2016-08-01T10:43:48-05:00 2015-12-31 591850025 GREGORY SHARER & STUART PA 100 2ND AVE SOUTH STE 600 SAINT PETERSBURG FL 337014336 990 2015-01-01 800420631 INTEGRAL HEALTH PLAN INC INTE 8135178383 4631 WOODLAND CORPORATE BLVD 201 TAMPA FL 33614 SANDRA STEELE CFO 8137750050 2016-07-29 true BYRON C SMITH CPA P00744293 7278216161 2016-08-01 2015 2016-12-15 16:53:06Z INTEGRAL QUALITY CARE SANDRA STEELE 4631 WOODLAND CORPORATE BLVD SUITE 201 TAMPA FL 33614 277927692 false X WWW.INTEGRALQUALITYCARE.COM X 2009 FL INTEGRAL QUALITY CARE IS A FLORIDA MEDICAID PROVIDER SERVICE NETWORK (PSN). WE MANAGE HIGH QUALITY ACCESSIBLE CARE FOR THE MEMBERS WE SERVE. X 4 1 149 2 0 0 163205806 207339261 185564 65988185 0 163391370 273327446 0 140888264 200684728 5356878 9418707 0 0 19311382 29176693 165556524 239280128 -2165154 34047318 43042036 52976492 38939760 15726377 4102276 37250115 X INTEGRAL QUALITY CARE IS A FLORIDA MEDICAID PROVIDER SERVICE NETWORK (PSN). WE MANAGE HIGH QUALITY ACCESSIBLE CARE FOR THE MEMBERS WE SERVE. WE ARE COMMITTED TO COLLABORATIVE RELATIONSHIPS WITH OUR PROVIDERS WHILE SERVING OUR MEMBERS WITH COMPASSION AND CARE. false true 200684728 207339261 INTEGRAL HEALTH PLAN, INC BEGAN ENROLLING MEMBERS IN APRIL 2010. PRIOR TO THE SALE ON NOVEMBER 1, 2015, THE ORGANIZATION MANAGED HEALTHCARE SERVICES FOR APPROXIMATELY 100,000 BENEFICIARIES. AFTER THE SALE, IT CEASED MANAGING HEALTHCARE SERVICES. 200684728 true false false false false false false false false false true false false true true false true true false false false false false false false false false false false true false false false false false true false false false false false true false true false false false true 1988 0 true 149 true false false false false false false false false false false X 4 1 false true false false true true true true true false false true true true true true true true true false X X ANN PROKOP 8135178423 4631 WOODLAND CORPORATE BLVD TAMPA FL 33614 JERRY STARKEY CHAIRRMAN 1.00 40.00 X 410000 0 0 WILLIAM ELLIS DIRECTOR 1.00 40.00 X 0 0 0 GREGORY PRESTON CMO 40.00 0.00 X 363007 0 28431 SANDRA STEELE CFO 1.00 40.00 X 0 0 0 JENNIFER SWEET COO/CEO 40.00 0.00 X 262788 0 28348 ANN CLAUSSEN CHAIRMAN 1.00 40.00 X 0 0 0 BARBARA NABRIT MEDICAL DIRE 40.00 0.00 X 223614 0 23725 LORI DILLARD COMPLIANCE D 40.00 0.00 X 126601 0 16815 DEBORAH SMITH PHARMACY DIR 40.00 0.00 X 129262 0 13788 GEORGIANNA MCDANIEL HR DIRECTOR 40.00 X 135302 0 0 CODY WRAY IT DIRECTOR 40.00 0.00 X 135000 0 0 1785574 111107 13 false true false EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 60673 PHARMACYBENEFIT 45906930 INDEPENDENT LIVING SYSTEMS LLC 5201 BLUE LAGOON DR MIAMI FL 33126 MANAGEMENT 9761691 JAMES P DIETZ 17201 TALENCE CT TAMPA FL 33647 CFO CONSULTING 321424 3 MEDICAID PREMIUM REVENUES 207339261 207339261 207339261 58461 58461 4652118 65877852 4600246 51872 65877852 65929724 65877852 51872 273327446 273217113 110333 200684728 200684728 1092574 1092574 7059417 7059417 199879 199879 608119 608119 458718 458718 11636791 11636791 1372315 1372315 139954 139954 14979 14979 656874 656874 93303 93303 609486 609486 786416 786416 2082425 2082425 118897 118897 271659 271659 35315 35315 648055 648055 499058 499058 ADS PAYMENTS 8252006 8252006 DEFERRED ACQUISITION COST 901320 901320 CONSULTING FEES 667757 667757 CREDENTIALING FEES 142257 142257 247826 247826 239280128 200684728 38595400 0 17226505 31137163 8934398 9895569 165000 