2015-02-13T16:15:17-06:00 2012-12-31 420714325 MCGLADREY LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2012-01-01 411242261 MEDICA HEALTH PLANS MEDI 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 MARK L BAIRD 9529922058 2015-01-14 1 TODD A JACKSON P00092672 6123324300 2012 2016-02-25 16:41:14Z X DAVID TILFORD 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 1938554978 0 X WWW.MEDICA.COM X 1973 MN MEDICA'S MISSION IS TO MEET OUR CUSTOMERS' NEED FOR HEALTH PLAN PRODUCTS AND SERVICES. IN DOING SO, WE WORK WITH OUR MEMBERS AND PROVIDERS TO MAKE HEALTH CARE ACCESSIBLE, AFFORDABLE AND A MEANS BY WHICH OUR MEMBERS IMPROVE THEIR HEALTH. 5 4 1367 0 1324169 0 0 0 1721786050 1739770823 20476422 17703859 488499 837299 1742750971 1758311981 10913725 11218300 1473196095 1448611093 98919793 107801496 0 0 0 145457268 146196590 1728486881 1713827479 14264090 44484502 718887557 681817662 302567425 239757907 416320132 442059755 X MEDICA'S MISSION IS TO MEET OUR CUSTOMERS' NEEDS FOR HEALTH PLAN PRODUCTS AND SERVICES. IN DOING SO, WE WORK WITH MEMBERS AND PROVIDERS TO MAKE HEALTH CARE ACCESSIBLE, AFFORDABLE AND A MEANS BY WHICH OUR MEMBERS IMPROVE THEIR HEALTH. 0 0 1044387198 1125825497 MEDICA HEALTH PLANS (MHP) IN 2012 PROVIDED NONPROFIT HMO COVERAGE TO ENROLLEES IN THE STATE OF MINNESOTA'S PREPAID MEDICAL ASSISTANCE (MEDICAID) AND MINNESOTACARE PROGRAMS. IT ALSO PROVIDED A SPECIAL NEEDS BASIC CARE (SBNBC) PRODUCT FOR INDIVIDUALS WITH PHYSICAL, DEVELOPMENTAL OR MENTAL DISABILITIES. A TOTAL OF 127,304 MEDICA MEMBERS OR 91.5% OF MHP'S TOTAL ENROLLMENT WERE IN STATE PROGRAMS AS OF 12/31/2012. THERE WERE 88,963 PREPAID MEDICAL ASSISTANCE PROGRAM MEMBERS, 22,749 MINNESOTACARE MEMBERS, AND 15,592 SPECIAL NEEDS BASIC CARE MEMBERS. IN 2012 MEDICA HEALTH PLANS ACHIEVED THE HIGHEST RANKINGS IN MINNESOTA FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). THAT RANKING PLACED MHP AMONG THE TOP 14 MEDICAID HMO PLANS IN THE UNITED STATES. ALONG WITH THE RANKING, MHP ACHIEVED EXCELLENT ACCREDITATION STATUS, THE HIGHEST STATUS AWARDED BY NCQA. 12455833 11579728 IN 2012 MHP PROVIDED FULLY INSURED COMMERCIAL HMO HEALTH INSURANCE COVERAGE IN MINNESOTA. AS OF 12/31/2012, THE ENROLLMENT IN MHP FULLY INSURED MINNESOTA GROUP PLANS WAS 1,228. MHP IN 2012 ALSO INSURED 71 PERSONS WHOSE COVERAGE WAS CONVERTED FROM GROUP INSURANCE TO INDIVIDUAL INSURANCE.THE 1,299 PERSONS WITH FULLY INSURED COVERAGE REPRESENTED 0.9% OF MHP'S TOTAL ENROLLMENT AS OF 12/31/2012 2012.IN 2012, MHP ASSUMED RISK FROM A RELATED ENTITY, MEDICA INSURANCE COMPANY (MIC), THROUGH A QUOTA SHARE REINSURANCE ARRANGEMENT. IN 2012, MHP ASSUMED $461,252,000 GROSS PREMIUMS AND $389,830,000 OF CLAIMS. 