Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1105 N MARKET ST NO 1300
 
Room/suite
City or town, state or country, and ZIP + 4
WILMINGTON, DE19899
D Employer identification number

20-4191006
E Telephone number

G Gross receipts $ 98,039,078
F Name and address of principal officer:
KIRK E GORMAN
1105 N MARKET ST NO 1300
WILMINGTON,DE19899
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 2006
M State of legal domicile: DE
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE COMPANY IS A NON-PROFIT SPONSORED CAPTIVE INSURANCE COMPANY ORGANIZED AND OPERATED
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 0
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 0
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 63,334,390 52,162,514
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 11,575,122 7,569,064
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 168,191 58,669
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 75,077,703 59,790,247
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 70,192,919 35,654,620
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 70,192,919 35,654,620
19 Revenue less expenses. Subtract line 18 from line 12...... 4,884,784 24,135,627
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 278,098,537 260,649,112
21 Total liabilities (Part X, line 26)............ 233,645,581 183,513,643
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 44,452,956 77,135,469
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SEE SCHEDULE O, FORM 990, PART I, LINE 1 FOR DESCRIPTION OF MISSION STATEMENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 35,576,814 including grants of $   ) (Revenue $ 52,221,183 )
FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY PROVIDES REINSURANCE TO MOUNTAIN LAUREL RISK RETENTION GROUP, INC. ("MLRRG") AND EXCESS PROFESSIONAL LIABILITY INSURANCE COVERAGE TO JEFFERSON HEALTH SYSTEM, INC. ("JHS"), A TAX EXEMPT ENTITY AND CERTAIN OF ITS CHARITABLE INSTITUTIONS WHICH ARE CONTROLLED BY JHS OR AFFILIATED WITH JHS. THE REINSURANCE COVERAGES ASSIST WITH THE MANAGEMENT AND FUNDING OF THE PROFESSIONAL LIABILITY RISK THEREBY ESSENTIALLY FUNCTIONING AS A SELF-INSURANCE VEHICLE FOR JHS HOSPITALS AND AFFILIATED HEALTHCARE ORGANIZATIONS.A SPONSORED CAPTIVE INSURANCE COMPANY IN THE STATE OF DELAWARE HAS THE ABILITY TO ESTABLISH AND MAINTAIN SEPARATE PROTECTED CELLS WITHIN THE COMPANY WHEREBY THE ASSETS AND LIABILITIES OF ANY ONE CELL ARE FINANCIALLY AND LEGALY PROTECTED FROM THE ASSETS AND LIABILITIES OF OTHER CELLS. THE COMPANY ESTABLISHED PROTECTED CELLS PURSUANT TO PREFERRED MEMBERSHIP AGREEMENTS FOR JHS AND ITS MEMBER ORGANIZATIONS: MAIN LINE HEALTH, INC. (MLH), TJUH SYSTEM, INC. (TJUH), ARIA HEALTH SYSTEM (ARIA) (FORMERLY KNOWN AS FRANKFORD HEALTH CARE SYSTEM (FHS), INC.), MAGEE MEMORIAL HOSPITAL FOR CONVALESCENTS (MAGEE), AND ALBERT EINSTEIN HEALTHCARE NETWORK (AEHN) (COLLECTIVELY, THE MEMBERS), ALL OF WHICH ARE ORGANIZATIONS DESCRIBED UNDER IRC SECTION 501(C)(3). EFFECTIVE DURING THE YEAR ENDED JUNE 30, 2009, ARIA AND AEHN ARE NO LONGER MEMBER ORGANIZATIONS OF JHS. EFFECTIVE JULY 1, 2010, THE COMPANY ENTERED INTO AN INSURANCE PROGRAM WITHDRAWAL AGREEMENT WITH MLRRG AND AEHN, WHEREBY ALL RIGHTS, LIABILITES AND OBLIGATIONS OF MLRRG AND THE COMPANY UNDER SPECIFIED AEHN POLICIES WERE ASSIGNED, CONVEYED AND TRANSFERRED TO, AND ASSUMED BY A RISK RETENTION GROUP FORMED BY AEHN. CORRESPONDINGLY, AEHN'S PREFERRED MEMBERSHIP INTEREST IN THE COMPANY WAS TERMINATED.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 35,576,814
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
5
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
No
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
No
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
No
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
12
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MARSH MANAGEMENT SERVICES INC
100 BANK STREET SUITE 610
BURLINGTON,VT05401
(802) 864-5912
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) DIANNE P SALTER
VICE PRESIDENT
 10.00 X   X       0 0 0
(2) ROBERT L BARCHI MD PHD
DIRECTOR
 .20 X           0 0 0
(3) MICHAEL J BUONGIORNO
DIRECTOR
 .20 X           0 0 0
(4) JACK A CARROLL PHD MHA
DIRECTOR
 .20 X           0 0 0
(5) ROBERT J CROSSIN
DIRECTOR
 .20 X           0 0 0
(6) GUY W FRIED MD
DIRECTOR
 .20 X           0 0 0
(7) JOHN J LYNCH III
DIRECTOR
 .20 X           0 0 0
(8) FRANK P SLATTERY JR
DIRECTOR
 .20 X           0 0 0
(9) NEIL G LUBARSKY
DIRECTOR
 .20 X           0 0 0
(10) JOSEPH T SEBASTIANELLI
CHAIRMAN
 .70 X   X       0 0 0
(11) THOMAS J LEWIS
PRESIDENT
 .70 X   X       0 0 0
(12) KATHLEEN KINSLOW
DIRECTOR
 .20 X           0 0 0
(13) KIRK E GORMAN
TREASURER
 .20     X       0 607,890 22,341
(14) R CHRISTOPHER RAPHAELY
GENERAL COUNSEL
 .20     X       0 0 0
(15) SHAWNA R WHITE
SECRETARY
 .20     X       0 0 0
(16) BARRY R FREEDMAN
DIRECTOR
 .70           X 0 0 0
(17) ROY A POWELL
DIRECTOR
 .20           X 0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) DAVID F SIMON ESQUIRE
GENERAL COUNSEL
 .20           X 0 0 0
























