2019-06-14T11:24:40-05:00 2018-12-31 111986323 MARCUM LLP 1899 L STREET NW SUITE 850 WASHINGTON DC 20036 990 2018-01-01 200413676 HEALTHWELL FOUNDATION HEAL 2406325305 20440 CENTURY BOULEVARD NO 250 GERMANTOWN MD 20874 STEPHEN M WEINER BOARD CHAIR 2406325305 2019-06-14 1 FRANK H SMITH P00639053 2022274000 2019-06-14 47.19.127.190 2019-06-14 11:24:36 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 E2CB7C2DBDD6F28DFA06D5BDBA6EDF54E799736D 2018 2019-02-21 02:37:17Z KRISTA ZODET 20440 CENTURY BOULEVARD NO 250 GERMANTOWN MD 20874 510244453 0 X WWW.HEALTHWELLFOUNDATION.ORG X 2003 VA HELP ELIGIBLE PATIENTS WITH CHRONIC OR LIFE-ALTERING DISEASES AFFORD THEIR MEDICAL TREATMENTS. 6 6 18 0 0 0 350046179 427570435 0 0 3870987 9999378 0 0 353917166 437569813 236290414 316767028 0 0 1937260 2241287 195325 254792 728096 7381879 8560545 245804878 327823652 108112288 109746161 245686236 345846006 12244285 16748679 233441951 329097327 X THE HEALTHWELL FOUNDATION (THE FOUNDATION) REDUCES FINANCIAL BARRIERS TO CARE FOR UNDERINSURED PATIENTS WITH CHRONIC OR LIFE-ALTERING DISEASES. HEALTHWELL'S VISION IS TO ENSURE THAT NO PATIENT - ADULT OR CHILD - GOES WITHOUT MEDICAL TREATMENTS BECAUSE THEY CANNOT AFFORD THEM. 0 1 99985575 98223345 MULTIPLE MYELOMA - MEDICARE ACCESS - PROVIDED DEDUCTIBLE, COINSURANCE, COPAYMENT AND PREMIUM ASSISTANCE TO 19,529 ELIGIBLE MEDICARE PATIENTS RECEIVING TREATMENT FOR MULTIPLE MYELOMA. 38726083 38232892 PULMONARY FIBROSIS - PROVIDED DEDUCTIBLE, COINSURANCE, COPAYMENT AND PREMIUM ASSISTANCE TO 8,886 ELIGIBLE PATIENTS BEING TREATED FOR PULMONARY FIBROSIS. 36419154 36154031 HEPATITIS C - PROVIDED DEDUCTIBLE, COINSURANCE AND COPAYMENT ASSISTANCE TO 6,229 ELIGIBLE PATIENTS RECEIVING TREATMENT FOR HEPATITIS C. 35216090 34916679 MULTIPLE SCLEROSIS - MEDICARE ACCESS 10988544 10863964 RENAL CELL CARCINOMA - MEDICARE ACCESS 9890238 9354230 CYSTIC FIBROSIS TREATMENTS 9568634 8925200 POST MENOPAUSAL OSTEOPOROSIS - MEDICARE ACCESS 8648356 8181420 CHEMOTHERAPY INDUCED NEUTROPENIA - MEDICARE ACCESS 8362443 7720188 BONE METASTASES - MEDICARE ACCESS 6851219 6625217 NON-SMALL CELL LUNG CANCER - MEDICARE ACCESS 6306528 6175208 BREAST CANCER - MEDICARE ACCESS 5181704 4964547 SECONDARY HYPERPARATHYROIDISM 4787697 4625511 ACUTE MYELOID LEUKEMIA - MEDICARE ACCESS 4974893 4884841 MELANOMA - MEDICARE ACCESS 4512496 4277781 SYSTEMIC LUPUS ERYTHEMATOSUS 3296495 3039914 MACULAR DEGENERATION 2890065 2838110 TARDIVE DYSKINESIA - MEDICARE ACCESS 2671064 2200602 CYSTIC FIBROSIS VITAMINS AND SUPPLEMENTS 2595441 2443121 URTICARIA 2518793 2441032 AMYOTROPHIC LATERAL SCLEROSIS - MEDICARE ACCESS 1921226 1847873 GOUT - MEDICARE ACCESS 1811314 1770248 PEYRONIE'S DISEASE 1708504 1663911 DUPUYTREN'S DISEASE 1608007 1559413 IDIOPATHIC THROMBOCYTOPENIC PURPURA 1534126 1399047 COLORECTAL CARCINOMA - MEDICARE ACCESS 1490195 1439624 OVARIAN CANCER - MEDICARE ACCESS 1419080 1393867 HUNTINGTON'S DISEASE - MEDICARE ACCESS 1337859 1274544 CARCINOID TUMORS AND ASSOCIATED SYMPTOMS - MEDICARE ACCESS 1094617 1086301 MOVEMENT DISORDERS - MEDICARE ACCESS 1022955 959687 BLADDER AND UROTHELIAL CANCER - MEDICARE ACCESS 877595 863527 GIANT CELL ARTERITIS OR TEMPORAL ARTERITIS - MEDICARE ACCESS 814861 806296 CHRONIC MYELOID