INDEPENDENT HEALTH ASSOCIATION INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- INDEPENDENT HEALTH ASSOCIATION INC (EIN 16-1080163)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201213199349303371
- 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 | 2012-11-14T12:23:06-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 RENAISSANCE CENTER SUITE 3900 | AddressLine1 |
| City | DETROIT | City |
| State | MI | State |
| ZIP Code | 482431300 | 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 | 161080163 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDEPENDENT HEALTH ASSOCIATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INDE | NameControl |
| Phone | 7166313001 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 511 FARBER LAKES DRIVE | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14221 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL CROPP MD | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 7166313001 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LORI BOYCE | Name |
| PTIN | P00121981 | PTIN |
| Phone | 3133963000 | Phone |
| 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 | MICHAEL CROPPMD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 511 FARBER LAKES DRIVE | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14221 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1376723576 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.INDEPENDENTHEALTH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1980 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | AN HMO THAT PROVIDES HEALTH CARE BENEFITS AND HEALTH RELATED PRODUCTS AND SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1183 | TotalNbrEmployees |
| Total Nbr Volunteers | 132 | TotalNbrVolunteers |
| Total Gross UBI | 63206144 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 609554 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1082999986 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1207031999 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 14075545 | InvestmentIncomePriorYear |
| Investment Income Current Year | 12576768 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 52711470 | OtherRevenuePriorYear |
| Other Revenue Current Year | 63208988 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1149787001 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1282817755 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 529860 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 543850 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 921283054 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 1047641195 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 89077982 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 116261330 | 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 | 73180592 | OtherExpensePriorYear |
| Other Expenses Current Year | 105832903 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1084071488 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1270279278 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 65715513 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 12538477 | RevenuesLessExpensesCY |
| Total Assets BOY | 639408380 | TotalAssetsBOY |
| Total Assets EOY | 672797157 | TotalAssetsEOY |
| Total Liabilities BOY | 111382202 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 126927851 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 528026178 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 545869306 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO IMPROVE HEALTH IN THE COMMUNITY THROUGH LEADERSHIP IN MANAGING AND DEVELOPING INNOVATIVE QUALITY HEALTH CARE SYSTEMS AND PROVIDING HEALTHCARE PRODUCTS AND SERVICES THAT OFFER AFFORDABLE ACCESS TO QUALITY HEALTH CARE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1075500628 | Expense |
| Grants | 543850 | Grants |
| Revenue | 1207031999 | Revenue |
| Description | SEE SCHEDULE O, PAGE 39INDEPENDENT HEALTH ASSOCIATION (IHA) COORDINATES THE DELIVERY OF QUALITY HEALTH CARE COVERAGE THROUGH CONTRACTS WITH INDIVIDUAL PRACTICE ASSOCIATION OF WESTERN NEW YORK (IPAWNY), A TAXABLE NON-PROFIT, FOR ITS COMMERCIAL AND MEDICARE HMO PRODUCTS WITHIN THE 8 COUNTIES OF WESTERN NEW YORK (WNY). IHA ALSO PROVIDES COVERAGE AND COORDINATES SERVICES TO ITS MEDICAID HMO PRODUCT (WHICH INCLUDES THE FAMILY HEALTH PLUS (FHP) PROGRAM AVAILABLE TO ELIGIBLE RESIDENTS OF ERIE COUNTY AND THE CHILD HEALTH PLUS (CHP) PROGRAM) FOR THE ARRANGEMENT OF PHYSICIAN, HOSPITAL, MEDICALLY NECESSARY HEALTH SERVICES, DIAGNOSTIC AND PREVENTIVE HEALTH SERVICES TO THE COMMUNITIES LOCATED IN ERIE AND NIAGARA COUNTY. PARTICIPATING HEALTH CARE PROVIDERS ARE REIMBURSED USING A FEE FOR SERVICE PAYMENT METHODOLOGY, WITH SUCH RATES TYPICALLY BELOW THE PROVIDER'S NORMAL AND CUSTOMARY RATES. IHA OFFERS ITS MEMBERS HEALTH RISK MANAGEMENT TOOLS INCLUDING AN ONLINE HEALTH RISK ASSESSMENT AND THE USE OF A DATA WAREHOUSE TO ANALYZE AND PREDICT POTENTIAL RISK AND DEVELOP SOLUTIONS TO HELP CONTROL CURRENT AND PREVENT FUTURE PROBLEMS. PROGRAMS FOR COVERED EMPLOYEES AS WELL AS FOR EMPLOYERS HELP THEM MAKE GOOD HEALTH A PART OF THEIR CULTURE. IHA OFFERS A 24 HOUR MEDICAL HELP LINE WITH ACCESS TO A REGISTERED NURSE, CASE MANAGEMENT, DISEASE MANAGEMENT AND HEALTH COACHES. INDEPENDENT HEALTH ALSO ESTABLISHED AN ADVANCED PATIENT CENTERED MEDICAL HOME (PCMH) PILOT PROGRAM IN JANUARY 2009. THE PCMH PROGRAM INCLUDES 18 DIVERSE PRIMARY CARE PRACTICES ACROSS WNY, 130 PHYSICIANS AND NEARLY 50,000 IHA MEMBERS. THE PRACTICES WORK TOWARD IMPROVED QUALITY OF CARE WITH EXPANDED ACCESS TO ALLOW SAME DAY APPOINTMENTS AND AFTER HOURS CARE; ENHANCED TECHNOLOGY TO INCLUDE ELECTRONIC MEDICAL RECORDS AND EMAILS WITH PATIENTS; AND A COMPREHENSIVE CARE TEAM FOR THOSE WITH, OR AT RISK, OF HAVING A CHRONIC CONDITION. ADMINISTRATIVE ASSISTANCE IS ALSO