MEDICA CENTRAL HEALTH PLAN: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MEDICA CENTRAL HEALTH PLAN (EIN 83-1979548)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202213189349306556
- Schema version
- 2021v4.2
- 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 | 2022-11-14T11:05:31-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CTR 90 S 7TH | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 831979548 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SSM HEALTH PLAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SSMH | BusinessNameControlTxt |
| Phone | 3149947800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 WOODFIELD LANE | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDY RUPLINGER | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3149947800 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RANDY | PersonFirstNm |
| Person Last | RUPLINGER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MONROE J GIERL | PreparerPersonNm |
| PTIN | P01413237 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLFIRST HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID DOCHERTY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 WOODFIELD LANE | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,135,845 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.SSMHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O.TO OPERATE A HEALTH MAINTENANCE ORGANIZATION (HMO) TO SERVE PRIMARILY MEDICAID AND MEDICARE ADVANTAGE BENEFICIARIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 5 | 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 | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,174,081 | CYProgramServiceRevenueAmt |
| PY Investment Income | $14,964 | PYInvestmentIncomeAmt |
| CY Investment Income | -$38,236 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $14,964 | PYTotalRevenueAmt |
| CY Total Revenue | $9,135,845 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,714,973 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,679,155 | PYOtherExpensesAmt |
| CY Other Expenses | $11,049,804 | CYOtherExpensesAmt |
| PY Total Expenses | $11,679,155 | PYTotalExpensesAmt |
| CY Total Expenses | $15,764,777 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$11,664,191 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$6,628,932 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,906,016 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,646,843 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,600,245 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,507,890 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,305,771 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,138,953 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THROUGH OUR EXCEPTIONAL HEAL TH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,117,348 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $9,174,081 | RevenueAmt |
| Desc | SSM HEALTH PLAN WILL OPERATE A HEALTH MAINTENANCE ORGANIZATION(HMO) THAT WILL FOCUS ITS ACTIVITIES PRIMARILY ON SERVING MEDICARE ADVANTAGE BENEFICIARIES, SUBJECT TO REGULATORY APPROVALS. | Desc |
| Total Program Service Expenses | $10,117,348 | TotalProgramServiceExpensesAmt |
| 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| 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 | 0 | 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 |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | 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 | DEAN SUTTON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6088274301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1277 DEMING WAY | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53717 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| MARK BAIRD | ||||||||
| SVP AND CFO | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $1,288,249 | $46,819 | |
| RANDY COMBS | ||||||||
| CFO AT SSM HEALTH | 1.00 | 40.00 | Yes (X) | $0 | $1,290,602 | $485,852 | ||
| RICK CORCORAN | ||||||||
| DIRECTOR THRU NOV 2021 | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID DOCHERTY | ||||||||
| DIR, PRES AT HEALTH PLANS | 10.00 | 30.00 | Yes (X) | Yes (X) | $0 | $527,114 | $216,954 | |
| DAVID ELLENBOGEN | ||||||||
| SVP SEC & GENERAL COUNSEL | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $683,704 | $90,914 | |
