2024-04-15T14:27:41-05:00 2022-06-30 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS ROAD SUITE 1500 RALEIGH NC 27609 990 2022-01-01 461056754 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY CHES 4104942000 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 FRANCIS LINARDI CFO 4104942000 2023-11-14 1 FRANCIS LINARDI 999009999 0 J CALVIN MARKS P01226973 9197196400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X THOMAS PHELAN 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 705509490 0 X WWW.CEIWC.COM X 2012 MD CHESAPEAKE EMPLOYERS' INSURANCE COMPANY WAS ESTABLISHED BY STATUTE TO BE THE WORKERS' COMPENSATION INSURER OF LAST RESORT AS WELL AS A COMPETITIVE INSURER IN THE STATE OF MARYLAND. X 9 0 0 0 0 0 0 0 169321067 91457426 167646106 42411194 103572 1005672 337070745 134874292 302325 126326 0 0 40939190 20047890 0 0 0 168464787 81057645 209706302 101231861 127364443 33642431 2512331700 0 1374799656 0 1137532044 0 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY WAS ESTABLISHED BY STATUTE TO BE THE WORKERS' COMPENSATION INSURER OF LAST RESORT AS WELL AS A COMPETITIVE INSURER IN THE STATE OF MARYLAND. 0 0 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY HAD OVER 20,500 IN-FORCE POLICIES AND WAS MANAGING MORE THAN 2,910 OPEN CLAIMS AT JUNE 30, 2022. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 9 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X FRANCIS LINARDI 4104942000 8722 LOCH RAVEN BLVD TOWSON MD 212862235 THOMAS PHELAN CHIEF EXECUTIVE OFFICER 30.00 10.00 X 405160 0 12200 KEVIN BINGHAM CHIEF RESULTS OFFICER 30.00 10.00 X 339681 0 33114 PAIGE BECK PRESIDENT 30.00 10.00 X 215914 0 12200 FRANK LINARDI CHIEF FINANCIAL OFFICER 30.00 10.00 X 153165 0 15971 CARMINE D'ALESSANDRO CHIEF LEGAL OFFICER 30.00 10.00 X 144506 0 17737 SHARON ROWELL CHIEF ADMINISTRATIVE OFFICER 30.00 10.00 X 148375 0 10580 SONG HE CHIEF INVESTMENT OFFICER 30.00 10.00 X 129545 0 27053 STEPHEN FISHER MEDICAL CONSULTANT 30.00 10.00 X 115440 0 11427 SUZANNE THOMPSON BOARD CHAIR 1.50 0.50 X X 23244 0 0 FRANKLIN HAJEK DIRECTOR 1.50 0.50 X 22699 0 300 MARIA TILDON DIRECTOR (TO JUN '22) 1.50 0.50 X 22715 0 224 SPENCER CAVALIER DIRECTOR 1.50 0.50 X 21563 0 0 KETURAH MCGHEE DIRECTOR 1.50 0.50 X 20819 0 0 MARTIN MADDEN DIRECTOR 1.50 0.50 X 20719 0 0 JOHN SCOTT JR VICE CHAIR 1.50 0.50 X X 20719 0 0 JASON SCHUPP DIRECTOR 1.50 0.50 X 20719 0 0 THEODORE ALEXANDER III DIRECTOR 1.50 0.50 X 10361 0 0 SALLY JAMESON DIRECTOR (FROM JUN '22) 1.50 0.50 X 0 0 0 1835344 0 140806 10 0 1 0 THE COOPER HEALTH SYSTEM 1 FEDERAL ST STE 200 CAMDEN NJ 08103 MEDICAL/HEALTH SERVICES 936547 UNIV OF MD MEDICAL SYSTEM CORP PO BOX 64468 BALTIMORE MD 21264 MEDICAL/HEALTH SERVICES 876326 EXPRESS SCRIPTS INC ONE EXPRESS WAY MS HQ2E04 ST LOUIS MO 63121 MEDICAL/HEALTH SERVICES 718160 VGM GROUP INC PO BOX 1860 WATERLOO IA 50704 INVESTMENT SERVICES 648576 ADVANCED HOME SUPPORT INC 15800 CRABBS BRANCH WAY STE 205 ROCKVILLE MD 20855 MEDICAL/HEALTH SERVICES 588598 69 PREMIUMS EARNED 900099 91276789 91276789 INSTALLMENT FEES & NSF CHARGES 