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HEALTH CHOICE NETWORK OF FLORIDA INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HEALTH CHOICE NETWORK OF FLORIDA INC (EIN 65-0504316)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-14
IRS object ID
201232279349301573
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-08-14T14:49:12-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1AVERETT WARMUS DURKEE OSBURN HENNING PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11417 E CONCORD STREETAddressLine1
CityORLANDOCity
StateFLState
ZIP Code32803ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN650504316EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HEALTH CHOICE NETWORK OF FLORIDA INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHEALNameControl
Phone3055991015Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19064 NORTHWEST 13 TERRACEAddressLine1
CityDORALCity
StateFLState
ZIP Code33172ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN KEARNSName
TitlePRESIDENT AND CEOTitle
Phone3055991015Phone
Date Signed2012-07-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameEDWARD A HOFMA CPAName
Phone4078491569Phone
Date Prepared2012-07-10DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEVIN KEARNSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line19064 NORTHWEST 13 TERRACEAddressLine1
CityDORALCity
StateFLState
ZIP Code33172ZIPCode
FieldValueIRS element (for citing)
Gross Receipts31442303GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HCNETWORK.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH ADMINISTRATIVE SERVICES AND SUPPORT TO COMMUNITY HEALTH CENTER MEMBERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees165TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year11523933ContributionsGrantsPriorYear
Contributions Grants Current Year13163533ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13978715ProgramServiceRevenuePriorYear
Program Service Revenue CY13100968ProgramServiceRevenueCY
Investment Income Prior Year245960InvestmentIncomePriorYear
Investment Income Current Year49403InvestmentIncomeCurrentYear
Other Revenue Prior Year1496856OtherRevenuePriorYear
Other Revenue Current Year5092861OtherRevenueCurrentYear
Total Revenue Prior Year27245464TotalRevenuePriorYear
Total Revenue Current Year31406765TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9341325SalariesEtcPriorYear
Salaries Etc Current Year12398141SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year129363TotalFundrsngExpCurrentYear
Other Expense Prior Year16264767OtherExpensePriorYear
Other Expenses Current Year18984308OtherExpensesCurrentYear
Total Expenses Prior Year25606092TotalExpensesPriorYear
Total Expenses Current Year31382449TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1639372RevenuesLessExpensesPriorYear
Revenues Less Expenses CY24316RevenuesLessExpensesCY
Total Assets BOY11515054TotalAssetsBOY
Total Assets EOY12931294TotalAssetsEOY
Total Liabilities BOY6564671TotalLiabilitiesBOY
