TY 2019 Form 990

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

SC INSURANCE COMPANY
C/O DOUGLAS WELDAY

Employer identification number

27-3312053

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................1

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) SWEDISH COVENANT HEALTH	362179813	3	Yes		10,825,159	0

Total 1					10,825,159	0

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Yes

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Yes

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SC INSURANCE COMPANY
C/O DOUGLAS WELDAY

Employer identification number

27-3312053

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 ....
c	Leasehold improvements
d	Equipment ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..		0

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2019

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	3,726,728
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	0
3	Subtract line 2e from line 1..................		3	3,726,728
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
c	Add lines 4a and 4b....................		4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	3,726,728

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	1,469,810
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	0
3	Subtract line 2e from line 1...................		3	1,469,810
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
c	Add lines 4a and 4b.....................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	1,469,810

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2:	SCIC IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, LITERARY, SCIENTIFIC OR EDUCATION PURPOSES AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). SCIC IS OPERATED UNDER THE SUPERVISION AND CONTROL OF THE HOSPITAL AND IS AN INTEGRAL PART OF THE PERFORMANCE OF THE EXEMPT PURPOSES OF THE HOSPITAL. AS AN IRC SECTION 501(C)(3) ORGANIZATION, SCIC FILED ITS FORM 1023, APPLICATION FOR RECOGNITION OF EXEMPTION UNDER SECTION 501(C)(3) OF THE IRC, ON SEPTEMBER 1, 2011. THE INTERNAL REVENUE SERVICE GRANTED TAX-EXEMPT STATUS AND, ACCORDINGLY, NO TAXES ARE PAID OR ACCRUED RELATED TO THE FINANCIAL STATEMENTS PRESENTED. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE 'MORE LIKELY THAN NOT' RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE CONSOLIDATED BALANCE SHEET INCLUDES ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT DECEMBER 31, 2019 THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES.

Return Reference

Explanation

PART X, LINE 2:

SCIC IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, LITERARY, SCIENTIFIC OR EDUCATION PURPOSES AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). SCIC IS OPERATED UNDER THE SUPERVISION AND CONTROL OF THE HOSPITAL AND IS AN INTEGRAL PART OF THE PERFORMANCE OF THE EXEMPT PURPOSES OF THE HOSPITAL. AS AN IRC SECTION 501(C)(3) ORGANIZATION, SCIC FILED ITS FORM 1023, APPLICATION FOR RECOGNITION OF EXEMPTION UNDER SECTION 501(C)(3) OF THE IRC, ON SEPTEMBER 1, 2011. THE INTERNAL REVENUE SERVICE GRANTED TAX-EXEMPT STATUS AND, ACCORDINGLY, NO TAXES ARE PAID OR ACCRUED RELATED TO THE FINANCIAL STATEMENTS PRESENTED. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE 'MORE LIKELY THAN NOT' RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE CONSOLIDATED BALANCE SHEET INCLUDES ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT DECEMBER 31, 2019 THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES.

Schedule D (Form 990) 2019

Additional Data

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- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SC INSURANCE COMPANY
C/O DOUGLAS WELDAY

Employer identification number

27-3312053

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

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 on Line 1a? ..