PROVIDED TO HELP IMPLEMENT NEW OFFICE PROCEDURES. ANOTHER IMPORTANT ASPECT OF THE PCMH MODEL IS THAT IT ALSO INCLUDES MANY OF THE FEDERAL HEALTH CARE REFORM EFFORTS INCLUDING PREVENTION AND WELLNESS THROUGH COORDINATED CARE, EVIDENCED BASED GUIDELINES TO GAUGE OUTCOMES AND REFORM OF PHYSICIAN PAYMENT TO IMPROVE QUALITY AND EFFICIENCY. IHA HAS DEVOTED TIME AND FINANCIAL RESOURCES THAT ENABLE THE 130 PHYSICIANS IN THIS PROGRAM TO REDESIGN THEIR PRACTICE. IHA ALSO PROVIDES MEMBERS DETAILED INFORMATION TO THIS PROGRAM IN ORDER TO ENABLE OUR PHYSICIANS TO MANAGE CARE OPPORTUNITIES FOR IHA MEMBERS. AS OF DECEMBER 31, 2011, THE 18 PRIMARY CARE PRACTICES INVOLVED IN THE PILOT PROGRAM HAVE EACH ACHIEVED THE HIGHEST RECOGNITION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). THE PATIENT CENTRIC MODEL IS A VIABLE WAY TO ACHIEVE THE TRIPLE AIM: BETTER CARE, IMPROVED SATISFACTION AND BENDING THE MEDICAL TREND. HEALTH CARE REFORM INITIATIVES ENCOURAGE THIS TYPE OF CARE DELIVERY AND IHA AND THESE PROGRESSIVE PRIMARY CARE PHYSICIAN PRACTICES ARE AT THE FOREFRONT OF WHAT THE NATION WILL BE DOING. OTHER MEMBERSHIP SERVICES INCLUDES PREVENTIVE CARE THAT INVOLVES ACTIVE PARTICIPATION BY COMMUNITY ORGANIZATIONS IN INITIATIVES SUCH AS THE P2 COLLABORATIVE OF WESTERN NEW YORK, A NOT-FOR-PROFIT ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF PEOPLE IN WESTERN NEW YORK. IT DEPENDS ON UNPRECEDENTED COLLABORATION AMONG KEY STAKEHOLDERS AND THE SHARING OF CLINICAL INFORMATION, AND THE ADOPTION OF HEALTH INFORMATION TECHNOLOGY AND ELECTRONIC MEDICAL RECORDS THROUGH ORGANIZATIONS SUCH AS HEALTHELINK. HEALTH EDUCATION PROGRAMS ARE ALSO OFFERED TO IHA MEMBERS AND NONMEMBERS OUT OF THE 6 MEDICARE INFORMATION CENTERS IN WESTERN NEW YORK OPERATED BY IHA. THESE PROGRAMS INCLUDE GENERAL HEALTH EDUCATION, HEALTHY COOKING DEMONSTRATIONS, PHYSICAL FITNESS CLASSES, AND PROGRAMS THAT ADDRESS SPECIFIC CHRONIC CONDITIONS. THESE PROGRAMS ARE PROMOTED THROUGH DIRECT MAILINGS TO MEMBERS; APPROXIMATELY 10,000 EVENT CALENDARS DISTRIBUTED TO NON-MEMBERS, AND LIMITED ADVERTISING TO THE GENERAL PUBLIC IN LOCAL NEWSPAPERS. SERVICES OFFERED TO NON-MEMBERS ARE ONLY AVAILABLE THROUGH ONE OF THE MIC SITES, AS THE INTENT IS TO ATTRACT CURRENT MEMBERS TO ATTEND HEALTH EDUCATION PROGRAMS. | Description |
| Total Program Service Expense | 1075500628 | TotalProgramServiceExpense |
| 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 | 1 | 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 | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | 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 | 1 | 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 | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 169 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1183 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | BD | NameOfForeignCountry |
| 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 |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| 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 | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | 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 | 1 | MinutesOfCommittees |
| Officer Mailing Address | 1 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHAEL J FASO | NamePerson |
| Telephone Number | 7166313001 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 511 FARBER LAKES DRIVE | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14221 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (37 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| WINNICK BARRY N | ||||||||
| CHAIRPERSON | 1.00 | X | 37042 | 0 | 5419 | |||
| WINGATE R MARSHALL | ||||||||
| VICE CHAIRPERSON | 1.00 | X | 40000 | 0 | 5837 | |||
| WALSH III JOHN N | ||||||||
| SECOND VICE CHAIRPERSON | 1.00 | X | 40000 | 0 | 0 | |||
| MCDUFFIE BRENDA W | ||||||||
| CORRESPONDING SECRETARY | 1.00 | X | 32667 | 0 | 0 | |||
| ANGERT STUART H | ||||||||
| BOARD MEMBER | 1.00 | X | 43500 | 0 | 2076 | |||
| ANTKOWIAK JOHN | ||||||||
| BOARD MEMBER | 1.00 | X | 61308 | 0 | 0 | |||
| COLANTUONO FRANK J | ||||||||
| BOARD MEMBER | 1.00 | X | 40000 | 0 | 5837 | |||
| COPPOLA JAMES R | ||||||||
| BOARD MEMBER | 1.00 | X | 33000 | 0 | 5837 | |||
| COTTON SHAWN | ||||||||
| BOARD MEMBER | 1.00 | X | 35400 | 0 | 5837 | |||
| CULKIN JOHN J | ||||||||
| BOARD MEMBER | 1.00 | X | 33000 | 0 | 5837 | |||
| HEIMERL MICHAEL | ||||||||
| BOARD MEMBER | 1.00 | X | 39850 | 0 | 5837 | |||
| KELSCH DONNA M | ||||||||
| BOARD MEMBER | 1.00 | X | 36500 | 0 | 5837 | |||
| ROBINSON DONALD | ||||||||
| BOARD MEMBER | 1.00 | X | 38250 | 0 | 5837 | |||
| STEHLIK EDWARD | ||||||||
| BOARD MEMBER | 1.00 | X | 41400 | 0 | 5837 | |||
| SUDIT MOISES | ||||||||
| BOARD MEMBER | 1.00 | X | 40000 | 0 | 0 | |||
| SULLIVAN NORA B | ||||||||
| BOARD MEMBER | 1.00 | X | 32333 | 0 | 5837 | |||
| SUNDELL DUANE J | ||||||||
| BOARD MEMBER | 1.00 | X | 33000 | 0 | 0 | |||
| TILLOTSON JR RICHARD T | ||||||||
| BOARD MEMBER | 1.00 | X | 33000 | 0 | 5837 | |||
| WEISS SYDNEY N | ||||||||
| BOARD MEMBER | 1.00 | X | 40000 | 0 | 5837 | |||
| CROPP MICHAEL W | ||||||||
| PRESIDENT & CEO | 47.00 | X | 2315342 | 0 | 380471 | X | ||
| JOHNSON MARK | ||||||||
| EVP & CFO | 48.00 | 896699 | 0 | 311493 | X | |||
| DIGIULIO LAWRENCE C | ||||||||
| VP & GENERAL COUNSEL | 47.00 | 243391 | 0 | 26807 | X | |||
| TULYK-ROSSI LAURA | ||||||||
| COMPLIANCE OFFICER | 43.00 | 86106 | 0 | 18876 | X | |||
| FOELS THOMAS J | ||||||||
| EVP-CHIEF MED. OFFICER | 47.00 | 526882 | 0 | 176721 | X | |||
| WALLESHAUSER JAMES B | ||||||||
| VP - OFFICE STRATEGY | 38.00 | 238982 | 0 | 30474 | X | |||
| RODGERS JOHN R | ||||||||
| EVP-CHIEF MARKETING OFF | 46.00 | 518466 | 0 | 179596 | X | |||
| PENTKOWSKI ANN M | ||||||||
| SVP-CHIEF ACT & UNDERWRI | 44.00 | 412433 | 0 | 109362 | X | |||
| SYRACUSE JILL | ||||||||
