2023-11-08T15:23:04-06:00 2022-12-31 135565207 KPMG LLP 90 S 7TH ST STE 4200 MINNEAPOLIS MN 55402 990 2022-01-01 411242261 MEDICA HEALTH PLANS MEDI 9529922753 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 ELIZABETH ERICKSON PRESIDENT AND CEO 9529922753 2023-10-23 1 ELIZABETH ERICKSON 999009999 0 HOLLY MOEN P01800653 6123055000 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ELIZABETH ERICKSON 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 2230886023 0 X WWW.MEDICA.COM X 1973 MN TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 5 4 22 0 0 0 0 0 1181111064 1312233602 28126391 9735241 8876786 -1890955 1218114241 1320077888 183600 3336971 1050241683 1147262175 13049123 0 0 0 0 63484133 95897302 1126958539 1246496448 91155702 73581440 840677670 849808305 246099760 232560461 594577910 617247844 X TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 0 0 326383435 0 382929298 SEE SCHEDULE O. 10007508 0 11683848 SEE SCHEDULE O. 810871232 0 917620456 SEE SCHEDULE O. 3336971 3336971 0 CONTRIBUTIONS BY MEDICA ON BEHALF OF MEMBERS BEYOND CONTRACTED SERVICES IN 2022 MHP SPENT APPROXIMATELY $3.3 MILLION TO PROVIDE ADDITIONAL, NON-STATE PLAN SERVICES ON BEHALF OF THE FOLLOWING CATEGORIES OF MINNESOTA HEALTH CARE PROGRAMS: MSC+; MSHO; AND SNBC.NON-STATE PLAN SERVICES INCLUDED: VALUE OF WAIVED FAMILY DEDUCTIBLES; MSC+/MSHO ELDERLY WAIVER FOR NON-ELIGIBLE MEMBERS; NON-MEDICARE PART D PHARMACY COPAYMENTS; DRUGS NOT ELIGIBLE FOR REBATES; AND NON-MEDICARE VALUE OF COST-SHARING WAIVED COPAYS.MHP PROVIDED OTHER COMMUNITY BENEFITS WITH A WIDE RANGE OF PROGRAMS AND INITIATIVES TO PROMOTE PUBLIC AND INDIVIDUAL HEALTH, REDUCE DISPARITIES IN ACCESS TO CARE, IMPROVE HEALTH CARE SYSTEM PERFORMANCE, AND HELP PROVIDE FINANCIAL ASSISTANCE TO ACCESS CARE.MHP DONATES FUNDING, EMPLOYEE TIME AND OTHER RESOURCES IN SUPPORT OF MORE THAN TWO DOZEN COLLABORATIVE EFFORTS WITH LOCAL, STATE, REGIONAL AND NATIONAL ORGANIZATIONS. EXAMPLES INCLUDE: MINNESOTA COMMUNITY MEASUREMENT, WHICH PROMOTES COMMUNITY-BASED, EVIDENCE-BASED CARE, AND QUALITY COMPARISONS OF PROVIDER GROUPS AND CLINICS; INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT, WHICH PROVIDES EVIDENCE-GRADED GUIDELINES AND ASSESSMENTS.MEDICA UNDERTAKES A VARIETY OF INITIATIVES TO MAKE HEALTH CARE MORE AFFORDABLE, AVAILABLE AND EFFECTIVE. EXAMPLES INCLUDE:-IMPROVEMENTS IN RATES OF ANNUAL SCREENINGS AMONG MEMBERS FOR DISEASES SUCH AS CANCERS, HEART DISEASE AND DIABETES, PRE AND POST-BIRTH MATERNITY CARE, IMMUNIZATIONS, AND ANNUAL DENTAL VISITS.