2024-11-14T10:29:38-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2023-01-01 030317160 CHILD DIMENSIONS INSURANCE COMPANY CHIL 3305438171 ONE PERKINS SQUARE AKRON OH 44308 ALICIA LAMANCUSA TREASURER 3305438171 2024-11-13 1 1 AMY CIMINELLO P00796388 2483757100 2024-10-31 2023 2024-10-15 13:58:12Z CHRISTOPHER GESSNER ONE PERKINS SQUARE AKRON OH 44308 119272203 0 X N/A X 1988 VT TRANSACTS BUSINESS AS A CAPTIVE INSURANCE COMPANY. 9 2 0 2 0 0 0 0 3748411 3860199 1409514 9998129 0 0 5157925 13858328 0 0 0 0 0 0 0 0 0 -3558951 152488 -3558951 152488 8716876 13705840 64324391 41641644 20397142 21266040 43927249 20375604 X CHILD DIMENSIONS INSURANCE COMPANY (CDIC) TRANSACTS BUSINESS AS A CAPTIVE INSURANCE COMPANY. CDIC PROVIDES PROFESSIONAL, GENERAL AND EXCESS LIABILITY COVERAGE TO CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON AND ITS SUBSIDIARIES AS WELL AS A PORTION OF THE STOP LOSS COVERAGE FOR AKRON CHILDREN'S HEALTH COLLABORATIVE. 0 0 -186301 0 3860199 CHILD DIMENSIONS INSURANCE COMPANY IS A PURE CAPTIVE INSURANCE COMPANY PROVIDING PROFESSIONAL LIABILITY (MEDICAL MALPRACTICE), GENERAL, AND EXCESS LIABILITY INSURANCE TO CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON AND ITS SUBSIDIARIES AS WELL AS A PORTION OF THE STOP LOSS COVERAGE FOR AKRON CHILDREN'S HEALTH COLLABORATIVE. -186301 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 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 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 2 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X ALICIA LAMANCUSA 3305438171 ONE PERKINS SQUARE AKRON OH 44308 LISA AURILIO DIRECTOR/CHIEF OPERATING OFFICER 1.00 49.00 X 0 788243 154582 CHRISTOPHER GESSNER PRESIDENT/CHIEF EXECUTIVE OFFICER 1.50 48.50 X X 0 1409649 321825 TARUN BHALLA MD DIRECTOR/CHAIR OF ANESTHESIOLOGY 1.00 49.00 X 0 821691 65821 ROBERT MCGREGOR MD DIRECTOR/CHIEF MEDICAL OFFICER 1.00 49.00 X 0 1119476 85679 ALICIA LAMANCUSA TREASURER/VP FINANCE 2.00 48.00 X X 0 469758 59086 MICHAEL BIGHAM MD DIRECTOR/CHIEF QUALITY OFFICER 2.00 48.00 X X 0 594622 142178 RUSSELL YOUNG SECRETARY 2.00 0.00 X X 0 0 0 COURTNEY DOHERTY DIRECTOR 1.00 0.00 X 0 0 0 GORDON EDWARDS DIRECTOR/CHIEF FINANCIAL OFFICER/TREASURER 1.00 49.00 X 0 789672 85888 SHAWN LYDEN DIRECTOR/CHIEF STRATEGY OFFICER - PART YEAR 1.00 49.00 X X 0 828662 167523 KARA WILLIAMS VP CLAIMS/ASSOCIATE GENERAL COUNSEL 2.00 48.00 X 0 158738 25432 ANTHEA DANIELS DIRECTOR/VP CLAIMS/CHIEF LEGAL OFFICER - PART YEAR 2.00 48.00 X 0 556297 8738 0 7536808 1116752 0 0 1 0 0 PREMIUMS EARNED 900099 3860199 3860199 3860199 1895585 1895585 113516419 105413875 8102544 8102544 8102544 13858328 3860199 0 9998129 X 81535 81535 13792 13792 30449 30449 109800 109800 39091 37450 1641 23267 23267 4990644 4990644 STATE TAXES 78305 78305 REDUCTION IN MALPRACTIC -5214395 -5214395 152488 -186301 338789 0 161770 235884 4032777 5482879 60129844 35922881 64324391 41641644 69821 304769 20327321 20961271 20397142 21266040 X 100000 100000 1600000 1600000 42227249 18675604 43927249 20375604 64324391 41641644 X 13705840 -2257485 -35000000 X X 0 1 X 1 0 X X 1 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON 340714357 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 1 CHILD DIMENSIONS INSURANCE COMPANY (CDIC), THE FILING ORGANIZATION, IS ORGANIZED AND OPERATED FOR THE EXCLUSIVE BENEFIT OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA) AS STATED IN ITS GOVERNING DOCUMENTS. 