2019-07-23T15:33:58-05:00 2018-12-31 411489071 SMITH SCHAFER & ASSOCIATES LTD 7500 HIGHWAY 55 SUITE 350 MINNEAPOLIS MN 55427 990 2018-01-01 410417040 MINNESOTA WORKERS COMPENSATION INSURERS ASSOCIATION INC MINN 9528971737 7701 FRANCE AVENUE SOUTH NO 450 MINNEAPOLIS MN 55435 BRANDON MILLER PRESIDENT 9528971737 2019-07-23 GRANT M TENTIS CPA P00216766 9529201455 2019-07-18 192.55.242.200 2019-07-23 15:33:35 CD P B236223D03FBDCEDD0FF9513F3D6B97E6F96E895 0659BEB047D3AB56C2BCA66B26B5C2492DAA3789 2018 2019-02-21 02:37:17Z BRANDON MILLER 7701 FRANCE AVE S STE 450 EDINA MN 55435 7597856 0 X WWW.MWCIA.ORG X 1983 MN TO PROVIDE TO ITS MEMBERS SERVICES AND INFORMATION REQUIRED UNDER PROVISIONS OF MN STATUTES. 12 12 50 0 0 0 0 0 7367659 7477101 85683 120755 0 0 7453342 7597856 0 0 0 0 4985008 4937861 0 0 0 2419931 2333436 7404939 7271297 48403 326559 6474790 6659152 6358481 6402432 116309 256720 THE MINNESOTA WORKERS' COMPENSATION INSURERS ASSOCIATION, INC. IS A NOT-FOR-PROFIT CORPORATION FORMED TO PROVIDE TO ITS MEMBERS THOSE ACTIVITIES WHICH ARE REQUIRED AND PERMITTED OF A DATA SERVICE ORGANIZATION UNDER THE PROVISIONS OF MINNESOTA STATUTES. 0 0 5082407 7287789 PROVIDE SERVICES TO INSURANCE COMPANIES LICENSED TO WRITE WORKERS' COMPENSATION INSURANCE IN MINNESOTA TO ENABLE THEM TO COMPLY WITH STATUTORY REQUIREMENTS. 48901 189312 COVER CLAIMS FOR INSURANCE COMPANIES THAT WENT INSOLVENT PRIOR TO 1983. 5131308 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 50 1 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X KATHLEEN PETERSON 9528976420 7701 FRANCE AVE SOUTH 450 MINNEAPOLIS MN 55435 IRA FEUERLICHT BOARD MEMBER 0.50 X 0 0 0 BARRY PRESLASKI BOARD MEMBER 0.50 X 0 0 0 PAUL LARSON BOARD MEMBER 0.50 X 0 0 0 DONNA GLENN BOARD MEMBER 0.50 X 0 0 0 SETH DAGGETT BOARD MEMBER 0.50 X 0 0 0 CHRIS WESTERMEYER BOARD MEMBER 0.50 X 0 0 0 JIM KEAL BOARD MEMBER 0.50 X 0 0 0 KEVIN CHRISTY BOARD MEMBER 0.50 X 0 0 0 KEVIN GREGERSON BOARD MEMBER 0.50 X 0 0 0 JIM KAYNISH BOARD MEMBER 0.50 X 0 0 0 GARY THADEN BOARD MEMBER 0.50 X 0 0 0 AMANDA APONTE BOARD MEMBER 0.50 X 0 0 0 BRANDON MILLER PRESIDENT 40.00 X 182904 0 34941 CRAIG A ANDERSON VP - ACTUARIAL 40.00 X 145282 0 45609 KATHLEEN PETERSON SR. VP - OPERATIONS/TREASU 40.00 X 152138 0 49601 SUSAN R LEVEY VP - INFORMATION TECHNOLOG 40.00 X 134080 0 46560 PAMELA FLATEN DATA REPORTING MANAGER 40.00 X 111399 0 38246 THOMAS GOODRICH SR. PROGRAM ANALYST 40.00 X 110776 0 40198 MUHAMMAD KASHIF TECHNICAL PROJECT LEAD 40.00 X 114936 0 36517 PATRICK RILEY SR. NETWORK ADMINISTRATOR 40.00 X 106170 0 37716 SONDRA MATTKE SR. BUSINESS ANALYST 40.00 X 101073 0 28175 THOMAS HARMS DEFERRED COMPENSATION 0.00 X 148642 0 0 1307400 0 357563 10 1 1 0 SPECTRUM PARTNERS LLC 7701 FRANCE AVENUE SOUTH SUITE 450 MINNEAPOLIS MN 55435 DATABASE SUPPORT 300000 SOUND ACTUARIAL CONSULTING 403-2 EAST MAIN STREET PORT JEFFERSON NY 11777 ACTUARIAL CONSULTING 114808 DYNAMICVIEW LLC 13808 AUTUMNWOOD AVENUE ROSEMOUNT MN 55068 COMMERCIAL ASPHALT CONSTRUCTION 111974 3 MEMBER ASSESSMENTS 518210 6675665 6675665 ASSIGNED RISK SERVICE 518210 477435 477435 SERVICES & OTHER INC 518210 257507 257507 U.S.P. FINES 518210 63950 63950 PAPER PROCESSING FEES 518210 2544 2544 7477101 120755 120755 7597856 7477101 0 120755 614404 402956 211448 2674281 1753921 920360 712626 467374 245252 681161 446738 234423 255389 167496 87893 150000 106500 43500 35165 24967 10198 6800 4828 1972 140426 99705 40721 926866 776729 150137 508640 361135 147505 85389 67640 17749 RESEARCH IST. DATA COLL 195000 195000 RATEMAKING CONSULTING 114808 114808 PUBLIC AFFAIRS 69118 49202 19916 OTHER