2025-11-14T12:52:56-06:00 2024-12-31 135565207 KPMG LLP 350 NORTH 5TH ST STE 600 MINNEAPOLIS MN 55401 990 2024-01-01 411812461 MEDICA FOUNDATION MEDI 9529922058 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 KRISTA DUSIL CFO 9529922058 2025-11-12 1 0 HOLLY MOEN P01800653 6123055000 2025-11-12 2024 2025-03-06 01:10:19Z ELIZABETH ERICKSON 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 10694305 0 X WWW.MEDICAFOUNDATION.ORG X 1996 MN THE MEDICA FOUNDATION FUNDS PROGRAMS THAT IMPROVE HEATH AND INCREASE ACCESS TO HEALTH CARE SERVICES 5 5 0 0 0 0 3500000 0 0 0 2492092 7617966 0 0 5992092 7617966 2190000 2850000 0 0 0 0 0 0 0 643682 662890 2833682 3512890 3158410 4105076 70831578 76228960 535000 1801500 70296578 74427460 X THE FOUNDATION GENERALLY SEEKS TO IMPROVE THE HEALTH OF THOSE IN NEED BY INVESTING IN COMMUNITY-LED INITIATIVES THAT ADVANCE HEALTH EQUITY. 0 0 1500000 1500000 BEHAVIORAL HEALTH: WE SEEK PROPOSALS FOR PROGRAMS THAT IMPROVE THE HEALTH OUTCOMES FOR PEOPLE EXPERIENCING OR AT RISK OF SERIOUS MENTAL ILLNESS AND/OR SUBSTANCE USE DISORDERS. WE PRIORITIZE PROPOSALS THAT PROVIDE CULTURALLY-RESPONSIVE CARE AND STRATEGICALLY ALIGN THEIR WORK TO ADVANCE HEALTH EQUITY.WE PRIORITIZE PROPOSALS FOR PROGRAMS THAT IMPROVE THE MENTAL AND CHEMICAL HEALTH OF INDIVIDUALS BY ADDRESSING: BEHAVIORAL HEALTH WORKFORCE, CO-OCCURRING DISORDERS, INTEGRATION OF PHYSICAL AND BEHAVIORAL HEALTH CARE, SERVICE DELIVERY GAPS, SUPPORTIVE AND INTENSIVE CASE MANAGEMENT SERVICESELIGIBILITY: WE PROVIDE BEHAVIORAL HEALTH GRANT FUNDING TO SUPPORT CHEMICAL OR MENTAL HEALTH. PROGRAMMING THAT ADDRESSES THE LIFESTYLE BEHAVIORS OF INDIVIDUALS DOESN'T MEET OUR CRITERIA AND IS INELIGIBLE. PLEASE NOTE THAT THESE ARE PROGRAM GRANTS. ALTHOUGH WE DO NOT PROVIDE FULLY UNRESTRICTED FUNDING, OUR GRANTS CAN BE USED FOR EXPENSES NEEDED TO CARRY OUT THE PROGRAM, INCLUDING STAFF AND A PORTION FOR OVERHEAD. 400000 400000 EARLY CHILDHOOD HEALTH: WE SEEK PROPOSALS FOR EARLY INTERVENTION PROGRAMS THAT SUPPORT FAMILIES AND CHILDREN, AND FOSTER OPTIMAL GROWTH AND DEVELOPMENT FOR CHILDREN FROM BIRTH THROUGH AGE 12. WE PRIORITIZE PROPOSALS THAT PROVIDE CULTURALLY FOCUSED CARE AND THAT STRATEGICALLY ALIGN THEIR WORK TO ADVANCE HEALTH EQUITY. WE PRIORITIZE PROPOSALS THAT ADDRESS: ABUSE PREVENTION, MATERNAL HEALTH AND BIRTH EQUITY (E.G., PRENATAL/PERINATAL CARE AND DOULA SUPPORT), ORAL HEALTH, PARENTING SKILLS, PRIMARY CARE AND IMMUNIZATIONS ELIGIBILITY: NON-HEALTH RELATED EDUCATION AND LIFESTYLE PROGRAMS, INCLUDING PHYSICAL ACTIVITY AND NUTRITION, ARE INELIGIBLE. PROGRAMS, SUCH AS CAMPS, THAT ARE ONE-TIME EXPERIENCES ARE ALSO INELIGIBLE. MENTAL HEALTH PROPOSALS FOR CHILDREN SHOULD BE SUBMITTED THROUGH OUR BEHAVIORAL HEALTH FUNDING AREA. PLEASE NOTE THAT THESE ARE PROGRAM GRANTS. ALTHOUGH WE DO NOT PROVIDE FULLY UNRESTRICTED FUNDING, OUR GRANTS CAN BE USED FOR EXPENSES NEEDED TO CARRY OUT THE PROGRAM, INCLUDING STAFF AND A PORTION FOR OVERHEAD. 