| SVP-MEMBER SERVICES | 45.00 | 372029 | 0 | 125800 | X | |||
| DISERAFINO LOUIS | ||||||||
| CHIEF RISK OFFICER | 45.00 | 338727 | 0 | 39139 | X | |||
| FASO MICHAEL J | ||||||||
| SVP-FINANCE & ANCILL BUS | 40.00 | 326874 | 0 | 27649 | X | |||
| FELDMAN JUDITH ANN | ||||||||
| SVP-INFORMATION TECHNOLO | 46.00 | 336863 | 0 | 104688 | X | |||
| CUMMING GORDON B | ||||||||
| VP-HUMAN RESOURCES & ORG | 43.00 | 379872 | 0 | 115864 | X | |||
| NAIDOO ALLEN | ||||||||
| VP- CLINICAL & BUS. INFO | 42.00 | 334441 | 0 | 30456 | X | |||
| DONOVAN DAVID W | ||||||||
| VP - SALES | 43.00 | 325693 | 0 | 7272 | X | |||
| MYLOTTE KATHLEEN MARIE | ||||||||
| ASSOC. MED DIRECTOR | 38.00 | 256634 | 0 | 67004 | X | |||
| MENARD PAMELA | ||||||||
| VP - HEALTH PROM & CARE | 45.00 | 255818 | 0 | 58351 | X | |||
| BUTLER THEODORE J | ||||||||
| NATIONAL DIR - SF, ANC | 38.00 | 251546 | 0 | 55773 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 9147048 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1943335 | TotalOtherCompensation |
| Number Individuals GT100 K | 133 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| INDIVIDUAL PRACTICE ASSOCIATION OF WNY | |||||
| 511 FARBER LAKES DRIVE | BUFFALO | NY | 14221 | MEDICAL & PHARMACY BENEFIT SERVICES | 915697511 |
| SIRIUS COMPUTER SOLUTIONS | |||||
| 4810 KIRKWOOD ROAD | COHOCTON | NY | 14826 | SALE AND MAINTENANCE OF SERVERS | 15409146 |
| COMPUTER TASK GROUP | |||||
| PO BOX 711778 | CINCINNATI | OH | 452711778 | PRODUCTION & PROJECT SUPPORT SERVICES | 10941716 |
| ORACLE AMERICA INC | |||||
| PO BOX 203448 | DALLAS | TX | 753203448 | NETWORK COMPUTING INFRASTRUCTURE SOLUTIO | 4725978 |
| EYEMED VISION CARE | |||||
| 15274 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | VISION BENEFITS COMPANY | 4679402 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 194 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PREMIUMS, COB & REINS | Description |
| Business Code | 524114 | BusinessCode |
| Total Revenue Column | 1207031999 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1207031999 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1207031999 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11602607 | TotalRevenueColumn |
| Exclusion | $11,602,607 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3575 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 731 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2844 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2844 | TotalRevenueColumn |
| Exclusion | $2,844 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 94872318 | Securities |
| Other | 6933 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 93864541 | Securities |
| Other | 40549 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1007777 | Securities |
| Other | -33616 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 974161 | TotalRevenueColumn |
| Exclusion | $974,161 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CONSULTING | Description |
| Business Code | 541610 | BusinessCode |
| Total Revenue Column | 63206144 | TotalRevenueColumn |
| Unrelated Business Revenue | 63206144 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 63206144 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1282817755 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1207031999 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 63206144 | UnrelatedBusinessRevenue |
| Exclusion | $12,579,612 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 541900 | Total |
| Program Services | 541900 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1950 | Total |
| Program Services | 1950 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1047641195 | Total |
| Program Services | 1047641195 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9447393 | Total |
| Management And General | 9447393 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66421195 | Total |
| Program Services | 9898509 | ProgramServices |
| Management And General | 56522686 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23529091 | Total |
| Program Services | 437664 | ProgramServices |
| Management And General | 23091427 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12060463 | Total |
| Program Services | 1967633 | ProgramServices |
| Management And General | 10092830 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4803188 | Total |
| Program Services | 758379 | ProgramServices |
| Management And General | 4044809 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165525 | Total |
| Management And General | 165525 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191372 | Total |
| Management And General | 191372 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174767 | Total |
| Management And General | 174767 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 789612 | Total |
| Management And General | 789612 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31974905 | Total |
| Program Services | 298329 | ProgramServices |
| Management And General | 31676576 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4509350 | Total |
| Program Services | 128553 | ProgramServices |
| Management And General | 4380797 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10192368 | Total |
| Program Services | 391234 | ProgramServices |
| Management And General | 9801134 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17033091 | Total |
| Program Services | 2670360 | ProgramServices |
| Management And General | 14362731 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6837212 | Total |
| Management And General | 6837212 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 404982 | Total |
| Program Services | 49923 | ProgramServices |
| Management And General | 355059 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 342651 | Total |
| Program Services | 31146 | ProgramServices |
