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Nonprofiteer
← KEYSTONE INDEMNITY COMPANY LTD

Form 990 for tax year 2022

Filed by KEYSTONE INDEMNITY COMPANY LTD.

Totals

Total revenue
$1,352,918
Total expenses
$274,010
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$503,000
Investment income
$849,918
Other revenue
$0
Total assets, end of year
$16,488,638
Total liabilities, end of year
$3,768,122
Net assets or fund balances, end of year
$12,720,516
Program services expenses (Part IX)
$186,160
Management and general expenses
$87,850
Fundraising expenses
$0
Program service expenses (Part III)
$186,160

Program services were 67.9% 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: NET EARNED PREMIUM

    total $503,000 · related or exempt $503,000

  • 3 · Investment income

    total $818,816 · unrelated business $370 · excluded $818,446

  • 7a · Gross sales of assets other than inventory

    securities $8,251,254

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

    securities $8,220,152

  • 7c · Gain or loss

    securities $31,102

  • 7d · Net gain or loss

    total $31,102 · unrelated business -$1,289 · excluded $32,391

Functional expenses

Part IX, the statement of functional expenses.

  • 11b · Fees: legal

    total $12,717 · management and general $12,717

  • 11c · Fees: accounting

    total $24,146 · management and general $24,146

  • 11f · Fees: investment management

    total $50,987 · management and general $50,987

  • 11g · Fees: other

    total $139,240 · program services $139,240

  • 13 · Office expenses

    total $166 · program services $166

  • 14 · Information technology

    total $46,379 · program services $46,379

  • 24a · Other expenses: TAXES AND RENEWALS

    total $375 · program services $375

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $28,110

  • 2 · Savings and temporary cash investments

    beginning of year $1,122,129 · end of year $779,003

  • 4 · Accounts receivable

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $97,605 · end of year $98,610

  • 11 · Investments: publicly traded securities

    beginning of year $12,206,072 · end of year $10,431,347

  • 12 · Investments: other securities

    beginning of year $592,500 · end of year $0

  • 15 · Other assets

    beginning of year $5,131,568 · end of year $5,151,568

  • 17 · Accounts payable and accrued expenses

    beginning of year $51,574 · end of year $44,827

  • 25 · Other liabilities

    beginning of year $3,464,914 · end of year $3,723,295

  • 29 · Capital stock, trust principal or current funds

    beginning of year $250,000 · end of year $250,000

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

    beginning of year $2,971,423 · end of year $2,971,423

  • 31 · Retained earnings, endowment or other funds

    beginning of year $12,411,963 · end of year $9,499,093

Mission and programs · 2022

Mission

PROVIDE PROFESSIONAL MEDICAL LIABILITY INSURANCE AND GENERAL LIABILITY INSURANCE FOR MASONICARE CORPORATION AND ITS AFFILIATES.

  • MASONICARE IS THE LEADING PROVIDER OF HEALTHCARE AND RETIREMENT LIVING FOR SENIORS IN THE STATE OF CONNECTICUT. THROUGH ITS AFFILIATES, MASONICARE PROVIDES CONTINUING CARE RETIREMENT COMMUNITY LIVING, INDEPENDENT LIVING, ASSISTED LIVING, SKILLED NURSING CARE (LONG TERM INCLUDING MEMORY CARE AND SHORTTERM REHABILITATION), ACUTE CARE (PSYCHIATRIC AND HOSPICE), HOME HEALTH AND HOSPICE SERVICES AND ATHOME SERVICES (LIVEIN, PATIENT CARE ATTENDANTS AND HOMEMAKER). KEYSTONE INDEMNITY COMPANY PROVIDES PROFESSIONAL AND GENERAL LIABILITY INSURANCE COVERAGES TO MEMBERS OF THE MASONICARE FAMILY.

    Expenses $186,160 · Revenue $503,000

As filed on the 2022 return.

Listed in Part VII

  • Robert F Polito Jr

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    1 + 7 related

  • Christopher J Earle

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 8 related

  • Robert J Furce

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 7 related

  • Newton Buckner

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 7 related

  • Sherwin M Borsuk MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Jon-Paul Venoit President

    & CEO, ASSISTANT SECRETARY

    Total calculated
    $769,379
    From this org
    $0
    From related orgs
    $717,186
    Other
    $52,193
    Hours/week
    1 + 47 related

    Schedule J breakdown matched by us

    Base
    $0 + $664,976 related
    Bonus
    $0 + $30,000 related
    Other
    $0 + $22,210 related
    Deferred
    $0 + $11,202 related
    Nontaxable benefits
    $0 + $40,991 related
    Filer's total
    $0 + $769,379 related

  • Steven D Beaulieu

    CFO, ASSISTANT TREASURER

    Total calculated
    $322,426
    From this org
    $0
    From related orgs
    $275,148
    Other
    $47,278
    Hours/week
    1 + 47 related

    Schedule J breakdown matched by us

    Base
    $0 + $247,662 related
    Bonus
    $0 + $3,000 related
    Other
    $0 + $24,486 related
    Deferred
    $0 + $10,056 related
    Nontaxable benefits
    $0 + $37,222 related
    Filer's total
    $0 + $322,426 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

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.

  • GENM SENIOR CARE CONSULTING GROUP LLC

    C · CONSULTING · CT

    Directly controlled by MASONICARE CORPORATION

Provenance

Return type
form_990
Tax year
2022
Filed
15 August 2024
IRS schema version
2022v5.0
Source object
202412289349301781

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