2024-10-28T07:34:48-05:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 20 STANWIX STREET PITTSBURGH PA 15222 990 2023-01-01 854350386 LECOM HEALTH RISK RETENTION GROUP LECO 8148605101 1858 WEST GRANDVIEW BLVD ERIE PA 16509 STEVEN G INMAN CPA CGMA VP FISCAL AFFAIRS/CFO 8148605101 2024-10-25 1 1 JEFFREY J PETRELL P00138808 4126976400 2024-10-25 2023 2024-10-15 13:58:12Z JOHN M FERRETTI DO 1858 WEST GRANDVIEW BLVD ERIE PA 16509 6991380 0 X HTTPS://LECOMHEALTH.COM X 2020 PA THE CORPORATION'S PRIMARY PURPOSE IS TO SUPPORT THE CHARITABLE PURPOSES OF (I) MILLCREEK HEALTH SYSTEM, A PENNSYLVANIA NONPROFIT CORPORATION D/B/A LECOM HEALTH (THE "PARENT"), AND (II) EACH AFFILIATE OF THE PARENT THAT IS IN EXISTENCE ON THE DATE HEREOF OR IS FORMED AFTER THE DATE HEREOF AND THAT IS EXEMPT FROM FEDERAL INCOME TAX AND IS AN ENTITY OF THE TYPE DESCRIBED IN SECTION 501(C)(3) OF THE CODE (THE "LECOM EXEMPT AFFILIATES") BY PROVIDING INSURANCE AND/OR CLAIMS DEFENSE, ADMINISTRATION, AND INDEMNITY TO, OR IN RESPECT OF RISKS PRESENTED BY AND ACTIVITIES ENGAGED IN BY, THE PARENT AND/OR THE LECOM EXEMPT AFFILIATES, TOGETHER WITH THEIR RESPECTIVE EMPLOYEES AND OTHERS PROVIDING SERVICES ON BEHALF OF AND WITHIN THE SCOPE OF THE EXEMPT ACTIVITIES ENGAGED IN BY THE PARENT AND/OR THE LECOM EXEMPT AFFILIATES. 5 1 0 1 0 0 0 0 4259363 6559231 38012 432149 0 0 4297375 6991380 0 0 0 0 0 0 0 0 0 3619554 3044341 3619554 3044341 677821 3947039 7550098 14468311 5301545 8162253 2248553 6306058 X THE CORPORATION'S PRIMARY PURPOSE IS TO SUPPORT THE CHARITABLE PURPOSES OF (I) MILLCREEK HEALTH SYSTEM, A PENNSYLVANIA NONPROFIT CORPORATION D/B/A LECOM HEALTH (THE "PARENT"), AND (II) EACH AFFILIATE OF THE PARENT THAT IS IN EXISTENCE ON THE DATE HEREOF OR IS FORMED AFTER THE DATE HEREOF AND THAT IS EXEMPT FROM FEDERAL INCOME TAX AND IS AN ENTITY OF THE TYPE DESCRIBED IN SECTION 501(C)(3) OF THE CODE (THE "LECOM EXEMPT AFFILIATES") BY PROVIDING INSURANCE AND/OR CLAIMS DEFENSE, ADMINISTRATION, AND INDEMNITY TO, OR IN RESPECT OF RISKS PRESENTED BY AND ACTIVITIES ENGAGED IN BY, THE PARENT AND/OR THE LECOM EXEMPT AFFILIATES, TOGETHER WITH THEIR RESPECTIVE EMPLOYEES AND OTHERS PROVIDING SERVICES ON BEHALF OF AND WITHIN THE SCOPE OF THE EXEMPT ACTIVITIES ENGAGED IN BY THE PARENT AND/OR THE LECOM EXEMPT AFFILIATES. 0 0 2874098 6559231 THE CORPORATION'S PRIMARY PURPOSE IS TO SUPPORT THE CHARITABLE PURPOSES OF (I) MILLCREEK HEALTH SYSTEM, A PENNSYLVANIA NONPROFIT CORPORATION D/B/A LECOM HEALTH (THE "PARENT"), AND (II) EACH AFFILIATE OF THE PARENT THAT IS IN EXISTENCE ON THE DATE HEREOF OR IS FORMED AFTER THE DATE HEREOF AND THAT IS EXEMPT FROM FEDERAL INCOME TAX AND IS AN ENTITY OF THE TYPE DESCRIBED IN SECTION 501(C)(3) OF THE CODE (THE "LECOM EXEMPT AFFILIATES") BY PROVIDING INSURANCE AND/OR CLAIMS DEFENSE, ADMINISTRATION, AND INDEMNITY TO, OR IN RESPECT OF RISKS PRESENTED BY AND ACTIVITIES ENGAGED IN BY, THE PARENT AND/OR THE LECOM EXEMPT AFFILIATES, TOGETHER WITH THEIR RESPECTIVE EMPLOYEES AND OTHERS PROVIDING SERVICES ON BEHALF OF AND WITHIN THE SCOPE OF THE EXEMPT ACTIVITIES ENGAGED IN BY THE PARENT AND/OR THE LECOM EXEMPT AFFILIATES. 