2025-11-14T12:52:56-06:00 2024-12-31 135565207 KPMG LLP 350 NORTH 5TH ST STE 600 MINNEAPOLIS MN 55401 990 2024-01-01 411843804 MEDICA COMMUNITY HEALTH PLAN MEDI 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 KRISTA DUSIL CFO 9529922058 2025-11-12 1 0 HOLLY MOEN P01800653 6123055000 2025-11-12 2024 2025-03-06 01:10:19Z ELIZABETH ERICKSON 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 149518018 0 X WWW.MEDICA.COM X 1996 WI TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 11 9 0 0 0 0 0 0 149373340 131028366 2681488 3441252 0 0 152054828 134469618 0 0 119095421 137376295 0 0 0 0 0 14820598 12807559 133916019 150183854 18138809 -15714236 148944995 138195533 30488524 34889774 118456471 103305759 X TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 0 0 137376295 131028366 SEE SCHEDULE O 137376295 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 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 0 0 1 14687 0 1 0 0 0 0 0 0 0 0 0 X 11 9 0 1 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X KRISTA DUSIL 9529923908 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 X ELIZABETH F ERICKSON PRESIDENT, CEO, & TREAS THRU 1/2024 0.00 40.00 X X 0 1669649 201202 JOHN BUCK DIRECTOR & CHAIR 0.00 15.00 X X 0 145250 0 JOHN STANOCH DIRECTOR & VICE CHAIR 0.00 10.00 X X 0 128500 0 MARY TWINEM DIRECTOR 0.00 10.00 X 0 90250 0 PETER KELLEY DIRECTOR 0.00 10.00 X 0 94750 0 RAJ AGGARWAL DIRECTOR 0.00 10.00 X 0 100000 0 BRIGID BONNER DIRECTOR 0.00 10.00 X 0 98750 0 GAYE ADAMS MASSEY DIRECTOR 0.00 10.00 X 0 87750 0 EARL STRATTON DIRECTOR 0.00 10.00 X 0 95250 0 MARY P QUIST SR. VP, FINANCE THRU 6/2024 0.00 40.00 X X 0 604708 35245 UGWUJI MADUEKWE DIRECTOR 0.00 10.00 X 0 18500 0 ALICIA REUTER SVP, CHIEF LEGAL OFFICER, & SEC 0.00 40.00 X X 0 408482 72742 KRISTA DUSIL SVP, CFO, & TREASURER 0.00 40.00 X 0 804123 116115 SAM LEON FORMER DIRECTOR 0.00 10.00 X 0 23250 0 MARK L BAIRD FORMER SVP & CFO 0.00 0.00 X 0 370125 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNS 0.00 0.00 X 0 403815 0 DAVID H ELLENBOGEN FORMER SVP SEC & GEN COUNSEL 0.00 40.00 X 0 224611 1619 JOHN NAYLOR FORMER PRESIDENT & CEO 0.00 40.00 X 0 565230 0 0 5932993 426923 0 1 1 0 MEDICA SERVICES COMPANY 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 LEASED EMPLOYEES 5569683 1 PREMIUM REVENUE 524114 131028366 131028366 131028366 3803271 3803271 14686381 15048400 -362019 -362019 -362019 134469618 131028366 0 3441252 137376295 137376295 56550 56550 16558 16558 3208 3208 1951160 1951160 271874 271874 101457 101457 902302 902302 104213 104213 20399 20399 8752 8752 666927 666927 50783 50783 LEASED EMPLOYEES 5569683 5569683 OTHER EXPENSES 2032691 2032691 PREMIUM TAXES 912883 912883 PRINTING & PUBLICATION 138119 138119 150183854 137376295 12807559 0 30600320 23981762 13359638 7750930 87083250 89157391 17901787 17305450 148944995 138195533 913433 744554 762782 1140582 28812309 33004638 30488524 34889774 X 0 0 0 0 118456471 103305759 118456471 103305759 148944995 138195533 X -15714236 563524 X 0 1 X 1 0 0 OTHER LT SECURITIES 89157391 F 