2024-10-09T17:38:18-05:00 2023-12-31 341884125 CBIZ ADVISORS LLC 4722 N 24TH ST STE 300 PHOENIX AZ 85016 990 2023-01-01 261262665 DMG INSURANCE COMPANY INC DMGI 6024705000 2929 E THOMAS ROAD PHOENIX AZ 85016 CRAIG JONES PRESIDENT 6024705000 2024-10-09 1 1 AMY A O'LOUGHLIN P00869687 6022646835 2024-10-07 2023 2024-10-15 13:58:12Z CRAIG JONES 2929 E THOMAS ROAD PHOENIX AZ 85016 5081195 0 X N/A X 2007 AZ OPERATE AS A SUPPORTING ORGANIZATION TO PROVIDE PURE CAPTIVE INSURANCE SERVICES FOR THE EXCLUSIVE BENEFIT OF DISTRICT MEDICAL GROUP, INC. 6 1 0 0 0 0 0 0 3813919 4288414 239920 792781 0 0 4053839 5081195 0 0 0 0 0 0 0 0 0 2613639 1678978 2613639 1678978 1440200 3402217 25651703 29342490 13175858 13311978 12475845 16030512 DMG INSURANCE IS ORANIZED AND OPERATED AS A SUPPORTING ORGANIZATION TO DISTRICT MEDICAL GROUP, INC. 0 0 1511195 4288414 DMG INSURANCE IS ORGANIZED AND OPERATED AS A SUPPORTING ORGANIZATION TO DISTRICT MEDICAL GROUP, INC.DMG INSURANCE PROVIDES MEDICAL PROFESSIONAL LIABILITY COVERAGE FOR THE PHYSICIANS AND PROFESSIONAL STAFF OF DISTRICT MEDICAL GROUP, INC. DMG INSURANCE ALSO PROVIDES GENERAL LIABILITY COVERAGE TO DISTRICT MEDICAL GROUP. 1511195 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 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 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 1 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X CRAIG JONES 6024705000 2929 E THOMAS RD PHOENIX AZ 85016 DR KOTE CHUNDU CHAIRMAN OF THE BOARD 0.30 65.00 X 0 1419602 99826 PHYLLIS BIEDESS BOARD MEMBER 0.10 0.50 X 0 16620 0 CRAIG JONES PRESIDENT, CEO & TREASURER 0.50 50.00 X X 0 294887 66036 DR DANIEL GRIDLEY VICE PRESIDENT 0.10 60.00 X X 0 665428 94708 DENISE ATWOOD VICE PRESIDENT 1.00 50.00 X X 0 186454 23455 PATRICIA BAYLESS SECRETARY 0.30 50.00 X X 0 194277 81206 0 2777268 365231 0 0 1 0 JONES SKELTON & HOCHULI 40 N CENTRAL AVENUE PHOENIX AZ 85004 LEGAL SERVICES 223307 1 PREMIUM REVENUE 524114 4288414 4288414 4288414 792781 792781 5081195 4288414 0 792781 74133 74133 18425 18425 16083 16083 49060 49060 INC(DEC) IN OSLR & IBNR 854389 854389 CLAIMS PAID 647289 647289 INC(DEC) IN ULAE 9517 9517 LICENSE FEES LESS PREM 5788 5788 4294 4294 1678978 1511195 167783 0 2980259 2780447 13169009 16978189 3605675 3409700 18700 0 5296195 5544693 581865 629461 25651703 29342490 2800 33959 3655569 3098000 9517489 10180019 13175858 13311978 X 0 0 475000 475000 12000845 15555512 12475845 16030512 25651703 29342490 3402217 152450 0 X 0 1 X 1 0 X X X 1 DISTRICT MEDICAL GROUP INC 208106540 10 1 647289 0 1 647289 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 O/S LOSS RESERVE & INCURRED BUT NOT REPORTED 9963016 UNALLOCATED LOSS ADJ EXP RESERVE 217003 10180019 X 4288414 0 4288414 792781 792781 5081195 1560256 149566 149566 1410690 16083 252205 268288 1678978 PART X, LINE 2: DMG IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. DMG'S REVENUE IS