2022-05-06T07:44:33-05:00 2021-12-31 273605969 CBIZ MHM LLC 140 FOUNTAIN PKWY N STE 410 ST PETERSBURG FL 33716 990 2021-01-01 133095444 ARBITRATION FORUMS INC ARBI 8139314004 3820 NORTHDALE BOULEVARD 115 TAMPA FL 33624 STEVE JANICKI CFO & SECRETARY/TREASURER 8139314004 2022-04-25 1 STEVE JANICKI XXX-XX-XXXX PAUL DUNHAM P00100222 7275721400 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ELENA GERVINO 3820 NORTHDALE BOULEVARD 115 TAMPA FL 33624 169888813 0 X WWW.ARBFILE.ORG X 1981 NY TO SERVE OUR MEMBER'S RECOVERY AND RESOLUTION NEEDS THROUGH SERVICE, COLLABORATION, AND INNOVATION. 12 11 191 11559 0 0 0 0 42431327 36282544 2700343 645050 2253 -742 45133923 36926852 79431 103532 0 0 27477891 29157793 0 0 0 13662636 12287761 41219958 41549086 3913965 -4622234 105255521 106671146 24332939 26509853 80922582 80161293 TO FACILITATE THE EFFICIENCY AND EQUITABLE DISPOSITION OF INSURANCE RELATED DISPUTES TO AVOID THE COSTS AND DELAYS OF LITIGATION. 0 0 ARBITRATION SERVICES: IN 2021, ITS MEMBERS FILED ALMOST 869,000 DISPUTES AND 2 MILLION SUBROGATION DEMANDS COLLECTIVELY WORTH MORE THAN $17.6 BILLION IN CLAIMS AS A COST EFFECTIVE ALTERNATIVE TO LITIGATION FOR THE INSURANCE INDUSTRY. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 1 191 1 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X STEVE JANICKI 8139152207 3820 NORTHDALE BLVD SUITE 115 TAMPA FL 33624 KATHLEEN MAHNE PRESIDENT & CEO 40.00 X X 698266 0 155289 ELENA GERVINO CHAIR 1.00 X 0 0 0 SETH INGALL VICE CHAIR 1.00 X 0 0 0 BRENDON KELLY AUDIT COMMITTEE CHAIR 1.00 X 0 0 0 CHRIS WOLF NOMINATING COMMITTEE CHAIR 1.00 X 0 0 0 ANURAG BAIRATHI DIRECTOR 1.00 X 0 0 0 SHANNON CRAGG DIRECTOR 1.00 X 0 0 0 PAUL DIEMER DIRECTOR 1.00 X 0 0 0 ROBERT HOWARD DIRECTOR 1.00 X 0 0 0 DAVE PREJNA DIRECTOR 1.00 X 0 0 0 ERIC SPENCER DIRECTOR 1.00 X 0 0 0 SEAN WELCH DIRECTOR 1.00 X 0 0 0 SEJUNG KIM DIRECTOR (1/1/21-4/15/21) 1.00 X 0 0 0 SUE MURRAY DIRECTOR (1/1/21-10/15/21) 1.00 X 0 0 0 ANNMARIE SIMONSON DIRECTOR (1/1/21-1/31/21) 1.00 X 0 0 0 LARRY SPINOSA DIRECTOR (1/1/21-5/1/21) 1.00 X 0 0 0 RICK STICCA DIRECTOR (1/1/21-3/31/21) 1.00 X 0 0 0 JAIRO ARCILA CFO & SECRETARY/TREASURER 40.00 X 370081 0 80082 KENNETH BUTLER DIRECTOR OF HR & FACILITIES 40.00 X 277587 0 54970 JENNIFER FELDER DIRECTOR OF MARKETING 40.00 X 153388 0 61531 STEPHEN JANICKI DIRECTOR OF PRODUCT INNOVATION 40.00 X 275351 0 81922 DAVID LEVIN DIRECTOR OF QUALITY/FIELD 40.00 X 289878 0 67379 JOHN SHEDD CHIEF IT OFFICER 40.00 X 338094 0 71209 SHEILA WALTON-MOORE DIRECTOR OF COMPLIANCE/PROCUREMENT 40.00 X 203649 0 43099 RONALD COOKSEY SR SOFTWARE DEVELOPMENT MANAGER 40.00 X 196600 0 25945 WILLIAM PFEIFFER ENTERPRISE ARCHITECT 40.00 X 189458 0 45856 JOHN ALCHIN SOFTWARE DEVELOPMENT MANAGER 40.00 X 183613 0 46785 TIMOTHY MCKERNAN MANAGER OPERATIONS-FIELD 40.00 X 170986 0 48378 CHARLES PARENTI MANAGER OPERATIONS-FIELD 40.00 X 168335 0 23989 3515286 0 806434 73 0 1 0 ORACLE AMERICA INC PO BOX 203448 DALLAS TX 753203448 SOFTWARE/HARDWARE IT SERVICES 820359 AHEAD INC 5905 E GALBRAITH RD 3RD FL CINCINNATI