INCLUSA INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- INCLUSA INC (EIN 81-3565570)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-01
- IRS object ID
- 201803059349301120
- 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 | 2018-11-01T10:41:13-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 544028010 | 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 | 813565570 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INCLUSA INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INCL | BusinessNameControlTxt |
| Phone | 8776226700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3349 CHURCH ST STE 1 | AddressLine1Txt |
| City | STEVENS POINT | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54481 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON TAYLOR | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 8776226700 | PhoneNum |
| Signature | 2018-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIMBERLY HELLER CPA | PreparerPersonNm |
| PTIN | P00766668 | PTIN |
| Phone | 7158453111 | PhoneNum |
| Preparation | 2018-10-25 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.50.56.238 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-26 | IPDt |
| IP Tm | 07:49:21 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 8C6700BA2289AFF4DA35F5CBAFA36D123994248C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 798C0E2031A00A5626CA0661E437931A55DDEADE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | MARK HILLIKER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3349 CHURCH STREET SUITE 1 | AddressLine1Txt |
| City | STEVENS POINT | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54481 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $610,088,597 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.INCLUSA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2016 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | INCLUSA, INC. PROACTIVELY PARTNERS WITH OTHERS TO BUILD A SHARED VISION OF LONG-TERM CARE THAT OFFERS THE PEOPLE WE SERVE CHOICE, CONNECTIONS, AND DIGNITY; FOSTERING FULL PARTICIPATION IN COMMUNITIES. INCLUSA, INC. PROVIDES MEDICAID MANAGED LONG-TERM CARE SERVICES AND SUPPORT TO 15,500 ELDERS AND PEOPLE WITH PHYSICAL AND INTELLECTUAL/DEVELOPMENTAL DISABILITIES ACROSS 51 WISCONSIN COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1337 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $44,639 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $609,812,068 | CYProgramServiceRevenueAmt |
| CY Investment Income | $231,890 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $610,088,597 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $91,078,237 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $536,649,659 | CYOtherExpensesAmt |
| CY Total Expenses | $627,727,896 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | -$17,639,299 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $76,637,102 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $54,757,983 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $21,879,119 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | INCLUSA, INC. PROACTIVELY PARTNERS WITH OTHERS TO BUILD A SHARED VISION OF LONG-TERM CARE THAT OFFERS THE PEOPLE WE SERVE CHOICE, CONNECTIONS, AND DIGNITY; FOSTERING FULL PARTICIPATION IN COMMUNITIES. INCLUSA, INC. PROVIDES MEDICAID MANAGED LONG-TERM CARE SERVICES AND SUPPORT TO 15,500 ELDERS AND PEOPLE WITH PHYSICAL AND INTELLECTUAL/DEVELOPMENTAL DISABILITIES ACROSS 51 WISCONSIN COUNTIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $594,956,040 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $609,812,068 | RevenueAmt |
| Desc | INCLUSA, INC. PROACTIVELY PARTNERS WITH OTHERS TO BUILD A SHARED VISION OF LONG-TERM CARE THAT OFFERS THE PEOPLE WE SERVE CHOICE, CONNECTIONS, AND DIGNITY; FOSTERING FULL PARTICIPATION IN COMMUNITIES. INCLUSA, INC. PROVIDES MEDICAID MANAGED LONG-TERM CARE SERVICES AND SUPPORT TO 15,500 ELDERS AND PEOPLE WITH PHYSICAL AND INTELLECTUAL/DEVELOPMENTAL DISABILITIES ACROSS 51 WISCONSIN COUNTIES. | Desc |
| Total Program Service Expenses | $594,956,040 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | 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 | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 125 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1337 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 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 | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON TAYLOR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7152041810 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3349 CHURCH ST STE 1 | AddressLine1Txt |
