2023-11-13T07:50:39-06:00 2023-06-30 390859910 BAKER TILLY US LLP 790 N WATER ST SUITE 2000 MILWAUKEE WI 53202 990 2022-07-01 320086947 WAICU BENEFITS CONSORTIUM INC WAIC 6082567761 122 W WASHINGTON AVE 700 MADISON WI 53703 ERIC FULCOMER INTERIM PRESIDENT 6082567761 2023-10-26 1 ERIC FULCOMER XXX-XX-XXXX 0 TROY MARINE CPA P00187863 4147775500 2023-10-19 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ERIC FULCOMER 122 W WASHINGTON AVE 700 MADISON WI 53703 24118925 0 X N/A X 2003 WI WAICU BENEFITS CONSORTIUM, INC. WAS ORGANIZED TO ESTABLISH AND MAINTAIN A HEALTH AND WELFARE PLAN. 9 9 0 9 0 0 0 0 23600941 23748020 344365 67653 0 0 23945306 23815673 0 0 22496016 24667151 0 0 0 0 0 1916202 1854349 24412218 26521500 -466912 -2705827 13047345 11901634 74427 285211 12972918 11616423 X WAICU BENEFITS CONSORTIUM, INC. WAS ORGANIZED TO ESTABLISH AND MAINTAIN A HEALTH AND WELFARE PLAN FOR THE PAYMENT OF LIFE, SICK, ACCIDENT, AND SIMILAR BENEFITS CONSTITUTING AN "EMPLOYEE WELFARE BENEFIT PLAN" WITHIN THE MEANING OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974. THE PLAN IS MAINTAINED FOR THE BENEFIT OF EMPLOYEES OF VARIOUS COLLEGE AND UNIVERSITY MEMBERS OF WAICU. 0 0 WAICU BENEFITS CONSORTIUM, INC. WAS ORGANIZED TO ESTABLISH AND MAINTAIN A HEALTH AND WELFARE PLAN FOR THE PAYMENT OF LIFE, SICK, ACCIDENT, AND SIMILAR BENEFITS CONSTITUTING AN "EMPLOYEE WELFARE BENEFIT PLAN" WITHIN THE MEANING OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974. THE PLAN IS MAINTAINED FOR THE BENEFIT OF EMPLOYEES OF VARIOUS COLLEGE AND UNIVERSITY MEMBERS OF WAICU. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ERIC FULCOMER 6082045229 122 W WASHINGTON AVE 700 MADISON WI 53703 X AMANDA BAKER DIRECTOR 1.00 X 0 0 0 BECKY PLOECKLMAN DIRECTOR 1.00 X 0 0 0 DAVID WESSE DIRECTOR 1.00 X 0 0 0 DAWN PETERSON DIRECTOR 1.00 X 0 0 0 DUSTY HOOT DIRECTOR 1.00 X 0 0 0 JACQUELINE KLENZ DIRECTOR 1.00 X 0 0 0 JIM JONES DIRECTOR 1.00 X 0 0 0 ROBERT O'KEEFE DIRECTOR 1.00 X 0 0 0 SHERRI VENERO DIRECTOR 1.00 X 0 0 0 ROLF WEGENKE PRESIDENT (THROUGH 08/2022) 2.00 X 0 0 0 ERIC FULCOMER PRESIDENT 2.00 X 0 0 0 JENNIFER DEHART SECRETARY/TREASURER 12.00 X 0 0 0 0 0 0 0 0 0 0 UMR 115 WAUSAU AVENUE WAUSAU WI 54401 THIRD PARTY ADMINISTRATOR 984395 WAICU 122 W WASHINGTON AVE SUITE 700 MADISON WI 53703 ADMINISTRATION 492373 MILLIMAN 15800 W BLUEMOUND ROAD SUITE 100 BROOKFIELD WI 53005 ACTUARY 110892 3 PLAN CONTRIBUTIONS 525100 23748020 23748020 23748020 370905 370905 303252 -303252 -303252 -303252 23815673 23748020 0 67653 24667151 508007 50400 29097 21749 115363 THIRD PARTY ADMINISTRAT 599970 PPO NETWORK FEES 513904 LICENSE & FEES 9060 BANK FEES 6799 26521500 762658 926694 734457 382955 11550230 10591985 13047345 11901634 74427 275496 0 9715 74427 285211 X 12972918 11616423 12972918 11616423 13047345 11901634 -2705827 1349332 0 X X 0 1 X 1 0 0 PREMIUMS RECEIVED IN ADVANCE 9715 9715 X 25165005 1349332 1349332 23815673 0 23815673 26521500 0 26521500 0 26521500 PART X, LINE 2: THE PLAN OBTAINED ITS LATEST DETERMINATION LETTER ON NOVEMBER 12, 2004, IN WHICH THE INTERNAL REVENUE SERVICE ("IRS") STATED THAT THE PLAN, AS THEN DESIGNED, WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE ("IRC") AND WAS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE IRC AS A VOLUNTARY EMPLOYEE BENEFICIARY ASSOCIATION. THE PLAN IS REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN ITS QUALIFICATION. THE PLAN HAS BEEN AMENDED SUBSEQUENT TO THE DATE OF THE PLAN'S DETERMINATION LETTER; HOWEVER, THE PLAN ADMINISTRATOR IS NOT AWARE OF ANY EVENTS THAT HAVE OCCURRED THAT MIGHT ADVERSELY AFFECT THE PLAN'S QUALIFIED STATUS. U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF FORM 990 IS POSTED TO A WEB PORTAL AT LEAST ONE WEEK PRIOR TO A FINANCE COMMITTEE MEETING. AN EMAIL IS SENT TO THE BOARD OF DIRECTORS NOTIFYING THEM OF THE FORM'S AVAILABILITY FOR REVIEW AND COMMENT. AT THIS MEETING, THE FINANCE COMMITTEE IS GIVEN THE OPPORTUNITY TO DISCUSS AND POSE QUESTIONS TO THE AUDITORS. ANY CHANGES ARE MADE, AND THE REPORT IS RESUBMITTED TO THE COMMITTEE. WHEN THE COMMITTEE AGREES TO THE REPORT, THE REPORT IS POSTED TO A WEB PORTAL AS PART OF THE FALL BOARD MEETING PACKET. THE BOARD OF DIRECTORS IS ASKED TO VOTE TO ACCEPT THE FILING OF THE FORM AT THE FALL BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AND ALL ESSENTIAL WAICU PERSONNEL WHO ARE ALLOCATED TO THE WAICU BENEFITS CONSORTIUM, INC. ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST FORMS. PERSONAL OR FINANCIAL RELATIONSHIPS WITH VENDORS OR POTENTIAL VENDORS WILL BE DISCLOSED TO THE BOARD AND PRESIDENT. THE PRESIDENT AND THE BOARD WILL TAKE PROMPT AFFIRMATIVE STEPS TO ELIMINATE ANY CONFLICT. NO CONFLICTS OR INTEREST HAVE OCCURRED IN THE PAST. FORM 990, PART VI, SECTION B, LINE 15 THE DIRECTOR AND OFFICERS OF WAICU BENEFITS CONSORTIUM, INC. ARE COMPENSATED BY THE UNRELATED BUT AFFILIATED ORGANIZATION, WISCONSIN ASSOCIATION OF INDEPENDENT COLLEGES AND UNIVERSITIES, INC. (WAICU). WAICU HAS PROCESSES FOR DETERMINING THE COMPENSATION OF THESE PERSONS THAT INCLUDE AN ANNUAL REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REFERENCE TO COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE WAICU BENEFITS CONSORTIUM, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. 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