2021-11-13T11:35:45-06:00 2020-12-31 135565207 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH MINNEAPOLIS MN 55402 990 2020-01-01 411812461 MEDICA FOUNDATION MEDI 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 MARK L BAIRD SVP & CFO, TREASURER 9529922058 2021-11-11 1 MARK BAIRD 999009999 HOLLY MOEN P01800653 6123055000 2021-11-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MARK L BAIRD 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 25987730 0 X WWW.MEDICAFOUNDATION.ORG X 1996 MN SEE SCHEDULE OTHE MEDICA FOUNDATION FUNDS PROGRAMS THAT IMPROVE HEALTH AND INCREASE ACCESS TO HEALTH CARE SERVICES. 5 5 0 0 0 0 8500000 10000000 0 0 1694683 3054845 0 0 10194683 13054845 1810000 4220000 0 0 0 0 0 0 0 707205 751959 2517205 4971959 7677478 8082886 52383395 64599900 1858711 1744000 50524684 62855900 X THE FOUNDATION GENERALLY SEEKS TO FUND COMMUNITY-BASED PROGRAMS AND INITIATIVES THAT CAN PROVIDE SUSTAINABLE AND MEASURABLE IMPROVEMENTS IN THE AVAILABILITY, ACCESS, AND QUALITY OF HEALTHCARE SERVICES. 0 0 895000 895000 0 BEHAVIORAL HEALTH: THE BEHAVIORAL HEALTH FUNDING AREA SEEKS PROPOSALS FOR NEW OR EXPANDING PROGRAMS THAT PROVIDE SUPPORT FOR SERIOUS MENTAL ILLNESS AND CHEMICAL ADDICTION RECOVERY, INCLUDING PROGRAMS THAT ADDRESS GAPS IN CURRENT SERVICE; INTEGRATE PHYSICAL AND MENTAL HEALTH CARE; ADDRESS CO-OCCURRING DISORDERS AND PROVIDE SUPPORTIVE AND INTENSIVE CASE MANAGEMENT SERVICES. ORGANIZATIONS EXHIBITING TRAUMA-SENSITIVE PRACTICES AND USING A STRENGTHS-BASED APPROACH TO CARE ARE PREFERRED. 525000 525000 0 EARLY CHILDHOOD HEALTH: THE EARLY CHILDHOOD HEALTH FUNDING AREA SEEKS PROPOSALS FOR NEW OR EXPANDING EARLY INTERVENTION PROGRAMS THAT FOCUS ON DEVELOPING HEALTHY FAMILIES TO FOSTER OPTIMAL GROWTH AND DEVELOPMENT OF YOUNG CHILDREN. PROGRAMS SHOULD EMBRACE THE NEEDS OF THE WHOLE-CHILD/WHOLE-FAMILY AND MAY INCORPORATE THE HEALTH AND WELLBEING COMPONENTS OF THE TWO-GENERATION APPROACH THAT IS CENTRAL TO SUPPORTING CHILDREN AND PARENTS SIMULTANEOUSLY. PROGRAMMING FOCUSES ON CHILDREN BIRTH THROUGH AGE TWELVE AND MAY INVOLVE PARENTS, CAREGIVERS, HEALTH CARE PROVIDERS, SCHOOLS, SHELTERS, EARLY CHILDHOOD PROGRAMS AND THE OVERALL COMMUNITY. ORGANIZATIONS EXHIBITING TRAUMA-SENSITIVE PRACTICES AND USING A STRENGTHS-BASED APPROACH TO CARE ARE PREFERRED. 315000 315000 0 RURAL HEALTH: RURAL AREAS HAVE SPECIFIC HEALTH NEEDS THAT ARE UNDERSTOOD BEST BY THOSE WITHIN THEIR OWN COMMUNITIES. WE AIM TO SUPPORT COMMUNITY-LED SOLUTIONS TO HEALTH CONCERNS WITH THE NONPROFITS IN THOSE AREAS. THIS FUNDING AREA SUPPORTS HEALTH-RELATED PROGRAMMING THAT IS ESSENTIAL TO AN ORGANIZATION'S NONPROFIT MISSION. 