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Nonprofiteer
← QUARTZ HEALTH PLAN MN CORPORATION

Form 990 for tax year 2023

Filed by QUARTZ HEALTH PLAN MN CORPORATION.

Totals

Total revenue
$44,268,496
Total expenses
$43,689,775
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$43,747,329
Investment income
$521,167
Other revenue
$0
Total assets, end of year
$19,664,103
Total liabilities, end of year
$10,688,717
Net assets or fund balances, end of year
$8,975,386
Program services expenses (Part IX)
$40,863,348
Management and general expenses
$2,826,427
Fundraising expenses
$0
Program service expenses (Part III)
$40,863,348

Program services were 93.5% 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.

  • 2a · Program service revenue: PREMIUM REVENUE

    total $43,747,329 · related or exempt $43,747,329

  • 3 · Investment income

    total $521,167 · excluded $521,167

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $1,036,831 · program services $356,089 · management and general $680,742

  • 8 · Pension plan contributions

    total $32,568 · program services $11,696 · management and general $20,872

  • 9 · Other employee benefits

    total $198,872 · program services $5,139 · management and general $193,733

  • 10 · Payroll taxes

    total $71,306 · program services $27,105 · management and general $44,201

  • 11c · Fees: accounting

    total $19,068 · management and general $19,068

  • 11f · Fees: investment management

    total $41,560 · management and general $41,560

  • 11g · Fees: other

    total $41,101 · management and general $41,101

  • 12 · Advertising and promotion

    total $90,634 · program services $3,854 · management and general $86,780

  • 13 · Office expenses

    total $61,685 · program services $6,222 · management and general $55,463

  • 14 · Information technology

    total $420,770 · program services $196,887 · management and general $223,883

  • 16 · Occupancy

    total $40,200 · management and general $40,200

  • 17 · Travel

    total $8,834 · program services $1,839 · management and general $6,995

  • 19 · Conferences, conventions and meetings

    total $4,400 · program services $690 · management and general $3,710

  • 20 · Interest

    total $2,716 · program services $2,716

  • 22 · Depreciation, depletion and amortization

    total $38,421 · program services $722 · management and general $37,699

  • 23 · Insurance

    total $28,018 · management and general $28,018

  • 24a · Other expenses: MEDICAL EXPENSES

    total $39,818,827 · program services $39,818,827

  • 24b · Other expenses: COMMISSIONS

    total $602,653 · management and general $602,653

  • 24c · Other expenses: OUTSOURCED SERVICES

    total $593,488 · program services $416,865 · management and general $176,623

  • 24d · Other expenses: REGULATORY ACA FEES

    total $343,835 · management and general $343,835

  • 24e · All other expenses

    total $193,988 · program services $14,697 · management and general $179,291

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $12,593,116 · end of year $12,965,829

  • 2 · Savings and temporary cash investments

    beginning of year $0 · end of year $278,141

  • 4 · Accounts receivable

    beginning of year $4,350,392 · end of year $4,749,744

  • 11 · Investments: publicly traded securities

    beginning of year $549,027 · end of year $291,406

  • 15 · Other assets

    beginning of year $859,941 · end of year $1,378,983

  • 17 · Accounts payable and accrued expenses

    beginning of year $4,999,920 · end of year $5,140,212

  • 19 · Deferred revenue

    beginning of year $469,475 · end of year $433,821

  • 25 · Other liabilities

    beginning of year $4,504,338 · end of year $5,114,684

  • 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 $7,950,000 · end of year $7,950,000

  • 31 · Retained earnings, endowment or other funds

    beginning of year $428,743 · end of year $1,025,386

Mission and programs · 2023

Mission

TO PROMOTE SOCIAL WELFARE BY OPERATION OF A HEALTH MAINTENANCE ORGANIZATION AND OTHER ACTIVITIES INCIDENTAL THERETO, AND ANY OTHER LAWFUL ACTIVITY WITHIN THE PURPOSE FOR WHICH A CORPORATION MAY BE ORGANIZED UNDER THE MINNESOTA NONPROFIT CORPORATION ACT, SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND THE MINNESOTA HEALTH MAINTENANCE ACT.

Activities or mission (Part I)

TO PROMOTE SOCIAL WELFARE BY OPERATION OF A HEALTH MAINTENANCE ORGANIZATION AND OTHER ACTIVITIES INCIDENTAL THERETO.

  • TO PROMOTE SOCIAL WELFARE BY OPERATION OF HEALTH MAINTENANCE ORGANIZATION PROVIDING COMPREHENSIVE HEALTH CARE INSURANCE AND OTHER HEALTH CARE ACTIVITIES FOR 5,859 MINNESOTA MEMBERS UNDER THE MINNESOTA NONPROFIT CORPORATION ACT, SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND THE MINNESOTA HEALTH MAINTENANCE ACT.

    Expenses $40,863,348 · Revenue $43,747,329

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Mark J Selna MD

    PRESIDENT & CEO (TERM 05/2023)

    Total calculated
    $847,355
    From this org
    $0
    From related orgs
    $810,251
    Other
    $37,104
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $275,095 related
    Bonus
    $0 + $179,925 related
    Other
    $0 + $355,231 related
    Deferred
    $0 + $11,154 related
    Nontaxable benefits
    $0 + $25,950 related
    Filer's total
    $0 + $847,355 related

  • Christine C Senty JD

    PRESIDENT & CEO

    Total calculated
    $618,458
    From this org
    $0
    From related orgs
    $571,762
    Other
    $46,696
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $485,829 related
    Bonus
    $0 + $52,629 related
    Other
    $0 + $33,304 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $33,496 related
    Filer's total
    $0 + $618,458 related

  • Charles L Johnson

    BOD - MEMBER

    Total calculated
    $0
    Hours/week
    1 + 48 related

  • Christina Brennan Ott

    BOD - MEMBER

    Total calculated
    $0
    Hours/week
    1 + 48 related

  • Roberta J Haugan

    BOD - MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Stacey L Mounce Arnold

    BOD - MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Jeffrey A Butcher

    SENIOR VP, TREASURER & CFO

    Total calculated
    $686,402
    From this org
    $0
    From related orgs
    $650,584
    Other
    $35,818
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $379,608 related
    Bonus
    $0 + $176,057 related
    Other
    $0 + $94,919 related
    Deferred
    $0 + $12,072 related
    Nontaxable benefits
    $0 + $23,746 related
    Filer's total
    $0 + $686,402 related

  • David S Hanekom MD

    SENIOR VP & CHIEF MEDICAL OFFICER

    Total calculated
    $588,700
    From this org
    $0
    From related orgs
    $540,460
    Other
    $48,240
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $460,111 related
    Bonus
    $0 + $76,685 related
    Other
    $0 + $3,664 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $35,040 related
    Filer's total
    $0 + $588,700 related

  • James L Hiveley

    VP, TREASURER & CFO (TERM 04/2023)

    Total calculated
    $540,467
    From this org
    $0
    From related orgs
    $517,354
    Other
    $23,113
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $189,501 related
    Bonus
    $0 + $50,989 related
    Other
    $0 + $276,864 related
    Deferred
    $0 + $4,688 related
    Nontaxable benefits
    $0 + $18,425 related
    Filer's total
    $0 + $540,467 related

  • Kristie S Breunig JD

    GENERAL COUNSEL, VP & SECRETARY

    Total calculated
    $311,194
    From this org
    $0
    From related orgs
    $272,239
    Other
    $38,955
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $204,156 related
    Bonus
    $0 + $67,387 related
    Other
    $0 + $696 related
    Deferred
    $0 + $8,273 related
    Nontaxable benefits
    $0 + $30,682 related
    Filer's total
    $0 + $311,194 related

  • Jami J Berger Sr Vp Chief

    CLINICAL OFFICER (AS OF 11/2023)

    Total calculated
    $78,958
    From this org
    $0
    From related orgs
    $78,958
    Other
    $0
    Hours/week
    2 + 48 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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
QUARTZ HEALTH PLAN MN CORPORATION RELIED ON A RELATED ORGANIZATION, QUARTZ HEALTH SOLUTIONS, INC., THAT USED METHODS DESCRIBED BELOW TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION. - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-B
PART I, LINE 4A: SOME EMPLOYEES RECEIVED A SEVERANCE PAYMENT DURING THE CALENDER YEAR. THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. PART I, LINE 4B: QUARTZ HEALTH SOLUTIONS, INC. INITIATED A NONQUALIFIED DEFERRED RETIREMENT PLAN IN 2019 AND STARTED FUNDING IN 2020. A NUMBER OF EMPLOYEES PARTICIPATED IN THE PLAN DURING THE YEAR. THE DEFERRED AMOUNT IS INCLUDED IN PART VII, COLUMN F AND SCHEDULE J, PART II, COLUMN C AND THE VESTED AMOUNT IS INCLUDED IN PART VII, COLUMN D AND SCHEDULE J, PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL AGREEMENTS ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. THE AMOUNT PAID TO JAMES L. HIVELEY DURING 2023 WAS $150,308. THERE WERE NO AMOUNTS PAID OUT TO ANY OTHER PARTICIPANTS.

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.

  • QUARTZ HEALTH BENEFIT PLANS CORPORATION

    C · HEALTH MAINTENANCE ORGANIZATION · WI

  • QUARTZ HOLDING COMPANY

    C · HOLDING COMPANY · WI

  • QUARTZ HEALTH SOLUTIONS INC

    C · TPA · WI

  • QUARTZ HEALTH INSURANCE CORPORATION

    C · INDEMNITY CORPORATION · WI

Provenance

Return type
form_990
Tax year
2023
Filed
12 November 2024
IRS schema version
2023v5.1
Source object
202403179349303690

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