LEUKEMIA - MEDICARE ACCESS 766211 665002 PEDIATRIC ASSISTANCE 590991 566740 ANCA-ASSOCIATED VASCULITIS, WEGENERS AND GRANULOMATOSIS WITH POLYANGIITIS 383402 347072 HEAD AND NECK CANCER - MEDICARE ACCESS 359785 312864 CYSTIC FIBROSIS 340587 325557 DIABETIC FOOT ULCERS 190950 185240 CYTOMEGALOVIRUS DISEASE - PREVENTION AND TREATMENT 175659 172589 ACROMEGALY - MEDICARE ACCESS 166969 162704 FUNGAL INFECTIONS-ASPERGILLOSIS AND CANDIDIASIS 159638 133613 IMMUNOSUPPRESSIVE TREATMENT FOR SOLID ORGAN TRANSPLANT RECIPIENTS MEDICARE ACCESS 158005 156137 BREAKTHROUGH CANCER PAIN MEDICARE ACCESS 136673 123715 ASTHMA 111944 109102 AUTOIMMUNE - MEDICARE ACCESS 93822 90637 INFLAMMATORY BOWEL DISEASE - MEDICARE ACCESS 72748 71542 CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY 73200 64586 OTHER 45456 27823 CHEMOTHERAPY INDUCED NAUSEA OR VOMITING MEDICARE ACCESS 41022 40592 HIV AND AIDS WASTING SYNDROME AND ANOREXIA DUE TO HIV OR AIDS MEDICARE ACCESS 38789 29379 GASTRIC CANCER - MEDICARE ACCESS 30832 29963 HOMOCYSTINURIA 149837722 144156760 324968534 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 56 0 1 18 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AK AZ AR CA CT FL GA HI IL KS KY LA ME MD MA MI MN MS NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VT VA WA WV WI X X X KRISTA ZODET 2406325305 20440 CENTURY BLVD STE 250 GERMANTOWN MD 20874 STEPHEN M WEINER BOARD CHAIR 2.00 X X 0 0 0 JERRI SCARZELLA BSN VICE CHAIR & TREASURER 1.00 X X 15188 0 0 DAVID L KNOWLTON VICE CHAIR & SECRETARY 1.00 X X 26156 0 0 NANCY CARTERON MD FACR BOARD MEMBER 1.00 X 15000 0 0 DON LISS MD BOARD MEMBER 1.00 X 0 0 0 SUZANNE M MILLER PHD BOARD MEMBER 1.00 X 12563 0 0 KRISTA ZODET PRESIDENT 40.00 X 309046 0 26171 ALAN KLEIN CHIEF DEVELOPMENT OFFICER 40.00 X 284978 0 27803 BASKARAN VELLANDURAI DIRECTOR OF FIN. & IT UNTIL 06/2018 40.00 X 85165 0 13986 SHELA HALPER SR. DIRECTOR OF EXTERNAL RELATIONS 40.00 X 188548 0 30504 COLLIN ALEXANDER CONTROLLER 40.00 X 118021 0 37608 RAFAELLA RAOFI SENIOR ASSOCIATE DIRECTOR OF OPS. 40.00 X 117022 0 27842 FRED ASIEDU LARBI SENIOR ASSOCIATE DIRECTOR OF OPS. 40.00 X 111823 0 11548 VIRGINIA DUNN ASSOCIATE DIR. COMMS. & MARKETING 40.00 X 106105 0 37927 SUSAN GOLDEN ASSOCIATE DIR ANALYTICS & PROCESS IMPROVEMENT 40.00 X 100952 0 22979 1490567 0 236368 8 0 1 0 WRB COMMUNICATIONS INC 4200 LAFAYETTE CENTER DRIVE SUITE CHANTILLY VA 20151 HOTLINE SERVICES 4892880 MORGAN STANLEY 595 SOUTH FEDERAL HIGHWAY SUITE 40 BOCA RATON FL 33432 INVESTMENT MANAGEMENT 201525 AB DATA GROUP 600 A B DATA DRIVE MILWAUKEE WI 53217 DIRECT MAIL SERVICES 180266 BAKER DONELSON 901 K STREET NW WASHINGTON DC 20001 LEGAL SERVICES 177755 PCS 7 LYTLE STREET PRINCETON NJ 08542 CONSULTING SERVICES 162934 7 427570435 427570435 7058197 7058197 75615821 72674640 2941181 2941181 2941181 437569813 0 0 9999378 316767028 316767028 1035108 160173 615842 259093 873258 372353 414866 86039 38728 19182 19397 149 157789 52165 98662 6962 136404 38042 77207 21155 6187072 6187072 181797 17436 164361 79524 79524 254792 254792 264072 264072 814416 651852 162564 212949 154675 42712 15562 323405 283212 33429 6764 98200 42631 45621 9948 87964 42155 45809 42260 33510 8750 105393 82352 23041 7048 7048 MEMBERSHIPS/SUBS. 