2012-08-14T14:49:12-05:00 2011-09-30 AVERETT WARMUS DURKEE OSBURN HENNING PA 1417 E CONCORD STREET ORLANDO FL 32803 990 2010-10-01 650504316 HEALTH CHOICE NETWORK OF FLORIDA INC HEAL 3055991015 9064 NORTHWEST 13 TERRACE DORAL FL 33172 KEVIN KEARNS 3055991015 2012-07-10 1 EDWARD A HOFMA CPA 4078491569 2012-07-10 2010 2016-02-24 21:20:13Z KEVIN KEARNS 9064 NORTHWEST 13 TERRACE DORAL FL 33172 31442303 0 X WWW.HCNETWORK.ORG X 1994 FL TO PROVIDE HEALTH ADMINISTRATIVE SERVICES AND SUPPORT TO COMMUNITY HEALTH CENTER MEMBERS. 14 14 165 0 0 0 11523933 13163533 13978715 13100968 245960 49403 1496856 5092861 27245464 31406765 0 0 0 0 9341325 12398141 0 0 129363 16264767 18984308 25606092 31382449 1639372 24316 11515054 12931294 6564671 7956595 4950383 4974699 X TO 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. 0 0 8637077 HEALTH 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. 12727361 FISCAL/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. 3329413 CENTRALIZED 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. 2007047 3503558 MANAGED 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. 16714 ELECTRONIC 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. 932061 9597410 MEMBER SERVICES - A SINGLE RESOURCE ON BEHALF OF ALL CENTERS FOR SERVICES SUCH AS EDUCATION ON CURRENT GRANTS, LEGISLATIVE ISSUES, BOARD TRAINING, ETC. 2726741 SOUTH 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. 417347 JESSIE 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. 6099910 13100968 30793761 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 35 0 1 165 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X BRIAN MORTON 3055991015 9064 NORTHWEST 13 TERRACE DORAL FL 33172 COL BRODES HARTLEY JR 1.00 X 0 0 0 ROSALYN FRAZIER 1.00 X 0 0 0 CHARLES BOTTOMS 1.00 X 0 0 0 BAKARI BURNS 1.00 X 0 0 0 ANNIE NEASMAN 1.00 X 0 0 0 CALEB A DAVIS 1.00 X 0 0 0 FRANK MAZZEO 1.00 X 0 0 0 HIRUT KASSAYE 1.00 X 0 0 0 KATHRYN ABBATE 1.00 X 0 0 0 MARIO JARDON 1.00 X 0 0 0 BOB LINDER 1.00 X 0 0 0 PAT MABE 1.00 X 0 0 0 CLAUDIO M PEREZ 1.00 X 0 0 0 MARK RABINOWITZ MD 1.00 X 0 0 0 KEVIN S KEARNS 50.00 X 418788 0 26123 ALEJANDRO ROMILLO 50.00 X 273561 0 19122 BRIAN MORTON 50.00 X 169471 0 9166 TERISA A JAMES 40.00 X 142147 0 12379 MICHELE RUSSELL 40.00 X 142792 0 12217 GEORGE KARNEGIS 40.00 X 131082 0 0 THEODORE MAREFKA 40.00 X 129339 0 11485 LISA RAWLINS 40.00 X 210008 0 10070 1617188 0 100562 18 0 1 0 TERREMARK NORTH AMERICAN INC PO BOX 864416 ORLANDO FL 32886 IT INFRASTRUCTURE SERVICES 553087 ALLZONE MANAGEMENT SOLUTIONS 3200 WILSHIRE BLVD S TOWER STE 115 LOS ANGELES CA 90010 DATA PROCESSING & A/R SERVICES 164000 AUTOMATIC DATA PROCESSING PO BOX 9001006 LOUISVILLE KY 40290 PAYROLL PROCESSING 110881 3 13163533 13163533 MEMBER SERVICES 561000 9111209 9111209 MANAGED CARE 524298 3503558 3503558 MEMBERSHIP DUES 561000 486201 486201 13100968 49403 49403 214400 35538 178862 178862 CONTRACT SERVICES 561000 4274406 4274406 ADMINISTRATIVE SERVICE 561000 849342 849342 EQUITY IN EARNINGS OF 900003 -209749 -209749 4913999 31406765 13100968 0 5142264 797450 637960 141490 18000 9832732 9681575 122769 28388 357202 342418 12737 2047 616340 599254 13853 3233 794417 774100 16690 3627 53507 53011 496 43338 