2022-05-12T13:05:59-05:00 2021-06-30 350921680 CROWE LLP 3399 Peachtree Road NE Suite 700 Atlanta GA 303262832 990 2020-07-01 204191006 Five Pointe Professional Liability Insurance Company co Wilmington Trust FIVE 8028642037 1105 N Market Street 1300 Wilmington DE 19899 DIANNE SALTER PRESIDENT 2022-05-12 true DIANNE SALTER 999009999 Scott Tidwell P01729213 4044421600 2020 2022-09-23 18:48:47Z DIANNE SALTER 1105 N Market Street 1300 Wilmington DE 19899 120978229 false X N/A X 2006 DE THE COMPANY IS A NON-PROFIT SPONSORED CAPTIVE INSURANCE COMPANY ORGANIZED AND OPERATED EXCLUSIVELY FOR THE CHARITABLE PURPOSES FOR THE BENEFIT OF ITS MEMBER ORGANIZATIONS. THE CORPORATION SERVES AS AN INTEGRAL PART OF AND FURTHERS THE EXEMPT PURPOSES OF its members, charitable HOSPITALS and RELATED healthcare organizations BY PROVIDING "SELF-INSURANCE" PROFESSIONAL LIABILITY COVERAGE FOR CERTAIN HOSPITALS AND HEALTHCARE ENTITIES DESCRIBED IN IRC SECTION 501(C)(3). THE MEMBERS ARE MAIN LINE HOSPITALS, INC., Riddle Memorial Hospital, THOMAS JEFFERSON UNIVERSITY HOSPITALS, INC., AND Magee REHABILITATION HOSPITAL. 9 1 0 0 0 0 0 0 34342044 35528854 8092786 10232683 0 0 42434830 45761537 0 0 0 0 0 0 0 0 0 30232201 46277350 30232201 46277350 12202629 -515813 212943544 241906004 154823018 183934001 58120526 57972003 THE COMPANY IS A NON-PROFIT SPONSORED CAPTIVE INSURANCE COMPANY ORGANIZED AND OPERATED EXCLUSIVELY FOR THE CHARITABLE PURPOSES FOR THE BENEFIT OF ITS MEMBER ORGANIZATIONS. THE CORPORATION SERVES AS AN INTEGRAL PART OF AND FURTHERS THE EXEMPT PURPOSES OF its members, charitable HOSPITALS and RELATED healthcare organizations BY PROVIDING "SELF-INSURANCE" PROFESSIONAL LIABILITY COVERAGE FOR CERTAIN HOSPITALS AND HEALTHCARE ENTITIES DESCRIBED IN IRC SECTION 501(C)(3). THE MEMBERS ARE MAIN LINE HOSPITALS, INC., Riddle Memorial Hospital, THOMAS JEFFERSON UNIVERSITY HOSPITALS, INC., and Magee REHABILITATION HOSPITAL. false false 45283473 35528854 FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY PROVIDES REINSURANCE TO MOUNTAIN LAUREL RISK RETENTION GROUP, INC. ("MLRRG"), A RELATED PARTY THROUGH COMMON OWNERSHIP THAT PROVIDES GENERAL LIABILITY AND PROFESSIONAL LIABILITY INSURANCE TO ITS SHAREHOLDERS THAT ARE THE TAX EXEMPT MEMBERS OF FIVE POINTE. THE REINSURANCE COVERAGES ASSIST WITH THE MANAGEMENT AND FUNDING OF THE PROFESSIONAL LIABILITY RISK THEREBY ESSENTIALLY FUNCTIONING AS A SELF-INSURANCE VEHICLE FOR THE TAX EXEMPT MEMBER HOSPITALS AND HEALTHCARE ORGANIZATIONS. A SPONSORED CAPTIVE INSURANCE COMPANY IN THE STATE OF DELAWARE HAS THE ABILITY TO ESTABLISH AND MAINTAIN SEPARATE PROTECTED CELLS WITHIN THE COMPANY WHEREBY THE ASSETS AND LIABILITIES OF ANY ONE CELL ARE FINANCIALLY AND LEGALLY PROTECTED FROM THE ASSETS AND LIABILITIES OF OTHER CELLS. THE COMPANY INSURES THE RISKS OF THE MEMBERS PURSUANT TO MEMBERSHIP AGREEMENTS, AND SEGREGATES SUCH RISKS INTO PROTECTED CELLS. EACH PROTECTED CELL IS ACCOUNTED FOR SEPARATELY ON THE BOOKS AND RECORDS OF THE COMPANY. THE ASSETS AND LIABILITIES OF THE COMPANY ARE SEGREGATED INTO CELL ASSETS AND LIABILITIES AND GENERAL ASSETS AND LIABILITIES. THE GENERAL ASSETS AND LIABILITIES OF THE COMPANY COMPRISE THE ASSETS AND LIABILITIES THAT ARE NOT ASSETS AND LIABILITIES OF ANY ONE OF THE PROTECTED CELLS. THE ACTIVITIES REPRESENTING THE GENERAL ASSETS AND LIABILITIES OF THE COMPANY ARE REFERRED TO AS "THE CORE." 45283473 true false false false false false false false false false true false true true true true false false false true false false false false false false false false true false false false false false false false false false false false false false true false false false true 3 0 true 0 false false