| Management And General | 311505 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10379916 | Total |
| Management And General | 10379916 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2097571 | Total |
| Program Services | 1218515 | ProgramServices |
| Management And General | 879056 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SURCHARGES | 7963722 | 7963722 | 0 | 0 |
| MISCELLANEOUS | 4689851 | 1501616 | 3188235 | 0 |
| FAMILY CHOICE | 4204421 | 0 | 4204421 | 0 |
| NYS ASSESSMENT | 2285681 | 0 | 2285681 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1595906 | Total |
| Management And General | 1595906 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1270279278 | Total |
| Program Services | 1075500628 | ProgramServices |
| Management And General | 194778650 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95747074 | BOY |
| EOY | 60536178 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57043241 | BOY |
| EOY | 86424404 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11768232 | BOY |
| EOY | 11871620 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 123283266 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 78772295 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23174993 | BOY |
| EOY | 44510971 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 289610016 | BOY |
| EOY | 299108574 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2396667 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 162064824 | BOY |
| EOY | 167948743 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 639408380 | BOY |
| EOY | 672797157 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49727956 | BOY |
| EOY | 58805445 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6524 | BOY |
| EOY | 6324 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7891976 | BOY |
| EOY | 12608512 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1256920 | BOY |
| EOY | 1260068 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52498826 | BOY |
| EOY | 54247502 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 111382202 | BOY |
| EOY | 126927851 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 425714394 | BOY |
| EOY | 419149742 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 102311784 | BOY |
| EOY | 126719564 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 528026178 | BOY |
| EOY | 545869306 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 639408380 | BOY |
| EOY | 672797157 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 12538477 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 5304651 | 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 Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 542713 | OtherCostOrOtherBasis |
| Book Value | 542713 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12436551 | OtherCostOrOtherBasis |
| Depreciation | 4849161 | Depreciation |
| Book Value | 7587390 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4561081 | OtherCostOrOtherBasis |
| Depreciation | 2615063 | Depreciation |
| Book Value | 1946018 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 28491912 | OtherCostOrOtherBasis |
| Depreciation | 19268935 | Depreciation |
| Book Value | 9222977 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 77251009 | OtherCostOrOtherBasis |
| Depreciation | 52039136 | Depreciation |
| Book Value | 25211873 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 44510971 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENTS RESTRICTED AS TO USE | 56579893 |
| INVESTMENTS IN AFFILIATES | 111368850 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 167948743 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| BENEFITS PAYABLE | $12,380,738 |
| CAPITATION PAYABLE | $28,839,983 |
| INTERCOMPANY PAYABLE | $603,986 |
| PENSION LIABILITY OBLIGATION | $12,422,795 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 54247502 | TotalOfAmounts |
| Total Revenue | 1282817755 | TotalRevenue |
| Total Expenses | 1270279278 | TotalExpenses |
| Excess Or Deficit For Year | 12538477 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 5304651 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 5304651 | TotalAdjustments |
| Excess Or Deficit Per FS | 17843128 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1283609399 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 5304648 | NetUnrealizedGainsInvestments |
| Other Revenues | -1337782 | OtherRevenues |
| Revenue Not Rptd F990 | 3966866 | RevenueNotRptdF990 |
| Revenue Subtotal | 1279642533 | RevenueSubtotal |
| Other Revenues Not Included | 3175222 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 3175222 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1282817755 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1246950050 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -3175220 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -3175220 | ExpensesNotRptdF990 |
| Expenses Subtotal | 1250125270 | ExpensesSubtotal |
| Other Expenses Not Included | 20154008 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 20154008 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 1270279278 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 2B: | LONG TERM INCENTIVE DEFERRED COMPENSATION PLAN IS OFFERED TO KEY EXECUTIVES. FUTURE PAYMENT IS BASED ON PERFORMANCE AND HISTORICAL COMPENSATION. ASSETS ARE UNDER CUSTODIAL ARRANGEMENT WITH M&T BANK. | |
| PART X: | INDEPENDENT HEALTH ASSOCIATION & AFFILIATES (THE ASSOCIATION) ADOPTED THE PROVISIONS OF ASC 740 RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES EFFECTIVE JANUARY 1, 2009. THE ASSOCIATION RECOGNIZED NO MATERIAL ADJUSTMENT IN THE LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS. THE ASSOCIATION DID NOT RECORD INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN 2011. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| BANK CHARGES NETTED AGAINST OTHER INCOME -1,293,588. P4P GRANT EXPENSE NETTED AGAINST OTHER INCOME -44,194. | PART XII, LINE 2D - OTHER ADJUSTMENTS: | |
