AFFINITY HEALTH PLAN INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- AFFINITY HEALTH PLAN INC (EIN 13-3330672)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-14
- IRS object ID
- 202303189349300620
- Schema version
- 2022v5.0
- 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 | 2023-11-14T07:27:33-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 345 PARK AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 101540102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133330672 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AFFINITY LEGACY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AFFI | BusinessNameControlTxt |
| Phone | 7187947700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 922 E TREMONT AVE 2105 | AddressLine1Txt |
| City | BRONX | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10460 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RACHEL AMALFITANO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5169821146 | PhoneNum |
| Signature | 2023-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RACHEL | PersonFirstNm |
| Person Last | AMALFITANO | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | OMO-OSE JOSEPH-ERAMEH | PreparerPersonNm |
| PTIN | P02534927 | PTIN |
| Phone | 2127589700 | PhoneNum |
| Preparation | 2023-11-07 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CLARA HANSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 922 E TREMONT AVE 2105 | AddressLine1Txt |
| City | BRONX | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10460 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,990,285 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | AFFINITYLEGACY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,311,867,660 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $812,922 | PYInvestmentIncomeAmt |
| CY Investment Income | $356,942 | CYInvestmentIncomeAmt |
| PY Other Revenue | $626,941 | PYOtherRevenueAmt |
| CY Other Revenue | $1,522,977 | CYOtherRevenueAmt |
| PY Total Revenue | $1,313,307,523 | PYTotalRevenueAmt |
| CY Total Revenue | $1,879,919 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,000,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $66,398,515 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $655,218 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,221,886,550 | PYOtherExpensesAmt |
| CY Other Expenses | $1,089,903 | CYOtherExpensesAmt |
| PY Total Expenses | $1,288,285,065 | PYTotalExpensesAmt |
| CY Total Expenses | $6,745,121 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $25,022,458 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,865,202 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $103,380,908 | TotalAssetsBOYAmt |
| Total Assets EOY | $104,244,580 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,377,925 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $437,739 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $102,002,983 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $103,806,841 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF AFFINITY LEGACY, INC., F/K/A AFFINITY HEALTH PLAN (AFFINITY), IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $5,000,000 | ExpenseAmt |
| Grant | $5,000,000 | GrantAmt |
| Desc | COMMUNITY GRANT PROGRAM : DURING 2022, AFFINITY ESTABLISHED A COMMUNITY GRANT PROGRAM (THE PROGRAM) FUNDED BY A PORTION OF THE PROCEEDS FROM THE SALE TO MOLINA HEALTHCARE. UNDER THE PROGRAM, GRANTS ARE DISTRIBUTED TO ELIGIBLE COMMUNITY-BASED ORGANIZATIONS THROUGH AN APPLICATION PROCESS. GRANT FUNDING IS MADE AVAILABLE FOR PROJECTS THAT ARE PROVIDED FOR THE BENEFIT OF RESIDENTS WITHIN THE 10-COUNTY SERVICE AREA PREVIOUSLY SERVED BY AFFINITY HEALTH PLAN AND THAT ARE FOCUSED ON ONE OF FOUR FUNDING PRIORITIES: 1) MENTAL HEALTH; 2) FOOD INSECURITY; 3) FORMERLY INCARCERATED INDIVIDUALS; AND 4) WORKFORCE ADVANCEMENT AND CONSUMER EDUCATION. | Desc |
| Total Program Service Expenses | $5,000,000 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RACHEL AMALFITANO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5169821146 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 922 E TREMONT AVE 2105 | AddressLine1Txt |
| City | BRONX | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10460 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| AMY KNAPP | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $11,000 | $0 | $0 | |||
| JOHN SARDELIS | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $25,000 | $0 | $0 | |||
| YVETTE WALKER MD | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $25,000 | $0 | $0 | |||
| NANETTE FALKENBERG | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $24,000 | $0 | $0 | |||
| VERONA GREENLAND | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $17,000 | $0 | $0 | |||
| PALOMA IZQUIERDO-HERNANDEZ | |||||||||
