2025-11-14T12:52:56-06:00 2024-12-31 135565207 KPMG LLP 350 NORTH 5TH ST STE 600 MINNEAPOLIS MN 55401 990 2024-01-01 411242261 MEDICA HEALTH PLANS MEDI 9529922753 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 KRISTA DUSIL CFO 9529922753 2025-11-12 1 0 HOLLY MOEN P01800653 6123055000 2025-11-12 2024 2025-03-06 01:10:19Z ELIZABETH ERICKSON 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 3562820716 0 X WWW.MEDICA.COM X 1973 MN TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES 5 4 14 0 0 0 0 0 1437609915 1780776947 19013780 43654053 -2661678 3376730 1453962017 1827807730 3500000 0 1297076549 1731503812 0 0 0 0 0 124981158 203266935 1425557707 1934770747 28404310 -106963017 925548510 971675180 272367606 416251506 653180904 555423674 TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 0 0 450019510 456290387 SEE SCHEDULE O 34519660 11569959 SEE SCHEDULE O 1246964642 1312916601 SEE SCHEDULE O 1731503812 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 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 1 0 0 1 1 0 1 14 1 0 0 0 0 0 0 0 0 X 5 4 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X KRISTA DUSIL 9529923908 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 X ELIZABETH F ERICKSON PRESIDENT, CEO, & TREAS THRU 1/2024 0.00 40.00 X X 0 1669649 201202 JOHN BUCK DIRECTOR & CHAIR 0.00 15.00 X X 0 145250 0 JOHN STANOCH DIRECTOR & VICE CHAIR 0.00 10.00 X X 0 128500 0 PETER KELLEY DIRECTOR 0.00 10.00 X 0 94750 0 MARY TWINEM DIRECTOR 0.00 10.00 X 0 90250 0 MARY P QUIST SR. VP, FINANCE THRU 6/2024 0.00 40.00 X 0 604708 35245 KRISTA DUSIL SVP, CFO, & TREASURER 0.00 40.00 X 0 804123 116115 ALICIA REUTER SVP & CLO, SECRETARY 0.00 40.00 X 0 408482 72742 MARK L BAIRD FORMER SVP & CFO 0.00 0.00 X 0 370125 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNSEL 0.00 0.00 X 0 403815 0 JOHN NAYLOR FORMER PRESIDENT & CEO 0.00 40.00 X 0 565230 0 DAVID H ELLENBOGEN FORMER SVP SEC & GEN COUNSEL 0.00 40.00 X 0 224611 1619 0 5509493 426923 6 1 1 0 MEDICA SERVICES COMPANY 401 CARLSON PARKWAY CP 300 MINNETONKA MN 55305 LEASED EMPLOYEES 69894564 1 MEDICARE REVENUE 524114 1312916601 1312916601 MEDICAID REVENUE 524114 456290387 456290387 GROUP & INDIVIDUAL 524114 11569959 11569959 1780776947 29203003 29203003 5390506 2013776 3376730 3376730 3376730 1747450260 1732999210 14451050 14451050 14451050 1827807730 1780776947 0 47030783 1731503812 1731503812 718615 718615 210406 210406 40763 40763 867854 867854 24794395 24794395 3454848 3454848 1289271 1289271 11466016 11466016 1324284 1324284 259218 259218 111220 111220 529115 529115 8474980 8474980 645326 645326 LEASED EMPLOYEES 69894564 69894564 INTERCOMPANY EXPENSE 63458313 63458313 PREMIUM TAXES 11600469 11600469 PRINTING & PUBLICATION 1755143 1755143 2372135 2372135 1934770747 1731503812 203266935 0 72415894 4983997 49601043 35350794 97708502 86522976 97625864 29272561 70379584 68353303 557477401 694427073 4264185 7963778 73701901 74073259 925548510 971675180 269812962 413558269 2554644 2693237 272367606 416251506 X 0 0 0 0 653180904 555423674 653180904 555423674 925548510 971675180 X -106963017 4236702 4969085 X 0 1 X 1 0 18775799 18775799 67824201 20691736 47132465 11025864 8580825 2445039 68353303 INVESTMENT INCOME ACCRUED 3942549 UNINSURED PLANS RECEIVABLE 30074544 INTERCOMPANY RECEIVABLES 11351967 GENERAL EXPENSE RECEIVABLE 26879698 REINSURANCE RECOVERIES 1824501 74073259 X 1828089416 3824665 3824665 1824264751 1396969 2146010 3542979 1827807730 1935052433 3824665 3824665 1931227768 1396969 2146010 3542979 1934770747 PART X, LINE 2: THE COMPANY IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE IRC, WITH THE EXCEPTION OF TAXES ON UNRELATED BUSINESS ACTIVITIES. THE FEDERAL UNRELATED BUSINESS INCOME TAX BENEFIT IS INCLUDED IN FEDERAL INCOME TAX BENEFIT IN THE STATUTORY STATEMENTS OF REVENUE AND EXPENSES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS FOR NII AND SGA EXPENSES 3,824,665. PART XI, LINE 4B - OTHER ADJUSTMENTS: STATUTORY GROSS UP FOR SGA EXPENSES 2,146,010. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS FOR NII AND SGA EXPENSES 3,824,665. PART XII, LINE 4B - OTHER ADJUSTMENTS: STATUTORY GROSS UP FOR SGA EXPENSES 2,146,010. 