| COB REVENUE 887,627. RENTAL EXPENSE INCLUDED ON PART VIII, LINE 6B -731. NYS REINSURANCE 1,647,116. REINSURANCE ADJUSTMENT 596,130. RX REBATE 45,080. | PART XII, LINE 4B - OTHER ADJUSTMENTS: | |
| COB REVENUE -887,627. RENTAL EXPENSE INCLUDED ON PART VIII, LINE 6B 731. NYS REINSURANCE -1,647,116. REINSURANCE ADJUSTMENT -596,128. RX REBATE -45,080. | PART XIII, LINE 2D - OTHER ADJUSTMENTS: | |
| BANK CHARGES 1,293,588. P4P GRANT EXPENSE 44,200. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 18,816,220. | PART XIII, LINE 4B - OTHER ADJUSTMENTS: |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN | Region |
| Number Of Offices | 0 | NumberOfOffices |
| Number Of Employees | 0 | NumberOfEmployees |
| Type Of Activities Conducted | PROGRAM SERVICE | TypeOfActivitiesConducted |
| Specific Services Provided | REINSURANCE | SpecificServicesProvided |
| Total Expenditures | 6523993 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 6523993 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 6523993 | TotalAmountSpent |
| Transfer To Foreign Corp | 1 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (24 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|
| THEATRE OF YOUTH | ||||||||
| 203 ALLEN STREET | BUFFALO | NY | 14201 | 237286004 | 501(C)(3) | 100000 | 0 | TO IMPACT THE HEALTH OF YOUTH THROUGH LIVE THEATRE. STRATEGIC TRANSFORMATION SPONSORSHIP |
| SENECA DIABETES FOUNDATION | ||||||||
| PO BOX 309 | IRVING | NY | 140810309 | 203214056 | 501(C)(3) | 55000 | 0 | GENERAL SUPPORT TO SUPPORT THE MISSION TO PROVIDE EDUCATION OUTREACH, PREVENTION AWARENESS, AND FUND RESEARCH TO IMPROVE THE LIVES OF THOSE AFFECTED WITH DIABETES. |
| BUFFALO NIAGARA PARTNERSHIP | ||||||||
| PO BOX 53 | BUFFALO | NY | 14205 | 160365700 | 501(C)(3) | 30000 | 0 | STRATEGIC SUPPORT FOR COMMUNITY. |
| P2 COLLABORATIVE | ||||||||
| 6225 SHERIDAN DRIVE SUITE 206 | WILLIAMSVILLE | NY | 14221 | 421604185 | 501(C)(3) | 30000 | 0 | SUPPORT THE ORGANIZATION'S COMMITMENT TO COLLABORATION AND IMPROVING THE HEALTH OF ALL INDIVIDUALS IN WNY. STRATEGIC TRANSFORMATION SPONSORSHIP |
| SHEA'S PERFORMING ARTS CENTER | ||||||||
| 646 MAIN STREET | BUFFALO | NY | 142021978 | 161158412 | 501(C)(3) | 26250 | CORPORATE SPONSORSHIP TO SUPPORT THE ARTS AND IMPROVE INDIVIDUALS' WELL-BEING AND QUALITY OF LIFE | |
| CANISIUS COLLEGE | ||||||||
| 2001 MAIN STREET | BUFFALO | NY | 14208 | 160743942 | 501(C)(3) | 25000 | GENERAL SUPPORT - 2011 REGENTS SCHOLARSHIP BALL & CONFERENCE | |
| KALEIDA HEALTH FOUNDATION | ||||||||
| 726 EXCHANGE STREET | BUFFALO | NY | 14210 | 161579143 | 501(C)(3) | 5000 | GENERAL SUPPORT. | |
| BUFFALO URBAN LEAGUE | ||||||||
| 15 E GENESEE ST | BUFFALO | NY | 14203 | 160743940 | 501(C)(3) | 25000 | SUPPORT TO EMPOWER MINORITIES AND DISADVANTAGE INDIVDIUALS, SPECIFICALLY IN THE AREAS OF HEALTH AND QUALITY OF LIFE. | |
| UNIVERSITY AT BUFFALO FOUNDATION | ||||||||
| BOX 900 | BUFFALO | NY | 14226 | 160865182 | 501(C)(3) | 25000 | STRATEGIC SUPPORT FOR COMMUNITY. | |
| LEADERSHIP BUFFALO | ||||||||
| 237 MAIN STREET - SUITE 1500 | BUFFALO | NY | 142032720 | 161363536 | 501(C)(3) | 22000 | STRATEGIC SUPPORT COMBINING COMMUNITY SUPPORT, VISIBILIY AND ALIGNMENT WITH OUR MISSION | |
| BUFFALO NIAGARA MEDICAL CAMPUS | ||||||||
| 640 ELLICOTT STREET | BUFFALO | NY | 14203 | 161388796 | 501(C)(3) | 20000 | GENERAL SUPPORT FOR A PROGRAM THAT ENCOURAGES USES OF ACTIVE TRANSPORTATION OPTIONS | |
| BUFFALO ZOO (ZOOLOGICAL SOCITY OF BUFFALO INC) | ||||||||
| 300 PARKSIDE AVENUE | BUFFALO | NY | 14214 | 160911204 | 501(C)(3) | 20000 | GENERAL SUPPORT TO INCOPORATE FUN FAMILY FITNESS ACTIVITIES AT BUFFALO ZOO TO SUPPORT COMMUNITY HEALTH ENGAGEMENT | |
| TASTE OF BUFFALO INC | ||||||||
| 276 GREENWOOD COURT | EAST AURORA | NY | 14052 | 161390601 | 501(C)(6) | 10500 | GENERAL SUPPORT FOR THE 2011 TASTE OF BUFFALO | |
| LEUKEMIA & LYMPHOMA SOCIETY | ||||||||
| 1311 MAMARONECK AVENUE SUITE 310 | WHITE PLAINS | NY | 10605 | 135644916 | 501(C)(3) | 8000 | GENERAL SUPPORT TO ORGANIZATION ALIGNED WITH OUR MISSION | |
| BUFFALO PHILHARMONIC ORCHESTRA | ||||||||
| 499 FRANKLIN STREET | BUFFALO | NY | 14202 | 160755739 | 501(C)(3) | 12500 | CORPORATE SPONSORHIP TO SUPPORT THE ARTS AND IMPROVE INDIVIDUALS' WELL BEING AND QUALITY OF LIFE AND GENERAL SUPPORT FOR THE ANNUAL GALA. | |
| POLICE ATHLETIC LEAGUE | ||||||||
| 65 NIAGARA SQUARE 21ST FL | BUFFALO | NY | 14202 | 161468698 | 501(C)(3) | 7500 | TO SUPPORT THE IMPROVEMENT OF THE IMMEDIATE AND FUTURE QUALITY OF LIFE FOR THE YOUTH IN THE COMMUNITY THROUGH EDUCATIONAL, RECREATIONAL, CULTURAL, ENVIRONMENTAL, AND PREVENTION PROGRAMMING. | |
| NFADA CHARITABLE FOUNDATION | ||||||||
| 1144 WEHRLE DRIVE PO BOX 9019 | WILLIAMSVILLE | NY | 14231 | 166486097 | 501(C)(3) | 12500 | GENERAL SUPPORT - 2011 CHARITY GALA AND 2011 SPONSORSHIP | |
| CANISIUS COLLEGE ATHLETICS | ||||||||
| 2001 MAIN STREET | BUFFALO | NY | 14208 | 160743942 | 501(C)(3) | 6000 | GENERAL SUPPORT - COPORATE SPONSORSHIP | |
| THE STEADFAST FOUNDATION | ||||||||
| 700 WALBRIDGE DRIVE | EAST LANSING | MI | 48823 | 205894294 | 501(C)(3) | 6000 | GENERAL SUPPORT - CATWALK FOR CHARITY, FOR ORGANIZATION ALIGNED WITH OUR MISSION | |
| NFJC | ||||||||
| 360 DELAWARE AVENUE ROOM 106 | BUFFALO | NY | 14202 | 203185568 | 501(C)(3) | 5500 | GENERAL SUPPORT - ORGANIZATION ALIGNED WITH OUR MISSION | |
| OPPORTUNITIES UNLIMITED OF NIAGARA | ||||||||
| 1555 FACTORY OUTLET BLVD | NIAGARA FALLS | NY | 14304 | 222221343 | 501(C)(3) | 5150 | GENERAL SUPPORT - CORPORATE SPONSORSHIP | |
| AMERICAN HEART ASSOCIATION | ||||||||
| 7272 GREENVILLE AVE | DALLAS | TX | 75231 | 135613797 | 501(C)(3) | 5000 | SUPPORT THE ENCOURAGEMENT OF HEALTHY LIFESTYLES TO PREVENT CARDIOVASCULAR DISEASES AND STROKES | |