400000 400000 RURAL HEALTH: WE AIM TO FUND COMMUNITY-LED SOLUTIONS THAT ADDRESS HEALTH EQUITY IN RURAL COMMUNITIES. WE PRIORITIZE PROPOSALS THAT ADDRESS: CULTURALLY-FOCUSED CARE, DENTAL HEALTH, DOMESTIC VIOLENCE AND SEXUAL ASSAULT SERVICES AND PREVENTION, INDEPENDENT LIVING FOR SENIORS, MATERNAL AND BIRTH HEALTH, MENTAL HEALTH AND CHEMICAL HEALTH, PRIMARY CARE FOR UNDERSERVED COMMUNITIES, SEXUAL HEALTH, TRANSPORTATION FOR MEDICAL/HEALTH APPOINTMENTS. ELIGIBILITY: RURAL HEALTH GRANT RECIPIENTS ARE ELIGIBLE TO SUBMIT AN APPLICATION FOR FUNDING IN CONSECUTIVE YEARS. FUNDING IS LIMITED TO ORGANIZATIONS BASED OUTSIDE OF THE SEVEN-COUNTY TWIN CITIES METROPOLITAN AREA. ORGANIZATIONS SEEKING TO DO WORK WITHIN OUR SERVICE AREA BUT DO NOT HAVE A PHYSICAL PRESENCE IN GREATER MINNESOTA ARE INELIGIBLE. FUNDING REQUESTS FOR EVENTS, SPONSORSHIPS, SEMINARS, MUSEUMS, CAMPS, AND GENERAL HEALTH AND WELLNESS ACTIVITIES INCLUDING NUTRITION, EXERCISE, ETC., ARE INELIGIBLE. 350000 350000 MEDICA FOUNDATION GENERAL FUNDING 200000 200000 MEDICA FOUNDATION STRATEGIC GRANT 550000 550000 2850000 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X KRISTA DUSIL 9529923908 401 CARLSON PARKWAY CP 300 MINNETONKA MN 55305 X JOHN BUCK DIRECTOR 0.00 15.00 X 0 145250 0 JOHN STANOCH DIRECTOR & CHAIR 0.00 10.00 X X 0 128500 0 MARY TWINEM DIRECTOR & VICE CHAIR 0.00 10.00 X X 0 90250 0 GAYE ADAMS MASSEY DIRECTOR 0.00 10.00 X 0 87750 0 UGWUJI MADUEKWE DIRECTOR 0.00 10.00 X 0 18500 0 ELIZABETH F ERICKSON PRESIDENT, CEO, & TREAS THRU 1/2024 0.00 40.00 X 0 1669649 201202 MARY P QUIST SR. VP, FINANCE THRU 6/2024 0.00 40.00 X 0 604708 35245 KRISTA DUSIL SVP, CFO, & TREASURER 0.00 40.00 X 0 804123 116115 ALICIA REUTER SVP & CHIEF LEGAL OFFICER, SECRETARY 0.00 40.00 X 0 408482 72742 SAMUEL LEON FORMER DIRECTOR 0.00 10.00 X 0 23250 0 MARK L BAIRD FORMER SVP & CFO 0.00 40.00 X 0 370125 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNSEL 0.00 40.00 X 0 403815 0 DAVID H ELLENBOGEN FORMER SVP SEC & GEN COUNSEL 0.00 40.00 X 0 224611 1619 0 4979013 426923 0 1 1 0 MEDICA SERVICES COMPANY 401 CARLSON PARKWAY CP 330 MINNETONKA MN 55305 LEASED EMPLOYEES 480000 1 1982798 1982798 8711507 3076339 5635168 5635168 5635168 7617966 0 0 7617966 2850000 2850000 182890 182890 LEASED EMPLOYEES 480000 480000 3512890 2850000 662890 0 306382 1749700 67766 38835 70457430 74440425 70831578 76228960 535000 1801500 535000 1801500 X 70296578 74427460 70296578 74427460 70831578 76228960 4105076 25806 0 X 1 X 0 1 0 X X 1 MEDICA HEALTH PLANS 411242261 10 1 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 PART IV, SECTION A LINE 3B: MEDICA HEALTH PLANS, THE SUPPORTED ORGANIZATION, IS A 501(C)(4) ORGANIZATION. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, ANY CHANGE IN EXEMPT STATUS OR ACTIVITIES OF MEDICA HEALTH PLANS WOULD BE KNOWN BY MEDICA FOUNDATION. EACH YEAR, IT IS DETERMINED IF MHP CONTINUES TO MEET THE PUBLIC SUPPORT TESTS UNDER SECTION 509(A)(2) BEFORE THE TAX RETURN IS FILED. PART IV, SECTION A, LINE 3C: THE MEDICA FOUNDATION MONITORS THE USE OF GRANT FUNDS THROUGH SEVERAL MECHANISMS. ALL GRANTEES ARE ASKED TO SUBMIT PROGRESS REPORTS RELATED TO THE GRANT FUNDING. UPDATES ON PROGRAM GRANTS ARE RECEIVED DURING AND AT THE END OF THE GRANT PERIOD. SEE SCHEDULE I, PART I, LINE 2 NARRATIVE FOR ADDITIONAL INFORMATION RELATED TO THE PROCESS USED FOR GRANT MONITORING. 0 SHORT TERM INVESTMENTS 74440425 C 74440425 X PART X, LINE 2: THE COMPANY RECOGNIZES TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. 1 OPEN ARMS OF MINNESOTA 2500 BLOOMINGTON AVE SO MINNEAPOLIS MN 55404 411681317 501C(3) 10000 0 GENERAL FUNDING WAY TO GROW 201 IRVING AVE N STE 100 MINNEAPOLIS MN 55405 710956749 501C(3) 25000 0 EARLY CHILDHOOD HEALTH DIVISION OF INDIAN WORK 1001 E LAKE ST MINNEAPOLIS MN 55407 815265328 501C(3) 20000 0 EARLY CHILDHOOD HEALTH MEWINZHA ONDAADIZIIKE WIIGAMING 802 PAUL BUNYAN DR STE 12 BEMIDJI MN 56601 462523191 501C(3) 200000 0 EARLY CHILDHOOD HEALTH SENIOR COMMUNITY SERVICES 10201 WAYZATA BLVD STE 335 MINNETONKA MN 55305 410720473 501C(3) 7500 0 GENERAL FUNDING PROPEL NONPROFITS ONE MAIN ST SE STE 600 MINNEAPOLIS MN 55414 411916337 501C(3) 20000 0 GENERAL FUNDING ARROWS FAMILY SERVICES 160 3RD AVE NW MILACA MN 56353 873475099 501C(3) 10000 0 RURAL HEALTH ELY COMMUNITY HEALTH CENTER 33 E CHAPMAN ST ELY MN 55731 475399418 501C(3) 10000 0 RURAL HEALTH WE HEALTH CLINIC PA 32 E FIRST ST STE 300 DULUTH MN 55802 411444270 501C(3) 10000 0 RURAL HEALTH NORTHERN DENTAL ACCESS CENTER 1405 ANNE ST NW BEMIDJI MN 56601 841711812 501C(3) 10000 0 RURAL HEALTH GRANITE FALLS LIVING AT HOMEBLOCK NURSE PROGRAM 752 PRENTICE ST GRANITE FALLS MN 56241 411971745 501C(3) 10000 0 RURAL HEALTH LA CRESCENT AREA HEALTHY COMMUNITY PARTNERSHIP 333 MAIN ST LA CRESCENT MN 55947 202665775 501C(3) 10000 0 RURAL HEALTH PROGRAM FOR AID TO VICTIMS OF SEXUAL ASSAULT 32 E 1ST ST STE 200 DULUTH MN 55802 411350021 501C(3) 10000 0 RURAL HEALTH TRI-VALLEY OPPORTUNITY COUNCIL INC 107 NORTH BROADWAY STE 200 CROOKSTON MN 56716 410888488 501C(3) 10000 0 RURAL HEALTH PROJECT CARE FREE CLINIC 3112 6TH AVE E HIBBING MN 55746 273176137 501C(3) 10000 0 RURAL HEALTH TEREBINTH REFUGE 110 2ND ST S STE 231 WAITE PARK MN 56387 813807059 501C(3) 10000 0 RURAL HEALTH ANNEX TEEN CLINIC 5810 42ND AVE N ROBBINSDALE MN 55422 237236943 501C(3) 100000 0 BEHAVIORAL HEALTH COMMUNITY CONNECT CENTER 1132 28TH AVE S STE 101A MOORHEAD MN 56560 834476088 501C(3) 