2024-11-01T12:45:29-05:00 2023-12-31 381910111 UHY ADVISORS GREAT LAKES INC 455 E EISENHOWER SUITE 102 ANN ARBOR MI 48108 990 2023-01-01 382435776 MICHIGAN WORKERS' COMPENSATION PLACEMENT FACILITY MICH 7344629600 19500 VICTORY PARKWAY DRIVE 475 LIVONIA MI 48152 DAVE BRUECKMAN PRESIDENT 7344629600 2024-11-01 1 0 MICHAEL SANTICCHIA P00046899 7342131040 2024-11-01 2023 2024-10-15 13:58:12Z DAVE BRUECKMAN 19500 VICTORY PARKWAY DRIVE 475 LIVONIA MI 48152 3183448 0 X WWW.CAOM.COM X 1983 MI RESPONSIBLE FOR ADDRESSING ALL PLAN AND POOL ADMINISTRATION DUTIES ASSOCIATED WITH SUPPORTING THE MICHIGAN WORKERS' COMPENSATION RESIDUAL MARKET, I.E. MARKET OF LAST RESORT 9 9 0 0 0 0 0 0 2833657 3148522 0 34926 0 0 2833657 3183448 0 0 0 0 1989976 1841038 0 0 0 349921 403270 2339897 2244308 493760 939140 2370177 3058469 2009001 2251911 361176 806558 X THE MICHIGAN WORKERS' COMPENSATION PLACEMENT FACILITY (A.K.A. THE FACILITY) ADDRESSES ALL PLAN AND POOL ADMINISTRATION RESPONSIBILITIES REQUIRED TO OFFER AN ALTERNATIVE COVERAGE SOURCE FOR BUSINESSES UNABLE TO PROCURE WC INSURANCE COVERAGE IN THE VOLUNTARY MARKET. PLAN ADMINISTRATION DUTIES INCLUDE PROCESSING APPLICATIONS AGAINST ESTABLISHED ELIGIBILITY GUIDELINES, APPOINTING SERVICING CARRIERS TO ISSUE POLICIES AND PROCESS ANY SUBSEQUENT CLAIM ACTIVITY AND ESTABLISHING A VIABLE OUTSIDE VENDOR AND/OR SUITABLE INTERNAL RESOURCES TO ADDRESS THE VARIOUS POOL ADMINISTRATION RESPONSIBILITIES 0 0 1993876 3148524 THE FACILITY'S PRIMARY FOCUS IS REVIEWING POTENTIAL INSURANCE APPLICANTS AND ASSIGNING THEM TO ONE OF THE ESTABLISHED SERVICING CARRIERS CONSISTENT WITH THEIR ESTABLISHED QUOTA SHARE. THE FACILITY UTILIZES EXTERNAL RESOURCES TO ASSIST WITH THE SERVICING CARRIER SELECTION PROCESS, TO ANNUALLY EVALUATE EACH SERVICING CARRIER'S PERFORMANCE AGAINST ESTABLISHED PERFORMANCE STANDARDS, TO PROMULGATE EXPERIENCE MODS, TO PREPARE THE ANNUAL FACILITY RATE FILING AND TO MAINTAIN POOL RESERVES SUFFICIENT TO COVER THE FACILITY'S ULTIMATE LIABILITY 1993876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 5 0 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X X DAVE BRUECKMAN 7344629600 19500 VICTORY PARKWAY DRIVE 475 LIVONIA MI 48152 TRACEY MCLENON BOARD MEMBER 1.00 X 0 0 0 DAWN ELZINGA BOARD MEMBER 1.00 X 0 0 0 AMANDA WARNER BOARD MEMBER 1.00 X 0 0 0 ED HANLON BOARD MEMBER 1.00 1.00 X 0 0 0 RYAN VAUGHN BOARD MEMBER 1.00 1.00 X 0 0 0 BRIAN MELAS BOARD MEMBER 1.00 1.00 X 0 0 0 JASON SWEET BOARD MEMBER 1.00 X 0 0 0 KYLEE MITCHELL WELLS BOARD MEMBER 1.00 X 0 0 0 JAMES RALPH BOARD MEMBER 1.00 X 0 0 0 PAUL LIPSCOMB VP, OPERATIONS 20.50 17.00 X 0 144777 4798 DAVE BRUECKMAN PRESIDENT 20.50 17.00 X 0 315451 5309 ALAN BURNS SVP, CHIEF ACTUARY 20.50 17.00 X 0 245866 6814 ALEX BEDOWAY VP, LEAD ACTUARY 20.50 17.00 X 0 162595 4193 JAYARAJ SUBRAMANIAN IT MANAGER 20.50 17.00 X 0 178418 3235 MICHAEL C TITHOF ACTUARY III 20.50 17.00 X 0 117371 4328 0 1164478 28677 0 0 1 0 0 MEMBER ASSESSMENTS 524298 3148522 3148522 3148522 34926 34926 3183448 3148522 0 34926 304987 304987 1110558 935820 174738 120607 105772 14835 204468 174026 30442 100418 90660 9758 5311 5311 25200 25200 94746 94746 44403 39133 5270 67662 67662 109922 94533 15389 11908 11908 10375 10375 30155 30155 SUBSCRIPTION 1985 1985 EQUIPMENT MAINTENANCE A 1546 1546 PROPERTY TAXES 57 57 2244308 1993876 250432 0 1380602 2177657 970840 845878 18735 34934 2370177 3058469 2009001 2251911 2009001 2251911 X 361176 806558 361176 806558 2370177 3058469 X 939140 -493758 X X 0 1 X 1 0 0 X 3183448 0 3183448 0 3183448 2738066 493758 493758 2244308 0 2244308 PART X, LINE 2: ASC GUIDANCE REGARDING ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES THAT CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD AN INCOME TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS AND APPLIES TO ALL INCOME TAX POSITIONS. EACH INCOME TAX POSITION IS ASSESSED USING A TWO-STEP PROCESS. A DETERMINATION IS FIRST MADE AS TO WHETHER IT IS MORE LIKELY THAN NOT THAT THE INCOME TAX POSITION WILL BE SUSTAINED, BASED UPON TECHNICAL MERITS, UPON EXAMINATION BY THE TAXING AUTHORITIES. IF THE INCOME TAX POSITION IS EXPECTED TO MEET THE MORE LIKELY THAN NOT CRITERIA, THE BENEFIT RECORDED IN THE FINANCIAL STATEMENTS EQUALS THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY TO BE REALIZED UPON ITS ULTIMATE SETTLEMENT. AT DECEMBER 31, 2022, THERE WERE NO UNCERTAIN TAX POSITIONS THAT REQUIRED ACCRUAL. PART XII, LINE 2D - OTHER ADJUSTMENTS: PRIOR YEAR REAPPORTIONMENT 493,758. X X 0 0 0 DAVE BRUECKMAN PRESIDENT 0 311665 0 0 0 3786 0 0 0 5309 0 320760 0 0 ALAN BURNS SVP, CHIEF ACTUARY 0 242856 0 0 0 3010 0 0 0 6814 0 252680 0 0 JAYARAJ SUBRAMANIAN IT MANAGER 0 177161 0 0 0 1257 0 0 0 3235 0 181653 0 0 ALEX BEDOWAY VP, LEAD ACTUARY 0 161888 0 0 0 707 0 0 0 4193 0 166788 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED AND VERIFIED BY THE PRESIDENT AND THE OFFICE MANAGER PRIOR TO NOTIFYING THE GOVERNING BOARD MEMBERS OF ITS AVAILABILITY. THE GOVERNING BOARD MEMBERS MAY REQUEST A COPY FOR THEIR REVIEW AND/OR RAISE ANY QUESTIONS AT THE SEPTEMBER GOVERNING BOARD MEETING PRIOR TO FILING THE RETURN FORM 990, PART VI, SECTION B, LINE 12C GOVERNING BOARD MEMBERS ARE ANNUALLY REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ACKNOWLEDGING THAT THEY DO NOT HAVE ANY CONFLICTS OF INTEREST SERVING ON THE BOARD. FURTHER, SINCE THE BOARD IS COMPRISED OF MEMBER CARRIERS, BOARD REPRESENTATIVES ARE ASKED TO ABSTAIN FROM VOTING IF THE ISSUE BEING DISCUSSED COULD IMPACT THEIR COMPANY FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING BOARDS REVIEW THE PRESIDENT & CEO'S SALARY ANNUALLY AND DETERMINES ANY INCREASE OR BONUS. THE BOARD CHAIR SENDS THAT SALARY INFORMATION TO THE OFFICE MANAGER ADMINISTRATIVE AND COPIES THE ORGANIZATION'S LEGAL COUNSEL TO ENSURE THAT THE INFORMATION IS NOT COMPROMISED. MANAGEMENT AND STAFF ARE EVALUATED AGAINST BENCHMARKED JOB DESCRIPTIONS ON AN ANNUAL BASIS. THE ORGANIZATION'S SALARY BUDGET IS REVIEWED BY THE OPERATIONS COMMITTEE PRIOR TO SUBMITTING THE ENTIRE ANNUAL BUDGET TO THE GOVERNING BOARD FOR APPROVAL FORM 990, PART VI, SECTION C, LINE 18 THE IRS POSTS FORM 990 TO ITS WEBSITE. ALL GOVERNING BOARD MEMBERS ARE MADE AWARE OF A PENDING 990 FILING AND OFFERED A COPY SHOULD THEY WISH TO REVIEW. ADDITIONALLY, FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST TO THE ORGANIZATION FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE PUBLICLY AVAILABLE ON OUR WEBSITE (WWW.CAOM.COM ). THE CONFLICT OF INTEREST POLICY IS MADE AVAILABLE TO EMPLOYEES IN THE EMPLOYEE HANDBOOK. ALL EMPLOYEES HAVE ACCESS TO THIS DOCUMENT THROUGH INTERNAL FILE SHARING. THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO BOARD AND COMMITTEE MEMBERS ANNUALLY AND MUST BE SIGNED TO ENSURE THOSE MEMBERS HAVE NO CONFLICT OF INTEREST WHITE SITTING ON THE BOARD. THE CONFLICT OF INTEREST POLICY IS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FINANCIAL STATEMENTS ARE REVIEWED AND APPROVED ANNUALLY BY THE AUDIT COMMITTEE AND THE JOINT GOVERNING BOARD. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST FORM 990, PART XI, LINE 9: PRIOR YEAR REAPPORTIONMENT -493,758. PART XII, LINE 2C THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITOR HAVE NOT CHANGED DURING THE YEAR. COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN 17197 N LAUREL PARK DRIVE LIVONIA MI 48152 382435780 PROVIDES MEMBERS WITH WORKERS' COMP PREMIUM, LOSS & INFORMATION MI 501(C)(6) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN N 198097 ACTUAL EXPENSES COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN O 1841036 ACTUAL EXPENSES COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN P 205175 ACTUAL EXPENSES