GENESEE VALLEY GROUP HEALTH ASSOCIATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- GENESEE VALLEY GROUP HEALTH ASSOCIATION (EIN 16-1005419)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-06-27
- IRS object ID
- 201911789349300866
- Schema version
- 2018v3.0
- 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 | 2019-06-27T13:40:33-07:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161005419 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENESEE VALLEY GROUP HEALTH ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GENE | BusinessNameControlTxt |
| Phone | 5852384579 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 165 Court Street | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14647 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary OReilly | PersonNm |
| Person Title | Vice President & Asst Treasurer | PersonTitleTxt |
| Phone | 5855305680 | PhoneNum |
| Signature | 2019-06-27 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 206.197.236.42 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lifetime Health Medical Group | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Paul Einsenstat | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 165 Court Street | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14647 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,512,144 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | Genesee Valley Group Health Association, Inc. previously provided primary health care for patients in Buffalo & Rochester. A variety of services were offered at each health center and most sites to include pharmacy, laboratory, radiology, internal medicine, pediatrics, family practice & specialty care. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 0 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 385 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,508,935 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,916,450 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,873,221 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,771,235 | PYOtherRevenueAmt |
| CY Other Revenue | $214,328 | CYOtherRevenueAmt |
| PY Total Revenue | $38,196,620 | PYTotalRevenueAmt |
| CY Total Revenue | $2,087,549 | 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 | $41,343,128 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,206,821 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,812,368 | PYOtherExpensesAmt |
| CY Other Expenses | $3,974,153 | CYOtherExpensesAmt |
| PY Total Expenses | $54,155,496 | PYTotalExpensesAmt |
| CY Total Expenses | $6,180,974 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$15,958,876 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,093,425 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,270,189 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $49,436,327 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$37,166,138 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Prior to its dissolution, Lifetime Health Medical Group existed to support its patients' pursuit of healthier lives by providing exceptional, high quality and affordable services in a caring environment. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $0 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Health Care Delivery: Health Services (0 visits) | Desc |
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | Yes (1) | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 385 | 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 | 0 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | NY | StatesWhereCopyOfReturnIsFldCd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary O'Reilly | PersonNm |
| Phone | 5855305680 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 165 Court Street | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14647 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Christopher C Booth | ||||||||||
| Director | 0.4 | 40 | Yes (X) | $0 | $2,890,585 | $262,374 | ||||
| Dorothy Coleman | ||||||||||
| CFO and Treasurer | 0.4 | 40 | Yes (X) | $0 | $1,386,373 | $102,901 | Yes (X) | |||
| Stephen Sloan | ||||||||||
| Secretary | 0.4 | 40 | Yes (X) | $0 | $1,078,679 | $128,552 | Yes (X) | |||
| Paul Eisenstat | ||||||||||
| CEO | 2.0 | 40 | $0 | $705,837 | $74,124 | Yes (X) | ||||
| Stephen LaSalle | ||||||||||
| COO | 40 | 0 | $0 | $391,221 | $65,778 | Yes (X) | Yes (X) | |||
| Margaret Cassady | ||||||||||
| Assistant Secretary | 8.8 | 40 | $0 | $302,409 | $43,297 | Yes (X) | ||||
| James Haefner | ||||||||||
| Assistant Treasurer | 0.8 | 40 | $0 | $340,173 | $97,963 | Yes (X) | ||||
| Mary O'Reilly | ||||||||||
