SELF-INSURANCE INSTITUTE OF AMERICA, INC. PAC (SELF-INSURANCE PAC)
Political Action Committee
Campaign Contribution Details
2012 Election Cycle

Committee Information
Download all of the 2012 Individual Contribution Records for this Committee to a Spreadsheet or Other File Type
Name	SELF-INSURANCE INSTITUTE OF AMERICA, INC. PAC (SELF-INSURANCE PAC)
Connected Organization Name	SELF-INSURANCE INSTITUTE OF AMERICA, I
Address	1250 H STREET, NW SUITE 901 WASHINGTON, DC 20005
Interest Group Category	Trade/Memership/Health
Affiliated Party	--
Affiliated Candidate	--
Download all of the 2012 Individual Contribution Records for this Committee to a Spreadsheet or Other File Type

Financial Details in the 2012 Election Cycle
SELF-INSURANCE INSTITUTE OF AMERICA, INC. PAC (SELF-INSURANCE PAC)

Through 11/26/2012

Category	$ Dollar Amount
Total Receipts	$121,512
Transfers From Affiliates	$0
Contributions From Individuals	$105,506
Contributions From Other Political Committees	$16,000
Total Loans Received	$0
Total Disbursements	$77,318
Transfers To Affiliates	$0
Refunds To Individuals	$735
Refunds to Committees	$0
Loan Repayments	$0
Beginning Cash	$23,487
Ending Cash	$67,681
Debts Owed By	$0
Nonfederal Transfers Received	$0
Contributions Made To Other Committees	$61,000
Independent Expenditures Made	$0
Party Coordinated Expenditures Made	$0
Nonfederal Share of Expenditures	$0

Top 100 Donations/Contributions in the 2012 Election Cycle
SELF-INSURANCE INSTITUTE OF AMERICA, INC. PAC (SELF-INSURANCE PAC)

Name/ Location	Employer/ Occupation	Contribution $ Amount	Primary/ General	Date
TIERNEY, ROBERT SHERBORN, MA 01770	Star Line Group/President	$2,731		09/26/2012
MELOCH, MICHAEL MR. SHOREVIEW, MN 55126	Tpac Underwriters, Inc./President	$2,500		05/04/2011
MCPETERS, JERRY L DALLAS, TX 75254	Group & Pension Administrators/President	$2,500		11/10/2011
MCPETERS, JERRY L DALLAS, TX 75254	Group & Pension Administrators/President	$2,500		02/22/2012
WILNEFF, MITCHELL GLENCOE, IL 60022	Allied Benefit Systems, Inc./President	$2,500		06/04/2012
YOUNGS, JOHN ELK GROVE, CA 95757	Onesource Stop Loss/Ceo	$2,090		08/20/2012
MOLBECK, JOHN N. JR. HOUSTON, TX 77024	Hcc Insurance Holdings/Ceo	$1,500		09/11/2012
BELDING, THOMAS EDMOND, OK 73013	Pro. Reinsurance Marketing Srv/President	$1,000		02/23/2011
REPKE, ROBERT SAN FRANSISCO, CA 94127	Medical Destination Thailand/President	$1,000		02/23/2011
AXTELL, GENE MR. FOLSOM, CA 95630	Affinity Group Administrators/Chief Operating Officer	$1,000		04/05/2011
MERZ, MARCUS MR. GOLDEN VALLEY, MN 55416	Preferredone/President	$1,000		04/05/2011
RITCHIE, ANDREW J WOODSTOCK, GA 30189	Hcc Life Insurance Company/Senior Vice President	$1,000		04/22/2011
