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Nonprofiteer
← The Methodist Medical Center of Illinois Self Insurance Trust Agre

Form 990 for tax year 2023

Filed by The Methodist Medical Center of Illinois Self Insurance Trust Agre.

Totals

Total revenue
$221,024
Total expenses
$2,007,530
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$221,024
Other revenue
$0
Total assets, end of year
$4,132,385
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$4,132,385
Program services expenses (Part IX)
$2,000,000
Management and general expenses
$7,530
Fundraising expenses
$0
Program service expenses (Part III)
$2,000,000

Program services were 99.6% 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.

  • 2f · All other program service revenue

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

  • 3 · Investment income

    total $182,285 · excluded $182,285

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $2,044,871

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

    securities $2,006,132

  • 7c · Gain or loss

    securities $38,739 · other assets $0

  • 7d · Net gain or loss

    total $38,739 · excluded $38,739

  • 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.

  • 11f · Fees: investment management

    total $7,530 · management and general $7,530

  • 11g · Fees: other

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

  • 24a · Other expenses: SETTLEMENT PAYOUT

    total $2,000,000 · program services $2,000,000

  • 24e · All other expenses

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

Balance sheet

Part X, book values.

  • 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

  • 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 $5,663,946 · end of year $4,132,385

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 29 · Capital stock, trust principal or current funds

    beginning of year $5,663,946 · end of year $4,132,385

Mission and programs · 2023

Mission

Provide self-insurance funds through investment activities to The Methodist Medical Center of Illinois, a tax-exempt organization under Section 501(c)(3).

  • The exclusive function of the self insurance trust is to provide for self-insurance risks arising from the operation of The Methodist Medical Center of Illinois, a tax-exempt organization under Section 501(c)(3). Program service expenses result when their is a payment for claim, no payment for claims were made in TY2023.

    Expenses $2,000,000

As filed on the 2023 return.

Listed in Part VII

  • Sei Investments Management Corp

    TRUSTEE

    Total calculated
    $7,530
    From this org
    $7,530
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Dennis Hesch

    VICE CHAIR // OFFICER - EVP, CHIEF FINANCE & STRATEGY OFFICER

    Total calculated
    $1,762,884
    From this org
    $0
    From related orgs
    $1,395,995
    Other
    $366,889
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,104,200 related
    Bonus
    $0 + $262,608 related
    Other
    $0 + $29,187 related
    Deferred
    $0 + $346,286 related
    Nontaxable benefits
    $0 + $20,603 related
    Filer's total
    $0 + $1,762,884 related

  • John Peters

    SECRETARY/TREASURER/CFO (THRU 3/2023)

    Total calculated
    $339,225
    From this org
    $0
    From related orgs
    $314,895
    Other
    $24,330
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $213,222 related
    Bonus
    $0 + $83,782 related
    Other
    $0 + $17,891 related
    Deferred
    $0 + $11,390 related
    Nontaxable benefits
    $0 + $12,940 related
    Filer's total
    $0 + $339,225 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 4b Supplemental nonqualified retirement plan
DENNIS HESCH PARTICIPATED IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF THE METHODIST MEDICAL CENTER OF ILLINOIS SELF INSURANCE TRUST AGREEMENT. DENNIS HESCH DID NOT RECIEVE A PAYMENT FROM THE 457(F) PLAN IN 2023.

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.

