MANIFEST MEDEX: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: MANIFEST MEDEX (EIN 27-2367522)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-14
IRS object ID: 202233189349309468
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule J
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-14T12:50:44-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	910189318	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	MOSS ADAMS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	101 SECOND STREET SUITE 900	AddressLine1Txt
City	SAN FRANCISCO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94105	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	272367522	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MANIFEST MEDEX	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MANI	BusinessNameControlTxt
Phone	5106831333	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	6001 SHELLMOUND STREET 500	AddressLine1Txt
City	EMERYVILLE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94608	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	PATRICIA GROBECK	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	5106831309	PhoneNum
Signature	2022-11-12	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	PATRICIA	PersonFirstNm
Person Last	GROBECK	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	LESLIE VAN	PreparerPersonNm
PTIN	P01294411	PTIN
Phone	4159561500	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

Field	Value	IRS element (for citing)
Principal Officer	ERICA GALVEZ	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	6001 SHELLMOUND STREET 500	AddressLine1Txt
City	EMERYVILLE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94608	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$40,119,770	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTPS://WWW.MANIFESTMEDEX.ORG/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2010	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	MANIFEST MEDEX FACILITATES THE COLLECTION OF ELECTRONIC CLINICAL RECORDS FROM HEALTHCARE PROVIDERS AND CLAIMS DATA FROM HEALTH INSURERS. THE CLINICAL AND CLAIMS DATA IS AGGREGATED TO PROVIDE COMPREHENSIVE LONGITUDINAL PATIENT RECORDS THAT EMPOWER MANIFEST MEDEX PARTICIPANTS WITH POWERFUL DATA TO EFFECTIVELY MANAGE THE CONTINUUM OF CARE AND DRIVE HIGHER QUALITY CARE AT A LOWER COST.	ActivityOrMissionDesc
Voting Members Governing Body	8	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	81	TotalEmployeeCnt
Total Volunteers	8	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$23,323,957	PYContributionsGrantsAmt
CY Contributions Grants	$27,316,877	CYContributionsGrantsAmt
PY Program Service Revenue	$12,017,231	PYProgramServiceRevenueAmt
CY Program Service Revenue	$12,797,745	CYProgramServiceRevenueAmt
PY Investment Income	$88,459	PYInvestmentIncomeAmt
CY Investment Income	$1,521	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$3,627	CYOtherRevenueAmt
PY Total Revenue	$35,429,647	PYTotalRevenueAmt
CY Total Revenue	$40,119,770	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	$11,940,230	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,588,036	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$17,335,235	PYOtherExpensesAmt
CY Other Expenses	$18,292,211	CYOtherExpensesAmt
PY Total Expenses	$29,275,465	PYTotalExpensesAmt
CY Total Expenses	$31,880,247	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,154,182	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$8,239,523	CYRevenuesLessExpensesAmt
Total Assets BOY	$29,856,630	TotalAssetsBOYAmt
Total Assets EOY	$35,771,057	TotalAssetsEOYAmt
Total Liabilities BOY	$12,974,454	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$10,649,358	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$16,882,176	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$25,121,699	NetAssetsOrFundBalancesEOYAmt
