2021-11-15T13:27:50-06:00 2020-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-01-01 264826604 MONTAGE MEDICAL GROUP MONT 8317189720 PO BOX HH MONTEREY CA 93942 MATT MORGAN VP, CFO 8317189720 2021-11-10 1 MATT MORGAN 999009999 RICHARD CROGHAN P00089862 4159561500 2021-11-03 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEVEN PACKER PO BOX HH MONTEREY CA 93942 52709173 0 X WWW.MONTAGEMEDICALGROUP.ORG X 2009 CA TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 9 6 297 5 0 0 1624000 22158002 26104620 27934437 0 0 2379799 2616734 30108419 52709173 0 0 0 0 27951742 32659199 0 0 0 17338561 15506281 45290303 48165480 -15181884 4543693 7809381 6330652 58638032 52615610 -50828651 -46284958 TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 0 0 45502515 27934437 DIRECT CLINICAL SERVICES. 45502515 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 15 0 1 297 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X SHIRLEY NORMAN 8312428605 PO BOX HH MONTEREY CA 93942 RANDY CHARLES VICE CHAIR 2.00 0.00 X X 0 0 0 GURU KHALSA MD DIRECTOR 4.00 0.00 X 0 169928 0 STAN MCKEE CHAIR 9.00 9.00 X X 0 0 0 DAVID STRAFACE MD DIRECTOR 2.00 0.00 X 0 0 0 STEVEN PACKER MD DIRECTOR & PRESIDENT 10.00 45.00 X X 0 1273470 102945 WAYNE MOON DIRECTOR 2.00 0.00 X 0 0 0 LANCELOT ALEXANDER MD DIRECTOR 2.00 0.00 X 0 0 0 JACK JEWETT DIRECTOR 3.00 3.00 X 0 0 0 LAURA ZEHM DIRECTOR 1.00 54.00 X 0 719570 256951 MARK CARVLHO MD CEO, MONTAGE MEDICAL GROUP 50.00 0.00 X 0 572020 73926 MATTHEW MORGAN VP, CFO 2.00 53.00 X 0 624558 107515 SINHA NUPUR PHYSICIAN 50.00 0.00 X 507899 0 36118 STEVEN L GOLDBERG PHYSICIAN 50.00 0.00 X 587000 0 33402 AMBREEN LAEEQ PHYSICIAN 50.00 0.00 X 807000 0 1926 GREGORY SCOTT SPOWART PHYSICIAN 50.00 0.00 X 908545 0 8087 STEVEN J FOWLER PHYSICIAN 50.00 0.00 X 1015563 0 29403 3826007 3359546 650273 60 0 1 0 CYPRESS HEALTHCARE PARTNERS 100 WILSON RD STE 100 MONTEREY CA 93940 MANAGEMENT SERVICES 2457172 NEXTGEN HEALTHCARE INC PO BOX 511449 LOS ANGELES CA 90051 MEDICAL BILLING 171299 SPOTLESS FACILITY SERVICES 9000 CROW CANYON ROAD SUITE S-329 DANVILLE CA 94506 JANITORIAL SERVICES 154055 3 21482080 674822 1100 22158002 PATIENT FEES 900099 21641825 21641825 CAPITATION 900099 6292612 6292612 27934437 OTHER REVENUE 900099 2616734 2616734 2616734 52709173 27934437 0 2616734 27149653 27149653 482143 482143 3664719 3664719 1362684 1362684 3052605 389640 2662965 79627 79627 427685 427685 266600 266600 2683928 2683928 2409 2409 66167 66167 602609 602609 194400 194400 CAPITATION EXPENSE 6072079 6072079 MEDICAL SUPPLIES 1843137 1843137 DUES & SUBSCRIPTIONS 99928 99928 OTHER TAXES 48135 48135 66972 66972 48165480 45502515 2662965 0 3413732 2499322 1855646 2024829 41120 69098 4911515 3275781 2158639 1635734 340244 101669 7809381 6330652 3703991 4242895 54934041 48372715 58638032 52615610 X -50828651 -46284958 -50828651 -46284958 7809381 6330652 4543693 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 257474 257474 4654041 3275781 1378260 1635734 INTERCOMPANY PAYABLES 48372715 48372715 X