HEALTH CHOICE NETWORK INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HEALTH CHOICE NETWORK INC (EIN 90-0525658)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-07-15
- IRS object ID
- 201411969349301146
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-07-15T14:51:12-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593214308 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AVERETT WARMUS DURKEE PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1417 E CONCORD STREET | AddressLine1 |
| City | ORLANDO | City |
| State | FL | State |
| ZIP Code | 32803 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900525658 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH CHOICE NETWORK INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HEAL | NameControl |
| Phone | 3055991015 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9064 NORTHWEST 13TH TERRACE | AddressLine1 |
| City | DORAL | City |
| State | FL | State |
| ZIP Code | 33172 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEVIN KEARNS | Name |
| Title | CEO | Title |
| Phone | 3055991015 | Phone |
| Date Signed | 2014-07-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EDWARD A HOFMA CPA | Name |
| PTIN | P00735723 | PTIN |
| Phone | 4078491569 | Phone |
| Date Prepared | 2014-06-17 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEVIN KEARNS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9064 NORTHWEST 13TH TERRACE | AddressLine1 |
| City | DORAL | City |
| State | FL | State |
| ZIP Code | 33172 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12749987 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HCNETWORK.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2010 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CHOICE NETWORKS MISSION IS DELIVERING TECHNOLOGY SOLUTIONS TO IMPROVE HEALTH OUTCOMES. THE VISION IS TO BE AN INDUSTRY LEADER IN INNOVATIVE TECHNOLOGY SOLUTIONS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 72 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 508351 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10733547 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11836563 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1017 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 405073 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10734564 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12749987 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4148451 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5344260 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6391317 | OtherExpensePriorYear |
| Other Expenses Current Year | 6537109 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 10539768 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11881369 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 194796 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 868618 | RevenuesLessExpensesCY |
| Total Assets BOY | 1386074 | TotalAssetsBOY |
| Total Assets EOY | 3655262 | TotalAssetsEOY |
| Total Liabilities BOY | 1554435 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2955005 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -168361 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 700257 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO IMPROVE HEALTH OUTCOMES BY DELIVERING TECHNOLOGY SOLUTIONS AS AN INDUSTRY LEADER. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 10198601 | Expense |
| Revenue | 12241636 | Revenue |
| Description | TO ASSIST MEMBER CENTERS IN PROVIDING QUALITY FISCAL AND MANAGEMENT INFORMATION SYSTEM SERVICES. THE NETWORK'S MAIN MISSION IS TO PROVIDE HIGH QUALITY SERVICE, SUPPORT, AND EXPERTISE TO MEMBER ORGANIZATIONS AND TO ACT AS A VEHICLE FOR STRATEGIC EFFORTS THAT STRENGTHEN OUR COMMUNITY HEALTH PARTNERS. BY SHARING COMMON TECHNOLOGY AND MANAGEMENT INFORMATION SERVICES, MEMBER CENTERS CAN PROVIDE BETTER AND MORE ACCESSIBLE CARE BY USING THE VERY LATEST IN ELECTRONIC HEALTH RECORDS, INFORMATICS RESEARCH, AND FINANCIAL AND CLINICAL SERVICES. THE NETWORK IS DEDICATED TO PROVIDING THE FINEST IN THESE SERVICES TO ITS MEMBER CENTERS SO THEY CAN IMPROVE THE QUALITY AND ACCESSIBILITY OF MEDICAL AND DENTAL HEALTH CARE THEY PROVIDE TO THEIR PATIENTS. | Description |
