2025-11-17T10:49:31-06:00 2024-12-31 331498605 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2024-01-01 811970070 MY CHOICE WISCONSIN INC MYCH 4144058034 5400 S 60TH STREET GREENDALE WI 53129 MARIA LEDGER CHIEF EXECUTIVE OFFICER 4144058034 2025-11-16 1 1 DAVID LOWENTHAL P00378651 3122071040 2025-11-16 2024 2025-03-06 01:10:19Z X MARIA LEDGER 5400 S 60TH STREET GREENDALE WI 53129 5129343 0 X N/A X 2016 WI FORMER WISCONSIN BASED MANAGED CARE ORGANIZATION. X 9 9 5 0 0 0 10361 0 533257357 0 6233166 5129343 146797523 0 686298407 5129343 0 0 456229681 0 51801148 3989962 0 0 0 16949022 498707 524979851 4488669 161318556 640674 266601317 168202889 0 108495 266601317 168094394 WE INSPIRE PEOPLE TO EXPERIENCE LIFE AT ITS FULLEST BY ENCOURAGING OWNERSHIP OF HEALTH, FOSTERING INDEPENDENCE, AND SERVING THE WHOLE PERSON; AND DO SO WITH AN UNWAVERING COMMITMENT AS STEWARDS OF MEDICAID FUNDING. 0 0 0 0 MY CHOICE WISCONSIN, INC. (THE "COMPANY OR "MCW") WAS A MANAGED CARE ORGANIZATION (MCO) THAT OPERATED THE STATE OF WISCONSIN FAMILY CARE PROGRAM. FAMILY CARE IS A MEDICAID LONG-TERM CARE PROGRAM WHICH HELPED FRAIL ELDERS AND ADULTS WITH DISABILITIES GET THE SERVICES THEY NEED TO REMAIN IN THEIR HOMES. IN 2023, MY CHOICE WISCONSIN, INC. SOLD ITS OPERATIONS TO MOLINA HEALTHCARE, INC. PER THE OPERATING AGREEMENT, MY CHOICE WISCONSIN, INC. HAS NOT DISSOLVED AS OF 12/31/2024 HOWEVER IT IS IN THE PROCESS OF WINDING DOWN. ALL REMAINING ASSETS WILL BE TRANSFERRED TO A RELATED PARTY, THE TRILLIUM FOUNDATION, INC. 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 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 0 0 1 5 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X MARIA LEDGER CEO 4144058034 5400 S 60TH STREET GREENDALE WI 53129 MARIA LEDGER DIRECTOR AND CEO 10.00 30.00 X X 832500 116667 0 THOMAS ORENDORFF DIRECTOR AND CHAIR 2.00 3.00 X X 3334 6666 0 MICHAEL MAYO SR DIRECTOR AND VICE CHAIR 2.00 2.00 X X 3334 6666 0 MARIA RODRIGUEZ DIRECTOR AND TREASURER 1.00 1.00 X X 3334 6666 0 KENNETH BYOM DO DIRECTOR AND SECRETARY 1.00 1.00 X X 3333 6667 0 LYNDA KRELLWITZ DIRECTOR 1.00 1.00 X 3333 6667 0 LEE S SEESE DIRECTOR 2.00 2.00 X 3333 6667 0 THOMAS BERGERUD DIRECTOR 1.00 1.00 X 3333 6667 0 KATHRYN BRIETZMAN DIRECTOR 1.00 1.00 X 3333 6667 0 JOHN HINTZE DIRECTOR 1.00 1.00 X 3333 6667 0 JAMES HODSON CHIEF FINANCIAL OFFICER 10.00 30.00 X 884000 100000 0 KEVIN COLLINS FORMER CHIEF COMPLIANCE OFFICER 0.00 0.00 X 780000 0 0 BETSY VAN HEESCH FORMER CHIEF OPERATIONS OFFICER 0.00 0.00 X 750000 0 0 BRION BEAUCHENE FORMER CHIEF INFORMATION OFFICER 0.00 0.00 X 474490 0 0 3750990 276667 0 5 1 1 0 0 5129343 5129343 5129343 0 0 5129343 3881152 3881152 108810 108810 164883 164883 170699 170699 72360 72360 25000 25000 54438 54438 SURPLUS LINE TAX 9536 9536 PAYROLL ADMIN FEES 962 962 FUTUREPLAN 457B FEES 829 829 4488669 0 4488669 0 187973221 153184786 78628096 15018103 266601317 168202889 0 108495 0 108495 X 266601317 168094394 266601317 168094394 266601317 168202889 X 640674 -99147597 X 0 0 0 X 