89157391 INVESTMENT INTEREST RECEIVABLE 834117 CSR RECEIVABLE 232936 HEALTHCARE RECEIVABLE 2156650 REINSURANCE 14081747 17305450 INTERCOMPANY PAYABLE 12544300 CLAIMS PAYABLE 17594435 SECURITIES PAYABLE 247332 ACCRUED MEDICAL INCENTIVE POOL AND BONUS AMOUNTS 2618571 33004638 X 134469618 0 134469618 0 134469618 150183854 0 150183854 0 150183854 PART X, LINE 2: THE COMPANY RECOGNIZES 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 TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. 1 1 0 0 0 1 1 0 0 ELIZABETH F ERICKSON PRESIDENT, CEO, & TREAS THRU 1/2024 0 985480 0 522989 0 161180 0 160811 0 40391 0 1870851 0 152285 KRISTA DUSIL SVP, CFO, & TREASURER 0 428011 0 300026 0 76086 0 91882 0 24233 0 920238 0 0 MARY P QUIST SR. VP, FINANCE THRU 6/2024 0 185247 0 355809 0 63652 0 13800 0 21445 0 639953 0 58545 JOHN NAYLOR FORMER PRESIDENT & CEO 0 0 0 0 0 565230 0 0 0 0 0 565230 0 208756 ALICIA REUTER SVP, CHIEF LEGAL OFFICER, & SEC 0 244472 0 125026 0 38984 0 55274 0 17468 0 481224 0 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNS 0 0 0 0 0 403815 0 0 0 0 0 403815 0 126993 MARK L BAIRD FORMER SVP & CFO 0 0 0 124000 0 246125 0 0 0 0 0 370125 0 43667 DAVID H ELLENBOGEN FORMER SVP SEC & GEN COUNSEL 0 11188 0 0 0 213423 0 453 0 1166 0 226230 0 213151 SAM LEON FORMER DIRECTOR 0 23250 0 0 0 0 0 0 0 0 0 23250 0 0 PART I, LINE 3 MEDICA COMMUNITY HEALTH PLAN, THE FILING ORGANIZATION DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA SERVICES COMPANY, A RELATED ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA HEALTH PLANS UTILIZES THE FOLLOWING; COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 7 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATION'S OPERATING EARNINGS. PART I, LINE 4B: THE FOLLOWING RECEIVED A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA SERVICES COMPANY, A RELATED ORGANIZATION: MARK L. BAIRD - $43,667 KRISTA DUSIL - $73,769 DAVID H. ELLENBOGEN - $213,151 ELIZABETH F. ERICKSON - $152,285 JAMES P. JACOBSON - $126,993 JOHN W. NAYLOR - $208,756 ALICIA REUTER - $37,500 MARY P. QUIST - $58,545 FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: MEDICA COMMUNITY HEALTH PLAN (THE COMPANY) IS ORGANIZED AND SHALL BE OPERATED FOR THE PROMOTION OF SOCIAL WELFARE, INCLUDING THE OPERATION OF A HEALTH INSURANCE ORGANIZATION AND OTHER ACTIVITIES INCIDENTAL THERETO. IT IS A WHOLLY OWNED SUBSIDIARY OF MEDICA HOLDING COMPANY (MHC) WHICH IS A NON-PROFIT, TAX EXEMPT CORPORATION. THE COMPANY IS TAX-EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. THE COMPANY OFFERS COMPREHENSIVE HEALTH CARE COVERAGE; PRODUCTS ARE QUALIFIED HEALTH PLANS (QHPS). QHPS ARE DEFINED BY THE AFFORDABLE CARE ACT (ACA) AND FALL WITHIN THE METAL LEVELS GOLD, SILVER AND BRONZE, AS WELL AS CATASTROPHIC FOR THOSE UNDER AGE 30 OR THOSE WITH A HARDSHIP (AS DEEMED BY THE EXCHANGE). ADDITIONALLY, THE PRODUCTS FOLLOW THE RESPECTIVE ESSENTIAL HEALTH BENEFITS (EHBS), ABOVE AND BEYOND THOSE REQUIRED OF QHPS BY THE ACA, AS DETERMINED BY THE BENCHMARK/DEFAULT PLAN (AS DEFINED BY ACA) FOR WISCONSIN AND ARIZONA. THE