| BUFFALO PREP INC | ||||||||
| BOX 900 | BUFFALO | NY | 14226 | 161359846 | 501(C)(3) | 5000 | GENERAL SUPPORT - CELEBRATION OF SPECIAL HONORS SPONSORSHIP - TO SUPPORT ACADEMICS IN BUFFALO. | |
| JAMES P WILMOT CANCER CENTER | ||||||||
| 300 EAST RIVER ROAD BOX 278996 | ROCHESTER | NY | 14627 | 160743209 | 501(C)(3) | 75000 | GENERAL SUPPORT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 22 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: INDEPENDENT HEALTH ASSOCIATION SUPPORTS NON-PROFIT ORGANIZATIONS THAT ARE ALIGNED WITH OUR MISSION TO PROVIDE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE, AND/OR WOULD BENEFIT FROM INDEPENDENT HEALTH'S COMMUNITY LEADERSHIP AND GOODWILL. AMOUNTS ARE RECORDED IN THE GENERAL LEDGER, PRIMARILY UNDER COMMUNITY RELATIONS, AND HARD COPIES OF ALL PAYMENTS ARE KEPT ON FILE (BOTH PAPER AND ELECTRONICALLY). | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (17 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CROPP MICHAEL W | |||||||||||||
| 819079 | 0 | 1433452 | 0 | 62811 | 0 | 332082 | 0 | 48389 | 0 | 2695813 | 0 | 563533 | 0 |
| JOHNSON MARK | |||||||||||||
| 554477 | 0 | 314520 | 0 | 27702 | 0 | 265610 | 0 | 45883 | 0 | 1208192 | 0 | 0 | 0 |
| DIGIULIO LAWRENCE C | |||||||||||||
| 178064 | 0 | 51000 | 0 | 14327 | 0 | 10965 | 0 | 15842 | 0 | 270198 | 0 | 0 | 0 |
| FOELS THOMAS J | |||||||||||||
| 334942 | 0 | 166935 | 0 | 25005 | 0 | 138817 | 0 | 37904 | 0 | 703603 | 0 | 0 | 0 |
| WALLESHAUSER JAMES B | |||||||||||||
| 177613 | 0 | 51000 | 0 | 10369 | 0 | 13624 | 0 | 16850 | 0 | 269456 | 0 | 0 | 0 |
| RODGERS JOHN R | |||||||||||||
| 321669 | 0 | 177573 | 0 | 19224 | 0 | 125188 | 0 | 54408 | 0 | 698062 | 0 | 0 | 0 |
| PENTKOWSKI ANN M | |||||||||||||
| 286436 | 0 | 104000 | 0 | 21997 | 0 | 85457 | 0 | 23905 | 0 | 521795 | 0 | 0 | 0 |
| SYRACUSE JILL | |||||||||||||
| 274048 | 0 | 90000 | 0 | 7981 | 0 | 94873 | 0 | 30927 | 0 | 497829 | 0 | 0 | 0 |
| DISERAFINO LOUIS | |||||||||||||
| 237196 | 0 | 79702 | 0 | 21829 | 0 | 22020 | 0 | 17119 | 0 | 377866 | 0 | 0 | 0 |
| FASO MICHAEL J | |||||||||||||
| 228708 | 0 | 76300 | 0 | 21866 | 0 | 11227 | 0 | 16422 | 0 | 354523 | 0 | 0 | 0 |
| FELDMAN JUDITH ANN | |||||||||||||
| 232458 | 0 | 90000 | 0 | 14405 | 0 | 86259 | 0 | 18429 | 0 | 441551 | 0 | 0 | 0 |
| CUMMING GORDON B | |||||||||||||
| 272592 | 0 | 88000 | 0 | 19280 | 0 | 98356 | 0 | 17508 | 0 | 495736 | 0 | 0 | 0 |
| NAIDOO ALLEN | |||||||||||||
| 236227 | 0 | 82250 | 0 | 15964 | 0 | 12519 | 0 | 17937 | 0 | 364897 | 0 | 0 | 0 |
| DONOVAN DAVID W | |||||||||||||
| 219015 | 0 | 104771 | 0 | 1907 | 0 | 6842 | 0 | 430 | 0 | 332965 | 0 | 0 | 0 |
| MYLOTTE KATHLEEN MARIE | |||||||||||||
| 241271 | 0 | 12873 | 0 | 2490 | 0 | 55412 | 0 | 11592 | 0 | 323638 | 0 | 0 | 0 |
| MENARD PAMELA | |||||||||||||
| 196606 | 0 | 57010 | 0 | 2202 | 0 | 51865 | 0 | 6486 | 0 | 314169 | 0 | 0 | 0 |
| BUTLER THEODORE J | |||||||||||||
| 128646 | 0 | 122508 | 0 | 392 | 0 | 39647 | 0 | 16126 | 0 | 307319 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | AT THE DISCRETION OF THE CEO, KEY EXECUTIVES (OFFICERS AND KEY EMPLOYEES) ARE ELIGIBLE TO RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THESE AMOUNTS ARE A PERCENTAGE OF BASE COMPENSATION AND ARE CAPPED AT SPECIFIC AMOUNTS. ANY REIMBURSEMENT WHICH IS NOT DEDUCTIBLE UNDER IRS REGULATIONS OR ANY UNCLAIMED AMOUNT AT THE END OF THE CALENDAR YEAR IS TREATED AS INCOME AND ADDED TO THE EXECUTIVE'S W-2. $277,056 WAS RECEIVED IN 2011 AND $171,546 WAS REPORTED AS TAXABLE COMPENSATION. |
| PART I, LINE 4B | THE FOLLOWING LISTED PERSONS FROM PART VII, SECTION A PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F)) WITH INDEPENDENT HEALTH. MICHAEL CROPP, M.D.: AMOUNT RECEIVED: $854,623; VALUE INCREASE INCLUDED IN PART VIII, SECTION A, COLUMN F: $291,090. MARK JOHNSON: AMOUNT RECEIVED: $0; VALUE INCREASE INCLUDED IN PART VII, SECTION A, COLUMN F: $549,357. JOHN RODGERS: AMOUNT RECEIVED: $0; VALUE INCREASE INCLUDED IN PART VII, SECTION A, COLUMN F: $103,816. ANN PENTKOWSKI: AMOUNT RECEIVED $0; VALUE INCREASE INCLUDED IN PART VII, SECTION A, COLUMN F: $82,494. JILL SYRACUSE: AMOUNT RECEIVED $0; VALUE INCREASE INCLUDED IN PART VII, SECTION A, COLUMN F: $74,763. THOMAS J. FOELS: AMOUNT RECEIVED $0; VALUE INCREASE INCLUDED IN PART VII, SECTION A, COLUMN F: $104,487. JUDITH FELDMAN: AMOUNT RECEIVED $0; VALUE INCREAE INCLUDED IN PART VII, SECTION A, COLUMN F: $67,966. GORDON CUMMING: AMOUNT RECEIVED $0; VALUE INCREASE INLCUDED IN PART VII, SECTION A, COLUMN F: $76,336. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (10 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| EAST AURORA FAMILY PRACTICE | |||
| PARTNERSHIP MORE THAN 5% OWNED BY SHAWN COTTON, CURRENT BOARD MEMBER | 539957 | INDEPENDENT CONTRACTOR ARRANGEMENT, DELIVERY OF HEALTH CARE | 0 |
| TONAWANDA PEDIATRICS | |||
| PARTNERSHIP MORE THAN 5% OWNED BY MICHAEL HEIMERL, CURRENT BOARD MEMBER | 2037099 | INDEPENDENT CONTRACTOR ARRANGEMENT, DELIVERY OF HEALTH CARE | 0 |
| BUFFALO GERIATRIC AND REHABILITATION MEDICINE LLP | |||
| PARTNERSHIP MORE THAN 5% OWNED BY KATHLEEN MYLOTTE, CURRENT BOARD MEMBER | 384818 | PAYMENTS TO PROVIDER FOR HEALTHCARE SERVICES RENDERED TO IHA MEMBERS | 0 |
| WALSH DUFFIELD COMPANIES | |||
| ENTITY INDIRECTLY OWNED BY MORE THAN 35% BY JOHN WALSH,CURRENT BOARD MEMBER | 507312 | BROKER OF IHA PRODUCTS | 0 |
| DONALD W ROBINSON MD | |||
| 100% OWNERSHIP IN MEDICAL PRACTICE BY DR. DONALD ROBINSON | 435000 | INDEPENDENT CONTRACTOR ARRANGEMENT, DELIVERY OF HEALTH CARE | 0 |
| WESTERN NEW YORK CLINICAL INFORMATION EXCHANGE | |||
| SHARED BOARD MEMBER, DR. MICHAEL CROPP | 1980500 | FUNDING OF OPERATIONS | 0 |
| WESTERN NEW YORK HEALTHENET | |||
| SHARED BOARD MEMBER, JUDITH FELDMAN | 200000 | FUNDING OF OPERATIONS | 0 |
