2023-11-15T15:52:01-06:00 2022-12-31 990 2022-01-01 616145328 Baptist Healthcare System Inc Workers Compensation Trust BAPT 5028965000 1901 Campus Place Louisville KY 40299 Richard F Carrico VP, Treasurer, CFO 5028965000 2023-11-15 Richard Carrico 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X X Richard F Carrico 1901 Campus Place Louisville KY 40299 4138216 0 X n/a X 1985 KY To provide workers compensation benefits through a self-funded trust and excess insurance. X 16 15 0 0 0 0 0 0 6806670 4128667 -1108 9549 0 0 6805562 4138216 0 0 0 0 0 0 0 0 0 6809037 4148479 6809037 4148479 -3475 -10263 962738 0 0 0 962738 0 X The sole purpose for establishment of the Trust was to enable Baptist Healthcare System, Inc.(61-0444707),a 501(c)(3) corporation, to provide workers compensation benefits, as required by KY statute, directly through self-insurance & through excess insurance policies. 0 1 3940451 4128667 The Workers Compensation Trust provides workers compensation benefits to numerous related organizations. Payments are made to various healthcare providers for medical services and to employees for lost wages. 3940451 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 KY X Richard F Carrico 5028965000 1901 Campus Place Louisville KY 40299 X Gerard J Colman CEO & Director 1.00 40.00 X X 0 3233092 329946 Aaron Thompson PHD Director 1.00 1.00 X 0 3000 0 Bonnie Stith Director 1.00 1.00 X 0 3000 0 Dr Terry T Lester Director 1.00 1.00 X 0 3000 0 Dwain Morris Director 1.00 1.00 X 0 3000 0 Glenn Leveridge Director 1.00 1.00 X 0 3000 0 Kerry Stemler Director 1.00 1.00 X 0 3000 0 Linda J Thomas PHD Director 1.00 1.00 X 0 3000 0 Ramsey Nassar MD Director 1.00 1.00 X 0 3000 0 Jenny Oldham Director 1.00 1.00 X 0 3000 0 Robert Hook Jr Director 1.00 1.00 X 0 3000 0 Tammy Zimmerman Director 1.00 1.00 X 0 3000 0 Victoria D Buster Director 1.00 1.00 X 0 3000 0 Peter E Locken III MD Director 1.00 1.00 X 0 3000 0 William B Shircliff Director 1.00 1.00 X 0 3000 0 William Jeffrey Fultz Director 1.00 1.00 X 0 3000 0 Stephen R Oglesby CFO, VP, Treasurer 1.00 40.00 X 0 1627181 38060 Janet M Norton VP & Secretary 1.00 40.00 X 0 1089048 39420 William G Sisson Vice President 0.00 40.00 X 0 969533 22485 0 6963854 429911 0 1 1 0 0 Employer Contributions 525100 4128667 4128667 4128667 9549 9549 4138216 4128667 0 9549 1733 1733 206295 206295 676900 676900 Workers comp claims pai 3242227 3242227 Other 21324 21324 4148479 3940451 208028 0 0 0 0 0 0 0 0 0 0 0 962738 0 0 0 0 0 962738 0 0 0 X 962738 0 962738 0 962738 0 X -10263 -952475 X 0 1 X 1 0 X X 1 Baptist Healthcare System Inc 610444707 3 1 4148479 0 1 4148479 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 Gerard J Colman CEO & Director 0 1440569 0 1773891 0 18632 0 298326 0 31620 0 3563038 0 0 Stephen R Oglesby CFO, VP, Treasurer 0 687277 0 459500 0 480404 0 8700 0 29360 0 1665241 0 0 Janet M Norton VP & Secretary 0 583644 0 394044 0 111360 0 8700 0 30720 0 1128468 0 0 William G Sisson Vice President 0 645201 0 292796 0 31536 0 8700 0 13785 0 992018 0 0 Part I, Line 3 Baptist Healthcare System, Inc., (BHS), a related organization of Baptist Healthcare Workers Compensation Trust, uses the following to establish the compensation of BHS's CEO: --Compensation Committee --Independent compensation consultant --Form 990 of other organizations --Written employment contract --Compensation survey or study --Approval by the Board of Directors or Compensation Committee Part I, Line 4b During calendar year 2022, two officers of Baptist Healthcare System, Inc., a related entity of Baptist Healthcare System, Inc. Workers Compensation Trust, received a payout from a Supplemental Executive Retirement Plan, a nonqualified deferred compensation plan. The Plan is offered to a select group of management as determined by the BHS Executive Benefits Committee. The amounts paid in 2022 were recorded as wages in 2022 and reported on Schedule J, Part II, Column (B)(iii). Cash 2022-08-31 952475 Cash 981681017 Baptist Health Assurance Group LTD Cricket Square Hutchins Drive CJ Captive Insurance Company 1 0 0 0 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: Officers Part I, Line 2e: Explanation of Involvement: Officers of Baptist Healthcare System Inc. Workers Compensation Trust may be officers of Baptist Health Assurance Group LTD. Form 990, Part III, line 3 The Trust was dissolved during 2022 and all assets and activity were transferred to Baptist Health Assurance Group LTD, a captive insurance company that is a wholly-owned subsidiary of Baptist Healthcare System, Inc. Form 990, Part VI, Section A, line 6 Baptist Healthcare System, Inc. (61-0444707), is the sole member of the corporation. Form 