2019-10-02T12:43:34-05:00 2018-12-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS ROAD SUITE 1500 RALEIGH NC 27609 990 2018-01-01 461056754 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY CHES 4104942000 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 4104942000 2019-10-02 1 J CALVIN MARKS P01226973 9197196400 2019-10-02 34.206.232.202 2019-10-02 12:43:30 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9C238F1B6484ABD2E08FB3ED1A4A2692AD2A909B 2018 2019-02-21 02:37:17Z THOMAS PHELAN 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 807122464 0 X WWW.CEIWC.COM X 2012 MD CHESAPEAKE EMPLOYERS' INSURANCE COMPANY WAS ESTABLISHED BY STATUTE TO BE THE WORKERS' COMPENSATION INSURER OF LAST RESORT AS WELL AS A COMPETITIVE INSURER IN THE STATE OF MARYLAND. 11 0 254 0 0 36396 0 0 225538520 215009895 122705305 113383667 72895 94151 348316720 328487713 93335 17860 0 0 33377031 37263569 0 0 0 174287084 201912955 207757450 239194384 140559270 89293329 2317794587 2271677738 1622524174 1508257614 695270413 763420124 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY WAS ESTABLISHED BY STATUTE TO BE THE WORKERS' COMPENSATION INSURER OF LAST RESORT AS WELL AS A COMPETITIVE INSURER IN THE STATE OF MARYLAND. 0 0 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY HAD OVER 22,000 IN-FORCE POLICIES AND WAS MANAGING MORE THAN 3,650 OPEN CLAIMS AT DECEMBER 31, 2018. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1971 0 1 254 1 0 0 0 0 0 0 0 0 X 11 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X FRANCIS LINARDI 4104942000 8722 LOCH RAVEN BLVD TOWSON MD 212862235 VINCENT ROCKY GONZALEZ CHAIRMAN 1.50 0.50 X X 57959 0 4437 LEONARD SCHULER VICE CHAIRMAN 1.50 0.50 X X 56166 0 11016 PAUL V GILL TREASURER 1.50 0.50 X X 47980 0 34159 SUZANNE THOMPSON SECRETARY 1.50 0.50 X X 50027 0 26125 JOSEPH M COALE DIRECTOR (TO JUN '18) 1.50 0.50 X 25106 0 0 CHARLES H DANKMEYER JR DIRECTOR (TO JUN '18) 1.50 0.50 X 25072 0 0 PAULA ETTINGS DIRECTOR (FROM JUN '18) 1.50 0.50 X 27182 0 0 WAYNE R GIOIOSO SR DIRECTOR 1.50 0.50 X 52137 0 4015 FRANKLIN HAJEK DIRECTOR (FROM JUN '18) 1.50 0.50 X 27742 0 0 LEWIS POWELL DIRECTOR 1.50 0.50 X 40715 0 40698 MARIA TILDON DIRECTOR 1.50 0.50 X 53259 0 4076 THOMAS PHELAN PRESIDENT & CEO 30.00 10.00 X 444000 0 40500 FRANK LINARDI CHIEF FINANCIAL OFFICER 30.00 10.00 X 231569 0 29848 CARMINE D'ALESSANDRO CHIEF LEGAL OFFICER 30.00 10.00 X 207607 0 28035 PAIGE BECK CHIEF INNOVATION OFFICER 30.00 10.00 X 273699 0 42529 SHARON ROWELL CHIEF ADMINISTRATIVE OFFICER 30.00 10.00 X 209290 0 27585 SONG MITCH HE CHIEF INVESTMENT OFFICER 30.00 10.00 X 194741 0 28393 KAMA SCHNEIDER VICE PRESIDENT 30.00 10.00 X 193142 0 12240 RIAL SIMONS CHIEF ACTUARY 30.00 10.00 X 177370 0 0 LISA KRUSKA VICE PRESIDENT 30.00 10.00 X 158650 0 21499 WILLIAM SMULYAN MEDICAL CONSULTANT 30.00 10.00 X 221421 0 16848 STEPHEN