2015-08-11T12:45:02-05:00 2014-09-30 382157642 MANER COSTERISAN PC 2425 E GRAND RIVER SUITE 1 LANSING MI 489123291 990 2013-10-01 201477015 NORTHERN HEALTH PLAN NORT 2315477627 220 W GARFIELD CHARLEVOIX MI 49720 BRUCE MILLER EXECUTIVE DIRECTOR 2315477627 2015-07-31 1 JAMES A MC NEELEY CPA P00364811 5173237500 2013 2016-02-25 16:41:14Z BRUCE MILLER 220 W GARFIELD CHARLEVOIX MI 49720 2843036 0 X WWW.COMMUNITYHEALTHPLANS.ORG X 2001 MI TO PROVIDE MEDICAL SERVICES TO INDIGENT RESIDENTS OF NORTHERN MICHIGAN. 12 12 0 14 0 0 24 0 4231155 2843036 0 -982 0 0 4231179 2842054 0 0 0 0 0 0 0 0 0 3776467 2519984 3776467 2519984 454712 322070 3803948 3198480 990266 62728 2813682 3135752 THE PLAN PROVIDES MEDICAL SERVICES TO INDIGENT RESIDENTS OF THE NORTHERN PORTION ON MICHIGAN'S LOWER PENINSULA WHO ARE NOT COVERED BY A GOVERNMENTAL HEALTH PROGRAM OR HEALTH INSURANCE. 0 0 2393105 2843036 TO PROVIDE DIRECT MEDICAL SERVICES FOR LOW-INCOME, UNINSURED PEOPLE WITHOUT ACCESS TO OTHER GOVERNMENT HEALTH CARE PROGRAMS. DURING SEPTEMBER 30, 2014, A MONTHLY AVERAGE OF 3,156 PEOPLE RECEIVED MEDICAL SERVICES UNDER THE PLAN DURING THE FIRST 6 MONTHS OF THE PLAN YEAR. 2393105 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X X BRUCE MILLER 2315477627 220 W GARFIELD CHARLEVOIX MI 49720 X CHRISTINE BAUMGARDNER BOARD MEMBER 0.50 X 0 0 0 JOHN MCVEETY BOARD MEMBER 0.50 X 0 0 0 CAROL SHAFTO BOARD MEMBER 0.50 X 0 0 0 MYRNA HOLLAND BOARD MEMBER 0.50 X 0 0 0 LARRY LOSINSKI BOARD MEMBER 0.50 X 0 0 0 LYN JENKS BOARD MEMBER 0.50 X 0 0 0 DAVID BELLAMY BOARD MEMBER 0.50 X 0 0 0 FRED HARRIS BOARD MEMBER 0.50 X 0 0 0 ROBERT COURTOIS BOARD MEMBER 0.50 X 0 0 0 JOHN BRUNING PRESIDENT 2.00 X X 0 0 0 RICHARD WAKULAT SECRETARY 1.00 X X 0 0 0 LINDA YAROCH TREASURER 1.00 X X 0 0 0 BRUCE MILLER EXECUTIVE DIRECTOR 20.00 X 0 0 0 0 0 0 0 0 0 0 DISTRICT HEALTH DEPARTMENT #4 825 S HURON ST CHEBOYGAN MI 49721 MEDICAL SERVICES 218155 ALCONA CITIZENS FOR HEALTH INC PO BOX 655 ALPENA MI 49707 MEDICAL SERVICES 111355 2 MEDICAL PROGRAMS 621300 2843036 2843036 2843036 982 -982 -982 -982 2842054 2843036 0 -982 24943 24943 8264 8264 PURCHASED SERVICES 1253764 1253764 MEDICAL SERVICES 933901 933901 PHARMACY CLAIMS 202779 202779 ADMIN. SERVICES/SUPPORT 93672 93672 2661 2661 2519984 2393105 126879 0 2247144 2896121 44573 4593 257786 1552211 0 3803948 3198480 701796 12769 288470 49959 990266 62728 X 2813682 3135752 2813682 3135752 3803948 3198480 322070 0 X X 1 X 0 1 0 X 14370 24 14394 3839040 4377682 3996752 4231155 2843036 19287665 3839040 4392052 3996752 4231179 2843036 19302059 0 0 0 19302059 3339 514 1786 5639 3339 514 1786 5639 3842379 4392566 3998538 4231179 2843036 19307698 0.99970 0.99950 0.00030 0.00050 X 0 CLAIMS INCURRED BUT NOT REPORTED 10000 COST SETTLEMENT PAYABLE 39959 49959 X PART X, LINE 2: IN THE PREPARATION OF TAX RETURNS, TAX POSITIONS ARE TAKEN BASED ON INTERPRETATION OF FEDERAL, STATE AND LOCAL INCOME TAX LAWS. MANAGEMENT PERIODICALLY REVIEWS AND EVALUATES THE STATUS OF UNCERTAIN TAX POSITIONS AND MAKES ESTIMATES OF AMOUNTS, INCLUDING INTEREST AND PENALTIES, ULTIMATELY DUE OR OWED. NO AMOUNTS HAVE BEEN IDENTIFIED, OR RECORDED, AS UNCERTAIN TAX POSITIONS. FEDERAL, STATE AND LOCAL TAX RETURNS GENERALLY REMAIN OPEN FOR EXAMINATION BY THE VARIOUS TAXING AUTHORITIES FOR A PERIOD OF THREE TO FOUR YEARS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE BOARD PRESIDENT FOR ACCURACY. UPON APPROVAL, THE 990 IS ALSO MADE AVAILABLE TO THE BOARD OF DIRECTORS IN ELECTRONIC FORMAT. AFTER ANY CONCERNS PRESENTED BY THE BOARD ARE ADDRESSED, THE EXECUTIVE DIRECTOR SIGNS AND FILES THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENT IS GIVEN ANNUALLY TO BOARD MEMBERS WHO SIGN A WRITTEN STATEMENT ACKNOWLEDGING THAT THEY HAVE RECEIVED, UNDERSTAND AND AGREE TO ADHERE TO THE POLICY. THERE IS ALSO AN ETHICS COMMITTEE COMPRISED OF INDEPENDENT BOARD MEMBERS. BOARD MEMBERS AND CONTRACTED EMPLOYEES RECEIVE INFORMATION ON HOW TO REPORT POTENTIAL VIOLATIONS OF ETHICAL BEHAVIOR TO THIS COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990 IS ALSO POSTED ANNUALLY ON GUIDESTAR'S WEBSITE. THE 990 IS PUBLIC INFORMATION THROUGH THE MICHIGAN ATTORNEY GENERAL'S OFFICE. FORM 990, PART XI, LINE 2C NORTHERN HEALTH PLAN HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.