2020-11-12T10:52:23-06:00 2019-12-31 560574444 CHERRY BEKAERT LLP 221 W 6TH STREET STE 1900 AUSTIN TX 78701 990 2019-01-01 473641754 C2C INNOVATIVE SOLUTIONS INC C2CI 5123341622 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 PAMELA HOERNIS TREASURER 5123341622 2020-11-11 1 KELLY LOGAN P00677048 5124796000 74.194.175.126 2020-11-11 10:44:17 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 86472BABD63B551805D182B648D7FCF54F1029D7 2019 2021-01-29 14:40:06Z PAMELA HOERNIS 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 41292782 0 X WWW.C2CINC.COM X 2015 TX PROVIDE BEST VALUE ADMINISTRATIVE SERVICES AND QUALITY MANAGEMENT PRINCIPLES THAT PROMOTE CONTINUOUS IMPROVEMENT. 5 3 343 0 0 0 54345416 40725250 0 200295 10796 359335 0 0 54356212 41284880 0 42093 0 0 27559985 23069240 0 0 0 15923636 12785935 43483621 35897268 10872591 5387612 30115798 35440248 5845215 5745960 24270583 29694288 PROVIDE BEST VALUE ADMINISTRATIVE SERVICES AND QUALITY MANAGEMENT PRINCIPLES THAT PROMOTE CONTINUOUS IMPROVEMENT. 0 0 25679473 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. 83927 109410 C2C SERVES AS A SUBCONTRACTOR PERFORMING MEDICAL RECORD REVIEW OF VETERAN'S ADMINISTRATION DISABILITY RATINGS SUBMISSIONS OR CLAIMS. 89937 13234 C2C SERVES AS A CONTRACTOR ACROSS VARIOUS STATES AS AN INDEPENDENT REVIEW ORGANIZATION FOR WORKER'S COMPENSATION CLAIMS. 45435 42093 77651 45435 42093 77651 25898772 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 15 0 1 343 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 1.60 43.70 X X 0 904099 39954 LOUIS POLISE BOARD OF TRUSTEES 1.60 X 10250 0 0 DONALD P FORGIONE BOARD OF TRUSTEES 1.60 X 10250 0 0 GARY CRAYTON BOARD OF TRUSTEES 1.60 X 10250 0 0 JEFF PETERSON PRESIDENT 47.50 X X 461903 0 59708 PAMELA HOERNIS TREASURER 1.60 48.70 X 0 464637 59511 BRIAN ANDREW STOTLER PROGRAM DIRECTOR 44.70 X 227499 0 49920 SHERI L SOUERS PROGRAM DIRECTOR 48.50 X 202587 0 49742 LISA HANSON GENERAL COUNSEL 43.40 X 200552 0 37796 NICHOLETTE WARNER PROGRAM DIRECTOR 46.00 X 188971 0 17761 FRANK A DELLI CARPINI MD MEDICAL DIRECTOR 48.40 X 421660 0 52127 DYLAN DEATRICH PHYSICIAN REVIEWER 52.20 X 194186 0 53492 MICHAEL OWENS MD MEDICAL DIRECTOR 48.20 X 321856 0 58140 KENNETH STONE PHYSICIAN REVIEWER 30.00 X 180626 0 38145 CHARLOTTE STELLY-SEITZ MD ASSOCIATE MEDICAL DIRECTOR 38.40 X 224580 0 26833 2655170 1368736 543129 26 0 1 0 FEDERAL HEARINGS & APPEALS SERVICES INC 117 WEST MAIN STREET PLYMOUTH PA 18651 A CONTRACTOR PROCESSING QIC APPEALS 2690256 HM HEALTH SOLUTIONS INC 4800 DEERWOOD CAMPUS PARKWAY JACKSONVILLE FL 322466498 PRINTING AND MAILING SERVICES 633612 2 40725250 40725250 CONTRACTS 524298 200295 200295 200295 359335 359335 7902 7902 0 41284880 559630 0 0 42093 42093 2655169 2451603 203566 15860608 14644611 1215997 1466778 1354323 112455 1782814 1646130 136684 1303871 1203906 99965 45877 45877 132414 128261 4153 491040 475642 15398 133325 55033 78292 5871 2423 3448 287846 281075 6771 INTERCOMPANY 7894160 0 7894160 CONTRACTOR 3027628 3023128 4500 POSTAGE 304824 295266 9558 MAINTENANCE AND REPAIRS 137928 133603 4325 325022 161675 163347 35897268 25898772 9998496 0 21247435 28634087 7568719 5808972 29482 288654 2561585 2218314 639018 343271 265880 365264 365264 30115798 35440248 3645588 3013387 110094 497127 2089533 2235446 5845215 5745960 X 24270583 29694288 24270583 29694288 30115798 35440248 X 5387612 46303 -10210 X X 1 X 1 X 1 0 X 11368425 57629565 54400904 54345416 40725250 218469560 11368425 57629565 54400904 54345416 40725250 218469560 