Liabilities / Assets
51st percentile
Higher debt load relative to assets than 51% of similar nonprofits.
Advanced Providers Insurance Risk Retention Group Inc
990 • Fiscal year 2019 • EIN 20-1095828
Siviq Scores
Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.
0.03x
Liabilities / Revenue
76th percentile
Higher debt load relative to revenue than 76% of similar nonprofits.
Net Margin
75th percentile
Higher net margin than 75% of similar nonprofits.
Top Officer Pay
58th percentile
Higher top officer pay than 58% of similar nonprofits.
Top officer pay equals 31.6% of source-year revenue.
Asset Growth
56th percentile
Faster asset growth than 56% of similar nonprofits.
Revenue Growth
33rd percentile
Faster revenue growth than 33% of similar nonprofits.
Balance Sheet
Assets
Up$1,571,511
Up $59,455 (+3.9%) from 2018
Net Assets
Up$1,521,953
Up $70,685 (+4.9%) from 2018
Liabilities
Down$49,558
Down $11,230 (-18%) from 2018
Revenue And Expenses
Revenue
Down$165,854
Down $7,100 (-4.1%) from 2018
Expenses
Up$132,429
Up $16,204 (+14%) from 2018
Net Income
Down$33,425
Down $23,304 (-41%) from 2018
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2019 to Dec 31, 2019
- Signed
- Jul 30, 2020
- Return Version
- 2019v5.0
- Gross Receipts
- $186,520
Mission and Program Overview
Mission
To provide affordable medical malpractice insurance to medical professionals that provide home health care to the elderly
To provide affordable medical malpractice insurance to medical professionals that provide home healthcare to the elderly.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Rtn Earn Endowment Incm Other Fnds | $1,441,268 | $1,510,453 | ▲ $69,185 |
| Savings and Temporary Cash Investments | $984,781 | $1,024,525 | ▲ $39,744 |
| Investments in Publicly Traded Securities | $324,120 | $340,229 | ▲ $16,109 |
| Cash and Non-Interest-Bearing Accounts | $143,684 | $203,341 | ▲ $59,657 |
| Pd in Cap Srpls Land Bldg Eqp Fund | $9,980 | $11,477 | ▲ $1,497 |
| Accounts Receivable | $55,123 | $1,872 | ▼ $53,251 |
| Prepaid Expenses and Deferred Charges | $4,348 | $1,544 | ▼ $2,804 |
| Cap Stk Tr Prin Current Funds | $20 | $23 | ▲ $3 |
| Other Notes and Loans Receivable, Net | $0 | $0 | → $0 |
| Pledges and Grants Receivable | $0 | $0 | → $0 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Land, Buildings, and Equipment, Net | $0 | - | - |
| Inventories for Sale or Use | $0 | $0 | → $0 |
| Total Assets | $1,512,056 | $1,571,511 | ▲ $59,455 |
| Liabilities | |||
| Accounts Payable and Accrued Expenses | $46,419 | $40,392 | ▼ $6,027 |
| Deferred Revenue | $14,369 | $9,166 | ▼ $5,203 |
| Total Liabilities | $60,788 | $49,558 | ▼ $11,230 |
| Net Assets / Fund Balance | |||
| Total Net Assets Fund Balance | $1,451,268 | $1,521,953 | ▲ $70,685 |
| Total Liabilities and Net Assets / Fund Balance | $1,512,056 | $1,571,511 | ▲ $59,455 |
Compensation and Service Providers
Employees
| Name | Title | Full / Part Time | Other | Total |
|---|---|---|---|---|
| Charles Marlin | President, Treasurer and Director | PT | $52,344 | $52,344 |
Board Members and Trustees
| Name | Title |
|---|---|
| Edward Caldwell | Director |
| Tom Plamondon | Director |
| Edwin SolerValcourt MD | Secretary and Director |
| James Gordon | Assistant Secretary |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $0
- Program Service Revenue
- $147,889
- Investment Income
- $17,365
- Other Revenue
- $600
- Change in Net Assets
- $33,425
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Other Expenses | $132,429 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Salaries, Compensation, and Employee Benefits | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Fees for Services Accounting | $0 | $28,899 | $0 | $28,899 |
| Advertising | $0 | $11,700 | $0 | $11,700 |
| Travel | $0 | $9,480 | $0 | $9,480 |
| Office Expenses | $0 | $1,290 | $0 | $1,290 |
| Other Expenses | $0 | $300 | $0 | $300 |
| Total Functional Expenses | $9,213 | $123,216 | $0 | $132,429 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Subject to proxy tax
- No
Insider Transactions and Loans
Interested-Person Transactions
| Interested Party | Relationship | Description | Shared Revenue | Amount |
|---|---|---|---|---|
| - | Same President | Commissions and Consulting Fees | No | $70,547 |
Loans and Receivables
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Annual disclosure for covered persons
- Yes
- Business relationship with 35% controlled entity
- Yes
- Business relationship with family members
- No
- Business relationship with organization members
- Yes
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- No
- Other officer compensation reviewed
- No
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- No
- Key decisions subject to board approval
- No
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Section A, Line 6
“As a risk retention group, the Company is owned by the member policyholders. Policyholders are required to purchase voting common stock in the Company as part of issuance of the policy.”