FISHER MEDICAL ADVISOR 30.00 10.00 X 196826 0 0 JOSEPH CURRAN ASSISTANT VICE PRESIDENT 30.00 10.00 X 186102 0 0 RONA FINKELSTEIN SENIOR VICE PRESIDENT 30.00 10.00 X 184782 0 44282 DONNA WILSON SENIOR VICE PRESIDENT 30.00 10.00 X 182070 0 44359 3524614 0 460644 88 0 1 0 EXPRESS SCRIPTS INC ONE EXPRESS WAY MS HQ2E04 ST LOUIS MO 63121 MEDICAL/HEALTH SERVICES 2692341 VGM GROUP INC PO BOX 1860 WATERLOO IA 50704 MEDICAL/HEALTH SERVICES 2603569 CAPITAL DIALYSIS LLC PO BOX 843116 BOSTON MA 02284 MEDICAL/HEALTH SERVICES 1532678 BROWN CAPITAL MANAGEMENT 1201 N CALVERT ST BALTIMORE MD 21202 INVESTMENT SERVICES 1367881 UNIVERSITY OF MD MEDICAL SYSTEM CORP 11 S PACA ST STE LL BALTIMORE MD 21201 MEDICAL/HEALTH SERVICES 1352529 123 PREMIUMS EARNED 524150 214444681 214444681 INSTALLMENT FEES & NSF CHARGES 900099 565214 565214 215009895 67615449 67615449 524402969 478634751 45768218 45768218 45768218 94151 94151 94151 328487713 215104046 0 113383667 X 17860 2908569 26441939 2221487 3702221 1989353 1150598 245024 6223254 31806261 2472430 2885179 1318486 2465465 380750 190375 2032736 2317048 737599 LOSSES 116632405 DIVIDENDS 21312792 TAXES, LICENSES, FEES 9337462 405091 239194384 7985196 208512 72467709 49389401 77395395 71461482 40329537 31448984 9056574 8880553 1950144104 2028237436 38110306 43757673 162635303 69742681 2317794587 2271677738 23908583 20815750 102058007 96751722 1496557584 1390690142 1622524174 1508257614 X 695270413 763420124 695270413 763420124 2317794587 2271677738 X 89293329 -17921683 -3221935 X 0 1 X 1 0 1335400 1335400 14206861 7310561 6896300 24787276 24138423 648853 8880553 LOSSES & LOSS ADJUSTMENT EXPENSES 1215320000 BORROWED MONEY & ACCRUED INTEREST 100327656 PAYABLE FOR SECURITIES LENDING 40300684 DIVIDENDS PAYABLE 34433802 FUNDS HELD BY COMPANY UNDER REINSURANCE TREATY 308000 1390690142 X 299448876 -17921683 -17921683 317370559 11117154 11117154 328487713 231991628 3914398 3914398 228077230 11117154 11117154 239194384 PART X, LINE 2: CHESAPEAKE DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS AS OF DECEMBER 31, 2018. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT 3,914,398. 1 COLON CANCER ALLIANCE INC 1025 VERMONT AVE NW WASHINGTON DC 20005 860947831 501(C)(3) 12360 GENERAL SUPPORT FRANCISCAN CENTER INC 101 WEST 23RD ST BALTIMORE MD 21218 521164260 501(C)(3) 5500 GENERAL SUPPORT 2 PART I, LINE 2: CHESAPEAKE OCCASIONALLY MAKES SMALL CHARITABLE CONTRIBUTIONS AND GRANTS TO 501(C)(3)S AS A WAY OF GIVING BACK TO THE COMMUNITY. GRANTS ARE REVIEWED AND APPROVED BY AN INTERNAL COMMITTEE. X X 0 1 0 THOMAS PHELAN PRESIDENT & CEO 381954 0 19528 0 42518 0 40500 0 0 0 484500 0 0 0 FRANK LINARDI CHIEF FINANCIAL OFFICER 206027 0 9888 0 15654 0 15690 0 14158 0 261417 0 0 0 CARMINE D'ALESSANDRO CHIEF LEGAL OFFICER 183579 0 8625 0 15403 0 12734 0 15301 0 235642 0 0 0 PAIGE BECK CHIEF INNOVATION OFFICER 228463 