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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 07-01-2013 , 2013, and ending 06-30-2014
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 province, country, and ZIP or foreign postal code
WILMINGTON, DE19899
D Employer identification number

20-4191006
E Telephone number

G Gross receipts $ 125,920,081
F Name and address of principal officer:
DIANNE SALTER
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
subordinates?
H(b)
Are all subordinates
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 14
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 2013 (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) ......... 52,289,579 49,160,721
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 14,155,745 17,817,409
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 65,722 39
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 66,511,046 66,978,169
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–24e).... 26,044,781 28,522,537
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 26,044,781 28,522,537
19 Revenue less expenses. Subtract line 18 from line 12....... 40,466,265 38,455,632
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 271,170,397 273,208,080
21 Total liabilities (Part X, line 26)............. 166,835,085 158,809,774
22 Net assets or fund balances. Subtract line 21 from line 20..... 104,335,312 114,398,306
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 Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line 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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 27,336,487 including grants of $   ) (Revenue $ 66,978,169 )
SEE SCHEDULE O.
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 expensesMediumBullet27,336,487
Form 990 (2013)
Form 990 (2013)
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 (see instructions)? ...
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, or have a section 501(h) election in effect during the tax year? 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
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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 for escrow or custodial account liability; 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 temporarily restricted endowments, permanent endowments, 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, line 10?
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 VIIClick 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 VIIIClick 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 IXClick 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 XClick 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 XClick 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 and XII 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 and XII 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, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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 (see instructions)....
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
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government 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 or 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, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, 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 employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? 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 direct or indirect 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, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, 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...
35b
 
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
7
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” to line 3b, 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, securities account, or other financial 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 as charitable contributions?...
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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 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 (2013)
Form 990 (2013)
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 or note to any line 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
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
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
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete 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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, 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," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take 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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletMARSH MANAGEMENT SERVICES INC100 BANK STREET SUITE 610BURLINGTONVT05401 (802) 864-2037
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DIANNE P SALTER........................................................................
PRESIDENT & DIRECTOR
 10.00
.......................40.00 		X   X       0 401,578 20,913
(2) KIRK E GORMAN........................................................................
TREASURER, CHAIRMAN
 .70
.......................40.00 		X   X       0 0 0
(3) MICHAEL J BUONGIORNO........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(4) JACK A CARROLL PHD MHA........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(5) ROBERT J CROSSIN........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(6) GUY W FRIED MD........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(7) JOHN J LYNCH III........................................................................
DIRECTOR & PRESIDENT
 .70
.......................40.00 		X   X       0 0 0
(8) FRANK P SLATTERY JR........................................................................
DIRECTOR
 .20
.......................0.00 		X           0 0 0
(9) NEIL G LUBARSKY........................................................................
DIRECTOR, ASST. TREASURER
 .20
.......................40.00 		X   X       0 0 0
(10) JOSEPH T SEBASTIANELLI........................................................................
DIRECTOR & CHAIRMAN
 .70
.......................40.00 		X   X       0 0 0
(11) KATHLEEN KINSLOW........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(12) ELIZABETH J BALDERSTON........................................................................
DIRECTOR
 .20
.......................0.00 		X           0 0 0
(13) DAVID P MCQUAID........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(14) ALBERT C SALVATO........................................................................
DIRECTOR
 .20
.......................0.00 		X           0 0 0
(15) JOHN EKARIUS........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(16) ANDREW DEVOE........................................................................
DIRECTOR
 .20
.......................40.00 		X           0 0 0
(17) R CHRISTOPHER RAPHAELY........................................................................
GENERAL COUNSEL & SECRETARY
 .20
.......................40.00 		    X       0 0 0
Form 990 (2013)
Form 990 (2013)
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 (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) BENJAMIN M GERBER........................................................................
SECRETARY
 .20
.......................40.00 		    X       0 0 0
(19) MARCY WATERFALL........................................................................
ASST. SECRETARY
 .20
.......................40.00 		    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 0 401,578 20,913
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of 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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
RUSSELL INVESTMENT GROUP909 A STREETTACOMAWA98402 INVESTMENT SERVICES 1,035,458
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a PREMIUMS EARNED 524298 49,160,721 49,160,721    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 49,160,721
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 219     219
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 76,759,102  
b Less: cost or other basis and sales expenses 58,941,912  
c Gain or (loss) 17,817,190  
d Net gain or (loss)..........MediumBullet 17,817,190 17,817,190    
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 524298 39 39    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 39
12 Total revenue. See Instructions......MediumBullet 66,978,169 66,977,950 0 219
Form 990 (2013)
Form 990 (2013)
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).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 United States. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. 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 accruals and contributions (include section 401(k) and 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ...... 78,800 59,100 19,700  
b Legal ......... 87,962   87,962  
c Accounting ........... 41,329   41,329  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 1,035,458   1,035,458  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........        
12 Advertising and promotion ....        
13 Office expenses .......        
14 Information technology ......        
15 Royalties ..        
16 Occupancy ...........        
17 Travel ............        
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 (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a INCURRED LOSSES 27,033,851 27,033,851    
b LETTER OF CREDIT FEES 76,247 76,247    
c PREMIUM TAXES 69,378 69,378    
d ACTUARIAL FEES 67,025 67,025    
e All other expenses 32,487 30,886 1,601  
25 Total functional expenses. Add lines 1 through 24e 28,522,537 27,336,487 1,186,050 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 551,382 1 562,590
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 1,699,184 4 989,898
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) 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 .......... 16,932 9 19,700
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 ..........   11  
12 Investments—other securities. See Part IV, line 11 ..... 222,303,464 12 250,959,892
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 46,599,435 15 20,676,000
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 271,170,397 16 273,208,080
Liabilities 17 Accounts payable and accrued expenses ......... 100,318 17 114,954
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 Loans and other 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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 166,734,767 25 158,694,820
26 Total liabilities. Add lines 17 through 25......... 166,835,085 26 158,809,774
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), 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 (ASC 958), 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 ..... 7,914,200 31 9,795,789
32 Retained earnings, endowment, accumulated income, or other funds 96,421,112 32 104,602,517
33 Total net assets or fund balances ........... 104,335,312 33 114,398,306
34 Total liabilities and net assets/fund balances ........ 271,170,397 34 273,208,080
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
66,978,169
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
28,522,537
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
38,455,632
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
104,335,312
5
Net unrealized gains (losses) on investments ...............
5
7,590,659
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-35,983,297
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
114,398,306
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes No Yes No Yes No
(A) RIDDLE MEMORIAL HOSPITAL
  		231529076 3 Yes   Yes   Yes   0
(B) MAGEE REHABILITATION HOSPITAL
  		231476328 3 Yes   Yes   Yes   0
(C) MAIN LINE HOSPITALS INC
  		231352160 3 Yes   Yes   Yes   0
(D) THOMAS JEFFERSON UNIVERSITY HOSPITAL
  		232829095 3 Yes   Yes   Yes   0
(E) ARIA HEALTH
  		230596940 3 Yes   Yes   Yes   0
Total 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2013

