Form 990 for tax year 2023
Filed by SWEDISH AMERICAN HOSPITAL SELF INSURANCE TRUST.
Totals
- Total revenue
- $57,070
- Total expenses
- $3,081,580
- Contributions and grants received
- $0
- Grants paid
- $0
- Program service revenue
- $0
- Investment income
- $57,070
- Other revenue
- $0
- Total assets, end of year
- $8,485,703
- Total liabilities, end of year
- $0
- Net assets or fund balances, end of year
- $8,485,703
- Program services expenses (Part IX)
- $3,031,947
- Management and general expenses
- $49,633
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $3,031,947
Program services were 98.4% 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.
-
3 · Investment income
total $461,341 · excluded $461,341
-
7a · Gross sales of assets other than inventory
securities $3,710,307
-
7b · Less cost or other basis and sales expenses
securities $4,114,578
-
7c · Gain or loss
securities -$404,271
-
7d · Net gain or loss
total -$404,271 · excluded -$404,271
Functional expenses
Part IX, the statement of functional expenses.
-
11g · Fees: other
total $49,633 · management and general $49,633
-
24a · Other expenses: Malpractice/Gen Claims
total $2,950,000 · program services $2,950,000
-
24b · Other expenses: Shared Services
total $81,947 · program services $81,947
Balance sheet
Part X, book values.
-
2 · Savings and temporary cash investments
beginning of year $3,522,836 · end of year $1,803,657
-
11 · Investments: publicly traded securities
beginning of year $7,214,087 · end of year $6,682,046
-
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 $0 · end of year $0
-
31 · Retained earnings, endowment or other funds
beginning of year $0 · end of year $0
Mission and programs · 2023
Mission
Through excellence in healthcare and compassionate service, we care for our community.
Activities or mission (Part I)
Management and payment of Malpractice and General Liability claims of UW Health SwedishAmerican Hospital.
-
Management and payment of Malpractice and General Liability claims of UW Health SwedishAmerican Hospital.
Expenses $3,031,947
As filed on the 2023 return.
Listed in Part VII
-
Peter D Newcomer MD MMM
Trustee
- Total calculated
- $1,387,607
- From this org
- $0
- From related orgs
- $1,121,369
- Other
- $266,238
- Hours/week
- 2 + 55 related
Schedule J breakdown matched by us
- Base
- $0 + $773,250 related
- Bonus
- $0 + $348,119 related
- Other
- $0
- Deferred
- $0 + $264,810 related
- Nontaxable benefits
- $0 + $1,428 related
- Filer's total
- $0 + $1,387,607 related
-
Carey Gehl
Trustee
- Total calculated
- $1,343,722
- From this org
- $0
- From related orgs
- $1,169,859
- Other
- $173,863
- Hours/week
- 2 + 55 related
Schedule J breakdown matched by us
- Base
- $0 + $642,233 related
- Bonus
- $0 + $241,202 related
- Other
- $0 + $286,424 related
- Deferred
- $0 + $137,568 related
- Nontaxable benefits
- $0 + $36,295 related
- Filer's total
- $0 + $1,343,722 related
-
Travis Andersen
President/CEO
- Total calculated
- $1,155,921
- From this org
- $0
- From related orgs
- $948,984
- Other
- $206,937
- Hours/week
- 2 + 46 related
Schedule J breakdown matched by us
- Base
- $0 + $797,792 related
- Bonus
- $0 + $123,125 related
- Other
- $0 + $28,067 related
- Deferred
- $0 + $159,713 related
- Nontaxable benefits
- $0 + $47,224 related
- Filer's total
- $0 + $1,155,921 related
-
Timothy Flynn MD
President, SA Medical Group
- Total calculated
- $682,720
- From this org
- $0
- From related orgs
- $550,572
- Other
- $132,148
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $471,882 related
- Bonus
- $0 + $53,431 related
- Other
- $0 + $25,259 related
- Deferred
- $0 + $82,440 related
- Nontaxable benefits
- $0 + $49,708 related
- Filer's total
- $0 + $682,720 related
-
Sal Ababneh
COO & President of UWNI Hospitals
- Total calculated
- $678,610
- From this org
- $0
- From related orgs
- $571,410
- Other
- $107,200
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $474,686 related
- Bonus
- $0 + $54,163 related
- Other
- $0 + $42,561 related
- Deferred
- $0 + $60,914 related
- Nontaxable benefits
- $0 + $46,286 related
- Filer's total
- $0 + $678,610 related
-
Thomas O'Connor
Former President & CEO
- Total calculated
- $585,228
- From this org
- $0
- From related orgs
- $585,228
- Other
- $0
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $11,766 related
- Bonus
- $0
- Other
- $0 + $573,462 related
- Deferred
- $0
- Nontaxable benefits
- $0
