STRATEGY STUDIO / PUBLIC DATA EXPLORER

BUTLER HEALTH PLAN: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BUTLER HEALTH PLAN (EIN 31-1151537)
Tax period
2012-01-01 to 2012-09-30
Filed
2013-03-25
IRS object ID
201300849349300760
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

FieldValueIRS element (for citing)
Timestamp2013-03-25T14:56:18-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN310800053EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLARK SCHAEFER HACKETT AND COBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE EAST FOURTH ST SUITE 1200AddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN311151537EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BUTLER HEALTH PLANBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBUTLNameControl
Phone5132732520Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 NORTH ERIE BLVD STE BAddressLine1
CityHAMILTONCity
StateOHState
ZIP Code45011ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTEPHANIE HEARNName
TitleDIRECTORTitle
Phone5139426262Phone
Date Signed2013-03-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKEVIN T DAVIS CPAName
PTINP00039883PTIN
Phone5132413111Phone
Date Prepared2013-03-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Terminated ReturnXTerminatedReturn
Name Of Principal Officer PersonSTEPHANIE HEARNNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1400 NORTH ERIE BLVD STE BAddressLine1
CityHAMILTONCity
StateOHState
ZIP Code45011ZIPCode
FieldValueIRS element (for citing)
Gross Receipts48129923GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.BUTLERHEALTHPLAN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionPROVIDE MEDICAL AND DENTAL BENEFITS FOR THE EXCLUSIVE BENEFIT OF ITS MEMBERSActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees2TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI388126TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year79259226ProgramServiceRevenuePriorYear
Program Service Revenue CY47741797ProgramServiceRevenueCY
Investment Income Prior Year600498InvestmentIncomePriorYear
Investment Income Current Year388126InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year79859724TotalRevenuePriorYear
Total Revenue Current Year48129923TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year78601119BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY50677410BenefitsPaidToMembersCY
Salaries Etc Prior Year250560SalariesEtcPriorYear
Salaries Etc Current Year205600SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2908244OtherExpensePriorYear
Other Expenses Current Year1758192OtherExpensesCurrentYear
Total Expenses Prior Year81759923TotalExpensesPriorYear
Total Expenses Current Year52641202TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1900199RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4511279RevenuesLessExpensesCY
Total Assets BOY17271435TotalAssetsBOY
Total Assets EOY0TotalAssetsEOY
Total Liabilities BOY9206700TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8064735NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE PLAN PROVIDES HEALTH (HOSPITAL, SURGICAL, MAJOR MEDICAL, AND PRESCRIPTION DRUG) AND DENTAL BENEFITS COVERING SUBSTANTIALLY ALL EMPLOYEES AND ELIGIBLE DEPENDENTS OF A CONSORTIUM OF SCHOOL DISTRICTS IN SOUTHWESTERN OHIO.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
DescriptionHEALTH CARE BENEFITS - PROVIDING HEALTH CARE COVERAGE TO PARTICIPANTS EMPLOYED BY 14 LOCAL SCHOOL DISTRICTS AND RELATED EDUCATIONAL INSTITUTIONSDescription
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated1Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1STEPHANIE HEARNBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5139426262TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 NORTH ERIE BLVD STE BAddressLine1
CityHAMILTONCity
StateOHState
ZIP Code45011ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
BETH WEBER
TRUSTEE1.00X000
ROBIN WHITE
TRUSTEE-CHAIRPERSON1.00X000X
JAN KESSELRING
TRUSTEE (PART-YEAR)1.00X000
RICHARD PACKERT
TRUSTEE1.00X000
NANCY LANE
TRUSTEE1.00X000
CHRISTINE COOK-POETTER
TRUSTEE1.00X000
MIKE DAVIS
TRUSTEE1.00X000
PATTY SPATH-MEYER
TRUSTEE1.00X000
STEPHANIE HEARN
EXECUTIVE DIRECTOR40.0092769015422X
FieldValueIRS element (for citing)
Total Reportable Comp From Org92769TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation15422TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLIED BENEFIT SYSTEMS INC
208 SOUTH LASALLE ST STE 1300CHICAGOIL60604ADMINISTRATION FEES742960
HEALTHSPAN
225 PICTORIA DRIVE SUITE 320CINCINNATIOH45246ADMINISTRATION FEES566358
MULTIPLAN
115 FIFTH AVENUENEW YORKNY10003ADMINISTRATION FEES106546
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMEMBER CONTRIBUTIONSDescription
Business Code525100BusinessCode
Total Revenue Column47741797TotalRevenueColumn
Related Or Exempt Function Income47741797RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue47741797TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column388126TotalRevenueColumn
Unrelated Business Revenue388126UnrelatedBusinessRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column48129923TotalRevenueColumn
Related Or Exempt Function Income47741797RelatedOrExemptFunctionIncome
Unrelated Business Revenue388126UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total50677410Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total108191Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total72115Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3606Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total945Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total20743Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total40664Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total33300Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total21192Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total54311Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4332Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1500Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total9978Total