0 1 0 0 0 1 1 0 0 ELIZABETH F ERICKSON PRESIDENT, CEO, & TREAS THRU 1/2024 0 985480 0 522989 0 161180 0 160811 0 40391 0 1870851 0 152285 KRISTA DUSIL SVP, CFO, & TREASURER 0 428011 0 300026 0 76086 0 91882 0 24233 0 920238 0 0 MARY P QUIST SR. VP, FINANCE THRU 6/2024 0 185247 0 355809 0 63652 0 13800 0 21445 0 639953 0 58545 JOHN NAYLOR FORMER PRESIDENT & CEO 0 0 0 0 0 565230 0 0 0 0 0 565230 0 208756 ALICIA REUTER SVP & CLO, SECRETARY 0 244472 0 125026 0 38984 0 55274 0 17468 0 481224 0 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNSEL 0 0 0 0 0 403815 0 0 0 0 0 403815 0 126993 MARK L BAIRD FORMER SVP & CFO 0 0 0 124000 0 246125 0 0 0 0 0 370125 0 43667 DAVID H ELLENBOGEN FORMER SVP SEC & GEN COUNSEL 0 11188 0 0 0 213423 0 453 0 1166 0 226230 0 213151 PART I, LINE 3 MEDICA HEALTH PLANS, THE FILING ORGANIZATION, DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA SERVICES COMPANY, A RELATED TAXABLE ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA SERVICES COMPANY 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 SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA SERVICES COMPANY, A RELATED ORGANIZATION: MARK L. BAIRD - $43,667 KRISTA DUSIL - $73,769 DAVID H. ELLENBOGEN - $213,151 ELIZABETH F. ERICKSON - $152,285 JAMES P. JACOBSON - $126,993 JOHN W. NAYLOR - $208,756 ALICIA REUTER - $37,500 MARY P. QUIST - $58,545 PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATION'S OPERATING EARNINGS. FORM 990, PART VI, SECTION A, LINE 3 MEDICA HEALTH PLAN HAS ENTERED INTO AN ADMINISTRATIVE SERVICE AGREEMENT WITH MEDICA SERVICES COMPANY (MSC), A RELATED TAXABLE ORGANIZATION. THROUGH THIS AGREEMENT, MSC LEASES ITS EMPLOYEES AND PROVIDES VARIOUS MANAGEMENT/ADMINISTRATIVE SERVICES TO MEDICA HEALTH PLANS AND MEDICA HEALTH PLANS PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS EXIST WITHIN MEDICA HEALTH PLANS AS MEMBERS COVERED UNDER REGULATED INSURANCE PLANS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERSHIP OF MEDICA HEALTH PLANS ELECTS THE CONSUMER BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S FINANCE STAFF REVIEW 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 CONFLICT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 MEDICA HEALTH PLANS DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION WHICH USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION: A COMPENSATION COMMITTEE 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 REVIEW 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. 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 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, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FORM 990S ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1: CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN ALL ENTITIES UNDER MEDICA HOLDING COMPANY. THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. THE FOLLOWING CHANGES TO THE OFFICERS OF MEDICA HEALTH PLANS OCCURRED DURING THE TAXABLE PERIOD: IN 2024 KRISTA DUSIL WAS APPOINTED AS CHIEF FINANCIAL OFFICER OF THE ORGANIZATION. FORM 990, PART VII JOHN STANOCH'S BOARD STIPEND WAS PAID TO JNN VENTURES INC. FORM 990, PART XI, LINE 9: CHANGES IN VALUE OF NONADMITTED ASSETS 4,969,085. MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) LINE 12B MHC 0 MEDICA COMMUNITY HEALTH PLAN 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH CVRGE MN 501(C)(4) N/A MHC 0 MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING CO MN 501(C)(4) N/A N/A 0 MEDICA CENTRAL HEALTH PLAN 10101 WOODFIELD LANE ST LOUIS MO 63132 831979548 HEALTH CVRGE MO 501(C)(4) N/A MFCJVN 0 MS COMMUNITY NFP JV LLC (MFCJVN) 401 CARLSON PARKWAY MINNETONKA MN 55305 873268926 MN 0 0 0 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MAS C 0 MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMIN MN MAS C 0 MEDICA AFFILIATED SERVICES (MAS) 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MHC C 0 MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MGMT MN MAS C 0 MMSI INC 401 CARLSON PARKWAY MINNETONKA MN 55305 411547003 HEALTH INSURANCE MN MAS C 0 MEDICA SERVICES COMPANY LLC 401 CARLSON PARKWAY MINNETONKA MN 55305 852902940 ADMIN SERVICES MN MAS C 0 DEAN HEALTH PLAN INC 1277 DEMING WAY MADISON WI 53717 391535024 HEALTH INSURANCE WI DHI C 0 DEAN HEALTH INSURANCE INC (DHI) PO BOX 56099 MADISON WI 53705 391830837 HEALTH INSURANCE WI MSCJV C 0 MEDICA CENTRAL INSURANCE COMPANY 10101 WOODFIELD LANE ST LOUIS MO 63132 834718249 HEALTH INSURANCE MO MSCJV C 0 DEAN HEALTH SERVICES COMPANY LLC 1277 DEMING WAY MADISON WI 53717 842933639 ADMIN SERVICES WI MSCJV C 0 MS COMMUNITY JV LLC (MSCJV) 401 CARLSON PARKWAY MINNETONKA MN 55305 873240022 HOLDING COMPANY MN MHC C 0 MEDICA REGIONAL INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 854111612 HEALTH INSURANCE MN MAS C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0