Form990
Click to see attachment
Department of the TreasuryInternal 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.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
SECURITY HEALTH PLAN OF WISCONSIN INC
 
% GERALDINE BATTEN
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO Box 8000
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Marshfield, WI544498000
D Employer identification number

39-1572880
E Telephone number

G Gross receipts $ 1,200,358,817
F Name and address of principal officer:
JULIE BRUSSOW CEO
PO Box 8000
Marshfield,WI544498000
I
Tax-exempt status: ( 4 ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SECURITYHEALTH.ORG
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: 1986
M State of legal domicile: WI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: ENSURE OUR MEMBERS CAN GET THE CARE THEY NEED WHEN THEY NEED IT, HELP OUR MEMBERS RETAIN A STRONG VOICE IN THEIR HEALTH CARE, & KEEP QUALITY OF CARE & SERVICE HIGH AND COST LOW.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 9
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 1
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) ......... 1,098,011,394 1,158,289,700
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,619,826 8,641,761
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,263,681 3,232,687
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,109,894,901 1,170,164,148
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).... 1,080,934,351 1,163,274,577
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,080,934,351 1,163,274,577
19 Revenue less expenses. Subtract line 18 from line 12....... 28,960,550 6,889,571
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 346,497,044 376,832,511
21 Total liabilities (Part X, line 26)............. 135,103,376 152,127,897
22 Net assets or fund balances. Subtract line 21 from line 20..... 211,393,668 224,704,614
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 (2015)
Form 990 (2015)
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: SECURITY HEALTH PLAN'S MISSION IS TO ENSURE OUR MEMBERS CAN GET THE CARE THEY NEED WHEN THEY NEED IT, HELP OUR MEMBERS RETAIN A STRONG VOICE IN THEIR HEALTH CARE, AND KEEP QUALITY OF CARE AND SERVICE HIGH, AND COSTS LOW.
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 $ 1,104,486,342 including grants of $   ) (Revenue $ 1,158,289,700 )
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 expensesMediumBullet1,104,486,342
Form 990 (2015)
Form 990 (2015)
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 A.....................
1
 
No
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
 
 
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
Yes
 
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
 
No
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.........Click to see attachment
14b
Yes
 
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.....Click to see attachment
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...Click to see attachment
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 (2015)
Form 990 (2015)
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 domestic 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 or for domestic individuals 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), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
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 ...................
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 "Yes," complete Schedule L, Part II ................
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.........
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 ........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
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...
28c
 
No
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
Yes
 
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.............
36
 
 
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 (2015)
Form 990 (2015)
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
3,641
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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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
 
 
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
 
 
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
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
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
 
 
Form 990 (2015)
Form 990 (2015)
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
9
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
5
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
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
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
Yes
 