200000 200000 0 MEDICA FOUNDATION HAS THE FOLLOWING OTHER PROGRAM SERVICES:STRATEGIC GRANT 335000 335000 0 MEDICAL FOUNDATION GENERAL FUNDING 1950000 1950000 EMERGENCY RELIEF 2485000 2485000 0 4220000 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X MARY QUIST 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 X JOHN BUCK DIRECTOR 0.00 15.00 X 0 126625 0 SAM LEON DIRECTOR 0.00 10.00 X 0 78500 0 JOHN STANOCH DIRECTOR, CHAIR 0.00 10.00 X X 0 87875 0 ESTHER TOMLJANOVICH DIRECTOR, VICE CHAIR 0.00 6.00 X X 0 74125 0 MARY TWINEM DIRECTOR 0.00 10.00 X 0 87250 0 MARK BAIRD SVP & CFO, TREASURER 0.00 40.00 X 0 1252275 51449 DAVID ELLENBOGEN SVP & GEN COUNSEL, SECRETARY 0.00 40.00 X 0 55108 688 JAMES P JACOBSON SVP & GEN COUNSEL, SECRETARY 0.00 40.00 X 0 847800 54490 MARY QUIST SVP FIN & CORP CONTROLLER 0.00 40.00 X 0 675807 50108 0 3285365 156735 0 0 1 0 MEDICA HEALTH PLANS 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 LEASED EMPLOYEES 389265 1 10000000 10000000 1098015 1098015 14889715 12932885 1956830 1956830 1956830 13054845 0 0 3054845 4220000 4220000 201806 201806 122 122 104 104 26725 26725 2232 2232 1537 1537 LEASED EMPLOYEES 389265 389265 ALL OTHER EXPENSES 101269 101269 DUES, MEMBERSHIPS & SUB 15399 15399 COMMUNITY OUTREACH 7500 7500 6000 6000 4971959 4220000 751959 0 0 0 892891 8430 0 0 84937 68414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51405567 64523056 0 0 0 0 0 0 52383395 64599900 0 0 1772147 1744000 0 0 0 0 0 0 0 0 0 0 0 0 86564 0 1858711 1744000 X 50524684 62855900 0 0 50524684 62855900 52383395 64599900 8082886 4248330 0 X 0 0 0 X X 2 MEDICA HEALTH PLANS 411242261 10 1 9000000 0 MEDICA INSURANCE COMPANY 411490988 10 1 1000000 0 2 10000000 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 SCH A PART IV SECTION A LINE 3B MEDICA HEALTH PLANS, THE SUPPORTED ORGANIZATION, IS A 501(C)(4) ORGANIZATION. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, ANY CHANGE IN EXEMPT STATUS OR ACTIVITIES OF MEDICA HEALTH PLANS WOULD BE KNOWN BY MEDICA FOUNDATION. EACH YEAR, IT IS DETERMINED IF MHP CONTINUES TO MEET THE PUBLIC SUPPORT TESTS UNDER SECTION 509(A)(2) BEFORE THE TAX RETURN IS FILED. SCH A PART IV SECTION A LINE 3C THE MEDICA FOUNDATION MONITORS THE USE OF GRANT FUNDS THROUGH SEVERAL MECHANISMS. ALL GRANTEES ARE ASKED TO SUBMIT PROGRESS REPORTS RELATED TO THE GRANT FUNDING. UPDATES ON PROGRAM GRANTS ARE RECEIVED DURING AND AT THE END OF THE GRANT PERIOD. SEE SCHEDULE I, PART I, LINE 2 NARRATIVE FOR ADDITIONAL INFORMATION RELATED TO THE PROCESS USED FOR GRANT MONITORING. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 SHORT TERM INVESTMENTS 64523056 F 64523056 1 CHILDREN'S DENTAL SERVICES 636 BROADWAY STREET NE MINNEAPOLIS MN 55413 410857929 501C(3) 200000 PROGRAM SUPPORT GREATER TWIN CITIES UNITED WAY 404 SOUTH EIGHTH STREET MINNEAPOLIS MN 55404 411973442 501C(3) 137500 PROGRAM SUPPORT YMCA OF THE GREATER TWIN CITIES 651 NICOLLET AVENUE STE 500 MINNEAPOLIS MN 55402 452563299 501C(3) 125000 PROGRAM SUPPORT FRASER 2400 WEST 64TH STREET MINNEAPOLIS MN 55423 410781858 501C(3) 100000 PROGRAM SUPPORT HENNEPIN HEALTHCARE FOUNDATION 701 PARK AVENUE LSB-3 MINNEAPOLIS MN 55415 410845733 501C(3) 100000 PROGRAM SUPPORT MENTAL HEALTH RESOURCES INC 762 TRANSFER ROAD SUITE 21 ST PAUL MN 55114 411273885 501C(3) 100000 PROGRAM SUPPORT ST DAVID'S CENTER FOR CHILD & FAMILY DEVELOPMENT 3395 PLYMOUTH ROAD MINNETONKA MN 55305 411429208 501C(3) 100000 PROGRAM SUPPORT WASHBURN CENTER FOR CHILDREN 1100 GLENWOOD AVENUE MINNEAPOLIS MN 55405 410711618 501C(3) 100000 PROGRAM SUPPORT UNIVERSITY OF MINNESOTA FOUNDATION 200 OAK STREET SE SUITE 500 MINNEAPOLIS MN 55455 416042488 501C(3) 75000 PROGRAM SUPPORT AMERICAN RED CROSS 431 18TH STREET NW WASHINGTON DC 20006 530196605 501C(3) 60000 PROGRAM SUPPORT ANNA MARIE'S ALLIANCE 505 NORTH 10TH AVENUE ST CLOUD MN 56303 411344743 501C(3) 55000 PROGRAM SUPPORT BANISTERS LEADERSHIP ACADEMY PO BOX 4002 OMAHA NE 68104 510666677 501C(3) 50000 PROGRAM SUPPORT CANVAS HEALTH 7066 STILLWATER BLVD NORTH OAKDALE MN 55128 410955577 501C(3) 50000 PROGRAM SUPPORT CATHOLIC SOCIAL SERVICES 529 KANSAS CITY ST SUITE 100 RAPID CITY SD 57701 460418272 501C(3) 50000 PROGRAM SUPPORT CENTERPOINTE 2633 P ST LINCOLN NE 68503 470550702 501C(3) 50000 PROGRAM SUPPORT CHURCHES UNITED IN MINISTRY 102 W SECOND STREET DULUTH MN 55802 411227969 501C(3) 50000 PROGRAM SUPPORT COMUNIDADES LATINAS UNIDAS EN SERVICIO 797 EAST 7TH STREET ST PAUL MN 55106 411386986 501C(3) 50000 PROGRAM SUPPORT CORNERHOUSE INTERAGENCY CHILD ABUSE EVALUATION AND 2502 10TH AVENUE SOUTH MINNEAPOLIS MN 55404 411640731 501C(3) 50000 PROGRAM SUPPORT HEALTHFINDERS COLLABORATIVE INC PO BOX 731 NORTHFIELD MN 55057 201805262 501C(3) 50000 PROGRAM SUPPORT HEARTLAND FAMILY SERVICE 2101 S 42ND ST OMAHA NE 68105 470390618 501C(3) 50000 PROGRAM SUPPORT HENNEPIN COUNTY 300 SOUTH 6TH STREET MINNEAPOLIS MN 55487 416005801 GOVERNMENT AGEN 50000 PROGRAM SUPPORT KENTE CIRCLE TRAINING INSTITUTE 345 EAST 38TH ST MINNEAPOLIS MN 55409 474342558 501C(3) 50000 PROGRAM SUPPORT LIFE HOUSE INC 102 WEST FIRST STREET DULUTH MN 55802 411704840 501C(3) 50000 PROGRAM SUPPORT LUTHERAN SOCIAL SERVICES OF SOUTH DAKOTA 705 E 41ST STREET SUITE 200 SIOUX FALLS SD 57105 460224731 501C(3) 50000 PROGRAM SUPPORT MINNESOTA RECOVERY CONNECTION 800 TRANSFER ROAD SUITE 31 ST PAUL MN 55114 411948764 501C(3) 50000 PROGRAM SUPPORT NATIVE AMERICAN COMMUNITY CLINIC 1213 EAST FRANKLIN AVENUE MINNEAPOLIS MN 55404 030445789 501C(3) 50000 PROGRAM SUPPORT NEBRASKA METHODIST HOSPITAL FOUNDATION 8701 WEST DODGE ROAD SUITE 450 OMAHA NE 68114 470595345 501C(3) 50000 PROGRAM SUPPORT NIIBI CENTER PO BOX 133 CALLAWAY MN 56521 814593567 501C(3) 50000 PROGRAM SUPPORT OPEN CITIES HEALTH CENTER 409 NORTH DUNLAP STREET