31983 274482 32386 10361 0 349212 718046189 710270357 798043063 533344414 0 2759704023 718078172 710544839 798075449 533354775 2760053235 0 0 0 2760053235 1135990 2905210 2495173 6407598 5129343 18073314 1135990 2905210 2495173 6407598 5129343 18073314 25969 560149 46485 41036 673639 719240131 714010198 800617107 539803409 5129343 2778800188 0.99330 0.99510 0.00650 0.00470 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER - 2020 AMOUNT: $ 25,969. 2021 AMOUNT: $ 560,149. 2022 AMOUNT: $ 46,485. 2023 AMOUNT: $ 41,036. 2024 AMOUNT: $ 0. 0 FUNDS HELD IN ESCROW 15018103 15018103 X X X 1 0 0 0 0 0 0 0 0 JAMES HODSON CHIEF FINANCIAL OFFICER 0 100000 0 0 884000 0 0 0 0 0 884000 100000 0 0 MARIA LEDGER DIRECTOR AND CEO 0 116667 0 0 832500 0 0 0 0 0 832500 116667 0 0 KEVIN COLLINS FORMER CHIEF COMPLIANCE OFFICER 0 0 0 0 780000 0 0 0 0 0 780000 0 0 0 BETSY VAN HEESCH FORMER CHIEF OPERATIONS OFFICER 0 0 0 0 750000 0 0 0 0 0 750000 0 0 0 BRION BEAUCHENE FORMER CHIEF INFORMATION OFFICER 0 0 0 0 474490 0 0 0 0 0 474490 0 0 0 PART I, LINE 3 THE FOLLOWING INDIVIDUALS RECEIVED A CHANGE-OF-CONTROL PAYMENT RESULTING FROM THE SALE OF OPERATIONS OF MY CHOICE WISCONSIN, INC. TO MOLINA HEALTHCARE, INC. IN SEPTEMBER 2023. CHANGE-OF-CONTROL PAYMENTS WERE PAID AND TREATED AS REPORTABLE COMPENSATION IN 2024. JAMES HODSON: $884,000 MARIA LEDGER: $832,500 KEVIN COLLINS: $780,000 BETSY VAN HEESCH: $750,000 BRION BEAUCHENE: $474,490 CASH AND INVESTMENT SECURITIES 2024-12-31 99147597 FMV AS PROVIDED BY INVESTMENT STATEMENTS 871303591 THE TRILLIUM FOUNDATION INC 5400 S 60TH STREET GREENDALE WI 53129 501(C)(3) 1 0 0 0 PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: CERTAIN DIRECTORS OR EMPLOYEES OF MY CHOICE WISCONSIN, INC. WERE ALSO DIRECTORS OR EMPLOYEES OF THE TRILLIUM FOUNDATION, INC (FKA MY CHOICE FOUNDATION HOLDINGS) BEFORE AND AFTER THE TRANSFER OF ASSETS TO THE TRILLIUM FOUNDATION, INC. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF FINANCIAL OFFICER PERFORMS A REVIEW PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. THE FORM IS MADE AVAILABLE TO THE MEMBERS OF THE BOARD AFTER FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY FOR INTERESTED PERSONS THAT ADDRESSES TRANSACTIONS BETWEEN THE ORGANIZATION AND ANY CURRENT OR FORMER OFFICERS, DIRECTORS, COMMITTEE MEMBERS, KEY EMPLOYEE, STAFF MEMBERS, ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION, FAMILY MEMBERS, AND OTHER RELATED ENTITIES. CONFLICTS DISCLOSED ARE ADDRESSED IN ACCORDANCE WITH POLICY SUMMARIZED BELOW. IF AN INTERESTED PERSON HAS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, THAT INTERESTED PERSON SHALL NOTIFY THE BOARD CHAIR OF SUCH CONFLICT IN WRITING, OR IN THE CASE OF A COMMITTEE MEMBER, THE COMMITTEE CHAIR. THE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS, WHO ARE CONSIDERING THE PROPOSED MATTER THAT PRESENTS THE POTENTIAL CONFLICT. IF ANY STAFF MEMBER HAS ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, HE/SHE SHALL NOTIFY THE CHIEF EXECUTIVE OFFICER OF SUCH CONFLICT IN THE CONTEXT OF HER/HIS SUPERVISORY ROLE OR SHALL HAVE THE DISCRETION TO REFER THE MATTER TO THE BOARD. IF THE BOARD OR COMMITTEE DECIDES A CONFLICT OF INTEREST EXISTS, THE FOLLOWING PROCEDURES SHALL APPLY: 1. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. 2. IF THE CONFLICT IS NOT RESOLVED BY RECUSAL OF THE INTERESTED PERSON, THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF APPLICABLE. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 3. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OF COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. ALL CONFLICT OF INTEREST DETERMINATIONS WILL BE REFLECTED IN THE MINUTES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REPORTED IN FORM 990, PART VII, SECTION A, COLUMN (D) WERE PAID BY RELATED ORGANIZATION, MY CHOICE WISCONSIN, INC., FOR SERVICES PROVIDED TO MY CHOICE WISCONSIN, INC. AND MY CHOICE WISCONSIN HEALTH PLAN, INC. COMPENSATION REPORTED ON THE 2024 990 IS NOT FOR SERVICES PROVIDED IN 2024 BUT RATHER SEPARATION PAYMENTS RESULTING FROM THE SALE OF MY CHOICE WISCONSIN, INC AND MY CHOICE WISCONSIN HEALTH PLAN, INC TO MOLINA HEALTHCARE, INC. HISTORICALLY, FOR COMPENSATION PAID BY MY CHOICE WISCONSIN, INC., THE FINANCE COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF MY CHOICE WISCONSIN, INC WAS RESPONSIBLE FOR THE ANNUAL REVIEW OF THE COMPENSATION OF THE PRESIDENT/CEO OF THE ORGANIZATION. ALL MEMBERS OF THE COMMITTEE WERE INDEPENDENT IN DETERMINING THE COMPENSATION OF THE PRESIDENT/CEO. THE COMMITTEE EVALUATED THE CEO'S PERFORMANCE AGAINST PREVIOUSLY AGREED UPON CRITERIA, CONSIDERED COMPARABLE MARKET DATA, THEN DEBATEDAND DOCUMENTED ITS RECOMMENDATION OF REASONABLE COMPENSATION. THE PROCESS FOR DETERMINING COMPENSATION OF OFFICERS INCLUDED A MARKET ANALYSIS OF COMPARABLE POSITIONS FROM SIMILAR ORGANIZATIONS FOR BENCHMARKING PURPOSES. THIS INFORMATION WAS REVIEWED BY INTERNAL HUMAN RESOURCES PROFESSIONALS AND THE CEO. THE CEO EVALUATED THE OFFICERS PERFORMANCE AGAINST PREVIOUSLY AGREED UPON CRITERIA AND A DECISION IS MADE ON THE OFFICERS' SALARY. 2024 WAS THE FINAL YEAR IN WHICH REPORTABLE COMPENSATION WOULD BE PAID AND REPORTED BY MY CHOICE WISCONSIN, INC. COMPENSATION REPORTED IN FORM 990, PART VII, SECTION A, COLUMN (E) IS COMPENSATION PAID BY RELATED ORGANIZATION, TRILLIUM FOUNDATION, INC. FOR SERVICES PROVIDED TO THE FOUNDATION. COMPENSATION WAS DETERMINED USING DATA OF SIMILARLY SIZED FOUNDATIONS IN THE MIDWEST FOUND IN STUDIES PERFORMED BY THIRD PARTIES. COMPENSATION WAS APPROVED BY THE FULL BOARD AND THE PROCESS FOR DETERMINING THE COMPENSATION WAS CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: RELATED PARTY ASSET TRANSFERS -99,147,597. MY CHOICE WISCONSIN HEALTH PLAN INC 5400 S 60TH ST GREENDALE WI 53129 270093404 HEALTH CARE WI 501(C)(3) LINE 10 MY CHOICE WISCONSIN INC 1 THE TRILLIUM FOUNDATION INC 5400 S 60TH ST GREENDALE WI 53129 871303591 SUPPORTING ORGANIZATION WI 501(C)(3) LINE 12A, I MY CHOICE WISCONSIN INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0