2024-11-14T18:28:07-06:00 2023-12-31 135565207 KPMG LLP 350 N 5TH ST MINNEAPOLIS MN 55401 990 2023-01-01 010571840 MEDICA HOLDING COMPANY MEDI 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 KRISTA DUSIL CFO 9529922058 2024-11-14 1 0 HOLLY MOEN P01800653 6123055000 2024-11-12 2023 2024-10-15 13:58:12Z ELIZABETH ERICKSON 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 22445270 0 X WWW.MEDICA.COM X 2002 MN TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 10 9 0 0 0 0 0 0 0 0 1037106 22445270 0 0 1037106 22445270 0 0 0 0 0 0 0 0 0 652335 13956522 652335 13956522 384771 8488748 602876570 468669723 108433048 153000 494443522 468516723 TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 0 0 0 0 0 MEDICA HOLDING COMPANY IS THE HOLDING COMPANY FOR ALL OF THE MEDICA ENTITIES. THE GOAL OF MEDICA IS TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS, OUR EMPLOYEES. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 MN X ELIZABETH ERICKSON 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 X JOHN NAYLOR PRESIDENT & CEO (THRU 9/23) 0.00 40.00 X X 0 2577014 28672 JOHN BUCK DIRECTOR & CHAIR 0.00 15.00 X X 0 163750 0 SAMUEL LEON DIRECTOR 0.00 10.00 X 0 100250 0 JOHN STANOCH DIRECTOR & VICE CHAIR 0.00 10.00 X X 0 121250 0 MARY TWINEM DIRECTOR 0.00 10.00 X 0 111000 0 GAYE ADAMS MASSEY DIRECTOR 0.00 10.00 X 0 95000 0 RAJESH AGGARWAL DIRECTOR 0.00 10.00 X 0 119750 0 BRIGID BONNER DIRECTOR 0.00 10.00 X 0 108000 0 PETER KELLEY DIRECTOR 0.00 10.00 X 0 112500 0 EARL STRATTON DIRECTOR 0.00 10.00 X 0 114750 0 DAVID H ELLENBOGEN SVP SEC & GEN COUNSEL (THRU 12/23) 0.00 40.00 X 0 773584 45018 ELIZABETH F ERICKSON PRESIDENT & CEO & CFO 0.00 40.00 X 0 1203089 39039 MARK L BAIRD FORMER SVP & CFO 0.00 0.00 X 0 552044 0 JAMES JACOBSON FORMER SVP SEC & GEN COUNSEL 0.00 0.00 X 0 448077 0 MARY P QUIST TREASURER/INTERIM CFO 0.00 40.00 X 0 808429 49529 0 7408487 162258 0 1 1 0 0 22445270 22445270 22445270 0 0 22445270 641296 641296 321736 321736 MEMBERSHIP GUARANTEE 12993490 12993490 13956522 0 13956522 0 0 0 122250106 16000045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178390303 183860120 11636573 347214 0 0 0 0 290599588 268462344 602876570 468669723 153000 153000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108280048 0 108433048 153000 X 494443522 468516723 0 0 494443522 468516723 602876570 468669723 X 8488748 1303259 -35718806 X 0 1 X 1 0 0 OTHER INVESTED ASSETS 7810416 OTHER RECEIVABLE 1389547 INVESTMENT IN SUBSIDIARIES 214928926 INTERCOMPANY ACCOUNT 44333455 268462344 X PART X, LINE 2: THE COMPANY RECOGNIZES TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. X X X X X 0 1 0 0 0 0 1 0 0 JOHN NAYLOR PRESIDENT & CEO (THRU 9/23) 0 745040 0 1498719 0 333255 0 10532 0 18140 0 2605686 0 212534 ELIZABETH F ERICKSON PRESIDENT & CEO & CFO 0 487530 0 600051 0 115508 0 13200 0 25839 0 1242128 0 109692 MARY P QUIST TREASURER/INTERIM CFO 0 342386 0 349158 0 116885 0 13200 0 36329 0 857958 0 65748 DAVID H ELLENBOGEN SVP SEC & GEN COUNSEL (THRU 12/23) 0 407024 0 249087 0 117473 0 13200 0 31818 0 818602 0 62813 MARK L BAIRD FORMER SVP & CFO 0 0 0 329888 0 222156 0 0 0 0 0 552044 0 32279 JAMES JACOBSON FORMER SVP SEC & GEN COUNSEL 0 0 0 129138 0 318939 0 0 0 0 0 448077 0 91442 JOHN BUCK DIRECTOR & CHAIR 0 0 0 0 0 163750 0 0 0 0 0 163750 0 0 PART I, LINE 3 MEDICA HOLDING COMPANY, THE FILING ORGANIZATION, DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA SERVICES COMPANY, A RELATED ORGANIZATION. WHEN ESTABLISHING COMPENSATION, MEDICA