BETA

M3 INSURANCE FOUNDATION INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
M3 INSURANCE FOUNDATION INC (EIN 47-4842422)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-10-31
IRS object ID
202213049349300916
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-10-31T08:09:01-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1205 N MICHIGAN AVE 2800AddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP606015927ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN474842422EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1M3 INSURANCE FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlM3INBusinessNameControlTxt
Phone8002722443PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1828 JOHN NOLEN DRIVEAddressLine1Txt
CityMADISONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53713ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBETH DETTMANPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8002722443PhoneNum
Signature2022-10-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBETHPersonFirstNm
Person LastDETTMANPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARK HEROUXPreparerPersonNm
PTINP00959793PTIN
Phone3127298000PhoneNum
Preparation2022-10-28PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBETH DETTMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1828 JOHN NOLEN DRIVEAddressLine1Txt
CityMADISONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53713ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$404,915GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTPS://M3INS.COM/M3-FOUNDATION/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2015FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or Mission(SEE SCHEDULE O)THE FOUNDATION WAS ORGANIZED TO PROMOTE THE CHARITABLE ATTITUDES OF THE EMPLOYEES AT M3 SOLUTIONS, INC. THE FOUNDATION WILL FOCUS ON THE AREAS OF HEALTH CARE, SAFETY IMPROVEMENT, CATASTROPHIC EVENT RELIEF, FINANCIAL EDUCATION AND LITERACY, AND THE PROMOTION OF CAREERS IN THE INSURANCE INDUSTRY.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$339,789PYContributionsGrantsAmt
CY Contributions Grants$372,520CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$204PYInvestmentIncomeAmt
CY Investment Income$14,003CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$339,993PYTotalRevenueAmt
CY Total Revenue$386,523CYTotalRevenueAmt
PY Grants And Similar Paid$328,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$192,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,840PYOtherExpensesAmt
CY Other Expenses$21,101CYOtherExpensesAmt
PY Total Expenses$337,840PYTotalExpensesAmt
CY Total Expenses$213,601CYTotalExpensesAmt
PY Revenues Less Expenses$2,153PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$172,922CYRevenuesLessExpensesAmt
Total Assets BOY$522,233TotalAssetsBOYAmt
Total Assets EOY$676,549TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$206,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$522,233NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$470,549NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Mission(SEE SCHEDULE O)THE FOUNDATION WAS ORGANIZED TO PROMOTE THE CHARITABLE ATTITUDES OF THE EMPLOYEES AT M3 SOLUTIONS, INC. THE FOUNDATION WILL FOCUS ON THE AREAS OF HEALTH CARE, SAFETY IMPROVEMENT, CATASTROPHIC EVENT RELIEF, FINANCIAL EDUCATION AND LITERACY, AND THE PROMOTION OF CAREERS IN THE INSURANCE INDUSTRY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$192,500ExpenseAmt
Grant$192,500GrantAmt
DescTHE FOUNDATION DONATES TO LOCAL ORGANIZATIONS FOCUSING ON HEALTH CARE, SAFETY IMPROVEMENT, CATASTROPHIC EVENT RELIEF, FINANCIAL EDUCATION AND LITERACY, AND THE PROMOTION OF CAREERS IN THE INSURANCE INDUSTRY.Desc
Total Program Service Expenses$192,500TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BRIAN DONARSKIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6082882732PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1828 JOHN NOLEN DRAddressLine1Txt
CityMADISONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53713ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
BEC KURZYNSKE
DIRECTOR0.60Yes (X)$0$0$0
CANDICE ROTH
DIRECTOR0.60Yes (X)$0$0$0
JESSE MAAS
DIRECTOR0.60Yes (X)$0$0$0
KELSEY STACKS
DIRECTOR0.60Yes (X)$0$0$0
DANAE DORSEY
DIRECTOR0.60Yes (X)$0$0$0
MELISSA SEYFFER
DIRECTOR0.60Yes (X)$0$0$0
ELIZABETH DETTMAN
PRESIDENT0.60$0$0$0Yes (X)
KEVIN MILLER
SECRETARY0.60$0$0$0Yes (X)
LINDSEY HAMIELEC
TREASURER0.60$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$372,520AllOtherContributionsAmt
Total Contributions$372,520TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,053TotalRevenueColumnAmt
Exclusion$5,053ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$27,342SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$18,392SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$8,950SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,950TotalRevenueColumnAmt
Exclusion$8,950ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$386,523TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$14,003ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$191,500TotalAmt
Program Services$191,500ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Program Services$1,000ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$17,933TotalAmt
Management And General$17,933ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,738TotalAmt
Management And General$1,738ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$594TotalAmt
Management And General$594ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
SOFTWARE$755$755
BANK FEES$81$81

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$213,601TotalAmt
Program Services$192,500ProgramServicesAmt
Management And General$21,101ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$282,233BOYAmt
EOY$362,731EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$9,636EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$240,000BOYAmt
EOY$304,182EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$522,233BOYAmt
EOY$676,549EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$206,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$206,000EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$522,233BOYAmt
EOY$470,549EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$522,233BOYAmt
EOY$470,549EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$522,233BOYAmt
EOY$676,549EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$172,922ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$20,163NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$244,769OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (1)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS Audited0FSAuditedInd
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$123,676CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$543,828CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$325,473CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$339,789CurrentTaxYearMinus1YearAmt
Current Tax Year$372,250CurrentTaxYearAmt
Total$1,705,016TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$123,676CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$543,828CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$325,473CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$339,789CurrentTaxYearMinus1YearAmt
Current Tax Year$372,250CurrentTaxYearAmt
Total$1,705,016TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,519,296SubstantialContributorsTotAmt
Public Support Total170$185,720PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$126CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$586CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$204CurrentTaxYearMinus1YearAmt
Current Tax Year$5,053CurrentTaxYearAmt
Total$6,753TotalAmt
FieldValueIRS element (for citing)
Total Support$1,711,769TotalSupportAmt
Public Support CY1700.10850PublicSupportCY170Pct
Public Support PY1700.07290PublicSupportPY170Pct
Ten Pct Facts Crcmstncs Test CYYes (X)TenPctFactsCrcmstncsTestCYInd
Facts And Circumstances TestPART II, SECTION C, LINE 17B, FACTS AND CIRCUMSTANCES TEST: M3 INSURANCE FOUNDATION RECEIVED A MAJORITY OF START UP SUPPORT FROM M3 INSURANCE SOLUTION. THE ORGANIZATION PROVIDES A WIDE RANGE OF CONTRIBUTIONS TO THE COMMUNITY IT CALLS HOME AND WORKS TO ENRICH THE COMMUNITY IT CONDUCTS BUSINESS IN.FactsAndCircumstancesTestTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDONATIONS PAYABLEDesc
