MEDICA FOUNDATION: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
MEDICA FOUNDATION (EIN 41-1812461)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-14
IRS object ID
201823189349311202
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-14T16:19:59-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 Wells Fargo Ctr 90 S 7thAddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411812461EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Medica FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Mary QuistInCareOfNm
Business Name ControlMEDIBusinessNameControlTxt
Phone9529922058PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 CARLSON PARKWAY CW 104AddressLine1Txt
CityMINNETONKACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55305ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK L BAIRDPersonNm
Person TitleCFOPersonTitleTxt
Phone9529922058PhoneNum
Signature2018-11-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMonroe J GierlPreparerPersonNm
PTINP01413237PTIN
Phone6123055000PhoneNum
Preparation2018-11-08PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.102.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id41438720183185000004FederalOriginalSubmissionId
Federal Original Submission Id2018-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id80A177424C680C2DAD2A222932BC57697C814DADAtSubmissionCreationDeviceId
At Submission Filing Device Id1AC817DA654FAC82C3A77F7D3F33864379930489AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROBERT LONGENDYKEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 CARLSON PARKWAY CW 104AddressLine1Txt
CityMINNETONKACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55305ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,288,167GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MEDICAFOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionSee Schedule O.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,500,000PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$810,399PYInvestmentIncomeAmt
CY Investment Income$1,674,528CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$3,310,399PYTotalRevenueAmt
CY Total Revenue$1,674,528CYTotalRevenueAmt
PY Grants And Similar Paid$1,208,112PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,197,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$576,456PYOtherExpensesAmt
CY Other Expenses$614,951CYOtherExpensesAmt
PY Total Expenses$1,784,568PYTotalExpensesAmt
CY Total Expenses$1,811,951CYTotalExpensesAmt
PY Revenues Less Expenses$1,525,831PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$137,423CYRevenuesLessExpensesAmt
Total Assets BOY$29,290,892TotalAssetsBOYAmt
Total Assets EOY$31,977,835TotalAssetsEOYAmt
Total Liabilities BOY$1,204,014TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,254,335TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$28,086,878NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$30,723,500NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$300,000ExpenseAmt
Grant$300,000GrantAmt
DescBEHAVIORAL HEALTH: THIS FUNDING PRIORITY SEEKS PROGRAMS THAT FOCUS ON DEVELOPING CAPABILITIES OR CHANGING PROCESSES RELATED TO THE CONTINUUM OF BEHAVIORAL HEALTH CARE SERVICE INTERVENTIONS, ACCESSIBILITY AND SUSTAINABILITY. THIS INCLUDES PROGRAMS THAT ADDRESS GAPS IN CURRENT SERVICE, INTEGRATE PHYSICAL AND MENTAL HEALTH, PROVIDE SUPPORTIVE SERVICE AND CASE MANAGEMENT AND ADDRESS NEEDS IDENTIFIED BY THE MINNESOTA 10X10 ASSERTIVE COMMUNITY TREATMENT (ACT) INITIATIVE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$300,000ExpenseAmt
Grant$300,000GrantAmt
DescEARLY CHILDHOOD HEALTH: THIS FUNDING PRIORITY SEEKS PROGRAMS THAT FOCUS ON HEALTHY FAMILIES TO FOSTER OPTIMAL GROWTH AND DEVELOPMENT OF YOUNG CHILDREN. THIS INCLUDES PROGRAMS THAT IMPROVE ACCESS TO PRENATAL AND POSTNATAL CARE; PARENTING; PREVENTION, INCLUDING CHILD AND TEEN CHECKUPS; DENTAL SERVICES AND SOCIAL AND EMOTIONAL HEALTH. PROGRAMMING FOCUSES ON CHILDREN AGES BIRTH THROUGH AGE TWELVE AND MAY INVOLVE PARENTS, CAREGIVERS, HEALTH CARE PROVIDERS AND THE OVERALL COMMUNITY.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$200,000ExpenseAmt
Grant$200,000GrantAmt
DescORGANIZATIONAL CORE MISSION SUPPORT: THE MEDICA FOUNDATION PROVIDES GRANTS TO SUPPORT THE HEALTH-RELATED PROGRAMMING OF NONPROFIT ORGANIZATIONS LOCATED OUTSIDE OF THE TWIN CITIES METROPOLITAN AREA. THESE GRANTS PROVIDE CRITICAL SUPPORT TO SMALL ORGANIZATIONS, WHICH STRENGTHENS REGIONAL AND RURAL COMMUNITIES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)

ExpenseExpenseAmtGrantGrantAmtDescDesc
$197,000$197,000Medica Foundation General Funding
$200,000$200,000Strategic Grant
