MINNESOTA WORKERS COMPENSATION INSURERS ASSOCIATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MINNESOTA WORKERS COMPENSATION INSURERS ASSOCIATION INC (EIN 41-0417040)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-07-15
IRS object ID
201331969349301668
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)
Timestamp2013-07-15T18:52:33-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN411735076EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLANSKI PETER KRONLAGE & ZOCH PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line17500 OLSON MEM HWY STE 200AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55427ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN410417040EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MINNESOTA WORKERS COMPENSATIONBusinessNameLine1
Business Name Line2INSURERS ASSOCIATION INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMINNNameControl
Phone9528971737Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17701 FRANCE AVENUE SOUTH NO 450AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55435ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRUCE TOLLEFSONName
TitlePRESIDENTTitle
Phone9528971737Phone
Date Signed2013-06-20DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGARY J TURNQUIST CPAName
PTINP00051420PTIN
Phone7635466211Phone
Date Prepared2013-06-20DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRUCE TOLLEFSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line17701 FRANCE AVE S STE 450AddressLine1
CityEDINACity
StateMNState
ZIP Code55435ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7924620GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MWCIA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE TO ITS MEMBERS SERVICES AND INFORMATION REQUIRED UNDER PROVISIONS OF MN STATUTES.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees49TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI51744TotalGrossUBI
Net Unrelated Business Txbl Income34077NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7780618ProgramServiceRevenuePriorYear
Program Service Revenue CY7878737ProgramServiceRevenueCY
Investment Income Prior Year39117InvestmentIncomePriorYear
Investment Income Current Year45883InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year7819735TotalRevenuePriorYear
Total Revenue Current Year7924620TotalRevenueCurrentYear
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 Year4613872SalariesEtcPriorYear
Salaries Etc Current Year4643396SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2828810OtherExpensePriorYear
Other Expenses Current Year2808123OtherExpensesCurrentYear
Total Expenses Prior Year7442682TotalExpensesPriorYear
Total Expenses Current Year7451519TotalExpensesCurrentYear
Revenues Less Expenses Prior Year377053RevenuesLessExpensesPriorYear
Revenues Less Expenses CY473101RevenuesLessExpensesCY
Total Assets BOY5259872TotalAssetsBOY
Total Assets EOY5501541TotalAssetsEOY
Total Liabilities BOY5087306TotalLiabilitiesBOY
Total Liabilities EOY5388300TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY172566NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY113241NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MINNESOTA WORKERS' COMPENSATION INSURERS ASSOCIATION, INC. IS A NOT-FOR-PROFIT CORPORATION FORMED TO PROVIDE TO ITS MEMBERS THOSE ACTIVITIES WHICH ARE REQUIRED AND PERMITTED OF A DATA SERVICE ORGANIZATION UNDER THE PROVISIONS OF MINNESOTA STATUTES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5358384Expense
Revenue7825394Revenue
DescriptionPROVIDE SERVICES TO INSURANCE COMPANIES LICENSED TO WRITE WORKERS' COMPENSATION INSURANCE IN MINNESOTA TO ENABLE THEM TO COMPLY WITH STATUTORY REQUIREMENTS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense60923Expense
Revenue1599Revenue
DescriptionCOVER CLAIMS FOR INSURANCE COMPANIES THAT WENT INSOLVENT PRIOR TO 1983.Description
FieldValueIRS element (for citing)
Total Program Service Expense5419307TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees49NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BRUCE TOLLEFSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9528971737TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17701 FRANCE AVE SOUTH 450AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55435ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
KEITH KRUEGER
BOARD MEMBER1.00X000
MICHAEL LEVY
BOARD MEMBER1.00X000
SCOTT HOLZERLAND
BOARD MEMBER1.00X000
PETER CAMINITI
BOARD MEMBER1.00X000
BILL DUPONT
BOARD MEMBER1.00X000
GARY THADEN
BOARD CHAIR1.00X000X
BARRY PRESLASKI
BOARD MEMBER1.00X000
BRIAN BENT
BOARD MEMBER1.00X000
MARY WACHHOLZ
BOARD MEMBER1.00X000
KEVIN CHRISTY
BOARD MEMBER1.00X000
KEVIN GREGERSON
BOARD MEMBER1.00X000
WILLIAM MEYER
BOARD MEMBER1.00X000
CRAIG A ANDERSON
VICE PRESIDENT40.00120291039396X
KATHLEEN PETERSON
VP OPERATIONS/TREASURER40.00110521043386X
SUSAN R LEVEY
INFORMATION TECH DIRECTOR40.0087937036563X
BRUCE A TOLLEFSON
PRESIDENT40.00161805049000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org480554TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation168345TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SPECTRUM PARTNERS LLC
7701 FRANCE AVENUE SOUTH SUITE 450MINNEAPOLISMN55435DATABASE SUPPORT350000
THOMAS E HARMS
8111 XERXES CIRCLEBLOOMINGTONMN55431LEGAL SERVICES285504
DYNAMICVIEW LLC
13808 AUTUMWOOD AVENUEROSEMOUNTMN55068SOFTWARE DEVELOPMENT155003
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEMBER ASSESSMENTS51821070772107077210
ASSIGNED RISK SERVICE518210535662535662
PAPER PROCESSING FEES518210117323117323
