2018-11-14T16:19:45-06:00 2017-12-31 KPMG LLP 4200 Wells Fargo Ctr 90 S 7th Minneapolis MN 55402 990 2017-01-01 411843804 Medica Health Plans of Wisconsin % MARY QUIST MEDI 9529922058 401 CARLSON PARKWAY MINNETONKA MN 55305 MARK L BAIRD CFO 9529922058 2018-11-08 true MONROE J GIERL P01413237 6123055000 2018-11-08 167.68.102.5 41438720183185000005 2018-11-14 P 80A177424C680C2DAD2A222932BC57697C814DAD 1AC817DA654FAC82C3A77F7D3F33864379930489 2017 2019-02-21 02:37:17Z JOHN NAYLOR 401 CARLSON PARKWAY MINNETONKA MN 55305 529797820 false X WWW.MEDICA.COM X 1996 WI TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. 9 8 0 0 0 0 0 0 221551450 274734858 123124 695465 0 0 221674574 275430323 0 0 220741000 230246000 0 0 0 0 0 33220001 29913000 253961001 260159000 -32286427 15271323 98181846 110293050 70605766 38150350 27576080 72142700 X TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES. false false 230246000 274734858 See Schedule O. 230246000 false false false false false false false false false false true false true true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true false true false true 6765 0 true 0 false false false false false false X 9 8 false true false false true false false true true false false true true true true true true false false false WI X MARY QUIST 9529922058 PO BOX 9310 CP330 MINNEAPOLIS MN 55440 X John W Naylor President/CEO- Start Feb 2017 0.0 40.0 X X 0 1372499 43421 David Tilford Pres/CEO thru 1/17 0.0 40.0 X X 0 1444272 7239 Rajesh Aggarwal Director 0.0 10.0 X 0 85375 0 John Buck Director, Chair 0.0 15.0 X X 0 123250 0 Peter Kelly Director 0.0 10.0 X 0 71500 0 Samuel Leon Director 0.0 10.0 X 0 76000 0 John Stanoch Director, Vice Chair 0.0 10.0 X X 0 95125 0 Earl Stratton Director 0.0 10.0 X 0 95250 0 Esther Tomljanovich Director 0.0 6.0 X 0 78750 0 Mary Twinem Director 0.0 10.0 X 0 80750 0 Mark L Baird SVP & CFO, Treasurer 0.0 40.0 X 0 728871 50231 James P Jacobson SVP & Gen Counsel, Secretary 0.0 40.0 X 0 494384 52065 0 4746026 152956 0 false true false Medica Health Plans 401 Carlson Parkway CP 330 Minnestonka MN 55305 Leased Employees 16478473 1 0 Premium Revenue 524114 274734858 274734858 274734858 693372 693372 0 0 0 0 0 254369590 254367497 2093 2093 2093 0 0 0 0 0 0 0 0 0 0 275430323 274734858 0 695465 0 0 0 230246000 230246000 0 0 0 0 0 0 0 397742 397742 87052 87052 47320 47320 0 0 3481719 3481719 526612 526612 430115 430115 1449000 1449000 0 552191 552191 40331 40331 0 32109 32109 0 0 2828390 2828390 172390 172390 Premium Taxes 2247026 2247026 Printing and Publications 664462 664462 Leased Employees 16478473 16478473 All Other Expenses 478068 478068 260159000 230246000 29913000 0 0 0 37317995 18529082 0 0 2028445 7281081 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43889666 63015933 0 0 0 0 14945740 21466954 98181846 110293050 19997356 2228198 0 0 7289146 3325578 0 0 0 0 0 0 0 0 0 0 43319264 32596574 70605766 38150350 X 0 0 0 0 27576080 72142700 27576080 72142700 98181846 110293050 X 15271323 29295297 X false true X true false OTHER LT SECURITIES 63015933 C 63015933 INVESTMENT INTEREST RECEIVABLE 260400 HEALTHCARE RECEIVABLES 21206554 21466954 0 CLAIMS PAYABLE 30636215 INTERCOMPANY PAYABLE 1960359 32596574 X 275430323 275430323 275430323 260159000 260159000 260159000 Sch D Part X Line 2 THE COMPANY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON INCOME DERIVED FROM ACTIVITIES THAT ARE IN FURTHERANCE OF ITS EXEMPT PURPOSE. THE COMPANY MAY BE SUBJECT TO INCOME TAXATION ON UNRELATED BUSINESS INCOME. true true false false false true true false false Mark L Baird SVP & CFO, Treasurer 0 417556 0 236600 0 74715 0 24975 0 27150 0 780996 0 48290 James P Jacobson SVP & Gen Counsel, Secretary 0 322201 0 123500 0 48683 0 24975 0 28773 0 548132 0 24617 John W Naylor President/CEO- Start Feb 2017 0 632519 0 482000 0 257980 0 20250 0 25149 0 1417898 0 234207 David Tilford Pres/CEO thru 1/17 0 226344 0 679900 0 538028 0 4546 0 2996 0 1451814 0 61103 Sch J Part I Line 3 MEDICA HEALTH PLANS OF WISCONSIN, THE FILING ORGANIZATION DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA HEALTH PLANS, A RELATED ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA HEALTH PLANS UTILIZES THE FOLLOWING; 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 4b THE 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 JOHN W. NAYLOR $ 234,207 David Tilford $ 61,103 Sch J Part I Line 6a & 6b MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO OPERATING EARNINGS OF MEDICA HEALTH PLANS AND RELATED ORGANIZATIONS. Sch J Part II SCHEDULE 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. Form 990 Part III Line 4a Medica Health Plans of Wisconsin (MHPW) is organized and shall be