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← MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INS TR

Form 990 for tax year 2022

Filed by MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INS TR.

Totals

Total revenue
$1,282,735
Total expenses
$612,033
Contributions and grants received
$375,290
Grants paid
$0
Program service revenue
$0
Investment income
$907,445
Other revenue
$0
Total assets, end of year
$22,588,215
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$22,588,215
Program services expenses (Part IX)
$537,500
Management and general expenses
$74,533
Fundraising expenses
$0
Program service expenses (Part III)
$537,500

Program services were 87.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1f · All other contributions, gifts and grants

    $375,290

  • 3 · Investment income

    total $431,377 · excluded $431,377

  • 7a · Gross sales of assets other than inventory

    securities $476,068

  • 7b · Less cost or other basis and sales expenses

    securities $0

  • 7c · Gain or loss

    securities $476,068

  • 7d · Net gain or loss

    total $476,068 · excluded $476,068

Functional expenses

Part IX, the statement of functional expenses.

  • 11f · Fees: investment management

    total $74,533 · management and general $74,533

  • 24a · Other expenses: PROF. LIABILITY CLAIMS

    total $537,500 · program services $537,500

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $473,318 · end of year $182,317

  • 11 · Investments: publicly traded securities

    beginning of year $22,404,915 · end of year $22,331,529

  • 15 · Other assets

    beginning of year $61,270 · end of year $74,369

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $22,939,503 · end of year $22,588,215

Mission and programs · 2022

Mission

TO PROVIDE MANDATORY PROFESSIONAL LIABILITY COVERAGE TO AFFILIATED ORGANIZATIONS THAT ARE EXEMPT UNDER SECTION 501(C)(3).

  • PROVIDED MANDATORY PROFESSIONAL LIABILITY COVERAGE TO AFFILIATED ORGANIZATIONS THAT ARE EXEMPT UNDER SEC. 501(C)(3). THERE WAS A TOTAL OF $537,500 PAID IN LIABILITY CLAIMS DURING THE FISCAL YEAR ENDED JUNE 30, 2023.

    Expenses $537,500

As filed on the 2022 return.

Listed in Part VII

  • John M Ferretti Do

    PRESIDENT/CEO

    Total calculated
    $1,362,384
    From this org
    $0
    From related orgs
    $1,331,566
    Other
    $30,818
    Hours/week
    1 + 79 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,297,755 related
    Bonus
    $0
    Other
    $0 + $33,811 related
    Deferred
    $0 + $24,400 related
    Nontaxable benefits
    $0 + $6,418 related
    Filer's total
    $0 + $1,362,384 related

  • Richard P Olinger

    SECRETARY/TREASURER

    Total calculated
    $124,240
    From this org
    $0
    From related orgs
    $106,729
    Other
    $17,511
    Hours/week
    1 + 64 related

  • Mary L Eckert

    TRUSTEE

    Total calculated
    $713,020
    From this org
    $0
    From related orgs
    $685,987
    Other
    $27,033
    Hours/week
    1 + 79 related

    Schedule J breakdown matched by us

    Base
    $0 + $647,405 related
    Bonus
    $0
    Other
    $0 + $38,582 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $8,733 related
    Filer's total
    $0 + $713,020 related

  • Anthony John Ferretti Do

    TRUSTEE

    Total calculated
    $90,468
    From this org
    $0
    From related orgs
    $90,468
    Other
    $0
    Hours/week
    1 + 51 related

  • Vincent S Fierro Do

    TRUSTEE

    Total calculated
    $1,839
    From this org
    $0
    From related orgs
    $1,839
    Other
    $0
    Hours/week
    1 + 2 related

  • Gerald P Alonge

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Harry E Brown

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Silvia M Ferretti Do

    TRUSTEE

    Total calculated
    $1,560,918
    From this org
    $0
    From related orgs
    $1,530,100
    Other
    $30,818
    Hours/week
    1 + 79 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,498,208 related
    Bonus
    $0
    Other
    $0 + $31,892 related
    Deferred
    $0 + $24,400 related
    Nontaxable benefits
    $0 + $6,418 related
    Filer's total
    $0 + $1,560,918 related

  • Steven G Inman CPA Cgma

    VP FISCAL AFFAIRS/CFO

    Total calculated
    $362,506
    From this org
    $0
    From related orgs
    $332,130
    Other
    $30,376
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $326,548 related
    Bonus
    $0
    Other
    $0 + $5,582 related
    Deferred
    $0 + $23,958 related
    Nontaxable benefits
    $0 + $6,418 related
    Filer's total
    $0 + $362,506 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE ORGANIZATION'S CEO IS PAID BY LECOM. LECOM USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • MCH CORPORATION

    C · REAL ESTATE · PA

    Directly controlled by MILLCREEK HEALTH SYSTEM

  • CORRY HEALTH SERVICES INC

    C · HEALTH CARE · PA

    Directly controlled by CORRY MEMORIAL HOSPITAL ASSOCIATION

Provenance

Return type
form_990
Tax year
2022
Filed
7 May 2024
IRS schema version
2022v5.0
Source object
202411349349307551

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