2874098 1 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 1 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X STEVEN G INMAN CPA CGMA 8148688258 5515 PEACH ST ERIE PA 16509 JOHN M FERRETTI DO PRESIDENT 1.00 79.00 X X 0 1472076 38739 STEVEN G INMAN CPA CGMA TREASURER AND SECRETARY 1.00 64.00 X X 0 381899 38506 RICHARD E FERRETTI ESQ VICE PRESIDENT 1.00 64.00 X X 0 318254 42755 AARON E SUSMARSKI JD BOARD MEMBER 1.00 64.00 X 0 262485 32285 NICK RODRIGUEZ-CAYRO BOARD MEMBER 1.00 X 0 0 0 0 2434714 152285 0 0 1 0 0 PREMIUMS EARNED 524298 6559231 6559231 6559231 424682 424682 7467 0 7467 7467 7467 6991380 6559231 0 432149 145000 145000 2714 2714 18625 18625 3904 3904 52157 52157 8842 8842 LOSSES AND LOSS ADJUSTM 2618264 2618264 PREMIUM TAXES 165359 165359 ACTUARY FEES 28930 28930 MISCELLANEOUS EXPENSE 546 546 3044341 2874098 170243 0 6365486 233770 12888577 22906 23967 1161706 1321997 7550098 14468311 42353 149057 5259192 8013196 5301545 8162253 X 0 0 1125000 1125000 1123553 5181058 2248553 6306058 7550098 14468311 3947039 110466 0 X 0 1 X 1 0 X X X 8 LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE 251698677 2 1 0 0 MILLCREEK MANOR 251619204 3 1 0 0 MEDICAL ASSOCIATES OF ERIE 113716896 10 1 0 0 MILLCREEK COMMUNITY HOSPITAL 251002937 3 1 0 0 VISITING NURSE ASSN OF ERIE COUNTY 250969488 7 1 0 0 CORRY MEMORIAL HOSPITAL 250987222 3 1 0 0 LECOM AT PRESQUE ISLE 475049201 10 1 0 0 ACHIEVEMENT CENTER INC 250965336 10 1 0 0 8 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 LOSSES AND LOSS ADJUSTMENT EXPENSES 7439105 UNEARNED PREMIUMS 574091 8013196 X 7097942 110466 110466 6987476 3904 3904 6991380 3040437 0 3040437 3904 3904 3044341 PART X, LINE 2: THE COMPANY IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS RECOGNIZED AS TAX EXEMPT UNDER 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED AND FOR THE YEAR ENDED DECEMBER 31, 2023, THE ENTIRE BOOK INCOME OF THE COMPANY AS REPORTED IN THE NAIC ANNUAL STATEMENTS WAS ALLOCATED TO MEMBER SAVINGS ACCOUNTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE COMPANY TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY OR ASSET IF THE COMPANY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICES (IRS). THE COMPANY HAS CONCLUDED THAT AS OF DECEMBER 31, 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSETS OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 3,904. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 3,904. 0 0 0 0 0 0 0 0 0 JOHN M FERRETTI DO PRESIDENT 0 1436729 0 0 0 35347 0 26400 0 12339 0 1510815 0 0 STEVEN G INMAN CPA CGMA TREASURER AND SECRETARY 0 375024 0 0 0 6875 0 26363 0 12143 0 420405 0 0 RICHARD E FERRETTI ESQ VICE PRESIDENT 0 309167 0 0 0 9087 0 22954 0 19801 0 361009 0 0 AARON E SUSMARSKI JD BOARD MEMBER 0 261987 0 0 0 498 0 20164 0 12121 0 294770 0 0 PART I, LINE 3 THE ORGANIZATION'S CEO IS PAID BY LECOM. LECOM USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 2 DR. JOHN M. FERRETTI RICHARD FERRETTI PRES/CEO TRUSTEE FAMILY RELATIONSHIP FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING ITS FORM 990, THE ORGANIZATION PROVIDED ITS BOARD MEMBERS WITH ACCESS TO AN ELECTRONIC COPY OF THE TAX RETURN AND INVITED COMMENTS AND QUESTIONS FROM THE BOARD MEMBERS. PRIOR TO FILING FORM 990, MEMBERS OF THE ORGANIZATION'S FINANCIAL MANAGEMENT CONDUCTED A DETAILED REVIEW OF THE TAX FILING. THROUGHOUT THE REVIEW PROCESS, THERE WAS ONGOING DISCUSSION BETWEEN THE ORGANIZATION'S FINANCIAL MANAGEMENT AND THE TAX PREPARER. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF TRUSTEES IS REQUIRED TO COMPLETE A STANDARDIZED CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS OF INTEREST ARE ADDRESSED BY AN APPOINTED COMMITTEE WHOSE MEMBERS ARE INDEPENDENT WITH REGARD TO THE MATTER BEING EXAMINED. IF A POTENTIAL CONFLICT OF INTEREST ARISES, IT IS REVIEWED AND DOCUMENTED BY THE APPOINTED COMMITTEE, AND THEN THE APPOINTED COMMITTEE REPORTS THE RESULTS OF ITS REVIEW TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE SALARIES OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND CERTAIN MEMBERS OF ITS BOARD OF TRUSTEES ARE DETERMINED BY THE EMPLOYING ORGANIZATION'S BUDGET/FINANCE COMMITTEE, WHICH ALSO FUNCTIONS AS A COMPENSATION COMMITTEE. THE BUDGET/FINANCE COMMITTEE REVIEWED A STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT. ON AN ANNUAL BASIS, THE COMMITTEE REVIEWS VARIOUS FORM 990 FILINGS BY COMPARATIVE ORGANIZATIONS IN ORDER TO MAKE EXECUTIVE PAY COMPARISONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE 1858 W GRANDVIEW BLVD ERIE PA 16509 251698677 MEDICAL SCHOOL PA 501(C)(3) LINE 2 MILLCREEK HEALTH SYSTEM 0 MILLCREEK COMMUNITY HOSPITAL 5515 PEACH ST ERIE PA 16509 251002937 HOSPITAL PA 501(C)(3) LINE 3 MILLCREEK HEALTH SYSTEM 0 MEDICAL ASSOCIATES OF ERIE ONE LECOM PLACE ERIE PA 16509 113716896 PHYSICIAN MANAGEMENT PA 501(C)(3) LINE 10 MILLCREEK HEALTH SYSTEM 0 MILLCREEK MANOR 5515 PEACH ST ERIE PA 16509 251619204 LONG TERM CARE PA 501(C)(3) LINE 3 MILLCREEK HEALTH SYSTEM 0 MILLCREEK HEALTH SYSTEM MEDICAL PRO 5515 PEACH ST ERIE PA 16509 576204119 LIABILITY INSURANCE PA 501(C)(3) LINE 12C, III-FI 0 VISITING NURSE ASSOCIATION OF ERIE COUNTY 2253 WEST GRANDVIEW BOULEVARD ERIE PA 16506 250969488 HOME HEALTH PA 501(C)(3) LINE 7 MILLCREEK HEALTH SYSTEM 0 CORRY MEMORIAL HOSPITAL ASSN (CMH) 965 SHAMROCK LANE CORRY PA 16407 250987222 HOSPITAL PA 501(C)(3) LINE 3 MILLCREEK HEALTH SYSTEM 0 CORRY MEDICAL SERVICES 965 SHAMROCK LANE CORRY PA 16407 251425220 HEALTH CARE PA 501(C)(3) LINE 12B, II CORRY MEMORIAL HOSPITAL ASSOCIATION 0 CORRY MEMORIAL HOSPITAL FOUNDATION 965 SHAMROCK LANE CORRY PA 16407 208285800 FUNDRAISING PA 501(C)(3) LINE 12B, II CORRY MEMORIAL HOSPITAL ASSOCIATION 0 LECOM AT PRESQUE ISLE 4114 SCHAPER AVE ERIE PA 16508 475049201 LONG TERM CARE PA 501(C)(3) LINE 10 MILLCREEK HEALTH SYSTEM 0 ACHIEVEMENT CENTER INC 4950 WEST 23RD STREET SUITE 1 ERIE PA 16506 250965336 THERAPEUTIC SERVICES PA 501(C)(3) LINE 10 MILLCREEK HEALTH SYSTEM 0 COUNSELING SERVICES CENTER INC DBA CORRY COUNSELING SERVICES 45 EAST WASHINGTON STREET CORRY PA 16407 251323591 MENTAL HEALTH SERVICES PA 501(C)(3) LINE 7 MILLCREEK HEALTH SYSTEM 0 MILLCREEK HEALTH SYSTEM (MHS) 5515 PEACH ST ERIE PA 16509 251766164 PARENT CORPORATION PA 501(C)(3) LINE 12C, III-FI N/A 0 MCH CORPORATION 5515 PEACH ST ERIE PA 16509 251549695 REAL ESTATE PA MILLCREEK HEALTH SYSTEM C 0 CORRY HEALTH SERVICES INC 965 SHAMROCK LAME CORRY PA 16407 251488214 HEALTH CARE PA CORRY MEMORIAL HOSPITAL ASSOCIATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0