0 RESERVE FOR PROFESSIONAL AND GENERAL LIABILITIES 20102155 PAYABLE TO PARENT 31368 RESERVE FOR CYBER LIABILITIES 827748 20961271 11491043 -2257485 -2257485 13748528 109800 109800 13858328 42688 0 42688 109800 109800 152488 0 1 0 0 0 0 0 0 0 CHRISTOPHER GESSNER PRESIDENT/CHIEF EXECUTIVE OFFICER 0 985843 0 405000 0 18806 0 274116 0 47709 0 1731474 0 0 ROBERT MCGREGOR MD DIRECTOR/CHIEF MEDICAL OFFICER 0 547080 0 152625 0 419771 0 62339 0 23340 0 1205155 0 389396 SHAWN LYDEN DIRECTOR/CHIEF STRATEGY OFFICER - PA 0 662040 0 134772 0 31850 0 143975 0 23548 0 996185 0 0 LISA AURILIO DIRECTOR/CHIEF OPERATING OFFICER 0 583477 0 163059 0 41707 0 140820 0 13762 0 942825 0 0 TARUN BHALLA MD DIRECTOR/CHAIR OF ANESTHESIOLOGY 0 819108 0 0 0 2583 0 19800 0 46021 0 887512 0 0 GORDON EDWARDS DIRECTOR/CHIEF FINANCIAL OFFICER/TRE 0 672833 0 115000 0 1839 0 39782 0 46106 0 875560 0 0 MICHAEL BIGHAM MD DIRECTOR/CHIEF QUALITY OFFICER 0 408398 0 127554 0 58670 0 97634 0 44544 0 736800 0 0 ANTHEA DANIELS DIRECTOR/VP CLAIMS/CHIEF LEGAL OFFIC 0 384924 0 122822 0 48551 0 6091 0 2647 0 565035 0 0 ALICIA LAMANCUSA TREASURER/VP FINANCE 0 349504 0 102938 0 17316 0 36953 0 22133 0 528844 0 0 KARA WILLIAMS VP CLAIMS/ASSOCIATE GENERAL COUNSEL 0 157829 0 200 0 709 0 8347 0 17085 0 184170 0 0 PART I, LINE 3 CHILD DIMENSIONS INSURANCE COMPANY RELIES ON ITS MEMBER, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA), TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON'S EXECUTIVE TOTAL COMPENSATION PROGRAM IS ULTIMATELY GOVERNED BY THE COMPENSATION COMMITTEE (COMMITTEE) OF THE BOARD OF DIRECTORS. AN INDEPENDENT SALARY SURVEY WAS LAST COMPLETED IN 2023. PART I, LINE 4B THE FOLLOWING INDIVIDUALS BECAME PARTICIPANTS IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS DURING 2018, WHEREBY THEY BECOME VESTED PER THE TERMS OF THEIR EMPLOYMENT AGREEMENT. CHMCA IS ACCRUING FOR THE BENEFIT THAT WILL OCCUR, THEREFORE THESE AMOUNTS ARE INCLUDED IN THEIR DEFERRED COMPENSATION. DISTRIBUTIONS WERE MADE IN 2023 IN THE FOLLOWING AMOUNTS: ROBERT MCGREGOR M.D. - $389,396 SHAWN LYDEN - $0 ANTHEA DANIELS - $0 CHRISTOPHER GESSNER - $0 MICHAEL BIGHAM - $0 LISA AURILIO - $0 CHMCA HAS A SUPPLEMENTAL NONQUALIFIED PLAN OPEN TO SELECTED EMPLOYEES WHEN WAGES EXCEED THE MAXIMUM THRESHOLD FOR THE QUALIFIED RETIREMENT PLANS. THE AMOUNTS ARE CALCULATED IN THE FOLLOWING YEAR OF EARNINGS AND EITHER PAID TO THE EMPLOYEE IF THEY ARE VESTED AS TAXABLE INCOME OR PUT INTO THE PLAN UNTIL VESTED AND THEN PAID. FORM 990, PART VI, SECTION A, LINE 6 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON IS THE SOLE STOCKHOLDER OF CHILD DIMENSIONS INSURANCE COMPANY. FORM 990, PART