MAINLY DERIVED FROM INSURANCE OPERATIONS, WHICH ARE GENERALLY SUBJECT TO STATE PREMIUM TAXES AND NOT TO STATE INCOME TAXES. HOWEVER, INCOME DETERMINED TO BE UNRELATED BUSINESS TAXABLE INCOME, IF ANY, WOULD BE TAXABLE. DMG EVALUATES ITS UNCERTAIN TAX POSITIONS, IF ANY, ON A CONTINUAL BASIS THROUGH REVIEW OF ITS POLICIES AND PROCEDURES, REVIEW OF ITS REGULAR TAX FILINGS, AND DISCUSSIONS WITH OUTSIDE EXPERTS. AT DECEMBER 31, 2023, DMG DID NOT HAVE ANY UNCERTAIN TAX POSITIONS. DMG'S POLICY IS TO CLASSIFY INCOME TAX PENALTIES AS GENERAL AND ADMINISTRATIVE EXPENSES IN ITS FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 792,781. PART XII, LINE 2D - OTHER ADJUSTMENTS: CONTRIBUTIONS 149,566. PART XII, LINE 4B - OTHER ADJUSTMENTS: GENERAL ADMINISTRATIVE EXPENSES 252,205. 0 0 0 0 0 0 0 0 0 DR KOTE CHUNDU CHAIRMAN OF THE BOARD 0 1088161 0 325000 0 6441 0 66000 0 33826 0 1519428 0 0 DR DANIEL GRIDLEY VICE PRESIDENT 0 537766 0 0 0 127662 0 39600 0 55108 0 760136 0 0 CRAIG JONES PRESIDENT, CEO & TREASURER 0 290283 0 0 0 4604 0 36281 0 29755 0 360923 0 0 PATRICIA BAYLESS SECRETARY 0 182648 0 0 0 11629 0 51296 0 29910 0 275483 0 0 DENISE ATWOOD VICE PRESIDENT 0 184803 0 0 0 1651 0 21300 0 2155 0 209909 0 0 PART 1, LINE 3: ALL DIRECTORS ARE PAID BY THE SUPPORTED ORGANIZATION ACCORDING TO THE GUIDELINES OF THE SUPPORTED ORGANIZATION'S COMPENSATION PLAN. NONE OF THE COMPENSATION PAID BY THE SUPPORTED ORGANIZATION IS DIRECTLY RELATED TO THE DUTIES PERFORMED AS DIRECTORS AND OFFICERS OF DMG INSURANCE. FORM 990, PART VI, SECTION A, LINE 6 THE SUPPORTED ORGANIZATION, DISTRICT MEDICAL GROUP, IS THE SOLE MEMBER OF DMG INSURANCE COMPANY. FORM 990, PART VI, SECTION A, LINE 7A THE DISTRICT MEDICAL GROUP BOARD OF DIRECTORS HAS FINAL APPROVAL AUTHORITY OF THE ELECTED DIRECTORS OF DMG INSURANCE COMPANY. FORM 990, PART VI, SECTION A, LINE 8B DMG INSURANCE DOES NOT HAVE ANY COMMITTEES THAT ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY THE CFO AND SENT TO THE BOARD OF TRUSTEE PRIOR TO FILING TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND PROCEDURE IS REVIEWED WITH THE BOARD ANNUALLY, AND THE CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY, AND RETAINED BY THE PRESIDENT. ANY POTENTIAL CONFLICTS OF INTEREST IDENTIFIED FROM THE DISCLOSURE STATEMENTS ARE REVIEWED BY THE PRESIDENT, BOARD CHAIRMAN, AND THE ORGANIZATION'S LEGAL COUNSEL, IF NEEDED, AND UNRESOLVED POTENTIAL CONFLICTS ARE NOTED SO THAT ACTUAL CONFLICTS OF INTEREST ARE AVOIDED. FORM 990, PART VI, SECTION C, LINE 19 DMG MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH WRITTEN REQUESTS RECEIVED AT THE CORPORATE OFFICE. THE REQUEST IS TO BE REVIEWED BY THE APPROPRIATE CORPORATE OFFICER, WHO WILL OVERSEE THE FULFILLING OF THE REQUEST. DISTRICT MEDICAL GROUP INC 2929 E THOMAS ROAD PHOENIX AZ 85016 208106540 PHYSICIAN SERVICES AZ 501(C)(3) LINE 10 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1