2023-11-01T15:12:19-07:00 2022-12-31 990 2022-01-01 742615873 TEXAS MUTUAL INSURANCE COMPANY TEXA 8008595995 2200 Aldrich Street Austin TX 78723 Erica Sanchez VP Financial Services & Controller 5122247972 2023-11-01 1 1 11 1 AAL2 X 2022 2023-04-26 12:10:37Z X Bill Potter 2200 Aldrich Street Austin TX 78723 4904813136 0 X www.texasmutual.com X Mutual 1991 TX Established by Texas statute to provide a stable, competitive source of workers' compensation insurance for Texas employers, acts as an insurer of last resort, and helps to prevent on-the-job injuries and illnesses and minimize their consequences. 9 9 1100 0 4073436 2128272 0 0 982217298 1076017857 389831033 222927619 1373970 1409781 1373422301 1300355257 9252933 11358371 0 0 135807703 144637852 0 0 0 971493407 1053919082 1116554043 1209915305 256868258 90439952 8249270527 8234972587 3438067021 3500176871 4811203506 4734795716 Established by Texas statute to provide a stable, competitive source of workers' compensation insurance for Texas employers, acts as an insurer of last resort, and helps to prevent on-the-job injuries and illnesses and minimize their consequences. 0 0 1300355257 The Company wrote over 81,000 workers' compensation policies in 2022 covering over 1.5 million Texas employees. During the year, over 47,000 claims were processed and approximately $392 million in medical and income benefits were paid out to injured workers. $330 million in dividends was distributed to approximately 67,000 policyholders and an additional $21 million in dividends was distributed to 27 safety groups. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5812 0 1 1100 1 1 1 0 0 0 0 0 1 0 X 9 9 0 0 0 0 0 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 0 X Bill Potter 5122247972 2200 Aldrich Street Austin TX 78723 Richard Gergasko President & CEO 40 X 1842750 0 45340 Brenda Ward Chief Operating Officer 40 X 815189 0 131191 Leonard Johnson SVP Investments 40 X 728072 0 46192 Jo Betsy Norton SVP Public Affairs 40 X 673001 0 93195 Willard Potter SVP & CFO 40 X 559523 0 90337 Michael Hernandez Chief Data Officer 40 X 542751 0 88819 Paul Schlaud SVP Enterprise Affairs & General Counsel 40 X 536007 0 92857 Kim Haugaard SVP Policyholder Services 40 X 496938 0 101377 Jeffrey Lentz SVP Underwriting 40 X 474687 0 115776 Lawrence Martin SVP Human Resources 40 X 460633 0 87377 Jeannette Sprague SVP & Chief Information Officer 40 X 427761 0 64679 Elise Teeter SVP & General Auditor 40 X 409303 0 83118 David John VP IT Infrastructure 40 X 382236 0 107582 Mary Nichols SVP & General Counsel 40 X 439052 0 40544 Phoebe Murphy VP & Chief Actuary 40 X 379249 0 82011 Michael Stubblefield SVP & Chief Information Officer 40 X 381137 0 79303 Nathan Scott VP Investments 40 X 364616 0 89961 Erica Sanchez VP & Controller 40 X 343920 0 86812 Edward Coates VP HR Employee Services 40 X 325778 0 100252 Shannon Pounds VP & Associate General Counsel 40 X 345666 0 76512 Lisa Evans VP Distribution & Customer Engagement 40 X 358065 0 63859 Amy Green-Hinojosa VP Project Management Office 40 X 322811 0 96737 Billy Jackson VP Regional Operations 40 X 359915 0 57268 Peppia Sherrouse VP Regional Operations 40 X 337428 0 79218 Jeremiah Bentley VP Marketing & Community Affairs 40 X 319124 0 93675 Beverly Harris VP Corporate Strategy & Product 40 X 329633 0 78156 Adrian Vanzulli VP Applications 40 X 315520 0 82289 Roger Humecky VP Data Analytics & Business Intelligence 40 X 340448 0 56741 Richard Dabney VP Corporate Underwriting 40 X 309712 0 86843 Benjamin Siddons VP Business Development 40 X 312144 0 83463 Eric Bourquin VP Safety Services 40 X 303924 0 89726 Anthony Seraphim VP Data Governance 40 X 305008 0 83242 Greta Gonzales VP & Chief Risk Officer 40 X 304008 0 77968 Curtis Johnson VP Claim Operations 40 X 315978 0 61015 Nicholas Tsourmas Medical Director 30.00 X 332894 0 42268 Rhonda Barker VP Premium Audit 40 X 287404 0 59548 Toni Toliver VP Business Law 40 X 277371 0 67472 Jackie Kenyon VP Special