2018-11-08T14:28:25-06:00 2017-12-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS RD STE 1500 RALEIGH NC 27609 990 2017-01-01 461056754 CHESAPEAKE EMPLOYERS' INSURANCE COMPANY CHES 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 4104942000 2018-11-07 1 JOHN HUSKINS P01081531 9197196400 2018-11-08 66.77.128.118 2018-11-08 15:28:09 ES P E2AFCBC2CAC1A104CA8A10138DFED4C2A90A9C41 864A7BF621746F4ED5D3A0306E0732A43905445D 2017 2018-06-14 16:35:46Z THOMAS PHELAN 8722 LOCH RAVEN BOULEVARD TOWSON MD 212862235 860734959 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. 9 9 248 0 0 0 0 0 237646694 225538520 107001658 122705305 593669 72895 345242021 348316720 750000 93335 0 0 33523988 33377031 0 0 0 229476107 174287084 263750095 207757450 81491926 140559270 2210995457 2317794587 1669065290 1622524174 541930167 695270413 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 22,500 IN-FORCE POLICIES AND WAS MANAGING MORE THAN 3,800 OPEN CLAIMS AT DECEMBER 31, 2017. 0 0 0 0 0 0 0 0 0 1 0 0 1 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 2779 0 1 248 1 0 0 0 0 0 0 X 9 9 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 52186 0 3622 LEONARD SCHULER VICE CHAIRMAN 1.50 0.50 X X 54832 0 11016 PAUL V GILL TREASURER 1.50 0.50 X X 41892 0 32904 SUZANNE THOMPSON SECRETARY 1.50 0.50 X X 43117 0 24784 JOSEPH M COALE DIRECTOR 1.50 0.50 X 49933 0 3823 CHARLES H DANKMEYER JR DIRECTOR 1.50 0.50 X 49179 0 3769 WAYNE R GIOIOSO SR DIRECTOR 1.50 0.50 X 48592 0 3759 LEWIS C POWELL DIRECTOR 1.50 0.50 X 35913 0 39328 MARIA TILDON DIRECTOR 1.50 0.50 X 48009 0 3685 THOMAS PHELAN PRESIDENT & CEO 30.00 10.00 X 414287 0 39200 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 30.00 10.00 X 217823 0 30200 CARMINE D'ALESSANDRO CHIEF LEGAL OFFICER 30.00 10.00 X 189555 0 27197 PAIGE BECK CHIEF INNOVATION OFFICER 30.00 10.00 X 251477 0 59106 RIAL SIMONS CHIEF ACTUARY 30.00 10.00 X 192012 0 14804 SHARON ROWELL CHIEF ADMINISTRATIVE OFFICER 30.00 10.00 X 191303 0 27197 STEPHEN FISHER DIRECTOR OF HEALTH SERVICES 30.00 10.00 X 181608 0 13982 SONG MITCH HE CHIEF INVESTMENT OFFICER 30.00 10.00 X 178688 0 43676 KAMA SCHNEIDER VICE PRESIDENT 30.00 10.00 X 153773 0 27797 LISA KRUSKA VICE PRESIDENT 30.00 10.00 X 152664 0 21556 WILLIAM SMULYAN MEDICAL CONSULTANT 30.00 10.00 X 227120 0 17309 TIM MICHELS CHIEF OPERATING OFFICER 30.00 10.00 X 220753 0 59311 DENNIS CARROLL GENERAL COUNSEL 30.00 10.00 X 203319 0 2465 PAULETTE LUNDY VICE PRESIDENT 30.00 10.00 X 188457 0 5283 DONNA WILSON SENIOR VICE PRESIDENT 30.00 10.00 X 180576 0 43436 3567068 0 559209 86 0 1 0 EXPRESS SCRIPTS INC ONE EXPRESS WAY MS HQ2E04 ST LOUIS MO 63121 MEDICAL/HEALTH SERVICES 3297856 UNIVERSITY OF MD MEDICAL SYSTEM CORP 11 S PACA ST STE LL BALTIMORE MD 21201 MEDICAL/HEALTH SERVICES 2415470 VGM GROUP INC PO BOX 1860 WATERLOO IA 50704 MEDICAL/HEALTH SERVICES 2211539 BROWN CAPITAL MANAGEMENT 1201 N CALVERT ST BALTIMORE MD 21202 INVESTMENT SERVICES 1286178 ASSET ALLOCATION & MANAGEMENT COMPANY LL 30 W MONROE 3RD FLOOR CHICAGO IL 60603 INVESTMENT SERVICES 1019920 123 PREMIUMS EARNED 524150 224849681 224849681 INSTALLMENT FEES & NSF CHARGES 900099 688839 688839 225538520 63835372 63835372 571288172 512418239 58869933 58869933 58869933 72895 72895 72895 348316720 225611415 0 122705305 X 93335 2978246 23297949 2189350 3157661 1753825 600547 446658 5618059 31525582 2143644 2847582 1187644 2224951 377682 188841 1043874 2918075 747496 LOSSES 91954924 DIVIDENDS 20197453 TAXES, LICENSES, FEES 7495236 2768836 207757450 -1315308 7985196 39964419 72467709 86164314 