OH 45236 SOFTWARE/HARDWARE IT SERVICES 656266 RELIAQUEST LLC 777 S HARBOR ISLAND BLVD STE 500 TAMPA FL 33602 SIEM AND SOC SERVICES 455489 REURGENCY LLC 4798 S FLORIDA AVE LAKELAND FL 33813 IT CONSULTING 311156 DYNATRACE LLC PO BOX 74008118 CHICAGO IL 606748118 SOFTWARE/HARDWARE IT SERVICES 298614 11 CASE FILING ASSESSMENT CHARGES 541100 34135313 34135313 ADJOURNMENT FEES 541100 1287387 1287387 FEES TO DEFER CASES 541100 848844 848844 ARBITRATION APPEAL 541100 11000 11000 36282544 1447402 1447402 132159609 132961961 -802352 -802352 -802352 -742 -742 -742 36926852 36281802 0 645050 78532 25000 3221775 17044043 4051612 3535524 1304839 366174 80982 196078 2033415 28607 790806 2777297 568151 1245 55033 5180550 192542 STATE EXCISE TAX 12916 3965 41549086 1199533 696290 280087 3310312 5305019 2334770 2059025 9518032 7124029 3649945 2394003 76951337 80480890 17520602 15734824 8935 1095 105255521 106671146 5046921 12857733 2760425 989898 16525593 12662222 24332939 26509853 X 80922582 80161293 80922582 80161293 105255521 106671146 X -4622234 -499506 4360451 X X 0 1 X 1 0 152783 127602 25181 9125516 6789649 2335867 239733 206778 32955 2394003 LONG-TERM PENSION LIABILITY 8618466 DEFERRED COMPENSATION 3574507 LONG-TERM INCENTIVE COMPENSATION PAYABLE 469249 12662222 X 57502646 -499506 21271378 20771872 36730774 196078 196078 36926852 62624386 21271378 21271378 41353008 196078 196078 41549086 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(6). MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT OR DISCLOSURE IN THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISION OF THE ACCOUNTING GUIDANCE FOR INCOME TAXES AS OF DECEMBER 31, 2021 AND 2020, RESPECTIVELY. 1 AMERICAN RED CROSS PO BOX 4236 TAMPA FL 336774236 530196605 501(C)(3) 5742 0 N/A N/A TO FURTHER ORGANIZATION'S CHARITABLE PURPOSE HOPE CHILDREN'S HOME 11415 HOPE INTERNATIONAL DR TAMPA FL 33625 620879012 501(C)(3) 17395 0 N/A N/A TO FURTHER ORGANIZATION'S CHARITABLE PURPOSE THE SPRING OF TAMPA BAY INC PO BOX 4772 TAMPA FL 336779900 591777135 501(C)(3) 16137 0 N/A N/A TO FURTHER ORGANIZATION'S CHARITABLE PURPOSE METROPOLITAN MINISTRIES 2301 N TAMPA ST TAMPA FL 33602 591477007 501(C)(3) 8264 0 N/A N/A TO FURTHER ORGANIZATION'S CHARITABLE PURPOSE RONALD MCDONALD HOUSE CHARITIES OF TAMPA BAY INC 35 DAVIS BLVD TAMPA FL 33606 591835985 501(C)(3) 10924 0 N/A N/A TO FURTHER ORGANIZATION'S CHARITABLE PURPOSE HUMANE SOCIETY OF TAMPA BAY 3607 N ARMENIA AVE TAMPA FL 33607 590799907 501(C)(3) 5649 0 N/A N/A TO FURTHER ORGANIZATION'S CHARITABLE PURPOSE 6 DEPENDENT SCHOLARSHIP PROGRAM 14 25000 0 N/A N/A PART I, LINE 2: GRANTS TO ORGANIZATIONS: ARBITRATION FORUMS' EMPLOYEES VOLUNTARILY PARTICIPATE IN A CHARITABLE GIVING PROGRAM. EMPLOYEES HAVE THE OPTION TO CONTRIBUTE TO SIX CHARITABLE ORGANIZATIONS VIA PAYROLL DEDUCTION. A LARGER SET OF CHARITABLE ORGANIZATIONS WERE PRE-SCREENED AND SELECTED BY ARBITRATION FORUMS AND INCLUDE ONLY ESTABLISHED, REPUTABLE 501(C)(3) ORGANIZATIONS. EMPLOYEES THEN SELECTED THE TOP SIX VIA VOTING. ARBITRATION FORUMS, INC. MATCHES