
ISO
ISO
ISO
ISO
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
133973142
133973142
133973142
133973142
133973142
0247486
0247486
0247486
0247486
0247486
037
043
009
021
045
X71479
X74462
X97172
Z11927
Z11930
01
01
01
01
01
GL
GL
GL
GL
GL
BI
BI
BI
BI
BI
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682254
682255
682256
682257
682258
682259
682260
682261
682262
682263
682264
682265
682266
682267
682268
682269
682269
682269
682269
THOMAS WEBB
LEA MARIE SACCO
RICHARD JONES
DIANE HORNBECK
BRIAN TENNANT
JOHN HALLQUIST
SAMUEL STEEVER
DOUGLAS KROGER
FREDRICK CRESS
AARON FINCKE
PATRICK FOX
JOHN BLAIR
ERIC MCEWEN
STACY KUSKO
201901714
204484976
204484976
204484976
204484976
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
021
012
002
034
037
036
007
037
037
017
035
026
022
009
014
009
024
043
043
X75966
Z05059
X68379
X70759
X78767
X70760
X70118
X81753
X15390
X93675
Z08072
X91893
X95338
X94524
X99960
X87368
X99651
Z11033
Z11033
01
01
02
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
MED
MED
MED
MED
MED
3/20/15
3/20/15
3/20/15
682270 SHORE MEDICAL CENTER 210660835 0247486 009 Z11029 01 WC MED MCO00146115.
682271 SHORE MEDICAL CENTER 210660835 0247486 042 X52140 01 WC MED MCO00115029.
682271 SHORE MEDICAL CENTER 210660835 0247486 037 X81753 01 WC MED MCO00130428.
154
MCO00127081.
MCO00143022.
MCO00123122.
MCO00124253.
MCO00128655.
MCO00124272.
MCO00123995.
MCO00130428.
MCO00095531.
MCO00136979.
MCO00144503.
MCO00135994.
MCO00137810.
MCO00137519.
MCO00140045.
MCO00133503.
MCO00139832.
MCO00146102.
MCO00146102.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
3.00
3.00
3.00
3.00
15.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
150.00
10.00
10.00
10.00
10.00
10.00
50.00
880.00
1,362.84
880.00
880.00
880.00
1,040.16
880.00
1,059.40
1,686.08
815.14
1,710.00
900.00
3,768.75
535.50
63.00
93.76
111.62
93.76
329.77
628.91
998.40
7,701.45
1,201.20
8,902.65
EXP 12/28/14
EXP
1/08/15
EXP
2/12/15
EXP
2/16/15
TOTAL CHECK#:
EXP
3/19/14
EXP
8/03/12
EXP
9/04/12
EXP
8/23/13
EXP
1/27/14
EXP
3/19/14
EXP
8/06/14
EXP
9/06/14
EXP
2/24/15
EXP
3/01/15
EXP
2/27/15
EXP
3/01/15
EXP
3/02/15
EXP
3/02/15
EXP
3/02/15
EXP
3/02/15
TOTAL CHECK#:
EXP 12/18/12
EXP
8/17/13
EXP
7/13/14
EXP 11/27/14
EXP
2/06/15
TOTAL CHECK#:
LOSS 10/24/13
LOSS 11/27/14
LOSS 7/07/13
LOSS 7/31/13
LOSS 12/05/13
LOSS 8/15/13
LOSS 8/12/13
LOSS 1/13/14
LOSS 12/03/11
LOSS 6/14/14
LOSS 1/11/15
LOSS 5/21/14
LOSS 7/08/14
LOSS 6/26/14
LOSS 9/12/14
LOSS 3/16/14
LOSS 9/06/14
LOSS 2/18/15
LOSS 2/18/15
TOTAL CHECK#:
LOSS 2/18/15
LOSS 1/15/13
LOSS 1/13/14
TOTAL CHECK#:
14
15
15
15
027-7720NJ
024-7720NJ
009-7720NJ
008-7720NJ
682250
14 037-5509NJ
12 021-7720NJ
12 006-7720NJ
13 027-5509NJ
14 009-7711NJ
14 008-5509NJ
14 038-9053NJ
14 024-7720NJ
15 024-7711NJ
15 008-7720NJ
15 009-8810NJ
15 014-7720NJ
15 012-7720NJ
15 024-9430NJ
15 024-9430NJ
15 024-9430NJ
682252
12 037-7720NJ
13 043-5509NJ
14 009-5509NJ
14 021-5509NJ
15 045-7720NJ
682253
13 021-5509NJ
14 012-7715NJ
13 002-7720NJ
13 034-7720NJ
13 037-7720NJ
13 036-9430NJ
13 007-5509NJ
14 037-5509NJ
11 037-5509NJ
14 017-9053NJ
15 035-9430NJ
14 026-5509NJ
14 022-7720NJ
14 009-9053NJ
14 014-7720NJ
14 009-7720NJ
14 024-7720NJ
15 043-7720NJ
15 043-7720NJ
682269
15 009-7711NJ
13 042-7720NJ
14 037-5509NJ
682271
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
IRS#
BATCH#
CB002 00100NJ
GRP FILE#
CL
COV
CLIENT#
3/20/15
3/20/15
682272 CAPE REGIONAL MEDICA 210662542 0247486 043 Z11033 01 WC MED MCO00146102.
682272 CAPE REGIONAL MEDICA 210662542 0247486 043 Z11033 01 WC MED MCO00146102.
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682273
682274
682275
682276
682277
682278
682279
682280
682281
682282
682283
682284
682285
682286
682287
682288
682289
682290
682291
682292
682293
682294
682295
682295
682295
682295
682295
BRIGANTINE CITY
BRIGANTINE CITY
CAPE MAY CITY
CAPE MAY CITY
CAPE MAY CITY
CAPE MAY CITY
EGG HARBOR TOWNSHIP
EGG HARBOR TOWNSHIP
EGG HARBOR TOWNSHIP
HAMILTON TOWNSHIP
HAMILTON TOWNSHIP
HAMILTON TOWNSHIP
STATE OF NEW JERSEY
NORTHFIELD CITY
OCEAN CITY
PLEASANTVILLE CITY
PLEASANTVILLE CITY
WILDWOOD CITY
WILDWOOD CITY
DYLAN YOUNG
GEMMEL, TODD & MEREN
HEARTLAND REHABILITA
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682296
682297
682297
682297
682297
682297
682297
682297
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682298
682299
682300
682301
682302
682302
682302
682302
682302
682302
026
026
038
038
038
038
021
021
021
014
014
014
003
005
009
006
006
043
043
012
023
039
006
026
026
026
026
Z02843
Z05819
X88710
Z05471
Z11300
Z11300
X94614
X94614
X98251
X14840
X90115
X99960
Z05652
X86239
Z04848
Z05390
Z09891
Z11033
Z11033
Z07456
X50931
Z06101
Z05390
Z05819
Z05819
Z05819
Z05819
02
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
02
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
GL
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
IND
MED
IND
IND
IND
IND
IND
IND
IND
PD
MED
MED
MED
MED
MED
MED
MCO00141786.
MCO00143500.
MCO00134236.
MCO00143263.
MCO00146289.
MCO00146289.
MCO00137549.
MCO00137549.
MCO00139155.
MCO00095253.
MCO00134990.
MCO00140045.
MCO00143378.
MCO00132909.
MCO00142921.
MCO00143236.
MCO00145535.
MCO00146102.
MCO00146102.
MCO00144132.
222046544
222137595
222248597
222248597
222248597
222248597
222248597
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
UN
UN
UN
UN
UN
UN
UN
UN
222540040
222540040
222540040
222540040
222540040
222540040
222540040
222540040
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
006
044
044
008
008
008
026
023
Z09891
W98372
W98372
X82547
X82547
X82547
Z02923
Z09083
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MCO00145535.
MCO201105015
MCO201105015
MCO00130905.
MCO00130905.
MCO00130905.
MCO00141850.
MCO00145091.
CAPE MAY COURT HOUSE
CAPE EMERGENCY PHYSI
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
QUALCARE, INC.
222671500
222711719
222775331
222775331
223129563
223129563
223129563
223129563
223129563
223129563
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
012
026
038
027
036
037
039
045
006
036
Z07926
Z05819
X94068
Z06585
Z13599
Z13600
Z13602
Z13603
Z13713
Z13715
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00144361.
MCO00143500.
MCO00137306.
MCO00143911.
MCO00147578.
MCO00147551.
MCO00147555.
MCO00147547.
MCO00147596.
MCO00147602.
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
216000384
216000384
216000429
216000429
216000429
216000429
216000547
216000547
216000547
216000690
216000690
216000690
216000928
216000945
216000952
216001018
216001018
216001360
216001360
155
MCO00143632.
MCO00143236.
MCO00143500.
MCO00143500.
MCO00143500.
MCO00143500.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
795.00
1,903.20
2,698.20
1,686.00
1,686.00
1,070.08
1,686.00
1,710.00
1,343.56
450.00
450.00
948.94
1,584.00
1,686.00
1,686.00
1.15
450.00
963.43
1,445.15
1,710.00
610.70
1,710.00
805.46
9,000.00
153.00
90.00
63.00
63.00
63.00
63.00
342.00
121.80
300.00
84.00
119.75
132.00
66.00
110.00
119.75
931.50
34.61
60.80
413.12
240.00
472.00
472.00
472.00
472.00
472.00
472.00
2,832.00
LOSS 2/18/15
LOSS 2/18/15
TOTAL CHECK#:
LOSS 10/24/14
LOSS 12/12/14
LOSS 4/03/14
LOSS 12/07/14
LOSS 2/20/15
LOSS 2/20/15
LOSS 6/26/14
LOSS 6/26/14
LOSS 8/18/14
LOSS 11/26/11
LOSS 4/25/14
LOSS 9/12/14
EXP 12/10/14
LOSS 3/04/14
LOSS 11/24/14
LOSS 12/05/14
LOSS 2/04/15
LOSS 2/18/15
LOSS 2/18/15
LOSS 1/06/15
LGL 11/08/11
LOSS 12/16/14
LOSS 12/05/14
LOSS 12/12/14
LOSS 12/12/14
LOSS 12/12/14
LOSS 12/12/14
TOTAL CHECK#:
LOSS 2/04/15
LOSS 5/01/11
LOSS 5/01/11
LOSS 1/27/14
LOSS 1/27/14
LOSS 1/27/14
LOSS 10/25/14
LOSS 1/26/15
TOTAL CHECK#:
LOSS 1/09/15
LOSS 12/12/14
LOSS 6/17/14
LOSS 12/28/14
LOSS 3/18/15
LOSS 4/04/13
LOSS 3/17/15
LOSS 3/17/15
LOSS 3/19/15
LOSS 3/12/15
TOTAL CHECK#:
15 043-7720NJ
15 043-7720NJ
682272
14 026-7720NJ
14 026-5509NJ
14 038-5509NJ
14 038-9402NJ
15 038-7720NJ
15 038-7720NJ
14 021-7715NJ
14 021-7715NJ
14 021-5509NJ
11 014-7720NJ
14 014-7720NJ
14 014-7720NJ
14 003-7720NJ
14 005-9106NJ
14 009-7711NJ
14 006-7720NJ
15 006-7711NJ
15 043-7720NJ
15 043-7720NJ
15 012-7720NJ
11 023-9410NJ
14 039-5509NJ
14 006-7720NJ
14 026-5509NJ
14 026-5509NJ
14 026-5509NJ
14 026-5509NJ
682295
15 006-7711NJ
11 044-7720NJ
11 044-7720NJ
14 008-5509NJ
14 008-5509NJ
14 008-5509NJ
14 026-7720NJ
15 023-5509NJ
682297
15 012-7720NJ
14 026-5509NJ
14 038-9053NJ
14 027-7720NJ
15 036-7580NJ
13 037-7720NJ
15 039-5509NJ
15 045-9430NJ
15 006-9403NJ
15 036-7720NJ
682302
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682303
682304
682305
682306
682307
682308
682309
682310
682311
682312
682312
ATLANTICARE SURGERYC
COASTAL PHYSICIANS &
ANDREA BLOCH D.O.
ANDREA BLOCH D.O.
223218521
223218521
223218521
223218521
223265214
223491867
223584828
223700669
223700669
223752318
223752318
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
0247486
008
044
014
008
037
027
026
037
007
006
021
X82547
W98372
X58070
X82547
X97282
Z06585
Z02923
Z09085
Z01712
X75620
X77237
01
01
01
01
01
01
01
01
01
01
02
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00130905.
MCO201105015
MCO00117428.
MCO00130905.
MCO00138683.
MCO00143911.
MCO00141850.
MCO00145087.
MCO00141117.
MCO00126897.
MCO00127753.
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682313
682314
682314
682314
682314
682314
682314
223778333
223822612
223822612
223822612
223822612
223822612
223822612
0247486
0247486
0247486
0247486
0247486
0247486
0247486
039
005
005
017
017
017
017
Z06101
X04668
X04668
X93675
X93675
X93675
X93675
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MCO00143632.
MCO00081212.
MCO00081212.
MCO00136979.
MCO00136979.
MCO00136979.
MCO00136979.
3/20/15
3/20/15
3/20/15
3/20/15
682315
682316
682317
682317
REHAB CLINICS (SPT)
232736153
232736153
233024656
233024656
0247486
0247486
0247486
0247486
007
007
002
034
Z01712
Z01712
X15950
X84680
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00141117.
MCO00141117.
MCO00095809.
MCO00132008.
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682318
682319
682320
682321
682322
682322
682322
ADVANCED RADIOLOGY S
TRICARE MEDICAL TRAN
SHORE URGENT CARE
261212464
272378550
274211365
455388778
455564717
455564717
455564717
0247486
0247486
0247486
0247486
0247486
0247486
0247486
037
006
045
036
037
006
023
X81753
Z09891
Z11302
Z11462
X18295
X20408
X51540
01
02
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
IND
IND
IND
MCO00130428.
MCO00145535.
MCO00146294.
MCO00146386.
MCO00097011.
MCO00098265.
MCO00114613.
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
3/20/15
682323
682324
682325
682326
682326
682326
RVICE DOCTORS PATHOL
CAPE ANESTHESIA & PA
DJO LLC
PRIME PHYSICAL THERA
521855441
522156746
522165554
522344261
522344261
522344261
0247486
0247486
0247486
0247486
0247486
0247486
009
024
037
009
009
009
X87368
Z08071
X81753
X94190
X94190
X94190
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO00133503.
MCO00144540.
MCO00130428.
MCO00137338.
MCO00137338.
MCO00137338.
