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Nonprofiteer
← QUARTZ HEALTH PLAN MN CORPORATION

Form 990 for tax year 2022

Filed by QUARTZ HEALTH PLAN MN CORPORATION.

Totals

Total revenue
$38,902,465
Total expenses
$38,876,170
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$38,818,073
Investment income
$84,392
Other revenue
$0
Total assets, end of year
$18,352,476
Total liabilities, end of year
$9,973,733
Net assets or fund balances, end of year
$8,378,743
Program services expenses (Part IX)
$36,422,678
Management and general expenses
$2,453,492
Fundraising expenses
$0
Program service expenses (Part III)
$36,422,678

Program services were 93.7% 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 $38,818,073 · related or exempt $38,818,073

  • 3 · Investment income

    total $84,392 · excluded $84,392

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $909,248 · program services $335,139 · management and general $574,109

  • 8 · Pension plan contributions

    total $41,818 · program services $15,934 · management and general $25,884

  • 9 · Other employee benefits

    total $181,646 · program services $13,147 · management and general $168,499

  • 10 · Payroll taxes

    total $60,318 · program services $24,531 · management and general $35,787

  • 11a · Fees: management

    total $11,068 · program services $10,975 · management and general $93

  • 11b · Fees: legal

    total $9,340 · management and general $9,340

  • 11c · Fees: accounting

    total $60,792 · program services $1,300 · management and general $59,492

  • 11f · Fees: investment management

    total $57,898 · management and general $57,898

  • 11g · Fees: other

    total $51,805 · program services $605 · management and general $51,200

  • 12 · Advertising and promotion

    total $136,818 · program services $20,295 · management and general $116,523

  • 13 · Office expenses

    total $34,231 · program services $6,075 · management and general $28,156

  • 14 · Information technology

    total $878,793 · program services $627,723 · management and general $251,070

  • 16 · Occupancy

    total $30,810 · management and general $30,810

  • 17 · Travel

    total $6,937 · program services $1,140 · management and general $5,797

  • 22 · Depreciation, depletion and amortization

    total $11,583 · management and general $11,583

  • 23 · Insurance

    total $24,352 · management and general $24,352

  • 24a · Other expenses: MEDICAL EXPENSES

    total $35,308,541 · program services $35,308,541

  • 24b · Other expenses: COMMISSIONS

    total $474,991 · management and general $474,991

  • 24c · Other expenses: ASSESSMENT/FEES

    total $464,113 · management and general $464,113

  • 24d · Other expenses: LOSS ADJUSTMENT EXPENSE

    total $44,137 · program services $44,137

  • 24e · All other expenses

    total $76,931 · program services $13,136 · management and general $63,795

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $5,666,934 · end of year $12,593,116

  • 2 · Savings and temporary cash investments

    beginning of year $10,905 · end of year $0

  • 4 · Accounts receivable

    beginning of year $5,551,595 · end of year $4,350,392

  • 11 · Investments: publicly traded securities

    beginning of year $558,263 · end of year $549,027

  • 15 · Other assets

    beginning of year $984,355 · end of year $859,941

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,437,533 · end of year $4,999,920

  • 19 · Deferred revenue

    beginning of year $480,300 · end of year $469,475

  • 25 · Other liabilities

    beginning of year $3,677,714 · end of year $4,504,338

  • 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 $4,750,000 · end of year $7,950,000

  • 31 · Retained earnings, endowment or other funds

    beginning of year $426,505 · end of year $428,743

Mission and programs · 2022

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 OUR MINNESOTA MEMBERS UNDER THE MINNESOTA NONPROFIT CORPORATION ACT, SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND THE MINNESOTA HEALTH MAINTENANCE ACT.

    Expenses $36,422,678 · Revenue $38,818,073

As filed on the 2022 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
    $950,318
    From this org
    $0
    From related orgs
    $893,228
    Other
    $57,090
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $715,439 related
    Bonus
    $0 + $174,000 related
    Other
    $0 + $3,789 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $38,790 related
    Filer's total
    $0 + $950,318 related

  • Christine C Senty

    GENERAL COUNSEL, VP & SECRETARY

    Total calculated
    $475,277
    From this org
    $0
    From related orgs
    $424,642
    Other
    $50,635
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $340,216 related
    Bonus
    $0 + $50,896 related
    Other
    $0 + $33,530 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $32,335 related
    Filer's total
    $0 + $475,277 related

  • Charles L Johnson

    BOD - MEMBER

    Total calculated
    $0
    Hours/week
    1 + 48 related

  • Christina Brennan Ott

    BOD - MEMBER (AS OF 12/2022)

    Total calculated
    $0
    Hours/week
    1 + 48 related

  • Kimila A Daniels

    BOD - MEMBER (TERM. 08/2022)

    Total calculated
    $0
    Hours/week
    1

  • Roberta J Haugan

    BOD - MEMBER

    Total calculated
    $4,500
    From this org
    $0
    From related orgs
    $4,500
    Other
    $0
    Hours/week
    1

  • Stacey L Mounce Arnold

    BOD - MEMBER

    Total calculated
    $3,035
    From this org
    $0
    From related orgs
    $3,035
    Other
    $0
    Hours/week
    1

  • James L Hiveley

    VP, TREASURER & CFO (TERM. 04/2023)

    Total calculated
    $460,359
    From this org
    $0
    From related orgs
    $409,308
    Other
    $51,051
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $327,214 related
    Bonus
    $0 + $49,310 related
    Other
    $0 + $32,784 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $32,751 related
    Filer's total
    $0 + $460,359 related

  • Kristie S Breunig

    ASSISTANT SECRETARY

    Total calculated
    $243,575
    From this org
    $0
    From related orgs
    $212,153
    Other
    $31,422
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $195,375 related
    Bonus
    $0 + $16,120 related
    Other
    $0 + $658 related
    Deferred
    $0 + $11,833 related
    Nontaxable benefits
    $0 + $19,589 related
    Filer's total
    $0 + $243,575 related

  • David S Hanekom MD

    SENIOR VP & CHIEF MEDICAL OFFICER

    Total calculated
    $500,129
    From this org
    $0
    From related orgs
    $447,913
    Other
    $52,216
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $425,389 related
    Bonus
    $0 + $18,540 related
    Other
    $0 + $3,984 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $33,916 related
    Filer's total
    $0 + $500,129 related

  • Kyle P Brua

    FORMER CHIEF ACTUARY (TERM. 05/2021)

    Total calculated
    $177,658
    From this org
    $0
    From related orgs
    $177,658
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $177,658 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $177,658 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: KYLE P. BRUA RECEIVED A $177,658 SERVERANCE PAYMENT IN YEAR 2022. 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.

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
2022
Filed
13 November 2023
IRS schema version
2022v5.0
Source object
202343189349302214

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