| MATT HANLEY | ||||||||
| CCO, SSM HEALTH THRU NOV 2021 | 1.00 | 40.00 | Yes (X) | $0 | $1,200,046 | $718,286 | ||
| DON IMHOLZ | ||||||||
| DIRECTOR THRU NOV 2021 | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CANDACE JENNINGS | ||||||||
| REGIONAL PRES, THRU JUNE 2021 | 1.00 | 40.00 | Yes (X) | $0 | $768,695 | $18,648 | ||
| TIM JOHNSON | ||||||||
| VP-MEDICAL GROUP OPERATIONS | 1.00 | 40.00 | Yes (X) | $0 | $592,955 | $252,062 | ||
| MATT KINSELLA | ||||||||
| REGIONAL VP FINANCE-WISCONSIN | 1.00 | 40.00 | Yes (X) | $0 | $413,770 | $176,323 | ||
| DOUGLAS LONG | ||||||||
| GEN COUNSEL, THRU NOV 2021 | 1.00 | 40.00 | Yes (X) | $0 | $1,201,678 | $483,601 | ||
| LES MCPHEARSON | ||||||||
| PRESIDENT, DHP (THRU NOV 2021) | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $793,963 | $161,387 | |
| JOHN NAYLOR | ||||||||
| PRESIDENT & CEO AT MEDICA | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $2,863,360 | $43,901 | |
| JOHN PHELAN | ||||||||
| DIRECTOR THRU NOV 2021 | 1.00 | 0.00 | Yes (X) | $0 | $690,483 | $35,384 | ||
| MARY QUIST | ||||||||
| SVP FIN & CORP CONTROLLER | 1.00 | 40.00 | Yes (X) | $0 | $694,530 | $51,694 | ||
| KAREN REWERTS | ||||||||
| VP-FINANCIAL OPERATIONS | 1.00 | 50.00 | Yes (X) | $0 | $736,547 | $251,796 | ||
| EVANS RICHARDSON | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JEREMY FOTHERINGHAM | ||||||||
| DIRECTOR THRU NOV 2021 | 1.00 | 40.00 | Yes (X) | $0 | $758,769 | $418,183 | ||
| MINDY PHILLIPS | ||||||||
| DIRECTOR THRU NOV 2021 | 1.00 | 40.00 | Yes (X) | $0 | $378,356 | $143,350 | ||
| RANDY RUPLINGER | ||||||||
| CFO - HEALTH PLANS | 1.00 | 0.00 | Yes (X) | $0 | $509,187 | $212,908 | ||
| DEAN SUTTON | ||||||||
| VP & GEN COUNSEL - HP | 1.00 | 40.00 | Yes (X) | $0 | $288,516 | $52,188 | ||
| KRIS ZIMMER | ||||||||
| FORMER CFO AT SSM HEALTH | 0.00 | 0.00 | $0 | $219,380 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $15,899,904 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,860,250 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PREMIUM REVENUE | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $9,174,081 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,174,081 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,174,081 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$38,236 | TotalRevenueColumnAmt |
| Exclusion | -$38,236 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,135,845 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,174,081 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$38,236 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,370,531 | TotalAmt |
| Management And General | $3,370,531 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $966,359 | TotalAmt |
| Management And General | $966,359 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,083 | TotalAmt |
| Management And General | $378,083 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,842 | TotalAmt |
| Management And General | $6,842 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,078 | TotalAmt |
| Management And General | $6,078 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,895 | TotalAmt |
| Management And General | $3,895 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,334,906 | TotalAmt |
| Program Services | $9,334,906 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $732,086 | TotalAmt |
| Management And General | $732,086 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,099 | TotalAmt |
| Program Services | $74,099 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,594 | TotalAmt |
| Program Services | $10,594 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,126 | TotalAmt |
| Program Services | $34,126 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,356 | TotalAmt |
| Program Services | $8,356 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451 | TotalAmt |
| Program Services | $451 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,029 | TotalAmt |
| Program Services | $197,029 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,746 | TotalAmt |
| Program Services | $1,746 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER EXPENSES | $526,613 | $343,058 | $183,555 |
| BOOKS/SUBSCRIPTIONS | $47,487 | $47,487 | |
| LICENSES | $45,577 | $45,577 | |
