2022-11-02T14:05:34-05:00 2021-12-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS ROAD SUITE 1500 RALEIGH NC 27609 990 2021-01-01 061555318 ALLIANCE MEMBER SERVICES INC ALLI 8314590980 PO BOX 8507 SANTA CRUZ CA 950618507 KIM ADAY CFO, TREASURER 8314590980 2022-11-02 1 KIM ADAY 999009999 J CALVIN MARKS P01226973 9197196400 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z PAMELA DAVIS 300 PANETTA AVE SANTA CRUZ CA 95060 23122864 0 X WWW.INSURANCEFORNONPROFITS.ORG X 1999 VT SUPPORTS THE OPERATIONS AND ACTIVITIES OF THE NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA, THE ALLIANCE OF NONPROFITS FOR INSURANCE RISK RETENTION GROUP AND THE NATIONAL ALLIANCE OF NONPROFITS FOR INSURANCE, AS WELL AS SUCH OTHER INSTITUTIONS THAT QUALIFY UNDER SECTION 501(C)(3) AND 501(N) OF THE INTERNAL REVENUE CODE, COLLECTIVELY "NIA GROUP." NIA GROUP SERVES 501(C)(3) TAX EXEMPT NONPROFIT ORGANIZATIONS BY PROVIDING A STABLE SOURCE OF REASONABLE PRICED LIABILITY INSURANCE TAILORED TO THE SPECIALIZED NEEDS OF THE NONPROFIT SECTOR, AND ASSISTING THESE ORGANIZATIONS TO DEVELOP AND IMPLEMENT SUCCESSFUL LOSS CONTROL AND RISK MANAGEMENT PROGRAMS. 8 7 164 8 0 0 0 0 19742893 23122864 0 0 0 0 19742893 23122864 0 0 0 0 15491359 17815745 0 0 0 4251534 5307119 19742893 23122864 0 0 127727627 146353326 127727627 146353326 0 0 X ALLIANCE MEMBER SERVICES, INC. ("AMS") IS A SUPPORTING ORGANIZATION FOR THE FOLLOWING CHARITABLE RISK POOLS: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC), ALLIANCE OF NONPROFITS FOR INSURANCE RISK RETENTION GROUP (ANI), AND NATIONAL ALLIANCE OF NONPROFITS FOR INSURANCE (NANI). AMS PROVIDES ALL STAFF AND MANAGES ALL OTHER BUSINESS RELATIONSHIPS TO PROVIDE EXCELLENT PRODUCTS AND SERVICES TO THE MEMBERS OF THE SUPPORTED ORGANIZATIONS AT ITS COST. SERVICES INCLUDE UNDERWRITING, POLICY ISSUANCE AND SERVICING, CLAIMS HANDLING, LOSS CONTROL SERVICES, MARKETING, ACCOUNTING, INVESTMENT MANAGEMENT, REINSURANCE PLACEMENT AND ALL OTHER ADMINISTRATIVE AND MANAGEMENT SERVICES AS REQUIRED. 0 0 22568069 23122864 PROVIDED MANAGEMENT AND OPERATIONAL SERVICES TO AFFILIATES INCLUDING POLICY SERVICES, CLAIMS MANAGEMENT, MEMBER SERVICES, REINSURANCE NEGOTIATIONS, MARKETING, ACCOUNTING AND FINANCIAL MANAGEMENT, AND GENERAL AND ADMINISTRATIVE MANAGEMENT. 22568069 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 0 1 308 0 1 164 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X KIMBERLY ADAY CFO TREASURER 8314590980 300 PANETTA AVE SANTA CRUZ CA 95060 PAMELA DAVIS CEO, PRESIDENT 5.00 35.00 X X 474341 0 30579 KIM ADAY CFO & TREASURER 5.00 35.00 X 316064 0 31592 TOM BAKEWELL CHIEF INFORMATION OFFICER 40.00 X 310158 0 30114 BRIAN JOHNSON CHIEF UNDERWRITING OFFICER 40.00 X 299258 0 19173 DAVID GIBSON CHIEF CLAIMS OFFICER 40.00 X 298450 0 18237 SALAR SEPEHRDAD CHIEF RISK OFFICER 40.00 X 246070 0 21325 ANSHU AGARWAL CHIEF MARKETING OFFICER 40.00 X 233559 0 27554 MELISSA YARNELL SENIOR MANAGER, BUSINESS SYSTEMS 40.00 X 215919 0 16329 RANDALL CHRITTON CLAIMS COUNSEL 40.00 X 210125 0 26630 CHRISTOPHER REED CORPORATE COUNSEL 40.00 X 200836 0 23790 MICHELLE ALVIS CHIEF PEOPLE OFFICER (TO AUG '21) 40.00 X 191185 0 26014 KEVIN HUTH