| City | STEVENS POINT | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54481 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| KEN DAY | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $5,460 | $0 | $0 | |
| JOAN FORDHAM | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | |
| RON CARNEY | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | |
| KEN CORNISH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,600 | $0 | $0 | ||
| JANIS RIBBENS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,875 | $0 | $0 | ||
| JOHN KRIESEL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,600 | $0 | $0 | ||
| WADE DULL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,200 | $0 | $0 | ||
| GARY RANUM | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,200 | $0 | $0 | ||
| LORI BINA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,860 | $0 | $0 | ||
| TARA JOHNSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BETH ARIMOND | |||||||
| DIRECTOR | 1.00 | Yes (X) | $1,700 | $0 | $0 | ||
| MARK HILLIKER | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $286,733 | $0 | $48,465 | ||
| TIM GARRITY | |||||||
| CHIEF INNOVATION OFFICER | 40.00 | Yes (X) | $205,365 | $0 | $49,621 | ||
| GARY PRIEM | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $201,121 | $0 | $30,212 | ||
| MARYELLEN PAUDLER | |||||||
| CHIEF MEMBER SUPPORT OFFICER | 40.00 | Yes (X) | $200,257 | $0 | $33,120 | ||
| KRISTOPHER KUBNICK | |||||||
| CHIEF COMMUNITY RESOURCES & QUALITY OFFICER | 40.00 | Yes (X) | $197,606 | $0 | $42,130 | ||
| MICHELLE FELLENZ | |||||||
| CHIEF TLC OFFICER | 40.00 | Yes (X) | $197,832 | $0 | $42,130 | ||
| JOSHUA JANDRAIN | |||||||
| CHIEF INFORMATION OFFICER | 40.00 | Yes (X) | $195,314 | $0 | $42,206 | ||
| JASON TAYLOR | |||||||
| VP OF BUSINESS AND FINANCE | 40.00 | $137,357 | $0 | $41,268 | Yes (X) | ||
| PATRICK HENNEGER | |||||||
| GENERAL COUNSEL | 40.00 | $197,634 | $0 | $41,644 | Yes (X) | ||
| JENIFER HARRISON | |||||||
| VP OF CARE MANAGEMENT PRACTICE | 40.00 | $143,977 | $0 | $13,649 | Yes (X) | ||
| JANNA DUFFY | |||||||
| VP OF CARE MANAGEMENT SUPPORT | 40.00 | $144,442 | $0 | $8,654 | Yes (X) | ||
| DANA CYRA | |||||||
| VP OF QUALITY IMPROVEMENT | 40.00 | $126,996 | $0 | $30,007 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,254,729 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $423,106 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CAREDIRECTOR USA LLC | |||||
| 11921 FREEDOM DRIVE SUITE 550 | RESTON | VA | 20190 | SUPPORT FOR CAREDIRECTOR | $623,677 |
| 3RT NETWORKS LLC | |||||
| 3600 HWY 157 SUITE 205 | LA CROSSE | WI | 54601 | CONSULTING NETWORK AND VOICE | $420,962 |
| RUNNING INC | |||||
| 318 WEST DECKER STREET | VIROQUA | WI | 54665 | MEMBER TRANSPORTATION | $390,513 |
| TEKSYSTEMS | |||||
| 7437 RACE ROAD | HANOVER | MD | 21076 | IT CONTRACTED SERVICES | $369,522 |
| PER MAR SECURITY SERVICES | |||||
| 1910 KIMBERLY ROAD | DAVENPORT | IA | 52807 | SECURITY MONITORING SERVICES | $152,697 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $44,639 | GovernmentGrantsAmt |
| Total Contributions | $44,639 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAPITATION FEE REVENUE | 624100 | $563,450,845 | $563,450,845 |
| ROOM AND BOARD REIMBURSEMENT | 623000 | $46,125,316 | $46,125,316 |
| MEMBERSHIP PASSTHROUGH SUPPLIES | 339110 | $235,907 | $235,907 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $609,812,068 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $231,890 | TotalRevenueColumnAmt |
| Exclusion | $231,890 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $610,088,597 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $609,812,068 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $231,890 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,792,205 | TotalAmt |
| Program Services | $1,387,415 | ProgramServicesAmt |
| Management And General | $404,790 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,189,539 | TotalAmt |
| Program Services | $48,039,324 | ProgramServicesAmt |
| Management And General | $14,150,215 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,444,316 | TotalAmt |
| Program Services | $2,696,474 | ProgramServicesAmt |
| Management And General | $747,842 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,200,692 | TotalAmt |
| Program Services | $15,073,742 | ProgramServicesAmt |