900099 180637 180637 91457426 31987109 31987109 581059283 570608849 26349 10450434 -26349 10424085 10424085 PROCEEDS FROM FIRE INSURANCE 900099 999986 999986 5686 5686 1005672 134874292 91457426 0 43416866 X 126326 1533730 14195506 1066633 2156282 1095739 433807 50363 2805036 15148018 1428385 1839243 1374111 1448654 159755 79878 445183 3289276 434213 LOSSES 47791224 TAXES, LICENSES, FEES 4099236 231263 101231861 17156257 0 68610724 0 0 54308368 0 0 0 0 0 0 0 0 8567326 0 2220076387 0 107245467 0 0 0 36367171 0 2512331700 0 27707515 0 79969853 0 1267122288 0 1374799656 0 X 1137532044 0 1137532044 0 2512331700 0 X 33642431 -72542310 -1098632165 X 0 1 X 1 0 0 X PART X, LINE 2: CHESAPEAKE DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS AS OF DECEMBER 31, 2022. 1 UNITED WAY OF CENTRAL MARYLAND 1800 WASHINGTON BLVD STE 340 BALTIMORE MD 21230 520591543 501(C)(3) 35072 0 GENERAL SUPPORT AMERICAS CHARITIES 14200 PARK MEADOW DR STE 330S CHANTILLY VA 20151 541517707 501(C)(3) 13582 0 GENERAL SUPPORT ASSOCIATED BLACK CHARITIES 2 HAMILL RD STE 359 WEST QUAD BALTIMORE MD 21201 521427774 501(C)(3) 10000 0 CHARITY GOLF EVENT BALTIMORE SYMPHONY ORCHESTRA 1212 CATHEDRAL ST BALTIMORE MD 21201 520629696 501(C)(3) 10000 0 GENERAL SUPPORT FRANCISCAN CENTER INC 101 W 23RD ST BALTIMORE MD 21218 521164260 501(C)(3) 7800 0 CHARITY GOLF EVENT 5 0 PART I, LINE 2: CHESAPEAKE OCCASIONALLY MAKES SMALL CHARITABLE CONTRIBUTIONS AND GRANTS TO 501(C)(3)S AS A WAY OF GIVING BACK TO THE COMMUNITY. GRANTS ARE REVIEWED AND APPROVED BY AN INTERNAL COMMITTEE. X X 0 0 0 THOMAS PHELAN CHIEF EXECUTIVE OFFICER 325364 0 77758 0 2038 0 12200 0 0 0 417360 0 0 0 KEVIN BINGHAM CHIEF RESULTS OFFICER 243674 0 90000 0 6007 0 12200 0 20914 0 372795 0 0 0 PAIGE BECK PRESIDENT 204471 0 8433 0 3010 0 12200 0 0 0 228114 0 0 0 FRANK LINARDI CHIEF FINANCIAL OFFICER 139033 0 6112 0 8020 0 7211 0 8760 0 169136 0 0 0 CARMINE D'ALESSANDRO CHIEF LEGAL OFFICER 132126 0 5716 0 6664 0 8688 0 9049 0 162243 0 0 0 SHARON ROWELL CHIEF ADMINISTRATIVE OFFICER 138603 0 6091 0 3681 0 10580 0 0 0 158955 0 0 0 SONG HE CHIEF INVESTMENT OFFICER 123999 0 5546 0 0 0 9878 0 17175 0 156598 0 0 0 NET ASSETS OF ORGANIZATION 2022-06-30 1098271934 BOOK VALUE AT TRANSFER DATE 461056754 CHEAPEAKE EMPLOYERS' INSURANCE COMPANY 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 C-CORP 1 1 0 0 0 0 0 0 PART I, LINE 2E: PERSON(S) INVOLVED: THOMAS PHELAN; CHIEF EXECUTIVE OFFICERPAIGE BECK; PRESIDENTFRANK LINARDI; CHIEF FINANCIAL OFFICERCARMINE D'ALESSANDRO; CHIEF LEGAL OFFICERSUZANNE THOMPSON; BOARD CHAIRFRANKLIN HAJEK; DIRECTORSPENCER CAVALIER; DIRECTORKETURAH MCGHEE; DIRECTORMARTIN MADDEN; DIRECTORJOHN SCOTT JR; VICE CHAIRJASON SCHUPP; DIRECTORTHEODORE ALEXANDER III; DIRECTORSALLY JAMESON; DIRECTOR PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: THESE INDIVIDUALS' POSITIONS WITH THE ORGANIZATION DID NOT CHANGE DUE TO THE RELINQUISHMENT OF NON-PROFIT STATUS BY THE ORGANIZATION. PART I: AT THE START OF THE TAX PERIOD COVERED BY THIS RETURN, THE ORGANIZATIONOPERATED AS A NON-PROFIT, NON-STOCK