| Total Program Service Expense | 10198601 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 72 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICK FRIEDFELD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3055991015 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9064 NORTHWEST 13 TERRACE | AddressLine1 |
| City | MIAMI | City |
| State | FL | State |
| ZIP Code | 33172 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| BRODES HARTLEY JR | |||||||||
| CHAIRMAN | 1.00 | 1.00 | X | X | 0 | 0 | 0 | ||
| SEFERINO MONTANO | |||||||||
| VICE-CHAIR | 1.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| DENNIS KRUSE | |||||||||
| TREASURER | 1.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| ROSALYN FRAZIER | |||||||||
| SECRETARY | 1.00 | 1.00 | X | X | 0 | 0 | 0 | ||
| CHRISTOPHER VIAVANT | |||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| DAVID RODDY | |||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| JOE SHEEHAN | |||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| MERRILL THOMAS | |||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| RICHARD TAAFFE | |||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| ANTHONY AMOFAH | |||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| CHARLES BOTTOMS | |||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| KEVIN KEARNS | |||||||||
| CHIEF EXECUTIVE OFFICER | 1.00 | 40.00 | X | X | 0 | 412569 | 13281 | ||
| ALEJANDRO ROMILLO | |||||||||
| SVP & CHIEF OPERATING OFFICER | 0.00 | 40.00 | 0 | 377690 | 8119 | X | |||
| RICK FRIEDFELD | |||||||||
| CHIEF FINANCIAL OFFICER | 0.00 | 40.00 | 0 | 178077 | 956 | X | |||
| TERISA A JAMES | |||||||||
| EVP OF COMMUNITY INITIATIVES AND FUND DEVELOPMENT | 0.00 | 40.00 | 0 | 158385 | 8543 | X | |||
| BLANCA MARGARITA OLLET | |||||||||
| SVP OF ADMINISTRATION SERVICES | 0.00 | 40.00 | 0 | 193978 | 3129 | X | |||
| MICHAEL BIRDSONG | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 0.00 | 183888 | 0 | 1686 | X | |||
| ROGELIO FERNANDEZ | |||||||||
| VICE PRESIDENT OF CARE MANAGEMENT | 0.00 | 40.00 | 0 | 140854 | 2095 | X | |||
| THEODORE MAREFKA | |||||||||
| DIRECTOR OF OPERATIONS & HUMAN RESOURCES | 0.00 | 40.00 | 0 | 149801 | 5348 | X | |||
| GARY ROBINSON | |||||||||
| SR. DIRECTOR OF ENTERPRISE SUPPORT | 40.00 | 0.00 | 132541 | 0 | 3895 | X | |||
| MICHELLE RUSSELL | |||||||||
| VP BUSINESS DEVELOPMENT | 40.00 | 0.00 | 146754 | 0 | 7242 | X | |||
| JEFFREY URKEVICH | |||||||||
| DIRECTOR OF HEALTH SOLUTIONS | 40.00 | 0.00 | 120360 | 0 | 1544 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 583543 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1611354 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 55838 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TERREMARK NORTH AMERICAN INC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 864416 | AddressLine1 |
| City | ORLANDO | City |
| State | FL | State |
| ZIP Code | 32886 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | IT INFRASTRUCTURE SERVICES | DescriptionOfServices |
| Compensation | 580321 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 508351 | AllOtherContributions |
| Total Contributions | 508351 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEMBER SERVICES | 561000 | 11622230 | 11622230 |
| MEMBERSHIP DUES | 561000 | 214333 | 214333 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11836563 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ADMINISTRATIVE SERVICES FOR AFFIL | Description |
| Business Code | 561000 | BusinessCode |
| Total Revenue Column | 405073 | TotalRevenueColumn |
| Related Or Exempt Function Income | 405073 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 405073 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12749987 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12241636 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4525630 | Total |
| Program Services | 4092739 | ProgramServices |
| Management And General | 432891 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213249 | Total |
| Program Services | 192785 | ProgramServices |
| Management And General | 20464 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262755 | Total |
| Program Services | 253444 | ProgramServices |
| Management And General | 9311 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 342626 | Total |
| Program Services | 312195 | ProgramServices |
| Management And General | 30431 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250499 | Total |
| Program Services | 250499 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2968 | Total |
| Program Services | 625 | ProgramServices |
| Management And General | 2343 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16600 | Total |
| Management And General | 16600 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 986800 | Total |
| Program Services | 244094 | ProgramServices |
| Management And General | 742706 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25137 | Total |
| Program Services | 11585 | ProgramServices |
| Management And General | 13552 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3456255 | Total |
| Program Services | 3431068 | ProgramServices |
| Management And General | 25187 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150885 | Total |
| Management And General | 150885 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 146459 | Total |
| Program Services | 96300 | ProgramServices |
| Management And General | 50159 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 197976 | Total |
| Program Services | 54659 | ProgramServices |
| Management And General | 143317 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45007 | Total |
| Program Services | 38720 | ProgramServices |
| Management And General | 6287 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 662664 | Total |
| Program Services | 662664 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 581733 | Total |
| Program Services | 557224 | ProgramServices |
| Management And General | 24509 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS EXPENSES | Description |
| Total | 14126 | Total |
| Management And General | 14126 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11881369 | Total |
| Program Services | 10198601 | ProgramServices |
| Management And General | 1682768 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 278185 | BOY |
| EOY | 474239 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 46379 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 378842 | BOY |
| EOY | 744518 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 542931 | BOY |
| EOY | 696979 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2400986 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 709800 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 184155 | BOY |
| EOY | 1691186 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1961 | BOY |
| EOY | 1961 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1386074 | BOY |
| EOY | 3655262 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1142058 | BOY |
| EOY | 1353650 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 177446 | BOY |
| EOY | 484934 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234931 | BOY |
| EOY | 63232 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1053189 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1554435 | BOY |
| EOY | 2955005 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -168361 | BOY |
| EOY | 700257 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -168361 | BOY |
| EOY | 700257 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1386074 | BOY |
| EOY | 3655262 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 868618 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 508351 | CurrentTaxYear |
| Total | 508351 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 4455522 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10733546 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11836563 | CurrentTaxYear |
| Total | 27025631 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 4455522 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10733546 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12344914 | CurrentTaxYear |
| Total | 27533982 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 27533982 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 1764 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1017 | CurrentTaxYearMinus1Year |
| Total | 2781 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 1764 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1017 | CurrentTaxYearMinus1Year |
