2012-05-10T16:06:06-05:00 2011-12-31 410996210 WILKERSON GUTHMANN AND JOHNSON LTD 55 EAST FIFTH STREET SUITE 1300 ST PAUL MN 551011790 990 2011-01-01 410417040 MINNESOTA WORKERS' COMPENSATION INSURERS ASSOCIATION INC MINN 9528971737 7701 FRANCE AVENUE SOUTH NO 450 MINNEAPOLIS MN 55435 BRUCE A TOLLEFSON 9528971737 2012-05-10 1 ROBERT GEORGES P01209197 6512221801 2012-05-01 2011 2016-02-24 21:20:13Z BRUCE A TOLLEFSON 7701 FRANCE AVE S STE 450 EDINA MN 55435 7819735 0 X WWW.MWCIA.ORG X 1983 MN TO PROVIDE TO ITS MEMBERS SERVICES AND INFORMATION REQUIRED UNDER PROVISIONS OF MN STATUTES. 12 12 50 0 25882 11101 0 0 7488514 7780618 34679 39117 0 0 7523193 7819735 0 0 0 0 4638280 4613872 0 0 0 2808915 2828810 7447195 7442682 75998 377053 4728688 5259872 4497795 5087306 230893 172566 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 5432747 7754736 PROVIDE SERVICES TO INSURANCE COMPANIES LICENSED TO WRITE WORKERS' COMPENSATION INSURANCE IN MINNESOTA TO ENABLE THEM TO COMPLY WITH STATUTORY REQUIREMENTS. 58335 COVER CLAIMS FOR INSURANCE COMPANIES THAT WENT INSOLVENT PRIOR TO 1983. 5491082 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 0 0 0 0 0 0 0 0 0 0 1 44 0 1 50 1 1 1 0 0 0 0 0 X 12 12 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X BRUCE A TOLLEFSON 9528971737 7701 FRANCE AVENUE SOUTH STE 450 MINNEAPOLIS MN 55435 PETER CAMINITI 1.00 X X 0 0 0 BRIAN BENT 1.00 X 0 0 0 KEVIN CHRISTY 1.00 X 0 0 0 BILL DUPONT 1.00 X 0 0 0 KEVIN GREGERSON 1.00 X 0 0 0 SCOTT HOLZERLAND 1.00 X 0 0 0 KEITH KRUEGER 1.00 X 0 0 0 MICHAEL LEVY 1.00 X 0 0 0 WILLIAM MEYER 1.00 X 0 0 0 BARRY PRESLASKI 1.00 X 0 0 0 GARY THADEN 1.00 X 0 0 0 MARY WACHHOLZ 1.00 X 0 0 0 BRUCE TOLLEFSON 40.00 X 156677 0 41946 CRAIG A ANDERSON 40.00 X 116947 0 34473 KATHLEEN PETERSON 40.00 X 107405 0 39061 381029 0 115480 3 0 1 0 THOMAS E HARMS PLLC 7601 FRANCE AVENUE SOUTH SUITE 275 MINNEAPOLIS MN 55435 LEGAL SERVICES 275000 DYNAMICVIEW LLC 13808 AUTUMNWOOD AVE ROSEMOUNT MN 55068 DATABASE SUPPORT 199014 WORKERS' COMPENSATION RESEARCH INSTITUTE 955 MASSACHUSETS AVE CAMBRIDGE MA 02139 BENCHMARKING STUDY 195000 ACTUARIAL AND TECHNICAL SOLUTIONS 3555 VETERANS MEMORIAL HIGHWAY SUIT RONKONKOMA NY 11779 ACTUARIAL SERVICES 109620 4 MEMBER ASSESSMENTS 518210 6896523 6896523 ASSIGNED RISK SERVICE 518210 527814 527814 PAPER PROCESSING FEES 518210 182113 182113 U.S.P. FINES 518210 77198 77198 SERVICES AND OTHER INC 518210 71088 71088 25882 25882 7780618 39117 39117 7819735 7754736 25882 39117 496509 417067 79442 2720195 2284964 435231 431388 362366 69022 729820 613049 116771 235960 198206 37754 36550 36550 275000 275000 17467 5240 12227 162275 143674 18601 1104276 628809 475467 463037 416733 46304 96090 28827 67263 UBIT 1745 1745 RESEARCH DATA INST. COL 195000 195000 COLLABORATIVE LEGAL SUP 150632 150632 RATEMAKING CONSULTING 109620 109620 217118 87527 129591 7442682 5491082 1951600 0 666023 3920698 3006239 51436 28160 11788 1028266 1275950 4728688 5259872 4497795 5087306 4497795 5087306 X 230893 172566 230893 172566 4728688 5259872 X 377053 -435380 X X 0 1 1 X 0 0 MEMBER CASH RESERVE ASSESS PAYABLE 3443889 MEMBER ASSESS REAPPORTION PAYABLE 507135 DEFERRED COMPENSATION OBLIGATION 1136282 5087306 7819735 7442682 377053 71755 -507135 -435380 -58327 7891490 71755 71755 7819735 0 7819735 7442682 0 7442682 0 7442682 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ASSOCIATION'S FEDERAL TAX FILINGS FOR 2008 - 2010 ARE OPEN FOR INTERNAL REVENUE SERVICE EXAMINATION. THE RELATED STATE TAX FILINGS ARE OPEN FOR EXAMINATION BY THE TAXING AUTHORITY OF THE STATE OF MINNESOTA. PART XI, LINE 8 - OTHER ADJUSTMENTS: MEMBERSHIP REAPPORTIONMENT ADJUSTMENT -507,135. X X X X 0 0 0 BRUCE TOLLEFSON 156677 0 0 0 0 0 28623 0 13323 0 198623 0 0 0 CRAIG A ANDERSON 116947 0 0 0 0 0 21150 0 13323 0 151420 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ASSOCIATION PROVIDES SERVICE TO ITS MEMBERS. THE MEMBERSHIP INCLUDES ALL INSURANCE COMPANIES THAT WRITE WORKERS' COMPENSATION INSURANCE IN MINNESOTA. 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 PROCESS OF REQUIRING EMPLOYEES AND BOARD MEMBERS TO REVIEW THE POLICY, AND SIGN AN ACKNOWLEDGEMENT STATING THEIR COMPLIANCE WITH THE POLICY. THE POLICY REQUIRES EMPLOYEES AND 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. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT CONSULTANT IS USED TO SURVEY COMPENSATION LEVELS IN THE INSURANCE INDUSTRY, AND TO PERFORM MARKET ANALYSIS FOR LIKE POSITIONS. THE CONSULTANT RECOMMENDS COMPENSATION LEVELS FOR EXECUTIVES AND KEY EMPLOYEES TO THE EXECUTIVE COMMITTEE OF THE BOARD, WHICH REVIEWS THE RECOMMENDATIONS AND SUPPORT FOR THE RECOMMENDATIONS, AND APPROVES THE COMPENSATION LEVELS. FORM 990, PART VI, SECTION C, LINE 19 ARTICLES OF INCORPORATION AND BYLAWS ARE POSTED ON THE ORGANIZATION'S 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 MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 71,755. MEMBERSHIP REAPPORTIONMENT ADJUSTMENT -507,135. TOTAL TO FORM 990, PART XI, LINE 5: -435,380. FORM 990, PART XI, LINE 1: ACCOUNTING METHOD USED TO PREPARE THE FORM 990: MODIFIED CASH BASIS.