FIRST MEDICAL INSURANCE COMPANT A RISK RETENTION GROUP: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FIRST MEDICAL INSURANCE COMPANT A RISK RETENTION GROUP (EIN 01-0719207)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201303189349305185
Schema version
2012v2.1
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)
Timestamp2013-11-14T15:42:32-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010719207EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FIRST MEDICAL INSURANCE COMPANY (RRG)BusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARSH MANAGEMENT SERVICES INInCareOfName
Name ControlFIRSNameControl
Phone8028645599Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O MARSH MANAGEMENT SERVICEAddressLine1
Address Line2100 BANK STREET SuiteAddressLine2
CityBURLINGTONCity
StateVTState
ZIP Code05401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS J TODOROWName
TitlePRESIDENT & TREASURERTitle
Phone2673303000Phone
Date Signed2013-11-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS J TODOROWNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line134TH ST CIVIC CENTER BLVDAddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19107ZIPCode
FieldValueIRS element (for citing)
Gross Receipts81844834GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileVTStateLegalDomicile
Activity Or Mission Descriptionthe organization provides insurance for the children's hospital of philadelphia and certain affiliated tax-exempt organizations.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11997795ProgramServiceRevenuePriorYear
Program Service Revenue CY11693476ProgramServiceRevenueCY
Investment Income Prior Year6317550InvestmentIncomePriorYear
Investment Income Current Year7151394InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year18315345TotalRevenuePriorYear
Total Revenue Current Year18844870TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5288560OtherExpensePriorYear
Other Expenses Current Year5885682OtherExpensesCurrentYear
Total Expenses Prior Year5288560TotalExpensesPriorYear
Total Expenses Current Year5885682TotalExpensesCurrentYear
Revenues Less Expenses Prior Year13026785RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12959188RevenuesLessExpensesCY
Total Assets BOY113182074TotalAssetsBOY
Total Assets EOY110536071TotalAssetsEOY
Total Liabilities BOY47559876TotalLiabilitiesBOY
Total Liabilities EOY45878817TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY65622198NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY64657254NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION PROVIDES INSURANCE FOR THE CHILDREN'S HOSPITAL OF PHILADELPHIA AND CERTAIN AFFILIATED TAX-EXEMPT ORGANIZATIONS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense5504444Expense
Revenue11693476Revenue
DescriptionINSURANCE FOR CHILDREN'S HOSPITAL OF PHILADELPHIA AND ITS TAX EXEMPT ENTITIESDescription
Total Program Service Expense5504444TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARSH MANAGEMENT SERVICES INNamePerson
Telephone Number8028645599TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 BANK ST STE 610AddressLine1
CityBURLINGTONCity
StateVTState
ZIP Code05401ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (3 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
THOMAS J TODOROW
DIRECTOR,PRESIDENT & TREASURER1.039.0XX017110369020
EDWARD F PRECOURT
DIRECTOR & ASSISTANT TREASURER1.00.0XX000
LYNN CALHOUN
DIRECTOR & SECRETARY1.039.0XX0221117780
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1932153TotalReportableCompFrmRltdOrgs
Total Other Compensation9800TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WHITE WILLIAMS
ONE LIBERTY PL 1650 MARKET ST STEPHILADELPHIAPA19103LEGAL SERVICES833425
POST POST LLC
200 BERWYN PARK STE 102 920 CASSABERWYNPA19312LEGAL SERVICES359880
CONRAD O'BRIEN PC
1515 MARKET STREET 16TH FLOORPHILADELPHIAPA19103LEGAL SERVICES105486
POST SCHELL PC
FOUR PENN CENTER 1600 JFK BLVDPHILADELPHIAPA19103LEGAL SERVICES100428
STANDISH MELLON
1 BOSTON PL 5400BOSTONMA02108INVESTMENT227163
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionINSURANCE PREMIUM EARNEDDescription
Total Revenue Column11693476TotalRevenueColumn
Related Or Exempt Function Income11693476RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue11693476TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3403058TotalRevenueColumn
Exclusion$3,403,058ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities66748300Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities62999964Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3748336Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3748336TotalRevenueColumn
