2024-11-13T11:43:34-06:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 790 N WATER ST SUITE 2000 MILWAUKEE WI 53202 990 2023-01-01 453309488 COMMON GROUND HEALTHCARE COOPERATIVE COMM 4144550500 300 N EXECUTIVE DR 300 BROOKFIELD WI 530056034 TODD HUTCHISON CFO 4144550500 2024-11-06 1 1 TROY MARINE CPA P00187863 4147775500 2024-11-06 2023 2024-10-15 13:58:12Z X CATHY MAHAFFEY 300 N EXECUTIVE DR 300 BROOKFIELD WI 530056034 469662034 0 X WWW.COMMONGROUNDHEALTHCARE.ORG X CO-OP 2011 WI PROVIDE AFFORDABLE HEALTH INSURANCE SOLUTIONS TO SMALL BUS., INDIVIDUALS & NON-PROFITS IN WI. 9 9 179 0 0 0 0 0 418236478 450644587 3307273 6518500 0 2213081 421543751 459376168 491 6000 0 0 12498811 14503062 0 0 0 427003054 435851276 439502356 450360338 -17958605 9015830 304410600 262120622 232786613 182162182 71623987 79958440 COMMON GROUND HEALTHCARE COOPERATIVE ("CGHC") IS A NON-PROFIT MEMBER-GOVERNED HEALTH INSURANCE COMPANY DEDICATED TO PROVIDING AFFORDABLE, INNOVATIVE HEALTH INSURANCE SOLUTIONS TO SMALL BUSINESSES, NON-PROFITS, AND INDIVIDUALS IN WISCONSIN. 0 0 COMMON GROUND HEALTHCARE COOPERATIVE IS A NON-PROFIT MEMBER-GOVERNED HEALTH INSURANCE COOPERATIVE DEDICATED TO DELIVERING QUALITY, COMPREHENSIVE HEALTH INSURANCE TO SMALL BUSINESSES AND INDIVIDUALS IN WISCONSIN. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 1 2171 0 1 179 1 0 0 0 0 0 0 84193831 148000450 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X TODD HUTCHISON 4144550500 300 N EXECUTIVE DR SUITE 300 BROOKFIELD WI 530056034 CATHY MAHAFFEY CEO 40.00 X 633553 0 55673 SCOTT ANDERSON TERM 122023 CMO - CHIEF MEDICAL OFFICER 40.00 X 376992 0 60192 BRIAN DAMIANI CIO 40.00 X 299336 0 49256 BRIAN GARTNER CHIEF OF STAFF 40.00 X 283201 0 32553 JESSICA KOTTWITZ CAO - CHIEF ADMINISTRATIVE OFFICER 40.00 X 262038 0 32513 MELISSA HENDERSON CCO - CHIEF COMPLIANCE OFFICER 40.00 X 273297 0 18566 AARON JACKSON VP PROVIDER CONTRACTING & STRATEGY 40.00 X 251833 0 25230 JENNIFER WALKOWIAK VP OF BUSINESS DEVELOPMENT 40.00 X 200946 0 28219 SCOTT BERGMAN CONTROLLER 40.00 X 184277 0 40871 SHELLY JOHNSON HEALTH PLAN QUALITY ADMINISTRATOR 40.00 X 191677 0 27982 TODD HUTCHISON CFO 40.00 X 197390 0 20380 DAN SCHUMACHER DIR OF ACTUARIAL & ANALYTICAL SERVICES 40.00 X 186328 0 27533 TONNI LARSON BOARD CHAIR 6.00 X 12210 0 0 AMY MURPHY BOARD VICE-CHAIR 1.00 X 12210 0 0 KEVIN GILLIGAN SECRETARY/TREASURER 1.00 X 8880 0 0 WILLIAM KORT DIRECTOR 1.00 X 8880 0 0 DEAN SCHADRIE DIRECTOR 1.00 X 8880 0 0 DAVID STRAM DIRECTOR 1.00 X 8880 0 0 MICHAEL WINKLER DIRECTOR 1.00 X 8880 0 0 BECKY TUCHSCHERER DIRECTOR 1.00 X 8880 0 0 JAMES WESP NON-VOTING DIRECTOR 1.00 