2022-11-02T08:26:50-05:00 2021-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2021-01-01 396252984 GROUP HEALTH COOPERATIVE OF EAU CLAIRE GROU 7155524300 PO BOX 3217 EAU CLAIRE WI 547023217 DOUGLAS HOFFER PRESIDENT 7155524300 2022-10-20 1 DOUGLAS HOFFER 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2022-10-20 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DOUGLAS HOFFER PO BOX 3217 EAU CLAIRE WI 547023217 192300953 0 X WWW.GROUP-HEALTH.COM X NONSTOCK COOPERATIVE 1972 WI OPTIMIZE HEALTHCARE OF MEMBERS THROUGH POOLING OF HEALTH-RELATED RESOURCES. 12 12 52 11 0 0 0 0 159432571 167398769 1089578 1378984 78000 0 160600149 168777753 0 773700 0 0 4456916 4697288 0 0 0 142942428 151043940 147399344 156514928 13200805 12262825 71427480 86702714 27329307 31432247 44098173 55270467 X THE PURPOSE OF THIS ORGANIZATION SHALL BE TO PROVIDE: (A) A MEANS FOR SUBSCRIBERS TO SECURE FOR THEMSELVES, THEIR FAMILIES, AND THEIR DEPENDENTS COMPREHENSIVE PREPAID PREVENTATIVE AS WELL AS CURATIVE HEALTH CARE; (B) A MEANS TO EMPHASIZE DISEASE PREVENTION AND EARLY CARE; (C) INCENTIVES FOR HOLDING DOWN COSTS AND FOR INCREASING THE PRODUCTIVITY OF RESOURCES; (D) A MEANS TO IMPROVE BOTH THE QUALITY OF CARE AND ITS GEOGRAPHIC DISTRIBUTION. 0 0 139179482 773700 167398769 THE COOPERATIVE OFFERS INSURANCE COVERAGE FOR COMMERCIAL, MEDICAID AND SSI MEMBERS. IN 2021, THE COOPERATIVE HAD APPROXIMATELY 60,754 COMMERCIAL MEMBER MONTHS, 645,164 MEDICAID MEMBER MONTHS, AND 41,933 SSI MEMBER MONTHS. ALONG WITH INSURANCE COVERAGE, THE COOPERATIVE ALSO HELPS MEMBERS WITH MEDICAL MANAGEMENT AND COORDINATION OF CARE. 139179482 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 881 0 52 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ROBERT W TANNER 7155524300 2503 N HILLCREST PKWY ALTOONA WI 54720 X SARAH NORTH GENERAL MANAGER AND CEO 40.00 X 0 0 0 BOB TANNER CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 DOUGLAS HOFFER PRESIDENT 0.30 X X 0 0 0 EDWARD KASSING FIRST VICE PRESIDENT (THRU DECEMBER) 0.30 X X 0 0 0 TYLER FADNESS FIRST VICE PRESIDENT 0.30 X X 0 0 0 BRIAN LANNERS SECOND VICE PRESIDENT 0.30 X X 0 0 0 SUSAN MARCOTT TREASURER (THRU DECEMBER) 0.30 X X 0 0 0 CORRISSA WOLNIAK SECRETARY 0.30 X X 0 0 0 KENNETH ANIBAS DIRECTOR 0.30 X 0 0 0 GEORGIA CROWNHART DIRECTOR 0.30 X 0 0 0 CHRYSTAL MILLS DIRECTOR (THRU DECEMBER) 0.30 X 0 0 0 GERALDINE SEGAL DIRECTOR 0.30 X 0 0 0 DEBRA STANTON DIRECTOR 0.30 X 0 0 0 DEREK THOMAS DIRECTOR 0.30 X 0 0 0 0 0 0 0 0 0 0 KMTSJ INC PO BOX 3217 EAU CLAIRE WI 54702 RENT & MGMT SERVICES 15682074 MCHS HOSPITALS INC 611 N SAINT JOSEPH AVE MARSHFIELD WI 55486 MEDICAL SERVICES & ACCESS PAYMENT 5050287 MAYO CLINIC HEALTH SYSTEM - NW WI PO BOX 860081 MINNEAPOLIS MN 55486 MEDICAL SERVICES & ACCESS PAYMENT 4210351 MEMORIAL MEDICAL CENTER 1615 MAPLE LANE ASHLAND WI 54806 MEDICAL SERVICES & ACCESS PAYMENT 3547584 ST CROIX REGIONAL MEDICAL CENTER 216 S ADAMS ST SAINT CROIX FALLS WI 54024 MEDICAL SERVICES & ACCESS PAYMENT 3033251 87 MED & HOSP PREMIUM 524114 149308142 149308142 SSI & MA CAPITATION 524114 18090627 18090627 167398769 1271236 1271236 23630948 23523200 107748 107748 107748 168777753 167398769 0 1378984 X 773700 773700 2159493 1753458 406035 95771 79539 16232 2303249 2152535 150714 138775 111739 27036 14498510 14498510 214795 214795 400176 124902 275274 132792195 132695300 96895 50264 50264 194207 55971 138236 1297681 1289528 8153 51849 44776 7073 764 764 311386 11936 299450 18396 18396 67118 67118 62506 62506 INCOME TAX EXPENSE 1064541 1064541 PCORI TAX EXPENSE 14305 14305 5247 584 4663 156514928 139179482 17335446 0 7212287 5396091 55200355 72316106 6169777 4995208 785688 1283539 680647 68007 143111 612640 1524898 1579389 391364 519741 71427480 86702714 26432388 30308101 896919 1124146 27329307 31432247 X 1430 1430 1001422 1001422 43095321 54267615 44098173 55270467 71427480 86702714 X 12262825 -67888 -1022643 X 0 1 X 1 0 X 176849733 163705413 148535909 159432571 167398769 815922395 176849733 163705413 148535909 159432571 167398769 815922395 0 0 0 815922395 921134 966122 1141394 1100054 1271236 5399940 1840 1560 1560 1560 6520 922974 967682 1142954 1101614 1271236 5406460 177772707 164673095 149678863 160534185 168670005 821328855 0.99340 0.99390 0.00660 0.00610 X 680647 68007 612640 612640 UNEARNED PREMIUM REVENUE 1124146 1124146 168777753 0 168777753 0 168777753 156496532 -18396 -18396 156514928 0 156514928 PART XII, LINE 2D - OTHER ADJUSTMENTS: NET LOSS FROM PREMIUM BALANCES CHARGED OFF -18,396. 0 BOYS & GIRLS CLUB OF THE GREATER CHIPPEWA VALLEY 1005 OXFORD AVENUE EAU CLAIRE WI 54703 392032491 501(C)(3) 500000 0 CAPITAL PROJECT FOR CHIPPEWA FALLS CENTER CHIPPEWA FALLS AREA UNIFIED SCHOOL DISTRICT 1130 MILES STREET CHIPPEWA FALLS WI 54729 396008493 GOV'T 166200 0 DONATION FOR PARENT COACHING ADDITION CHILDREN'S MUSEUM OF EAU CLAIRE INC 220 SOUTH BARSTOW STREET EAU CLAIRE WI 54701 392015286 501(C)(3) 100000 0 CAPITAL CAMPAIGN EAU CLAIRE DOWNTOWN FARMERS MARKET 300 RIVERFRONT TERRACE EAU CLAIRE WI 54703 753137134 N/A 7500 0 MARKET MATCHING PROGRAM DONATION 3 1 FORM 990, PART VI, SECTION A, LINE 3 KMTSJ, AN UNRELATED CORPORATION, IS CONTRACTED TO PROVIDE SERVICE AS GENERAL MANAGER, ALONG WITH ACCOUNTING, MARKETING, CLAIMS PROCESSING, HUMAN RESOURCES, PAYROLL, AND DATA PROCESSING SERVICES. THE SERVICES OF CEO AND CFO ARE AMONG THESE PURCHASED THROUGH KMTSJ AND THE AMOUNT PAID IN TOTAL FOR THE CALENDAR YEAR IS REPRESENTED ON PART VII, SECTION B. FORM 990, PART VI, SECTION A, LINE 7A INDIVIDUALS COVERED UNDER GROUP HEALTH COOPERATIVE OF EAU CLAIRE'S INSURANCE POLICIES ARE CONSIDERED TO BE MEMBERS OF THE COOPERATIVE AND ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION REVIEWED FORM 990 IN THE FOLLOWING MANNER: EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVED A COPY OF FORM 990 FOR REVIEW. A HIGH-LEVEL REVIEW WAS COMPLETED WITH THE BOARD OF DIRECTORS AT A BOARD MEETING, AND ANY QUESTIONS OR CONCERNS WERE ADDRESSED PRIOR TO THE BOARD'S APPROVAL TO FILE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THE FOLLOWING MANNER: MEMBERS OF THE BOARD OF DIRECTORS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST ATTESTATION ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT HAVE A PROCESS FOR DETERMINING COMPENSATION FOR THE CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL OR KEY EMPLOYEES, AS THESE POSITIONS ARE CONTRACTED THROUGH AN UNRELATED CORPORATION. ADDITIONALLY, OFFICERS OF THE ORGANIZATION ARE NOT COMPENSATED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION A, LINE 8B ORGANIZATION HAS AN EXECUTIVE COMMITTEE IN ADDITION TO BOARD OF DIRECTORS. EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS AND SUCH ADDITIONAL DIRECTORS AS THE BOARD MAY DETERMINE. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT ON ANY MATTER REQUIRING ATTENTION BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART IX, LINE 11G REFERRALS - FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 91,683,191. MANAGEMENT AND GENERAL EXPENSES 3,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,686,191. BENEFITS - FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 31,846,375. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,846,375. CONTRACT SERVICES - MEDICAL: PROGRAM SERVICE EXPENSES 9,165,734. MANAGEMENT AND GENERAL EXPENSES 93,895. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,259,629. FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS -1,022,643.