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 607,890 22,341
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
RUSSELL INVESTMENT GROUP
909 A STREET
TACOMA,WA98402 		INVESTMENT SERVICES 926,680
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet1
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service Revenue Business Code
2a PREMIUMS EARNED 524,298 52,162,514 52,162,514    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 52,162,514
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 13     13
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 45,817,882  
b Less: cost or other basis and sales expenses 38,248,831  
c Gain or (loss) 7,569,051  
d Net gain or (loss)..........MediumBullet 7,569,051     7,569,051
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a OTHER INCOME 524,298 58,669 58,669    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 58,669
12 Total revenue. See Instructions....MediumBullet 59,790,247 52,221,183 0 7,569,064
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees ....        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages        
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ...... 76,500 57,375 19,125  
b Legal ......... 10,446   10,446  
c Accounting ........... 49,844   49,844  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 926,680 926,680    
g Other ..........        
12 Advertising and promotion ....        
13 Office expenses .......        
14 Information technology ......        
15 Royalties ..        
16 Occupancy ...........        
17 Travel ............ -1,609   -1,609  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .....        
23 Insurance ..............        
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a INCURRED LOSSES 34,292,061 34,292,061    
b ACTUARIAL FEES 84,625 84,625    
c LETTER OF CREDIT FEES 76,192 76,192    
d MISCELLANEOUS EXPENSES 59,334 59,334    
e PREMIUM TAXES 56,597 56,597    
f All other expenses 23,950 23,950    
25 Total functional expenses. Add lines 1 through 24f 35,654,620 35,576,814 77,806 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 411,526 1 456,743
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 528,328 4 600,288
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............ 59,166 9 31,868
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation. ..... 10b     10c  
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ...... 177,390,733 12 213,043,948
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 99,708,784 15 46,516,265
16 Total assets. Add lines 1 through 15 (must equal line 34)... 278,098,537 16 260,649,112
Liabilities 17 Accounts payable and accrued expenses . 112,000 17 73,192
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 233,533,581 25 183,440,451
26 Total liabilities. Add lines 17 through 25..... 233,645,581 26 183,513,643
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .....   27  
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 0 30 0
31 Paid-in or capital surplus, or land, building or equipment fund ..... 37,610,403 31 37,610,403
32 Retained earnings, endowment, accumulated income, or other funds 6,842,553 32 39,525,066
33 Total net assets or fund balances ..... 44,452,956 33 77,135,469
34 Total liabilities and net assets/fund balances ..... 278,098,537 34 260,649,112
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
59,790,247
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
35,654,620
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
24,135,627
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
44,452,956
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
8,546,886
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
77,135,469
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
(1) JEFFERSON HEALTH SYSTEM INC
  		232814503 3 Yes   Yes   Yes   0
(2) MAGEE REHABILITATION HOSPITAL
  		231476328 3 Yes   Yes   Yes   0
(3) MAIN LINE HEALTH INC
  		231396794 3 Yes   Yes   Yes   0
(4) THOMAS JEFFERSON UNIVERSITY HOSPITAL
  		232829095 3 Yes   Yes   Yes   0
(5) ARIA HEALTH SYSTEM (FKA FRANKFORD HEALTH CARE SYSTEM)
  		232239131 3 Yes   Yes   Yes   0
Total                 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART 1, LINE 11(H)(VII): FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY PROVIDES EXCESS AND REINSURANCE PROFESSIONAL LIABILITY INSURANCE COVERAGE AND RELATED INSURANCE SERVICES FOR THE SUPPORTED ORGANIZATIONS DESCRIBED HEREIN.
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................        
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 0
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) RUSSELL INSTITUTIONAL FUND LLC 		213,043,948 F








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 213,043,948
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) REINSURANCE RECOVERABLE ON UNPAID LOSSES 7,702,000
(2) ASSETS HELD FOR NON-JHS MEMBER PROTECTED CELLS 38,814,265







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 46,516,265
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
UNPAID LOSSES & LOSS ADJUSTMENT EXPENSES 144,626,186
LIABILITIES AND MEMBERS' EQUITY OF NON-JHS MEMBER PROTECTED CELLS 38,814,265