MANAGER, BUSINESS APPLICATIONS 40.00 X 183335 0 23403 KIMBERLY SPILKER SENIOR MANAGER, RISK MANAGEMENT SERVICES 40.00 X 172840 0 23020 TAMMY WILSON CHAIR 1.00 2.00 X X 0 0 0 STEPHEN SUMNER VICE CHAIR 1.00 2.00 X X 0 0 0 PAM ALVAREZ SECRETARY 1.00 1.00 X X 0 0 0 RHONDA GILLENWATERS DIRECTOR 1.00 2.00 X 0 0 0 AVNISH GUPTA DIRECTOR 1.00 2.00 X 0 0 0 EDWARD HAIK DIRECTOR (TO FEB '21) 1.00 2.00 X 0 0 0 MARTHA MARCON DIRECTOR 1.00 3.00 X 0 0 0 SAM SCHULTZ DIRECTOR (FROM FEB '21) 1.00 1.00 X 0 0 0 3352140 0 317760 51 0 1 0 DELOITTE CONSULTING LLP 4022 SELLS DRIVE HERMITAGE TN 37076 SOFTWARE DEVELOPMENT CONSULTING FEES 1558115 KPMG LLP 3 CHESTNUT RIDGE ROAD MONTVALE NJ 07645 SOFTWARE DEVELOPMENT CONSULTING FEES 787922 ACRISURE OF CALIFORNIA LLC 5664 PRAIRIE CREEK DR CALEDONIA MI 49316 BROKER COMMISSIONS 447995 LAMB FINANCIAL GROUP 145 W 45TH STREET NEW YORK NY 10036 BROKER COMMISSIONS 422966 INTERWEST INSURANCE SERVICES LLCCHICO 1357 EAST LASSEN AVE CHICO CA 95973 BROKER COMMISSIONS 372175 16 SERVICE FEES 561000 23122864 23122864 23122864 23122864 23122864 0 0 2573673 2496463 77210 12090203 11727497 362706 764193 741267 22926 1322801 1283117 39684 1064875 1064875 46723 46723 23750 23750 1742310 1690041 52269 73477 73477 2512987 2512987 180427 180427 473513 473513 18976 18976 3820 3820 316015 316015 345396 345396 ASSOCIATION DUES 404164 404164 RECRUITING & EMPLOYEE R 129010 129010 TRAINING 122717 122717 TAXES & LICENSES 70484 70484 -1156650 -1156650 23122864 22568069 554795 0 939806 416031 52089328 59928576 279989 358660 10528749 7747552 2713537 2781197 71704967 82868862 127727627 146353326 4751678 5169680 122975949 141183646 127727627 146353326 X 0 0 0 0 0 0 0 0 127727627 146353326 0 0 X 0 1 X 1 0 X X 3 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA 770203935 10 1 0 12587076 NATIONAL ALLIANCE OF NONPROFITS FOR INSURANCE INC 061555321 10 1 0 300000 ALLIANCE OF NONPROFITS FOR INSURANCE RISK RETENTION GROUP INC 061555320 10 1 0 7187280 3 0 20074356 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1020686 779684 241002 9508063 6967868 2540195 2781197 RECEIVABLE FROM AFFILIATES 63997521 OTHER RECEIVABLE 9398073 ALL OTHER ASSETS 9360421 DEPOSITS 112847 82868862 PREMIUM PAYABLE 81055987 PAYABLE TO AFFILIATES 58649473 FUNDS HELD-NAE 1478186 141183646 X PART X, LINE 2: MANAGEMENT CONCLUDED THAT ALL TAX-EXEMPT COMPANIES HAVE PROPERLY MAINTAINED THEIR EXEMPT STATUS AND THAT NO UNCERTAIN TAX POSITIONS EXIST AS OF DECEMBER 31, 2021. X X X 0 0 0 0 0 0 0 0 0 PAMELA DAVIS CEO, PRESIDENT 351937 0 100231 0 22173 0 17100 0 13479 0 504920 0 0 0 KIM ADAY CFO & TREASURER 291478 0 32457 0 -7871 0 17100 0 14492 0 347656 0 0 0 TOM BAKEWELL CHIEF INFORMATION OFFICER 263426 0 38712 0 8020 0 17100 0 13014 0 340272 0 0 0 BRIAN JOHNSON CHIEF UNDERWRITING OFFICER 257748 0 37880 0 3630 0 17100 0 2073 0 318431 0 0 0 DAVID GIBSON CHIEF CLAIMS OFFICER 240200 0 35351 0 22899 0 17100 0 1137 0 316687 0 0 0 SALAR SEPEHRDAD CHIEF RISK OFFICER 225106 0 20114 0 850 0 8050 0 13275 0 267395 0 0 0 ANSHU AGARWAL CHIEF MARKETING OFFICER 217677 0 30414 0 -14532 0 13413 0 14141 0 261113 0 0 0 MELISSA YARNELL SENIOR MANAGER, BUSINESS SYSTEMS 176494 0 26385 0 13040 0 14547 