Total Liabilities EOY7956595TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4950383NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4974699NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE HIGH QUALITY, SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS AND TO ACT AS A VEHICLE FOR STRATEGIC EFFORTS THAT STRENGTHEN OUR COMMUNITY HEALTH PARTNERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8637077Expense
DescriptionHEALTH CONNECT IN OUR SCHOOLS - A COMPREHENSIVE, THREE-TIER, QUALITY-DRIVEN HEALTH INITIATIVE, SPEARHEADED BY THE CHILDREN'S TRUST, WITH THE GOAL OF HAVING THE HEALTHIEST CHILDREN POSSIBLE IN MIAMI-DADE COUNTY. IT CONNECTS CHILDREN AND FAMILIES TO LOW COST MEDICAL INSURANCE OPTIONS AND HEALTH SERVICES WITH THE HELP OF HEALTH NAVIGATORS, PROVIDES INFORMATION AND SUPPORT THROUGH HOME VISITATIONS BY FAMILY COACHES TO ALL NEW AND TEEN MOTHERS AND PROVIDES A TEAM OF NURSES/NURSE PRACTITIONERS, SOCIAL WORKERS AND HEALTH AIDES TO PUBLIC SCHOOLS TO PROVIDE NEEDED HEALTH SERVICES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense12727361Expense
DescriptionFISCAL/MIS INTEGRATION - PROVIDES FISCAL AND MANAGEMENT INFORMATION SYSTEM SERVICES FOR MEMBER CENTERS. PRIMARY SERVICES INCLUDE OPERATING A CENTRALIZED MIS DEPARTMENT (HARDWARE AND SOFTWARE), AND SHARING OF CHIEF FINANCIAL OFFICER AND CHIEF INFORMATION OFFICER SERVICES THROUGH INTEGRATED ACTIVITIES OF THE CENTERS FINANCE AND IT DEPARTMENTS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3329413Expense
DescriptionCENTRALIZED BILLING - PROVIDES BILLING AND PAYMENT POSTING SERVICES FOR THE MEMBER CENTERS THAT HAVE ELECTED TO PARTICIPATE. THE CENTRAL BILLING OFFICE IS RESPONSIBLE FOR LIMITED CREDENTIALING SERVICES AND MOST ASPECTS OF THE BILLING AND COLLECTION OF PATIENT CHARGES ON BEHALF OF THE CENTERS, WHICH INCLUDES FOLLOW-UP ON ACCOUNTS RECEIVABLE.Description

Activity Other ActivityOther (5 entries)

ExpenseExpenseRevenueRevenueDescriptionDescription
20070473503558MANAGED CARE - PROVIDES HEALTH CARE MANAGEMENT TO THE HMO ASSIGNED MEMBERS AND MANAGED MEDICAID PREPAID OUTPATIENT MENTAL HEALTH SERVICES FOR PARTICIPATING MEMBER CENTERS TO ENSURE PROPER UTILIZATION OF HEALTH CARE IN THE MANAGED CARE ENVIRONMENT. THIS PROGRAM INCLUDES CREDENTIALING, CENTRALIZED REFERRALS FOR CENTER HMO CONTRACTS, PROVIDER RELATIONS, AND MANAGEMENT OF AT-RISK CONTRACTS. THE MANAGED CARE UNIT ALSO PROVIDES SUPPORT TO SHARED CLINICAL COMMITTEE COLLABORATIVE SERVICES.
16714ELECTRONIC HEALTH RECORDS - IMPLEMENT AND MAINTAIN INTEGRATED ELECTRONIC MEDICAL AND DENTAL HEALTH RECORDS IN PARTICIPATING MEMBER CENTERS TO ENHANCE THE ABILITY TO PROVIDE HIGH QUALITY PREVENTIVE AND PRIMARY CARE, AND IMPROVE PATIENT OUTCOMES.
9320619597410MEMBER SERVICES - A SINGLE RESOURCE ON BEHALF OF ALL CENTERS FOR SERVICES SUCH AS EDUCATION ON CURRENT GRANTS, LEGISLATIVE ISSUES, BOARD TRAINING, ETC.
2726741SOUTH FLORIDA REGIONAL EXTENSION CENTER PROJECT - TO FURNISH ASSISTANCE TO HELP PROVIDERS SELECT, SUCCESSFULLY IMPLEMENT, AND MEANINGFULLY USE CERTIFIED EHR TECHNOLOGY TO IMPROVE THE QUALITY AND VALUE OF HEALTH CARE.
417347JESSIE TRICE CANCER PREVENTION PROJECT - ADDRESSES THE DISPROPORTIONATE BURDEN OF CANCER IN LOW-INCOME AFRICAN-AMERICAN AND HISPANIC COMMUNITIES SERVED BY THE CENTERS. THE PROGRAM HAS EXPANDED FROM ITS ORIGINAL FOCUS ON LUNG CANCER SCREENING TO INCLUDE OTHER HEALTH PROMOTION ACTIVITIES. THESE ACTIVITIES INCLUDE CANCER PREVENTION, EDUCATION AND EARLY DETECTION PROJECTS THAT ADDRESS BREAST AND CERVICAL CANCER SCREENING DISPARITIES. THE PROGRAM OPERATES BY CONDUCTING THESE ACTIVITIES THROUGH HEALTH FAIRS AND FAITH-BASED EVENTS, AS WELL AS PROVIDING SIMILAR ACTIVITIES FOR EXISTING PATIENTS OF PARTICIPATING HEALTH CENTERS. IN ADDITION TO BREAST AND CERVICAL CANCER SCREENING ASSESSMENTS, THE PROGRAM PROMOTES THE PARTICIPATING HEALTH CENTERS AS A MEDICAL HOME FOR THOSE INDIVIDUALS WHO DO NOT HAVE A PRIMARY CARE PROVIDER. THE PROGRAM ALSO RECEIVES ASSISTANCE FROM OTHER COMMUNITY ORGANIZATIONS TO PROVIDE INFORMATION, SERVICES AND SUPPORT TO PROMOTE HEALTHY LIFESTYLES IN THE TARGETED COMMUNITIES.
FieldValueIRS element (for citing)
Total Of Other Program Service Exp6099910TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev13100968TotalOfOtherProgramServiceRev
Total Program Service Expense30793761TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109635NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees165NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BRIAN MORTONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3055991015TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19064 NORTHWEST 13 TERRACEAddressLine1
CityDORALCity
StateFLState
ZIP Code33172ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
COL BRODES HARTLEY JR
CHAIRMAN1.00X000
ROSALYN FRAZIER
VICE-CHAIR1.00X000
CHARLES BOTTOMS
SECRETARY1.00X000
BAKARI BURNS
TREASURER1.00X000
ANNIE NEASMAN
DIRECTOR1.00X000
CALEB A DAVIS
PAST CHAIR1.00X000
FRANK MAZZEO
DIRECTOR1.00X000
HIRUT KASSAYE
DIRECTOR1.00X000
KATHRYN ABBATE
DIRECTOR1.00X000
MARIO JARDON
DIRECTOR1.00X000
BOB LINDER
DIRECTOR1.00X000
PAT MABE
DIRECTOR1.00X000
CLAUDIO M PEREZ
DIRECTOR1.00X000
MARK RABINOWITZ MD
DIRECTOR1.00X000
KEVIN S KEARNS
CEO50.00418788026123X
ALEJANDRO ROMILLO
SR. VP & CIO50.00273561019122X
BRIAN MORTON
VP & CFO50.0016947109166X
TERISA A JAMES
VP OF PROGRAMS40.00142147012379X
MICHELE RUSSELL
VP OF IT40.00142792012217X
GEORGE KARNEGIS
SR. DIRECTOR, INFORMATION SYSTEMS40.0013108200X
THEODORE MAREFKA
DIRECTOR OF OPERATIONS/HUMAN RESOURCES40.00129339011485X
LISA RAWLINS
EXECUTIVE DIRECTOR - SOUTH FLORIDA EXTENSION CTR40.00210008010070X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1617188TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation100562TotalOtherCompensation
Number Individuals GT100 K18NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
TERREMARK NORTH AMERICAN INC
PO BOX 864416ORLANDOFL32886IT INFRASTRUCTURE SERVICES553087
ALLZONE MANAGEMENT SOLUTIONS
3200 WILSHIRE BLVD S TOWER STE 115LOS ANGELESCA90010DATA PROCESSING & A/R SERVICES164000
AUTOMATIC DATA PROCESSING
PO BOX 9001006LOUISVILLEKY40290PAYROLL PROCESSING110881
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Government Grants13163533GovernmentGrants
Total Contributions13163533TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEMBER SERVICES56100091112099111209
MANAGED CARE52429835035583503558
MEMBERSHIP DUES561000486201486201
FieldValueIRS element (for citing)
Total Program Service Revenue13100968TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column49403TotalRevenueColumn
Exclusion$49,403ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events214400GrossIncomeFundraisingEvents
Fundraising Direct Expenses35538FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column178862TotalRevenueColumn
Exclusion$178,862ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CONTRACT SERVICES5610004274406$4,274,406
ADMINISTRATIVE SERVICE561000849342$849,342
EQUITY IN EARNINGS OF900003-209749-$209,749
FieldValueIRS element (for citing)
Total Other Revenue4913999TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column31406765TotalRevenueColumn
Related Or Exempt Function Income13100968RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,142,264ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total797450Total
Program Services637960ProgramServices
Management And General141490ManagementAndGeneral
Fundraising18000Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total9832732Total
Program Services9681575ProgramServices
Management And General122769ManagementAndGeneral
Fundraising28388Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total357202Total
Program Services342418ProgramServices
Management And General12737ManagementAndGeneral
Fundraising2047Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total616340Total
Program Services599254ProgramServices
Management And General13853ManagementAndGeneral
Fundraising3233Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total794417Total
Program Services774100ProgramServices
Management And General16690ManagementAndGeneral
Fundraising3627Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total53507Total
Program Services53011ProgramServices
Management And General496ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total43338Total
Program Services36540ProgramServices
Management And General6798ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2893225Total
Program Services2869214ProgramServices
Management And General24011ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total219327Total
Program Services215287ProgramServices
Management And General1602ManagementAndGeneral
Fundraising2438Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total155394Total
Program Services131017ProgramServices
Management And General24377ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total296259Total
Program Services289754ProgramServices
Management And General6505ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total295877Total
Program Services270659ProgramServices
Management And General9115ManagementAndGeneral
Fundraising16103Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total160791Total
Program Services139954ProgramServices
Management And General20837ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1046234Total
Program Services1022745ProgramServices
Management And General23489ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total588708Total
Program Services578130ProgramServices
Management And General10578ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
CONTRACTED SERVICES12110481120421551289155435
CAPITATION10366101036610
PAYROLL SERVICES - ADP55840471438697
OTHER EXPENSES144631355182092
DUES AND SUBSCRIPTIONS14254126841570

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total31382449Total
Program Services30793761ProgramServices
Management And General459325ManagementAndGeneral
Fundraising129363Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2295368BOY
EOY2830352EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2115103BOY
EOY1400110EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY818320BOY
EOY2009385EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY500000EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1090721BOY
EOY783338EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11025500LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6009321LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4601370BOY
EOY5016179EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY488693BOY
EOY278944EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY105479BOY
EOY112986EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11515054BOY
EOY12931294EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3134493BOY
EOY4706154EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY903488BOY
EOY366774EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2526690BOY
EOY2232719EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY650948EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6564671BOY
EOY7956595EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4950383BOY
EOY4974699EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4950383BOY
EOY4974699EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11515054BOY
EOY12931294EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses24316ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8264442CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9536383CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10418021CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11523933CurrentTaxYearMinus1Year
Current Tax Year13649734CurrentTaxYear
Total53392513Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8264442CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9536383CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10418021CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11523933CurrentTaxYearMinus1Year