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JANIS A RUEPING ASSISTANT SECRETARY	(i) (ii)	0 ------------- 180,654	0 ------------- 101,060	0 ------------- 44,426	0 ------------- 21,484	0 ------------- 25,676	0 ------------- 373,300	0 ------------- 16,609
2JONATHAN LIND VP	(i) (ii)	0 ------------- 252,092	0 ------------- 130,340	0 ------------- 48,066	0 ------------- 29,086	0 ------------- 25,962	0 ------------- 485,546	0 ------------- 16,544
3ANTHONY GUACCIO PRESIDENT/CHAIR	(i) (ii)	0 ------------- 475,966	0 ------------- 303,180	0 ------------- 80,210	0 ------------- 68,316	0 ------------- 17,087	0 ------------- 944,759	0 ------------- 41,379
4THOMAS GARVEY VP/TREASURER	(i) (ii)	0 ------------- 351,525	0 ------------- 218,180	0 ------------- 197,044	0 ------------- 30,385	0 ------------- 13,940	0 ------------- 811,074	0 ------------- 167,125
5JUDITH A BORENSTEIN VP OPERATIONS/SECRETARY	(i) (ii)	0 ------------- 185,372	0 ------------- 3,043	0 ------------- 38,962	0 ------------- 6,955	0 ------------- 10,769	0 ------------- 245,101	0 ------------- 0
6NICOLA BYRNE ASSISTANT TREASURER	(i) (ii)	0 ------------- 194,966	0 ------------- 63,967	0 ------------- 25,000	0 ------------- 8,250	0 ------------- 4,415	0 ------------- 296,598	0 ------------- 0
7SCOTT HANSON ASSISTANT TREASURER	(i) (ii)	0 ------------- 138,768	0 ------------- 14,853	0 ------------- 11,309	0 ------------- 5,226	0 ------------- 26,605	0 ------------- 196,761	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 3	THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES ARE COMPENSATED BY THE RELATED ORGANIZATIONS COVENANT MINISTRIES OF BENEVOLENCE AND SWEDISH COVENANT HEALTH. THE HOSPITAL AND COVENANT MINISTRIES OF BENEVOLENCE FOLLOW THE REQUIREMENTS SET FORTH IN THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS AND EXECUTIVE LEADERS OF THE CORPORATION. THE PROCESS INCLUDES REVIEW OF COMPARABILITY DATA, RETENTION OF AN OUTSIDE COMPENSATION CONSULTANT, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION THROUGH DETAILED MINUTES OF THE COMPENSATION COMMITTEE AND FULL BOARD MEETINGS WHERE EXECUTIVE COMPENSATION IS CONSIDERED.
PART I, LINE 4B	EXECUTIVE BENEFIT PLAN COVENANT MINISTRIES OF BENEVOLENCE (CMB) PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO ITS OFFICERS AND KEY EMPLOYEES. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH A PORTION OF THE BENEFITS BEING EARNED ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE COMPENSATION COMMITTEE OF CMB'S BOARD TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. THE COMMITTEE APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER EXECUTIVES, IN A MANNER INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF FEDERAL INCOME TAX LAW. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE EXECUTIVE BENEFIT PLAN: THOMAS GARVEY - $29,675 ANTHONY GUACCIO - $64,370 JANIS A RUEPING - $16,910 JONATHAN LIND - $24,967

Return Reference

Explanation

PART I, LINE 3

THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES ARE COMPENSATED BY THE RELATED ORGANIZATIONS COVENANT MINISTRIES OF BENEVOLENCE AND SWEDISH COVENANT HEALTH. THE HOSPITAL AND COVENANT MINISTRIES OF BENEVOLENCE FOLLOW THE REQUIREMENTS SET FORTH IN THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS AND EXECUTIVE LEADERS OF THE CORPORATION. THE PROCESS INCLUDES REVIEW OF COMPARABILITY DATA, RETENTION OF AN OUTSIDE COMPENSATION CONSULTANT, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION THROUGH DETAILED MINUTES OF THE COMPENSATION COMMITTEE AND FULL BOARD MEETINGS WHERE EXECUTIVE COMPENSATION IS CONSIDERED.

PART I, LINE 4B

EXECUTIVE BENEFIT PLAN COVENANT MINISTRIES OF BENEVOLENCE (CMB) PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO ITS OFFICERS AND KEY EMPLOYEES. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH A PORTION OF THE BENEFITS BEING EARNED ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE COMPENSATION COMMITTEE OF CMB'S BOARD TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. THE COMMITTEE APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER EXECUTIVES, IN A MANNER INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF FEDERAL INCOME TAX LAW. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE EXECUTIVE BENEFIT PLAN: THOMAS GARVEY - $29,675 ANTHONY GUACCIO - $64,370 JANIS A RUEPING - $16,910 JONATHAN LIND - $24,967

Schedule J (Form 990) 2019

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SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet

Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet

Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet

Attach to Form 990 or 990-EZ.
bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
SC INSURANCE COMPANY
C/O DOUGLAS WELDAY

Employer identification number
27-3312053

Part I

Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36. Part I can be duplicated if additional space is needed.

1(a) Description of asset(s) distributed or transaction expenses paid	(b) Date of distribution	(c) Fair market value of asset(s) distributed or amount of transaction expenses	(d) Method of determining FMV for asset(s) distributed or transaction expenses	(e) EIN of recipient	(f) Name and address of recipient	(g) IRC section of recipient(s) (if tax-exempt) or type of entity
NET ASSETS TRANSFER TO SWEDISH COVENANT HEALTH	01-31-2020	24,214,502	TOTAL NET ASSETS VALUE AT THE TIME OF THE TRANSFER.	36-2179813	SWEDISH COVENANT HEALTH 5145 N CALIFORNIA AVENUE CHICAGO,IL60625	501(C)(3)

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? .........................