CORPORATION. PRIOR TO 2020, THEBOARD OF DIRECTORS WAS APPOINTED BY THE GOVERNOR OF THE STATE OFMARYLAND. THE BOARD OF DIRECTORS IS COMPRISED OF NINE MEMBERS WHOAPPOINT A CHIEF EXECUTIVE OFFICER TO ASSIST THEM IN OPERATING ANDADMINISTERING CHESAPEAKE. BEGINNING IN 2020, THE CHESAPEAKE BOARD OFDIRECTORS ELECTION PROCESS BEGAN TRANSITIONING TO POLICYHOLDERELECTION, WHICH WAS COMPLETED IN JUNE 2022. EFFECTIVE JULY 1, 2022,CHESAPEAKE BECAME A TAXABLE ENTITY FOR FEDERAL INCOME TAX PURPOSES.PRIOR TO JUNE 30, 2022, CHESAPEAKE WAS EXEMPT FROM FEDERAL INCOME TAXESUNDER 501(C)(27) OF THE INTERNAL REVENUE CODE. BEGINNING WITH THEINITIAL SHORT YEAR BEGINNING JULY 1ST, 2022 AND ENDING DECEMBER 31ST,2022, THE ORGANIZATION REPORTS THEIR ACTIVITY ON FORM 1120-PC, U.S.PROPERTY AND CASUALTY INSURANCE COMPANY TAX RETURN, AND IS NO LONGERREQUIRED TO FILE FORM 990.BECAUSE THE ORGANIZATION IS NO LONGER REQUIRED TO FILE FORM 990, IN ACCORDANCE WITH IRS INSTRUCTIONS, THE ORGANIZATION IS FILING SCHEDULE L TO SHOW THE ENTIRE NET ASSET BALANCE OF THE ORGANIZATION BEING TRANSFERRED TO ITSELF, AND THE ENDING BALANCE SHEET OF THE ORGANIZATION IS SHOWING ZERO NET ASSETS AS OF YEAR END. THE ORGANIZATION DID NOT CEASE TO EXIST, BUT RATHER CONTINUES TO OPERATE AS A FOR-PROFIT ENTITY.BECAUSE THIS TRANSACTION REPRESENTS A RELINQUISHMENT OF EXEMPT STATUS AND NOT A TERMINATION OF THE ORGANIZATION, SCHEDULE N, PART I, LINES 3-6 HAVE BEEN ANSWERED "NO OR LEFT BLANK, AS APPROPRIATE. FORM 990, HEADING, ITEMS A-B: AT THE START OF THE TAX PERIOD COVERED BY THIS RETURN, THE ORGANIZATION OPERATED AS A NON-PROFIT, NON-STOCK CORPORATION. PRIOR TO 2020, THE BOARD OF DIRECTORS WAS APPOINTED BY THE GOVERNOR OF THE STATE OF MARYLAND. THE BOARD OF DIRECTORS IS COMPRISED OF NINE MEMBERS WHO APPOINT A CHIEF EXECUTIVE OFFICER TO ASSIST THEM IN OPERATING AND ADMINISTERING CHESAPEAKE. BEGINNING IN 2020, THE CHESAPEAKE BOARD OF DIRECTORS ELECTION PROCESS BEGAN TRANSITIONING TO POLICYHOLDER ELECTION, WHICH WAS COMPLETED IN JUNE 2022. EFFECTIVE JULY 1, 2022, CHESAPEAKE BECAME A TAXABLE ENTITY FOR FEDERAL INCOME TAX PURPOSES. PRIOR TO JUNE 30, 2022, CHESAPEAKE WAS EXEMPT FROM FEDERAL INCOME TAXES UNDER 501(C)(27) OF THE INTERNAL REVENUE CODE. BEGINNING WITH THE INITIAL SHORT YEAR BEGINNING JULY 1ST, 2022 AND ENDING DECEMBER 31ST, 2022, THE ORGANIZATION REPORTS THEIR ACTIVITY ON FORM 1120-PC, U.S. PROPERTY AND CASUALTY INSURANCE COMPANY TAX RETURN, AND IS NO LONGER REQUIRED TO FILE FORM 990. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION MEMBERS CONSIST OF THE 9 BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A SINCE THE ORGANIZATION'S FORMATION, THE GOVERNOR OF MARYLAND HAS APPOINTED THE BOARD OF DIRECTORS WITH THE ADVICE AND CONSENT OF THE STATE SENATE. UNDER LEGISLATION ADOPTED BY THE STATE OF MARYLAND IN 2015, THE ORGANIZATION'S POLICYHOLDERS WERE GRANTED THE RIGHT, PHASED IN FROM 2020 THROUGH 2022, TO APPOINT SEVEN OF THE ORGANIZATION'S NINE DIRECTORS. BEGINNING ON JULY 1ST, 2022, SEVEN OF THE ORGANIZATION'S NINE BOARD MEMBERS HAD BEEN ELECTED