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$397,000TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$397,000TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$1,197,000TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMary QuistPersonNm
Phone9529922058PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 CARLSON PARKWAY CP330AddressLine1Txt
CityMINNETONKACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55305ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
John Buck
Director, Chair0.015.0Yes (X)Yes (X)$0$123,250$0
Burton Cohen
Director0.02.0Yes (X)$0$4,000$0
Samuel Leon
Director0.010.0Yes (X)$0$76,000$0
Esther Tomljanovich
Director, Vice Chair0.06.0Yes (X)Yes (X)$0$78,750$0
David Tilford
Pres/CEO thru 1/170.040.0Yes (X)Yes (X)$0$1,444,272$7,239
ROBERT LONGENDYKE
SVP & CMO, Executive Director0.040.0Yes (X)Yes (X)$0$471,138$50,357
Mark L Baird
SVP & CFO, Treasurer0.040.0Yes (X)$0$728,871$50,231
James P Jacobson
SVP & Gen Counsel, Secretary0.040.0Yes (X)$0$494,384$52,065
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,420,665TotReportableCompRltdOrgAmt
Total Other Compensation$159,892TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonMedica Health PlansPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Carlson Parkway CP 330AddressLine1Txt
CityMinnetonkaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55305ZIPCd
FieldValueIRS element (for citing)
ServicesLeased EmployeesServicesDesc
Compensation$275,017CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$780,952TotalRevenueColumnAmt
Exclusion$780,952ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,507,215SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$613,639SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$893,576SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$893,576TotalRevenueColumnAmt
Exclusion$893,576ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,674,528TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,674,528ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,197,000TotalAmt
Program Services$1,197,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$169,530TotalAmt
Management And General$169,530ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$477TotalAmt
Management And General$477ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$95,825TotalAmt
Management And General$95,825ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,724TotalAmt
Management And General$2,724ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,027TotalAmt
Management And General$4,027ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
Board Expenses$20,000$20,000
Dues, Memberships & Subs$13,679$13,679
Community Outreach$13,285$13,285
Leased Employees$275,017$275,017

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$20,387TotalAmt
Management And General$20,387ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,811,951TotalAmt
Program Services$1,197,000ProgramServicesAmt
Management And General$614,951ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$278,129BOYAmt
EOY$186,029EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$34,154BOYAmt
EOY$28,861EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$28,978,609BOYAmt
EOY$31,762,945EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$29,290,892BOYAmt
EOY$31,977,835EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$14,109EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$1,170,390BOYAmt
EOY$1,170,680EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,624BOYAmt
EOY$69,546EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,204,014BOYAmt
EOY$1,254,335EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$28,086,878BOYAmt
EOY$30,723,500EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,086,878BOYAmt
EOY$30,723,500EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,290,892BOYAmt
EOY$31,977,835EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$137,423ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,774,045NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Medica Health PlansBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN411242261EIN
Organization Type10OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456Yes (true)SupportedOrgSectionC456Ind
Supported Org QualifiedYes (true)SupportedOrgQualifiedInd
Suprt Exclusively Sec170c2 BYes (true)SuprtExclusivelySec170c2BInd
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (true)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Sch A Part IV Line Section A Line 3bMEDICA 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 Line Section A Line 3cTHE 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.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescSHORT TERM INVESTMENTSDesc