Yes

Become an employee of, or independent contractor for, a successor or transferee organization? .....................

Yes

Become a direct or indirect owner of a successor or transferee organization? .....................

Receive, or become entitled to, compensation or other similar payments as a result of the organization's significant disposition of assets? ........

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2019)

Page 2

Part I

Liquidation, Termination, or Dissolution (continued)

Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.

Yes

Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III .............

Yes

Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? ......

Yes

If "Yes," did the organization provide such notice? .....................

Yes

Did the organization discharge or pay all of its liabilities in accordance with state laws? .....................

Yes

Did the organization have any tax-exempt bonds outstanding during the year? .....................

If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?

If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.

Part II

Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.

1(a) Description of asset(s) distributed or transaction expenses paid	(b) Date of distribution	(c) Fair market value of asset(s) distributed or amount of transaction expenses	(d) Method of determining FMV for asset(s) distributed or transaction expenses	(e) EIN of recipient	(f) Name and address of recipient	(g) IRC section of recipient(s) (if tax-exempt) or type of entity

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? .........................

Yes

Become an employee of, or independent contractor for, a successor or transferee organization? .....................

Yes

Become a direct or indirect owner of a successor or transferee organization? .....................

Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? ........

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2019)

Page 3

Part III

Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.

Return Reference	Explanation

PART I, LINE 2E:

EXPLANATION OF INVOLVEMENT: THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF SWEDISH COVENANT HEALTH AND RECEIVED NO ADDITIONAL BENEFITS:ANTHONY GUACCIOTHOMAS GARVEYJONATHAN LINDJANIS A RUEPINGJUDITH A BORENSTEINNICOLA BYRNE

Schedule N (Form 990 or 990-EZ) (2019)

Additional Data

Software ID:
Software Version:

