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Nonprofiteer
← SELF INSURANCE FUND - NOVANT HEALTH INC

Form 990 for tax year 2024

Filed by SELF INSURANCE FUND - NOVANT HEALTH INC.

Totals

Total revenue
$2,460
Total expenses
$4,631
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$2,460
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$4,631
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$4,631

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DENISE MIHAL

    CHAIR/EVP

    Total calculated
    $2,017,153
    From this org
    $0
    From related orgs
    $1,983,434
    Other
    $33,719
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $878,062 related
    Bonus
    $0 + $871,473 related
    Other
    $0 + $233,899 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $13,019 related
    Filer's total
    $0 + $2,017,153 related

  • FRANK EMORY JR

    TRUSTEE/EVP

    Total calculated
    $1,929,101
    From this org
    $0
    From related orgs
    $1,881,320
    Other
    $47,781
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $828,360 related
    Bonus
    $0 + $826,334 related
    Other
    $0 + $226,626 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $27,081 related
    Filer's total
    $0 + $1,929,101 related

  • JULIA HYETT

    TRUSTEE/VP CORP INSURANCE

    Total calculated
    $353,559
    From this org
    $0
    From related orgs
    $323,731
    Other
    $29,828
    Hours/week
    0.2 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $232,494 related
    Bonus
    $0 + $60,004 related
    Other
    $0 + $31,233 related
    Deferred
    $0 + $10,454 related
    Nontaxable benefits
    $0 + $19,374 related
    Filer's total
    $0 + $353,559 related

  • NAN HOLLAND

    TRUSTEE/VP RISK MGMT

    Total calculated
    $395,818
    From this org
    $0
    From related orgs
    $364,005
    Other
    $31,813
    Hours/week
    0.2 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $259,390 related
    Bonus
    $0 + $67,509 related
    Other
    $0 + $37,106 related
    Deferred
    $0 + $15,396 related
    Nontaxable benefits
    $0 + $16,417 related
    Filer's total
    $0 + $395,818 related

  • SCOTT MYERS

    TRUSTEE/SVP CORP FINANCE

    Total calculated
    $1,071,364
    From this org
    $0
    From related orgs
    $961,679
    Other
    $109,685
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $489,275 related
    Bonus
    $0 + $353,029 related
    Other
    $0 + $119,375 related
    Deferred
    $0 + $96,128 related
    Nontaxable benefits
    $0 + $13,557 related
    Filer's total
    $0 + $1,071,364 related

  • STANLEY FULLER MD

    TRUSTEE/SVP CCO

    Total calculated
    $1,180,093
    From this org
    $0
    From related orgs
    $1,033,679
    Other
    $146,414
    Hours/week
    0.2 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $571,509 related
    Bonus
    $0 + $413,047 related
    Other
    $0 + $49,123 related
    Deferred
    $0 + $106,664 related
    Nontaxable benefits
    $0 + $39,750 related
    Filer's total
    $0 + $1,180,093 related

  • GEOFFREY GARDNER

    CFO (TO 5/12/24)

    Total calculated
    $1,299,829
    From this org
    $0
    From related orgs
    $1,254,251
    Other
    $45,578
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $457,289 related
    Bonus
    $0 + $732,220 related
    Other
    $0 + $64,742 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $24,878 related
    Filer's total
    $0 + $1,299,829 related

  • ALICE POPE

    CFO (FR 5/13/24)

    Total calculated
    $999,640
    From this org
    $0
    From related orgs
    $991,687
    Other
    $7,953
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $824,113 related
    Bonus
    $0
    Other
    $0 + $167,574 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $7,953 related
    Filer's total
    $0 + $999,640 related

  • ERIC ESKIOGLU MD

    FMR TRUSTEE (TO 12/1/22)/FMR KE

    Total calculated
    $105,023
    From this org
    $0
    From related orgs
    $100,800
    Other
    $4,223
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $100,800 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $4,223 related
    Filer's total
    $0 + $105,023 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
THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM AND RELIES UPON NOVANT HEALTH, INC., THE PARENT ORGANIZATION, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15A/15B OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION.
PART I, LINES 4A-B
PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE ERIC ESKIOGLU MD $97,612 NONQUALIFIED STANLEY FULLER MD $85,964 SCOTT MYERS $75,428 EQUITY-BASED NONE
PART I, LINE 4A - SEVERANCE PLAN:
ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS:
THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("COMMITTEE") WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SERP.

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.

Assets distributed on this return

Schedule N, as filed: what the organization did with its assets when it liquidated or dissolved, or disposed of more than a quarter of them, and who received them. A recipient with an EIN is usually a successor organization; filers also list expenses such as legal fees here.

Provenance

Return type
form_990
Tax year
2024
Filed
14 February 2025
IRS schema version
2024v5.0
Source object
202540459349300919

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