VI, SECTION A, LINE 7A CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON IS THE SOLE STOCKHOLDER OF CHILD DIMENSIONS INSURANCE COMPANY AND ITS GOVERNING BODY HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (MEMBER) FOR REVIEW AND DISCUSSION PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. THE AUDIT COMMITTEE IS A COMMITTEE OF THE BOARD OF DIRECTORS AND EMPOWERED TO COMPLETE THE REVIEW ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF CDIC TO FOLLOW THE POLICIES OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA). ALL OFFICERS, DIRECTORS, AND EMPLOYEES DISCLOSE REAL OR APPARENT CONFLICTS OF INTEREST AS A CONDITION OF BOARD MEMBERSHIP WITH CDIC. SINCE CDIC HAS NO EMPLOYEES, ONLY OFFICERS AND DIRECTORS DISCLOSE, IN WRITING, ON AN ANNUAL BASIS, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS IN WHICH HE/SHE (OR AN IMMEDIATE FAMILY MEMBER) IS AN OFFICER, MEMBER, OWNER, SHAREHOLDER, TRUSTEE OR EMPLOYEE FOR WHICH HE/SHE ACTS AS AN AGENT OR MIGHT REASONABLY IN THE NEAR FUTURE ENTER INTO A RELATIONSHIP OR TRANSACTION IN WHICH HE/SHE COULD HAVE A DUALITY OF INTEREST. IF A SITUATION ARISES IN WHICH THERE IS A DUALITY OF INTEREST AND AS SUCH, POTENTIAL FOR A CONFLICT OF INTEREST, IT IS THE PRIMARY RESPONSIBILITY OF SUCH INDIVIDUAL DIRECTLY INVOLVED TO MAKE IMMEDIATE AND COMPLETE DISCLOSURE TO THE APPROPRIATE SUPERVISOR. THE CHIEF HUMAN RESOURCES OFFICER SHALL REVIEW ALL DISCLOSURE STATEMENTS AND FORWARD THOSE WITH RECOMMENDATIONS TO THE CHIEF LEGAL OFFICER. THE CHIEF LEGAL OFFICER REFERS SELECTED ISSUES OR MATTERS FOR CONSULTATION TO THE AUDIT COMMITTEE OF THE BOARD. ANNUALLY, ALL DIRECTORS AND OFFICERS OF CDIC MUST DISCLOSE THIER CONFLICTS ON THE CONFLICT OF INTEREST/DUAL INTEREST DISCLOSURE STATEMENT IN ACCORDANCE WITH THE EMPLOYEE CONFLICT OF INTEREST POLICY WHICH POLICY APPLIES TO ALL EMPLOYEES OF CHMCA. FORM 990, PART VI, SECTION B, LINE 15 CDIC RELIES ON THE RELATED ORGANIZATION, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES - CONSULTING FEES: PROGRAM SERVICE EXPENSES 37,450. MANAGEMENT AND GENERAL EXPENSES 1,641. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,091. FORM 990, PART XI, LINE 9: DIVIDEND TO PARENT -35,000,000. PART XII, LINE 2C: CDIC THROUGH ITS PARENT COMPANY CHILDREN'S HOSPITAL CENTER OF AKRON HAS AN AUDIT COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, REVIEW, OR COMPILATION OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. CHILDREN'S HOSPITAL MED CENTER OF AKRON ONE PERKINS SQUARE AKRON OH 44308 340714357 HOSPITAL OH 501(C)(3) LINE 3 N/A 0 AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON OH 44308 237114013 FOUNDATION OH 501(C)(3) LINE 7 CHILDREN'S HOSPITAL MED CENTER OF AKRON 1 AKRON CHILDREN'S HEALTH COLLABORATIVE ONE PERKINS SQUARE AKRON OH 44308 870853487 ACCOUNTABLE CARE ORGANIZATION OH 501(C)(4) LINE 12A, I CHILDREN'S HOSPITAL MED CENTER OF AKRON 1 GAMUT QUALITY IMPROVEMENT COLLABORATIVE LLC 68 RAVENNA STREET 463 HUDSON OH 44236 871832345 CONTRACT MANAGEMENT OH N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0