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

SC INSURANCE COMPANY
C/O DOUGLAS WELDAY

Employer identification number

27-3312053

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	MANY OF THE PERSONS LISTED ON PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON RELATED SWEDISH COVENANT HEALTH ENTITY BOARDS.
FORM 990, PART VI, SECTION A, LINE 3	SC INSURANCE COMPANY ("SCIC") HAS A MANAGEMENT AGREEMENT WITH BEECHER CARLSON INSURANCE SERVICES, INC. ("BEECHER"). BEECHER PERFORMS, UNDER THE DIRECTION AND CONTROL OF SCIC, CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES, WHICH INCLUDE INSURANCE RELATED CONSULTING, ACCOUNTING SERVICES AND THE PREPARATION OF THE ANNUAL STATEMENT. THE MANAGEMENT FEE IS SUBJECT TO ANNUAL NEGOTIATION.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER IS SWEDISH COVENANT HEALTH (HOSPITAL).
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBER ELECTS THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE BYLAWS GRANT RESERVED POWERS TO THE MEMBER, SUCH AS APPROVAL OF AMENDMENTS TO THE BYLAWS OF THE CORPORATION, AND THE POWER TO ELECT OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	AN OUTSIDE ACCOUNTING FIRM PROVIDED A LIMITED SCOPE REVIEW FOR PRESENTATION AND REASONABLENESS. AFTER FILING, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND KEY PROVISIONS ARE DISCUSSED.
FORM 990, PART VI, SECTION B, LINE 12C	SC INSURANCE COMPANY HAS AN ADMINISTRATIVE POLICY ON CONFLICT OF INTEREST, IDENTIFYING THE PARAMETERS OF A CONFLICT OF INTEREST AND THE REQUIREMENT TO DISCLOSE ANY SUCH CONFLICT OF INTEREST. EACH SEPTEMBER, THE BOARD MEMBERS, DIRECTORS AND OFFICERS ARE ASKED TO SIGN A DISCLOSURE STATING THAT THEY DO NOT HAVE ANY CONFLICTS OF INTEREST. ALL CONFLICT OF INTEREST POLICIES HAVE BEEN SIGNED AND RETURNED, AND REVIEWED BY GENERAL COUNSEL. NO CONFLICTS OF ANY SORT WERE NOTED. IF A PERSON BECOMES AN INTERESTED PERSON HE OR SHE MAY BE CONSIDERED IN DETERMINING WHETHER A QUORUM IS PRESENT. THE INTERESTED PERSON MAY MAKE A SHORT STATEMENT RELATING TO THE TRANSACTION OR ARRANGEMENT IN QUESTION, BUT SHALL NOT VOTE ON THE MOTION ADDRESSING THE ACTUAL OR POTENTIAL CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES ARE COMPENSATED BY THE RELATED ORGANIZATIONS COVENANT MINISTRIES OF BENEVOLENCE AND SWEDISH COVENANT HEALTH. THE HOSPITAL AND COVENANT MINISTRIES OF BENEVOLENCE FOLLOW THE REQUIREMENTS SET FORTH IN THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS AND EXECUTIVE LEADERS OF THE CORPORATION. THE PROCESS INCLUDES REVIEW OF COMPARABILITY DATA, RETENTION OF AN OUTSIDE COMPENSATION CONSULTANT, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION THROUGH DETAILED MINUTES OF THE COMPENSATION COMMITTEE AND FULL BOARD MEETINGS WHERE EXECUTIVE COMPENSATION IS CONSIDERED. THE GOVERNANCE COMMITTEE OF SWEDISH COVENANT HEALTH HAS ESTABLISHED THE EXECUTIVE COMPENSATION PROGRAM TO ENABLE THE ORGANIZATION TO RECRUIT, MOTIVATE AND RETAIN HIGHLY QUALIFIED EXECUTIVES TO SUCCESSFULLY CARRY OUT ITS MISSION STATEMENT AND CORE VALUES. THE PROGRAM ALSO SERVES TO ALIGN THE INTERESTS OF OUR EXECUTIVE OFFICERS WITH THOSE OF OUR COMMUNITY BY PLACING A REASONABLE PORTION OF COMPENSATION AT RISK THROUGH PERFORMANCE GOALS THAT, IF ACHIEVED, ARE EXPECTED TO INCREASE THE AGGREGATE HEALTH LEVEL OF THE COMMUNITIES WE SERVE AND CONTRIBUTE TO THE LONG-TERM SUCCESS OF THE ORGANIZATION. ADDITIONALLY, THE EXECUTIVE COMPENSATION PROGRAM WILL ENABLE THE