| Total | 2781 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 405073 | CurrentTaxYear |
| Total | 405073 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 4457286 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10734563 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12749987 | CurrentTaxYear |
| Total | 27941836 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | X | First5Years509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2031609 | OtherCostOrOtherBasis |
| Depreciation | 586157 | Depreciation |
| Book Value | 1445452 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 369377 | OtherCostOrOtherBasis |
| Depreciation | 123643 | Depreciation |
| Book Value | 245734 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1691186 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OBLIGATION UNDER CAPITAL LEASE | Description |
| Amount | $1,053,189 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1053189 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 12783719 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 33732 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 33732 | RevenueNotRptdF990 |
| Revenue Subtotal | 12749987 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 12749987 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11915101 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 33732 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 33732 | ExpensesNotRptdF990 |
| Expenses Subtotal | 11881369 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 11881369 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | THE NETWORK IS A NONPROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PRESCRIBE REQUIREMENTS FOR THE RECOGNITION OF INCOME TAXES IN FINANCIAL STATEMENTS, AND THE AMOUNTS RECOGNIZED ARE AFFECTED BY INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS. THE NETWORK'S STATUS AS AN EXEMPT ORGANIZATION IS DEFINED AS AN INCOME TAX POSITION UNDER THESE REQUIREMENTS. WHILE MANAGEMENT BELIEVES IT HAS COMPLIED WITH THE INTERNAL REVENUE CODE, THE SUSTAINABILITY OF SOME INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS MAY BE UNCERTAIN. THERE ARE MINIMUM THRESHOLDS OF LIKELIHOOD THAT UNCERTAIN TAX POSITIONS ARE REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THAT THE NETWORK HAS ANY MATERIAL UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2013. IN THE EVENT INTEREST AND PENALTIES WERE DUE RELATING TO AN UNSUSTAINABLE TAX POSITION, THEY WOULD BE TREATED AS A COMPONENT OF INCOME TAX EXPENSE. THE NETWORK'S FEDERAL INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. AT SEPTEMBER 30, 2013, THE FISCAL YEARS 2011 THROUGH 2013 FEDERAL TAX RETURNS ARE SUBJECT TO EXAMINATION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KEARNS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | 0 | 382569 | 0 | 30000 | 0 | 0 | 0 | 0 | 0 | 13281 | 0 | 425850 | 0 | 0 |
| ALEJANDRO ROMILLO | ||||||||||||||
| SVP & CHIEF OPERATING OFFICER | 0 | 299990 | 0 | 77700 | 0 | 0 | 0 | 0 | 0 | 8119 | 0 | 385809 | 0 | 0 |
| RICK FRIEDFELD | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 0 | 168077 | 0 | 10000 | 0 | 0 | 0 | 0 | 0 | 956 | 0 | 179033 | 0 | 0 |
| TERISA A JAMES | ||||||||||||||
| EVP OF COMMUNITY INITIATIVES AND FUN | 0 | 150843 | 0 | 7542 | 0 | 0 | 0 | 0 | 0 | 8543 | 0 | 166928 | 0 | 0 |
| BLANCA MARGARITA OLLET | ||||||||||||||
| SVP OF ADMINISTRATION SERVICES | 0 | 133441 | 0 | 60537 | 0 | 0 | 0 | 0 | 0 | 3129 | 0 | 197107 | 0 | 0 |
| MICHAEL BIRDSONG | ||||||||||||||
| CHIEF INFORMATION OFFICER | 183888 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1686 | 0 | 185574 | 0 | 0 | 0 |
| THEODORE MAREFKA | ||||||||||||||
| DIRECTOR OF OPERATIONS & HUMAN RESOU | 0 | 136551 | 0 | 13250 | 0 | 0 | 0 | 0 | 0 | 5348 | 0 | 155149 | 0 | 0 |
| MICHELLE RUSSELL | ||||||||||||||
