2025-02-10T13:09:13-06:00 2024-03-31 331498605 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2023-04-01 854388186 MARY FREE BED INSURANCE COMPANY PCC MARY 8005288989 235 WEALTHY ST SE GRAND RAPIDS MI 49503 RYAN PODVIN CFO 8005288989 2025-02-05 1 1 SAMANTHA L BECKER P01344887 2483757100 2025-02-05 2023 2025-03-06 01:10:19Z CAPTIVE RYAN PODVIN 235 WEALTHY ST SE GRAND RAPIDS MI 49503 2840343 0 X N/A X 2020 DC THE CAPTIVE ISSUES DEDUCTIBLE REIMBURSEMENT POLICIES TO ITS NOT-FOR-PROFIT OWNER FOR LOSSES INCURRED UNDER COMMERCIAL INSURANCE POLICIES, COVERING GENERAL AND PROFESSIONAL LIABILITY, AND EXCESS WORKERS COMPENSATION AND EMPLOYEE MEDICAL PLAN EXPENSES.CAPTIVE PROMOTES THE HEALTH OF THE COMMUNITY IT AND MFB SERVE THROUGH VARIOUS MEANS, INCLUDING, BUT NOT LIMITED TO, PROVIDING HEALTH CARE SERVICES TO ALL PERSONS SEEKING CARE AT CAPTIVE'S PARENT'S FACILITIES WITHOUT REGARD TO ANY PERSON'S ABILITY TO PAY FOR SUCH CARE, AND, IN PARTICULAR, PROVIDING HEALTH CARE SERVICES ON A NON-DISCRIMINATORY BASIS TO ALL MEDICARE AND MEDICAID PATIENTS SEEKING CARE AT CAPTIVE'S FACILITIES. 3 0 0 0 0 0 0 0 2251992 2099382 62165 120112 0 0 2314157 2219494 0 0 0 0 0 0 0 0 0 1741345 3179283 1741345 3179283 572812 -959789 4768464 4126609 2987953 3204954 1780511 921655 X THE MARY FREE BED INSURANCE COMPANY PCC, SUPPORTS THE NOT FOR PROFIT MISSION OF ITS PARENT, THE MARY FREE BED REHABILITATION HOSPITAL, AND THE COMMUNITY SERVED BY ITS PARENT, BY ENHANCING THE MANAGEMENT OF PATIENT, EMPLOYEE AND OTHER RISKS, THUS REDUCING THE TOTAL COST OF ITS PARENT'S ENTERPRISE RISK. 0 0 3007540 2099382 THE CAPTIVE ISSUES DEDUCTIBLE REIMBURSEMENT POLICIES TO ITS NOT-FOR-PROFIT OWNER FOR LOSSES INCURRED UNDER COMMERCIAL INSURANCE POLICIES, COVERING GENERAL AND PROFESSIONAL LIABILITY, AND EXCESS WORKERS COMPENSATION AND EMPLOYEE MEDICAL PLAN EXPENSES.CAPTIVE PROMOTES THE HEALTH OF THE COMMUNITY IT AND MFB SERVE THROUGH VARIOUS MEANS, INCLUDING, BUT NOT LIMITED TO, PROVIDING HEALTH CARE SERVICES TO ALL PERSONS SEEKING CARE AT CAPTIVE'S PARENT'S FACILITIES WITHOUT REGARD TO ANY PERSON'S ABILITY TO PAY FOR SUCH CARE, AND, IN PARTICULAR, PROVIDING HEALTH CARE SERVICES ON A NON-DISCRIMINATORY BASIS TO ALL MEDICARE AND MEDICAID PATIENTS SEEKING CARE AT CAPTIVE'S FACILITIES. 3007540 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 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 MI X RYAN PODVIN 6168408676 235 WEALTHY ST SE GRAND RAPIDS MI 49503 KENT RIDDLE SECRETARY 1.00 58.00 X X 0 1065549 62494 RYAN PODVIN TREASURER 1.00 51.50 X X 0 357902 66261 NATHANIEL GUZMAN PRESIDENT 1.00 39.00 X X 0 198338 16817 0 1621789 145572 1 0 1 0 0 PREMIUM REVENUE 524298 2099382 2099382 2099382 131701 131701 609260 620849 -11589 -11589 -11589 2219494 2099382 0 120112 66250 66250 97116 97116 475 475 GROSS PAID CLAIMS 2439407 2439407 CHANGE IN IBNR 401877 401877 CHANGE IN OSLR 166256 166256 INSURANCE PREMIUM TAXES 7902 7902 3179283 3007540 171743 0 751966 459623 1305865 1530348 80000 0 74748 27814 2555885 2108824 4768464 4126609 1462240 1581790 1525713 1623164 2987953 3204954 X 0 0 395000 395000 1385511 526655 1780511 921655 4768464 4126609 -959789 100933 0 X 0 1 X 1 0 X X 1 MARY FREE BED REHABILITATION HOSPITAL 381359265 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 UNPAID LOSSES AND LOSS ADJUSTMENT EXPENSES 1615664 ACCRUED OTHER LIABILITIES 7500 1623164 2296452 100933 100933 2195519 23975 23975 2219494 3155308 0 3155308 23975 23975 3179283 0 1 0 0 0 0 0 0 0 KENT RIDDLE SECRETARY 0 906955 0 158594 0 0 0 44212 0 18282 0 1128043 0 0 RYAN PODVIN TREASURER 0 314815 