Travel Travel

FieldValueIRS element (for citing)
Total6253Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3568Total

Insurance Insurance

FieldValueIRS element (for citing)
Total72182Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
ADMINISTRATION FEES1418472
BANK FEES46823
WELLNESS & SUPPORT41348
DUES & SUBSCRIPTIONS2445

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1824Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total52641202Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1210594BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY590606BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY15470235BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17271435BOY
EOY0EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1206700BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8000000BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9206700BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY8064735BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8064735BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17271435BOY
EOY0EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4511279ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-184818ReconciliationUnrealizedInvest
Reconcilation Other Changes-3368638ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt47923913TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-184818NetUnrealizedGainsInvestments
Revenue Not Rptd F990-184818RevenueNotRptdF990
Revenue Subtotal48108731RevenueSubtotal
Investment Expenses Not Included21192InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt21192RevenueNotRptdOnFinStmt
Total Revenue Per Form99048129923TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt52620010TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal52620010ExpensesSubtotal
Investment Expenses Not Included221192InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt21192ExpensesNotRptdOnFinStmt
Total Expenses Per Form99052641202TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT, AS OF SEPTEMBER 1, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2009.Explanation

Schedule N IRS990ScheduleN

Liquidation Table LiquidationTable

Liquidation Detail LiquidationDetail (6 entries)

Description Of AssetDescriptionOfAssetDate Of DistributionDateOfDistributionFMV Of AssetFMVOfAssetMethod Of FMV DeterminationMethodOfFMVDeterminationAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCode
OPTIMAL HEALTH INITIATIVES CONSORTIUM
CASH2012-09-01480431BOOK VALUE10999 REED HARTMAN HIGHWAY SUITE 3CINCINNATIOH45242
OPTIMAL HEALTH INITIATIVES CONSORTIUM
ACCOUNTS RECEIVABLE2012-09-01275097BOOK VALUE10999 REED HARTMAN HIGHWAY SUITE 3CINCINNATIOH45242
OPTIMAL HEALTH INITIATIVES CONSORTIUM
INVESTMENTS2012-09-0112723766FMV IS READILY AVAILABLE FOR PUBLICLY TRADED ASSETS10999 REED HARTMAN HIGHWAY SUITE 3CINCINNATIOH45242
OPTIMAL HEALTH INITIATIVES CONSORTIUM
ALLIED CLAIM ACCOUNT2012-09-01-2104985BOOK VALUE10999 REED HARTMAN HIGHWAY SUITE 3CINCINNATIOH45242
OPTIMAL HEALTH INITIATIVES CONSORTIUM
BENEFIT OBLIGATIONS - IBNR2012-09-01-8500000BOOK VALUE10999 REED HARTMAN HIGHWAY SUITE 3CINCINNATIOH45242
OPTIMAL HEALTH INITIATIVES CONSORTIUM
ACCOUNTS PAYABLE2012-09-01-5671BOOK VALUE10999 REED HARTMAN HIGHWAY SUITE 3CINCINNATIOH45242
FieldValueIRS element (for citing)
Director Of Successor1DirectorOfSuccessor
Employee Of Successor1EmployeeOfSuccessor
Owner Of Successor0OwnerOfSuccessor
Receive Compensation0ReceiveCompensation
Assets Distributed1AssetsDistributed
Required To Notify AG1RequiredToNotifyAG
AG Notified1AGNotified
Liabilities Paid1LiabilitiesPaid
Bonds Outstanding0BondsOutstanding
Bond Liabilities Discharged0BondLiabilitiesDischarged

Form990 Schedule N Part III Form990ScheduleNPartIII (2 entries)

ExplanationExplanation
PART I, LINE 2E: STEPHANIE HEARN, BETH WEBER, ROBIN WHITE, RICHARD PACKERT, NANCY LANE, CHRISTINE COOK-POETTER, MIKE DAVIS & PATTY SPATH-MEYER
PART I, LINE 2E: THE EXISTING BOARD OF DIRECTORS CONTINUES TO DIRECT THE OPERATIONS OF BUTLER HEALTH PLAN, AS A DIVISION OF OPTIMAL HEALTH INITIATIVES. STEPHANIE HEARN CONTINUES TO FUNCTION AS EXECUTIVE DIRECTOR OF THE PLAN, BUT IS NOW AN EMPLOYEE OF SHAFELY PLAN MANAGEMENT.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGES IN PROGRAM SERVICESFORM 990, PART III, LINE 3IN MARCH 2012, THE TRUSTEES APPROVED A MERGER OF THE PLAN, SUBJECT TO THE CONSENT OF THE MAJORITY OF THE MEMBER DISTRICTS. THE PLAN SUBSEQUENTLY RECEIVED CONSENTS FROM A SUFFICIENT NUMBER OF SCHOOL DISTRICTS TO PROCEED WITH THE MERGER. EFFECTIVE SEPTEMBER 1, 2012, THE PLAN JOINED OPTIMAL HEALTH INITIATIVES TO FORM A STATE-WIDE, JOINTLY ADMINISTERED ARRANGEMENT WITH NORTHERN BUCKEYE HEALTH PLAN AND SCIOTO HEALTH PLAN. THE THREE MERGING PLANS WILL OPERATE AS DIVISIONS, PROVIDING LOCAL SEPARATION OF ASSETS AND DECISION MAKING FOR ISSUES, SUCH AS PLAN DESIGN, RATES, RESERVE MANAGEMENT, ETC. THE PURPOSE FOR THE MERGER IS TO ENHANCE THE INDEPENDENT SURVIVABILITY OF THE PLAN FROM STATE AND FEDERAL CONTROL BY SIGNIFICANTLY INCREASING THE NUMBER OF MEMBERS SERVED ON A STATE-WIDE BASIS.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE ANY GOVERNING COMMITTEES.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS INITIALLY REVIEWED BY THE EXECUTIVE DIRECTOR WHO PROVIDES THE FORM TO THE BOARD BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, BOARD MEMBERS MUST STATE IF THERE ARE ANY POTENTIAL CONFLICTS. ADDITIONALLY, IF ANY CONFLICTS OCCUR DURING THE YEAR, THE AFFECTED BOARD MEMBER MUST BRING THE CONFLICT BEFORE THE BOARD. THE BOARD MEMBER WITH THE POTENTIAL CONFLICT IS NOT ALLOWED TO VOTE ON THE MATTER.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION WILL PROVIDE PRINT COPIES OF ITS GOVERNING DOCUMENTS UPON WRITTEN REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 9:CHANGE IN BENEFIT OBLIGATIONS - CLAIMS INCURRED BUT NOT REPORTED -500,000. TRANSFER OF ASSETS OUT TO OHI -2,868,638.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS AN ANNUAL AUDIT OF THEIR FINANCIAL STATEMENTS AS REQUIRED BY THE DEPARTMENT OF LABOR. OVERSIGHT OF THE AUDIT IS PERFORMED BY MANAGEMENT AND THE BOARD OF TRUSTEES. THIS PROCESS IS CONSISTENT WITH THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
FAIRFIELD CITY SCHOOL DISTRICT
211 DONALD DRIVEFAIRFIELDOH45014PUBLIC SCHOOLINGOH501(C)(1)0
HAMILTON CITY SCHOOL DISTRICT
533 DAYTON STREETHAMILTONOH45012PUBLIC SCHOOLINGOH501(C)(1)0
LAKOTA LOCAL SCHOOLS
5572 PRINCETON ROADLIBERTY TOWNSHIPOH45011PUBLIC SCHOOLINGOH501(C)(1)0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
FAIRFIELD CITY SCHOOL DISTRICT
S5901978CASH
HAMILTON CITY SCHOOL DISTRICT
S6673033CASH
LAKOTA LOCAL SCHOOLS
S11132468CASH