- Filer's total
- $0 + $585,228 related
-
Patricia DeWane
VP, CFO, & Treasurer
- Total calculated
- $578,277
- From this org
- $0
- From related orgs
- $497,721
- Other
- $80,556
- Hours/week
- 2 + 46 related
Schedule J breakdown matched by us
- Base
- $0 + $426,805 related
- Bonus
- $0 + $67,788 related
- Other
- $0 + $3,128 related
- Deferred
- $0 + $72,684 related
- Nontaxable benefits
- $0 + $7,872 related
- Filer's total
- $0 + $578,277 related
-
Michael Polizzotto
Former CMO/CIO
- Total calculated
- $466,857
- From this org
- $0
- From related orgs
- $409,575
- Other
- $57,282
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $382,884 related
- Bonus
- $0 + $26,691 related
- Other
- $0
- Deferred
- $0 + $19,965 related
- Nontaxable benefits
- $0 + $37,317 related
- Filer's total
- $0 + $466,857 related
-
James Cole DO
VP Medical Affairs/CMO
- Total calculated
- $461,963
- From this org
- $0
- From related orgs
- $363,596
- Other
- $98,367
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $289,076 related
- Bonus
- $0 + $74,520 related
- Other
- $0
- Deferred
- $0 + $98,312 related
- Nontaxable benefits
- $0 + $55 related
- Filer's total
- $0 + $461,963 related
-
Julia Zimmerman
VP Strategic Growth
- Total calculated
- $434,201
- From this org
- $0
- From related orgs
- $314,180
- Other
- $120,021
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $277,273 related
- Bonus
- $0 + $33,991 related
- Other
- $0 + $2,916 related
- Deferred
- $0 + $48,957 related
- Nontaxable benefits
- $0 + $71,064 related
- Filer's total
- $0 + $434,201 related
-
William Mewes
Former Interim VP Patient Svcs/CNO
- Total calculated
- $433,782
- From this org
- $0
- From related orgs
- $393,941
- Other
- $39,841
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $248,557 related
- Bonus
- $0 + $12,145 related
- Other
- $0 + $133,239 related
- Deferred
- $0 + $4,326 related
- Nontaxable benefits
- $0 + $35,515 related
- Filer's total
- $0 + $433,782 related
-
Allen Williams MD
Trustee
- Total calculated
- $420,967
- From this org
- $0
- From related orgs
- $347,963
- Other
- $73,004
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $338,640 related
- Bonus
- $0 + $6,900 related
- Other
- $0 + $2,423 related
- Deferred
- $0 + $26,400 related
- Nontaxable benefits
- $0 + $46,604 related
- Filer's total
- $0 + $420,967 related
-
Rosa Jeschke
VP Human Resources
- Total calculated
- $337,589
- From this org
- $0
- From related orgs
- $297,585
- Other
- $40,004
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $268,720 related
- Bonus
- $0 + $26,193 related
- Other
- $0 + $2,672 related
- Deferred
- $0 + $34,668 related
- Nontaxable benefits
- $0 + $5,336 related
- Filer's total
- $0 + $337,589 related
-
Anna Taylor
VP Patient Services/CNO (until 2/24)
- Total calculated
- $201,908
- From this org
- $0
- From related orgs
- $196,225
- Other
- $5,683
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $187,369 related
- Bonus
- $0 + $8,856 related
- Other
- $0
- Deferred
- $0 + $5,538 related
- Nontaxable benefits
- $0 + $145 related
- Filer's total
- $0 + $201,908 related
-
Daniel T Ross
Chmn of the Board
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Jeffrey J Kaney Sr
Immediate Past Chairman (until 6/24)
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Jeffrey S Hultman
1st Vice Chmn/Secy
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Thomas R Walsh
Audit/Compliance Chairman
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Michael Broski
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Helen Chung Hill
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Kathleen Kelly MD
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Marco T Lenis
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Pamela Maher
Director
- Total calculated
- $0
- Hours/week
- 2 + 4 related
-
Anqunette Parham
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Steven C Sjogren
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Frank Walter
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 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
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
Answered no
- 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
- All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by UW Health SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President & CEO and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes.