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
WI
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletGERALDINE BATTEN1515 ST JOSEPH AVE   MARSHFIELD,WI54449 (715) 221-9859
Form 990 (2015)
Form 990 (2015)
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) NARYANA S MURALI MD......................................................................
SHP Director
 1.0
.................
40.0 		X           0 558,189 59,925
(2) MATTHEW THOMAS MD......................................................................
SHP Vice Chairperson
 1.0
.................
40.0 		X   X       0 548,302 46,032
(3) IVAN B SCHALLER MD......................................................................
SHP Secretary
 1.0
.................
40.0 		X   X       0 284,831 53,713
(4) JOHN P PRZYBYLINSKI MD......................................................................
SHP Director
 1.0
.................
40.0 		X           0 219,364 52,311
(5) MICHAEL LUEBKE......................................................................
SHP Chairperson
 1.0
.................
0.0 		X   X       16,000 4,000 0
(6) TIMOTHY PETERSON......................................................................
SHP Treasurer
 1.0
.................
0.0 		X   X       13,000 8,500 0
(7) ROBERT A CRIST......................................................................
SHP Director
 1.0
.................
0.0 		X           12,000 0 0
(8) TERRY FRANKLAND......................................................................
SHP Director
 1.0
.................
0.0 		X           9,000 0 0
(9) MARY JO JOHNSON......................................................................
SHP Director
 1.0
.................
0.0 		X           0 0 0
(10) JULE BRUSSOW......................................................................
SHP CHIEF EXECUTIVE OFFICER
 40.0
.................
0.0 		    X       0 404,938 45,850
(11) Gordon T Edwards......................................................................
SHP & MCHS CFO
 1.0
.................
40.0 		    X       0 128,695 8,418
(12) MARK LEPAGE MD......................................................................
SHP Chief Medical Officer
 40.0
.................
0.0 		      X     0 398,154 52,764
(13) JOHN KELLY......................................................................
SHP CHIEF MARKETING & OP OFFCR
 40.0
.................
0.0 		      X     0 263,644 55,348
(14) DAVE MARKSTEINER......................................................................
SHP Chief Information Officer
 40.0
.................
0.0 		      X     0 212,599 46,649
(15) Sue Turney MD......................................................................
MCHS CEO
 0.0
.................
40.0 		      X     0 1,091,169 169,540
(16) Daniel Ramsey......................................................................
MCHS COO
 0.0
.................
40.0 		      X     0 664,272 26,341
(17) John Cook......................................................................
MCHS CFO
 0.0
.................
40.0 		      X     0 201,496 9,266
Form 990 (2015)
Form 990 (2015)
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) Jerard Jensen........................................................................
General Counsel
 0.0
.......................40.0 		      X     0 353,735 19,077
(19) Ken Letkeman........................................................................
CIO MCHS, CEO MCIS
 0.0
.......................40.0 		      X     0 91,326 20,077
(20) LISA BOERO........................................................................
SHP CHIEF LEGAL OFFICER
 40.0
.......................0.0 		        X   0 206,257 30,503
(21) CHRIS BRUNI........................................................................
SHP DIRECTOR OF CONSUMER SALES
 40.0
.......................0.0 		        X   0 301,756 39,468
(22) SREELATHA CHALASANI MD........................................................................
SHP MEDICAL DIRECTOR
 20.0
.......................20.0 		        X   0 277,729 30,278
(23) ANUPAMA INAGANTI MD........................................................................
SHP MEDICAL DIRECTOR
 20.0
.......................20.0 		        X   0 272,064 61,862
(24) SUMEDHA PATHAK MD........................................................................
SHP MEDICAL DIRECTOR
 20.0
.......................20.0 		        X   0 288,319 30,286
(25) DAVID SIMENSTAD MD........................................................................
Former SHP Treasurer
 0.0
.......................40.0 		          X 0 950,169 58,084
(26) DOUGLAS REdING MD........................................................................
Former SHP Vice Chairperson
 0.0
.......................40.0 		          X 0 437,940 46,715
(27) BRIAN EWERT MD........................................................................
Former SHP Chairperson
 0.0
.......................40.0 		          X 0 220,409 53,639
(28) Alan Marshall........................................................................
Former Interim MCHS CFO
 1.0
.......................40.0 		          X 0 372,102 49,455




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 50,000 8,759,959 1,065,601
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet40
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
Yes
 