| Management And General | $4,126,950 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,451,485 | TotalAmt |
| Program Services | $3,468,362 | ProgramServicesAmt |
| Management And General | $983,123 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,599 | TotalAmt |
| Management And General | $149,599 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,658 | TotalAmt |
| Management And General | $166,658 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,725,490 | TotalAmt |
| Program Services | $340,780 | ProgramServicesAmt |
| Management And General | $4,384,710 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,345 | TotalAmt |
| Program Services | $47,345 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,490,514 | TotalAmt |
| Program Services | $1,146,773 | ProgramServicesAmt |
| Management And General | $343,741 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,067,045 | TotalAmt |
| Program Services | $95,426 | ProgramServicesAmt |
| Management And General | $2,971,619 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,525,460 | TotalAmt |
| Program Services | $159,536 | ProgramServicesAmt |
| Management And General | $2,365,924 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,198,820 | TotalAmt |
| Program Services | $1,693,062 | ProgramServicesAmt |
| Management And General | $505,758 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,504,373 | TotalAmt |
| Program Services | $402,011 | ProgramServicesAmt |
| Management And General | $1,102,362 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $458,883 | TotalAmt |
| Program Services | $121,878 | ProgramServicesAmt |
| Management And General | $337,005 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DIRECT MEMBER CARE EXPE | $519,969,615 | $519,969,615 | |
| EMPLOYEE TRAINING | $157,312 | $157,312 | |
| BOARD EXPENSES | $30,168 | $30,168 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,377 | TotalAmt |
| Program Services | $156,985 | ProgramServicesAmt |
| Management And General | $1,392 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $627,727,896 | TotalAmt |
| Program Services | $594,956,040 | ProgramServicesAmt |
| Management And General | $32,771,856 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,315 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $64,065,213 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $8,353,098 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $811,691 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,825,084 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,419,299 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,405,785 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $76,637,102 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $54,757,983 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $54,757,983 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $21,879,119 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $21,879,119 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $76,637,102 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$17,639,299 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $39,518,418 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $44,639 | CurrentTaxYearAmt |
| Total | $44,639 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $609,812,068 | CurrentTaxYearAmt |
| Total | $609,812,068 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $609,856,707 | CurrentTaxYearAmt |
| Total | $609,856,707 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $609,856,707 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $231,890 | CurrentTaxYearAmt |
| Total | $231,890 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $231,890 | CurrentTaxYearAmt |
| Total | $231,890 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $610,088,597 | CurrentTaxYearAmt |
| Total | $610,088,597 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,955,628 | OtherCostOrOtherBasisAmt |
| Book Value | $1,955,628 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,114,056 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,419,299 | DepreciationAmt |
| Book Value | $694,757 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $755,400 | OtherCostOrOtherBasisAmt |
| Book Value | $755,400 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,405,785 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $609,856,707 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $609,856,707 | RevenueSubtotalAmt |