EXPENSES 52323 43408 8915 48901 48901 7271297 5131308 2139989 0 3107592 3212655 3367198 3446497 6474790 6659152 6358481 6402432 6358481 6402432 X 116309 256720 116309 256720 6474790 6659152 X 326559 -265014 78866 X 0 1 X 1 0 0 MEMBER CASH RESERVE ASSESS PAYABLE 3536524 DEFERRED COMPENSATION OBLIGATION 1215908 ADVANCES FROM MEMBERS 1650000 6402432 7143530 -265014 -265014 7408544 189312 189312 7597856 7222396 0 7222396 48901 48901 7271297 PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUE RELATED TO INSOLVENT FUND 188,198. INVESTMENT INCOME 1,114. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES RELATED TO INSOLVENT FUND 48,901. X X X X 1 0 0 BRANDON MILLER PRESIDENT 182904 0 0 0 0 0 34136 0 805 0 217845 0 0 0 CRAIG A ANDERSON VP - ACTUARIAL 145282 0 0 0 0 0 28911 0 16698 0 190891 0 0 0 KATHLEEN PETERSON SR. VP - OPERATIONS/TREASU 152138 0 0 0 0 0 30275 0 19326 0 201739 0 0 0 SUSAN R LEVEY VP - INFORMATION TECHNOLOG 134080 0 0 0 0 0 26247 0 20313 0 180640 0 0 0 THOMAS GOODRICH SR. PROGRAM ANALYST 110776 0 0 0 0 0 22045 0 18153 0 150974 0 0 0 MUHAMMAD KASHIF TECHNICAL PROJECT LEAD 114936 0 0 0 0 0 20286 0 16231 0 151453 0 0 0 THOMAS HARMS DEFERRED COMPENSATION 148642 0 0 0 0 0 0 0 0 0 148642 0 0 0 PART I, LINE 4A THOMAS HARMS RECEIVED DEFERRED COMPENSATION PAYMENTS TOTALING $148,642. FORM 990, PART VI, SECTION A, LINE 6 ANY ENTITY THAT IS LICENSED THROUGH MN DEPARTMENT OF COMMERCE TO WRITE WORKERS COMPENSATION INSURANCE HAS TO BE A MEMBER OF A DATA SERVICE ORGANIZATION, MWCIA THE ONLY DSO IN THE STATE OF MINNESOTA. FORM 990, PART VI, SECTION A, LINE 7A GUIDED BY A BOARD OF TWELVE MEMBERS, MWCIA HAS TEN COMPANY MEMBERS AND TWO PUBLIC MEMBERS APPOINTED BY THE MINNESOTA DEPARTMENT OF COMMERCE FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THIS FORM 990 IS TRANSMITTED TO THE BUDGET AND INVESTMENT COMMITTEE MEMBERS FOR REVIEW. ONCE APPROVED BY THE COMMITTEE THE DRAFT IS THEN REVIEWED BY ALL BOARD MEMBERS WHO THEN VOTE TO APPROVE SUBMISSION OF THE FORM 990 TO ASSURE FULL AND ACCURATE DISCLOSURE TO THE IRS AND MAKE CERTAIN THE BOARD IS FULLY AWARE OF THE ITS CONTENTS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL PROCRESS OF REQUIRING EMPLOYEES AND BOARD MEMBERS TO REVIEW THE POLICY, AND SIGN AN ACKNOWLEDGEMENT STATING THEIR COMPLIANCE WITH THE POLICY. THE POLICY REQUIRES BOARD MEMBERS TO DISCLOSE POTENTIAL CONFLICT OF INTEREST RELATIONSHIPS THAT ARISE IN THE ORDINARY COURSE OF THE ORGANIZATION'S BUSINESS. IF CONFLICTS ARE IDENTIFIED, THE PRESIDENT AND SENIOR VICE PRESIDENT OF OPERATIONS, IN CONSULTATION WITH THE CHAIR OF THE BOARD OF DIRECTORS, ARE RESPONSIBLE TO MANAGE THE RELATIONSHIPS TO ENSURE THAT FINANCIAL DECISIONS ARE MADE WITH INDEPENDENCE. IN THE CUURENT YEAR, ONE BOARD MEMBER ALSO PROVIDES WORKERS' COMPENSATION INSURANCE TO ASSOCIATION AND ONE PUBLIC MEMBER PURCHASES DATA FROM THE ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 15 PRESIDENT SALARY IS SET BY EXECUTIVE COMMITTEE (BOARD OF DIRECTORS). ALL OTHER EMPLOYEES INCLUDING KEY EMPLOYEES ARE SET BY MANAGEMENT. A SALARY REVIEW PROGRAM HAS BEEN ESTABLISHED BY AN INDEPENDENT CONSULTING FIRM AND IS CONSISTENTLY REVIEWED TO ENSURE WAGES ARE COMPETITIVE AND FAIR. FORM 990, PART VI, SECTION C, LINE 19 THE ARTICLES OF INCORPORATION AND BYLAWS ARE POSTED ON THE ORGANIZATIONS WEBSITE. FINANCIAL INFORMATION IS INCLUDED IN SUMMARY FORM IN THE ANNUAL REPORT WHICH IS ALSO POSTED ON THE WEBSITE. OTHER INFORMATION, SUCH AS THE CONFLICT OF INTEREST POLICY IS AMADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: MEMBERSHIP REAPPORTIONMENT ASSESSMENT ADJUSTMENT 78,866.