FIRST MEDICAL INSURANCE COMPANT A RISK RETENTION GROUP: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
FIRST MEDICAL INSURANCE COMPANT A RISK RETENTION GROUP (EIN 01-0719207)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201203199349302135
Schema version
2011v1.3
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)
Timestamp2012-11-14T09:52:19-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

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 STREETAddressLine2
CityBURLINGTONCity
StateVTState
ZIP Code05401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS J TODOROWName
TitlePRESIDENT, TREASURERTitle
Date Signed2012-11-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
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 Receipts51273722GrossReceipts
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 Year11575585ProgramServiceRevenuePriorYear
Program Service Revenue CY11997795ProgramServiceRevenueCY
Investment Income Prior Year3223190InvestmentIncomePriorYear
Investment Income Current Year6317550InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14798775TotalRevenuePriorYear
Total Revenue Current Year18315345TotalRevenueCurrentYear
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 Year4865902OtherExpensePriorYear
Other Expenses Current Year5288560OtherExpensesCurrentYear
Total Expenses Prior Year4865902TotalExpensesPriorYear
Total Expenses Current Year5288560TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9932873RevenuesLessExpensesPriorYear
Revenues Less Expenses CY13026785RevenuesLessExpensesCY
Total Assets BOY102234652TotalAssetsBOY
Total Assets EOY113182074TotalAssetsEOY
Total Liabilities BOY50549403TotalLiabilitiesBOY
Total Liabilities EOY47559876TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY51685249NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY65622198NetAssetsOrFundBalancesEOY
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
Expense4945356Expense
Revenue11997795Revenue
DescriptionINSURANCE FOR CHILDREN'S HOSPITAL OF PHILADELPHIA AND ITS TAX EXEMPT ENTITIESDescription
Total Program Service Expense4945356TotalProgramServiceExpense
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
Transaction Related EntityfalseTransactionRelatedEntity
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 CEOfalseCompensationProcessCEO
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 WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
THOMAS J TODOROW
DIRECTOR,PRESIDENT & TREASURER1.0XX01100754152752
EDWARD F PRECOURT
DIRECTOR & ASSISTANT TREASURER1.0XX000
Lynn Calhoun
DIRECTOR & SECRETARY1.0XX0213464780
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1314218TotalReportableCompFrmRltdOrgs
Total Other Compensation153532TotalOtherCompensation
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 SERVICES946680
POST POST LLC
200 BERWYN PARK STE 102 920 CASSABERWYNPA19312LEGAL SERVICES296500
CONRAD O'BRIEN PC
1515 MARKET STREET 16TH FLOORPHILADELPHIAPA19103LEGAL SERVICES296889
POST SCHELL PC
FOUR PENN CENTER 1600 JFK BLVDPHILADELPHIAPA19103LEGAL SERVICES136896
STANDISH MELLON
1 BOSTON PL 5400BOSTONMA02108INVESTMENT203825
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionINSURANCE PREMIUM EARNEDDescription
Total Revenue Column11997795TotalRevenueColumn
Related Or Exempt Function Income11997795RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue11997795TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3581398TotalRevenueColumn
Exclusion$3,581,398ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities35694529Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities32958377Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2736152Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2736152TotalRevenueColumn
Exclusion$2,736,152ExclusionAmount

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 Column18315345TotalRevenueColumn
Related Or Exempt Function Income11997795RelatedOrExemptFunctionIncome
Exclusion$6,317,550ExclusionAmount

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)
Total83123Total
Management And General83123ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2346Total
Management And General2346ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total23700Total
Management And General23700ManagementAndGeneral

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)
Total207159Total
Management And General207159ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total20250Total
Management And General20250ManagementAndGeneral

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)
Total849Total
Management And General849ManagementAndGeneral

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 ServicesProgramServicesFundraisingFundraisingManagement And GeneralManagementAndGeneral
LOSSES & LOSS ADJUSTMENT403820040382000
PROVISION FOR IBNR5341745341740
POLICY ACQUIS.. & UNDERWRITING3729823729820
GENERAL & ADMINISTRATIVE568405684

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total93Total
Management And General93ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5288560Total
Program Services4945356ProgramServices
Management And General343204ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8800843BOY
EOY3716914EOY

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)
BOY179402BOY
EOY186771EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY37345207BOY
EOY48658507EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY55909200BOY
EOY60619882EOY