0 10605 0 34631 0 42529 0 0 0 316228 0 0 0 SHARON ROWELL CHIEF ADMINISTRATIVE OFFICER 183662 0 8625 0 17003 0 12284 0 15301 0 236875 0 0 0 SONG MITCH HE CHIEF INVESTMENT OFFICER 185831 0 8910 0 0 0 0 0 28393 0 223134 0 0 0 KAMA SCHNEIDER VICE PRESIDENT 169693 0 7566 0 15883 0 12240 0 0 0 205382 0 0 0 RIAL SIMONS CHIEF ACTUARY 169453 0 7917 0 0 0 0 0 0 0 177370 0 0 0 LISA KRUSKA VICE PRESIDENT 150884 0 7566 0 200 0 10483 0 11016 0 180149 0 0 0 WILLIAM SMULYAN MEDICAL CONSULTANT 210603 0 10818 0 0 0 16848 0 0 0 238269 0 0 0 STEPHEN FISHER MEDICAL ADVISOR 188087 0 8739 0 0 0 0 0 0 0 196826 0 0 0 JOSEPH CURRAN ASSISTANT VICE PRESIDENT 156498 0 7825 0 21779 0 0 0 0 0 186102 0 0 0 RONA FINKELSTEIN SENIOR VICE PRESIDENT 173782 0 9000 0 2000 0 14400 0 29882 0 229064 0 0 0 DONNA WILSON SENIOR VICE PRESIDENT 173100 0 8970 0 0 0 14477 0 29882 0 226429 0 0 0 PART I, LINE 4B PAIGE BECK SUPPLEMENTAL NON-QUALIFIED PLAN $30,780 FRANCIS LINARDI SUPPLEMENTAL NON-QUALIFIED PLAN $5,000 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION MEMBERS CONSIST OF THE 9 BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS, WHICH COMPOSE THE MEMBERS OF THE ORGANIZATION, ARE APPOINTED BY THE GOVERNOR OF THE STATE OF MARYLAND AND CONFIRMED BY THE MARYLAND STATE SENATE. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNOR OF MARYLAND RESERVES THE POWER TO REMOVE A BOARD MEMBER FOR INCOMPETANCE OR MISCONDUCT. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS COMPLETED BY AN EXTERNAL ACCOUNTANT AND THE RETURN IS PROVIDED TO EACH MEMBER OF THE BOARD PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. ANY INSTANCES OF POTENTIAL CONFLICT ARE REVIEWED BY HUMAN RESOURCES OR THE CHIEF LEGAL OFFICER FOR THE APPROPRIATE RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO, EXECUTIVES, AND TOP MANAGEMENT POSITIONS ARE DETERMINED UPON THE COMPLETION OF AN ANNUAL EVALUATION AND IS BASED UPON INDIVIDUAL AND COMPANY PERFORMANCE AS WELL AS INDUSTRY CONSIDERATIONS AND OTHER BENCHMARK DATA. COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS AND COMPENSATION FOR OTHER EXECUTIVES AND TOP MANAGEMENT POSITIONS ARE DETERMINED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE UPON REQUEST AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 11G COMMISSION 24,421,408. OTHER FEES FOR SERVICES 7,384,853. FORM 990, PART XI, LINE 9: CHANGE IN NON ADMITTED ASSETS 692,463. BAD DEBT -3,914,398. INJURED WORKERS INSURANCE FUND 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862226 522127565 STATE SPONSORED WORKMENS' COMPENSATION INSURANCE MD 501(C)27 0 STATE OF MARYLAND 100 STATE CIRCLE ANNAPOLIS MD 21401 522006962 STATE GOVERNMENT MD 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 INJURED WORKERS INSURANCE FUND Q 2654797 FAIR VALUE INJURED WORKERS INSURANCE FUND D 763567 FAIR VALUE INJURED WORKERS INSURANCE FUND S 10796076 FAIR VALUE