MARINER, ELIZABETH WELLINGTON, FL 33414	Re-Solutions/Executive Vice President	$1,000		05/04/2011
JACKSON, CLAY FOLSOM, CA 95630	Affinity Group Administrators/President	$1,000		09/29/2011
KIRK, MATTHEW LANCASTER, PA 17601	Benecon/President	$1,000		10/07/2011
NOBLE, RONALD CHESTER SPRINGS, PA 19425	Noble-Guardian Inc/President	$1,000		10/19/2011
BELDING, THOMAS EDMOND, OK 73013	Pro. Reinsurance Marketing Srv/President	$1,000		10/20/2011
RITCHIE, RICK GREEN COVE SPRINGS, FL 32043	Risk & Insurance Consulting/President	$1,000		10/20/2011
MERZ, MARCUS MR. GOLDEN VALLEY, MN 55416	Preferredone/President	$1,000		02/27/2012
CARLSON, AMY LAGANGE, IL 60525	Zurich/Business Development Manager	$1,000		03/16/2012
HODGES, JOSEPH TAMPA, FL 33679	Inetico/President	$1,000		03/16/2012
KELBEL, CRAIG HOUSTON, TX 77025	Hcc Life/President	$1,000		04/04/2012
RITCHIE, ANDREW J WOODSTOCK, GA 30189	Hcc Life Insurance Company/Senior Vice President	$1,000		04/05/2012
YOUNG, M DAVID MARETTA, GA 30062	Young Consulting/Owner	$1,000		04/06/2012
WAGONER, TOM MACON, GA 31201	Core Management Resources/President Ceo	$1,000		04/12/2012
BELDING, THOMAS EDMOND, OK 73013	Pro. Reinsurance Marketing Srv/President	$1,000		04/19/2012
CLEMENTE, ROBERT WARREN, NJ 07059	Pac Associates/Owner	$1,000		04/19/2012
SEXTON, MICHAEL P. EDINA, MN 55424	Midwest Risk Underwriters/Underwriter	$1,000		09/17/2012
BAISDEN, BOB FRANKLIN, TN 37064	International Assurance Of Ten/President	$1,000		09/19/2012
SCHROEDER, MICHAEL WESTLAKE, OH 44145	Roundstone/President	$1,000		09/24/2012
ZIOMEK, BOB MINNESTRISTA, MN 55364	Axia Strategies/Principal	$1,000		09/24/2012
DENOMA, TOM COLUMBUS, OH 43026	Nationwide Insurance/Business Development	$1,000		09/26/2012
PLAMPTON, ANTHONY MINNEAPOLIS, MN 55416	Re-Solutions/Reinsurance Broker	$1,000		09/26/2012
TRUPIANO, JEROME ROCKPORT, MA 01966	Tru Services, Llc/Principal	$1,000		09/26/2012
VAUGHAN, R. DALE ROCK HILL, SC 29732	Self/Insurance Executive	$1,000		09/26/2012
BELDING, THOMAS EDMOND, OK 73013	Pro. Reinsurance Marketing Srv/President	$1,000		10/08/2012
DRELICH, DONALD STAMFORD, CT 06902	D.W. Van Dyke & Co., Inc/Chairman And Ceo	$1,000		10/08/2012
MELOCH, MICHAEL MR. SHOREVIEW, MN 55126	Tpac Underwriters, Inc./President	$1,000		10/08/2012
RITCHIE, RICK GREEN COVE SPRINGS, FL 32043	Risk & Insurance Consulting/President	$1,000		10/08/2012
VANCE, CURTIS LARRY MADISON, MS 39110	Fox-Everett, Inc./President	$1,000		10/08/2012
TIERNEY, ROBERT SHERBORN, MA 01770	Star Line Group/President	$1,000		10/12/2012
TOUCHE, STEVE TUCSON, AZ 85715		$500		01/07/2011
CLEMENTE, CRAIG R. MR. JERSEY CITY, NJ 07302	Specialty Care Management/Cheif Operating Officer	$500		01/10/2011
BIGSBY, BRUCE ROSWELL, GA 30075	Globalcare, Inc/President/Ceo	$500		01/25/2011
RITCHIE, RICK GREEN COVE SPRINGS, FL 32043	Risk & Insurance Consulting/President	$500		03/11/2011
GARFIELD, HORACE LOUISVILLE, KY 40205	Aegon Alliances, Inc/President	$500		03/17/2011
BAYNE, RODGER MR. MONKTON, MD 21111	Group Benefit Services, Inc./Vp Of Marketing And Sales	$500		04/05/2011
BELDING, THOMAS EDMOND, OK 73013	Pro. Reinsurance Marketing Srv/President	$500		04/05/2011
CALDWELL, CHARLES OKLAHOMA CITY, OK 73112	Midlands Management Corporatio/President & Ceo	$500		04/05/2011
GIORDANO, ALEX BELLMORE, NY 11710	C.V. Starr/Executive Vice President	$500		04/05/2011
MARINER, ELIZABETH WELLINGTON, FL 33414	Re-Solutions/Executive Vice President	$500		04/05/2011
MASSEY, ERICA MS. MIDLAND, NC 28107	Calmetto Managment Group/Executive Vice President	$500		04/05/2011
NEWMAN, FRED MR. HOUSTON, TX 77042	Interface Eap/Ceo	$500		04/05/2011
ROSS, LAURA CHARLESTON, SC 29401	Eldorado/Vice President	$500		04/05/2011
SCHREIBER, STEVEN MR. ASHLAND, MA 01721	Sun Life Financial/Director Of Stop Loss Development	$500		04/05/2011
WILKIE, AARON MR. SPARTANBURG, SC 29302	East Coast Underwriters, Llc/President	$500		04/05/2011
HODGES, JOSEPH TAMPA, FL 33679	Inetico/President	$500		05/02/2011
RASNICK, STEVE NAPLES, FL 34110	Self Insured Plans, Llc/President	$500		05/04/2011
COSTNER, J. EDWARD BRENTWOOD, TN 37027	Casualty Acturarial Consultant/President	$500		05/20/2011
THERIAULT, JANICE SIMSBURY, CT 06070	Arbor Benefit Corp/Executive Vice President	$500		06/28/2011
BAEZ, RICARDO ROCKVILLE CENTRE, NY 11570	Stewart, Greenblatt, Manning &/Lawyer	$500		09/16/2011
KELBEL, CRAIG HOUSTON, TX 77025	Hcc Life/President	$500		09/16/2011
LAWRENZ, DONALD R. CORONA DEL MAR, CA 92625	Best Re/President & Ceo	$500		09/16/2011
MUELLER, JULIE ALEXANDRIA, KY 41001	Custom Design Benefits, Inc./President	$500		09/16/2011
LAWRENZ, DONALD R. CORONA DEL MAR, CA 92625	Best Re/President & Ceo	$500		09/26/2011
DRELICH, DONALD STAMFORD, CT 06902	D.W. Van Dyke & Co., Inc/Chairman And Ceo	$500		10/06/2011
REYNOLDS, DANNY DECATUR, IL 62521	Consociate - Dansig/President	$500		10/06/2011
RUSSO, ADAM V. BRAINTREE, MA 02184	The Phia Group, Llc/Ceo	$500		10/06/2011
BARTLETT, MARILYN BILLINGS, MT 59102	Ebms/Cfo	$500		10/19/2011
BOUGHNER, LESLIE HIGHLAND PARK, IL 60035	Willis/Executive Vice President	$500		10/19/2011
CLEMENTE, CRAIG R. MR. JERSEY CITY, NJ 07302	Specialty Care Management/Cheif Operating Officer	$500		10/19/2011
RASNICK, STEVE NAPLES, FL 34110	Self Insured Plans, Llc/President	$500		10/19/2011
SCHREIBER, STEVEN MR. ASHLAND, MA 01721	Sun Life Financial/Director Of Stop Loss Development	$500		10/19/2011
SMITH, DONNA PHOENIX, AZ 85016	Eldorado A Division Of Mphasis/Consultant	$500		10/19/2011
TIERNEY, ROBERT SHERBORN, MA 01770	Star Line Group/President	$500		10/19/2011
WILNEFF, MITCHELL GLENCOE, IL 60022	Allied Benefit Systems, Inc./President	$500		10/19/2011
CLEMENTE, ROBERT WARREN, NJ 07059	Pac Associates/Owner	$500		10/20/2011
FOX, ROMA ARRINGTON, TN 37014	Golden Triangle/Senior Vp And Coo	$500		10/20/2011
REPKE, ROBERT SAN FRANSISCO, CA 94127	Medical Destination Thailand/President	$500		10/20/2011
KELBEL, CRAIG HOUSTON, TX 77025	Hcc Life/President	$500		11/10/2011
TOUCHE, STEVE TUCSON, AZ 85715	Mountain States Administrative/President	$500		01/17/2012
KELBEL, CRAIG HOUSTON, TX 77025	Hcc Life/President	$500		02/10/2012
GRIDER, J. DAVID ATLANTA, GA 30328	Hcc Life/Senior Vp, Marketing & Sales	$500		05/03/2012
RUSSO, ADAM V. BRAINTREE, MA 02184	The Phia Group, Llc/Ceo	$500		05/11/2012
GREENBLOTT, LISA SAGLE, ID 83860	Dcc, Inc./President/Ceo	$500		06/26/2012
KELBEL, CRAIG HOUSTON, TX 77025	Hcc Life/President	$500		08/14/2012
FOLEY, JOHN NEW ORLENS, LA 70130	Panamerican Life Insurance/Senior Vice President	$500		08/20/2012
BAISDEN, BOB FRANKLIN, TN 37064	International Assurance Of Ten/President	$500		08/21/2012
BAISDEN, BRANDON FRANKLIN, TN 37067	International Assurance Of Tn/Executive Vice President	$500		08/21/2012
KRUEGER, RUSSELL AUGUST, GA 30907	Ocozzio/Owner	$500		08/29/2012
MCPETERS, JERRY L DALLAS, TX 75254	Group & Pension Administrators/President	$500		08/29/2012
HOITT, JIM ACTON, MA 01720	Berkley Accident & Health/Vice President Of Sales	$500		08/31/2012
MUELLER, JULIE ALEXANDRIA, KY 41001	Custom Design Benefits, Inc./President	$500		08/31/2012
STRUSZ, DAN APPLE VALLEY, MN 55124	Hcc Life Insurance Company/Executive Vice President	$500		09/21/2012
KURKUL, STEPHEN NORTH ANDOVER, MA 01845	Cba Solutions Llc/President	$500		09/26/2012
MCPETERS, JERRY L DALLAS, TX 75254	Group & Pension Administrators/President	$500		09/26/2012
BOCEK, REBECCA WALNUT CREEK, CA 94597	Stop Loss Insurance Services/Sales	$500		09/28/2012
GOFF, RICHARD TOWSON, MD 21286	The Taft Companies/Managing Member	$500		09/28/2012
COX, DAN PIPE CREEK, TX 78063	National Underwriting Services/Underwriter	$500		10/05/2012
BOUGHNER, LESLIE HIGHLAND PARK, IL 60035	Willis/Executive Vice President	$500		10/08/2012

Political Candidates Receiving Contributions in the 2012 Election Cycle from
SELF-INSURANCE INSTITUTE OF AMERICA, INC. PAC (SELF-INSURANCE PAC)

Candidate Name	Office	Party	State	District	Primary/ General	$ Dollar Amount	Date
BACHUS, SPENCER T III	House of Reps	Republican	AL	06	G	$1,000	03/06/2012
BAUCUS, MAX	Senate	Democrat	MT	--	G	$1,000	03/08/2012
BAUCUS, MAX	Senate	Democrat	MT	--	P	$1,000	06/21/2011
BAUCUS, MAX	Senate	Democrat	MT	--	P	$4,000	03/08/2012
BIGGERT, JUDY	House of Reps	Republican	IL	11	G	$1,000	06/14/2011
BIGGERT, JUDY	House of Reps	Republican	IL	11	G	$1,000	02/09/2012
BIGGERT, JUDY	House of Reps	Republican	IL	11	G	$1,000	09/19/2012
CAMP, DAVID LEE	House of Reps	Republican	MI	04	P	$1,000	07/06/2011
CAMP, DAVID LEE	House of Reps	Republican	MI	04	G	$1,000	03/01/2012
CAMPBELL, JOHN BT III	House of Reps	Republican	CA	45	G	$1,000	02/01/2012
CAMPBELL, JOHN BT III	House of Reps	Republican	CA	45	G	$1,000	09/19/2012
CAMPBELL, JOHN BT III	House of Reps	Republican	CA	45	G	$1,000	06/03/2011
CANTOR, ERIC IVAN	House of Reps	Republican	VA	07	P	$2,500	02/02/2012
GINGREY, J. PHILLIP	House of Reps	Republican	GA	11	G	$1,000	06/21/2012
GINGREY, J. PHILLIP	House of Reps	Republican	GA	11	G	$1,000	06/23/2011
HAGAN, KAY R	Senate	Democrat	NC	--	G	$1,000	09/25/2012
HATCH, ORRIN G	Senate	Republican	UT	--	G	$1,000	07/31/2012
HATCH, ORRIN G	Senate	Republican	UT	--	G	$1,000	06/19/2012
HATCH, ORRIN G	Senate	Republican	UT	--	G	$1,000	09/12/2012
HECK, JOE	House of Reps	Republican	NV	03	G	$1,000	05/31/2012
ISAKSON, JOHN HARDY	Senate	Republican	GA	--	P	$1,000	09/19/2012
ISSA, DARRELL	House of Reps	Republican	CA	49	P	$1,000	07/25/2011
JOHANNS, MICHAEL O	Senate	Republican	NE	--	G	$1,000	02/15/2012
JOHNSON, TIM	Senate	Democrat	SD	--	G	$1,000	02/29/2012
KLINE, JOHN PAUL JR	House of Reps	Republican	MN	02	G	$5,000	03/15/2011
KLINE, JOHN PAUL JR	House of Reps	Republican	MN	02	G	$1,000	06/11/2012
KLINE, JOHN PAUL JR	House of Reps	Republican	MN	02	G	$1,000	02/15/2012
MCCONNELL, MITCH	Senate	Republican	KY	--	G	$1,000	02/09/2012
MURPHY, TIM	House of Reps	Republican	PA	18	P	$1,000	07/08/2011
MURPHY, TIM	House of Reps	Republican	PA	18	G	$1,000	05/31/2012
NELSON, E BENJAMIN	Senate	Democrat	NE	--	G	$1,000	02/10/2011
PETTIGREW, WAYNE	House of Reps	Republican	OK	02	G	$1,000	02/02/2012
PRICE, THOMAS EDMUNDS	House of Reps	Republican	GA	06	G	$1,000	09/20/2012
REHBERG, DENNIS R	House of Reps	Republican	MT	00	G	$1,000	07/27/2012
TESTER, JON	Senate	Democrat	MT	--	G	$1,000	09/13/2012
TESTER, JON	Senate	Democrat	MT	--	P	$2,600	04/06/2011
TESTER, JON	Senate	Democrat	MT	--	G	$5,000	04/06/2011
WALBERG, TIMOTHY L. HON.	House of Reps	Republican	MI	07	G	$1,000	06/21/2012
WELCH, PETER	House of Reps	Democrat	VT	00	G	$1,000	09/19/2012
WELCH, PETER	House of Reps	Democrat	VT	00	P	$1,000	10/06/2011
WELCH, PETER	House of Reps	Democrat	VT	00	G	$1,000	06/26/2012