391768062 602458804 IN 2012 MHP PROVIDED MEDICARE-RELATED PRODUCTS IN THREE STATES: MINNESOTA, NORTH DAKOTA AND SOUTH DAKOTA. THE COMBINED MEDICARE-RELATED MHP MEMBERSHIP IN THOSE STATES WAS 10,581 OR 7.6% OF MHP'S TOTAL ENROLLMENT.IN 2012 MHP'S TOTAL MEDICARE-RELATED MEMBERSHIP IN MINNESOTA WAS 10,267. THIS INCLUDED 297 MEMBERS WITH MEDICARE ADVANTAGE SPECIAL NEEDS PLAN COVERAGE FOR SENIORS WITH CHRONIC CONDITIONS; 9,773 MEMBERS WITH MINNESOTA SENIOR HEALTH OPTIONS (MSHO) COVERAGE; 197 MEMBERS WITH MEDICARE SUPPLEMENTAL AND PRIVATE FEE FOR SERVICE (PFFS) COVERAGE.IN 2012 MHP PROVIDED MEDICARE PRIVATE FEE FOR SERVICE (PFFS) COVERAGE TO 126 MEMBERS IN NORTH DAKOTA AND TO 188 MEMBERS IN SOUTH DAKOTA.THE PRIVATE FEE-FOR-SERVICE (PFFS) PRODUCTS UNDER CMS CONTRACT HAVE PLAN DESIGNS THAT INCLUDE A VARIETY OF CO-PAY PLANS, PLANS WHICH COVER MEDICAL ONLY, AND PLANS THAT INCLUDE PRESCRIPTION DRUG COVERAGE. THESE PLANS DO NOT LIMIT BENEFICIARIES TO A CONTRACTED MEDICAL PROVIDER NETWORK, BUT RATHER UTILIZE A DEEMED NETWORK WHERE ALL MEDICARE CERTIFIED PROVIDERS MAY BE UTILIZED, AS LONG AS THEY AGREE TO MEDICARE PAYMENT ASSIGNMENT. 11218300 11218300 MEDICA HEALTH PLANS (MHP) AND COMMUNITY BENEFITMHPTHE STATE OF MINNESOTA SETS RATES WHEN IT CONTRACTS WITH THE STATE'S NONPROFIT HMOS, PAYING A FIXED SUM PER ENROLLEE. MHP BEARS THE RISK FOR COSTS ABOVE THE PREDETERMINED RATE. MHP'S PERFORMANCE ON BEHALF OF THE STATE OF MINNESOTA IS EFFICIENT. IN 2012 APPROXIMATELY 93 CENTS OF EACH STATE PROGRAM DOLLAR WENT TO PROVIDE CARE; THE ADMINISTRATIVE COST RATIO WAS APPROXIMATELY 6.0% INCLUDING PREMIUM TAXES AND CONTRIBUTIONS TO THE MEDICA FOUNDATION.CONTRIBUTIONS BY MEDICA ON BEHALF OF MEMBERS BEYOND CONTRACTED SERVICES IN 2012 MHP COVERED, ON BEHALF OF PMAP, MINNESOTACARE AND OTHER MINNESOTA HEALTH CARE PROGRAM MEMBERS, A NUMBER OF EXPENSES THAT WENT BEYOND ITS CONTRACTED SERVICES. THESE INCLUDED: THE WAY TO BETTER HEALTH (TWTBH), $391,488; ESTIMATED ADMINISTRATIVE EXPENSES FOR TWTBH, $66,028; VALUE OF WAIVED FAMILY DEDUCTIBLES, $63,661; MSC+ ELDERLY WAIVER COVERAGE FOR NON-ELIGIBLE MEMBERS, $212,744; AND ADDITIONAL SERVICES, $101,209.IN 2012 MHP PAID FOR, ON BEHALF OF MEDICARE-ONLY CHRONIC CARE SPECIAL NEEDS PLAN MEMBERS, A NUMBER OF EXPENSES THAT WENT BEYOND ITS CONTRACTED SERVICES. IN 2012 THESE EXPENSES INCLUDED: MEDICARE-ONLY CHRONIC CARE SNP, $3,705,579; MSHO ELDERLY WAIVER FOR NON-ELIGIBLE MEMBERS, $858,064; WAIVED MSHO NON-MEDICARE PART D PHARMACY COPAYMENTS, $223,864; AND MSHO ADDITIONAL SERVICES, $236,267.IN 2012 MHP PAID FOR, ON BEHALF OF SPECIAL NEEDS BASIC CARE PLAN MEMBERS, A NUMBER OF EXPENSES BEYOND ITS CONTRACTED SERVICES. THESE INCLUDED: SNBC NON-MEDICARE PART D PHARMACY COPAYMENTS, $508,740; SNBC NON0MEDICARE VALUE OF COST-SHARING WAIVED (DEDUCTIBLES, COPAYS), $265,234; AND SNBC ADDITIONAL SERVICES, $205,581.OTHER COMMUNITY BENEFITSMHP PROVIDED OTHER COMMUNITY BENEFITS WITH A WIDE RANGE OF PROGRAMS AND INITIATIVES TO PROMOTE PUBLIC AND INDIVIDUAL HEALTH, REDUCE DISPARITIES IN ACCESS TO CARE, IMPROVE HEALTH CARE SYSTEM PERFORMANCE, AND HELP PROVIDE FINANCIAL ASSISTANCE TO ACCESS CARE. MEDICA FOUNDATIONMHP IN 2012 CONTRIBUTED $5.5 MILLION TO ENABLE