156445 140361 3011 13073 327823652 324968534 2127022 728096 70927326 103975524 2476670 16655848 11788334 18042500 53192 215811 1675248 1297806 322366 377442 159639247 206039602 200558 197236 278543 342043 245686236 345846006 6438139 9908169 5806146 6840510 12244285 16748679 X 6451939 -756134 226990012 329853461 233441951 329097327 245686236 345846006 X 109746161 -14094993 4208 X 0 1 X 1 0 X 87271430 67134754 139091107 350046179 427570435 1071113905 87271430 67134754 139091107 350046179 427570435 1071113905 809680175 261433730 1729915 2004638 1866191 3017353 7058197 15676294 1086790199 0.24060 0.26630 X DISCUSSION OF FACTS AND CIRCUMSTANCES SUPPORTING CLASSIFICATIONOF ORGANIZATION AS A PUBLICLY SUPPORTED ORGANIZATION UNDER CODE SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI)THE HEALTHWELL FOUNDATION (THE "FOUNDATION") OFFERS THE FOLLOWING FACTS AND CIRCUMSTANCES IN SUPPORT OF ITS ONGOING CLASSIFICATION AS A PUBLIC CHARITY AND NOT A PRIVATE FOUNDATION.GENERAL BACKGROUND - THE FOUNDATION PROVIDES NEED-BASED FINANCIAL ASSISTANCE TO UNDERINSURED INDIVIDUALS LIVING WITH CHRONIC AND/OR LIFE-ALTERING ILLNESSES SUCH AS MULTIPLE SCLEROSIS, CYSTIC FIBROSIS, MULTIPLE MYELOMA AND MANY OTHER TYPES OF CANCER. THROUGH 2018, THE FOUNDATION HAS HELPED OVER 407,192 PATIENTS AFFORD THEIR PRESCRIPTION DRUG COPAYMENTS, PREMIUMS AND OTHER OUT-OF-POCKET HEALTH CARE COSTS.THE FOUNDATION GRANTS FUNDS TO PATIENTS WHO HAVE PRIVATE OR GOVERNMENT-SPONSORED INSURANCE BUT WHO ARE STILL UNABLE TO AFFORD THEIR INSURANCE COPAYMENTS OR PREMIUMS TO OBTAIN COVERAGE FOR THEIR CONDITIONS. THE FOUNDATION AWARDS GRANTS BASED ON THE OBJECTIVE CONSIDERATION OF FINANCIAL AND MEDICAL CRITERIA AND THE ADEQUACY OF THE RECIPIENT'S INSURANCE COVERAGE. GRANTS ARE AWARDED TO RECIPIENTS FOR A 12 MONTH CYCLE. THE FOUNDATION DOES NOT PLACE RESTRICTIONS ON THE MEDICATIONS ITS GRANT RECIPIENTS USE AS LONG AS THEIR MEDICATION IS INCLUDED ON THE FOUNDATION'S PRODUCT LIST FOR THE FUND UNDER WHICH THE PATIENT IS APPROVED. THE FOUNDATION'S PRODUCT LIST FOR EACH FUND IS BASED ON FDA LABELED INDICATIONS AND COMPENDIA COVERAGE. THE DECISION AS TO WHICH MEDICATIONS ARE PRESCRIBED IS A MEDICAL JUDGMENT. FURTHER, THE FOUNDATION DOES NOT LIMIT THE PROVIDERS OR PHARMACIES ITS GRANT RECIPIENTS MAY USE TO OBTAIN THEIR MEDICATIONS.PUBLIC SUPPORT PERCENTAGE - THE FOUNDATION'S CUMULATIVE PUBLIC SUPPORT PERCENTAGE THROUGH DECEMBER 31, 2018 IS 23.87%, WHICH IS ABOVE THE MINIMUM AMOUNT AT WHICH FACTS AND CIRCUMSTANCES WILL BE CONSIDERED BY THE SERVICE IN DETERMINING THE FOUNDATION'S ONGOING QUALIFICATION AS A PUBLICLY SUPPORTED CHARITY. THE FOUNDATION'S PUBLIC SUPPORT PERCENTAGE HAS GENERALLY MAINTAINED AN UPWARD TRAJECTORY SINCE 2004, WITH A SMALL FLUCTUATION DOWN IN 2018; THE FACTS AND CIRCUMSTANCES RELATING TO THE FOUNDATION'S STRUCTURE AND OPERATIONS PRESENT AN EXCEPTIONALLY STRONG CASE IN SUPPORT OF ITS ONGOING CLASSIFICATION AS A PUBLIC CHARITY AND NOT AS A PRIVATE FOUNDATION. THESE FACTS AND CIRCUMSTANCES, WHICH ARE DISCUSSED IN MORE DETAIL LATER, INCLUDE THE FOLLOWING:1. THE FOUNDATION IS NOT CONTROLLED BY ITS CONTRIBUTORS AND HAS NO ENDOWMENT FUND, CHARACTERISTICS WHICH DISTINGUISH IT FROM VIRTUALLY ALL PRIVATE FOUNDATIONS.2. THE