BUTLER HEALTH PLAN: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BUTLER HEALTH PLAN (EIN 31-1151537)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-09-06
- IRS object ID
- 201212509349300231
- Schema version
- 2011v1.2
- 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 | 2012-09-06T15:21:51-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310800053 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK SCHAEFER HACKETT AND CO | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE EAST FOURTH ST SUITE 1200 | AddressLine1 |
| City | CINCINNATI | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311151537 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BUTLER HEALTH PLAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BUTL | NameControl |
| Phone | 5138962300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH ERIE BLVD NO B | AddressLine1 |
| City | HAMILTON | City |
| State | OH | State |
| ZIP Code | 45011 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEPHANIE HEARN | Name |
| Title | DIRECTOR | Title |
| Phone | 5139426262 | Phone |
| Date Signed | 2012-08-23 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEVIN T DAVIS CPA | Name |
| PTIN | P00039883 | PTIN |
| Phone | 5132413111 | Phone |
| Date Prepared | 2012-08-23 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEPHANIE HEARN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1910 FAIRGROVE AVENUE SUITE C | AddressLine1 |
| City | HAMILTON | City |
| State | OH | State |
| ZIP Code | 45011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 79859724 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.BUTLERHEALTHPLAN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE MEDICAL AND DENTAL BENEFITS FOR THE EXCLUSIVE BENEFIT OF ITS MEMBERS | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 600498 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 75070315 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 79259226 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 881623 | InvestmentIncomePriorYear |
| Investment Income Current Year | 600498 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 75951938 | TotalRevenuePriorYear |
| Total Revenue Current Year | 79859724 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 76310608 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 78601119 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 236973 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 250560 | 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 | 2854377 | OtherExpensePriorYear |
| Other Expenses Current Year | 2908244 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 79401958 | TotalExpensesPriorYear |
| Total Expenses Current Year | 81759923 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3450020 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1900199 | RevenuesLessExpensesCY |
| Total Assets BOY | 21063812 | TotalAssetsBOY |
| Total Assets EOY | 17271435 | TotalAssetsEOY |
| Total Liabilities BOY | 11046164 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9206700 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10017648 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8064735 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE 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 Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Description | HEALTH CARE BENEFITS - PROVIDING HEALTH CARE COVERAGE TO PARTICIPATING SCHOOLS, SERVING APPROXIMATELY 6,400 INDIVIDUALS/FAMILIES. | Description |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| 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 | 0 | 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 | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 3 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 2 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | 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 | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | 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 | STEPHANIE HEARN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5139426262 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH ERIE BLVD NO B | AddressLine1 |
| City | HAMILTON | City |
| State | OH | State |
| ZIP Code | 45011 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| BETH WEBER | ||||||
| TRUSTEE | 1.00 | X | X | 0 | 0 | 0 |
| ROBIN WHITE | ||||||
| TRUSTEE-CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | |
| JAN KESSELRING | ||||||
| TRUSTEE-SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| RICHARD PACKERT | ||||||
| TRUSTEE | 1.00 | X | X | 0 | 0 | 0 |
| NANCY LANE | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| CHRISTINE COOK-POETTER | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| MARSHA MUEGGENBERG | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| STEPHANIE HEARN | ||||||
| EXECUTIVE DIRECTOR | 40.00 | X | 120000 | 0 | 21132 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 120000 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 21132 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ALLIED BENEFIT SYSTEMS INC | |||||
| 208 SOUTH LASALLE ST STE 1300 | CHICAGO | IL | 60604 | ADMINISTRATION FEES | 1201450 |
| HEALTHSPAN | |||||
| 225 PICTORIA DRIVE SUITE 320 | CINCINNATI | OH | 45246 | ADMINISTRATION FEES | 923141 |
| MULTIPLAN | |||||
| 115 FIFTH AVENUE | NEW YORK | NY | 10003 | ADMINISTRATION FEES | 122179 |
| FIFTH THIRD BANK | |||||
| 5050 KINGSLEY DRIVE | CINCINNATI | OH | 45263 | BANKING & INVESTMENT SERVICES | 116958 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEMBER CONTRIBUTIONS | Description |
| Business Code | 525100 | BusinessCode |
| Total Revenue Column | 79259226 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79259226 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 79259226 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 600498 | TotalRevenueColumn |