3/20/15
3/20/15
3/20/15
3/20/15
682327
682327
682327
682327
STONERIVER
STONERIVER
STONERIVER
STONERIVER
621770924
621770924
621770924
621770924
0247486
0247486
0247486
0247486
021
008
008
023
X77237
X79964
X79964
Z04088
02
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00127753.
MCO00129514.
MCO00129514.
MCO00142475.
3/20/15
3/24/15
3/24/15
3/24/15
682328
682329
682329
682329
SARA SCHEIMREIF
999999999
020701782
020701782
020701782
0247486
0247533
0247533
0247533
045
014
008
008
Z11075
Z07103
Z10717
Z10788
01
01
01
01
AL
WC
WC
WC
PD
MED MCO00144003.
MED MCO00145996.
MED MCO00146024.
3/24/15
PHARMACY
PHARMACY
PHARMACY
PHARMACY
133973142 0247533 037 Z12277 01 GL BI
156
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
535.00
485.00
500.00
560.00
81.51
1,396.10
378.58
73.90
73.90
300.00
300.00
600.00
8,860.40
63.00
63.00
63.00
63.00
63.00
63.00
378.00
80.63
292.00
225.00
151.50
376.50
13.56
720.00
199.00
160.00
50.00
370.85
295.00
715.85
64.00
720.00
3,138.00
280.00
280.00
280.00
840.00
443.32
26.44
168.92
45.04
683.72
354.94
11.17
298.90
63.37
373.44
10.00
LOSS 1/27/14
LOSS 5/01/11
LOSS 3/06/13
LOSS 1/27/14
LOSS 8/05/14
LOSS 12/28/14
LOSS 10/25/14
LOSS 1/24/15
LOSS 10/08/14
LOSS 10/21/13
LOSS 11/07/13
TOTAL CHECK#:
LOSS 12/16/14
LOSS 7/19/11
LOSS 7/19/11
LOSS 6/14/14
LOSS 6/14/14
LOSS 6/14/14
LOSS 6/14/14
TOTAL CHECK#:
LOSS 10/08/14
LOSS 10/08/14
EXP 12/06/11
EXP
2/18/14
TOTAL CHECK#:
LOSS 1/13/14
LOSS 2/04/15
LOSS 2/23/15
LOSS 2/20/15
LGL
1/17/12
LGL
2/09/12
LGL
1/07/13
TOTAL CHECK#:
LOSS 3/16/14
LOSS 1/08/15
LOSS 1/13/14
LOSS 6/21/14
LOSS 6/21/14
LOSS 6/21/14
TOTAL CHECK#:
LOSS 11/07/13
LOSS 12/16/13
LOSS 12/16/13
LOSS 11/12/14
TOTAL CHECK#:
LOSS 2/17/15
LOSS 1/03/15
LOSS 2/09/15
LOSS 2/16/15
TOTAL CHECK#:
EXP
3/04/15
14
11
13
14
14
14
14
15
14
13
13
008-5509NJ
044-7720NJ
014-7720NJ
008-5509NJ
037-7720NJ
027-7720NJ
026-7720NJ
037-7720NJ
007-5509NJ
006-7720NJ
021-7720NJ
682312
14 039-5509NJ
11 005-7720NJ
11 005-7720NJ
14 017-9053NJ
14 017-9053NJ
14 017-9053NJ
14 017-9053NJ
682314
14 007-5509NJ
14 007-5509NJ
11 002-7720NJ
14 034-9403NJ
682317
14 037-5509NJ
15 006-7711NJ
15 045-7720NJ
15 036-7520NJ
12 037-7720NJ
12 006-7711NJ
13 023-9403NJ
682322
14 009-7720NJ
15 024-7720NJ
14 037-5509NJ
14 009-9053NJ
14 009-9053NJ
14 009-9053NJ
682326
13 021-7720NJ
13 008-7720NJ
13 008-7720NJ
14 023-5509NJ
682327
15 045-5509NJ
15 014-7720NJ
15 008-7720NJ
15 008-7720NJ
682329
15 037-9015NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682331
682332
682332
682332
682332
682332
682332
682332
682332
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
010
038
009
036
024
005
015
036
034
Z00833
X69046
X90482
Z11462
Z12162
Z12290
Z12291
Z12294
Z12392
01
01
01
01
04
01
01
01
01
GL
WC
WC
WC
WC
WC
WC
WC
WC
PPPI
MED MCO00123483.
MED MCO00135192.
MED MCO00146386.
MED MCO00146803.
MED MCO00146904.
MED MCO00146711.
MED MCO00146891.
MED MCO00146918.
3/24/15
3/24/15
3/24/15
3/24/15
682333
682334
682335
682335
MICHAEL GIUFFRIDA
JOSE RUIZ
0247533
0247533
0247533
0247533
024
006
044
006
X93253
X77067
X46645
X70873
01
01
01
01
WC
WC
WC
WC
IND
IND
IND
IND
MCO00136725.
MCO00127678.
MCO00111594.
MCO00124315.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682336
682337
682338
682339
682340
682341
682342
682343
682344
682345
682346
682347
682348
682349
682350
682351
682352
682353
682354
682355
682356
682357
682358
682359
682360
682361
682362
682362
682362
682362
682362
682362
682362
682362
682362
682362
MARVIN BELL
ANGEL ORTIZ
VALERIE DAVIS
PATRICK FOX
DAVID ROESCH
STEWART SEGIN
NEW JERSEY IME ASSOC
CAPE URGENT CARE
CAPE URGENT CARE
HATHAWAY ABSTRACT CO
LOWE GREENWOOD ZERBO
INSPIRA HEALTH NETWO
CAPE MAY CITY EMCWC
MILLVILLE CITY
WILDWOOD CREST BOROU
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
021
002
009
035
006
039
044
038
024
027
022
006
011
006
037
014
021
012
038
036
012
037
037
006
006
006
014
014
014
005
005
021
021
021
009
026
W99406
X79605
W84056
Z08072
X70873
X78973
X46645
Z11300
Z12162
Z09374
X36165
X72846
X86241
Z09891
Z07931
Z07103
Z06674
Z12161
Z11300
Z12294
Z12161
Z04906
Z04906
Z08544
Z08544
Z08544
X14840
X14840
X14840
X86239
X86239
X98251
X98251
X98251
Z00080
Z02843
01
01
01
01
01
01
01
01
04
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
02
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
GL
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
IND
IND
IND
MED
MED
MED
MED
BI
MED
MED
MED
MED
MED
MED
MED
MED
IND
IND
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO201105095
MCO00129231.
MCO201102083
MCO00144503.
MCO00124315.
MCO00128784.
MCO00111594.
MCO00146289.
MCO00146803.
MCO00145225.
202197146
202896034
202896034
204484976
204987683
205558784
210634484
210634549
210634549
210634549
210634549
210662542
216000429
216000875
216001361
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
157
MCO00125284.
MCO00132886.
MCO00145535.
MCO00144392.
MCO00144003.
MCO00143953.
MCO00146741.
MCO00146289.
MCO00146891.
MCO00146741.
MCO00142983.
MCO00142983.
MCO00144841.
MCO00144841.
MCO00144841.
MCO00095253.
MCO00095253.
MCO00095253.
MCO00132909.
MCO00132909.
MCO00139155.
MCO00139155.
MCO00139155.
MCO00140147.
MCO00141786.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
80.00
900.00
880.00
167.50
1,545.23
1,712.73
2,112.00
880.00
3,168.00
1,710.00
4,000.00
880.00
550.00
86.87
204.94
93.76
910.00
65.00
422.80
2,511.00
1,030.00
22,810.00
2,511.00
795.00
532.50
1,692.18
1,710.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
EXP
8/12/13
EXP
7/29/13
EXP
5/01/14
EXP
2/20/15
EXP
3/02/15
EXP
3/04/15
EXP
3/01/15
EXP
3/01/15
EXP
3/04/15
TOTAL CHECK#:
LOSS 6/10/14
LOSS 11/07/13
LGL 11/05/12
LGL
8/19/13
TOTAL CHECK#:
LOSS 5/09/11
LOSS 12/08/13
LOSS 2/08/11
LOSS 1/11/15
LOSS 8/19/13
LOSS 12/09/13
LOSS 11/05/12
LOSS 2/20/15
LOSS 3/02/15
LOSS 1/29/15
EXP
7/27/12
LOSS 9/16/13
LOSS 3/01/14
LOSS 2/04/15
LOSS 1/09/15
LOSS 1/03/15
LOSS 12/30/14
LOSS 3/02/15
LOSS 2/20/15
LOSS 3/01/15
LOSS 3/02/15
LOSS 11/26/14
LOSS 11/26/14
LOSS 1/17/15
LOSS 1/17/15
LOSS 1/17/15
LOSS 11/26/11
LOSS 11/26/11
LOSS 11/26/11
LOSS 3/04/14
LOSS 3/04/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 9/14/14
LOSS 10/24/14
13
13
14
15
15
15
15
15
15
010-7720NJ
038-5509NJ
009-7711NJ
036-7520NJ
024-9430NJ
005-7711NJ
015-7720NJ
036-5509NJ
034-5509NJ
682332
14 024-9403NJ
13 006-7720NJ
12 044-8810NJ
13 006-7711NJ
682335
11 021-5509NJ
13 002-5509NJ
11 009-5509NJ
15 035-9430NJ
13 006-7711NJ
13 039-5509NJ
12 044-8810NJ
15 038-7720NJ
15 024-9430NJ
15 027-5509NJ
12 022-9053NJ
13 006-7720NJ
14 011-9430NJ
15 006-7711NJ
15 037-7720NJ
15 014-7720NJ
14 021-7720NJ
15 012-7720NJ
15 038-7720NJ
15 036-5509NJ
15 012-7720NJ
14 037-5509NJ
14 037-5509NJ
15 006-7711NJ
15 006-7711NJ
15 006-7711NJ
11 014-7720NJ
11 014-7720NJ
11 014-7720NJ
14 005-9106NJ
14 005-9106NJ
14 021-5509NJ
14 021-5509NJ
14 021-5509NJ
14 009-7711NJ
14 026-7720NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
BORO
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
PHYSICAL
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
T
T
T
T
T
T
T
T
T
T
T
T
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
026
026
026
006
006
037
037
037
037
037
021
021
Z02843
Z02843
Z02843
Z05390
Z05390
Z07931
Z07931
Z07931
Z07931
Z07931
Z11032
Z11032
02
02
02
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00141786.
MCO00141786.
MCO00141786.
MCO00143236.
MCO00143236.
MCO00144392.
MCO00144392.
MCO00144392.
MCO00144392.
MCO00144392.
MCO00146120.
MCO00146120.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682362
682362
682362
682362
682362
682362
682362
682362
682362
682362
682362
682362
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
TWIN
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682363
682363
682363
682363
682363
682363
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
UN
UN
UN
UN
UN
UN
222540040
222540040
222540040
222540040
222540040
222540040
0247533
0247533
0247533
0247533
0247533
0247533
023
006
044
009
043
012
X00875
X77067
Z07817
Z10520
Z10933
Z12161
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO201106024
MCO00127678.
MCO00144295.
MCO00145922.
MCO00146053.
MCO00146741.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682364
682365
682366
682367
682368
682369
682370
682371
682371
682371
682371
CAPE MAY COURT HOUSE
QUALCARE, INC.
222545917
222545917
222671500
222711719
222775331
223129563
223218521
223218521
223218521
223218521
223218521
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
010
036
012
009
027
009
006
026
038
027
006
Z02841
X90026
Z07456
X72481
Z07930
Z13714
Z08544
X70522
Z05471
Z09374
Z09891
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00141784.
MCO00134969.
MCO00144132.
MCO00125119.
MCO00144358.
MCO00147627.
MCO00144841.
MCO00124178.
MCO00143263.
MCO00145225.
MCO00145535.
3/24/15
3/24/15
3/24/15
682372 PACE ORTHOPEDICS AND 223319594 0247533 023 X88178 01 WC MED MCO00133926.
682372 PACE ORTHOPEDICS AND 223319594 0247533 021 Z11032 01 WC MED MCO00146120.
3/24/15
3/24/15
682373 COASTAL PHYSICIANS & 223584828 0247533 021 X98251 01 WC MED MCO00139155.
682373 COASTAL PHYSICIANS & 223584828 0247533 005 Z03152 01 WC MED MCO00141989.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682374
682375
682376
682377
682378
682378
682378
682378
682378
682378
682378
682378
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
DWYER & DUNNIGAN
223626977
223700669
223778333
223778333
223822612
223822612
223822612
223822612
223822612
223822612
223822612
223822612
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
006
014
037
008
038
038
038
017
017
024
024
024
X70873
X14840
X81753
X79964
X17061
X17061
X17061
X93675
X93675
X99651
X99651
X99651
158
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00124315.
MCO00095253.
MCO00130428.
MCO00129514.
MCO00096364.
MCO00096364.
MCO00096364.
MCO00136979.
MCO00136979.
MCO00139832.
MCO00139832.