Mission	BE THE SMART GRID FOR HEALTH INFORMATION - DELIVER DATA-DRIVEN INSIGHT TO INDIVIDUALS AND HEALTH TEAMS WHEN AND WHERE THEY NEED IT SO THEY CAN IMPROVE CARE, LOWER COSTS AND ENHANCE HEALTH.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$18,349,999	ExpenseAmt
Revenue	$12,797,745	RevenueAmt
Desc	AGGREGATING HEALTH CARE INFORMATION FROM DISPARATE PROVIDERS AND PAYERS TO ENABLE THEM TO PROVIDE MORE TIMELY, COMPLETE AND HIGHER QUALITY PATIENT-CENTERED CARE.	Desc
Total Program Service Expenses	$18,349,999	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
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	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	Yes (1)	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	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	41	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	81	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
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
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
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	8	GoverningBodyVotingMembersCnt
Independent Voting Member	8	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	0	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	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	TRISHA GROBECK	PersonNm
Phone	5106831309	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	6001 SHELLMOUND STREET NO 500	AddressLine1Txt
City	EMERYVILLE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94608	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
JARROD B MCNAUGHTON
CHAIR	2.50	Yes (X)	Yes (X)	$0	$0	$0
MARK SAVAGE
VICE CHAIR	2.50	Yes (X)	Yes (X)	$0	$0	$0
ABNER MASON
MEMBER	2.50	Yes (X)		$0	$0	$0
DEVEN MCGRAW
MEMBER	2.50	Yes (X)		$0	$0	$0
DOLORES GREEN
MEMBER	2.50	Yes (X)		$0	$0	$0
LEIGH HUTCHINS
MEMBER	2.50	Yes (X)		$0	$0	$0
PAUL MARKOVICH
MEMBER	2.50	Yes (X)		$0	$0	$0
MARK REYNOLDS
MEMBER	2.50	Yes (X)		$0	$0	$0
CLAUDIA WILLIAMS
CEO	40.00		Yes (X)	$757,441	$0	$16,622
PAUL BIBERKRAUT
CFO	40.00		Yes (X)	$394,948	$0	$19,299
SANDRA PARKER
SECRETARY	40.00		Yes (X)	$572,417	$0	$5,171
ERICA GALVEZ
CHIEF STRATEGY OFFICER	40.00			$371,213	$0	$23,551	Yes (X)
DAVID KATES
CHIEF TECHNOLOGY OFFICER	40.00			$378,751	$0	$22,601		Yes (X)
SARITA CHOY
VP, MARKETING & COMMUNICATIONS	40.00			$263,392	$0	$15,462		Yes (X)
JASON BUCKNER
CHIEF INFORMATION OFFICER	40.00			$279,189	$0	$30,192		Yes (X)
ADAM HARRISON
CHIEF GROWTH OFFICER	40.00			$289,040	$0	$31,774		Yes (X)
NICHOLAS RICHARD YARKER
MANAGING DIRECTOR	40.00			$250,865	$0	$22,146		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,557,256	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$186,818	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	46	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
LOGICWORKS SYSTEMS CORPORATION
155 AVENUE OF THE AMERICAS 8TH FL	NEW YORK	NY	10013	PLATFORM MAINTENANCE	$3,933,714
J2 INTERACTIVE LLC
2 THIRTEENTH STREET	CHARLESTOWN	MA	02129	TECHNICAL CONSULTING IT SERVICES	$2,136,859
SLALOM LLC
821 2ND AVE SUITE 1900	SEATTLE	WA	98104	CONSULTING SERVICES	$1,849,635
INTERSYSTEMS CORPORATION
PO BOX 84-5809	BOSTON	MA	022845809	CONSULTING SERVICES	$1,704,056
AUDACIOUS INQUIRYLLC
5523 RESEARCH PARK DRIVE SUITE 370	CATONSVILLE	MD	21228	CONSULTING SERVICES	$1,200,206

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	21	CntrctRcvdGreaterThan100KCnt
Government Grants	$12,316,877	GovernmentGrantsAmt
All Other Contributions	$15,000,000	AllOtherContributionsAmt
Total Contributions	$27,316,877	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	HEALTH INFORMATION EXC	Desc
Business	519100	BusinessCd
Total Revenue Column	$12,797,745	TotalRevenueColumnAmt
Related Or Exempt Func Income	$12,797,745	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$12,797,745	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,521	TotalRevenueColumnAmt
Exclusion	$1,521	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	OTHER INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$3,627	TotalRevenueColumnAmt