140000 0 BEHAVIORAL HEALTH CONNECTIONS TO INDEPENDENCE 310 E 38TH ST STE 300 MINNEAPOLIS MN 55409 800542940 501C(3) 140000 0 BEHAVIORAL HEALTH ELLISON CENTER 600 25TH AVE S ST CLOUD MN 56301 832525766 501C(3) 140000 0 BEHAVIORAL HEALTH FACE TO FACE HEALTH AND COUNSELING SERVICE INC 1165 ARCADE ST ST PAUL MN 55106 410986780 501C(3) 140000 0 BEHAVIORAL HEALTH OPEN PATH RESOURCES 504 CEDAR AVE S MINNEAPOLIS MN 55454 462424429 501C(3) 140000 0 BEHAVIORAL HEALTH RAICES SAGRADAS COMMUNITY MENTAL HEALTH 490 HALL AVE STE 104 ST PAUL MN 55107 834273268 501C(3) 140000 0 BEHAVIORAL HEALTH RECLAIM 2446 UNIVERSITY AVE W STE 104 ST PAUL MN 55114 800829665 501C(3) 140000 0 BEHAVIORAL HEALTH UNIVERSITY OF MINNESOTA FOUNDATION 200 OAK ST SE STE 500 MINNEAPOLIS MN 55455 416042488 501C(3) 140000 0 BEHAVIORAL HEALTH VETERAN RESILIENCE PROJECT INC PO BOX 1057 MINNETONKA MN 55345 473066936 501C(3) 140000 0 BEHAVIORAL HEALTH WOMEN'S ADVOCATES INC PO BOX 4039 ST PAUL MN 55104 237310701 501C(3) 140000 0 BEHAVIORAL HEALTH BABYS SPACE A PLACE TO GROW 2438 18TH AVE S MINNEAPOLIS MN 55404 204502788 501C(3) 50000 0 EARLY CHILDHOOD HEALTH BRIDGE FOR YOUTH 1111 W 22ND ST MINNEAPOLIS MN 55405 410983062 501C(3) 50000 0 EARLY CHILDHOOD HEALTH FIRST WITNESS CHILD ADVOCACY CENTER 1402 E 2ND ST DULUTH MN 55805 411737291 501C(3) 50000 0 EARLY CHILDHOOD HEALTH MERRICK COMMUNITY SERVICES 1669 N ARCADE ST STE 4 SAINT PAUL MN 55106 410693851 501C(3) 50000 0 EARLY CHILDHOOD HEALTH READY SET SMILE PA 3501 ALDRICH AVE S MINNEAPOLIS MN 55408 462229395 501C(3) 50000 0 EARLY CHILDHOOD HEALTH SABATHANI COMMUNITY CENTER 310 E 38TH ST MINNEAPOLIS MN 55409 410984859 501C(3) 50000 0 EARLY CHILDHOOD HEALTH SAWTOOTH MOUNTAIN CLINIC 513 5TH AVE W GRAND MARAIS MN 55604 411347593 501C(3) 25000 0 EARLY CHILDHOOD HEALTH ST DAVIDS CENTER FOR CHILD & FAMILY DEVELOPMENT 3395 PLYMOUTH RD MINNETONKA MN 55305 411429208 501C(3) 50000 0 EARLY CHILDHOOD HEALTH CAN DO CANINES 9440 SCIENCE CENTER DR NEW HOPE MN 55428 411594165 501C(3) 6000 0 GENERAL FUNDING CAPI USA 5930 BROOKLYN BLVD BROOKLYN CENTER MN 55429 411417198 501C(3) 20000 0 GENERAL FUNDING CREATING HEALTHIER COMMUNITIES 1199 N FAIRFAX STREET STE 600 ALEXANDRIA MN 22314 136167225 501C(3) 20000 0 GENERAL FUNDING CREATIVE HEALING SPACE INC 1450 COLLEGE WAY DR STE 114 WORTHINGTON MN 56187 844123924 501C(3) 6500 0 GENERAL FUNDING CULTURAL WELLNESS CENTER 2025 PORTLAND AVE S MINNEAPOLIS MN 55404 411850859 501C(3) 10000 0 GENERAL FUNDING DAMIANO OF DULUTH INC 206 W 4TH ST RM 201 DULUTH MN 55806 411453521 501C(3) 10000 0 GENERAL FUNDING LUTHERAN SOCIAL SERVICE OF MINNESOTA 921 1ST ST N ST CLOUD MN 56303 410872993 501C(3) 10000 0 GENERAL FUNDING MINNESOTA PERINATAL ORGANIZATION 13865 QUENTIN AVE S SAVAGE MN 55378 411377912 501C(3) 20000 0 GENERAL FUNDING NATIVE