2017-11-15T08:20:12-06:00 2016-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL SUITE 201 PITTSFORD NY 14534 990 2016-01-01 462602391 ICIRCLE SERVICES OF THE FINGER LAKES INC ICIR 8444247253 860 HARD RD WEBSTER NY 14580 ADAM SOUTHCOTT CFO 5853471209 2017-11-14 1 RICHARD LEICHT P01378913 5853811000 4.14.157.194 2017-11-14 15:32:02 ES P F810F9FE0C4C4DAD171A8C8E72DF89C05E51BF9A 2A601B88E5C13A8BD23DB41523EF60CFA6ABA5F0 2016 2021-01-29 14:40:06Z SANKAR SEWNAUTH 860 HARD RD WEBSTER NY 14580 46103355 0 X WWW.ICIRCLECNY.ORG X 2013 NY TO PROVIDE MEMBERS WITH HIGH-QUALITY HEALTH AND SOCIAL SERVICES THAT ARE CULTURALLY-APPROPRIATE, COMMUNITY-INTEGRATED, AND TAILORED TO THEIR INDIVIDUAL NEEDS, ENSURING A POSITIVE IMPACT ON THEIR PERSONAL HEALTH, LIFESTYLE, AND INDEPENDENCE. 18 18 85 0 0 0 217578 1753740 9033794 44321122 0 0 31850 28493 9283222 46103355 0 0 0 0 1188463 2455870 0 0 0 9309015 44746186 10497478 47202056 -1214256 -1098701 5803075 13620074 8892452 18621583 -3089377 -5001509 TO PROVIDE MEMBERS WITH HIGH-QUALITY HEALTH AND SOCIAL SERVICES THAT ARE CULTURALLY-APPROPRIATE, COMMUNITY-INTEGRATED, AND TAILORED TO THEIR INDIVIDUAL NEEDS, ENSURING A POSITIVE IMPACT ON THEIR PERSONAL HEALTH, LIFESTYLE, AND INDEPENDENCE. 0 0 42212422 44349615 MANAGED LONG TERM CARE INSURANCE2107 INDIVIDUALS SERVED 0 0 DEVELOPMENTAL DISABILITIES INDIVIDUAL SUPPORT AND CARE COORDINATION ORGANIZATION 42212422 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 255 0 85 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 1 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X ADAM SOUTHCOTT 5853471209 860 HARD RD WEBSTER NY 14580 MARK PETERSON BOARD CHAIR 1.00 X X 0 0 0 SANKAR SEWNAUTH BOARD CHAIR 0.00 40.00 X X 0 567579 12662 JOSEPH GABRIEL BOARD VICE CHAIR 1.00 X X 0 0 0 BILL WOODARD TREASURER 1.00 X X 0 0 0 GREG GRIBBEN SECRETARY 1.00 X X 0 0 0 MARY BOATFIELD BOARD MEMBER 1.00 X 0 0 0 HILDA ESCHER BOARD MEMBER 1.00 X 0 0 0 MARIA DIBBLE BOARD MEMBER 1.00 X 0 0 0 ROBERT RELPH BOARD MEMBER 1.00 X 0 0 0 RENE' SNYDER BOARD MEMBER 1.00 X 0 0 0 PATRICIA FRATANGELO BOARD MEMBER 1.00 X 0 0 0 ERIC GILBERT BOARD MEMBER 1.00 X 0 0 0 RICH YARMEL BOARD MEMBER 1.00 X 0 0 0 JEFF SINSEBOX BOARD MEMBER 1.00 X 0 0 0 SY ZIELINSKI BOARD MEMBER 1.00 X 0 0 0 LORI VANAUKEN BOARD MEMBER 1.00 X 0 0 0 JENNIFER CARLSON BOARD MEMBER 1.00 X 0 0 0 RICH FERRARI BOARD MEMBER 1.00 X 0 0 0 DENNIS BUCHAN BOARD MEMBER 1.00 X 0 0 0 HENRY PASZKOW CEO/CHIEF MEDICAL OFFICER 24.00 X 216374 0 4793 MARK CURLETTA CFO 0.00 40.00 X 0 285447 16828 SHARON MARBLE COO 0.00 40.00 X 139770 26978 11981 DEBRA LITZENBERGER VP OF CLINICAL OPERATIONS 40.00 X 103317 0 6895 459461 880004 53159 3 0 1 0 ROYAL HEALTH 1 CA PLAZA SUITE 200 ISLANDIA NY 11749 TPA AND CARE