THOSE CONTRIBUTIONS. DEPENDENT SCHOLARSHIP PROGRAM: ARBITRATION FORUMS HAS ESTABLISHED A DEPENDENT SCHOLARSHIP PROGRAM TO ASSIST EMPLOYEES' CHILDREN WHO PLAN TO FURTHER THEIR EDUCATION AFTER GRADUATING HIGH SCHOOL. SCHOLARSHIPS ARE OFFERED FOR FULL-TIME STUDY AT AN ACCREDITED INSTITUTION OR VOCATIONAL AND TECHNICAL TRAINING INSTITUTION OF THE STUDENT'S CHOICE. DEPENDENTS (APPLICANTS) MUST BE AN UNDERGRADUATE STUDENT ENTERING OR ATTENDING A 4-YEAR ACCREDITED COLLEGE OR UNIVERSITY, A 2-YEAR ACCREDITED COMMUNITY COLLEGE OR A VOCATIONAL/ TECHNICAL SCHOOL AND MUST BE TAKING A CLASS SCHEDULE OF A MINIMUM OF 12 CREDIT HOURS PER SEMESTER OR A FULL TIME CLASS SCHEDULE AS DETERMINED BY THE INSTITUTION. DEPENDENTS MUST HAVE OBTAINED A HIGH SCHOOL GRADE POINT AVERAGE (GPA) OF 3.0 OR HIGHER AND HAVE ACCUMULATED 100 HOURS OF HIGH SCHOOL VOLUNTEER HOURS. IF CURRENTLY ENROLLED IN AN ACCREDITED COLLEGE, UNIVERSITY OR A VOCATIONAL/ TECHNICAL SCHOOL, THE DEPENDENT MUST HAVE MAINTAINED A 3.0 GRADE POINT AVERAGE, EARNED 24 CREDITS OR MET ALL EDUCATIONAL REQUIREMENTS REQUIRED BY THE SCHOOL WITHIN THE LAST ACADEMIC YEAR. SCHOLARSHIPS ARE RENEWABLE FOR UP TO THREE ADDITIONAL YEARS, UNTIL A BACHELOR'S DEGREE IS OBTAINED OR THE EDUCATIONAL REQUIREMENTS OF THE SCHOOL ARE COMPLETED, WHICHEVER IS EARLIER. DEPENDENTS MUST SUBMIT A RENEWAL/NEW APPLICATION WITH ESSAY ALONG WITH AN ACADEMIC TRANSCRIPT OR LETTER FROM THE SCHOOL INDICATING ACADEMIC PERFORMANCE IN ORDER TO BE CONSIDERED FOR RENEWAL OF THEIR SCHOLARSHIP. X X X 0 1 0 KATHLEEN MAHNE PRESIDENT & CEO 431217 0 231625 0 35424 0 112739 0 42550 0 853555 0 0 0 JAIRO ARCILA CFO & SECRETARY/TREASURER 259042 0 85235 0 25804 0 44934 0 35148 0 450163 0 0 0 JOHN SHEDD CHIEF IT OFFICER 241433 0 91666 0 4995 0 38672 0 32537 0 409303 0 0 0 STEPHEN JANICKI DIRECTOR OF PRODUCT INNOVATION 200263 0 72448 0 2640 0 40012 0 41910 0 357273 0 0 0 DAVID LEVIN DIRECTOR OF QUALITY/FIELD 228970 0 59666 0 1242 0 26244 0 41135 0 357257 0 0 0 KENNETH BUTLER DIRECTOR OF HR & FACILITIES 193288 0 60720 0 23579 0 10807 0 44163 0 332557 0 0 0 SHEILA WALTON-MOORE DIRECTOR OF COMPLIANCE/PROCUREMENT 188190 0 11895 0 3564 0 14231 0 28868 0 246748 0 0 0 WILLIAM PFEIFFER ENTERPRISE ARCHITECT 165138 0 22656 0 1664 0 8646 0 37210 0 235314 0 0 0 JOHN ALCHIN SOFTWARE DEVELOPMENT MANAGER 162318 0 19600 0 1695 0 7107 0 39678 0 230398 0 0 0 RONALD COOKSEY SR SOFTWARE DEVELOPMENT MANAGER 170705 0 23248 0 2647 0 25945 0 0 0 222545 0 0 0 TIMOTHY MCKERNAN MANAGER OPERATIONS-FIELD 150720 0 17890 0 2376 0 7975 0 40403 0 219364 0 0 0 JENNIFER FELDER DIRECTOR OF MARKETING 136700 0 16000 0 688 0 21339 0 40192 0 214919 0 0 0 CHARLES PARENTI MANAGER OPERATIONS-FIELD 149819 0 17750 0 766 0 23989 0 0 0 192324 0 0 0 PART I, LINE 4B IN APRIL 2001 THE BOARD APPROVED A NON-QUALIFIED PLAN WITHIN THE MEANING OF SECTION 457(F) OF THE INTERNAL REVENUE CODE FOR CERTAIN OF THE ORGANIZATION'S OFFICERS (PARTICIPANTS). THE BOARD HAS A RIGHT TO AMEND, SUSPEND, OR TERMINATE THE PLAN IN WHOLE OR IN PART. HOWEVER, ANY DEFERRED COMPENSATION