Book Value$31,762,945BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$31,762,945TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescPAYABLE TO MEDICA HEALTH PLANSDesc
Amt$69,546Amt
FieldValueIRS element (for citing)
Total Liability$69,546TotalLiabilityAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
A Chance To Grow
1800 Second Street NEMinneapolisMN55418411444113501(C)(3)$20,000Program Support
American Heart Association
2750 Blue Waters Road Suite 250EaganMN55121135613797501(C)(3)$7,500Program Support
American Indian Family Center
579 Wells StreetSt PaulMN55130411841352501(C)(3)$40,000Program Support
American Red Cross
1201 West River ParkwayMinneapolisMN55454530196605501(C)(3)$10,000Program Support
Baby's Space
2438 18th Avenue SouthMinneapolisMN55436204502788501(C)(3)$25,000Program Support
Center for Victims of Torture
2356 University Avenue W Ste 430St PaulMN55114363383933501(C)(3)$40,000Program Support
Children's Dental Services
636 Broadway Street NEMinneapolisMN55413410857929501(C)(3)$25,000Program Support
Churches United in Ministry
102 W Second StreetDuluthMN55802411227969501(C)(3)$25,000Program Support
Community Dental Care
1670 Beam Avenue Suite 204MaplewoodMN55109043692982501(C)(3)$25,000Program Support
Community Health Charities Minnesota
1199 N Fairfax Street Suite 600AlexandriaVA22314136167225501(C)(3)$43,500Program Support
Comunidades Latinas Unidas En Servicio
797 East 7th StreetSt PaulMN55106411386986501(C)(3)$20,000Program Support
CornerHouse Interagency Child Abuse Evaluation and
2502 10th Avenue SouthMinneapolisMN55404411640731501(C)(3)$25,000Program Support
Emma Norton Services
670 N Robert StreetSt PaulMN55101410859485501(C)(3)$25,000Program Support
Greater Twin Cities United Way
404 South Eighth StreetMinneapolisMN55404411973442501(C)(3)$31,500Program Support
HealthEast Foundation
1690 University Avenue West 250St PaulMN55104411602044501(C)(3)$40,000Program Support
Interfaith Outreach & Community Partners
1605 County Road 101 NPlymouthMN55447363482724501(C)(3)$20,000Program Support
Life House Inc
102 West First StreetDuluthMN55802411704840501(C)(3)$40,000Program Support
March of Dimes
Minnesota ChapterEdinaMN55439131846366501(C)(3)$25,000Program Support
National Alliance on Mental Illness - Minnesota
1919 University Ave Suite 400St PaulMN55104411317030501(C)(3)$10,000Program Support
North Shore Health Care Foundation
PO Box 454Grand MaraisMN55604411694904501(C)(3)$10,000Program Support
Propel Nonprofits
One Main St SE Suite 600MinneapolisMN55414411916337501(C)(3)$10,000Program Support
Reclaim
771 Raymond AvenueSt PaulMN55114800829665501(C)(3)$40,000Program Support
St David's Center for Child & Family Development
3395 Plymouth RoadMinnetonkaMN55305411429208501(C)(3)$40,000Program Support
The Family Partnership
414 South 8th StreetMinneapolisMN55404410693858501(C)(3)$25,000Program Support
Ujamaa Place
1821 University Avenue Suite N257Saint PaulMN55104271216065501(C)(3)$40,000Program Support
University of Minnesota Foundation
200 Oak Street SE Suite 300MinneapolisMN55455416042488501(C)(3)$25,000Program Support
Washburn Center for Children
1100 Glenwood AvenueMinneapolisMN55405410711618501(C)(3)$25,000Program Support
Way to Grow
125 West Broadway Suite 110MinneapolisMN55411710956749501(C)(3)$25,000Program Support
YouthLink
41 North 12th StreetMinneapolisMN55403411341773501(C)(3)$200,000Program Support
FieldValueIRS element (for citing)
Total501c3 Org29Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSch I Part I Line 2FormAndLineReferenceDesc
ExplanationTHE 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (true)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mark L Baird
SVP & CFO, Treasurer$0$417,556$0$236,600$0$74,715$0$24,975$0$27,150$0$780,996$0$48,290
James P Jacobson
SVP & Gen Counsel, Secretary$0$322,201$0$123,500$0$48,683$0$24,975$0$28,773$0$548,132$0$24,617
David Tilford
Pres/CEO thru 1/17$0$226,344$0$679,900$0$538,028$0$4,546$0$2,996$0$1,451,814$0$61,103
ROBERT LONGENDYKE
SVP & CMO, Executive Director$0$298,228$0$123,500$0$49,410$0$24,975$0$26,990$0$523,103$0$23,568

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Sch J Part I Line 3MEDICA 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. Sch J Part I Line 4A Severance Payments: David Tilford - $456,923
Sch J Part I Line 4bTHE FOLLOWING RECEIVED A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA HEALTH PLANS, A RELATED ORGANIZATION: MARK L. BAIRD - $48,290 JAMES P. JACOBSON - $24,617 David Tilford - $61,103 Robert Longedyke - $23,568
Sch J Part I Line 6bManagement incentive compensation includes components related to operating earnings of Medica Health Plans.