Litigation 40 X 273170 0 70484 James Ziolkowski VP Regional Operations 40 X 285422 0 51111 Ronald Ellis Simmons Director 4 X 154500 0 0 John Dayton Swanson Director 4 X 107500 0 0 Tommy Dan Phillips Director 4 X 102500 0 0 Kristina Rose Koncaba Director 4 X 102500 0 0 Brett Baker Flagg Director 4 X 96250 0 0 Alexia Selene Elliott Director 4 X 92000 0 0 Steven Dudley Oldham Director 4 X 92000 0 0 William Francis Quinn Director 4 X 90000 0 0 Linda Stuckey Foster-Smith Director 4 X 51250 0 0 Kevin Mart Robnett Director 4 X 45000 0 0 17851748 0 3084318 421 0 1 0 OCCUPATIONAL HEALTH CENTERS OF PO BOX 75388 OKLAHOMA CITY OK 73147 Medical and Healthcare 14921948 TECHHEALTH INC PO BOX 206774 DALLAS TX 75320 Medical and Healthcare 10171754 MEMORIAL HERMANN HOSPITAL HEAL PO BOX 301208 DALLAS TX 75303 Medical and Healthcare 8205733 ALIGN NETWORKS INC PO BOX 105159 ATLANTA GA 30348 Medical and Healthcare 6093355 TMESYS LLC PO BOX 850001 DEPT 0559 ORLANDO FL 32885 Medical and Healthcare 3517121 338 0 Premiums Earned 524126 1076017857 1076017857 0 0 0 0 0 0 1076017857 237181461 0 -325290 237506751 0 0 0 0 0 0 0 0 738545 0 0 0 738545 0 738545 0 0 738545 3590204037 0 3604457879 0 -14253842 0 -14253842 0 4398726 -18652568 Finance and Service Charges 524126 620429 620429 0 0 Retroactive Reinsurance 524126 50807 50807 0 0 0 0 0 0 671236 1300355257 1076689093 4073436 219592728 11006680 351691 20936061 95058772 8515410 12498371 7629238 461426 482749 460564 38825038 30182558 7611478 4200306 23181710 20086244 1764524 569589 407309 5117975 1516007 Losses Incurred & Loss adjustment expense 384004148 Dividends to Policyholders 350858453 Net Commission and brokerage 147777949 Total taxes, licenses and fees 26402523 10008532 1209915305 0 0 0 -25990512 -30721234 127031677 142055396 413891642 446583722 119466931 21434544 102921522 98032387 6046080607 5823686093 1536974635 1702426936 48360956 52909287 8249270527 8234972587 118300834 138437427 482717520 507349014 0 0 2837048667 2854390430 3438067021 3500176871 X 0 0 0 0 4811203506 4734795716 4811203506 4734795716 8249270527 8234972587 X 90439952 -168598065 1750323 X 0 1 X 1 0 8173406 0 8173406 99978265 0 12585045 87393220 0 0 0 0 11315260 0 8849499 2465761 0 0 0 0 98032387 ARES GLOBAL MULTI-ASSET CREDIT FD 45844124 F CHURCHILL MID MKT SR LN FUND IV LP 136000000 F GOLUB CAPITAL PEARLS DLP LP 27357718 F SHENKMAN MULTI-ASSET CREDIT FUND 64774830 F WA EMERGING MARKETS LOCAL DEBT 18454796 F WA FLOATING RATE HIGH INCOME FUND 34105350 F WA OPPORTUNISTIC US$ HIGH YIELD 21090545 F WA STRUCTURED PROD OPPORTUNITIES 25090972 F PARAMETRIC DEFENSIVE EQTY FUND LLC 80385408 F SILCHESTER INTL VALUE EQUITY TRUST 135740897 F SPRUCEGROVE ACW EX US FUND 137542885 F CLARION LION PROPERTIES FUND 154167129 F HEITMAN CORE RE DEBT INCOME TR LP 47213740 F PRINCIPAL RE DEBT FUND II LP 34100294 F PRINCIPAL RE DEBT FUND III LP 77648038 F USAA EAGLE REAL ESTATE LP 145283828 F AMFAM VC FUND III LP 10505562 C AMFAM VC FUND IV LP 717094 F ARES PATHFINDER FUND LP 68119601 F ARROW CREDIT OPPTY FUND II LP 4700000 F CARLYLE CREDIT OPPTY FUND II LP 69154139 F CL GAS CO-INVEST LP 1900200 F CL ORANJE CO-INVEST LP 2856000 F CL RAIDERS CO-INVEST 1749014 F CL SLUMP CO-INVEST LP - MOJITO II 1855928 F CRESTLINE OPPORTUNITY FUND III LTD 35551000 F CRESTLINE OPPORTUNITY FUND IV LTD 63161000 F ELLIOTT ASSOCIATES LP 69519461 F GSO CREDIT ALPHA FUND II LP 12900476 F NML FOUR COLUMNS JR CAP FD VI LP 33842878 F NML BROOKS & WHITTLE CO-INVEST 3447715 F NML MONARCH CO-INVEST 2590299 F NML WITTICHEN CO-INVEST 2020939 F PARTNERS FUND 60175012 F PARTNERS GROUP RE SECOND 2013A LP 30609785 F SIXTH STREET TAO PARTNERS E LP 30150168 F CARLYLE TX CO-INVEST LLC 12333172 F TXM HOLDINGS LLC -233061 F 1702426936 Reserves for losses and loss adjustment expense 2829935372 Payable for securities 13030200 Advanced premiums 7520151 Amounts withheld/retained by company 3647031 Retroactive reinsurance reserve 216000 Provisions for reinsurance 200 Advanced rental income 41476 