MOSAIC EMPLOYEE WELFARE BENEFIT PLAN TRUST: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MOSAIC EMPLOYEE WELFARE BENEFIT PLAN TRUST (EIN 36-3831874)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-17
- IRS object ID
- 202232909349301943
- 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 | 2022-10-17T14:57:14-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | 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 | 363831874 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSAIC EMPLOYEE WELFARE BENEFIT PLAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOSA | BusinessNameControlTxt |
| Phone | 4028963884 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4980 SOUTH 118TH STREET A | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68137 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT HOFFMAN | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 4028963884 | PhoneNum |
| Signature | 2022-10-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SCOTT | PersonFirstNm |
| Person Last | HOFFMAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY R COOLEY | PreparerPersonNm |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2022-10-17 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT HOFFMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4980 SOUTH 118TH STREET A | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68137 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,299,451 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE SELF-FUNDED HEALTH CARE, DENTAL CARE AND EDUCATION COMPENSATION BENEFITS TO PARTICIPANTS WHO ARE ELIGIBLE EMPLOYEES OR TO A COVERED DEPENDENT OF AN ELIGIBLE EMPLOYEE OF MOSAIC AND ITS AFFILIATES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $132,339 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,463,830 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,951,429 | CYProgramServiceRevenueAmt |
| PY Investment Income | $218,829 | PYInvestmentIncomeAmt |
| CY Investment Income | $271,623 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $17,682,659 | PYTotalRevenueAmt |
| CY Total Revenue | $16,223,052 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $13,792,270 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $15,615,780 | 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 | $1,992,634 | PYOtherExpensesAmt |
| CY Other Expenses | $1,796,647 | CYOtherExpensesAmt |
| PY Total Expenses | $15,784,904 | PYTotalExpensesAmt |
| CY Total Expenses | $17,412,427 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,897,755 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,189,375 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,155,298 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,371,640 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,088,161 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,592,883 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,067,137 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,778,757 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE SELF-FUNDED HEALTH CARE, DENTAL CARE AND EDUCATION COMPENSATION BENEFITS TO PARTICIPANTS WHO ARE ELIGIBLE EMPLOYEES OR TO A COVERED DEPENDENT OF AN ELIGIBLE EMPLOYEE OF MOSAIC AND ITS AFFILIATES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | COMPREHENSIVE MEDICAL AND DENTAL CARE, EMPLOYEE ASSISTANCE WITH MENTAL AND NERVOUS DISORDERS AND EDUCATION COMPENSATION BENEFITS FOR ELIGIBLE EMPLOYEES AND DEPENDENTS. THERE WERE 4,005 ELIGIBLE EMPLOYEES, OF WHICH 2,013 WERE PARTICIPATING IN THE PLAN DURING THIS CALENDAR YEAR. | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| 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 | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | 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 | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | 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 | SCOTT HOFFMAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4028963884 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4980 S 118TH ST SUITE A | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68137 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (3 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 | Institutional TrusteeInstitutionalTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| LINDA TIMMONS | ||||||||
| CHIEF EXECUTIVE OFFICER | 0.10 | 39.90 | Yes (X) | Yes (X) | $0 | $613,998 | $6,847 | |
| SCOTT HOFFMAN | ||||||||
| CHIEF FINANCIAL OFFICER | 0.10 | 39.90 | Yes (X) | Yes (X) | $0 | $354,597 | $32,482 | |
| GREAT WESTERN BANK | ||||||||
| TRUSTEE | 0.10 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $968,595 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $39,329 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 525100 | $9,917,090 | $9,917,090 |
| EMPLOYEE CONTRIBUTIONS | 525100 | $5,861,311 | $5,861,311 |
| STOP LOSS INCOME | 525100 | $173,028 | $173,028 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,951,429 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132,339 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $132,339 | UnrelatedBusinessRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $215,683 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $76,399 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $139,284 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $139,284 | TotalRevenueColumnAmt |
| Exclusion | $139,284 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,223,052 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,951,429 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $132,339 | UnrelatedBusinessRevenueAmt |
| Exclusion | $139,284 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,615,780 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,425,350 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,520 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,798 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,700 | TotalAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt |
|---|---|
| LIFE INSURANCE PREMIUMS | $84,303 |
| WELLNESS | $34,976 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,412,427 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,940,007 | BOYAmt |
| EOY | $1,732,216 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,109,263 | BOYAmt |
| EOY | $266,791 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $228,681 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,106,028 | BOYAmt |
| EOY | $5,143,952 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,155,298 | BOYAmt |
| EOY | $7,371,640 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,088,161 | BOYAmt |
| EOY | $1,592,883 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,088,161 | BOYAmt |
| EOY | $1,592,883 | 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 | $7,067,137 | BOYAmt |
| EOY | $5,778,757 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,067,137 | BOYAmt |
| EOY | $5,778,757 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,155,298 | BOYAmt |
