2021-11-15T12:42:06-06:00 2020-12-31 560574444 CHERRY BEKAERT LLP 221 W 6TH STREET STE 1900 AUSTIN TX 78701 990 2020-01-01 473641754 C2C INNOVATIVE SOLUTIONS INC C2CI 5123341622 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 PAMELA L HOERNIS TREASURER 5123341622 2021-11-14 1 PAMELA HOERNIS 999009999 KELLY LOGAN P00677048 5124796000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PAMELA L HOERNIS 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 35889777 0 X WWW.C2CINC.COM X 2015 TX PROVIDE BEST VALUE ADMINISTRATIVE SERVICES AND QUALITY MANAGEMENT PRINCIPLES THAT PROMOTE CONTINUOUS IMPROVEMENT. 5 3 280 0 0 0 40725250 35343989 200295 399448 359335 146340 0 0 41284880 35889777 42093 38096 0 0 23069240 20083056 0 0 0 12785935 11795971 35897268 31917123 5387612 3972654 35440248 37848537 5745960 4136557 29694288 33711980 X PROVIDE BEST VALUE ADMINISTRATIVE SERVICES AND QUALITY MANAGEMENT PRINCIPLES THAT PROMOTE CONTINUOUS IMPROVEMENT. 0 0 20740307 C2C INNOVATIVE SOLUTIONS INC. (C2C) SERVES AS A FEDERAL CONTRACTOR FOR THE MEDICARE PROGRAM SINCE THE INCEPTION OF THE SECOND-LEVEL APPEAL PROCESS IN SEPTEMBER 2004. AS A QUALIFIED INDEPENDENT CONTRACTOR (QIC), C2C ADJUDICATES SECOND-LEVEL MEDICARE APPEALS CALLED RECONSIDERATIONS FOR SEVERAL JURISDICTIONS WITH NATIONAL SCOPE. 304445 348854 C2C SERVES AS A SUBCONTRACTOR PERFORMING MEDICAL RECORD REVIEW OF VETERAN'S ADMINISTRATION DISABILITY RATINGS SUBMISSIONS OR CLAIMS. 17184 27256 C2C SERVES AS A SUBCONTRACTOR CONDUCTING CODING AND COVERAGE REVIEWS OF MCO (MANAGED CARE ORGANIZATIONS) TO DETERMINE WHETHER MEDICARE CLAIMS WERE PAID IN ACCORDANCE WITH CMS COVERAGE, CODING, PAYMENT AND BILLING POLICIES, AND ALLOW FOR THE RECOUPMENT OF ANY OVERPAYMENT AS A RESULT OF IDENTIFIED ERRORS. 71910 38096 23338 C2C SERVES AS AN INTERNAL REVIEW ORGANIZATION FOR VARIOUS STATES. 71910 38096 23338 21133846 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 18 0 1 280 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PAMELA L HOERNIS 5123341622 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 THOMAS MANLEY CHAIRMAN 23.50 20.30 X X 0 852838 52942 LOUIS POLISE TRUSTEE 1.60 X 10125 0 0 DONALD P FORGIONE TRUSTEE 1.60 X 10125 0 0 GARY CRAYTON TRUSTEE 1.60 X 10125 0 0 JEFF PETERSON PRESIDENT 46.20 X X 440968 0 52559 PAMELA HOERNIS TREASURER 23.30 20.20 X 0 453596 38874 LISA HANSON SECRETARY/GENERAL COUNSEL 44.20 X 204953 0 33972 BRIAN ANDREW STOTLER PROGRAM DIRECTOR 47.90 X 218153 0 42428 SHERI L SOUERS PROGRAM DIRECTOR 46.30 X 200986 0 39715 NICHOLETTE WARNER PROGRAM DIRECTOR 45.30 X 187275 0 17099 FRANK A DELLI CARPINI MD CHIEF MEDICAL OFFICER 49.10 X 433043 0 46329 DYLAN DEATRICH MEDICAL DIRECTOR 40.00 X 201780 0 37341 MICHAEL OWENS MD MEDICAL DIRECTOR 47.10 X 327921 0 52103 MELISSA HORNER MD PHYSICIAN REVIEWER 30.40 X 167390 0 14527 BARBARA YAKIMOWICZ DIRECTOR, QUALITY & LEGAL AFFAIRS 43.50 X 177769 0 23929 2590613 1306434 451818 23 0 1 0 TMF HEALTH QUALITY INSTITUTE 3107 OAK CREEK DRIVE STE 200 AUSTIN TX 