AMERICAN COMMUNITY CLINIC 1213 E FRANKLIN AVE MINNEAPOLIS MN 55404 030445789 501C(3) 10000 0 GENERAL FUNDING NORTHWEST MINNESOTA FOUNDATION 201 3RD ST NW BEMIDJI MN 56601 411556013 501C(3) 20000 0 GENERAL FUNDING RS EDEN 1931 W BROADWAY MINNEAPOLIS MN 55411 411948604 501C(3) 20000 0 GENERAL FUNDING SAINT PAUL & MINNESOTA FOUNDATION 370 WABASHA ST N 300 SAINT PAUL MN 55102 416031510 501C(3) 20000 0 GENERAL FUNDING SECOND HARVEST HEARTLAND 7101 WINNETKA AVE N BROOKLYN PARK MN 55428 237417654 501C(3) 25000 0 GENERAL FUNDING THE ALIVENESS PROJECT 3808 NICOLLET AVE MINNEAPOLIS MN 55409 411593900 501C(3) 20000 0 GENERAL FUNDING THE MINNEAPOLIS FOUNDATION 800 IDS CENTER 80 S 8TH ST MINNEAPOLIS MN 55402 416029402 501C(3) 50000 0 GENERAL FUNDING YOUTHLINK 41 N 12TH ST MINNEAPOLIS MN 55403 411341773 501C(3) 20000 0 GENERAL FUNDING ADVOCATES FOR REPRODUCTIVE EDUCATION 615 OAK ST BRAINERD MN 56401 813828875 501C(3) 10000 0 RURAL HEALTH AKELEY REGIONAL COMMUNITY CENTER (ARCC) PO BOX 218 AKELEY MN 56433 432007564 501C(3) 10000 0 RURAL HEALTH AMERICAN INDIAN COMMUNITY HOUSING ORGANIZATION 202 W 2ND ST DULUTH MN 55802 411782394 501C(3) 10000 0 RURAL HEALTH BLUFF COUNTRY FAMILY RESOURCES 114 MAIN ST HOKAH MN 55941 411502808 501C(3) 10000 0 RURAL HEALTH CARE CLINIC 906 COLLEGE AVE RED WING MN 55066 270540451 501C(3) 10000 0 RURAL HEALTH CARE PARTNERS OF COOK COUNTY PO BOX 282 GRAND MARAIS MN 55604 473747964 501C(3) 10000 0 RURAL HEALTH CHIPPEWA COUNTY MONTEVIDEO HOSPITAL 824 N 11TH ST MONTEVIDEO MN 56265 416008775 501C(3) 10000 0 RURAL HEALTH COMMITTEE AGAINST DOMESTIC ABUSE INC 100 STADIUM COURT MANKATO MN 56001 411379525 501C(3) 10000 0 RURAL HEALTH EVERGREEN YOUTH & FAMILY SERVICES INC PO BOX 662 BEMIDJI MN 56619 411297737 501C(3) 10000 0 RURAL HEALTH FOOTNOTES TRAUMA FOUNDATION INC 808 N 2ND ST MANKATO MN 56001 844896207 501C(3) 10000 0 RURAL HEALTH HANDS OF HOPE RESOURCE CENTER INC PO BOX 67 LITTLE FALLS MN 56345 411740880 501C(3) 10000 0 RURAL HEALTH JUST KIDS DENTAL 1313 FAIRGROUNDS RD TWO HARBORS MN 55616 272311353 501C(3) 10000 0 RURAL HEALTH LAKES AREA INTERFAITH CAREGIVERS PO BOX 64 DEERWOOD MN 56425 134230071 501C(3) 10000 0 RURAL HEALTH LE SUEUR COUNTY FAMILY SERVICES COLLABORATIVE 88 S PARK AVE LE CENTER MN 56057 411278867 GOVERNMENT AGENCY 10000 0 RURAL HEALTH LEECH LAKE RESERVATION BUSINESS COMMITTEE INC 533 7TH ST NW CASS LAKE MN 56633 411242052 GOVERNMENT AGENCY 10000 0 RURAL HEALTH LET'S SMILE INC 155 OAKDALE ST OWATONNA MN 55060 462672230 501C(3) 10000 0 RURAL HEALTH LIFECARE MEDICAL CENTER 715 DELMORE DR ROSEAU MN 56751 411804205 501C(3) 10000 0 RURAL HEALTH MEN AS PEACEMAKERS 123 W SUPERIOR ST DULUTH MN 55802 411841689 501C(3) 10000 0 RURAL HEALTH MID-MN WOMEN'S CENTER DBA RELATIONSHIP SAFETY ALLIANCE 1414 MAPLE ST BRAINERD MN 56401 411324087 