| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | AT DECEMBER 31, 2024, THE COMPANY'S BOARD OF DIRECTORS INCLUDED FIVE INDIVIDUALS AS LISTED ON FORM 990, PART VII, PAGE 7, SECTION A. CHARLES MARLIN, EDWIN SOLER-VALCOURT M.D., TIFFANY REO, AND TOM PLAMONDON HAD EQUAL VOTING RIGHTS. MAUREEN BELL WAS A NON-VOTING RESIDENT DIRECTOR. |
| FORM 990, PART VI, SECTION A, LINE 3 | GPW & ASSOCIATES ENTERED INTO A MANAGEMENT AGREEMENT WITH APIRRG IN 2010. GPW PROVIDES CONSULTING, LICENSING, TREASURY, ACCOUNTING, AND TAX SERVICES TO APIRRG INCLUDING QUARTERLY NAIC FILINGS WITH THE ARIZONA DOI. |
| FORM 990, PART VI, SECTION A, LINE 6 | AS AN RRG, THE COMPANY IS OWNED BY THE MEMBER-POLICYHOLDERS. POLICYHOLDERS ARE REQUIRED TO PURCHASE VOTING COMMON STOCK IN THE COMPANY AS PART OF ISSUANCE OF THE POLICY. |
| FORM 990, PART VI, SECTION A, LINE 7A | PURSUANT TO THE COMPANY'S ARTICLES AND BYLAWS, DIRECTORS ARE ELECTED BY THE SHAREHOLDERS ON AN ANNUAL BASIS. ALSO, ALL ACTIONS TAKEN BY THE BOARD OF DIRECTORS AND OFFICERS FOR THE YEAR ARE RATIFIED BY THE SHAREHOLDERS AT THE ANNUAL MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY GPW AND ASSOCIATES, INC. (GPW), THE CONTRACTED CAPTIVE MANAGER OF THE COMPANY. GPW SPECIALIZES IN INSURANCE COMPANY ACCOUNTING AND REPORTING. FINANCIALS AND TAX FILINGS ARE REVIEWED AND ADDRESSED DURING THE ANNUAL BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPANY IS A CAPTIVE RISK RETENTION GROUP REGULATED BY THE ARIZONA DEPARTMENT OF INSURANCE AND THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC). FINANCIAL STATEMENTS ARE FILED WITH THE STATE OF ARIZONA AND THE NAIC ON A QUARTERLY AND ANNUAL BASIS. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE ALSO ON FILE WITH THE ARIZONA DEPARTMENT OF INSURANCE. INFORMATION IS AVAILABLE TO THE PUBLIC THROUGH THE ARIZONA DEPARTMENT OF INSURANCE UPON REQUEST AND APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | ADDRESSED UNDER EXPLANATION FOR FORM 990, PART VI, SECTION B, LINE 12C |
| FORM 990, PART VII, SECTION A, LINE 1A | THE COMPANY PAID $58,054 TO INTERSTATE HEALTHCARE FOR CONSULTING FEES AND COMMISSIONS. INTERSTATE HEALTHCARE IS THE UNDERWRITING AGENCY RESPONSIBLE FOR POLICIES ISSUED BY THE COMPANY THAT IS OWNED BY THE COMPANY'S PRESIDENT CHARLES MARLIN. (ALSO SEE SCHEDULE L) |
| FORM 990, PART XI, LINE 9: | EFFECTS OF POLICYHOLDER-STOCKHOLDER ADDITIONS / CANCELLATIONS: NET EFFECT ON CAPITAL STOCK ACCOUNT 1. NET EFFECT ON PAID-IN SURPLUS ACCOUNT 624. NET EFFECT ON RETAINED EARNINGS ACCOUNT ROUNDING |
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