2013-07-15T18:52:33-05:00 2012-12-31 411735076 BLANSKI PETER KRONLAGE & ZOCH PA 7500 OLSON MEM HWY STE 200 MINNEAPOLIS MN 55427 990 2012-01-01 410417040 MINNESOTA WORKERS COMPENSATION INSURERS ASSOCIATION INC MINN 9528971737 7701 FRANCE AVENUE SOUTH NO 450 MINNEAPOLIS MN 55435 BRUCE TOLLEFSON 9528971737 2013-06-20 1 GARY J TURNQUIST CPA P00051420 7635466211 2013-06-20 2012 2016-02-24 21:20:13Z BRUCE TOLLEFSON 7701 FRANCE AVE S STE 450 EDINA MN 55435 7924620 0 X WWW.MWCIA.ORG X 1983 MN TO PROVIDE TO ITS MEMBERS SERVICES AND INFORMATION REQUIRED UNDER PROVISIONS OF MN STATUTES. 12 12 49 0 51744 34077 0 0 7780618 7878737 39117 45883 0 0 7819735 7924620 0 0 0 0 4613872 4643396 0 0 0 2828810 2808123 7442682 7451519 377053 473101 5259872 5501541 5087306 5388300 172566 113241 THE 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. 0 0 5358384 7825394 PROVIDE SERVICES TO INSURANCE COMPANIES LICENSED TO WRITE WORKERS' COMPENSATION INSURANCE IN MINNESOTA TO ENABLE THEM TO COMPLY WITH STATUTORY REQUIREMENTS. 60923 1599 COVER CLAIMS FOR INSURANCE COMPANIES THAT WENT INSOLVENT PRIOR TO 1983. 5419307 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 18 0 49 1 1 1 0 0 0 0 0 X 12 12 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X X X BRUCE TOLLEFSON 9528971737 7701 FRANCE AVE SOUTH 450 MINNEAPOLIS MN 55435 KEITH KRUEGER 1.00 X 0 0 0 MICHAEL LEVY 1.00 X 0 0 0 SCOTT HOLZERLAND 1.00 X 0 0 0 PETER CAMINITI 1.00 X 0 0 0 BILL DUPONT 1.00 X 0 0 0 GARY THADEN 1.00 X X 0 0 0 BARRY PRESLASKI 1.00 X 0 0 0 BRIAN BENT 1.00 X 0 0 0 MARY WACHHOLZ 1.00 X 0 0 0 KEVIN CHRISTY 1.00 X 0 0 0 KEVIN GREGERSON 1.00 X 0 0 0 WILLIAM MEYER 1.00 X 0 0 0 CRAIG A ANDERSON 40.00 X 120291 0 39396 KATHLEEN PETERSON 40.00 X 110521 0 43386 SUSAN R LEVEY 40.00 X 87937 0 36563 BRUCE A TOLLEFSON 40.00 X 161805 0 49000 480554 0 168345 4 0 1 0 SPECTRUM PARTNERS LLC 7701 FRANCE AVENUE SOUTH SUITE 450 MINNEAPOLIS MN 55435 DATABASE SUPPORT 350000 THOMAS E HARMS 8111 XERXES CIRCLE BLOOMINGTON MN 55431 LEGAL SERVICES 285504 DYNAMICVIEW LLC 13808 AUTUMWOOD AVENUE ROSEMOUNT MN 55068 SOFTWARE DEVELOPMENT 155003 3 MEMBER ASSESSMENTS 518210 7077210 7077210 ASSIGNED RISK SERVICE 518210 535662 535662 PAPER PROCESSING FEES 518210 117323 117323 U.S.P. FINES 518210 57300 57300 SERVICES & OTHER INC 518210 39498 39498 51744 51744 7878737 45883 45883 7924620 7826993 51744 45883 506196 425205 80991 2571139 2159757 411382 790218 663783 126435 512468 430473 81995 263375 221235 42140 26950 26950 285504 285504 27252 5096 22156 143052 126601 16451 1093856 623498 470358 386185 347567 38618 89485 26846 62639 COLLABORATIVE LEGAL SUP 203708 203708 RESEARCH IST. DATA COLL 195000 195000 RATEMAKING CONSULTING 115613 115613 UBIT 5588 5588 235930 78633 157297 7451519 5419307 2032212 0 3920698 3939909 51436 17712 11788 6516 1275950 1537404 5259872 5501541 5087306 5388300 5087306 5388300 X 172566 113241 172566 113241 5259872 5501541 X 473101 51544 -583969 X X 0 1 X 1 0 0 MEMBER CASH RESERVE ASSESS PAYABLE 3536794 MEMBER ASSESS REAPORTION PAYABLE 583969 DEFERRED COMPENSATION OBLIGATION 1267537 5388300 7974565 51544 51544 7923021 1599 1599 7924620 7390596 0 7390596 60923 60923 7451519 PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUE RELATED TO INSOLVENT FUND PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES RELATED TO INSOLVENT FUND X X X X 0 0 0 CRAIG A ANDERSON 120291 0 0 0 0 0 25230 0 14166 0 159687 0 0 0 KATHLEEN PETERSON 110521 0 0 0 0 0 24023 0 19363 0 153907 0 0 0 BRUCE A TOLLEFSON 161805 0 0 0 0 0 34234 0 14766 0 210805 0 0 0 THOMAS E HARMS EMPLOYEE 285504 TOM HARMS IS A W-2 EMPLOYEE AND ALSO OWNS A LEGAL PRACTICE UNDER THE SAME NAME WHICH IS RETAINED AS OUTSIDE COUNCIL. 0 FORM 990, PART VI, SECTION A, LINE 6 ANY 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 7A GUIDED 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 11 A 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 12C THE 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 15 PRESIDENT 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 19 THE 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: MEMBERSHIP REAPOORTIONMENT ASSESSMENT ADJUSTMENT -583,969. 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.