2854390430 1248309997 0 0 0 0 0 1248309997 52045260 0 52045260 1300355257 1157870044 0 0 0 0 0 1157870044 52045261 0 52045261 1209915305 Europe (including Iceland and Greenland) Investments 160259627 Central America and the Caribbean Investments 37451200 0 0 197710827 1 0 1 1 1 0 1 LEE COLLEGE FOUNDATION PAM WARFORD EXECUTIVE DIRECTOR PO BOX 818 BAYTOWN TX 77522 746105635 501(c)3 100000 College Safety Grants DEL MAR COLLEGE FOUNDATION 101 BALDWIN BOULEVARD CORPUS CHRISTI TX 78404 742286234 501(c)3 100000 College Safety Grants COMMUNITY FOUNDATION OF THE TEXAS HILL COUNTRY 241 EARL GARRETT ST KERRVILLE TX 78028 742225369 501(c)3 50000 Disaster Relief Funds ONESTAR FOUNDATION INC 9011 MOUNTAIN RIDGE DR AUSTIN TX 78759 200166368 501(c)3 100000 Disaster Relief Funds MEADOWS MENTAL HEALTH POLICY INSTITUTE FOR TEXAS 2800 Swiss Ave DALLAS TX 75204 463992618 501(c)3 100000 Disaster Relief Funds United Way of San Antonio and Bexar County ATTN Patrick Gonzales PO Box 679247 DALLAS TX 75267 741272381 501(c)3 100000 Generational Learning El Paso Community Foundation PO Box 272 EL PASO TX 79943 741839536 501(c)3 100000 Generational Learning Big Brothers Big Sisters of Central Texas Inc PO Box 4555 AUSTIN TX 78723 741678586 501(c)3 45000 Generational Learning United Way of El Paso County PO Box 1707 DALLAS TX 75284 741291051 501(c)3 50000 Generational Learning United Way of Odessa PO Box 632 ODESSA TX 79761 750838777 501(c)3 30000 Generational Learning Child and Family Guidance Center of Texoma 804 E Pecan Grove Rd SHERMAN TX 75090 756067812 501(c)3 100000 Generational Learning Child Care Associates 3000 E Belknap FORT WORTH TX 76111 840587601 501(c)3 100000 Generational Learning AVANCE Inc 824 Broadway Ste 204 SAN ANTONIO TX 78215 741769114 501(c)3 75000 Generational Learning Foundation Communities Inc 3000 S IH 35 Ste 300 AUSTIN TX 78704 742563260 501(c)3 100000 Generational Learning Buckner Children & Family Services Inc 425 w pecan MIDLAND TX 79705 752571395 501(c)3 50000 Generational Learning Austin Public Education Foundation 4000 S Interstate 35 9th Floor AUSTIN TX 78704 742654168 501(c)3 55000 Generational Learning Mission of Mercy Inc 2421 Ayers St CORPUS CHRISTI TX 78404 860704883 501(c)3 60000 Generational Learning Catholic Charities Diocese of Fort Worth Inc PO Box 15610 FORT WORTH TX 76119 750808769 501(c)3 85000 Generational Learning The Salvation Army A Georgia Corporation The Salvation Army - Nacogdoches 118 E Hospital St Ste 101 NACOGDOCHES TX 75961 580660607 501(c)3 30000 Generational Learning I Care San Antonio PO Box 12490 SAN ANTONIO TX 78212 742690192 501(c)3 100000 Generational Learning Lone Star Circle of Care 205 East University Ave Ste 200 GEORGETOWN TX 78626 743001674 501(c)3 25000 Generational Learning Su Casa De Esperanza Inc PO Box 1333 PHARR TX 78577 742610449 501(c)3 35000 Generational Learning Chinese Community Center Inc 9800 Town Park Dr HOUSTON TX 77036 760067885 501(c)3 75000 Generational Learning Ronald McDonald House Charities of Amarillo 1501 Streit Dr AMARILLO TX 79106 751790186 501(c)3 40000 Generational Learning Jewish Family Service of Dallas Inc 5402 Arapaho Rd DALLAS TX 75248 751992728 501(c)3 100000 Generational Learning Making it Better Literacy Now 14781 Memorial Dr 25 HOUSTON TX 77079 562571141 501(c)3 25000 Generational Learning Attack Poverty 3727 Greenbriar Ste 100 STAFFORD TX 77477 452401548 501(c)3 100000 Generational Learning Alliance for Children 3609 Marquita Dr FORT WORTH TX 76116 752363035 501(c)3 40000 Generational Learning Unbound Global 4300 W Waco Dr Ste 2 Bldg B-244 WACO TX 76710 844960264 501(c)3 70000 Generational Learning United Way of Greater Houston PO Box 3247 HOUSTON TX 77253 741167964 501(c)3 100000 Generational Learning North Texas Public Broadcasting Inc KERA TV 3000 Harry Hines Blvd DALLAS TX 75201 752084961 501(c)3 25000 Generational Learning Bay Area Turning Point Inc 210 S Walnut St WEBSTER TX 77598 760353058 501(c)3 75000 Generational Learning The