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
ACCORDANT HEALTH SERVICES,
4900 KOGER BLVD STE 100
GREENSBORO,NC27407 		CARE MANAGMENT 1,449,540
ASSOCIATED FINANCIAL GROUP,
711 EISENHOWER DRIVE
KIMBERLY,WI54136 		SALES AGENCY 619,588
ANSAY ASSOCIATES LLC,
888 STATE HWY 153
MOSINEE,WI54455 		SALES AGENCY 424,874
SPECTRUM BENEFIT SOLUTIONS OF CENTR,
7402 STONE RIDGE DR
WESTON,WI54476 		SALES AGENCY 359,099
ZIPPERER FINANCIAL,
1015 N 6TH STREET
WAUSAU,WI54402 		SALES AGENCY 358,346
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet20
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 0
Program Service RevenueAmt Business Code
2a FEES FOR PROV OF PREPAID HEALTH 524298 1,158,289,700 1,158,289,700    
b
c
d
e
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 1,158,289,700
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 8,452,988     8,452,988
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   904,197
b Less: rental expenses   904,197
c Rental income or (loss) 0 0
d Net rental income or (loss)......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 5,085 29,474,160
b Less: cost or other basis and sales expenses 1,953 29,288,519
c Gain or (loss) 3,132 185,641
d Net gain or (loss).....MediumBullet 188,773     188,773
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 0    
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 0      
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 0      
Business Code Miscellaneous Revenue
11a ASO ADMIN FEES 561000 3,181,109     3,181,109
b CREDENTIALING FEES 561000 7,700     7,700
c COMMISSION 561000 5,501     5,501
d All other revenue .... 38,377     38,377
e Total. Add lines 11a–11d ...... MediumBullet 3,232,687
12 Total revenue. See Instructions......MediumBullet 1,170,164,148 1,158,289,700   11,874,448
Form 990 (2015)
Form 990 (2015)
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 domestic organizations and domestic governments. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 0      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 8,154,873 6,924,908 1,229,965  
b Legal ......... 209,199   209,199  
c Accounting ........... 292,311   292,311  
d Lobbying ........... 72,522   72,522  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 777,428   777,428  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 4,508,447   4,508,447  
12 Advertising and promotion .... 2,386,348   2,386,348  
13 Office expenses ....... 3,191,303   3,191,303  
14 Information technology ...... 9,701,565   9,701,565  
15 Royalties .. 0      
16 Occupancy ........... 1,015,554   1,015,554  
17 Travel ............ 306,029   306,029  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 149,690   149,690  
20 Interest ........... 0      
21 Payments to affiliates ....... 35,902,272 18,740,439 17,161,833  
22 Depreciation, depletion, and amortization .. 6,828,234   6,828,234  
23 Insurance ... 269,588   269,588  
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 HOSPITAL/MEDICAL BENEFITS 930,490,430 930,490,430    
b PRESCRIPTION DRUG BENEFITS 119,212,817 119,212,817    
c AFFORDABLE CARE ACT FEES 19,352,996 19,352,996    
d COMMISSIONS 9,764,752 9,764,752    
e All other expenses 10,688,219   10,688,219  
25 Total functional expenses. Add lines 1 through 24e 1,163,274,577 1,104,486,342 58,788,235 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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 1,150 1 1,150
2 Savings and temporary cash investments ......... 18,041,068 2 38,263,596
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 50,514,947 4 54,912,265
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
0 5 0
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
0 6 0
7 Notes and loans receivable, net .... 0 7 0
8 Inventories for sale or use ........ 0 8 0
9 Prepaid expenses and deferred charges ...... 20,601,986 9 19,415,153
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 53,776,003
b Less: accumulated depreciation 10b 31,927,449 25,076,729 10c 21,848,554
11 Investments—publicly traded securities . 232,261,164 11 147,893,892
12 Investments—other securities. See Part IV, line 11 ..... 0 12 94,497,901
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 0 15 0
16 Total assets. Add lines 1 through 15 (must equal line 34)... 346,497,044 16 376,832,511
Liabilities 17 Accounts payable and accrued expenses ..... 108,636,229 17 122,412,515
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 20,644,282 19 23,403,583
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
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.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 3,554,163 23 2,860,799
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
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 2,268,702 25 3,451,000
26 Total liabilities. Add lines 17 through 25.. 135,103,376 26 152,127,897
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 ... 0 31 0
32 Retained earnings, endowment, accumulated income, or other funds 211,393,668 32 224,704,614
33 Total net assets or fund balances ........... 211,393,668 33 224,704,614
34 Total liabilities and net assets/fund balances ........ 346,497,044 34 376,832,511
Form 990 (2015)
Form 990 (2015)
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
1,170,164,148
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,163,274,577
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
6,889,571
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
211,393,668
5
Net unrealized gains (losses) on investments ...............
5
-5,294,830
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
11,716,205
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
224,704,614
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 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SECURITY HEALTH PLAN OF WISCONSIN INC
 
Employer identification number

39-1572880
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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)
Revenue included on 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
Revenue included on 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) 2015

Schedule D (Form 990) 2015
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" on 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, for escrow or custodial account liability?
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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c 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 on 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" on 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' on 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   9,526,962 4,164,767 5,362,195
c Leasehold improvements   902,563 273,594 628,969
d Equipment ...   40,052,205 27,489,087 12,563,118
e Other ...   3,294,272   3,294,272
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 21,848,554
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on 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) JP MORGAN CORE BOND 		30,377,197 F