MCO00139832.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
90.00
63.00
63.00
90.00
1,440.00
84.00
84.00
247.41
84.00
66.00
331.03
896.44
1,613.88
68.00
10.84
300.00
413.12
472.00
485.00
900.00
485.00
75.00
485.00
1,945.00
194.43
91.93
132.63
418.99
89.82
89.82
179.64
1,000.00
1,034.81
419.65
8,860.40
63.00
63.00
153.00
63.00
63.00
63.00
63.00
63.00
LOSS 10/24/14
LOSS 10/24/14
LOSS 10/24/14
LOSS 12/05/14
LOSS 12/05/14
LOSS 1/09/15
LOSS 1/09/15
LOSS 1/09/15
LOSS 1/09/15
LOSS 1/09/15
LOSS 2/19/15
LOSS 2/19/15
TOTAL CHECK#:
LOSS 6/02/11
LOSS 11/07/13
LOSS 1/09/15
LOSS 2/12/15
LOSS 2/16/15
LOSS 3/02/15
TOTAL CHECK#:
LOSS 10/23/14
LOSS 4/16/14
LOSS 1/06/15
LOSS 9/07/13
LOSS 1/12/15
LOSS 3/17/15
LOSS 1/17/15
LOSS 8/15/13
LOSS 12/07/14
LOSS 1/29/15
LOSS 2/04/15
TOTAL CHECK#:
LOSS 3/27/14
LOSS 2/19/15
LOSS 2/23/15
TOTAL CHECK#:
LOSS 8/18/14
LOSS 10/13/14
TOTAL CHECK#:
LOSS 8/19/13
LOSS 11/26/11
LOSS 1/13/14
LOSS 12/16/13
LOSS 12/29/11
LOSS 12/29/11
LOSS 12/29/11
LOSS 6/14/14
LOSS 6/14/14
LOSS 9/06/14
LOSS 9/06/14
LOSS 9/06/14
14
14
14
14
14
15
15
15
15
15
15
15
026-7720NJ
026-7720NJ
026-7720NJ
006-7720NJ
006-7720NJ
037-7720NJ
037-7720NJ
037-7720NJ
037-7720NJ
037-7720NJ
021-7720NJ
021-7720NJ
682362
11 023-5509NJ
13 006-7720NJ
15 044-7720NJ
15 009-7720NJ
15 043-7520NJ
15 012-7720NJ
682363
14 010-7720NJ
14 036-7720NJ
15 012-7720NJ
13 009-7720NJ
15 027-9015NJ
15 009-7720NJ
15 006-7711NJ
13 026-8810NJ
14 038-9402NJ
15 027-5509NJ
15 006-7711NJ
682371
14 023-9403NJ
15 021-7720NJ
15 023-9403NJ
682372
14 021-5509NJ
14 005-7720NJ
682373
13 006-7711NJ
11 014-7720NJ
14 037-5509NJ
13 008-7720NJ
11 038-5509NJ
11 038-5509NJ
11 038-5509NJ
14 017-9053NJ
14 017-9053NJ
14 024-7720NJ
14 024-7720NJ
14 024-7720NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
IRS#
BATCH#
CB002 00100NJ
GRP FILE#
CL
COV
CLIENT#
3/24/15
3/24/15
3/24/15
682378 FOX OUTPATIENT REHAB 223822612 0247533 012 Z05059 01 WC MED MCO00143022.
682378 FOX OUTPATIENT REHAB 223822612 0247533 009 Z10520 01 WC MED MCO00145922.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682379
682380
682381
682381
682381
THE PHILADELPHIA HAN
MCBREARTY & ASSOCIAT
MAIN LINE MEDICAL SU
231896300
232095018
232275517
232275517
232275517
0247533
0247533
0247533
0247533
0247533
009
036
036
036
036
X94524
Z10817
X73094
X73094
X73094
01
01
01
01
01
WC
PR
WC
WC
WC
MED
B/C
MED
MED
MED
MCO00137519.
MILLVILLE CI
MCO00125478.
MCO00125478.
MCO00125478.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682382
682382
682382
682382
682382
682382
682382
682382
NOVACARE
NOVACARE
NOVACARE
NOVACARE
NOVACARE
NOVACARE
NOVACARE
NOVACARE
REHABILITAT
REHABILITAT
REHABILITAT
REHABILITAT
REHABILITAT
REHABILITAT
REHABILITAT
REHABILITAT
232736153
232736153
232736153
232736153
232736153
232736153
232736153
232736153
0247533
0247533
0247533
0247533
0247533
0247533
0247533
0247533
036
033
033
033
033
033
033
007
X73094
Z00459
Z00459
Z00459
Z00459
Z00459
Z00459
Z01712
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MCO00125478.
MCO00140300.
MCO00140300.
MCO00140300.
MCO00140300.
MCO00140300.
MCO00140300.
MCO00141117.
3/24/15
3/24/15
3/24/15
3/24/15
682383
682383
682383
682383
PREMIER
PREMIER
PREMIER
PREMIER
ORTHOPAEDICS
ORTHOPAEDICS
ORTHOPAEDICS
ORTHOPAEDICS
232866529
232866529
232866529
232866529
0247533
0247533
0247533
0247533
009
009
009
009
X94524
X94524
X94524
X94524
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00137519.
MCO00137519.
MCO00137519.
MCO00137519.
3/24/15
3/24/15
3/24/15
3/24/15
682384
682385
682386
682386
M. JODY WHITEHOUSE,
DAVID S. DEWEESE
DAVID S. DEWEESE
DAVID S. DEWEESE
261540860
272802400
272802400
272802400
0247533
0247533
0247533
0247533
008
006
022
022
X91331
Z08347
Z10506
Z13532
01
01
01
01
WC
GL
GL
GL
MED
EPL
POL
POL
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682387
682388
682389
682390
682391
682391
COMPREHENSIVE MEDICA
CLIFF GRAY APPRAISAL
JERSEY SPINE ASSOCIA
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
371558333
431958510
452889776
455564717
463266146
463266146
0247533
0247533
0247533
0247533
0247533
0247533
007
043
037
021
007
037
X44748
Z13470
X81753
X26953
X21631
X81753
01
01
01
01
01
01
WC
AL
WC
PR
WC
WC
MED
PD
MED
COL
IND
IND
MCO00110385.
3/24/15
3/24/15
3/24/15
3/24/15
3/24/15
682392
682392
682392
682392
682392
STONERIVER
STONERIVER
STONERIVER
STONERIVER
STONERIVER
621770924
621770924
621770924
621770924
621770924
0247533
0247533
0247533
0247533
0247533
006
006
002
037
014
X75620
X75620
X79605
X81753
X90115
01
01
01
01
01
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MCO00126897.
MCO00126897.
MCO00129231.
MCO00130428.
MCO00134990.
3/24/15
3/24/15
3/27/15
3/27/15
3/27/15
3/27/15
682393
682394
682395
682396
682397
682397
CITY OF SOMERS POINT
OCEAN CITY
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
999999999
999999999
133973142
133973142
133973142
133973142
0247533
0247533
0247617
0247617
0247617
0247617
010
009
007
036
021
034
X96271
Z10681
X99395
Z10154
Z06724
Z08882
01
01
01
01
01
01
PR
PR
AL
GL
WC
WC
COL
COL
BI
PI
MED
MED
SOMERS POINT
OCEAN CITY
3/27/15
3/27/15
PHARMACY
PHARMACY
PHARMACY
PHARMACY
PHARMACY
MCO00130428.
EGG HARBOR T
MCO00099062.
MCO00130428.
MCO00143965.
MCO00144993.
133973142 0247617 006 X08695 01 WC MED MCO00082985.
133973142 0247617 027 X27002 01 WC MED MCO00102468.
159
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
63.00
63.00
63.00
783.00
220.00
839.85
95.00
95.00
95.00
285.00
80.63
80.63
80.63
80.63
80.63
80.63
80.63
80.63
645.04
238.00
238.00
238.00
238.00
952.00
140.00
750.00
750.00
750.00
1,500.00
1,200.00
90.00
86.11
3,831.00
141.00
246.00
387.00
103.70
36.78
82.67
123.89
564.98
912.02
1,000.00
8,462.50
10.00
10.00
8.15
8.15
16.30
10.00
10.00
LOSS 9/06/14
LOSS 11/27/14
LOSS 2/12/15
TOTAL CHECK#:
LOSS 6/26/14
EXP
1/28/15
LOSS 9/19/13
LOSS 9/19/13
LOSS 9/19/13
TOTAL CHECK#:
LOSS 9/19/13
LOSS 9/19/14
LOSS 9/19/14
LOSS 9/19/14
LOSS 9/19/14
LOSS 9/19/14
LOSS 9/19/14
LOSS 10/08/14
TOTAL CHECK#:
LOSS 6/26/14
LOSS 6/26/14
LOSS 6/26/14
LOSS 6/26/14
TOTAL CHECK#:
LOSS 9/23/13
LGL
1/07/15
LGL
1/20/15
LGL
2/06/15
TOTAL CHECK#:
LOSS 10/09/12
EXP
3/05/15
LOSS 1/13/14
LGL
4/23/12
LGL
2/28/12
LGL
1/13/14
TOTAL CHECK#:
LOSS 10/21/13
LOSS 10/21/13
LOSS 12/08/13
LOSS 1/13/14
LOSS 4/25/14
TOTAL CHECK#:
LOSS 7/16/14
LOSS 2/12/15
EXP
8/20/14
EXP
9/27/14
EXP 12/30/14
EXP
1/22/15
TOTAL CHECK#:
EXP
9/03/11
EXP
4/18/12
14 024-7720NJ
14 012-7715NJ
15 009-7720NJ
682378
14 009-9053NJ
15 036-9015NJ
13 036-7720NJ
13 036-7720NJ
13 036-7720NJ
682381
13 036-7720NJ
14 033-5509NJ
14 033-5509NJ
14 033-5509NJ
14 033-5509NJ
14 033-5509NJ
14 033-5509NJ
14 007-5509NJ
682382
14 009-9053NJ
14 009-9053NJ
14 009-9053NJ
14 009-9053NJ
682383
13 008-7720NJ
15 006-7720NJ
15 022-9410NJ
15 022-9410NJ
682386
12 007-5509NJ
15 043-7720NJ
14 037-5509NJ
12 021-7720NJ
12 007-7715NJ
14 037-5509NJ
682391
13 006-7720NJ
13 006-7720NJ
13 002-5509NJ
14 037-5509NJ
14 014-7720NJ
682392
14 010-9430NJ
15 009-9410NJ
14 007-7720NJ
14 036-7720NJ
14 021-9403NJ
15 034-5509NJ
682397
11 006-7711NJ
12 027-5509NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
ISO
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
IRS#
BATCH#
GRP FILE#
CL
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
024
021
021
021
008
009
014
036
005
011
023
036
009
034
027
01
01
02
04
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
3/27/15
3/27/15
133973142 0247617 037 Z12559 01 GL PPPI
133973142 0247617 027 Z12718 01 GL PPPI
3/27/15
3/27/15
3/27/15
3/27/15
682400
682400
682400
682400
ISO
ISO
ISO
ISO
133973142
133973142
133973142
133973142
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682401
682402
682403
682404
682405
682406
682407
682408
682409
682410
682410
682410
682410
ANDREW MATTERN
GARY SMILEY
DANIEL GLEASON
JERSEY SHORE REPORTI
KEVIN OLSON
JOHN ANDREWS
DANIEL CASEY
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
CAPE URGENT CARE
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682411
682412
682413
682414
682415
682416
682417
682418
682419
682420
682421
682422
682423
ARMC FACULTY PRACTIC
BACHARACH INSTITUTE
NORTH WILDWOOD CITY
EGG HARBOR TOWNSHIP
HAMILTON TOWNSHIP
MARGATE CITY
MILLVILLE CITY
NORTHFIELD CITY
NORTHFIELD CITY
CLIENT#
682398
682398
682398
682398
682398
682398
682398
682398
682398
682398
682398
682398
682398
682398
682398
INC.
INC.
INC.
INC.
X55550
X61139
X61139
X61139
X61435
X64302
X99960
Z11993
Z12289
Z12471
Z12472
Z12474
Z12671
Z12672
Z12827
COV
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
INC.
CB002 00100NJ
MCO00116184.
MCO00119006.
MCO00119006.
MCO00119006.
MCO00119184.
MCO00120892.
MCO00140045.
MCO00146698.
MCO00146848.
MCO00146942.
MCO00146947.
MCO00146979.
MCO00146994.
MCO00147009.
MCO00147041.
0247617
0247617
0247617
0247617
043
043
036
036
X71172
X99567
X99887
Z00794
01
01
01
01
GL
GL
GL
GL
BI
BI
BI
BI
202896034
202896034
202896034
202896034
202896034
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
023
037
045
009
009
043
009
009
043
043
043
043
043
X48720
X11298
X15392
X34889
X34889
Z10933
X34889
X94190
Z13084
Z11573
Z11697
Z11697
Z12991
01
01
02
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
IND
MED
IND
IND
IND
IND
MED
MED
MED
MED
MED
MCO00112875.
MCO00093322.
MCO00095556.
MCO00106782.
MCO00106782.
MCO00146053.
MCO00106782.
MCO00137338.
MCO00147264.
MCO00146463.
MCO00146558.
MCO00146558.
MCO00147238.
210634549
210634549
210634549
210634549
210634964
210662542
214000944
216000547
216000690
216000828
216000875
216000945
216000945
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
006
006
005
014
034
043
022
021
014
044
036
005
005
Z09891
Z09891
Z03152
X14840
X44750
Z10521
X73306
X94614
X99960
Z07817
X73094
Z03152
Z12289
02
02
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
IND
IND
IND
IND
IND
IND
IND
MCO00145535.
MCO00145535.
MCO00141989.
MCO00095253.
MCO00110343.
MCO00145901.
MCO00125565.
MCO00137549.
MCO00140045.
MCO00144295.
MCO00125478.
MCO00141989.
MCO00146848.
141867044
141872046
160
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
170.00
10.00
10.00
20.00
10.00
10.00
10.00
10.00
40.00
697.30
1,034.86
1,480.00
90.00
392.50
1,519.28
6,621.00
1,715.63
86.87
142.03
86.87
86.87
198.59
514.36
17.00
1,562.60
401.70
1,673.47
396.00
795.00
1,652.00
450.00
1,686.00
1,710.00
1,652.00
1,686.00
456.00
EXP
2/05/13
EXP
4/12/13
EXP
4/12/13
EXP
4/12/13
EXP
4/16/13
EXP
5/24/13
EXP
9/12/14
EXP
2/27/15
EXP
3/02/15
EXP
3/06/15
EXP
3/06/15
EXP
3/06/15
EXP
3/06/15
EXP
3/07/15
EXP
3/08/15
TOTAL CHECK#:
EXP
1/27/15
EXP
9/20/14
TOTAL CHECK#:
EXP
7/10/13
EXP
7/07/14
EXP
6/14/14
EXP
8/12/14
TOTAL CHECK#:
LOSS 11/24/12
LOSS 10/06/11
LOSS 12/03/11
EXP
7/14/12
LGL
7/14/12
LOSS 2/16/15
LOSS 7/14/12
LOSS 6/21/14
LOSS 3/11/15
LOSS 2/22/15
LOSS 2/25/15
LOSS 2/25/15
LOSS 3/10/15
TOTAL CHECK#:
LOSS 2/04/15
LOSS 2/04/15
LOSS 10/13/14
LOSS 11/26/11
LOSS 10/09/12
LOSS 2/11/15
LOSS 9/20/13
LOSS 6/26/14
LOSS 9/12/14
LOSS 1/09/15
LOSS 9/19/13
LOSS 10/13/14
LOSS 3/02/15
13
13
13
13
13
13
14
15
15
15
15
15
15
15
15
024-9403NJ
021-7720NJ
021-7720NJ
021-7720NJ
008-9403NJ
009-9015NJ
014-7720NJ
036-7720NJ
005-9106NJ
011-9403NJ
023-5509NJ
036-9102NJ
009-9102NJ
034-7720NJ
027-9430NJ
682398
15 037-7720NJ
14 027-7720NJ
682399
13 043-9410NJ
14 043-5509NJ
14 036-5509NJ
14 036-9410NJ
682400
12 023-5509NJ
11 037-5509NJ
11 045-7720NJ
12 009-9403NJ
12 009-9403NJ
15 043-7520NJ
12 009-9403NJ
14 009-9053NJ
15 043-8810NJ
15 043-7580NJ
15 043-7520NJ
15 043-7520NJ
15 043-5509NJ
682410
15 006-7711NJ
15 006-7711NJ
14 005-7720NJ
11 014-7720NJ
12 034-9403NJ
15 043-5509NJ
13 022-7711NJ
14 021-7715NJ
14 014-7720NJ
15 044-7720NJ
13 036-7720NJ
14 005-7720NJ
15 005-9106NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682424
682425
682426
682427
682428
682429
682430
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
682431
SOMERS POINT CITY
GOLDENBERG MACKLER &
HEARTLAND REHABILITA
ATLANTIC MEDICAL IMA
216001196
221980737
222137595
222222502
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
222248597
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
010
009
039
021
037
037
037
014
014
014
008
008
021
021
021
009
009
009
026
026
006
006
037
008
008
008
021
021
Z02841
X34889
Z06101
X24691
Z04906
Z04906
Z04906
X14840
X14840
X14840
X79964
X79964
X98251
X98251
X98251
Z00080
Z00080
Z00080
Z02843
Z02843
Z05390
Z05390
Z07931
Z10788
Z10788
Z10788
Z11032
Z11032
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
02
02
01
01
01
01
01
01
01
01
WC
WC
WC
GL
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
MED
BI
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00141784.