501C(3) 10000 0 RURAL HEALTH NORTHWOODS PARTNERS 760 EAST MINERS DR ELY MN 55731 412016401 501C(3) 10000 0 RURAL HEALTH NORTHWOODS INTERFAITH VOLUNTEER CAREGIVERS PROGRAM 616 AMERICA AVE STE 170 BEMIDJI MN 56601 411993133 501C(3) 10000 0 RURAL HEALTH OPEN DOOR HEALTH CENTER 309 HOLLY LANE MANKATO MN 56001 411461726 501C(3) 10000 0 RURAL HEALTH RIVERS OF HOPE 517 PINE ST MONTICELLO MN 55362 411670536 501C(3) 10000 0 RURAL HEALTH RUTH'S HOUSE OF HOPE INC PO BOX 593 FARIBAULT MN 55021 870709671 501C(3) 10000 0 RURAL HEALTH SOUTHWEST CRISIS CENTER 320 S LAKE ST WORTHINGTON MN 561870111 411807048 501C(3) 10000 0 RURAL HEALTH TEUBY CONTINUED 21092 451ST AVE ARLINGTON MN 55307 842398238 501C(3) 10000 0 RURAL HEALTH THE OWATONNA HEALTHY SENIORS PROGRAM PO BOX 1089 OWATONNA MN 55060 411885511 501C(3) 10000 0 RURAL HEALTH ZUMBRO VALLEY MEDICAL SOCIETY FOUNDATION PO BOX 9264 ROCHESTER MN 55903 411934705 501C(3) 10000 0 RURAL HEALTH 82 2 PART I, LINE 2: THE MEDICA FOUNDATION MONITORS THE USE OF GRANT FUNDS THROUGH SEVERAL MECHANISMS. ALL GRANTEES ARE ASKED TO SUBMIT PROGRESS REPORTS RELATED TO THE GRANT FUNDING. UPDATES ON PROGRAM GRANTS ARE RECEIVED DURING AND AT THE END OF THE GRANT PERIOD. ADDITIONALLY, THE FOUNDATION ENGAGES A COMMITTEE OF EMPLOYEES TO WORK DIRECTLY WITH GRANT RECIPIENTS TO PROVIDE OVERSIGHT AND SUPPORT TO HELP ENSURE GRANT OBJECTIVES ARE ACCOMPLISHED. THE COMMITTEE FUNCTIONS UNDER THE DIRECTION OF FOUNDATION STAFF. COMMITTEE MEMBERS REVIEW PROPOSALS, PERFORM SITE VISITS AND PROVIDE QUARTERLY UPDATES FOR THE BOARD OF DIRECTORS. 0 1 0 0 0 1 1 0 0 ELIZABETH F ERICKSON PRESIDENT, CEO, & TREAS THRU 1/2024 0 985480 0 522989 0 161180 0 160811 0 40391 0 1870851 0 152285 KRISTA DUSIL SVP, CFO, & TREASURER 0 428011 0 300026 0 76086 0 91882 0 24233 0 920238 0 0 MARY P QUIST SR. VP, FINANCE THRU 6/2024 0 185247 0 355809 0 63652 0 13800 0 21445 0 639953 0 58545 ALICIA REUTER SVP & CHIEF LEGAL OFFICER, SECRETARY 0 244472 0 125026 0 38984 0 55274 0 17468 0 481224 0 0 JAMES P JACOBSON FORMER SVP SEC & GEN COUNSEL 0 0 0 0 0 403815 0 0 0 0 0 403815 0 126993 MARK L BAIRD FORMER SVP & CFO 0 0 0 124000 0 246125 0 0 0 0 0 370125 0 43667 DAVID H ELLENBOGEN FORMER SVP SEC & GEN COUNSEL 0 11188 0 0 0 213423 0 453 0 1166 0 226230 0 213151 SAMUEL LEON FORMER DIRECTOR 0 23250 0 0 0 0 0 0 0 0 0 23250 0 0 PART I, LINE 3 MEDICA FOUNDATION, THE FILING ORGANIZATION DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA SERVICES COMPANY, A RELATED ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA SERVICES COMPANY USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING RECEIVED A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA SERVICES COMPANY, A RELATED ORGANIZATION: MARK L. BAIRD - $43,667 KRISTA DUSIL - $73,769 DAVID H. ELLENBOGEN - $213,151 ELIZABETH