(B) WESTERN ASSET US CORE BOND 		18,462,139 F

(C) RREEF AMERICA REIT II 		13,222,206 F

(D) PIMCO BRAVO II 		9,675,359 F

(E) OAKTREE SENIOR LOAN FUND 		22,761,000 F
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 94,497,901
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
CONTRACT RESERVES 3,451,000
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 3,451,000
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) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 1,158,289,700
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) 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  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3 1,158,289,700
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  
b Other (Describe in Part XIII.) ........... 4b 11,874,448
c Add lines 4a and 4b.................... 4c 11,874,448
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 1,170,164,148
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 1,148,322,553
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  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3 1,148,322,553
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  
b Other (Describe in Part XIII.) ............ 4b 14,952,024
c Add lines 4a and 4b..................... 4c 14,952,024
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 1,163,274,577

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
Form Sch D Part X Line 2 THE SYSTEM APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. BASED ON AN ANALYSIS PREPARED BY THE SYSTEM, IT WAS DETERMINED THAT THE APPLICATION OF ASC 740 HAD NO MATERIAL EFFECT ON THE SYSTEM AT SEPTEMBER 30, 2015 OR 2014.
Form Sch D Part XI Line 4b NET GAIN (LOSS) ON THE SALE OF INVESTMENTS 185,641 INTEREST INCOME 8,452,988 ASO ADMINISTRATION FEES 3,181,109 CREDENTIALING FEES 7,700 COMMISSION 5,501 MISCELLANEOUS 38,377 NET GAIN (LOSS) ON THE SALE OF ASSETS 3,132 -------------- TOTAL 11,874,448
Form Sch D Part XII Line 4b CHANGE IN RESERVES 11,716,205 ASO ADMINISTRATION FEES 3,181,109 CREDENTIALING FEES 7,700 COMMISSION 5,501 OTHER RENTAL INCOME 38,377 NET GAIN (LOSS) ON THE SALE OF ASSETS 3,132 -------------- TOTAL 14,952,024
Schedule D (Form 990) 2015


Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SECURITY HEALTH PLAN OF WISCONSIN INC
 
Employer identification number

39-1572880
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Investments N/A 2,667,737
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     2,667,737
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     2,667,737
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2015
Additional Data


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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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SECURITY HEALTH PLAN OF WISCONSIN INC
 
Employer identification number

39-1572880
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 on 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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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
Yes
 
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 on 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" on 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) 2015

Schedule J (Form 990) 2015
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 on 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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1NARYANA S MURALI MDSHP Director (i)

(ii)		  
-------------
528,688 		 
-------------
9,866 		 
-------------
19,635 		 
-------------
30,062 		 
-------------
29,863 		 
-------------
618,114 		 
-------------
 
2MATTHEW THOMAS MDSHP Vice Chairperson (i)

(ii)		  
-------------
515,188 		 
-------------
13,689 		 
-------------
19,425 		 
-------------
30,062 		 
-------------
15,970 		 
-------------
594,334 		 
-------------
 
3IVAN B SCHALLER MDSHP Secretary (i)

(ii)		  
-------------
256,707 		 
-------------
9,035 		 
-------------
19,089 		 
-------------
30,062 		 
-------------
23,651 		 
-------------
338,544 		 
-------------
 
4JOHN P PRZYBYLINSKI MDSHP Director (i)

(ii)		  
-------------
210,009 		 
-------------
5,426 		 
-------------
3,929 		 
-------------
30,062 		 
-------------
22,249 		 
-------------
271,675 		 
-------------
 
5MARK LEPAGE MDSHP Chief Medical Officer (i)

(ii)		  
-------------
387,289 		 
-------------
9,230 		 
-------------
1,635 		 
-------------
30,062 		 
-------------
22,702 		 
-------------
450,918 		 
-------------
 
6JULE BRUSSOWSHP CHIEF EXECUTIVE OFFICER (i)

(ii)		  
-------------
395,821 		 
-------------
1,523 		 
-------------
7,594 		 
-------------
30,062 		 
-------------
15,788 		 
-------------
450,788 		 
-------------
 
7JOHN KELLYSHP CHIEF MARKETING & OP OFFCR (i)