MANAGEMENT SERVICES 4343826 CENTER FOR DISABILITY RIGHTS 497 STATE STREET ROCHESTER NY 14608 PROVIDER OF SERVICES TO ICIRCLE MEMBERS 2311421 METROPOLITAN MEDICAL TRANSPORTATION IPA 992 SOUTH SECOND STREET SUITE 1 RONKONKOMA NY 11779 PROVIDER OF SERVICES TO 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-5001509 -3089377 -5001509 5803075 13620074 X -1098701 -813431 X X 0 1 X 1 1 1 X 217578 1753740 1971318 9033794 44321122 53354916 9251372 46074862 55326234 0 0 0 55326234 31850 28493 60343 9283222 46103355 55386577 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 136917 136917 310758 28309 282449 419366 RESTRICTED DEPOSITS 1233393 1233393 DUE TO RELATED PARTIES 1551551 OTHER CURRENT LIABILITIES 62500 UNSECURED NOTE PAYABLE TO RELATED PARTY 3990891 5604942 0 0 0 0 0 0 0 0 0 SANKAR SEWNAUTH BOARD CHAIR 0 337070 0 116523 0 113986 0 874 0 11788 0 580241 0 0 HENRY PASZKOW CEO/CHIEF MEDICAL OFFICER 193096 0 23078 0 200 0 522 0 4271 0 221167 0 0 0 MARK CURLETTA CFO 0 223872 0 41499 0 20076 0 874 0 15954 0 302275 0 0 SHARON MARBLE COO 111193 26978 18531 0 10046 0 874 0 11107 0 151751 26978 0 0 SY ZIELINSKI BOARD MEMBER 9550 PAYMENT FOR CONSULTING SERVICES PERFORMED BY GOLDEN OAKS, LLC, A COMPANY OWNED IN EXCESS OF 35% BY SY ZIELINSKI 0 FORM 990, PART VI, SECTION A, LINE 4 DURING 2016, THE BY-LAWS WERE UPDATED SUCH THAT THE CONCEPT OF MEMBER ORGANIZATIONS WAS ELIMINATED AND CDS MONARCH, INC. IS NOW THE SOLE CORPORATE MEMBER OF ICIRCLE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERS INCLUDE INDIVIDUALS ENROLLED IN MEDICAID IN 22 COUNTIES THROUGHOUT THE WESTERN, CENTRAL, AND SOUTHERN TIER REGIONS OF NEW YORK. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE ORGANIZATION'S FINAL FORM 990 WAS PROVIDED IN ELECTRONIC FORM TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING THE FORM. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS WRITTEN CONFLICT OF INTEREST POLICY BY REQUIRING ALL EMPLOYEES, VOLUNTEERS, CONSULTANTS, AND BOARD MEMBERS UPON JOINING THE ORGANIZATION AND ANNUALLY THEREAFTER TO REVIEW, COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT TO REPORT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. REPORTS OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE REPORTED TO THE DIRECTOR OF QA, THE EXECUTIVE TEAM, OR TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR RESOLUTION, AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSUTANT, COMPENSATION SURVEYS, WRITTEN EMPLOYMENT CONTRACTS, AND APPROVALBY THE BOARD OF DIRECTORS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: PRIOR YEAR REVENUE (EXPENSE) ADJUSTMENTS, NET -813,431. FORM 990, PART XII, LINE 2C: NO CHANGES FROM PRIOR YEAR. 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