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 183,440,451
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 59,790,247
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 35,654,620
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 24,135,627
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 8,546,886
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 8,546,886
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 32,682,513
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 58,863,567
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 58,863,567
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a 926,680
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c 926,680
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 59,790,247
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 34,727,940
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e 0
3 Subtract line 2e from line 1..................... 3 34,727,940
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a 926,680
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 926,680
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 35,654,620
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE COMPANY ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740,"INCOME TAXES." FASB ASC 740 IS AN ASSET AND LIABILITY METHOD, WHICH REQUIRES THE RECOGNITION OF DEFERRED TAX ASSETS AND LIABILITIES. THE COMPANY, UNDER CERTAIN PROVISIONS OF FASB ASC 740, ACCOUNTS FOR HOW UNCERTAIN TAX POSITIONS SHOULD BE RECOGNIZED, MEASURED, PRESENTED AND DISCLOSED WITHIN THEIR FINANCIAL STATEMENTS. THE COMPANY MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE COMPANY DID NOT RECORD ANY UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2011 AND 2010. THE COMPANY DOES NOT BELIEVE IT IS REASONABLY POSSIBLE THAT ITS UNRECOGNIZED TAX BENEFITS WOULD MATERIALLY CHANGE IN THE NEXT TWELVE MONTHS. THE COMPANY'S POLICY IS TO INCLUDE INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS A COMPONENT OF ITS PROVISION FOR INCOME TAXES. AS OF JUNE 30, 2011 AND 2010, THE COMPANY DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS. ALL TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION.
    PART XI, LINE 8: OTHER CHANGES TO MEMBERS' EQUITY: OTHER COMPREHENSIVE INCOME 22,577,046 DIVIDENDS PAID (11,184,612) NON-JHS MEMBERS' NET GAIN REPORTED (2,845,548) TOTAL OTHER CHANGES TO MEMBERS' EQUITY 8,546,886
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) KIRK E GORMAN (i)
(ii)		 0
464,510 		0
143,380 		0
0 		0
0 		0
22,341 		0
630,231 		0
0















Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 4B SEE SCHEDULE O FOR MORE DETAILS
SUPPLEMENTAL INFORMATION PART III PLEASE SEE SCHEDULE O FOR INFORMATION ON REPORTABLE COMPENSATION RECEIVED BY CURRENT AND FORMER OFFICERS AND DIRECTORS FROM MEMBER ORGANIZATIONS.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MARSH MANAGEMENT SERVICES INC
  		MANAGEMENT COMPANY 76,500 PROVIDES MANAGEMENT SERVICES   No
(2) MOUNTAIN LAUREL RISK RETENTION GROUP INC
  		INSURANCE COMPANY 51,633,383 PROVIDES DIRECT WRITTEN PRIMARY PROFESSIONAL LIABILITY COVERAGE   No
(3) MOUNTAIN LAUREL RISK RETENTION GROUP INC
  		INSURANCE COMPANY -30,556,108 PAYMENT OF LOSSES UNDER INSURANCE CONTRACT   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Identifier Return Reference Explanation
ORGANIZATION MISSION STATEMENT FORM 990, PART I, LINE 1 EXCLUSIVELY FOR THE CHARITABLE PURPOSES TO SUPPORT AND FURTHER THE EXEMPT PURPOSES OF JEFFERSON HEALTH SYSTEM, INC. ("JHS") AND CERTAIN OF ITS CHARITABLE MEMBER INSTITUTIONS WHICH ARE CONTROLLED BY JHS. THE CORPORATION SERVES AS AN INTEGRAL PART OF THE AND FURTHERS THE EXEMPT PURPOSES OF JHS AND ITS CHARITABLE HOSPITALS AND HEALTHCARE ORGANIZATIONS BY PROVIDING "SELF-INSURANCE" PROFESSIONAL LIABILITY COVERAGE FOR CERTAIN HOSPITALS AND HEALTHCARE ENTITIES DESCRIBED IN IRC SECTION 501(C)(3) WITHIN THE JHS FAMILY OF ENTITIES. JHS, A PENNSYLVANIA NONPROFIT CORPORATION HEADQUARTERED IN RADNOR, PENNSYLVANIA, IS THE PARENT OF A SYSTEM OF HEALTH CARE ORGANIZATIONS COMPRISED OF THREE MEMBER HEALTH SYSTEMS. JHS IS THE SOLE CORPORATE MEMBER OF THE PARENT COMPANIES OF EACH OF THE THREE MEMBER HEALTH SYSTEMS. THESE THREE MEMBER SYSTEMS ARE THE MAGEE MEMORIAL HOSPITAL FOR CONVALESCENTS, D/B/A MAGEE REHABILITATION HOSPITAL ("MAGEE"), MAIN LINE HEALTH, INC. ("MLH") AND TJUH SYSTEM INC. ("TJUH") (MAGEE, MLH AND TJUH ARE COLLECTIVELY REFERRED TO AS "MEMBERS").
PROGRAM SERVICE STATEMENT FORM 990,SCHEDULE J, PART I, LINE 4B: THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUAL'S IS DISCLOSED ON THE JEFFERSON HEALTH SYSTEM (EIN:23-2814503) FORM 990: JOSEPH T. SEBASTIANELLI, DIANNE P. SALTER, KIRK E. GORMAN, R. CHRISTOPHER RAPHAELY AND SHAWNA R. WHITE. THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUAL'S IS DISCLOSED ON THE THOMAS JEFFERSON UNIVERSITY HOSPITAL (EIN:23-2829095) FORM 990: THOMAS J. LEWIS AND NEIL G. LUBARSKY. THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUAL'S IS DISCLOSED ON THE MAIN LINE HEALTH (EIN:23-1396794) FORM 990: JOHN J. LYNCH III, MICHAEL J. BUONGIORNO. THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUAL'S IS DISCLOSED ON THE MAGEE REHABILITATION HOSPITAL (EIN:23-1476328) FORM 990: JACK A. CARROLL AND GUY W. FRIED. THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUAL'S IS DISCLOSED ON ARIA HEALTH SYSTEM (FKA THE FRANKFORD HEALTH CARE SYSTEM, INC.) (EIN:23-2239131) FORM 990: KATHLEEN KINSLOW AND ROBERT J. CROSSIN.
FORM 990, PART VI, SECTION A, LINE 3   MARSH MANAGEMENT SERVICES, INC. IS A PROVIDER OF SPECIALIZED INSURANCE MANAGEMENT SERVICES TO THE CAPTIVE INSURANCE INDUSTRY. THE ORGANIZATION CONTRACTS WITH MARSH MANAGEMENT SERVICES, INC. TO RECEIVE SPECIALIZED INSURANCE ACCOUNTING AND MANAGEMENT SERVICES.
FORM 990, PART VI, SECTION A, LINE 6   THE ORGANIZATION IS A NON-STOCK MEMBER CORPORATION WITH EACH MEMBER HOLDING A MEMBERSHIP INTEREST. EACH MEMBER HOLDS EITHER A COMMON MEMBERSHIP OR PREFERRED MEMBERSHIP. EACH COMMON MEMBERSHIP UNIT IS ENTITLED TO ONE VOTE, WHILE PREFERRED MEMBERSHIP UNITS ARE NON-VOTING. THE ONLY COMMON MEMBERSHIP UNIT HAS BEEN ISSUED TO JEFFERSON HEALTH SYSTEM, INC. (JHS). ALL OTHER MEMBERS OF THE ORGANIZATION HAVE BEEN ISSUED ONE PREFERRED MEMBERSHIP UNIT.
FORM 990, PART VI, SECTION A, LINE 7A   THE COMPANY'S BOARD OF TRUSTEES VOTE ON THE COMPOSITION OF THE BOARD WHICH INCLUDES REPRESENTATIVES FROM JHS, JHS MEMBERS AND NON-JHS MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B   JEFFERSON HEALTH SYSTEM, INC. (JHS) IS THE ONLY MEMBER OF THE ORGANIZATION WITH VOTING RIGHTS.
FORM 990, PART VI, SECTION B, LINE 11   FORM 990 IS SENT TO THE COMPANY'S AUDIT AND FINANCE COMMITTEE BEFORE IT IS SENT TO THE COMPANY'S BOARD OF DIRECTORS. THE RETURN IS REVIEWED BY THE AUDIT AND FINANCE COMMITTEE AT ONE OF ITS MEETINGS AND ANY QUESTIONS ARE RESPONDED TO ACCORDINGLY BY MANAGEMENT. THE AUDIT AND FINANCE COMMITTEE THEN MAKES A RECOMMENDATION TO THE BOARD THAT THE FORM 990 BE APPROVED. ONCE THE BOARD APPROVES THE RETURN, IT IS THEN AVAILABLE TO BE FILED WITH THE IRS.
  FORM 990, PART VI, SECTION B, LINE 12C THE LEGAL DEPARTMENT OF JEFFERSON HEALTH SYSTEM, INC., ON BEHALF OF THE COMPANY, REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
  FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON THE JEFFERSON HEALTH SYSTEM (EIN:23-2814503) FORM 990: JOSEPH T. SEBASTIANELLI, DIANNE P. SALTER, KIRK E. GORMAN, R. CHRISTOPHER RAPHAELY AND SHAWNA R. WHITE. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON THE THOMAS JEFFERSON UNIVERSITY HOSPITAL (EIN:23-2829095) FORM 990: THOMAS J. LEWIS AND NEIL G. LUBARSKY. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON THE MAIN LINE HEALTH (EIN:23-1396794) FORM 990: JOHN J. LYNCH III, MICHAEL J. BUONGIORNO. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON THE MAGEE REHABILITATION HOSPITAL (EIN:23-1476328) FORM 990: JACK A. CARROLL AND GUY W. FRIED. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON ARIA HEALTH SYSTEM (FKA THE FRANKFORD HEALTH CARE SYSTEM, INC.) (EIN:23-2239131) FORM 990: KATHLEEN KINSLOW AND ROBERT J. CROSSIN.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
  FORM 990, PART VII, SECTION A ALL FEDERAL EMPLOYMENT TAX RESPONSIBILITIES FOR INDIVIDUALS EMPLOYED BY JEFFERSON HEALTH SYSTEM, INC. ("JHS") (INCLUDING W-2 AND W-3 FILINGS) ARE HANDLED BY MAIN LINE HEALTH, INC. JHS'S EMPLOYEES ARE INCLUDED IN THE W-2 AND W-3 FILINGS OF MAIN LINE HEALTH, INC. WITH MAIN LINE HEALTH, INC.'S EMPLOYEES. W-2 AND W-3 FORMS ARE NOT FILED UNDER THE JHS TAX IDENTIFICATION NUMBER.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGES TO MEMBERS' EQUITY 8,546,886. TOTAL TO FORM 990, PART XI, LINE 5: 8,546,886.
  FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILTY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNTANTS.
  FORM 990, PART VII, COLUMN E, RELATED ORGANIZATION COMPENSATION: IN COMPLYING WITH THE REASONABLE EFFORT REQUIREMENT TO REPORT ACCURATE COMPENSATION INFORMATION FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY (FIVE POINTE) KNOWS THAT EACH OF THE INSURED MEMBERS, WHICH ARE ALSO NOT-FOR-PROFIT CORPORATIONS, HAVE FILING REQUIREMENTS THAT WILL BE EXTENDED TO THE MAXIMUM TIME ALLOWED BY LAW. FIVE POINTE MAY FILE ITS FORM 990 EARLIER THAN THE INSURED MEMBERS AND TO PREVENT DIFFERENCES IN COMPENSATION AMOUNTS, FIVE POINTE IN AN EFFORT TO PROVIDE ACCURATE INFORMATION HAS PROVIDED REFERENCES TO THE INSURED MEMBERS' FORM 990 THAT WILL HAVE EACH OF THE INDIVIDUAL'S COMPENSATION REPORTED ACCURATELY. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON THE JEFFERSON HEALTH SYSTEM (EIN:23-2814503) FORM 990: JOSEPH T. SEBASTIANELLI, DIANNE P. SALTER, KIRK E. GORMAN, R. CHRISTOPHER RAPHAELY AND SHAWNA R. WHITE. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON THE THOMAS JEFFERSON UNIVERSITY HOSPITAL (EIN:23-2829095) FORM 990: THOMAS J. LEWIS AND NEIL G. LUBARSKY. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON THE MAIN LINE HEALTH (EIN:23-1396794) FORM 990: JOHN J. LYNCH III, MICHAEL J. BUONGIORNO. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON THE MAGEE REHABILITATION HOSPITAL (EIN:23-1476328) FORM 990: JACK A. CARROLL AND GUY W. FRIED. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON ARIA HEALTH SYSTEM (FKA THE FRANKFORD HEALTH CARE SYSTEM, INC.) (EIN:23-2239131) FORM 990: KATHLEEN KINSLOW AND ROBERT J. CROSSIN.
  FORM 990, SCHEDULE R - (EXPLANATION OF TICKMARKS) (1) THE BRYN MAWR HOSPITAL FOUNDATION, THE LANKENAU HOSPITAL FOUNDATION, PAOLI HOSPITAL FOUNDATION, THE BRYN MAWR REHABILITATION FOUNDATION AND THE RIDDLE HEALTHCARE FOUNDATION (COLLECTIVELY "THE FOUNDATIONS") ARE SPECIFICALLY EXCLUDED FROM JHS. THE FOUNDATIONS ARE SEPARATELY INCORPORATED, NON-MEMBERSHIP, NONPROFIT CORPORATIONS GOVERNED BY SELF-PERPETUATING BOARDS OF TRUSTEES. THE BY-LAWS OF EACH FOUNDATION PROVIDE THAT ALL ASSETS HELD BY IT SHALL NOT BE SUBJECT TO ATTACHMENT, EXECUTION OR SEQUESTRATION FOR ANY DEBT, OBLIGATION OR LIABILITY OF ITS HOSPITAL AFFILIATE OR ANY OTHER PERSON OR ENTITY, AND SHALL NOT BE SUBJECT TO PLEDGE, ASSIGNMENT, CONVEYANCE OR ANTICIPATION BY THAT HOSPITAL AFFILIATE OR ANY OTHER PERSON OR ENTITY. (2) THE MAGEE REHABILITATION HOSPITAL FOUNDATION ("MRHF"), A SEPARATE CORPORATION NOT UNDER THE CONTROL OF MAGEE REHABILITATION HOSPITAL, ACCEPTS GIFTS AND BEQUESTS AND ENGAGES IN FUNDRAISING ACTIVITIES FOR THE BENEFIT OF MRHF. THE BOARD OF TRUSTEES OF MRHF, AT ITS SOLE DISCRETION, IS AUTHORIZED TO CONTRIBUTE MRHF FUNDS TO THE HOSPITAL. THE BY-LAWS OF MRHF PROVIDE THAT ALL ASSETS HELD BY IT SHALL NOT BE SUBJECT TO ATTACHMENT, EXECUTION, OR SEQUESTRATION FOR ANY DEBT, OBLIGATION OR LIABILITY OF MAGEE REHABILITATION HOSPITAL OR ANY OTHER PERSON OR ENTITY, AND SHALL NOT BE SUBJECT TO PLEDGE, ASSIGNMENT, CONVEYANCE OR ANTICIPATION BY MAGEE REHABILITATION HOSPITAL OR ANY OTHER PERSON OR ENTITY. IN PARTICULAR, MRHF IS NOT A PARTY OR OBLIGATED BY ANY DEBT INSTRUMENT OF MRHF OR MAGEE REHABILITATION HOSPITAL, AND ASSETS OWNED BY MRHF ARE NOT SUBJECT TO THE LIEN OF ANY SUCH DEBT INSTRUMENT.
  FORM 990, PART VI, SECTION A, LINE 1B, INDEPENDENT VOTING MEMBERS: FIVE POINT PROFESSIONAL LIABILITY INSURANCE COMPANY IS A WHOLLY OWNED SUBSIDIARY OF JEFFERSON HEALTH SYSTEM ("JHS"), A 501(C)(3) TAX EXEMPT HEALTH SYSTEM. THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY DO NOT QUALIFY AS INDEPENDENT UNDER IRS DEFINITIONS SOLELY AS A RESULT OF THEIR POSITIONS AS DIRECTORS, OFFICERS, OR EMPLOYEES OF OTHER WHOLLY OWNED SUBSIDIARIES OF JHS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) ACCOUNTABLE CARE ORGANIZATION OF PENNSYLVANIA
259 N RADNOR CHESTER RD SUI
RADNOR,PA19087
27-4553972 		HEALTHCARE PA 0 0 JHS
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) MAIN LINE HEALTH INC

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2331531 		HEALTHCARE PA 501(C)(3) 11B JHS
 
Yes
 
(2) TJUH SYSTEM INC

111 SOUTH 11 ST

PHILADELPHIA,PA19107
26-3026795 		HEALTHCARE PA 501(C)(3) 11 JHS
 
Yes
 
(3) MAGEE REHABILITATION HOSPITAL

1513 RACE STREET

PHILADELPHIA,PA19102
23-1476328 		HEALTHCARE PA 501(C)(3) 3 JHS
 
Yes
 
(4) MAIN LINE HOSPITALS INC

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-1352160 		HEALTHCARE PA 501(C)(3) 3 MAIN LINE HEALTH INC
 
Yes
 
(5) THE BRYN MAWR HOSPITAL DBA

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-1352160 		HEALTHCARE PA 501(C)(3) 3 ML HOSPITALS
 
Yes
 
(6) THE LANKENAU HOSPITAL

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-1352160 		HEALTHCARE PA 501(C)(3) 3 ML HOSPITALS
 
Yes
 
(7) PAOLI HOSPITAL

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-1352160 		HEALTHCARE PA 501(C)(3) 3 ML HOSPITALS
 
Yes
 
(8) LANKENAU INSTITUTE FOR MEDICAL RESEARCH

100 LANCASTER AVENUE

WYNNEWOOD,PA19096
23-2175659 		MEDICAL RESEARCH PA 501(C)(3) 4 MAIN LINE HEALTH INC
 
Yes
 
(9) RIDDLE MEMORIAL HOSPITAL

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-1529076 		HEALTHCARE PA 501(C)(3) 3 MAIN LINE HEALTH INC
 
Yes
 
(10) RIDDLE SYSTEM SERVICES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
22-2606542 		MANAGEMENT SERVICES PA 501(C)(3) 11B RIDDLE MEMORIAL HOSPITAL
 
Yes
 
(11) MIRMONT ALCOHOL REHABILITATION CENTER

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2215243 		HEALTHCARE PA 501(C)(3) 3 RIDDLE MEMORIAL HOSPITAL
 
Yes
 
(12) RMH PHYSICIAN SERVICES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
22-2606540 		PROFESSIONAL SERVICES FOR PHYSICIAN GROUPS PA 501(C)(3) 11A RIDDLE MEMORIAL HOSPITAL
 
Yes
 
(13) RIDDLE HEALTH CARE SERVICES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
22-2606545 		HEALTHCARE PA 501(C)(3) 11B RIDDLE MEMORIAL HOSPITAL
 
Yes
 
(14) RIDDLE HEALTHCARE ASSOCIATES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2900844 		PHYSICIAN PRACTICES PA 501(C)(3) 9 MAIN LINE HEALTH INC
 
Yes
 
(15) MAIN LINE DIVERSIFIED SERVICES INC

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2859148 		HEALTHCARE PA 501(C)(3) 11A MAIN LINE HEALTH INC
 
Yes
 
(16) MID COUNTY SENIOR SERVICES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2257114 		ELDER CARE PA 501(C)(3) 9 MAIN LINE DIVERSIFIED SERVICES INC
 
Yes
 
(17) JEFFERSON HOME CARE NETWORK

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2308028 		HEALTHCARE PA 501(C)(3) 9 MAIN LINE DIVERSIFIED SERVICES INC
 
Yes
 
(18) THE HOSPICE AND HOME CARE FOUNDATION

100 MATSONFORD ROAD SUITE 400

RADNOR,PA19087
23-2306936 		FUNDRAISING PA 501(C)(3) 11C JEFFERSON HOME CARE
 
Yes
 
(19) MAIN LINE SERVICES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2359402 		HEALTHCARE PA 501(C)(3) 11B MAIN LINE DIVERSIFIED SERVICES INC
 
Yes
 
(20) MAIN LINE HEALTH LABORATORIES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2774744 		LABORATORY SERVICES PA 501(C)(3) 11B MAIN LINE DIVERSIFIED SERVICES INC
 
Yes
 
(21) MAIN LINE AFFILIATES

240 RADNOR CHESTER ROAD

RADNOR,PA19087
23-2308668 		HEALTHCARE PA 501(C)(3) 9 MAIN LINE DIVERSIFIED SERVICES INC
 
Yes
 
(22) MAIN LINE REALTY CORPORATION

240 RADNOR CHESTER ROAD

RADNOR,PA19087
22-2440273 		REAL ESTATE PA 501(C)(3) 11A MAIN LINE HEALTH INC
 
Yes
 
(23) MAIN LINE HEALTHCARE

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2359401 		PHYSICIAN MG PA 501(C)(3) 11A MAIN LINE HEALTH INC
 