QHP PRODUCT, ESSENTIA CHOICE CARE WITH MEDICA, IS AVAILABLE IN WESTERN WISCONSIN, NORTHERN MINNESOTA, AND EASTERN NORTH DAKOTA. THE ESSENTIA CHOICE CARE PRODUCT FEATURES ACCESS TO ESSENTIA HEALTH DOCTORS PLUS OTHERS WITH OVER 3,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, ENGAGE BY MEDICA, IS AVAILABLE IN WESTERN WISCONSIN AND SOUTHEASTERN MINNESOTA. THE ENGAGE BY MEDICA PRODUCT FEATURES ACCESS TO MAYO CLINIC HEALTH SYSTEM DOCTORS PLUS OTHERS IN NORTHERN IOWA, SOUTHERN MINNESOTA, AND WESTERN WISCONSIN, WITH OVER 12,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, MEDICA PINNACLE, IS AVAILABLE IN MARICOPA COUNTY, ARIZONA. THE MEDICA PINNACLE PRODUCT FEATURES ACCESS TO ARIZONA CARE NETWORK, DIGNITY HEALTH, AND PHOENIX CHILDREN'S, WITH OVER 4,400 PRIMARY AND SPECIALTY CARE PROVIDERS. THE COMPANY CONTRACTS WITH PROVIDERS IN WISCONSIN, MINNESOTA, SOUTH DAKOTA, NORTH DAKOTA, NEBRASKA AND IOWA TO MAKE HEALTH CARE SERVICES AVAILABLE TO ITS ENROLLEES. THE PROVIDER CONTRACTS INCLUDE HOLD-HARMLESS PROVISIONS FOR THE PROTECTION OF POLICYHOLDERS. THE CONTRACTS HAVE A ONE- OR TWO-YEAR TERM AND MAY BE TERMINATED IMMEDIATELY FOR BREACH OF CONTRACT IF THE PROVIDER LOSES HIS/HER LICENSE TO PROVIDE CONTRACTED SERVICES. HOSPITALS ARE REIMBURSED USING A VARIETY OF METHODS INCLUDING FEE-FOR-SERVICE (FFS), DISCOUNTED FFS, PER DIEM, PER CASE AND/OR PER STAY BASIS. THE COMPANY CURRENTLY MARKETS DIRECTLY TO INDIVIDUALS, USING INDEPENDENT AGENCIES, PAYING A FLAT DOLLAR COMMISSION ON NEW AND RENEWAL BUSINESS. THE COMPANY ALSO MARKETS POLICIES DIRECTLY ONLINE AND OVER THE PHONE. DURING 2020, THE COMPANY STARTED OFFERING MEDICARE ADVANTAGE PRODUCTS IN NEBRASKA. DURING 2023, MEDICARE ADVANTAGE ENROLLMENT WAS 782 MEMBERS, OR 5.4% OF MCHP'S TOTAL ENROLLMENT. IN 2024, MCHP NO LONGER OFFERED MEDICARE ADVANTAGE PRODUCTS. FORM 990, PART VI, SECTION A, LINE 3 MEDICA COMMUNITY HEALTH PLAN HAS ENTERED INTO AN ADMINISTRATIVE SERVICE AGREEMENT WITH MEDICA SERVICES COMPANY (MSC), A RELATED TAXABLE ORGANIZATION. THROUGH THIS AGREEMENT, MSC LEASES ITS EMPLOYEES AND PROVIDES VARIOUS MANAGEMENT/ADMINISTRATIVE SERVICES TO MEDICA COMMUNITY HEALTH PLAN AND MEDICA COMMUNITY HEALTH PLAN PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE POLICY HOLDERS ARE CONSIDERED MEMBERS, BUT DO NOT PAY DUES. FORM 990, PART VI, SECTION B, LINE 11B MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S FINANCE STAFF REVIEWS THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL EMPLOYEES OF MEDICA SERVICES COMPANY AND DIRECTORS OF ALL MEDICA ENTITIES COMPLETE A CONFLICT-OF-INTEREST DISCLOSURE AND ARE REQUIRED TO REVIEW THE CURRENT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 MEDICA COMMUNITY HEALTH PLAN DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION WHICH USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION: A COMPENSATION COMMITTEE REVIEWS AND OBTAINS THE BOARD'S APPROVAL FOR TOTAL COMPENSATION FOR THE PRESIDENT/CEO. THE COMMITTEE ALSO REVIEWS AND APPROVES TOTAL COMPENSATION RECOMMENDATIONS MADE BY THE CEO FOR THE EXECUTIVE