| TAXES | $19,919 | $19,919 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,764,777 | TotalAmt |
| Program Services | $10,117,348 | ProgramServicesAmt |
| Management And General | $5,647,429 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,961,043 | BOYAmt |
| EOY | $5,801,789 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $939,929 | BOYAmt |
| EOY | $939,909 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,044 | BOYAmt |
| EOY | $1,905,145 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,906,016 | BOYAmt |
| EOY | $8,646,843 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,506,597 | BOYAmt |
| EOY | $1,828,422 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,705 | BOYAmt |
| EOY | $92,132 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,943 | BOYAmt |
| EOY | $587,336 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,600,245 | BOYAmt |
| EOY | $2,507,890 | 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 | $5,305,771 | BOYAmt |
| EOY | $6,138,953 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,305,771 | BOYAmt |
| EOY | $6,138,953 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,906,016 | BOYAmt |
| EOY | $8,646,843 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$6,628,932 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $9 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $7,462,105 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ACCRUED INVESTMENT INCOME | $704 |
| PREMIUMS IN THE COURSE OF COLLECTIONS | $59,527 |
| RECEIVABLES FROM AFFILIATES | $1,844,914 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,905,145 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $510,195 |
| OTHER ACCRUED EXPENSES | $69,772 |
| UNINSURED PLANS LIABILITY | $7,369 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $587,336 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SSM HEALTH PLAN'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). SSMH EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2021 OR 2020. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN NAYLOR | ||||||||||||||
| PRESIDENT & CEO AT MEDICA | $0 | $1,043,892 | $0 | $1,597,510 | $0 | $221,958 | $0 | $20,012 | $0 | $23,889 | $0 | $2,907,261 | $0 | $0 |
| MATT HANLEY | ||||||||||||||
| CCO, SSM HEALTH THRU NOV 2021 | $0 | $767,127 | $0 | $426,143 | $0 | $6,776 | $0 | $681,835 | $0 | $36,451 | $0 | $1,918,332 | $0 | $426,143 |
| RANDY COMBS | ||||||||||||||
| CFO AT SSM HEALTH | $0 | $940,014 | $0 | $182,693 | $0 | $167,895 | $0 | $478,907 | $0 | $6,945 | $0 | $1,776,454 | $0 | $82,693 |
| DOUGLAS LONG | ||||||||||||||
| GEN COUNSEL, THRU NOV 2021 | $0 | $683,805 | $0 | $374,673 | $0 | $143,200 | $0 | $460,492 | $0 | $23,109 | $0 | $1,685,279 | $0 | $374,673 |
| MARK BAIRD | ||||||||||||||
| SVP AND CFO | $0 | $489,477 | $0 | $693,738 | $0 | $105,034 | $0 | $22,275 | $0 | $24,544 | $0 | $1,335,068 | $0 | $0 |
| JEREMY FOTHERINGHAM | ||||||||||||||
| DIRECTOR THRU NOV 2021 | $0 | $624,103 | $0 | $50,000 | $0 | $84,666 | $0 | $382,896 | $0 | $35,287 | $0 | $1,176,952 | $0 | $0 |
| KAREN REWERTS | ||||||||||||||
| VP-FINANCIAL OPERATIONS | $0 | $572,568 | $0 | $96,173 | $0 | $67,806 | $0 | $219,658 | $0 | $32,138 | $0 | $988,343 | $0 | $159,077 |
| LES MCPHEARSON | ||||||||||||||
| PRESIDENT, DHP (THRU NOV 2021) | $0 | $561,978 | $0 | $227,271 | $0 | $4,714 | $0 | $117,496 | $0 | $43,891 | $0 | $955,350 | $0 | $85,185 |
| TIM JOHNSON | ||||||||||||||
| VP-MEDICAL GROUP OPERATIONS | $0 | $499,194 | $0 | $92,051 | $0 | $1,710 | $0 | $216,780 | $0 | $35,282 | $0 | $845,017 | $0 | $92,051 |
| CANDACE JENNINGS | ||||||||||||||
| REGIONAL PRES, THRU JUNE 2021 | $0 | $354,947 | $0 | $408,824 | $0 | $4,924 | $0 | $4,685 | $0 | $13,963 | $0 | $787,343 | $0 | $307,508 |
| DAVID ELLENBOGEN | ||||||||||||||
| SVP SEC & GENERAL COUNSEL | $0 | $509,159 | $0 | $120,133 | $0 | $54,412 | $0 | $66,025 | $0 | $24,889 | $0 | $774,618 | $0 | $0 |
| MARY QUIST | ||||||||||||||
| SVP FIN & CORP CONTROLLER | $0 | $327,656 | $0 | $306,704 | $0 | $60,170 | $0 | $22,275 | $0 | $29,419 | $0 | $746,224 | $0 | $0 |
| DAVID DOCHERTY | ||||||||||||||
| DIR, PRES AT HEALTH PLANS | $0 | $303,770 | $0 | $222,155 | $0 | $1,189 | $0 | $176,990 | $0 | $39,964 | $0 | $744,068 | $0 | $112,706 |
| JOHN PHELAN | ||||||||||||||