Family Place PO Box 7999 DALLAS TX 75209 751590896 501(c)3 75000 Generational Learning Interfaith Ministries for Greater Houston 3303 Main Street HOUSTON TX 77002 741488102 501(c)3 50000 Generational Learning Loaves & Fishes of the Rio Grande Valley Inc PO Box 248 HARLINGEN TX 78551 742589451 501(c)3 100000 Generational Learning African American Mens Heath Clinic Black Mens Health Clinic 11313 Runnel Ridge Rd MANOR TX 78653 872368435 501(c)3 60000 Generational Learning Communities in Schools of the South Plains Inc 1946 Avenue Q LUBBOCK TX 79411 752819581 501(c)3 45000 Generational Learning The Sanctuary Foster Care Services 1350 NASA PKWY Ste 210 HOUSTON TX 77058 825440662 501(c)3 75000 Generational Learning Family Pathfinders of Tarrant County Inc Pathfinders 6550 Camp Bowie Blvd Ste 111 FORT WORTH TX 76116 731643384 501(c)3 50000 Generational Learning Interfaith Caring Ministries Inc 151 Park Ave LEAGUE CITY TX 77573 760143694 501(c)3 30000 Generational Learning Readers 2 Leaders PO Box 195076 DALLAS TX 75219 900641325 501(c)3 50000 Generational Learning United Way of Smith County PO Box 10029 TYLER TX 75711 750957331 501(c)3 40000 Generational Learning Austin Voices for Education and Youth 5221 Ledesma Rd AUSTIN TX 78721 743017284 501(c)3 100000 Generational Learning Meadows Mental Health Policy Institute for Texas 2800 Swiss Ave DALLAS TX 75204 463992618 501(c)3 90000 Generational Learning Communities in Schools of Houston Inc 1111 North Loop West St Ste 300 HOUSTON TX 77008 760031827 501(c)3 75000 Generational Learning LiftFund Inc 2014 S Hackberry St SAN ANTONIO TX 78210 742712770 501(c)3 100000 Generational Learning United Way of the Brazos Valley Inc 1716 Briarcrest Dr Ste 155 BRYAN TX 77802 742050241 501(c)3 35000 Generational Learning Easterseals North Texas Inc 1424 Hemphill St FORT WORTH TX 76104 750827419 501(c)3 75000 Generational Learning Communities In Schools of Cameron County 356 N Sam Houston Blvd SAN BENITO TX 78586 742746090 501(c)3 60000 Generational Learning Santa Maria Hostel Inc PO Box 550048 HOUSTON TX 77255 741669131 501(c)3 100000 Generational Learning DOWNHOME RANCH 6210 E HIGHWAY 290 AUSTIN TX 78723 742536461 501(c)3 25000 Workforce Development & Safety Training MEMORIAL ASSISTANCE MINISTRIES 1625 BLALOCK ROAD HOUSTON TX 77080 760044172 501(c)3 100000 Workforce Development & Safety Training CAPITAL INVESTING IN DEVELOPMENT AND EMPLOYMENT OF ADULTS INC PO BOX 1784 AUSTIN TX 78767 742893041 501(c)3 75000 Workforce Development & Safety Training CRISTO REY DALLAS HIGH SCHOOL INC DALLAS CORP WORK STUDY INC 9701 SAN LEON AVE DALLAS TX 75217 463737066 501(c)3 50000 Workforce Development & Safety Training RESTORE EDUCATION 4205 SAN PEDRO AVE SAN ANTONIO TX 78212 262966263 501(c)3 75000 Workforce Development & Safety Training GREATER WACO COLLECTIVE IMPACT INITIATIVE ATTN DEXTER HALL 1105 WOODED ACRES DR STE 400 WACO TX 76710 465714986 501(c)3 100000 Workforce Development & Safety Training MISSION ROAD DEVELOPMENTAL CENTER 8706 MISSION ROAD SAN ANTONIO TX 78214 746024405 501(c)3 40000 Workforce Development & Safety Training SKILLPOINT ALLIANCE 8868 RESEARCH BLVD AUSTIN TX 78758 742704188 501(c)3 75000 Workforce Development & Safety Training TARRANT COUNTY ASSOCIATION FOR THE BLIND ATTN LISA A FELLERS 912 W BROADWAY FORT WORTH TX 76104 751228722 501(c)3 50000 Workforce Development & Safety Training MAVERICK BOYS & GIRLS CLUB OF AMARILLO 1923 S LINCOLN AMARILLO TX 79109 750808760 501(c)3 50000 Workforce Development & Safety Training UNITED WAY OF METROPOLITAN DALLAS ATTN FINANCE DEPT 1800 N LAMAR DALLAS TX 75202 756005352 501(c)3 100000 Workforce Development & Safety Training TEXARKANA RESOURCES FOR THE DISABLED PO BOX 19 TEXARKANA TX 75504 582004441 501(c)3 42000 Workforce Development & Safety Training CITYSQUARE C/O DEVELOPMENT DEPT PO BOX 140024 DALLAS TX 75214 752332948 501(c)3 100000 Workforce Development & Safety Training GENERATION USA PO BOX 14280 WASHINGTON DC 20044 843357705 501(c)3 