FOUNDATION'S BOARD REPRESENTS MANY DIVERSE ASPECTS OF THE HEALTH CARE COMMUNITY, DEMONSTRATING THE FOUNDATION'S COMMITMENT TO THE BROAD PUBLIC BENEFIT AND THE FOUNDATION'S COMMITMENT TO OPERATE AN OUTSTANDING ORGANIZATION THAT WILL ATTRACT FUTURE PUBLIC SUPPORT.3. THE FOUNDATION'S ACTIVITIES BROADLY BENEFIT THE GENERAL PUBLIC AS WELL AS OTHER CHARITABLE ORGANIZATIONS THAT ARE ATTEMPTING TO HELP PATIENTS COPE WITH A VARIETY OF ILLNESSES AND CONDITIONS.FACTS AND CIRCUMSTANCES SUPPORTING QUALIFICATION AS A PUBLICLY SUPPORTED ORGANIZATION1. ATTRACTION OF PUBLIC SUPPORT. THE FOUNDATION'S POLICY IS TO ACCEPT CONTRIBUTIONS FROM DONORS AND TO DISBURSE THE CONTRIBUTIONS IN THE FORM OF GRANTS AS SOON AS PRACTICAL. THE FOUNDATION DOES NOT HAVE AN ENDOWMENT FUND, AND ITS ABILITY TO FULFILL ITS FUTURE MISSION IS ENTIRELY DEPENDENT ON ITS ABILITY TO ATTRACT FUTURE SUPPORT FROM DONORS ON A CONTINUOUS BASIS. NONE OF THE FOUNDATION'S HISTORICAL SUBSTANTIAL CONTRIBUTORS HAVE PLEDGED OR OTHERWISE COMMITTED TO CONTINUE TO SUPPORT THE FOUNDATION IN FUTURE YEARS. THEREFORE, THE FOUNDATION MUST CONTINUALLY SEEK NEW DONORS TO SUSTAIN ITS FUNDS, AND IT HAS DONE SO. SPECIFICALLY: - THE FOUNDATION EMPLOYS 15 PERSONS WHO, IN ADDITION TO THEIR PRIMARY TASKS, MAY ALSO WORK ON FUNDRAISING PROJECTS AS NEEDED. - THE FOUNDATION'S CORPORATE CUMULATIVE DONOR BASE HAS INCREASED EACH YEAR FROM ONE CORPORATE DONOR IN 2004 TO 43 CORPORATE DONORS. - THE FOUNDATION'S CHIEF DEVELOPMENT OFFICER WORKS WITH THE PRESIDENT AND BOARD TO IDENTIFY AND PURSUE NEW CORPORATE FUNDRAISING OPPORTUNITIES. - THE FOUNDATION'S SENIOR DIRECTOR OF EXTERNAL RELATIONS WORKS TO IDENTIFY AND SECURE PARTNERS AND SPONSORS FOR THE FOUNDATION'S BROAD-BASED INITIATIVES, INCLUDING ITS PEDIATRIC ASSISTANCE FUND. - THE FOUNDATION REGULARLY SOLICITS SUPPORT FROM PRIVATE INDIVIDUALS, WHICH HAS RESULTED IN DONATIONS FROM MORE THAN 37,500 INDIVIDUAL DONORS. 2. REPRESENTATIVE GOVERNING BODY. THE FOUNDATION'S BOARD CONSISTS ENTIRELY OF NATIONALLY-RECOGNIZED HEALTH CARE EXPERTS WITH DEEP EXPERIENCE IN THE FIELDS OF HEALTH CARE ADMINISTRATION, CLINICAL PRACTICE AND RESEARCH, DIRECT PATIENT CARE, PATIENT ADVOCACY AND HEALTH LAW. THE COMPOSITION OF THE BOARD EXEMPLIFIES THE FOUNDATION'S COMMITMENT TO REPRESENT THE BROAD INTERESTS OF THE GENERAL PUBLIC AND TO OPERATE IN A MANNER THAT WILL ATTRACT ATTENTION - AND SUPPORT - FROM A BROAD RANGE OF POTENTIAL DONORS.GIVEN THEIR DIVERSE EXPERTISE, THE FOUNDATION'S BOARD MEMBERS BRING FORWARD A VARIETY OF IMPORTANT ISSUES TO ENCOURAGE DISCUSSION ABOUT HOW THE FOUNDATION'S PROGRAMS AND SERVICES WILL DIRECTLY IMPACT THE GENERAL PUBLIC. THEIR WIDE-RANGING OPINIONS HELP TO EXPAND THE FOUNDATION'S VIEWPOINT AND RESULT IN AN ORGANIZATION THAT CAN RESPOND SUCCESSFULLY TO IMPORTANT CHANGES IN THE HEALTH CARE ENVIRONMENT.SIGNIFICANTLY, NONE OF THE FOUNDATION'S BOARD MEMBERS ARE AFFILIATED WITH ANY CONTRIBUTOR TO THE FOUNDATION AND IT IS THE FOUNDATION'S STRICT POLICY THAT THERE NOT BE SUCH AFFILIATIONS. MOREOVER, NO CONTRIBUTOR HAS THE POWER TO APPOINT DIRECTORS TO THE FOUNDATION'S BOARD. IN THIS REGARD, THE FOUNDATION DIFFERS MARKEDLY FROM A PRIVATE FOUNDATION, WHERE THE GOVERNING BODY IS TYPICALLY COMPOSED OF SUBSTANTIAL CONTRIBUTORS AND/OR MEMBERS CHOSEN BY SUBSTANTIAL CONTRIBUTORS. 