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and 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 current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
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 XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (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 through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 0
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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 		250,959,892 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 250,959,892
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) REINSURANCE RECOVERABLE ON UNPAID LOSSES 20,676,000








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 20,676,000
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
UNPAID LOSSES & LOSS ADJUSTMENT EXPENSES 158,689,767
LOSSES PAYABLE 5,053







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 158,694,820
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 66,316,711
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 XIII.) ............ 2d 374,000
e Add lines 2a through 2d ..................... 2e 374,000
3 Subtract line 2e from line 1..................... 3 65,942,711
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 1,035,458
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c 1,035,458
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 66,978,169
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 27,861,079
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 XIII.) ............ 2d 374,000
e Add lines 2a through 2d...................... 2e 374,000
3 Subtract line 2e from line 1..................... 3 27,487,079
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 1,035,458
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c 1,035,458
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 28,522,537
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: 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, 2014. 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, 2014, THE COMPANY DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS. TAX YEARS FROM 2011 FORWARD ARE OPEN AND SUBJECT TO EXAMINATION.
PART XI, LINE 2D - OTHER ADJUSTMENTS: FEES PAID TO THE CORE BY PROTECTED CELLS TO PROVIDE OPERATING SERVICES NOT ELIMIATED ON THE COMBINED FINANCIAL STATEMENTS
PART XII, LINE 2D - OTHER ADJUSTMENTS: MEMBER OPERATING EXPENSES CHARGED BY THE CORE INCLUDED ON THE COMBINED FINANCIAL STATEMENTS
PART XI, LINE 9: OTHER CHANGES TO EQUITY: DIVIDENDS PAID (39,929,260) RECLASSIFICATION OF PRIOR YEAR NON-JHS MEMBER EQUITY 3,945,963 TOTAL OTHER CHANGES TO EQUITY (35,983,297)
PART XI, LINE 2D: THE AMOUNT OF $374,000 HAS BEEN ELIMINATED, AS THIS IS REVENUE FROM THE CELLS. FIVE POINTE IS A CELL CAPTIVE, THEREFORE, THE ACTIVITY BETWEEN THE CORE AND CELLS NEEDS TO BE ELIMINATED.
Schedule D (Form 990) 2013

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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 or provision of all of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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 Regulations 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)DIANNE P SALTERPRESIDENT & DIRECTOR (i)
(ii)		 0
284,078 		0
117,500 		0
0 		0
0 		0
20,913 		0
422,491 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 4B SEE SCHEDULE O FOR MORE DETAILS PLEASE SEE SCHEDULE O FOR INFORMATION ON REPORTABLE COMPENSATION RECEIVED BY CURRENT AND FORMER OFFICERS AND DIRECTORS FROM JHS MEMBER ORGANIZATIONS AND ARIA HEALTH SYSTEM.
Schedule J (Form 990) 2013

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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
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 78,800 PROVIDES MANAGEMENT SERVICES   No
(2) MOUNTAIN LAUREL RISK RETENTION GROUP INC
  		INSURANCE COMPANY 49,840,873 PROVIDES DIRECT WRITTEN PRIMARY PROFESSIONAL LIABILITY COVERAGE   No
(3) MOUNTAIN LAUREL RISK RETENTION GROUP INC
  		INSURANCE COMPANY 35,507,021 PAYMENT OF LOSSES UNDER INSURANCE CONTRACT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FIVE POINTE PROFESSIONAL LIABILITY
INSURANCE COMPANY C/O WILMINGTON TRUST
Employer identification number

20-4191006
Return Reference Explanation
FORM 990, PART I, LINE 1 EXCLUSIVELY FOR THE CHARITABLE PURPOSES FOR THE BENEFIT OF ITS MEMBER ORGANIZATIONS. THE CORPORATION SERVES AS AN INTEGRAL PART OF AND FURTHERS THE EXEMPT PURPOSES OF ITS MEMBERS, CHARITABLE HOSPITALS AND RELATED HEALTHCARE ORGANIZATIONS BY PROVIDING "SELF-INSURANCE" PROFESSIONAL LIABILITY COVERAGE FOR CERTAIN HOSPITALS AND HEALTHCARE ENTITIES DESCRIBED IN IRC SECTION 501(C)(3). EFFECTIVE JUNE 30, 2014, THE MEMBERS ARE MAIN LINE HOSPITALS, INC., RIDDLE MEMORIAL HOSPITAL, THOMAS JEFFERSON UNIVERSITY HOSPITALS, INC., MAGEE REHABILITATION HOSPITAL, AND ARIA HEALTH.
FORM 990,SCHEDULE J, PART I, LINE 4B: THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE MAIN LINE HEALTH SYSTEM (FORMERLY JEFFERSON HEALTH SYSTEM ("JHS")) (EIN:23-2814503) FORM 990: JOSEPH T. SEBASTIANELLI, KIRK E. GORMAN, R. CHRISTOPHER RAPHAELY, AND BENJAMIN GERBER. THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE THOMAS JEFFERSON UNIVERSITY HOSPITAL (EIN:23-2829095) FORM 990: NEIL G. LUBARSKY, DAVID MCQUAID, JOHN EKARIUS, AND ALFRED C. SALVATO. THE PARTICIPATION IN, OR THE RECEIVING PAYMENTS FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE MAIN LINE HOSPITALS, INC. (EIN:23-1352160) 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 INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, 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 INDIVIDUALS IS DISCLOSED, WHERE APPLICABLE, ON THE ARIA HEALTH (EIN:23-0596940) FORM 990: KATHLEEN KINSLOW, ROBERT J. CROSSIN, AND ANDREW DEVOE.
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 4 PRIOR TO JUNE 30, 2014, JEFFERSON HEALTH SYSTEM ("JHS") MEMBER ORGANIZATIONS INCLUDED MAIN LINE HEALTH ("MLH"), THOMAS JEFFERSON UNIVERSITY HOSPITAL ("TJUH"), AND MAGEE REHABILITATION HOSPITAL ("MAGEE"). ON MAY 16, 2014, THE JHS BOARD OF TRUSTEES APPROVED THE SEPARATION OF MLH, TJUH AND MAGEE EFFECTIVE JUNE 30, 2014. THE SEPARATION REQUIRED THE TRANSFER OF JHS' COMMON MEMBERSHIP INTEREST AND COMMON MEMBERSHIP UNITS IN THE COMPANY, WHICH WAS APPROVED BY THE BOARD OF DIRECTORS OF THE COMPANY ON JUNE 26, 2014. EFFECTIVE JUNE 30, 2014, THE TRANSFER OF JHS' COMMON MEMBERSHIP INTEREST AND COMMON MEMBERSHIP INTEREST UNITS IN THE COMPANY, AS DEFINED IN THE SEPARATION AGREEMENT, RESULTED IN THE FOLLOWING VOTING/OWNERSHIP OF THE COMPANY: MAIN LINE HOSPITALS, INC. (44%), RIDDLE MEMORIAL HOSPITAL (4%), TJUH (48%), MAGEE (2%) AND ARIA (2%). THERE ARE NO LONGER "COMMON" OR "PREFERRED MEMBERSHIP UNITS" AND EACH MEMBER CURRENTLY HOLDS "MEMBERSHIP UNITS." EACH MEMBER IS AN ORGANIZATION DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. FURTHERMORE, THE TERMS OF THE SEPARATION REQUIRED THE TRANSFER OF JHS' RIGHT, TITLE AND INTEREST IN THE "JHS PROTECTED CELL" (JHS CELL) AND THE "EXCESS PROTECTED CELL" (XS CELL) OF THE COMPANY AS DEFINED IN THE SEPARATION AGREEMENT AS FOLLOWS: MLH (49%), TJUH (49%) AND MAGEE (2%) WITH THE UNDERSTANDING THAT THESE TWO CELLS WILL BE PUT INTO "RUN-OFF" MODE. AS A RESULT, JHS ENTERED INTO A SPONSORED CAPTIVE INSURANCE CELL TRANSFER AGREEMENT WITH MAIN LINE HOSPITALS, INC., TJUH AND MAGEE. CLAIMS COVERED BY THE JHS CELL WILL BE ADMINISTERED SOLELY BY MAIN LINE HEALTH, INC., WITH THE DISTRIBUTION OF ALL ASSETS IN THE CELLS UPON CLOSE OF ALL CLAIMS TO EACH IN PROPORTION TO THEIR RESPECTIVE OWNERSHIP PERCENTAGES.
FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE CORPORATION SHALL ELECT DIRECTORS, EACH OF WHOM SHALL HOLD OFFICE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS ELECTED AND QUALIFIED. ANY DIRECTOR MAY RESIGN AT ANY TIME UPON WRITTEN NOTICE TO THE CORPORATION. SUBJECT TO ANY LIMITATIONS IMPOSED BY APPLICABLE LAW, THE BOARD OF DIRECTORS OR ANY DIRECTOR MAY BE REMOVED FROM OFFICE AT ANY TIME WITH OR WITHOUT CAUSE BY THE AFFIRMATIVE VOTE OF MEMBERS HOLDING NOT LESS THAN 75% OF THE OUTSTANDING MEMBERSHIP UNITS. ANY NEWLY CREATED DIRECTORSHIP OR ANY VACANCY OCCURRING IN THE BOARD OF DIRECTORS FOR ANY REASON MAY BE FILLED BY A MAJORITY OF THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS, ALTHOUGH SUCH MAJORITY IS LESS THAN A QUORNM, AND EACH DIRECTOR SO ELECTED SHALL HOLD OFFICE UNTIL THE EXPIRATION OF THE TERM OF OFFICE OF THE DIRECTOR WHOM HE OR SHE HAS REPLACED OR UNTIL HIS OR HER SUCCESSOR IS ELECTED AND QUALIFIED.
FORM 990, PART VI, SECTION A, LINE 7A THE COMPANY'S COMMON MEMBER ELECTS THE BOARD BY MAJORITY VOTE OF MEMBERSHIP UNITS TO FILLS BOARD VACANCIES AND 75% OF MEMBERSHIP UNITS TO VOTE FOR THE REMOVAL OF DIRECTORS.
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. SUBSEQUENTLY, THE BOARD REVIEWS THE FORM 990 PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12C THE LEGAL DEPARTMENT OF MAIN LINE HEALTH SYSTEM (FORMERLY JHS), 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 THERE ARE NO EMPLOYEES COMPENSATED BY THE REPORTING ENTITY. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON THE MAIN LINE HEALTH SYSTEM (FORMERLY JHS) (EIN:23-2814503) FORM 990: JOSEPH T. SEBASTIANELLI, KIRK E. GORMAN, R. CHRISTOPHER RAPHAELY, AND BENJAMIN GERBER. 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: NEIL G. LUBARSKY, DAVID MCQUAID, JOHN EKARIUS, AND ALFRED C. SALVATO. THE PROCESS FOR DETERMINING THE COMPENSATION FOR THE FOLLOWING INDIVIDUAL'S COMPENSATION IS DISCLOSED ON THE MAIN LINE HOSPITALS, INC. (EIN:23-1352160) 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 (EIN:23-0596940) FORM 990: KATHLEEN KINSLOW, ROBERT J. CROSSIN, AND ANDREW DEVOE.
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 XI, LINE 9: CHANGE IN EQUITY -35,983,297.
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: FIVE POINTE MAY FILE ITS FORM 990 EARLIER THAN THE INSURED MEMBERS AND TO PREVENT DIFFERENCES IN REPORTED COMPENSATION AMOUNTS, FIVE POINTE IN AN EFFORT TO PROVIDE THE MOST CURRENT INFORMATION HAS PROVIDED REFERENCES TO THE INSURED MEMBERS' FORM 990 THAT WILL HAVE EACH OF THE INDIVIDUAL'S COMPENSATION REPORTED BY THE ORGANIZATION THAT EMPLOYS SUCH INDIVIDUAL. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON THE MAIN LINE HEALTH SYSTEM (FORMERLY JHS) (EIN:23-2814503) FORM 990: JOSEPH T. SEBASTIANELLI, KIRK E. GORMAN, R. CHRISTOPHER RAPHAELY, AND BENJAMIN GERBER. 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: NEIL G. LUBARSKY, DAVID MCQUAID, JOHN EKARIUS, AND ALFRED C. SALVATO. THE FOLLOWING INDIVIDUAL'S COMPENSATION AND EMPLOYEE BENEFIT PLAN COMPENSATION AND EXPENSE ACCOUNT DATA IS DISCLOSED ON THE MAIN LINE HOSPITALS, INC. (EIN:23-1352160) FORM 990: JOHN J. LYNCH III AND 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 (EIN:23-0596940) FORM 990: KATHLEEN KINSLOW, ROBERT J. CROSSIN, AND ANDREW DEVOE.
FORM 990, SCHEDULE R - (1) THE BRYN MAWR HOSPITAL FOUNDATION, THE LANKENAU MEDICAL CENTER FOUNDATION, PAOLI HOSPITAL FOUNDATION, THE BRYN MAWR REHABILITATION FOUNDATION AND THE RIDDLE HEALTHCARE FOUNDATION (COLLECTIVELY "THE FOUNDATIONS") ARE SPECIFICALLY EXCLUDED. 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: EFFECTIVE JUNE 30, 2014, THE MEMBERS ARE MAIN LINE HOSPITALS, INC. (44%), RIDDLE MEMORIAL HOSPITAL (4%), THOMAS JEFFERSON UNIVERSITY HOSPITALS, INC. (48%), MAGEE REHABILITATION HOSPITAL (2%), AND ARIA HEALTH (2%). THE VOTING 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 THE MEMBER ORGANIZATIONS THAT OWN THE COMPANY.
FORM 990, PART III, LINE 4A FIVE POINTE PROFESSIONAL LIABILITY INSURANCE COMPANY PROVIDES REINSURANCE TO MOUNTAIN LAUREL RISK RETENTION GROUP, INC. ("MLRRG"),A RELATED PARTY THROUGH COMMON OWNERSHIP THAT PROVIDES GENERAL LIABILITY AND PROFESSIONAL LIABILITY INSURANCE TO ITS SHAREHOLDERS THAT ARE THE TAX EXEMPT MEMBERS OF FIVE POINTE. THE REINSURANCE COVERAGES ASSIST WITH THE MANAGEMENT AND FUNDING OF THE PROFESSIONAL LIABILITY RISK THEREBY ESSENTIALLY FUNCTIONING AS A SELF-INSURANCE VEHICLE FOR THE TAX EXEMPT MEMBER HOSPITALS AND 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 LEGALLY PROTECTED FROM THE ASSETS AND LIABILITIES OF OTHER CELLS. THE COMPANY INSURES THE RISKS OF THE MEMBERS PURSUANT TO MEMBERSHIP AGREEMENTS, AND SEGREGATES SUCH RISKS INTO PROTECTED CELLS. EACH PROTECTED CELL IS ACCOUNTED FOR SEPARATELY ON THE BOOKS AND RECORDS OF THE COMPANY. THE ASSETS AND LIABILITIES OF THE COMPANY ARE SEGREGATED INTO CELL ASSETS AND LIABILITIES AND GENERAL ASSETS AND LIABILITIES. THE GENERAL ASSETS AND LIABILITIES OF THE COMPANY COMPRISE THE ASSETS AND LIABILITIES THAT ARE NOT ASSETS AND LIABILITIES OF ANY ONE OF THE PROTECTED CELLS. THE ACTIVITIES REPRESENTING THE GENERAL ASSETS AND LIABILITIES OF THE COMPANY ARE REFERRED TO AS "THE CORE."
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
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 (if applicable) 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










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 entity?
Yes No
(1) MAIN LINE HEALTH INC

950 HAVERFORD ROAD SUITE 110

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

111 SOUTH 11 ST

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

1513 RACE STREET

PHILADELPHIA,PA19102
23-1476328 		HEALTHCARE PA 501(C)(3) 3 N/A
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) LANKENAU INSTITUTE FOR MEDICAL RESEARCH

100 LANCASTER AVENUE

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

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-1529076 		HEALTHCARE PA 501(C)(3) 3 MAIN LINE HEALTH INC
 
Yes
 
(7) MIRMONT ALCOHOL REHABILITATION CENTER

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2215243 		HEALTHCARE PA 501(C)(3) 3 RIDDLE MEMORIAL HOSPITAL
 
Yes
 
(8) RIDDLE HEALTH CARE SERVICES

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
22-2606545 		HEALTHCARE PA 501(C)(3) 11B RIDDLE MEMORIAL HOSPITAL
 
Yes
 
(9) 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
 
(10) MAIN LINE DIVERSIFIED SERVICES INC

240 RADNOR CHESTER ROAD

RADNOR,PA19087
23-2859148 		HEALTHCARE PA 501(C)(3) 11A MAIN LINE HEALTH INC
 
Yes
 
(11) MAIN LINE HEALTH HOMECARE AND HOSPICE

950 HAVERFORD ROAD SUITE 110

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

240 RADNOR CHESTER ROAD

RADNOR,PA19087
23-2306936 		FUNDRAISING PA 501(C)(3) 11C JEFFERSON HOME CARE
 
 
No
(13) 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
 
(14) MAIN LINE AFFILIATES

240 RADNOR CHESTER ROAD

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

240 RADNOR CHESTER ROAD

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

950 HAVERFORD ROAD SUITE 110

BRYN MAWR,PA19010
23-2359401 		PHYSICIAN MGT PA 501(C)(3) 11A MAIN LINE HEALTH INC
 
Yes
 
(17) THE BRYN MAWR HOSPITAL FOUNDATION (1)

130 SOUTH BRYN MAWR AVENUE

BRYN MAWR,PA19010
23-2179020 		FUNDRAISING PA 501(C)(3) 11C N/A
 
No
(18) THE LANKENAU MEDICAL CENTER FOUNDATION (1)

100 LANCASTER AVENUE

WYNNEWOOD,PA19096
23-2176723 		FUNDRAISING PA 501(C)(3) 11D N/A
 
No
(19) PAOLI HOSPITAL FOUNDATION (1)

255 WEST LANCASTER AVENUE

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

414 PAOLI PIKE

MALVERN,PA19355
23-2507348 		FUNDRAISING PA 501(C)(3) 11C N/A
 
No
(21) THE RIDDLE HEALTHCARE FOUNDATION (1)

1068 WEST BALTIMORE PIKE

MEDIA,PA19063
04-3601189 		FUNDRAISING PA 501(C)(3) 11C N/A
 
No
(22) JEFFEX INC

925 CHESTNUT STREET SUITE 311

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

414 NORTH 5TH STREET

PHILADELPHIA,PA19107
23-2622004 		HEALTHCARE PA 501(C)(3) 9 TJUH SYSTEM
 
Yes
 
(24) WALNUT HOME THERAPEUTICS

919 WALNUT STREET 5TH FLOOR

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

2301 SOUTH BROAD STREET

PHILADELPHIA,PA19148
23-2214351 		HEALTHCARE PA 501(C)(3) N/A TJUH SYSTEM
 
Yes
 
(26) TJUH HEALTH AFFILIATES

111 SOUTH 11 ST

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

2301 SOUTH BROAD STREET

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

111 SOUTH 11 ST

PHILADELPHIA,PA19107
23-3537847 		HEALTHCARE PA 501(C)(3) 11A TJUH SYSTEM
 
Yes
 
(29) JEFFERSON MEDICAL CARE

111 SOUTH 11 ST

PHILADELPHIA,PA19107
23-2858320 		HEALTHCARE PA 501(C)(3) 11A TJUH SYSTEM
 
Yes
 
(30) MAGEE REHABILITATION HOSPITAL FOUNDATION

1513 RACE STREET

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

111 SOUTH 11TH STREET

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

2301 SOUTH BROAD STREET

PHILADELPHIA,PA19148
23-2014559 		FUNDRAISING PA 501(C)(3) 11A TJUH SYSTEM
 
Yes
 
(33) ARIA HEALTH SYSTEM

10800 KNIGHTS ROAD

PHILADELPHIA,PA19114
23-2239131 		HEALTH SERVICES PA 501(C)(3) 11-TYPE II N/A
 
No
(34) ARIA HEALTH PHYSICIAN SERVICES

10800 KNIGHTS ROAD

PHILADELPHIA,PA19114
23-2691968 		PHYSICIAN HEALTH SERVICES PA 501(C)(3) 3 ARIA HEALTH SYSTEM
 
 
No
(35) HOSPITAL MEDICAL IMAGING

KNIGHTS RED LION ROAD

PHILADELPHIA,PA19119
23-2472600 		HEALTH SERVICES PA 501(C)(3) 1 ARIA HEALTH SYSTEM
 
 
No
(36) ARIA HEALTH ORTHOPEDICS

380 NORTH OXFORD VALLEY ROAD

LANGHORNE,PA19047
46-0779942 		HEALTH SERVICES PA 501(C)(3) 1 ARIA HEALTH SYSTEM
 
 
No
(37) ARIA HEALTH

KNIGHTS RED LION ROAD

PHILADELPHIA,PA19114
23-0596940 		HEALTH SERVICES PA 501(C)(3) 3 ARIA HEALTH SYSTEM
 
 
No
(38) JEFFERSON UNIVERSITY PHYSICIANS

1025 WALNUT STREET SUITE 100

PHILADELPHIA,PA19107
23-2809585 		PHYSICIAN SERVICES PA 501(C)(3) 11A TJU
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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

130 S BRYN MAWR AVENUE
BRYN MAWR,PA19010
23-2409186 		HEALTHCARE PA ML REALTY
  		N/A       No     No  
(2) RMH HEALTH CARE CENTER ASSOCIATES

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

1118 WEST BALITMORE PIKE
MEDIA,PA19063
26-3899068 		HEALTHCARE PA RIDDLE MEMORIAL
  		N/A       No     No  
(4) BMHR ASSOCIATES

240 RADNOR CHESTER ROAD
RADNOR,PA19087
23-2311589 		HEALTHCARE PA ML REALTY
  		N/A       No     No  
(5) RMH HEALTH CARE ASSOCIATES III

950 HAVERFORD ROAD SUITE 110
BRYN MAWR,PA19010
23-2693651 		OFFICE RENTAL PA RIDDLE MEMORIAL
  		N/A       No     No  
(6) RIVERVIEW SURGERY CENTER LP

11221 ROE AVENUE SUITE 320
LEAWOOD,KS66211
26-3910345 		HEALTHCARE PA TJUH INC
  		N/A       No     No  
(7) MAIN LINE HEALTH REAL ESTATE LP

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

1068 WEST BALITMORE PIKE
MEDIA,PA19063
23-2975542 		INACTIVE PA RMH
  		N/A       No     No  
(9) RIDDLE DIALYSIS LLC

100 GRANITE DRIVE
MEDIA,PA19063
20-8438006 		HEALTHCARE PA N/A
 N/A       No     No  
(10) PAOLI AMBULATORY SURGERY CENTER

1 INDUSTRIAL BLVD
PAOLI,PA19301
62-1595402 		HEALTHCARE PA N/A
 N/A       No     No  
(11) RIVERVIEW SURGERY CENTER LLC

11221 ROE AVENUE SUITE 320
LEAWOOD,KS66211
26-3911509 		HEALTHCARE PA TJUH INC
  		N/A       No     No  
(12) MAIN LINE HEALTH REALTY LLC

240 RADNOR CHESTER ROAD
RADNOR,PA19088
23-3089502 		REAL ESTATE PA N/A
 N/A       No     No  
(13) TMB ENTERPRISES

3 VILLAGE ROAD SUITE 200
HORSHAM,PA19044
23-2400586 		REAL ESTATE PA N/A
 N/A       No     No  
(14) JUNIATA MEDICAL BLDG PARTNERS

3 VILLAGE ROAD SUITE 200
HORSHAM,PA19044
23-2450132 		REAL ESTATE PA N/A
 N/A       No     No  
(15) MEDICAL IMAGING ASSOCIATES LP

KNIGHTS RED LION ROAD
PHILADELPHIA,PA19119
 HEALTH SERVICES PA N/A
 N/A       No     No  
(16) JEFFERSON COMPREHENSIVE CONCUSSION CENTER LLC

4050 S 26TH ST
PHILADELPHIA,PA19145
46-4254983 		HEALTHCARE PA N/A
 N/A       No     No  
(17) JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES LLC

1020 WALNUT ST 6TH FL SCOTT
PHILADELPHIA,PA19107
 HEALTHCARE PA N/A
 N/A       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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) MOUNTAIN LAUREL RISK RETENTION GROUP INC

259 N RADNOR CHESTER RD SUITE 290
RADNOR,PA19087
14-1868175 		INSURANCE VT JHS
  		C         No
(2) LIMR DEVELOPMENT INC

100 LANCASTER AVENUE
WYNNEWOOD,PA19096
26-0442830 		PRODUCT DEVELOPMENT PA N/A
 C         No
(3) LIMR CHEMICAL GENOMIC CENTER INC

100 LANCASTER AVENUE
WYNNEWOOD,PA19096
26-0442929 		SERVICE ORG PA N/A
 C         No
(4) MAIN LINE CORPORATION

100 MATSONFORD ROAD SUITE 400
RADNOR,PA19087
23-1704075 		INACTIVE PA N/A
 C         No
(5) JEFFCARE INC

211 S 9TH STREET WALNUT TOWERS
PHILADELPHIA,PA19107
23-2830152 		HEALTHCARE PA N/A
 C         No
(6) THE ATRIUM CORPORATION

925 CHESTNUT STREET SUITE 311
PHILADELPHIA,PA19107
23-2075587 		HEALTHCARE PA N/A
 C         No
(7) HEALTHMARK INC

2301 S BROAD STREET
PHILADELPHIA,PA19148
23-2259593 		HEALTHCARE PA N/A
 C         No
(8) JEFFERSON HEALTH NETWORK INC

259 N RADNOR CHESTER RD SUITE 290
RADNOR,PA19087
23-2859149 		INACTIVE PA JHS
  		C     100.000 %   No
(9) MID-ATLANTIC MATERNAL FETAL INSTITUTE

925 CHESTNUT STREET SUITE 311
PHILADELPHIA,PA19107
23-2922471 		HEALTHCARE PA N/A
 C         No
(10) MID-ATLANTIC MATERNAL FETAL INSTITUTE PC

925 CHESTNUT STREET SUITE 311
PHILADELPHIA,PA19107
22-3536371 		HEALTHCARE PA N/A
 C         No
(11) SYSTEM SERVICE CORPORATION

1105 N MARKET STREET SUITE 1300
WILMINGTON,DE19801
23-2218944 		HOLDING CO DE N/A
 C         No
(12) TF DEVELOPMENT

3 VILLAGE ROAD SUITE 200
HORSHAM,PA19044
23-2197865 		REAL ESTATE PA N/A
 C         No
(13) HEALTH CARE INC

10800 KNIGHTS ROAD
PHILADELPHIA,PA19114
20-0214524 		RETAIL PHARMACY PA N/A
 C         No
(14) RHOQ INC

270 CURWEN ROAD
BRYN MAWR,PA19010
46-4983648 		PHARM R&D DE N/A
 C         No
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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