2015-11-10T11:05:22-06:00 2014-12-31 521446779 JOHNSON LAMBERT LLP 700 SPRING FOREST ROAD STE 115 RALEIGH NC 27609 990 2014-01-01 461056754 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY CHES 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 4104942000 2015-11-10 1 JOHN HUSKINS P01081531 9197196400 2015-11-10 2014 2016-03-07 17:11:31Z THOMAS PHELAN 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 633453862 0 X WWW.CEIWC.COM X 2012 MD CHESAPEAKE EMPLOYERS' INSURANCE COMPANY WAS ESTABLISHED BY STATUTE TO BE THE WORKERS' COMPENSATION INSURER OF LAST RESORT AS WELL AS A COMPETITIVE INSURER IN THE STATE OF MARYLAND. 9 9 184 0 0 0 0 0 56547698 228711230 16953345 93507680 187107 653179 73688150 322872089 0 115000 0 0 26740502 50568433 0 0 0 50759237 222273780 77499739 272957213 -3811589 49914876 1868899594 1998234981 1528170409 1606143006 340729185 392091975 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY WAS ESTABLISHED BY STATUTE TO BE THE WORKERS' COMPENSATION INSURER OF LAST RESORT AS WELL AS A COMPETITIVE INSURER IN THE STATE OF MARYLAND. 0 0 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY HAD OVER 21,000 IN-FORCE POLICIES AND WAS MANAGING MORE THAN 5,100 OPEN CLAIMS AT DECEMBER 31, 2014. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2007 0 1 184 1 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X FRANCIS LINARDI 4104942000 8722 LOCH RAVEN BLVD TOWSON MD 212862235 PAUL V GILL SR DIRECTOR 1.50 0.50 X 33334 0 12936 WAYNE R GIOIOSO SR DIRECTOR 1.50 0.50 X 38449 0 3112 LEONARD SCHULER DIRECTOR 1.50 0.50 X 37187 0 10285 IVORY E TUCKER DIRECTOR 1.50 0.50 X 38969 0 3153 MARIA TILDON DIRECTOR (FROM JUNE 2014) 1.50 0.50 X 16869 0 1349 KENNETH NWAFOR DIRECTOR (TO JUNE 2014) 1.50 0.50 X 16403 0 5708 LEWIS C POWELL CHAIRMAN 1.50 0.50 X X 36057 0 17199 CHARLES DANKMEYER VICE CHAIRMAN 1.50 0.50 X X 41492 0 3319 JOSEPH M COALE TREASURER 1.50 0.50 X X 40973 0 3278 VINCENT ROCKY GONZALEZ SECRETARY 1.50 0.50 X X 40973 0 3059 THOMAS PHELAN PRESIDENT 30.00 10.00 X 366379 0 37782 TIMOTHY MICHELS CHIEF OPERATING OFFICER 30.00 10.00 X 206923 0 46411 PAIGE BECK CHIEF ADMINISTRATIVE OFFIC 30.00 10.00 X 207722 0 43643 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 30.00 10.00 X 173083 0 27343 DENNIS CARROLL GENERAL COUNSEL 30.00 10.00 X 261690 0 38827 PAULETTE LUNDY VICE PRESIDENT 30.00 10.00 X 180376 0 14603 DONNA C WILSON SENIOR VICE PRESIDENT 30.00 10.00 X 177555 0 31278 RONA FINKELSTEIN SENIOR VICE PRESIDENT 30.00 10.00 X 174865 0 32502 RIAL SIMONS CHIEF ACTUARY 30.00 10.00 X 153974 0 15149 ROBERT MARSHALL VICE PRESIDENT 30.00 10.00 X 152737 0 21740 J JOSEPH CURRAN JR ASSISTANT VICE PRESIDENT 30.00 10.00 X 169508 0 13561 ANUJ JAIN CONSULTANT 30.00 10.00 X 159507 0 12761 STEVEN ADAMS CONSULTANT 