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      <OfficeExpensesGrp>
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      <InformationTechnologyGrp>
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      <PaymentsToAffiliatesGrp>
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      <OtherExpensesGrp>
        <Desc>LOSSES &amp; LOSS ADJ EXPENSES</Desc>
        <TotalAmt>1640690</TotalAmt>
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        <TotalAmt>154</TotalAmt>
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      <OtherExpensesGrp>
        <Desc>COMMISSION EXPENSE</Desc>
        <TotalAmt>15651</TotalAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>3998</TotalAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>1869358</TotalAmt>
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      <TotalJointCostsGrp>
        <TotalAmt>0</TotalAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>151331</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>3240795</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>1789128</BOYAmt>
        <EOYAmt>3295999</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
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        <EOYAmt>3914400</EOYAmt>
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      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>-1690036</BOYAmt>
        <EOYAmt>-3197297</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2224364</BOYAmt>
        <EOYAmt>717103</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>4013492</BOYAmt>
        <EOYAmt>4013102</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1507261</ReconcilationRevenueExpnssAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingOtherInd methodOfAccountingOtherDesc="STATUTORY">X</MethodOfAccountingOtherInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
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      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp />
      <BuildingsGrp />
      <LeaseholdImprovementsGrp />
      <EquipmentGrp />
      <OtherLandBuildingsGrp />
      <InvstProgramRelatedOrgGrp>
        <Desc>BONDS</Desc>
        <BookValueAmt>3839706</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <TotalBookValueProgramRltdAmt>3839706</TotalBookValueProgramRltdAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RESERVE FOR LOSSES AND LAE</Desc>
        <Amt>3172420</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNEARNED PREMIUMS</Desc>
        <Amt>68375</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>3240795</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>350270</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>350270</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>11827</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>11827</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>362097</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>1857531</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>1857531</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>11827</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>11827</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>1869358</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, QUESTION 2</FormAndLineReferenceDesc>
        <ExplanationTxt>TAX POSITIONS ARE EVALUATED AT THE REPORTING DATE TO DETERMINE WHETHER AN UNRECOGNIZED TAX BENEFIT SHOULD BE RECORDED. THE ASSOCIATION DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2019 OR 2018. THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2019 AND 2018.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A</FormAndLineReferenceDesc>
        <ExplanationTxt>MISSOURI MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION IS GOVERNED BY MISSOURI REVISED STATUTES 383.150-383.195. MISSOURI MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION IS MANAGED BY THE BOARD OF DIRECTORS APPOINTED BY THE COMMISSIONER OF THE MISSOURI DEPARTMENT OF COMMERCE &amp; INSURANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS HIRED HEALTHCARE SERVICES GROUP AS A SERVICING AGENT FOR MISSOURI MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, QUSTION 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE RETURN IS PREPARED BY BROWN SMITH WALLACE LLP, AN INDEPENDENT CPA FIRM AND IS REVIEWED BY HEALTHCARE SERVICES GROUP AND THE SIGNATORY, TREASURER GINA GERVINO BEFORE BEING FILED WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION FILES ALL REQUIRED DOCUMENTS WITH THE MISSOURI DEPARTMENT OF COMMERCE &amp; INSURANCE, FINANCIAL INSTITUTIONS, AND PROFESSIONAL REGISTRATION WHICH ARE OPEN TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TAXPAYER IS AN INSURANCE COMPANY WHICH UTILIZES THE STATUTORY ACCOUNTING METHOD TO PREPARE ITS FINANCIAL STATEMENTS AND FORM 990.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>