0 1782 0 232248 0 0 0 RANDALL CHRITTON CLAIMS COUNSEL 188749 0 18224 0 3152 0 12709 0 13921 0 236755 0 0 0 CHRISTOPHER REED CORPORATE COUNSEL 184025 0 16780 0 31 0 10362 0 13428 0 224626 0 0 0 MICHELLE ALVIS CHIEF PEOPLE OFFICER (TO AUG '21) 143988 0 32922 0 14275 0 15747 0 10267 0 217199 0 0 0 KEVIN HUTH MANAGER, BUSINESS APPLICATIONS 156717 0 15165 0 11453 0 10229 0 13174 0 206738 0 0 0 KIMBERLY SPILKER SENIOR MANAGER, RISK MANAGEMENT SERV 157916 0 14258 0 666 0 9838 0 13182 0 195860 0 0 0 FORM 990, PART VI, SECTION A, LINE 7B A VOTE OF TWO-THIRDS OF THE MEMBERS IS REQUIRED TO MERGE OR DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WILL BE MADE AVAILABLE ELECTRONICALLY TO AMS MANAGEMENT, OFFICERS, AND BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS AND SENIOR STAFF ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THESE FORMS ARE REVIEWED BY THE CHAIRMAN OF THE AUDIT COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S SALARY IS COMPARED ANNUALLY TO A NATIONAL DATABASE, COMPANALYST, WHICH PRODUCES SALARY INFORMATION FOR SIMILARLY SIZED INSURANCE ORGANIZATIONS AND ADJUSTS FOR GEOGRAPHIC REGION. THE BOARD OF DIRECTORS REVIEWS THIS INFORMATION IN A MEETING WITHOUT THE CEO PRESENT AND DETERMINES THE APPROPRIATE SALARY. TYPICALLY, THE SALARY CHOSEN IS SUCH THAT THE COMPANY HAS TO ACHIEVE 100% OF ITS GOALS FOR THE CEO TO ACHIEVE A SALARY THAT IS AT LEAST 10% LESS THAN THE AVERAGE REPORTED COMPENSATION OF FOR-PROFIT PEER COMPANIES CEOS. EACH YEAR THE CEO HAS 30% OF HER SALARY "AT RISK" IF THE CHARITABLE RISK POOLS DO NOT MEET THEIR GOALS. THIS LOWER THAN AVERAGE SALARY RECOGNIZES THE NONPROFIT NATURE OF OUR WORK, AND DOES NOT REFLECT POORER THAN AVERAGE PERFORMANCE. THE SAME PROCESS AS FOR THE CEO IS DONE FOR EACH MEMBER OF THE SENIOR MANAGEMENT TEAM. THE DIFFERENCE IN THE PROCESS IS THAT THE CEO ESTABLISHES THE SALARIES OF THE OTHER MANAGERS AROUND THE COMPANALYST AVERAGES FOR SIMILAR POSITIONS. THE BOARD OF DIRECTORS HAS PRE-ESTABLISHED RANGES WITHIN WHICH THE CEO MAY ESTABLISH SALARIES OF OTHER SENIOR MANAGERS AND THE ENTIRE STAFF. TYPICALLY, THE STAFF ARE AT OR SLIGHTLY ABOVE AVERAGE FOR PEERS AND SENIOR MANAGERS ARE AT OR SLIGHTLY BELOW AVERAGES. THESE COMPENSATION FIGURES ASSUME THAT THE CHARITABLE RISK POOLS BEING SERVED MEET THEIR GOALS. IF THEY DO NOT, A CERTAIN PORTION OF EACH EMPLOYEES STAFF IS "AT RISK AND COMPENSATION FALLS FARTHER BELOW AVERAGE. FORM 990, PART VI, SECTION C, LINE 19 AMS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND FORM 990 ARE AVAILABLE UPON REQUEST. NATIONAL ALLIANCE OF NONPROFITS FOR INSURANCE 300 PANETTA AVE SANTA CRUZ CA 95060 061555321 CHARITABLE RISK POOL VT 501(C)(3) 10 N/A 0 ALLIANCE OF NONPROFITS FOR INSURANCE RISK RETENTION GROUP 300 PANETTA AVE SANTA CRUZ CA 95060 061555320 CHARITABLE RISK POOL VT 501(C)(3) 10 N/A 0 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA 300 PANETTA AVE SANTA CRUZ CA 95060 770203935 CHARITABLE RISK POOL CA 501(C)(3) 10 N/A 0 AMS INSURANCE SERVICES PO BOX 8507 SANTA CRUZ CA 95061 770513798 INSURANCE BROKER CA N/A C 3280945 63858284 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 AMS INSURANCE SERVICES L 3048507 FMV