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Nonprofiteer
← PROVIDERS INSURANCE CORPORATION

Form 990 for tax year 2023

Filed by PROVIDERS INSURANCE CORPORATION.

Totals

Total revenue
$28,631,693
Total expenses
$24,839,597
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$25,201,764
Investment income
$3,398,467
Other revenue
$31,462
Total assets, end of year
$91,711,190
Total liabilities, end of year
$68,604,143
Net assets or fund balances, end of year
$23,107,047
Program services expenses (Part IX)
$24,112,215
Management and general expenses
$727,382
Fundraising expenses
$0
Program service expenses (Part III)
$24,112,215

Program services were 97.1% 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: PREMIUM REVENUE

    total $25,201,764 · related or exempt $25,201,764

  • 2f · All other program service revenue

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

  • 3 · Investment income

    total $3,449,032 · excluded $3,449,032

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $1,186,922

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

    securities $1,237,487

  • 7c · Gain or loss

    securities -$50,565 · other assets $0

  • 7d · Net gain or loss

    total -$50,565 · excluded -$50,565

  • 8c · Net income from fundraising events

    total $0 · unrelated business $0 · excluded $0

  • 9c · Net income from gaming

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

  • 11a · Other revenue: RISK MGMT. EDUCATION FUND

    total $31,462 · excluded $31,462

  • 11d · All other revenue

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

  • 11e · Other revenue, total

    $31,462

Functional expenses

Part IX, the statement of functional expenses.

  • 11b · Fees: legal

    total $9,861 · management and general $9,861

  • 11c · Fees: accounting

    total $48,761 · management and general $48,761

  • 11f · Fees: investment management

    total $42,735 · management and general $42,735

  • 11g · Fees: other

    total $449,546 · program services $0 · management and general $449,546 · fundraising $0

  • 17 · Travel

    total $11,951 · management and general $11,951

  • 19 · Conferences, conventions and meetings

    total $5,263 · management and general $5,263

  • 23 · Insurance

    total $8,373,918 · program services $8,373,918

  • 24a · Other expenses: LOSS ADJUSTMENT EXPENSE

    total $15,745,271 · program services $15,738,297 · management and general $6,974

  • 24b · Other expenses: OTHER PURCHASES

    total $94,053 · management and general $94,053

  • 24c · Other expenses: CORPORATE ALLOCATION

    total $32,093 · management and general $32,093

  • 24d · Other expenses: BANK SERVICE CHARGES

    total $20,645 · management and general $20,645

  • 24e · All other expenses

    total $5,500 · program services $0 · management and general $5,500 · fundraising $0

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $30,655,888 · end of year $39,344,050

  • 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

  • 9 · Prepaid expenses and deferred charges

    beginning of year $6,915,374 · end of year $7,387,424

  • 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 $24,731,321 · end of year $26,383,668

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $19,877,528 · end of year $18,596,048

  • 17 · Accounts payable and accrued expenses

    beginning of year $137,083 · end of year $145,292

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $64,790,641 · end of year $68,458,851

  • 27 · Net assets without donor restrictions

    beginning of year $17,252,387 · end of year $23,107,047

Mission and programs · 2023

Mission

AS A CAPTIVE INSURANCE COMPANY, PROVIDERS INSURANCE COMPANY PROVIDES GENERAL LIABILITY OCCURANCE BASED COVERAGE AND HEALTHCARE PROFESSIONAL LIABILITY CLAIMS-MADE COVERAGE ON A DIRECT BASIS TO HAWAI'I PACIFIC HEALTH AND ITS AFFILIATES.

Activities or mission (Part I)

SEE SCHEDULE O

  • HEALTHCARE PROFESSIONAL LIABILITY INCLUDING BLANKET SPECIAL EVENTS, DRUGGIST PROFESSIONAL LIABILITY, MANAGED CARE LIABILITY, INSTITUTIONAL REVIEW BOARD COVERAGE, PUNITIVE DAMAGES, AND EXEMPLARY AND/OR MULTIPLIED DAMAGES COVERAGE. GENERAL LIABILITY COVERAGE INCLUDING BLANKET SPECIAL EVENTS, EMPLOYEE BENEFIT ADMINISTRATION LIABILITY, EMPLOYER'S LIABILITY EXCESS, EXCESS AUTOMOBILE LIABILITY, HEALTH CARE BENEFIT ADMINISTRATION, INSTITUTIONAL REVIEW BOARD COVERAGE, PUNITIVE DAMAGES AND EXEMPLARY AND/OR MULTIPLIED DAMAGES, SEXUAL MISCONDUCT AND MEDICAL EXPENSES. PROVIDERS INSURANCE CORPORATION'S REVENUES FROM INSURANCE PREMIUMS ARE CHARGED BASED ON EXPECTED LOSSES AS DETERMINED BY ACTUARIAL ASSUMPTIONS.

    Expenses $24,112,215 · Revenue $25,201,764

As filed on the 2023 return.

