| Return Reference | Explanation |
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| FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: | MEDICA COMMUNITY HEALTH PLAN (THE COMPANY) IS ORGANIZED AND SHALL BE OPERATED FOR THE PROMOTION OF SOCIAL WELFARE, INCLUDING THE OPERATION OF A HEALTH INSURANCE ORGANIZATION AND OTHER ACTIVITIES INCIDENTAL THERETO. IT IS A WHOLLY OWNED SUBSIDIARY OF MEDICA HOLDING COMPANY (MHC) WHICH IS A NON-PROFIT, TAX EXEMPT CORPORATION. THE COMPANY IS TAX-EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. THE COMPANY OFFERS COMPREHENSIVE HEALTH CARE COVERAGE; ALL PRODUCTS ARE MEDICARE ADVANTAGE, OR QUALIFIED HEALTH PLANS (QHPS). QHPS ARE DEFINED BY THE AFFORDABLE CARE ACT (ACA) AND FALL WITHIN THE METAL LEVELS GOLD, SILVER AND BRONZE, AS WELL AS CATASTROPHIC FOR THOSE UNDER AGE 30 OR THOSE WITH A HARDSHIP (AS DEEMED BY THE EXCHANGE). ADDITIONALLY, THE PRODUCTS FOLLOW THE RESPECTIVE ESSENTIAL HEALTH BENEFITS (EHBS), ABOVE AND BEYOND THOSE REQUIRED OF QHPS BY THE ACA, AS DETERMINED BY THE BENCHMARK/DEFAULT PLAN (AS DEFINED BY ACA) FOR WISCONSIN AND ARIZONA. THE QHP PRODUCT, ESSENTIA CHOICE CARE WITH MEDICA, IS AVAILABLE IN WESTERN WISCONSIN, NORTHERN MINNESOTA, AND EASTERN NORTH DAKOTA. THE ESSENTIA CHOICE CARE PRODUCT FEATURES ACCESS TO ESSENTIA HEALTH DOCTORS PLUS OTHERS WITH OVER 3,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, ENGAGE BY MEDICA, IS AVAILABLE IN WESTERN WISCONSIN AND SOUTHEASTERN MINNESOTA. THE ENGAGE BY MEDICA PRODUCT FEATURES ACCESS TO MAYO CLINIC HEALTH SYSTEM DOCTORS PLUS OTHERS IN NORTHERN IOWA, SOUTHERN MINNESOTA, AND WESTERN WISCONSIN, WITH OVER 12,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, MEDICA PINNACLE, IS AVAILABLE IN MARICOPA COUNTY, ARIZONA. THE MEDICA PINNACLE PRODUCT FEATURES ACCESS TO ARIZONA CARE NETWORK, DIGNITY HEALTH, AND PHOENIX CHILDREN'S, WITH OVER 4,400 PRIMARY AND SPECIALTY CARE PROVIDERS. THE COMPANY OFFERS MEDICARE ADVANTAGE PRODUCTS IN PORTIONS OF NEBRASKA AND IOWA, OFFERING THE MEDICA ADVANTAGE SOLUTION PRODUCT IN THE ELEVEN COUNTY OMAHA/LINCOLN/COUNCIL BLUFFS AREA. THE MEDICA ADVANTAGE SOLUTION PRODUCT OFFERS AN HMO OPTION WITH CHI HEALTH AND A BROADER NETWORK PPO OPTION. THE ADVANTAGE SOLUTION NETWORK HAS 1,600+ PRIMARY CARE AND SPECIALTY CARE DOCTORS. THE COMPANY CONTRACTS WITH PROVIDERS IN WISCONSIN, MINNESOTA, SOUTH DAKOTA, NORTH DAKOTA, NEBRASKA AND IOWA TO MAKE HEALTH CARE SERVICES AVAILABLE TO ITS ENROLLEES. THE PROVIDER CONTRACTS INCLUDE HOLD-HARMLESS PROVISIONS FOR THE PROTECTION OF POLICYHOLDERS. THE CONTRACTS HAVE A ONE- OR TWO-YEAR TERM AND MAY BE TERMINATED IMMEDIATELY FOR BREACH OF CONTRACT IF THE PROVIDER LOSES HIS/HER LICENSE TO PROVIDE CONTRACTED SERVICES. HOSPITALS ARE REIMBURSED USING A VARIETY OF METHODS INCLUDING FEE-FOR-SERVICE (FFS), DISCOUNTED FFS, PER DIEM, PER CASE AND/OR PER STAY BASIS. THE COMPANY CURRENTLY MARKETS DIRECTLY TO INDIVIDUALS, USING INDEPENDENT AGENCIES, PAYING A FLAT DOLLAR COMMISSION ON NEW AND RENEWAL BUSINESS. THE COMPANY ALSO MARKETS POLICIES DIRECTLY ONLINE AND OVER THE PHONE. DURING 2020, THE COMPANY STARTED OFFERING MEDICARE ADVANTAGE PRODUCTS IN NEBRASKA. DURING 2023, MEDICARE ADVANTAGE ENROLLMENT WAS 782 MEMBERS, OR 5.4% OF MCHP'S TOTAL ENROLLMENT. MEDICARE ADVANTAGE IS A HEALTH PLAN THAT PROVIDES ALL ENROLLEES PART A AND B BENEFITS. |
| FORM 990, PART VI, SECTION A, LINE 3 | MEDICA COMMUNITY HEALTH PLAN HAS ENTERED INTO AN ADMINISTRATIVE SERVICE AGREEMENT WITH MEDICA SERVICES COMPANY (MSC), A RELATED TAXABLE ORGANIZATION. THROUGH THIS AGREEMENT, MSC LEASES ITS EMPLOYEES AND PROVIDES VARIOUS MANAGEMENT/ADMINISTRATIVE SERVICES TO MEDICA COMMUNITY HEALTH PLAN AND MEDICA COMMUNITY HEALTH PLAN PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE POLICY HOLDERS ARE CONSIDERED MEMBERS, BUT DO NOT PAY DUES. |
| FORM 990, PART VI, SECTION B, LINE 11B | MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S FINANCE STAFF REVIEWS THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY ALL EMPLOYEES OF MEDICA SERVICES COMPANY AND DIRECTORS OF ALL MEDICA ENTITIES COMPLETE A CONFLICT-OF-INTEREST DISCLOSURE AND ARE REQUIRED TO REVIEW THE CURRENT POLICY. ALL POTENTIAL CONFLICTS ARE REVIEWED BY LEGAL/COMPLIANCE. |
| FORM 990, PART VI, SECTION B, LINE 15 | MEDICA COMMUNITY HEALTH PLAN DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION. WHICH USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. THE PERSONNEL AND COMPENSATION COMMITTEE, AS DESCRIBED IN THE CHARTER, REVIEWS AND OBTAINS THE BOARD'S APPROVAL FOR TOTAL COMPENSATION FOR THE PRESIDENT/CEO. THE COMMITTEE ALSO REVIEWS AND APPROVES TOTAL COMPENSATION RECOMMENDATIONS MADE BY THE CEO FOR THE EXECUTIVE AND SENIOR VICE PRESIDENTS, AND REVIEWS ALL OFFICER COMPENSATION AND ANNUAL PERFORMANCE GOALS APPROVED BY THE CEO. THE COMMITTEE REVIEW AND MAKES RECOMMENDATIONS TO THE BOARD REGARDING OFFICER AND NON-OFFICER COMPENSATION GUIDELINES FOR MEDICA AND ITS SUBSIDIARIES, PERIODICALLY REVIEWING MARKET DATA TO ASSESS MEDICA'S COMPETITIVE POSITION. OUTSIDE THE CHARTER, THE PERSONNEL AND COMPENSATION COMMITTEE WORKS WITH AN OUTSIDE CONSULTANT TO REVIEW MARKET DATA THAT AIDS IN SETTING THE COMPENSATION FOR THE OFFICERS AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | MEDICA DOES NOT CONSIDER ITS CONFLICT-OF-INTEREST POLICY TO BE A CONFIDENTIAL OR PROPRIETARY DOCUMENT. THEREFORE, MEDICA WOULD MAKE THIS POLICY AVAILABLE TO ANYONE WHO REQUESTS IT. CERTAIN OF THE MEDICA ENTITIES ARE REQUIRED TO FILE ANNUAL FINANCIAL STATEMENTS WITH THE REGULATORS. MEDICA CONSIDERS FINANCIAL STATEMENTS THAT ARE FILED WITH THE REGULATORS TO BE PUBLIC DOCUMENTS. FINANCIAL STATEMENTS, CONFLICT-OF-INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
| FORM 990, PART VII, SECTION A, LINE 1: | CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN ALL ENTITIES UNDER MEDICA HOLDING COMPANY. THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL MEDICA ORGANIZATIONS. THE FOLLOWING CHANGES TO THE OFFICERS OF MEDICA COMMUNITY HEALTH PLAN OCCURRED DURING THE TAXABLE PERIOD: IN APRIL OF 2023 ELIZABETH F. ERICKSON WAS ELECTED CHIEF FINANCIAL OFFICER AND TREASURER, SUCCEEDING MARY P. QUIST AS FORMER INTERIM CHIEF FINANCIAL OFFICER AND TREASURER. ELIZABETH F. ERICKSON WAS SUBSEQUENTLY ELECTED INTERIM PRESIDENT IN SEPTEMBER OF 2023, AND ELECTED PRESIDENT AND CHIEF EXECUTIVE OFFICER IN NOVEMBER OF 2023. IN 2024 KRISTA DUSIL WAS APPOINTED AS CHIEF FINANCIAL OFFICER OF THE ORGANIZATION. FORM 990, PART VII JOHN STANOCH'S BOARD STIPEND WAS PAID TO STANOCH, LLC. |
| FORM 990, PART XI, LINE 9: | CHANGE IN NONADMITTED ASSETS -789,476. |
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