X 8880 0 0 JOHN MAGLIO NON-VOTING DIRECTOR 1.00 X 8880 0 0 CHERYL THOMAS DIRECTOR 1.00 X 5180 0 0 JANET SARGENT DIRECTOR 1.00 X 5180 0 0 RACHAEL BUSH DIRECTOR 1.00 X 3700 0 0 ROBERT CONNOLLY NON-VOTING DIRECTOR 1.00 X 3700 0 0 3454088 0 418968 36 0 1 0 SECURITY HEALTH PLAN OF WISCONSIN INC 1515 SAINT JOSEPH AVENUE MARSHFIELD WI 54449 COST CONTAINMENT 1394083 HUMANA WISCONSIN HEALTH ORG INSURANCE CO PO BOX 4616 CAROL SREAM IL 60197 HEALTH INSURANCE 1379873 MILLIMAN INC 17335 GOLF PARKWAY STE 100 BROOKFIELD WI 53045 ACTUARIAL 1235902 OPTUM HEALTH CARE SOLUTIONS INC PO BOX 84019 CHICAGO IL 50689 MEDICAL MANAGEMENT 872069 MPX 2301 CONGRESS ST PORTLAND ME 04102 PRINTING AND POSTAGE 764024 54 PREMIUMS EARNED 525100 450644587 450644587 450644587 6359864 6359864 10444502 10285866 158636 158636 158636 MISCELLANEOUS REVENUE 900099 2213081 2213081 2213081 459376168 450644587 0 8731581 6000 2708159 9450802 565885 1628203 150013 226422 2264295 55800 5884852 317901 1785940 2650315 437472 118551 190443 333552 155860 301930 CLAIMS EXPENSE 398348485 CMS EXCHANGE USER FEE E 11514307 COMMISSIONS 8370020 BANK CHARGES 2034875 860256 450360338 41731277 26253575 150588074 128745328 5735780 5946379 613396 1204292 2040812 1817985 375688 222827 105366385 99748221 304410600 262120622 5160270 5572142 81026950 62219209 80302872 69270520 66296521 45100311 232786613 182162182 X 0 0 0 0 71623987 79958440 71623987 79958440 304410600 262120622 X 9015830 883047 -1420112 -144312 X X 0 1 X 1 1 1 405301 353870 51431 1041623 986795 54828 593888 477320 116568 222827 REINSURANCE RECOVERABLES 54030345 HEALTH CARE RECEIVABLE 16417737 ADVANCED PREMIUM TAX CREDIT RECEIVABLE 25976462 PROVIDER RECEIVABLE 290973 METLIFE FUNDING 3032704 99748221 UNEARNED PREMIUM 36693807 MLR PAYABLE TO MEMBERS -6147 INSURANCE FEE PAYABLE 8302163 INTEREST PAYABLE 110488 45100311 X 459376168 0 459376168 0 459376168 450360338 0 450360338 0 450360338 PART X, LINE 2: THE ACA ESTABLISHED SECTION 501(C) (29) OF THE INTERNAL REVENUE CODE AS A NEW TAX-EXEMPT CATEGORY SPECIFICALLY FOR QUALIFIED NON-PROFIT HEALTH INSURANCE ISSUERS THAT HAVE RECEIVED A LOAN OR GRANT UNDER THE CMS CO-OP PROGRAM FOR PERIODS THAT THEY MEET BOTH THE REQUIREMENTS OF SECTION 1322 OF THE ACA AND ANY LOAN AGREEMENT WITH CMS. THE COMPANY RECEIVED AN APPROVAL LETTER FROM THE INTERNAL REVENUE SERVICE STATING THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C) (29). X 1 1 X X 1 0 0 0 0 1 0 0 0 CATHY MAHAFFEY CEO 507343 0 0 0 126210 0 16236 0 39437 0 689226 0 0 0 SCOTT ANDERSON TERM 122023 CMO - CHIEF MEDICAL OFFICER 275918 0 0 0 101074 0 17338 0 42854 0 437184 0 0 0 BRIAN DAMIANI