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)
BOY102234652BOY
EOY113182074EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY389572BOY
EOY161107EOY

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)
BOY50159831BOY
EOY47398769EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY50549403BOY
EOY47559876EOY
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)
BOY46535733BOY
EOY60472682EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY51685249BOY
EOY65622198EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY102234652BOY
EOY113182074EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses13026785ReconcilationRevenueExpenses
Reconcilation Other Changes910164ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
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
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (7 entries)

DescriptionDescriptionBook ValueBookValue
SPONSORED ENTERPRISES18638360
ASSET-BACKED SECURITIES4424250
COMMERCIAL MORTGAGE BACKED SEC2012299
MUNICIPAL BONDS1462665
CORPORATE DEBT SECURITIES32254165
ACCRUED INTEREST788041
FOREIGN GOVERNMENTS1040102
FieldValueIRS element (for citing)
Total Of Book Value Securities60619882TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
LOSSES PAYABLE$789,279
UNEARNED PREMIUM RESERVES$6,071,142
LOSS ADJUSTMENT EXPENSES$40,538,328
PAYABLE FOR SECURITY PURCHASED$20
FieldValueIRS element (for citing)
Total Of Amounts47398769TotalOfAmounts
Total Revenue18315345TotalRevenue
Total Expenses5288560TotalExpenses
Excess Or Deficit For Year13026785ExcessOrDeficitForYear
Net Unrealized GL On Investments910164NetUnrealizedGLOnInvestments
Total Adjustments910164TotalAdjustments
Excess Or Deficit Per FS13936949ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt19018350TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments910164NetUnrealizedGainsInvestments
Revenue Not Rptd F990910164RevenueNotRptdF990
Revenue Subtotal18108186RevenueSubtotal
Investment Expenses Not Included207159InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt207159RevenueNotRptdOnFinStmt
Total Revenue Per Form99018315345TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5081401TotExpensesEtcAuditedFinclStmt
Expenses Subtotal5081401ExpensesSubtotal
Investment Expenses Not Included2207159InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt207159ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905288560TotalExpensesPerForm990

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)

Base 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
058894204312500805620148650041020125350600
Lynn Calhoun
01822910310420131000780021424400

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 (6 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 11AFMIC 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 12ALL 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 15ALL INDIVIDUALS REPORTED ON PART VII WHO RECEIVE COMPENSATION ARE PAID BY A RELATED ORGANIZATION. FORM 990, PART XI LINE 5 - UNREALIZED GAIN ON INVESTMENTS: $910,164
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:THOMAS J. TODOROW TITLE:DIRECTOR,PRESIDENT & TREASURER HOURS:39FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Lynn Calhoun TITLE:DIRECTOR & SECRETARY HOURS:39FORM 990 PART VII

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 BLVDPHILADELPHIAPA19104231352166HospitalPA501(C)(3)3CHOP FNDfalse
CHOP FOUNDATION
34TH ST CIVIC CENTER BLVDPHILADELPHIAPA19104232237932HOSP SUPPORTPA501(C)(3)7NAfalse
CHOP PRACTICE ASSOCIATION
34th st Civic center blvdphiladelphiaPA19104232311482healthcarePA501(C)(3)9CHOPfalse
chop clinical associates inc
34th st civic center blvdphiladlephiaPA19104223548970healthcareNJ501(C)(3)9CHOPfalse
children's anesthesiology associates ltd
34th and civic center boulevardphiladelphiaPA19104232592835healthcarePA501(C)(3)9CHOPfalse
children's anesthesiology assoc of nj
100 north 20th streetphiladelphiaPA19103223405673healthcareNJ501(C)(3)9CHOPfalse
children's health care associates inc
100 north 20th streetphiladelphiaPA19103222785804healthcarePA501(C)(3)9CHOPfalse
children's health care associates of nj
51 haddonfield roadcherry hillNJ08002233036699healthcareNJ501(C)(3)9CHOPfalse
children's surgical associates ltd
1 childrens centerphiladelphiaPA19104232589322healthcarePA501(C)(3)9CHOPfalse
Children's Surgical Associates of NJ
1012 laurel oaks roadvoorheesNJ08043223348481healthcareNJ501(C)(3)9CHOPfalse
radiology associates of children's hosp
34th Civic center blvdphiladelphiaPA19104232665855healthcarePA501(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-FICHOPfalse
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
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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