| Other Revenues Not Included | $231,890 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $231,890 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $610,088,597 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $627,727,896 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $627,727,896 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $627,727,896 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART XI, LINE 4B - OTHER ADJUSTMENTS: | FormAndLineReferenceDesc |
| Explanation | INVESTMENT INCOME 231,890. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK HILLIKER | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $284,768 | $0 | $0 | $0 | $1,965 | $0 | $16,200 | $0 | $32,265 | $0 | $335,198 | $0 | $0 | $0 |
| TIM GARRITY | ||||||||||||||
| CHIEF INNOVATION OFFICER | $204,454 | $0 | $0 | $0 | $911 | $0 | $12,692 | $0 | $36,929 | $0 | $254,986 | $0 | $0 | $0 |
| GARY PRIEM | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $198,641 | $0 | $0 | $0 | $2,480 | $0 | $9,208 | $0 | $21,004 | $0 | $231,333 | $0 | $0 | $0 |
| MARYELLEN PAUDLER | ||||||||||||||
| CHIEF MEMBER SUPPORT OFFICER | $198,641 | $0 | $0 | $0 | $1,616 | $0 | $12,116 | $0 | $21,004 | $0 | $233,377 | $0 | $0 | $0 |
| KRISTOPHER KUBNICK | ||||||||||||||
| CHIEF COMMUNITY RESOURCES & QUALITY | $197,268 | $0 | $0 | $0 | $338 | $0 | $12,116 | $0 | $30,014 | $0 | $239,736 | $0 | $0 | $0 |
| MICHELLE FELLENZ | ||||||||||||||
| CHIEF TLC OFFICER | $197,268 | $0 | $0 | $0 | $564 | $0 | $12,116 | $0 | $30,014 | $0 | $239,962 | $0 | $0 | $0 |
| JOSHUA JANDRAIN | ||||||||||||||
| CHIEF INFORMATION OFFICER | $194,939 | $0 | $0 | $0 | $375 | $0 | $9,692 | $0 | $32,514 | $0 | $237,520 | $0 | $0 | $0 |
| JASON TAYLOR | ||||||||||||||
| VP OF BUSINESS AND FINANCE | $136,976 | $0 | $0 | $0 | $381 | $0 | $8,654 | $0 | $32,614 | $0 | $178,625 | $0 | $0 | $0 |
| PATRICK HENNEGER | ||||||||||||||
| GENERAL COUNSEL | $197,258 | $0 | $0 | $0 | $376 | $0 | $11,630 | $0 | $30,014 | $0 | $239,278 | $0 | $0 | $0 |
| JENIFER HARRISON | ||||||||||||||
| VP OF CARE MANAGEMENT PRACTICE | $143,384 | $0 | $0 | $0 | $593 | $0 | $11,049 | $0 | $2,600 | $0 | $157,626 | $0 | $0 | $0 |
| JANNA DUFFY | ||||||||||||||
| VP OF CARE MANAGEMENT SUPPORT | $144,061 | $0 | $0 | $0 | $381 | $0 | $8,654 | $0 | $0 | $0 | $153,096 | $0 | $0 | $0 |
| DANA CYRA | ||||||||||||||
| VP OF QUALITY IMPROVEMENT | $126,010 | $0 | $0 | $0 | $986 | $0 | $7,904 | $0 | $22,103 | $0 | $157,003 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND THE CHIEF EXECUTIVE OFFICER. A COPY OF THE 990 IS PROVIDED TO THE GOVERNING BODY BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS SHALL ADOPT AND ALWAYS MAINTAIN A WRITTEN CONFLICT OF INTEREST POLICY ("THE POLICY") THAT IS CONSISTENT WITH BEST PRACTICES FOR CHARITABLE ORGANIZATIONS. ALL DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS SHALL SIGN, AS A CONDITION TO SERVING THE CORPORATION IN HIS OR HER RESPECTIVE ROLE, A STATEMENT AGREEING TO BE BOUND BY THE TERMS OF THE POLICY. PURSUANT TO THE POLICY, ANY DIRECTOR, OFFICER, OR COMMITTEE MEMBER HAVING A MATERIAL FINANCIAL INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR AUTHORIZATION, APPROVAL, OR RATIFICATION SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF SUCH PERSON'S INTEREST TO THE BOARD OF DIRECTORS OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. IF THE CONFLICT IS CONFIRMED BY THE BOARD OF DIRECTORS, THE OFFICER OR COMMITTEE MEMBER IS NOT ALLOWED TO PARTICIPATE IN THE DISCUSSION OR VOTE ON THE MATTER. EACH YEAR THE PRESIDENT OF THE BOARD OF DIRECTORS SHALL DISTRIBUTE TO EACH DIRECTOR, OFFICER, AND ALL SENIOR STAFF OF THE CORPORATION THE CONFLICT OF INTEREST POLICY OF THE CORPORATION. THE DIRECTORS SHALL COMPLY WITH THE CONFLICT OF INTEREST POLICY OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION OF ORG'S OFFICERS AND KEY EMPLOYEES - OPEN |
| FORM 990, PART VI, SECTION C, LINE 19 | INCLUSA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF NET ASSETS FROM MERGER 39,518,418. |
| FORM 990, PART XI, LINE 9 | EFFECTIVE JANUARY 1, 2017, THE LONG-TERM CARE DISTRICTS OF COMMUNITY CARE CONNECTIONS OF WISCONSIN (CCCW), CONTINUUS, AND WESTERN WISCONSIN CARES (WWC) SUCCESSFULLY MERGED INTO THE NONSTOCK, TAX-EXEMPT CORPORATION, INCLUSA. LEADING UP TO THE JANUARY 1, 2017 MERGER, THE THREE ORGANIZATIONS FORMING INCLUSA WORKED COLLABORATIVELY WITH DHS AND OCI TO MEET ALL FAMILY CARE CERTIFICATIONS, BUSINESS PLANNING, AND PERMITTING REQUIREMENTS NECESSARY TO BEGIN OPERATIONS ON JANUARY 1, 2017. |