MCO00106782.
MCO00143632.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682432
682433
682434
682434
682434
682434
682434
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
SHORE
222540040
222540040
222540040
222540040
222540040
222540040
222540040
0247617
0247617
0247617
0247617
0247617
0247617
0247617
044
034
034
010
014
026
005
X83693
Z07304
X44750
X89935
X99960
Z06186
Z12290
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MCO00131507.
MCO00144051.
MCO00110343.
MCO00134920.
MCO00140045.
MCO00143674.
MCO00146904.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682436
682437
682438
682438
682438
682438
682438
3/27/15
3/27/15
3/27/15
682439 CAPE PHYSICIANS ASSO 223172481 0247617 024 X93459 01 WC MED MCO00136903.
682440 KINEMATIC CONSULTANT 223211494 0247617 017 X74153 01 WC MED MCO00126020.
682441 ONE CALL MEDICAL, IN 223218521 0247617 034 X44750 01 WC MED MCO00110343.
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
ORTHOPAEDIC
UN
UN
UN
UN
UN
UN
UN
CAPE EMERGENCY PHYSI 222775331 0247617 027 Z08308 01 WC
CAPE EMERGENCY PHYSI 222775331 0247617 043 Z08796 01 WC
QUALCARE, INC.
223129563 0247617 006 Z13964 01 WC
QUALCARE, INC.
223129563 0247617 043 Z13968 01 WC
QUALCARE, INC.
223129563 0247617 039 Z14087 01 WC
QUALCARE, INC.
223129563 0247617 036 Z14212 01 WC
QUALCARE, INC.
223129563 0247617 006 Z14298 01 WC
161
MED
MED
MED
MED
MED
MED
MED
MCO00142983.
MCO00142983.
MCO00142983.
MCO00095253.
MCO00095253.
MCO00095253.
MCO00129514.
MCO00129514.
MCO00139155.
MCO00139155.
MCO00139155.
MCO00140147.
MCO00140147.
MCO00140147.
MCO00141786.
MCO00141786.
MCO00143236.
MCO00143236.
MCO00144392.
MCO00146024.
MCO00146024.
MCO00146024.
MCO00146120.
MCO00146120.
MCO00144689.
MCO00144941.
MCO00147717.
MCO00147712.
MCO00147793.
MCO00147823.
MCO00147875.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
1,686.00
1,925.00
189.00
217.00
63.00
63.00
63.00
63.00
63.00
63.00
90.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
63.00
1,350.00
102.38
37.42
84.00
84.00
241.23
84.00
301.00
794.23
68.00
68.00
136.00
248.00
248.00
472.00
472.00
472.00
472.00
472.00
2,360.00
22.00
720.00
1,150.00
LOSS 10/23/14
LOSS 7/14/12
LOSS 12/16/14
EXP
1/28/12
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/14
LOSS 11/26/11
LOSS 11/26/11
LOSS 11/26/11
LOSS 12/16/13
LOSS 12/16/13
LOSS 8/18/14
LOSS 8/18/14
LOSS 8/18/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 9/14/14
LOSS 10/24/14
LOSS 10/24/14
LOSS 12/05/14
LOSS 12/05/14
LOSS 1/09/15
LOSS 2/16/15
LOSS 2/16/15
LOSS 2/16/15
LOSS 2/19/15
LOSS 2/19/15
TOTAL CHECK#:
LOSS 2/06/14
LOSS 1/05/15
LOSS 10/09/12
LOSS 4/22/14
LOSS 9/12/14
LOSS 12/17/14
LOSS 3/04/15
TOTAL CHECK#:
LOSS 4/16/14
LOSS 4/16/14
TOTAL CHECK#:
LOSS 1/15/15
LOSS 1/21/15
LOSS 3/23/15
LOSS 3/17/15
LOSS 3/24/15
LOSS 3/23/15
LOSS 3/26/15
TOTAL CHECK#:
EXP
6/11/14
LOSS 10/01/13
LOSS 10/09/12
14
12
14
12
14
14
14
11
11
11
13
13
14
14
14
14
14
14
14
14
14
14
15
15
15
15
15
15
010-7720NJ
009-9403NJ
039-5509NJ
021-5509NJ
037-5509NJ
037-5509NJ
037-5509NJ
014-7720NJ
014-7720NJ
014-7720NJ
008-7720NJ
008-7720NJ
021-5509NJ
021-5509NJ
021-5509NJ
009-7711NJ
009-7711NJ
009-7711NJ
026-7720NJ
026-7720NJ
006-7720NJ
006-7720NJ
037-7720NJ
008-7720NJ
008-7720NJ
008-7720NJ
021-7720NJ
021-7720NJ
682431
14 044-9403NJ
15 034-5509NJ
12 034-9403NJ
14 010-9403NJ
14 014-7720NJ
14 026-7715NJ
15 005-7711NJ
682434
14 036-7720NJ
14 036-7720NJ
682435
15 027-5509NJ
15 043-7720NJ
15 006-9403NJ
15 043-7720NJ
15 039-9403NJ
15 036-9430NJ
15 006-7720NJ
682438
14 024-5509NJ
13 017-9102NJ
12 034-9403NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CALL
CALL
CALL
CALL
MEDICAL,
MEDICAL,
MEDICAL,
MEDICAL,
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/27/15
3/27/15
3/27/15
3/27/15
682441
682441
682441
682441
ONE
ONE
ONE
ONE
IN
IN
IN
IN
223218521
223218521
223218521
223218521
0247617
0247617
0247617
0247617
026
037
027
043
Z06186
Z07931
Z08547
Z11033
01
01
01
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00143674.
MCO00144392.
MCO00144830.
MCO00146102.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682442
682443
682444
682445
682446
682447
682448
682449
682450
682450
682450
JOSEPH T. SCHWARTZ,
PROFESSIONAL PAIN MA
I.C.U. INVESTIGATION
EMERGENCY PHYSICIAN,
SOUTH JERSEY HS EMG
223275385
223319594
223351986
223492387
223586506
223589282
223700669
223700669
223700669
223700669
223700669
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
024
005
037
021
007
036
002
017
022
005
005
X93459
Z12289
W86835
Z11084
Z02920
Z05062
X41650
X74153
X73306
X78968
Z03152
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
PR
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
COL
MED
MED
MED
MED
MED
MED
MED
MCO00136903.
MCO00146848.
MCO201103101
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682451
682451
682451
682451
682451
682451
682451
682451
682451
ANDREA
ANDREA
ANDREA
ANDREA
ANDREA
ANDREA
ANDREA
ANDREA
ANDREA
223752318
223752318
223752318
223752318
223752318
223752318
223752318
223752318
223752318
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
015
023
021
021
006
006
006
006
033
X45469
X48720
X77237
X77237
X88172
X88172
X88172
X88172
Z07107
02
01
01
02
01
02
03
03
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00110918.
MCO00112875.
MCO00127753.
MCO00127753.
MCO00133944.
MCO00133944.
MCO00133944.
MCO00133944.
MCO00144001.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682452
682453
682453
682453
682453
682453
FOX
FOX
FOX
FOX
FOX
FOX
REHAB
REHAB
REHAB
REHAB
REHAB
REHAB
223822612
223822612
223822612
223822612
223822612
223822612
0247617
0247617
0247617
0247617
0247617
0247617
009
038
024
027
027
027
X72481
X17061
X99651
Z08547
Z08547
Z08547
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO00125119.
MCO00096364.
MCO00139832.
MCO00144830.
MCO00144830.
MCO00144830.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682454
682455
682456
682457
682458
682458
682458
682458
682458
682458
DJS ASSOCIATES, INC.
RT ENVIRONMENTAL SER
ERIC W. FINE, M.D.
REHAB CLINICS (SPT)
232208440
232534548
232552654
232736153
232736153
232736153
232736153
232736153
232736153
232736153
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
024
023
044
007
036
007
038
024
043
043
X05467
X50931
X45657
Z01712
X73094
Z01712
Z05471
Z08071
Z11033
Z11033
01
01
01
01
01
01
01
01
01
01
GL
GL
GL
WC
WC
WC
WC
WC
WC
WC
BI
PD
BI
MED
MED
MED
MED
MED
MED
MED
MCO00141117.
MCO00125478.
MCO00141117.
MCO00143263.
MCO00144540.
MCO00146102.
MCO00146102.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682459
682460
682461
682462
682462
NICOLAPT LLC
GLOBAL ANESTHESIA AS
GLOBAL ANESTHESIA AS
233024656
262230453
272584205
273776592
273776592
0247617
0247617
0247617
0247617
0247617
009
003
027
026
026
X87368
Z05652
Z08547
Z02843
Z02843
01
01
01
02
02
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MCO00133503.
MCO00143378.
MCO00144830.
MCO00141786.
MCO00141786.
BLOCH
BLOCH
BLOCH
BLOCH
BLOCH
BLOCH
BLOCH
BLOCH
BLOCH
D.O.
D.O.
D.O.
D.O.
D.O.
D.O.
D.O.
D.O.
D.O.
OUTPATIENT
OUTPATIENT
OUTPATIENT
OUTPATIENT
OUTPATIENT
OUTPATIENT
162
MCO00141886.
MCO00143055.
MCO00108313.
MCO00126020.
MCO00125565.
MCO00128802.
MCO00141989.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
1,150.00
1,100.00
485.00
485.00
4,370.00
120.50
203.53
91.93
150.00
163.29
266.89
73.90
500.00
90.00
73.90
6,852.93
7,016.83
275.00
275.00
300.00
300.00
300.00
300.00
300.00
300.00
250.00
2,600.00
63.00
63.00
63.00
90.00
126.00
63.00
405.00
2,750.00
287.62
2,000.00
292.00
80.63
80.63
80.63
80.63
80.63
80.63
483.78
240.75
63.00
156.30
38.00
38.00
76.00
LOSS 12/17/14
LOSS 1/09/15
LOSS 1/15/15
LOSS 2/18/15
TOTAL CHECK#:
EXP
6/11/14
LOSS 3/02/15
LOSS 3/10/11
EXP
2/08/15
LOSS 10/27/14
LOSS 11/29/14
LOSS 8/25/12
LOSS 10/01/13
LOSS 9/20/13
LOSS 12/09/13
LOSS 10/13/14
TOTAL CHECK#:
LOSS 8/17/12
LOSS 11/24/12
LOSS 11/07/13
LOSS 11/07/13
LOSS 3/27/14
LOSS 3/27/14
LOSS 3/27/14
LOSS 3/27/14
LOSS 12/20/14
TOTAL CHECK#:
LOSS 9/07/13
LOSS 12/29/11
LOSS 9/06/14
LOSS 1/15/15
LOSS 1/15/15
LOSS 1/15/15
TOTAL CHECK#:
EXP
7/22/11
EXP 11/08/11
EXP
7/24/12
LOSS 10/08/14
LOSS 9/19/13
LOSS 10/08/14
LOSS 12/07/14
LOSS 1/08/15
LOSS 2/18/15
LOSS 2/18/15
TOTAL CHECK#:
EXP
3/16/14
LOSS 12/10/14
LOSS 1/15/15
LOSS 10/24/14
LOSS 10/24/14
TOTAL CHECK#:
14
15
15
15
026-7715NJ
037-7720NJ
027-7720NJ
043-7720NJ
682441
14 024-5509NJ
15 005-9106NJ
11 037-8810NJ
15 021-7720NJ
14 007-7720NJ
14 036-7711NJ
12 002-7720NJ
13 017-9102NJ
13 022-7711NJ
13 005-7720NJ
14 005-7720NJ
682450
12 015-7720NJ
12 023-5509NJ
13 021-7720NJ
13 021-7720NJ
14 006-7720NJ
14 006-7720NJ
14 006-7720NJ
14 006-7720NJ
14 033-7720NJ
682451
13 009-7720NJ
11 038-5509NJ
14 024-7720NJ
15 027-7720NJ
15 027-7720NJ
15 027-7720NJ
682453
11 024-5509NJ
11 023-9410NJ
12 044-9410NJ
14 007-5509NJ
13 036-7720NJ
14 007-5509NJ
14 038-9402NJ
15 024-7720NJ
15 043-7720NJ
15 043-7720NJ
682458
14 009-7720NJ
14 003-7720NJ
15 027-7720NJ
14 026-7720NJ
14 026-7720NJ
682462
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
COV
CLIENT#
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682463
682464
682465
682466
682467
682467
SHORE URGENT CARE
SYSTEM SUPPORT SERVI
274211365
274404037
455388778
455388778
455388778
455388778
0247617
0247617
0247617
0247617
0247617
0247617
005
006
036
036
036
036
Z12290
X21424
Z11993
Z12474
Z11462
Z11993
01
01
01
01
01
01
WC
GL
WC
WC
WC
WC
MED MCO00146904.
PPBI
MED MCO00146698.
MED MCO00146979.
MED MCO00146386.
MED MCO00146698.
3/27/15
3/27/15
3/27/15
3/27/15
682468
682469
682469
682469
455564717
472344815
472344815
472344815
0247617
0247617
0247617
0247617
006
043
038
043
X12964
X10123
X18811
X45844
01
01
01
01
WC
GL
GL
GL
MED MCO00094266.