990, Part VI, Section A, line 7a The sole member appoints all directors. The consent and approval of the sole member shall be required for all major corporate actions. Form 990, Part VI, Section B, line 11b A copy of the Form 990 is provided to the administrative committee immediately following the filing of the return. Any questions or comments are addressed by explanation or a change to the form. Form 990, Part VI, Section B, line 12c Annually, the secretary of Baptist Healthcare System, Inc., (BHS), sends out a conflict of interest questionnaire to each of the officers and directors. After completion, they are returned to the secretary and reviewed by the board or the Governance Effectiveness Committee of BHS for any potential conflicts. A conflict of interest is any circumstance, relationship, (financial or otherwise), activity or decision, (made in the course of governance, management or professional responsibilities or otherwise), that adversely influences or appears to adversely influence the ability of a Covered Person to: 1.) make objective decisions on behalf of WCT, and/or 2.) act in the best interest of WCT in a manner consistent with the tax-exempt purpose of WCT. The board or committee will determine by a majority vote of disinterested directors whether the disclosed financial or special interest may result in a conflict of interest. Form 990, Part VI, Section B, line 15 The President and CEO of Baptist Healthcare System, Inc. Workers Compensation Trust, (the Trust), is not an employee of the Trust, but is an employee of Baptist Healthcare System, Inc., a tax-exempt 501(c)(3) organization which is the sole member of the Trust. The President and CEO is compensated by Baptist Healthcare System, Inc. Officers of the Trust are not employees of the Trust, nor are they compensated by the Trust. All of the Workers Compensation Trust officers are employees of Baptist Healthcare System, Inc. and are compensated solely by Baptist Healthcare System, Inc. The compensation of all officers is either reviewed and approved by the Baptist Healthcare System, Inc. compensation committee, or reviewed and approved by the Baptist Healthcare System, Inc. President and CEO. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII Officers of Baptist Healthcare System, Inc. Workers Compensation Trust provide services to Baptist Healthcare System, Inc. and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore, all officers and key employee hours reported on Form 990, Part VII represent aggregate hours worked per week for all entities. Form 990, Part XI, line 9: Transfer to Baptist Health Assurance Group -952,475. Baptist Health Medical Group Inc 1901 Campus Place Louisville KY 40299 205497203 Physician Services KY 501(c)(3) Line 3 BHS 1 Mercy Regional Emergency Medical Systems 126 Lone Oak Road Paducah KY 42001 611310466 Ambulance Service KY 501(c)(3) Line 12a, I BHS 1 Baptist Health Foundation Richmond Inc 1901 Campus Place Louisville KY 40299 311506378 Fundraising KY 501(c)(3) Line 12a, I BHS 1 Baptist Health Foundation Corbin Inc 1901 Campus Place Louisville KY 40299 473033550 Fundraising KY 501(c)(3) Line 12a, I BHS 1 Baptist Health Foundation Lexington Inc 1901 Campus Place Louisville KY 40299 611480774 Fundraising KY 501(c)(3) Line 12a, I BHS 1 Baptist Health Foundation Paducah Inc 1901 Campus Place Louisville KY 40299 264057759 Fundraising KY 501(c)(3) Line 12a, I BHS 1 Baptist Health Foundation Greater Louisville Inc 1901 Campus Place Louisville KY 40299 200292291 Fundraising KY 501(c)(3) Line 12a, I BHS 1 Baptist Healthcare Foundation Inc 1901 Campus Place Louisville KY 40299 311122867 Fundraising KY 501(c)(3) Line 12a, I BHS 1 Pattie A Clay Hospital Auxiliary PO Box 1600 Richmond KY 40476 510172717 Hospital Support KY 501(c)(3) Line 12a, I BHS 0 Baptist Healthcare System Inc 1901 Campus Place Louisville KY 40299 610444707 Hospital KY 501(c)(3) Line 3 N/A 0 Baptist East Milestone Fitness Center 750 Cypress Station Road Louisville KY 40207 611355065 Fitness Center KY N/A N/A 0 0 Baptist Physicians Surgery Center 1720 Nicholasville Road Lexington KY 40503 043665929 Ambulatory Surgery Center KY N/A N/A 0 0 Medical Associates of Middletown 4000 Kresge Way Louisville KY 40207 200399400 Medical Office Building KY N/A N/A 0 0 Cumberland Valley Surgical Center LLC PO Box 1620 Corbin KY 40701 611348280 Ambulatory Surgery Center KY N/A N/A 0 0 Baptist Health Assurance Group LTD Cricket Square Hutchins Drive Grand Cayman CJ 981681017 Captive Insurance Company CJ N/A T 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Baptist Healthcare System Inc C 4148479 Book Value Baptist Health Assurance Group LTD R 952475 Book Value