Yes
 
(24) BRYN MAWR HOSPITAL SELF-INSURANCE TRUST

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2096652 		SELF INSURANCE PA 501(C)(3) 11A N/A
Yes
 
(25) THE BRYN MAWR HOSPITAL FOUNDATION (1)

130 SOUTH BRYN MAWR AVENUE

BRYN MAWR,PA19010
23-2179020 		FUNDRAISING PA 501(C)(3) 11C N/A
Yes
 
(26) THE LANKENAU HOSPITAL FOUNDATION (1)

100 LANCASTER AVENUE

WYNNEWOOD,PA19096
23-2176723 		FUNDRAISING PA 501(C)(3) 11D N/A
Yes
 
(27) PAOLI HOSPITAL FOUNDATION (1)

255 WEST LANCASTER AVENUE

PAOLI,PA19301
23-2359407 		FUNDRAISING PA 501(C)(3) 11C N/A
 
No
(28) BRYN MAWR REHABILITATION FOUNDATION (1)

414 PAOLI PIKE

MALVERN,PA19355
23-2507348 		FUNDRAISING PA 501(C)(3) 11C N/A
Yes
 
(29) RIDDLE HEALTH SYSTEM (INACTIVE)

1068 WEST BALTIMORE PIKE

MEDIA,PA19063
22-2606535 		INACTIVE PA INACTIVE   N/A
Yes
 
(30) THE SHARPE - STRUMIA RESEARCH FOUNDATION

100 LANCASTER AVENUE

WYNNEWOOD,PA19096
20-0106546 		HOSPTIAL SUPPORT PA 501(C)(3) 11C N/A
 
No
(31) THE RIDDLE HEALTHCARE FOUNDATION (1)

1068 WEST BALTIMORE PIKE

MEDIA,PA19063
04-3601189 		FUNDRAISING PA 501(C)(3) 11C N/A
 
No
(32) MAIN LINE HEART CENTER

100 LANCASTER AVENUE SUITE 558

WYNNEWOOD,PA19096
23-2119720 		HEALTHCARE PA 501(C)(3) 11D N/A
 
No
(33) JEFFEX INC

925 CHESTNUT STREET SUITE 311

PHILADELPHIA,PA19107
23-2622009 		HEALTHCARE PA 501(C)(3) 11 TJUH SYSTEM
 
Yes
 
(34) EMERGENCY TRANSPORT ASSOCIATES INC

414 NORTH 5TH STREET

PHILADELPHIA,PA19107
23-2622004 		HEALTHCARE PA 501(C)(3) 9 TJUH SYSTEM
 
Yes
 
(35) JEFFQUIP INC

12 CREEK PARKWAY

BOOTHWYN,PA19061
23-2622001 		HEALTHCARE PA 501(C)(3) 9 TJUH SYSTEM
 
Yes
 
(36) WALNUT HOME THERAPEUTICS

919 WALNUT STREET 5TH FLOOR

PHILADELPHIA,PA19107
23-2622006 		HEALTHCARE PA 501(C)(3) 9 TJUH SYSTEM
 
Yes
 
(37) SUTHBREIT PROPERTIES LTD

2301 SOUTH BROAD STREET

PHILADELPHIA,PA19148
23-2214351 		HEALTHCARE PA 501(C)(3) 11 TJUH SYSTEM
 
Yes
 
(38) TJUH HEALTH AFFILIATES

925 CHESTNUT STREET SUITE 311

PHILADELPHIA,PA19107
23-3026939 		HEALTHCARE PA 501(C)(3) 11 TJUH SYSTEM
 
Yes
 
(39) METHODIST ASSOCIATES IN HEALTHCARE

2301 SOUTH BROAD STREET

PHILADELPHIA,PA19148
23-2678055 		HEALTHCARE PA 501(C)(3) 11 TJUH SYSTEM
 
Yes
 
(40) JEFFERESON MEDICAL CARE PC (NJ)

925 CHESTNUT STREET SUITE 311

PHILADELPHIA,PA19107
23-3537847 		HEALTHCARE PA 501(C)(3) 11 TJUH SYSTEM
 
Yes
 
(41) JEFFERESON MEDICAL CARE

925 CHESTNUT STREET SUITE 311

PHILADELPHIA,PA19107
23-2858320 		HEALTHCARE PA 501(C)(3) 11 TJUH SYSTEM
 
Yes
 
(42) MAGEE REHABILITATION SERVICES INC

1513 RACE STREET

PHILADELPHIA,PA19102
23-2431331 		HEALTHCARE PA 501(C)(3) 11 TYPE I MAGEE REHAB
 
Yes
 
(43) MAGEE REHABILITATION HOSPITAL FOUNDATION

1513 RACE STREET

PHILADELPHIA,PA19102
23-2937749 		FUNDRAISING PA 501(C)(3) 11 TYPE II MRH
 
Yes
 
(44) THOMAS JEFFERSON UNIVERSITY HOSPITALS INC

111 SOUTH 11TH STREET

PHILADELPHIA,PA19107
23-2829095 		HEALTHCARE PA 501(C)(3) 3 TJUH SYSTEM
 
Yes
 
(45) METHODIST HOSPITAL FOUNDATION

2301 SOUTH BROAD STREET

PHILADELPHIA,PA19148
23-2014559 		FUNDRAISING PA 501(C)(3) 11 N/A
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) MAIN LINE HEALTH IMAGING LP