30.00 10.00 X 148894 0 33028 DEREK MEEKS ASSISTANT VICE PRESIDENT 30.00 10.00 X 147776 0 19799 SHARON ROWELL ASSISTANT VICE PRESIDENT 30.00 10.00 X 146569 0 23936 3168264 0 475761 70 0 1 0 EXPRESS SCRIPTS INC ONE EXPRESS WAY MS HQ2E04 ST LOUIS MO 63121 MEDICAL/HEALTH SERVICES 5731121 UNIVERSITY OF MD MEDICAL SYSTEM CORP 11 S PACA ST STE LL BALTIMORE MD 21201 MEDICAL/HEALTH SERVICES 2179838 VGM GROUP INC PO BOX 1860 WATERLOO IA 50704 MEDICAL/HEALTH SERVICES 1767877 ASSET ALLOCATION & MANAGEMENT COMPANY LL 30 W MONROE 3RD FLOOR CHICAGO IL 60603 INVESTMENT SERVICES 1271360 UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 MEDICAL/HEALTH SERVICES 1127399 103 PREMIUMS EARNED 524150 228711230 228711230 228711230 55331059 55331059 348758394 310581773 38176621 38176621 38176621 MISCELLANEOUS INCOME 900099 653179 653179 653179 322872089 229364409 0 93507680 X 115000 2768686 23037247 19373230 3548277 1840993 840664 4143171 31559841 2059296 2531093 1472425 2165883 385379 263881 3253856 618492 LOSSES 160640093 TAXES, LICENSES, FEES 10496974 1842732 272957213 14785893 5389433 39931518 69746020 78908205 78025388 34339705 22519954 18119861 11819751 1531582426 1590727855 44238251 76204289 141333440 166322245 1868899594 1998234981 17310622 16853783 109964629 108038161 1400895158 1481251062 1528170409 1606143006 X 338729185 390091975 2000000 2000000 340729185 392091975 1868899594 1998234981 X 49914876 7933865 -6485951 X 0 1 X 1 0 1335400 1335400 14206861 6362078 7844783 18797444 16157876 2639568 11819751 RECEIVABLES FOR SECURITIES 1309908 SECURITIES LENDING REINVESTED COLLATERAL ASSETS 127527930 INVESTMENT INCOME, DUE AND ACCRUED 11105669 FUND HELD BY REINSURED COMPANIES 1111130 RECEIVABLES FROM AFFILIATE 11141957 OTHER ASSETS 740001 AMOUNTS RECOVERABLE FROM REINSURERS 13250000 AMOUNTS RECEIVABLE FOR TPA SERVICES 135650 166322245 LOSSES 1254427000 LOSS ADJUSTMENT EXPENSES 98893000 FUNDS HELD BY COMPANY UNDER REINSURANCE TREATY 264000 PROVISION FOR REINSURANCE 20000 PAYABLE FOR SECURITIES LENDING 127527930 DIVIDENDS 119132 1481251062 316624450 0 316624450 6247639 6247639 322872089 266709574 0 266709574 6247639 6247639 272957213 X 0 1 0 THOMAS PHELAN PRESIDENT 360962 0 0 0 5417 0 37782 0 0 0 404161 0 0 0 TIMOTHY MICHELS CHIEF OPERATING OFFICER 198729 0 0 0 8194 0 32125 0 14286 0 253334 0 0 0 PAIGE BECK CHIEF ADMINISTRATIVE OFFIC 199448 0 0 0 8274 0 30619 0 13024 0 251365 0 0 0 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 173083 0 0 0 0 0 14123 0 13220 0 200426 0 0 0 DENNIS CARROLL GENERAL COUNSEL 257468 0 0 0 4222 0 20800 0 18027 0 300517 0 0 0 PAULETTE LUNDY VICE PRESIDENT 180330 0 0 0 46 0 14603 0 0 0 194979 0 0 0 DONNA C WILSON SENIOR VICE PRESIDENT 177555 0 0 0 0 0 14516 0 16762 0 208833 0 0 0 RONA FINKELSTEIN SENIOR