BI
BI
BI
3/27/15
3/27/15
3/27/15
3/27/15
682470
682470
682470
682470
STONERIVER
STONERIVER
STONERIVER
STONERIVER
621770924
621770924
621770924
621770924
0247617
0247617
0247617
0247617
023
006
006
037
X48720
X88172
X88172
Z09085
01
03
03
01
WC
WC
WC
WC
MED
MED
MED
MED
MCO00112875.
MCO00133944.
MCO00133944.
MCO00145087.
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682471
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
682472
IOD INCORPORATED
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
EBIX.COM, INC
650765287
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
770021975
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
0247617
006
037
006
022
006
006
036
037
036
036
034
036
027
021
026
014
021
036
036
021
023
009
021
017
036
037
021
014
022
022
045
017
034
012
X84677
X81753
X89719
X95338
Z00271
Z02563
Z03943
Z04906
Z05062
Z05063
Z05111
Z05112
Z05233
Z05548
Z06186
Z06331
Z06332
Z06456
Z06456
Z06674
Z06675
Z06723
Z06724
Z07105
Z07108
Z07109
Z07303
Z07647
Z07649
Z07650
Z07651
Z07815
Z07816
Z07926
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
02
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00132009.
MCO00130428.
MCO00134785.
MCO00137810.
MCO00140213.
MCO00141602.
MCO00142402.
MCO00142983.
MCO00143055.
MCO00143061.
MCO00143066.
MCO00143083.
MCO00143126.
MCO00143311.
MCO00143674.
MCO00143835.
MCO00143808.
MCO00143890.
MCO00143890.
MCO00143953.
MCO00143947.
MCO00143989.
MCO00143965.
MCO00144040.
MCO00144048.
MCO00144000.
MCO00144056.
MCO00144236.
MCO00144198.
MCO00144201.
MCO00144219.
MCO00144306.
MCO00144287.
MCO00144361.
PHARMACY
PHARMACY
PHARMACY
PHARMACY
163
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
118.00
905.00
160.00
160.00
112.80
112.80
225.60
100.00
5,193.00
308.00
3,020.50
8,521.50
616.66
201.41
36.78
48.94
903.79
92.17
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
1.75
LOSS 3/04/15
EXP 12/06/11
LOSS 2/27/15
LOSS 3/06/15
LOSS 2/20/15
LOSS 2/27/15
TOTAL CHECK#:
EXP
9/11/11
LGL
6/23/11
LGL 10/29/11
LGL
9/26/12
TOTAL CHECK#:
LOSS 11/24/12
LOSS 3/27/14
LOSS 3/27/14
LOSS 1/24/15
TOTAL CHECK#:
EXP
2/17/14
EXP
1/13/14
EXP
4/15/14
EXP
7/08/14
EXP
8/14/14
EXP 10/18/14
EXP 11/06/14
EXP 11/26/14
EXP 11/29/14
EXP 11/26/14
EXP 12/01/14
EXP 11/29/14
EXP 12/03/14
EXP 12/08/14
EXP 12/17/14
EXP 12/22/14
EXP 12/21/14
EXP 12/23/14
EXP 12/23/14
EXP 12/30/14
EXP 12/24/14
EXP
8/30/14
EXP 12/30/14
EXP
1/05/15
EXP
1/04/15
EXP
1/03/15
EXP
1/06/15
EXP
1/08/15
EXP
1/06/15
EXP
1/07/15
EXP
1/08/15
EXP
1/08/15
EXP
1/09/15
EXP
1/09/15
15
11
15
15
15
15
005-7711NJ
006-7720NJ
036-7720NJ
036-9102NJ
036-7520NJ
036-7720NJ
682467
11 006-7720NJ
11 043-5509NJ
11 038-5509NJ
12 043-5509NJ
682469
12 023-5509NJ
14 006-7720NJ
14 006-7720NJ
15 037-7720NJ
682470
14 006-7720NJ
14 037-5509NJ
14 006-9106NJ
14 022-7720NJ
14 006-7720NJ
14 006-7720NJ
14 036-7720NJ
14 037-5509NJ
14 036-7711NJ
14 036-7720NJ
14 034-5509NJ
14 036-7720NJ
14 027-5509NJ
14 021-7720NJ
14 026-7715NJ
14 014-7720NJ
14 021-7715NJ
14 036-7720NJ
14 036-7720NJ
14 021-7720NJ
14 023-9430NJ
14 009-9053NJ
14 021-9403NJ
15 017-5509NJ
15 036-7711NJ
15 037-9430NJ
15 021-5509NJ
15 014-5509NJ
15 022-7720NJ
15 022-7720NJ
15 045-9430NJ
15 017-8810NJ
15 034-9403NJ
15 012-7720NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
IRS#
BATCH#
GRP FILE#
CL
COV
770021975
770021975
770021975
770021975
770021975
0247617
0247617
0247617
0247617
0247617
021
027
026
036
036
Z07927
Z07930
Z11381
Z11462
Z11993
01
01
01
01
01
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
999999999
999999999
999999999
999999999
999999999
999999999
010661910
020701782
020701782
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
133973142
0247617
0247617
0247617
0247617
0247617
0247617
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
036
042
021
043
026
022
014
006
014
045
008
034
009
008
024
026
036
043
043
Z06631
Z11903
X26953
Z13470
Z02301
Z08705
X34622
Z09081
Z11571
X71468
X65399
X70759
Z12824
Z12986
Z12987
Z12988
Z12990
Z12991
Z13084
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
01
GL
AL
PR
AL
GL
GL
GL
WC
WC
GL
WC
WC
WC
WC
WC
WC
WC
WC
WC
PD
PD
COL
PD
PD
PD
BI
MED
MED
PI
MED
MED
MED
MED
MED
MED
MED
MED
MED
CLIENT#
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
682472
682472
682472
682472
682472
EBIX.COM,
EBIX.COM,
EBIX.COM,
EBIX.COM,
EBIX.COM,
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/27/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682473
682474
682475
682476
682477
682478
682479
682480
682481
682482
682483
682483
682483
682483
682483
682483
682483
682483
682483
ARLENE SUTCLIFFE
DENNIS PICCONE
EGG HARBOR TOWNSHIP
JASON MOHR
RAMAN BEACH RESORT C
ROSE HOLLIDAY
MRO CORPORATION
ATLANTICARE URGENT C
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
ISO SERVICES, INC.
3/31/15
3/31/15
133973142 0247663 021 X76975 01 GL PPBI
133973142 0247663 015 Z00508 01 GL PPBI
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682485
682485
682485
682485
682485
682485
682485
133973142
133973142
133973142
133973142
133973142
133973142
133973142
3/31/15
3/31/15
682486 JERSEY SHORE REPORTI 141867044 0247663 006 X43298 01 WC MED MCO00109303.
682486 JERSEY SHORE REPORTI 141867044 0247663 004 X70872 01 WC MED MCO00124334.
3/31/15
3/31/15
3/31/15
682487 PIETRAS, SARACINO, S 141872046 0247663 024 X81602 01 WC IND MCO00130379.
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682488
682489
682490
682491
682492
682493
682494
ISO
ISO
ISO
ISO
ISO
ISO
ISO
INC
INC
INC
INC
INC
CB002 00100NJ
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
SERVICES,
INC.
INC.
INC.
INC.
INC.
INC.
INC.
0247663
0247663
0247663
0247663
0247663
0247663
0247663
009
043
033
038
010
037
017
ALLEN MAGNAVITA
0247663 024
LUKE DONAHUE
0247663 012
MICHAEL COSTELLO
0247663 009
GEORGE BARGER
0247663 024
EAST COAST ORTHO. &, 204484976 0247663 043
INSPIRA MEDICAL CENT 210634484 0247663 036
ATLANTICARE REGIONAL 210634549 0247663 014
X72165
X72768
X81537
X88419
Z06447
Z11218
Z12880
X81602
Z12161
X35537
X93459
Z11033
X73094
X90115
164
01
01
01
01
01
01
01
01
01
01
01
01
01
01
GL
GL
GL
GL
GL
GL
GL
WC
WC
WC
WC
WC
WC
WC
MCO00144370.
MCO00144358.
MCO00146386.
MCO00146698.
EGG HARBOR T
MCO00145130.
MCO00146422.
MCO00124253.
MCO00147024.
MCO00147212.
MCO00147232.
MCO00147173.
MCO00147202.
MCO00147238.
MCO00147264.
BI
BI
BI
BI
BI
BI
BI
IND
IND
IND
IND
MED
MED
MED
MCO00130379.
MCO00146741.
MCO00107163.
MCO00136903.
MCO00146102.
MCO00125478.
MCO00134990.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
1.75
1.75
1.75
1.75
1.75
66.50
924.23
524.47
1,000.00
4,778.55
2,374.93
368.00
103.92
219.29
66.94
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
90.00
10.00
10.00
20.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
70.00
90.00
90.00
180.00
407.50
160.50
160.00
728.00
159.00
2,565.00
954.84
900.00
93.76
118.06
1,364.47
EXP
1/07/15
EXP
1/12/15
EXP
7/30/14
EXP
2/20/15
EXP
2/27/15
TOTAL CHECK#:
LOSS 12/25/14
LOSS 2/26/15
LOSS 4/23/12
LOSS 3/05/15
LOSS 7/05/14
LOSS 1/16/15
EXP
5/12/12
LOSS 1/10/15
LOSS 2/23/15
EXP
6/05/13
EXP
4/16/13
EXP
7/31/13
EXP
3/02/15
EXP
3/11/15
EXP
3/10/15
EXP
3/10/15
EXP
3/09/15
EXP
3/10/15
EXP
3/11/15
TOTAL CHECK#:
EXP 11/07/13
EXP
6/20/14
TOTAL CHECK#:
EXP
6/13/13
EXP
8/31/13
EXP 10/27/13
EXP
1/04/14
EXP
5/23/14
EXP
1/25/15
EXP
1/07/15
TOTAL CHECK#:
EXP
9/18/12
EXP
8/20/13
TOTAL CHECK#:
LGL
1/13/14
LGL
6/27/14
LGL
7/10/14
TOTAL CHECK#:
LOSS 1/13/14
LOSS 3/02/15
LOSS 7/25/12
LOSS 6/11/14
LOSS 2/18/15
LOSS 9/19/13
LOSS 4/25/14
15
15
14
15
15
021-9430NJ
027-9015NJ
026-5509NJ
036-7520NJ
036-7720NJ
682472
14 036-5509NJ
15 042-5509NJ
12 021-7720NJ
15 043-7720NJ
14 026-7580NJ
15 022-5509NJ
12 014-5509NJ
15 006-7720NJ
15 014-7711NJ
13 045-9410NJ
13 008-5509NJ
13 034-7720NJ
15 009-8810NJ
15 008-7720NJ
15 024-9430NJ
15 026-7720NJ
15 036-7720NJ
15 043-5509NJ
15 043-8810NJ
682483
13 021-7720NJ
14 015-7720NJ
682484
13 009-5509NJ
13 043-9410NJ
13 033-5509NJ
14 038-5509NJ
14 010-5509NJ
15 037-5509NJ
15 017-5509NJ
682485
12 006-5509NJ
13 004-7720NJ
682486
14 024-5509NJ
14 037-5509NJ
14 037-5509NJ
682487
14 024-5509NJ
15 012-7720NJ
12 009-5509NJ
14 024-5509NJ
15 043-7720NJ
13 036-7720NJ
14 014-7720NJ
LR0503685
QUAL-LYNX
ACCOUNT:002
PERIOD:03/2015
PAYMENT REGISTER
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
CB002 00100NJ
IRS#
BATCH#
GRP FILE#
CL
216000945
216001361
222248597
222248597
222540040
222540040
222540040
222540040
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
005
012
008
008
039
021
006
006
X86239
Z12161
Z11985
Z11985
Z06101
X79478
Z09081
Z09081
COV
CLIENT#
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682495
682496
682497
682498
682499
682500
682500
682500
NORTHFIELD CITY
WILDWOOD CREST BOROU
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
IND
IND
MED
MED
MED
MED
MED
MED
MCO00132909.
MCO00146741.
MCO00146697.
MCO00146697.
MCO00143632.
MCO00129113.
MCO00145130.
MCO00145130.
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682501
682502
682503
682503
682503
682503
HAND SURGERY AND REH 222545917 0247663 036 X90026 01
HAND SURGERY AND REH 222545917 0247663 036 X90026 01
QUALCARE, INC.
223129563 0247663 037 Z14398 01
QUALCARE, INC.
223129563 0247663 009 Z14545 01
QUALCARE, INC.
223129563 0247663 017 Z14546 01
QUALCARE, INC.
223129563 0247663 024 Z14547 01
WC
WC
WC
WC
WC
WC
MED
MED
MED
MED
MED
MED
MCO00134969.
MCO00134969.
MCO00147898.
MCO00147964.
MCO00147999.
MCO00147958.
3/31/15
3/31/15
682504 ONE CALL MEDICAL, IN 223218521 0247663 002 X41650 01 WC MED MCO00108313.
682504 ONE CALL MEDICAL, IN 223218521 0247663 044 Z07817 01 WC MED MCO00144295.
3/31/15
3/31/15
3/31/15
682505 PACE ORTHOPEDICS AND 223319594 0247663 006 X98348 01 WC MED MCO00139185.
3/31/15
3/31/15
3/31/15
682506 C S R ASSOCIATES
223409929 0247663 021 X07030 01 GL BI
682507 ATLANTICARE SURGERYC 223491867 0247663 014 X90115 01 WC MED MCO00134990.
682507 ATLANTICARE SURGERYC 223491867 0247663 005 Z03152 01 WC MED MCO00141989.
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682508
682509
682510
682511
682512
682513
682514
682514
682514
682514
682514
682514
682514
PETRO-COHEN, ESQS.
COASTAL PHYSICIANS &
REHAB CLINICS (SPT)
223579970
223584828
223822612
223822612
223822612
232736153
232736153
232736153
232736153
232736153
232736153
232736153
232736153
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
024
008
038
038
027
007
036
005
005
007
038
024
043
X81602
Z09082
X17061
Z03495
Z08547
Z01712
X73094
X78968
X78968
Z01712
Z05471
Z08071
Z11033
01
01
01
01
01
01
01
01
01
01
01
01
01
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
IND
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MED
MCO00130379.
MCO00145101.
MCO00096364.
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682515
682516
682517
682518
682519
682520
682521
682521
682521
IMX MEDICAL MANAGEME
PREMIER ORTHO ASSOCS
LEO PETETTI, LLC.