| DIRECTOR THRU NOV 2021 | $0 | $685,648 | $0 | $0 | $0 | $4,835 | $0 | $8,700 | $0 | $26,684 | $0 | $725,867 | $0 | $0 |
| RANDY RUPLINGER | ||||||||||||||
| CFO - HEALTH PLANS | $0 | $291,047 | $0 | $216,613 | $0 | $1,527 | $0 | $172,380 | $0 | $40,528 | $0 | $722,095 | $0 | $109,107 |
| MATT KINSELLA | ||||||||||||||
| REGIONAL VP FINANCE-WISCONSIN | $0 | $339,271 | $0 | $62,880 | $0 | $11,619 | $0 | $138,111 | $0 | $38,212 | $0 | $590,093 | $0 | $66,793 |
| MINDY PHILLIPS | ||||||||||||||
| DIRECTOR THRU NOV 2021 | $0 | $307,064 | $0 | $51,059 | $0 | $20,233 | $0 | $120,896 | $0 | $22,454 | $0 | $521,706 | $0 | $70,656 |
| DEAN SUTTON | ||||||||||||||
| VP & GEN COUNSEL - HP | $0 | $209,263 | $0 | $78,163 | $0 | $1,090 | $0 | $13,656 | $0 | $38,532 | $0 | $340,704 | $0 | $43,909 |
| KRIS ZIMMER | ||||||||||||||
| FORMER CFO AT SSM HEALTH | $0 | $0 | $0 | $219,008 | $0 | $372 | $0 | $0 | $0 | $0 | $0 | $219,380 | $0 | $372 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | PENSION RESTORATION PLAN: SSM HEALTH (SSMH) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMH QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER THE SSMH QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMH OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMH. NO INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2021. CAPITAL ACCUMULATION PLAN: SSMH PROVIDES THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO EXECUTIVE LEVEL EMPLOYEES. THE ORGANIZATION CONTRIBUTED A PERCENTAGE OF THE EMPLOYEE'S BASE SALARY INTO THEIR CHOICE OF A SELECT LIST OF INVESTMENTS. THE DEPOSITS AND EARNINGS OF THE PLAN ARE OWNED BY SSMH AND ARE TAX-DEFERRED UNTIL A DISTRIBUTION IS MADE TO THE EMPLOYEE. IN ADDITION, THE PLAN HAS SPECIAL SAFEGUARDS IN PLACE TO PROTECT THE FUNDS FROM CONTINGENCIES, OTHER THAN INSOLVENCY. FOR CONTRIBUTIONS MADE TO THE PLAN IN 2014 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF FOUR PLAN YEARS FOR ALL EXECUTIVES THAT ARE STILL ACTIVELY EMPLOYED ON THE DISTRIBUTION DATE. ANY ACTIVE PARTICIPANT 65 YEARS OR OLDER WILL RECEIVE THE CONTRIBUTION IN THE CURRENT YEAR. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DEFERRALS FROM THIS PLAN IN 2021: DAVID DOCHERTY $32,943 MATT HANLEY $150,807 TIM JOHNSON $47,262 MATT KINSELLA $31,550 LES MCPHEARSON $109,131 KAREN REWERTS $52,238 RANDY RUPLINGER $31,959 DEAN SUTTON $10,222 JEREMY FOTHERINGHAM $110,880 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2021. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. MATT KINSELLA $10,849 KAREN REWERTS $59,124 MINDY PHILLIPS $19,506 |
| PART I, LINE 6 | MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO THE ORGANIZATION'S OPERATING EARNINGS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE DECEMBER 1, 2021 SSM HEALTH PLAN'S (THE CORPORATION'S ) BYLAWS WERE AMENDED TO REFLECT MS COMMUNITY NFP JV, LLC AS THE SOLE MEMBER OF THE CORPORATION. THE CORPORATION'S BYLAWS WERE ALSO AMENDED TO REFLECT CHANGES TO CERTAIN POWERS RESERVED FOR AND EXERCISED BY THE MEMBER CONSISTENT WITH THE PROVISIONS OF THE MEMBER'S LIMITED LIABILITY COMPANY AGREEMENT, AND TO REVISE THE TERM LENGTHS AND NUMBER OF DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MS COMMUNITY NFP JV, LLC, A DELAWARE LIMITED LIABILITY COMPANY. BOTH SSM HEALTH PLAN AND MS COMMUNITY NFP JV, LLC ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS MEDICA HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND APPOINT AND REMOVE DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN POWERS WITH RESPECT TO THE CORPORATION ARE RESERVED TO THE MEMBER AND SHALL BE EXERCISED BY THE MEMBER CONSISTENT WITH THE PROVISIONS OF THE MEMBER'S LIMITED LIABILITY COMPANY AGREEMENT. THE MEMBER MAY EXERCISE ANY OF ITS RESERVED POWERS THROUGH AUTHORITY DELEGATED TO THE OFFICERS OR MANAGEMENT OF THE MEMBER OR THE BOARD OR OFFICERS OF THE CORPORATION PURSUANT TO CORPORATE RESOLUTIONS AND POLICIES WHICH MAY BE ADOPTED BY THE MEMBER, PROVIDED THAT THE EXERCISE OF THE RESERVED POWERS REMAINS THE ULTIMATE RESPONSIBILITY OF THE MEMBER. THE POWERS OF THE MEMBER WITH RESPECT TO THE CORPORATION INCLUDE, AMONG OTHER DUTIES, THE POWER TO APPROVE ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS; TO APPOINT AND REMOVE THE DIRECTORS/OFFICERS; TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION; AND TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OR TO ANY OTHER 501(C)(3) EXEMPT ENTITY, WHICH IS CONTROLLED BY THE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF THE MEMBER AS DETERMINED BY THE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | MEDICA'S TAX ADVISORS COMPLETE THE RETURN, MEDICA'S CONTROLLER AND FINANCE DIRECTOR REVIEW THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY OF THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. |