Exclusion	$3,627	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$3,627	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$40,119,770	TotalRevenueColumnAmt
Related Or Exempt Func Income	$12,797,745	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$5,148	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,118,895	TotalAmt
Program Services	$693,792	ProgramServicesAmt
Management And General	$1,425,103	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$9,452,120	TotalAmt
Program Services	$4,266,166	ProgramServicesAmt
Management And General	$5,185,954	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$311,908	TotalAmt
Program Services	$160,185	ProgramServicesAmt
Management And General	$151,723	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,705,113	TotalAmt
Program Services	$833,944	ProgramServicesAmt
Management And General	$871,169	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$52,178	TotalAmt
Management And General	$52,178	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$96,183	TotalAmt
Management And General	$96,183	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,836,860	TotalAmt
Program Services	$2,787,154	ProgramServicesAmt
Management And General	$1,049,706	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$97,074	TotalAmt
Management And General	$97,074	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$92,066	TotalAmt
Program Services	$42,092	ProgramServicesAmt
Management And General	$49,974	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$562,170	TotalAmt
Program Services	$399,343	ProgramServicesAmt
Management And General	$162,827	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$374,171	TotalAmt
Management And General	$374,171	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$81,681	TotalAmt
Program Services	$4,474	ProgramServicesAmt
Management And General	$77,207	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$59,186	TotalAmt
Program Services	$6,338	ProgramServicesAmt
Management And General	$52,848	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$154,464	TotalAmt
Management And General	$154,464	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,852,669	TotalAmt
Management And General	$1,852,669	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$235,187	TotalAmt
Management And General	$235,187	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SAAS FEES	$4,926,885	$4,926,885
PLATFORM MAINTENANCE AN	$4,229,626	$4,229,626
INCENTIVES	$1,445,000		$1,445,000
HIO CONTRIBUTION EXPENS	$204,000		$204,000

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$7,189	TotalAmt
Management And General	-$7,189	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$31,880,247	TotalAmt
Program Services	$18,349,999	ProgramServicesAmt
Management And General	$13,530,248	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$373,536	BOYAmt
EOY	$10,000	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$21,629,866	BOYAmt
EOY	$29,816,675	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,439,867	BOYAmt
EOY	$514,023	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,706,168	BOYAmt
EOY	$2,263,596	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$8,657,221	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$6,740,934	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,145,245	BOYAmt
EOY	$1,916,287	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,561,948	BOYAmt
EOY	$1,250,476	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$29,856,630	BOYAmt
EOY	$35,771,057	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$5,639,392	BOYAmt
EOY	$4,252,106	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$700,000	BOYAmt
EOY	$30,000	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$5,000,000	BOYAmt
EOY	$5,000,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,635,062	BOYAmt
EOY	$1,367,252	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$12,974,454	BOYAmt