(ii)		  
-------------
257,473 		 
-------------
5,481 		 
-------------
690 		 
-------------
30,062 		 
-------------
25,286 		 
-------------
318,992 		 
-------------
 
8DAVE MARKSTEINERSHP Chief Information Officer (i)

(ii)		  
-------------
207,825 		 
-------------
4,084 		 
-------------
690 		 
-------------
30,062 		 
-------------
16,587 		 
-------------
259,248 		 
-------------
 
9LISA BOEROSHP CHIEF LEGAL OFFICER (i)

(ii)		  
-------------
201,713 		 
-------------
4,244 		 
-------------
300 		 
-------------
29,700 		 
-------------
803 		 
-------------
236,760 		 
-------------
 
10CHRIS BRUNISHP DIRECTOR OF CONSUMER SALES (i)

(ii)		  
-------------
165,715 		 
-------------
135,591 		 
-------------
450 		 
-------------
30,062 		 
-------------
9,406 		 
-------------
341,224 		 
-------------
 
11SREELATHA CHALASANI MDSHP MEDICAL DIRECTOR (i)

(ii)		  
-------------
263,871 		 
-------------
12,596 		 
-------------
1,262 		 
-------------
30,062 		 
-------------
216 		 
-------------
308,007 		 
-------------
 
12ANUPAMA INAGANTI MDSHP MEDICAL DIRECTOR (i)

(ii)		  
-------------
244,838 		 
-------------
7,911 		 
-------------
19,315 		 
-------------
30,062 		 
-------------
31,800 		 
-------------
333,926 		 
-------------
 
13SUMEDHA PATHAK MDSHP MEDICAL DIRECTOR (i)

(ii)		  
-------------
257,376 		 
-------------
11,390 		 
-------------
19,553 		 
-------------
30,062 		 
-------------
224 		 
-------------
318,605 		 
-------------
 
14DAVID SIMENSTAD MDFormer SHP Treasurer (i)

(ii)		  
-------------
903,860 		 
-------------
25,498 		 
-------------
20,811 		 
-------------
30,062 		 
-------------
28,022 		 
-------------
1,008,253 		 
-------------
 
15DOUGLAS REdING MDFormer SHP Vice Chairperson (i)

(ii)		  
-------------
386,413 		 
-------------
  		 
-------------
51,527 		 
-------------
30,062 		 
-------------
16,653 		 
-------------
484,655 		 
-------------
 
16BRIAN EWERT MDFormer SHP Chairperson (i)

(ii)		  
-------------
202,208 		 
-------------
15,688 		 
-------------
2,513 		 
-------------
30,062 		 
-------------
23,577 		 
-------------
274,048 		 
-------------
 
17Sue Turney MDMCHS CEO (i)

(ii)		  
-------------
844,302 		 
-------------
170,000 		 
-------------
76,867 		 
-------------
150,762 		 
-------------
18,778 		 
-------------
1,260,709 		 
-------------
60,100
18Daniel RamseyMCHS COO (i)

(ii)		  
-------------
660,776 		 
-------------
  		 
-------------
3,496 		 
-------------
2,080 		 
-------------
24,261 		 
-------------
690,613 		 
-------------
 
19John CookMCHS CFO (i)

(ii)		  
-------------
193,751 		 
-------------
  		 
-------------
7,745 		 
-------------
1,542 		 
-------------
7,724 		 
-------------
210,762 		 
-------------
 
20Jerard JensenGeneral Counsel (i)

(ii)		  
-------------
349,375 		 
-------------
  		 
-------------
4,360 		 
-------------
2,080 		 
-------------
16,997 		 
-------------
372,812 		 
-------------
 
21Alan MarshallFormer Interim MCHS CFO (i)

(ii)		  
-------------
359,264 		 
-------------
9,061 		 
-------------
3,777 		 
-------------
30,062 		 
-------------
19,393 		 
-------------
421,557 		 
-------------
 
