KENTUCKY HOSPITAL EMPLOYEE HEALTH: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- KENTUCKY HOSPITAL EMPLOYEE HEALTH (EIN 31-1114441)
- Tax period
- 2010-05-01 to 2011-04-30
- Filed
- 2011-12-13
- IRS object ID
- 201113479349300856
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-12-13T10:53:50-06:00 | Timestamp |
| Tax Period End Date | 2011-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOUNTJOY CHILTON MEDLEY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 S FOURTH ST 2000 MEIDINGER TOWE | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 402023445 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311114441 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENTUCKY HOSPITAL EMPLOYEE HEALTH BENEFIT TRUST | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KENT | NameControl |
| Phone | 5024266220 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2501 NELSON MILLER PARKWAY | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN BREZOSKY | Name |
| Title | PLAN ADMISITRATOR | Title |
| Phone | 5024266220 | Phone |
| Date Signed | 2011-12-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VICTORIA D BUSTER CPA | Name |
| Phone | 5027491900 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRUSTCARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | J MILTON BROOKS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2501 NELSON MILLER PARKWAY | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 27216440 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE DEPOSITORY FOR ASSETS OF EMPLOYEE WELFARE BENEFIT PLANS AND TO ADMINISTER SUCH ASSETS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 5 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26756027 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 27212006 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3848 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4295 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 139 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26759875 | TotalRevenuePriorYear |
| Total Revenue Current Year | 27216440 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 23853834 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 23181752 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | 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 | 3177643 | OtherExpensePriorYear |
| Other Expenses Current Year | 3572957 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 27031477 | TotalExpensesPriorYear |
| Total Expenses Current Year | 26754709 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -271602 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 461731 | RevenuesLessExpensesCY |
| Total Assets BOY | 1103550 | TotalAssetsBOY |
| Total Assets EOY | 1565279 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1103550 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1565279 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDING A DEPOSITORY FOR ASSETS OF EMPLOYEE WELFARE BENEFIT PLANS AND TO ADMINISTER SUCH ASSETS IN ACCORDANCE WITH SUCH PLANS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Description | PROVIDING A DEPOSITORY FOR ASSETS OF EMPLOYEE WELFARE BENEFIT PLANS AND TO ADMINISTER SUCH ASSETS IN ACCORDANCE WITH SUCH PLANS. | Description |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | J MILTON BROOKS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5024266220 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2501 NELSON MILLER PARKWAY | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| J MILTON BROOKS | ||||||
| CHAIR | 0.50 | X | X | 0 | 0 | 0 |
| AUSTIN MOSS | ||||||
| VICE CHAIR | 0.50 | X | X | 0 | 0 | 0 |
| HAROLD WARMAN | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| J D MULLINS | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| MIA SUTER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| BARRY LINDEMAN | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| BRIAN BREZOSKY | ||||||
| PLAN ADMINISTRATOR | 5.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MERITAIN HEALTH | |||||
| PO BOX 1090 | EVANSVILLE | IN | 477061090 | THIRD PARTY ADMINISTRATOR | 475066 |
| KENTUCKY HOSPITAL SERVICE CORP | |||||
| 2501 NELSON MILLER PARKWAY | LOUISVILLE | KY | 40223 | ADMINISTRATIVE FEES | 195461 |
| UMR | |||||
| 333 WEST VINE SUITE 500 | LEXINGTON | KY | 40507 | THIRD PARTY ADMINISTRATOR | 127808 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | EMPLOYER CONTRIBUTIONS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 27212006 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27212006 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 27212006 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4295 | TotalRevenueColumn |
| Exclusion | $4,295 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 139 | TotalRevenueColumn |
| Exclusion | $139 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 139 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27216440 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27212006 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $4,434 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23181752 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9308 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1787357 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 303 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12751 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16314 | Total |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | REINSURANCE EXPENSE | Description |
| Total | 1746924 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26754709 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | -2 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103550 | BOY |
| EOY | 1565281 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103550 | BOY |
| EOY | 1565279 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103550 | BOY |
| EOY | 1565279 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103550 | BOY |
| EOY | 1565279 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103550 | BOY |
| EOY | 1565279 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 461731 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BRIAN BREZOSKY | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | CURRENT OFFICER - PLAN ADMINISTRATOR | Relationship |
| Amount Of Transaction | 366509 | AmountOfTransaction |
| Description Of Transaction | BRIAN BREZOSKY IS THE SENIOR VICE PRESIDENT OF KHA SOLUTIONS GROUP WHICH HAS A MANAGEMENT CONTRACT WITH TRUSTCARE. FEES ASSOCIATED WITH THE MANAGEMENT CONTRACT TOTALED $156,159. KHA SOLUTIONS GROUP ALSO RECEIVES COMMISSIONS ON THE REINSURANCE POLICY. THE COMMISSIONS TOTALED $210,350 FOR THE YEAR. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | KENTUCKY HOSPITAL SERVICE COMPANY OF KENTUCKY, LLC BOARD OF TRUSTEES MANAGES THE DAY-TO-DAY OPERATIONS OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH MEMBER HAS THE AUTHORIY TO ELECT A DIRECTOR. | |
| FORM 990, PART VI, SECTION A, LINE 7B | EACH MEMBER MAKES DECISIONS ON THEIR INDIVIDUAL PLANS, BUT THE BOARD MAKES THE DECISIONS THAT AFFECT THE TRUST AS A WHOLE. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE RETURN IS REVIEWED FIRST BY INTERNAL MANAGEMENT. AFTER INTERNAL MANAGEMENT HAS REVIEWED THE RETURN AND ANY CHANGES ARE MADE, A COPY IS THEN EMAILED IN PDF FORMAT TO THE BOARD PRIOR TO ITS FILING. | |
| THE FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 |