Listed in Part VII

  • Charles R Ching

    Board of Director, Chair

    Total calculated
    $1,125,301
    From this org
    $0
    From related orgs
    $830,806
    Other
    $294,495
    Hours/week
    1.3 + 38.7 related

    Schedule J breakdown matched by us

    Base
    $0 + $474,538 related
    Bonus
    $0 + $139,662 related
    Other
    $0 + $216,606 related
    Deferred
    $0 + $278,322 related
    Nontaxable benefits
    $0 + $16,173 related
    Filer's total
    $0 + $1,125,301 related

  • David Okabe

    Board of Director, Treasurer

    Total calculated
    $1,548,574
    From this org
    $0
    From related orgs
    $1,124,153
    Other
    $424,421
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $601,227 related
    Bonus
    $0 + $206,576 related
    Other
    $0 + $316,350 related
    Deferred
    $0 + $408,248 related
    Nontaxable benefits
    $0 + $16,173 related
    Filer's total
    $0 + $1,548,574 related

  • Gregg Timmons

    Board of Director, President

    Total calculated
    $253,089
    From this org
    $0
    From related orgs
    $220,707
    Other
    $32,382
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $167,285 related
    Bonus
    $0 + $17,903 related
    Other
    $0 + $35,519 related
    Deferred
    $0 + $21,206 related
    Nontaxable benefits
    $0 + $11,176 related
    Filer's total
    $0 + $253,089 related

  • Shilpa Patel MD

    VICE CHAIR & SECRETARY

    Total calculated
    $608,878
    From this org
    $0
    From related orgs
    $488,357
    Other
    $120,521
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $356,250 related
    Bonus
    $0 + $72,211 related
    Other
    $0 + $59,896 related
    Deferred
    $0 + $95,189 related
    Nontaxable benefits
    $0 + $25,332 related
    Filer's total
    $0 + $608,878 related

  • Michael Gibson Esq

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Raymond P Vara Jr

    Board of Director

    Total calculated
    $4,411,352
    From this org
    $0
    From related orgs
    $2,464,885
    Other
    $1,946,467
    Hours/week
    1 + 61.1 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,231,412 related
    Bonus
    $0 + $505,774 related
    Other
    $0 + $727,699 related
    Deferred
    $0 + $1,923,428 related
    Nontaxable benefits
    $0 + $23,039 related
    Filer's total
    $0 + $4,411,352 related

  • Carrie Ann Tsutsui

    Assistant Treasurer

    Total calculated
    $386,410
    From this org
    $0
    From related orgs
    $307,290
    Other
    $79,120
    Hours/week
    0.5 + 47.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $239,446 related
    Bonus
    $0 + $42,745 related
    Other
    $0 + $25,099 related
    Deferred
    $0 + $67,840 related
    Nontaxable benefits
    $0 + $11,280 related
    Filer's total
    $0 + $386,410 related

  • Jessica Lewis

    Assistant Secretary

    Total calculated
    $229,658
    From this org
    $0
    From related orgs
    $183,999
    Other
    $45,659
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $176,275 related
    Bonus
    $0 + $5,000 related
    Other
    $0 + $2,724 related
    Deferred
    $0 + $18,051 related
    Nontaxable benefits
    $0 + $27,608 related
    Filer's total
    $0 + $229,658 related

  • Karen Maciorowski

    Vice President

    Total calculated
    $177,802
    From this org
    $0
    From related orgs
    $140,954
    Other
    $36,848
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $131,718 related
    Bonus
    $0 + $6,109 related
    Other
    $0 + $3,127 related
    Deferred
    $0 + $12,416 related
    Nontaxable benefits
    $0 + $24,432 related
    Filer's total
    $0 + $177,802 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)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ('HPH'), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, FORM 990, PART VI, SECTION A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $307,960 DAVID OKABE - $114,710 CHARLES R. CHING - $77,492 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $505,774 DAVID OKABE - $176,576 CHARLES R. CHING - $139,662 CARRIE ANN TSUTSUI - $42,745 SHILPA PATEL - $72,211 RETENTION INCENTIVE PLAN THE RETENTION INCENTIVE PLAN WAS DESIGNED TO ENCOURAGE CONTINUED INTEREST IN THE SUCCESS OF THE ORGANIZATION AND PROVIDE COMPETITIVE RETIREMENT BENEFITS. THE SOLE PLAN PARTICIPANT IS HAWAI'I PACIFIC HEALTH'S CHIEF EXECUTIVE OFFICER, RAYMOND P. VARA JR. THE PLAN DOES NOT REPLACE THE ANNUAL AND LONG-TERM INCENTIVE PLAN NOR THE SERP RESTORATION PLAN. AMOUNTS PAID OUT DURING THE YEAR BY A RELATED ORGANIZATION: RAYMOND P. VARA JR. - $500,000

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 partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • Honolulu Surgery Center LP

    N/A · Ambu. Surg. Center · TN

    Directly controlled by NA

  • Specialty Surgical Suites LLC

    N/A · Ambu. Surg. Center · HI

    Directly controlled by NA

  • HONOLULU IMAGING CENTER LLC

    N/A · DIAG. IMAGING CTR · DE

    Directly controlled by NA

  • HAWAI'I ISOTOPE TECHNOLOGY LLC

    N/A · PHARMACEUTICAL MANUFACTURING · HI

    Directly controlled by NA

  • ALL ACCESS ORTHO OAHU LLC

    N/A · URGENT CARE CLINICS · HI

    Directly controlled by NA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • HAWAI'I PACIFIC HEALTH PARTNERS INC

    C Corporation · HOLDING COMPANY · HI

    Directly controlled by NA

  • STRAUB PHARMACY INC

    C Corporation · INACTIVE · HI

    Directly controlled by NA

  • HICORD INC

    C Corporation · INVESTMENT · HI

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2023
Filed
15 May 2025
IRS schema version
2023v6.0
Source object
202511359349311756

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