FIRST MEDICAL INSURANCE COMPANT A RISK RETENTION GROUP: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
FIRST MEDICAL INSURANCE COMPANT A RISK RETENTION GROUP (EIN 01-0719207)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-13
IRS object ID
201513179349308316
Schema version
2014v5.0
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)
Return2015-11-13T15:46:36-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1800AddressLine1Txt
CityPHILADELPHIACityNm
State AbbreviationPAStateAbbreviationCd
ZIP19103ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010719207EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FIRST MEDICAL INSURANCE COMPANY (RRG)BusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARSH MANAGEMENT SERVICES IInCareOfNm
Business Name ControlFIRSBusinessNameControlTxt
Phone8028645599PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O MARSH MANAGEMENT SERVICES INCAddressLine1Txt
CityBURLINGTONCityNm
State AbbreviationVTStateAbbreviationCd
ZIP05401ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS J TODOROWPersonNm
Person TitleEVP AND CHIEF FINANCIAL OFFICERPersonTitleTxt
Signature2014-11-14SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERICA R MCREYNOLDS DIRECTORPreparerPersonNm
PTINP00977806PTIN
Phone2673303000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS J TODOROWPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13401 CIVIC CENTER BLVDAddressLine1Txt
CityPHILADELPHIACityNm
State AbbreviationPAStateAbbreviationCd
ZIP19104ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$86,301,543GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateVTLegalDomicileStateCd
Activity Or Missionthe organization provides insurance for the children's hospital of philadelphia and certain affiliated tax -exempt organizations.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$10,890,359PYProgramServiceRevenueAmt
CY Program Service Revenue$10,510,510CYProgramServiceRevenueAmt
PY Investment Income$5,124,235PYInvestmentIncomeAmt
CY Investment Income$5,734,463CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$16,014,594PYTotalRevenueAmt
CY Total Revenue$16,244,973CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
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$7,507,826PYOtherExpensesAmt
CY Other Expenses$6,435,651CYOtherExpensesAmt
PY Total Expenses$7,507,826PYTotalExpensesAmt
CY Total Expenses$6,435,651CYTotalExpensesAmt
PY Revenues Less Expenses$8,506,768PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,809,322CYRevenuesLessExpensesAmt
Total Assets BOY$120,918,146TotalAssetsBOYAmt
Total Assets EOY$101,935,720TotalAssetsEOYAmt
Total Liabilities BOY$64,390,578TotalLiabilitiesBOYAmt
Total Liabilities EOY$42,107,221TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$56,527,568NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$59,828,499NetAssetsOrFundBalancesEOYAmt
MissionTHE ORGANIZATION PROVIDES INSURANCE FOR THE CHILDREN'S HOSPITAL OF PHILADELPHIA AND CERTAIN AFFILIATED TAX-EXEMPT ORGANIZATIONS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$6,022,910ExpenseAmt
Revenue$10,510,510RevenueAmt
DescINSURANCE FOR CHILDREN'S HOSPITAL OF PHILADELPHIA AND ITS TAX-EXEMPT ENTITIES.Desc
Total Program Service Expenses$6,022,910TotalProgramServiceExpensesAmt
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 StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
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 OrganizationsfalseGrantsToOrganizationsInd
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 OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
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
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
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
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARSH MANAGEMENT SERVICES IPersonNm
Phone8028645599PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 BANK ST STE 610AddressLine1Txt
CityBURLINGTONCityNm
State AbbreviationVTStateAbbreviationCd
ZIP05401ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
THOMAS J TODOROW
DIRECTOR,PRESIDENT & TREASURER1.042.0Yes (X)Yes (X)$0$1,270,829$33,496
EDWARD F PRECOURT
DIRECTOR & ASSISTANT TREASURER1.00.0Yes (X)Yes (X)$0$0$0
LYNN CALHOUN
DIRECTOR & SECRETARY1.039.0Yes (X)Yes (X)$0$239,599$13,446
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,510,428TotReportableCompRltdOrgAmt
Total Other Compensation$46,942TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WHITE WILLIAMS
ONE LIBERTY PL 1650 MARKET ST STEPHILADELPHIAPA19103LEGAL SERVICES$1,294,600
POST POST LLC
200 BERWYN PARK STE 102 920 CASSABERWYNPA19312LEGAL SERVICES$674,080
STANDISH MELLON
1 BOSTON PL 5400BOSTONMA02108INVESTMENT$216,187
POST SCHELL PC
FOUR PENN CENTER 1600 JFK BLVDPHILADELPHIAPA19103LEGAL SERVICES$263,696
CHRISTIE PABARUE YOUNG
1800 JOHN F KENNEDY BLVD 1000PHILADELPHIAPA19103LEGAL SERVICES$201,964
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescINSURANCE PREMIUM EARNEDDesc
Total Revenue Column$10,510,510TotalRevenueColumnAmt
Related Or Exempt Func Income$10,510,510RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,510,510TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,758,079TotalRevenueColumnAmt
Exclusion$2,758,079ExclusionAmt

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$73,032,954SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$70,056,570SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,976,384SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,976,384TotalRevenueColumnAmt
Exclusion$2,976,384ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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$16,244,973TotalRevenueColumnAmt
Related Or Exempt Func Income$10,510,510RelatedOrExemptFuncIncomeAmt
Exclusion$5,734,463ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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$87,250TotalAmt
Management And General$87,250ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,537TotalAmt
Management And General$2,537ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,300TotalAmt
Management And General$37,300ManagementAndGeneralAmt

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$216,187TotalAmt
Management And General$216,187ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$23,350TotalAmt
Management And General$23,350ManagementAndGeneralAmt

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$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$584TotalAmt
Management And General$584ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
LOSSES & LOSS ADJUSTMENT$8,776,836$8,776,836
PROVISION FOR IBNR-$3,095,340-$3,095,340
POLICY ACQUIS & UNDERWRITING$341,414$341,414
GENERAL & ADMINISTRATIVE$45,533$45,533

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,435,651TotalAmt
Program Services$6,022,910ProgramServicesAmt
Management And General$412,741ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,032,591BOYAmt
EOY$12,588,432EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

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

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$168,043BOYAmt
EOY$188,392EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$52,804,577BOYAmt
EOY$32,989,331EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$60,912,935BOYAmt
EOY$55,370,199EOYAmt

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$799,366EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$120,918,146BOYAmt
EOY$101,935,720EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$135,033BOYAmt
EOY$171,975EOYAmt

Grants Payable GrantsPayableGrp

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

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$64,255,545BOYAmt
EOY$41,935,246EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$64,390,578BOYAmt
EOY$42,107,221EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

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

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$5,149,516BOYAmt
EOY$5,149,516EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$51,378,052BOYAmt
EOY$54,678,983EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$56,527,568BOYAmt
EOY$59,828,499EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$120,918,146BOYAmt
EOY$101,935,720EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$9,809,322ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$425,609NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,934,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations11SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (11 entries)

EINEINOrganization TypeOrganizationTypeDescGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
23135216603Yes (true)$0$0
THE CHILDREN'S HOSPITAL OF PHILADELPHIA FOUNDATION
23223793207Yes (true)$0$0
THE CHILDREN'S HOSPITAL OF PHILADELPHIA PRACTICE ASSOCIATION
2323114820Yes (true)$0$0
CHOP CLINICAL ASSOCIATES INC
2235489700Yes (true)$0$0
CHILDREN'S ANESTHESIOLOGY ASSOCIATES LTD
23259283509Yes (true)$0$0
CHILDREN'S ANESTHESIOLOGY ASSOCIATES OF NEW JERSEY INC
22340567309Yes (true)$0$0
CHILDREN'S HEALTH CARE ASSOCIATES INC
22278580409Yes (true)$0$0
CHILDREN'S HEALTH CARE ASSOCIATES OF NEW JERSEY INC
23303669909Yes (true)$0$0
CHILDREN'S SURGICAL ASSOCIATES LTD
23258932209Yes (true)$0$0
CHILDREN'S SURGICAL ASSOCIATES OF NEW JERSEY INC
22334848109Yes (true)$0$0
RADIOLOGY ASSOCIATES OF THE CHILDREN'S HOSPITAL INC
23266585509Yes (true)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total11SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocfalseListedByNameGoverningDocInd
Suprt Org No IRS DeterminationYes (true)SuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
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

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE A, PART IV, SECTION A, LINE 1FMIC provides insurance to The Children's Hospital of Philadelphia
SCHEDULE A, PART IV, SECTION A, LINE 2Two of the supported organizations, The Children's Hospital of

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 (7 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
SPONSORED ENTERPRISES$16,345,273F
ASSET-BACKED SECURITIES$7,085,041F
COMMERCIAL MORTGAGE BACKED SEC$3,659,024F
MUNICIPAL BONDS$4,074,600F
CORPORATE DEBT SECURITIES$23,683,165F
ACCRUED INTEREST$459,627F
FOREIGN GOVERNMENTS$63,469F
FieldValueIRS element (for citing)
Total Book Value Securities$55,370,199TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
LOSSES PAYABLE$562,224
UNEARNED PREMIUM RESERVES$5,152,797
LOSS ADJUSTMENT EXPENSES$36,220,225
FieldValueIRS element (for citing)
Total Liability$41,935,246TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$16,454,397TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$425,609NetUnrealizedGainsInvstAmt
Revenue Not Reported$425,609RevenueNotReportedAmt
Revenue Subtotal$16,028,788RevenueSubtotalAmt
Investment Expenses Not Incld$216,185InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$216,185RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,244,973TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,219,466TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$6,219,466ExpensesSubtotalAmt
Investment Expenses Not Incld2$216,185InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$216,185ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,435,651TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
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 OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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
THOMAS J TODOROW
DIRECTOR,PRESIDENT & TREASURER$0$673,009$0$497,297$0$100,523$0$5,200$0$28,296$0$1,304,325$0$0
LYNN CALHOUN
DIRECTOR & SECRETARY$0$199,482$0$40,117$0$0$0$2,442$0$11,004$0$253,045$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 4SOME OFFICERS, DIRECTORS, AND KEY EMPLOYEES LISTED IN FORM 990, PART VII PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS ("SERPS"). ANY SERP PAYMENTS ARE REPORTED IN PART II COLUMN (B)(III).
FORM 990, SCHEDULE J, PART II, COLUMN (C)THE AMOUNT REPORTED HERE MAY INCLUDE CHANGES IN ACTUARIAL VALUES OF SERPS AS REQUIRED TO BE REPORTED BY THE IRS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINES 6 AND 7THE FOLLOWING ORGANIZATIONS ARE MEMBERS OF FIRST MEDICAL INSURANCE COMPANY (RRG): - The CHILDREN'S HOSPITAL OF PHILADELPHIA - The CHILDREN'S HOSPITAL OF PHILADELPHIA foundation - The Children's Hospital of Philadelphia Practice Association - CHOP Clinical Associates, Inc. - Children's Anesthesiology Associates, Ltd. - Children's Anesthesiology Associates of New Jersey - Children's Health Care Associates, Inc. - Children's Health Care Associates of New Jersey, Inc. - Children's Surgical Associates, Ltd. - Children's Surgical Associates of New Jersey, Inc. - Radiology Associates of the Children's Hospital, Inc. Form 990, Part VI, Section A, Line 7b Under FMIC's Bylaws, Members have the authority to elect or remove the Directors.
FORM 990, PART VI, SECTION B, LINE 11BFMIC RECEIVES AUDITED FINANCIAL STATEMENTS. A PUBLIC ACCOUNTING FIRM PREPARES THE FORM 990 BASED ON THESE FINANCIAL STATEMENTS AS WELL AS OTHER INFORMATION GATHERED. ONCE PREPARED, THE FORM 990 WAS REVIEWED BY THE FINANCE OFFICE OF CHOP AS WELL AS THE DIRECTORS AND BOARD MEMBERS OF FMIC PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12BALL OFFICERS, DIRECTORS OF FMIC ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM.