36540 6798 2893225 2869214 24011 219327 215287 1602 2438 155394 131017 24377 296259 289754 6505 295877 270659 9115 16103 160791 139954 20837 1046234 1022745 23489 588708 578130 10578 CONTRACTED SERVICES 12110481 12042155 12891 55435 CAPITATION 1036610 1036610 PAYROLL SERVICES - ADP 55840 47143 8697 OTHER EXPENSES 14463 13551 820 92 DUES AND SUBSCRIPTIONS 14254 12684 1570 31382449 30793761 459325 129363 2295368 2830352 2115103 1400110 818320 2009385 500000 1090721 783338 11025500 6009321 4601370 5016179 488693 278944 105479 112986 11515054 12931294 3134493 4706154 903488 366774 2526690 2232719 0 650948 6564671 7956595 X 4950383 4974699 4950383 4974699 11515054 12931294 24316 0 X X 0 1 1 X 1 1 X 8264442 9536383 10418021 11523933 13649734 53392513 8264442 9536383 10418021 11523933 13649734 53392513 53392513 9361 20254 49403 79018 161025 38704 464209 1276975 4913999 6854912 60326443 59664788 0.88510 0.95570 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CONTRACT SERVICES ADMINISTRATIVE SERVICE EQUITY IN EARNINGS OF AFFILIATE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2991435 612949 2378486 775490 25640 749850 3825759 2684867 1140892 3432816 2685865 746951 5016179 CAPITAL LEASE OBLIGATION 650948 650948 31406765 31382449 24316 0 24316 31477292 34989 35538 70527 31406765 0 31406765 31452976 34989 35538 70527 31382449 0 31382449 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 JESSIE TRICE HEALTH BENEFIT DINNER 214400 214400 16783 18755 214400 214400 16783 18755 35538 178862 X X 0 0 0 0 0 0 0 0 0 KEVIN S KEARNS 358788 0 60000 0 0 0 20939 0 5184 0 444911 0 0 0 ALEJANDRO ROMILLO 263561 0 10000 0 0 0 13678 0 5444 0 292683 0 0 0 BRIAN MORTON 169471 0 0 0 0 0 8474 0 692 0 178637 0 0 0 TERISA A JAMES 142147 0 0 0 0 0 7107 0 5272 0 154526 0 0 0 MICHELE RUSSELL 142792 0 0 0 0 0 7140 0 5077 0 155009 0 0 0 LISA RAWLINS 190008 0 20000 0 0 0 4654 0 5416 0 220078 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE 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 7A THE 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 7B ALL 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 11 THE 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. FORM 990, PART VI, SECTION B, LINE 12C 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 15 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 C, LINE 18 THE NETWORK MAKES THESE FORMS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT CURRENTLY MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS AND REPORTING FORM 990, PART XII, LINE 2C THE 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. HEALTH CHOICE NETWORK INC 9064 NORTHWEST 13TH TERRACE DORAL FL 33172 900525658 TO PROVIDE SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS FL 501(C)(3) LINE 9 N/A 0 PRESTIGE HEALTH CHOICE LLC 9064 NW 13TH TERRACE DORAL FL 33172 450563075 MANAGED HEALTH CARE ACTIVITIES FL NO MEDICAID FUNDING -209749 278944 1 0 0.22000 0 0 0 1 0 0 0 0 1 0 1 1 0 1 0 0 0 0 HEALTH CHOICE NETWORK INC K 4274406 ADMINISTRATIVE SERVICES HEALTH CHOICE NETWORK INC D 500000 NOTE RECEIVABLE HEALTH CHOICE NETWORK INC L 1742971 MEMBERSHIP FEES RECEIVED HEALTH CHOICE NETWORK INC N 444911 DIRECTOR SALARY HEALTH CHOICE NETWORK INC I 23855 RENT INCOME