Form 990, Part VI, Section A, Line 7A
“Pursuant to the Company's Article and Bylaws, Directors are elected by the shareholders on an annual basis. Also, all actions taken by the Board of Directors and officers for the year are ratified by the shareholders at the annual meeting.”
Form 990, Part VI, Section A, Line 9
“Charles Marlin 24150 Little Mack, St Clair Shores, MI 48080 Dr. Edwin Soler-Valcourt 20927 Kelly Road, Eastpointe, MI 48021 Tom Plamondon, 1184 Cleaver Rd STE 300, Caro, MI 48723”
Form 990, Part VI, Section B, Line 11B
“The Form 990is prepared by GPW and Associates, Inc. (GPW), the contracted captive manager of the company. GPW specializes in insurance company accounting and reporting. Financials and tax filings are reviewed and addressed during the annual Board meeting.”
Form 990, Part VI, Section B, Line 12C
“The company is a captive risk retention group regulated by the Arizona Department of Insurance and the National Association of Insurance Commissioners (NAIC). Financial statements are filed with the State of Arizona adn the NAIC on a quarterly and annual basis. Governing documents and conflict of interest statements are also filed with the Arizona Department of Insurance. Information is available to the public through the Arizona Department of Insurance upon request and approval.”
Form 990, Part VI, Section C, Line 19
“The company is a captive risk retention group regulated by the Arizona Department of Insurance and the National Association of Insurance Commissioners (NAIC). Financial statements are filed with the State of Arizona adn the NAIC on a quarterly and annual basis. Governing documents and conflict of interest statements are also filed with the Arizona Department of Insurance. Information is available to the public through the Arizona Department of Insurance upon request and approval.”
Form 990, Part VII, Section A, Line 1A
“The Company paid $70,547 to Interstate Healthcare for consulting fees and commissions. Interstate Healthcare is the underwriting agency responsible for policies issued by the Company that is owned by the Company's President Charles Marlin.”
Filing and Contact Details
Filer
- Filer Name
- Advanced Providers Insurance Risk Retention Group Inc
- EIN
- 20-1095828
- Phone
- 6022006900
- Address
- 3101 N Central Ave STE400, Phoenix, AZ 85012
Signing Officer
- Name
- Charles E Marlin
- Title
- President
- Phone
- 8004195999
- Signed
- 2020-07-30
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Charles E Marlin
- Formed
- 2004
- Legal Domicile
- Az
- Voting Board Members
- 23
- Independent Board Members
- 23
- Employees
- 0
- Volunteers
- 0
Preparer
- Firm
- GPW and Associates
- Address
- 3101 N Central Ave Suite 400, Phoenix, AZ 85012
- Preparer
- Aimee Andersen
- Phone
- 6022006900
Supplemental Narrative
Additional Explanations
Form 990, Part V, Line 3B
“The Company had no unrelated business income in 2019.”
Form 990, Part XI, Line 9
“Three policyholders purchased common stock resulting in $1,500 increase in capital.”
Raw XML AppendixShowing 400 of 474 raw XML fields
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990/AccountantCompileOrReviewInd | 0 | 0 |
| IRS990/AccountsPayableAccrExpnssGrp/BOYAmt | 0 | 46419 |
| IRS990/AccountsPayableAccrExpnssGrp/EOYAmt | 0 | 40392 |
| IRS990/AccountsReceivableGrp/BOYAmt | 0 | 55123 |
| IRS990/AccountsReceivableGrp/EOYAmt | 0 | 1872 |
| IRS990/ActivitiesConductedPrtshpInd | 0 | 0 |
| IRS990/ActivityOrMissionDesc | 0 | To provide affordable medical malpractice insurance to medical professionals that provide home healthcare to the elderly. |
| IRS990/AdvertisingGrp/FundraisingAmt | 0 | 0 |
| IRS990/AdvertisingGrp/ManagementAndGeneralAmt | 0 | 11700 |
| IRS990/AdvertisingGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/AdvertisingGrp/TotalAmt | 0 | 11700 |
| IRS990/AnnualDisclosureCoveredPrsnInd | 0 | 1 |
| IRS990/BenefitsToMembersGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/BenefitsToMembersGrp/TotalAmt | 0 | 0 |
| IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt | 0 | GPW and Associates Inc |
| IRS990/BooksInCareOfDetail/PhoneNum | 0 | 6022006900 |
| IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 3101 N Central Ave STE400 |
| IRS990/BooksInCareOfDetail/USAddress/CityNm | 0 | Phoenix |
| IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | AZ |
| IRS990/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 85012 |
| IRS990/BusinessRlnWith35CtrlEntInd | 0 | 1 |
| IRS990/BusinessRlnWithFamMemInd | 0 | 0 |
| IRS990/BusinessRlnWithOrgMemInd | 0 | 1 |
| IRS990/CapStkTrPrinCurrentFundsGrp/BOYAmt | 0 | 20 |
| IRS990/CapStkTrPrinCurrentFundsGrp/EOYAmt | 0 | 23 |
| IRS990/CashNonInterestBearingGrp/BOYAmt | 0 | 143684 |
| IRS990/CashNonInterestBearingGrp/EOYAmt | 0 | 203341 |
| IRS990/ChangeToOrgDocumentsInd | 0 | 0 |
| IRS990/CntrctRcvdGreaterThan100KCnt | 0 | 0 |
| IRS990/CollectionsOfArtInd | 0 | 0 |
| IRS990/CompCurrentOfcrDirectorsGrp/FundraisingAmt | 0 | 0 |
| IRS990/CompCurrentOfcrDirectorsGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/CompCurrentOfcrDirectorsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/CompCurrentOfcrDirectorsGrp/TotalAmt | 0 | 0 |
| IRS990/CompDisqualPersonsGrp/FundraisingAmt | 0 | 0 |
| IRS990/CompDisqualPersonsGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/CompDisqualPersonsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/CompDisqualPersonsGrp/TotalAmt | 0 | 0 |
| IRS990/CompensationFromOtherSrcsInd | 0 | 0 |
| IRS990/CompensationProcessCEOInd | 0 | 0 |
| IRS990/CompensationProcessOtherInd | 0 | 0 |
| IRS990/ConferencesMeetingsGrp/FundraisingAmt | 0 | 0 |
| IRS990/ConferencesMeetingsGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/ConferencesMeetingsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/ConferencesMeetingsGrp/TotalAmt | 0 | 0 |
| IRS990/ConflictOfInterestPolicyInd | 0 | 1 |
| IRS990/ConservationEasementsInd | 0 | 0 |
| IRS990/ConsolidatedAuditFinclStmtInd | 0 | 0 |
| IRS990/CreditCounselingInd | 0 | 0 |
| IRS990/CYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/CYContributionsGrantsAmt | 0 | 0 |
| IRS990/CYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/CYInvestmentIncomeAmt | 0 | 17365 |
| IRS990/CYOtherExpensesAmt | 0 | 132429 |
| IRS990/CYOtherRevenueAmt | 0 | 600 |
| IRS990/CYProgramServiceRevenueAmt | 0 | 147889 |
| IRS990/CYRevenuesLessExpensesAmt | 0 | 33425 |
| IRS990/CYSalariesCompEmpBnftPaidAmt | 0 | 0 |
| IRS990/CYTotalExpensesAmt | 0 | 132429 |
| IRS990/CYTotalFundraisingExpenseAmt | 0 | 0 |
| IRS990/CYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/CYTotalRevenueAmt | 0 | 165854 |
| IRS990/DecisionsSubjectToApprovaInd | 0 | 0 |
| IRS990/DeductibleArtContributionInd | 0 | 0 |
| IRS990/DeductibleNonCashContriInd | 0 | 0 |
| IRS990/DeferredRevenueGrp/BOYAmt | 0 | 14369 |
| IRS990/DeferredRevenueGrp/EOYAmt | 0 | 9166 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | 0 |