FORM 990, PART VI, SECTION B, LINE 12CFMIC has a Conflicts of Interest Policy. That policy applies by its terms to the directors and officers of FMIC who are employees of The Children's Hospital of Philadelphia; by virtue of its adoption by FMIC, the Policy also applies to the directors and officers of FMIC who are not employees of The Children's Hospital of Philadelphia, with respect to their duties regarding FMIC. (FMIC does not have any employees.) Pursuant to the Policy, annual conflicts of interest statements are completed by all covered persons, including all directors and officers of FMIC. The statements are reviewed by FMIC board for further review and follow-up as needed. Form 990, Part VI, Section C, Line 19 Form 990 and financial statements are made available upon request. The conflicts of interest policy is available on The Children's Hospital of Philadelphia's website.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS OR FUND BALANCES DISTRIBUTION FROM SURPLUS - ($6,934,000)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104231352166HEALTHCAREPA501(C)(3)3CHOP FNDYes (true)
CHOP FOUNDATION
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104232237932SUPPORTPA501(C)(3)7NAfalse
CHOP PRACTICE ASSOCIATION
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104232311482HEALTHCAREPA501(C)(3)11 iii-fiCHOPYes (true)
CHOP CLINICAL ASSOCIATES INC
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104223548970HEALTHCARENJ501(C)(3)11 iii-fiCHOPYes (true)
CHILDREN'S ANESTHESIOLOGY ASSOC LTD
3401 CIVIC CENTER BLVDphiladelphiaPA19104232592835HEALTHCAREPA501(C)(3)9CHOPYes (true)
CHILDREN'S ANESTHESIOLOGY ASSOC OF NJ
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104223405673HEALTHCARENJ501(C)(3)9CHOPYes (true)
CHILDREN'S HEALTH CARE ASSOCIATES INC
100 PENN SQ E 9TH FLPHILADELPHIAPA19107222785804HEALTHCAREPA501(C)(3)9CHOPYes (true)
CHILDREN'S HEALTH CARE ASSOCIATES OF NJ
51 HADDONFIELD ROADCHERRY HILLNJ08002233036699HEALTHCARENJ501(C)(3)9CHOPYes (true)
CHILDREN'S SURGICAL ASSOCIATES LTD
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104232589322HEALTHCAREPA501(C)(3)9CHOPYes (true)
CHILDREN'S SURGICAL ASSOCIATES OF NJ
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104223348481HEALTHCARENJ501(C)(3)9CHOPYes (true)
RADIOLOGY ASSOCIATES OF CHOP
100 PENN SQUARE EASTPHILADELPHIAPA19107232665855HEALTHCAREPA501(C)(3)9CHOPYes (true)
PGH DEVELOPMENT CORPORATION
426 CURIE BLVDPHILADELPHIAPA19104232351015SUPPORTPA501(C)(3)11 INAfalse
SURGICAL ASSOCIATES RESEARCH & EDUCATION
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104232181768RESEARCHPA501(C)(3)11 III - FICHOPYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
4865 MARKET ASSOC
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104461341918REAL ESTATEPANA
SPARK THERAPEUTICS
3401 CIVIC CENTER BLVDPHILADELPHIAPA19104462654405RESEARCHPACHOP

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SPARK THERAPEUTICS INC
3737 MARKET ST STE 1300PHILADELPHIAPA19104462654405BIOTECHDENAC CORPfalse
HAYSTACK INFORMATICS INC
3401 MARKET ST STE 200PHILADELPHIAPA19104472433511TECHNOLOGYDENAC CORPfalse
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 FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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