3. AVAILABILITY OF PUBLIC FACILITIES OR SERVICES; PUBLIC PARTICIPATION IN PROGRAMS OR POLICIES. THE FOUNDATION PUTS FORTH SIGNIFICANT EFFORTS TO MAKE THE AVAILABILITY OF ITS PROGRAMS AND SERVICES KNOWN TO THE GENERAL PUBLIC THROUGH AVENUES SUCH AS ITS WEBSITE (WWW.HEALTHWELLFOUNDATION.ORG), WHERE PATIENTS, PROVIDERS, PHARMACIES AND ADVOCATES CAN OBTAIN INFORMATION ON THE FOUNDATION'S PROGRAM, APPLY ONLINE AND, THROUGH INTERACTIVE PORTALS, MANAGE THEIR PATIENTS' GRANTS (PROVIDERS AND PHARMACIES) OR MONITOR THEIR OWN GRANT (PATIENTS). THESE AVENUES ARE UPDATED CONTINUOUSLY AND MONITORED CLOSELY THROUGHOUT THE YEAR. THE FOUNDATION ENGAGES IN A WIDE RANGE OF PROMOTIONAL OUTREACH ACTIVITIES, INCLUDING MEDIA RELATIONS AND BLOG ACTIVITIES (WWW.REALWORLDHEALTHCARE.ORG) IN ADDITION TO TARGETED SOCIAL MEDIA CAMPAIGNS TO EDUCATE THE PUBLIC, PROVIDERS, PHARMACIES AND OTHER HEALTH-RELATED ORGANIZATIONS ABOUT ITS WORK. NEWS ABOUT THE FOUNDATION'S PROGRAMS REGULARLY APPEARS IN LOCAL AND NATIONAL PUBLICATIONS, INCLUDING MEDICAL JOURNALS, NEWSPAPERS, MAGAZINES, BLOGS AND HEALTH CARE WEBSITES. REPRESENTATIVES OF THE FOUNDATION REGULARLY ATTEND NATIONAL AND LOCAL CONFERENCES TO PROMOTE THE FOUNDATION'S PROGRAMS, INCLUDING THOSE OF SUCH ENTITIES AS CBI PATIENT ASSISTANCE PROGRAM, THE LIVER MEETING, AMERICAN SOCIETY OF CLINICAL ONCOLOGY, NORTH AMERICAN CYSTIC FIBROSIS CONFERENCE, ASEMBIA SPECIALTY PHARMACY SUMMIT, CBI PATIENT ADHERENCE & SUPPORT, AMERICAN SOCIETY OF HEMATOLOGY, AND CBI PAP LEGAL UPDATE.ADDITIONALLY, WHEN THE FOUNDATION ESTABLISHES A NEW FUND WITH RESPECT TO A PARTICULAR DISEASE OR CONDITION, THE FOUNDATION: - IDENTIFIES KEY NATIONAL PATIENT ADVOCACY GROUPS AND HEALTH CARE ORGANIZATIONS THAT ARE ABLE TO REACH OUT TO PATIENTS IN THE NEW FUND AREA. - IDENTIFIES APPROPRIATE CONTACTS IN EACH ORGANIZATION THAT FOCUS ON PATIENT ADVOCACY AND/OR REIMBURSEMENT ISSUES. - INVITES THESE ORGANIZATIONS TO EDUCATE PATIENTS, PROVIDERS, ADVOCATES AND THEIR BROADER NETWORKS ABOUT THE FOUNDATION'S PROGRAMS BY POSTING A LINK TO WWW.HEALTHWELLFOUNDATION.ORG ON THEIR WEBSITES, PROMOTING VIA SOCIAL MEDIA AND/OR INCLUDING INFORMATION ABOUT THE FOUNDATION'S SERVICES IN THEIR MARKETING AND EDUCATIONAL MATERIALS. - ISSUES A PRESS RELEASE TO ANNOUNCE A NEW FUND TO THE MEDIA, PATIENT ADVOCACY GROUPS AND THE BROADER HEALTH CARE COMMUNITY. - REACHES OUT TO PROSPECTIVE DONORS TO SOLICIT ADDITIONAL SUPPORT FOR THE DISEASE AREA. - PROMOTES THE NEW FUND IN ITS NEWSLETTER, "THE PULSE," WHICH REACHES OVER 42,000 INDIVIDUALS FOUR TIMES A YEAR, AND THROUGH SOCIAL MEDIA. PART II, SECTION C, LINE 17A, FACTS AND CIRCUMSTANCES TEST: FURTHERMORE, THE FOUNDATION IS REFERENCED BY, OR IS LINKED TO, THE WEBSITES OF A NUMBER OF ORGANIZATIONS THAT DIRECT PATIENTS FOR COPAYMENT AND PREMIUM ASSISTANCE. SUCH ORGANIZATIONS INCLUDE PARTNERSHIP FOR PRESCRIPTION ASSISTANCE, AMERICAN CANCER SOCIETY, CMS, AMERICAN LIVER FOUNDATION, ALS FOUNDATION, NATIONAL MS SOCIETY, PSORIASIS FOUNDATION, LUPUS FOUNDATION OF AMERICA, CANCERCARE, PORPHYRIA FOUNDATION AND NEEDYMEDS, AMONG OTHERS. CONCLUSION IN SUMMARY, THE HEALTHWELL FOUNDATION HAS THE CHARACTERISTICS OF A "PUBLICLY SUPPORTED