RUBICON INSURANCE COMPANY: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
RUBICON INSURANCE COMPANY (EIN 36-3694409)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-02
IRS object ID
201312149349301001
Schema version
2012v2.0
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)
Timestamp2013-08-02T08:15:11-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WONG & KNOWLES CPA PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1340 W BUTTERFIELD STE 3CAddressLine1
CityELMHURSTCity
StateILState
ZIP Code601265043ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363694409EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RUBICON INSURANCE COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlRUBINameControl
Phone8474918518Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O CHRISTOPHER JOHNSON 2020 RIDGEAddressLine1
CityEVANSTONCity
StateILState
ZIP Code602084335ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHRISTOPHER JOHNSONName
TitleDIRECTOR OF RISK MANAGEMENTTitle
Phone8474918518Phone
Date Signed2013-08-02DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMES M WONGName
Phone6309932223Phone
Date Prepared2013-08-02DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHRISTOPHER JOHNSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12020 RIDGE AVEAddressLine1
CityEVANSTONCity
StateILState
ZIP Code60208ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3082040GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1990YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionRubicon provides medical malpractice, general and automobile liabilty insurance to Northwestern University and its tax exempt subsidiaries, to ensure the availability of coverage at a reasonable cost, and provide access to insurance market.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3576874ProgramServiceRevenuePriorYear
Program Service Revenue CY3082040ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year3576874TotalRevenuePriorYear
Total Revenue Current Year3082040TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year-2125058OtherExpensePriorYear
Other Expenses Current Year3616851OtherExpensesCurrentYear
Total Expenses Prior Year-2125058TotalExpensesPriorYear
Total Expenses Current Year3616851TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5701932RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-534811RevenuesLessExpensesCY
Total Assets BOY50331571TotalAssetsBOY
Total Assets EOY53267068TotalAssetsEOY
Total Liabilities BOY16675202TotalLiabilitiesBOY
Total Liabilities EOY16957284TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY33656369NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY36309784NetAssetsOrFundBalancesEOY
Mission DescriptionRubicon provides medicalMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3616851Expense
Revenue3082040Revenue
DescriptionRUBICON PROVIDES MEDICAL MALPRACTICE, GENERAL LIABILITY, AND AUTOMOBILE LIABILITY INSURANCE TO NORTHWESTERN UNIVERSITY AND ITS TAX EXEMPT SUBSIDIARIES. THE PURPOSE OF PLACING THESE RISKS OF NORTHWESTERN UNIVERSITY AND ITS TAX EXEMPT SUBSIDIARIES WITH RUBICON IS TO REDUCE COSTS, ENSURE THE AVAILABILITY OF COVERAGE, AND PROVIDE ACCESS TO REINSURANCE MARKETS.Description
Total Program Service Expense3616851TotalProgramServiceExpense
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 SecuritiesfalseReportInvestOthSecurities
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
Transaction Related EntityfalseTransactionRelatedEntity
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
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHRISTOPHER JOHNSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8474918518TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12020 RIDGE AVENUE SUITE 240AddressLine1
CityEVANSTONCity
StateILState
ZIP Code602084335ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
BRIAN WALSH
Director1.00X000
CRAIG JOHNSON
Director1.00X030394626938
STEVEN GREEN
Director1.00X017048419767
EUGENE S SUNSHINE
President1.00079259531153X
JAMES M HURLEY
Vice President1.00033401028302X
INGRID S STAFFORD
Treasurer1.00028720526022X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1888240TotalReportableCompFrmRltdOrgs
Total Other Compensation132182TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SIDLEY & AUSTINBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE SOUTH DEARBORNAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60603ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesLegalDescriptionOfServices
Compensation165018Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumn
Insurance Premium5242981025280
Investment Income5242982056760
Realized Gains524298
FieldValueIRS element (for citing)
Total Program Service Revenue3082040TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3082040TotalRevenueColumn
Related Or Exempt Function Income3082040RelatedOrExemptFunctionIncome

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Loss & Loss Adjustment2717387271738700
Operating Expenses89946489946400
Dividend to Policy Holder0000

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3616851Total
Program Services3616851ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY425068BOY
EOY891183EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY155637EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1600000BOY
EOY1600000EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY48306503BOY
EOY50620248EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY50331571BOY
EOY53267068EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY256226BOY
EOY288923EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16418976BOY
EOY16668361EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY16675202BOY
EOY16957284EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY1000000BOY
EOY1000000EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY1031430BOY
EOY1031430EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY31624939BOY
EOY34278354EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33656369BOY
EOY36309784EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY50331571BOY
EOY53267068EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-534811ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2892204ReconciliationUnrealizedInvest
Reconcilation Other Changes296022ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
NORTHWESTERN UNIVERSITY
363694409501(c)3truetruetrue$2,240,235
NMFF
363097297501(c)3truetruetrue$259,512
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts2499747SumOfAmounts
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionInsurance Loss ReserveDescription
Amount$16,668,361Amount
FieldValueIRS element (for citing)
Total Of Amounts16668361TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 (5 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CRAIG JOHNSON
2504175331321624229270933088414667
STEVEN GREEN
1583337500465115899393419031714117
EUGENE S SUNSHINE
790505209025000615382374824500
JAMES M HURLEY
3279785000103225000330236231224500
INGRID S STAFFORD
27617310000103225000102231322724766

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 11bThe Director of Risk Management of Northwestern
University reviewed and approved the form 990
before Rubicon files with the IRS.
Pt VI, Line 12cA designated official of Northwestern University
reviews and identifies any conflict of interest
disclosed annually.
Pt VI, Line 19As a subsidiary of Northwestern University, Rubicon
follows the conflict of interest policy of the
University, and this policy is posted online.
The financial statements of Northwestern University
which includes the financial statements of Rubicon
Insurance Company are also posted online. The
governing documents are available to the public
upon request.
Form 990EZ, Part II, Line 24OTHER RECEIVABLES INVESTMENTS
Form 990EZ, Part II, Line 26ACCOUNTS PAYABLE & ACCRUED EXPENSES

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NORTHWESTERN UNIVERSITY
633 CLARK STREETEVANSTONIL60208363694409UNIVERSITYIL501(c)32NA
NMFF
680 N LAKE SHORE DRCHICAGOIL60611363097297Physician Faculty Northwestern UnivIL501(c)39NA
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 OrgstruePerformOfServicesForOtherOrgs
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 OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
NORTHWESTERN UNIVERSITY INSURANCE CLAIM PAYMENTS
l2240235Cash
NMFF INSURANCE CLAIM PAYMENTS
l259512Cash
NORTHWESTERN UNIVERSITY INSURANCE PREMIUM
s452319Cash

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