| TRUSTEE & CHAIR | 1.00 | 2.00 | Yes (X) | $25,000 | $0 | $0 | Yes (X) | ||
| LYNN SHERMAN | |||||||||
| TRUSTEE & TREASURER | 1.00 | 2.00 | Yes (X) | $18,000 | $0 | $0 | Yes (X) | ||
| BRIAN MCINDOE | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $15,000 | $0 | $0 | |||
| LINDA MULLER | |||||||||
| TRUSTEE & SECRETARY | 1.00 | 2.00 | Yes (X) | $13,000 | $0 | $0 | Yes (X) | ||
| JUDITH FAIRWEATHER | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $18,000 | $0 | $0 | |||
| CLARA MERCEDES HANSEN | |||||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | $333,340 | $0 | $28,424 | Yes (X) | |||
| RACHEL AMALFITANO | |||||||||
| CONSULTANT/CFO | 14.00 | 0.00 | $244,650 | $0 | $0 | Yes (X) | |||
| SCOTT BREIDBART | |||||||||
| FORMER CHIEF MEDICAL OFFICER | 35.00 | 0.00 | $143,182 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $912,172 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $28,424 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GREENBERG TRAURIG LLP | |||||
| 8400 NW 36TH STREET SUITE 400 | DORAL | FL | 33166 | LEGAL SERVICES | $297,734 |
| KPMG LLP | |||||
| 3 CHESTNUT RIDGE ROAD | MONTVALE | NJ | 07645 | ACCOUNTING SERVICES | $272,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $864,182 | TotalRevenueColumnAmt |
| Exclusion | $864,182 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,603,126 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $30,110,366 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$507,240 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$507,240 | TotalRevenueColumnAmt |
| Exclusion | -$507,240 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|
| PHARMACY REBATES | $675,184 | $675,184 | |
| OTHER REVENUE | $569,441 | $569,441 | |
| PREMIUM AMORTIZATION I | $278,352 | $278,352 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,522,977 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,879,919 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,244,625 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $635,294 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000,000 | TotalAmt |
| Program Services | $5,000,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $797,414 | TotalAmt |
| Management And General | $797,414 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$142,196 | TotalAmt |
| Management And General | -$142,196 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $410,209 | TotalAmt |
| Management And General | $410,209 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$43,137 | TotalAmt |
| Management And General | -$43,137 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,669 | TotalAmt |
| Management And General | $100,669 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,127 | TotalAmt |
| Management And General | $211,127 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490 | TotalAmt |
| Management And General | $490 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,719 | TotalAmt |
| Management And General | $4,719 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,104 | TotalAmt |
| Management And General | $69,104 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $858 | TotalAmt |
| Management And General | $858 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55 | TotalAmt |
| Management And General | $55 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,055 | TotalAmt |
| Management And General | $349,055 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BANK CHARGES/FILLING FE | Desc |
| Total | $379 | TotalAmt |
| Management And General | $379 | ManagementAndGeneralAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$13,625 | TotalAmt |
| Management And General | -$13,625 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,745,121 | TotalAmt |
| Program Services | $5,000,000 | ProgramServicesAmt |
| Management And General | $1,745,121 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,680,357 | BOYAmt |
| EOY | $18,341,212 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,677,052 | BOYAmt |
| EOY | $15,010,783 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,089,930 | BOYAmt |
| EOY | $1,723,631 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,481,213 | BOYAmt |
| EOY | $23,402,569 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,452,356 | BOYAmt |
| EOY | $45,766,385 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,380,908 | BOYAmt |
| EOY | $104,244,580 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,377,925 | BOYAmt |
| EOY | $437,739 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,377,925 | BOYAmt |
| EOY | $437,739 | 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 | $102,002,983 | BOYAmt |
| EOY | $103,806,841 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,002,983 | BOYAmt |
