| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE TWO EMPLOYER REPRESENTATIVE BOARD MEMBERS DO NOT HAVE VOTING RIGHTS TO VOTE ON BUDGET AND OPERATING EXPENSES OF THE BUREAU. THEY CAN VOTE ON ALL OTHER MATTERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | EVERY INSURER WRITING WORKERS' COMPENSATION INSURANCE OR THE LIABILITY FOR SIMILAR BENEFITS OF EMPLOYERS EXEMPT FROM WORKERS' COMPENSATION INSURANCE IN THE STATE OF WISCONSIN IS AUTOMATICALLY A MEMBER OF THE BUREAU. MEMBERS OF THE BUREAU ELECT THE MEMBERS OF THE GOVERNING BODY FROM AMONG THE MEMBERSHIP. |
| FORM 990, PART VI, SECTION A, LINE 7B | WHILE NOT A STATE AGENCY, WCRB IS REGULATED BY THE STATE OF WISCONSIN OFFICE OF THE COMMISSIONER OF INSURANCE (OCI) AND WORKS VERY CLOSELY WITH THE WORKER'S COMPENSATION DIVISION OF THE WISCONSIN DEPARTMENT OF WORKFORCE DEVELOPMENT (DWD). |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATIONS MANAGEMENT FOR REVIEW PRIOR TO FILING AND IS MADE AVAILABLE TO GOVERNING BOARD MEMBERS UPON FINALIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND KEY PERSONNEL ARE REQUIRED TO SIGN A "CODE OF ETHICS AND STANDARDS OF PROFESSIONAL CONDUCT" YEARLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE VIA WEBSITE: WWW.WCRB.ORG |
| FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | AMERICAN HOME ASSURANCE COMPANY - 175 WATER STREET, NEW YORK, NY 10038. SENTRY INSURANCE, A MUTUAL COMPANY - 1800 NORTH POINT DR, STEVENS POINT, WI 54481. EMPLOYERS INSURANCE COMPANY OF WAUSAU - P.O. BOX 8017, WAUSAU, WI 54402. UNITED WISCONSIN INSURANCE COMPANY - P.O. BOX 3026, MILWAUKEE, WI 53201. TRAVLERS INDEMNITY COMPANY - 1 TOWER SQUARE, HARTFORD, CT 06183. GENERAL CASUALTY INSURANCE COMPANY - 500 PARK BLVD. #1205, ITASCA, IL 60143. SOCIETY INSURANCE COMPANY - 150 CAMELOT DRIVE, FOND DU LAC, WI 54936. MIKE LESTER - 3829 SWOBODA ROAD, VERONA, WI 53593. DAN BURAZIN - 1243 N. 10TH STREET, STE 175, MILWAUKEE, WI 53205. SFM MUTUAL INSURANCE COMPANY - 3500 AMERICAN BLVD W #700, BLOOMINGTON, MN 55431. WEST BEND MUTUAL INSURANCE CO. - 1900 SOUTH 18TH AVE., WEST BEND, WI 53095. SECURA INSURANCE COMPANY - 1500 MUTUAL WAY, NEENAH, WI 54956. |
| FORM 990, PART XI, LINE 9: | SURPLUS - EXCESS OF INCOME -2,676,043. NET ACTUARIAL (GAIN)/LOSS ON POS 894,179. PRIOR SERVICE COST ON POSTRETIREMENT -149,222. ACCRUED PENSION TRUST ADJUSTMENT 768,875. CHANGE IN ACCRUED POSTRETIREMENT BENEFITS 139,427. |
| FORM 990, PART XII, LINE 2C: | NO CHANGE FROM PRIOR YEAR. |
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