1328700 165000 4988065 10564368 11778760 43042036 52976492 4302354 7069696 8822440 4138045 21676921 8656681 38939760 15726377 X 4102276 37250115 4102276 37250115 43042036 52976492 34047318 -899479 X false true X true false X 165000 165000 165000 NOTE RECEIVABLE MOLINA HEALTHCARE 6663228 CASH IN ESCROW FOR WIND-DOWN SERVICE 3063515 CASH HELD IN ESCROW FOR LEASE 1600000 OTHER PREPAID EXPENSES 389708 SECURITY DEPOSIT 62309 OTHER RECEIVABLES DEFERRED CONTRACT ACQUISITION DUE FROM MANAGEMENT SERVICE PROVIDER DUE FROM PARENT 11778760 MEDICAL CLAIMS PAYABLE 8656681 DUE TO MANAGEMENT SERVICE PROVIDER RISK ADJUSTMENT PAYABLE DEFERRED RENT 8656681 273312467 273312467 14979 14979 273327446 240164628 899479 899479 239265149 14979 14979 239280128 SCHEDULE D, PAGE 4, PART XI, LINE 4B INVESTMENT FEES 14,979 SCHEDULE D, PAGE 4, PART XII, LINE 2D IMPAIRMENT LOSS 899,479 SCHEDULE D, PAGE 4, PART XII, LINE 4B INVESTMENT FEES 14,979 X true false false false false false false false false JERRY STARKEY CHAIRRMAN 410000 410000 GREGORY PRESTON CMO 363007 18831 9600 391438 JENNIFER SWEET COO/CEO 246335 16453 23728 4620 291136 BARBARA NABRIT MEDICAL DIRECTOR 223614 15725 8000 247339 SCHEDULE J, PAGE 1, PART I, LINE 4 JENNIFER SWEET 259,634 0 0 BARBARA NABRIT 38,462 0 0 LORI DILLARD 46,154 0 0 DEBORAH SMITH 21,538 0 0 JERRY STARKEY CHAIRMAN 410000 CONSULTING false SALE OF MEDICAID BUS 2015-11-01 65865957 COST 260155137 MOLINA HEALTHCARE OF FLORIDA INC 8300 NW 33RD STREET STE 400 DORAL FL 33122 CORP false false false false SCHEDULE N ON AUGUST 3, 2015, THE BOARD OF DIRECTORS (BOARD) APPROVED AN ASSET PURCHASE AGREEMENT (APA) WITH MOLINA HEALTHCARE OF FLORIDA, INC. (MHF) HAVING AN EFFECTIVE DATE OF NOVEMBER 1, 2015. AS PER THE APA, MHF ASSUMED THE COMPANYS MEDICAID BUSINESS IN EXCHANGE FOR CASH, LEAVING THE COMPANY RESPONSIBLE FOR ALL OPEN AND REMAINING CLAIMS AND OTHER LIABILITIES INCURRED BEFORE THE TRANSACTION DATE. THE APA ALSO INCLUDES A COVENANT NOT TO COMPETE FOR 5 YEARS. THE COMPANYS BOARD APPROVED A PLAN OF LIQUIDATION ON NOVEMBER 2, 2015, AND THE COMPANY DETERMINED LIQUIDATION IS IMMINENT. AS A RESULT, THE COMPANY HAS CHANGED ITS BASIS OF ACCOUNTING FOR PERIODS SUBSEQUENT TO NOVEMBER 1, 2015 FROM THE GOING-CONCERN BASIS TO A LIQUIDATION BASIS. FORM 990 - ORGANIZATION'S MISSION INTEGRAL QUALITY CARE IS A FLORIDA MEDICAID PROVIDER SERVICE NETWORK (PSN). WE MANAGE HIGH QUALITY ACCESSIBLE CARE FOR THE MEMBERS WE SERVE. WE ARE COMMITTED TO COLLABORATIVE RELATIONSHIPS WITH OUR PROVIDERS WHILE SERVING OUR MEMBERS WITH COMPASSION AND CARE. FORM 990, PAGE 2, PART III, LINE 3 THE ORGANIZATION SOLD THE MEDICAID BUSINESS ON NOVEMBER 1, 2015. IT WILL CONTINUE TO RECEIVE PAYMENTS ON CLAIMS UNTIL 2016. SEE SCHEDULE N FOR ADDITIONAL INFORMATION. FORM 990, PAGE 6, PART VI, LINE 3 THE COMPANY WAS MANAGED BY INDEPENDENT LIVING SYSTEMS LLC, A MANAGEMENT SERVICE ORGANIZATION, AS PART OF A MANAGEMENT SERVICES AGREEMENT. FORM 990, PAGE 6, PART VI, LINE 6 INTEGRAL HEALTH PLAN HAS TWO MEMBERS, WITH COLLIER HEALTH SERVICES HAVING MAJORITY MEMBERSHIP AND ASSOCIATION OF AREA DELIVERY SYSTEM SPONSORS, INC (AADS), A 501C(3) NOT-FOR-PROFIT CORPORATION, HOLDING THE MINORITY MEMBERSHIP POSITION. FORM 990, PAGE 6, PART VI, LINE 7A INTEGRAL HEALTH PLAN HAS TWO MEMBERS, WITH COLLIER HEALTH SERVICES HAVING MAJORITY MEMBERSHIP AND ASSOCIATION OF AREA DELIVERY SYSTEM SPONSORS, INC (AADS), A 501C(3) NOT-FOR-PROFIT CORPORATION, HOLDING THE MINORITY MEMBERSHIP POSITION. FORM 990, PAGE 6, PART VI, LINE 7B INTEGRAL HEALTH PLAN HAS TWO MEMBERS, WITH COLLIER HEALTH SERVICES HAVING MAJORITY MEMBERSHIP AND ASSOCIATION OF AREA DELIVERY SYSTEM SPONSORS, INC (AADS), A 501C(3) NOT-FOR-PROFIT CORPORATION, HOLDING THE MINORITY MEMBERSHIP POSITION. FORM 990, PAGE 6, PART VI, LINE 11B MANAGEMENT REVIEWS THE FORM 990 AND PROVIDES A FINAL DRAFT VIA E-MAIL TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C INTEGRAL HEALTH PLAN, INC HAS ESTABLISHED A CONFLICT OF INTEREST POLICY WHICH HAS BEEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. INTEGRAL IS COMMITTED TO THE BELIEF THAT SOUND BUSINESS PRACTICES START WITH AN ABSOLUTE COMMITMENT FROM EACH EMPLOYEE TO ACT ETHICALLY IN CARRYING OUT BUSINESS AND TO COMPLY WITH THE LAWS AND REGULATIONS THAT IMPACT ITS BUSINESS, THUS INTEGRAL'S EMPLOYEES MUST AVOID PARTICIPATING IN ACTIVITIES THAT CREATE OR APPEAR TO CREATE A CONFLICT OF INTEREST. INTEGRAL HAS SPECIFICALLY IDENTIFIED THE FOLLOWING AREAS IN ITS POLICY TO BE POTENTIAL CONFLICTS OF INTEREST; FINANCIAL INTEREST, OUTSIDE EMPLOYMENT, PAID FACULTY ARRANGEMENTS, CONSULTANT OR RESEARCH CONTRACTS, ACCEPTANCE OF GIFTS, GRATUITIES, BUSINESS COURTESIES, TRAVEL, LODGING AND ENTERTAINMENT, MISUSE OF RESOURCES OR ASSETS, PERSONAL GAIN USING UNDUE INFLUENCE, DIRECT DEALINGS WITH VENDORS, AND USE OF CONFIDENTIAL INFORMATION. THE POLICY REQUIRES ALL EMPLOYEES TO DISCLOSE PARTICIPATION IN ACTIVITIES OR CIRCUMSTANCES THAT MAY PRESENT A CONFLICT OF INTEREST ON AN ANNUAL BASIS OR IF AT ANY TIME SUCH INDIVIDUAL BECOMES AWARE OF CIRCUMSTANCES THAT MAY PRESENT A CONFLICT OF INTEREST. THESE DISCLOSURES ARE REVIEWED BY COMPLIANCE AND REGULATORY AFFAIRS, AS NECESSARY. FORM 990, PAGE 6, PART VI, LINE 15A INTEGRAL HEALTH PLAN WORKED WITH ITS MAJORITY MEMBER, COLLIER HEALTH SERVICES IN UTILIZING THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT CEO SALARY REVIEW. FORM 990, PAGE 6, PART VI, LINE 15B INTEGRAL HEALTH PLAN WORKED WITH ITS MAJORITY MEMBER, COLLIER HEALTH SERVICES IN UTILIZING THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT CEO SALARY REVIEW. FORM 990, PAGE 6, PART VI, LINE 19 INTEGRAL HEALTH PLAN, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. HOWEVER INTEGRAL HEALTH PLAN, INC'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE THROUGH FLORIDA'S SECRETARY OF STATE WEBSITE. INTEGRAL HEALTH PLAN INC'S CONFLICT OF INTEREST POLICY CAN BE FOUND ON INTEGRAL'S WEBSITE. INTEGRAL HEALTH PLAN'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON THE FLORIDA AGENCY FOR HEALTHCARE ADMINISTRATION WEBSITE. FORM 990, PART XI, LINE 9 IMPAIRMENT LOSS -899,479 TOTAL -899,479 COLLIER HEALTH SERVICES INC 1454 MADISON AVENUE IMMOKALEE FL 34142 591741277 MEDICAL FL 501C3 7 NA false CENTRAL FLORIDA HEALTHCARE INC 47 5TH STREET NW WINTER HAVEN FL 33881 591404594 MEDICAL FL 501C3 7 NA false MANATEE COUNTY RURAL HCS 700 8TH AVE WEST PALMETTO FL 34221 591773262 MEDICAL FL 501C3 7 NA false false false false false false false false false false false false false true false true false false true false COLLIER HEALTH SERVICES R 5034934 CASH MANATEE COUNTY RURAL HEALTHCARE SYS R 2250000 CASH CENTRAL FLORIDA HEALTHCARE INC R 967072 CASH COLLIER HEALTH SERVICES M 35315 CASH COLLIER HEALTH SERVICES M 2767730 CASH COLLIER HEALTH SERVICES O SHARING OF PAID EMPLOYEES SCHEDULE R ITEM O: COLLIER HEALTH SERVICES, INC. SHARES PAID EMPLOYEES WITH THE COMPANY.