| EOY | $103,806,841 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,380,908 | BOYAmt |
| EOY | $104,244,580 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,865,202 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$314,759 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $6,983,819 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,534,514,333 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,304,530,050 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,354,403,147 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,311,867,660 | CurrentTaxYearMinus1YearAmt |
| Total | $5,505,315,190 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,534,514,333 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,304,530,050 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,354,403,147 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,311,867,660 | CurrentTaxYearMinus1YearAmt |
| Total | $5,505,315,190 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $5,505,315,190 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,276,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,647,573 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,372,084 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,957,343 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,142,534 | CurrentTaxYearAmt |
| Total | $10,395,715 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,276,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,647,573 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,372,084 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,957,343 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,142,534 | CurrentTaxYearAmt |
| Total | $10,395,715 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,183,743 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,221,197 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,667,749 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $626,941 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,244,625 | CurrentTaxYearAmt |
| Total | $43,944,255 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,543,974,257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,319,398,820 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,379,442,980 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,314,451,944 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,387,159 | CurrentTaxYearAmt |
| Total | $5,559,655,160 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99020 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99180 | PublicSupportPY509Pct |
| Investment Income CY | 0.00190 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00170 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST RECEIVABLE | $176,933 |
| PHARMACY REBATE RECEIVABLE | $914,028 |
| MOLINA ESCROW AGREEMENT | $37,542,659 |
| OTHER RECEIVABLE | $7,127,000 |
| ESCROW RECEIVABLE | $5,765 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $45,766,385 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $8,548,979 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$314,759 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $6,983,819 | OtherRevenueAmt |
| Revenue Not Reported | $6,669,060 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,879,919 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,879,919 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,745,121 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,745,121 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,745,121 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | ASC 740 FOOTNOTE AFFINITY IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ITS INCOME IS GENERALLY NOT SUBJECT TO FEDERAL, NEW YORK STATE, OR LOCAL INCOME TAXES. AFFINITY RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2022. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | GAIN ON SALE OF HEALTH PLAN, NET 6,983,819. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| BRONX COMMUNITY HEALTH NETWORK INC | ||||||||
| 1 FORDAM PLAZA SUITE 1108 | BRONX | NY | 10458 | 133905296 | 501(C)(3) | $1,000,000 | $0 | COMMUNITY GRANT PROGRAM |
| BRONXCARE DR MARTIN LUTHER KING JR HEALTH CENTER | ||||||||
| 1276 FULTON AVENUE | BRONX | NY | 10456 | 132707945 | 501(C)(3) | $1,000,000 | $0 | COMMUNITY GRANT PROGRAM |
| BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION | ||||||||
| 892 ROCKAWAY AVENUE | BROOKLYN | NY | 11212 | 112544630 | 501(C)(3) | $1,000,000 | $0 | COMMUNITY GRANT PROGRAM |
| COMMUNITY HEALTHCARE NETWORK INC | ||||||||
| 60 MADISON AVENUE FLOOR 5 | NEW YORK | NY | 100101600 | 133083068 | 501(C)(3) | $1,000,000 | $0 | COMMUNITY GRANT PROGRAM |
| PLANNED PARENTHOOD OF GREATER NEW YORK INC | ||||||||
| 26 BLEECKER STREET | NEW YORK | NY | 10012 | 132621497 | 501(C)(3) | $1,000,000 | $0 | COMMUNITY GRANT PROGRAM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLARA MERCEDES HANSEN | ||||||||||||||