ORGANIZATION, BASED ON THE FACTS AND CIRCUMSTANCES TEST DESCRIBED IN SECTION 1.170A-9(E)(3) OF THE TREASURY REGULATIONS. SPECIFICALLY, A SMALL NUMBER OF DONORS DO NOT CONTROL HEALTHWELL; RATHER HEALTHWELL IS A GROWING INSTITUTION THAT BEARS MANY OF THE INDICIA OF A "PUBLICLY SUPPORTED ORGANIZATION, INCLUDING PUBLIC SUPPORT FROM A WIDE CROSS-SECTION OF DONORS WITH A REPRESENTATIVE GOVERNING BODY. MOREOVER, HEALTHWELL IS CONTINUING TO SEEK NEW SOURCES OF SUPPORT FROM THE GENERAL PUBLIC AS WELL AS OTHER ORGANIZATIONS. ACCORDINGLY, THE FOUNDATION QUALIFIES AS A "PUBLICLY SUPPORTED ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(VI). 258157 127200 130957 1417091 1170606 246485 377442 COPAYMENTS AND PREMIUM ASSISTANCE PAYABLE 6805835 DEFERRED RENT 34675 6840510 X PART X, LINE 2: THE FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED DECEMBER 31, 2018, AND DETERMINED THAT THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE FINANCIAL STATEMENTS OR THAT MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS. X X X 1 AB DATA GROUP 600 A B DATA DRIVE MILWAUKEE WI 53217 DIRECT MAIL CAMPAIGN 0 615856 180266 435590 615856 180266 435590 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE FOUNDATION PAID IN TOTAL $180,266 TO A.B. DATA GROUP OF WHICH, $14,392 WAS FOR EXPENSE REIMBURSEMENTS. 1 MULTIPLE MYELOMA 19529 98223345 PULMONARY FIBROSIS 8886 38232892 HEPATITIS C 6229 36154031 MULTIPLE SCLEROSIS 9252 34916679 RENAL CELL CARCINOMA 2482 10863964 CYSTIC FIBROSIS TREATMENTS 5891 9354230 POST MENOPAUSAL OSTEOPOROSIS - MEDICARE ACCESS 22083 8925200 CHEMOTHERAPY INDUCED NEUTROPENIA - MEDICARE ACCESS 4517 8181420 BONE METASTISES 5577 7720188 NON-SMALL CELL LUNG CANCER - MEDICARE ACCESS 1916 6625217 BREAST CANCER 1698 6175208 SECONDARY HYPERPARATHYROIDISM 4031 4964547 MELANOMA - MEDICARE ACCESS 976 4884841 ACUTE MYELOID LEUKEMIA - MEDICARE ACCESS 1469 4625511 SYSTEMIC LUPUS ERYTHEMATOSUS 1519 4277781 MACULAR DEGENERATION 1946 3039914 TARDIVE DYSKINESIA - MEDICARE ACCESS 1097 2838110 URTICARIA 1158 2443121 AMYOTROPHIC LATERAL SCLEROSIS - MEDICARE ACCESS 542 2441032 CYSTIC FIBROSIS VITAMINS AND SUPPLEMENTS 5175 2200602 GOUT 811 1847873 PEYRONIE'S 674 1770248 DUPUYTREN'S DIEASE 1207 1663911 IDIOPATHIC THROMBOCYTOPENIC PURPURA 871 1559413 OVARIAN CANCER - MEDICARE ACCESS 606 1439624 COLORECTAL CARCINOMA 635 1399047 HUNTINGTON'S DISEASE - MEDICARE ACCESS 430 1393867 CARCINOID TUMORS AND ASSOCIATED SYMPTOMS - MEDICARE ACCESS 613 1274544 MOVEMENT DISORDERS - MEDICARE ACCESS 272 1086301 BLADDER AND UROTHELIAL CANCER - MEDICARE ACCESS 556 959687 GIANT CELL ARTERITIS OR TEMPORAL ARTERITIS - MEDICARE ACCESS 298 863527 CHRONIC MYELOID LEUKEMIA - MEDICARE ACCESS 166 806296 PEDIATRIC FUND 440 665002 ANCA-ASSOCIATED VASCULITIS, WEGENERS AND GRANULOMATOSIS WITH POLYANGIITIS 213 566740 HEAD AND NECK CANCER 153 347072 DIABETIC FOOT ULCERS 602 325557 CYSTIC FIBROSIS 775 312864 CYTOMEGALOVIRUS 179 185240 ACROMEGALY - MEDICARE ACCESS 57 172589 FUNGAL INFECTIONS-ASPERGILLOSIS AND CANDIDIASIS 134 162704 BREAKTHROUGH CANCER PAIN - MEDICARE ACCESS 60 156137 IMMUNOSUPPRESSIVE TREATMENT FOR TRANSPLANT 487 133613 ASTHMA, MODERATE TO SEVERE 186 123715 AUTOIMMUNE 54 109102 INFLAMMATORY BOWEL DISEASE 106 