78727 MANAGEMENT SERVICES 8827774 FEDERAL HEARINGS & APPEALS SERVICES INC 117 WEST MAIN STREET PLYMOUTH PA 18651 SUBCONTRACTOR- PROCESSING OF APPEALS 1383158 HM HEALTH SOLUTIONS INC 4800 DEERWOOD CAMPUS PARKWAY JACKSONVILLE FL 322466498 PRINTING AND MAILING SERVICES 400529 KONICA MINOLTA BUSINESS SOLUTIONS USA I DEPT 952823 ATLANTA GA 311922823 PRINTER MAINTENANCE 131257 4 35343989 35343989 PROJECT REVENUE 524298 399448 399448 399448 146340 146340 35889777 399448 0 146340 X 38096 38096 1468483 1342791 125692 14779220 13514224 1264996 1280975 1171333 109642 1399029 1279282 119747 1155349 1056459 98890 10650 10650 10349539 1471179 8878360 456198 439555 16643 483931 466277 17654 7941 4616 3325 245857 235517 10340 DUES AND SUBSCRIPTIONS 114203 54168 60035 BOARD EXPENSES 35420 35420 EMPLOYEE RELATIONS 34461 15015 19446 COMMUNICATIONS 32221 27458 4763 25550 17876 7674 31917123 21133846 10783277 0 28634087 6762776 25505700 5808972 4380029 288654 741559 2561585 2468376 343271 93209 365264 365264 35440248 37848537 3013387 2784823 497127 74246 2235446 1277488 5745960 4136557 X 29694288 33711980 29694288 33711980 35440248 37848537 3972654 45038 0 X 1 X 1 X 1 0 X 57629565 54400904 54345416 40725250 35343989 242445124 57629565 54400904 54345416 40725250 35343989 242445124 242445124 1462 4224 10772 359335 146340 522133 242967257 599743 0.99790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1715027 1623474 91553 846558 844902 1656 93209 PAYABLE TO TMF HEALTH QUALITY INSTITUTE 1140143 DEFERRED LEASES 137345 1277488 X PART X, LINE 2: C2C ASSESSES UNCERTAINTIES IN INCOME TAX RECOGNITION IN ITS FINANCIAL STATEMENTS AND USES A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION AND DERECOGNITION OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN. C2C HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020 OR 2019. 1 RONALD MCDONALD HOUSE CHARITIES 824 CHILDRENS WAY JACKSONVILLE FL 32207 592625008 501(C)(3) 7500 DONATION DREAMS COME TRUE OF JACKSONVILLE INC 6803 SOUTHPOINT PARKWAY JACKSONVILLE FL 32216 592967803 501(C)(3) 5000 DONATION CITY RESCUE MISSION INC 800 W CALIFORNIA AVE OKLAHOMA CITY OK 73106 730713883 501(C)(3) 10000 DONATION 3 PART I, LINE 2: THE ORGANIZATION ONLY MAKES GRANTS TO ESTABLISHED 501(C)(3) ORGANIZATIONS FOR GENERAL SUPPORT SO MONITORING THE USE OF THE GRANT FUNDS IS NOT CONSIDERED NECESSARY. X X X X 0 1 0 1 1 1 1 1 0 THOMAS MANLEY CHAIRMAN 0 562716 0 255309 0 34813 0 28692 0 24250 0 905780 0 0 JEFF PETERSON PRESIDENT 337314 0 103654 0 0 0 28692 0 23867 0 493527 0 0 0 PAMELA HOERNIS TREASURER 0 326567 0 101738 0 25291 0 28692 0 10182 0 492470 0 0 FRANK A DELLI CARPINI MD CHIEF MEDICAL OFFICER 336903 0 70100 0 26040 0 28312 0 18017 0 479372 0 0 0 MICHAEL OWENS MD MEDICAL DIRECTOR 257959 0 59578 0 10384 0 28692 0 23411 0 380024 0 0 0 BRIAN ANDREW STOTLER PROGRAM DIRECTOR 167420 0 36992 0 13741 0 22110 0 20318 0 260581 0 0 0 SHERI L SOUERS PROGRAM DIRECTOR 152620 0 35818 0 12548 0 19964 0 19751 0 240701 0 0 0 DYLAN DEATRICH MEDICAL