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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
990 PART VII, LINE 1 AND SCHEDULES J-1 AND J-2 MARSHFIELD CLINIC (EIN# 39-0452970) AND SECURITY HEALTH PLAN ARE AFFILIATES AND ORGANIZED UNDER THE MARSHFIELD CLINIC HEALTH SYSTEM. ALL SECURITY HEALTH PLAN STAFF ARE EMPLOYEES OF THE MARSHFIELD CLINIC AND ALL PAYROLL AND BENEFITS ARE PAID AND ADMINISTERED BY THE MARSHFIELD CLINIC.
Form Sch J Part I Line 3 THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE "COMMITTEE") HAS FINAL AUTHORITY FOR APPROVIING COMPENSATION AND BENEFITS OF ALL "DISQUALIFIED PERSONS" EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. COMPENSATION TO THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR WAS PAID BY RELATED PARTY MARSHFIELD CLINIC. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: A. COMPENSATION COMMITTEE B. INDEPENDENT COMPENSATION CONSULTANT C. COMPENSATION SURVEY OR STUDY D. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE E. WRITTEN EMPLOYMENT CONTRACTS
Form Sch J Part I Line 4b Susan Turney, MD - $120,700 deferred employer contribution in current reporting year Susan Turney, MD - $60,100 deferred employer contribution in prior reporting year, vested in current year PLEASE SEE SCHEDULE O DISCLOSURE RELATING TO PART VI GOVERNANCE, MANAGEMENT, AND DISCLOSURES, LINES 15A AND 15B FOR FURTHER INFORMATION.
Form Sch J Part I Line 5a Incentives are paid to internal sales representatives for achieving and maintaining membership goals.
Schedule J (Form 990) 2015
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 990-EZ 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
2015
Open to Public
Inspection
Name of the organization
SECURITY HEALTH PLAN OF WISCONSIN INC
 
Employer identification number

39-1572880
Return Reference Explanation
Form 990 Part III Line 4a SECURITY HEALTH PLAN OF WISCONSIN, INC. (SHP) PROVIDES A NETWORK FOR PREPAID HEALTH CARE SERVICES TO APPROXIMATELY 220,000 MEMBERS. IN 2015, 51% OF SHP ENROLLMENT WAS FROM EMPLOYER GROUPS AND DIRECT PAY SUBSCRIBERS WITHIN THE HEALTHCARE, MANUFACTURING, GOVERNMENT, AND DAIRY INDUSTRIES; 27% FROM MEDICAID; 1% FROM MEDICARE SUPPLEMENT; 21% WAS FROM MEDICARE ADVANTAGE. SHP ALSO OFFERS ADMINISTRATIVE SERVICES ONLY CONTRACTS (ASO) TO SELF INSURED GROUPS. SHP OFFERS COMMUNITY RATING FOR MEDICARE SUPPLEMENT MEMBERS PARTICIPATING IN THE MEDICAID HMO. IN ADDITION, SHP OFFERS COVERAGE TO INDIVIDUALS AND LARGE AND SMALL GROUPS, WITH PORTABILITY UPON LEAVING THE GROUP. SHP PARTICIPATES IN MEDICAL RESEARCH, EDUCATION OF OUR MEMBERS, COMMUNITY EDUCATION, CANCER SCREENING TESTS, AND THE MEDICARE ADVANTAGE PROGRAM.
Form 990 Part IV, Line 12 THE AUDITED FINANCIAL STATEMENTS WERE PREPARED USING ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE STATE OF WISCONSIN OFFICE OF THE COMMISSIONER OF INSURANCE, STATUTORY ACCOUNTING, WHICH DIFFERS FROM U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES
FORM 990 PART VI, SECTION A, LINE 1B SECURITY HEALTH PLAN (SHP) PAYS A STIPEND TO THEIR INDEPENDENT BOARD MEMBERS EACH YEAR. THE COMPENSATION IS ONLY FOR THE SERVICES PROVIDED IN THEIR CAPACITY AS A MEMBER OF THE GOVERNING BODY. SHP FEELS THE STIPEND IS NECESSARY TO ATTRACT AND MAINTAIN HIGHLY QUALIFIED INDEPENDENT BOARD MEMBERS.
Form 990 Part VI Line 7a & 7b MARSHFIELD CLINIC HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF SECURITY HEALTH PLAN. THERE ARE NINE MEMBERS ON THE SHP BOARD; FOUR MEMBERS SERVE ON THE MARSHFIELD CLINIC, INC. BOARD OF DIRECTORS; TWO MEMBERS ARE "INDEPENDENT MEMBERS" OF THE. SOLE CORPORATE MEMBER'S BOARD OF DIRECTORS AND THREE MEMBERS ARE "INDEPENDENT" MEMBERS WITHIN THE MEANING OF WIS ADMIN CODE INS 50.15(4).
Form 990 Part VI Line 11a AFTER AN IN-DEPTH REVIEW BY THE CONTROLLER, MCHS CFO, AS WELL AS OUTSIDE TAX ADVISOR, KPMG, LLP, AND PRIOR TO FILLING WITH THE IRS, FORM 990 WILL BE DISTRIBUTED TO EACH BOARD MEMBER. ANY QUESTIONS THAT ARISE FROM THE BOARD OF DIRECTORS ARE ANSWERED BY THE CONTROLLER OR MCHS CFO.
Form 990 Part VI Line 12c SECURITY HEALTH PLAN OFFICERS, BOARD OF DIRECTORS, KEY EMPLOYEES, AND OTHER MANAGEMENT PERSONNEL ALL SIGN A CONFLICT OF INTEREST DISCLOSURE FORM EACH YEAR.
FORM 990, PART VI, LINE 15a & 15b THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL "DISQUALIFIED PERSONS" (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE "CODE")) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM "DISQUALIFIED PERSONS" INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXCERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO ENSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE ICC SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION THE COMMITTEE CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION.
Form 990 Part VI Line 19 THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE FOR REVIEW UPON REQUEST. ANNUAL FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST FROM THE WISCONSIN OFFICE OF THE COMMISSIONER OF INSURANCE.
Form 990 Part XI Line 9 CHANGE IN RESERVES (11,716,205)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