25000 Workforce Development & Safety Training CODE2COLLEGE INC 19112 LEIGH LANE PFLUGERVILLE TX 78660 812361556 501(c)3 80000 Workforce Development & Safety Training LUBBOCK CHAMBER OF COMMERCE FOUNDATION 1500 BROADWAY STE 101 LUBBOCK TX 79401 752081274 501(c)3 100000 Workforce Development & Safety Training TODOS JUNTOS LEARNING CENTER PO BOX 41213 AUSTIN TX 78704 463028927 501(c)3 52500 Workforce Development & Safety Training GOODWILL INDUSTRIES OF EAST TEXAS INC 409 W LOCUST ST TYLER TX 75702 751478918 501(c)3 65000 Workforce Development & Safety Training GOOD WORK AUSTIN 1900 SIMOND AVE STE 100 AUSTIN TX 78723 834589863 501(c)3 40000 Workforce Development & Safety Training NEXTOP INC PO BOX 266 HOUSTON TX 77001 471429344 501(c)3 75000 Workforce Development & Safety Training CAFE MOMENTUM 1510 PACIFIC AVE DALLAS TX 75201 320384561 501(c)3 50000 Workforce Development & Safety Training THE LADDER ALLIANCE INC 1100 HEMPHILL STREET 302 FORT WORTH TX 76104 061674011 501(c)3 25000 Workforce Development & Safety Training THE JIM H GREEN KIDZ HARBOR INC 638 HARBOR DR LIVERPOOL TX 77577 900198510 501(c)3 95000 Workforce Development & Safety Training FAMILY SERVICE ASSOCIATION OF SAN ANTONIO INC 702 SAN PEDRO SAN ANTONIO TX 78212 741117341 501(c)3 65000 Workforce Development & Safety Training TEXAS NEW COMMUNITY ALLIANCE 1091 SHEPARD HILL RD WILLIS TX 77318 141925138 501(c)3 60000 Workforce Development & Safety Training SER-JOBS FOR PROGRESS OF THE TEXAS GULF COAST INC 1710 TELEPHONE RD HOUSTON TX 77023 741590387 501(c)3 100000 Workforce Development & Safety Training KILGORE COLLEGE 1100 BROADWAY KILGORE TX 75662 752599820 501(c)3 90000 Workforce Development & Safety Training VALLEY INITIATIVE FOR DEVELOPMENT AND ADVANCEMENT 417 S OHIO AVE MERCEDES TX 78570 742768931 501(c)3 75000 Workforce Development & Safety Training REBIRTH EMPOWERMENT EDUCATION 11700 PRESTON RD STE 660 175 DALLAS TX 75230 822696648 501(c)3 100000 Workforce Development & Safety Training THE GEORGETOWN PROJECT PO BOX 957 GEORGETOWN TX 78627 742807713 501(c)3 25000 Workforce Development & Safety Training WILKINSON CENTER PO BOX 720248 DALLAS TX 75372 752712117 501(c)3 75000 Workforce Development & Safety Training LONE STAR JUSTICE ALLIANCE 3809 S 1ST ST AUSTIN TX 78704 822345921 501(c)3 100000 Workforce Development & Safety Training HOUSTONS CAPITAL INVESTING IN DEVELOPMENT AND EMPLOYMENT OF ADULTS ATTN GARRET BERG 111 EAST LOOP NORTH HOUSTON TX 77029 472462360 501(c)3 100000 Workforce Development & Safety Training BOYS & GIRLS CLUB OF GREATER HOUSTON PO BOX 676465 DALLAS TX 75267 760270942 501(c)3 100000 Workforce Development & Safety Training THE TSTC FOUNDATION 3801 CAMPUS DRIVE WACO TX 76705 752892470 501(c)3 100000 Workforce Development & Safety Training SOUTH TEXAS COLLEGE PO BOX 9500 MCALLEN TX 78502 742683499 501(c)3 100000 Workforce Development & Safety Training BAKERRIPLEY ATTN GIFT PROCESSING PO BOX 231808 HOUSTON TX 77223 237062976 501(c)3 62500 Workforce Development & Safety Training CONSTRUCTION CAREER COLLABORATIVE PO BOX 920920 HOUSTON TX 77292 463402653 501(c)3 80000 Workforce Development & Safety Training WOMENS SHELTER FOR EAST TEXAS INC PO BOX 510 LUFKIN TX 75902 751694437 501(c)3 25000 Workforce Development & Safety Training CITIZENS FOR EDUCATIONAL EXCELLENCE EDUCATION TO EMPLOYMENT PARTNERS 5488 S PADRE ISLAND DR STE 1572 CORPUS CHRISTI TX 78411 753137924 501(c)3 90000 Workforce Development & Safety Training INDEPENDENT INSURANCE AGENTS FOUNDATION OF SAN ANTONIO 84 NE LOOP 410 STE 260 SAN ANTONIO TX 78216 822037056 501(c)3 100000 Workforce Development & Safety Training BOYS & GIRLS CLUB OF GREATER TARRANT COUNTY INC 3218 E BELKNAP ST FORT WORTH TX 76111 750808785 501(c)3 75000 Workforce Development & Safety Training GOODWILL INDUSTRIES OF CENTRAL TEXAS 1015 NORWOOD PARK BLVD AUSTIN TX 78753 741322808 501(c)3 60000 Workforce Development & Safety Training AUSTIN URBAN TECNOLOGY MOVEMENT 6633 E HIGHWAY 290 STE 212 AUSTIN TX 78723 842709414 