2024-11-14T15:04:54-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOIS MN 55402 990 2023-01-01 880661315 UCARE IOWA UCAR 6126766500 500 STINSON BLVD NE MINNEAPOLIS MN 55413 BETH MONSRUD SVP, CFO & TREASURER 6126766500 2024-11-14 1 1 KURT BENNION P01469618 6123764500 2024-11-14 2023 2024-10-15 13:58:12Z X HILARY MARDEN-RESNIK 500 STINSON BLVD NE MINNEAPOLIS MN 55413 0 0 X WWW.UCARE.ORG X 2022 IA TO PROVIDE COMPREHENSIVE HEALTH SERVICES AND CARE MANAGEMENT SERVICES TO OUR MEMBERS. 17 17 0 19 0 0 5500000 0 0 0 0 0 0 0 5500000 0 0 0 0 0 0 0 0 0 0 0 340 0 340 5500000 -340 5500000 5499660 0 0 5500000 5499660 UCARE IOWA WILL IMPROVE THE HEALTH OF OUR MEMBERS THROUGH INNOVATIVE SERVICES AND PARTNERSHIPS ACROSS COMMUNITIES. 0 0 0 0 0 UCARE IOWA INC. IS A NON-PROFIT SERVICE INSURANCE CORPORATION THAT WILL PROVIDE ACCESS TO COMPREHENSIVE HEALTH SERVICES AND CARE MANAGEMENT PROGRAMS DESIGNED TO IMPROVE THE HEALTH AND HEALTH COVERAGE OF OUR ENROLLED MEMBERS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 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 1 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X GREG MARSHALL 6126766500 500 STINSON BLVD NE MINNEAPOLIS MN 55413 HILARY MARDEN-RESNIK PRESIDENT & CEO 0.10 39.90 X 0 1198356 182880 BETH MONSRUD SVP, CFO & TREASURER 0.10 39.90 X 0 713738 98201 DANIEL SANTOS CHIEF LEGAL OFFICER & SECRETARY 0.10 39.90 X 0 663906 82178 GHITIANN WORCESTER EVP CHIEF MARKETING OFFICER (THROUGH SEP 2023) 0.10 39.90 X 0 602986 26884 TENBIT EMIRU EVP, CHIEF MEDICAL OFFICER 0.10 39.90 X 0 504508 89960 MARIE ZIMMERMAN EVP, CHIEF STRATEGY OFFICER 0.10 39.90 X 0 426273 55255 JAY SIVASAILAM EVP, CHIEF GROWTH OFFICER 0.10 39.90 X 0 268127 33674 MERIAM MOHAMED DIRECTOR 0.10 0.40 X 0 15000 0 CHARITY BENNETT DIRECTOR 0.10 0.40 X 0 14963 0 P JAY KIEDROWSKI DIRECTOR 0.10 0.40 X 0 14750 0 ROBERT RISKIN DIRECTOR 0.10 0.40 X 0 13000 0 JAMES VAN VOOREN MD BOARD CHAIR 0.10 0.40 X X 0 11500 0 TERESA MCCARTHY MD VICE CHAIR 0.10 0.40 X X 0 11500 0 TOM DEPHILLIPS DIRECTOR 0.10 0.40 X 0 10500 0 PATRICIA ADAM MD DIRECTOR 0.10 0.40 X 0 10250 0 ALLISON O'TOOLE DIRECTOR 0.10 0.40 X 0 10250 0 JEFF BANGSBERG DIRECTOR 0.10 0.40 X 0 10000 0 PATRICIA NELSON DIRECTOR 0.10 0.40 X 0 10000 0 MICHAEL WOOTTEN MD DIRECTOR 0.10 0.40 X 0 10000 0 WILLIAM ROBERTS MD DIRECTOR 0.10 0.40 X 0 9000 0 JAMES PACALA MD DIRECTOR (THROUGH AUG 2023) 0.10 0.40 X 0 6500 0 ANTHONY MENDOZA DIRECTOR 0.10 0.40 X 0 3500 0 MARTINA SAGAYAM DIRECTOR 0.10 0.40 X 0 2750 0 JAMES KOPPEL DIRECTOR 0.10 0.40 X 0 2750 0 DOROTHY BRIDGES DIRECTOR 0.10 0.40 X 0 0 0 MYRON FRANS DIRECTOR (THROUGH AUG 2023) 0.10 0.40 X 0 0 0 0 4544107 569032 0 0 1 0 0 0 0 0 0 LICENSES AND FEES 340 340 340 0 340 0 5500000 5499660 5500000 5499660 0 0 X 5500000 5499660 0 5500000 5499660 5500000 5499660 -340 0 X 0 1 X 1 0 0 X PART X, LINE 2: UCARE HAD ELECTED TO ADOPT GUIDANCE ON THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. UCARE FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON UCARE'S CONSOLIDATED FINANCIAL STATEMENTS. UCARE'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. 