| IRS990/DepreciationDepletionGrp/FundraisingAmt | 0 | 0 |
| IRS990/DepreciationDepletionGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/DepreciationDepletionGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/DepreciationDepletionGrp/TotalAmt | 0 | 0 |
| IRS990/Desc | 0 | The company provides medical malpractice insurance at reduced premium rates to its member policyholders who provide medical care to geriatric home bound patients. The company currently has 23 policies issued that cover participating physicians, physician assistants and nurse practitioners. Through participation in the RRG, the health care providers are able to keep their premium rates low enough to continue to serve the elderly home bound patients. |
| IRS990/DescribedInSection501c3Ind | 0 | 0 |
| IRS990/DisregardedEntityInd | 0 | 0 |
| IRS990/DocumentRetentionPolicyInd | 0 | 0 |
| IRS990/DonatedServicesAndUseFcltsAmt | 0 | 0 |
| IRS990/DonorAdvisedFundInd | 0 | 0 |
| IRS990/DonorRstrOrQuasiEndowmentsInd | 0 | 0 |
| IRS990/ElectionOfBoardMembersInd | 0 | 1 |
| IRS990/EmployeeCnt | 0 | 0 |
| IRS990/ExpenseAmt | 0 | 9213 |
| IRS990/FamilyOrBusinessRlnInd | 0 | 0 |
| IRS990/FederalGrantAuditRequiredInd | 0 | 0 |
| IRS990/FeesForServicesAccountingGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt | 0 | 28899 |
| IRS990/FeesForServicesAccountingGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 28899 |
| IRS990/FeesForServicesLegalGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesLegalGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/FeesForServicesLegalGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 0 |
| IRS990/FeesForServicesLobbyingGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesLobbyingGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/FeesForServicesLobbyingGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/FeesForServicesLobbyingGrp/TotalAmt | 0 | 0 |
| IRS990/FeesForServicesManagementGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesManagementGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/FeesForServicesManagementGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/FeesForServicesManagementGrp/TotalAmt | 0 | 0 |
| IRS990/FeesForServicesOtherGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesOtherGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/FeesForServicesOtherGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/FeesForServicesOtherGrp/TotalAmt | 0 | 0 |
| IRS990/FeesForServicesProfFundraising/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesProfFundraising/TotalAmt | 0 | 0 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt | 0 | 0 |
| IRS990/ForeignActivitiesInd | 0 | 0 |
| IRS990/ForeignFinancialAccountInd | 0 | 0 |
| IRS990/ForeignGrantsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/ForeignGrantsGrp/TotalAmt | 0 | 0 |
| IRS990/ForeignOfficeInd | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 0 | 40 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 10 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 52344 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | Charles Marlin |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | Edwin SolerValcourt MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | Tom Plamondon |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | Edward Caldwell |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | James Gordon |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | President, Treasurer and Director |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | Secretary and Director |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | Director |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | Director |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | Assistant Secretary |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | 0 |
| IRS990/FormationYr | 0 | 2004 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | 0 |
