Skip to content
Nonprofiteer
← HAMDEN ASSURANCE RISK RETENTION GROUP INC

Form 990 for tax year 2023

Filed by HAMDEN ASSURANCE RISK RETENTION GROUP INC.

Totals

Total revenue
$990,212
Total expenses
$911,023
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$993,900
Investment income
-$3,688
Other revenue
$0
Total assets, end of year
$109,891,808
Total liabilities, end of year
$109,841,808
Net assets or fund balances, end of year
$50,000
Program services expenses (Part IX)
$823,810
Management and general expenses
$87,213
Fundraising expenses
$0
Program service expenses (Part III)
$823,810

Program services were 90.4% 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: CEDING COMMISSIONS

    total $993,900 · related or exempt $993,900

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $6,489 · excluded $6,489

  • 6c · Rental income or loss

    real property $0 · personal property $0

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

    securities $10,177

  • 7c · Gain or loss

    securities -$10,177 · other assets $0

  • 7d · Net gain or loss

    total -$10,177 · excluded -$10,177

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 11a · Fees: management

    total $80,825 · program services $56,345 · management and general $24,480

  • 11b · Fees: legal

    total $24,326 · management and general $24,326

  • 11c · Fees: accounting

    total $33,534 · management and general $33,534

  • 11f · Fees: investment management

    total $2,863 · management and general $2,863

  • 11g · Fees: other

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 13 · Office expenses

    total $866 · management and general $866

  • 14 · Information technology

    total $75,982 · program services $75,982

  • 24a · Other expenses: ACTUARIAL FEES

    total $259,127 · program services $259,127

  • 24b · Other expenses: PREMIUM TAX EXPENSE

    total $422,087 · program services $422,087

  • 24c · Other expenses: LETTER OF CREDIT FEES

    total $7,804 · program services $7,804

  • 24d · Other expenses: STATE FEES AND REG

    total $1,490 · program services $1,490

  • 24e · All other expenses

    total $2,119 · program services $975 · management and general $1,144 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $1,185,915 · end of year $5,555,829

  • 3 · Pledges and grants receivable

    beginning of year $0

  • 4 · Accounts receivable

    beginning of year $11,494,760 · end of year $13,176,314

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0

  • 8 · Inventories for sale or use

    beginning of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $360,921 · end of year $300,293

  • 10a · Land, buildings and equipment: cost or other basis

    $0

  • 10b · Land, buildings and equipment: accumulated depreciation

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $351,543 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $0

  • 15 · Other assets

    beginning of year $74,542,498 · end of year $90,859,372

  • 17 · Accounts payable and accrued expenses

    beginning of year $34,941 · end of year $34,432

  • 18 · Grants payable

    beginning of year $0

  • 19 · Deferred revenue

    beginning of year $462,218 · end of year $390,721

  • 20 · Tax-exempt bond liabilities

    beginning of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0

  • 25 · Other liabilities

    beginning of year $87,388,478 · end of year $109,416,655

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

    beginning of year $50,000 · end of year $50,000

Mission and programs · 2023

Mission

TO BENEFIT, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF THE CHARITABLE CLASS OF BENEFICIARIES, THROUGH THE PROVISION OF SELF-INSURANCE COVERAGE AND OTHER SERVICES THAT RISK RETENTION GROUPS ARE PERMITTED TO PROVIDE UNDER THE APPLICABLE FEDERAL AND STATE LAW; TO ACQUIRE, ESTABLISH, RETAIN AND MAINTAIN A FUND OR FUNDS TO BE HELD, INVESTED AND USED EXCLUSIVELY FOR THE FOREGOING PURPOSES.