Exclusion$3,748,336ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18844870TotalRevenueColumn
Related Or Exempt Function Income11693476RelatedOrExemptFunctionIncome
Exclusion$7,151,394ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total84375Total
Management And General84375ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total4943Total
Management And General4943ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27400Total
Management And General27400ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total227163Total
Management And General227163ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total31789Total
Management And General31789ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total824Total
Management And General824ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
LOSSES & LOSS ADJUSTMENT32909403290940
PROVISION FOR IBNR18111391811139
POLICY ACQUIS. & UNDERWRITING402365402365
GENERAL & ADMINISTRATIVE47444744

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5885682Total
Program Services5504444ProgramServices
Management And General381238ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3716914BOY
EOY13721653EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY186771BOY
EOY142773EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY48658507BOY
EOY36389884EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY60619882BOY
EOY60281761EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY113182074BOY
EOY110536071EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY161107BOY
EOY186669EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY47398769BOY
EOY45692148EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY47559876BOY
EOY45878817EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY5149516BOY
EOY5149516EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY60472682BOY
EOY59507738EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY65622198BOY
EOY64657254EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY113182074BOY
EOY110536071EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses12959188ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1507868ReconciliationUnrealizedInvest
Reconcilation Other Changes-15432000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (11 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
23135216603truetruetrue$0
THE CHILDREN'S HOSPITAL OF PHILADELPHIA FOUNDATION
23223793203truetruetrue$0
THE CHILDREN'S HOSPITAL OF PHILADELPHIA PRACTICE ASSOCIATION
23231148204truetruetrue$0
CHOP CLINICAL ASSOCIATES INC
22354897004truetruetrue$0
CHILDREN'S ANESTHESIOLOGY ASSOCIATES LTD
23259283504truetruetrue$0
CHILDREN'S ANESTHESIOLOGY ASSOCIATES OF NEW JERSEY INC
22340567304truetruetrue$0
CHILDREN'S HEALTH CARE ASSOCIATES INC
23303669904truetruetrue$0
CHILDREN'S HEALTH CARE ASSOCIATES OF NEW JERSEY INC
22278580404truetruetrue$0
CHILDREN'S SURGICAL ASSOCIATES LTD
23258932204truetruetrue$0
CHILDREN'S SURGICAL ASSOCIATES OF NEW JERSEY INC
22334848104truetruetrue$0
RADIOLOGY ASSOCIATES OF THE CHILDREN'S HOSPITAL INC
23266585503truetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs11TotalNumberOfSupportedOrgs

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (7 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
SPONSORED ENTERPRISES18940927F
ASSET-BACKED SECURITIES6950133F
COMMERCIAL MORTGAGE BACKED SEC2636533F
MUNICIPAL BONDS2119196F
CORPORATE DEBT SECURITIES28711011F
ACCRUED INTEREST599242F
FOREIGN GOVERNMENTS324719F
FieldValueIRS element (for citing)
Total Of Book Value Securities60281761TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
LOSSES PAYABLE$1,434,295
UNEARNED PREMIUM RESERVES$5,530,665
LOSS ADJUSTMENT EXPENSES$38,727,188
FieldValueIRS element (for citing)
Total Of Amounts45692148TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt20118286TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1507868NetUnrealizedGainsInvestments
Revenue Not Rptd F9901507868RevenueNotRptdF990
Revenue Subtotal18610418RevenueSubtotal
Investment Expenses Not Included234452InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt234452RevenueNotRptdOnFinStmt
Total Revenue Per Form99018844870TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5651230TotExpensesEtcAuditedFinclStmt
Expenses Subtotal5651230ExpensesSubtotal
Investment Expenses Not Included2234452InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt234452ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905885682TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
THOMAS J TODOROW
DIRECTOR,PRESIDENT & TREASURER0634375046875006079110500004020017200560363806
LYNN CALHOUN
DIRECTOR & SECRETARY018776003207301284000780022189700