DIRECTOR 172020 0 22735 0 7025 0 19906 0 17435 0 239121 0 0 0 LISA HANSON SECRETARY/GENERAL COUNSEL 158274 0 34036 0 12643 0 19910 0 14062 0 238925 0 0 0 NICHOLETTE WARNER PROGRAM DIRECTOR 162445 0 24830 0 0 0 16750 0 349 0 204374 0 0 0 BARBARA YAKIMOWICZ DIRECTOR, QUALITY & LEGAL AFFAIRS 153671 0 24098 0 0 0 16097 0 7832 0 201698 0 0 0 MELISSA HORNER MD PHYSICIAN REVIEWER 145476 0 15851 0 6063 0 14527 0 0 0 181917 0 0 0 PART I, LINE 4B THE ORGANIZATION MAINTAINS A DEFINED CONTRIBUTION SUPPLEMENTAL RETIREMENT PLAN IN WHICH A SELECT GROUP OF HIGHLY COMPENSATED EMPLOYEES PARTICIPATES. THE PLAN IS INTENDED TO BE, AND SHALL BE CONSTRUED AS, UNFUNDED FOR TAX PURPOSES AND FOR PURPOSES OF ERISA. EACH PARTICIPATING EMPLOYEE WILL BECOME 100 PERCENT VESTED IN THE BALANCE AND BE PAID ON OR WITHIN 30 DAYS OF ONE OF THE FOLLOWING: ATTAINMENT OF AGE 63 WHILE STILL EMPLOYED, SEPARATION FROM SERVICE BY REASON OF DEATH OR DISABILITY, SEPARATION FROM SERVICE FOR GOOD REASON OR INVOLUNTARY SEPARATION OF SERVICE. DURING THE TAX YEAR, THE FOLLOWING AMOUNTS WERE CONTRIBUTED TO THE PLAN ON BEHALF OF THE LISTED INDIVIDUALS: JEFF PETERSON: $73,295 TOM MANLEY: $83,550 PAMELA HOERNIS: $16,439 PART I, LINE 5 C2C INNOVATIVE SOLUTIONS, INC. HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE REVENUES OF THE ORGANIZATION. THE ORGANIZATION HAS AN ANNUAL SCORECARD WHERE REVENUE IS MEASURED. THERE IS A MINIMUM, TARGET AND MAXIMUM AND THE AMOUNT OF THE INCENTIVE IS BASED ON WHERE THE FINAL REVENUES END UP IN COMPARISON TO THE MINIMUM, TARGET AND MAXIMUM. THE MAXIMUM PAYOUT IS 120% OF TARGET PERCENTAGE AND IS ADJUSTED BASED ON REVENUE ACHIEVED. ALL C2C EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. PART I, LINE 6 C2C INNOVATIVE SOLUTIONS, INC. HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION. THE ORGANIZATION HAS AN ANNUAL SCORECARD OF WHICH REVENUE AND NET INCOME ARE MEASURED. THERE IS A MINIMUM, TARGET AND MAXIMUM AND THE AMOUNT OF THE INCENTIVE IS BASED ON WHERE THE FINAL NET EARNINGS ENDS UP IN COMPARISON TO THE MINIMUM, TARGET AND MAXIMUM. THE MAXIMUM PAYOUT IS 120% OF TARGET PERCENTAGE AND IS ADJUSTED BASED ON NET EARNINGS ACHIEVED. ALL C2C EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. PART I, LINE 7 C2C INNOVATIVE SOLUTIONS, INC. HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON OTHER PERFORMANCE INCLUDING BUT NOT LIMITED TO NEW BUSINESS GOALS, PROFIT MARGIN AND COMPLIANCE REQUIREMENTS OF THE ORGANIZATION. THE MAXIMUM PAYOUT IS 120% OF TARGET PERCENTAGE AND IS ADJUSTED BASED ON TOTAL RESULTS ACHIEVED. ALL C2C EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. FORM 990, PART VI, SECTION A, LINE 6 TMF HEALTH QUALITY INSTITUTE IS THE ONLY MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ELECT TRUSTEES FROM A SLATE OF CANDIDATES CHOSEN BY THE NOMINATING COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B THE APPOINTED BOARD MEMBER OF C2C INNOVATIVE SOLUTIONS, INC.'S BOARD OF TRUSTEES WILL RECEIVE A REDACTED COPY OF THE IRS FORM 990 