| EOY | $7,371,640 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,189,375 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$99,005 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LINDA TIMMONS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $0 | $486,127 | $0 | $123,724 | $0 | $4,147 | $0 | -$31,879 | $0 | $38,726 | $0 | $620,845 | $0 | $0 |
| SCOTT HOFFMAN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $301,014 | $0 | $52,416 | $0 | $1,167 | $0 | $6,458 | $0 | $26,024 | $0 | $387,079 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE SALARIES OF LINDA TIMMONS AND SCOTT HOFFMAN ARE PAID FROM A RELATED ORGANIZATION, MOSAIC. MS. TIMMONS SERVES AS CEO OF MOSAIC. MR. HOFFMAN SERVES AS CFO OF MOSAIC. THE SALARY FOR MS. TIMMONS IS SET BY THE MOSAIC EXECUTIVE COMMITTEE AND MOSAIC BOARD OF DIRECTORS. MR. HOFFMAN'S SALARY IS SET BY THE CEO OF MOSAIC WORKING WITHIN THE SALARY RANGES ESTABLISHED BY THE EXECUTIVE COMMITTEE. MOSAIC'S BOARD AND COMPENSATION COMMITTEE USE AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND A COMPENSATION SURVEY IN ESTABLISHING THE COMPENSATION OF THE PRESIDENT AND CEO OF MOSAIC AND GUIDELINES FOR OTHER KEY STAFF. |
| SCHEDULE J, PART II, COLUMN C: | MOSAIC EVALUATES THE LIABILITY RELATED TO THEIR POSTRETIREMENT BENEFITS (SALARY AND HEALTH INSURANCE CONTINUATION) THROUGH AN ACTUARIAL REVIEW. THE ADJUSTMENT IS INCLUDED IN RETIREMENT AND OTHER DEFERRED COMPENSATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 AND SUPPORTING SCHEDULES ARE PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. FURTHERMORE, THE FORM 990 IS REVIEWED BY THE FINANCE DEPARTMENT OF MOSAIC, A RELATED ENTITY, PRIOR TO SUBMISSION OF THE FORM 990 TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS EACH TRUSTEE COMPLETES A CONFLICT OF INTEREST FORM AND SUBMITS IT TO THE CHAIRPERSON OF THE BOARD INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. |
| FORM 990, PART VI, SECTION B, LINE 15 | MOSAIC EMPLOYEE WELFARE BENEFIT PLAN DOES NOT PAY COMPENSATION TO A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OFFICERS, OR EMPLOYEES. THEREFORE, THERE IS NOT A PROCESS IN PLACE FOR DETERMINING COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | MOSAIC EMPLOYEE WELFARE BENEFIT PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | GREAT WESTERN BANK - 6015 RADIAL HWY, OMAHA, NE 68104-3425. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MOSAIC | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 113669999 | SERVICES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES | NE | 501(C)(3) | LINE 10 | N/A | 0 | |
| THE MOSAIC FOUNDATION INC | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 363837360 | FUNDRAISING AND INVESTMENT ASSET MANAGEMENT | NE | 501(C)(3) | LINE 12A, I | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION I | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 363756911 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION II | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 470773689 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION IV | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 911823422 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION VII | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 470828015 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION VIII | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 470828012 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION IX | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 742838413 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION X | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 742908789 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XI | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 311706640 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XII | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 481297244 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XIII | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 421626679 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XIV - ROCKFORD | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 204417891 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XV - COUNCIL BLUFFS | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 205765691 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XVI - FARMINGTON | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 205765731 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XVII - BEATRICE | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 261710013 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XVIII - OSCEOLA-WAUKON | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 261710184 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XIX - WINFIELD | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 261710259 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XX - GARDEN CITY | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 264555206 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XXI - MEMPHIS | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 264555313 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XXII - LOGAN | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 273483415 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC HOUSING CORPORATION XXIII - AUSTIN | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 710875364 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| OAKS OF DUNN COUNTY INC | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 391913323 | SENIOR LIVING SERVICES | WI | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC ILLINOIS HOUSING I | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 202997161 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC ILLINOIS HOUSING II | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 204417645 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC ILLINOIS HOUSING AT MACOMB I | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 204841909 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC ILLINOIS HOUSING OF ROCKFORD I | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 204841856 | LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | MOSAIC | |
| MOSAIC SENIOR SERVICES INC | |||||||||||
| 4980 S 118 STREET | OMAHA | NE | 68137 | 831746407 | SENIOR LIVING SERVICES | AZ | 501(C)(3) | LINE 12A, I | Yes (1) | MOSAIC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4980 S 118 ST | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68137 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271695051 | EIN |
| Primary Activities | LOW INCOME HOUSING | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|
| EASE-E MEDICAL INC | ||||||||||
| 731 SOUTH 8TH STREET | CANON CITY | CO | 81212 | 470842353 | MEDICAL EQUIPMENT/SUPPLIES SALES | NE | N/A | C | Yes (1) | |
| MOSAIC HOUSING CORPORATION V | ||||||||||
| 4980 S 118 ST | OMAHA | NE | 68137 | 470805545 | LOW INCOME HOUSING | NE | N/A | C | Yes (1) | |
| BICO | ||||||||||
| 4980 S 118 ST | OMAHA | NE | 68137 | CAPTIVE INSURANCE | N/A | C | Yes (1) | BD | ||
| CHARITABLE REMAINDER TRUSTS (6) | ||||||||||
| INVESTMENT MANAGEMENT | NE | N/A | T | Yes (1) | ||||||
| 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |