Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | ILLINOIS FAIR PLAN HANDLES CLAIM MANAGEMENT AND DATA PROCESSING DUTIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | WISCONSIN INSURANCE PLAN IS AN ASSOCIATION CREATED BY STATE CHARTER. PROPERTY CASUALTY INSURANCE COMPANIES LICENSED TO DO BUSINESS IN WISCONSIN CAN BE ASSESSED BASED ON THEIR ANNUAL PREMIUMS TO COVER WISCONSIN INSURANCE PLAN'S LOSSES AND CAN APPOINT MEMBERS TO WISCONSIN INSURANCE PLAN'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7A | WISCONSIN INSURANCE PLAN IS AN ASSOCIATION CREATED BY STATE CHARTER. PROPERTY CASUALTY INSURANCE COMPANIES LICENSED TO DO BUSINESS IN WISCONSIN CAN BE ASSESSSED BASED ON THEIR ANNUAL PREMIUMS TO COVER WISCONSIN INSURANCE PLAN'S LOSSES AND CAN APPOINT MEMBERS TO WISCONSIN INSURANCE PLAN'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 PREPARED BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT IS REVIEWED BY THE PLAN MANAGER BEFORE SIGNING THE FORM. |
| FORM 990, PART VI, SECTION B, LINE 12C | EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION WILL PROVIDE COPIES OF THE DOCUMENTS UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE PART OF THE WISCONSIN ADMINISTRATIVE CODE. FINANCIAL STATMENTS ARE FURNISHED TO THE STATE OFFICE OF THE COMMISSIONER OF INSURANCE. THE DOCUMENTS, STATEMENTS AND CONFLICT OF INTEREST STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION AT THE PLAN'S OFFICE. |
| FORM 990, PART XI, LINE 9: | CHANGE IN NON-ADMITTED ASSETS 248,056. |
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