| ALLIANCE OF COMMUNITY HEALTH PLANS | |||
| SHARED BOARD MEMBER, DR. MICHAEL CROPP | 169895 | SERVICE PROVIDER (MEMBERSHIP DUES, LOBBYING ACTIVITIES) | 0 |
| AMERICA'S HEATH INSURANCE PLANS | |||
| SHARED BOARD MEMBER, DR. MICHAEL CROPP | 176719 | SERVICE PROVIDER (MEMBERSHIP DUES, LOBBYING ACTIVITIES) | 0 |
| NORTHTOWNS MEDICAL GROUP | |||
| PARTNERSHIP MORE THAN 5% OWNED BY EDWARD STEHLIK, CURRENT BOARD MEMBER | 312347 | INDEPENDENT CONTRACTOR ARRANGEMENT, DELIVERY OF HEALTH CARE | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI | FORM 990, PART VI, SECTION B, LINE 9: LAWRENCE DIGIULIO - 385 MT. VERNON RD. SYNDER, NY 14226; GORD CUMMING - 210 LORD BYRON LANE, WILLIAMSVILLE, NY 14221 | |
| FORM 990, PART VI, SECTION A, LINE 2 | THOMAS J. FOELS AND KATHLEEN MARIE MYLOTTE HAVE A BUSINESS RELATIONSHIP (BOARD MEMBERS OF AN AFFILIATED ENTITY). MICHAEL W. CROPP, MARK JOHNSON, JOHN R. RODGERS, THOMAS J. FOELS, LAWRENCE C. DIGIULIO, AND MICHAEL J. FASO HAVE A BUSINESS RELATIONSHIP (BOARD MEMBERS OF AFFILIATED ENTITIES). SIDNEY N. WEISS, R. MARSHALL WINGATE, STUART H. ANGERT, JAMES R. COPPOLA, FRANK J. COLANTUONO, MICHAEL W. CROPP, MOISES SUDIT, LAWRENCE C. DIGIULIO, JOHN R. RODGERS, NORA B. SULLIVAN, AND JAMES B. WALLESHAUSER HAVE A BUSINESS RELATIONSHIP (BOARD MEMBERS OF AN AFFILIATED ENTITY). FRANK J. COLANTUONO, JAMES R. COPPOLA, AND THOMAS J. FOELS HAVE A BUSINESS RELATIONSHIP (BOARD MEMBERS OF AN AFFILIATED ENTITY). R. MARSHALL WINGATE, FRANK J. COLANTUONO, MARK JOHNSON, AND ANN M. PENTKOWSKI HAVE A BUSINESS RELATIONSHIP (PRIVATE ENTERPRISE). MICHAEL W. CROPP, GORDON B. CUMMING, BARRY N. WINNICK, JOHN N. WALSH, III, BRENDA W. MCDUFFIE, STUART H. ANGERT & JOHN ANTKOWIAK HAVE A BUSINESS RELATIONSHIP (BOARD MEMEBERS OF AN AFFILIATED NOT FOR PROFIT). | |
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOLLOWING CHANGES WERE MADE TO IHA'S BY-LAWS DURING 2011: THE AUDIT & FINANCE COMMITTEE WAS SPLIT INTO TWO INDIVDIUAL COMMITTEES. THE AUDIT COMMITTEE SHALL BE COMPOSED ENTIRELY OF INDEPENDENT DIRECTORS AND SHALL REPRESENT AND REPORT TO THE BOARD OF DIRECTORS IN DISCHARGING ITS OVERSIGHT RESPONSIBILITIES RELATING TO FINANCIAL STATEMENT REVIEW, INTERNAL CONTROL REVIEW, INTERNAL AUDIT REVIEW, THE SELECTION AND MANAGEMENT OF EXTERNAL AUDITORS. THE AUDIT COMMITTEE SHALL ADHERE TO A CHARTER APPROVED BY THE BOARD THAT SETS FORTH ITS RESPONSIBILITIES AND SHALL REVIEW ITS CHARTER AT LEAST ANNUALLY, SOONER IF NECESSARY, TO ENSURE THAT ITS PURPOSE AND RESPONSIBILITIES ARE IN CONCERT WITH THE MISSION, VISION AND VALUES OF THE CORPORATION AND TO ENSURE THE CHARTER MEETS ALL APPLICABLE REGULATORY REQUIREMENTS. THE FINANCE COMMITTEE SHALL BE COMPOSED OF A MAJORITY OF NON-MANAGEMENT DIRECTORS AND SHALL BE RESPONSIBLE FOR ADVISING THE BOARD OF DIRECTORS ON FINANCIAL MATTERS RELATED TO THE CORPORATION. THE FINANCE COMMITTEE SHALL ADHERE TO A CHARTER APPROVED BY THE BOARD WHICH SETS FORTH ITS RESPONSIBILITIES AND SHALL REVIEW ITS CHARTER AT LEAST ANNUALLY, SOONER IF NECESSARY, TO ENSURE THAT ITS PURPOSE AND RESPONSIBILITIES ARE IN CONCERT WITH THE MISSION, VISION AND VALUES OF THE CORPORATION. IN ADDITION, THERE WERE CHANGES TO THE DIRECTOR TERMS, SPECIFICALLY, EACH DIRECTOR SHALL BE LIMITED TO 5 CONSECUTIVE TERMS BEGINNING WITH THE TERMS COMMENCING ON MAY 1, 2010 AND MAY 1, 2011. AFTER SERVING 5 CONSECUTIVE TERMS, A DIRECTOR SHALL BE ELIGIBLE TO RETURN TO THE BOARD ONCE ONE YEAR HAS LAPSED SINCE THE CONCLUSION OF HIS OR HER LAST TERM. | |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 WAS REVIEWED WITH THE EXECUTIVE COMMITTEE OF IHA'S BOARD OF DIRECTORS. THE FINAL FORM 990 WAS DISTRIBUTED TO THE BOARD OF DIRECTORS AT THE BOARD MEETING PRIOR TO THE FILING OF THE RETURN. | |
| FORM 990, PART VI, SECTION B, LINE 12C | IHA'S CONFLICT OF INTEREST REPORTING POLICY ENCOMPASSES ALL CURRENT IHA OFFICERS AND EMPLOYEES (INCLUDING KEY EMPLOYEES) OF THE ORGANIZATION. THE CEO, CHIEF LEGAL COUNSEL, CORPORATE COMPLIANCE/PRIVACY OFFICER, OR SPECIAL INVESTIGATIONS UNIT MAY MAKE THE DETERMINATION THAT A CONFLICT OF INTEREST EXISTS AND WILL REVIEW THE ACTUAL CONFLICT AS CONFLICTS ARE REPORTED TO THEM. CONFLICTS ARE ALSO IDENTIFIED ANNUALLY WHEN THE SIGNED EMPLOYEE ATTESTATIONS, CONFIDENTIAL QUESTIONNAIRES & PLEDGE OF CONFIDENTIALITY AND CONTINUING DISCLOSURE FORM (FOR BOD MEMBERS) ARE RECEIVED. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE DELIBERATIONS OR DECISIONS RELATED TO THIS TRANSACTION. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE GOVERNING BOARD OF DIRECTORS OF INDEPENDENT HEALTH ASSOCIATION, INC. APPOINTED A GROUP OF BOARD MEMBERS TO ACT AS THE COMPENSATION COMMITTEE. COMPENSATION OF THE CEO IS SUBJECT TO REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE AND THE BOD ANNUALLY. ADDITIONALLY, THE RECOMMENDATIONS OF THE CEO PERTAINING TO THE COMPENSATION OF HIS/HER DIRECT REPORTS ARE SUBJECT TO REVIEW AND ADVISEMENT BY THE COMPENSATION COMMITTEE. TO DETERMINE EXECUTIVE COMPENSATION AND INCENTIVE ELIGIBILITY OF THE CEO AND HIS/HER DIRECT REPORTS, THE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE RECOMMENDATIONS AND ANY COMPARABLE DATA (COMPENSATION OF SIMILARLY QUALIFIED PERSONS IN FUNCTIONALITY COMPARABLE POSITIONS AT SIMILARLY SIZED ORGANIZATIONS). COMPARABILITY DATA MAY BE OBTAINED VIA THE FORM 990 OF OTHER ORGANIZATIONS AND/OR COMPENSATION SURVEYS OR STUDIES. THE COMPENSATION COMMITTEE, IN DELIBERATIONS WITH THE INDEPENDENT CONSULTANT, DETERMINES THE COMPENSATION AND INCENTIVE FOR THE CEO. THE CEO EXCLUDES HIMSELF/HERSELF FROM THESE DELIBERATIONS WHEN DISCUSSING HIS/HER COMPENSATION. THE COMPENSATION COMMITTEE WILL DOCUMENT THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. THE BOD WILL THEN RATIFY ALL DECISIONS OF THE COMPENSATION COMMITTEE AT ITS REGULARLY SCHEDULED BOARD MEETING. IHA'S EXECUTIVE COMPENSATION POLICY/PROCESS IS AN ANNUAL PROCESS (LAST PERFORMED IN 2011) AND WAS USED TO ESTABLISH COMPENSATION FOR THE FOLLOWING POSITIONS: EXECUTIVE VICE PRESIDENT - CHIEF FINANCIAL OFFICER; EXECUTIVE VICE PRESIDENT - CHIEF SERVICING OFFICER; EXECUTIVE VICE PRESIDENT - CHIEF OPERATING OFFICER; SENIOR VICE PRESIDENT - CHIEF ADMINISTRATIVE OFFICER; EXECUTIVE VICE PRESIDENT - CHIEF MEDICAL OFFICER; VICE PRESIDENT & GENERAL COUNSEL, AND VICE PRESIDENT - GOVERNMENT AFFAIRS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE: A COPY OF ITS 990, ITS AUDITED FINANCIAL STATEMENTS, AND ANY OTHER DOCUMENTS AS REQUIRED. | |