100 MATSONFORD ROAD SUITE 400
RADNOR,PA19087
23-2409186 		HEALTHCARE PA ML REALTY
  		        No     No  
(2) RMH HEALTH CARE CENTER II

950 HAVERFORD ROAD SUITE 110
BRYN MAWR,PA19010
23-2236644 		OFFICE RENTAL PA RIDDLE MEMORIAL
  		        No     No  
(3) RIDDLE SURGICAL CENTER LLC

1121 ROE AVENUE SUITE 300
LEAWOOD,KS66211
26-3899069 		HEALTHCARE PA RIDDLE MEMORIAL
  		        No     No  
(4) BMHR ASSOCIATES

100 MATSONFORD ROAD SUITE 400
RADNOR,PA19087
23-2311589 		HEALTHCARE PA ML REALTY
  		        No     No  
(5) RIDDLE MEMORIAL H CENTER III A

950 HAVERFORD ROAD SUITE 110
BRYN MAWR,PA19010
23-2693651 		OFFICE RENTAL PA RIDDLE MEMORIAL
  		        No     No  
(6) RIDDLE IMAGING ASSOCIATES LP

1068 WEST BALTIMORE PIKE
MEDIA,PA19063
23-2488083 		HEALTHCARE PA RHCS
  		        No     No  
(7) RIVERVIEW SURGERY CENTER

3 CRESCENT DRIVE
PHILADELPHIA,PA19112
26-3910345 		HEALTHCARE PA TJUH INC
  		        No     No  
(8) MAGEE-MOSS REHAB LLC

443 LAUREL OAK ROAD SUITE 200
VOORHEES,NJ08043
52-2196209 		HEALTHCARE PA MRH
  		        No     No  
(9) MAIN LINE HEALTH REAL ESTATE LP

240 RADNOR CHESTER ROAD
RADNOR,PA19088
23-3089503 		REAL ESTATE PA JHS
  		        No     No  
(10) RIDDLE HEALTH NETWORK LLC

1068 WEST BALITMORE PIKE
MEDIA,PA19063
23-2975542 		INACTIVE PA RMH
  		        No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) MOUNTAIN LAUREL RISK RETENTION GROUP INC
259 N RADNOR CHESTER RD SUITE 290
RADNOR,PA19087
14-1868175 		INSURANCE VT JHS
  		C -373,363 174,317,911 100.000 %
(2) SEPA HEALTHCARE ALLIANCE INC
259 N RADNOR CHESTER RD SUITE 290
RADNOR,PA19087
20-3855830 		INACTIVE PA JHS
  		C   100 100.000 %
(3) LIMR DEVELOPMENT INC
100 LANCASTER AVENUE
WYNNEWOOD,PA19096
26-0442830 		PRODUCT DEVELOPMENT PA LIMR
  		C      
(4) LIMR CHEMICAL GENOMIC CENTER INC
100 LANCASTER AVENUE
WYNNEWOOD,PA19096
26-0442929 		SERVICE ORG PA LIMR
  		C      
(5) RIDDLE ENTERPRISES INC
1068 W BALITMORE PIKE
MEDIA,PA19063
23-2359873 		FACILITY SUPPORT PA RMH
  		C      
(6) MAIN LINE HEALTH CARE PSYCH GROUP
950 HAVERFORD ROAD SUITE 110
BRYN MAWR,PA19010
23-2481107 		INACTIVE PA N/A
 C      
(7) MAIN LINE CORPORATION
240 RADNOR CHESTER ROAD
RADNOR,PA19087
23-1704075 		HEALTHCARE PA N/A
 C      
(8) JEFFCARE INC
211 S 9TH STREET WALNUT TOWERS
PHILADELPHIA,PA19107
23-2830152 		HEALTHCARE PA TJUH SYSTEM INC
  		C      
(9) THE ATRIUM CORPORATION
925 CHESTNUT STREET SUITE 311
PHILADELPHIA,PA19107
23-2075587 		HEALTHCARE PA TJUH SYSTEM INC
  		C      
(10) HEALTHMARK INC
2301 S BROAD STREET
PHILADELPHIA,PA19148
23-2259593 		HEALTHCARE PA TJUH SYSTEM INC
  		C      
(11) JEFFERSON HEALTH NETWORK INC
259 N RADNOR CHESTER RD SUITE 290
RADNOR,PA19087
23-2859149 		INACTIVE PA JHS
  		C     100.000 %
(12) MID-ATLANTIC MATERNAL FETAL INSTITUTE
925 CHESTNUT STREET SUITE 311
PHILADELPHIA,PA19107
23-2922471 		HEALTHCARE PA TJUH AFFILIATES
  		C     100.000 %
(13) MID-ATLANTIC MATERNAL FETAL INSTITUTE PC
926 CHESTNUT STREET SUITE 311
PHILADELPHIA,PA19107
22-3536371 		HEALTHCARE PA TJUH AFFILIATES
  		C     100.000 %
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MOUNTAIN LAUREL RISK RETENTION GROUP INC

 R 51,633,383 PREMIUMS RECEIVED
(2) MOUNTAIN LAUREL RISK RETENTION GROUP INC

 Q -30,556,108 AMOUNT OF PAID LOSSES
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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