operated for the promotion of social Welfare, including the operation of a health insurance organization and other activities incidental thereto. It Is a wholly owned subsidiary of Medica Holding Company (MHC) which is a non-profit, tax exempt Corporation. MHPW is tax-exempt from federal income taxes under Section 501(c)(4) of the Internal Revenue Code. The company offers comprehensive health care coverage; all products are qualified health plans (QHP) As defined by the Affordable Care Act (ACA) and fall within the metal levels Gold, Silver and Bronze, as Well as Catastrophic for those under age 30 or those with a hardship (as deemed by the exchange). Additionally, the products follow the respective essential health benefits (ehbs), above and beyond those Required of qhps by the ACA, as determined by the benchmark/default plan (as defined by ACA) for Minnesota and Wisconsin. APPLAUSE/INDIVIDUAL CHOICE PRODUCT OFFERS ACCESS TO THE LARGEST NETWORK: NEARLY 33,000 PROVIDERS OF ALL TYPES AT MORE THAN 6,000 OFFICES, CLINICS AND HOSPITALS IN MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA AND WESTERN WISCONSIN. INSPIRATION HEALTH FEATURES HEALTHEAST, AND IS ONLY AVAILABLE IN THE TWIN CITIES EAST METRO AREA. NORTH MEMORIAL ACCLAIM FEATURES NORTH MEMORIAL AND IS AVAILABLE IN COUNTIES SURROUNDING MINNEAPOLIS. ALTRUPRIME FEATURES ALTRU AND IS AVAILABLE IN NORTHEASTERN MINNESOTA. ENGAGE FEATURES MAYO HEALTH SYSTEM AND IS AVAILABLE IN WESTERN WISCONSIN AND SOUTHEASTERN MINNESOTA. THE COMPANY CONTRACTS WITH PROVIDERS IN WISCONSIN, MINNESOTA, SOUTH DAKOTA AND NORTH DAKOTA TO MAKE HEALTH CARE SERVICES AVAILABLE TO ITS ENROLLEES. THE PROVIDER CONTRACTS INCLUDE HOLD-HARMLESS PROVISIONS FOR THE PROTECTION OF POLICYHOLDERS. THE CONTRACTS HAVE A ONE- OR TWO-YEAR TERM AND MAY BE TERMINATED IMMEDIATELY FOR BREACH OF CONTRACT IF THE PROVIDER LOSES HIS/HER LICENSE TO PROVIDE CONTRACTED SERVICES. HOSPITALS ARE REIMBURSED USING A VARIETY OF METHODS INCLUDING FEE-FOR-SERVICE (FFS), DISCOUNTED FFS, PER DIEM, PER CASE AND/OR PER STAY BASIS. THE COMPANY CURRENTLY MARKETS DIRECTLY TO INDIVIDUALS, USING INDEPENDENT AGENCIES, PAYING A FLAT DOLLAR COMMISSION ON NEW AND RENEWAL BUSINESS. THE COMPANY ALSO MARKETS POLICIES DIRECTLY ONLINE AND OVER THE PHONE. Form 990 Part VI Line 3 MEDICA HEALTH PLANS OF WISCONSIN 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 HEALTH PLANS OF WISCONSIN AND MEDICA HEALTH PLANS OF WISCONSIN PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. Form 990 Part VI Line 6 THE POLICY HOLDERS ARE CONSIDERED MEMBERS, BUT DO NOT PAY DUES. Form 990 Part VI Line 11b MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S CONTROLLER AND FINANCE DIRECTOR 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 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 CURRENT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. Form 990 Part VI Line 15a MEDICA HEALTH PLANS OF WISCONSIN 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 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. 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 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 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 Section B Line 1 CERTAIN 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, AND MMSI, INC). THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. Form 990 Part XI Line 9 CHANGES IN NET ASSETS: CHANGE IN STATUTORY BASIS ACCOUNTING NONADMITTED ASSETS $(704,703) TRANSFER RECEIVED FROM AFFILIATES $30,000,000 TOTAL CHANGES IN NET ASSETS $29,295,297 MEDICA HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411242261 HEALTH CVRGE MN 501(C)(4) MH COMPANY false MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) Line 12b MH COMPANY false MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING CO MN 501(C)(4) NA false Mayo Research Inc 401 CARLSON PARKWAY MINNETONKA MN 55305 270600894 RESEARCH FDTN MN 501(C)(3) Line 12a MH COMPANY false MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MEDICA AFF C Corp 0 0 false MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMIN MN MEDICA AFF C Corp 0 0 false MEDICA HEALTH MANAGMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MGMT MN MEDICA AFF C Corp 0 0 false MEDICA AFFILIATED SERVICES 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MH COMPANY C Corp 0 0 false MMSI Inc 401 CARLSON PARKWAY MINNETONKA MN 55305 411547003 THIRD PARTY ADMIN MN MEDICA AFF C Corp 0 0 false false false false false true false false false false false false false false true true true false false false Medica Health Plan e 33250000 BOOK Medica Health Plan n 13434527 BOOK Medica Health Plan o 16478473 BOOK Medica Health Plan p 12720851 BOOK