90637 CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY 34 71542 HIV AND AIDS WASTING SYNDROME AND ANOREXIA DUE TO HIV OR AIDS - MEDICARE ACCESS 11 40592 HOMOCYSTINURIA 15 29963 GASTRIC CANCER - MEDICARE ACCESS 52 29379 CHEMOTHERAPY INDUCED NAUSEA OR VOMITING - MEDICARE ACCESS 110 27823 PORPHYRIAS 9 20491 NON-HODGKINS LYMPHOMA 16 14610 HAF 6 6300 CANCER RELATED BEHAVIORAL HEALTH 17 5118 GOUT TRAVEL 7 4251 UREA CYCLES DISORDER 2 3385 GROWTH HORMONE 5 2402 HODGKINS DISEASE 1 2294 GLIOBLASTOMA MULTIFORME AND ANAPLASTIC 2 2229 CHRONIC LYMPHOCYTIC LEUKEMIA - MEDICARE ACCESS 1 1257 WILM'S TUMOR 1 1008 HEPATOCELLULAR CARCINOMA - MEDICARE ACCESS 1 771 MIGRAINE 2 470 PART I, LINE 2: EACH PATIENT SEEKING ASSISTANCE IS SCREENED FOR ELIGIBILITY EITHER BY A SPECIALIST THROUGH THE FOUNDATION HOTLINE OR THROUGH THE FOUNDATION'S ONLINE APPLICATION TOOL. CRITERIA ARE STATIC ACROSS ALL THE FOUNDATION FUNDS: THE PATIENT'S HOUSEHOLD INCOME MAY BE UP TO 500% OF THE FEDERAL POVERTY LEVEL, ADJUSTED FOR HOUSEHOLD SIZE AND HIGH COST OF LIVING AREAS; THE PATIENT MUST HAVE A DIAGNOSIS THAT THE FOUNDATION CURRENTLY SUPPORTS; THE PATIENT MUST HAVE INSURANCE COVERAGE FOR THE TREATMENT FOR WHICH THEY ARE SEEKING ASSISTANCE AND THAT TREATMENT MUST BE AN ELIGIBLE TREATMENT UNDER THE HEALTHWELL FUND AND TREATMENT MUST BE DISPENSED IN THE UNITED STATES. IN ADDITION, DURING THE APPROVAL PROCESS, A SOFT CREDIT CHECK IS RUN ON THE APPLICANT TO DETERMINE THAT THEY MEET THE INCOME REQUIREMENTS FOR THE PROGRAM. IF THE SOFT CREDIT CHECK DOES NOT RETURN A SATISFACTORY RESULT, THE PATIENT IS REQUIRED TO SUBMIT A FULL INCOME DOCUMENT REVIEW IN ORDER TO RECEIVE ASSISTANCE FROM THE PROGRAM. OTHERWISE, PATIENTS ARE APPROVED IF ALL CRITERIA ARE MET DURING SCREENING. PATIENTS RECEIVE A PHARMACY CARD TO USE AT THE LOCAL RETAIL PHARMACY, THROUGH MAIL ORDER PHARMACY, OR THROUGH SPECIALTY PHARMACY. THE PHARMACY CARD CANNOT BE USED FOR PRIMARY PAYMENT AND PROVIDES ELECTRONIC POINT OF SALE REIMBURSEMENT FOR THE PHARMACY. IN CASES WHERE THE PHARMACY CARD CANNOT BE USED, THE FOUNDATION REQUIRES THE SUBMISSION OF A COMPLETED REIMBURSEMENT REQUEST FORM ALONG WITH ADDITIONAL INFORMATION AS OUTLINED ON THE FORM. UPON RECEIPT, THE REQUEST IS REVIEWED: A FOUNDATION PAYMENT SPECIALIST ENTERS THE RECEIVED INFORMATION INTO THE SYSTEM AND THE SYSTEM VALIDATES THE DATE OF SERVICE, AN INSURER PAID FIRST, THE PRODUCT IS AN ELIGIBLE TREATMENT UNDER THE HEALTHWELL FUND, AND THE PATIENT HAS AN ACTIVE, FULLY APPROVED GRANT. ONLY IF ALL SYSTEMATIC CHECKS PASS, THE PAYMENT SPECIALIST PROCESSES THE PAYMENT. X X X X X 0 0 0 0 0 0 0 1 0 KRISTA ZODET PRESIDENT 246811 0 62235 0 0 0 13287 0 12884 0 335217 0 0 0 ALAN KLEIN CHIEF DEVELOPMENT OFFICER 220078 0 64900 0 0 0 17099 0 10704 0 312781 0 0 0 SHELA HALPER SR. DIRECTOR OF EXTERNAL RELATIONS 168748 0 19800 0 0 0 11734 0 18770 0 219052 0 0 0 COLLIN ALEXANDER CONTROLLER 101326 0 16695 0 0 0 7217 0 30391 0 155629 0 0 0 PART I, LINE 7 ALL BONUS PAYMENTS RECEIVED BY OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES LISTED IN FORM 990, PART VII ARE BASED ON AN APPRAISAL OF HIS/HER PERFORMANCE. FORM 990, PART VII, LINE 5: THE BOARD CHAIR OF THE FOUNDATION, STEPHEN WEINER, IS ALSO A PARTNER AT