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSchedule J, Part I, Line 4bIdentifier
ExplanationSome officers, directors, and key employees listed in Part VII participate in Supplemental Employee Retirement Plans ("SERPs"). Any SERP payments are reported in Column (B)(iii).Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3FIRST MEDICAL INSURANCE COMPANY DELEGATES THE MANAGEMENT OF ITS DAY TO DAY ACTIVITIES TO MARSH MANAGEMENT COMPANY. Form 990, PART VI, SECTION A, LINES 6 AND 7 THE 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 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 ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. Form 990, Part VI, Section B, Line 12C FMIC 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 B, LINE 15ATHE COMPENSATION OF OFFICERS OR KEY EMPLOYEES WHO ARE PHYSICIANS/SCIENTISTS (INCLUDING THE CHAIRMAN) IS REVIEWED AND APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF THE BOARDS OF THE CHILDREN'S HOSPITAL OF PHILADELPHIA AND THE CHILDREN'S HOPSITAL OF PHILADELPHIA FOUNDATION. THE COMMITTEE REVIEWS AND APPROVES IN ADVANCE THE COMPENSATION TO BE PROVIDED TO ALL FACULTY PHYSICIANS AND SCIENTISTS, INCLUDING THE CHAIRMAN. FOR EACH SUCH PERSON, THIS PROCESS WAS LAST PERFORMED IN 2012. IN MAKING ITS DETERMINATIONS, THE COMMITTEE CONSIDERS THE PERFORMANCE OF THE ORGANIZATION AND THAT OF THE COVERED INDIVIDUAL AS WELL AS RELATED BUSINESS JUDGMENT FACTORS. IT ALSO CONSIDERS MARKET COMPARISON REPORTS PREPARED BY AN EXTERNAL COMPENSATION CONSULTANT WITH SIGNIFICANT EXPERIENCE IN PERFORMING EXECUTIVE AND PHYSICIAN COMPENSATION ASSESSMENTS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE'S PROCESS IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR THOSE INDIVIDUALS WHO ARE DISQUALIFIED PERSONS. THE PEER GROUP FOR EXECUTIVES GENERALLY INCLUDES LARGE AND COMPLEX ACADEMIC MEDICAL CENTERS AND HEALTH SYSTEMS. FOR PHYSICIANS AND SCIENTISTS, THE PEER GROUP GENERALLY INCLUDES ACADEMIC MEDICAL CENTERS. INFORMATION FROM OTHER ORGANIZATIONS MAY ALSO BE CONSIDERED WHERE APPROPRIATE FOR THE POSITION. FOR THOSE INDIVIDUALS WHO ARE NOT PHYSICIANS OR SCIENTISTS, THEIR COMPENSATION IS ESTABLISHED ACCORDING TO AN ADMINISTRATIVE COMPENSATION PLAN OF THE CHILDREN'S HOSPITAL OF PHILADELPHIA, WHICH INCLUDES CONSIDERATION OF MARKET COMPENSATION FOR SIMILAR POSITIONS, AND THAT HAS A POTENTIAL FOR INCENTIVE COMPENSATION BASED ON PRODUCTIVITY, PERFORMANCE AND OTHER FACTORS FOR CERTAIN POSITIONS. ALL INDIVIDUALS REPORTED ON PART VII WHO RECEIVE COMPENSATION ARE PAID BY A RELATED ORGANIZATION.
FORM 990, PART XI, LINE 9DISTRIBUTION FROM SURPLUS - $15,432,000OTHER CHANGES IN NET ASSETS OR FUND BALANCES

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104231352166HEALTHCAREPA501(C)(3)3CHOP FNDfalse
CHOP FOUNDATION
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104232237932SUPPORTPA501(C)(3)7NAfalse
CHOP PRACTICE ASSOCIATION
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104232311482HEALTHCAREPA501(C)(3)9CHOPfalse
CHOP CLINICAL ASSOCIATES INC
C/O CHOP 34TH ST CIVIC CTRPHILADELPHIAPA19104223548970HEALTHCARENJ501(C)(3)9CHOPfalse
CHILDREN'S ANESTHESIOLOGY ASSOC LTD
34TH ST CIVIC CENTER BLVDphiladelphiaPA19104232592835HEALTHCAREPA501(C)(3)9CHOPfalse
CHILDREN'S ANESTHESIOLOGY ASSOC OF NJ
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19103223405673HEALTHCARENJ501(C)(3)9CHOPfalse
CHILDREN'S HEALTH CARE ASSOCIATES INC
100 PENN SQ E 9TH FLPHILADELPHIAPA19107222785804HEALTHCAREPA501(C)(3)9CHOPfalse
CHILDREN'S HEALTH CARE ASSOCIATES OF NJ
51 HADDONFIELD ROADCHERRY HILLNJ08002233036699HEALTHCARENJ501(C)(3)9CHOPfalse
CHILDREN'S SURGICAL ASSOCIATES LTD
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104232589322HEALTHCAREPA501(C)(3)9CHOPfalse
CHILDREN'S SURGICAL ASSOCIATES OF NJ
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104223348481HEALTHCARENJ501(C)(3)9CHOPfalse
RADIOLOGY ASSOCIATES OF CHOP
100 PENN SQUARE EASTPHILADELPHIAPA19107232665855HEALTHCAREPA501(C)(3)9CHOPfalse
PGH DEVELOPMENT CORPORATION
426 CURIE BLVDPHILADELPHIAPA19104232351015SUPPORTPA501(C)(3)11 III - FINAfalse
SURGICAL ASSOCIATES RESEARCH & EDUCATION
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104232181768RESEARCHPA501(C)(3)11 III - F1CHOPfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line14865 MARKET ASSOC LPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line134TH ST CIVIC CENTER BLVDAddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19104ZIPCode
FieldValueIRS element (for citing)
EIN461341918EIN
Primary ActivityREAL ESTATEPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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