501(c)3 100000 Workforce Development & Safety Training CONCHO VALLEY REGIONAL FOOD BANK OF TEXAS 1213 S HILL SAN ANGELO TX 76903 751897032 501(c)3 70000 Workforce Development & Safety Training ALLIANCE OF COMMUNITY ASSISTANCE MINISTRIES INC 710 N POST OAK ROAD STE 210 HOUSTON TX 77024 275410988 501(c)3 90000 Workforce Development & Safety Training NPOWER INC 55 WASHINGTON ST STE 560 BROOKLYN NY 11201 134145441 501(c)3 40000 Workforce Development & Safety Training Texas 2036 ATTN MARGARET WEINKAUF 3889 MAPLE AVE STE 210 DALLAS TX 75219 813063099 501(c)3 300000 Generational Learning RONALD MCDONALD HOUSE CHARITIES OF CENTRAL TEXAS INC 1315 BARBARA JORDAN BOULEVARD AUSTIN TX 78723 742277664 501(c)3 100000 Generational Learning COMMUNITY FOUNDATION OF ABILENE 850 N 1ST ST ABILENE TX 79601 752045832 501(c)3 15000 Disaster Relief Funds ANGELINA COUNTY JUNIOR COLLEGE VICE PRESIDENT OF BUSINESS 3500 SOUTH FIRST ST LUFKIN TX 75904 751244347 100000 College Safety Grants LAMAR INSTITUTE OF TECHNOLOGY 855 E LAVACA CECIL BEESON BLDG ROOM 249 BEAUMONT TX 77705 760694136 100000 College Safety Grants COLLEGE OF THE MAINLAND 1200 AMBURN ROAD TEXAS CITY TX 77591 741555808 100000 College Safety Grants KILGORE COLLEGE ATTN PRESIDENT 1100 BROADWAY KILGORE TX 75662 756001909 100000 College Safety Grants EL PASO COMMUNITY COLLEGE DIST PO BOX 20500 EL PASO TX 79998 741690850 100000 College Safety Grants ODESSA COLLEGE 201 W UNIVERSITY ODESSA TX 79764 756002907 100000 College Safety Grants MIDLAND COLLEGE DISTRICT 3600 N GARFIELD STREET MIDLAND TX 79705 751403958 100000 College Safety Grants AMARILLO JUNIOR COLLEGE DISTRICT P O BOX 447 AMARILLO TX 79178 756000031 100000 College Safety Grants TEXARKANA COLLEGE ATTN PRESIDENT 2500 N ROBISON RD TEXARKANA TX 75501 756004413 100000 College Safety Grants AVANCE Austin Inc PO Box 19105 AUSTIN TX 78760 911916705 85000 Generational Learning Saint Joseph Academy Franco American Educational Society 101 St Joseph Dr BROWNSVILLE TX 78520 741319922 60000 Generational Learning AVANCE Dallas Inc AVANCE North Texas 2060 Singleton Blvd Ste 103 DALLAS TX 75212 752699260 100000 Generational Learning STATE FIREMENS AND FIRE MARSHALS ASSOCIATION OF TEXAS PO BOX 1709 MANCHACA TX 78652 741707516 300000 Workforce Development & Safety Training TRIO EDUCATION 11413 TODD ST HOUSTON TX 77055 843902797 100000 Workforce Development & Safety Training CMC FOUNDATION OF CENTRAL TEXAS 4900 MUELLER BLVD AUSTIN TX 78723 200468031 100000 Generational Learning THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER 11937 US HWY 271 TYLER TX 75708 756001354 75000 Generational Learning THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER 1200 PRESSLER ST HOUSTON TX 77030 741761309 75000 Generational Learning American Heart Association Inc 7272 Greenville Avenue Dallas TX 75231 135613797 501(c)3 37200 gross proceeds from sale Four vehicles donated Texas Can Cars for Kids 7100 Marvin D Love Freeway Dallas TX 75237 462077931 501(c)3 79500 gross proceeds from sale Six vehicles donated 102 17 Scholarships for students attending College of Southern Nevada 1 13200 Scholarships for students attending Hillsborough Community College 1 19205 Scholarships for students attending Huntington University 1 13200 Scholarships for students attending Lamar State College 1 11880 Scholarships for students attending Lamar University 1 19800 Scholarships for students attending Midland College 1 6600 Scholarships for students attending Midwestern State University 1 6600 Scholarships for students attending Oklahoma State University 1 6600 Scholarships for students attending Paris Junior College 1 6600 Scholarships for students attending Pima Medical Institute 1 6600 Scholarships for students attending Sam Houston State University 1 13200 Scholarships for students attending Tarleton State 3 39600 Scholarships for students attending Tarrant County College 2 13200 Scholarships for students attending Texas A&M - Kingsville 1 13200 Scholarships for