UNION HEALTH SERVICE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- UNION HEALTH SERVICE INC (EIN 36-2302593)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-08-04
- IRS object ID
- 201732169349301358
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-04T16:33:36-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 320043599 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEGACY PROFESSIONALS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 S WACKER DRIVE STE 4000 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362302593 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION HEALTH SERVICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIO | BusinessNameControlTxt |
| Phone | 3124234200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 WEST POLK STREET | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60612 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | W JOE GARRETT | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3124234200 | PhoneNum |
| Signature | 2017-08-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | COLIN THOMPSON | PreparerPersonNm |
| PTIN | P01460524 | PTIN |
| Phone | 3123680500 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.197.118.215 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-08-04 | IPDt |
| IP Tm | 16:33:19 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D56625F7C0621E1EB8BA8C5A7372C18F0F4BC985 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C3168D624729577079CA47B99B0ED2C5793BD89E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | W JOE GARRETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 WEST POLK STREET | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $80,433,468 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNIONHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1952 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE A VOLUNTARY HEALTH SERVICES PLAN AND HEALTH MAINTENANCE ORGANIZATION | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 274 | 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 | $69,874,835 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,610,377 | CYProgramServiceRevenueAmt |
| PY Investment Income | $249,732 | PYInvestmentIncomeAmt |
| CY Investment Income | $400,225 | CYInvestmentIncomeAmt |
| PY Other Revenue | $112,014 | PYOtherRevenueAmt |
| CY Other Revenue | $115,735 | CYOtherRevenueAmt |
| PY Total Revenue | $70,236,581 | PYTotalRevenueAmt |
| CY Total Revenue | $74,126,337 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $39,095,505 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $41,219,652 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,137,085 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $27,113,612 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,163,467 | PYOtherExpensesAmt |
| CY Other Expenses | $5,597,637 | CYOtherExpensesAmt |
| PY Total Expenses | $69,396,057 | PYTotalExpensesAmt |
| CY Total Expenses | $73,930,901 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $840,524 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $195,436 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,856,723 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,582,171 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,805,825 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,742,781 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,050,898 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,839,390 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO OPERATE A VOLUNTARY HEALTH SERVICES PLAN AND HEALTH MAINTENANCE ORGANIZATION AND EDUCATE CONSUMERS, PROVIDERS, GOVERNMENT AND THE BUSINESS SECTOR ABOUT THE CONCEPT AND ADVANTAGES OF PREPAID HEALTH CARE | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $68,584,349 | ExpenseAmt |
| Revenue | $73,610,377 | RevenueAmt |
| Desc | PREPAID GROUP HEALTH PLAN INCLUDING OUTPATIENT MEDICAL, DENTAL, VISION AND INPATIENT MEDICAL CARE. | Desc |
| Total Program Service Expenses | $68,584,349 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | 560 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 274 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | W JOE GARRETT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3124234200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 W POLK ST | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60612 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 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 |
|---|---|---|---|---|---|---|---|
| LEON WOLIN | |||||||
| BOARD PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| THOMAS BALANOFF | |||||||
| BOARD VICE PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LAURA GARZA | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| KENNETH CLIFF | |||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT WIGGS | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DR RADOMIR JOVANOVICH | |||||||
| BOARD SECRETARY/PHYSICIAN | 32.00 | Yes (X) | Yes (X) | $64,996 | $0 | $12,135 | |
| DR AGNIESZKA BANKOWSKA-BRUKASZ | |||||||
| TRUSTEE/PHYSICIAN | 33.50 | Yes (X) | $209,094 | $0 | $44,089 | ||
| W JOE GARRETT | |||||||
| EXECUTIVE DIRECTOR | 37.50 | Yes (X) | $263,319 | $0 | $87,736 | ||
| RAMESH B JOSHI | |||||||
| DIRECTOR OF OPERATIONS | 37.50 | Yes (X) | $265,434 | $0 | $100,974 | ||
