Form 990 for tax year 2025
Filed by PENNSYLVANIA ACACIA INSURANCE COMPANY LTD.
Totals
- Total revenue
- $358,993
- Total expenses
- $180,220
- Contributions and grants received
- $0
- Grants paid
- $0
- Program service revenue
- $25,000
- Investment income
- $333,993
- Other revenue
- $0
- Total assets, end of year
- $20,185,208
- Total liabilities, end of year
- $563,933
- Net assets or fund balances, end of year
- $19,621,275
- Program services expenses (Part IX)
- $57,676
- Management and general expenses
- $122,544
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $57,676
Program services were 32.0% 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 EARNED
total $25,000 · related or exempt $25,000
-
3 · Investment income
total $333,993 · excluded $333,993
Functional expenses
Part IX, the statement of functional expenses.
-
11a · Fees: management
total $44,000 · management and general $44,000
-
11b · Fees: legal
total $6,787 · management and general $6,787
-
11c · Fees: accounting
total $29,669 · management and general $29,669
-
11g · Fees: other
total $31,538 · management and general $31,538
-
19 · Conferences, conventions and meetings
total $9,014 · management and general $9,014
-
24a · Other expenses: LOSSES AND LAE EXPENSES
total $51,639 · program services $51,639
-
24b · Other expenses: VERMONT PREMIUM TAX
total $7,500 · program services $7,500
-
24c · Other expenses: DUES AND REGULATORY FEE
total $1,408 · program services $1,408
-
24d · Other expenses: PREMIUM DEFICIENCY
total -$2,871 · program services -$2,871
-
24e · All other expenses
total $1,536 · management and general $1,536
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $46,049 · end of year $79,276
-
2 · Savings and temporary cash investments
beginning of year $192,939 · end of year $194,465
-
9 · Prepaid expenses and deferred charges
end of year $181
-
12 · Investments: other securities
beginning of year $17,762,748 · end of year $19,844,095
-
15 · Other assets
beginning of year $49,724 · end of year $67,191
-
17 · Accounts payable and accrued expenses
beginning of year $49,488 · end of year $64,348
-
19 · Deferred revenue
beginning of year $10,417 · end of year $10,417
-
25 · Other liabilities
beginning of year $440,400 · end of year $489,168
-
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 $2,500,000 · end of year $2,500,000
-
31 · Retained earnings, endowment or other funds
beginning of year $15,051,155 · end of year $17,121,275
Mission and programs · 2025
Mission
THE COMPANY WAS FORMED TO PROVIDE HEALTHCARE PROFESSIONAL LIABILITY, EMPLOYEE BENEFITS LIABILITY, SEXUAL MISCONDUCT LIABILITY AND GENERAL LIABILITY INSURANCE COVERAGE TO MASONIC VILLAGES, A PENNSYLVANIA NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAXES AS A CHARITABLE ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
Activities or mission (Part I)
TO PROVIDE HEALTHCARE PROFESSIONAL LIABILITY, EMPLOYEE BENEFITS LIABILITY, SEXUAL MISCONDUCT LIABILITY AND GENERAL LIABILITY COVERAGE TO MASONIC VILLAGES
-
THE COMPANY PROVIDES HEALTHCARE PROFESSIONAL LIABILITY, SEXUAL MISCONDUCT LIABILITY AND GENERAL LIABILITY INSURANCE COVERAGE TO ITS PARENT, MASONIC VILLAGES, A PENNSYLVANIA NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAXES AS A CHARITABLE ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
Expenses $57,676 · Revenue $25,000
As filed on the 2025 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
William KingsburyWILLIAM KINGSBURY
PRESIDENT/DIRECTOR
- Total calculated
- $516,263
- From this org
- $0
- From related orgs
- $475,458
- Other
- $40,805
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $475,458 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $20,549 related
- Nontaxable benefits
- $0 + $20,256 related
- Filer's total
- $0 + $516,263 related
-
Pamela S FormicaPAMELA S FORMICA
TREASURER/DIRECTOR
- Total calculated
- $329,977
- From this org
- $0
- From related orgs
- $302,543
- Other
- $27,434
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $302,543 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $15,825 related
- Nontaxable benefits
- $0 + $11,609 related
- Filer's total
- $0 + $329,977 related
-
Debra BrockmanDEBRA BROCKMAN
VP/DIRECTOR
- Total calculated
- $279,536
- From this org
- $0
- From related orgs
- $250,624
- Other
- $28,912
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $250,624 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $13,196 related
- Nontaxable benefits
- $0 + $15,716 related
- Filer's total
- $0 + $279,536 related
-
Patrick SampsellPATRICK SAMPSELL
DIRECTOR
- Total calculated
- $272,020
- From this org
- $0
- From related orgs
- $239,128
- Other
- $32,892
- Hours/week
- 1
Schedule J breakdown matched by us
- Base
- $0 + $239,128 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $12,636 related
- Nontaxable benefits
- $0 + $20,256 related
- Filer's total
- $0 + $272,020 related
-
Robert Snyder IIROBERT SNYDER II
CHAIRPERSON/DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 20 related
-
Benjamin GouldBENJAMIN GOULD
SECRETARY/DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Michael MaglarasMICHAEL MAGLARAS
ASST SECRETARY/DIRECTOR
- Total calculated
- $0
- Hours/week
- 2
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
The filer's explanations (Part III)
- PART I, LINE 3
- THE CEO OF THE PARENT COMPANY (MASONIC VILLAGES) SERVES AS PRESIDENT OF PENNSYLVANIA ACACIA INSURANCE COMPANY. THE COMPENSATION OF MASONIC VILLAGES' CEO IS BASED UPON COMPENSATION SURVEYS AND IS APPROVED BY THE MASONIC VILLAGES' BOARD OF DIRECTORS.
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.
-
MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA
501 (C) (3) · HEALTHCARE / CONTINUING CARE RETIREMENT COMMUNITIES · PA
Directly controlled by GRAND LODGE
-
GRAND LODGE OF FREE AND ACCEPTED MASONS OF PENNSYLVANIA
501 (C)(10) · OVERSEE ACTIVITIES OF MASONIC ENTITIES & PROMOTE MASONIC CULTURE · PA
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.
-
GRAND LODGE CONSOLIDATED FUND
T · INVESTMENT · PA
Provenance
- Return type
- form_990
- Tax year
- 2025
- Filed
- 21 April 2026
- IRS schema version
- 2025v4.1
- Source object
- 202631119349300103
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