false false false false false false false false false false X 9 1 false true false false true true false true true false false true true true true true true false false false X MARSH MANAGEMENT SERVICES INC 8028642744 463 Mountain View Drive Suite 301 Colchester VT 05446 BRIAN T CORBETT DIRECTOR, SECRETARY 1.0 39.0 X X 0 836850 178126 DIANNE P SALTER DIRECTOR, PRESIDENT 10.0 30.0 X X 0 410446 28281 MICHAEL J BUONGIORNO DIRECTOR, CHAIRMAN 1.0 39.0 X X 0 987494 210981 PETER L DEANGELIS JR DIRECTOR, TREASURER (AS OF 2/3/2021) 1.0 39.0 X X 0 2540010 215626 Edmund D Pribitkin DIRECTOR 1.0 39.0 X 0 1080830 162863 JOHN J LYNCH III DIRECTOR 1.0 39.0 X 0 1849471 591141 Jonathan L Gleason DIRECTOR 1.0 39.0 X 0 710337 51098 KIRK E GORMAN DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL B WALSH DIRECTOR 1.0 39.0 X 0 954385 117304 ALFRED C SALVATO CHIEF INVESTMENT OFFICER 1.0 39.0 X 0 702424 71687 MARCY WATERFALL ASSISTANT SECRETARY 1.0 0.0 X 0 0 0 NEIL G LUBARSKY FORMER DIRECTOR, TREASURER 0.0 39.0 X 0 616275 38755 0 10688522 1665862 0 true true false RUSSELL INVESTMENT GROUP 909 A STREET TACOMA WA 98402 INVESTMENT SERVICES 886856 1 0 PREMIUMS EARNED 524298 35528854 35528854 0 0 0 0 35528854 13718 13718 0 0 85435657 75216692 10218965 0 10218965 10218965 0 0 0 0 0 45761537 35528854 0 10232683 91554 68665 22889 30427 30427 53705 53705 886856 886856 71800 71800 0 0 INCURRED LOSSES 45078949 45078949 PREMIUM TAXES 59431 59431 EXCISE TAXES 14600 14600 REGULATORY AGENCY EXPENSE -11725 -11725 1753 1753 0 0 46277350 45283473 993877 0 1518437 3906824 0 0 0 0 0 0 0 0 176050635 200015180 0 35374472 37984000 212943544 241906004 128150 79600 0 0 154694868 183854401 154823018 183934001 X 3936407 3936407 54184119 54035596 58120526 57972003 212943544 241906004 X -515813 13388765 -13021475 X false true X true false X X X 5 RIDDLE MEMORIAL HOSPITAL 231529076 3 true 0 0 MAGEE REHABILITATION HOSPITAL 231476328 3 true 0 0 MAIN LINE HOSPITALS INC 231352160 3 true 0 0 THOMAS JEFFERSON UNIVERSITY HOSPITALS INC 232829095 3 true 0 0 Kennedy University Hospital Inc 221773539 3 false 0 0 5 0 0 false false false false false false false false false false false false false false false true false Schedule A, Part IV, Section A, Line 1 Supported Orgs Listed By Name All of the organization's supported organizations are listed by name in the organization's governing documents except for Kennedy University Hospital, Inc. which was provided insurance coverage by the organization, effective October 15, 2018. In April 2018, Kennedy Health System, Inc. merged with Thomas Jefferson University (which controls Thomas Jefferson University Hospitals, Inc.). Kennedy University Hospital, Inc. is a supported organization designed by a common class and purpose in that it is a hospital, related to Thomas Jefferson University Hospitals, Inc. Kennedy University Hospital, Inc. and Thomas Jefferson University Hospitals, Inc. are related organizations, both controlled by Thomas Jefferson University. RUSSELL INSTITUTIONAL FUND LLC 175649812 F PRIVATE LIMITED LIABILITY COMPANIES 24365368 F 200015180 REINSURANCE RECOVERABLE ON UNPAID LOSSES 37984000 37984000 UNPAID LOSSES & LOSS ADJUSTMENT EXPENSES 182342841 Losses Payable 1511560 183854401 X 58263446 13388765 0 13388765 44874681 886856 0 886856 45761537 45390494 0 0 45390494 886856 0 886856 46277350 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Company accounts for income taxes in accordance with FASB ASC 740, "Income Taxes." FASB ASC 740 is an asset and liability method, which requires the recognition of deferred tax assets and liabilities. The Company, under certain provisions of FASB ASC 740, accounts for how uncertain tax