PLAN A HEALTH CARE PLAN TR: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PLAN A HEALTH CARE PLAN TR (EIN 36-7742028)
- Tax period
- 2022-11-01 to 2023-10-31
- Filed
- 2024-09-05
- IRS object ID
- 202422499349300237
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-09-05T10:16:39-05:00 | ReturnTs |
| Tax Period End | 2023-10-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 S PATTERSON BLVD | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-11-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 367742028 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLAN A HEALTH CARE PLAN TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PLAN | BusinessNameControlTxt |
| Phone | 3093431550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 285 S FARNHAM ST | AddressLine1Txt |
| City | GALESBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD WILSON | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 3093431550 | PhoneNum |
| Signature | 2024-08-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAREN O CRIM | PreparerPersonNm |
| PTIN | P00368385 | PTIN |
| Phone | 9372980201 | PhoneNum |
| Preparation | 2024-08-26 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RONALD WILSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 285 S FARNHAM ST | AddressLine1Txt |
| City | GALESBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,720,479 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 2019 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL, SHORT-TERM DISABILITY & DEATH BENEFITS FOR ELIGIBLE EMPLOYEES & DEPENDENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,788,284 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,674,736 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,833 | PYInvestmentIncomeAmt |
| CY Investment Income | $45,743 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,793,117 | PYTotalRevenueAmt |
| CY Total Revenue | $7,720,479 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $6,913,138 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $8,443,311 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,470,746 | PYOtherExpensesAmt |
| CY Other Expenses | $1,508,270 | CYOtherExpensesAmt |
| PY Total Expenses | $8,383,884 | PYTotalExpensesAmt |
| CY Total Expenses | $9,951,581 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$590,767 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,231,102 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,134,120 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,738,825 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,083,158 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,905,063 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,050,962 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $833,762 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE PLAN IS A SELF-INSURED BENEFIT PROGRAM FUNDED BY THE EMPLOYERS AND PARTICIPANTS WITHIN THE PLAN. PARTICIPANTS IN THE PLAN ARE CURRENT AND FORMER EMPLOYEES OF THE FOLLOWING SPONSORS: COMMUNITY LIVING OPTIONS, INC., FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., ACHIEVEMENT UNLIMITED, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., AND DESERT HEALTH CARE FACILITIES, INC. PLAN ASSETS ARE HELD IN A VOLUNTARY EMPLOYEES' BENEFIT ASSOCIATION (VEBA) TRUST. THE PLAN IS SUBJECT TO THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA), AS AMENDED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | THE PURPOSE OF THE PLAN IS TO PROVIDE MEDICAL, SHORT-TERM DISABILITY, AND DEATH BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS THAT VOLUNTARILY ELECT TO PARTICIPATE IN THE PLAN. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | 0 | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RON WILSON RFMS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3093431550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 285 SOUTH FARNHAM | AddressLine1Txt |
| City | GALESBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (2 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| RONALD WILSON | |||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 |
| BRIAN BURGER | |||||
| TRUSTEE AS OF 7/24/23 | 1.00 | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MUTUAL MEDICAL PLANS INC | |||||
| 416 MAIN STREET SUITE 1025 | PEORIA | IL | 61602 | ADMINISTRATIVE SERVICES | $411,840 |
| RSM US LLP | |||||
| 401 MAIN STREET SUITE 1200 | PEORIA | IL | 61602 | ACCOUNTING SERVICES | $126,395 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PLAN CONTRIBUTIONS | Desc |
| Business | 900001 | BusinessCd |
