2024-05-13T11:51:06-05:00 2023-06-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2022-07-01 411634385 MINNESOTA SELF-INSURER'S SECURITY FUND MINN 6122919155 161 RONDO AVENUE 818 ST PAUL MN 55103 JANEL WAHL FRENCH TREASURER 6122919155 2024-05-13 1 JANEL WAHL FRENCH 999009999 0 JULIE BOYER P01278549 2187275025 2024-05-13 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X JANEL WAHL FRENCH 88 - 11TH AVENUE NE MINNEAPOLIS MN 55413 14419163 0 X WWW.MNSISF.ORG X 1988 MN THE FUND'S PRIMARY PURPOSE IS TO PROMOTE THE COMMON BUSINESS INTERESTS OF ITS MEMBER ORGANIZATIONS. 9 9 0 2 0 0 0 0 1964175 2321891 175204 583170 0 0 2139379 2905061 0 0 0 0 61006 60750 0 0 0 1903916 2116967 1964922 2177717 174457 727344 14241443 13214298 11020843 9509011 3220600 3705287 X THE PURPOSE OF MINNESOTA SELF-INSURERS' SECURITY FUND IS TO FULFILL THE OBLIGATIONS PLACED UPON IT BY MINNESOTA SESSION LAWS, CHAPTER 674 (1988), CODIFIED AS MINN. STAT. SECTION 79A.01 ET.SEQ., AND ACTS AMENDATORY THERETO, AND SUCH OTHER PURPOSES WITH UNLIMITED POWER TO ENGAGE IN AND DO ANY LAWFUL ACT WHICH ANY CORPORATION ORGANIZED AS A NON-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF MINNESOTA MAY DO. 0 0 THE ORGANIZATION WAS SET UP AS A RESULT OF AN ACT PASSED BY THE MINNESOTA LEGISLATURE IN REGARD TO WORKERS' COMPENSATION. THE PURPOSE OF THE FUND IS TO INSURE THAT ANY WORKERS WHOSE WORK RELATED INJURY OCCURRED WHEN AN EMPLOYER WAS DULY SELF-INSURED IN THE STATE OF MINNESOTA, WILL CONTINUE TO RECEIVE WORKERS' COMPENSATION BENEFITS IN THE EVENT THE SELF-INSURED EMPLOYER FILES FOR BANKRUPTCY, BECOMES INSOLVENT AND/OR DEFAULTS ON ITS WORKERS' COMPENSATION OBLIGATION. CURRENTLY THE MINNESOTA SELF-INSURERS' SECURITY FUND IS UTILIZING POSTED SECURITY OBTAINED FROM DEFAULTING MEMBERS AND ASSESSMENTS TO PAY CLAIMS TO OR ON BEHALF OF THE INJURED EMPLOYEES.IF THE POSTED SECURITY IS INADEQUATE, MEMBERS OF THE MINNESOTA SELF-INSURERS' SECURITY FUND WILL BE ASSESSED SO THAT THE INJURED EMPLOYEES CONTINUE TO RECEIVE APPROPRIATE BENEFITS. 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 0 1 1 0 0 X JANEL WAHL FRENCH 6126236729 88 -11TH AVENUE NE MINNEAPOLIS MN 55413 JANEL WAHL FRENCH TREASURER 3.00 X X 4700 0 0 BRAD KOLAND VICE CHAIR 1.00 X X 2400 0 0 RICK THEISEN SECRETARY 1.00 X X 2250 0 0 BILL MCCARTHY PRESIDENT EMERITUS 1.00 X X 1900 0 0 JAMES OUKROP TRUSTEE 1.00 X 1900 0 0 HOWARD BICKER TRUSTEE 1.00 X 1750 0 0 SUMRATI TICKOO TRUSTEE 1.00 X 900 0 0 DALE HAUG CHAIR 1.00 X X 0 0 0 JEFF MCBRIDE TRUSTEE 1.00 X 0 0 0 CARL W CUMMINS III EXECUTIVE DIRECTOR 9.00 X 50000 0 0 65800 0 0 0 0 0 0 0 RECOVERIES RECEIVED 900099 1832315 1832315 GENERAL MEMBERSHIP ASSESSMENTS 900099 489576 489576 2321891 167099 167099 11930173 11514102 416071 416071 416071 2905061 2321891 0 583170 60750 33200 114646 29009 66168 10484 19116 4200 19753 CLAIMS INCURRED 1723028 CLAIMS ADMINISTRATIVE F 60503 MISCELLANEOUS EXPENSE 36860 2177717 2784274 2609573 45 8181 3845202 4061138 7611922 6535406 14241443 13214298 25703 37188 512788 510738 10482352 8961085 11020843 9509011 X 0 0 0 0 3220600 3705287 3220600 3705287 14241443 13214298 727344 -242657 0 X X 0 1 X 1 0 0 REINSURANCE RECEIVABLE 6523608 MEMBER ASSESSMENT RECEIVABLES 917 RIGHT-OF-USE ASSET 10881 6535406 ESTIMATED CLAIMS PAYABLE 8949844 LEASE LIABILITY 11241 8961085 830089 -242657 -242657 1072746 1832315 1832315 2905061 345402 -1832315 -1832315 2177717 0 2177717 PART XI, LINE 4B - OTHER ADJUSTMENTS: CLAIMS RECOVERED RECLASSIFIED FROM EXPENSE 1,832,315. PART XII, LINE 2D - OTHER ADJUSTMENTS: CLAIMS RECOVERED RECLASSIFIED AS REVENUE -1,832,315. FORM 990, PART VI, SECTION A, LINE 6 ALL PRIVATE SELF INSURERS' ARE MEMBERS OF MINNESOTA SELF INSURERS' SECURITY FUND (SISF). THE MEMBERS OF SISF HAVE RIGHTS TO ELECT THE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS ELECTED BY THE MEMBERS OF SISF AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE SISF TREASURER, EXECUTIVE DIRECTOR, AND GENERAL COUNSEL. THE TREASURER'S REVIEW INCLUDES COMPARISONS TO AUDITED FINANCIAL STATEMENTS NOTING AGREEMENT, ETC. FORM 990, PART VI, SECTION B, LINE 12C THE WRITTEN CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO ALL BOARD MEMBERS ANNUALLY. A WRITTEN CONFIRMATION OF ITS RECEIPT BY EVERY BOARD MEMBER IS REQUIRED. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION OF THE TRUSTEES OF THE MINNESOTA SELF-INSURERS' SECURITY FUND IS ESTABLISHED IN THE PLAN OF OPERATION. THE BOARD OF TRUSTEES MAY REVISE THIS COMPENSATION BY AMENDING THE PLAN OF OPERATION, BUT ANY CHANGE IN COMPENSATION OR OTHER AMENDMENTS TO THE PLAN OF OPERATION MUST BE APPROVED BY THE MINNESOTA COMMISSIONER OF COMMERCE BEFORE THEY BECOME EFFECTIVE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS ARE MADE AVAILABLE ON THE SISF WEBSITE. THE AUDITED FINANCIAL STATEMENT IS DISTRIBUTED TO SISF MEMBERS ONLY. FORM 990, PART XII, LINE 2C: THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED SINCE THE PRIOR TAX YEAR.