PART X, LINE 2: MONTAGE, CHOMP, ASPIRE (EXCLUDING COASTAL), THE FOUNDATION, AND MMG HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME PURSUANT TO SECTION 501(C)(3) AND SECTION 23701(D) OF THE INTERNAL REVENUE CODE AND CALIFORNIA REVENUE AND TAXATION CODE, RESPECTIVELY. CCCMIC AND COASTAL ARE TAXABLE ENTITIES AND INCOME TAXES ARE ACCOUNTED FOR USING AN ASSET AND LIABILITY APPROACH THAT REQUIRES THE RECOGNITION OF DEFERRED TAX ASSETS AND LIABILITIES FOR THE EXPECTED FUTURE TAX CONSEQUENCES OF EVENTS THAT HAVE BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER THIS METHOD, DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT AND TAX BASIS OF ASSETS AND LIABILITIES USING ENACTED TAX RATES IN EFFECT FOR THE YEAR IN WHICH THE DIFFERENCES ARE EXPECTED TO REVERSE. CCCMIC AND COASTAL HAVE NET CUMULATIVE LOSSES AND THE DEFERRED TAX ASSETS ASSOCIATED WITH THESE LOSSES HAVE BEEN FULLY RESERVED. THE ORGANIZATION ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ASC TOPIC 740-10, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020 AND 2019. 0 0 0 0 0 1 1 0 0 STEVEN PACKER MD DIRECTOR & PRESIDENT 0 898356 0 318750 0 56364 0 62656 0 40289 0 1376415 0 0 STEVEN J FOWLER PHYSICIAN 651493 0 364070 0 0 0 19500 0 9903 0 1044966 0 0 0 LAURA ZEHM DIRECTOR 0 537876 0 143520 0 38174 0 225300 0 31651 0 976521 0 0 GREGORY SCOTT SPOWART PHYSICIAN 686333 0 69712 0 152500 0 0 0 8087 0 916632 0 0 0 AMBREEN LAEEQ PHYSICIAN 725000 0 0 0 82000 0 0 0 1926 0 808926 0 0 0 MATTHEW MORGAN VP, CFO 0 448062 0 150150 0 26346 0 65510 0 42005 0 732073 0 0 MARK CARVLHO MD CEO, MONTAGE MEDICAL GROUP 0 464227 0 75000 0 32793 0 24938 0 48988 0 645946 0 0 STEVEN L GOLDBERG PHYSICIAN 567433 0 0 0 19567 0 23284 0 10118 0 620402 0 0 0 SINHA NUPUR PHYSICIAN 392667 0 109232 0 6000 0 26000 0 10118 0 544017 0 0 0 GURU KHALSA MD DIRECTOR 0 169928 0 0 0 0 0 0 0 0 0 169928 0 0 PART I, LINE 3 A RELATED ORGANIZATION HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES THAT REVIEWS AND APPROVES THE OFFICERS' COMPENSATION. A CONSULTING FIRM IS ENGAGED TO PROVIDE COMPARABLE DATA. PART I, LINE 6 PRESIDENT/CEO HAS A DEFERRED COMPENSATION ARRANGEMENT BASED ON POSITIVE NET EARNINGS OF COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA. FORM 990, PART VI, SECTION A, LINE 3 CYPRESS HEALTHCARE IS A PROFESSIONAL PHYSICIAN MANAGEMENT COMPANY. WHEN THE FORMER EXECUTIVE DIRECTOR LEFT, CYPRESS HEALTHCARE ASSUMED SOME OF THE RESPONSIBILITIES OF THE ED. FORM 990, PART VI, SECTION A, LINE 6 MONTAGE HEALTH IS THE SOLE CORPORATE MEMBER OF MONTAGE MEDICAL GROUP. FORM 990, PART VI, SECTION A, LINE 7A MONTAGE HEALTH HAS THE RIGHT TO ELECT AND APPOINT THE DIRECTORS OF MONTAGE MEDICAL GROUP. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED FOR MONTAGE HEALTH: (A) THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) THE AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (C) THE AGGREGATE BORROWING FOR ANY PURPOSE OF AN AMOUNT IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY MONTAGE HEALTH FROM TIME TO TIME. FOR PURPOSES OF THIS SUBSECTION, AGGREGATE BORROWING INCLUDES, BUT IS NOT LIMITED TO, LEASE AGREEMENTS AND CONTRACTS OF SALE OR PURCHASE; (D) THE PURCHASE, SALE, LEASE, DISPOSITION, EXCHANGE, GIFT, PLEDGE OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, OF THE CORPORATION WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY MONTAGE HEALTH FROM TIME TO TIME; (E) THE APPROVAL OF ANY TRANSACTION OF THE CORPORATION IN WHICH A DIRECTOR OR OFFICER OF THE CORPORATION HAS A MATERIAL FINANCIAL INTEREST; (F) THE APPOINTMENT OF LEGAL COUNSEL AND AUDITORS FOR THE CORPORATION; (G) THE APPOINTMENT OF THE AUDIT COMMITTEE FOR THE CORPORATION; (H) THE ESTABLISHMENT OF LONG RANGE GOALS, PLANS AND STRATEGIES FOR THE CORPORATION; (I) THE APPOINTMENT OR REMOVAL OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; (J) THE APPROVAL OF THE EXACT NUMBER OF AUTHORIZED DIRECTORS WITHIN THE VARIABLE RANGE ESTABLISHED PURSUANT TO SECTION 2 OF ARTICLE IV OF THESE BYLAWS; AND (K) THE FILLING OF ANY VACANCY ON THE BOARD OF DIRECTORS, INCLUDING, WITHOUT LIMITATION, ANY VACANCY CREATED BY THE REMOVAL OF A DIRECTOR. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND VP FINANCE IS RESPONSIBLE FOR REVIEWING THE FORM 990 BEFORE FILING. ELECTRONIC COPIES ARE SENT TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION USES SELF DISCLOSURE BY INTERESTED PERSONS AND MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY REQUEST. MONTAGE HEALTH PO BOX HH MONTEREY CA 93942 942789696 SUPPORT SERVICES CA 501(C)(3) LINE 10 N/A 0 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PO BOX HH MONTEREY CA 93942 940760193 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 ASPIRE HEALTH PLAN 10 RAGSDALE DRIVE SUITE 101 MONTEREY CA 93940 461567681 INSURANCE COMPANY CA 501(C)(4) MONTAGE HEALTH 0 MONTAGE HEALTH FOUNDATION PO BOX HH MONTEREY CA 93942 812889645 SUPPORT SERVICES CA 501(C)(3) LINE 7 MONTAGE HEALTH 0 MOGO URGENT CARE PO BOX HH MONTEREY CA 93942 832329260 MEDICAL SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 CENTRAL COAST HEALTH CONNECT LLC 10 RAGSDALE DRIVE SUITE 102 MONTEREY CA 93940 611759835 HEALTH SERVICES CA N/A 0 0 COMMUNITY HEALTH INNOVATIONS LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 454537290 HEALTH SERVICES CA N/A 0 0 SAN CARLOS & 7TH LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 274672809 REAL ESTATE CA N/A 0 0 MONTEREY BAY ENDOSCOPY CENTER LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 770324855 ENDOSCOPY CENTER CA N/A 0 0 CYPRESS MEDICAL NETWORK INC PO BOX HH MONTEREY CA 93942 770438780 MEDICAL SERVICES CA N/A 0 CENTRAL COAST COMMUNITY MUTUAL INSURANCE COMPANY 40 MAIN STREET SUITE 200 BURLINGTON VT 05401 454016797 INSURANCE CA N/A 0 COASTAL TPA INC PO BOX 80308 SALINAS CA 93912 770523382 MEDICAL CLAIMS PROCESSING CA N/A 0 COASTAL HEALTHCARE ADMINISTRATORS PO BOX 80308 SALINAS CA 93912 770311413 MEDICAL CLAIMS PROCESSING CA N/A 0 BAY SERVICES INC PO BOX 80308 SALINAS CA 93912 942250761 SERVICES CA N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1