students attending Texas A&M University 2 26400 Scholarships for students attending Texas State University 5 33000 Scholarships for students attending University of North Texas 1 13200 Scholarships for students attending University of South Florida 1 13200 Scholarships for students attending University of St. Thomas 1 13200 Scholarships for students attending University of Texas at Arlington 1 13200 Scholarships for students attending University of Texas at El Paso 1 9900 Scholarships for students attending University of Utah 1 13200 Scholarships for students attending UT Rio Grande Valley 1 5974 Scholarships for students attending West Texas A&M 1 7199 Schedule I, Part I, Line 2 Students qualify for the scholarship if they are a dependent of an individual that has had a death or lifetime benefits claim with Texas Mutual. The number of applicants is driven by the number of those types of workers compensation claims with dependents and is not preset. X 1 1 X 1 1 0 Richard Gergasko President & CEO 763066 0 864827 0 214857 0 36820 0 8520 0 1888090 0 0 0 Brenda Ward Chief Operating Officer 443274 0 321244 0 50671 0 121819 0 9372 0 946380 0 40393 0 Leonard Johnson SVP Investments 429331 0 206902 0 91839 0 36820 0 9372 0 774264 0 0 0 Jo Betsy Norton SVP Public Affairs 298646 0 135693 0 238662 0 83823 0 9372 0 766196 0 172525 0 Willard Potter SVP & CFO 383725 0 165699 0 10099 0 61640 0 28698 0 649861 0 0 0 Michael Hernandez Chief Data Officer 354857 0 174989 0 12905 0 67121 0 21698 0 631570 0 0 0 Paul Schlaud SVP Enterprise Affairs & General Counsel 365627 0 160471 0 9908 0 64633 0 28224 0 628863 0 0 0 Kim Haugaard SVP Policyholder Services 308398 0 151486 0 37054 0 89255 0 12122 0 598315 0 26279 0 Jeffrey Lentz SVP Underwriting 290621 0 140762 0 43305 0 85167 0 30609 0 590464 0 33634 0 Lawrence Martin SVP Human Resources 299680 0 126092 0 34861 0 76925 0 10452 0 548010 0 24084 0 Jeannette Sprague SVP & Chief Information Officer 278782 0 86021 0 62958 0 36820 0 27859 0 492440 0 0 0 Elise Teeter SVP & General Auditor 258336 0 126609 0 24358 0 65922 0 17196 0 492421 0 14276 0 David John VP IT Infrastructure 247615 0 94906 0 39715 0 77160 0 30422 0 489818 0 30176 0 Mary Nichols SVP & General Counsel 142164 0 191634 0 105253 0 36820 0 3724 0 479595 0 0 0 Phoebe Murphy VP & Chief Actuary 249655 0 92153 0 37441 0 68295 0 13716 0 461260 0 27843 0 Michael Stubblefield SVP & Chief Information Officer 200081 0 174470 0 6586 0 67083 0 12220 0 460440 0 0 0 Nathan Scott VP Investments 253061 0 88076 0 23479 0 60937 0 29024 0 454577 0 12268 0 Erica Sanchez VP & Controller 229592 0 82540 0 31788 0 66866 0 19946 0 430732 0 22241 0 Edward Coates VP HR Employee Services 213138 0 80124 0 32515 0 70478 0 29774 0 426029 0 22436 0 Shannon Pounds VP & Associate General Counsel 237153 0 81613 0 26900 0 59316 0 17196 0 422178 0 17424 0 Lisa Evans VP Distribution & Customer Engagement 254489 0 93656 0 9919 0 63259 0 600 0 421923 0 0 0 Amy Green-Hinojosa VP Project Management Office 213402 0 77668 0 31742 0 69713 0 27024 0 419549 0 22249 0 Billy Jackson VP Regional Operations 229834 0 83148 0 46933 0 36820 0 20448 0 417183 0 0 0 Peppia Sherrouse VP Regional Operations 231078 0 85852 0 20498 0 61022 0 18196 0 416646 0 8490 0 Jeremiah Bentley VP Marketing & Community Affairs 210103 0 77314 0 31707 0 63901 0 29774 0 412799 0 22475 0 Beverly Harris VP Corporate Strategy & Product 224634 0 79689 0 25310 0 59208 0 18948 0 407789 0 15933 0 Adrian Vanzulli VP Applications 227339 0 78369 0 9812 0 52515 0 29774 0 397809 0 0 0 Roger Humecky VP Data Analytics & Business Intelligence 232425 0 89249 0 18773 0 36795 0 19946 0 397188 0 0 0 Richard Dabney VP Corporate Underwriting 211657 0 77326 0 20730 0 57069 0 29774 0 396556 0 10614 0 Benjamin Siddons VP Business Development 222968 0 79642 0 9534 0 54639 0 28824 0 395607 0 0 0 Eric Bourquin VP Safety Services 205663 0 78047 0 20214 0 57595 0 32131 0 393650 0 10813 0 Anthony Seraphim VP Data Governance 218556 0 76928 