ORGANIZATION TO REWARD PERFORMANCE THAT EMPHASIZES TEAMWORK AND CLOSE COLLABORATION AMONG EXECUTIVE OFFICERS, SUPPORTS ORGANIZATIONAL EXCELLENCE BY LEVERAGING ENTERPRISE-WIDE CAPABILITIES, DRIVES EFFICIENCIES AND INTEGRATES CARE AND SERVICES FOR THE BENEFIT OF OUR COMMUNITIES. THE PROGRAM WILL ALSO ASSIST THE ORGANIZATION IN REWARDING THE ACHIEVEMENT OF SPECIFIC ANNUAL, LONG-TERM AND STRATEGIC GOALS, AND ALIGN EXECUTIVE OFFICERS' INTERESTS WITH THOSE OF THE COMMUNITIES WE SERVE BY REWARDING PERFORMANCE THAT MEETS OR EXCEEDS ESTABLISHED GOALS, WITH THE ULTIMATE OBJECTIVE OF INCREASING COMMUNITY HEALTH. THE OVERALL EXECUTIVE COMPENSATION PROGRAM ALIGNS SHORT- AND LONG-TERM PERFORMANCE WITH THE GOALS OF THE ORGANIZATION AND ENSURES COST-EFFECTIVE AND EFFICIENT USE OF CAPITAL RESOURCES BY OFFERING THE APPROPRIATE AMOUNTS AND MIX OF COMPENSATION. BASE SALARY REPRESENTS A FIXED COMPENSATION COMPONENT SET AT A LEVEL COMMENSURATE WITH THE ROLES AND RESPONSIBILITIES IF EACH INDIVIDUAL EXECUTIVE POSITION TO ATTRACT, MOTIVATE AND RETAIN TOP EXECUTIVE TALENT. THE ANNUAL INCENTIVE PLAN IS A VARIABLE SHORT-TERM PERFORMANCE-BASED COMPENSATION COMPONENT WITH TARGET AWARD AMOUNTS SET BY THE GOVERNANCE COMMITTEE FOR EACH ELIGIBLE EXECUTIVE POSITION. PAYOUTS REFLECT THE DEGREE TO WHICH THE ORGANIZATION AND THE INDIVIDUAL EXECUTIVES HAVE PERFORMED AGAINST PREDETERMINED 12-MONTH METRICS. RESULTING TOTAL CASH COMPENSATION LEVELS MAY BE BELOW OR ABOVE TARGET AMOUNTS BASED ON THE ORGANIZATION'S PERFORMANCE AGAINST ITS SHORT-TERM GOALS. GOALS ARE SOMETIMES SET AT A "STRETCH" LEVEL SUCH THAT TARGET PERFORMANCE MAY RESULT IN ABOVE-MEDIAN LEVELS OF COMPENSATION. THE ANNUAL INCENTIVE PLAN IS INTENDED TO ALIGN THE EXECUTIVE COMPENSATION PROGRAM WITH THE ORGANIZATION'S BUSINESS STRATEGY, AND STRENGTHEN THE RELATIONSHIP BETWEEN PAY AND PERFORMANCE. THE LONG-TERM INCENTIVE PLAN IS A VARIABLE THREE-YEAR PERFORMANCE-BASED COMPENSATION COMPONENT WITH TARGET AWARD AMOUNTS SET BY THE GOVERNANCE COMMITTEE FOR EACH ELIGIBLE EXECUTIVE POSITION. PAYOUTS REFLECT THE DEGREE TO WHICH THE ORGANIZATION AND THE INDIVIDUAL EXECUTIVES HAVE PERFORMED AGAINST PREDETERMINED 12-, 24- AND 36-MONTH METRICS. RESULTING TOTAL CASH LEVELS MAY BE BELOW OR ABOVE TARGET AMOUNTS BASED ON THE ORGANIZATION'S PERFORMANCE AGAINST ITS LONG-TERM GOALS. GOALS ARE SOMETIMES SET AT A "STRETCH" LEVEL SUCH THAT TARGET PERFORMANCE MAY RESULT IN ABOVE-MEDIAN LEVELS OF COMPENSATION. THE LONG-TERM INCENTIVE PLAN IS INTENDED TO ALIGN THE EXECUTIVE COMPENSATION PROGRAM WITH THE ORGANIZATION'S BUSINESS STRATEGY, STRENGTHEN THE RELATIONSHIP BETWEEN PAY AND PERFORMANCE, REINFORCE THE LINK BETWEEN THE INTERESTS OF EXECUTIVES AND THE LONG-RANGE VISION OF THE BOARD OF DIRECTORS AND PROMOTE THE RETENTION OF EXECUTIVE TALENT. QUALIFIED AND NON-QUALIFIED RETIREMENT BENEFIT PLANS ARE PROVIDED BY THE ORGANIZATION TO HELP MEET THE EXECUTIVES' PRE- AND POST-RETIREMENT FINANCIAL NEEDS, SERVE AS A BACKSTOP FOR OUR PERFORMANCE-BASED PROGRAMS AND PROMOTE THE RETENTION OF EXECUTIVE TALENT. THE BOARD OF DIRECTORS AND THE GOVERNANCE COMMITTEE ARE COMPRISED OF VOLUNTARY CITIZENS OF THE COMMUNITY WHO PERFORM THEIR DUTIES WITHOUT COMPENSATION FOR HOURS DEVOTED TO BOARD WORK. THE GOVERNANCE COMMITTEE INCLUDES AN EXECUTIVE FROM THE COVENANT MINISTRIES OF BENEVOLENCE, THE CONTROLLING MEMBER OF SWEDISH COVENANT HEALTH. A MAJORITY OF VOTING MEMBERS OF THE GOVERNANCE COMMITTEE ARE INDEPENDENT, AND THE COMMITTEE