| DR YEVGENYA KAYDANOVA | |||||||
| MEDICAL DIRECTOR | 42.50 | Yes (X) | $107,616 | $0 | $3,908 | ||
| DR TIPBHRAPA JAOJAROENKUL | |||||||
| PHYSICIAN | 36.00 | $263,060 | $0 | $101,333 | Yes (X) | ||
| DR CHARANJEET S RAY | |||||||
| PHYSICIAN | 24.00 | $320,070 | $0 | $26,941 | Yes (X) | ||
| DR SUBHASH GOYAL | |||||||
| PHYSICIAN | 46.50 | $300,548 | $0 | $84,785 | Yes (X) | ||
| DR DORIS J MCCULLEY | |||||||
| PHYSICIAN | 36.00 | $237,954 | $0 | $155,646 | Yes (X) | ||
| DR HARRY P POULOS | |||||||
| PHYSICIAN | 42.50 | $280,500 | $0 | $69,984 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,312,591 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $687,531 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 52 | 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 |
|---|---|---|---|---|---|
| ADVOCATE NORTHSIDE HEALTH NETWORK | |||||
| 75 REMITTANCE DR STE 6994 | CHICAGO | IL | 60122 | MEDICAL SERVICES | $4,258,122 |
| UNIVERSITY OF ILLINOIS | |||||
| 7732 SOLUTION CENTER | CHICAGO | IL | 60677 | MEDICAL SERVICES | $2,192,454 |
| FRESENIUS MEDICAL CARE | |||||
| 7600 SOLUTION CENTER | CHICAGO | IL | 60434 | MEDICAL SERVICES | $1,459,961 |
| ADVOCATE MEDICAL GROUP | |||||
| 75 REMITTANCE DR STE 1787 | CHICAGO | IL | 60678 | MEDICAL SERVICES | $1,126,065 |
| LCMH CARE STATION PHYSICIANS | |||||
| 2800 WEST 95TH STREET | EVERGREEN PARK | IL | 60805 | MEDICAL SERVICES | $472,238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 48 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PREMIUMS EARNED | 900099 | $65,265,548 | $65,265,548 |
| PATIENT CHARGES | 900099 | $4,994,693 | $4,994,693 |
| MEDICARE PAYMENTS | 900099 | $3,108,843 | $3,108,843 |
| THIRD PARTY REIMBURSEMENTS | 900099 | $241,293 | $241,293 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,610,377 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $273,034 | TotalRevenueColumnAmt |
| Exclusion | $273,034 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,434,322 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,307,131 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $127,191 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,191 | TotalRevenueColumnAmt |
| Exclusion | $127,191 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $115,735 | TotalRevenueColumnAmt |
| Exclusion | $115,735 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $115,735 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,126,337 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,610,377 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $515,960 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,219,652 | TotalAmt |
| Program Services | $41,219,652 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,159,301 | TotalAmt |
| Program Services | $441,838 | ProgramServicesAmt |
| Management And General | $717,463 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,826,008 | TotalAmt |
| Program Services | $16,615,457 | ProgramServicesAmt |
| Management And General | $2,210,551 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,537,558 | TotalAmt |
| Program Services | $2,239,649 | ProgramServicesAmt |
| Management And General | $297,909 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,273,630 | TotalAmt |
| Program Services | $2,889,306 | ProgramServicesAmt |
| Management And General | $384,324 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,317,115 | TotalAmt |
| Program Services | $1,134,307 | ProgramServicesAmt |
| Management And General | $182,808 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,648 | TotalAmt |
| Program Services | $5,838 | ProgramServicesAmt |
| Management And General | $73,810 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,500 | TotalAmt |
| Management And General | $48,500 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,567 | TotalAmt |
| Management And General | $66,567 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $710,333 | TotalAmt |
| Program Services | $251,320 | ProgramServicesAmt |
| Management And General | $459,013 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,791 | TotalAmt |
| Management And General | $5,791 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $828,784 | TotalAmt |
| Program Services | $529,609 | ProgramServicesAmt |
| Management And General | $299,175 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,237 | TotalAmt |
| Program Services | $398,162 | ProgramServicesAmt |
| Management And General | $158,075 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,565,791 | TotalAmt |
| Program Services | $1,475,626 | ProgramServicesAmt |
| Management And General | $90,165 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,017 | TotalAmt |
| Management And General | $10,017 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,962 | TotalAmt |
| Management And General | $8,962 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $523,658 | TotalAmt |
| Program Services | $500,556 | ProgramServicesAmt |
| Management And General | $23,102 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,117,097 | TotalAmt |
| Program Services | $876,481 | ProgramServicesAmt |
| Management And General | $240,616 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| DUES & SUBSCRIPTIONS | $46,689 | $46,689 | |
| CORPORATE SPONSORED EVE | $23,015 | $23,015 | |
| HEALTH PROMOTION LIBRAR | $6,548 | $6,548 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,930,901 | TotalAmt |
| Program Services | $68,584,349 | ProgramServicesAmt |
| Management And General | $5,346,552 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,102,230 | BOYAmt |
| EOY | $2,693,363 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,746,415 | BOYAmt |
| EOY | $3,112,876 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,382,403 | BOYAmt |
| EOY | $2,624,767 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $772,213 | BOYAmt |
| EOY | $745,383 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,935,457 | BOYAmt |
| EOY | $3,465,821 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,742,818 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,867,663 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $730,197 | BOYAmt |
| EOY | $875,155 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,207,877 | BOYAmt |
| EOY | $14,963,632 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $979,931 | BOYAmt |
| EOY | $1,101,174 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,856,723 | BOYAmt |
| EOY | $29,582,171 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,165,894 | BOYAmt |
| EOY | $9,961,607 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $639,931 | BOYAmt |
| EOY | $781,174 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,805,825 | BOYAmt |
| EOY | $10,742,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,050,898 | BOYAmt |
| EOY | $18,839,390 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,050,898 | BOYAmt |
| EOY | $18,839,390 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,856,723 | BOYAmt |
| EOY | $29,582,171 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $195,436 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $764,135 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $828,921 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,473,551 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,181,684 | DepreciationAmt |
| Book Value | $291,867 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,269,267 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,685,979 | DepreciationAmt |
| Book Value | $583,288 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $875,155 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GROUP ANNUITY CONTRACT | Desc |
| Amt | $781,174 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $781,174 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $74,823,905 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $764,135 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $764,135 | RevenueNotReportedAmt |
| Revenue Subtotal | $74,059,770 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $66,567 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $66,567 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $74,126,337 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $73,864,334 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $73,864,334 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $66,567 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $66,567 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $73,930,901 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CORPORATION IS A CERTIFIED HEALTH MAINTENANCE ORGANIZATION UNDER THE PROVISIONS OF THE ILLINOIS HEALTH MAINTENANCE ORGANIZATION ACT. THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE CORPORATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR AGNIESZKA BANKOWSKA-BRUKASZ | ||||||||||||||
| TRUSTEE/PHYSICIAN | $209,094 | $0 | $0 | $0 | $0 | $0 | $13,481 | $0 | $30,608 | $0 | $253,183 | $0 | $0 | $0 |
| W JOE GARRETT | ||||||||||||||
| EXECUTIVE DIRECTOR | $263,319 | $0 | $0 | $0 | $0 | $0 | $61,012 | $0 | $26,724 | $0 | $351,055 | $0 | $0 | $0 |
| RAMESH B JOSHI | ||||||||||||||
| DIRECTOR OF OPERATIONS | $265,434 | $0 | $0 | $0 | $0 | $0 | $73,629 | $0 | $27,345 | $0 | $366,408 | $0 | $0 | $0 |
| DR TIPBHRAPA JAOJAROENKUL | ||||||||||||||
| PHYSICIAN | $263,060 | $0 | $0 | $0 | $0 | $0 | $71,728 | $0 | $29,605 | $0 | $364,393 | $0 | $0 | $0 |
| DR CHARANJEET S RAY | ||||||||||||||
| PHYSICIAN | $320,070 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,941 | $0 | $347,011 | $0 | $0 | $0 |
| DR SUBHASH GOYAL | ||||||||||||||
| PHYSICIAN | $300,548 | $0 | $0 | $0 | $0 | $0 | $55,308 | $0 | $29,477 | $0 | $385,333 | $0 | $0 | $0 |
| DR DORIS J MCCULLEY | ||||||||||||||
| PHYSICIAN | $237,954 | $0 | $0 | $0 | $0 | $0 | $126,345 | $0 | $29,301 | $0 | $393,600 | $0 | $0 | $0 |
| DR HARRY P POULOS | ||||||||||||||
| PHYSICIAN | $280,500 | $0 | $0 | $0 | $0 | $0 | $39,214 | $0 | $30,770 | $0 | $350,484 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PROVIDED TO THE ENTIRE BOARD FOR ITS THROUGH REVIEW PRIOR TO ITS FILING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PRESIDENT OF THE BOARD OF TRUSTEES REVIEWS AND APPROVES THE COMPENSATION, INCLUDING RAISES AND ANY BONUSES, FOR EXECUTIVE DIRECTOR, MEDICAL DIRECTOR AND DIRECTOR OF OPERATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATION MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION PLAN FUNDED STATUS 828,921. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |