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Nonprofiteer
← HAMDEN ASSURANCE RISK RETENTION GROUP INC

Form 990 for tax year 2022

Filed by HAMDEN ASSURANCE RISK RETENTION GROUP INC.

Totals

Total revenue
$963,318
Total expenses
$950,249
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$963,227
Investment income
$91
Other revenue
$0
Total assets, end of year
$87,935,637
Total liabilities, end of year
$87,885,637
Net assets or fund balances, end of year
$50,000
Program services expenses (Part IX)
$848,091
Management and general expenses
$102,158
Fundraising expenses
$0
Program service expenses (Part III)
$848,091

Program services were 89.2% 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 $963,227 · related or exempt $963,227

  • 2f · All other program service revenue

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

  • 3 · Investment income

    total $1,535 · excluded $1,535

  • 6c · Rental income or loss

    real property $0 · personal property $0

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

    securities $1,444

  • 7c · Gain or loss

    securities -$1,444 · other assets $0

  • 7d · Net gain or loss

    total -$1,444 · excluded -$1,444

  • 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 $81,600 · program services $57,120 · management and general $24,480

  • 11b · Fees: legal

    total $43,304 · management and general $43,304

  • 11c · Fees: accounting

    total $31,596 · management and general $31,596

  • 11f · Fees: investment management

    total $1,944 · management and general $1,944

  • 11g · Fees: other

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

  • 13 · Office expenses

    total $829 · management and general $829

  • 14 · Information technology

    total $72,442 · program services $72,442

  • 24a · Other expenses: ACTUARIAL FEES

    total $183,926 · program services $183,926

  • 24b · Other expenses: PREMIUM TAX EXPENSE

    total $493,991 · program services $493,991

  • 24c · Other expenses: LETTER OF CREDIT FEES

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

  • 24d · Other expenses: STATE FEES AND REG

    total $31,833 · program services $31,833

  • 24e · All other expenses

    total $980 · program services $975 · management and general $5 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $1,042,014 · end of year $1,185,915

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $7,943,737 · end of year $11,494,760

  • 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 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $334,498 · end of year $360,921

  • 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 $394,844 · end of year $351,543

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $66,751,221 · end of year $74,542,498

  • 17 · Accounts payable and accrued expenses

    beginning of year $31,989 · end of year $34,941

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $418,416 · end of year $462,218

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    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

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $75,965,909 · end of year $87,388,478

  • 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 · 2022

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 $848,091 · Revenue $963,227

As filed on the 2022 return.

Listed in Part VII

  • Carol Barsky MD

    Board Vice President

    Total calculated
    $583,935
    From this org
    $0
    From related orgs
    $562,809
    Other
    $21,126
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $550,000 related
    Bonus
    $0
    Other
    $0 + $12,809 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $2,826 related
    Filer's total
    $0 + $583,935 related

  • Daniel P Jantzen

    BOARD TREASURER

    Total calculated
    $1,033,483
    From this org
    $0
    From related orgs
    $968,827
    Other
    $64,656
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $815,505 related
    Bonus
    $0
    Other
    $0 + $153,322 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $35,406 related
    Filer's total
    $0 + $1,033,483 related

  • Edward Merrens

    BOARD PRESIDENT

    Total calculated
    $851,308
    From this org
    $0
    From related orgs
    $801,775
    Other
    $49,533
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $725,384 related
    Bonus
    $0
    Other
    $0 + $76,391 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $20,283 related
    Filer's total
    $0 + $851,308 related

  • John Kacavas

    BOARD SECRETARY

    Total calculated
    $875,216
    From this org
    $0
    From related orgs
    $805,496
    Other
    $69,720
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $680,386 related
    Bonus
    $0
    Other
    $0 + $125,110 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $40,470 related
    Filer's total
    $0 + $875,216 related

  • Lawrence Dacey MD

    BOARD CHAIRMAN

    Total calculated
    $48,049
    From this org
    $0
    From related orgs
    $38,990
    Other
    $9,059
    Hours/week
    1 + 40.5 related

  • Randall Wachsmann

    BOARD ASSISTANT SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Robert Gagliardi

    BOARD DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • George T Blike MD

    FORMER BOARD VICE PRESIDENT

    Total calculated
    $166,194
    From this org
    $0
    From related orgs
    $154,960
    Other
    $11,234
    Hours/week
    1 + 20.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $154,960 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $11,234 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $166,194 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
2022
Filed
23 October 2023
IRS schema version
2022v5.0
Source object
202342969349301119

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