  • ADVANCED IMAGING CENTER LLC

    N/A · Diagnostic Radiology Center · IA

    Directly controlled by NA

  • ANKENY MEDICAL PARK SURGERY CENTER LC

    N/A · Ambulatory Surgery Center · IA

    Directly controlled by NA

  • CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC

    N/A · Cardiovascular Management & Administrative Services · IA

    Directly controlled by NA

  • CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY

    N/A · Oncology Management & Administrative Services · IA

    Directly controlled by NA

  • CENTRAL IOWA PHYSIO LLC

    N/A · Physical Therapy Services · IA

    Directly controlled by NA

  • CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC

    N/A · Surgical Management & Administrative Services · IA

    Directly controlled by NA

  • CHAMPAIGN SURGICENTER LLC

    N/A · Surgical Center · IL

    Directly controlled by NA

  • DUBUQUE ENDOSCOPY CENTER LC

    N/A · Ambulatory Surgery Center · IA

    Directly controlled by NA

  • EASTERN IOWA SLEEP SUPPLY LLC

    N/A · Medical Equipment Retail Sales · IA

    Directly controlled by NA

  • FIELDS SOUTH LLC

    N/A · Property & Facility Management · IL

    Directly controlled by NA

  • HEALTH CARE AFFILIATES OF THE TRI-STATES LLC

    N/A · Provide Access to Licensed Software · IA

    Directly controlled by NA

  • IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC

    N/A · Outpatient Diagnostic Imaging · IA

    Directly controlled by NA

  • IOWA HEALTH SYSTEM CONTRACTING SERVICES LC

    N/A · Group Purchasing · IA

    Directly controlled by NA

  • LAKEVIEW SURGERY CENTER LC

    N/A · Surgery Center · IA

    Directly controlled by NA

  • MOUPH LLC

    N/A · Outpatient Orthopedic Services · IL

    Directly controlled by NA

  • MR ASSOCIATES LLP

    N/A · Own and Operate MR Unit · IA

    Directly controlled by NA

  • ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC

    N/A · Ambulatory Surgery Center · IA

    Directly controlled by NA

  • REHABILITATION THERAPY SERVICES LLC

    N/A · Rehabilitation Therapy · IL

    Directly controlled by NA

  • THE CENTER FOR ORTHOPEDIC MEDICINE LLC RECOVERY CARE CENTER

    N/A · Outpatient Orthopedic Services · IL

    Directly controlled by NA

  • THE CENTER FOR ORTHOPEDIC MEDICINE LLC SURGERY CENTER

    N/A · Outpatient Orthopedic Services · IL

    Directly controlled by NA

  • THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC

    N/A · Ambulatory Surgery Center · IA

    Directly controlled by NA

  • UNITED MEDICAL PARK ASC LLC DBA THE SURGERY CENTER AT UNITED MEDICAL PARK

    N/A · Ambulatory Surgery Center · IA

    Directly controlled by NA

  • UPHT-SCA HOLDINGS LLC

    N/A · Ambulatory Surgery Center Investment · DE

    Directly controlled by NA

  • WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC

    N/A · Orthopedic Service Lines Management · IA

    Directly controlled by NA

  • WEST LAKES SLEEP CENTER LLC

    N/A · Sleep Disorder Diagnostic Testing Facility · IA

    Directly controlled by NA

Related corporations and trusts

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

  • ABBE MANAGEMENT CORPORATION

    C Corporation · Management Services · IA

    Directly controlled by NA

  • BELCREST SERVICES LTD

    C Corporation · Medical Services · IL · controlled entity

    Directly controlled by NA

  • BROADBAND INC

    C Corporation · Information Technology Management · IA

    Directly controlled by NA

  • CARLE HEALTH JUNCTION MEDICAL LLC

    C Corporation · Care Coordination · IL · controlled entity

    Directly controlled by NA

  • CARLE HEALTH PHYSICIAN PARTNERS INC

    C Corporation · Physician Services · IL · controlled entity

    Directly controlled by NA

  • CARLE HOLDING COMPANY INC

    C Corporation · Holding Co. · IL · controlled entity

    Directly controlled by NA

  • CARLE RESEARCH PRODUCTS INC

    C Corporation · Medical Research - INACTIVE · IL · controlled entity

    Directly controlled by NA

  • CARLE RISK MANAGEMENT COMPANY

    C Corporation · Risk Management · IL · controlled entity

    Directly controlled by NA

  • CARLE VENTURES INC

    C Corporation · Health Care Partnerships · IL · controlled entity

    Directly controlled by NA

  • CHA HOLDING INC

    C Corporation · Holding Co. · IL · controlled entity

    Directly controlled by NA

  • DELHI POINT CONDO ASSOCIATION

    C Corporation · Real Estate Management · IA

    Directly controlled by NA

  • FIRSTCAROLINACARE INSURANCE COMPANY

    C Corporation · Insurance · IL · controlled entity

    Directly controlled by NA

  • HANSEN CHARITABLE REMAINDER ANNUITY TRUST

    Trust · Investment · IA

    Directly controlled by NA

  • HANSEN CHARITABLE REMAINDER UNITRUST

    Trust · Investment · IA

    Directly controlled by NA

  • HCP CORPORATION

    C Corporation · Real Estate Rental · WI

    Directly controlled by NA

  • HEALTH ADVANTAGE PLUS INC

    C Corporation · Physical Therapy · IA

    Directly controlled by NA

  • HEALTH ALLIANCE CONNECT INC

    C Corporation · Health Care Coordination · IL · controlled entity

    Directly controlled by NA

  • HEALTH ALLIANCE MEDICAL PLANS INC

    C Corporation · Health Coverage · IL · controlled entity

    Directly controlled by NA

  • HEALTH ALLIANCE MIDWEST INC

    C Corporation · Health Coverage · IL · controlled entity

    Directly controlled by NA

  • HEALTH ALLIANCE NORTHWEST HEALTH PLAN

    C Corporation · Health Coverage · WA · controlled entity

    Directly controlled by NA

  • HEALTH ALLIANCE NORTHWEST HOLDING

    C Corporation · Holding Co. · WA · controlled entity

    Directly controlled by NA

  • HEALTH PLUS INC

    C Corporation · Contracting · IL · controlled entity

    Directly controlled by NA

  • HEALTH SYSTEMS INSURANCE LIMITED

    C Corporation · Insurance · CJ · controlled entity

    Directly controlled by NA

  • HNC SERVICES

    C Corporation · Fiber Optic Network Services · IA

    Directly controlled by NA

  • MEDIMORE INC

    C Corporation · Managed Care · IA

    Directly controlled by NA

  • MERITER HEALTH ENTERPRISES INC

    C Corporation · Management Services · WI

    Directly controlled by NA

  • MERITER MANAGEMENT SERVICES INC

    C Corporation · Administrative Services · WI

    Directly controlled by NA

  • METHODIST HEALTH VENTURES INC

    C Corporation · Holding Co. · IL · controlled entity

    Directly controlled by NA

  • OPTIMUM HEALTH SOLUTIONS INC

    C Corporation · Care Coordination - INACTIVE · IL · controlled entity

    Directly controlled by NA

  • PEKIN PROHEALTH INC

    C Corporation · Clinical Operations · IL · controlled entity

    Directly controlled by NA

  • PRECEDENCE PLUS INC

    C Corporation · Managed Mental Care · IA

    Directly controlled by NA

  • PRECEDENCE INC

    C Corporation · Managed Mental Care · IA

    Directly controlled by NA

  • PROVIDER RESOURCE MANAGEMENT INC

    C Corporation · Physician Services · IL · controlled entity

    Directly controlled by NA

  • STL HEALTH RESOURCES CO

    C Corporation · Physician Office Rental · IA

    Directly controlled by NA

  • TRINITY HEALTH ENTERPRISES INC

    C Corporation · Retail Durable Medical Equipment & Pharmacy · IL

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2023
Filed
15 November 2024
IRS schema version
2023v5.1
Source object
202403209349322085

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