2020-11-11T18:36:28-06:00 2019-12-31 990 2019-01-01 030317160 Child Dimensions Insurance Company % MARSH MANAGEMENT SERVICES CHIL 3305438171 ONE PERKINS SQUARE AKRON OH 44308 SPENCER KOWAL CHIEF FINAN OFFICER 3305434251 2020-11-11 65.25.82.113 34238420203165000000 2020-11-11 P 8A711B9E1866DEB3CD6BE1F32897BC19B7710CD4 8926F5B1779455CD3DAE70861609C9F06FDBC616 2019 2021-01-29 14:40:06Z SPENCER KOWAL ONE PERKINS SQUARE AKRON OH 44308 19992823 false X N/A X 1988 VT TRANSACTS BUSINESS AS A CAPTIVE INSURANCE COMPANY. 11 2 0 0 0 0 0 0 6952288 6124785 6208188 2270019 0 0 13160476 8394804 0 0 0 0 0 0 0 0 0 479542 1715725 479542 1715725 12680934 6679079 65936915 79198437 33877821 32461249 32059094 46737188 X CHILD DIMENSIONS INSURANCE COMPANY (CDIC) TRANSACTS BUSINESS AS A CAPTIVE INSURANCE COMPANY. CDIC PROVIDES PROFESSIONAL, GENERAL AND EXCESS LIABILITY COVERAGE TO CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON AND ITS SUBSIDIARIES. false false 1408967 6124785 CHILD DIMENSIONS INSURANCE COMPANY IS A PURE CAPTIVE INSURANCE COMPANY PROVIDING PROFESSIONAL LIABILITY (MEDICAL MALPRACTICE), GENERAL, AND EXCESS LIABILITY INSURANCE TO CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON AND ITS SUBSIDIARIES. 1408967 true false false false false false false false false false false false false true false true true false false false 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 false 8 0 true 0 false false false false false false false false false false false false X 11 2 false false false false true true false true true false false false true true true true true true true false OH X MARSH MANAGEMENT SERVICES 8028645599 100 BANK STREET SUITE 610 BURLINGTON VT 05401 GRACE WAKULCHIK PRESIDENT & CEO 2.0 51.0 X X 0 1218636 497337 WILLIAM CONSIDINE CEO EMERITUS 0.0 40.0 X 0 1589082 114906 SHAWN M LYDEN SECRETARY/CHIEF STRATEGY OFF 2.0 41.0 X X 0 963927 140788 JOHN CROW MD DIRECTOR/CHAIR PED SURGERY 1.0 49.0 X 0 1071008 30422 LISA AURILIO DIRECTOR/CHIEF OPERATING OFF 1.0 42.0 X 0 678185 225345 ROBERT MCGREGOR MD DIRECTOR/CHIEF MEDICAL OFFICER 1.0 52.0 X 0 670594 114495 MICHAEL P TRAINER VP & TREAS/CFO(RET 7/26/2019) 2.0 42.0 X X 0 607301 11633 MICHAEL BIRD MD VP LOSS PREVENT/VP SAFETY 2.0 42.0 X X 0 382292 215495 ALICIA LAMANCUSA DIRECTOR/VP FINANCE 1.0 43.0 X 0 309693 183490 ANTHEA DANIELS VP CLAIMS/CHIEF LEGAL OFFICER 2.0 44.0 X X 0 457290 19505 SPENCER KOWAL VP & TREAS/CFO(BEG 7/19/2019) 2.0 44.0 X X 0 400335 10371 LISA KANE MARSH DIRECTOR 1.0 0.0 X 0 0 0 RUSSELL YOUNG ASST. SECRETARY 2.0 0.0 X X 0 0 0 0 8348343 1563787 0 true true false HANNA CAMPBELL POWELL LLP 3737 EMBASSY PARKWAY SUITE 100 AKRON OH 44333 LEGAL 451116 1 0 PREMIUMS EARNED 900099 6124785 6124785 6124785 1926345 1926345 0 0 0 0 0 11941693 11598019 343674 343674 343674 0 0 0 0 0 0 0 0 0 0 8394804 6124785 0 2270019 0 0 0 0 0 0 0 0 0 0 77910 77910 19863 19863 58800 58800 0 0 122939 122939 55246 28000 27246 0 0 0 0 0 0 0 0 0 0 0 0 UNDERWRITING EXPENSES 1380967 1380967 1715725 1408967 306758 0 101290 80710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484149 6166390 0 0 63251476 72951337 0 0 0 0 0 0 2100000 0 65936915 79198437 54872 87258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33822949 32373991 33877821 32461249 X 100000 100000 1600000 1600000 30359094 45037188 32059094 46737188 65936915 79198437 6679079 7999015 X X false true X true false X X 2 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON 340714357 3 true 0 0 AKRON CHILDREN'S HOSPITAL FOUNDATION 237114013 7 false 0 0 2 false false false false false false false false false false false false false false false true false PART IV, SECTION A, LINE 1 CHILD DIMENSIONS INSURANCE COMPANY (CDIC), THE FILING ORGANIZATION, IS ORGANIZED AND OPERATED FOR THE EXCLUSIVE BENEFIT OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA) AS STATED IN ITS GOVERNING DOCUMENTS. CHMCA IS THE PARENT OF AKRON CHILDREN'S HOSPITAL FOUNDATION (THE FOUNDATION) AND ITS GOVERNING BODY, AND AS SUCH HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE FOUNDATION'S GOVERNING BODY. BECAUSE OF THE CLOSE RELATIONSHIP BETWEEN CHMCA AND THE FOUNDATION, CDIC BY WAY OF ITS SUPPORT OF CHMCA ALSO SUPPORTS THE FOUNDATION. THE FOUNDATION IS NOT LISTED IN ITS GOVERNING DOCUMENTS. ADDITIONALLY, CDIC PROVIDES INSURANCE COVERAGED TO CHILDREN'S HOME CARE GROUP, A SUBSIDIARY OF CHMCA. 0 RESERVE FOR PROFESSIONAL/GEN LIAB 32351553 PAYABLE TO PARENT 22438 32373991 16270880 7999015 7999015 8271865 122939 122939 8394804 1592786 1592786 122939 122939 1715725 false true false false false false false false false GRACE WAKULCHIK PRESIDENT & CEO 0 888585 0 264167 0 65884 0 488068 0 9269 0 1715973 0 0 SHAWN M LYDEN SECRETARY/CHIEF STRATEGY OFF 0 628943 0 185000 0 149984 0 116757 0 24031 0 1104715 0 0 WILLIAM CONSIDINE CEO EMERITUS 0 759989 0 630000 0 199093 0 96448 0 18458 0 1703988 0 0 MICHAEL BIRD MD VP LOSS PREVENT/VP SAFETY 0 289537 0 59333 0 33422 0 192407 0 23088 0 597787 0 0 MICHAEL P TRAINER VP & TREAS/CFO(RET 7/26/2019) 0 301848 0 175000 0 130453 0 5600 0 6033 0 618934 0 0 ALICIA LAMANCUSA DIRECTOR/VP FINANCE 0 256410 0 52717 0 566 0 174575 0 8915 0 493183 0 0 ROBERT MCGREGOR MD DIRECTOR/CHIEF MEDICAL OFFICER 0 498459 0 150000 0 22135 0 114495 0 17585 0 802674 0 0 ANTHEA DANIELS VP CLAIMS/CHIEF LEGAL OFFICER 0 382323 0 73259 0 1708 0 17723 0 1782 0 476795 0 0 LISA AURILIO DIRECTOR/CHIEF OPERATING OFF 0 494271 0 140000 0 43914 0 215492 0 9853 0 903530 0 0 SPENCER KOWAL VP & TREAS/CFO(BEG 7/19/2019) 0 211963 0 150000 0 38372 0 0 0 10372 0 410707 0 0 JOHN CROW MD DIRECTOR/CHAIR PED SURGERY 0 1067396 0 0 0 3612 0 21042 0 9380 0 1101430 0 0 PART 1, LINE 4B WILLIAM CONSIDINE IS A PARTICIPANT IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AS OF JANUARY 1, 2010. THE PLAN IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN. IT IS AN UNFUNDED PLAN MAINTAINED PRIMARILY FOR THE PURPOSE OF PROVIDING DEFERRED COMPENSATION BENEFITS. THE PARTICIPANT RECEIVES CREDITS IN THE PLAN FOR EACH FULL CALENDAR YEAR OF SERVICE AND HE IS 100% VESTED. THERE WERE NO PAYMENTS IN 2019. THE FOLLOWING INDIVIDUALS BECAME PARTICIPANTS IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS DURING 2018, WHEREBY THEY BECOME VESTED PER THE TERMS OF THEIR EMPLOYMENT AGREEMENT. CHMCA IS ACCRUING FOR THE BENEFIT THAT WILL OCCUR, THEREFORE THESE AMOUNTS ARE INCLUDED IN THEIR DEFERRED COMPENSATION. NO DISTRIBUTIONS WERE MADE IN 2019. GRACE WAKULCHIK SHAWN LYDEN LISA AURILIO ROBERT MCGREGOR M.D. SPENCER KOWAL PART II, COLUMN C INCLUDED IN RETIREMENT AND DEFERRED COMPENSATION IS THE CHANGE IN THE PRESENT VALUE OF THE ACCRUED BENEFITS FROM THE PENSION PLAN OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FOR THOSE PERSONS THAT ARE PARTICIPATING IN THE DEFINED BENEFIT PLAN. PART III - ADDITIONAL INFORMATION CHILD DIMENSIONS INSURANCE GROUP RELIES ON THE RELATED