0 1 0 0 0 0 0 0 0 HILARY MARDEN-RESNIK PRESIDENT & CEO 0 909162 0 244065 0 45129 0 11000 0 171880 0 1381236 0 0 BETH MONSRUD SVP, CFO & TREASURER 0 477761 0 193431 0 42546 0 8250 0 89951 0 811939 0 0 DANIEL SANTOS CHIEF LEGAL OFFICER & SECRETARY 0 458828 0 169974 0 35104 0 11002 0 71176 0 746084 0 0 GHITIANN WORCESTER EVP CHIEF MARKETING OFFICER (THROUGH SEP 2023) 0 308611 0 252991 0 41384 0 10196 0 16688 0 629870 0 0 TENBIT EMIRU EVP, CHIEF MEDICAL OFFICER 0 461273 0 43185 0 50 0 11000 0 78960 0 594468 0 0 MARIE ZIMMERMAN EVP, CHIEF STRATEGY OFFICER 0 384006 0 42217 0 50 0 11000 0 44255 0 481528 0 0 JAY SIVASAILAM EVP, CHIEF GROWTH OFFICER 0 268077 0 0 0 50 0 4415 0 29259 0 301801 0 0 PART I, LINE 3 THE COMPENSATION FOR THE PRESIDENT AND CEO IS DETERMINED BY UCARE MINNESOTA, THE SOLE MEMBER. THE FOLLOWING METHODS ARE USED BY UCARE MINNESOTA WHEN DETERMINING THE PRESIDENT AND CEO'S COMPENSATION: (1) COMPENSATION COMMITTEE (2) INDEPENDENT COMPENSATION CONSULTANT (3) FORM 990 OF OTHER ORGANIZATIONS (4) WRITTEN EMPLOYMENT CONTRACT (5) COMPENSATION SURVEY OR STUDY (6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN UCARE MINNESOTA'S 457(F) PLAN IN 2023: CONTRIBUTIONS: HILARY MARDEN-RESNIK - $144,248 BETH MONSRUD - $63,408 GHITIANN WORCESTER - $15,108 DANIEL SANTOS - $58,227 TENBIT EMIRU - $60,162 MARIE ZIMMERMAN - $44,211 JAY SIVASAILAM - $26,650 DISTRIBUTIONS: HILARY MARDEN-RESNIK - $45,079 BETH MONSRUD - $42,496 GHITIANN WORCESTER - $41,384 DANIEL SANTOS - $34,979 FORM 990, PART VI, SECTION A, LINE 3 UCARE IOWA, INC. HAS AN ADMINISTRATIVE SERVICE AGREEMENT WITH UCARE MINNESOTA TO PROVIDE OVERALL MANAGEMENT AND ADMINISTRATION OF UCARE IOWA, INC.'S BUSINESS. UCARE IOWA, INC.'S BUSINESS INCLUDES, BUT IS NOT LIMITED TO, ADMINISTRATIVE MANAGEMENT, FINANCIAL MANAGEMENT, PROVIDER CONTRACTING SERVICES, MARKETING SERVICES AND PUBLIC AFFAIRS SERVICES, AND OTHER TASKS AS MAY BE NECESSARY TO CARRY OUT ANY POLICIES RELATED TO UCARE IOWA, INC.'S BUSINESS. UCARE IOWA, INC. REIMBURSES UCARE MINNESOTA FOR ALL COSTS AND EXPENSES DIRECTLY AND INDIRECTLY INCURRED AND ASSOCIATED WITH THE BUSINESS AND OPERATION OF UCARE IOWA, INC. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION'S SOLE MEMBER IS UCARE MINNESOTA, A MINNESOTA NON-PROFIT CORPORATION ORGANIZED TO OPERATE AS A HEALTH MAINTENANCE ORGANIZATION UNDER MINNESOTA STATUTES, CHAPTER 62D AND EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE SERVICE CODE. UCARE MINNESOTA AS THE CORPORATE MEMBER, HAS ALL POWERS AND VOTING RIGHTS AFFORDED BY LAW TO VOTING MEMBERS OF SERVICE INSURANCE CORPORATIONS UNDER WISCONSIN STATUTES CHAPTER 613 AND APPLICABLE SECTIONS OF IOWA STATUTES. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS ARE ELECTED AUTOMATICALLY BY VIRTUE OF THEIR ELECTION TO THE UCARE MINNESOTA BOARD OF DIRECTORS, UNLESS A DIFFERENT DIRECTOR IS ELECTED BY UCARE MINNESOTA AS CORPORATE MEMBER ACTING THROUGH ITS BOARD OF DIRECTORS. SUCH DIFFERENT DIRECTORS NEED NOT BE RESIDENT OF IOWA, AND MAY OR MAY NOT BE ENROLLEES RECEIVING COVERAGE OR SERVICES FROM THE CORPORATION ALTHOUGH AT LEAST 40% OF THE DIRECTORS SHALL BE ENROLLEES OF THE CORPORATION OR UCARE MINNESOTA. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO THE POWERS SET FORTH IN IOWA FOR MEMBERS, UCARE MINNESOTA HAS RESERVED TO ITSELF THE FOLLOWING POWERS CONCERNING THE GOVERNANCE OF THE CORPORATION, WHICH SHALL BE EXPRESSED THROUGH THE UCARE MINNESOTA BOARD OF DIRECTORS: (A) THE APPROVAL OF ANY PLANS OF MERGER OR CONSOLIDATION BY THE CORPORATION WITH ANY FOREIGN OR DOMESTIC CORPORATION, VOLUNTARY DISSOLUTION OF THE CORPORATION, OR ANY SALES, LEASE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; (B) THE APPROVAL OF THE GRANT OF A SECURITY INTEREST IN ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS OR THE GUARANTEE OF ANY INDEBTEDNESS BEFORE SUCH SECURITY INTEREST OR GUARANTEE BECOMES LEGALLY BINDING, AND (C) THE AMENDMENT OF THE ARTICLES OF INCORPORATION OR BY LAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY THE CONTROLLER AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. UCARE PROVIDED A COPY AND REVIEWED THE DETAIL OF THE COMPLETED FORM 990 WITH THE BOARD'S FINANCE, AUDIT & BUSINESS DEVELOPMENT COMMITTEE. UCARE ALSO PROVIDED A COPY OF THE COMPLETED FORM 990 TO ALL MEMBERS OF THE BOARD OF DIRECTORS VIA ON-LINE PORTAL PRIOR TO THE FINANCE, AUDIT & BUSINESS DEVELOPMENT COMMITTEE'S REPORT TO THE BOARD. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE FORM 990 WAS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C UCARE REQUIRES COMPLETION OF AN ANNUAL QUESTIONNAIRE BY ITS BOARD MEMBERS, OFFICERS, AND SENIOR EXECUTIVES, WHICH IS DESIGNED TO SURFACE POTENTIAL CONFLICTS OF INTEREST. IN ADDITION, UCARE'S CONFLICT OF INTEREST POLICY REQUIRES DISCLOSURE TO THE BOARD CHAIR AND/OR CEO OF A POTENTIAL CONFLICT INVOLVING A DIRECTOR, OFFICER, OR MANAGEMENT STAFF WHEN A PARTICULAR TRANSACTION ARISES. IF THE BOARD OR DESIGNATED BOARD COMMITTEE DETERMINES THAT A POTENTIAL CONFLICT EXISTS RELATED TO A TRANSACTION REQUIRING ACTION BY THE BOARD, THE POLICY CALLS FOR THE BOARD MEMBER WITH THE POTENTIAL CONFLICT TO ABSTAIN FROM VOTING. IN ADDITION, A MAJORITY OF THE DISINTERESTED DIRECTORS MUST FIND THAT THE TRANSACTION IS FAIR AND REASONABLE TO THE OPERATION AND THAT THE ORGANIZATION COULD NOT REASONABLY FIND A MORE ADVANTAGEOUS TRANSACTION FROM ANOTHER ENTITY WITHOUT A POTENTIAL CONFLICT. THE POLICY ALSO REQUIRES DISCLOSURE OF POTENTIAL CONFLICTS TO THE BOARD OR DESIGNATED COMMITTEE EVEN FOR TRANSACTIONS NOT REQUIRING BOARD ACTION. FORM 990, PART VI, SECTION C, LINE 19 UCARE IOWA, INC. WILL PROVIDE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND/OR FINANCIAL STATEMENTS UPON REQUEST. UCARE FOUNDATION 500 STINSON BLVD NE MINNEAPOLIS MN 55413 464795214 COMMUNITY-DIRECTED INITIATIVE OF UCARE MINNESOTA MN 501(C)(3) LINE 12A, I UCARE MINNESOTA 0 UCARE MINNESOTA 500 STINSON BLVD NE MINNEAPOLIS MN 55413 363573805 NOT-FOR-PROFIT HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) LINE 10 N/A 0 UCARE HEALTH INC 500 STINSON BLVD NE MINNEAPOLIS MN 55413 208295948 NON-PROFIT SERVICE INSURANCE ORGANIZATION WI 501(C)(4) UCARE MINNESOTA 0 UCARE KANSAS 500 STINSON BLVD NE MINNEAPOLIS MN 55413 932931013 NON-PROFIT SERVICE INSURANCE ORGANIZATION KS 501(C)(4) UCARE MINNESOTA 0 UCARE COMMUNITY HEALTH PLAN 500 STINSON BLVD NE MINNEAPOLIS MN 55413 411796007 NON-PROFIT SERVICE INSURANCE ORGANIZATION MN 501(C)(4) UCARE MINNESOTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0