| EXECUTIVE DIRECTOR | $273,750 | $0 | $59,590 | $0 | $0 | $0 | $6,250 | $0 | $22,174 | $0 | $361,764 | $0 | $0 | $0 |
| RACHEL AMALFITANO | ||||||||||||||
| CONSULTANT/CFO | $244,650 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $244,650 | $0 | $0 | $0 |
| SCOTT BREIDBART | ||||||||||||||
| FORMER CHIEF MEDICAL OFFICER | $143,182 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $143,182 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS FORM 990, SCHEDULE J, PART I, LINE 7 INDIVIDUALS LISTED ON SCHEDULE J, PART II RECEIVED DISCRETIONARY BONUS COMPENSATION, INCLUDING ANNUAL BONUSES IN CALENDAR YEAR 2022. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | IN OCTOBER 2020, AFFINITY ENTERED INTO AN ASSET PURCHASE AGREEMENT ("APA") TO SELL ITS HEALTH PLAN OPERATIONS TO MOLINA. THE PARTIES SUBSEQUENTLY RECEIVED ALL REQUIRED REGULATORY APPROVALS FROM THE NEW YORK STATE DEPARTMENT OF HEALTH AND THE NEW YORK STATE ATTORNEY GENERAL AND CLOSED ON THE TRANSACTION ON OCTOBER 25, 2021. THE PURCHASE PRICE FOR THE TRANSACTION WAS $500,000,000, LESS THE AMOUNT BY WHICH THE TARGET NET ASSET VALUE ("NAV") IS GREATER THAN THE ESTIMATED NAV OF THE ASSETS AND LIABILITIES ASSUMED BY MOLINA AS OF OCTOBER 25, 2021. IN MARCH 2023, MOLINA PREPARED AND DELIVERED TO AFFINITY A STATEMENT SETTING FORTH MOLINA'S UPDATED CALCULATION OF THE NAV OF THE ASSETS AND LIABILITIES THEY ASSUMED ON OCTOBER 25, 2021, AS REQUIRED BY THE APA. THE NAV ON THAT STATEMENT WAS $(183,684,000), AN INCREASE OF $6,984,000 FROM THE NAV ON OCTOBER 25, 2021 OF $(190,668,000). THEREFORE, AFFINITY RECORDED A GAIN ON THE SALE OF $6,983,819 WHICH IS RECORDED IN OTHER NON-OPERATING REVENUE (EXPENSES) IN THE STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS AS OF DECEMBER 31, 2022. FOR PURPOSES OF FORM 990, THE GAIN IS REPORTED AS AN OTHER CHANGE IN NET ASSETS OR FUND BALANCES ON PART XI, LINE 9. |
| FORM 990, PART VI, SECTION A, LINE 4 | GOVERNING DOCUMENTS IN NOVEMBER 2021, THE ORGANIZATION'S CERTIFICATE OF INCORPORATION WAS AMENDED TO FORMALLY CHANGE THE NAME TO AFFINITY LEGACY, INC. AT THIS TIME, THE BYLAWS WERE ALSO AMENDED TO REMOVE ORGANIZATIONAL MEMBERS AND UPDATE CERTAIN BOARD COMMITTEES. IN JULY 2023, THE CERTIFICATE OF INCORPORATION WAS AMENDED TO REMOVE ORGANIZATIONAL MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW THE FINANCIAL STAFF COMPILES THE FINANCIAL AND OTHER INFORMATION REQUIRED IN THE 990 RETURN. KPMG LLP PREPARES THE RETURN AND THE INFORMATION IS REVIEWED BY THE COMPANY'S CFO. A FINAL COPY OF THE FORM 990 IS MADE AVAILABLE TO THE ENTIRE GOVERNING BODY BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 1. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO APPROPRIATE MANAGEMENT PERSONNEL, HUMAN RESOURCES OR THE CORPORATE COMPLIANCE OFFICER. 2. EMPLOYEES MUST SEEK GUIDANCE AND APPROVAL FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MAY CONSTITUTE A CONFLICT OF INTEREST. 3. MANAGEMENT, WITH PURCHASING AUTHORITY, WILL COMPLETE A RELATED PARTY QUESTIONNAIRE ANNUALLY TO IDENTIFY ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST. 4. EMPLOYEES, UPON HIRE AND ANNUALLY THEREAFTER, REVIEW THE CODE OF ETHICS WHICH INCLUDES INFORMATION ON CONFLICTS OF INTEREST. IN ADDITION, EMPLOYEES ARE REQUIRED TO SIGN AN ATTESTATION, UPON HIRE AND ANNUALLY THEREAFTER, THAT THEY ACKNOWLEDGE AND UNDERSTOOD THE CODE OF ETHICS. IF A CONFLICT OF INTEREST IS FOUND, PERSONS WITH A CONFLICT RECUSE THEMSELVES FROM DECISIONS RELATED TO THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION REVIEW THE PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE DIRECTOR AND CFO INCLUDED REVIEW AND APPROVAL BY A COMPENSATION COMMITTEE (THE "COMMITTEE") COMPRISED OF INDEPENDENT DIRECTORS CHARGED WITH THIS RESPONSIBILITY, CONSIDERATION OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION AND DOCUMENTATION OF THE DELIBERATION AND DECISION. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | GAIN ON SALE OF HEALTH PLAN, NET 6,983,819. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|
| AHP ENTERPRISES INC | ||||||||||
| 922 E TREMONT AVE 2105 | BRONX | NY | 10460 | 473885217 | MGMT SVCS | DE | AHSH | C | 0 | |
| AFFINITY HEALTH SERVICES HOLDINGS INC | ||||||||||
| 922 E TREMONT AVE 2105 | BRONX | NY | 10460 | 473909849 | HOLDING CO | DE | C | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R PART IV | FormAndLineReferenceDesc |
| Explanation | AFFINITY INCORPORATED AHP ENTERPRISES, INC. ON DECEMBER 12, 2013 AS A DELAWARE CORPORATION FOR THE PURPOSE OF PROVIDING MANAGEMENT SERVICES. AFFINITY HEALTH SERVICES HOLDINGS, INC. IS THE SOLE CORPORATE MEMBER OF AFFINITY. BOTH AFFINITY HEALTH SERVICES HOLDINGS, INC. AND AHP ENTERPRISES, INC. ARE IN THE PROCESS OF DISSOLUTION. | ExplanationTxt |