IS RESPONSIBLE FOR THE DEVELOPMENT OF THE PHILOSOPHY, POLICY AND OBJECTIVES THAT GUIDE THE ORGANIZATION'S EXECUTIVE PAY PROGRAMS AS WELL AS ESTABLISHING OUR PERFORMANCE STANDARDS AND DETERMINING THE COMPENSATION OF OUR SENIOR EXECUTIVES. THE GOVERNANCE COMMITTEE RETAINS PEARL MEYER AS THEIR INDEPENDENT COMPENSATION CONSULTANT TO ASSIST THE COMMITTEE IN THE CONTINUED DEVELOPMENT AND EVALUATION OF THE ORGANIZATION'S COMPENSATION POLICIES AND PRACTICES AND THE COMMITTEE'S DETERMINATION OF COMPENSATION. THE GOVERNANCE COMMITTEE HAS THE SOLE AUTHORITY TO RETAIN AND TERMINATE THE INDEPENDENT COMPENSATION CONSULTANT AND TO REVIEW AND APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. THE GOVERNANCE COMMITTEE HAS THE AUTHORITY TO APPROVE NEW EXECUTIVE COMPENSATION PLANS AND MATERIAL AMENDMENTS TO EXISTING EXECUTIVE COMPENSATION PLANS. THE GOVERNANCE COMMITTEE PROVIDES THE BOARD WITH REPORTS ON ITS ACTIONS AND DECISIONS FOLLOWING EVERY GOVERNANCE COMMITTEE MEETING. MANAGEMENT PROVIDES DATA, ANALYSIS AND RECOMMENDATIONS FOR THE GOVERNANCE COMMITTEE'S CONSIDERATION REGARDING THE ORGANIZATION'S EXECUTIVE COMPENSATION PROGRAMS AND POLICIES AND ASSISTS THE GOVERNANCE COMMITTEE IN CARRYING OUT ITS RESPONSIBILITIES. MANAGEMENT ALSO PROVIDES INFORMATION TO THE GOVERNANCE COMMITTEE'S INDEPENDENT COMPENSATION CONSULTANT IN CONNECTION WITH THE CONSULTANT'S ROLE IN ADVISING THE GOVERNANCE COMMITTEE. THE CEO TYPICALLY ATTENDS THE COMMITTEE MEETINGS. THE GOVERNANCE COMMITTEE ALSO MEETS REGULARLY IN EXECUTIVE SESSION OUTSIDE THE PRESENCE OF MANAGEMENT. WHILE THE GOVERNANCE COMMITTEE CONSIDERS THE RECOMMENDATIONS OF THE CEO AND THE INPUT RECEIVED FROM ITS INDEPENDENT COMPENSATION CONSULTANT, MOST COMPENSATION DECISIONS FOR THE ORGANIZATION'S EXECUTIVES ARE MADE BY MANAGEMENT WITHIN THEIR PRESCRIBED PARAMETERS DICTATED BY THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE RETAINS ITS INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT A COMPREHENSIVE REVIEW OF THE TOTAL COMPENSATION PROVIDED TO THE ORGANIZATION'S EXECUTIVES RELATIVE TO COMPETITIVE AND COMPARABLE MARKET PRACTICES, ENSURE THAT THE ORGANIZATION'S COMPENSATION PROGRAMS PROVIDE TOTAL COMPENSATION OPPORTUNITIES THAT ARE REASONABLE FOR PURPOSES OF INTERMEDIATE SANCTIONS (IRC SECTION 4958), ASSESS THE COMPETITIVENESS OF THE ORGANIZATION'S COMPENSATION PROGRAMS WITH RESPECT TO HEALTHCARE INDUSTRY PEER ORGANIZATIONS, ASSIST THE GOVERNANCE COMMITTEE WITH ITS CHARTER REVIEW, REVIEW ANNUAL DISCLOSURES AND THE COMPENSATION OF "DISQUALIFIED INDIVIDUALS" WHOSE COMPENSATION IS SUBJECT TO A REASONABLENESS REVIEW UNDER IRC SECTION 4958, PROVIDE AN OPINION LETTER TO THE GOVERNANCE COMMITTEE REGARDING THE REASONABLENESS OF THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVES AND OTHER "DISQUALIFIED PERSONS AND HELP TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS WITH REGARD TO EXECUTIVE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 18	A COPY OF THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST BY CONTACTING THE PARENT COMPANY SWEDISH COVENANT HEALTH ADMINISTRATION DEPARTMENT AT (773)878-8200.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D), BY CONTACTING THE PARENT COMPANY SWEDISH COVENANT HEALTH ADMINISTRATION DEPARTMENT AT (773)878-8200.
FORM 990, PART XI, LINE 9:	NET ASSETS TRANSFER TO SWEDISH COVENANT HEALTH -24,214,502.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SC INSURANCE COMPANY
C/O DOUGLAS WELDAY

Employer identification number

27-3312053

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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	Yes	No
(1)COVENANT MINISTRIES OF BENEVOLENCE (CMB) 5145 N CALIFORNIA AVENUE CHICAGO,ID60625 36-3486813	MANAGEMENT/SUPPORT SERVICES	IL	501(C)(3)	LINE 12A, I	EVANGELICAL COVENANT CHURCH (ECC)		No
(2)SWEDISH COVENANT HEALTH 5145 N CALIFORNIA AVENUE CHICAGO,IL60625 36-2179813	HOSPITAL	IL	501(C)(3)	LINE 3	COVENANT MINISTRIES OF BENEVOLENCE (CMB)		No
(3)SWEDISH COVENANT HOSPITAL FOUNDATION (SCHF) 5145 N CALIFORNIA AVENUE CHICAGO,IL60625 20-5055155	SUPPORT OF SWEDISH COVENANT HOSPITAL	IL	501(C)(3)	LINE 7	SWEDISH COVENANT HOSPITAL (SCH)	Yes
(4)NORTHSHORE UNIVERSITY HEALTHSYSTEM 1301 N CENTRAL AVE EVANSTON,IL60201 36-2167060	HEALTHCARE	IL	501(C)(3)	LINE 3	N/A		No
(5)NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES 1301 CENTRAL AVE EVANSTON,IL60201 36-3738206	HEALTHCARE	IL	501(C)(3)	LINE 3	NORTHSHORE UNIVERSITY HEALTHSYSTEM	Yes
(6)RADIATION MEDICINE INSTITUTE 1301 CENTRAL AVE EVANSTON,IL60201 36-3815543	HEALTHCARE	IL	501(C)(3)	LINE 3	NORTHSHORE UNIVERSITY HEALTHSYSTEM	Yes
(7)HEALTHCARE FOUNDATION OF HIGHLAND PARK 610 CENTRAL AVE HIGHLAND PARK,IL60035 36-3196647	HEALTHCARE	IL	501(C)(3)	LINE 7	NORTHSHORE UNIVERSITY HEALTHSYSTEM	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) COVENANT VILLAGE OF PORTLAND LP 420 NE MASON ST PORTLAND,OR97211 36-4356838	ASSISTED LIVING COMMUNITY	OR	N/A
(2) RAVINE WAY SURGERY CENTER LLC 2401 RAVINE WAY GLENVIEW,IL60025 20-1245279	HEALTHCARE	IL	N/A
(3) HPMOB LIMITED PARTNERSHIP 1301 CENTRAL STREET EVANSTON,IL60201 36-3497502	HEALTHCARE	IL	N/A
(4) NORTHSHORE-NORTHWEST COMMUNITY COLLABORATIONCO LLC 1301 CENTRAL STREET EVANSTON,IL60201 84-2017997	HEALTHCARE	IL	N/A

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) COVENANT INTERNATIONAL INSURANCE COMPANY LTD CRAWFORD HOUSE 50 CEDAR AVENUE HAMILTON BD	INSURANCE	BD	N/A	C				No
(2) COVENANT TRUST COMPANY 8303 W HIGGINS ROAD 6TH FLOOR CHICAGO,IL60631 36-3583163	FINANCIAL SERVICES	IL	N/A	C				No
(3) SWEDISH COVENANT MANAGEMENT SERVICES INC (SCMS) 5145 N CALIFORNIA AVENUE CHICAGO,IL60625 36-4073303	PHYSICIAN PRACTICE MANAGEMENT	IL	N/A	C				No
(4) SWEDISH COVENANT PHYSICIAN PARTNERS LTD 5145 N CALIFORNIA AVENUE CHICAGO,IL60625 36-3120220	MANAGED HEALTHCARE PROVIDER	IL	N/A	C				No
(5) NORTHSHORE PHYSICIAN ASSOCIATES INC 1301 CENTRAL STREET EVANSTON,IL60201 36-3648026	HEALTHCARE	IL	N/A	C			Yes
(6) COMMUNITY CARE PARTNERS LLC 1301 CENTRAL STREET EVANSTON,IL60201 47-1374487	HEALTHCARE	IL	N/A	C			Yes
(7) NORTHSHORE PHYSICIAN ASSOCIATES VALUE BASED CARE LLC 1301 CENTRAL STREET EVANSTON,IL60201 82-2268872	HEALTHCARE	IL	N/A	C			Yes
(8) NORTHSHORE UNIVERSITY HEALTHSYSTEM INSURANCE INTERNATIONAL GOVERNORS SQUARE BUILDING 4 GRAND CAYMAN CJ 98-0419452	INSURANCE	CJ	N/A	C				No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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
(1) SWEDISH COVENANT HEALTH	M	60,000	FAIR MARKET VALUE OF SERVICES
(2) SWEDISH COVENANT HEALTH	S	1,316,960	ACTUARIALLY DETERMINED
(3) NORTHSHORE UNIVERSITY HEALTHSYSTEM	R	41,686,756	FAIR MARKET VALUE OF SERVICES
(4) SWEDISH COVENANT HEALTH	R	24,214,502	NET ASSETS

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SUPPORTING ORGANIZATION OF SWEDISH COVENANT HEALTH (HOSPITAL).
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	2
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	2
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 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	6,766,558	1,600,440
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,640,474	2,126,288
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	8,407,032	3,726,728
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) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	12,615,464	1,469,810
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	12,615,464	1,469,810
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,208,432	2,256,918
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	53,207,933	0
21	Total liabilities (Part X, line 26).............	31,250,349	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	21,957,584	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,339,440 including grants of $ ) (Revenue $ 1,600,440 )
	THE ORGANIZATION PERFORMS A FUNCTION (COVERAGE OF PRIMARY MEDICAL MALPRACTICE RISK) THAT IS AN INTEGRAL PART OF THE EXEMPT ACTIVITIES OF SWEDISH COVENANT HEALTH.

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 expenses1,339,440

(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
(A) Name and title
(1) FRANK BERANEK...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(2) DAVID PUTMAN...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(3) JANIS A RUEPING...................................................................... ASSISTANT SECRETARY	1.00 ................. 40.00	X	X	0	326,140	47,160
(4) JONATHAN LIND...................................................................... VP	1.00 ................. 40.00	X	X	0	430,498	55,048
(5) ANTHONY GUACCIO...................................................................... PRESIDENT/CHAIR	1.00 ................. 40.00	X	X	0	859,356	85,403
(6) THOMAS GARVEY...................................................................... VP/TREASURER	1.00 ................. 40.00	X	X	0	766,749	44,325
(7) JUDITH A BORENSTEIN...................................................................... VP OPERATIONS/SECRETARY	1.00 ................. 40.00	X	X	0	227,377	17,724
(8) NICOLA BYRNE...................................................................... ASSISTANT TREASURER	1.00 ................. 40.00		X	0	283,933	12,665
(9) SCOTT HANSON...................................................................... ASSISTANT TREASURER	1.00 ................. 40.00		X	0	164,930	31,556

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	3,058,983	293,881

(A) Name and business address	(B) Description of services	(C) Compensation
LOWIS & GLENN LLP 175 WEST JACKSON BLVD SUITE 950 CHICAGO,IL60604	LEGAL SERVICES	588,587
HALL PRANGLE & SCHOONVELD LLC 200 S WACKER DRIVE SUITE 3300 CHICAGO,IL60606	LEGAL SERVICES	181,833



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 2

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	PREMIUMS EARNED	524298	1,600,440	1,600,440
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,600,440

3 Investment income (including dividends, interest, and othersimilar amounts) ......			421,787			421,787
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		41,686,756	7a
b	Less: cost or other basis and sales expenses		39,982,255	7b
c	Gain or (loss)		1,704,501	7c
d	Net gain or (loss).........			1,704,501			1,704,501
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			3,726,728	1,600,440	0	2,126,288

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	12,875		12,875
b	Legal .........	11,226		11,226
c	Accounting ...........	8,031		8,031
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	27,067		27,067
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	966		966
12	Advertising and promotion ....
13	Office expenses .......
14	Information technology ......
15	Royalties ..
16	Occupancy ...........
17	Travel ............	80		80
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	228		228
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	LOSS ADJUSTMENT	1,339,440	1,339,440
b	ADMINISTRATION EXPENSES	60,000		60,000
c	LICENSE & PERMITS	5,370		5,370
d	CREDIT CARD FEES	4,527		4,527
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	1,469,810	1,339,440	130,370	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		4,194,736	1	0
2	Savings and temporary cash investments .........		41,942	2	0
3	Pledges and grants receivable, net ......			3	0
4	Accounts receivable, net .............			4	0
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				6	0
7	Notes and loans receivable, net ...........			7	0
8	Inventories for sale or use ............			8	0
9	Prepaid expenses and deferred charges ......			9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c	0
11	Investments—publicly traded securities .		45,178,058	11	0
12	Investments—other securities. See Part IV, line 11 .....			12	0
13	Investments—program-related. See Part IV, line 11 ..			13	0
14	Intangible assets ...............			14	0
15	Other assets. See Part IV, line 11 ...........		3,793,197	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...		53,207,933	16	0

17	Accounts payable and accrued expenses .....	156,646	17
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	31,093,703	25	0
26	Total liabilities. Add lines 17 through 25..	31,250,349	26	0

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	250,000	30	0
31	Retained earnings, endowment, accumulated income, or other funds	21,707,584	31	0
32	Total net assets or fund balances ...........	21,957,584	32	0
33	Total liabilities and net assets/fund balances ........	53,207,933	33	0