SERVICES COMPANY USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATION'S OPERATING EARNINGS. PART-I LINE-4B THE FOLLOWING RECEIVED A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA SERVICES COMPANY, A RELATED ORGANIZATION: MARK L. BAIRD - $32,279 JOHN W. NAYLOR - $212,534 DAVID H. ELLENBOGEN - $62,813 MARY P. QUIST - $65,748 JAMES P. JACOBSON - $91,442 ELIZABETH F. ERICKSON - $109,692 FORM 990, PART VI, SECTION A, LINE 3 MEDICA HOLDING COMPANY HAS ENTERED INTO AN ADMINISTRATIVE SERVICE AGREEMENT WITH MEDICA SERVICES COMPANY (MSC), A RELATED TAXABLE ORGANIZATION. THROUGH THIS AGREEMENT, MSC LEASES ITS EMPLOYEES AND PROVIDES VARIOUS MANAGEMENT/ADMINISTRATIVE SERVICES TO MEDICA HOLDING COMPANY AND MEDICA HOLDING COMPANY PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B MEDICA'S TAX ADVISORS COMPLETE THE RETURN, FINANCE STAFF REVIEWS THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL EMPLOYEES OF MEDICA HEALTH AND DIRECTORS OF ALL MEDICA ENTITIES COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND ARE REQUIRED TO REVIEW THE CURRENT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 MEDICA HOLDING COMPANY, THE FILING ORGANIZATION, DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION, WHICH USES THE FOLLOWING TO DETERMINE COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 MEDICA DOES NOT CONSIDER ITS CONFLICT OF INTEREST POLICY TO BE A CONFIDENTIAL OR PROPRIETARY DOCUMENT. THEREFORE, MEDICA WOULD MAKE THIS POLICY AVAILABLE TO ANYONE WHO REQUESTS IT. CERTAIN MEDICA ENTITIES ARE REQUIRED TO FILE ANNUAL FINANCIAL STATEMENT WITH THE REGULATORS. MEDICA CONSIDERS FINANCIAL STATEMENTS THAT ARE FILED WITH THE REGULATORS TO BE PUBLIC DOCUMENTS. FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 612(D). FORM 990, PART VII, SECTION A, LINE 1: CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN ALL ENTITIES UNDER MEDICA HOLDING COMPANY. THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. THE FOLLOWING CHANGES TO THE OFFICERS OF MEDICA HOLDING COMPANY OCCURRED DURING THE TAXABLE PERIOD: IN APRIL OF 2023 ELIZABETH F. ERICKSON WAS ELECTED CHIEF FINANCIAL OFFICER AND TREASURER, SUCCEEDING MARY P. QUIST AS FORMER INTERIM CHIEF FINANCIAL OFFICER AND TREASURER. ELIZABETH F. ERICKSON WAS SUBSEQUENTLY ELECTED INTERIM PRESIDENT IN SEPTEMBER OF 2023, AND ELECTED PRESIDENT AND CHIEF EXECUTIVE OFFICER IN NOVEMBER OF 2023. IN 2024 KRISTA DUSIL WAS APPOINTED AS CHIEF FINANCIAL OFFICER OF THE ORGANIZATION. FORM 990, PART VII JOHN STANOCH'S BOARD STIPEND WAS PAID TO STANOCH, LLC. FORM 990, PART XI, LINE 9: INVESTMENT IN SUBSIDIARY 2,656,194. CAPITAL CONTRIBUTIONS TO MAS -25,000,000. INTANGIBLE TRANSFERRED TO MAS -13,375,000. MEDICA HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411242261 HEALTH COVERAGE MN 501(C)(4) N/A MHC 1 MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) LINE 12B MHC 1 MEDICA COMMUNITY HEALTH PLAN 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH COVERAGE MN 501(C)(4) N/A MHC 1 MEDICA CENTRAL HEALTH PLAN 10101 WOODFIELD LANE ST LOUIS MO 63132 831979548 HEALTH INSURANCE MO 501(C)(4) N/A MFCJVN 0 MS COMMUNITY NFP JV LLC (MFCJVN) 401 CARLSON PARKWAY MINNETONKA MN 55305 873268926 HOLDING COMPANY MN MHC RELATED 5114402 0 0 0.55000 MEDICA SERVICES COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 852902940 ADMIN. SERVICES MN MAS C 0 DEAN HEALTH SERVICES COMPANY LLC 1277 DEMING WAY MADISON WI 53717 842933639 ADMIN. 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