GRANTS BY THE MEDICA FOUNDATION, A 501(C)(3) NONPROFIT CHARITABLE GRANT-MAKING FOUNDATION, WHICH PROVIDES FUNDING FOR NUMEROUS NONPROFIT COMMUNITY ORGANIZATIONS THAT PROVIDE HEALTH-RELATED SERVICES TO THE COMMUNITY. THE MEDICA FOUNDATION IN 2012 MADE 88 GRANTS TOTALING $1.35 MILLION TO SUPPORT PROJECTS STATEWIDE AROUND BEHAVIORAL HEALTH, DISPARITIES IN HEALTH CARE, HEALTHY LIVING, WORKSITE WELLNESS AND GENERAL HEALTH IMPROVEMENT. FROM 2003-2012 MEDICA FOUNDATION GRANTS TOTALED NEARLY $14.4 MILLION. MEDICA RESEARCH INSTITUTEIN 2012 MHP GAVE $4.5 MILLION TO SUPPORT THE MISSION OF THE MEDICA RESEARCH INSTITUTE. THE MEDICA RESEARCH INSTITUTE, ESTABLISHED IN JANUARY 2010, IS A NONPROFIT 501(C)(3) FOUNDATION AND A SISTER ORGANIZATION TO MEDICA HEALTH PLANS. ITS MISSION IS TO CONDUCT RESEARCH THAT GENERATES INFORMATION FOR TIMELY TRANSLATION INTO ACTIVITIES WHICH PROTECT HEALTH AND IMPROVE LIVES. COLLABORATIVE EFFORTSIN ADDITION, MHP DONATED FUNDING, EMPLOYEE TIME AND OTHER RESOURCES IN SUPPORT OF MORE THAN TWO DOZEN COLLABORATIVE EFFORTS WITH LOCAL, STATE, REGIONAL AND NATIONAL COLLABORATIVE EFFORTS AND CHARITIES. EXAMPLES INCLUDE: MINNESOTA COMMUNITY MEASUREMENT, WHICH PROMOTES COMMUNITY-BASED, EVIDENCE-BASED CARE AND PROVIDES THE PUBLIC WITH QUALITY COMPARISONS OF PROVIDER GROUPS AND CLINICS; INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT, WHICH PROVIDES EVIDENCE-GRADED PRACTICAL GUIDELINES AND TECHNOLOGY ASSESSMENT REPORTS; MINNESOTA HEALTH INFORMATION EXCHANGE, WHICH CONNECTS DOCTORS, HOSPITALS AND CLINICS STATEWIDE SO THEY CAN QUICKLY ACCESS MEDICAL RECORDS, IMPROVING SAFETY AND QUALITY. MEDICA ALSO FUNDED CONFERENCES AND EVENTS SUCH AS THE AGE AND DISABILITIES ODYSSEY CONFERENCE, WORLD REFUGEE DAY, HMONG HEALTH CARE PROFESSIONALS COALITION HEALTH FAIR AND LA OPPORTUNIDAD PEACE CONFERENCE. 11218300 11218300 1459829393 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 258 0 1 1367 1 1 1 0 0 0 0 0 X 5 4 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MN X MARY QUIST 9529922058 PO BOX 9310 CP 330 MINNEAPOLIS MN 554409310 JOHN BUCK 15.00 X X 103000 0 0 ESTHER TOMLJANOVICH 10.00 X X 71000 0 0 KRIS SANDA 10.00 X X 71000 0 0 DAVID TILFORD 40.00 X X 2341634 0 33615 PETER KELLY MD 10.00 X 67000 0 0 AARON L REYNOLDS 40.00 X 1163231 0 35591 JAMES P JACOBSON 40.00 X 562531 0 29681 JANA L JOHNSON 40.00 X 609821 0 32221 GLENN E ANDIS 40.00 X 658316 0 41337 ROBERT LONGENDYKE 40.00 X 565843 0 39660 DEBBY S KNUTSON 40.00 X 537782 0 21775 SIMEON A SCHINDELMAN 40.00 X 972434 0 28261 TIMOTHY D THULL 40.00 X 439157 0 45344 JOHN W NAYLOR 40.00 X 597557 0 68911 THEODORE J LOFTNESS 40.00 X 537639 0 41529 MARK L BAIRD 40.00 X 570073 0 35250 RICHARD H SYKORA 40.00 X 494428 0 31675 DANNETTE M COLEMAN 40.00 X 416891 0 30382 SCOTT REID 40.00 X 410426 0 32035 DARYL DURUM 0.00 X 11000 0 0 11200763 0 547267 180 1 1 0 UNITED HEALTHCARE SERVICES INC 9900 BREN DR E MN008-T380 MINNETONKA MN 55343 CLAIMS