EOY	$10,649,358	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,882,176	BOYAmt
EOY	$25,121,699	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$16,882,176	BOYAmt
EOY	$25,121,699	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$29,856,630	BOYAmt
EOY	$35,771,057	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$8,239,523	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	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)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Public Organization170	Yes (X)	PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$21,644,124	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$15,000,000	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,738,590	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$23,323,957	CurrentTaxYearMinus1YearAmt
Current Tax Year	$27,316,877	CurrentTaxYearAmt
Total	$99,023,548	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$21,644,124	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$15,000,000	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,738,590	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$23,323,957	CurrentTaxYearMinus1YearAmt
Current Tax Year	$27,316,877	CurrentTaxYearAmt
Total	$99,023,548	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$79,752,391	SubstantialContributorsTotAmt
Public Support Total170	$19,271,157	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus3 Years	$19,487	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$173,321	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$88,459	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,521	CurrentTaxYearAmt
Total	$282,788	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year	$3,627	CurrentTaxYearAmt
Total	$3,627	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$99,309,963	TotalSupportAmt
Gross Receipts Rltd Activities	$50,985,046	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.19410	PublicSupportCY170Pct
Public Support PY170	0.10180	PublicSupportPY170Pct
Ten Pct Facts Crcmstncs Test CY	Yes (X)	TenPctFactsCrcmstncsTestCYInd
Facts And Circumstances Test	PURSUANT TO REGULATION 1.170A-9(F)(3), THE ORGANIZATION NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT DIRECTLY OR INDIRECTLY FROM THE GENERAL PUBLIC AND IS ACTIVELY ENGAGED IN THE ATTRACTION OF PUBLIC SUPPORT. THE ORGANIZATION IS PUBLICLY SUPPORTED UNDER THE FACTS AND CIRCUMSTANCES TEST AS FOLLOWS:(I) TEN PERCENT-OF-SUPPORT LIMITATION: THE PERCENTAGE OF SUPPORT NORMALLY RECEIVED BY THE ORGANIZATION FROM CONTRIBUTIONS MADE BY GOVERNMENT UNITS, FROM CONTRIBUTIONS MADE DIRECTLY OR INDIRECTLY BY THE GENERAL PUBLIC, OR FROM A COMBINATION OF THESE SOURCES EQUALS AT LEAST 10 PERCENT.(II) ATTRACTION OF PUBLIC SUPPORT: THE ORGANIZATION IS ORGANIZED AND OPERATED TO CONTINUOUSLY ATTRACT NEW AND ADDITIONAL SOURCES OF PUBLIC SUPPORT. THE ORGANIZATION CONTINUES TO SOLICIT ADDITIONAL HOSPITALS AND HOSPITAL SYSTEMS FOR INCREMENTAL REVENUE, ALTHOUGH HEALTH PLANS CONTRIBUTE SIGNIFICANTLY MORE REVENUE IN SUBSCRIPTION FEES. THE ORGANIZATION ALREADY HAS THE TWO LARGEST HEALTH PLANS IN THE STATE OF CALIFORNIA (OTHER THAN KAISER) WITH MEMBERSHIPS FROM ANTHEM BLUE CROSS AND BLUE SHIELD SO REVENUE IS MORE HIGHLY CONCENTRATED FROM THOSE TWO HEALTH PLANS. THE ORGANIZATION IS ACTIVELY PURSUING OTHER HEALTH PLANS. (III) SOURCES OF SUPPORT: THE ORGANIZATION HAS BEEN IN EXISTENCE SINCE 2010 (JUST OVER 10 YEARS). THREE YEARS AGO, THERE WAS A CHANGE IN STRATEGY OF THE ORGANIZATION THERE WAS A MERGER OF TWO ENTITIES THAT CHANGED THE SOURCE OF FUNDING THAT HAD HISTORICALLY BEEN DONE. AS THIS NEW STRATEGY WAS BEING IMPLEMENTED, THE ORGANIZATION WAS BEING LARGELY SUPPORTED BY A SINGLE SOURCE FOR THE FIRST COUPLE OF YEARS AFTER THE MERGER OCCURRED. THE ORGANIZATION HAS TAKEN OFF AFTER THE INITIAL START-UP PHASE AFTER THE MERGER AND IS CONTINUING TO EXPAND ITS BASE OF PUBLIC SUPPORT. THE ORGANIZATION ALSO RECEIVED APPROVAL