BENEFITS ACCRUED PRIOR TO THE LATTER OF THE ADOPTION OF OR EFFECTIVE DATE OF SUCH AMENDMENT, SUSPENSION, OR TERMINATION WILL BE THE RIGHT OF THE PARTICIPANT. THE AMOUNTS CONTRIBUTED ON BEHALF OF OFFICERS AND KEY EMPLOYEES DURING 2021 ARE AS FOLLOWS: KATHLEEN MAHNE: $76,302 JAIRO ARCILA: $34,027 STEVEN JANICKI: $2,565 JOHN SHEDD: $1,670 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO TYPES OF MEMBERS: INSURER MEMBER: A PROPERTY OR CASUALTY INSURANCE COMPANY THAT UTILIZES THE INSURANCE ARBITRATION SERVICES OF THE ORGANIZATION OR INDIVIDUAL WHO IS EMPLOYED BY A PROPERTY OR CASUALTY INSURANCE COMPANY. NON-INSURER MEMBER: A COMPANY OR INDIVIDUAL WHO IS NOT AN INSURER MEMBER. A NON-INSURER MEMBER WOULD INCLUDE SELF-INSUREDS, TPAS (THIRD PARTY ADMINISTRATORS) AND ANY OTHER PERSON OR ENTITY THAT IS AUTHORIZED TO AND DOES UTILIZE THE SERVICES OF THE ORGANIZATION. AS OF DECEMBER 31, 2021, THE ORGANIZATION HAS 5,341 MEMBERS CONSISTING SOLELY OF INSURERS, SELF-INSUREDS, AND TPAS. FORM 990, PART VI, SECTION A, LINE 7A THE VOTING MEMBERS ELECT THE BOARD OF DIRECTORS (GOVERNING BODY). THE MEMBER COMPANIES DO NOT APPROVE THE DECISIONS OF THE GOVERNING BODY; HOWEVER, A VOTE OF MORE THAN 50% OF THE MEMBER COMPANIES OPPOSING THE DECISION CAN OVERTURN A BOARD DECISION. FORM 990, PART VI, SECTION B, LINE 11B THE SECRETARY/TREASURER SENDS THE FORM 990 TO THE ENTIRE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS ONE OF SEVERAL THAT THE COMPANY UPLOADS TO THE ADP SYSTEM. ALL EMPLOYEES MUST ACKNOWLEDGE IN THE ADP PAYROLL SYSTEM THAT THEY READ AND UNDERSTOOD THE POLICY. THE CFO RECEIVES A SUMMARY REPORT WHICH IS SHARED WITH THE AUDIT COMMITTEE. DIRECTORS AND OFFICERS RECEIVE THE CONFLICT OF INTEREST POLICY AND PROCEDURES DISCLOSURE FORM AND ARE REQUIRED TO SIGN AND DATE THE POLICY DISCLOSURE FORM PRIOR TO THE CONCLUSION OF THE APRIL BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE HR DEPARTMENT UTILIZES AN INDEPENDENT THIRD PARTY TO DETERMINE THE APPROPRIATE COMPENSATION AMOUNTS FOR THE CEO AND SENIOR MANAGERS. THIS INFORMATION IS SHARED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, WHO APPROVES THE COMPENSATION AND BENEFITS AMOUNTS. FORM 990, PART VI, SECTION C, LINE 19 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: NET PERIODIC PENSION COST -102,125. OTHER PENSION RELATED CHANGES 4,462,576. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE, COMPRISED OF FOUR DIRECTORS INDEPENDENT OF MANAGEMENT, ASSISTS THE BOARD IN CARRYING OUT ITS FIDUCIARY RESPONSIBILITIES RELATING TO ACCOUNTING AND REPORTING PRACTICES. THE COMMITTEE REVIEWS, APPRAISES, AND REPORTS TO THE BOARD ON THE FOLLOWING MATTERS: - THE INDEPENDENT AUDITORS RETAINED BY THE COMPANY; - THE QUALITY OF THE ACCOUNTING AND INTERNAL CONTROL SYSTEM; - THE ACCOUNTING PRINCIPLES ADOPTED BY MANAGEMENT AND ACCEPTED BY THE INDEPENDENT AUDITORS; - ANY CHANGES IN ACCOUNTING PRINCIPLES AND THEIR AFFECT UPON THE CORPORATION; AND - ANY SIGNIFICANT DIFFICULTIES ENCOUNTERED OR IMPORTANT DISCOVERIES MADE BY THE INDEPENDENT AUDITORS.