| Assistant Treasurer | 0.4 | 40 | $0 | $174,177 | $36,012 | Yes (X) | ||||
| Stephen Cohen | ||||||||||
| President | 20 | 20 | $0 | $440,610 | $87,971 | Yes (X) | Yes (X) | |||
| Mark Perry | ||||||||||
| Chief Medical Officer | 40 | 0 | $0 | $241,917 | $5,776 | Yes (X) | ||||
| Robert Cole | ||||||||||
| Medical Director | 40 | 0 | $202,291 | $0 | $3,074 | Yes (X) | ||||
| Douglas Golding | ||||||||||
| Medical Director | 40 | 0 | $0 | $205,853 | $11,290 | Yes (X) | ||||
| Deborah Carlascio | ||||||||||
| VP Patient Clinicial Services | 40 | 0 | $0 | $291,019 | $26,926 | Yes (X) | ||||
| Karen Feigel | ||||||||||
| Communications Director | 3.0 | 40.00 | $36,997 | $131,640 | $37,715 | Yes (X) | ||||
| Mary Kolbert | ||||||||||
| Highly Compensated Employee | 40 | 0 | $113,084 | $0 | $0 | Yes (X) | ||||
| Shannon O'Brien | ||||||||||
| Highly Compensated Employee | 40 | 0 | $107,363 | $0 | $2,090 | Yes (X) | ||||
| Marc Reinhardt | ||||||||||
| Highly Compensated Employee | 40 | 0 | $105,874 | $0 | $13,829 | Yes (X) | ||||
| Maritza Baez | ||||||||||
| Former Highly Compensated Employee | 0 | 0 | $121,666 | $0 | $0 | Yes (X) | ||||
| Richard Vienne | ||||||||||
| Former Highly Compensated Employee | 0 | 40.00 | $0 | $339,157 | $60,057 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $687,275 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,919,650 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,059,729 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Ciminelli Real Estate Corp | |||||
| 50 Fountain Plaza | Buffalo | NY | 14202 | Property Mgmt Services | $477,669 |
| Quality Systems Inc | |||||
| PO Box 809390 | Chicago | IL | 60680 | Software Maintenance | $356,671 |
| Windsong Radiology Group | |||||
| 55 Spindrift Drive | Williamsville | NY | 14221 | Radiology Services | $286,775 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $2,297,816 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $424,595 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $1,873,221 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,873,221 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,873,221 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $214,328 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $214,328 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $214,328 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,087,549 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $214,328 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,873,221 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,142,493 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,142,493 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,069 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $378,069 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,305 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $98,305 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,796 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $375,796 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,158 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $212,158 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,583 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $110,583 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,465 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $10,465 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,271 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $638,271 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,027,659 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,027,659 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $376,272 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $376,272 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,389,632 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,389,632 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,834 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $4,834 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,032 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,032 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,486 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $12,486 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $671 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,051 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $362,051 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Exp - Miscellaneous | Desc |
| Total | $40,197 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $40,197 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,180,974 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $6,180,974 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,204,349 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,041 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,154 | BOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $426,608 | BOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,568,037 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,270,189 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,579,553 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,856,774 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,436,327 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$37,166,138 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$37,166,138 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,270,189 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,093,425 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $41,259,563 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Christopher C Booth | ||||||||||||||
| Director | $0 | $1,069,395 | $0 | $1,811,782 | $0 | $9,408 | $0 | $234,746 | $0 | $27,628 | $0 | $3,152,959 | $0 | $0 |
| Deborah Carlascio | ||||||||||||||
| VP Patient Clinicial Services | $0 | $52,755 | $0 | $55,836 | $0 | $182,428 | $0 | $12,259 | $0 | $14,667 | $0 | $317,945 | $0 | $0 |
| Margaret Cassady | ||||||||||||||
| Assistant Secretary | $0 | $247,613 | $0 | $51,933 | $0 | $2,863 | $0 | $29,810 | $0 | $13,487 | $0 | $345,706 | $0 | $0 |
| Stephen Cohen | ||||||||||||||
| President | $0 | $316,097 | $0 | $119,226 | $0 | $5,287 | $0 | $65,578 | $0 | $22,393 | $0 | $528,581 | $0 | $0 |
| Robert Cole | ||||||||||||||
| Medical Director | $0 | $0 | $167,564 | $0 | $34,727 | $0 | $0 | $0 | $3,074 | $0 | $205,365 | $0 | $0 | $0 |
| Dorothy Coleman | ||||||||||||||
| CFO and Treasurer | $0 | $602,573 | $0 | $776,357 | $0 | $7,443 | $0 | $78,230 | $0 | $24,671 | $0 | $1,489,274 | $0 | $0 |
| Paul Eisenstat | ||||||||||||||
| CEO | $0 | $398,715 | $0 | $305,034 | $0 | $2,088 | $0 | $50,413 | $0 | $23,711 | $0 | $779,961 | $0 | $0 |
| Karen Feigel | ||||||||||||||
| Communications Director | $5,852 | $87,084 | $20,752 | $0 | $10,393 | $44,556 | $186 | $10,908 | $999 | $25,622 | $38,182 | $168,170 | $0 | $0 |
| Douglas Golding | ||||||||||||||
| Medical Director | $0 | $4,286 | $0 | $74,294 | $0 | $127,273 | $0 | $0 | $0 | $11,290 | $0 | $217,143 | $0 | $0 |
| James Haefner | ||||||||||||||
| Assistant Treasurer | $0 | $232,349 | $0 | $103,867 | $0 | $3,957 | $0 | $75,711 | $0 | $22,252 | $0 | $438,136 | $0 | $0 |
| Stephen LaSalle | ||||||||||||||
| COO | $0 | $231,308 | $0 | $84,692 | $0 | $75,221 | $0 | $44,243 | $0 | $21,535 | $0 | $456,999 | $0 | $0 |
| Mary O'Reilly | ||||||||||||||
| Assistant Treasurer | $0 | $163,396 | $0 | $10,000 | $0 | $781 | $0 | $12,159 | $0 | $23,853 | $0 | $210,189 | $0 | $0 |
| Mark Perry | ||||||||||||||
| Chief Medical Officer | $0 | $9,748 | $0 | $74,082 | $0 | $158,087 | $0 | $0 | $0 | $5,776 | $0 | $247,693 | $0 | $0 |
| Stephen Sloan | ||||||||||||||
| Secretary | $0 | $515,076 | $0 | $553,376 | $0 | $10,227 | $0 | $108,105 | $0 | $20,447 | $0 | $1,207,231 | $0 | $0 |
| Richard Vienne | ||||||||||||||
| Former Highly Compensated Employee | $0 | $276,245 | $0 | $59,731 | $0 | $3,181 | $0 | $41,560 | $0 | $18,497 | $0 | $399,214 | $0 | $0 |
| Maritza Baez | ||||||||||||||
| Former Highly Compensated Employee | $0 | $0 | $38,234 | $0 | $83,432 | $0 | $0 | $0 | $0 | $0 | $121,666 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 | The CEO of the filing organization was compensated by a related organization. His compensation was determined in accordance with the Board of Directors' approved Executive Compensation Philosophy. The executive process includes an evaluation of market comparable organizations. The Secretary, CFO, and Treasurer of the filing organization were also the Secretary, CFO and Treasurer of the related organization. The process to determine their compensation includes the use of an external consultant and approval of the Board of Directors of the related organization. |
| Schedule J, Part I, Line 4 | Line 4a: The following received severance pay from the organization and related organization during 2018: M. Perry $141,125; R. Cole $34,727; D. Golding $122,051; D. Carlascio $97,471; M. Kolbert $19,021; S. Obrien $4,849; M. Reinhardt $61,459; M. Baez $21,771. Line 4b: The following persons participated in a supplemental nonqualified retirement plan of a related organization: D. Coleman, C. Booth, S. Sloan, P. Eisenstat, J. Haefner, M. Cassady, M. Perry, D. Golding, S. LaSalle, S. Cohen, M. Bartels and R. Vienne. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Excellus Health Plan Inc | |||
