2011-11-15T08:37:19-06:00 2010-12-31 RSM MCGLADREY INC 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2010-01-01 411242261 MEDICA HEALTH PLANS MEDI 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 AARON REYNOLDS 9529922058 2011-11-14 1 COLLIN F BUZZELL 6125738750 2010 2016-02-24 21:20:13Z DAVID TILFORD 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 1724880450 0 X WWW.MEDICA.COM X 1973 MN MEDICA'S MISSION IS TO MEET OUR CUSTOMERS' NEED FOR HEALTH PLAN PRODUCTS AND SERVICES. IN DOING SO, WE WORK WITH OUR MEMBERS AND PROVIDERS TO MAKE HEALTH CARE ACCESSIBLE, AFFORDABLE AND A MEANS BY WHICH OUR MEMBERS IMPROVE THEIR HEALTH. 12 11 1193 0 2302666 -330334 0 0 1367530236 1706184411 20797269 19424490 -424856 -728451 1387902649 1724880450 5000000 11526241 1237406667 1565038859 116496142 98487054 0 0 0 -20172724 21434630 1338730085 1696486784 49172564 28393666 586325665 675307053 225052658 275977683 361273007 399329370 X MEDICA'S MISSION IS TO MEET OUR CUSTOMERS' NEEDS FOR HEALTH PLAN PRODUCTS AND SERVICES. IN DOING SO, WE WORK WITH MEMBERS AND PROVIDERS TO MAKE HEALTH CARE ACCESSIBLE, AFFORDABLE AND A MEANS BY WHICH OUR MEMBERS IMPROVE THEIR HEALTH. 0 0 443767100 11526241 477731000 MEDICA'S HMO PRODUCTS PROVIDE EMPLOYER GROUPS WITH HEALTH COVERAGE AND HEALTH MAINTENANCE SERVICES. MANY OF THESE EMPLOYER GROUPS ARE SMALL BUSINESSES. MEDICA'S HMO PLANS PROVIDE IN-NETWORK ACCESS TO APPROXIMATELY 96 PERCENT OF MINNESOTA PHYSICIANS. MEDICA HMO PLANS ALSO OFFER A WIDE RANGE OF CARE MANAGEMENT, CARE COORDINATION AND HEALTH PROMOTION PROGRAMS TO HELP MEMBERS IMPROVE AND MAINTAIN THEIR HEALTH. 1132798000 1225820000 THROUGH MINNESOTA HEALTH CARE PROGRAMS, MEDICA IN 2010 OFFERED COVERAGE TO INDIVIDUALS WHO ARE ELIGIBLE FOR ONE OF THREE OF THE STATE OF MINNESOTA'S PUBLICLY FUNDED BASIC HEALTH CARE PROGRAMS: MEDICAL ASSISTANCE (MA); MINNESOTA'S MEDICAID PROGRAM, GENERAL ASSISTANCE MEDICAL CARE (GAMC); AND MINNESOTACARE. MEDICA OFFERS MEDICARE SUPPLEMENT PLANS, MEDICARE ADVANTAGE PRIVATE FEE-FOR-SERVICE PLANS, AND MEDICARE PART D PRESCRIPTION DRUG PLANS. MEDICA ALSO OFFERS MEDICARE ADVANTAGE PRIVATE FEE-FOR-SERVICE SPECIAL NEEDS PLANS THAT PROVIDE HEALTH CARE COVERAGE, CARE COORDINATION SERVICES AND ADDITIONAL SERVICES TO MEDICARE AND/OR MEDICAID ELIGIBLE INDIVIDUALS WITH SPECIFIED CHRONIC CONDITIONS OR DISABILITIES. 1576565100 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 297 0 1 1193 1 1 1 0 0 0 0 0 X 12 11 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MN X MARY QUIST 9529922058 PO BOX 9310 CP 330 MINNEAPOLIS MN 554409310 JOHN BUCK 15.00 X X 77833 0 0 ESTHER TOMLJANOVICH 10.00 X X 62000 0 0 KRIS SANDA 10.00 X X 61000 0 0 DAVID TILFORD 40.00 X X 2029937 0 138484 BURTON COHEN 7.00 X 56000 0 0 DARYL DURUM 10.00 X 61000 0 0 PETER KELLY MD 10.00 X 61000 0 0 SAMUEL LEON MD 7.00 X 56000 0 0 RAJESH AGGARWAL 7.00 X 60000 0 0 EARL STRATTON 10.00 X 58000 0 0 AUSTIN SULLIVAN 10.00 X 64000 0 0 BEN BACHE-WIIG