| Total Revenue Column | $7,674,736 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,674,736 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,674,736 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,743 | TotalRevenueColumnAmt |
| Exclusion | $45,743 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,720,479 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,674,736 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $45,743 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,443,311 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,296 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,950 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $945,485 | TotalAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt |
|---|---|
| ADMINISTRATIVE EXPENSES | $431,402 |
| FEDERAL EXCISE TAX | $4,137 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,951,581 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $696,815 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,575 | BOYAmt |
| EOY | $1,503,627 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,697 | BOYAmt |
| EOY | $237,381 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,497 | BOYAmt |
| EOY | $301,002 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,688,351 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,134,120 | BOYAmt |
| EOY | $2,738,825 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,308 | BOYAmt |
| EOY | $3,750 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,055,850 | BOYAmt |
| EOY | $1,901,313 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,083,158 | BOYAmt |
| EOY | $1,905,063 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,050,962 | BOYAmt |
| EOY | $833,762 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,050,962 | BOYAmt |
| EOY | $833,762 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,134,120 | BOYAmt |
| EOY | $2,738,825 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,231,102 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,838 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $18,740 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFITS PAYABLE | Desc |
| Amt | $1,901,313 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,901,313 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,734,381 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$4,838 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $18,740 | OtherRevenueAmt |
| Revenue Not Reported | $13,902 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,720,479 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,720,479 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,106,118 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,106,118 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $845,463 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $845,463 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,951,581 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION. MANAGEMENT HAS EVALUATED THE PLAN'S TAX POSITIONS AND CONCLUDED THAT THE PLAN HAS MAINTAINED ITS TAX EXEMPT STATUS AND HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | TRANSFER OF ASSETS FROM RFMS MEDICAL BENEFIT PLAN TRUST (EIN: 36-7042729) 18,740. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INCREASES IN ESTIMATED OBLIGATIONS FOR CLAIMS INCURRED BUT NOT REPORTED 845,463. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY LIVING OPTIONS INC (CLO) | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CLO, INC. IS THE SPONSOR OF PLAN A HEALTH CARE PLAN TRUST. | RelationshipDescriptionTxt |
| Transaction | $749,699 | TransactionAmt |
| Transaction | PREMIUMS WERE PAID BY COMMUNITY LIVING OPTIONS, INC. IN THE AMOUNT OF $749,699 TO THE PLAN A HEALTH CARE PLAN TRUST FOR THE FISCAL YEAR ENDING OCTOBER 31, 2023. THE PREMIUM AMOUNT FOR COMMUNITY LIVING OPTIONS, INC. PARTICIPANTS IS THE SAME AS THAT CHARGED TO ALL OTHER PARTICIPANTS IN THE PLAN. COMMUNITY LIVING OPTIONS, INC. RECEIVES NO MONEY FROM THE PLAN A HEALTH CARE PLAN TRUST. RONALD WILSON, THE TRUSTEE OF THE PLAN A HEALTH CARE PLAN TRUST IS THE CHIEF FINANCIAL OFFICER OF COMMUNITY LIVING OPTIONS, INC. THE PLAN A HEALTH CARE PLAN TRUST TRUST PAYS NO COMPENSATION TO THE TRUSTEE OR TO COMMUNITY LIVING OPTIONS, INC. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: | THE THIRD PARTY ADMINISTRATOR FOR THE PLAN A HEALTH CARE PLAN TRUST FILES JOINT FORMS 1099 FOR ALL PLANS UNDER THEIR ADMINISTRATION. |