Sch J Part IISCHEDULE 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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Part I Line 1OUR MISSION IS TO FUND COMMUNITY-BASED INITIATIVES AND PROGRAMS THAT SUPPORT THE NEEDS OF MEDICA'S CUSTOMERS AND THE GREATER COMMUNITY BY IMPROVING THEIR HEALTH AND REMOVING BARRIERS TO HEALTH CARE SERVICES. Form 990 Part III Line 4d OTHER PROGRAM SERVICES: MEDICA FOUNDATION HAS THE FOLLOWING OTHER PROGRAM SERVICES: 1) Strategic Grant - TOTAL EXPENSES: $200,000; GRANTS: $200,000 2) MEDICA FOUNDATION GENERAL FUNDING - TOTAL EXPENSES: $197,000; GRANTS: $197,000
Form 990 Part VI Line 3MEDICA 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.
Form 990 Part VI Line 11bMEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S CONTROLLER AND FINANCE MANAGER 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 Line 12cANNUALLY 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 Line 15aMEDICA FOUNDATION DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY MEDICA HEALTH PLANS, A RELATED ORGANIZATION. MEDICA HEALTH PLANS 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 Line 19MEDICA 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 1CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN SEVERAL OF THE MEDICA ENTITIES (MEDICA HEALTH PLANS, MEDICA HEALTH PLANS WI, MEDICA FOUNDATION, MEDICA RESEARCH INSTITUTE, MEDICA AFFILIATED SERVICES, MEDICA INSURANCE COMPANY, MEDICA SELF-INSURED, AND MEDICA HEALTH MANAGEMENT). THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndPublic Charity StatusPublicCharityStatusTxt
MEDICA HEALTH PLANS
401 CARLSON PARKWAYMINNETONKAMN55305411242261HEALTH CVRGEMN501(C)(4)MH COMPANYfalse
MEDICA HEALTH PLANS OF WISCONSIN
401 CARLSON PARKWAYMINNETONKAMN55305411843804HEALTH CVRGEMN501(C)(4)MH COMPANYfalse
MEDICA HOLDING COMPANY
401 CARLSON PARKWAYMINNETONKAMN55305010571840HOLDING COMN501(C)(4)NAfalse
Mayo Research Inc
401 CARLSON PARKWAYMINNETONKAMN55305270600894RESEARCH FDTNMN501(C)(3)MH COMPANYfalseLine 12A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtControlled OrganizationControlledOrganizationInd
MEDICA INSURANCE COMPANY
401 CARLSON PARKWAYMINNETONKAMN55305411490988HEALTH INSURANCEMNMEDICA AFFC Corp$0$0false
MEDICA SELF-INSURED
401 CARLSON PARKWAYMINNETONKAMN55305411479417THIRD PARTY ADMINMNMEDICA AFFC Corp$0$0false
MEDICA AFFILIATED SERVICES
401 CARLSON PARKWAYMINNETONKAMN55305411716415HOLDING COMNMH COMPANYC Corp$0$0false
MEDICA HEALTH MANAGEMENT
401 CARLSON PARKWAYMINNETONKAMN55305208005519HEALTH MGMTMNMEDICA AFFC Corp$0$0false
MMSI Inc
401 CARLSON PARKWAYMINNETONKAMN55305411547003THIRD PARTY ADMINMNMEDICA AFFC Corp$0$0false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Medica Health Plans
n$170,404Actual Amount
Medica Health Plans
o$275,017Actual Amount
Medica Health Plans
p$95,825Actual Amount

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