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MONROE PLAN FOR MEDICAL CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MONROE PLAN FOR MEDICAL CARE INC (EIN 16-0973194)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201343199349304714
Schema version
2012v2.0
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

FieldValueIRS element (for citing)
Timestamp2013-11-15T09:01:42-08:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Robinson & Gordon CPAS PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line195 Allens Creek Rd Bldg 1 202AddressLine1
CityRochesterCity
StateNYState
ZIP Code14618ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN160973194EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MONROE PLAN FOR MEDICAL CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMONRNameControl
Phone5852568462Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11120 PITTSFORD-VICTOR ROADAddressLine1
CityPITTSFORDCity
StateNYState
ZIP Code14534ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL MESSIERName
TitleCFO\EVPTitle
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMark J RobinsonName
PTINP00189672PTIN
Phone5852449590Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts1040478835GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web Sitewww.monroeplan.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH CARE TO GOVERNMENT PROGRAM ELIGIBLESActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees233TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year14000ContributionsGrantsPriorYear
Contributions Grants Current Year96000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year585279915ProgramServiceRevenuePriorYear
Program Service Revenue CY802518941ProgramServiceRevenueCY
Investment Income Prior Year2293468InvestmentIncomePriorYear
Investment Income Current Year5288173InvestmentIncomeCurrentYear
Other Revenue Prior Year7635504OtherRevenuePriorYear
Other Revenue Current Year2864684OtherRevenueCurrentYear
Total Revenue Prior Year595222887TotalRevenuePriorYear
Total Revenue Current Year810767798TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13314607SalariesEtcPriorYear
Salaries Etc Current Year15391856SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year595137366OtherExpensePriorYear
Other Expenses Current Year833385675OtherExpensesCurrentYear
Total Expenses Prior Year608451973TotalExpensesPriorYear
Total Expenses Current Year848777531TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-13229086RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-38009733RevenuesLessExpensesCY
Total Assets BOY153862514TotalAssetsBOY
Total Assets EOY135396394TotalAssetsEOY
Total Liabilities BOY63066020TotalLiabilitiesBOY
Total Liabilities EOY80952451TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY90796494NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY54443943NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE HEALTH CARE TO GOVERNMENT PROGRAM ELIGIBLESMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionTO PROVIDE MEDICAL AND MENTAL HEALTH MANAGED CARE TO GOVERNMENT PROGRAM ELIGIBLES ADULTS AND CHILDRENDescription
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109642NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees233NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL MESSIERNamePerson
Telephone Number5852568462TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11120 PITTSFORD-VICTOR ROADAddressLine1
CityPITTSFORDCity
StateNYState
ZIP Code14534ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ALEXANDER STRASSER MD
DIRECTOR1.000.00X000
BRENDAN BRADY MD
Treasurer1.000.00X000X
PETER SZILAGYI MD MPH
Chairman1.000.00X000X
ELIZABETH NAUMBURG MD
Director1.000.00X000
LEON N ZOGHLIN MD
Director1.000.00X000
LARRY DENK MD
Director1.000.00X000
AARON SATLOFF MD
DIRECTOR1.000.00X000
JUAN VILLANUEVA
Director1.000.00X000
MARDY SANDLER LMSW
Director1.000.00X000
JAMES NORMAN
Director1.000.00X000
ARTHUR D PELLITTIERI MD
Director1.000.00X000
LISA HARRIS MD
Vice CHAIR1.000.00X000X
WILLIAM A DOLAN MD
DIRECTOR1.000.00X000
MARILYN R BROWN MD
Secretary1.000.00X000
DENNIS GRAZIANO
President & CEO40.000.00X425348084920X
WILLIAM H BAYER MD
Director1.000.00X000X
SUSAN H MCDANIEL PHD
Director1.000.00X000
MICHAEL MESSIER
CFO/EVP40.000.003155220108109X
KIM HESS
COO40.000.00266571058547X
JOSEPH STANKAITIS
Chief Med Off.40.000.003979950113858X
LINDA O'DONNELL
DIR. CLINICAL MANAGEMENT40.000.00121001032424X
DEBORAH PEARTREE
DIRECTOR OF QI40.000.00152940023149X
GEORGE HUGHES
DIRECTOR OF BENEFITS & PR40.000.00189957042561X
HOWARD BRILL
DIRECTOR OF INFORMATICS40.000.00217116042416X
CLINT KOENIG
MEDICAL DIRECTOR40.000.00163423019015X
DANA BESAW
PROCESS IMPROV MGR40.000.00111684033965X
SCOTT FERRIS
MANAGER I.T.40.000.00100791018465X
MARIO MACIAS
MGR PROV. RELATION40.000.0093611011719X
MICHAEL THORNTON
CONTROLLER40.000.0091742013484X
MARY JOAN MUSCOLINO
MANAGER40.000.0098619019525X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2746320TotalReportableCompFromOrg
Total Other Compensation622157TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
THE HARWICH GROUP
48 HARWICH ROADPROVIDENCERI02906CONSULTING348107
SUNGARD AVAILABILITY SERVICES LP
PO BOX 91233CHICAGOIL60693COMPUTER CONSULTING159142
MANATT PHELPS & PHILLIPS LLP
7 TIMES SQUARE 23RD FLOORNEW YORKNY10036LEGAL149198
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Government Grants96000GovernmentGrants
Total Contributions96000TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM REVENUESDescription
Total Revenue Column802518941TotalRevenueColumn
Related Or Exempt Function Income802518941RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue802518941TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3876018TotalRevenueColumn
Exclusion$3,876,018ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities230273192Securities
Other850000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities228981719Securities
Other729318Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1291473Securities
Other120682Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1412155TotalRevenueColumn
Exclusion$1,412,155ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionEQUITY ERNGS JNT VENTUREDescription
Total Revenue Column2864684TotalRevenueColumn
Related Or Exempt Function Income2864684RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2864684TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column810767798TotalRevenueColumn
Related Or Exempt Function Income805383625RelatedOrExemptFunctionIncome
Exclusion$5,288,173ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2774872Total
Management And General1445752ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10943623Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total696435Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total976926Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total245647Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total49928Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2779959Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total286344Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total174159Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total109860Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total405067Total

Insurance Insurance

FieldValueIRS element (for citing)
Total2257643Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
Printing and Publications419562
MISCELLANEOUS PRINCIPALLY RENT570265
TEMPORARY HELP1769845
PROGRAM SERVICES823113240

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1204156Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total848777531Total
Program Services0ProgramServices
Management And General1445752ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21347403BOY
EOY17948940EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13313587BOY
EOY25707806EOY

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)
BOY100000BOY
EOY80000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY293480BOY
EOY302672EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4393290LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1676330LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3687914BOY
EOY2716960EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY62431504BOY
EOY45449285EOY

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)
BOY52688626BOY
EOY43190731EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY153862514BOY
EOY135396394EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2295609BOY
EOY4227397EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY60770411BOY
EOY76725054EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY63066020BOY
EOY80952451EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY90796494BOY
EOY54443943EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY90796494BOY
EOY54443943EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY153862514BOY
EOY135396394EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-38009733ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1657182ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1350538OtherCostOrOtherBasis
Depreciation388135Depreciation
Book Value962403BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1125220OtherCostOrOtherBasis
Depreciation100084Depreciation
Book Value1025136BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1917532OtherCostOrOtherBasis
Depreciation1188111Depreciation
Book Value729421BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2716960TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
RECEIVABLE FROM JOINT VENTURE5071117
DEPOSITS250000
DEFERRED COMP ASSET116667
ASSETS HELD IN TRUST317500
ADVANCE PAYMENTS4987666
FieldValueIRS element (for citing)
Total Book Value Other Assets43190731TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OTHER PAYABLES$6,419,466
LIABILITIES HELD IN TRUST$317,500
BENEFIT CLAIMS PAYABLE$69,838,088
ACCRUED DEFERRED COMPENSATION$150,000
FieldValueIRS element (for citing)
Total Of Amounts76725054TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt812424980TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1657182NetUnrealizedGainsInvestments
Revenue Not Rptd F9901657182RevenueNotRptdF990
Revenue Subtotal810767798RevenueSubtotal
Total Revenue Per Form990810767798TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt848777531TotExpensesEtcAuditedFinclStmt
Expenses Subtotal848777531ExpensesSubtotal
Total Expenses Per Form990848777531TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPart XIdentifier
Return ReferencePart X : FIN48 FootnoteReturnReference
ExplanationManagement evaluates any significant tax implications that may effect the financial statements and does not believe that it has taken any positions that would affect the audited statements.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
MICHAEL MESSIER
CFO/EVP2756688849310057785030259423631
LINDA O'DONNELL
DIR. CLINICAL MANAGEMENT11100981321860975722667153425
KIM HESS
COO21502022151294002485033697325118
JOSEPH STANKAITIS
Chief Med Off.34878314582346307785036008511853
HOWARD BRILL
DIRECTOR OF INFORMATICS1995461477127991710125315259532
GEORGE HUGHES
DIRECTOR OF BENEFITS & PR1745021310223531537427187232518
DENNIS GRAZIANO
President & CEO34175549821337726138523535510268
DEBORAH PEARTREE
DIRECTOR OF QI139669111592112426818881176089
CLINT KOENIG
MEDICAL DIRECTOR144933162852205475914256182438

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableFINANCIAL STATEMENTS,TAX RETURNS AND GOVERNING DOCUMENTS are AVAILABLE UPON REQUEST. OTHER policies are available on the organization's website.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesComparability data and other outside sources are used for the officers and Key employees.
Form 990, Part VI, Line 15aForm 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementCOMPARABILITY DATA AND OTHER OUTSIDE SOURCES ARE USED TO DETERMINE THE CEO SALARY. THE BOARD APPROVES THE SALARY AND MAINTAINS AN EMPLOYMENT AGREEMENT FOR THAT POSITION.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe Organization requires annual disclosures from Directors, Key Employees and Officers concerning conflicts of interest. The Chief Compliance Officer is responsible for ensuring compliance with this policy.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessTHE CEO/CFO/COO & CHIEF COMPLIANCE OFFICER REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1UNIVERA COMMUNITY HEALTH INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1205 PARK CLUB LANEAddressLine1
CityBUFFALOCity
StateNYState
ZIP Code142215239ZIPCode
FieldValueIRS element (for citing)
EIN161500379EIN
Primary ActivitiesHEALTH CAREPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501C3ExemptCodeSection
Public Charity Status509(a)(2)PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1UNIVERA IPA LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1165 COURT STREETAddressLine1
CityROCHESTERCity
StateNYState
ZIP Code14647ZIPCode
FieldValueIRS element (for citing)
EIN454058523EIN
Primary ActivityIPAPrimaryActivity
Legal Domicile StateNYLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Share Of EOY Assets9798ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.50000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
UNIVERA IPA LLC
b2206434CONTRACT
UNIVERA COMMUNITY HEALTH INC
q5071117exp accrual
UNIVERA COMMUNITY HEALTH INC
l4560011CONTRACT
UNIVERA COMMUNITY HEALTH INC
b4000000contract