CONSUMERS CHOICE HEALTH INSURANCE COMPANY: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CONSUMERS CHOICE HEALTH INSURANCE COMPANY (EIN 45-3124969)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-08-21
- IRS object ID
- 201812339349300301
- Schema version
- 2017v2.3
- 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 | 2018-08-21T07:14:42-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621199757 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LBMC PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2095 LAKESIDE CENTRE WAY SUITE 220 | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37922 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453124969 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONSUMERS' CHOICE HEALTH INSURANCE | BusinessNameLine1Txt |
| Business Name Line2 | COMPANY IN LIQUIDATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CONS | BusinessNameControlTxt |
| Phone | 4809484351 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9821 N 95TH STREET NO 105 | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85258 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL J FITZGIBBONS | PersonNm |
| Person Title | SPECIAL DEPUTY RECEIVER | PersonTitleTxt |
| Phone | 4809484351 | PhoneNum |
| Signature | 2018-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMANDA P HENSLEY CPA | PreparerPersonNm |
| PTIN | P01524172 | PTIN |
| Phone | 8656919000 | PhoneNum |
| Preparation | 2018-08-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONSUMERS' CHOICE HEALTH PLAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J FITZGIBBONS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9821 N 95TH STREET STE 105 | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85258 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $230,319 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.CCHPSC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | HAS PROVIDED HEALTHCARE BENEFITS TO ITS MEMBERS - PRESENTLY IN LIQUIDATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 0 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 3 | 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 | -$8,846,415 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $126,412 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$1,063,744 | PYInvestmentIncomeAmt |
| CY Investment Income | $103,907 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | -$9,910,159 | PYTotalRevenueAmt |
| CY Total Revenue | $230,319 | 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 | $1,985,859 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $258,043 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | -$11,220,560 | PYOtherExpensesAmt |
| CY Other Expenses | -$2,284,819 | CYOtherExpensesAmt |
| PY Total Expenses | -$9,234,701 | PYTotalExpensesAmt |
| CY Total Expenses | -$2,026,776 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$675,458 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,257,095 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,963,858 | TotalAssetsBOYAmt |
| Total Assets EOY | $53,600,624 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $85,221,141 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $84,177,461 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$35,257,283 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$30,576,837 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HAS PROVIDED HEALTHCARE BENEFITS TO ITS MEMBERS - PRESENTLY IN LIQUIDATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | THE COMPANY CEASED PROVIDING HEALTH INSURANCE COVERAGE AFTER DECEMBER 31, 2015, AND WAS PLACED IN RECEIVERSHIP ON JANUARY 8, 2016. COVERED CLAIMS ARE NOW BEING PAID BY THE SOUTH CAROLINA LIFE AND ACCIDENT AND HEALTH GUARANTY ASSOCIATION. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | 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 | 0 | 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 | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3 | 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 |
| Licensed More Than One State | 0 | LicensedMoreThanOneStateInd |
| State Required Reserves | $0 | StateRequiredReservesAmt |
| Reserves Maintained | $0 | ReservesMaintainedAmt |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 0 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | 0 | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL J FITZGIBBONS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4809484351 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9821 N 95TH STREET SUITE 105 | AddressLine1Txt |
| City | SCOTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85258 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (2 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| MELISSA CRUZE | |||||
| CONTROLLER | 40.00 | Yes (X) | $123,636 | $0 | $3,447 |
| JANET ADAMS | |||||
| VP CLAIMS & MEMBER SERVICES | 40.00 | Yes (X) | $113,074 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $236,710 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,447 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NELSON MULLINS RILEY & SCARBOROUGH LLP | |||||
| 150 FOURTH AVE N STE 1100 | NASHVILLE | TN | 37219 | LAW SERVICES | $534,483 |
| FITZGIBBONS AND COMPANY INC | |||||
| 9821 N 95TH ST STE 105 | SCOTTSDALE | AZ | 85258 | SPECIAL DEPUTY SERVICES | $276,455 |
| JONATHAN LEONARD | |||||
| 809 HILLSHIRE DR | BIRMINGHAM | AL | 35244 | CLAIMS CONSULTING SERVICES | $137,093 |
| JAMES F MITCHELL | |||||
| 517 MITCHELL RD SE | CLEVELAND | TN | 37323 | ACCOUNTING CONSULTING SERVICES | $106,125 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ADMINISTRATIVE SERVICE | 524298 | $157,501 | $157,501 |
| PREMIUMS | 524298 | -$31,089 | -$31,089 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $126,412 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $103,227 | TotalRevenueColumnAmt |
