2024-09-30T09:56:33-05:00 2023-12-31 390747409 REILLY PENNER & BENTON LLP 1233 NORTH MAYFAIR RD SUITE 302 MILWAUKEE WI 532263255 990 2023-01-01 390712330 WISCONSIN COMPENSATION RATING BUREAU WISC 2627964540 20700 SWENSON DR 100 100 WAUKESHA WI 53186 LAURA VANDE HEY VP - ACCOUNTING AND HR 2627964540 2024-09-17 1 1 BRIAN MECHENICH P00976753 4142717800 2023 2024-10-15 13:58:12Z LAURA VANDE HEY 20700 SWENSON DR 100 100 WAUKESHA WI 53186 13855652 0 X WWW.WCRB.ORG X 1917 WI RATING WORKERS COMPENSATION INSURANCE RISKS. 12 0 55 12 0 0 0 0 10837730 11700868 5896 261083 11757 26144 10855383 11988095 0 0 0 0 5238733 5650091 0 0 0 2956766 3600036 8195499 9250127 2659884 2737968 9375619 7794717 5669392 5748400 3706227 2046317 X THE MISSION OF THE WCRB IS TO ADMINISTER AND ENHANCE WISCONSIN'S SYSTEM OF WORKER'S COMPENSATION CLASSIFICATIONS, RATES, RATING PLANS, AND FORMS. THE BUREAU WILL PERFORM ITS DUTIES IN AN EQUITABLE, PROFESSIONAL, AND RESPONSIVE MANNER WHEN DEALING WITH ALL OF THE PARTICIPANTS IN THE SYSTEM. 0 0 RATING WORKERS COMPENSATION RISKS 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 3 0 1 55 1 0 0 0 0 0 0 0 0 0 0 X 12 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 0 X X LAURA VANDE HEY 6083323197 20700 SWENSON DRIVE WAUKESHA WI 53186 MIKE LESTER EMPLOYER REPRESENTATIVE 1.00 X 0 0 0 DAN BURAZIN EMPLOYER REPRESENTATIVE 1.00 X 0 0 0 AMERICAN HOME ASSURANCE COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 SENTRY INSURANCE A MUTUAL COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 EMPLOYERS INSURANCE COMPANY OF WAUSAU COMMITTEE MEMBER 1.00 X 0 0 0 UNITED WISCONSIN INSURANCE COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 TRAVLERS INDEMNITY COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 GENERAL CASUALTY INSURANCE COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 SOCIETY INSURANCE COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 SFM MUTUAL INSURANCE COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 WEST BEND MUTUAL INSURANCE CO COMMITTEE MEMBER 1.00 X 0 0 0 SECURA INSURANCE COMPANY COMMITTEE MEMBER 1.00 X 0 0 0 BERNARD ROSAUER PRESIDENT 34.00 6.00 X 388880 0 67565 TAD CLEVELAND VICE PRESIDENT - TECHNICAL 40.00 X 214837 0 39960 MICHAEL MANN VICE PRESIDENT - IT 40.00 X 162423 0 30324 BETH NICKEL VICE PRESIDENT - OPERATION 40.00 X 145708 0 33348 NANCY KIERZEK VICE PRESIDENT - ADMINISTR 40.00 X 63730 0 39535 LAURA VANDE HEY VP ACCOUNTING AND HR 40.00 X 137560 0 29414 PAUL ROHDE IT SUPPORT 40.00 X 126462 0 20418 DONNA KNEPPER EXECUTIVE SECRETARY 40.00 X 123761 0 24913 MICHELLE SWESSEL VP OF IT 40.00 X 161288 0 35424 VARUN RAVISHANKAR BUSINESS DATA ANALYST 40.00 X 104466 0 1053 WENDY ROBERTS SYSTEM SUPPORT TEAM 40.00 X 110569 0 15922 1739684 0 337876 10 0 1 0 0 MEMBERSHIP DUES & ASSESSMENTS 900099 9563035 9563035 UNIT STATISTICAL CARDS 900099 1425400 1425400 REPORT SERVICES 900099 327965 327965 NOTICE