CIO 261104 0 0 0 38232 0 12387 0 36869 0 348592 0 0 0 BRIAN GARTNER CHIEF OF STAFF 247348 0 0 0 35853 0 17302 0 15251 0 315754 0 0 0 JESSICA KOTTWITZ CAO - CHIEF ADMINISTRATIVE OFFICER 195622 0 0 0 66416 0 15925 0 16588 0 294551 0 0 0 MELISSA HENDERSON CCO - CHIEF COMPLIANCE OFFICER 222057 0 0 0 51240 0 15849 0 2717 0 291863 0 0 0 AARON JACKSON VP PROVIDER CONTRACTING & STRATEGY 193715 0 10000 0 48118 0 13816 0 11414 0 277063 0 0 0 JENNIFER WALKOWIAK VP OF BUSINESS DEVELOPMENT 168028 0 0 0 32918 0 12109 0 16110 0 229165 0 0 0 SCOTT BERGMAN CONTROLLER 132825 0 1506 0 49946 0 11596 0 29275 0 225148 0 0 0 SHELLY JOHNSON HEALTH PLAN QUALITY ADMINISTRATOR 167122 0 0 0 24555 0 11781 0 16201 0 219659 0 0 0 TODD HUTCHISON CFO 183470 0 0 0 13920 0 7386 0 12994 0 217770 0 0 0 DAN SCHUMACHER DIR OF ACTUARIAL & ANALYTICAL SERVICES 175621 0 0 0 10707 0 11382 0 16151 0 213861 0 0 0 PART I, LINE 1A COMMON GROUND MADE REIMBURSMENTS OF INCOME FOR GROUP TERM LIFE OVER $50,000 INCLUDED IN WAGES. COMMON GROUND MADE GROSS-UP PAYMENTS OF $1,000 FOR ITS 10 YEAR ANNIVERSARY. PART I, LINE 4A SCOTT ANDERSON RECEIVED $30,280 IN SEVERANCE PAY IN 2023. PART I, LINE 6 CO-OP NET INCOME WAS ONE OF THE METRICS FOR QUALIFICATION FOR THE INCENTIVE COMPENSATION PLAN FOR 2023. MELISSA DUFFY FORMER OFFICER 223200 INDEPENDENT CONTRACTOR 0 WENDIGO ADVISORS WENDIGO ADVISORS IS 100% OWNED BY BRIAN DAMIANI, AN OFFICER. 378210 WENDIGO ADVISORS CONTRACTED WITH COMMON GROUND TO PROVIDE CONTRACT AND TEMPORARY STAFFING. 0 FORM 990, PART V, LINE 13A WI FORM 990, PART VI, SECTION A, LINE 6 COMMON GROUND HEALTHCARE COOPERATIVE BEGAN ISSUING HEALTH INSURANCE POLICIES IN 2014. WE OPERATE AS A HEALTH INSURANCE COMPANY SERVING BOTH INDIVIDUALS AND SMALL BUSINESSES. ALL ACTIVE POLICYHOLDERS ARE ALSO CONSIDERED MEMBERS OF THE COOPERATIVE. THIS STRUCTURE FOSTERS A SENSE OF COMMUNITY AND SHARED PURPOSE AMONG ITS MEMBERS, AS WE COLLECTIVELY STRIVE TO ACHIEVE THE COMMON GOAL OF PROMOTING AND MAINTAINING GOOD HEALTH WHILE KEEPING HEALTHCARE COSTS AS AFFORDABLE AS POSSIBLE. FORM 990, PART VI, SECTION A, LINE 7A COMMON GROUND HEALTHCARE COOPERATIVE IS GOVERNED BY A BOARD OF DIRECTORS, AND ALL VOTING DIRECTORS ARE ACTIVE MEMBERS WHO HAVE BEEN NOMINATED AND ELECTED BY THEIR FELLOW MEMBERS. THIS PROCESS ENSURES THAT THE VOICES AND PERSPECTIVES OF THE POLICYHOLDERS/MEMBERS ARE REPRESENTED IN THE COOPERATIVE'S DECISION-MAKING PROCESSES. THE COOPERATIVE'S MISSION OF "PUTTING MEMBERS FIRST. PURSUING BETTER HEALTHCARE" UNDERSCORES ITS COMMITMENT TO PRIORITIZING THE WELL-BEING OF ITS MEMBERS AND CONTINUALLY STRIVING TO IMPROVE THE QUALITY AND