| FORM 990, PART VI, SECTION A, LINE 8A | THE NATURE OF THE ENTITY DOES NOT REQUIRE REGULARLY SCHEDULED AND STRUCTURED MEETINGS WITH THE TRUSTEES. THE PURPOSE OF THE ENTITY IS TO ACT AS A CONDUIT FOR MEDICAL BENEFIT PREMIUMS TO BE USED FOR PAYMENT OF MEDICAL CLAIMS OF THE PARTICIPANTS. THE TRUSTEES OVERSEE THE RECEIPT OF PREMIUMS AND THE PAYMENT OF BENEFITS AS REQUIRED, AND ALSO MAKE CERTAIN THAT THE THIRD PARTY ADMINISTRATOR FULFILLS ITS RESPONSIBILITIES. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE NATURE OF THE ENTITY DOES NOT REQUIRE REGULARLY SCHEDULED AND STRUCTURED MEETINGS WITH THE TRUSTEES. THE PURPOSE OF THE ENTITY IS TO ACT AS A CONDUIT FOR MEDICAL BENEFIT PREMIUMS TO BE USED FOR PAYMENT OF MEDICAL CLAIMS OF THE PARTICIPANTS. THE TRUSTEES OVERSEE THE RECEIPT OF PREMIUMS AND THE PAYMENT OF BENEFITS AS REQUIRED, AND ALSO MAKE CERTAIN THAT THE THIRD PARTY ADMINISTRATOR FULFILLS ITS RESPONSIBILITIES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE TRUSTEES RECEIVE A PAPER COPY OF FORM 990 FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING. |
| FORM 990, PART VI, SECTION C, LINE 18 | A COPY OF THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D). |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXCEPT TO COMPLY WITH THE PUBLIC DISCLOSURE REQUIREMENTS. |
| FORM 990, PART VI, SECTION B, LINE 12A: | A CONFLICT OF INTEREST POLICY IS NOT REQUIRED FOR THIS ENTITY. THE TRUSTEES RECEIVE NO PAYMENTS OR COMPENSATION FROM THE PLAN A HEALTH CARE PLAN TRUST. THE TRUSTEES ARE EMPLOYED BY RFMS, INC., AN UNRELATED ORGANIZATION, AND RFMS, INC., PROVIDES ADMINISTRATIVE SERVICES TO THE PLAN FREE OF CHARGE. |
| FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B: | THE TRUSTEES DEVOTE A PORTION OF THE AVERAGE HOURS PER WEEK TO THE RELATED ORGANIZATIONS LISTED ON SCHEDULE R. HOWEVER, THE ACTUAL HOURS ATTRIBUTABLE TO THESE RELATED ORGANIZATIONS ARE NOT SPECIFICALLY TRACKED. THE HOURS REPORTED IN COLUMN B ARE A REASONABLE ESTIMATE, AND THE TRUSTEES NORMALLY DEVOTE LESS THAN ONE HOUR PER WEEK TO THE PLAN A HEALTH CARE PLAN TRUST. |
| FORM 990, PART VIII, LINE 3 AND PART V, LINE 3A: | THE ORGANIZATION IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX ON INVESTMENT INCOME UNDER SECTION 512(A)(3)(E)(III). SUBSTANTIALLY ALL OF THE CONTRIBUTIONS TO THE PLAN A HEALTH CARE PLAN TRUST ARE MADE BY EMPLOYERS WHO WERE EXEMPT FROM TAX THROUGHOUT THE 5-TAXABLE-YEAR PERIOD ENDING WITH THE TAXABLE YEAR IN WHICH THE CONTRIBUTIONS ARE MADE. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF ASSETS FROM RFMS MEDICAL BENEFIT PLAN TRUST (EIN: 36-7042729) 18,740. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT IS THAT THE TWO TRUSTEES MAKE ARRANGEMENTS FOR THE AUDIT, HOWEVER THE ORGANIZATION DOES NOT HAVE A SEPERATE AUDIT COMMITTEE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY LIVING OPTIONS INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 371079626 | OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED | 501(C)(3) | LINE 10 | N/A | 0 | |
| RESIDENTIAL ALTERNATIVES OF ILLINOIS INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 371223846 | OPERATES ELDERLY SKILLED NURSING, ASSISTED/INDEPENDENT LIVING FACILITIES | 501(C)(3) | LINE 10 | 0 | FRANCES HOUSE INC | |
| UNLIMITED DEVELOPMENT INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 364094409 | OPERATES ELDERLY SKILLED NURSING, ASSISTED/INDEPENDENT LIVING FACILITIES | 501(C)(3) | LINE 10 | N/A | 0 | |
| FRANCES HOUSE INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 371087901 | OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED | 501(C)(3) | LINE 10 | N/A | 0 | |
| ACHIEVEMENT UNLIMITED INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 364143598 | OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED | 501(C)(3) | LINE 10 | N/A | 0 | |
| PINNACLE OPPORTUNITIES INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 364143605 | OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED | 501(C)(3) | LINE 10 | 0 | FRANCES HOUSE INC | |
| PIONEER CONCEPTS INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 364143602 | OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED | 501(C)(3) | LINE 10 | 0 | FRANCES HOUSE INC | |
| DESERT HEALTH CARE FACILITIES INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 371138846 | OPERATES ELDERLY SKILLED NURSING, ASSISTED/INDEPENDENT LIVING FACILITIES | 501(C)(3) | LINE 10 | N/A | 0 | |
| FLORIDA LIVING OPTIONS INC | ||||||||||
| 285 S FARNHAM ST | GALESBURG | IL | 61401 | 364467489 | OPERATES ELDERLY SKILLED NURSING, ASSISTED/INDEPENDENT LIVING FACILITIES | 501(C)(3) | LINE 10 | N/A | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART IV: | FormAndLineReferenceDesc |