MD 10.00 X 64250 0 0 AARON REYNOLDS 40.00 X 875520 0 84169 JAMES P JACOBSON 40.00 X 435707 0 48499 CHARLES J FAZIO 40.00 X 647472 0 70529 TOM L HENKE 40.00 X 647974 0 14710 JANA L JOHNSON 40.00 X 461860 0 56275 GLENN E ANDIS 40.00 X 537802 0 63051 ROBERT LONGENDYKE 40.00 X 453564 0 53253 DEBBY S KNUTSON 40.00 X 430505 0 44836 GERALD FILLER 40.00 X 329718 0 37892 SIMEON SCHINDELMAN 40.00 X 569336 0 68095 THEODORE J LOFTNESS 40.00 X 400133 0 49539 MARK L BAIRD 40.00 X 427362 0 51721 ROBERT LACHER 40.00 X 341034 0 21652 RICHARD H SYKORA 40.00 X 346296 0 43754 JOHN CHOMEAU 40.00 X 338911 0 44310 9954214 0 890769 175 0 1 0 UNITED HEATHCARE SERVICES 9900 BREN DR E MN008-T380 MINNETONKA MN 55343 CLAIMS PROCESSING 87174880 CDW DIRECT LLC PO BOX 88626 MILWAUKEE WI 553288062 IT SERVICES 2690029 XEROX CORPORATION PO BOX 802555 CHICAGO IL 606802555 COPY SERVICES 2570137 DAHL CONSULTING INC 418 COUNTY ROAD D E ST PAUL MN 55117 TEMP SERVICES 2291220 MILLIMAN USA 8500 NORMANDALE LAKE BLVD STE 1850 MINNEAPOLIS MN 55437 ACTUARIAL SERVICES 2262884 25 MEDICARE REVENUE 524114 1225820114 1225820114 SUBSCRIBER REVENUE 524114 469257466 469257466 OTHER REVENUE 524114 8075714 8075714 DENTAL REVENUE 541900 3031117 3031117 1706184411 14905338 14905338 4519152 4519152 4519152 4519152 PARTNERSHIP INCOME 561499 -728451 -728451 -728451 1724880450 1703153294 2302666 19424490 11526241 11526241 1565038859 1565038859 8780271 8780271 68167039 68167039 6912138 6912138 8906013 8906013 5721593 5721593 670348 670348 515203 515203 246601 246601 36603202 36603202 3947898 3947898 3031542 3031542 12269978 12269978 9974837 9974837 343089 343089 513608 513608 7806742 7806742 1200973 1200973 REINSURANCE 37279852 37279852 PREMIUM TAXES 17373878 17373878 PRINTING AND PUBLICATIO 7021806 7021806 BROKER COMMISSIONS 5417393 5417393 INTERCOMPANY ADMIN FEES -124831018 -124831018 2048698 2048698 1696486784 1576565100 119921684 0 174040909 343031090 60134459 73380437 29917954 21267662 8550521 8650292 277118296 199371755 66481480 50873479 586325665 675307053 223190489 275376573 1862169 601110 225052658 275977683 X 361273007 399329370 361273007 399329370 586325665 675307053 X 28393666 9662697 X 0 1 1 X 0 12056300 5155712 6900588 17861654 16111950 1749704 8650292 BONDS 197922686 C PREFERRED STOCK 1449069 C 199371755 INVESTMENT RELATED RECEIVABLES 1689216 HEALTH CARE RECEIVABLES 4360028 DUE FROM AFFILIATES 15844380 FUNDS HELD BY REINSURED COMPANIES 28979855 50873479 1724880450 1696486784 28393666 180975 9481722 9662697 38056363 1725608901 0 1725608901 -728451 -728451 1724880450 1696486784 0 1696486784 0 1696486784 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS. THE COMPANY DID NOT INCUR ANY INTEREST OR PENALTIES DURING THE YEARS ENDED DECEMBER 31, 2010 AND 2009, HOWEVER, IF INTEREST WERE TO BE INCURED, IT WOULD BE RECORDED IN NET INVESTMENT INCOME ON THE COMBINED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS, AND IF THE COMPANY INCURRED PENALTIES DURING THE YEAR, IT WOULD BE RECORDED IN ADMINISTRATIVE EXPENSE ON THE COMBINED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. GENERALLY, THE COMPANY IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE US FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR THE YEARS ENDED BEFORE DECEMBER 31, 2007. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF NONADMITTED ASSETS 8,753,271. MN HEALTH INFO EXCHANGE K-1 728,451. PART XII, LINE 4B - OTHER ADJUSTMENTS: MN HEALTH INFO EXCHANGE K-1 -728,451. 1 MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 501(C)(3) 3500000 SUPPORT OF THE MANY PROGRAMS CONDUCTED BY THE FOUNDATION. MEDICA RESEARCH FOUNDATION DBA MEDICA RESEARCH INSTITUTE 401 CARLSON PARKWAY MINNETONKA MN 55305 270600894 501(C)(3) 6500000 SUPPORT OF THE MANY PROGRAMS CONDUCTED BY THE FOUNDATION. INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT 8009 34TH AVE SO STE 1200 BLOOMINGTON MN 55425 411782168 501(C)(3) 1526241 SUPPORT THE BEST PRACTICES IN THE MEDICAL WORLD PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: MEDICA HEALTH PLANS DONATES FUNDS ANNUALLY TO ITS RELATED ORGANIZATIONS, MEDICA FOUNDATION AND MEDICA RESEARCH FOUNDATION DBA MEDICA RESEARCH INSTITUTE, AS WELL AS OTHER 501(C)(3) ORGANIZATIONS. THE FOUNDATIONS RETAIN RECORDS TO SUBSTANTIATE THE USE OF THESE FUNDS. X X X X X 1 1 0 0 0 1 0 0 0 DAVID TILFORD 716239 0 749113 0 564585 0 125523 0 12961 0 2168421 0 0 0 AARON REYNOLDS 418008 0 381520 0 75992 0 69419 0 14750 0 959689 0 0 0 JAMES P JACOBSON 252453 0 164068 0 19186 0 35002 0 13497 0 484206 0 0 0 CHARLES J FAZIO 157719 0 428379 0 61374 0 55284 0 15245 0 718001 0 0 0 TOM L HENKE 43464 0 262963 0 341547 0 1753 0 12957 0 662684 0 0 0 JANA L JOHNSON 255253 0 186705 0 19902 0 41918 0 14357 0 518135 0 0 0 GLENN E ANDIS 263943 0 219883 0 53976 0 47820 0 15231 0 600853 0 0 0 ROBERT LONGENDYKE 247757 0 163067 0 42740 0 38278 0 14975 0 506817 0 0 0 DEBBY S KNUTSON 238007 0 153792 0 38706 0 32719 0 12117 0 475341 0 0 0 GERALD FILLER 214370 0 97331 0 18017 0 27404 0 10488 0 367610 0 0 0 SIMEON SCHINDELMAN 326452 0 223366 0 19518 0 52490 0 15605 0 637431 0 0 0 THEODORE J LOFTNESS 247691 0 131538 0 20904 0 36170 0 13369 0 449672 0 0 0 MARK L BAIRD 247089 0 159351 0 20922 0 36793 0 14928 0 479083 0 0 0 ROBERT LACHER 126999 0 0 0 214035 0 9800 0 11852 0 362686 0 0 0 RICHARD H SYKORA 218644 0 107567 0 20085 0 29754 0 14000 0 390050 0 0 0 JOHN CHOMEAU 172708 0 147270 0 18933 0 28990 0 15320 0 383221 0 0 0 PART I, LINES 4A-B TOM L HENKE RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $230,556. THE FOLLOWING RECEIVED PAYMENTS FROM A NON-QUALIFIED RETIREMENT PLAN: DAVID TILFORD $235,752 AARON REYNOLDS $ 18,080 CHARLES J FAZIO $ 13,132 TOM L HENKE $ 48,009 GLENN E ANDIS $ 10,091 ROBERT LONGENDYKE $ 7,180 DEBBY S KNUTSON $ 6,307 THE FOLLOWING PARTICIPATED IN, BUT DID NOT RECEIVE A PAYMENT, FROM A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN FROM MEDICA HEALTH PLANS, A RELATED ORGANIZATION: JAMES JACOBSON JANA L JOHNSON GERLAD FILLER SIMEON SCHINDELMAN MARK L BAIRD THEODORE J LOFTNESS RICHARD H SYKORA JOHN CHOMEAU PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATIONS OPERATING EARNINGS. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS EXIST WITHIN MEDICA HEALTH PLANS AS MEMBERS COVERED UNDER REGULATED INSURANCE PLANS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERSHIP OF MEDICA HEALTH PLANS ELECTS THE CONSUMER BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S CONTROLLER AND DIRECTOR OF TREASURY REVIEW THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL EMPLOYEES OF MEDICA HEALTH PLANS 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 THE BOARD'S PERSONNEL AND COMPENSATION COMMITTEE REVIEWS AND OBTAINS THE BOARD'S APPROVAL OF THE TOTAL COMPENSATION FOR THE PRESIDENT/CEO AND REVIEWS AND APPROVES THE TOTAL COMPENSATION RECOMMENDATIONS MADE BY THE CEO FOR THE EXECUTIVE AND SENIOR VICE PRESIDENTS; REVIEWS ALL OFFICER COMPENSATION AND PERFORMANCE GOALS APPROVED BY THE CEO ANNUALLY. THE PERSONNEL AND COMPENSATION COMMITTEE ALSO REVIEWS AND RECOMMENDS TO THE BOARD, OFFICER AND NON-OFFICER COMPENSATION GUIDELINES FOR THE COMPANY AND ITS SUBSIDIARIES PERIODICALLY REVIEWING MARKET DATA TO ASSESS THE COMPANY'S COMPETITIVE POSITION. PROCESS OUTSIDE THE CHARTER: THE PERSONNEL AND COMPENSATION COMMITTEE WORKS WITH AN OUTSIDE CONSULTANT IN REVIEWING MARKET COMPETITIVE DATA THAT AIDS IN SETTING THE COMPENSATION FOR THE OFFICERS AND KEY EMPLOYEES. 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 OF THE 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. ARTICLES AND BYLAWS, CONFLICT OF INTEREST POLICY, AND FORM 990S ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 180,975. CHANGE IN VALUE OF NONADMITTED ASSETS 8,753,271. MN HEALTH INFO EXCHANGE K-1 728,451. TOTAL TO FORM 990, PART XI, LINE 5: 9,662,697. MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) 509(A)(3) II MEDICA HOLDING COMPANY 1 MEDICA HEALTH PLANS OF WISCONSIN 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH COVERAGE MN 501(C)(4) MEDICA HOLDING COMPANY 1 MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING COMPANY/NO ACTIVITY MN 501(C)(4) N/A 0 MEDICA RESEARCH FOUNDATION DBA MEDICA RESEARCH INSTITUTE 401 CARLSON PARKWAY MINNETONKA MN 55305 270600894 RESEARCH FOUNDATION MN 501(C)(3) 509(A)(3) I MEDICA HOLDING COMPANY 0 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MEDICA AFFILIATED SERVICES C MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMINISTRATOR MN MEDICA AFFILIATED SERVICES C MEDICA AFFILIATED SERVICES 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MEDICA HOLDING COMPANY C MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MANAGEMENT MN MEDICA AFFILIATED SERVICES C 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 MEDICA FOUNDATION B 3500000 ACTUAL AMOUNT MEDICA FOUNDATION M 108488 ACTUAL AMOUNT MEDICA FOUNDATION N 162049 ACTUAL AMOUNT