ACCESSIBILITY OF HEALTHCARE SERVICES. FORM 990, PART VI, SECTION B, LINE 11B FINANCE MANAGEMENT PRESENTS FORM 990 TO COMMON GROUND HEALTHCARE COOPERATIVE'S AUDIT & FINANCE COMMITTEE, AFTER WHICH A MOTION IS MADE, AND VOTE TAKEN TO APPROVE AND PRESENT TO THE FULL BOARD. THE BOARD IS LIKEWISE SUBSEQUENTLY PROVIDED THE FORM 990, AND AFTER REVIEW, IS ASKED FOR A MOTION AND ULTIMATELY APPROVAL OF FORM 990. ONCE APPROVAL IS GIVEN, THE FORM IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY SETS FORTH CLEAR EXPECTATIONS AND GUIDANCE THAT IS TO BE FOLLOWED BY ALL DIRECTORS, OFFICERS, EMPLOYEES AND THIRD PARTY REPRESENTATIVES. THE COOPERATIVE WILL EVALUATE ITS ADHERENCE AND COMPLIANCE TO THIS POLICY BY REQUESTING FEEDBACK ON A REGULAR BASIS FROM OUR MEMBERS, EMPLOYEES, DIRECTORS AND THIRD PARTY REPRESENTATIVES. IF ANY INDIVIDUAL HAS QUESTIONS OR CONCERNS ABOUT COMPLIANCE WITH THE SUBJECTS DESCRIBED IN THIS POLICY, ARE UNSURE ABOUT WHAT IS THE "RIGHT THING" TO DO, OR REASONABLY BELIEVES THAT SOME POLICY, PRACTICE OR ACTIVITY OF THE COOPERATIVE IS IN VIOLATION OF THE ETHICS POLICY OR CODE, THIS INDIVIDUAL SHOULD SHARE THEIR QUESTIONS, CONCERNS, SUGGESTIONS OR COMPLAINTS WITH SOMEONE WHO CAN ADDRESS THEM PROPERLY. IN MOST CASES, AN INDIVIDUAL'S SUPERVISOR IS IN THE BEST POSITION TO ADDRESS AN AREA OF CONCERN. HOWEVER, IF THE INDIVIDUAL IS NOT COMFORTABLE SPEAKING WITH HIS OR HER SUPERVISOR OR IS NOT SATISFIED WITH THE SUPERVISOR'S RESPONSE, THE INDIVIDUAL IS ENCOURAGED TO SPEAK WITH THE COMPLIANCE OFFICER, OR ANYONE IN MANAGEMENT WHOM THE INDIVIDUAL IS COMFORTABLE IN APPROACHING. THE COOPERATIVE PROVIDES ALL INDIVIDUALS AN ADDITIONAL MECHANISM TO REPORT UNETHICAL CONDUCT WHICH IS DISCUSSED FURTHER IN THE COMPLIANCE COMMUNICATION, REPORTING, AND INVESTIGATION POLICY. FORM 990, PART VI, SECTION B, LINE 15 CGHC'S MEMBER-ELECTED BOARD OF DIRECTORS' REVIEWS AND APPROVES CEO COMPENSATION ANNUALLY. CGHC RECOGNIZES THAT EMPLOYEES ARE KEY TO FULFILLING ITS MISSION; THEREFORE, CGHC ENGAGES WITH A 3RD PARTY CONSULTANT TO EVALUATE INTERNAL PAY PRACTICES AND CONDUCT MARKET ANALYSIS TO ENSURE CGHC APPROPRIATELY ATTRACTS AND RETAINS EMPLOYEES, INCLUDING THOSE OF THE EXECUTIVE LEADERSHIP TEAM. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET CHANGE IN BOARD FUNDS -144,312. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. COMMON GROUND HEALTHCARE FOUNDATION INC 300 N EXECUTIVE DR STE 300 BROOKFIELD WI 530056034 883360460 PROVIDE FUNDING WI 501 (C )(3) PF COMMON GROUND HEALTH COOPERATIVE 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 COMMON GROUND HEALTHCARE FOUNDATION B 764061 CASH PAYMENTS