Medica Community Health Plan
Public records raise at least one point you should look into before giving.
What it says it does
TO BE THE TRUSTED HEALTH PLAN OF CHOICE FOR CUSTOMERS, MEMBERS, PARTNERS AND OUR EMPLOYEES.
- Income
- $134.5 million
- Spending
- $150.2 million
- Employees
- 0
- Volunteers
- 0
- Highest pay
- $1.9 million, president, ceo, & treas thru 1/2024
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. How we rate
Financial health
We do not score finances when yearly spending is very small or the return has too little detail. The ratios stop meaning much at that size.
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. How we rate
Governance
This return does not answer enough of the governance questions to score.
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. How we rate
Impact evidence
Describes programs. Its tax return describes what it does but we have found no measurable results in it.
Programs described in its return (1)
- $137.4 million spent. MEDICA COMMUNITY HEALTH PLAN (THE COMPANY) IS ORGANIZED AND SHALL BE OPERATED FOR THE PROMOTION OF SOCIAL WELFARE, INCLUDING THE OPERATION OF A HEALTH INSURANCE ORGANIZATION AND OTHER ACTIVITIES INCIDENTAL THERETO. IT IS A WHOLLY OWNED SUBSIDIARY OF MEDICA HOLDING COMPANY (MHC) WHICH IS A NON-PROFIT, TAX EXEMPT CORPORATION. THE COMPANY IS TAX-EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. THE COMPANY OFFERS COMPREHENSIVE HEALTH CARE COVERAGE; PRODUCTS ARE QUALIFIED HEALTH PLANS (QHPS). QHPS ARE DEFINED BY THE AFFORDABLE CARE ACT (ACA) AND FALL WITHIN THE METAL LEVELS GOLD, SILVER AND BRONZE, AS WELL AS CATASTROPHIC FOR THOSE UNDER AGE 30 OR THOSE WITH A HARDSHIP (AS DEEMED BY THE EXCHANGE). ADDITIONALLY, THE PRODUCTS FOLLOW THE RESPECTIVE ESSENTIAL HEALTH BENEFITS (EHBS), ABOVE AND BEYOND THOSE REQUIRED OF QHPS BY THE ACA, AS DETERMINED BY THE BENCHMARK/DEFAULT PLAN (AS DEFINED BY ACA) FOR WISCONSIN AND ARIZONA. THE QHP PRODUCT, ESSENTIA CHOICE CARE WITH MEDICA, IS AVAILABLE IN WESTERN WISCONSIN, NORTHERN MINNESOTA, AND EASTERN NORTH DAKOTA. THE ESSENTIA CHOICE CARE PRODUCT FEATURES ACCESS TO ESSENTIA HEALTH DOCTORS PLUS OTHERS WITH OVER 3,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, ENGAGE BY MEDICA, IS AVAILABLE IN WESTERN WISCONSIN AND SOUTHEASTERN MINNESOTA. THE ENGAGE BY MEDICA PRODUCT FEATURES ACCESS TO MAYO CLINIC HEALTH SYSTEM DOCTORS PLUS OTHERS IN NORTHERN IOWA, SOUTHERN MINNESOTA, AND WESTERN WISCONSIN, WITH OVER 12,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, MEDICA PINNACLE, IS AVAILABLE IN MARICOPA COUNTY, ARIZONA. THE MEDICA PINNACLE PRODUCT FEATURES ACCESS TO ARIZONA CARE NETWORK, DIGNITY HEALTH, AND PHOENIX CHILDREN'S, WITH OVER 4,400 PRIMARY AND SPECIALTY CARE PROVIDERS. THE COMPANY CONTRACTS WITH PROVIDERS IN WISCONSIN, MINNESOTA, SOUTH DAKOTA, NORTH DAKOTA, NEBRASKA AND IOWA TO MAKE HEALTH CARE SERVICES AVAILABLE TO ITS ENROLLEES. THE PROVIDER CONTRACTS INCLUDE HOLD-HARMLESS PROVISIONS FOR THE PROTECTION OF POLICYHOLDERS. THE CONTRACTS HAVE A ONE- OR TWO-YEAR TERM AND MAY BE TERMINATED IMMEDIATELY FOR BREACH OF CONTRACT IF THE PROVIDER LOSES HIS/HER LICENSE TO PROVIDE CONTRACTED SERVICES. HOSPITALS ARE REIMBURSED USING A VARIETY OF METHODS INCLUDING FEE-FOR-SERVICE (FFS), DISCOUNTED FFS, PER DIEM, PER CASE AND/OR PER STAY BASIS. THE COMPANY CURRENTLY MARKETS DIRECTLY TO INDIVIDUALS, USING INDEPENDENT AGENCIES, PAYING A FLAT DOLLAR COMMISSION ON NEW AND RENEWAL BUSINESS. THE COMPANY ALSO MARKETS POLICIES DIRECTLY ONLINE AND OVER THE PHONE. DURING 2020, THE COMPANY STARTED OFFERING MEDICARE ADVANTAGE PRODUCTS IN NEBRASKA. DURING 2023, MEDICARE ADVANTAGE ENROLLMENT WAS 782 MEMBERS, OR 5.4% OF MCHP'S TOTAL ENROLLMENT. IN 2024, MCHP NO LONGER OFFERED MEDICARE ADVANTAGE PRODUCTS.
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. How we rate
Legitimacy checks
Is it registered with the IRS? Passed.
Listed in the IRS master file of tax-exempt organizations as a 501(c)(4) social welfare organization.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated October 13, 2026.
Has the IRS revoked its tax-exempt status? Passed.
Not on the IRS automatic revocation list.
Source: Automatic revocation of exemption list, Internal Revenue Service, file dated November 6, 2026.
Are donations tax-deductible? Caution.
The IRS master file records contributions to this 501(c)(4) social welfare organization as not deductible.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated October 13, 2026.
Is it keeping up with its IRS filings? Passed.
Most recent return on file covers the year ending December 2024.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated October 13, 2026.
How long has it been tax-exempt? Passed.
Recognized by the IRS since March 2000.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated October 13, 2026.
Is it in good standing with state regulators? Passed.
Not on California's list of charities barred from soliciting. Other states are not yet checked.
Source: May Not Operate or Solicit for Charitable Purposes list, California Attorney General, Registry of Charities and Fundraisers, file dated November 4, 2026.
Ratings and checks are our reading of public records, using the published method. They are not a statement about anyone's honesty. If you work for this organization, you can send corrections or results, confirm you want gifts through Veridonate, or ask to be removed from giving.