F. ERICKSON - $152,285 JAMES P. JACOBSON - $126,993 ALICIA REUTER - $37,500 MARY P. QUIST -$58,545 PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATION'S OPERATING EARNINGS. FORM 990, PART VI, SECTION A, LINE 3 MEDICA FOUNDATION 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 FOUNDATION AND MEDICA FOUNDATION PAYS FOR SUCH SERVICES THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B MEDICA'S TAX ADVISORS COMPLETE THE RETURN, 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 FOUNDATION DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION WHICH USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION: A COMPENSATION COMMITTEE 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. 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 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, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FORM 990S ARE AVAILABLE UPON REQUEST. 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 HEALTH PLANS OCCURRED DURING THE TAXABLE PERIOD: 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 JNN VENTURES INC. MEDICA HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411242261 HEALTH COVERAGE MN 501(C)(4) MHC 0 MEDICA COMMUNITY HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH COVERAGE MN 501(C)(4) MHC 0 MEDICA HOLDING COMPANY (MHC) 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING COMPANY MN 501(C)(4) N/A 0 MEDICA CENTRAL HEALTH PLAN 10101 WOODFIELD LANE ST LOUIS MO 63132 831979548 HEALTH COVERAGE MO 501(C)(4) MFCJVN 0 MS COMMUNITY NFP JV (MFCJVN) LLC 401 CARLSON PARKWAY MINNETONKA MN 55305 873268926 MN 0 0 0 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MAS C 0 MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 THIRD PARTY ADMIN MN MAS C 0 MEDICA AFFILIATED SERVICES (MAS) 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MHC C 0 MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MANAGEMENT MN MAS C 0 MMSI INC 401 CARLSON PARKWAY MINNETONKA MN 55305 411547003 HEALTH INSURANCE MN MAS C 0 MEDICA SERVICES COMPANY LLC 401 CARLSON PARKWAY MINNETONKA MN 55305 852902940 ADMIN SERVICES MN MAS C 0 DEAN HEALTH PLAN INC 1277 DEMING WAY MADISON WI 53717 391535024 HEALTH INSURANCE WI DHI C 0 DEAN HEALTH INSURANCE INC (DHI) PO BOX 56099 MADISON WI 53705 391830837 HEALTH INSURANCE WI MSCJV C 0 MEDICA CENTRAL INSURANCE COMPANY 10101 WOODFIELD LANE ST LOUIS MO 63132 834718249 HEALTH INSURANCE MO MSCJV C 0 DEAN HEALTH SERVICES COMPANY LLC 1277 DEMING WAY MADISON WI 53717 842933639 ADMIN SERVICES WI MSCJV C 0 MS COMMUNITY JV LLC (MSCJV) 401 CARLSON PARKWAY MINNETONKA MN 55305 873240022 HOLDING COMPANY MN MHC C 0 MEDICA REGIONAL INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 854111612 HEALTH INSURANCE MN MAS C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0