FOR A $4.9 MILLION GRANT FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) FOR THE CALIFORNIA EMERGENCY MEDICAL SERVICES AUTHORITY PROGRAM, OF WHICH THE ORGANIZATION RECEIVED APPROXIMATELY $700K IN 2021. THE ORGANIZATION HAS ALSO APPLIED FOR FUNDING UNDER THE 2019 CALIFORNIA HEALTH INFORMATION EXCHANGE ONBOARDING PROGRAM (CAL-HOP) WHICH IS FUNDED BY A $50 MILLION CMS GRANT AND THE STATE OF CALIFORNIA. CAL-HOP WILL PROVIDE FUNDING TO ASSIST MEDI-CAL PROVIDERS ACCESS AND USE OF HEALTH INFORMATION EXCHANGE TO IMPROVE QUALITY OF CARE FOR MEDI-CAL BENEFICIARIES. FINALLY, THE ORGANIZATION ENDED THE FEE HOLIDAY GRANTED TO HOSPITAL PARTICIPANTS AT THE END OF 2018 AND DURING 2019 AND 2020 COMMENCED BILLING AND COLLECTION OF SUBSCRIPTION DUES FOR JUST UNDER 100 HOSPITAL PARTICIPANTS. (V) REPRESENTATIVE GOVERNING BODY: THE ORGANIZATION'S BOARD OF DIRECTORS IS COMPRISED OF INDIVIDUALS HAVING SPECIFIC KNOWLEDGE OR EXPERTISE IN THE INDUSTRY AS WELL AS INCLUDES DIRECTORS FROM THE GENERAL PUBLIC.(VI) AVAILABILITY OF PUBLIC SERVICES: THE ORGANIZATION SUPPORTS THE GREATER PUBLIC AT LARGE IN THAT IT ASSISTS WITH PROVIDING DATA DRIVEN HEALTH INFORMATION AND MAKING FOR READILY AVAILABLE TO INDIVIDUALS AND HEALTH TEAMS SO THE HEALTH TEAMS CAN IMPROVE CARE, LOWER COSTS, AND ENHANCE HEALTH.	FactsAndCircumstancesTestTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$150,000	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$150,000	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	LOBBYING FOR A STATEWIDE HEALTHCARE DATA EXCHANGE INFRASTRUCTURE FOR KEY MEDI-CAL PROGRAM AND STATE FUNCTIONS, INCLUDING THE RESPONSE TO COVID-19, FUNDED WITH FEDERAL MEDICAID MATCH, AND WITH A STATEWIDE MANDATE FOR PARTICIPATION. THERE ARE NO ACTIVE BILLS IN THE LEGISLATURE, BUT WE HAVE MET THE GOVERNOR'S OFFICE, SENATE, AND ASSEMBLY HEALTH COMMITTEES, AND MULTIPLE STATE AGENCIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$134,050	OtherCostOrOtherBasisAmt
Depreciation	$102,257	DepreciationAmt
Book Value	$31,793	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,874,598	OtherCostOrOtherBasisAmt
Depreciation	$6,615,785	DepreciationAmt
Book Value	$258,813	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,648,573	OtherCostOrOtherBasisAmt
Depreciation	$22,892	DepreciationAmt
Book Value	$1,625,681	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,916,287	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	OPERATING LEASE LIABILITY	Desc
Amt	$1,367,252	Amt

Field	Value	IRS element (for citing)
Total Liability	$1,367,252	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$40,230,442	TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts	$110,672	DonatedServicesAndUseFcltsAmt
Revenue Not Reported	$110,672	RevenueNotReportedAmt
Revenue Subtotal	$40,119,770	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$40,119,770	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$31,990,919	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$110,672	DonatedServicesUseFcltsAmt
Expenses Not Reported	$110,672	ExpensesNotReportedAmt
Expenses Subtotal	$31,880,247	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$31,880,247	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	MANIFEST MEDEX IS EXEMPT FROM FEDERAL INCOME TAXES AS A NOT-FOR-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A COMPARABLE EXEMPTION HAS BEEN GRANTED BY THE STATE OF CALIFORNIA. IN ADDITION, THE COMPANY IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSES. MANAGEMENT HAS DETERMINED THAT THE COMPANY IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND, ACCORDINGLY, HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE COMPANY'S FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX IS SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS FROM THE DATE OF FILING. MANAGEMENT HAS DETERMINED THAT THE COMPANY HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. ANY FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES WOULD BE RECOGNIZED IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	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	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