BY POLICYHOLDERS. THE POLICYHOLDERS EXERCISING THEIR NEW RIGHT TO APPOINT DIRECTORS MAY NOT RESULT IN ANY EXCHANGE BY THE POLICYHOLDERS FOR U.S. FEDERAL INCOME TAX PURPOSES. THE CONSEQUENCES SHOULD BE THE SAME UNDER EITHER ALTERNATIVE: NO GAIN OR LOSS WILL BE RECOGNIZED BY THE ORGANIZATION OR ITS POLICYHOLDERS AS A RESULT OF THE POLICYHOLDERS EXERCISING THEIR NEW RIGHT TO APPOINT DIRECTORS. ON APRIL 15, 2022, THE IRS ISSUED PRIVATE LETTER RULING("PLR") XXX-XX-XXXX (CONTROL NUMBER PLR 121522-21) STATING THAT THE ORGANIZATION'S STATUS CHANGE WILL NOT BE TREATED AS A SALE OR EXCHANGE, AND ACCORDINGLY, NO GAIN OR LOSS WILL BE REALIZED UNDER SECTION 1001 AS A RESULT OF THE STATUS CHANGE. FORM 990, PART VI, SECTION A, LINE 7B A DIRECTOR APPOINTED BY THE GOVERNOR OF MARYLAND MAY BE REMOVED BY THE GOVERNOR FOR INCOMPETENCE OR MISCONDUCT. A DIRECTOR ELECTED BY MEMBERS MAY BE REMOVED BY THE MEMBERS AT ANY TIME, FOR ANY REASON, BY THE AFFIRMATIVE VOTE OF A MAJORITY OF ALL OF THE VOTES ENTITLED TO BE CAST GENERALLY IN THE ELECTION OF DIRECTORS. THE MARYLAND INSURANCE COMMISSIONER MAY REMOVE A DIRECTOR ELECTED BY THE MEMBERS FOR INCOMPETENCE, MISCONDUCT, OR MALFEASANCE AFTER NOTICE AND AN OPPORTUNITY FOR A HEARING AS REQUIRED PURSUANT TO THE INSURANCE CODE. FORM 990, PART VI, SECTION B, LINE 11B THE 990 TAX RETURN IS COMPLETED BY AN EXTERNAL ACCOUNTANT AND THE RETURN IS REVIEWED BY MANAGEMENT PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. ANY INSTANCES OF POTENTIAL CONFLICT ARE REVIEWED BY HUMAN RESOURCES OR THE CHIEF LEGAL OFFICER FOR THE APPROPRIATE RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO, EXECUTIVES, AND TOP MANAGEMENT POSITIONS ARE DETERMINED UPON THE COMPLETION OF AN ANNUAL EVALUATION AND IS BASED UPON INDIVIDUAL AND COMPANY PERFORMANCE AS WELL AS INDUSTRY CONSIDERATIONS AND OTHER BENCHMARK DATA. COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS AND COMPENSATION FOR OTHER EXECUTIVES AND TOP MANAGEMENT POSITIONS ARE DETERMINED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE UPON REQUEST AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES 15,148,018. FORM 990, PART XI, LINE 9: NET ASSETS ADJUSTMENT DUE TO CHANGE IN EXEMPT STATUS -1,098,271,934. CHANGE IN NON ADMITTED ASSETS 1,086,759. BAD DEBT -1,446,990. ICUBED VENTURES LLC 8722 LOCH RAVEN BOULEVARD BALTIMORE MD 212862235 832289224 INVESTING MD 53771 28307823 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY INJURED WORKERS INSURANCE FUND 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 522127565 STATE SPONSORED WORKMENS' COMPENSATION INSURANCE MD 501(C)27 0 STATE OF MARYLAND 100 STATE CIRCLE ANNAPOLIS MD 21401 522006962 STATE GOVERNMENT MD 0 CHESAPEAKE RISK SOLUTIONS INC 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 832306359 THIRD PARTY RISK MANAGEMENT MD CHESAPEAKE EMPLOYERS' INSURANCE COMPANY C 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 INJURED WORKERS INSURANCE FUND S 6135013 FAIR VALUE INJURED WORKERS INSURANCE FUND Q 1678396 FAIR VALUE INJURED WORKERS INSURANCE FUND D 1281172 FAIR VALUE