| FORM 990, PART VI, SECTION B, LINE 15 | A RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENT FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,334,906. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,334,906. |
| FORM 990, PART XI, LINE 9: | PAID IN CAPITAL 7,500,000. CHANGE IN NONADMITTED ASSETS -37,895. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (57 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AGNESIAN HEALTHCARE FOUNDATION INC | |||||||||||
| 430 E DIVISION ST | FOND DU LAC | WI | 54935 | 391684956 | FUNDRAISING | WI | 501(C)(3) | 12 | SSM HEALTH C | 0 | |
| AGNESIAN HEALTHCARE INC | |||||||||||
| 430 E DIVISION ST | FOND DU LAC | WI | 54935 | 390807236 | HEALTH CARE | WI | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| AUDRAIN MEDICAL CENTER FOUNDATION INC | |||||||||||
| 620 E MONROE ST | MEXICO | MO | 65265 | 431265060 | FUNDRAISING | MO | 501(C)(3) | 12 | 0 | N/A | |
| CARDINAL GLENNON CHILDREN'S FOUNDATION | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431754347 | FUNDRAISING | MO | 501(C)(3) | 7 | SSM CARDINAL | 0 | |
| CENTRALIA MEDICAL SERVICES BLDG ASSOC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | IL | 63132 | 237408025 | MOB | IL | 501(C)(3) | 12 | SSM REGIONAL | 0 | |
| DELLS MEDICAL BUILDING INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | WI | 63132 | 391613292 | MOB | WI | 501(C)(2) | N/A | SSM HEALTH C | 0 | |
| GOOD SAMARITAN HOSPITAL AUXILIARY | |||||||||||
| 1 GOOD SAMARITAN WAY | MOUNT VERNON | IL | 62864 | 237049599 | FUNDRAISING | IL | 501(C)(3) | 12 | 0 | N/A | |
| GOOD SAMARITAN REGIONAL HEALTH CENTER | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | IL | 63132 | 430653587 | HEALTH CARE | IL | 501(C)(3) | 3 | SSM REGIONAL | 0 | |
| GOOD SAMARITAN REGIONAL HEALTH CENTER FO | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | IL | 63132 | 262884795 | FUNDRAISING | IL | 501(C)(3) | 7 | ST MARY'S-GO | 0 | |
| HHU XTRA CARE INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391705111 | HEALTH CARE | WI | 501(C)(3) | 10 | SSM HEALTH C | 0 | |
| HOME CARE UNITED INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391776340 | HEALTH CARE | WI | 501(C)(3) | 10 | SSM HEALTH C | 0 | |
| HOME HEALTH UNITED INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391539827 | HEALTH CARE | WI | 501(C)(3) | 10 | SSM HEALTH C | 0 | |
| LEE DEWEY CORPORATION | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | OK | 63132 | 731279603 | MOB | OK | 501(C)(3) | 12 | SSM HEALTH C | 0 | |
| MONROE CLINIC AND HOSPITAL FOUNDATION I | |||||||||||
| 515 22ND AVENUE | MONROE | WI | 53566 | 205769038 | FUNDRAISING | WI | 501(C)(3) | 7 | SSM HEALTH C | 0 | |
| RIPON MEDICAL CENTER INC | |||||||||||
| 845 PARKSIDE STREET | RIPON | WI | 54971 | 391101287 | HEALTH CARE | WI | 501(C)(3) | 3 | AGNESIAN HEA | 0 | |
| SHARED MAGNETIC RESONANCE IMAGING FACILI | |||||||||||
| 1104 JOHN NOLEN DRIVE | MADISON | WI | 53713 | 391534744 | HEALTH CARE | WI | 501(C)(3) | 12 | SSM HEALTH C | 0 | |
| SISTER SERVANTS OF CHRIST THE KING VILLA | |||||||||||
| N8114 COUNTY WW | MOUNT CALVARY | WI | 53057 | 391022770 | HEALTH CARE | WI | 501(C)(3) | 10 | AGNESIAN HEA | 0 | |
| SSM AUDRAIN HEALTH CARE INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431550298 | HEALTH CARE | MO | 501(C)(3) | 3 | SSM REGIONAL | 0 | |
| SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 430738490 | HEALTH CARE | MO | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| SSM CONSOLIDATED HEALTH SERVICES | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431473657 | HEALTH CARE | MO | 501(C)(3) | 10 | SSM HEALTH C | 0 | |
| SSM HEALTH AT HOME FOUNDATION OF WISCONS | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391839309 | FUNDRAISING | WI | 501(C)(3) | 12 | HOME HEALTH | 0 | |