| Unrelated Business Revenue | 600498 | UnrelatedBusinessRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 79859724 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79259226 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 600498 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78601119 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135132 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75000 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9750 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7395 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23283 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74558 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26900 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37326 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150985 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18051 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1675 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17731 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7703 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8637 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130568 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| ADMINISTRATION FEES | 2270106 |
| BANK FEES | 79632 |
| WELLNESS & SUPPORT | 42294 |
| DUES & SUBSCRIPTIONS | 24841 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17237 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81759923 | Total |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1244602 | BOY |
| EOY | 1210594 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 941200 | BOY |
| EOY | 590606 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18878010 | BOY |
| EOY | 15470235 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21063812 | BOY |
| EOY | 17271435 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2846164 | BOY |
| EOY | 1206700 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8200000 | BOY |
| EOY | 8000000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11046164 | BOY |
| EOY | 9206700 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10017648 | BOY |
| EOY | 8064735 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10017648 | BOY |
| EOY | 8064735 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21063812 | BOY |
| EOY | 17271435 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1900199 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -52714 | 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 |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BENEFIT OBLIGATIONS - IBNR | Description |
| Amount | $8,000,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8000000 | TotalOfAmounts |
| Total Revenue | 79859724 | TotalRevenue |
| Total Expenses | 81759923 | TotalExpenses |
| Excess Or Deficit For Year | -1900199 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -52714 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -52714 | TotalAdjustments |
| Excess Or Deficit Per FS | -1952913 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 79769684 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -52714 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -52714 | RevenueNotRptdF990 |
| Revenue Subtotal | 79822398 | RevenueSubtotal |
| Investment Expenses Not Included | 37326 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 37326 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 79859724 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 81922597 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 200000 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 200000 | ExpensesNotRptdF990 |
| Expenses Subtotal | 81722597 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 37326 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 37326 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 81759923 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | ACCOUNTING 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 DECEMBER 31, 2011, 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, 2008. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN BENEFIT OBLIGATIONS - CLAIMS INCURRED BUT NOT REPORTED 200,000. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART IV, LINE 32: | IN 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. THE PLAN INTENDS TO JOIN 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. THE ANTICIPATED EFFECTIVE DATE OF THE MERGER IS SEPTEMBER 1, 2012. | |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY GOVERNING COMMITTEES. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 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 12C | ANNUALLY, 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 19 | THE ORGANIZATION WILL PROVIDE PRINT COPIES OF ITS GOVERNING DOCUMENTS UPON WRITTEN REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -52,714. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| 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 (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|
| FAIRFIELD CITY SCHOOL DISTRICT | |||||||
| 211 DONALD DRIVE | FAIRFIELD | OH | 45014 | PUBLIC SCHOOLING | OH | 501(C)(1) | 0 |
| HAMILTON CITY SCHOOL DISTRICT | |||||||
| 533 DAYTON STREET | HAMILTON | OH | 45012 | PUBLIC SCHOOLING | OH | 501(C)(1) | 0 |
| LAKOTA LOCAL SCHOOLS | |||||||
| 5572 PRINCETON ROAD | LIBERTY TOWNSHIP | OH | 45011 | PUBLIC SCHOOLING | OH | 501(C)(1) | 0 |
| MIDDLETOWN CITY SCHOOLS | |||||||
| 1515 GIRARD AVENUE | MIDDLETOWN | OH | 45044 | PUBLIC SCHOOLING | OH | 501(C)(1) | 0 |
| 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 | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | 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 | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| FAIRFIELD CITY SCHOOL DISTRICT | ||
| R | 8935045 | CASH |
| HAMILTON CITY SCHOOL DISTRICT | ||
| R | 10057530 | CASH |
| LAKOTA LOCAL SCHOOLS | ||
| R | 17732963 | CASH |
| MIDDLETOWN CITY SCHOOLS | ||
| R | 7658316 | CASH |