- Part I, Lines 4a-b
- Severance payments during 2023 include: Tom O'Connor - $573,462; William Mewes - $87,850. These payments are reported as taxable compensation on Part II, column (B)(iii). Contributions to the 457(f) plan during 2023 include: Travis Andersen - $151,133; Faisal Ababneh - $55,164; Timothy Flynn MD - $56,040; Patricia DeWane - $46,284; Julia Zimmerman - $29,700; Rose Jeschke - $30,972; James Cole - $32,312; Carey Gehl - $112,158; Peter Newcomer - $198,810. Payments from the 457(f) plan during 2023 include: Julia Zimmerman - $18,973; Carey Gehl - $285,741. These payments are reported as taxable income on Part II, column (B) (iii). Part II, Column F: The amounts shown in column F were reported as deferred compensation in prior years but paid out in the current year. The amounts are also included in column (B) (iii).
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.
-
501(c)(3) · Reproductive endocrinology and infertility services · WI
-
501(c)(3) · Research and innovation · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Health care services and training · WI
-
501(c)(3) · Regional Parent Corp. to manage and direct activities of entities. · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
SwedishAmerican Health Foundation
501(c)(3) · Supports fundraising for SwedishAmerican Hospital · IL
Directly controlled by SwedishAmerican Health System Corporation
-
SwedishAmerican Health System Corporation
501(c)(3) · Parent Corp. to manage and direct activities of entities · IL
Directly controlled by Regional Division Inc
-
501(c)(3) · Hospital · IL
Directly controlled by SwedishAmerican Health System Corporation
-
SwedishAmerican Realty Corporation
501(c)(2) · Title Holding Company leases properties to subsidiaries · IL
Directly controlled by SwedishAmerican Health System Corporation
-
501(c)(3) · Support Organization · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
University of Wisconsin Hospital and Clinics Authority
501(c)(3) · Hospital and Clinics · WI
-
University of Wisconsin Medical Foundation
501(c)(3) · Physician Services · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Accountable Care Organization · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Infusion Therapy · WI
Directly controlled by University of WI Hospital and Clinics Authority
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.
-
Chartwell Wisconsin Enterprises LLC
Parent Entity of CW and CMW-HR · WI
-
Sixth Street Medical LLC
Real Estate · WI
-
Three Rivers Partners LLC
Information Technology Services · IL
Related corporations and trusts
Part IV: related organizations taxable as a corporation or trust.
-
Physician's Care Network
C · Health Services · IL
-
Quartz Health Benefit Plans Corporation
C · Health Maintenance Organization · WI
-
Quartz Health Insurance Corporation
C · Health Maintenance Organization · WI
-
Quartz Health Solutions Inc
C · Insurance · WI
-
Quartz Holding Company
C · Holding Company · WI
-
State & Charles Inc
C · Holding Company · IL
-
SwedishAmerican Health Managment Corp
C · Management Services · IL
-
C · Dialysis Services · WI
-
Charitable Remainder Unitrusts (5)
T · Trust · IL
Provenance
- Return type
- form_990
- Tax year
- 2023
- Filed
- 6 May 2025
- IRS schema version
- 2023v6.0
- Source object
- 202521279349302947
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
The source document this was parsed from is served over the API, which is where bulk and document access live.