CADUCEUS INDEMNITY INSURANCE CORPORATION LTD: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CADUCEUS INDEMNITY INSURANCE CORPORATION LTD (EIN 99-0343363)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201321339349304447
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-13T16:48:07-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860683059 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEACHFLEISCHMAN PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 64130 | AddressLine1 |
| City | TUCSON | City |
| State | AZ | State |
| ZIP Code | 857284130 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990343363 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CADUCEUS INDEMNITY INSURANCE CORPORATION LTD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CADU | NameControl |
| Phone | 5206942700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 745 FORT STREET | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MISTY D HANSEN | Name |
| Title | TREASURER | Title |
| Phone | 5206942700 | Phone |
| Date Signed | 2013-05-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KAREN K MCCLOSKEY CPA | Name |
| PTIN | P00099644 | PTIN |
| Phone | 5203214600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | FARSHAD M SHIRAZI | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 N CAMPBELL AVENUE | AddressLine1 |
| City | TUCSON | City |
| State | AZ | State |
| ZIP Code | 85724 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17710242 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.UAHEALTH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | HI | StateLegalDomicile |
| Activity Or Mission Description | PURE CAPTIVE INSURANCE COMPANY WHOLLY-OWNED BY THE UNIVERSITY OF ARIZONA PHYSICIANS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 3 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5544095 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5230191 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3551969 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2041834 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9096064 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7272025 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1500 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5244170 | OtherExpensePriorYear |
| Other Expenses Current Year | 6846313 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5245670 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6846313 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3850394 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 425712 | RevenuesLessExpensesCY |
| Total Assets BOY | 55163584 | TotalAssetsBOY |
| Total Assets EOY | 65003556 | TotalAssetsEOY |
| Total Liabilities BOY | 18352265 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 27515675 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 36811319 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 37487881 | NetAssetsOrFundBalancesEOY |
| Mission Description | CADUCEUS INDEMNITY INSURANCE COPORATION, LTD. IS A WHOLLY-OWNED SUBSIDIARY OF THE UNIVERSITY OF ARIZONA PHYSICIANS AND WAS CREATED AS A PURE CAPTIVE INSURANCE COMPANY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6322115 | Expense |
| Revenue | 5230191 | Revenue |
| Description | INSURES THE UNIVERSITY OF ARIZONA PHYSICIANS ON A CLAIMS-MADE BASIS FOR MEDICAL PROFESSIONAL LIABILITY, MANAGED CARE PROFESSIONAL LIABILITY, AND DEFENSE COSTS. | Description |
| Total Program Service Expense | 6322115 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DONELLA FONES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5206942700 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 N CAMPBELL AVENUE | AddressLine1 |
| City | TUCSON | City |
| State | AZ | State |
| ZIP Code | 85724 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| KEVIN J BURNS | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 1880456 | 26542 |
| ROBERT GOSHAY | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| MISTY D HANSEN | ||||||
| TREASURER | 1.00 | X | X | 0 | 595126 | 91107 |
| SCOT STERENBERG | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| FARSHAD M SHIRAZI | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 341877 | 71296 |
| BRUCE M COULL | ||||||
| DIRECTOR | 1.00 | X | 0 | 378828 | 69668 | |
| LAURA EBERLY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3196287 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 258613 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROPES & GRAY LLP | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 12TH STREET NW SUITE 900 | AddressLine1 |
| City | WASHINGTON | City |
| State | DC | State |
| ZIP Code | 200053948 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | LEGAL SERVICE | DescriptionOfServices |
| Compensation | 110610 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DIRECT WRITTEN PREMIUM | Description |
| Business Code | 525190 | BusinessCode |
| Total Revenue Column | 5230191 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5230191 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5230191 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1517649 | TotalRevenueColumn |
| Exclusion | $1,517,649 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10962402 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10438217 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 524185 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 524185 | TotalRevenueColumn |
| Exclusion | $524,185 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7272025 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5230191 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,041,834 | ExclusionAmount |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63127 | Total |
| Management And General | 63127 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194329 | Total |
| Management And General | 194329 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27500 | Total |
| Management And General | 27500 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151847 | Total |
| Management And General | 151847 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87395 | Total |
| Management And General | 87395 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| LOSS RESERVE EXPENSE | 6307635 | 6307635 |
| UNDERWRITING EXPENSE | 14480 | 14480 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6846313 | Total |
| Program Services | 6322115 | ProgramServices |
| Management And General | 524198 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4989946 | BOY |
| EOY | 4085284 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14563 | BOY |
| EOY | 161349 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49947177 | BOY |
| EOY | 55829763 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 211898 | BOY |
| EOY | 4927160 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55163584 | BOY |
| EOY | 65003556 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73265 | BOY |
| EOY | 136817 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18279000 | BOY |
| EOY | 27378858 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18352265 | BOY |
| EOY | 27515675 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2500000 | BOY |
| EOY | 2500000 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34311319 | BOY |
| EOY | 34987881 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36811319 | BOY |
| EOY | 37487881 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55163584 | BOY |
| EOY | 65003556 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 425712 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 250850 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY PHYSICIANS HEALTHCARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942958258 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $6,846,313 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 6846313 | SumOfAmounts |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM THE UNIVERSITY OF ARIZONA PHYSICIANS HEALTHCARE | Description |
| Book Value | 4927160 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4927160 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THE UNIVERSITY OF ARIZONA PHYSICIANS HEALTHCARE | $36,197 |
| UNEARNED PREMIUM | $4,913,661 |
| RESERVE FOR LOSSES | $22,429,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 27378858 | TotalOfAmounts |
| Total Revenue | 7272025 | TotalRevenue |
| Total Expenses | 6846313 | TotalExpenses |
| Excess Or Deficit For Year | 425712 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 250850 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 250850 | TotalAdjustments |
| Excess Or Deficit Per FS | 676562 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 7522875 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 250850 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 250850 | RevenueNotRptdF990 |
| Revenue Subtotal | 7272025 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7272025 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 6846313 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 6846313 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 6846313 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | TAXES: THE COMPANY QUALIFIES FOR TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES IN THE ACCOMPANYING STATEMENTS OF OPERATIONS. HOWEVER, FOR THE STATE OF HAWAII, A 0.25 PERCENT GROSS PREMIUM TAX IS ASSESSED IN LIEU OF STATE INCOME AND GENERAL EXCISE TAXES. THE COMPANY HAS ADOPTED THE PROVISIONS OF THE INCOME TAXES TOPIC IN THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION. THE INCOME TAXES TOPIC CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE TOPIC AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE COMPANY HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED THAT THE ADOPTION OF THIS TOPIC DID NOT AFFECT THE FINANCIAL STATEMENT PRESENTATION. GENERALLY, THE COMPANY IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE AND LOCAL TAX AUTHORITIES FOR YEARS ENDED JUNE 30, 2008, AND BEFORE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN J BURNS | |||||||||||||
| 0 | 310302 | 0 | 286209 | 0 | 1283945 | 0 | 7055 | 0 | 19487 | 0 | 1906998 | 0 | 0 |
| MISTY D HANSEN | |||||||||||||
| 0 | 395981 | 0 | 196796 | 0 | 2349 | 0 | 75461 | 0 | 15646 | 0 | 686233 | 0 | 0 |
| FARSHAD M SHIRAZI | |||||||||||||
| 0 | 223677 | 0 | 116900 | 0 | 1300 | 0 | 52806 | 0 | 18490 | 0 | 413173 | 0 | 0 |
| BRUCE M COULL | |||||||||||||
| 0 | 374447 | 0 | 0 | 0 | 4381 | 0 | 50254 | 0 | 19414 | 0 | 448496 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINES 4A-B | KEVIN J. BURNS RECEIVED $1,281,641 IN SEVERANCE PAYMENTS IN ACCORDANCE WITH THE EMPLOYMENT CONTRACT. THE FOLLOWING PEOPLE PARTICIPATED IN OR RECEIVED PAYMENTS FROM A NON-QUALIFIED RETIREMENT PLAN: KEVIN J. BURNS $286,209 AND MISTY D. HANSEN $52,050. | |
| PART III | PART I, LINE 3: THE ORGANIZATION DOES NOT COMPENSATE THE PRESIDENT, BUT RATHER RELIES ON ITS RELATED ORGANIZATION THE UNIVERSITY OF ARIZONA HEALTH NETWORK, WHICH USED THE FOLLOWING TO ESTABLISH COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OF DIRECTORS OR COMPENSATION COMMITTEE. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE CORPORATION EMPLOYS MARSH MANAGEMENT SERVICES TO MANAGE DAILY OPERATIONS. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE UNIVERSITY OF ARIZONA PHYSICIANS IS A THE SOLE MEMBER OF CADUCEUS INDEMNITY INSURANCE CORPORATION, LTD. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE UNIVERSITY OF ARIZONA PHYSICIANS, AS SOLE MEMBER OF CADUCEUS INDEMNITY INSURANCE CORPORATION, MAY ELECT MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BYLAWS PROVIDE FOR SPECIFIC MATTERS THAT ARE RESERVED FOR APPROVAL FROM THE MEMBER. MAJOR ACTIVITIES ARE ALSO SUBJECT TO REVIEW BY THE MEMBER. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS AND BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. ANY REPORTED CONFLICT OF INTEREST IS REVIEWED BY GENERAL COUNSEL, PRESIDENT AND THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 250,850. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ARIZONA BOARD OF REGENTS | |||||||||||
| 2020 N CENTRAL AVENUE | PHOENIX | AZ | 85004 | 866004791 | GOVERNING BOARD OF ARIZONA'S PUBLIC UNIVERSITIES | AZ | N/A | 0 | |||
| THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE | |||||||||||
| 888 N EUCLID | TUCSON | AZ | 85719 | 742652689 | PUBLIC UNIVERSITY | AZ | 0 | ARIZONA BOARD OF REGENTS | |||
| THE UNIVERSITY OF ARIZONA HEALTH NETWORK INC | |||||||||||
| 1501 N CAMPBELL AVENUE | TUCSON | AZ | 85724 | 272936985 | ENHANCE RELATIONSHIP BETWEEN UAMCC AND UAP | AZ | 0 | ARIZONA BOARD OF REGENTS | 501(C)(3) | LINE 11B, II | |
| UNIVERSITY MEDICAL CENTER CORPORATION | |||||||||||
| 1501 N CAMPBELL AVENUE | TUCSON | AZ | 85724 | 860492210 | HEALTHCARE | AZ | 0 | THE UNIVERSITY OF ARIZONA HEALTH NETWORK | 501(C)(3) | LINE 3 | |
| UNIVERSITY PHYSICIANS HEALTHCARE | |||||||||||
| 2701 E ELVIRA ROAD | TUCSON | AZ | 85756 | 942958258 | HEALTHCARE | AZ | 0 | THE UNIVERSITY OF ARIZONA HEALTH NETWORK | 501(C)(3) | LINE 3 | |
| UNIVERSITY MEDICAL CENTER FOUNDATION | |||||||||||
| 1501 N CAMPBELL AVENUE | TUCSON | AZ | 85724 | 860572438 | FUNDRAISING | AZ | 0 | UNIVERSITY MEDICAL CENTER CORPORATION | 501(C)(3) | LINE 11A, I | |
| UNIVERSITY PHYSICIANS HEALTHCARE FOUNDATION | |||||||||||
| 2701 E ELVIRA ROAD | TUCSON | AZ | 85756 | 202826747 | FUNDRAISING | AZ | 0 | UNIVERSITY PHYSICIANS HEALTHCARE | 501(C)(3) | LINE 11A, I | |
| DEVICE PRESERVATION INC | |||||||||||
| 1501 N CAMPBELL AVENUE | TUCSON | AZ | 85724 | 860687598 | SUPPORT | AZ | 0 | UNIVERSITY MEDICAL CENTER CORPORATION | 501(C)(3) | LINE 11A, I | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UM LEASING LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4291 N CAMPBELL AVENUE | AddressLine1 |
| City | TUCSON | City |
| State | AZ | State |
| ZIP Code | 85724 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203400643 | EIN |
| Primary Activity | LEASING | PrimaryActivity |
| Legal Domicile State | AZ | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UMCC INSURANCE FUNDING LIMITED | ||||||||||||
| PO BOX 1051 GEORGETOWN | GRAND CAYMAN KY1-1102 | CJ | 980116943 | CAPTIVE INSURANCE | CJ | N/A | C | |||||
| THE UNIVERSITY OF ARIZONA HEALTH PLANS - UNIVERSITY HEALTHCARE INC | ||||||||||||
| 454370907 | HEALTH INSURANCE | N/A | C | 2701 E ELVIRA ROAD | TUCSON | AZ | 85756 | AZ | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |