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Nonprofiteer
← SOUTHERN OREGON INSURANCE INC

Form 990 for tax year 2024

Filed by SOUTHERN OREGON INSURANCE INC.

Totals

Total revenue
$6,333,181
Total expenses
$6,065,465
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$4,149,079
Investment income
$2,184,102
Other revenue
$0
Total assets, end of year
$50,173,547
Total liabilities, end of year
$14,933,738
Net assets or fund balances, end of year
$35,239,809
Program services expenses (Part IX)
$5,578,602
Management and general expenses
$486,863
Fundraising expenses
$0
Program service expenses (Part III)
$5,578,602

Program services were 92.0% 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: PREMIUMS

    total $4,149,079 · related or exempt $4,149,079

  • 3 · Investment income

    total $1,328,062 · excluded $1,328,062

  • 7a · Gross sales of assets other than inventory

    securities $29,937,939

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

    securities $29,081,899

  • 7c · Gain or loss

    securities $856,040

  • 7d · Net gain or loss

    total $856,040 · excluded $856,040

Functional expenses

Part IX, the statement of functional expenses.

  • 11a · Fees: management

    total $70,224 · management and general $70,224

  • 11b · Fees: legal

    total $11,580 · management and general $11,580

  • 11c · Fees: accounting

    total $48,272 · management and general $48,272

  • 11f · Fees: investment management

    total $95,160 · management and general $95,160

  • 11g · Fees: other

    total $250,000 · management and general $250,000

  • 24a · Other expenses: LOSSES & LOSS ADJUSTMEN

    total $5,459,979 · program services $5,459,979

  • 24b · Other expenses: CLAIMS MANAGEMENT FEES

    total $88,750 · program services $88,750

  • 24c · Other expenses: ACTUARIAL FEES

    total $19,500 · program services $19,500

  • 24d · Other expenses: PREMIUM TAX

    total $10,373 · program services $10,373

  • 24e · All other expenses

    total $11,627 · management and general $11,627

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $9,778,733 · end of year $8,346,007

  • 11 · Investments: publicly traded securities

    beginning of year $32,703,530 · end of year $36,991,426

  • 15 · Other assets

    beginning of year $839,873 · end of year $4,836,114

  • 17 · Accounts payable and accrued expenses

    beginning of year $174,535 · end of year $344,927

  • 19 · Deferred revenue

    beginning of year $1,087,887 · end of year $2,007,739

  • 25 · Other liabilities

    beginning of year $9,559,595 · end of year $12,581,072

  • 29 · Capital stock, trust principal or current funds

    beginning of year $3,000,000 · end of year $3,000,000

  • 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 $29,500,119 · end of year $32,239,809

Mission and programs · 2024

Mission

SCHEDULE OTHE PRIMARY PUPOSE FOR WHICH THIS CORPORATION IS FORMED IS TO BE A NONPROFIT CAPTIVE INSURANCE COMPANY PURSUANT TO ARTICLE 19 OF CHAPTER 431 OF THE HAWAII REVISED STATUTES, AS AMENDED.THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES, BY SUPPORTING, BENEFITING OR CARRYING OUT SOME OR ALL OF THE PURPOSES OF ASANTE, DBA ASANTE HEALTH SYSTEM (AHS) AND OTHER ORGANIZATIONS ("AFFILIATES") THAT ARE CONTROLLED DIRECTLY OR INDIRECTLY BY AHS AND THAT ARE NON-PRIVATE FOUNDATIONS UNDER SECTION 509(A)(1) OR (2) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED ("CODE"), OR CORRESPONDING SECTIONS OF ANY FUTURE FEDERAL TAX CODE.

Activities or mission (Part I)

TO BE A NONPROFIT CAPTIVE INS. CO PURSUANT TO ART. 19 OF CH. 431 OF THE HI REV. STATUTES, AS AMD.

  • SOUTHERN OREGON INSURANCE INC. RECEIVED ITS CERTIFICATE OF AUTHORITY AS A PURE CAPTIVE INSURANCE COMPANY FROM THE INSURANCE COMMISSIONER OF THE STATE OF HAWAII. THE COMPANY PROVIDES ITS PARENT WITH ALTERNATIVE RISK FINANCING OPTIONS, AND IS AUTHORIZED TO PROVIDE HEALTHCARE PROFESSIONAL AND GENERAL LIABILITY COVERAGE ON A CLAIMS-MADE BASIS.

    Expenses $5,578,602 · Revenue $4,149,079

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Tom Gessel

    CHAIR/PRESIDENT

    Total calculated
    $1,522,267
    From this org
    $0
    From related orgs
    $1,522,267
    Other
    $0
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,050,000 related
    Bonus
    $0 + $472,267 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $1,522,267 related

  • Heather Rowenhorst

    TREASURER

    Total calculated
    $649,525
    From this org
    $0
    From related orgs
    $649,525
    Other
    $0
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $499,000 related
    Bonus
    $0 + $150,515 related
    Other
    $0 + $10 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $649,525 related

  • Peter Angstadt

    VP/SECRETARY

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • Jennifer Ligons

    ASSISTANT SECRETARY THRU 10/2/24

    Total calculated
    $105,896
    From this org
    $0
    From related orgs
    $105,896
    Other
    $0
    Hours/week
    40 + 1 related

  • James Grebosky MD

    DIRECTOR THRU 1/2/24

    Total calculated
    $651,270
    From this org
    $0
    From related orgs
    $651,270
    Other
    $0
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $651,270 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $651,270 related

  • Scott Kelly

    FORMER CHAIR/PRES THRU 2/13/23

    Total calculated
    $1,593,392
    From this org
    $0
    From related orgs
    $1,593,392
    Other
    $0
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,045,116 related
    Bonus
    $0
    Other
    $0 + $548,276 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $1,593,392 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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
CEO COMPENSATION SOUTHERN OREGON INSURANCE DOES NOT PAY ANY OF ITS OFFICERS OR DIRECTORS DIRECTLY. ASANTE, THE PARENT ORGANIZATION OF SOUTHERN OREGON INSURANCE, PAYS ITS FORMER CEO, SCOTT KELLY. HOWEVER, ASANTE HAS A COMPENSATION COMMITTEE THAT UTILIZES AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT CONDUCTS COMPENSATION SURVEYS. ASANTE'S COMPENSATION COMMITTEE RECOMMENDS THE TERMS OF THE CEO COMPENSATION PACKAGE, AND ASANTE'S BOARD APPROVES ITS TERMS.
PART I, LINE 4B
ASANTE HAS AN EXECUTIVE RESTORATION PLAN WHICH INCLUDES JAMES GREBOSKY, AND SCOTT KELLY. THIS PLAN STATES FIXED PAYMENTS WILL BE RECEIVED AT PRE-DETERMINED INTERVALS FROM ASANTE IF STILL EMPLOYED BY ASANTE IN THEIR CURRENT ROLE AT THE TIME OF VESTING. IF EMPLOYMENT IS TERMINATED BY ASANTE FOR ANY REASON PRIOR TO VESTING, THEY WILL NOT HAVE CLAIM TO THE FUNDS.

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.

Provenance

Return type
form_990
Tax year
2024
Filed
13 August 2026
IRS schema version
2024v5.5
Source object
202642269349302299

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