ORGANIZATION, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, TO ESTABLISH THE TOP MANAGMENT OFFICIAL'S COMPENSATION. CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON'S EXECUTIVE TOTAL COMPENSATION PROGRAM IS ULTIMATELY GOVERNED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. AN INDEPENDENT SALARY SURVEY WAS COMPLETED IN 2019 AND RECOMMENDATIONS WERE PROVIDED AND PRESENTED BY THE INDEPENDENT CONSULTANT TO THE COMMITTEE FOR APPROVAL. PART 1, LINE 1 - ORGANIZATION'S MISSION CHILD DIMENSIONS INSURANCE COMPANY (CDIC) TRANSACTS BUSINESS AS A CAPTIVE INSURANCE COMPANY. CDIC PROVIDES HOSPITAL, PROFESSIONAL, GENERAL AND EXCESS LIABILITY COVERAGE TO CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON AND ITS SUBSIDIARIES. PART VI, SECTION A, LINE 6 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON IS THE SOLE STOCKHOLDER OF CHILD DIMENSIONS INSURANCE COMPANY. PART VI, SECTION A, LINE 7A CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON IS THE SOLE STOCKHOLDER OF CHILD DIMENSIONS INSURANCE COMPANY AND ITS GOVERNING BODY HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (PARENT) FOR REVIEW AND DISCUSSION PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. THE AUDIT COMMITTEE IS A COMMITTEE OF THE BOARD OF DIRECTORS AND EMPOWERED TO COMPLETE THE REVIEW ON BEHALF OF THE BOARD OF DIRECTORS. PART VI, SECTION B, LINE 12C IT IS THE POLICY OF CDIC THAT ALL OFFICERS, DIRECTORS, AND EMPLOYEES DISCLOSE REAL OR APPARENT CONFLICTS OF INTEREST AS A CONDITION OF BOARD MEMBERSHIP WITH CDIC. SINCE CDIC HAS NO EMPLOYEES, ONLY OFFICERS AND DIRECTORS DISCLOSE, IN WRITING, ON AN ANNUAL BASIS, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS IN WHICH HE/SHE IS AN OFFICER, MEMBER, OWNER, SHAREHOLDER, TRUSTEE OR EMPLOYEE FOR WHICH HE/SHE ACTS AS AN AGENT OR MIGHT REASONABLY IN THE NEAR FUTURE ENTER INTO A RELATIONSHIP OR TRANSACTION IN WHICH HE/SHE COULD HAVE A DUALITY OF INTEREST. ANY SITUATIONS THAT ARISE ARE REVIEWED AT THE ANNUAL MEETING. EACH OFFICER AND DIRECTOR OF CDIC COMPLETES AN ANNUAL CONFLICT OF INTEREST MEETING THE REQUIREMENTS OF SECTION 12 OF REGULATION C-81-2 OF THE VERMONT DEPARTMENT OF FINANCIAL REGULATION. IF A SITUATION ARISES IN WHICH THERE IS A DUALITY OF INTEREST OR A QUESTION OF DUALITY ON INTEREST AND, AS SUCH, POTENTIAL FOR A CONFLICT OF INTEREST, IT IS THE PRIMARY RESPONSIBILITY OF THE INDIVIDUAL DIRECTLY INVOLVED AND RESPONSIBILITY OF OTHER PERSONNEL, TO THE EXTENT THAT THEY BECOME AWARE OF A DUALITY OF INTEREST, TO MAKE IMMEDIATE AND COMPLETE WRITTEN DISCLOSURE TO THE BOARD. THEY WILL REVIEW THE SITUATION AND TAKE ANY NECESSARY ACTION. IT IS THE RESPONSIBILITY OF THE BOARD TO EVALUATE ANY CIRCUMSTANCES IN WHICH A DUALITY OF INTEREST EXISTS TO DETERMINE WHETHER THE DUALITY REPRESENTS THE POTENTIAL FOR A CONFLICT OF INTEREST, AND WHETHER SUCH CONFLICT IS SO SUBSTANTIAL THAT IT IS DEEMED DETRIMENTAL TO CDIC. PART VI, SECTION B, LINE 15 CDIC RELIES ON THE RELATED ORGANIZATION, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. CHILDREN'S HOSPITAL MED CENTER OF AKRON ONE PERKINS SQUARE AKRON OH 44308 340714357 HOSPITAL OH 501(C)(3) 3 NA false AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON OH 44308 237114013 FOUNDATION OH 501(C)(3) 7 CHMCA false CHILDREN'S HOME CARE GROUP ONE PERKINS SQUARE AKRON OH 44308 341575266 HOME CARE OH 501(C)(3) 12A, I CHMCA false false false false false false false false false false false false false false false true true false false