Civic Intelligence

Rosemount Inc Basic Health Major Medical & Dental Plan Trust

990 • Fiscal year 2016 • EIN 41-1312839

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 15, 2016

Organization Profile
8200 Market BlvdChanhassen, MN 55317

(952) 949-7839

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

99th percentile

1.80x

Higher debt load relative to assets than 99% of similar nonprofits.

2016 filings • 501(c)9 • $10M-$25M nonprofits • Source year 2016

Liabilities / Revenue

70th percentile

0.12x

Higher debt load relative to revenue than 70% of similar nonprofits.

2016 filings • 501(c)9 • $10M-$25M nonprofits • Source year 2016

Net Margin

27th percentile

-2.7%

Higher net margin than 27% of similar nonprofits.

2016 filings • 501(c)9 • $10M-$25M nonprofits • Source year 2016

Top Officer Pay

46th percentile

$0

Higher top officer pay than 46% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2016 filings • 501(c)9 • $10M-$25M nonprofits • Source year 2016

Asset Growth

68th percentile

8.6%

Faster asset growth than 68% of similar nonprofits.

2016 filings • 501(c)9 • $10M-$25M nonprofits • Annualized from 2015 to 2016

Revenue Growth

50th percentile

4.3%

Faster revenue growth than 50% of similar nonprofits.

2016 filings • 501(c)9 • $10M-$25M nonprofits • Annualized from 2015 to 2016

Balance Sheet
Liabilities / Assets99th percentile

Assets

Up

$1,439,656

Up $114,513 (+8.6%) from 2015

Net Assets

Down

-$1,152,454

Down $464,799 (-68%) from 2015

Liabilities

Up

$2,592,110

Up $579,312 (+29%) from 2015

Revenue And Expenses
Liabilities / Revenue70th percentileNet Margin27th percentile

Revenue

Up

$21,586,333

Up $892,778 (+4.3%) from 2015

Expenses

Up

$22,170,753

Up $1,801,303 (+8.8%) from 2015

Net Income

Down

-$584,420

Down $908,525 (-280%) from 2015

Historical Trend

Balance Sheet Trend

Asset Growth68th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$4.0M$2.0M$0-$2.0MAssets 2011: $876,029Liabilities 2011: $1,582,886Net Assets 2011: -$706,8572011Assets 2012: $1,702,611Liabilities 2012: $1,296,812Net Assets 2012: $405,7992012Assets 2013: $1,428,863Liabilities 2013: $1,332,226Net Assets 2013: $96,6372013Assets 2014: $1,440,583Liabilities 2014: $2,452,343Net Assets 2014: -$1,011,7602014Assets 2015: $1,325,143Liabilities 2015: $2,012,798Net Assets 2015: -$687,6552015Assets 2016: $1,439,656Liabilities 2016: $2,592,110Net Assets 2016: -$1,152,4542016Assets 2017: $1,326,090Liabilities 2017: $3,175,936Net Assets 2017: -$1,849,8462017Assets 2018: $95,090Liabilities 2018: $810,494Net Assets 2018: -$715,4042018Assets 2019: $0Liabilities 2019: $0Net Assets 2019: $02019

Highlighted filing

2016

Assets$1,439,656
Liabilities$2,592,110
Net Assets-$1,152,454
Open 2016 Filing

Operations Trend

Revenue Growth50th percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$30M$20M$10M$0-$10MExpenses 2011: $13,994,3252011Expenses 2012: $16,627,9622012Revenue 2013: $16,968,960Expenses 2013: $17,278,122Net Income 2013: -$309,1622013Revenue 2014: $19,798,034Expenses 2014: $20,906,431Net Income 2014: -$1,108,3972014Revenue 2015: $20,693,555Expenses 2015: $20,369,450Net Income 2015: $324,1052015Revenue 2016: $21,586,333Expenses 2016: $22,170,753Net Income 2016: -$584,4202016Revenue 2017: $19,310,535Expenses 2017: $20,007,927Net Income 2017: -$697,3922017Revenue 2018: $3,312,951Expenses 2018: $2,178,509Net Income 2018: $1,134,4422018Revenue 2019: $766,485Expenses 2019: $51,081Net Income 2019: $715,4042019

Highlighted filing

2016

Revenue$21,586,333
Expenses$22,170,753
Net Income-$584,420
Open 2016 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 15, 2016
Return Version
2016v3.0
Gross Receipts
$21,586,333
Mission and Program Overview

Mission

The plan operates to provide health and dental benefits to members.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments-$684,301-
Accounts Receivable$1,170,121$630,040▼ $540,081
Prepaid Expenses and Deferred Charges$152,773$125,315▼ $27,458
Cap Stk Tr Prin Current Funds$-568,034$-1,152,454▼ $584,420
Total Assets$1,322,894$1,439,656▲ $116,762
Liabilities
Accounts Payable and Accrued Expenses$1,890,928$2,592,110▲ $701,182
Total Liabilities$1,890,928$2,592,110▲ $701,182
Net Assets / Fund Balance
Total Net Assets Fund Balance$-568,034$-1,152,454▼ $584,420
Total Liabilities and Net Assets / Fund Balance$1,322,894$1,439,656▲ $116,762
Compensation and Service Providers
Top Officer Pay46th percentile

