Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE POOL COMMITTEE CONSISTS OF THE SERVICING CARRIERS FOR THE WISCONSIN WORKER'S COMPENSATION INSURANCE POOL, AND ONE OR MORE ADDITIONAL CARRIERS ADDED TO MEET THE REQUIREMENT THAT THE COMMITTEE BE COMPRISED OF AN EQUAL NUMBER OF STOCK AND MUTUAL CARRIERS. THE POOL COMMITTEE PRIMARILY EXISTS TO BRING ABOUT A MAXIMUM DEGREE OF UNIFORMITY IN THE POOL BY ALLOWING A REGULAR MEETING FORMAT TO DISCUSS OPERATIONAL PROBLEMS AND SOLUTIONS. RECOMMENDATIONS FROM THE POOL COMMITTEE ARE REGULARLY FORWARDED TO THE GOVERNING BOARD FOR ACTION AND ADOPTION. |
| FORM 990, PART VI, SECTION A, LINE 7B | WHILE NOT A STATE AGENCY, WWCIP IS REGULATED BY THE STATE OF WISCONSIN OFFICE OF THE COMMISSIONER OF INSURANCE (OCI) AND WORKS VERY CLOSELY WITH THE WORKER'S COMPENSATION DIVISION OF THE WISCONSIN DEPARTMENT OF WORKFORCE DEVELOPMENT (DWD). |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATIONS MANAGEMENT FOR REVIEW PRIOR TO FILING AND IS MADE AVAILABLE TO GOVERNING BOARD MEMBERS UPON FINALIZATION. |
| FORM 990, PART VI, SECTION C, LINE 18 | PUBLIC INSPECTION OF DOCUMENTS AVAILABLE ONLINE AT WWW.WCRB.ORG |
| FORM 990, PART VI, SECTION C, LINE 19 | PUBLIC INSPECTION OF DOCUMENTS AVAILABLE ONLINE AT WWW.WCRB.ORG |
| FORM 990, PART VII | EMPLOYERS MUTUAL CASUALTY CO - P.O. BOX 327, BROOKFIELD, WI 53005. LIBERTY MUTUAL GROUP - P.O. BOX 8090, WAUSAU, WI XXX-XX-XXXX. TRI-STATE INSURANCE CO. OF MN - 222 SOUTH NINTH STREET, MINNEAPOLIS, MN XXX-XX-XXXX. GENERAL CASUALTY COMPANY - 500 PARK BLVD #1205, ITASCA, IL 60143. WEST BEND MUTUAL INSURANCE COMPANY - 1900 SOUTH 18TH AVE., WEST BEND, WI 53095. SOCIETY INSURANCE - P.O. BOX 1029, FOND DU LAC, WI XXX-XX-XXXX. MIDDLESEX INSURANCE CO - 1800 N. POINT DRIVE, STEVENS POINT, WI 54481. TRAVELERS INSURANCE CO - 1 TOWER SQUARE, HARTFORD, CT 06183. |
| FORM 990, PART VII | ALL MEMBERS OF THE REJECTED RISK COMMITTEE SERVE WITHOUT COMPENSATION AND WITHOUT REIMBURSEMENT OF EXPENSES INCURRED IN THEIR DUTIES. TIME DEVOTED TO THE ORGANIZATION CANNOT BE REASONABLY ESTIMATED AND ACTUAL TIME IS UNKOWN. |
| FORM 990, PART XI, LINE 9: | ASSESSMENTS DECLARED AND NOT COLLECTED TO NET ASSETS DISBURSEMENTS DECLARED, NOT DISTRIB -10,558,446. |
| PART XI LINE 2C | NO CHANGE FROM PRIOR YEAR. |
| FORM 990, PART XI, LINE 5 | POOL RULES REQUIRE THAT AN ASSESSMENT BE DECLARED BUT NOT COLLECTED OR DISBURSED IN AN AMOUNT SUFFICIENT TO ACHIEVE THE TARGET FUND VALUE BASED ON ACTUARIAL ESTIMATES OF OUTSTANDING LOSSES THUS, 2014 DISBURSEMENTS OF $10,558,446 WERE DECLARED BUT NOT DISTRIBUTED TO ALL POOL MEMBERS IN 2014 BASED ON PRIOR PREMIUM WRITINGS IN ACCORDANCE WITH POOL RULES. THE ASSESSMENTS IS ACCOUNTED FOR AS A LIABILITY AND ADJUSTMENT TO NET ASSETS. |
| SCHEDULE R (FORM 990), PART V, LINE 1M | ADMINISTRATIVE SERVICES ARE PROVIDED TO THE WISCONSIN WORKER'S COMPENSATION INSURANCE POOL (WWCIP) BY THE WISCONSIN COMPENSATION RATING BUREAU (BUREAU). SINCE THE ADMINISTRATION OF THE POOL BY THE BUREAU IS PROVIDED FOR BY THE STATUTES OF THE STATE OF WISCONSIN, THE POOL DOES NOT REIMBURSE THE BUREAU. |
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