| IRS990/FSAuditedInd | 0 | 0 |
| IRS990/FundraisingActivitiesInd | 0 | 0 |
| IRS990/GainOrLossGrp/OtherAmt | 0 | 0 |
| IRS990/GainOrLossGrp/SecuritiesAmt | 0 | 4249 |
| IRS990/GamingActivitiesInd | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 23 |
| IRS990/GrantAmt | 0 | 0 |
| IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/GrantsToDomesticIndividualsGrp/TotalAmt | 0 | 0 |
| IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/GrantsToDomesticOrgsGrp/TotalAmt | 0 | 0 |
| IRS990/GrantsToIndividualsInd | 0 | 0 |
| IRS990/GrantsToOrganizationsInd | 0 | 0 |
| IRS990/GrantToRelatedPersonInd | 0 | 0 |
| IRS990/GrossAmountSalesAssetsGrp/OtherAmt | 0 | 0 |
| IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt | 0 | 24915 |
| IRS990/GrossReceiptsAmt | 0 | 186520 |
| IRS990/GroupReturnForAffiliatesInd | 0 | 0 |
| IRS990/IncludeFIN48FootnoteInd | 0 | 0 |
| IRS990/IncmFromInvestBondProceedsGrp/ExclusionAmt | 0 | 0 |
| IRS990/IncmFromInvestBondProceedsGrp/RelatedOrExemptFuncIncomeAmt | 0 | 0 |
| IRS990/IncmFromInvestBondProceedsGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/IncmFromInvestBondProceedsGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/IndependentAuditFinclStmtInd | 0 | 0 |
| IRS990/IndependentVotingMemberCnt | 0 | 23 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 0 |
| IRS990/IndoorTanningServicesInd | 0 | 0 |
| IRS990/InfoInScheduleOPartVIIInd | 0 | X |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartVInd | 0 | X |
| IRS990/InfoInScheduleOPartXIInd | 0 | X |
| IRS990/InformationTechnologyGrp/FundraisingAmt | 0 | 0 |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/InformationTechnologyGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 0 |
| IRS990/InsuranceGrp/FundraisingAmt | 0 | 0 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/InsuranceGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 0 |
| IRS990/InterestGrp/FundraisingAmt | 0 | 0 |
| IRS990/InterestGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/InterestGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/InterestGrp/TotalAmt | 0 | 0 |
| IRS990/InventoriesForSaleOrUseGrp/BOYAmt | 0 | 0 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 0 |
| IRS990/InvestmentExpenseAmt | 0 | 0 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 0 |
| IRS990/InvestmentIncomeGrp/RelatedOrExemptFuncIncomeAmt | 0 | 13116 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 13116 |
| IRS990/InvestmentIncomeGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/InvestmentInJointVentureInd | 0 | 0 |
| IRS990/InvestmentsPubTradedSecGrp/BOYAmt | 0 | 324120 |
| IRS990/InvestmentsPubTradedSecGrp/EOYAmt | 0 | 340229 |
| IRS990/IRPDocumentCnt | 0 | 0 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipBasisNetGrp/BOYAmt | 0 | 0 |
| IRS990/LegalDomicileStateCd | 0 | AZ |
| IRS990/LessCostOthBasisSalesExpnssGrp/OtherAmt | 0 | 0 |
| IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt | 0 | 20666 |
| IRS990/LoanOutstandingInd | 0 | 0 |
| IRS990/LocalChaptersInd | 0 | 0 |
| IRS990/MaterialDiversionOrMisuseInd | 0 | 0 |
| IRS990/MembersOrStockholdersInd | 0 | 1 |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | 1 |
| IRS990/MinutesOfGoverningBodyInd | 0 | 1 |
| IRS990/MiscellaneousRevenueGrp/ExclusionAmt | 0 | 0 |
| IRS990/MiscellaneousRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 600 |
| IRS990/MiscellaneousRevenueGrp/TotalRevenueColumnAmt | 0 | 600 |
| IRS990/MiscellaneousRevenueGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/MissionDesc | 0 | To provide affordable medical malpractice insurance to medical professionals that provide home health care to the elderly |
| IRS990/MoreThan5000KToIndividualsInd | 0 | 0 |
| IRS990/MoreThan5000KToOrgInd | 0 | 0 |
| IRS990/NetAssetsOrFundBalancesBOYAmt | 0 | 1451268 |
| IRS990/NetAssetsOrFundBalancesEOYAmt | 0 | 1521953 |
| IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt | 0 | 0 |
| IRS990/NetGainOrLossInvestmentsGrp/RelatedOrExemptFuncIncomeAmt | 0 | 4249 |
| IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt | 0 | 4249 |
| IRS990/NetGainOrLossInvestmentsGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/NetUnrelatedBusTxblIncmAmt | 0 | 0 |
| IRS990/NetUnrlzdGainsLossesInvstAmt | 0 | 35760 |
| IRS990/NondeductibleContributionsInd | 0 | 0 |
| IRS990/OccupancyGrp/FundraisingAmt | 0 | 0 |
| IRS990/OccupancyGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/OccupancyGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/OccupancyGrp/TotalAmt | 0 | 0 |
| IRS990/OfficeExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt | 0 | 1290 |
| IRS990/OfficeExpensesGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/OfficeExpensesGrp/TotalAmt | 0 | 1290 |
| IRS990/OfficerMailingAddressInd | 0 | 1 |
| IRS990/OperateHospitalInd | 0 | 0 |
| IRS990/Organization501cInd | 0 | X |
| IRS990/OrgDoesNotFollowFASB117Ind | 0 | X |
| IRS990/OtherChangesInNetAssetsAmt | 0 | 1500 |
| IRS990/OtherEmployeeBenefitsGrp/FundraisingAmt | 0 | 0 |
| IRS990/OtherEmployeeBenefitsGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/OtherEmployeeBenefitsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/OtherEmployeeBenefitsGrp/TotalAmt | 0 | 0 |
| IRS990/OtherExpensesGrp/Desc | 0 | State Taxes, Licenses and Fees |
| IRS990/OtherExpensesGrp/Desc | 1 | Non-Employee Compensation |
| IRS990/OtherExpensesGrp/Desc | 2 | Consulting fees |
| IRS990/OtherExpensesGrp/Desc | 3 | Bank Service Charges |
| IRS990/OtherExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/OtherExpensesGrp/FundraisingAmt | 1 | 0 |
| IRS990/OtherExpensesGrp/FundraisingAmt | 2 | 0 |
| IRS990/OtherExpensesGrp/FundraisingAmt | 3 | 0 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 1 | 18203 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 2 | 53344 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 3 | 300 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 0 | 9213 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 1 | 0 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 2 | 0 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 3 | 0 |
| IRS990/OtherExpensesGrp/TotalAmt | 0 | 9213 |
| IRS990/OtherExpensesGrp/TotalAmt | 1 | 18203 |
| IRS990/OtherExpensesGrp/TotalAmt | 2 | 53344 |
| IRS990/OtherExpensesGrp/TotalAmt | 3 | 300 |
| IRS990/OtherRevenueTotalAmt | 0 | 600 |
| IRS990/OtherSalariesAndWagesGrp/FundraisingAmt | 0 | 0 |
| IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/OtherSalariesAndWagesGrp/TotalAmt | 0 | 0 |
| IRS990/OthNotesLoansReceivableNetGrp/BOYAmt | 0 | 0 |
| IRS990/OthNotesLoansReceivableNetGrp/EOYAmt | 0 | 0 |
| IRS990/PartialLiquidationInd | 0 | 0 |
| IRS990/PaymentsToAffiliatesGrp/FundraisingAmt | 0 | 0 |
| IRS990/PaymentsToAffiliatesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/PaymentsToAffiliatesGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/PaymentsToAffiliatesGrp/TotalAmt | 0 | 0 |
| IRS990/PayrollTaxesGrp/FundraisingAmt | 0 | 0 |
| IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/PayrollTaxesGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/PayrollTaxesGrp/TotalAmt | 0 | 0 |
| IRS990/PdInCapSrplsLandBldgEqpFundGrp/BOYAmt | 0 | 9980 |
| IRS990/PdInCapSrplsLandBldgEqpFundGrp/EOYAmt | 0 | 11477 |
| IRS990/PensionPlanContributionsGrp/FundraisingAmt | 0 | 0 |
| IRS990/PensionPlanContributionsGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/PensionPlanContributionsGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/PensionPlanContributionsGrp/TotalAmt | 0 | 0 |
| IRS990/PledgesAndGrantsReceivableGrp/BOYAmt | 0 | 0 |
| IRS990/PledgesAndGrantsReceivableGrp/EOYAmt | 0 | 0 |
| IRS990/PoliticalCampaignActyInd | 0 | 0 |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 4348 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 1544 |
| IRS990/PrincipalOfficerNm | 0 | Charles E Marlin |
| IRS990/PriorPeriodAdjustmentsAmt | 0 | 0 |