| VP BUSINESS DEVELOPMENT | 146754 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7242 | 0 | 153996 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE NETWORK HAS TWO CLASSES OF MEMBERSHIP, CLASS A MEMBERS, AND CLASS B MEMBERS. CLASS A MEMBERS ARE 501(C)(3) ORGANIZATIONS THAT PROVIDE COMPREHENSIVE FAMILY AND PRIMARY HEALTH CARE SERVICES/BEHAVIORAL HEALTH CARE SERVICES WITH A FOCUS ON LOW-INCOME, MEDICALLY UNDERSERVED AND OTHER VULNERABLE POPULATIONS. CLASS B MEMBERS ARE NETWORKS OR AFFILIATIONS OF ORGANIZATIONS OF THE TYPE THAT WOULD QUALIFY AS CLASS A MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BY-LAWS INDICATE THAT THE BOARD OF DIRECTORS SHALL CONSIST OF 9 TO 13 DIRECTORS CHOSEN AS FOLLOWS: TWO DIRECTORS APPOINTED BY HEALTH CHOICE NETWORK OF FLORIDA, INC.; ONE DIRECTOR APPOINTED BY UTAH HEALTH CHOICE NETWORK; ONE DIRECTOR APPOINTED BY NEW MEXICO HEALTH CHOICE NETWORK; AT LEAST FIVE AT LARGE MEMBERS ELECTED BY THE CLASS A MEMBERS; NO MORE THAN THREE AT LARGE MEMBERS ELECTED BY THE CLASS B MEMBERS; ONE DIRECTOR APPOINTED BY THE BOARD OF DIRECTORS WHO SHALL BE A CLINICIAN EMPLOYED BY, OR OTHERWISE CLOSELY AFFILIATED WITH A MEMBER; AND THE NETWORK'S CEO SHALL BE AN EX-OFFICIO, NON-VOTING MEMBER OF THE BOARD. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ALL THE POWERS OF THE NETWORK SHALL BE EXERCISED BY OR UNDER THE CONTROL OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 WAS REVIEWED IN DRAFT FORM AND APPROVED BY THE FINANCE COMMITTEE. A COPY WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE NETWORK HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT EVERY EMPLOYEE IS REQUIRED TO READ AND SIGN. THE NETWORK'S BYLAWS ALSO REQUIRE ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT TO ADHERE TO THE STANDARDS OF CONDUCT PERTAINING TO THE CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | HEALTH CHOICE NETWORK DOES NOT SET THE CEO'S COMPENSATION OR COMPENSATE HIM DIRECTLY. THE RELATED ORGANIZATION NOTED IN SECTION J (HEALTH CHOICE NETWORK OF FLORIDA)DETERMINES BASE AND ANY INCENTIVE COMPENSATION. HEALTH CHOICE NETWORK COMPENSATES THE RELATED ORGANIZATION ON A PERCENTAGE OF THE CEO'S COMPENSATION THROUGH A MANAGEMENT CONTRACT WHICH IS APPROVED BY THE BOARD OF DIRECTORS. THE CEO ESTABLISHES THE PROCESS FOR DETERMINATION OF THE COMPENSATION OF OTHER OFFICERS CONSISTENT WITH THE APPROVED BUDGET. | |
| FORM 990, PART VI, SECTION C, LINE 18 | THE NETWORK MAKES THESE FORMS AVAILABLE UPON REQUEST. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT CURRENTLY MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART XII, LINE 2C: | THE NETWORK HAS A FINANCE COMMITTEE ESTABLISHED BY THE BOARD OF DIRECTORS THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT, REVIEWING OF ITS FINANCIAL STATEMENTS, AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FINANCIAL STATEMENTS AND REPORTING: |
| FORM 990, SCHEDULE J, PART II, LINE 1 | COMPENSATION FOR KEVIN KEARNS INCLUDES AMOUNTS FROM HEALTH CHOICE NETWORK OF FLORIDA AND PRESTIGE HEALTH CHOICE, A RELATED COMPANY. THESE AMOUNTS ARE BROKEN DOWN AS FOLLOWS: BASE COMPENSATION INCENTIVE COMPENSATION TOTAL HCN OF FLORIDA $202,569 $ 30,000 $232,569 PRESTIGE HEALTH 180,000 180,000 TOTAL $382,569 $ 30,000 $412,569 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH CHOICE NETWORK OF FLORIDA INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9064 NORTHWEST 13TH TERRACE | AddressLine1 |
| City | DORAL | City |
| State | FL | State |
| ZIP Code | 33172 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 650504316 | EIN |
| Primary Activities | TO PROVIDE SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS | PrimaryActivities |
| Legal Domicile State | FL | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 7 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRESTIGE HEALTH CHOICE LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9064 NW 13TH TERRACE | AddressLine1 |
| City | MIAMI | City |
| State | FL | State |
| ZIP Code | 33172 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450563075 | EIN |
| Primary Activity | MANAGED HEALTH CARE ACTIVITIES | PrimaryActivity |
| Legal Domicile State | FL | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | N/A | PredominantIncomeType |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| HEALTH CHOICE NETWORK OF FLORIDA INC | ||
| E | 171699 | REDUCTION OF NOTE PAYABLE BALANCE |
| HEALTH CHOICE NETWORK OF FLORIDA INC | ||
| L | 7323668 | MEMBERSHIP FEES FROM HCNFL |
| HEALTH CHOICE NETWORK OF FLORIDA INC | ||
| K | 120086 | RENT EXPENSE PAID TO HCNFL |
| HEALTH CHOICE NETWORK OF FLORIDA INC | ||
| M | 1440420 | ADMIN EXPENSES PAID TO HCNFL |
| HEALTH CHOICE NETWORK OF FLORIDA INC | ||
| O | 245850 | DIRECTOR SALARY |
| PRESTIGE HEALTH CHOICE LLC | ||
| L | 405073 | MEMBERSHIP FEES FROM PRESTI |