WASHTENAW HEALTH PLAN CORPORATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- WASHTENAW HEALTH PLAN CORPORATION (EIN 02-0585175)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-15
- IRS object ID
- 202312279349302621
- Schema version
- 2021v4.0
- 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) |
|---|---|---|
| Return | 2023-08-15T13:43:47-04:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 461335331 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALTRUIC ADVISORS CPAS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4088 WASHTENAW AVE | AddressLine1Txt |
| City | ANN ARBOR | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020585175 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WASHTENAW HEALTH PLAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WASH | BusinessNameControlTxt |
| Phone | 7347149929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 TOWNER STREET | AddressLine1Txt |
| City | YPSILANTI | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48198 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEREMY LAPEDIS | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7347149929 | PhoneNum |
| Signature | 2023-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEREMY | PersonFirstNm |
| Person Last | LAPEDIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN N HAGAN CPA | PreparerPersonNm |
| PTIN | P00293011 | PTIN |
| Phone | 8882985297 | PhoneNum |
| Preparation | 2023-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEREMY LAPEDIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 TOWNER STREET | AddressLine1Txt |
| City | YPSILANTI | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48198 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,639,994 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WASHTENAW.ORG/WHP | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO ENSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,196,630 | PYContributionsGrantsAmt |
| CY Contributions Grants | $624,812 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $924,378 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $968,077 | CYProgramServiceRevenueAmt |
| PY Investment Income | $35,132 | PYInvestmentIncomeAmt |
| CY Investment Income | $47,105 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,156,140 | PYTotalRevenueAmt |
| CY Total Revenue | $1,639,994 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $210,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,679,129 | PYOtherExpensesAmt |
| CY Other Expenses | $2,060,787 | CYOtherExpensesAmt |
| PY Total Expenses | $1,889,129 | PYTotalExpensesAmt |
| CY Total Expenses | $2,060,787 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $267,011 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$420,793 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,253,300 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,909,271 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $138,833 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $343,423 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,114,467 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,565,848 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ENSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS WITHOUT INSURANCE AND/OR PERSONS INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,310,797 | ExpenseAmt |
| Revenue | $968,077 | RevenueAmt |
| Desc | WASHTENAW HEALTH PLAN - PLAN B: TO PROVIDE HEALTH COVERAGE TO LOW-INCOME INDIVIDUALS WHO DON'T QUALIFY FOR ANY OTHER GOVERNMENT-SPONSORED HEALTH COVERAGE. AS OF 9/30/22 THERE ARE 2,790 MEMBERS ENROLLED IN PLAN B. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $550,017 | ExpenseAmt |
| Desc | PROGRAMS TO SUPPORT HEALTH INSURANCE ENROLLMENT, ACCESS TO HEALTHCARE, AND ADDRESSING THE SOCIAL DETERMINATIONS OF HEALTH. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,860,814 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEREMY LAPEDIS | PersonNm |
| Phone | 7347149929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 TOWNER STREET | AddressLine1Txt |
| City | YPSILANTI | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48198 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| ROBERT F GILLETT | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BRENT WILLIAMS MD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ALONZO T LEWIS | ||||||
| VP/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MIKE RANDALL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GREG DILL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RON ROMERO MD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CHARO LEDON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| COREY DEAN MD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ALFREDA ROOKS | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DOUGLAS STRONG | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JIMENA LOVELUCK | ||||||
| VICE PRESIDE | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARKELL MILLER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JEREMY LAPEDIS | ||||||
| EXECUTIVE DI | 32.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WASHTENAW COUNTY PUBLIC HEALTH | |||||
| 555 TOWNER ST | YPSILANTI | MI | 48198 | HEALTH SERVICES | $1,044,398 |
| 4D PHARMACY MANAGEMENT SYSTEMS | |||||
| 2520 INDUSTRIAL ROW DRIVE | TROY | MI | 48084 | HEALTH SERVICES | $269,962 |
| INGHAM HEALTH PLAN CORP | |||||
| 3425 BELLE CHASE WAY | LANSING | MI | 48911 | HEALTH SERVICES | $194,282 |
| PACKARD HEALTH INC | |||||
| 3174 PACKARD ROAD | ANN ARBOR | MI | 48108 | HEALTH SERVICES | $185,175 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $330,000 | GovernmentGrantsAmt |
| All Other Contributions | $294,812 | AllOtherContributionsAmt |
| Total Contributions | $624,812 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| WASHTENAW COUNTY PAYMENTS | 621300 | $600,000 | $600,000 |
| STATE INNOVATION MODEL (SIM) | 621300 | $368,077 | $368,077 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $968,077 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,105 | TotalRevenueColumnAmt |
| Exclusion | $47,105 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,639,994 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $968,077 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $47,105 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,449 | TotalAmt |
| Management And General | $29,449 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $899,791 | TotalAmt |
| Program Services | $777,755 | ProgramServicesAmt |
| Management And General | $122,036 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192 | TotalAmt |
| Management And General | $192 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,887 | TotalAmt |
| Management And General | $5,887 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,480 | TotalAmt |
| Program Services | $3,356 | ProgramServicesAmt |
| Management And General | $4,124 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $821 | TotalAmt |
