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← POCONO HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF INS TR

Form 990 for tax year 2022

Filed by POCONO HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF INS TR.

Totals

Total revenue
-$111,965
Total expenses
$189,655
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$184,413
Management and general expenses
$5,242
Fundraising expenses
$0
Program service expenses (Part III)
$184,413

Program services were 97.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • PNC BANK

    TRUSTEE

    Total calculated
    $5,242
    From this org
    $5,242
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • CORNELIO R CATENA

    PRESIDENT

    Total calculated
    $625,907
    From this org
    $0
    From related orgs
    $609,316
    Other
    $16,591
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $488,769 related
    Bonus
    $0 + $115,000 related
    Other
    $0 + $5,547 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $16,591 related
    Filer's total
    $0 + $625,907 related

  • ELIZABETH M WISE

    FORMER PRESIDENT

    Total calculated
    $38,189
    From this org
    $0
    From related orgs
    $37,387
    Other
    $802
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $34,812 related
    Bonus
    $0
    Other
    $0 + $2,575 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $802 related
    Filer's total
    $0 + $38,189 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 — 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)

PART I, LINE 3
THE FORMER PRESIDENT/CEO, ELIZABETH WISE, WAS COMPENSATED BY LEHIGH VALLEY HOSPITAL-POCONO (LVH-P), A RELATED ORGANIZATION. LVH-P USES THE FOLLOWING METHODS TO DETERMINE THEIR COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE PRESIDENT, CORNELIO R. CATENA, IS COMPENSATED BY LEHIGH VALLEY HOSPITAL (LVH), A RELATED ORGANIZATION. LVH USES THE FOLLOWING METHODS TO DETERMINE THEIR COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
THE FOLLOWING INDIVIDUAL PARTICIPATED IN THE 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF LEHIGH VALLEY HOSPITAL-POCONO, A RELATED ORGANIZATION, IN CALENDAR YEAR 2022: ELIZABETH M. WISE, FORMER PRESIDENT/CEO - $1,741

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.

Provenance

Return type
form_990
Tax year
2022
Filed
14 June 2024
IRS schema version
2022v5.0
Source object
202441669349300809

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