TAX RETURN PRIOR TO ITS FILING WITH THE IRS. THE APPOINTED BOARD MEMBER AND THE CFO WILL REVIEW THE FORM. THE REVIEW WILL INCLUDE THE FOLLOWING: * DISCUSSION OF NEW IRS REQUIREMENTS AND REVISIONS TO THE FORM 990 FROM THE PREVIOUS YEAR. * A BRIEF DESCRIPTION OF SCHEDULES AND RELATED ATTACHMENTS ALL MEMBERS OF THE BOARD OF TRUSTEES WILL RECEIVE A PRINTED OR ELECTRONIC COPY OF THE COMPLETED FORM 990 PRIOR TO FILING OF THE IRS FORM 990. DURING THE NEXT SCHEDULED BOARD MEETING, THE BOARD WILL DISCUSS THE IRS FORM 990. THERE WILL BE AN OPPORTUNITY FOR ALL BOARD MEMBERS TO ASK QUESTIONS REGARDING THE TAX RETURN. ANY DISCUSSIONS OF THE COMPLETED IRS FORM 990 WILL BE DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO PROVIDE C2C WITH A DISCLOSURE OF ENTITIES AND RELATIONSHIPS THAT COULD GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST. THIS INFORMATION IS PROVIDED TO AND REVIEWED BY C2C'S COMPLIANCE OFFICER. BEFORE C2C ENTERS INTO A CONTRACT OR OTHER FINANCIAL RELATIONSHIP WITH A THIRD PARTY, THE CONTRACT OR SUBSTANCE OF THE FINANCIAL RELATIONSHIP IS SUBMITTED TO C2C'S COMPLIANCE OFFICER WHO CONDUCTS A CONFLICTS OF INTEREST ASSESSMENT. IF C2C'S COMPLIANCE OFFICER IS SATISFIED THAT THE CONTRACT OR OTHER RELATIONSHIP WOULD NOT RESULT IN A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST, C2C WILL PROCEED WITH THE CONTRACT OR RELATIONSHIP. IF A CONFLICT OR THE APPEARANCE OF A CONFLICT IS DETERMINED, C2C WILL NOT PROCEED WITH THE CONTRACT OR RELATIONSHIP UNLESS AN ACCEPTABLE MITIGATION PLAN CAN BE DEVELOPED AND IMPLEMENTED. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES OBTAINS INFORMATION FROM SOURCES IT DEEMS RELEVANT AND NECESSARY TO DETERMINE REASONABLE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. IN ADDITION TO C2C'S CHIEF HUMAN RESOURCES OFFICER, AN INDEPENDENT CONSULTANT IS OBTAINED PERIODICALLY, TO REVIEW APPROPRIATE LEVELS OF COMPENSATION FOR ALL THESE PEOPLE AND MAKE RECOMMENDATIONS TO THE BOARD. THE CONSULTANT WAS LAST OBTAINED IN 2021. THE PRESIDENT REVIEWS THE RECOMMENDATIONS OF THE CHIEF HUMAN RESOURCES OFFICER AND ANY INDEPENDENT CONSULTANT AND ADVISES THE BOARD OF THE DETERMINATION CONCERNING THE COMPENSATION OF ALL OFFICERS AND KEY EMPLOYEES OTHER THAN THE PRESIDENT. THE BOARD MAY ACCEPT THE PRESIDENT'S DETERMINATION OR MODIFY IT. THE BOARD SETS WHAT IT DETERMINES TO APPROPRIATE COMPENSATION FOR THE PRESIDENT. THE PROCESS AND INFORMATION REVIEWED IN MAKING THESE DETERMINATIONS IS DOCUMENTED CONTEMPORANEOUSLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,827,774. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,827,774. SUBCONTRACTORS: PROGRAM SERVICE EXPENSES 1,471,179. MANAGEMENT AND GENERAL EXPENSES 50,586. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,521,765. TMF HEALTH QUALITY INSTITUTE 3107 OAK CREEK DRIVE STE 200 AUSTIN TX 78727 521002260 ENCOURAGE THE DELIVERY OF HIGH QUALITY MEDICAL CARE TX 501(C)(3) 170(B)(1)(A)(VI) N/A 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 1 1 0 0 0