SHORE URGENT CARE
SHORE URGENT CARE
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
AFFANATO MARUT, LLC
232804615
263527324
270005874
274211365
274211365
455388778
463266146
463266146
463266146
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
0247663
041
036
014
045
005
036
014
004
014
X55173
X73094
Z12360
Z11302
Z12290
Z12294
X68719
X70872
X71485
01
01
01
01
01
01
01
01
01
WC
WC
PR
WC
WC
WC
WC
WC
WC
MED
MED
COL
MED
MED
MED
IND
IND
IND
MCO00115876.
MCO00125478.
HAMILTON TWP
MCO00146294.
MCO00146904.
MCO00146891.
MCO00123343.
MCO00124334.
MCO00124579.
165
MCO00144830.
MCO00141117.
MCO00125478.
MCO00128802.
MCO00128802.
MCO00141117.
MCO00143263.
MCO00144540.
MCO00146102.
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
96.43
610.71
63.00
90.00
237.80
84.00
165.00
110.00
359.00
213.14
68.00
472.00
472.00
472.00
472.00
1,888.00
485.00
485.00
970.00
135.61
91.93
203.53
431.07
222.50
3,131.16
4,102.88
7,234.04
2,228.00
89.82
63.00
63.00
63.00
417.00
80.63
80.63
80.63
80.63
80.63
161.26
80.63
645.04
1,475.00
8,960.50
35.00
110.00
185.00
160.00
186.00
529.00
186.00
901.00
LOSS 3/04/14
LOSS 3/02/15
LOSS 3/01/15
LOSS 3/01/15
LOSS 12/16/14
LOSS 12/12/13
LOSS 1/10/15
LOSS 1/10/15
TOTAL CHECK#:
LOSS 4/16/14
LOSS 4/16/14
LOSS 3/26/15
LOSS 3/29/15
LOSS 3/25/15
LOSS 3/23/15
TOTAL CHECK#:
LOSS 8/25/12
LOSS 1/09/15
TOTAL CHECK#:
LOSS 8/15/14
LOSS 3/02/15
LOSS 3/06/15
TOTAL CHECK#:
EXP
8/07/11
LOSS 4/25/14
LOSS 10/13/14
TOTAL CHECK#:
LOSS 1/13/14
LOSS 1/25/15
LOSS 12/29/11
LOSS 10/27/14
LOSS 1/15/15
LOSS 10/08/14
LOSS 9/19/13
LOSS 12/09/13
LOSS 12/09/13
LOSS 10/08/14
LOSS 12/07/14
LOSS 1/08/15
LOSS 2/18/15
TOTAL CHECK#:
LOSS 1/31/13
LOSS 9/19/13
EXP
3/01/15
LOSS 2/23/15
LOSS 3/04/15
LOSS 3/01/15
LGL
7/24/13
LGL
8/20/13
LGL
8/28/13
TOTAL CHECK#:
14
15
15
15
14
13
15
15
005-9106NJ
012-7720NJ
008-7720NJ
008-7720NJ
039-5509NJ
021-7720NJ
006-7720NJ
006-7720NJ
682500
14 036-7720NJ
14 036-7720NJ
15 037-7720NJ
15 009-9102NJ
15 017-9403NJ
15 024-9430NJ
682503
12 002-7720NJ
15 044-7720NJ
682504
14 006-9102NJ
15 005-9106NJ
15 023-5509NJ
682505
11 021-7720NJ
14 014-7720NJ
14 005-7720NJ
682507
14 024-5509NJ
15 008-7720NJ
11 038-5509NJ
14 038-5509NJ
15 027-7720NJ
14 007-5509NJ
13 036-7720NJ
13 005-7720NJ
13 005-7720NJ
14 007-5509NJ
14 038-9402NJ
15 024-7720NJ
15 043-7720NJ
682514
13 041-8810NJ
13 036-7720NJ
15 014-7720NJ
15 045-7720NJ
15 005-7711NJ
15 036-5509NJ
13 014-7720NJ
13 004-7720NJ
13 014-7720NJ
682521
LR0503685
ACCOUNT:002
PERIOD:03/2015
QUAL-LYNX
BANK->
CHECK NUMBER ORDER
DATE
CHECK# PAYEE
3/31/15
3/31/15
3/31/15
3/31/15
3/31/15
682522
682523
682524
682525
682526
PAYMENT REGISTER
IRS#
ANTHONY VENUTO
STONERIVER PHARMACY
CITY OF NORTHFIELD
HAMILTON TOWNSHIP
BATCH#
522344261 0247663
0247663
621770924 0247663
999999999 0247663
999999999 0247663
ACCOUNT TOTALS:
# CHECKS SPOILED:
CB002 00100NJ
GRP FILE#
CL
009
021
017
005
014
01
03
01
01
01
X94190
X62430
Z11458
Z06609
Z12360
COV
WC
WC
WC
PR
PR
# OF CHECKS:
# OF VOIDS.:
166
MED
IND
MED
I/M
COL
612
CLIENT#
MCO00137338.
MCO00119842.
MCO00146349.
NORTHFIELD C
HAMILTON TWP
RUN TIME: 14:03:43
POLICY
AMOUNT
DOL
YR LOCATION
280.00
1,984.00
27.95
1,000.00
395.91
887925.04
744088.88
57136.07
86700.09
LOSS 6/21/14 14
LOSS 4/30/13 13
LOSS 2/24/15 15
LOSS 12/22/14 14
LOSS 3/01/15 15
LOSS PYMT
EXPENSE
LEGAL
009-9053NJ
021-7720NJ
017-7720NJ
005-9102NJ
014-7720NJ
LR0503685
ACCOUNT:002
VALUED AS OF: 3/01/2015 THRU 3/31/2015
POLICY PERIOD: 00/00/0000 TO 00/00/0000
QUAL-LYNX
ADJUSTMENT REGISTER
BANK->
CB002 00100NJ
ENTRY
ADJST
CHECK AMT
DATE
AMOUNT
ADJUSTED
CHECK DATE/NUMBER ADJUSTMENT DESCRIPTION
GROUP FILE ID
CLAIMANT NAME
RUN DATE:
4/01/2015
RUN TIME: 14:03:46
PAGE
1
ADJ DATE PLCY LOCATION
LOSS DATE YEAR COVR ACNT
1/12/2010
644149 VOID CHECK KJG
036
E77970 01 GRIFFITHS ,IAIN
ADJS
3/16/2015
13.87-
13.87
LOS
3/16/2015 2009 03-6--7520 NJ
11/04/2009
WCMED 002
6/04/2010
014
E60870 02 ALCOTT ,ANTHONY
ADJS
3/16/2015
1,703.75-
1,703.75
LOS
3/16/2015 2008 01-4--7720 NJ
02/13/2008
WCMED 002
8/31/2010
045
E80575 01 LYONS ,JENNIFER
ADJS
3/16/2015
107.57-
107.57
LOS
3/16/2015 2010 04-5--7720 NJ
02/26/2010
WCMED 002
9/24/2010
014
E60870 02 ALCOTT ,ANTHONY
ADJS
3/16/2015
83.00-
83.00
LOS
3/16/2015 2008 01-4--7720 NJ
02/13/2008
WCMED 002
9/24/2010
021
E81973 01 VONELLINGTON ,VINCENT
ADJS
3/16/2015
90.50-
90.50
LOS
3/16/2015 2010 02-1--9403 NJ
04/30/2010
WCMED 002
11/02/2010
006
E68398 01 ORTIZ ,JOHN
ADJS
3/16/2015
3,168.00-
3,168.00
LOS
3/16/2015 2008 00-6--9403 NJ
11/14/2008
WCIND 002
3/25/2011
036
E78710 01 LOPEZ ,ANGEL
ADJS
3/16/2015
150.00-
150.00
EXP
3/16/2015 2009 03-6--7720 NJ
12/09/2009
WCMED 002
12/27/2011
006
X08951 01 VALENTIN ,ANGEL
ADJS
3/16/2015
23.71-
23.71
LOS
3/16/2015 2011 00-6--7720 NJ
08/30/2011
WCMED 002
1/27/2012
036
W87273 01 AUSBURN ,CHARLES
ADJS
3/16/2015
798.78-
798.78
LOS
3/16/2015 2011 03-6--5509 NJ
03/16/2011
WCMED 002
2/10/2012
010
W73328 01 GANDY ,LEROY R
ADJS
3/16/2015
130.63-
130.63
LOS
3/16/2015 2010 01-0--7720 NJ
11/17/2010
WCMED 002
2/21/2012
002
X17203 01 SACCO ,PAUL
ADJS
3/16/2015
135.94-
135.94
LOS
3/16/2015 2011 00-2--7720 NJ
12/29/2011
WCMED 002
4/19/2012
042
W70681 01 CROMPTON ,DEBRA
ADJS
3/16/2015
1,000.00-
1,000.00
LOS
3/16/2015 2010 04-2--9106 NJ
11/12/2010
WCMED 002
8/10/2012
021
X27082 01 FRAZIN ,LYNNE
ADJS
3/16/2015
12.43-
12.43
LOS
3/16/2015 2012 02-1--7711 NJ
04/25/2012
WCMED 002
8/14/2012
006
E83217 01 GRAVES ,ANDRE
ADJS
3/16/2015
934.64-
934.64
LOS
3/16/2015 2010 00-6--7720 NJ
06/20/2010
WCIND 002
9/11/2012
014
W85909 01 DARE ,NICHOLAS
ADJS
3/16/2015
359.00-
359.00
EXP
3/16/2015 2011 01-4--7720 NJ
02/26/2011
WCMED 002
9/21/2012
043
X40884 01 STOCKS ,STEVEN
ADJS
3/16/2015
13.50-
13.50
LOS
3/16/2015 2012 04-3--9053 NJ
08/14/2012
WCMED 002
10/05/2012
024
X40978 01 ERAZMUS ,RICHARD
ADJS
3/16/2015
15.00-
15.00
EXP
3/16/2015 2012 02-4--9430 NJ
08/18/2012
WCMED 002
167
LR0503685
QUAL-LYNX
ACCOUNT:002
VALUED AS OF: 3/01/2015 THRU 3/31/2015
POLICY PERIOD: 00/00/0000 TO 00/00/0000
ADJUSTMENT REGISTER
BANK->
CB002 00100NJ
ENTRY
ADJST
CHECK AMT
DATE
AMOUNT
ADJUSTED
CHECK DATE/NUMBER ADJUSTMENT DESCRIPTION
GROUP FILE ID
CLAIMANT NAME
RUN DATE:
4/01/2015
RUN TIME: 14:03:46
PAGE
2
ADJ DATE PLCY LOCATION
LOSS DATE YEAR COVR ACNT
11/20/2012
036
X43856 01 MATOS ,SHAWN
ADJS
3/16/2015
89.94-
89.94
LOS
3/16/2015 2012 03-6--7720 NJ
09/21/2012
WCMED 002
3/01/2013
036
X34147 02 SEIDEL ,JOHNATHAN
ADJS
3/16/2015
11.77-
11.77
LOS
3/16/2015 2012 03-6--7720 NJ
07/08/2012
WCMED 002
3/22/2013
034
X22764 01 ALLEN ,RAYMOND
ADJS
3/16/2015
77.00-
77.00
EXP
3/16/2015 2012 03-4--5509 NJ
03/14/2012
WCMED 002
4/05/2013
037
X52387 01 GAWLE ,JOHN
ADJS
3/16/2015
59.80-
59.80
LOS
3/16/2015 2013 03-7--5509 NJ
01/17/2013
WCMED 002
5/03/2013
006
X42017 01 VALENTIN ,ANGEL
ADJS
3/16/2015
1,620.00-
1,620.00
LOS
3/16/2015 2012 00-6--7720 NJ
09/04/2012
WCIND 002
5/28/2013
037
E71070 01 TARTAGLIO ,ROBERT
ADJS
3/16/2015
9.20-
9.20
EXP
3/16/2015 2009 03-7--5509 NJ
03/03/2009
WCMED 002
5/28/2013
014
X63049 01 JENSEN ,JAMES
ADJS
3/16/2015
9.20-
9.20
EXP
3/16/2015 2013 01-4--5509 NJ
05/07/2013
WCMED 002
5/28/2013
043
X63050 01 GREGG ,SCOTT
ADJS
3/16/2015
9.20-
9.20
EXP
3/16/2015 2013 04-3--5509 NJ
05/06/2013
WCMED 002
6/21/2013
027
X12966 01 FIORE ,CAROL
ADJS
3/16/2015
400.00-
400.00
LOS
3/16/2015 2011 02-7--8810 NJ
10/31/2011
WCIND 002
7/05/2013
043
X62959 01 MATTEO ,JOHN
ADJS
3/16/2015
35.00-
35.00
EXP
3/16/2015 2013 04-3--7720 NJ
05/06/2013
WCMED 002
11/08/2013
024
E83313 01 BAILEY JR. ,ROBERT
ADJS
3/16/2015
308.00-
308.00
LGL
3/16/2015 2010 02-4--9403 NJ
06/23/2010
WCIND 002
11/08/2013
009
E83796 01 OVES ,ALEXANDER
ADJS
3/16/2015
364.00-
364.00
LGL
3/16/2015 2010 00-9--7711 NJ
07/13/2010
WCIND 002
11/08/2013
024
X05966 01 KIRK ,DOLORES
ADJS
3/16/2015
91.00-
91.00
LGL
3/16/2015 2011 02-4--8810 NJ
08/03/2011
WCIND 002
12/03/2013
039
X74155 01 LLOYD ,JOEL
ADJS
3/16/2015
27.00-
27.00
LOS
3/16/2015 2013 03-9--9403 NJ
10/01/2013
WCMED 002
12/03/2013
673144 UNVOID
039
X74155 01 LLOYD ,JOEL
ADJS
3/20/2015
27.00
27.00
LOS
3/20/2015 2013 03-9--9403 NJ
10/01/2013
WCMED 002
8/01/2014
677900 VOIDED CHECK/STOP PAY PLACED
042
X62854 01 JASPE ,CHRISTIAN
ADJS
3/09/2015
550.00-
550.00
LOS
3/09/2015 2013 04-2--9430 NJ
05/03/2013
WCMED 002
2/13/2015
681625 VOIDED CHECK/PER:ADJ
043
X69721 01 MURAVENA ,LIUDMILA
ADJS
3/12/2015
3,592.32-
3,592.32
LGL
3/12/2015 2011 04-3--7720 NJ
08/05/2011
GLPPPI 002
DMC
168
LOSS ADJS:
POSTED TOTAL
10,947.83-
PRIOR CHECKS
10,947.83-
CURRENT CHECKS
LEGAL....:
ACCOUNT TOTALS: # OF ADJS:
34
169
4,355.3215,966.75-
4,355.3215,966.75-
LR0503685
ACCOUNT:002
VALUED AS OF:
QUAL-LYNX
RECOVERY REGISTER
3/01/2015 THRU 3/31/2015
RUN DATE: 4/01/2015 PAGE
RUN TIME: 14:03:46
CHECK DATE/NUMBER
GROUP FILE ID
CLAIMANT NAME
ENTRY
DATE
3/20/2015 172843526 SUBROGATION
005
Z06609 01
NORTHFIELD CITY ,
BAP
CHECK AMT
1
CHK DATE PLCY LOCATION
LOSS DATE YEAR TYPE COVR
SUBR
3/26/2015
2,623.79
2014 00-5--9102 NJ
12/22/2014
PRI/M
3/12/2015
095065 SUBROGATION
BAP
006
X20408 01
KETSCHEK ,JACOB
SUBR
3/24/2015
12,018.82
2012 00-6--7711 NJ
02/09/2012
WCIND
3/12/2015
095065 SUBROGATION
006
X20408 01
KETSCHEK ,JACOB
SUBR
3/24/2015
7,981.18
2012 00-6--7711 NJ
02/09/2012
WCMED
BAP
3/03/2015
81493792 SUBROGATION
010
X00420 01
BARBIERI ,JOHN
BAP
SUBR
3/17/2015
13.00
2011 01-0--7720 NJ
05/26/2011
WCMED
3/03/2015
010
X47931 01
SAMBUCCI ,GINA
BAP
SUBR
3/19/2015
49.00
2012 01-0--7720 NJ
11/17/2012
WCMED
3/03/2015
010
X47931 02
MILLER ,JOHN
BAP
SUBR
3/19/2015
49.00
2012 01-0--7720 NJ
11/17/2012
WCMED
3/12/2015 300022193 SUBROGATION
010
X96271 01
SOMERS POINT ,
BAP
SUBR
3/19/2015
13,435.90
2014 01-0--9430 NJ
07/16/2014
PRCOL
SUBR
3/12/2015
459.70
2014 01-1--5509 NJ
08/11/2014
PRI/M
SUBR
3/19/2015
98.00
2013 01-2--7720 NJ
06/02/2013
WCMED
3/05/2015 485258216 SUBROGATION
011
X97914 01
UPPER DEERFIELD ,
BAP
3/03/2015
012
X64777 01
DONAHUE ,LUKE
BAP
3/03/2015
014
X68719 01
MILLER ,BRIAN
BAP
SUBR
3/17/2015
40.00
2013 01-4--7720 NJ
07/24/2013
WCMED
2/11/2015
151690 SUBROGATION
021
T02587 01
EGG HARBOR TWP ,
BAP
SUBR
3/17/2015
86.60
2002 02-1--7720 NJ
02/17/2002
PRCOMP
3/14/2015
000209 SUBROGATION
021
U76470 01
EGG HARBOR TWP ,
BAP
SUBR
3/24/2015
50.00
2009 02-1--7720 NJ
02/09/2009
PRCOL
3/02/2015
000213 SUBROGATION
021
U76470 01
EGG HARBOR TWP ,
BAP
SUBR
3/10/2015
50.00
2009 02-1--7720 NJ
02/09/2009
PRCOL
SUBR
3/20/2015
11,504.60
2012 02-1--7720 NJ
04/23/2012
PRCOL
SUBR
3/02/2015
71,957.46
2012 02-1--7720 NJ
04/23/2012
WCIND
SUBR
3/17/2015
962.00
2013 02-1--7720 NJ
04/30/2013
WCMED
SUBR
3/17/2015
962.00
2013 02-1--7720 NJ
04/30/2013
WCMED
3/13/2015 172718868 SUBROGATION
021
X26953 01
EGG HARBOR TWP ,
2/18/2015
031618 SUBROGATION
021
X26999 01
REED ,WILLIAM
3/03/2015
021
X62430 02
ROCCO ,THOMAS
BAP
BAP
3/03/2015
BAP
021
X62430 03
VENUTO ,ANTHONY
170
LR0503685
ACCOUNT:002
VALUED AS OF:
QUAL-LYNX
RECOVERY REGISTER
3/01/2015 THRU 3/31/2015
RUN TIME: 14:03:46
CHECK DATE/NUMBER
GROUP FILE ID
CLAIMANT NAME
ENTRY
DATE
2/25/2015 103734929 SUBROGATION
021
X99845 01
EGG HARBOR TWP ,
CHECK AMT
2
CHK DATE PLCY LOCATION
LOSS DATE YEAR TYPE COVR
BAP
SUBR
3/04/2015
431.59
2014 02-1--7720 NJ
08/30/2014
PRCOL
2/11/2015
151713 SUBROGATION
BAP
023
X43020 01
BRADSHAW ,WILLIAM
SUBR
3/17/2015
90.73
2012 02-3--7720 NJ
09/16/2012
WCMED
3/03/2015
024
X64896 01
EDWARDS ,EDWARD
BAP
SUBR
3/13/2015
49.00
2013 02-4--7720 NJ
05/31/2013
WCIND
3/03/2015
024
X64896 02
FESSLER ,ROBERT
BAP
SUBR
3/13/2015
49.00
2013 02-4--7720 NJ
05/31/2013
WCIND
1/31/2015
000116 SUBROGATION
BAP
036
X14540 01
KAVANAGH ,BRANDON
SUBR
3/02/2015
100.00
2011 03-6--7720 NJ
11/19/2011
WCMED
3/03/2015
000116 SUBROGATION
036
X30762 01
MOONEY ,CINDI
SUBR
3/13/2015
200.00
2012 03-6--7720 NJ
05/16/2012
WCMED
BAP
3/03/2015
037
X08156 01
GOEHRINGER ,RYAN
BAP
SUBR
3/17/2015
102.00
2011 03-7--7720 NJ
08/30/2011
WCMED
3/03/2015
042
X21494 01
DEVINE ,TIMOTHY
BAP
SUBR
3/23/2015
50.50
2012 04-2--7720 NJ
02/27/2012
WCMED
3/03/2015
042
X21494 02
OLSON ,JAMES
BAP
SUBR
3/23/2015
50.50
2012 04-2--7720 NJ
02/27/2012
WCMED
3/03/2015
045
X61784 01
WILLIAMS ,MARK
BAP
SUBR
3/19/2015
5.00
2013 04-5--7720 NJ
04/19/2013
WCMED
3/03/2015
045
X61784 02
KRAUSE ,DANIEL
BAP
SUBR
3/19/2015
5.00
2013 04-5--7720 NJ
04/19/2013
WCMED
RECOVERIES
EXCESS RECOVERIES
ACCOUNT TOTALS: # OF CHKS:
ACCOUNT TOTALS: # OF CHKS:
28
171
POSTED TOTAL
123,474.37
LR0503685
ACCOUNT:002
VALUED AS OF:
LOSS
YEAR
QUAL-LYNX
RECOVERY REGISTER
3/01/2015 THRU 3/31/2015
FILE TYPE
DESCRIPTION
RUN TIME: 14:03:46
RECOVERY
GROUP
Period Beginning: 01 01 2002
Ending...: 12 31 2002
PR
PROPERTY
045
86.60
Ending...: 12 31 2009
PR
PROPERTY
045
100.00
Ending...: 12 31 2011
WC
WORKERS COMPENSATION
045
215.00
Ending...: 12 31 2012
PR
PROPERTY
045
11,504.60
Ending...: 12 31 2012
WC
045
92,447.19
Ending...: 12 31 2013
WC
045
2,170.00
Ending...: 12 31 2014
PR
PROPERTY
045
16,950.98
EXCESS TOTALS:
172
RECOVERY TOTALS:
123,474.37
TOTALS:
123,474.37
1
173
SUMMARY OF CASH TRANSACTIONS
FUND YEAR
2015
Month Ending:
March
Prop
OPEN BALANCE
167,813.08
RECEIPTS
Assessments
8,238.47
Refunds
0.00
Invest Pymnts
72.40
Invest Adj
0.00
Subtotal Invest
72.40
Other *
0.00
TOTAL
8,310.87
Liab
76,745.01
Auto
99,364.78
WC
1,797,346.99
Ded
504,109.92
48,221.95
0.00
64.50
0.00
64.50
0.00
48,286.45
4,397.73
0.00
43.17
0.00
43.17
0.00
4,440.90
79,109.22
0.00
776.92
0.00
776.92
0.00
79,886.14
2,728.00
0.00
0.00
2,728.00
122,303.46
5,767.96
0.00
0.00
5,767.96
98,037.72
Liab
2,731,460.11
Cont
EJIF
MEL
(919,813.43)
Admin
1,239,441.02
TOTAL
2,966,007.01
0.00
72,273.61
0.00
0.00
0.00
0.00
0.00
510.89
0.00
510.89
625.00
73,409.50
233,211.00
0.00
1,688.34
0.00
1,688.34
625.00
235,524.34
0.00
204,788.86
0.00
204,788.86
1,108,061.66
176,427.67
204,788.86
0.00
381,216.53
2,820,314.82
MEL
199,211.72
Admin
260,838.53
TOTAL
11,692,955.53
0.00
0.00
0.00
20.20
0.00
20.20
0.00
20.20
0.00
0.00
0.00
0.00
0.00
130.96
0.00
130.96
0.00
130.96
2,526.06
0.00
2,526.06
0.00
2,526.06
0.00
16,950.98
16,570.67
0.00
16,570.67
0.00
33,521.65
0.00
0.00
0.00
0.00
30,754.16
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
199,342.68
0.00
11,590.31
0.00
11,590.31
251,774.28
228,842.20
11,590.31
0.00
240,432.51
11,486,044.67
999.64
0.00
20,970.02
0.00
0.00
219.80
0.00
219.80
0.00
21,189.82
0.66
0.00
0.66
0.00
0.66
0.00
0.00
0.00
0.00
0.00
131,437.44
0.00
0.00
131,437.44
1,745,795.69
0.00
0.00
0.00
0.00
525,299.74
0.00
0.00
0.00
0.00
1,000.30
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
(919,813.43)
Auto
379,324.82
WC
5,896,240.94
Ded
2,287,704.01
Cont
30,733.96
0.00
0.00
0.00
2,367.04
0.00
2,367.04
0.00
2,367.04
0.00
0.00
502.57
0.00
502.57
0.00
502.57
0.00
0.00
8,066.62
0.00
8,066.62
0.00
8,066.62
0.00
0.00
2,903.12
0.00
2,903.12
0.00
2,903.12
7,514.43
0.00
0.00
7,514.43
2,726,312.72
30.00
0.00
0.00
30.00
379,797.39
203,154.21
0.00
0.00
203,154.21
5,701,153.35
0.00
0.00
0.00
0.00
2,290,607.13
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
36,494.27
0.00
0.00
36,494.27
139,629.68
FUND YEAR
2014
Month Ending:
March
Prop
OPEN BALANCE
(92,558.56)
RECEIPTS
Assessments
0.00
Refunds
16,950.98
Invest Pymnts
54.10
Invest Adj
0.00
Subtotal Invest
54.10
Other *
0.00
TOTAL
17,005.08
EJIF
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
2015 CIR_ACM.xls
18,143.56
0.00
0.00
18,143.56
(93,697.04)
SCT_REPORTS
Page 1
174
4/3/2015
11:04 AM
FUND YEAR
2013
Month Ending:
March
Prop
OPEN BALANCE
105,440.36
RECEIPTS
Assessments
0.00
Refunds
0.00
Invest Pymnts
134.21
Invest Adj
0.00
Subtotal Invest
134.21
Other *
0.00
TOTAL
134.21
Liab
2,567,565.00
Auto
322,176.54
WC
4,674,504.36
Ded
2,352,236.31
0.00
0.00
3,473.65
0.00
3,473.65
0.00
3,473.65
0.00
0.00
433.66
0.00
433.66
0.00
433.66
0.00
2,170.00
6,654.66
0.00
6,654.66
0.00
8,824.66
2,081.50
0.00
0.00
2,081.50
2,568,957.15
20.00
0.00
0.00
20.00
322,590.20
Liab
2,106,449.69
Cont
0.00
EJIF
0.00
MEL
167,131.06
Admin
102,535.98
TOTAL
10,291,589.61
0.00
0.00
0.00
0.00
0.00
3,153.63
0.00
3,153.63
0.00
3,153.63
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
225.39
0.00
225.39
0.00
225.39
169.44
0.00
169.44
0.00
169.44
0.00
2,170.00
14,244.64
0.00
14,244.64
0.00
16,414.64
93,776.41
0.00
0.00
93,776.41
4,589,552.61
0.00
0.00
0.00
0.00
2,355,389.94
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
167,356.45
0.00
1,000.00
0.00
1,000.00
101,705.42
95,877.91
1,000.00
0.00
96,877.91
10,211,126.34
Auto
268,703.94
WC
4,545,602.77
Ded
1,409,769.84
0.00
0.00
MEL
241,180.06
Admin
122,022.94
TOTAL
8,759,192.38
0.00
0.00
2,886.79
0.00
2,886.79
0.00
2,886.79
0.00
0.00
369.81
0.00
369.81
0.00
369.81
0.00
92,447.19
6,163.62
0.00
6,163.62
0.00
98,610.81
0.00
0.00
0.00
0.00
0.00
1,942.58
0.00
1,942.58
0.00
1,942.58
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
324.38
0.00
324.38
0.00
324.38
172.41
0.00
172.41
0.00
172.41
0.00
103,951.79
11,902.82
0.00
11,902.82
0.00
115,854.61
194,312.19
0.00
0.00
194,312.19
1,915,024.29
2,454.50
0.00
0.00
2,454.50
266,619.25
108,943.89
0.00
0.00
108,943.89
4,535,269.69
0.00
0.00
0.00
0.00
1,411,712.42
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
241,504.44
0.00
0.00
0.00
0.00
122,195.35
310,571.58
0.00
0.00
310,571.58
8,564,475.41
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
0.00
0.00
0.00
0.00
105,574.57
FUND YEAR
2012
Month Ending:
March
Prop
OPEN BALANCE
65,463.14
RECEIPTS
Assessments
0.00
Refunds
11,504.60
Invest Pymnts
43.23
Invest Adj
0.00
Subtotal Invest
43.23
Other *
0.00
TOTAL
11,547.83
Cont
EJIF
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
2015 CIR_ACM.xls
4,861.00
0.00
0.00
4,861.00
72,149.97
SCT_REPORTS
Page 1
175
4/3/2015
11:04 AM
FUND YEAR
2011
Month Ending:
March
Prop
OPEN BALANCE
95,110.31
RECEIPTS
Assessments
0.00
Refunds
0.00
Invest Pymnts
127.01
Invest Adj
0.00
Subtotal Invest
127.01
Other *
0.00
TOTAL
127.01
Liab
799,158.23
Auto
59,423.27
WC
2,601,004.57
Ded
2,123,576.60
0.00
0.00
1,221.80
0.00
1,221.80
0.00
1,221.80
0.00
0.00
80.47
0.00
80.47
0.00
80.47
0.00
215.00
3,603.29
0.00
3,603.29
0.00
3,818.29
40,397.90
0.00
0.00
40,397.90
759,982.13
0.00
0.00
0.00
0.00
59,503.74
27,425.30
0.00
0.00
27,425.30
2,577,397.56
Cont
EJIF
Admin
157,313.02
TOTAL
5,835,585.46
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
211.09
0.00
211.09
0.00
211.09
0.00
215.00
8,088.04
0.00
8,088.04
0.00
8,303.04
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
(0.54)
0.00
0.00
0.00
0.00
157,524.11
68,000.56
0.00
0.00
68,000.56
5,775,887.94
0.00
0.00
0.00
0.00
0.00
2,844.38
0.00
2,844.38
0.00
2,844.38
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,126,420.98
0.00
0.00
0.00
0.00
0.00
MEL
(0.54)
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
177.36
0.00
0.00
177.36
95,059.96
FUND YEAR
Closed
Month Ending:
March
Prop
OPEN BALANCE
108.86
RECEIPTS
Assessments
0.00
Refunds
0.00
Invest Pymnts
0.07
Invest Adj
0.00
Subtotal Invest
0.07
Other *
186.60
TOTAL
186.67
Liab
0.00
Auto
0.00
WC
0.00
Ded
0.00
Cont
0.00
EJIF
0.00
MEL
0.00
Admin
8,858,301.79
TOTAL
8,858,410.65
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
8,063.16
0.00
0.00
0.00
0.00
8,063.16
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
14,501.34
0.00
14,501.34
0.00
14,501.34
0.00
8,063.16
14,501.41
0.00
14,501.41
186.60
22,751.17
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
8,063.16
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
8,872,803.13
0.00
301.53
0.00
301.53
8,880,860.29
EXPENSES
Claims Transfers
Expenses
Other *
TOTAL
END BALANCE
2015 CIR_ACM.xls
0.00
301.53
0.00
301.53
(6.00)
SCT_REPORTS
Page 1
176
4/3/2015
11:05 AM
CERTIFICATION AND RECONCILIATION OF CLAIMS PAYMENTS AND RECOVERIES
Month
Current Fund Year
Policy
Year
2015
2014
2013
2012
2011
Coverage
Prop
Liab
Auto
WC
Total
Prop
Liab
Auto
WC
Total
Prop
Liab
Auto
WC
Total
Prop
Liab
Auto
WC
Total
Prop
Liab
Auto
WC
Total
TOTAL
March
2015
1.
2.
3.
4.
5.
6.
Calc. Net
Monthly
Monthly
Calc. Net
TPA Net
Variance
Paid Thru
Net Paid
Recoveries
Paid Thru
Paid Thru
To Be
Last Month
March
March
March
March
Reconciled
30,238.39
36,494.27
0.00
66,732.66
66,732.66
1,565.20
2,728.00
0.00
4,293.20
4,293.20
6,355.16
5,767.96
0.00
12,123.12
12,123.12
104,417.78
131,437.44
0.00
235,855.22
235,855.22
142,576.53
176,427.67
0.00
319,004.20
319,004.20
886,293.32
18,143.56
16,950.98
887,485.90
887,485.90
67,288.94
7,514.43
0.00
74,803.37
74,803.37
69,785.82
30.00
0.00
69,815.82
69,815.82
2,991,611.80
203,154.21
0.00
3,194,766.01
3,194,766.01
4,014,979.88
228,842.20
16,950.98
4,226,871.10
4,226,871.10
645,568.95
0.00
0.00
645,568.95
645,568.95
251,342.40
2,081.50
0.00
253,423.90
253,423.90
98,075.00
20.00
0.00
98,095.00
98,095.00
4,638,290.53
93,776.41
2,170.00
4,729,896.94
4,729,896.94
5,633,276.88
95,877.91
2,170.00
5,726,984.79
5,726,984.79
1,510,260.26
4,861.00
11,504.60
1,503,616.66
1,503,616.66
382,632.74
194,312.19
0.00
576,944.93
576,944.93
104,780.25
2,454.50
0.00
107,234.75
107,234.75
4,778,524.92
108,943.89
92,447.19
4,795,021.62
4,795,021.62
6,776,198.17
310,571.58
103,951.79
6,982,817.96
6,982,817.96
873,221.79
177.36
0.00
873,399.15
873,399.15
1,300,650.17
40,397.90
0.00
1,341,048.07
1,341,048.07
400,371.60
0.00
0.00
400,371.60
400,371.60
6,642,561.95
27,425.30
215.00
6,669,772.25
6,669,772.25
9,284,591.07
9,284,591.07
9,216,805.51
68,000.56
215.00
25,783,836.97
879,719.92
123,287.77
26,540,269.12
26,540,269.12
2015 CIR_ACM.xls
CRC_REPORTS
Page 1
177
7.
Delinquent
Unreconciled
Variance From
0.00
0.00
(0.00)
0.00
(0.00)
0.00
0.00
(0.00)
0.00
(0.00)
(0.00)
0.00
(0.00)
(0.00)
(0.00)
(0.00)
(0.00)
(0.00)
(0.00)
(0.00)
0.00
(0.00)
0.00
(0.00)
(0.00)
(0.00)
8.
Change
This
Month
0.00
0.00
0.00
0.00
0.00
0.00
0.00
(0.00)
0.00
(0.00)
(0.00)
0.00
(0.00)
(0.00)
(0.00)
(0.00)
0.00
(0.00)
(0.00)
(0.00)
0.00
(0.00)
0.00
(0.00)
(0.00)
(0.00)
0.00
0.00
(0.00)
0.00
(0.00)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
(0.00)
0.00
(0.00)
(0.00)
0.00
(0.00)
0.00
0.00
(0.00)
(0.00)
4/3/2015
11:05 AM
178
BILL LIST - APRIL 2015
Payable To:
The DeWeese Law Firm, P.C.
Qual-Lynx
Tracy Forlenza
J.A. Montgomery Risk Control Services
John Hansen
Joyce Media
Valerie Smith
Debby Schiffer
FY 2015
69,986.00
327.87
9,773.00
64,015.00
487.00
15,647.00
1,875.00
925.00
311.00
7,812.00
2,499.00
12 Apex Insurance Services c/o XL Insurance
1,060,966.50
1
2
3
4
5
6
7
8
9
10
11
Arthur J. Gallagher Risk Management Services, Inc.
Arthur J. Gallagher Risk Management Services, Inc.
13 Apex Insurance Services c/o XL Insurance
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Apex Insurance Services c/o XL Insurance
MEL
MEL
MEL
PRIMA
4imprint Inc.
ARC Reprographics
Armando Riccio, LLC
Brownies Squared
Charley's Other Brother
OfficeMax Contract, Inc.
JIF BILL LIST TOTAL
Appropriation
Prof Services/Administration
Misc/Postage/Copies/Faxes
Prof Services/Attorney
Prof Services/Claims Administration
Misc/Recording Secretary
Prof Services/Safety Director
Prof Services/Treasurer
Prof Services/Underwriting Mgr
Misc/JIF Website
Wellness
Wellness
EPL/POL Policy - XL Insurance
7,658.00
12,300.00
681,632.40
232,355.91
4,825.12
570.00
212.15
197.84
140.00
200.00
2,152.80
MEL
Property Claims and Premium
435.48
Faithful Performance Bond
Misc/AGRIP/PRIMA
Misc/Office Supplies
EPL Consulting & Training
Misc/Meeting Expense
Misc/Office Supplies
Safety Incentive Program
Optional Safety Budget
1,250.00 Safety Incentive Program
3,836.00
86.00
1,000.00
750.00
750.00
Paul's Custom Awards and Trophies
Buena Borough
Cape May Point Borough
Folsom Borough
Sea Isle City
Somers Point City
Subtotals
FY 2014
722.82
2,178,026.89
2,181,862.89
179
Description
April 2015 Fees
March 2015 Fees
April 2015 Fees
April 2015 Fees
April 2015 Fees
April 2015 Fees
April 2015 Fees
April 2015 Fees
April 2015 Fees
Director - March 19-31 and April 2015 Fees
Consultant - March 19-31 and April 2015 Fees
EPL/POL coverage;Policy #PJA9519005-04; 1/1//15-1/1/16; 2nd instmt;
Inv#1918897
VDO coverage;Policy #VJA9519005-03; 1/1//15-1/1/16; 2nd instmt;
Inv#1921290
Cyber coverage;Policy #MTP0039477-02; 1/1//15-1/1/16; 2nd instmt;
Inv#1929520
MEL 2015 WC & Excess Liability - 2nd installment
MEL 2015 Property claims & prem. -2nd installment
MEL 2015 Fidelity Bond - 2nd installment
PRIMA June 6-10/2015 Conf. Reg-Ed Beck
JIF pens; split by 3; Inv#3825270
3/11/15 Elected Officials Handout; split by 3
3/11/15 Elected Officials Presenter (eastampton); split by 3
Claims Meeting 04/9/15 F&B
3/11/15 Elected Officials Dinner; split by 3
Acct#228332; PO#164631700(CC binders/tabs); Inv#28075(LR
binders/tabs); PO#16475419 (Finance wkbks)
Engraving for awards; Inv#30439
Direct check for safety monies
Reimbursement for safety monies
180
ACCOUNT ACTIVITY RECONCILIATION
FY 2015
January
Opening Balance for the Period:
RECEIPTS:
Interest Income ( Cash )
Premium Assessment Receipts
Prior Yr. Premium Assessment Receipts
Subrogation & Reimb. Receipts:
Fund Year 2015
Fund Year 2014
Fund Year 2013
Fund Year 2012
Fund Year 2011
Closed Fund Year
Total Subrogation & Reimb.Receipts
FY 2015 Appropriation Refunds
Closed Fund Year
DUE ATLANTIC COUNTY
VOID STALE DATED CHECKS
TOTAL RECEIPTS:
46,613,374.40
47,099.66
646,608.00
February
45,595,905.31
(12,227.97)
4,959,913.75
Year To Date
Total
March
48,403,741.36
66,995.89
233,211.00
5,565.88
1,539.00
191,735.80
48.00
2,427.63
2,410.00
784.00
148.00
16,950.98
2,170.00
103,951.79
215.00
198,888.68
8.90
5,778.53
123,287.77
100.00
7,573.00
186.60
625.00
8,063.16
900,269.34
4,953,464.31
432,369.42
101,867.58
5,839,732.75
0.00
0.00
24,944.49
6,119.00
296,471.59
411.00
0.00
8.90
327,954.98
0.00
0.00
0.00
286.60
7,573.00
625.00
8,063.16
0.00
0.00
6,286,103.07
DISBURSEMENTS:
Net Claim Payments:
Fund Year 2015
Fund Year 2014
Fund Year 2013
Fund Year 2012
Fund Year 2011
Closed Fund Year
Total Net Claim Payments
Exp.& Admin Bill List Payments:
Exp. & Cont. Charges FY 2015
RELEASE OF AELCF
CLOSED FUND YEAR
Closed Fund Year
MISC.
Total Bill List Payments
Auditor's 2012 Audit Adjustments
TOTAL DISBURSEMENTS:
Closing Balance for the Period:
Account Net Cash Change During the Period:
Loss Account
Loss Account:other;see above
Expense & Contingency Account
Investment Account
TD Wealth Management Account
Exp & Contin Reconciliation Account
Claims Imprest Reconciliation Account
"Line of Coverage" Accounts
Total Change in Account Net Cash:
47,771.28
360,761.70
148,990.56
101,573.98
83,277.59
94,805.25
294,350.62
152,227.09
121,637.18
72,695.73
176,427.67
228,842.20
95,877.91
310,571.58
68,000.56
742,375.11
735,715.87
301.53
880,021.45
1,093,940.81
14,631.94
9,369.56
1,383,404.80
2,441.38
4,000.00
204,788.86
11,590.31
1,000.00
20,066.20
57,421.00
0.01
1,175,363.32
0.01
1,409,912.39
217,379.17
1,917,738.43
2,145,628.26
1,097,400.62
45,595,905.31
48,403,741.36
47,738,710.16
(1,065,068.74)
(2,175,952.19)
(5,728,715.32)
(19,200.00)
5,003,488.24
5,017,820.00
45,864.12
44,200.00
2,899.65
500.00
(1,017,469.09)
(500.00)
2,807,836.05
Proof:
0.00
0.00
file:\\C:\Users\Kkristie\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\Y0LF9D5A\ACM RECONCILIATION REPORT 2015.xls\2015
181
(665,031.20)
0.00
319,004.20
883,954.52
397,095.56
533,782.74
223,973.88
0.00
301.53
2,358,112.43
2,682,134.47
28,663.63
14,369.56
0.00
20,066.20
57,421.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.02
2,802,654.88
0.00
5,160,767.31
-8,969,736.25
0.00
0.00
5,042,820.00
5,052,252.01
0.00
0.00
0.00
1,125,335.76
4/3/2015
ANALYSIS OF NON ASSESSMENT RECEIPTS
2012
Subrogation
Salvage & Reimbursements
subtotal
366,375.79
$
$
$
2014
907,442.56
79,499.23
986,941.79
563.08 $
25,207.36
$ 1,000,000.00
$
260,985.88
750.00 $
4,431.25
1,313.08 $ 1,290,624.49
$
$
$
$
$
11,847.22
599,229.08
258,565.98
14,769.35
884,411.63
$ 585,292.73 $
2013
Reimbursments
Storm related
MEL
Other
subtotal
$
Total
$ 586,605.81 $ 1,657,000.28
$
$
$ 1,871,353.42
Information from 2012 & 2013 Year End Reports/2014~current
file:ANALYSIS OF NON ASSESSMENT COLLECTIONS 2015.xlsx//2015
182
4/3/2015

agendapacket - Atlantic County Municipal Joint Insurance Fund

Transcription

Similar documents

Die BUCHSTAVIER - Das Dosierte Leben