Amt$206,000Amt
FieldValueIRS element (for citing)
Total Liability$206,000TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$407,335TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$20,163NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$649DonatedServicesAndUseFcltsAmt
Revenue Not Reported$20,812RevenueNotReportedAmt
Revenue Subtotal$386,523RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$386,523TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$214,250TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$649DonatedServicesUseFcltsAmt
Expenses Not Reported$649ExpensesNotReportedAmt
Expenses Subtotal$213,601ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$213,601TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FOUNDATION IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FOUNDATION'S FINANCIAL STATEMENTS. THE FOUNDATION IS CLASSIFIED AS A PUBLIC CHARITY ON INTERNAL REVENUE CODE 170(B)(1)(A)(VI). THE FOUNDATION DOES NOT BELIEVE THAT IT HAS ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2021.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
DOMESTIC ABUSE INTERVENTION SERVICES (DAIS)
2102 FORDEM AVENUEMADISONWI53704411382134501(C)(3)$7,000$0GENERAL ASSISTANCE
LUTHERAN SOCIAL SERVICES
6737 W WASHING ST 2275MILWAUKEEWI53214390816846501(C)(3)$20,000$0GENERAL ASSISTANCE
MADISON COLLEGE FOUNDATION
3591 ANDERSON ST SUITE 203AMADISONWI53704237265867501(C)(3)$16,500$0GENERAL ASSISTANCE
SECOND HARVEST FOODBANK OF SOUTHERN WISCONSIN
2802 DAIRY DRMADISONWI53718391490691501(C)(3)$10,000$0GENERAL ASSISTANCE
UNITED WAY OF DANE COUNTY
PO BOX 7548MADISONWI53707390817532501(C)(3)$32,000$0GENERAL ASSISTANCE
UNITED WAY OF GREATER MILWAUKEE & WAUKESHA COUNTY
BOX 88110MILWAUKEEWI53288390806190501(C)(3)$6,000$0GENERAL ASSISTANCE
UNITED WAY OF MARATHON COUNTY
705 S 24TH AVE SUITE 400BWAUSAUWI54401390935496501(C)(3)$6,000$0GENERAL ASSISTANCE
CHIPPEWA VALLEY HEALTH CLINIC INC
1030 OAK RIDGE DRIVEEAU CLAIREWI54701391840231501(C)(3)$6,000$0GENERAL ASSISTANCE
FieldValueIRS element (for citing)
Total501c3 Org79Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIP - DIANE WILKINSON SCHOLARSHIPGrantTypeTxt
Recipient1RecipientCnt
Cash Grant$1,000CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationM3 INSURANCE FOUNDATION HAS A FORMAL APPLICATION PROCESS FOR GRANT REQUESTS. MOST GRANTS ARE APPLICATION BASED. THE BOARD MEMBERS HAVE THE ABILITY TO RECOMMEND GRANTEES BASED ON THEIR COMMUNITY CONTRIBUTIONS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FORM 990 IS REVIEWED BY THE BOARD AND APPROVED BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CIN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST, THE ORGANIZATION WILL PROVIDE CERTAIN DOCUMENTS INCLUDING OUR FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS THAT SUPPORT OUR TAX EXEMPT STATUS, INCLUDING, BUT NOT LIMITED TO, ARTICLES OF INCORPORATION AND BYLAWS.
FORM 990, PART XI, LINE 9:ADJUSTMENT DUE TO CHANGE IN ACCOUNTING METHODS -244,769.
FORM 990, PART XII, LINE 1:IN 2021, THE FOUNDATION CHANGED ACCOUNTING METHODS FROM THE MODIFIED CASH BASIS TO ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (U.S. GAAP), WHICH REQUIRE THE ACCRUAL BASIS OF ACCOUNTING. THE FOUNDATION PREFERRED U.S. GAAP TO THE MODIFIED CASH BASIS OF ACCOUNTING AS IT ALIGNS WITH THE ACCOUNTING POLICIES USED BY ITS RELATED PARTY, M3 INSURANCE SOLUTIONS, INC. THIS CHANGE IN ACCOUNTING PRINCIPLE IMPACTS THE PRESENTATION OF INVESTMENTS WHICH ARE RECOGNIZED AT FAIR VALUE, PUBLIC SUPPORT WHICH IS RECOGNIZED WHEN THE UNCONDITIONAL OBLIGATION IS INCURRED. THE FOUNDATION ADJUSTED ITS FINANCIAL STATEMENTS FOR ALL PERIODS PRESENTED, AND THE CHANGE IN ACCOUNTING METHOD DID HAVE A MATERIAL IMPACT ON THE STATEMENT OF FINANCIAL POSITION AS OF DECEMBER 31, 2020, AND THE STATEMENTS OF ACTIVITIES AND CASH FLOWS FOR THE YEAR THEN ENDED.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS NEITHER CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.

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