U.S.P. FINES5182105730057300
SERVICES & OTHER INC5182103949839498

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column51744TotalRevenueColumn
Unrelated Business Revenue51744UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue7878737TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column45883TotalRevenueColumn
Exclusion$45,883ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7924620TotalRevenueColumn
Related Or Exempt Function Income7826993RelatedOrExemptFunctionIncome
Unrelated Business Revenue51744UnrelatedBusinessRevenue
Exclusion$45,883ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total506196Total
Program Services425205ProgramServices
Management And General80991ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2571139Total
Program Services2159757ProgramServices
Management And General411382ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total790218Total
Program Services663783ProgramServices
Management And General126435ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total512468Total
Program Services430473ProgramServices
Management And General81995ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total263375Total
Program Services221235ProgramServices
Management And General42140ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total26950Total
Management And General26950ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total285504Total
Management And General285504ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total27252Total
Program Services5096ProgramServices
Management And General22156ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total143052Total
Program Services126601ProgramServices
Management And General16451ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1093856Total
Program Services623498ProgramServices
Management And General470358ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total386185Total
Program Services347567ProgramServices
Management And General38618ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total89485Total
Program Services26846ProgramServices
Management And General62639ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
COLLABORATIVE LEGAL SUP203708203708
RESEARCH IST. DATA COLL195000195000
RATEMAKING CONSULTING115613115613
UBIT55885588

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total235930Total
Program Services78633ProgramServices
Management And General157297ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7451519Total
Program Services5419307ProgramServices
Management And General2032212ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3920698BOY
EOY3939909EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY51436BOY
EOY17712EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11788BOY
EOY6516EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1275950BOY
EOY1537404EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5259872BOY
EOY5501541EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5087306BOY
EOY5388300EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5087306BOY
EOY5388300EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY172566BOY
EOY113241EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY172566BOY
EOY113241EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5259872BOY
EOY5501541EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses473101ReconcilationRevenueExpenses
Reconciliation Unrealized Invest51544ReconciliationUnrealizedInvest
Reconcilation Other Changes-583969ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting OtherXMethodOfAccountingOther
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
MEMBER CASH RESERVE ASSESS PAYABLE$3,536,794
MEMBER ASSESS REAPORTION PAYABLE$583,969
DEFERRED COMPENSATION OBLIGATION$1,267,537
FieldValueIRS element (for citing)
Total Of Amounts5388300TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt7974565TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments51544NetUnrealizedGainsInvestments
Revenue Not Rptd F99051544RevenueNotRptdF990
Revenue Subtotal7923021RevenueSubtotal
Other Revenues Not Included1599OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1599RevenueNotRptdOnFinStmt
Total Revenue Per Form9907924620TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7390596TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal7390596ExpensesSubtotal
Other Expenses Not Included60923OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt60923ExpensesNotRptdOnFinStmt
Total Expenses Per Form9907451519TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 4B - OTHER ADJUSTMENTS:REVENUE RELATED TO INSOLVENT FUND
PART XII, LINE 4B - OTHER ADJUSTMENTS:EXPENSES RELATED TO INSOLVENT FUND

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (3 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
CRAIG A ANDERSON
VICE PRESIDENT12029100000252300141660159687000
KATHLEEN PETERSON
VP OPERATIONS/TREASURER11052100000240230193630153907000
BRUCE A TOLLEFSON
PRESIDENT16180500000342340147660210805000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonTHOMAS E HARMSNamePerson
FieldValueIRS element (for citing)
RelationshipEMPLOYEERelationship
Amount Of Transaction285504AmountOfTransaction
Description Of TransactionTOM HARMS IS A W-2 EMPLOYEE AND ALSO OWNS A LEGAL PRACTICE UNDER THE SAME NAME WHICH IS RETAINED AS OUTSIDE COUNCIL.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6ANY ENTITY THAT IS LICENSED THROUGH MN DEPARTMENT OF COMMERCE TO WRITE WORKERS COMPENSATION INSURANCE HAS TO BE A MEMBER OF A DATA SERVICE ORGANIZATION, MWCIA THE ONLY DSO IN THE STATE OF MINNESOTA.
FORM 990, PART VI, SECTION A, LINE 7AGUIDED BY A BOARD OF TWELVE MEMBERS, MWCIA HAS TEN COMPANY MEMBERS AND TWO PUBLIC MEMBERS APPOINTED BY THE MINNESOTA DEPARTMENT OF COMMERCE
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THIS FORM 990 IS TRANSMITTED TO THE AUDIT COMMITTEE. AUDIT COMMITTEE MEMBERS, ALONG WITH THE PRESIDENT AND SECRETARY/TREASURER, HAVE OPPORTUNITY TO REVIEW AND,IF NEEDED, DISCUSS THE FORM. SUBSEQUENT TO REVIEW, THE AUDIT COMMITTEE APPROVES THE FORM 990 FOR FILING, AND INFORMS THE BOARD OF DIRECTORS IN WRITING OF ITS REVIEW AND APPROVAL. COPIES OF THE FORM 990 ARE MADE AVAILABLE TO THE BOARD MEMBERS AFTER THE COMMITTEE'S APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL PROCRESS OF REQUIRING EMPLOYEES AND BOARD MEMBERS TO REVIEW THE POLICY, AND SIGN AN ACKNOWLEDGEMENT STATING THEIR COMPLIANCE WITH THE POLICY. THE POLICY REQUIRES BOARD MEMBERS TO DISCLOSE POTENTIAL CONFLICT OF INTEREST RELATIONSHIPS THAT ARISE IN THE ORDINARY COURSE OF THE ORGANIZATION'S BUSINESS. IF CONFLICTS ARE IDENTIFIED, THE PRESIDENT AND VICE PRESIDENT OF OPERATIONS, IN CONSULTATION WITH THE CHAIR OF THE BOARD OF DIRECTORS, ARE RESPONSIBLE TO MANAGE THE RELATIONSHIPS TO ENSURE THAT FINANCIAL DECISIONS ARE MADE WITH INDEPENDENCE. IN THE CUURENT YEAR, ONE BOARD MEMBER ALSO PROVIDES WORKERS' COMPENSATION INSURANCE TO ASSOCIATION AND ONE PUBLIC MEMBER PURCHASES DATA FROM THE ASSOCIATION.S,
FORM 990, PART VI, SECTION B, LINE 15PRESIDENT SALARY IS SET BY EXECUTIVE COMMITTEE (BOARD OF DIRECTORS). ALL OTHER EMPLOYEES INCLUDING KEY EMPLOYEES ARE SET BY MANAGEMENT. A SALARY REVIEW PROGRAM HAS BEEN ESTABLISHED BY AN INDEPENDENT CONSULTING FIRM AND IS CONSISTENTLY REVIEWED TO ENSURE WAGES ARE COMPETITIVE AND FAIR.
FORM 990, PART VI, SECTION C, LINE 19THE ARTICLES OF INCORPORATION AND BYLAWS ARE POSTED ON THE ORGANIZATIONS WEBSITE. FINANCIAL INFORMATION IS INCLUDED IN SUMMARY FORM IN THE ANNUAL REPORT WHICH IS ALSO POSTED ON THE WEBSITE. OTHER INFORMATION, SUCH AS THE CONFLICT OF INTEREST POLICY IS AMADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:MEMBERSHIP REAPOORTIONMENT ASSESSMENT ADJUSTMENT -583,969.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 900, PART XI, LINE 1:ACCOUNTING METHOD USED TO PREPARE THE FORM 990: MODIFIED CASH BASIS.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT.

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