SAINT PAUL MN 55104 363381598 501C(3) 50000 PROGRAM SUPPORT OPEN DOORS FOR YOUTH 554 3RD STREET NW SUITE 201 ELK RIVER MN 55330 472291925 501C(3) 50000 PROGRAM SUPPORT PEOPLE SERVING PEOPLE CHARITIES INC 614 3RD STREET SOUTH MINNEAPOLIS MN 55415 411965067 501C(3) 50000 PROGRAM SUPPORT RAICES SAGRADAS COMMUNITY MENTAL HEALTH 3817 PLEASANT AVE MINNEAPOLIS MN 55408 834273268 501C(3) 50000 PROGRAM SUPPORT SOUTHSIDE FAMILY NURTURING CENTER 2448 18TH AVENUE SOUTH MINNEAPOLIS MN 55404 411274177 501C(3) 50000 PROGRAM SUPPORT TASKS UNLIMITED INC 2419 NICOLLET AVENUE SOUTH MINNEAPOLIS MN 55404 237087205 501C(3) 50000 PROGRAM SUPPORT YWCA OF MINNEAPOLIS 1130 NICOLLET MALL MINNEAPOLIS MN 55403 410693891 501C(3) 50000 PROGRAM SUPPORT CENTER FOR VICTIMS OF TORTURE 2356 UNIVERSITY AVENUE W STE 430 ST PAUL MN 55114 363383933 501C(3) 40000 PROGRAM SUPPORT CHARLES DREW HEALTH CENTER INC 2915 GRANT ST OMAHA NE 68111 470666715 501C(3) 40000 PROGRAM SUPPORT ONEWORLD COMMUNITY HEALTH CENTERS INC 4920 S 30TH ST STE 103 OMAHA NE 68107 470548990 501C(3) 40000 PROGRAM SUPPORT CREATING HEALTHIER COMMUNITIES 1199 N FAIRFAX STREET SUITE 600 ALEXANDRIA VA 22314 136167225 501C(3) 37500 PROGRAM SUPPORT HELPCARE CLINIC 3015 AVENUE A KEARNEY NE 68847 465551263 501C(3) 30000 PROGRAM SUPPORT UNITED WAY OF THE MIDLANDS 2201 FARNAM STREET SUITE 200 OMAHA NE 68102 470376605 501C(3) 30000 PROGRAM SUPPORT AMERICAN INDIAN COMMUNITY DEVELOPMENT CORPORATION 1508 E FRANKLIN AVE MINNEAPOLIS MN 55404 411716667 501C(3) 25000 PROGRAM SUPPORT ASSOCIATION FOR TRAINING ON TRAUMA AND ATTACHMENT 3001 METRO DRIVE SUITE 290 BLOOMINGTON MN 55425 841153488 501C(3) 25000 PROGRAM SUPPORT AVIVO 1900 CHICAGO AVENUE MINNEAPOLIS MN 554041903 410828779 501C(3) 25000 PROGRAM SUPPORT BABY'S SPACE 2438 18TH AVENUE SOUTH MINNEAPOLIS MN 55404 204502788 501C(3) 25000 PROGRAM SUPPORT BETTER FUTURES MINNESOTA 2620 MINNEHAHA AVENUE SOUTH MINNEAPOLIS MN 55406 450550557 501C(3) 25000 PROGRAM SUPPORT CARE CLINIC 906 COLLEGE AVENUE DOOR 1 RED WING MN 55066 270540451 501C(3) 25000 PROGRAM SUPPORT CARVER COUNTY HEALTH AND HUMAN SERVICES GOVERNMENT CENTER CHASKA MN 55318 416005768 GOVERNMENT AGEN 25000 PROGRAM SUPPORT CHILDREN'S HOSPITAL & MEDICAL CENTER FOUNDATION 8404 INDIAN HILLS DRIVE SUITE 650 OMAHA NE 68114 476105603 501C(3) 25000 PROGRAM SUPPORT COLLEGE POSSIBLE 755 PRIOR AVENUE N 200 ST PAUL MN 55104 411968798 501C(3) 25000 PROGRAM SUPPORT COMMUNITY DENTAL CARE 1670 BEAM AVENUE SUITE 204 MAPLEWOOD MN 55109 043692982 501C(3) 25000 PROGRAM SUPPORT COOKIE CART 1119 WEST BROADWAY AVENUE MINNEAPOLIS MN 55411 411866804 501C(3) 25000 PROGRAM SUPPORT DIVISION OF INDIAN WORK 1001 EAST LAKE STREET MINNEAPOLIS MN 55407 815265328 501C(3) 25000 PROGRAM SUPPORT FAMILY INC 3501 HARRY LANGDON BLVD STE 150 COUNCIL BLUFFS IA 51503 510657063 501C(3) 25000 PROGRAM SUPPORT FAMILYWISE SERVICES 3036 UNIVERSITY AVE SE MINNEAPOLIS MN 55414 411343909 501C(3) 25000 PROGRAM SUPPORT GENESYS WORKS - TWIN CITIES 445 MINNESOTA STREET SUITE 720 ST PAUL MN 55101 262999242 501C(3) 25000 PROGRAM SUPPORT HALLIE Q BROWN COMMUNITY CENTER 270 N KENT ST SAINT PAUL MN 55102 410693846 501C(3) 25000 PROGRAM SUPPORT HOPESPOKE 2444 O STREET LINCOLN NE 68510 470398819 501C(3) 25000 PROGRAM SUPPORT LUTHERAN FAMILY SERVICES OF NEBRASKA INC 124 SOUTH 24TH STREET OMAHA NE 69102 237267972 501C(3) 25000 PROGRAM SUPPORT MARCH OF DIMES 1550 CRYSTAL DRIVE SUITE 1300 ARLINGTON VA 22202 131846366 501C(3) 25000 PROGRAM SUPPORT MARNITA'S TABLE INC 1330 LAGOON AVENUE 4TH FLOOR MINNEAPOLIS MN 55408 204045171 501C(3) 25000 PROGRAM SUPPORT NEBRASKA CHILDREN'S HOME SOCIETY 4939 SOUTH 118TH STREET OMAHA NE 68137 470378995 501C(3) 25000 PROGRAM SUPPORT NORTHERN DENTAL ACCESS CENTER 1405 ANNE STREET NW BEMIDJI MN 56601 841711812 501C(3) 25000 PROGRAM SUPPORT NORTHSIDE ACHIEVEMENT ZONE 2123 WEST BROADWAY AVE SUITE 100 MINNEAPOLIS MN 55411 300238807 501C(3) 25000 PROGRAM SUPPORT NORTHSIDE ECONOMIC OPPORTUNITY NETWORK 1007 W BROADWAY AVE MINNEAPOLIS MN 55411 800163521 501C(3) 25000 PROGRAM SUPPORT OSTARA INITIATIVE PO BOX 18603 MINNEAPOLIS MN 55418 824855661 501C(3) 25000 PROGRAM SUPPORT PAGE EDUCATION FOUNDATION PO BOX 581254 MINNEAPOLIS MN 55458 363605013 501C(3) 25000 PROGRAM SUPPORT PREVENT CHILD ABUSE MINNESOTA 709 UNIVERSITY AVENUE WEST SUITE 141 SAINT PAUL MN 55104 411354842 501C(3) 25000 PROGRAM SUPPORT PROJECT HARMONY CHILD ADVOCACY CENTER (HAVEN FOR A 11949 Q STREET OMAHA NE 68137 470789054 501C(3) 25000 PROGRAM SUPPORT RELATE INC 5125 COUNTY ROAD 101 SUITE 300 MINNETONKA MN 553451511 410993494 501C(3) 25000 PROGRAM SUPPORT SICANGU COMMUNITY DEVELOPMENT CORPORATION 27565 RESEARCH PARK DR MISSION SD 57555 833857527 501C(3) 25000 PROGRAM SUPPORT SUMMIT ACADEMY OIC 935 OLSON MEMORIAL HIGHWAY MINNEAPOLIS MN 55405 410908458 501C(3) 25000 PROGRAM SUPPORT THE BRIDGE FOR YOUTH 1111 W 22ND STREET MINNEAPOLIS MN 55405 410983062 501C(3) 25000 PROGRAM SUPPORT THE FAMILY PARTNERSHIP 414 SOUTH 8TH STREET MINNEAPOLIS MN 55404 410693858 501C(3) 25000 PROGRAM SUPPORT THE MINNESOTA ACADEMY OF PEDIATRICS FOUNDATION 1043 GRAND AVE 544 ST PAUL MN 55105 411670813 501C(3) 25000 PROGRAM SUPPORT URBAN LEAGUE TWIN CITIES 2100 PLYMOUTH AVENUE NORTH MINNEAPOLIS MN 55411 410706915 501C(3) 25000 PROGRAM SUPPORT WAY TO GROW 201 IRVING AVE NORTH SUITE 100 MINNEAPOLIS MN 55405 710956749 501C(3) 25000 PROGRAM SUPPORT YOUTHLINK 41 NORTH 12TH STREET MINNEAPOLIS MN 55403 411341773 501C(3) 25000 PROGRAM SUPPORT YOUTHPRISE 3001 BROADWAY STREET NE SUITE 330 MINNEAPOLIS MN 55413 274126970 501C(3) 25000 PROGRAM SUPPORT YWCA OF DULUTH 32 EAST FIRST STREET SUITE 202 