2021-11-08T08:52:54-06:00 2020-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-01-01 396252984 GROUP HEALTH COOPERATIVE OF EAU CLAIRE GROU 7155524300 PO BOX 3217 EAU CLAIRE WI 547023217 DOUGLAS HOFFER PRESIDENT 7155524300 2021-10-21 1 DOUGLAS HOFFER 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2021-10-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z DOUGLAS HOFFER PO BOX 3217 EAU CLAIRE WI 547023217 186133578 0 X WWW.GROUP-HEALTH.COM X NONSTOCK COOPERATIVE 1972 WI OPTIMIZE HEALTHCARE OF MEMBERS THROUGH POOLING OF HEALTH-RELATED RESOURCES. 10 10 38 10 78000 560 0 0 148535909 159432571 1150939 1089578 78000 78000 149764848 160600149 0 0 0 0 2786877 4456916 0 0 0 138608840 142942428 141395717 147399344 8369131 13200805 53338487 71427480 22207324 27329307 31131163 44098173 X THE PURPOSE OF THIS ORGANIZATION SHALL BE TO PROVIDE: (A) A MEANS FOR SUBSCRIBERS TO SECURE FOR THEMSELVES, THEIR FAMILIES, AND THEIR DEPENDENTS COMPREHENSIVE PREPAID PREVENTATIVE AS WELL AS CURATIVE HEALTH CARE; (B) A MEANS TO EMPHASIZE DISEASE PREVENTION AND EARLY CARE; (C) INCENTIVES FOR HOLDING DOWN COSTS AND FOR INCREASING THE PRODUCTIVITY OF RESOURCES; (D) A MEANS TO IMPROVE BOTH THE QUALITY OF CARE AND ITS GEOGRAPHIC DISTRIBUTION. 0 0 131073594 0 159432571 THE COOPERATIVE OFFERS INSURANCE COVERAGE FOR COMMERCIAL, MEDICAID AND SSI MEMBERS. IN 2020, THE COOPERATIVE HAD APPROXIMATELY 64,597 COMMERCIAL MEMBER MONTHS, 573,216 MEDICAID MEMBER MONTHS, AND 40,119 SSI MEMBER MONTHS. ALONG WITH INSURANCE COVERAGE, THE COOPERATIVE ALSO HELPS MEMBERS WITH MEDICAL MANAGEMENT AND COORDINATION OF CARE. 131073594 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 954 0 38 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ROBERT W TANNER 7155524300 2503 N HILLCREST PKWY ALTOONA WI 54720 X SARAH NORTH GENERAL MANAGER AND CEO 40.00 X 0 0 0 BOB TANNER CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 DOUGLAS HOFFER PRESIDENT 0.30 X X 0 0 0 MARY BETH STEINKE PRESIDENT (THRU DECEMBER) 0.30 X X 0 0 0 EDWARD KASSING FIRST VICE PRESIDENT 0.30 X X 0 0 0 DESSIN CAMPBELL TREASURER (THRU MARCH) 0.30 X X 0 0 0 SUSAN MARCOTT TREASURER 0.30 X X 0 0 0 LUCAS SALTER SECRETARY (THRU MARCH) 0.30 X X 0 0 0 DEBRA STANTON SECRETARY 0.30 X X 0 0 0 JEFFREY BOWE DIRECTOR 0.30 X 0 0 0 GEORGIA CROWNHART DIRECTOR 0.30 X 0 0 0 WESLEY ESCONDO DIRECTOR (THRU JULY) 0.30 X 0 0 0 TYLER FADNESS DIRECTOR 0.30 X 0 0 0 BRIAN LANNERS DIRECTOR 0.30 X 0 0 0 CHRYSTAL MILLS DIRECTOR 0.30 X 0 0 0 ROBERT MOELTER DIRECTOR (THRU OCTOBER) 0.30 X 0 0 0 SHERRY WEINKAUF DIRECTOR (THRU OCTOBER) 0.30 X 0 0 0 CORRISSA WOLNIAK DIRECTOR 0.30 X 0 0 0 0 0 0 0 0 0 0 KMTSJ INC PO BOX 3217 EAU CLAIRE WI 54702 RENT & MGMT SERVICES 14772844 MARSHFIELD HOSPITAL 1000 N OAK AVE MARSHFIELD WI 54449 MEDICAL SERVICES & ACCESS PAYMENT 4236100 MAYO CLINIC HEALTH SYSTEM 1221 WHIPPLE ST EAU CLAIRE WI 54703 MEDICAL SERVICES & ACCESS PAYMENT 3767648 ST CROIX REGIONAL MEDICAL CENTER 235 STATE ST SAINT CROIX FALLS WI 54024 MEDICAL SERVICES & ACCESS PAYMENT 3446293 MEMORIAL MEDICAL CENTER 1615 MAPLE LANE ASHLAND WI 54806 MEDICAL SERVICES & ACCESS PAYMENT 3075008 91 MED & HOSP PREMIUM 524114 141246820 141246820 SSI & MA CAPITATION 524114 18185751 18185751 159432571 1100054 1100054 25522953 25305268 228161 217685 -228161 -10476 -10476 ADMINISTRATIVE SERVICES REVENUE 524114 78000 78000 78000 160600149 159432571 78000 1089578 X 2190415 1754765 435650 98302 84965 13337 2026464 1884945 141519 141735 109895 31840 13272647 13272647 67750 67750 380567 104547 276020 126877180 126731916 145264 36808 36808 151869 29132 122737 347826 326045 21781 49047 42397 6650 2109 1800 309 237921 1803 236118 889 889 56586 56586 INCOME TAX EXPENSE 1227517 1227517 PPACA PREMIUM TAX EXPEN 191336 191336 PCORI TAX EXPENSE 12134 12134 30242 495 29747 147399344 131073594 16325750 0 5365920 7212287 40641206 55200355 5069358 6169777 285691 785688 144000 889 228161 143111 1523558 1524898 224593 391364 53338487 71427480 20898104 26432388 1309220 896919 22207324 27329307 X 1430 1430 1001422 1001422 30128311 43095321 31131163 44098173 53338487 71427480 X 13200805 -14844 -218951 X 0 1 X 1 0 X 174107252 176849733 163705413 148535909 159432571 822630878 174107252 176849733 163705413 148535909 159432571 822630878 0 0 0 822630878 890583 921134 966122 1141394 1100054 5019287 1840 1560 1560 1560 6520 890583 922974 967682 1142954 1101614 5025807 174997835 177772707 164673095 149678863 160534185 827656685 0.99390 0.99440 0.00610 0.00560 X 144000 889 143111 143111 UNEARNED PREMIUM REVENUE 896919 896919 160828310 228161 228161 160600149 0 160600149 147399344 0 147399344 0 147399344 PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT 228,161. FORM 990, PART VI, SECTION A, LINE 3 KMTSJ, AN UNRELATED CORPORATION, IS CONTRACTED TO PROVIDE SERVICE AS GENERAL MANAGER, ALONG WITH ACCOUNTING, MARKETING, CLAIMS PROCESSING, HUMAN RESOURCES, PAYROLL, AND DATA PROCESSING SERVICES. THE SERVICES OF CEO AND CFO ARE AMONG THESE PURCHASED THROUGH KMTSJ AND THE AMOUNT PAID IN TOTAL FOR THE CALENDAR YEAR IS REPRESENTED ON PART VII, SECTION B. FORM 990, PART VI, SECTION A, LINE 7A INDIVIDUALS COVERED UNDER GROUP HEALTH COOPERATIVE OF EAU CLAIRE'S INSURANCE POLICIES ARE CONSIDERED TO BE MEMBERS OF THE COOPERATIVE AND ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION REVIEWED FORM 990 IN THE FOLLOWING MANNER: EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVED A COPY OF FORM 990 FOR REVIEW. A HIGH-LEVEL REVIEW WAS COMPLETED WITH THE BOARD OF DIRECTORS AT A BOARD MEETING, AND ANY QUESTIONS OR CONCERNS WERE ADDRESSED PRIOR TO THE BOARD'S APPROVAL TO FILE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THE FOLLOWING MANNER: MEMBERS OF THE BOARD OF DIRECTORS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST ATTESTATION ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT HAVE A PROCESS FOR DETERMINING COMPENSATION FOR THE CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL OR KEY EMPLOYEES, AS THESE POSITIONS ARE CONTRACTED THROUGH AN UNRELATED CORPORATION. ADDITIONALLY, OFFICERS OF THE ORGANIZATION ARE NOT COMPENSATED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION A, LINE 8B ORGANIZATION HAS AN EXECUTIVE COMMITTEE IN ADDITION TO BOARD OF DIRECTORS. EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS AND SUCH ADDITIONAL DIRECTORS AS THE BOARD MAY DETERMINE. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT ON ANY MATTER REQUIRING ATTENTION BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART IX, LINE 11G REFERRALS - FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 85,640,007. MANAGEMENT AND GENERAL EXPENSES 2,250. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,642,257. BENEFITS - FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 30,965,206. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,965,206. CONTRACT SERVICES - MEDICAL: PROGRAM SERVICE EXPENSES 10,126,703. MANAGEMENT AND GENERAL EXPENSES 143,014. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,269,717. FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS -447,112. LOSS ON SALE OF EQUIPMENT 228,161.