218469560 1462 4224 10772 359335 375793 218845353 200295 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1715027 1381177 333850 846558 837137 9421 343271 PAYABLE TO TMF HEALTH QUALITY INSTITUTE 1744469 DEFERRED LEASES 490977 2235446 X 41331183 46303 46303 41284880 0 41284880 35907478 10210 10210 35897268 0 35897268 PART X, LINE 2: C2C IS A NON-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. UNRELATED BUSINESS TAXABLE INCOME WAS NOMINAL FOR C2C AS OF DECEMBER 31, 2019 AND 2018. C2C IS GENERALLY NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR RETURNS SUBMITTED PAST THREE YEARS. 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, 2019 OR 2018. PART XII, LINE 2D - OTHER ADJUSTMENTS: PRIOR YEAR FEDERAL INCOME TAX BENEFIT 10,210. 0 RONALD MCDONALD HOUSE CHARITIES OF CENTRAL TEXAS INC 1315 BARBARA JORDAN BLVD AUSTIN TX 78723 742277664 501(C)(3) 10000 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) 11955 DONATION 3 X X X X 0 1 0 1 1 1 1 1 0 THOMAS MANLEY CHAIRMAN 0 562638 0 303970 0 37491 0 28284 0 11670 0 944053 0 0 JEFF PETERSON PRESIDENT 336120 0 125783 0 0 0 28284 0 31424 0 521611 0 0 0 PAMELA HOERNIS TREASURER 0 320401 0 120465 0 23771 0 28284 0 31227 0 524148 0 0 BRIAN ANDREW STOTLER PROGRAM DIRECTOR 167302 0 46456 0 13741 0 23355 0 26565 0 277419 0 0 0 SHERI L SOUERS PROGRAM DIRECTOR 151999 0 38040 0 12548 0 20538 0 29204 0 252329 0 0 0 LISA HANSON GENERAL COUNSEL 157897 0 36333 0 6322 0 19554 0 18242 0 238348 0 0 0 NICHOLETTE WARNER PROGRAM DIRECTOR 161009 0 27962 0 0 0 17255 0 506 0 206732 0 0 0 FRANK A DELLI CARPINI MD MEDICAL DIRECTOR 343099 0 78561 0 0 0 28284 0 23843 0 473787 0 0 0 DYLAN DEATRICH PHYSICIAN REVIEWER 164536 0 22780 0 6870 0 19606 0 33886 0 247678 0 0 0 MICHAEL OWENS MD MEDICAL DIRECTOR 258894 0 62962 0 0 0 28284 0 29856 0 379996 0 0 0 KENNETH STONE PHYSICIAN REVIEWER 154592 0 21893 0 4141 0 17124 0 21021 0 218771 0 0 0 CHARLOTTE STELLY-SEITZ MD ASSOCIATE MEDICAL DIRECTOR 191700 0 32880 0 0 0 21451 0 5382 0 251413 0 0 0 PART I, LINE 4B JEFF PETERSON: $73,041 TOM MANLEY: $83,550 PAMELA HOERNIS: $15,451 PART I, LINE 5 TMF HEALTH QUALITY INSTITUTE HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE REVENUES OF THE ORGANIZATION AND IT'S SUBSIDIARY, C2C INNOVATIVE SOLUTIONS, INC. 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. PART I, LINE 6 TMF HEALTH QUALITY INSTITUTE HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION AND IT'S SUBSIDIARY, C2C INNOVATIVE SOLUTIONS, INC.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. PART I, LINE 7 TMF HEALTH QUALITY INSTITUTE 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 AND IT'S SUBSIDIARY, C2C INNOVATIVE SOLUTIONS, INC. 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. 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 2019. 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 PRESIDENTS'S DETERMINATION OR MODIFY IT. THE BOARD SETS WHAT IT DETERMINES TO BE APPROPRIATE COMPENSATION FOR THE PRESIDENT. THE PROCESS AND INFORMATION REVIEWED IN MAKING THESE DETERMINATIONS IS DOCUMENTED CONTEMPORANEOUSLY. FORM 990, PART VI, SECTION C, LINE 18 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: FEDERAL INCOME TAX EXPENSE -10,210. FORM 990, PART XII, LINE 2C: THE PROCESS OF OVERSEEING THE AUDIT OF THE FINANACIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. TMF HEALTH QUALITY INSTITUTE 3107 OAK CREEK DRIVE STE 200 AUSTIN TX 78727 521002260 HEALTH 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 TMF HEALTH QUALITY INSTITUTE O 7894160 FMV