DULUTH MN 55802 410696493 501C(3) 25000 PROGRAM SUPPORT COMMUNITY ACTION PARTNERSHIP OF WESTERN NEBRASKA 3350 10TH STREET GERING NE 69341 470493594 501C(3) 15000 PROGRAM SUPPORT ALZHEIMER'S ASSOCIATION MINNESOTA - NORTH DAKOTA 7900 WEST 78TH STREET SUITE 100 MINNEAPOLIS MN 55439 133039601 501C(3) 10000 PROGRAM SUPPORT BIG LAKE COMMUNITY FOOD SHELF 160 LAKE STREET N BIG LAKE MN 55309 411820136 501C(3) 10000 PROGRAM SUPPORT COMMUNITY ACTION PARTNERSHIP OF MID-NEBRASKA 16 W 11TH STREET KEARNEY NE 68848 476039628 501C(3) 10000 PROGRAM SUPPORT COMMUNITY EMERGENCY SERVICE INC 1900 11TH AVE S MINNEAPOLIS MN 55404 411728341 501C(3) 10000 PROGRAM SUPPORT CREIGHTON UNIVERSITY MAGIS CLINIC 2500 CALIFORNIA PLAZA OMAHA NE 68178 470376583 501C(3) 10000 PROGRAM SUPPORT CULTURAL WELLNESS CENTER 2025 PORTLAND AVENUE S MINNEAPOLIS MN 55404 411850859 501C(3) 10000 PROGRAM SUPPORT FEEDING OUR COMMUNITIES PARTNERS 2120 HOWARD DRIVE WEST SUITE F MANKATO MN 56003 272374187 501C(3) 10000 PROGRAM SUPPORT FOOD BANK FOR THE HEARTLAND 10525 J STREET OMAHA NE 68127 470637701 501C(3) 10000 PROGRAM SUPPORT GUILD 130 SOUTH WABASHA STREET SUITE 90 ST PAUL MN 55107 411669233 501C(3) 10000 PROGRAM SUPPORT HEALTH CENTER ASSOCIATION OF NEBRASKA 3929 S 147TH ST SUITE 100A OMAHA NE 68144 215731401 501C(3) 10000 PROGRAM SUPPORT HEARTLAND HEALTH CENTER INC 3307 W CAPITAL AVENUE GRAND ISLAND NE 68803 271700281 501C(3) 10000 PROGRAM SUPPORT INTERFAITH ACTION OF GREATER SAINT PAUL 1671 SUMMIT AVENUE ST PAUL MN 55105 410694741 501C(3) 10000 PROGRAM SUPPORT LUTHERAN SOCIAL SERVICE OF MINNESOTA 2485 COMO AVENUE ST PAUL MN 55108 410872993 501C(3) 10000 PROGRAM SUPPORT MICAH HOUSE CORPORATION 1415 AVENUE J COUNCIL BLUFFS IA 51501 421292393 501C(3) 10000 PROGRAM SUPPORT NEBRASKA FARM BUREAU FOUNDATION FOR AGRICULTURE I 5225 S 16TH STREET LINCOLN NE 68512 461740947 501C(3) 10000 PROGRAM SUPPORT OPEN ARMS OF MINNESOTA 2500 BLOOMINGTON AVE SO MINNEAPOLIS MN 55404 411681317 501C(3) 10000 PROGRAM SUPPORT PEOPLE'S CENTER HEALTH SERVICES 425 20TH AVENUE SOUTH MINNEAPOLIS MN 55454 410982430 501C(3) 10000 PROGRAM SUPPORT PILLSBURY UNITED COMMUNITIES 125 WEST BROADWAY AVE SUITE 130 MINNEAPOLIS MN 55411 410916478 501C(3) 10000 PROGRAM SUPPORT PROPEL NONPROFITS ONE MAIN ST SE SUITE 600 MINNEAPOLIS MN 55414 411916337 501C(3) 10000 PROGRAM SUPPORT RAINBOW HEALTH 2577 TERRITORIAL ROAD ST PAUL MN 55114 411524746 501C(3) 10000 PROGRAM SUPPORT SAWTOOTH MOUNTAIN CLINIC INC 513 5TH AVE W GRAND MARAIS MN 55604 411347593 501C(3) 10000 PROGRAM SUPPORT THE FOOD GROUP MINNESOTA INC 8501 54TH AVENUE NORTH NEW HOPE MN 55428 411246504 501C(3) 10000 PROGRAM SUPPORT TWO HARBORS AREA FOOD SHELF 2124 10TH ST TWO HARBORS MN 55616 471321541 501C(3) 10000 PROGRAM SUPPORT URBAN VENTURES LEADERSHIP FOUNDATION 2924 4TH AVE S MINNEAPOLIS