| IRS990/ProfessionalFundraisingInd | 0 | 0 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 524126 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | Casualty Insurance |
| IRS990/ProgramServiceRevenueGrp/ExclusionAmt | 0 | 0 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 147889 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 147889 |
| IRS990/ProgramServiceRevenueGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | 0 |
| IRS990/PYInvestmentIncomeAmt | 0 | 18577 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/FundraisingAmt | 0 | 0 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt | 0 | 0 |
| IRS990/PYOtherExpensesAmt | 0 | 116225 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 154377 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | 56729 |
| IRS990/PYTotalExpensesAmt | 0 | 116225 |
| IRS990/PYTotalRevenueAmt | 0 | 172954 |
| IRS990/RcvblFromDisqualifiedPrsnGrp/BOYAmt | 0 | 0 |
| IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt | 0 | 0 |
| IRS990/ReceivablesFromOfficersEtcGrp/BOYAmt | 0 | 0 |
| IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | 33425 |
| IRS990/RegularMonitoringEnfrcInd | 0 | 1 |
| IRS990/RelatedEntityInd | 0 | 0 |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | 0 |
| IRS990/RentalIncomeOrLossGrp/PersonalAmt | 0 | 0 |
| IRS990/RentalIncomeOrLossGrp/RealAmt | 0 | 0 |
| IRS990/ReportInvestmentsOtherSecInd | 0 | 0 |
| IRS990/ReportLandBuildingEquipmentInd | 0 | 0 |
| IRS990/ReportOtherAssetsInd | 0 | 0 |
| IRS990/ReportOtherLiabilitiesInd | 0 | 0 |
| IRS990/ReportProgramRelatedInvstInd | 0 | 0 |
| IRS990/RevenueAmt | 0 | 165854 |
| IRS990/RoyaltiesGrp/FundraisingAmt | 0 | 0 |
| IRS990/RoyaltiesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/RoyaltiesGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/RoyaltiesGrp/TotalAmt | 0 | 0 |
| IRS990/RoyaltiesRevenueGrp/ExclusionAmt | 0 | 0 |
| IRS990/RoyaltiesRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 0 |
| IRS990/RoyaltiesRevenueGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/RoyaltiesRevenueGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/RtnEarnEndowmentIncmOthFndsGrp/BOYAmt | 0 | 1441268 |
| IRS990/RtnEarnEndowmentIncmOthFndsGrp/EOYAmt | 0 | 1510453 |
| IRS990/SavingsAndTempCashInvstGrp/BOYAmt | 0 | 984781 |
| IRS990/SavingsAndTempCashInvstGrp/EOYAmt | 0 | 1024525 |
| IRS990/ScheduleBRequiredInd | 0 | 0 |
| IRS990/ScheduleJRequiredInd | 0 | 0 |
| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/NameOfInterested/BusinessName/BusinessNameLine1Txt | 0 | Interstate Healthcare |
| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt | 0 | Same President |
| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/SharingOfRevenuesInd | 0 | 0 |
| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionAmt | 0 | 70547 |
| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc | 0 | Commissions and Consulting Fees |
| IRS990ScheduleL/SupplementalInformationDetail/ExplanationTxt | 0 | Interstate Healthcare provides policy issuance and underwriting services for the company. Charles Marlin is the President and owner of Interstate Healthcare. The stockholders of the company elected Mr. Marlin to the Board of Directors and the Board of Directors subsequently elected Mr. Marlin President due to his vast experience in the insurance industry. |
| IRS990ScheduleL/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Schedule L, Part IV |
| IRS990/ScheduleORequiredInd | 0 | 1 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | The Company had no unrelated business income in 2019. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | As a risk retention group, the Company is owned by the member policyholders. Policyholders are required to purchase voting common stock in the Company as part of issuance of the policy. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | Pursuant to the Company's Article and Bylaws, Directors are elected by the shareholders on an annual basis. Also, all actions taken by the Board of Directors and officers for the year are ratified by the shareholders at the annual meeting. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | Charles Marlin 24150 Little Mack, St Clair Shores, MI 48080 Dr. Edwin Soler-Valcourt 20927 Kelly Road, Eastpointe, MI 48021 Tom Plamondon, 1184 Cleaver Rd STE 300, Caro, MI 48723 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | The Form 990is prepared by GPW and Associates, Inc. (GPW), the contracted captive manager of the company. GPW specializes in insurance company accounting and reporting. Financials and tax filings are reviewed and addressed during the annual Board meeting. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | The company is a captive risk retention group regulated by the Arizona Department of Insurance and the National Association of Insurance Commissioners (NAIC). Financial statements are filed with the State of Arizona adn the NAIC on a quarterly and annual basis. Governing documents and conflict of interest statements are also filed with the Arizona Department of Insurance. Information is available to the public through the Arizona Department of Insurance upon request and approval. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | The company is a captive risk retention group regulated by the Arizona Department of Insurance and the National Association of Insurance Commissioners (NAIC). Financial statements are filed with the State of Arizona adn the NAIC on a quarterly and annual basis. Governing documents and conflict of interest statements are also filed with the Arizona Department of Insurance. Information is available to the public through the Arizona Department of Insurance upon request and approval. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 7 | The Company paid $70,547 to Interstate Healthcare for consulting fees and commissions. Interstate Healthcare is the underwriting agency responsible for policies issued by the Company that is owned by the Company's President Charles Marlin. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 8 | Three policyholders purchased common stock resulting in $1,500 increase in capital. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Form 990, Part V, Line 3b |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Form 990, Part VI, Section A, Line 6 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | Form 990, Part VI, Section A, Line 7a |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | Form 990, Part VI, Section A, Line 9 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | Form 990, Part VI, Section B, Line 11b |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | Form 990, Part VI, Section B, Line 12c |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | Form 990, Part VI, Section C, Line 19 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 7 | Form 990, Part VII, Section A, Line 1a |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 8 | Form 990, Part XI, Line 9 |
| IRS990/SchoolOperatingInd | 0 | 0 |
| IRS990/SignificantChangeInd | 0 | 0 |
| IRS990/SignificantNewProgramSrvcInd | 0 | 0 |
| IRS990/SubjectToExcsTaxNetInvstIncInd | 0 | 0 |
| IRS990/SubjectToProxyTaxInd | 0 | 0 |
| IRS990/SubjToTaxRmnrtnExPrchtPymtInd | 0 | 0 |
| IRS990/TaxablePartyNotificationInd | 0 | 0 |
| IRS990/TaxExemptBondsInd | 0 | 0 |
| IRS990/TerminateOperationsInd | 0 | 0 |
| IRS990/TotalAssetsBOYAmt | 0 | 1512056 |
| IRS990/TotalAssetsEOYAmt | 0 | 1571511 |
| IRS990/TotalAssetsGrp/BOYAmt | 0 | 1512056 |
| IRS990/TotalAssetsGrp/EOYAmt | 0 | 1571511 |
| IRS990/TotalCompGreaterThan150KInd | 0 | 0 |
| IRS990/TotalContributionsAmt | 0 | 0 |
| IRS990/TotalEmployeeCnt | 0 | 0 |
| IRS990/TotalFunctionalExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt | 0 | 123216 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2019 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $1,571,511
- Liabilities
- $49,558
- Net assets
- $1,521,953
- Revenue
- $165,854
- Expenses
- $132,429
- Net income
- $33,425