AND SENIOR VICE PRESIDENTS, AND REVIEWS ALL OFFICER COMPENSATION AND ANNUAL PERFORMANCE GOALS APPROVED BY THE CEO. THE COMMITTEE REVIEW AND MAKES RECOMMENDATIONS TO THE BOARD REGARDING OFFICER AND NON-OFFICER COMPENSATION GUIDELINES FOR MEDICA AND ITS SUBSIDIARIES, PERIODICALLY REVIEWING MARKET DATA TO ASSESS MEDICA'S COMPETITIVE POSITION. FORM 990, PART VI, SECTION C, LINE 19 MEDICA DOES NOT CONSIDER ITS CONFLICT-OF-INTEREST POLICY TO BE A CONFIDENTIAL OR PROPRIETARY DOCUMENT. THEREFORE, MEDICA WOULD MAKE THIS POLICY AVAILABLE TO ANYONE WHO REQUESTS IT. CERTAIN MEDICA ENTITIES ARE REQUIRED TO FILE ANNUAL FINANCIAL STATEMENTS WITH THE REGULATORS. MEDICA CONSIDERS FINANCIAL STATEMENTS THAT ARE FILED WITH THE REGULATORS TO BE PUBLIC DOCUMENTS. FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FORM 990S ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1: CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN ALL ENTITIES UNDER MEDICA HOLDING COMPANY. THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. THE FOLLOWING CHANGES TO THE OFFICERS OF MEDICA COMMUNITY HEALTH PLAN OCCURRED DURING THE TAXABLE PERIOD: IN 2024 KRISTA DUSIL WAS APPOINTED AS CHIEF FINANCIAL OFFICER OF THE ORGANIZATION. FORM 990, PART VII JOHN STANOCH'S BOARD STIPEND WAS PAID TO JNN VENTURES INC . FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS 563,524. MEDICA HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411242261 HEALTH COVERAGE MN 501(C)(4) N/A MHC 0 MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) LINE 12B MHC 0 MEDICA HOLDING COMPANY (MHC) 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING COMPANY MN 501(C)(4) N/A N/A 0 MEDICA CENTRAL HEALTH PLAN INC 10101 WOODFIELD LANE ST LOUIS MO 63132 831979548 HEALTH COVERAGE MO 501(C)(4) N/A MFCJVN 0 MS COMMUNITY NFP JV LLC (MFCJVN) 401 CARLSON PARKWAY MINNETONKA MN 55305 873268926 MN 0 0 0 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MAS C 0 MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMIN MN MAS C 0 MEDICA HEALTH MANAGMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MANAGEMENT MN MAS C 0 MEDICA AFFILIATED SERVICES (MAS) 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MHC C 0 MMSI INC 401 CARLSON PARKWAY MINNETONKA MN 55305 411547003 THIRD PARTY ADMIN MN MAS C 0 MEDICA SERVICES COMPANY LLC 401 CARLSON PARKWAY MINNETONKA MN 55305 852902940 ADMIN. SERVICES MN MAS C 0 DEAN HEALTH PLAN INC 1277 DEMING WAY MADISON WI 53717 391535024 HEALTH INSURANCE WI DHI C 0 DEAN HEALTH INSURANCE INC (DHI) PO BOX 56099 MADISON WI 53705 391830837 HEALTH INSURANCE WI MSCJV C 0 MEDICA CENTRAL INSURANCE COMPANY 10101 WOODFIELD LANE ST LOUIS MO 63132 834718249 HEALTH INSURANCE MO MSCJV C 0 DEAN HEALTH SERVICES COMPANY LLC 1277 DEMING WAY MADISON WI 53717 842933639 ADMIN. SERVICES WI MSCJV C 0 MS COMMUNITY JV LLC (MSCJV) 401 CARLSON PARKWAY MINNETONKA MN 55305 873240022 HOLDING COMPANY MN MHC C 0 MEDICA REGIONAL INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 854111612 HEALTH INSURANCE MN MAS C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0