TO CARRIERS 900099 306700 306700 WAIP MISC 900099 59968 59968 17800 17800 11700868 297037 297037 1831603 1867557 -35954 -35954 -35954 MISCELLANEOUS 900099 20219 20219 ALLOWANCES 900099 5925 5925 26144 11988095 11727012 0 261083 1353464 2722499 750187 559376 264565 81607 55600 6750 505233 91395 1861945 386214 238141 15935 7746 11054 50076 WORKERS COMP RESEARCH I 195000 MISCELLANEOUS 50456 DR EXPENSES 39923 BUSINESS ENTERTAINMENT 2961 9250127 250426 48476 4400542 2800542 390787 384566 103942 112979 3779546 3837709 450376 610445 9375619 7794717 5510924 5510999 2835 109369 155633 128032 5669392 5748400 X 3706227 2046317 3706227 2046317 9375619 7794717 X 2737968 -4397878 X X 0 1 X 1 0 0 610445 C 610445 DEFERRED RENT 127460 401K CATCH-UP CONTRIBUTIONS 572 128032 X 7505227 -4476118 -4476118 11981345 6750 6750 11988095 9165137 -78240 -78240 9243377 6750 6750 9250127 PART X, LINE 2: UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, MANAGEMENT IS REQUIRED TO EVALUATE ANY UNCERTAIN TAX POSITIONS TAKEN, IF ANY, AND PROVIDE ADDITIONAL DISCLOSURES. AT THIS TIME, THE BUREAU DOES NOT BELIEVE IT HAS TAKEN ANY UNCERTAIN TAX POSITIONS THAT MAY HAVE A MATERIAL EFFECT ON ITS FINANCIAL STATEMENTS OR NOTE DISCLOSURES. PART XI, LINE 2D - OTHER ADJUSTMENTS: SURPLUS -4,452,372. NET ACTUARIAL (GAIN) OR LOSS ON POS -115,200. PRIOR SERVICE COST ON POSTRETIREMEN 91,454. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 6,750. PART XII, LINE 2D - OTHER ADJUSTMENTS: ACCRUED PENSION TRUST ADJUSTMENT -125,903. CHANGE IN ACCRUED POSTRETIREMENT BE 47,663. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 6,750. X 0 1 0 BERNARD ROSAUER PRESIDENT 346380 0 42500 0 0 0 19800 0 47765 0 456445 0 0 0 TAD CLEVELAND VICE PRESIDENT - TECHNICAL 202837 0 12000 0 0 0 12454 0 27506 0 254797 0 0 0 MICHELLE SWESSEL VP OF IT 146288 0 15000 0 0 0 10077 0 25347 0 196712 0 0 0 MICHAEL MANN VICE PRESIDENT - IT 162423 0 0 0 0 0 7716 0 22608 0 192747 0 0 0 BETH NICKEL VICE PRESIDENT - OPERATION 133708 0 12000 0 0 0 9025 0 24323 0 179056 0 0 0 LAURA VANDE HEY VP ACCOUNTING AND HR 122560 0 15000 0 0 0 6205 0 23209 0 166974 0 0 0 PART I, LINE 4B NANCY KIERZEK - DEFERRED $2,353 TAD CLEVELAND - DEFERRED $13,587 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 -4,452,372. NET ACTUARIAL (GAIN)/LOSS ON POS -115,200. PRIOR SERVICE COST ON POSTRETIREMENT 91,454. ACCRUED PENSION TRUST ADJUSTMENT 125,903. CHANGE IN ACCRUED POSTRETIREMENT BENEFITS -47,663. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. WISCONSIN AUTOMOBILE INSURACE PLAN 20700 SWENSON DR WAUKESHA WI 53186 132902515 ASSIGNMENT OF AUTO RISK INSURANCE WI 501 (C) (6) N/A N/A 0 WISCONSIN WORKERS COMPENSATION INVESTMENT POOL 20700 SWENSON DR WAUKESHA WI 53186 396084300 STATUTORY WORKERS COMPENSATION RISK CEDING POOL WI 501 (C) (6) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 WISCONSIN AUTOMOBILE INSURANCE PLAN Q 59968 MANAGEMENT FEE