-REDUCTIONS IN MEDICALLY UNNECESSARY ER VISITS AND IN-PATIENT HOSPITAL ADMISSIONS-TYING PROVIDER REIMBURSEMENT TO IMPROVEMENTS IN CARE OUTCOMES, QUALITY AND EFFICIENCY-INCREASED PARTICIPATION IN EXERCISE.MEDICA'S OPTUM ONEPASS FITNESS PROGRAM OFFERED A LARGE, NATIONWIDE NETWORK OF GYMS AND FITNESS LOCATIONS. ADDITIONALLY, MEMBERS RECEIVED ONLINE ACCESS TO THOUSANDS OF ON-DEMAND WORKOUT VIDEOS AND CUSTOMIZABLE WORKOUT PROGRAMS ACCESSIBLE VIA A MOBILE APP CALLED MY HEALTH REWARDS WHICH ALSO OFFERS OPPORTUNITIES FOR PERSON-TO-PERSON DIRECT GUIDANCE IN CREATING A PERSONALIZED NUTRITION AND FITNESS PLAN. IN 2022, MEDICA OFFERED THE OPTUM ONEPASS PROGRAM TO MEMBERS IN MEDICARE ADVANTAGE PRODUCTS THAT INCLUDED THE MSHO AND SNBC SNP MINNESOTA STATE PROGRAMS.MEDICA'S TOBACCO CESSATION COACHING PROGRAM IS A SELF-DIRECTED PROGRAM OFFERING A WIDE VARIETY OF TOOLS AND RESOURCES TO HELP MEMBERS QUIT TOBACCO USE. COACHING SUPPORT INCLUDES PRIVATE, CONFIDENTIAL ACCESS TO TRAINED HEALTH COACHES. THERE WAS NO COST TO MEDICA MEMBERS TO PARTICIPATE IN THE TOBACCO CESSATION COACHING PROGRAM.IN 2022 OFFERED A PORTFOLIO OF DISEASE MANAGEMENT PROGRAMS FOR PHYSICAL AND MENTAL HEALTH, TOBACCO CESSATION, HEALTHY PREGNANCY, COMMON CHRONIC MEDICAL DISEASES, AND RARE AND COMPLEX DISEASES.THESE PROGRAMS PROVIDE EDUCATION AND RESOURCES THAT HELP SUPPORT THE MEMBERS' ABILITY TO MANAGE CHRONIC CONDITIONS. THE GOALS ARE TO IMPROVE HEALTH AND QUALITY OF LIFE, REDUCE COMPLICATIONS THROUGH EARLYINTERVENTION AND MONITORING, PROMOTE MEDICAL CARE AND COMPLIANCE WITH THE PATIENT'S PHYSICIAN-RECOMMENDED MEDICAL TREATMENT REGIMEN, AND TO IMPROVE SATISFACTION WITH HEALTH CARE SERVICES.MEDICA'S DISEASE MANAGEMENT PROGRAMS WERE PROVIDED AT NO ADDITIONAL CHARGE TO FULLY INSURED GROUPS, AND TO MINNESOTA STATE HEALTH CARE PROGRAM ENROLLEES SERVED BY MEDICA. THERE IS NO COST TO ELIGIBLE MEDICA MEMBERS. 3336971 3336971 0 1150599146 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 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 0 0 1 338 0 1 22 1 0 0 0 0 0 0 0 0 X 5 4 0 1 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 0 0 0 MN X ELIZABETH ERICKSON 9529922753 401 CARLSON PARKWAY CP330 MINNETONKA MN 55305 X JOHN W NAYLOR PRESIDENT & CEO 0.00 40.00 X X 0 2835957 44105 JOHN BUCK DIRECTOR & CHAIR 0.00 15.00 X X 0 133000 0 PETER KELLY DIRECTOR 0.00 10.00 X 0 87375 0 JOHN STANOCH DIRECTOR & VICE CHAIR 0.00 10.00 X X 0 92625 0 MARY TWINEM DIRECTOR 0.00 10.00 X 0 87375 0 MARY P QUIST SVP FIN & CORP CONTROLLER 0.00 40.00 X 0 663642 55294 MARK L BAIRD SVP & CFO 0.00 40.00 X 0 1039962 27542 DAVID H ELLENBOGEN SVP SEC & GENERAL COUNSEL 0.00 40.00 X 0 735741 99633 ESTHER TOMLJANOVICH FORMER DIRECTOR 0.00 0.00 X 0 11500 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNSEL 0.00 0.00 X 0 595469 0 0 6282646 226574 0 1 1 0 MEDICA SERVICES COMPANY 401 CARLSON PARKWAY CP 300 MINNETONKA MN 55305 LEASED EMPLOYEES 43711782 1 MEDICARE REVENUE 524114 917620456 917620456 MEDICAID REVENUE 524114 382929298 382929298 GROUP & INDIV. PREM. 524114 11683848 11683848 1312233602 11829545 11829545 4151017 6041972 -1890955 -1890955 -1890955 902671859 904766163 -2094304 -2094304 -2094304 1320077888 1312233602 0 7844286 3336971 3336971 1147262175 1147262175 368285 368285 228746 228746 64784 64784 804882 804882 16099615 16099615 1600464 1600464 753580 753580 5546543 5546543 1077055 1077055 81404 81404 63921 63921 207316 207316 4331659 4331659 435758 435758 LEASED EMPLOYEES 43711782 43711782 PREMIUM TAXES 9553225 9553225 OTHER 9439538 9439538 PRINTING & PUBLICATION 1528745 1528745 1246496448 1150599146 95897302 0 7281830 1459642 133889675 204690335 0 0 78443518 86770845 0 0 0 0 0 0 0 0 0 0 97343269 24923703 74401309 72419566 473466505 425390573 0 6474775 0 0 0 0 73194833 52602569 840677670 849808305 244414522 229545568 0 0 1685238 3014893 0 0 0 0 0 0 0 0 0 0 246099760 232560461 X 0 0 0 0 594577910 617247844 594577910 617247844 840677670 849808305 X 73581440 -47132883 -3778623 X 0 1 X 1 0 18775799 18775799 67824201 17289443 50534758 10743269 7634260 3109009 72419566 INVESTMENT INCOME ACCRUED 2414167 UNINSURED PLANS RECEIVABLE 24035791 INTERCOMPANY RECEIVABLES 2386560 GENERAL EXPENSE RECEIVABLE 22260197 REINSURANCE RECOVERIES 1505854 52602569 X 1325703009 8805593 8805593 1316897416 1012198 2168274 3180472 1320077888 1252127549 8805593 8805593 1243321956 1012198 2162294 3174492 1246496448 PART X, LINE 2: THE COMPANY IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE IRC, WITH THE EXCEPTION OF TAXES ON UNRELATED BUSINESS ACTIVITIES. THE FEDERAL UNRELATED BUSINESS INCOME TAX BENEFIT IS INCLUDED IN FEDERAL INCOME TAX BENEFIT IN THE STATUTORY STATEMENTS OF REVENUE AND EXPENSES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS FOR NII AND SGA EXPENSES 8,805,593. PART XI, LINE 4B - OTHER ADJUSTMENTS: STATUTORY GROSS UP FOR SGA EXPENSES 2,168,274. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS FOR NII AND SGA EXPENSES 8,805,593. PART XII, LINE 4B - OTHER ADJUSTMENTS: STATUTORY GROSS UP FOR SGA EXPENSES 2,162,294. 1 CHI HEALTH FOUNDATION 12809 WEST DODGE ROAD OMAHA NE 68154 470484764 501(C)(3) 108530 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. CHILDREN'S HOSPITAL & MEDICAL CENTER FOUNDATION 8404 INDIAN HILLS DRIVE SUITE 650 OMAHA NE 68114 476105603 501(C)(3) 75000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. CHILDREN'S HOSPITAL & MEDICAL CENTER FOUNDATION 8404 INDIAN HILLS DRIVE SUITE 650 OMAHA NE 68114 476105603 501(C)(3) 50000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. YOUTH EMERGENCY SERVICES INC 2566 FARNAM STREET SUITE 301 OMAHA NE 68131 470586898 501(C)(3) 25000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. PONCA TRIBE OF NEBRASKA PO BOX 288 NIOBRARA NE 68760 470744117 GOV 25000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. SANTEE HEALTH & WELLNESS CENTER 425 FRAZIER AVE N STE 2 NIOBRARA NE 68760 470533471 25000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. FOSTER CARE CLOSET 643 S 26TH ST STE 8 LINCOLN NE 68510 260595115 501(C)(3) 25000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. CEDARS YOUTH SERVICES 6601 PIONEERS BOULEVARD SUITE 1 LINCOLN NE 68506 470551975 501(C)(3) 25000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. WOMEN'S FUND OF GREATER OMAHA 1111 N 13TH ST 106 OMAHA NE 68102 470840885 501(C)(3) 20000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. RISE