| Management And General | $821 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $626 | TotalAmt |
| Management And General | $626 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,210 | TotalAmt |
| Management And General | $10,210 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| HEALTH/PHARMACY SERVICES | $673,569 | $673,569 | |
| ADMINISTRATIVE SERVICES | $359,973 | $334,448 | $25,525 |
| HEALTH INSURANCE PROGRAM | $66,236 | $66,236 | |
| SMALL MEDICAL EQUIPMENT | $5,450 | $5,450 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,103 | TotalAmt |
| Management And General | $1,103 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,060,787 | TotalAmt |
| Program Services | $1,860,814 | ProgramServicesAmt |
| Management And General | $199,973 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,395 | BOYAmt |
| EOY | $186,891 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $262,668 | BOYAmt |
| EOY | $312,683 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,413 | BOYAmt |
| EOY | $8,984 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,840,824 | BOYAmt |
| EOY | $2,400,713 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,253,300 | BOYAmt |
| EOY | $2,909,271 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,382 | BOYAmt |
| EOY | $341,659 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,451 | BOYAmt |
| EOY | $1,764 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,833 | BOYAmt |
| EOY | $343,423 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,332,049 | BOYAmt |
| EOY | $2,029,398 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $782,418 | BOYAmt |
| EOY | $536,450 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,114,467 | BOYAmt |
| EOY | $2,565,848 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,253,300 | BOYAmt |
| EOY | $2,909,271 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$420,793 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$127,826 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $192,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $543,082 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $898,680 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,196,630 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $624,812 | CurrentTaxYearAmt |
| Total | $3,455,454 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $650,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $669,207 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $845,981 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $924,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $968,077 | CurrentTaxYearAmt |
| Total | $4,057,643 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $842,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,212,289 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,744,661 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,121,008 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,592,889 | CurrentTaxYearAmt |
| Total | $7,513,097 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $641,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $587,331 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $582,252 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $578,439 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $583,600 | CurrentTaxYearAmt |
| Total | $2,973,117 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $641,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $587,331 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $582,252 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $578,439 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $583,600 | CurrentTaxYearAmt |
| Total | $2,973,117 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $4,539,980 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,238 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,636 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,128 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $35,132 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $47,105 | CurrentTaxYearAmt |
| Total | $175,239 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,238 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,636 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,128 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $35,132 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $47,105 | CurrentTaxYearAmt |
| Total | $175,239 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $850,488 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,266,925 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,774,789 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,156,140 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,639,994 | CurrentTaxYearAmt |
| Total | $7,688,336 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.59050 | PublicSupportCY509Pct |
| Public Support PY509 | 0.56740 | PublicSupportPY509Pct |
| Investment Income CY | 0.02000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Rev Etc Audited Fincl Stmt | $1,512,168 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$127,826 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$127,826 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,639,994 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,639,994 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,060,787 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $2,060,787 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,060,787 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | DRAFT OF FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND MEMBERS OF THE BOARD BEFORE FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY INDICATING ANY CONFLICTS. THE BOARD REVIEWS AND APPROVES THESE STATEMENTS ANNUALLY AT THE SEPTEMBER BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 15A | WASHTENAW HEALTH PLAN CONTRACTS ITS EMPLOYEES FROM WASHTENAW COUNTY, A GOVERNMENTAL ENTITY AND UNRELATED PARTY. WASHTENAW COUNTY IS RESPONSIBLE FOR PAYING STAFF AND DETERMINING COMPENSATION SCALES. WASHTENAW COUNTY DETERMINES COMPENSATION BY USING MARKET DATA TO CREATE BENCHMARK CLASSIFICATIONS THAT DETERMINE THE MINIMUMS, MIDPOINTS, AND MAXIMUMS FOR THE PAY RANGES FOR ITS EMPLOYEES, INCLUDING THE EXECUTIVE DIRECTOR FOR WASHTENAW HEALTH PLAN. |
| FORM 990, PAGE 6, PART VI, LINE 15B | WASHTENAW HEALTH PLAN CONTRACTS ITS EMPLOYEES FROM WASHTENAW COUNTY, A GOVERNMENTAL ENTITY AND UNRELATED PARTY. WASHTENAW COUNTY IS RESPONSIBLE FOR PAYING STAFF AND DETERMINING COMPENSATION SCALES. WASHTENAW COUNTY DETERMINES COMPENSATION BY USING MARKET DATA TO CREATE BENCHMARK CLASSIFICATIONS THAT DETERMINE THE MINIMUMS, MIDPOINTS, AND MAXIMUMS FOR THE PAY RANGES FOR ITS EMPLOYEES, INCLUDING THE EXECUTIVE DIRECTOR FOR WASHTENAW HEALTH PLAN. |
| FORM 990, PAGE 6, PART VI, LINE 19 | ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990 RETURNS ARE ALSO AVAILABALE TO THE PUBLIC AT WWW.GUIDESTAR.ORG. |
| FORM 990, PART IX, LINE 11G | LEASED EMPLOYEES 777,755 122,036 0 |
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