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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 Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SECURITY HEALTH PLAN OF WISCONSIN INC
 
Employer identification number

39-1572880
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
(1) SECURITY ADMINISTRATIVE SERVICES LLC
1515 NORTH SAINT JOSEPH AVENUE
MARSHFIELD,WI54449
47-4820788 		Administrator WI 0 0 SHP
 










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)Marshfield Clinic Inc
1000 NORTH OAK AVENUE

MARSHFIELD,WI54449
39-0452970 		HOSPITAL WI 501(C)(3) 3 NA
 
 
No
(2)LAKEVIEW MEDICAL CENTER OF RICE LAKE
1700 W STOUT STREET

RICE LAKE,WI54868
39-0837206 		HOSPITAL WI 501(C)(3) 3 NA
 
 
No
(3)VOLUNTEER PARTNERS OF LAKE MED CNTR
1700 W STOUT STREET

RICE LAKE,WI54868
39-1329084 		SUPPORT ORG WI 501(C)(3) 11, III-O NA
 
 
No
(4)FLAMBEAU HOSPITAL INC
98 SHERRY AVENUE

PARK FALLS,WI54552
39-0973724 		HOSPITAL WI 501(C)(3) 3 NA
 
 
No
(5)MARSHFIELD CLINIC HEALTH SYSTEM INC
1000 NORTH OAK AVENUE

MARSHFIELD,WI54449
46-1495343 		SUPPORT ORG WI 501(C)(3) 11, III-0 NA
 
 
No
(6)MARSHFIELD CLINIC HERITAGE FNDTN INC
1000 NORTH OAK AVENUE

MARSHFIELD,WI54449
39-1865942 		HONOR INDIVID WI 501(C)(3) 11-TYPE 1 NA
 
 
No
(7)FAMILY HEALTH CENTER OF MARSHFIELD Inc
1307 NORTH ST JOSEPHS AVENUE

MARSHFIELD,WI54449
39-0452970 		HOSPITAL WI 501(C)(3) 7 NA
 
 
No
(8)MCHS HOSPITALS INC
1000 NORTH OAK AVENUE

MARSHFIELD,WI54449
81-0977948 		HOSPITAL WI 501(C)(3) 3 NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) DIAGNOSTIC TREATMENT CTR

3401 CRANBERRY BOULEVARD
WESTON,WI54449
20-0691634 		Medical Services WI NA
  		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) MARSHFIELD CLINIC INFO Services INC