PROCESSING 88571810 CDW DIRECT LLC 7145 BOONE AVE N BROOKLYN PARK MN 55128 TECHNOLOGY SERVICES 5883874 CIBER INC 4400 W 78TH ST 100 BLOOMINGTON MN 55435 TECHNOLOGY SERVICES 2455934 DELOITTE CONSULTING LLP 50 SOUTH SIXTH STREET MINNEAPOLIS MN 55402 CONSULTING 2304083 DAHL CONSULTING INC 418 COUNTY ROAD D E ST PAUL MN 55117 TEMP SERVICES 2237788 37 MEDICARE REVENUE 524114 1145114853 1145114853 SUBSCRIBER REVENUE 524114 445050747 443821858 1228889 INTERCOMPANY ADMIN FEES 561000 145345405 145345405 DENTAL REVENUE 541900 3698613 3698613 OTHER REVENUE 524114 561205 561205 1739770823 13593155 13593155 1087093 343000 744093 744093 744093 184010701 179899997 4110704 4110704 4110704 MEDICA TAX PARTNERSHIP 900099 95280 95280 MN EXCHANGE PARTNERSHIP 561499 -2074 -2074 93206 1758311981 1738539860 1324169 18447952 11218300 11218300 1448611093 1448611093 9034156 9034156 74048552 74048552 7328172 7328172 11270955 11270955 6119661 6119661 1775412 1775412 600150 600150 486385 486385 1514146 1514146 8596206 8596206 3438624 3438624 8855759 8855759 1910503 1910503 507174 507174 735594 735594 134010 134010 9383470 9383470 1257900 1257900 REINSURANCE 43818894 43818894 OUTSOURCED SERVICES 35213335 35213335 PREMIUM TAXES 16434051 16434051 PRINTING AND PUBLICATIO 7150342 7150342 4384635 4384635 1713827479 1459829393 253998086 0 307823502 125085764 83746555 84326924 110471125 16790906 7719297 93680219 278618283 326705482 40979920 52019273 718887557 681817662 302307602 239605872 259823 152035 302567425 239757907 X 416320132 442059755 416320132 442059755 718887557 681817662 X 44484502 122799 -18867678 X 0 1 X 1 0 20449010 20449010 66050990 6900365 59150625 12573182 340781 12232401 11397943 9549760 1848183 93680219 BONDS 326032643 C PREFERRED STOCK 672839 C 326705482 INVESTMENT RELATED RECEIVABLES 1922161 HEALTH CARE RECEIVABLES 4716151 DUE FROM AFFILIATES 2917901 FUNDS HELD BY REINSURED COMPANIES 41588333 ACCOUNTS RECEIVABLE RELATING TO UNINSURED PLANS 874727 52019273 X 1610576401 -1648156 -1648156 1612224557 146087424 146087424 1758311981 1566089825 -146089498 -146089498 1712179323 1648156 1648156 1713827479 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: AS OF DECEMBER 31, 2012, THE COMPANY'S TAX YEARS 2008 THROUGH 2012 REMAIN OPEN TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) AND VARIOUS STATE AUTHORITIES. TAX YEARS 2008, 2009 AND 2010 ARE CURRENTLY UNDER EXAMINATION BY THE IRS. MANAGEMENT HAS NOT RECORDED AN AMOUNT FOR UNCERTAIN TAX POSITIONS FOR ANY MATTERS, INCLUDING THOSE CURRENTLY UNDER EXAMINATION. HOWEVER, THE ULTIMATE RESOLUTION OF THESE ITEMS IS DEPENDENT ON A NUMBER OF FACTORS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSE RECLASSED AS EXPENSE -1,514,146. INTEREST EXPENSE RECLASSED AS EXPENSE -134,010. PART XI, LINE 4B - OTHER ADJUSTMENTS: MN HEALTH INFO EXCHANGE K-1 -2,074. INTERCOMPANY ADMIN FEES RECLASSED FROM EXPENSE 145,345,405. NET RENTAL INCOME RECLASSED FROM EXPENSE 744,093. PART XII, LINE 2D - OTHER ADJUSTMENTS: INTERCOMPANY ADMIN FEES RECLASSED AS REVENUE -145,345,405. NET RENTAL INCOME RECLASSED AS REVENUE -744,093. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EXPENSE RECLASSED AS REVENUE 1,514,146. INTEREST EXPENSE RECLASSED AS REVENUE 134,010. 1 MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 501(C)(3) 5500000 SUPPORT OF THE MANY PROGRAMS CONDUCTED BY THE FOUNDATION. MEDICA RESEARCH INSTITUTE 401 CARLSON PARKWAY MINNETONKA MN 55305 270600894 501(C)(3) 4500000 SUPPORT OF THE MANY PROGRAMS CONDUCTED BY THE INSTITUTE. INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT 8009 34TH AVE SO STE 1200 BLOOMINGTON MN 55425 411782168 501(C)(3) 1218300 SUPPORT THE BEST PRACTICES IN THE MEDICAL WORLD 3 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: MEDICA HEALTH PLANS DONATES FUNDS PERIODICALLY TO ITS RELATED ORGANIZATIONS, MEDICA FOUNDATION AND MEDICA RESEARCH INSTITUTE, AS WELL AS OTHER 501(C)(3) ORGANIZATIONS. THE FOUNDATIONS RETAIN RECORDS TO SUBSTANTIATE THE USE OF THESE FUNDS. X X X X X 0 1 0 0 0 1 0 0 0 DAVID TILFORD 765069 0 679359 0 897206 0 18840 0 14775 0 2375249 0 0 0 AARON L REYNOLDS 436332 0 282291 0 444608 0 19003 0 16588 0 1198822 0 0 0 JAMES P JACOBSON 262079 0 121279 0 179173 0 14900 0 14781 0 592212 0 0 0 JANA L JOHNSON 265235 0 139854 0 204732 0 17963 0 14258 0 642042 0 0 0 GLENN E ANDIS 289319 0 153743 0 215254 0 19187 0 22150 0 699653 0 0 0 ROBERT LONGENDYKE 258567 0 122217 0 185059 0 17963 0 21697 0 605503 0 0 0 DEBBY S KNUTSON 250456 0 115758 0 171568 0 14900 0 6875 0 559557 0 0 0 SIMEON A SCHINDELMAN 607572 0 237287 0 127575 0 13063 0 15198 0 1000695 0 0 0 TIMOTHY D THULL 247650 0 95936 0 95571 0 28342 0 17002 0 484501 0 0 0 JOHN W NAYLOR 297722 0 243064 0 56771 0 51809 0 17102 0 666468 0 0 0 THEODORE J LOFTNESS 248987 0 100794 0 187858 0 19188 0 22341 0 579168 0 0 0 MARK L BAIRD 256576 0 132693 0 180804 0 17963 0 17287 0 605323 0 0 0 RICHARD H SYKORA 226128 0 110057 0 158243 0 17963 0 13712 0 526103 0 0 0 DANNETTE M COLEMAN 219450 0 100250 0 97191 0 19188 0 11194 0 447273 0 0 0 SCOTT REID 207138 0 101870 0 101418 0 17963 0 14072 0 442461 0 0 0 DARYL DURUM 0 0 0 0 11000 0 0 0 0 0 11000 0 0 0 PART I, LINE 4B THE FOLLOWING RECEIVED PAYMENTS FROM A NON-QUALIFIED RETIREMENT PLAN: DAVID TILFORD $64,451 AARON REYNOLDS $27,891 GLENN ANDIS $14,264 JANA JOHNSON $11,841 MARK BAIRD $10,614 ROBERT LONGENDYKE $10,660 JAMES JACOBSON $ 9,346 DEBBY KNUTSON $ 8,498 THEODORE LOFTNESS $ 9,589 RICHARD SYKORA $ 8,102 TIMOTHY THULL $ 3,633 DANNETTE COLEMAN $ 6,446 SCOTT REID $ 5,607 PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATIONS OPERATING EARNINGS. 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 11 MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S CONTROLLER AND TAX MANAGER REVIEW THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING FORM 990 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 CURRENT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S PERSONNEL AND COMPENSATION COMMITTEE REVIEWS AND OBTAINS THE BOARD'S APPROVAL OF THE TOTAL COMPENSATION FOR THE PRESIDENT/CEO AND REVIEWS AND APPROVES THE TOTAL COMPENSATION RECOMMENDATIONS MADE BY THE CEO FOR THE EXECUTIVE AND SENIOR VICE PRESIDENTS; REVIEWS ALL OFFICER COMPENSATION AND PERFORMANCE GOALS APPROVED BY THE CEO ANNUALLY. THE PERSONNEL AND COMPENSATION COMMITTEE ALSO REVIEWS AND RECOMMENDS TO THE BOARD, OFFICER AND NON-OFFICER COMPENSATION GUIDELINES FOR THE COMPANY AND ITS SUBSIDIARIES PERIODICALLY REVIEWING MARKET DATA TO ASSESS THE COMPANY'S COMPETITIVE POSITION. PROCESS OUTSIDE THE CHARTER: THE PERSONNEL AND COMPENSATION COMMITTEE WORKS WITH AN OUTSIDE CONSULTANT IN REVIEWING MARKET COMPETITIVE DATA THAT AIDS IN SETTING THE COMPENSATION FOR THE OFFICERS AND KEY EMPLOYEES. 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 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. ARTICLES AND BYLAWS, CONFLICT OF INTEREST POLICY, AND FORM 990S ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF NONADMITTED ASSETS -18,869,752. MN HEALTH INFO EXCHANGE K-1 2,074. AVERAGE HOURS PER WEEK FORM 990, PART VII, COLUMN B 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, AND MEDICA RESEARCH INSTITUTE). THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. FORM 990, BOX B, AMENDED RETURN FORM 990 IS BEING AMENDED TO CORRECLTY REPORT DEFERRED COMPENSATION THAT WAS DOUBLE REPORTED ON THE ORIGINALLY FILED RETURN. DEFERRED COMPENSATION REPORTED IN PART VII, COLUMN (F) AND SCHEDULE J, PART II, COLUMN (C) HAS BEEN REDUCED TO ACCOUNT FOR THE PORTION OF DEFERRED COMPENSATION THAT WAS INCLUDED IN REPORTABLE W-2 COMPENSATION. MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) 509(A)(3) II MEDICA HOLDING COMPANY 1 MEDICA HEALTH PLANS OF WISCONSIN 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH COVERAGE MN 501(C)(4) MEDICA HOLDING COMPANY 1 MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING COMPANY/NO ACTIVITY MN 501(C)(4) N/A 0 MEDICA RESEARCH INSTITUTE 401 CARLSON PARKWAY MINNETONKA MN 55305 270600894 RESEARCH FOUNDATION MN 501(C)(3) 509(A)(3) I MEDICA HOLDING COMPANY 1 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MEDICA AFFILIATED SERVICES C 0 MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMINISTRATOR MN MEDICA AFFILIATED SERVICES C 0 MEDICA AFFILIATED SERVICES 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MEDICA HOLDING COMPANY C 0 MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MANAGEMENT MN MEDICA AFFILIATED SERVICES C 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 MEDICA FOUNDATION B 5500000 ACTUAL AMOUNT MEDICA FOUNDATION N 125062 ACTUAL AMOUNT MEDICA FOUNDATION O 237174 ACTUAL AMOUNT MEDICA RESEARCH INSTITUTE B 4500000 ACTUAL AMOUNT MEDICA RESEARCH INSTITUTE N 714976 ACTUAL AMOUNT MEDICA RESEARCH INSTITUTE O 153785 ACTUAL AMOUNT MEDICA HEALTH PLANS OF WISCONSIN A 105964 ACTUAL AMOUNT