0 9523 0 54082 0 29160 0 388249 0 0 0 Greta Gonzales VP & Chief Risk Officer 215766 0 77784 0 10458 0 58732 0 19236 0 381976 0 0 0 Curtis Johnson VP Claim Operations 205176 0 75589 0 35213 0 31241 0 29774 0 376993 0 0 0 Nicholas Tsourmas Medical Director 235662 0 77506 0 19726 0 36820 0 5448 0 375162 0 0 0 Rhonda Barker VP Premium Audit 206915 0 65786 0 14702 0 50176 0 9372 0 346951 0 4337 0 Toni Toliver VP Business Law 195649 0 72024 0 9698 0 47982 0 19490 0 344843 0 0 0 Jackie Kenyon VP Special Litigation 191310 0 71909 0 9951 0 52476 0 18008 0 343654 0 0 0 James Ziolkowski VP Regional Operations 208815 0 39371 0 37236 0 30163 0 20948 0 336533 0 0 0 Schedule J, Part I, Line 1a Social Club Memberships were paid for Jeanette Ward, Jo Betsy Norton, Richard Gergasko, Jeff Lentz, and Jim Ziolkowski. The memberships are used for business and marketing purposes, such as meeting with agents or stakeholders (legislators). Schedule J, Part I, Line 4 a) Mary Nichols $98,899 b) Richard Gergasko $195,873; Brenda Ward $125,392; Leonard Johnson $76,662; Jo Betsy Norton $272,034; Willard Potter $24,820; Michael Hernandez $30,301; Paul Schlaud $27,813; Kim Haugaard $78,714; Jeffrey Lentz $81,981; Lawrence Martin $64,189; Jeannette Sprague $44,594; Elise Teeter $43,379; David John $70,516; Phoebe Murphy $59,318; Michael Stubblefield $30,263; Nathan Scott $36,385; Erica Sanchez $52,287; Edward Coates $56,493; Shannon Pounds $39,921; Lisa Evans $26,439; Amy Green-Hinojosa $56,127; Billy Jackson $31,862; Peppia Sherrouse $32,692; Jeremiah Bentley $50,642; Beverly Harris $38,321; Adrian Vanzulli $15,720; Roger Humecky $18,275; Richard Dabney $31,733; Benjamin Siddons $17,819; Eric Bourquin $32,851; Anthony Seraphim $17,402; Greta Gonzales $22,640; Curtis Johnson $23,159; Rhonda Barker $21,685; Toni Toliver $15,293; Jackie Kenyon $20,365; James Ziolkowski $20,346 Form 990, Part VI, Section A, Line 7a The company was established by Texas statute. The company has a nine-member Board of Directors consisting of Texas business employers. Five members, including the chair, are appointed by the Governor of Texas and confirmed by the Senate. The remaining four board members are elected by the policyholders. Form 990, Part VI, Section A, Line 7b Legislation prohibits the appointment or election of any person who has a potential conflict of interest because of other involvement in the insurance industry. Form 990, Part VI, Section B, Line 11b The 990 Tax Return is completed by an accountant in the Financial Reporting department using work papers and verification to the Company's Annual Statement and Audited Statutory Annual Report. The return is reviewed by management prior to filing the return. Form 990, Part VI, Section B, Line 12c The company's Conflict of Interest Policy is reviewed annually. The policy is distributed to all employees annually and all employees are required to acknowledge receipt. Form 990, Part VI, Section B, Line 15 An annual compensation review is performed by the company's Human Resources Department for all benchmark positions, including executive positions. The Board of Directors reviews and approves the compensation package for the President, General Counsel, and General Auditor. The President or his designee approves the pay for all other employees. Form 990, Part VI, Section C, Line 19 All external requests for the organizational information can be obtained through written requests. Additionally, certain financial information is available on the Company's website. Form 990, Part XI, Line 9 Change in Nonadmitted Assets $1,750,323; Change in Provision for Reinsurance $0. Carlyle Credit Opportunities TX Co-Invest LLC 1001 Pennsylvania Avenue NW Suite 220 South Washington DC 20004 742615873 Generate investment income DE 306329 12333172 Texas Mutual Insurance Company TXM Holdings LLC 2200 Aldrich Street Austin TX 78723 742615873 Holding company for future healthcare subsidiary TX 0 -233061 Texas Mutual Insurance Company