Board Members and Trustees

NameTitle
Stephen ShonkaChairman
David BakerMember
Steven a ChelesnikMember
Surendralal KarsanbhaiMember
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$21,586,173
Investment Income
$160
Other Revenue
$0
Change in Net Assets
$-584,420

Audited Revenue Reconciliation

Revenue per Audited Statements
$21,586,333
Total Revenue per Audited Statements
$21,586,333
Total Revenue per Form 990
$21,586,333
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$1,182,333
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members$20,988,420--$20,988,420
Fees for Services Management$1,182,333--$1,182,333
Total Functional Expenses$22,170,753$0$0$22,170,753

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$22,170,753
Total Expenses per Audited Statements$22,170,753
Total Expenses per Form 990$22,170,753
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
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, Page 6, Part VI, Line 11B

“Form 990 is reviewed and approved by brian harstad who is vice president and controller of the plan administrator.”

Form 990, Page 6, Part VI, Line 12C

“Applicable policies are corporate policies of the plan administrator enforceable by that entity. Line 15: no officers or directors of the plan are compensated by the plan but are compensated by the plan administrator.”

Form 990, Page 6, Part VI, Line 19

“The governing documents of the plan, conflict of interest policy, financial statements, and other policies, rules and regulations governing the plan are available upon request from the plan administrator.”

Filing and Contact Details

Filer

Filer Name
Rosemount Inc Basic Health
EIN
41-1312839
Phone
9529497839
Address
8200 MARKET BLVD, CHANHASSEN, MN 55317

Signing Officer

Name
Michelle Carlson
Title
Signature Officer
Phone
9529497839
Signed
2016-11-15
Discuss with paid preparer
Yes

Organization Details

Formed
1958
Legal Domicile
Mn
Voting Board Members
4
Independent Board Members
0
Employees
0

Preparer

Firm
Hamilton Juffer & Associates Llp
Address
666 GRAND AVE STE 2400, DES MOINES, IA 50309-2506
Preparer
Holly Larson
Phone
5152453737
Supplemental Narrative

Additional Explanations

Form 990

“Form 990, part ix - benefits paid to or for members claims paid to participants 20,092,118 premiums paid to insurance carrier 896,302 totals 20,988,420”

Raw XML Appendix289 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.

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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0FORM 990, PART IX - BENEFITS PAID TO OR FOR MEMBERS CLAIMS PAID TO PARTICIPANTS 20,092,118 PREMIUMS PAID TO INSURANCE CARRIER 896,302 TOTALS 20,988,420
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1FORM 990 IS REVIEWED AND APPROVED BY BRIAN HARSTAD WHO IS VICE PRESIDENT AND CONTROLLER OF THE PLAN ADMINISTRATOR.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2APPLICABLE POLICIES ARE CORPORATE POLICIES OF THE PLAN ADMINISTRATOR ENFORCEABLE BY THAT ENTITY. LINE 15: NO OFFICERS OR DIRECTORS OF THE PLAN ARE COMPENSATED BY THE PLAN BUT ARE COMPENSATED BY THE PLAN ADMINISTRATOR.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE GOVERNING DOCUMENTS OF THE PLAN, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER POLICIES, RULES AND REGULATIONS GOVERNING THE PLAN ARE AVAILABLE UPON REQUEST FROM THE PLAN ADMINISTRATOR.
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IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 11B
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ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0203626340
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0HAMILTON JUFFER & ASSOCIATES LLP
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0666 GRAND AVE STE 2400
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0DES MOINES
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0IA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0503092506
ReturnHeader/PreparerPersonGrp/PhoneNum05152453737
ReturnHeader/PreparerPersonGrp/PreparationDt02017-11-15
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0HOLLY LARSON
ReturnHeader/ReturnTs02017-11-15T13:36:30-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02016-01-01
ReturnHeader/TaxPeriodEndDt02016-12-31
ReturnHeader/TaxYr02016

Document Assets

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Filings

Displayed year

2016 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$1,439,656
Liabilities
$2,592,110
Net assets
-$1,152,454
Revenue
$21,586,333
Expenses
$22,170,753
Net income
-$584,420
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2019Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.77$0.05$0.72
2018Detailed filing. Detailed filing data is available for this year.$0.10$0.81$0.72$3.31$2.18$1.13
2017Detailed filing. Detailed filing data is available for this year.$1.33$3.18$1.85$19.3$20.0$0.70
2016Detailed filing. Detailed filing data is available for this year.$1.44$2.59$1.15$21.6$22.2$0.58
2015Summary only. Only limited summary data is available for this year.$1.33$2.01$0.69$20.7$20.4$0.32
2014Detailed filing. Detailed filing data is available for this year.$1.44$2.45$1.01$19.8$20.9$1.11
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.43$1.33$0.10$17.0$17.3$0.31
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.70$1.30$0.41$16.6
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.88$1.58$0.71$14.0