positions should be recognized, measured, presented and disclosed within their financial statements. The Company may recognize the 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 the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial statements from such position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The Company did not record any unrecognized tax benefits as of June 30, 2021 and 2020. The Company does not believe it is reasonably possible that its unrecognized tax benefits would materially change in the next twelve months. The Company's policy is to include interest and penalties related to unrecognized tax benefits as a component of its provision for income taxes. As of June 30, 2021 and 2020, the Company did not record any penalties or interest associated with unrecognized tax benefits. Tax years from 2019 forward are open and subject to examination by the IRS. Central America and the Caribbean 0 0 Investments 20822595 Europe (Including Iceland and Greenland) 0 0 Investments 1309238 North America (Canada & Mexico only) 0 0 Investments 1731167 0 0 0 0 0 0 23863000 0 23863000 true false true true false false true true false false false false false false false PETER L DEANGELIS JR DIRECTOR, TREASURER (AS OF 2/3/2021) 0 1057295 0 165000 0 1317715 0 198500 0 17126 0 2755636 0 1057347 DIANNE P SALTER DIRECTOR, PRESIDENT 0 363973 0 46473 0 0 0 0 0 28281 0 438727 0 0 MICHAEL J BUONGIORNO DIRECTOR, CHAIRMAN 0 693799 0 238476 0 55219 0 166270 0 44711 0 1198475 0 99365 BRIAN T CORBETT DIRECTOR, SECRETARY 0 522591 0 141268 0 172991 0 130334 0 47792 0 1014976 0 195450 Edmund D Pribitkin DIRECTOR 0 782976 0 122250 0 175604 0 137795 0 25068 0 1243693 0 74724 JOHN J LYNCH III DIRECTOR 0 1193001 0 500605 0 155865 0 545981 0 45160 0 2440612 0 213895 Jonathan L Gleason DIRECTOR 0 593123 0 90000 0 27214 0 27923 0 23175 0 761435 0 0 MICHAEL B WALSH DIRECTOR 0 472792 0 59479 0 422114 0 98977 0 18327 0 1071689 0 130344 ALFRED C SALVATO CHIEF INVESTMENT OFFICER 0 541738 0 69806 0 90880 0 53099 0 18588 0 774111 0 37993 NEIL G LUBARSKY FORMER DIRECTOR, TREASURER 0 225188 0 10000 0 381087 0 34139 0 4616 0 655030 0 49719 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE MAIN LINE HEALTH BOARD IS RESPONSIBLE FOR EVALUATING AND DETERMINING THE APPROPRIATENESS OF THE PRESIDENT'S COMPENSATION. AFTER REVIEW AND DELIBERATION, THE COMMITTEE DOCUMENTS ITS DECISIONS AND THE RESULTS ARE REPORTED TO THE BOARD OF DIRECTORS OF FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY AND MOUNTIAN LAUREL RISK RETENTION GROUP, WHO REVIEW AND APPROVE THE COMPENSATION DECISIONS. Schedule J, Part I, Line 4a Severance or change-of-control payment During 2020, severance of $226,793 was paid to NEIL G. LUBARSKY, former DIRECTOR and TREASURER. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE THOMAS JEFFERSON UNIVERSITY HOSPITAL (EIN: 23-2829095) FORM 990: EDMUND D. PRIBITKIN THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE THOMAS JEFFERSON UNIVERSITY (EIN: 23-1352651) FORM 990: ALFRED C. SALVATO PETER L. DEANGELIS JR. JONATHAN L. GLEASON MICHAEL B. WALSH THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE MAIN LINE HOSPITALS, INC. (EIN: 23 1352160) FORM 990: JOHN J. LYNCH III MICHAEL J. BUONGIORNO BRIAN T. CORBETT Form 990, Part VI, Line 15b Compensation of the organization's other officers or key employees THERE ARE NO EMPLOYEES COMPENSATED BY THE REPORTING ENTITY. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUALS' COMPENSATION IS DISCLOSED ON THE THOMAS JEFFERSON UNIVERSITY HOSPITAL (EIN:23-2829095) FORM 990: EDMUND D. PRIBITKIN. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUALS' COMPENSATION IS DISCLOSED ON THE THOMAS JEFFERSON UNIVERSITY (EIN:23-1352651) FORM 990: ALFRED C. SALVATO, PETER DEANGELIS JR., MICHAEL B. WALSH AND JONATHAN L. GLEASON. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUALS' COMPENSATION IS DISCLOSED ON THE MAIN LINE HOSPITALS, INC. (EIN:23-1352160) FORM 990: JOHN J. LYNCH III, MICHAEL J. BUONGIORNO AND BRIAN T. CORBETT. Form 990, Part VI, Line 15a Compensation of the President THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE MAIN LINE HEALTH BOARD IS RESPONSIBLE FOR EVALUATING AND DETERMINING THE APPROPRIATENESS OF THE PRESIDENT'S COMPENSATION. AFTER REVIEW AND DELIBERATION, THE COMMITTEE DOCUMENTS ITS DECISIONS AND THE RESULTS ARE REPORTED TO THE BOARD OF DIRECTORS OF FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY AND MOUNTIAN LAUREL RISK RETENTION GROUP, WHO REVIEW AND APPROVE THE COMPENSATION DECISIONS. Form 990, Part VI, Line 3 Delegation of management duties THE ORGANIZATION CONTRACTS WITH MARSH MANAGEMENT SERVICES, INC. TO RECEIVE SPECIALIZED INSURANCE ACCOUNTING AND MANAGEMENT SERVICES. MARCY WATERFALL, ASSISTANT SECRETARY AND DIRECTOR OF THE ORGANIZATION, IS A SENIOR VICE PRESIDENT AND IS COMPENSATED BY MARSH MANAGEMENT SERVICES. Form 990, Part VI, Line 6 Classes of members or stockholders THE MEMBERS ARE MAIN LINE HOSPITALS, INC., RIDDLE MEMORIAL HOSPITAL, THOMAS JEFFERSON UNIVERSITY HOSPITALS, INC., AND MAGEE REHABILITATION HOSPITAL. MEMBERS / OWNERS HAVE MEMBERSHIP AGREEMENTS AND HAVE AN OWNERSHIP IN THE ORGANIZATION BASED ON THEIR RELATIVE QUANTITY OF MEMBERSHIP UNITS OWNED. VOTING IS BASED ON MEMBERSHIP UNITS. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body BOARD VACANCIES ARE FILLED BY MAJORITY VOTE AND BOARD REMOVALS ARE BY MAJORITY VOTE OF MEMBERSHIP UNITS. Form 990, Part VI, Line 11b Review of form 990 by governing body The return is reviewed by the Audit and Finance Committee at one of its meetings. Subsequently, the Board reviews the Form 990 prior to its filing. Form 990, Part VI, Line 12c Conflict of interest policy The company regularly and consistently monitors and enforces compliance with the Conflict of Interest policy. Persons covered under the Conflict of Interest policy are the board members and officers of Five Pointe Professional Liability Insurance Company. Any conflict of interest situation must be disclosed to the board of directors of the organization and reviewed by the board to determine if a conflict does exist. If it is determined that a Conflict of Interest does exist, the individual will be required to refrain from participating in any discussion or action concerning such conflicted situation. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances DIVIDENDS AND RETURN OF CAPITAL DECLARED AND PAID - -13021475; MAGEE REHABILITATION HOSPITAL 1513 RACE STREET PHILADELPHIA PA 19102 231476328 HEALTHCARE PA 501(c)(3) 3 TJU false MAIN LINE HOSPITALS INC 3803 WEST CHESTER PIKE SUITE 250 NEWTOWN SQUARE PA 19073 231352160 HEALTHCARE PA 501(c)(3) 3 MAIN LINE HEALTH INC false RIDDLE MEMORIAL HOSPITAL 3803 WEST CHESTER PIKE SUITE 250 NEWTOWN SQUARE PA 19073 231529076 HEALTHCARE PA 501(c)(3) 3 MAIN LINE HEALTH INC false THOMAS JEFFERSON UNIVERSITY HOSPITALS INC 111 SOUTH 11TH STREET PHILADELPHIA PA 19107 232829095 HEALTHCARE PA 501(c)(3) 3 TJUH SYSTEM INC false KENNEDY UNIVERSITY HOSPITAL INC 500 MARLBORO AVENUE CHERRY HILL NJ 08002 221773439 HEALTHCARE NJ 501(c)(3) 3 Kennedy Health System Inc false MOUNTAIN LAUREL RISK RETENTION GROUP INC 259 N RADNOR CHESTER RD SUITE 290 RADNOR PA 19087 141868175 INSURANCE VT NA C Corporation 0 0 0 false false false false false false false false false false false false true true false false false false true true