VICE PRESIDENT 174865 0 0 0 0 0 14475 0 18027 0 207367 0 0 0 RIAL SIMONS CHIEF ACTUARY 153624 0 0 0 350 0 10064 0 5085 0 169123 0 0 0 ROBERT MARSHALL VICE PRESIDENT 152737 0 0 0 0 0 13521 0 8219 0 174477 0 0 0 J JOSEPH CURRAN JR ASSISTANT VICE PRESIDENT 167994 0 0 0 1514 0 13561 0 0 0 183069 0 0 0 ANUJ JAIN CONSULTANT 149575 0 0 0 9932 0 12761 0 0 0 172268 0 0 0 STEVEN ADAMS CONSULTANT 148894 0 0 0 0 0 12442 0 20586 0 181922 0 0 0 DEREK MEEKS ASSISTANT VICE PRESIDENT 139449 0 0 0 8327 0 6579 0 13220 0 167575 0 0 0 SHARON ROWELL ASSISTANT VICE PRESIDENT 142691 0 0 0 3878 0 9650 0 14286 0 170505 0 0 0 PART I, LINE 4B TIMOTHY MICHELS RECEIVED A PAYMENT TO A SUPPLEMENTAL NON-QUALIFIED PLAN IN THE AMOUNT OF $19,937 PAIGE BECK RECEIVED A PAYMENT TO A SUPPLEMENTAL NON-QUALIFIED PLAN IN THE AMOUNT OF $18,432 FRANCIS LINARDI RECEIVED A PAYMENT TO A SUPPLEMENTAL NON-QUALIFIED PLAN IN THE AMOUNT OF $3,503 ROBERT MARSHALL RECEIVED A PAYMENT TO A SUPPLEMENTAL NON-QUALIFIED PLAN IN THE AMOUNT OF $3,503 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION MEMBERS CONSIST OF THE 9 BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS, WHICH COMPOSE THE MEMBERS OF THE ORGANIZATION, ARE APPOINTED BY THE GOVERNOR OF THE STATE OF MARYLAND AND CONFIRMED BY THE MARYLAND STATE SENATE. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNOR OF MARYLAND RESERVES THE POWER TO REMOVE A BOARD MEMBER FOR INCOMPETANCE OR MISCONDUCT. FORM 990, PART VI, SECTION B, LINE 11 THE 990 TAX RETURN IS COMPLETED BY AN EXTERNAL ACCOUNTANT AND THE RETURN IS REVIEWED BY MANAGEMENT PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. ANY INSTANCES OF POTENTIAL CONFLICT ARE REVIEWED BY HUMAN RESOURCES OR THE GENERAL COUNSEL FOR THE APPROPRIATE RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO, EXECUTIVES, AND TOP MANAGEMENT POSITIONS ARE DETERMINED UPON THE COMPLETION OF AN ANNUAL EVALUATION AND IS BASED UPON INDIVIDUAL AND COMPANY PERFORMANCE AS WELL AS INDUSTRY CONSIDERATIONS AND OTHER BENCHMARK DATA. COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS AND COMPENSATION FOR OTHER EXECUTIVES AND TOP MANAGEMENT POSITIONS ARE DETERMINED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE UPON REQUEST AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 11G OTHER 8,971,971. COMMISSIONS 22,587,870. FORM 990, PART XI, LINE 9: CHANGE IN NON ADMITTED ASSETS -6,602,951. CHANGE IN PROVISION FOR REINSURANCE 117,000. INJURED WORKERS INSURANCE FUND 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862226 522127565 STATE SPONSORED WORKMENS' COMPENSATION INSURANCE MD 501(C)27 0 STATE OF MARYLAND 100 STATE CIRCLE ANNAPOLIS MD 21401 522006962 STATE GOVERNMENT MD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 INJURED WORKERS INSURANCE FUND Q 1743069