77395395 39819963 30763389 9589751 9056574 1871478977 1950144104 52550988 38110306 152562316 162635303 2210995457 2317794587 20210910 23908583 384918 0 111092428 102058007 1537377034 1496557584 1669065290 1622524174 X 539930167 695270413 2000000 0 541930167 695270413 2210995457 2317794587 X 140559270 19067126 -6286150 X 0 1 X 1 0 1335400 1335400 14206861 7073441 7133420 24277702 23689948 587754 9056574 SECURITIES LENDING REINVESTED COLLATERAL ASSETS 135608379 INVESTMENT INCOME, DUE AND ACCRUED 13656550 RECEIVABLES FROM AFFILIATE 11087461 FUNDS HELD BY REINSURED COMPANIES 877993 PREMIUM TAXES RECOVERABLE 535202 FEDERAL TAXES RECEIVABLE 168078 RECEIVABLES FOR SECURITIES 701640 162635303 LOSSES & LOSS ADJUSTMENT EXPENSES 1240320000 PAYABLE FOR SECURITIES LENDING 135608379 BORROWED MONEY & ACCRUED INTEREST 100175184 DIVIDENDS PAYABLE 20146021 FUNDS HELD BY COMPANY UNDER REINSURANCE TREATY 308000 1496557584 X 358350348 19067126 19067126 339283222 9033498 9033498 348316720 198723952 0 198723952 9033498 9033498 207757450 PART X, LINE 2: CHESAPEAKE DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS AS OF DECEMBER 31, 2017. 1 SEXUAL ASSAULTSPOUSE ABUSE RESOURCE CENTER INC PO BOX 1207 BEL AIR MD 21014 521224705 501(C)(3) 40000 GENERAL SUPPORT PRINCE GEORGE'S COMMUNITY COLLEGE FOUNDATION INC 301 LARGO RD NO A312 LARGO MD 20774 521429928 501(C)(3) 25000 GENERAL SUPPORT COLON CANCER ALLIANCE INC 1025 VERMONT AVE NW WASHINGTON DC 20005 860947831 501(C)(3) 12360 GENERAL SUPPORT SALVATION ARMY OF CENTRAL MARYLAND 814 LIGHT ST BALTIMORE MD 21230 580660607 501(C)(3) 10475 GENERAL SUPPORT MARYLAND FOOD BANK INC 2200 HALETHORPE FARMS RD SW BALTIMORE MD 21227 521135690 501(C)(3) 5500 GENERAL SUPPORT 5 0 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 361600 0 17837 0 34850 0 39200 0 0 0 453487 0 0 0 FRANCIS LINARDI CHIEF FINANCIAL OFFICER 193087 0 9438 0 15298 0 16042 0 14158 0 248023 0 0 0 CARMINE D'ALESSANDRO CHIEF LEGAL OFFICER 167632 0 7692 0 14231 0 11896 0 15301 0 216752 0 0 0 PAIGE BECK CHIEF INNOVATION OFFICER 207237 0 10068 0 34172 0 44057 0 15049 0 310583 0 0 0 RIAL SIMONS CHIEF ACTUARY 156158 0 7664 0 28190 0 10731 0 4073 0 206816 0 0 0 SHARON ROWELL CHIEF ADMINISTRATIVE OFFICER 167715 0 7692 0 15896 0 11896 0 15301 0 218500 0 0 0 STEPHEN FISHER DIRECTOR OF HEALTH SERVICES 173275 0 8333 0 0 0 13982 0 0 0 195590 0 0 0 SONG MITCH HE CHIEF INVESTMENT OFFICER 170480 0 8208 0 0 0 14256 0 29420 0 222364 0 0 0 KAMA SCHNEIDER VICE PRESIDENT 146073 0 7500 0 200 0 14212 0 13585 0 181570 0 0 0 LISA KRUSKA VICE PRESIDENT 145164 0 7500 0 0 0 10540 0 11016 0 174220 0 0 0 WILLIAM SMULYAN MEDICAL CONSULTANT 216356 0 10764 0 0 0 17309 0 0 0 244429 0 0 0 TIM MICHELS CHIEF OPERATING OFFICER 201266 0 10068 0 9419 0 46523 0 12788 0 280064 0 0 0 DENNIS CARROLL GENERAL COUNSEL 203319 0 0 0 0 0 0 0 2465 0 205784 0 0 0 PAULETTE LUNDY VICE PRESIDENT 168847 0 8500 0 11110 0 5283 0 0 0 193740 0 0 0 DONNA WILSON SENIOR VICE PRESIDENT 171684 0 8892 0 0 0 14352 0 29084 0 224012 0 0 0 PART I, LINE 4B TIMOTHY MICHELS SUPPLEMENTAL NON-QUALIFIED PLAN $32,012 PAIGE BECK SUPPLEMENTAL NON-QUALIFIED PLAN $29,600 FRANCIS LINARDI SUPPLEMENTAL NON-QUALIFIED PLAN $5,000 KAMA SCHNEIDER 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 25,380,822. OTHER FEES FOR SERVICES 6,144,760. FORM 990, PART XI, LINE 9: CHANGE IN NON ADMITTED ASSETS -6,286,150. 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 2266826 FAIR VALUE INJURED WORKERS INSURANCE FUND D 1087461 FAIR VALUE INJURED WORKERS INSURANCE FUND S 11173386 FAIR VALUE