ACADEMY 3555 FARNAM STREET SUITE 209 OMAHA NE 68131 830583165 501(C)(3) 20000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. OMAHA HEALTHY HOUSING 1425 S 13TH ST OMAHA NE 68108 205085175 501(C)(3) 15000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. CARE CORPS LIFEHOUSE 723 N BROAD STREET FREMONT NE 68025 470792729 501(C)(3) 15000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. CHICANO AWARENESS CENTER DBA LATINO CENTER OF THE 4821 SOUTH 24TH STREET OMAHA NE 68107 237208431 501(C)(3) 15000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. BRYAN FOUNDATION 1600 SOUTH 48TH STREET LINCOLN NE 68506 237005720 501(C)(3) 15000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. NEBRASKA CHILDREN'S AND FAMILIES FOUNDATION 215 CENTENNIAL MALL S STE 200 LINCOLN NE 68508 911829974 501(C)(3) 15000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. THE HUB CENTRAL ACCESS POINT FOR YOUNG ADULTS 1037 S 12TH STREET LINCOLN NE 68508 208008617 501(C)(3) 10000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. THE CONNECTION HOMELESS SHELTER INC 414 EAST 6TH STREET NORTH PLATTE NE 691031881 363957293 501(C)(3) 10000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. MEDICA FOUNDATION 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 411812461 501(C)(3) 2800000 0 FMV TO SUPPORT BEST PRACTICES OF ORGANIZATION. 16 1 PART I, LINE 2: MEDICA HEALTH PLANS (MHP) DONATES TO 501(C)(3) ORGANIZATIONS. MHP HAS MEETINGS TO MONITOR THE WORK BEING DONE TO SUPPORT THE MISSION OF THE GRANT RECIPIENTS. 1 X X X X X 0 1 0 0 0 1 1 0 0 JOHN W NAYLOR PRESIDENT & CEO 0 1064714 0 1511877 0 259366 0 19605 0 24500 0 2880062 0 250332 MARK L BAIRD SVP & CFO 0 336343 0 548698 0 154921 0 12200 0 15342 0 1067504 0 84354 DAVID H ELLENBOGEN SVP SEC & GENERAL COUNSEL 0 395550 0 261312 0 78879 0 74554 0 25079 0 835374 0 75880 MARY P QUIST SVP FIN & CORP CONTROLLER 0 329723 0 268265 0 65654 0 23638 0 31656 0 718936 0 58551 JAMES P JACOBSON FORMER SVP SEC & GEN COUNSEL 0 0 0 124339 0 471130 0 0 0 0 0 595469 0 150790 ESTHER TOMLJANOVICH FORMER DIRECTOR 0 0 0 0 0 11500 0 0 0 0 0 11500 0 0 PART I, LINE 3 MEDICA HEALTH PLANS, THE FILING ORGANIZATION, DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA SERVICES COMPANY, A RELATED TAXABLE ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA SERVICES COMPANY USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATION'S OPERATING EARNINGS. PART-I LINE-4B THE FOLLOWING RECEIVED A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA SERVICES COMPANY, A RELATED ORGANIZATION: QUIST, MARY P. - $58,551 BAIRD, MARK L. - $84,354 NAYLOR, JOHN W. - $250,332 ELLENBOGEN, DAVID H. - $75,880 JACOBSON, JAMES P. - $150,790 FORM 990, PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS MEDICA HEALTH PLANS (MHP) IN 2022 PROVIDED HMO COVERAGE TO ENROLLEES IN THE STATE OF MINNESOTA'S SENIOR CARE PLUS (MSC+) AND SPECIAL NEEDS BASIC CARE PROGRAMS (SNBC). MSC+ PROVIDES MANAGED CARE FOR LOW-INCOME