MN 55408 363558710 501C(3) 10000 PROGRAM SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501C(3) 7500 PROGRAM SUPPORT 106 0 PART I, LINE 2: THE MEDICA FOUNDATION MONITORS THE USE OF GRANT FUNDS THROUGH SEVERAL MECHANISMS. ALL GRANTEES ARE ASKED TO SUBMIT PROGRESS REPORTS RELATED TO THE GRANT FUNDING. UPDATES ON PROGRAM GRANTS ARE RECEIVED DURING AND AT THE END OF THE GRANT PERIOD. ADDITIONALLY, THE FOUNDATION ENGAGES A COMMITTEE OF EMPLOYEES TO WORK DIRECTLY WITH GRANT RECIPIENTS TO PROVIDE OVERSIGHT AND SUPPORT TO HELP ENSURE GRANT OBJECTIVES ARE ACCOMPLISHED. THE COMMITTEE FUNCTIONS UNDER THE DIRECTION OF FOUNDATION STAFF. COMMITTEE MEMBERS REVIEW PROPOSALS, PERFORM SITE VISITS AND PROVIDE QUARTERLY UPDATES FOR THE BOARD OF DIRECTORS. 0 1 0 0 0 0 1 0 0 MARK BAIRD SVP & CFO, TREASURER 0 466139 0 673136 0 113000 0 22088 0 29361 0 1303724 0 84595 JAMES P JACOBSON SVP & GEN COUNSEL, SECRETARY 0 373654 0 390196 0 83950 0 22088 0 32402 0 902290 0 53911 MARY QUIST SVP FIN & CORP CONTROLLER 0 319568 0 292887 0 63352 0 22088 0 28020 0 725915 0 37144 PART I, LINE 3 MEDICA FOUNDATION, THE FILING ORGANIZATION DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA HEALTH PLANS, A RELATED ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA HEALTH PLANS USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING RECEIVED A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA HEALTH PLANS, A RELATED ORGANIZATION: MAEY P. QUIST - $37,144 JAMES P. JACOBSON - $53,911 MARK L. BAIRD - $84,595 SCH J PART I LINE 6B MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO OPERATING EARNINGS OF MEDICA HEALTH PLANS. SCH J PART II SCHEDULE J, PART II, COLUMN (F), COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED IN PRIOR FORM 990: COLUMN (F) INCLUDES AMOUNTS VESTED IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION. FORM 990, PART VI, SECTION A, LINE 3 MEDICA FOUNDATION HAS ENTERED INTO AN ADMINISTRATIVE SERVICE AGREEMENT WITH MEDICA HEALTH PLANS (MHP), A RELATED EXEMPT ORGANIZATION. THROUGH THIS AGREEMENT, MHP LEASES ITS EMPLOYEES AND PROVIDES VARIOUS MANAGEMENT/ADMINISTRATIVE SERVICES TO MEDICA FOUNDATION AND MEDICA FOUNDATION PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. THE ADMINISTRATIVE SERVICE AGREEMENT WAS MOVED TO MEDICA SERVICES COMPANY (MSC) IN NOVEMBER OF 2020. FORM 990, PART VI, SECTION B, LINE 11B MEDICA'S TAX ADVISORS COMPLETE THE RETURN, FINANCE STAFF REVIEWS THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL EMPLOYEES OF MEDICA HEALTH PLANS AND DIRECTORS OF ALL MEDICA ENTITIES COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND ARE REQUIRED TO REVIEW THE CURRENT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 MEDICA FOUNDATION DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION. WHICH USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. THE PERSONNEL AND COMPENSATION COMMITTEE, AS DESCRIBED IN THE CHARTER, REVIEWS AND OBTAINS THE BOARD'S APPROVAL FOR TOTAL COMPENSATION FOR THE PRESIDENT/CEO. THE COMMITTEE ALSO REVIEWS AND APPROVES TOTAL COMPENSATION RECOMMENDATIONS MADE BY THE CEO FOR THE EXECUTIVE AND SENIOR VICE PRESIDENTS, AND REVIEWS ALL OFFICER COMPENSATION AND ANNUAL PERFORMANCE GOALS APPROVED BY THE CEO. THE COMMITTEE REVIEWS AND MAKES RECOMMENDATIONS TO THE BOARD REGARDING OFFICER AND NON-OFFICER COMPENSATION GUIDELINES FOR MEDICA AND ITS SUBSIDIARIES, PERIODICALLY REVIEWING MARKET DATA TO ASSESS MEDICA'S COMPETITIVE POSITION. OUTSIDE THE CHARTER, THE PERSONNEL AND COMPENSATION COMMITTEE WORKS WITH AN OUTSIDE CONSULTANT TO REVIEW MARKET DATA THAT AIDS IN SETTING THE COMPENSATION FOR THE OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 MEDICA DOES NOT CONSIDER ITS CONFLICT OF INTEREST POLICY TO BE A CONFIDENTIAL OR PROPRIETARY DOCUMENT. THEREFORE, MEDICA WOULD MAKE THIS POLICY AVAILABLE TO ANYONE WHO REQUESTS IT. CERTAIN OF THE MEDICA ENTITIES ARE REQUIRED TO FILE ANNUAL FINANCIAL STATEMENTS WITH THE REGULATORS. MEDICA CONSIDERS FINANCIAL STATEMENTS THAT ARE FILED WITH THE REGULATORS TO BE PUBLIC DOCUMENTS. FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990 PART VII LINE SECTION B LINE 1: CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN SEVERAL OF THE MEDICA ENTITIES (MEDICA HEALTH PLANS, MEDICA COMMUNITY HEALTH PLAN, MEDICA FOUNDATION, MEDICA AFFILIATED SERVICES, MEDICA INSURANCE COMPANY, MEDICA SELF-INSURED, MEDICA HEALTH MANAGEMENT, MMSI, INC, MEDICA SERVICES COMPANY, MEDICA REGIONAL INSURANCE COMPANY, AND MEDICA HOLDING COMPANY). THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. MEDICA HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411242261 HEALTH COVERAGE MN 501(C)(4) MH COMPANY 0 MEDICA COMMUNITY HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH COVERAGE MN 501(C)(4) MH COMPANY 0 MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING COMPANY MN 501(C)(4) N/A 0 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MEDICA AFF C 0 MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMIN MN MEDICA AFF C 0 MEDICA AFFILIATED SERVICES 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MH COMPANY C 0 MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MGMT MN MEDICA AFF C 0 MMSI INC 401 CARLSON PARKWAY MINNETONKA MN 55305 411547003 HEALTH INSURANCE MN MEDICA AFF C 0 MEDICA SERVICES COMPANY LLC 401 CARLSON PARKWAY MINNETONKA MN 55305 852902940 ADMIN SERVICES MN MEDICA AFF C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 MEDICA HEALTH PLANS N 160887 ACTUAL AMOUNT MEDICA HEALTH PLANS O 389265 ACTUAL AMOUNT MEDICA HEALTH PLANS P 26725 ACTUAL AMOUNT MEDICA HEALTH PLANS C 9000000 ACTUAL AMOUNT