  • HAMDEN ASSURANCE RISK RETENTION GROUP, INC. (HAMDEN) WAS INCORPORATED ON FEBRUARY 28, 2007 UNDER THE LAWS OF THE STATE OF VERMONT BY ITS CLASS A MEMBERS: DARTMOUTH-HITCHCOCK MEDICAL CENTER, DARTMOUTH-HITCHCOCK CLINIC, MARY HITCHCOCK MEMORIAL HOSPITAL, AND THE TRUSTEES OF DARTMOUTH COLLEGE. COMMENCING OPERATIONS ON OCTOBER 1, 2007, HAMDEN WRITES MEDICAL, PROFESSIONAL, AND GENERAL LIABILITY COVERAGE FOR ITS MEMBERS (INSUREDS) WHICH ARE ALSO THE OWNERS. INSURANCE COVERAGE IS PROVIDED THROUGH A PRIMARY AND AN EXCESS POLICY. THE EXCESS (UMBRELLA) POLICY ALSO INCLUDES COVERAGE FOR UNDERLYING AUTO, EMPLOYMENT PRACTICES AND AVIATION POLICIES. LIMITED D&O AND EPL COVERAGE FOR MEMBERS IS ALSO UNDERWRITTEN BY HAMDEN.

    Expenses $823,810 · Revenue $993,900

As filed on the 2023 return.

Listed in Part VII

  • Carol Barsky MD

    Board Vice President

    Total calculated
    $618,654
    From this org
    $0
    From related orgs
    $596,078
    Other
    $22,576
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $550,000 related
    Bonus
    $0 + $27,500 related
    Other
    $0 + $18,578 related
    Deferred
    $0 + $19,800 related
    Nontaxable benefits
    $0 + $2,776 related
    Filer's total
    $0 + $618,654 related

  • Daniel P Jantzen

    VICE PRESIDENT

    Total calculated
    $1,172,612
    From this org
    $0
    From related orgs
    $1,105,647
    Other
    $66,965
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $812,887 related
    Bonus
    $0 + $148,750 related
    Other
    $0 + $144,010 related
    Deferred
    $0 + $31,590 related
    Nontaxable benefits
    $0 + $35,375 related
    Filer's total
    $0 + $1,172,612 related

  • Edward J Merrens MD

    BOARD PRESIDENT

    Total calculated
    $982,066
    From this org
    $0
    From related orgs
    $931,192
    Other
    $50,874
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $723,268 related
    Bonus
    $0 + $131,250 related
    Other
    $0 + $76,674 related
    Deferred
    $0 + $31,590 related
    Nontaxable benefits
    $0 + $19,284 related
    Filer's total
    $0 + $982,066 related

  • John Kacavas

    BOARD SECRETARY

    Total calculated
    $55,362
    From this org
    $0
    From related orgs
    $55,362
    Other
    $0
    Hours/week
    1 + 42 related

  • Lawrence Dacey MD

    BOARD CHAIRMAN

    Total calculated
    $0
    Hours/week
    1 + 40.5 related

  • Randall Wachsmann

    BOARD ASSISTANT SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Wendy Fielding

    TREASURER

    Total calculated
    $490,861
    From this org
    $0
    From related orgs
    $443,212
    Other
    $47,649
    Hours/week
    1 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $363,306 related
    Bonus
    $0 + $28,000 related
    Other
    $0 + $51,906 related
    Deferred
    $0 + $31,590 related
    Nontaxable benefits
    $0 + $16,059 related
    Filer's total
    $0 + $490,861 related

  • Robert Gagliardi

    BOARD DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • George T Blike MD Mhcds

    FORMER BOARD VICE PRESIDENT

    Total calculated
    $113,878
    From this org
    $0
    From related orgs
    $106,407
    Other
    $7,471
    Hours/week
    1 + 20.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $106,407 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $7,449 related
    Nontaxable benefits
    $0 + $22 related
    Filer's total
    $0 + $113,878 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.

  • DARTMOUTH-HITCHCOCK CLINIC

    501(c)(3) · PHYSICIAN SERVICES · NH

    Directly controlled by Dartmouth-Hitchcock Health

  • Dartmouth-Hitchcock Health

    501(c)(3) · Supporting Org · NH

    Directly controlled by NA

  • The Hitchcock Foundation

    501(c)(3) · Health Care Research · NH

    Directly controlled by Dartmouth Hitchcock Clinic

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.

  • Pompanoosuc Investment Corporation

    C Corporation · Real Estate Holding · NH · 0% owned · share of income $0 · share of assets $0

    Directly controlled by Dartmouth Hitchcock Clinic

Provenance

Return type
form_990
Tax year
2023
Filed
1 October 2024
IRS schema version
2023v5.1
Source object
202442759349300329

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.