PEOPLE IN MINNESOTA WHO ARE AGES 65 OR OLDER ON MEDICAL ASSISTANCE. SNBC PROVIDES MANAGED CARE FOR INDIVIDUALS AGES 18-64 ON MEDICAL ASSISTANCE AND ARE CERTIFIED WITH PHYSICAL, DEVELOPMENTAL OR MENTAL DISABILITIES. A TOTAL OF 16,904 MEDICA MEMBERS - 23.1% OF MHP'S TOTAL ENROLLMENT - WERE IN MINNESOTA STATE PROGRAMS AS OF 12/31/2022. THERE WERE 5,181 MINNESOTA SENIOR CARE PLUS MEMBERS AND 11,723 SPECIAL NEEDS BASIC CARE MEMBERS. STATE OF MINNESOTA HEALTH CARE PROGRAMS MINNESOTA REQUIRES A HEALTH PLAN THAT CONTRACTS WITH THE MINNESOTA DEPARTMENT OF HUMAN SERVICES (DHS) TO PROVIDE MANAGED CARE BE LICENSED BY THE MINNESOTA DEPARTMENT OF HEALTH (MDH) AS AN HMO. MINNESOTA HEALTH CARE PROGRAMS COVER PEOPLE WHO CANNOT GET OR AFFORD HEALTH INSURANCE ELSEWHERE AND HELPS THEM PAY SOME OR ALL MEDICAL BILLS. DHS MANAGES THE ENROLLMENT OF ENROLLEES AND ENFORCES ELIGIBILITY RULES THAT PERTAIN TO INCOME, ASSETS AND OTHER FACTORS. MEDICA'S MANAGED CARE PRODUCTS SERVE ADULTS WITH DISABILITIES, SOME CHILDREN WITH DISABILITIES, AND LOW-INCOME PEOPLE AGES 0-65 AND OLDER. MANAGED CARE IS AVAILABLE FOR LOW-INCOME PEOPLE 65 OR OLDER WHO ARE ASSESSED TO REQUIRE AN INSTITUTIONAL LEVEL OF CARE. MINNESOTA DHS DETERMINES CAPITATED RATES AS A COMPONENT OF THE ANNUAL CONTRACT NEGOTIATION PROCESS WITH MHP AND PAYS MHP A FIXED RATE PER ENROLLEE PER MONTH. MHP BEARS THE RISK FOR THE TOTAL COST OF CARE FOR THESE ENROLLEES. -IN 2022 MEDICA HEALTH PLANS MEDICAL LOSS RATIO FOR STATE OF MINNESOTA HEALTH PROGRAMS WAS 85.2%. -THE ADMINISTRATIVE COST RATIO WAS APPROXIMATELY 7.1% INCLUDING PREMIUM TAXES. FORM 990, PART III, LINE 4B: PROGRAM SERVICE ACCOMPLISHMENTS IN 2022 MHP PROVIDED FULLY INSURED COMMERCIAL HMO HEALTH INSURANCE COVERAGE TO GROUPS AND INDIVIDUALS IN MINNESOTA. AS OF 12/31/2022 THE ENROLLMENT IN MHP FULLY INSURED MINNESOTA GROUP WAS 1,441 WHICH WAS APPROXIMATELY 2.0% OF MHP'S TOTAL 2022 ENROLLMENT. FORM 990, PART III, LINE 4C: PROGRAM SERVICE ACCOMPLISHMENTS IN 2022, MHP PARTICIPATED IN MINNESOTA SENIOR HEALTH OPTIONS (MSHO), A MEDICARE-RELATED PRODUCT, IN MINNESOTA. ENROLLMENT IN THAT PRODUCT WAS 9,845 OR 13.5% OF MHP'S TOTAL ENROLLMENT. MSHO IS A PRODUCT FOR PEOPLE AGE 65 AND OLDER AND ELIGIBLE IN 2022, MEDICA OFFERED MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENT PLANS. MEDICARE ADVANTAGE HAD ENROLLMENT OF 29,369 MEMBERS OR 40.2% OF MHP'S TOTAL ENROLLMENT. MEDICARE ADVANTAGE IS A HEALTH PLAN THAT PROVIDES ALL ENROLLEES PART A AND PART B BENEFITS. MEDICARE SUPPLEMENT HAD ENROLLMENT OF 12,603 MEMBERS OR 17.2% OF MHP'S TOTAL ENROLLMENT. MEDICARE SUPPLEMENT IS A PLAN THAT HELPS PAY SOME HEALTH CARE COSTS THAT MEDICARE DOES NOT COVER, SUCH AS COPAYMENTS, COINSURANCE, AND DEDUCTIBLES. IN 2020, MEDICA BEGAN OFFERING I-SNP PLANS. I-SNP'S RESTRICT ENROLLMENT TO MA ELIGIBLE INDIVIDUALS WHO, FOR 90 DAYS OR MORE, HAVE HAD OR ARE EXPECTED TO NEED THE LEVEL OF SERVICES PROVIDED IN A LONG-TERM CARE(LTC) SNF, A LTC NURSING FACILITY, A SNF/NF, AN INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES, OR AN INPATIENT PSYCHIATRIC FACILITY. I-SNP HAD ENROLLMENT OF 17 MEMBERS. FORM 990, PART VI, SECTION A, LINE 3 MEDICA HEALTH PLAN HAS ENTERED INTO AN ADMINISTRATIVE SERVICE AGREEMENT WITH MEDICA SERVICES COMPANY (MSC), A RELATED EXEMPT ORGANIZATION. THROUGH THIS AGREEMENT, MSC LEASES ITS EMPLOYEES AND PROVIDES VARIOUS MANAGEMENT/ADMINISTRATIVE SERVICES TO MEDICA HEALTH PLAN AND MEDICA HEALTH PLAN PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. 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 11B MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S FINANCE STAFF REVIEW THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING 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 CONFLICT 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 CFO 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 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. FORM 990, PART VII, SECTION B, LINE 1: CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN ALL ENTITIES UNDER MEDICA HOLDING COMPANY. THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. FORM 990, PART VII JOHN STANOCH'S BOARD STIPEND WAS PAID TO STANOCH, LLC. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF NONADMITTED ASSETS -5,114,105. STAT GROSS DOWN FOR DEPRECIATION 1,335,482. MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) LINE 12B MHC 0 MEDICA COMMUNITY HEALTH PLAN 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH CVRGE MN 501(C)(4) N/A MHC 0 MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING CO MN 501(C)(4) N/A N/A 0 SSM HEALTH PLAN 10101 WOODFIELD LANE ST LOUIS MO 63132 831979548 HEALTH CVRGE MO 501(C)(4) N/A MFCJVN 0 MS COMMUNITY NFP JV LLC (MFCJVN) 401 CARLSON PARKWAY MINNETONKA MN 55305 873268926 HOLDING COMPANY MN MHC 0 0 0 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MAS C 0 MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMIN MN MAS C 0 MEDICA AFFILIATED SERVICES (MAS) 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MHC C 0 MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MGMT MN MAS C 0 MMSI INC 401 CARLSON PARKWAY MINNETONKA MN 55305 411547003 HEALTH INSURANCE MN MAS C 0 MEDICA SERVICES COMPANY LLC 401 CARLSON PARKWAY MINNETONKA MN 55305 852902940 ADMIN SERVICES MN MAS C 0 DEAN HEALTH PLAN INC 1277 DEMING WAY MADISON WI 53717 391535024 HEALTH INSURANCE WI DHI C 0 DEAN HEALTH INSURANCE INC (DHI) PO BOX 56099 MADISON WI 53705 391830837 HEALTH INSURANCE WI MSCJV C 0 SSM HEALTH INSURANCE COMPANY 10101 WOODFIELD LANE ST LOUIS MO 63132 834718249 HEALTH INSURANCE MO MSCJV C 0 DEAN HEALTH SERVICES COMPANY LLC 1277 DEMING WAY MADISON WI 53717 842933639 ADMIN SERVICES WI MSCJV C 0 MS COMMUNITY JV LLC (MSCJV) 401 CARLSON PARKWAY MINNETONKA MN 55305 873240022 HOLDING COMPANY MN MHC C 0 MEDICA REGIONAL INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 854111612 HEALTH INSURANCE MN MAS C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0