ASSOCIATED HEALTH ASSURANCE LTD
3300 OAKDALE AVENUE NORTH, ROBBINSDALE, MN 55422 www.northmemorial.com

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Organizations Filed Purposes: ASSOCIATED HEALTH ASSURANCE, LTD IS A CAPTIVE INSURANCE COMPANY WHICH PROVIDES PROFESSIONAL LIABILITY INSURANCE AND WORKER'S COMPENSATION REIMBURSEMENT COVERAGE SOLELY FOR NORTH MEMORIAL HEALTH CARE, THE TAX EXEMPT PARENT COMPANY.

PROVIDED HOSPITAL PROFESSIONAL LIABILITY (NON-PHYSICIAN) INSURANCE POLICY, ON A FIRST DOLLAR BASIS, EXCLUSIVELY TO NORTH MEMORIAL HEALTH CARE. SPECIFIC COVERAGE PROVIDED: $2MM EACH CLAIM, $4MM IN THE AGGREGATE ON A CLAIMS-MADE BASIS, WITH A RETROACTIVE DATE OF 3-1-1976. 4 NEW PROFESSIONAL LIABILITY CLAIMS WERE MADE DURING THE YEAR, ALL 4 REMAINED OPEN AS OF YEAR-END. $180,131 WAS PAID ON NEW CLAIMS DURING THE YEAR, WHILE $705,080 WAS PAID ON CLAIMS FROM PRIOR POLICY YEARS.

PROVIDED WORKERS COMPENSATION AND EMPLOYERS LIABILITY DEDUCTIBLE INSURANCE POLICY THAT COVERED NORTH MEMORIAL HEALTH CARE'S $750,000 PER CLAIM DEDUCTIBLE WITH RESPECT TO ITS WORKER'S COMPENSATION INSURANCE POLICY THAT IS CARRIED BY A DIFFERENT THIRD-PARTY INSURANCE COMPANY ($12.7MM IN ANNUAL AGGREGATE). NORTH MEMORIAL HEALTH CARE MAKES MONTHLY WORKERS' COMPENSATION PAYMENTS TO ITS INSURANCE PROVIDER THEN SUBMITS A CLAIM FOR REIMBURSEMENT FROM ASSOCIATED HEALTH ASSURANCE FOR ITS INSURED DEDUCTIBLE. 126 NEW WORKERS' COMPENSATION INDEMNITY CLAIMS WERE MADE DURING THE YEAR, IN ADDITION TO 286 MEDICAL ONLY CLAIMS. $1,029,097 WAS PAID ON NEW CLAIMS DURING THE YEAR, WHILE $1,647,153 WAS PAID ON CLAIMS FROM PRIOR POLICY YEARS.

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