| FORM 990, PART VII: | HOURS WORKED PER WEEK FOR RELATED ORGANIZATIONS INCLUDED IN THE HOURS REPORTED ON FORM 990, PART VII, THE FOLLOWING INDIVIDUALS DEVOTED TIME EACH WEEK TO RELATED ORGANIZATIONS: CROPP, MICHAEL W. - 20 HOURS JOHNSON, MARK - 18 HOURS DIGIULIO, LAWRENCE C. - 21 HOURS DISERAFINO, LOUIS - 9 HOURS RODGERS, JOHN R. - 11 HOURS TULYK-ROSSI, LAURA - 17 HOURS CUMMING, GORDON B. - 17 HOURS FASO, MICHAEL J. - 18 HOURS PENTKOWSKI, ANN M. - 17 HOURS SYRACUSE, JILL - 26 HOURS FOELS, THOMAS J. - 15 HOURS NAIDOO, ALLEN - 18 HOURS FELDMAN, JUDITH ANN - 20 HOURS DONOVAN, DAVID W. - 17 HOURS MENARD, PAMELA - 15 HOURS BUTLER, THEODORE J. - 38 HOURS WALLESHAUSER, JAMES B. - 17 HOURS MYLOTTE, KATHLEEN MARIE - 11 HOURS | AVG HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 5,304,651. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | DURING 2011, THE AUDIT & FINANCE COMMITTEE WAS SPLIT INTO TWO INDIVIDUAL COMMITTEES. THE AUDIT COMMITTEE SHALL BE COMPOSED ENTIRELY OF INDEPENDENT DIRECTORS AND SHALL REPRESENT AND REPORT TO THE BOARD OF DIRECTORS IN DISCHARGING ITS OVERSIGHT RESPONSIBILITIES RELATING TO FINANCIAL STATEMENT REVIEW, INTERNAL CONTROL REVIEW, INTERNAL AUDIT REVIEW, THE SELECTION AND MANAGEMENT OF EXTERNAL AUDITORS. THE AUDIT COMMITTEE SHALL ADHERE TO A CHARTER APPROVED BY THE BOARD THAT SETS FORTH ITS RESPONSIBILITIES AND SHALL REVIEW ITS CHARTER AT LEAST ANNUALLY, SOONER IF NECESSARY, TO ENSURE THAT ITS PURPOSE AND RESPONSIBILITIES ARE IN CONCERT WITH THE MISSION, VISION AND VALUES OF THE CORPORATION AND TO ENSURE THE CHARTER MEETS ALL APPLICABLE REGULATORY REQUIREMENTS. THE FINANCE COMMITTEE SHALL BE COMPOSED OF A MAJORITY OF NON-MANAGEMENT DIRECTORS AND SHALL BE RESPONSIBLE FOR ADVISING THE BOARD OF DIRECTORS ON FINANCIAL MATTERS RELATED TO THE CORPORATION. THE FINANCE COMMITTEE SHALL ADHERE TO A CHARTER APPROVED BY THE BOARD WHICH SETS FORTH ITS RESPONSIBILITIES AND SHALL REVIEW ITS CHARTER AT LEAST ANNUALLY, SOONER IF NECESSARY, TO ENSURE THAT ITS PURPOSE AND RESPONSIBILITIES ARE IN CONCERT WITH THE MISSION, VISION AND VALUES OF THE CORPORATION. | DESCRIPTION OF CHANGE TO COMMITTEE OVERSIGHT REVIEW PROCESS FROM PRIOR YEAR |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDEPENDENT HEALTH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 777 INTERNATIONAL DRIVE | AddressLine1 |
| City | WILLIAMSVILLE | City |
| State | NY | State |
| ZIP Code | 14221 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161417199 | EIN |
| Primary Activities | TO PROMOTE GOOD HEALTH IN WESTERN NY & TO SUPPORT THE ACTIVITIES OF IHA, INC | PrimaryActivities |
| Legal Domicile State | NY | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 9: 509(A)(2) | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDEPENDENT HEALTH ASSOCIATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LIGHTHOUSE NATURALS LLC | ||||||||||||
| 525 OVERLOOK DRIVE | N PALM BEACH | FL | 33408 | 262015851 | RETAIL SALES OF FOOD-BASED NUTRITIONAL SUPPLEMENTS | FL | INDEPENDENT HEALTH CORPORATION | RELATED | 62670 | 50352 | 0 | 0 |
| SPECIALTY PHARMACY MANAGEMENT LLC | ||||||||||||
| 45 EARHART DRIVE | WILLIAMSVILLE | NY | 14221 | 272204019 | SPECIALTY PHARMACEUTICAL MANAGEMENT | NY | INDEPENDENT HEALTH CORPORATION | RELATED | 1314013 | 7534014 | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| INDEPENDENT HEALTH CORPORATION & SUBSIDIARIES | |||||||||||||||
| 511 FARBER LAKES DRIVE | BUFFALO | NY | 14221 | 161237733 | THIRD PARTY CLAIMS ADMINISTRATION | NY | INDEPENDENT HEALTH ASSOCIATION | C | 26665276 | 25825562 | 1.00000 | ||||
| INDEPENDENT HEALTH BENEFITS CORPORATION | |||||||||||||||
| 511 FARBER LAKES DRIVE | BUFFALO | NY | 14221 | 161483784 | POS AND INDEMNITY PRODUCT ADMINISTRATION | NY | INDEPENDENT HEALTH ASSOCIATION | C | 478530717 | 168952831 | 1.00000 | ||||
| MASON INSURANCE COMPANY LTD | |||||||||||||||
| REINSURANCE | INDEPENDENT HEALTH ASSOCIATION | C | 12891981 | 13409521 | 1.00000 | 16 CHURCH STREET | HAMILTON | BD | BD | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | 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 | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (17 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| INDEPENDENT HEALTH FOUNDATION | ||
| B | 346000 | FMV |
| INDEPENDENT HEALTH BENEFITS CORPORATION | ||
| L | 11274404 | FMV |
| INDEPENDENT HEALTH BENEFITS CORPORATION | ||
| M | 22278226 | FMV |
| INDEPENDENT HEALTH CORPORATION | ||
| M | 3403900 | FMV |
| INDEPENDENT HEALTH BENEFITS CORPORATION | ||
| N | 24497448 | FMV |
| INDEPENDENT HEALTH CORPORATION | ||
| N | 12816309 | FMV |
| INDEPENDENT HEALTH FOUNDATION | ||
| O | 296841 | FMV |
| INDEPENDENT HEALTH FOUNDATION | ||
| P | 306757 | FMV |
| INDEPENDENT HEALTH FOUNDATION | ||
| Q | 661518 | FMV |
| INDEPENDENT HEALTH FOUNDATION | ||
| L | 81991 | FMV |
| INDEPENDENT HEALTH BENEFITS CORPORATION | ||
| O | 19594417 | FMV |
| INDEPENDENT HEALTH CORPORATION | ||
| O | 182175887 | FMV |
| INDEPENDENT HEALTH CORPORATION | ||
| P | 250000 | FMV |
| MASON INSURANCE CORPORATION | ||
| Q | 9924257 | FMV |
| MASON INSURANCE CORPORATION | ||
| R | 11161187 | FMV |
| INDEPENDENT HEALTH BENEFITS CORPORATION | ||
| R | 4658591 | FMV |
| INDEPENDENT HEALTH CORPORATION | ||
| R | 174514000 | FMV |