1701 N FIG AVE
MARSHFIELD,WI54449
46-3943697 		INFO TECH SVCS WI MFLD CLINIC
  		C Corp         No
(2) MCIS Inc

1701 N FIG AVE
MARSHFIELD,WI54449
47-2138889 		INFO TECH SVCS WI MFLD CLINIC
  		C Corp         No










Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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
Yes
 
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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
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
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
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) 2015
Schedule R (Form 990) 2015
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) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Part I NOTE 1: MARSHFIELD CLINIC HEALTH SYSTEM, INC. (A 501(C)3 ORGANIZATION), IS THE PARENT ORGANIZATION OF MARSHFIELD CLINIC, INC. NOTE 2: THE FOLLOWING COMPANIES ARE RELATED TO to Security Health Plan, Inc. THROUGH BROTHER/SISTER RELATIONSHIPS (ALL WITH PARENT COMPANY BEING MARSHFIELD CLINIC HEALTH SYSTEM, INC.): LAKEVIEW MEDICAL CENTER, INC. SECURITY HEALTH PLAN OF WISCONSIN, INC. FLAMBEAU HOSPITAL, INC. (SEE NOTE5 BELOW) MCIS, INC. (SEE NOTE 9 BELOW) NOTE 3: THE FOLLOWING COMPANIES ARE SUBSIDIARIES OF MARSHFIELD CLINIC, INC., A RELATED 501(C)(3) ORGANIZATION: MARSHFIELD FOOD SAFETY, LLC (SEE NOTE 8 BELOW) MARSHFIELD CLINIC HERITAGE FOUNDATION, INC. FAMILY HEALTH CENTER OF MARSHFIELD, INC. (SEE NOTE 10 BELOW) DIAGNOSTIC & TREATMENT CENTER, LLC (SEE NOTE 4 BELOW) MARSHFIELD CLINIC INFORMATION SERVICES, INC. (SEE NOTE 7 BELOW) NOTE 4: MARSHFIELD CLINIC, INC. OWNS A 50% INTEREST IN THE DIAGNOSTIC & TREATMENT CENTER, LLC. THOSE RESULTS ARE REPORTED ON THE BOOKS AND RECORDS OF MARSHFIELD CLINIC, INC. NOTE 5: MARSHFIELD CLINIC HEALTH SYSTEM, INC. HAS A 50% MEMBER INTEREST IN FLAMBEAU HOSPITAL, INC. THOSE RESULTS ARE REPORTED ON THE BOOKS AND RECORDS OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. NOTE 6: VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL CENTER, INC., IS A SUPPORTING ORGANIZATION OF LAKEVIEW MEDICAL CENTER, INC. NOTE 7: AS OF 1/1/15, AND AS DIRECTED BY AN OFFICIAL PLAN OF MERGER, MARSHFIELD CLINIC INFORMATION SERVICES, INC. EFFECTIVELY MERGED WITH AND INTO MCIS, INC., THE SURVIVING COPORATION. MARSHFIELD CLINIC INFORMATION SERVICES, INC. WAS EFFECTIVELY DISSOLVED AS OF 1/1/15. NOTE 8: MARSHFIELD FOOD SAFETY, INC. IS A 100% OWNED SUBSIDIARY OF MARSHFIELD CLINIC, INC. AND IS a disregarded entity of MARSHFIELD CLINIC, INC FOR TAX PURPOSES. NOTE 9: STOCK OWNERSHIP OF MCIS, INC. TRANSFERRED FROM MARSHFIELD CLINIC, INC. TO MARSHFIELD CLINIC HEALTH SYSTEM, INC. ON 1/1/15. NOTE 10: MARSHFIELD CLINIC, INC. IS THE SOLE CORPORATE (NON-VOTING) MEMBER OF FAMILY HEALTH CENTER OF MARSHFIELD, INC. MARSHFIELD CLINIC, INC. DOES NOT HAVE THE AUTHORITY TO APPOINT BOARD MEMBERS AND THEREFORE IS NOT CONSIDERED TO HAVE CONTROL (AS DEFINED FOR 990 REPORTING PURPOSES) OVER FAMILY HEALTH CENTER OF MARSHFIELD, INC.
Schedule R (Form 990) 2015

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