INGHAM HEALTH PLAN CORPORATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- INGHAM HEALTH PLAN CORPORATION (EIN 38-3430461)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-09-09
- IRS object ID
- 202102529349301510
- Schema version
- 2020v4.1
- 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 | 2021-09-09T15:13:13-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382157642 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MANER COSTERISAN PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 E GRAND RIVER SUITE 1 | AddressLine1Txt |
| City | LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 489123291 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383430461 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INGHAM HEALTH PLAN CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INGH | BusinessNameControlTxt |
| Phone | 8662918691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 30125 | AddressLine1Txt |
| City | LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48909 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANET OLSZEWSKI | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8662918691 | PhoneNum |
| Signature | 2021-08-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JANET | PersonFirstNm |
| Person Last | OLSZEWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JAMES A MC NEELEY CPA | PreparerPersonNm |
| PTIN | P00364811 | PTIN |
| Phone | 5173237500 | PhoneNum |
| Preparation | 2021-09-01 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JANET OLSZEWSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 30125 | AddressLine1Txt |
| City | LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48909 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,165,093 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IHPMI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO ENSURE ACCESS TO HEALTH CARE FOR LOW-INCOME PERSONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 6 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $58,696 | PYContributionsGrantsAmt |
| CY Contributions Grants | $42,080 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,655,433 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,568,686 | CYProgramServiceRevenueAmt |
| PY Investment Income | $75,349 | PYInvestmentIncomeAmt |
| CY Investment Income | $54,327 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,789,478 | PYTotalRevenueAmt |
| CY Total Revenue | $1,665,093 | 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 | $489,545 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $495,425 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,817,259 | PYOtherExpensesAmt |
| CY Other Expenses | $1,444,093 | CYOtherExpensesAmt |
| PY Total Expenses | $2,306,804 | PYTotalExpensesAmt |
| CY Total Expenses | $1,939,518 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$517,326 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$274,425 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,053,434 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,805,960 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $108,187 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $106,793 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,945,247 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,699,167 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ACT AS A VEHICLE TO PROVIDE ACCESS TO ORGANIZED SYSTEMS OF HEALTH CARE AND IMPROVE THE HEALTH STATUS OF INDIVIDUALS IN THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,786,363 | ExpenseAmt |
| Revenue | $1,568,686 | RevenueAmt |
| Desc | PROVIDE A BASIC MEDICAL & DENTAL BENEFIT FOR LOW-INCOME PEOPLE WITHOUT ACCESS TO HEALTH CARE BENEFITS AND SERVICES. PROVIDE COMMUNITY HEALTH WORKER (CHW) SERVICES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH TO IMPROVE THE OVERALL HEALTH STATUS OF INDIVIDUALS. ASTHMA CASE MANAGEMENT REFERRALS, EDUCATION AND HOME VISITS. | Desc |
| Total Program Service Expenses | $1,786,363 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 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 | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 6 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LORI NOYER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8662918691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 30125 | AddressLine1Txt |
| City | LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48909 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| DERRELL SLAUGHTER | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| MATHEW NOBIS | ||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| BARB MONROE | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| SCOTT LYON | ||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| MICHELLE LOUBERT DO | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| ELDON LIGGON | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| JOE GARCIA | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| FARHAN BHATTI MD | ||||||
| BOARD MEMBER (JAN-MAY) | 0.25 | Yes (X) | $0 | $0 | $0 | |
| NEVIN BRITTAIN | ||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| BRUCE BRAGG | ||||||
| TREASURER | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DALE THOMPSON | ||||||
| VICE PRESIDENT | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JANET OLSZEWSKI | ||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LORI NOYER | ||||||
| EXECUTIVE DIRECTOR | 40.00 | $104,005 | $0 | $19,779 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $104,005 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $19,779 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EDWARD W SPARROW HOSPITAL | |||||
| 8175 RELIABLE PARKWAY | CHICAGO | IL | 60686 | MEDICAL SERVICES | $283,606 |
| DELTA DENTAL | |||||
| 16082 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | DENTAL INSURANCE PROVIDER | $241,476 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $42,080 | AllOtherContributionsAmt |
| Total Contributions | $42,080 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTH & PHARMACY SRVC. | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $1,568,686 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,568,686 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,568,686 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,327 | TotalRevenueColumnAmt |
| Exclusion | $54,327 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,500,000 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,500,000 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,665,093 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,568,686 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $54,327 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,784 | TotalAmt |
| Program Services | $49,514 | ProgramServicesAmt |
| Management And General | $74,270 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,901 | TotalAmt |
| Program Services | $264,085 | ProgramServicesAmt |
| Management And General | $23,816 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,508 | TotalAmt |
| Program Services | $11,276 | ProgramServicesAmt |
| Management And General | $1,232 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,169 | TotalAmt |
| Program Services | $35,768 | ProgramServicesAmt |
| Management And General | $2,401 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,063 | TotalAmt |
| Program Services | $25,789 | ProgramServicesAmt |
| Management And General | $7,274 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $990 | TotalAmt |
| Program Services | $891 | ProgramServicesAmt |
| Management And General | $99 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,250 | TotalAmt |
| Program Services | $26,325 | ProgramServicesAmt |
| Management And General | $2,925 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,481 | TotalAmt |
| Management And General | $1,481 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $833 | TotalAmt |
| Program Services | $650 | ProgramServicesAmt |
| Management And General | $183 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,945 | TotalAmt |
| Program Services | $7,096 | ProgramServicesAmt |
| Management And General | $849 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,412 | TotalAmt |
| Program Services | $89,241 | ProgramServicesAmt |
| Management And General | $25,171 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,264 | TotalAmt |
| Program Services | $15,026 | ProgramServicesAmt |
| Management And General | $4,238 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639 | TotalAmt |
| Program Services | $552 | ProgramServicesAmt |
| Management And General | $87 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,953 | TotalAmt |
| Program Services | $5,424 | ProgramServicesAmt |
| Management And General | $1,529 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,350 | TotalAmt |
| Program Services | $10,413 | ProgramServicesAmt |
| Management And General | $2,937 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SERVICES | $799,909 | $799,909 |
| DENTAL SERVICES | $238,299 | $238,299 |
| PHARMACY SERVICES | $169,378 | $169,378 |
| CLAIMS PROCESSING | $17,659 | $17,659 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,731 | TotalAmt |
| Program Services | $19,068 | ProgramServicesAmt |
| Management And General | $4,663 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,939,518 | TotalAmt |
| Program Services | $1,786,363 | ProgramServicesAmt |
| Management And General | $153,155 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,010,092 | BOYAmt |
| EOY | $1,131,500 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,999,343 | BOYAmt |
| EOY | $3,527,688 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,499 | BOYAmt |
| EOY | $131,303 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,547 | BOYAmt |
| EOY | $15,469 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $847,677 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $847,677 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,953 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,053,434 | BOYAmt |
| EOY | $4,805,960 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,187 | BOYAmt |
| EOY | $26,793 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,000 | BOYAmt |
| EOY | $80,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,187 | BOYAmt |
| EOY | $106,793 | 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 | $4,945,247 | BOYAmt |
| EOY | $4,699,167 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,945,247 | BOYAmt |
| EOY | $4,699,167 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,053,434 | BOYAmt |
| EOY | $4,805,960 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$274,425 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $28,345 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $312,604 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $369,111 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $361,943 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $58,696 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,080 | CurrentTaxYearAmt |
| Total | $1,144,434 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $312,604 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $369,111 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $361,943 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $58,696 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,080 | CurrentTaxYearAmt |
| Total | $1,144,434 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,144,434 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $104,841 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $35,716 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $61,306 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $75,349 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $54,327 | CurrentTaxYearAmt |
| Total | $331,539 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,475,973 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $6,599,525 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.77540 | PublicSupportCY170Pct |
| Public Support PY170 | 0.80750 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $847,677 | OtherCostOrOtherBasisAmt |
| Depreciation | $847,677 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CLAIMS INCURRED BUT NOT REPORTED | Desc |
| Amt | $80,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $80,000 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $1,691,957 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $28,345 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $28,345 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,663,612 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $1,481 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $1,481 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,665,093 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,938,037 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,938,037 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $1,481 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $1,481 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,939,518 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | IN PREPARING FINANCIAL STATEMENTS IN CONFORMITY WITH U.S. GAAP MANAGEMENT IS REQUIRED TO MAKE ESTIMATES AND ASSUMPTIONS THAT AFFECT THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES, THE DISCLOSURE OF CONTINGENT ASSETS AND LIABILITIES AT THE DATE OF THE FINANCIAL STATEMENTS, AND THE REPORTED AMOUNTS OF REVENUES AND EXPENSES DURING THE REPORTING PERIOD. ACTUAL RESULTS COULD DIFFER FROM THOSE ESTIMATES. THE ESTIMATE THAT IS PARTICULARLY SUSCEPTIBLE TO CHANGE IN THE NEAR TERM IS THE ACCRUAL FOR THE IBNR (INCURRED BUT NOT REPORTED) MEDICAL CLAIMS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS RECEIVED BY THE EXECUTIVE DIRECTOR, WHO REVIEWS THE RETURN FOR ACCURACY. IT IS THEN PASSED ON TO THE PRESIDENT. UPON THE PRESIDENT'S APPROVAL, THE PRESIDENT SIGNS AND FILES THE RETURN AND MAKES A COPY AVAILABLE TO THE BOARD OF DIRECTORS IN ELECTRONIC FORMAT. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS PROVIDE AN ANNUAL WRITTEN STATEMENT REGARDING CONFLICTS OR POTENTIAL CONFLICTS. BOARD MEMBERS PROVIDE VERBAL REPORTING TO THE BOARD OF CONFLICTS OR POTENTIAL CONFLICTS THAT MAY ARISE DURING THE YEAR. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE DIRECTOR WITH THE CONFLICT IS ASKED TO LEAVE THE ROOM DURING BOARD MEETINGS FOR FINAL DISCUSSION AND THE FINAL VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION COMPARES THE SALARY OF THE EXECUTIVE DIRECTOR TO THE SAME POSITION IN OTHER SIMILAR ORGANIZATIONS. A COMPARISON GUIDE ISSUED BY THE MICHIGAN NONPROFIT ASSOCIATION FOR SIMILAR POSITIONS IN THE REGION IS ALSO USED. THE PRESIDENT IS RESPONSIBLE FOR NEGOTIATING THE SALARY OR SALARY ADJUSTMENTS WITH THE EXECUTIVE DIRECTOR. ONCE AGREED, THE EXECUTIVE COMMITTEE MUST APPROVE ANY ADJUSTMENTS TO THE SALARY AND BENEFITS FOR THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990 IS ALSO POSTED ANNUALLY ON GUIDESTAR'S WEBSITE. THE 990 IS PUBLIC INFORMATION THROUGH THE MICHIGAN ATTORNEY GENERAL'S OFFICE. |