Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990, Part VI, Section A, line 3 | UCare Wisconsin (UCare) has an administrative service agreement with UCare Minnesota to provide overall management and administration of UCare Wisconsin's business. UCare Wisconsin reimburses UCare Minnesota for all costs and expenses directly and indirectly incurred and associated with the business and operation of UCare Wisconsin. | |
| Form 990, Part VI, Section A, line 6 | Individuals enrolled in UCare's health plans are considered members, although they do not elect directors or have other powers. There are no classes of member or other rights. UCare Minnesota is a coprorate memeber of UCare Wisconsin, Inc. | |
| Form 990, Part VI, Section A, line 7a | The corporation's sole member is UCare Minnesota, a Minnesota nonprofit corporation organized to operate as a health maintenance organization under Minnesota Statutes, Chapter 62D and exempt from taxation under section 501(c)(3) of the Internal Revenue Service Code. UCare Minnesota as the corporate member has all powers and voting rights afforded by law to voting members of service insurance corporations under Wisconsin Statutes, Chapter 613 and applicable sections of Wisconsin Statutes. | |
| Form 990, Part VI, Section B, line 11 | UCare provides a copy and reviews the detail of the 990 with the Finance and Audit Committee. UCare also provides a copy of the 990 to all Board of Directors members via e-mail, prior to the Finance and Audit Committee's report to the Board. Upon approval by the Board of Directors, the 990 is filed with the Internal Revenue Service. | |
| Form 990, Part VI, Section B, line 12c | UCare requires completion of an annual questionnaire by its board members, officers and senior executives, which is designed to surface potential conflicts of interest. In addition, UCare's policy requires disclosure to the Board Chair and/or CEO of a potential conflict involving a director, officer or management staff when a particular transaction arises. If the Board or a designated Board Committee determines that a potential conflict exists related to a transaction requiring action by the board, the policy calls for the board member with the potential conflict to abstain from voting and for a majority of the disinterested directors to find that the transaction is fair and reasonable to the corporation, and that the organization could not reasonably find a more advantageous transaction from another entity without a potential conflict. In practice, UCare seeks to manage certain business matters so that they are not subject to action by the board or senior executives where a potential conflict exists. For example, the board includes members who are enrolled in UCare's health plans, and the benefit designs and premium amounts of such plans are not brought before the board for action. The policy also requires disclosure of potential conflicts to the board or designated committee even for transactions not requiring board action. | |
| Form 990, Part VI, Section B, line 15 | On an annual basis, UCare's Compensation Committee Reviews and approves the President and CEO's total cash compensation, including base pay and incentive pay. Benefits are reviewed, as described below, every three years, with the most recent review in 2010. The Compensation Committee is composed of independent members of the Board of Directors. UCare engages an independent consultant organization that specializes in advising health care organizations about executive compensation issues. The independent consultant organization conducts a comparability analysis that incorporates multiple industry surveys and compensation data for comparable positions at peer organizations. The independent consultant organization then shares the results of this comparability analysis with the Compensation Committee. After deliberation about the comparability analysis and recommendations, the Committee approves the annual cash compensation package for the President & CEO. Minutes are recorded contemporaneously to accurately document the Committee's discussions and actions, and the independent consultant organization's report is retained for recordkeeping purposes. The Compensation Committee reports its actions to the Board. The Compensation Committee also participates in the compensation process for other senior executives, including the Treasurer & Chief Finance Officer, the Secretary & General Counsel, the Chief Medical Officer, the Senior Vice President of Administration, the Senior Vice President of Operations, the Senior Vice President of Public Affairs & Marketing, and the Senior Vice President of Product Management. The process for determining compensation for these positions follows a compensation philosophy approved by the Board of Directors. Every three years, an independent consultant organization conducts a comparability analysis for these positions, focusing on total compensation data including base, pay, incentive pay, and benefits for comparable positions at peer organizations. The President and CEO's position is also included in this comparability analysis. The most recent 3-year analysis occurred in 2010. The Compensation Committee receives and discusses the analysis and recommendations with the independent consultant organization, and provides input for the President & CEO in determining cash compensation for the officers and senior executives. All changes in the benefit structure are approved by the Committee. The Committee's discussion and input are reflected in contemporaneous documentation, and a copy of the independent consultant organization's report is retained. | |
| Form 990, Part VI, Section C, line 19 | UCare will provide year-end financial statements, governing documents and Conflict of Interest Policy upon request. | |
| Changes in Net Assets or Fund Balances: | Form 990, Part XI, line 5: | Contributed Capital from UCare Minnesota 9,000,000. Total to Form 990, Part XI, Line 5: 9,000,000. |
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