Current Tax Year13649734CurrentTaxYear
Total53392513Total
FieldValueIRS element (for citing)
Public Support Total17053392513PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years9361CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20254CurrentTaxYearMinus1Year
Current Tax Year49403CurrentTaxYear
Total79018Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years161025CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38704CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years464209CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1276975CurrentTaxYearMinus1Year
Current Tax Year4913999CurrentTaxYear
Total6854912Total
FieldValueIRS element (for citing)
Total Support60326443TotalSupport
Gross Receipts From Admissions Etc59664788GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.88510PublicSupportPertcentage170
Public Support Pertcent Prior Year0.95570PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CONTRACT SERVICES ADMINISTRATIVE SERVICE EQUITY IN EARNINGS OF AFFILIATEGeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2991435OtherCostOrOtherBasis
Depreciation612949Depreciation
Book Value2378486BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis775490OtherCostOrOtherBasis
Depreciation25640Depreciation
Book Value749850BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3825759OtherCostOrOtherBasis
Depreciation2684867Depreciation
Book Value1140892BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3432816OtherCostOrOtherBasis
Depreciation2685865Depreciation
Book Value746951BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5016179TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCAPITAL LEASE OBLIGATIONDescription
Amount$650,948Amount
FieldValueIRS element (for citing)
Total Of Amounts650948TotalOfAmounts
Total Revenue31406765TotalRevenue
Total Expenses31382449TotalExpenses
Excess Or Deficit For Year24316ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS24316ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt31477292TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities34989DonatedSrvcAndUseOfFacilities
Other Revenues35538OtherRevenues
Revenue Not Rptd F99070527RevenueNotRptdF990
Revenue Subtotal31406765RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99031406765TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt31452976TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities34989DonatedServicesUseOfFacilities
Other Expenses Included35538OtherExpensesIncluded
Expenses Not Rptd F99070527ExpensesNotRptdF990
Expenses Subtotal31382449ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99031382449TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:INCOME TAXES - THE NETWORK IS A NONPROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PRESCRIBE REQUIREMENTS FOR THE RECOGNITION OF INCOME TAXES IN FINANCIAL STATEMENTS, AND THE AMOUNTS RECOGNIZED ARE AFFECTED BY INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS. THE NETWORK'S STATUS AS AN EXEMPT ORGANIZATION IS DEFINED AS AN INCOME TAX POSITION UNDER THESE REQUIREMENTS. WHILE MANAGEMENT BELIEVES IT HAS COMPLIED WITH THE INTERNAL REVENUE CODE, THE SUSTAINABILITY OF SOME INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS MAY BE UNCERTAIN. THERE ARE MINIMUM THRESHOLDS OF LIKELIHOOD THAT UNCERTAIN TAX POSITIONS ARE REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THAT THE NETWORK HAS ANY MATERIAL UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2011. IN THE EVENT INTEREST AND PENALITES WERE DUE RELATING TO AN UNSUSTAINABLE TAX POSITION, THEY WOULD BE TREATED AS A COMPONENT OF INCOME TAX EXPENSE. THE NETWORK'S FEDERAL INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. AT SEPTEMBER 30, 2011, THE 2010 THROUGH 2007 FEDERAL TAX RETURNS ARE SUBJECT TO EXAMINATION.
PART XII, LINE 2D: DIRECT FUNDRAISING EXPENSES REDUCED GROSS INCOME FROM FUNDRAISING EVENT ON FORM 990

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1JESSIE TRICE HEALTH BENEFIT DINNERNameOfEvent1
Gross Receipts Event1214400GrossReceiptsEvent1
Gross Revenue Event1214400GrossRevenueEvent1
Rent Facility Costs Event116783RentFacilityCostsEvent1
Other Direct Expenses Event118755OtherDirectExpensesEvent1
Gross Receipts Total214400GrossReceiptsTotal
Gross Revenue Total Events214400GrossRevenueTotalEvents
Rent Facility Costs Total Events16783RentFacilityCostsTotalEvents
Other Direct Expenses Total Events18755OtherDirectExpensesTotalEvents
Direct Expense Summary Events35538DirectExpenseSummaryEvents
Net Income Summary178862NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEVIN S KEARNS
35878806000000020939051840444911000
ALEJANDRO ROMILLO
26356101000000013678054440292683000
BRIAN MORTON
16947100000847406920178637000
TERISA A JAMES
142147000007107052720154526000
MICHELE RUSSELL
142792000007140050770155009000
LISA RAWLINS
1900080200000004654054160220078000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6THE NETWORK IS MANAGED BY THREE CATEGORIES OF MEMBERS: FOUNDING MEMBERS, PARTICIPATING MEMBERS AND PARTICIPATING NETWORK MEMBERS UNDER A NON-STOCK BASIS. THE MEMBERS OF THE BOARD OF DIRECTORS MUST BE EMPLOYED BY OR SERVE ON THE BOARD OF DIRECTORS OF CORPORTIONS WHICH ARE EITHER FOUNDING PARTICIPATING MEMBERS OR PARTICIPATING NETWORK MEMBERS OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBERS OF THE BOARD OF DIRECTORS SHALL BE LIMITED TO FOUNDING, PARTICIPATING AND PARTICIPATING NETWORK MEMBERS. EACH FOUNDING MEMBER SHALL BE ENTITLED TO APPOINT TWO QUALIFIED PERSONS TO SERVE ON THE NETWORK BOARD OF DIRECTORS. EACH PARTICIPATING MEMBER SHALL BE ENTITLED TO APPOINT ONE QUALIFIED PERSON TO SERVE ON THE NETWORK BOARD OF DIRECTORS UPON SATISFACTION OF ELIGIBILITY CRITERIA FOR SUCH ENTITLEMENT AS ESTABLISHED BY THE BOARD OF DIRECTORS. EACH PARTICIPATING NETWORK MEMBER CEO (OR TOP EXECUTIVE) WILL BE APPOINTED TO SERVE ON THE NETWORK BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BALL THE POWERS OF THE NETWORK SHALL BE EXERCISED BY OR UNDER THE CONTROL OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11THE 990 WAS REVIEWED IN DRAFT FORM AND APPROVED BY THE FINANCE COMMITTEE. A COPY WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING.
THE NETWORK HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT EVERY EMPLOYEE IS REQUIRED TO READ AND SIGN. THE NETWORK'S BYLAWS ALSO REQUIRE ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT TO ADHERE TO THE STANDARDS OF CONDUCT PERTAINING TO THE CONFLICT OF INTEREST POLICY.FORM 990, PART VI, SECTION B, LINE 12C
THE NETWORK'S BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION AND ESTABLISHES THE COMPENSATION WITH A WRITTEN EMPLOYMENT CONTRACT. THE CEO ESTABLISHES THE PROCESSES FOR DETERMINATION OF THE COMPENSATION OF OTHER OFFICERS.FORM 990, PART VI, SECTION B, LINE 15
THE NETWORK MAKES THESE FORMS AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 18
THE ORGANIZATION DOES NOT CURRENTLY MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
FINANCIAL STATEMENTS AND REPORTINGTHE NETWORK HAS A FINANCE COMMITTEE ESTABLISHED BY THE BOARD OF DIRECTORS THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT, REVIEWING OF ITS FINANCIAL STATEMENTS AND TO SELECT AN INDEPENDENT ACCOUNTANT.FORM 990, PART XII, LINE 2C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HEALTH CHOICE NETWORK INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19064 NORTHWEST 13TH TERRACEAddressLine1
CityDORALCity
StateFLState
ZIP Code33172ZIPCode
FieldValueIRS element (for citing)
EIN900525658EIN
Primary ActivitiesTO PROVIDE SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONSPrimaryActivities
Legal Domicile StateFLLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 9PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PRESTIGE HEALTH CHOICE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19064 NW 13TH TERRACEAddressLine1
CityDORALCity
StateFLState
ZIP Code33172ZIPCode
FieldValueIRS element (for citing)
EIN450563075EIN
Primary ActivityMANAGED HEALTH CARE ACTIVITIESPrimaryActivity
Legal Domicile StateFLLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NOBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeMEDICAID FUNDINGPredominantIncomeType
Share Of Total Income-209749ShareOfTotalIncome
Share Of EOY Assets278944ShareOfEOYAssets
Disproportionate Allocations1DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.22000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HEALTH CHOICE NETWORK INC
K4274406ADMINISTRATIVE SERVICES
HEALTH CHOICE NETWORK INC
D500000NOTE RECEIVABLE
HEALTH CHOICE NETWORK INC
L1742971MEMBERSHIP FEES RECEIVED
HEALTH CHOICE NETWORK INC
N444911DIRECTOR SALARY
HEALTH CHOICE NETWORK INC
I23855RENT INCOME