| SSM HEALTH BUSINESSES | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431333488 | HEALTH CARE | MO | 501(C)(3) | 10 | SSM HEALTH C | 0 | |
| SSM HEALTH CARDINAL GLENNON TRANSPORT | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 863519607 | HEALTH CARE | MO | 501(C)(3) | 12 | SSM CARDINAL | 0 | |
| SSM HEALTH CARE CORPORATION | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 466029223 | HEALTH CARE | MO | 501(C)(3) | 12 | SSM HEALTH M | 0 | |
| SSM HEALTH CARE OF OKLAHOMA INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | OK | 63132 | 730657693 | HEALTH CARE | OK | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| SSM HEALTH CARE OF WISCONSIN INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | WI | 63132 | 430688874 | HEALTH CARE | WI | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| SSM HEALTH CARE PORTFOLIO MANAGEMENT CO | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431825256 | MANAGEMENT | MO | 501(C)(3) | 12 | SSM HEALTH C | 0 | |
| SSM HEALTH CARE ST LOUIS | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431343281 | HEALTH CARE | MO | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| SSM HEALTH FOUNDATION | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 874109859 | FUNDRAISING | MO | 501(C)(3) | 12 | SSM HEALTH C | 0 | |
| SSM HEALTH FOUNDATION - ST LOUIS | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431552945 | FUNDRAISING | MO | 501(C)(3) | 7 | SSM HEALTH C | 0 | |
| SSM HEALTH MINISTRIES | |||||||||||
| 3221 MCKELVEY ROAD SUITE 107 | BRIDGETON | MO | 63044 | 431012492 | RELIGIOUS ORG | MO | 501(C)(3) | 1 | 0 | N/A | |
| SSM HEALTH PLAN | |||||||||||
| 1277 DEMING WAY | MADISON | MO | 53717 | 831979548 | INSURANCE | MO | 501(C)(4) | N/A | SSM HEALTH B | 0 | |
| SSM HOSPICE & HOME CARE FOUNDATION | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 300012246 | FUNDRAISING | MO | 501(C)(3) | 7 | SSM HEALTH B | 0 | |
| SSM POLICY INSTITUTE | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431788151 | HEALTH CARE | MO | 501(C)(4) | N/A | SSM HEALTH C | 0 | |
| SSM REGIONAL HEALTH SERVICES | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 440579850 | HEALTH CARE | MO | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| SSMHC LIABILITY TRUST I | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 436331003 | INSURANCE | MO | 501(C)(3) | 12 | SSM HEALTH C | 0 | |
| SSM-SLUH INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 474196634 | HEALTH CARE | MO | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| ST ANTHONY SHAWNEE HOSPITAL INC | |||||||||||
| 1000 N LEE AVE | OKLAHOMA CITY | OK | 73102 | 455055149 | HEALTH CARE | OK | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| ST MARY'S JANESVILLE FOUNDATION INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | WI | 63132 | 273439133 | FUNDRAISING | WI | 501(C)(3) | 7 | SSM HEALTH C | 0 | |
| ST CLARE HEALTH CARE FOUNDATION INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | WI | 63132 | 431940683 | FUNDRAISING | WI | 501(C)(3) | 7 | SSM HEALTH C | 0 | |
| ST FRANCIS HOME OF FOND DU LAC WISCONS | |||||||||||
| 33 EVERETT STREET | FOND DU LAC | WI | 54935 | 391029998 | HEALTH CARE | WI | 501(C)(3) | 10 | AGNESIAN HEA | 0 | |
| ST MARY'S - GOOD SAMARITAN INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | IL | 63132 | 364170833 | HEALTH CARE | IL | 501(C)(3) | 12 | SSM REGIONAL | 0 | |
| ST MARY'S FOUNDATION INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | WI | 63132 | 431940686 | FUNDRAISING | WI | 501(C)(3) | 7 | SSM HEALTH C | 0 | |
| ST MARY'S HEALTH CENTER JEFFERSON CITY | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431575307 | FUNDRAISING | MO | 501(C)(3) | 12 | SSM REGIONAL | 0 | |
| ST MARY'S HOSPITAL AUXILIARY | |||||||||||
| 400 N PLEASANT | CENTRALIA | IL | 62801 | 237126345 | FUNDRAISING | IL | 501(C)(3) | 10 | ST MARY'S HO | 0 | |
| ST MARY'S HOSPITAL FOUNDATION | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | IL | 63132 | 364636691 | FUNDRAISING | IL | 501(C)(3) | 7 | ST MARY'S-GO | 0 | |
| ST MARY'S HOSPITAL CENTRALIA ILLINOIS | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | IL | 63132 | 370662580 | HEALTH CARE | IL | 501(C)(3) | 3 | SSM REGIONAL | 0 | |
| THE CHRISTIAN HOME AND REHABILITATION CE | |||||||||||