| Exclusion | $103,227 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $680 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $680 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $680 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $680 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $230,319 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $127,092 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $103,227 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,870 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,798 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,375 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $542,463 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,669 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $313,753 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,053 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,953 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,417 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,908 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt |
|---|---|
| DOI ASSESSMENT & FEES | $402,701 |
| CLAIMS ADJUSTMENT EXPEN | $241,446 |
| STATE PREMIUM TAX EXPEN | $60,738 |
| COMPUTER SOFTWARE | $29,728 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$3,997,648 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$2,026,776 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,456,556 | BOYAmt |
| EOY | $3,274,539 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,149,042 | BOYAmt |
| EOY | $11,276,111 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,066,065 | BOYAmt |
| EOY | $38,853,117 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,963 | BOYAmt |
| EOY | $126,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,232 | BOYAmt |
| EOY | $70,857 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,963,858 | BOYAmt |
| EOY | $53,600,624 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,303,180 | BOYAmt |
| EOY | $62,499,620 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,208,161 | BOYAmt |
| EOY | $2,968,041 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,709,800 | BOYAmt |
| EOY | $18,709,800 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,221,141 | BOYAmt |
| EOY | $84,177,461 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,868,408 | BOYAmt |
| EOY | $68,868,408 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$104,125,691 | BOYAmt |
| EOY | -$99,445,245 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$35,257,283 | BOYAmt |
| EOY | -$30,576,837 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,963,858 | BOYAmt |
| EOY | $53,600,624 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,257,095 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,423,351 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Other | Yes (X) | MethodOfAccountingOtherInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 2B: | FormAndLineReferenceDesc |
| Explanation | DURING 2016, COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY (CHA) WAS VOLUNTARILY WINDING DOWN ITS BUSINESS AND PREPARING TO DISSOLVE UNDER THE SUPERVISION OF THE TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE (TDCI). EFFECTIVE OCTOBER 1, 2016, CHA ENGAGED CONSUMERS' CHOICE HEALTH INSURANCE INSURANCE COMPANY IN LIQUIDATION (CCHP) TO MANAGE THE DAILY OPERATION AND DISSOLUTION OF CHA AND TO SHARE IN THE COST OF THESE EFFORTS WITH CCHP AS CCHP LIQUIDATES ITS ASSETS AND DISSOLVES ITS CORPORATE ENTITY. THESE MANAGEMENT FUNCTIONS WERE TO INCLUDE (I) OVERSIGHT AND PAYMENT OF REMAINING CLAIMS, (II) PREPARATION AND DISSEMINATION OF ALL FINANCIAL REPORTS, REGULATORY FILINGS AND PAYMENT OF EXISTING VENDOR OBLIGATIONS, (III) OVERSIGHT OF ALL BUSINESS FUNCTIONS RELATED TO FINANCE, ACCOUNTING, CLAIMS, CUSTOMER SERVICE, APPEALS, HUMAN RESOURCES, MEDICAL MANAGEMENT, PROVIDER RELATIONS AND EXECUTION OF CHA'S WIND DOWN PLAN, (IV) COMMUNICATIONS ON BEHALF OF CHA WITH FEDERAL, STATE AND LOCAL GOVERNMENT BODIES, AND (V) COMPLETION OF OPERATIONAL REQUIREMENTS NECESSARY TO PROPERLY DISSOLVE CHA AS A CORPORATE ENTITY. CCHP AGREED TO BE RESPONSIBLE FOR ALL DIRECT EXPENSES OF CHA TO INCLUDE BUT NOT BE LIMITED TO RENT, LABOR, OFFICE, POSTAGE, COMMUNICATIONS, TECHNOLOGY, STORAGE AND PETTY CASH. CHA AGREED TO, AND DID, PAY CCHP IN ADVANCE FOR ALL ANTICIPATED EXPENSES THAT WOULD BE INCURRED BY CHA DURING THE LIFE OF THE AGREEMENT. CCHP AGREED THAT AFTER PAYMENT OF ALL CLAIMS, TRANSACTIONS AND COLLECTION ACTIONS ON BEHALF OF CHA IT WOULD REMIT WITHIN 60 CALENDAR DAYS ALL EXCESS PROCEEDS FROM CHA'S ADVANCE PAYMENT TO CCHP TO TDCI. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8A | NONE - NOT APPLICABLE. |
| FORM 990, PART VI, SECTION A, LINE 8B | NONE - NOT APPLICABLE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 WAS REVIEWED BY THE SPECIAL DEPUTY RECEIVER BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONSUMERS' CHOICE HEALTH INSURANCE COMPANY DID REGULARLY MONITOR THE CONFLICT OF INTEREST POLICY. IT WAS PART OF THE CODE OF CONDUCT. EACH BOARD MEMBER AND MEMBER OF SR. MANAGEMENT WAS REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT AND DISCLOSE ANY CONFLICTS AT LEAST ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | CONSUMERS' CHOICE HEALTH INSURANCE COMPANY HAD A GOVERNANCE AND COMPENSATION COMMITTEE THAT MET AND DETERMINED A REASONABLE COMPENSATION. THE COMMITTEE WAS MADE OF INDEPENDENT PERSONS, REVIEWED COMPARABLE DATA, AND MADE A PRESENTATION TO THE DIRECTORS WHICH WAS INCLUDED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | CONSUMERS' CHOICE HEALTH INSURANCE COMPANY MADE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | HUMAN RESOURCE OUTSOURCING FEES 2,391. OUTSOURCING SERVICES 311,362. |
| FORM 990, PART XI, LINE 9: | NONADMITTED ASSETS - ACCOUNTS RECEIVABLE 2,392,477. NONADMITTED ASSETS - PREPAID EXPENSES 30,874. |
| FORM 990, PART XII, LINE 1: | THE ORGANIZATION USES THE STATUTORY-BASIS METHOD OF ACCOUNTING IN CONFORMITY WITH THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' (NAIC) ACCOUNTING PRACTICES AND PROCEDURES MANUAL, EXCEPT TO THE EXTENT THAT THE LAWS OF SOUTH CAROLINA DIFFER FROM THESE RULES. |