MINTZ, LEVIN, COHN, FERRIS, GLOVSKY, AND POPEO, PC, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2018, THE FOUNDATION PAID A TOTAL OF $30,975 TO THE UNRELATED ORGANIZATION FOR THE TIME INCURRED BY MR. WEINER. FORM 990, PART III, LINE 3 HWF DIRECT, LLC, (HWF) AN AFFILIATE OF HEALTHWELL, WAS ORGANIZED ON OCTOBER 10, 2018, AS A SINGLE-MEMBER LIMITED LIABILITY CORPORATION (LLC) TO ADMINISTER THE FOUNDATION'S CALL-CENTER FUNCTIONS. HEALTHWELL IS THE SOLE MEMBER OF HWF AND FUNDS ITS OPERATIONS THROUGH INTERCOMPANY SERVICE CHARGES. FORM 990, PART VI, SECTION B, LINE 11B THE PRESIDENT, THE FOUNDATION'S DIRECTORS, AND THE CONTROLLER REVIEWS THE FEDERAL FORM 990 AND THEN FORWARD IT TO THE TREASURER FOR REVIEW. REVIEW CONSISTS OF TRACKING ALL FIGURES FROM AUDITED FINANCIAL STATEMENTS TO THE PREPARED FEDERAL FORM 990, AND REVIEWING ANY DISCREPANCIES WITH THE TAX PREPARERS. UPON COMPLETION OF THE INTERNAL REVIEWS, THE FOUNDATION'S FINANCE DEPARTMENT PROVIDES EACH BOARD MEMBER A COPY FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. ONCE THE BOARD HAS REVIEWED AND APPROVED THE FILING, THE BOARD CHAIR AUTHORIZES THE FEDERAL FORM 990 BE E-FILED AND THEN RETURNS THE FEDERAL FORM 990 TO THE PRESIDENT AND THE CONTROLLER. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S PRESIDENT AND THE BOARD COMPLIANCE OFFICER WORK TOGETHER TO ENSURE ADHERENCE TO THE FOUNDATION'S COMPLIANCE PROGRAM. INCLUDED IN THIS COMPLIANCE PROGRAM ARE: STAFF AND BOARD OF DIRECTORS FOLLOW A CODE OF CONDUCT; STAFF MUST SIGN A CONFIDENTIALITY AND CONFLICT OF INTEREST AGREEMENT UPON HIRE; MEMBERS OF THE BOARD OF DIRECTORS AND SENIOR STAFF MUST SIGN A CONFLICT OF INTEREST DISCLOSURE ANNUALLY (MEMBERS THAT ARE DEEMED TO HAVE A CONFLICT OF INTEREST BASED ON THIS DISCLOSURE ARE RECUSED FROM PARTICIPATING IN A VOTE WITHIN THAT AREA OF CONFLICT); AND SENIOR STAFF AND BOARD ALSO ATTEST TO UNDERSTANDING AND ADHERING TO THE POLICY AND PRACTICE OF THE HEALTHWELL FOUNDATION. THE SENIOR STAFF AND BOARD CANNOT REFER PATIENTS TO, OR RECOMMEND A PARTICULAR PROVIDER, SUPPLIER, OR PRODUCT NOR THE IDENTITY ANY PROGRAM DONOR. FORM 990, PART VI, SECTION B, LINE 15 HEALTHWELL CONDUCTED A COMPENSATION REVIEW IN 2018, WHILE THE LAST REVIEW TOOK PLACE IN 2016. HEALTHWELL ENGAGED AN INDEPENDENT CONSULTANT, MARCUM LLP, TO CONDUCT A COMPENSATION ANALYSIS FOR ALL POSITIONS AT HEALTHWELL BASED ON UPDATED JOB DESCRIPTIONS. THE BOARD CHAIR, TREASURER, A BOARD DIRECTOR AND THE PRESIDENT REVIEWED AND APPROVED ALL COMPENSATION FOR THE FOUNDATION STAFF OTHER THAN THE PRESIDENT. INDEPENDENTLY THE BOARD CHAIR, TREASURER AND A BOARD DIRECTOR REVIEWED/APPROVED THE PRESIDENT'S JOB DESCRIPTION AND COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND THE FEDERAL FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FEDERAL FORM 990, THE FOUNDATION'S FINANCIALS, AND ANNUAL REPORT ARE ALSO AVAILABLE AT WWW.HEALTHWELLFOUNDATION.ORG. FORM 990, PART XI, LINE 9: RETURNED GRANTS 4,208. HWF DIRECT LLC 5280 CORPORATE DRIVE SUITE 210B FREDERICK MD 21073 832192839 CONTACT CENTER VA 437888 663621 HEALTHWELL FOUNDATION 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 HEALTHWELL FOUNDATION E 500000 HEALTHWELL FOUNDATION L 437874 HEALTHWELL FOUNDATION P 448687