| 331 BLY STREET | WAUPUN | WI | 53963 | 390884514 | HEALTH CARE | WI | 501(C)(3) | 10 | AGNESIAN HEA | 0 | |
| THE MONROE CLINIC INC | |||||||||||
| 515 22ND AVENUE | MONROE | WI | 53566 | 390808509 | HEALTH CARE | WI | 501(C)(3) | 3 | SSM HEALTH C | 0 | |
| THE ST ANTHONY HOSPITAL FOUNDATION INC | |||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | OK | 63132 | 736104300 | FUNDRAISING | OK | 501(C)(3) | 7 | SSM HEALTH C | 0 | |
| VILLA ROSA INC | |||||||||||
| N8120 COUNTY WW | MOUNT CALVARY | WI | 53057 | 421670962 | HEALTH CARE | WI | 501(C)(3) | 10 | AGNESIAN HEA | 0 | |
| WAUPUN MEMORIAL HOSPITAL INC | |||||||||||
| 620 WEST BROWN STREET | WAUPUN | WI | 53963 | 390806265 | HEALTH CARE | WI | 501(C)(3) | 3 | AGNESIAN HEA | 0 | |
| ST MARY'S HOSPITAL AUXILIARY | |||||||||||
| 100 ST MARYS MEDICAL PLAZA | JEFFERSON CITY | MO | 65101 | 436049878 | FUNDRAISING | MO | 501(C)(3) | 12 | 0 | N/A | |
| MEDICA FOUNDATION | |||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 411812461 | FOUNDATION | MN | 501(C)(3) | 12 | MH COMPANY | 0 | |
| MEDICA COMMUNITY HEALTH PLAN | |||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 411843804 | HEALTH CARE | MN | 501(C)(3) | N/A | MH COMPANY | 0 | |
| MEDICA HOLDING COMPANY | |||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 010571840 | HOLDING CO | MN | 501(C)(3) | N/A | 0 | N/A | |
| MEDICA HEALTH PLANS | |||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 411242261 | HEALTH CARE | MN | 501(C)(4) | MH COMPANY | 0 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (19 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SSM ST JOSEPH ENDOSCOPY CENTER LLC | ||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 270046559 | SURGERY SERVICES | MO | MHC | EXCLUDED | 0 | 0 |
| ST CLARE IMAGING SERVICES LLC | ||||||||||
| 707 14TH STREET SUITE A | BARABOO | WI | 53913 | 200122365 | DIAG. SERVICES | WI | MHC | EXCLUDED | 0 | 0 |
| MT VERNON RADIATION THERAPY CENTER LLC | ||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 201382620 | RADIATION THERAPY | IL | MHC | EXCLUDED | 0 | 0 |
| SLEEP & NEUROLOGY CENTER OF SOUTHERN ILLINOIS LLC | ||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 208468195 | DIAG. SERVICES | IL | MHC | EXCLUDED | 0 | 0 |
| CHOWSMGSI OFFICE BUILDING LLC | ||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 371383861 | MOB | IL | MHC | EXCLUDED | 0 | 0 |
| OZA CANCER CENTER LLC | ||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 201382727 | MOB | IL | MHC | EXCLUDED | 0 | 0 |
| SHAWNEE REAL ESTATE HOLDINGS LLC | ||||||||||
| 1000 N LEE AVE | OKLAHOMA CITY | OK | 73102 | 455458304 | MOB | OK | MHC | EXCLUDED | 0 | 0 |
| DEAN CLINIC & ST MARY'S HOSPITAL ACCOUNTABLE CARE ORGANIZATION LLC | ||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 452995500 | ACCOUNTABLE CARE | WI | MHC | EXCLUDED | 0 | 0 |
| WISCONSIN INTEGRATED INFORMATION TECHNOLOGY AND TELEMEDICINE SYSTEMS LLC | ||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 392016715 | INFORMATION TECHN | WI | MHC | EXCLUDED | 0 | 0 |
| DEAN HEALTH HOLDINGS LLC | ||||||||||
| 1277 DEMING WAY | MADISON | WI | 53717 | 261594709 | SUPPORT SERVICES | WI | MHC | EXCLUDED | 0 | 0 |
| WINGRA BUILDING GROUP | ||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 390237060 | MOB | WI | MHC | EXCLUDED | 0 | 0 |
| JANESVILLE RIVERVIEW CLINIC BUILDING PARTNERSHIP | ||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 396220698 | MOB | WI | MHC | EXCLUDED | 0 | 0 |
| 1110 N CLASSEN BLVD LLC | ||||||||||
| 1110 N CLASSEN BOULEVARD | OKLAHOMA CITY | OK | 73106 | 731158158 | MOB | OK | MHC | EXCLUDED | 0 | 0 |
| SSM ST CLARE SURGICAL CENTER LLC | ||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 261439695 | SURGERY SERVICES | MO | MHC | EXCLUDED | 0 | 0 |
| WINDMILL LLP | ||||||||||
| 50 VILLAGE VIEW LANE | CHESTERFIELD | MO | 63017 | 431804651 | INVESTMENTS | MO | MHC | EXCLUDED | 0 | 0 |
| NAVITUS HEALTH SOLUTIONS LLC | ||||||||||
| 361 INTEGRITY DRIVE | MADISON | WI | 53717 | 043608530 | PHARMACY BENEFITS | WI | MHC | EXCLUDED | 0 | 0 |
| SSM SELECT REHAB ST LOUIS LLC | ||||||||||
| 4714 GETTYSBURG ROAD | MECHANICSBURG | PA | 17055 | 263694972 | HEALTH CARE | DE | MHC | EXCLUDED | 0 | 0 |
| EPIPHANY RX LLC | ||||||||||
| 361 INTEGRITY DRIVE | MADISON | WI | 53717 | 364855405 | PHARMACY BENEFITS | DE | MHC | EXCLUDED | 0 | 0 |