0 43087 0 0 0 45460 0 20801 0 424163 0 0 NATHANIEL GUZMAN PRESIDENT 0 181147 0 17191 0 0 0 11887 0 4930 0 215155 0 0 PART I, LINE 3 KENT RIDDLE IS COMPENSATED BY A RELATED PARTY WHO USES A COMPENSATION COMMITTEE, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE HIS COMPENSATION. PART I, LINE 4B MARY FREE BED REHABILITATION HOSPITAL (MFB) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF MFB AND ITS AFFILIATED ENTITIES. THIS SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THIS SERP IS TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. KENT RIDDLE IS A PARTICIPANT OF THIS PLAN. THERE WERE NO SERP PAYMENTS DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS MARY FREE BED REHABILITATION HOSPITAL, AS DICTATED BY THE BY-LAWS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, MARY FREE BED REHABILITATION HOSPITAL, ELECTS THE DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS ARE DICTATED BY THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO PRIOR TO FILING. AFTER COMPLETION OF THE RETURN, RETURN WILL BE POSTED TO AN INTERNAL WEBSITE PORTAL FOR ALL BOARD MEMBERS TO REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICIES ARE UPDATED ANNUALLY BY ALL BOARD MEMBERS, OFFICERS AND STAFF. PROCESS IS ADMINISTERED OUT OF THE EXECUTIVE ADMINISTRATION OFFICE. ANY DISCLOSED CONFLICTS OF INTEREST WOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND ASSURANCES OBTAINED THAT NO ILLEGAL OR SUBSIDIZED ACTIVITIES ARE OCCURRING. ALL DISCLOSURES ARE REVIEWED BY THE HOSPITAL'S COMPLIANCE COMMITTEE. IF A CONFLICT OF INTEREST IS EXPOSED, THE INDIVIDUAL WHO IS THE SUBJECT OF THE CONFLICT IS EXCUSED FROM THE MEETING SO THE REST OF THE BOARD MAY DISCUSS THE ISSUE AND TAKE APPROPRIATE ACTION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FINANCIAL STATEMENTS ARE SUMMARIZED IN AN ANNUAL REPORT WHICH IS AVAILABLE TO THE PUBLIC. MARY FREE BED GUILD FUND 235 WEALTHY STREET SE GRAND RAPIDS MI 49503 382643392 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MARY FREE BED GUILD 1 MARY FREE BED GUILD 235 WEALTHY STREET SE GRAND RAPIDS MI 49503 382649369 CHARITABLE HEALTHCARE MI 501(C)(3) LINE 7 N/A 0 MARY FREE BED ORTHOTICS AND PROSTHETICS 235 WEALTHY STREET SE GRAND RAPIDS MI 49503 382643391 ORTHOTICS AND PROSTHETICS MI 501(C)(3) LINE 10 MARY FREE BED REHABILITATION HOSPITAL 1 MARY FREE BED REHABILITATION HOSPITAL 235 WEALTHY STREET SE GRAND RAPIDS MI 49503 381359265 CHARITABLE HEALTHCARE MI 501(C)(3) LINE 3 MARY FREE BED GUILD 1 MARY FREE BED REHABILITATION HOSPITAL FOUNDATION 235 WEALTHY STREET SE GRAND RAPIDS MI 49503 461164285 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MARY FREE BED REHABILITATION HOSPITAL 1 ASSOCIATION FOR THE BLIND AND VISUALLY IMPAIRED 456 CHERRY SE GRAND RAPIDS MI 49503 381387122 CHARITABLE HEALTHCARE MI 501(C)(3) LINE 7 MARY FREE BED REHABILITATION HOSPITAL 1 THE FOUNDATION IN SUPPORT OF THE ASSOCIATION FOR THE BLIND 456 CHERRY SE GRAND RAPIDS MI 49503 383382541 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I ASSOCIATION FOR THE BLIND AND VISUALLY IMPAIRED 1 RHH-MFB HEALTH VENTURES LLC 400 NORTHPOINTE CIRCLE SUITE 203 SEVEN FIELDS PA 16046 811066258 IN-HOME NURSING MI N/A 0 0 MARY FREE BED REHABILITATION LLC 235 WEALTHY ST SE GRAND RAPIDS MI 49503 383584123 PHYSICAL THERAPY MI N/A C 0 MARY FREE BED CONDOMINIUM ASSOCIATION 235 WEALTHY ST SE GRAND RAPIDS MI 49503 382694280 CONDO MAINTENANCE MI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 MARY FREE BED REHABILITATION HOSPITAL S 2040981 CASH MARY FREE BED REHABILITATION HOSPITAL P 2321886 ACTUAL COST