CLAUDIA WILLIAMS
CEO	$570,724	$0	$186,717	$0	$0	$0	$0	$0	$16,622	$0	$774,063	$0	$0	$0
SANDRA PARKER
SECRETARY	$141,038	$0	$61,379	$0	$370,000	$0	$0	$0	$5,171	$0	$577,588	$0	$0	$0
PAUL BIBERKRAUT
CFO	$297,125	$0	$97,823	$0	$0	$0	$11,600	$0	$7,699	$0	$414,247	$0	$0	$0
DAVID KATES
CHIEF TECHNOLOGY OFFICER	$318,588	$0	$60,163	$0	$0	$0	$5,403	$0	$17,198	$0	$401,352	$0	$0	$0
ERICA GALVEZ
CHIEF STRATEGY OFFICER	$280,297	$0	$90,916	$0	$0	$0	$11,274	$0	$12,277	$0	$394,764	$0	$0	$0
ADAM HARRISON
CHIEF GROWTH OFFICER	$210,851	$0	$78,189	$0	$0	$0	$11,600	$0	$20,174	$0	$320,814	$0	$0	$0
JASON BUCKNER
CHIEF INFORMATION OFFICER	$233,839	$0	$45,350	$0	$0	$0	$11,156	$0	$19,036	$0	$309,381	$0	$0	$0
SARITA CHOY
VP, MARKETING & COMMUNICATIONS	$242,892	$0	$20,500	$0	$0	$0	$9,220	$0	$6,242	$0	$278,854	$0	$0	$0
NICHOLAS RICHARD YARKER
MANAGING DIRECTOR	$209,902	$0	$40,963	$0	$0	$0	$9,009	$0	$13,137	$0	$273,011	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 4A	FormAndLineReferenceDesc
Explanation	SANDRA PARKER RECEIVED SEVERANCE OF $370,000 IN 2021, WHICH HAS BEEN INCLUDED ON SCHEDULE J, COLUMN B(III).	ExplanationTxt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BLUE SHIELD OF CALIFORNIA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship With Org	FOUNDER & SUBSTANTIAL CONTRIBUTOR	RelationshipWithOrgTxt
Loan Purpose	OPERATING CASH FLOW	LoanPurposeTxt
Loan To Organization	Yes (X)	LoanToOrganizationInd
Original Principal	$5,000,000	OriginalPrincipalAmt
Balance Due	$5,000,000	BalanceDueAmt
Default	0	DefaultInd
Board Or Committee Approval	Yes (1)	BoardOrCommitteeApprovalInd
Written Agreement	Yes (1)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$5,000,000	TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	PROCESS SUMMARY 1-MANIFEST MEDEX'S AUDITORS COMPLETE AN AUDIT OF THE FINANCIAL STATEMENTS FOR THE APPLICABLE YEAR. 2-MANIFEST MEDEX'S TAX PREPARER USES INFORMATION FROM (I) THE AUDITED FINANCIAL STATEMENTS AND (II) MANIFEST MEDEX AND COMPLETES A DRAFT OF THE FORM 990. 3-INTERNAL STAFF, INCLUDING THE AVP OF FINANCE, CFO AND CEO REVIEW THE DRAFT FORM 990 AND MAKE ANY REQUIRED ADJUSTMENTS TO IT. 4-THE MANIFEST MEDEX BOARD IS PROVIDED A COPY OF THE FINAL DRAFT OF THE FORM 990 AND PROVIDED A REASONABLE PERIOD OF TIME TO REVIEW IT AND ASK ANY QUESTIONS OF MANAGEMENT BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	EACH "INSIDER" IS RESPONSIBLE FOR KNOWING AND FOLLOWING THE POLICY INCLUDING HAVING A DUTY TO DISCOVER AND DISCLOSE A CONFLICT. ALSO, EACH INSIDER, AND OTHER PERSONS THAT MX'S BOARD MAY IDENTIFY FROM TIME TO TIME, SHALL ANNUALLY SIGN A DISCLOSURE STATEMENT IN THE FORM ATTACHED HERETO, THAT: 1. AFFIRMS THAT THE PERSON HAS RECEIVED, READ AND UNDERSTANDS THIS POLICY, AND AGREES TO COMPLY WITH THE POLICY; AND 2. DISCLOSES THE PERSON'S INTERESTS AND FAMILY RELATIONSHIPS THAT COULD GIVE RISE TO A CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPANY'S BOARD ADOPTED AN EMPLOYEE COMPENSATION POLICY AND ESTABLISHED A COMPENSATION COMMITTEE. THIS COMMITTEE REVIEWS AND RECOMMENDS TO THE BOARD ALL COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES, EXCEPT FOR THE CEO WHICH THE BOARD AS A WHOLE ANALYZES AND APPROVES. THE REVIEW PROCESS INCLUDES A REVIEW OF BACKGROUND INFORMATION (E.G. EDUCATION, EXPERIENCE, ETC.) AND COMPARABILITY DATA (E.G. COMPENSATION SURVEYS). THE BOARD THEN DETERMINES WHETHER TO APPROVE THE COMPENSATION OF THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES BASED ON THE INFORMATION COMPILED.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	CONSULTANTS & CONTRACTORS: PROGRAM SERVICE EXPENSES 2,787,154. MANAGEMENT AND GENERAL EXPENSES 1,049,706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,836,860.