| Member | $41,259,563 | Forgiveness of Debt | 0 |
| Excellus Health Plan Inc | |||
| Member | $2,491,874 | Mgmt Fees & Purchased Services | 0 |
| Excellus Health Plan Inc | |||
| Member | $2,100,000 | Property Transfer | 0 |
| Excellus Health Plan Inc | |||
| Member | $1,147,057 | Rental of Space | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part IV | FormAndLineReferenceDesc |
| Explanation | The filing organization had various business transactions with Excellus Health Plan Inc whose CEO, CFO/Treasurer, Secretary, Assistant Secretary and Assistant Treasurers were also officers of the filing organization. | ExplanationTxt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (5 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| Excellus Health Plan Inc | |||||||||
| LLC Ownership Interest | 2018-04-20 | $4,568,037 | Stock Market Value | 150329043 | 165 Court Street | Rochester | NY | 14647 | Corporation |
| Excellus Health Plan Inc | |||||||||
| Medical Building and Equipment | 2018-07-31 | $2,100,000 | Third Party Appraisal & Book Value | 150329043 | 165 Court Street | Rochester | NY | 14647 | Corporation |
| Various | |||||||||
| Medical Equipment, Office Equipment, Office Furniture & Fixtures | 2018-03-14 | $234,469 | Book Value & Auction Value | ||||||
| Hinman Straub PC | |||||||||
| Legal Fees Related to Dissolution | 2018-12-05 | $45,294 | Hourly Rate | 121 State Street | Albany | NY | 122071693 | PC | |
| Bond Schoeneck & King PLLC | |||||||||
| Legal Fees Related to Dissolution | 2018-12-05 | $16,749 | Hourly Rate | One Lincoln Center | Syracuse | NY | 132021355 | PLLC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 0 | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (1) | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | Yes (1) | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule N, Part I, Line 2 | FormAndLineReferenceDesc |
| Explanation | Effective 12/31/17 the filing organization ceased operations. The majority of the assets associated with the health centers were sold or shut down in 2017. No program services were performed in 2018 and the organization was dissolved as of December 5, 2018. Assets distributed during the year satisfied a portion of the liability owed to the sole member Excellus Health Plan Inc (EHP). The investment which represents ownership interest in a limited liability company was transferred to EHP in April 2018 as partial payment of the amount due to EHP. The organization also transferred land and a building to EHP in July 2018 for the fair market value of $2,100,000 as an additional payment of the liability owed to EHP. Certain employees of the filing organization were offered positions with the purchaser. Of these, Robert Cole MD a key employee of the filing entity accepted a position with the purchaser in 2018. The following employees received severances and or retention packages during 2018: Officer/Key Employee: Stephen LaSalle (COO); Key Employees: Mark Perry (CMO); Robert Cole (Medical Director); Douglas Golding (Medical Director); Deborah Carlascio (VP Patient Clinical Services); Karen Feigel (Communications Director). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 3 | Effective December 31, 2017, Genesee Valley Group Health Association (GVGHA) ceased operations. No healthcare delivery services were performed at any time during 2018. The corporation was dissolved as of December 5, 2018. |
| Form 990, Part VI, Section A, Line 2 | During the year, GVGHA officers: Stephen Cohen and Stephen LaSalle and GVGHA key employees: Mark Perry, Douglas Golding, Deb Carlascio and Karen Feigel were employees of Excellus Health Plan, Inc (a related organization). Such employees had a business relationship with GVGHA officers Christopher Booth, Dorothy Coleman, Stephen Sloan, James Haefner, Mary O'Reilly and Margaret Cassady who are also officers of Excellus Health Plan, Inc. |
| Form 990, Part VI, Section A, Line 6 | Prior to the dissolution of the organization the organization's sole member was Excellus Health Plan, Inc. |
| Form 990, Part VI, Section A, Line 7a | Prior to the dissolution of the organization and pursuant to a resolution of the Board of Directors of Excellus Health Plan, Inc. (the previous sole member of the organization), the Chief Executive Officer of Excellus Health Plan, Inc. was empowered to act on behalf of Excellus Health Plan, Inc. to elect or reelect the organization's directors. |
| Form 990, Part VI, Section A, Line 7b | Prior to the dissolution of the organization bylaw amendments were required to be approved by the sole member. Certain governance actions (such as the sale of all or substantially all of the assets of the organization) also required approval of the member under the New York Not-for-Profit Corporation Law. |
| Form 990, Part VI, Section B, Line 11b | The completed IRS Form 990 was provided to the organization's Board of Directors prior to filing allowing the opportunity for review. Responses were provided to questions raised by the governing body and any comments were analyzed and incorporated as applicable. |
| Form 990, Part VI, Section B, Line 12c | Prior to dissolution, the organization's Conflict of Interest Policy was regularly and consistently enforced via a robust annual process. Annually, all employees who held a position at the director level or above completed the Conflict of Interest Questionnaire. New or newly promoted employees at the director level or above completed the questionnaire at the time of employment or promotion. The Corporate Director of Ethical Compliance was responsible for the annual distribution, tracking, review and reporting of the Conflict of Interest or potential Conflict of Interest Questionnaires for employees of the corporation. Corporate legal counsel reviewed all Conflicts of Interest or potential Conflicts of Interest and made recommendations. |
| Form 990, Part VI, Section B, Line 15 | Prior to dissolution, the CEO and other officer's compensation was established in conjunction with the Board of Directors by having Human Resources engage independent compensation consultants that provide compensation surveys and information of comparable organizations, as well as market standards and best practices, to make informed compensation decisions on a prospective basis. |
| Form 990, Part VI, Section C, Line 18 | The organization's Form 990 is available online via GuideStar.org. |
| Form 990, Part VI, Section C, Line 19 | Prior to dissolution, governing documents, conflict of interest policy and financial statements were available to the public upon request. |
| Form 990, Part IX, Line 11g | Fees for Services - Other |
| Form 990, Part XI, Line 9 | Forgiveness of Debt |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Genesee Region Home Care Assoc Inc | ||||||||||
| 165 Court Street | Rochester | NY | 14647 | 160844109 | Home Health Services | NY | 501(c)(3) | 509(a)(2) | Excellus Health Plan Inc | Yes (1) |
| Genesee Region Home Care of Ontario County Inc | ||||||||||
| 165 Court Street | Rochester | NY | 14647 | 223257719 | Home Health Services | NY | 501(c)(3) | 509(a)(2) | Excellus Health Plan Inc | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Business Name Line2RelatedOrganizationName/BusinessNameLine2Txt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Lifetime Healthcare Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161514675 | Holding Co | NY | N/A | C | 0 | ||
| Excellus Health Plan Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 150329043 | Health Insurer | NY | N/A | C | |||
| Beacon Network Services Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 141830065 | Inactive | NY | N/A | C | |||
| Excellus Acquisition Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 141830065 | Holding Co | NY | N/A | C | |||
| MedAmerica Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161581817 | Holding Co | NY | N/A | C | |||
| Excellus Ventures Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161550984 | Holding Co | NY | N/A | C | |||
| MedAmerica Insurance Company of NY | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161310986 | Long Term Care Ins | NY | N/A | C | |||
| MedAmerica Insurance Company | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 340977231 | Long Term Care Ins | PA | N/A | C | |||
| MedAmerica Insurance Company of FL | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 141993330 | Long Term Care Ins | FL | N/A | C | |||
| Lifetime Benefit Solutions Inc | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161171765 | Third Party Administrator | NY | N/A | C | |||
| MedAmerica Reinsurance Company | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 980210843 | Long Term Care Insurance | N/A | C | f/k/a MIG Assurance Ltd | CJ | ||
| Lifetime Healthcare Companies Workers' | |||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161483185 | Grantor Trust | NY | N/A | T | Compensation Trust | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Excellus Health Plan Inc | ||
| k | $1,147,057 | Fair Market Value |
| Excellus Health Plan Inc | ||
| m | $2,491,874 | Fair Market Value |
| Excellus Health Plan Inc | ||
| r | $2,100,000 | Fair Market Value |