| MS COMMUNITY NFP JV LLC (MFCJVN) | ||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 873268926 | HOLDING COMPANY | MN | MHC | EXCLUDED | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SSM MANAGED CARE ORGANIZATION LLC | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431708511 | HEALTH PROMOTION | MO | MHC | C | 0 | |||||
| FPP INC & SUBS | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431465174 | HEALTH CARE | MO | MHC | C | 0 | |||||
| DIVERSIFIED HEALTH SERVICES CORP | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431369305 | MEDICAL EQUIPMENT | MO | MHC | C | 0 | |||||
| SSM PROPERTIES INC | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431462486 | PROPERTY SERVICES | MO | MHC | C | 0 | |||||
| HEALTHFIRST PHYSICIAN MANAGEMENT SERVICE | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 731534336 | MEDICAL SERVICES | OK | MHC | C | 0 | |||||
| SSMHC LIABILITY TRUST II | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 816128118 | INSURANCE | MO | MHC | C | 0 | |||||
| SSM MEDICAL GROUP INC | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 431664107 | PHYSICIAN OFFICES | MO | MHC | C | 0 | |||||
| SSMHC INSURANCE COMPANY | ||||||||||||||
| 030310431 | INSURANCE | MHC | C | 0 | PO BOX 1051 GT | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| PHYSICIANS SERVICES CORP OF SOUTHERN IL | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 364161526 | HEALTH CARE | IL | MHC | C | 0 | |||||
| DEAN HEALTH SYSTEMS INC | ||||||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 391128616 | PHYSICIAN OFFICES | WI | MHC | C | 0 | |||||
| DEAN HEALTH INSURANCE INC | ||||||||||||||
| PO BOX 56099 | MADISON | WI | 53705 | 391830837 | INSURANCE | WI | MHC | C | 0 | |||||
| DEAN HEALTH PLAN INC | ||||||||||||||
| PO BOX 56099 | MADISON | WI | 53705 | 391535024 | INSURANCE | WI | MHC | C | 0 | |||||
| DEAN RETAIL SERVICES INC | ||||||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 391717636 | PROPERTY SERVICES | WI | MHC | C | 0 | |||||
| OZA ONCOLOGY INC | ||||||||||||||
| 4117 VETERANS MEMORIAL DRIVE | MT VERNON | IL | 62804 | 371343746 | PHYSICIAN OFFICES | IL | MHC | S | 0 | |||||
| SSM HEALTH JANESVILLE CAMPUS CONDOMINIUM | ||||||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 832038674 | CONDO ASSOCIATION | WI | MHC | C | 0 | |||||
| SSM HEALTH PHARMACY LLC | ||||||||||||||
| 10101 WOODFIELD LANE | ST LOUIS | MO | 63132 | 264031708 | PHARMACY | MO | MHC | C | 0 | |||||
| SSM HEALTH INSURANCE COMPANY | ||||||||||||||
| 1277 DEMING WAY | MADISON | WI | 53717 | 834718249 | INSURANCE | MO | MHC | C | 0 | |||||
| NAVITUS HOLDINGS LLC | ||||||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 800968174 | PHARMACY | WI | MHC | C | 0 | |||||
| MS COMMUNITY JV LLC | ||||||||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 873240022 | INSURANCE | DE | MHC | C | 0 | |||||
| QUALITY DRUG CORPORATION | ||||||||||||||
| 239 BROADWAY | LAGUNA BEACH | CA | 92651 | 330644268 | PHARMACY BENEFITS | CA | MHC | C | 0 | |||||
| ST MARY'S HOSPITAL CAMPUS CONDOMINIUM O | ||||||||||||||
| 707 SOUTH MILLS STREET | MADISON | WI | 53715 | 000000000 | CONDO ASSOCIATION | WI | MHC | C | 0 | |||||
| MEDICA INSURANCE COMPANY | ||||||||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 411490988 | INSURANCE | MN | MAS | C | 0 | |||||
| MEDICA SLEF-INSURED | ||||||||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 411479417 | 3RD PARTY ADMIN | MN | MAS | C | 0 | |||||
| MEDICA AFFILIATED SERVICES | ||||||||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 411716415 | HOLDING CO | MN | MH COMPANY | C | 0 | |||||
| MEDICA HEALTH MANAGEMENT | ||||||||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 208005519 | HEALTH MGMT | MN | MAS | C | 0 | |||||
| MMSI INC | ||||||||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 411547003 | HEALTH INSURANCE | MN | MAS | C | 0 | |||||
| MEDICA SERVICES COMPANY LLC | ||||||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 852902940 | ADMIN SERVICES | MN | MAS | C | 0 | |||||
| MEDICA REGIONAL INSURANCE COMPANY | ||||||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 854111612 | HEALTH INSURANCE | MN | MAS | C | 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 | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |