2023-10-30T10:32:19-05:00 2022-12-31 363168081 SIKICH LLP 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2022-01-01 271494977 CHORUS COMMUNITY HEALTH PLANS INC CHOR 4142665420 PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 MARC A CADIEUX TREASURER 4142665420 2023-10-25 1 MARC CADIEUX 999009999 0 JILL M BOYLE CPA P01246734 2627549400 2023-10-25 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARK RAKOWSKI PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 462830834 0 X HTTPS://CHORUSHEALTHPLANS.ORG X 2009 WI TO PROVIDE ACCESS TO QUALITY HEALTH CARE AND SERVICES TO ITS MEMBERS IN WI. 9 7 149 7 0 0 0 0 426477163 460810003 217624 1764379 27345 29586 426722132 462603968 116039 169745 339751000 358408920 12833329 13576648 0 0 0 56139561 66555446 408839929 438710759 17882203 23893209 219109708 253600863 77707720 89569966 141401988 164030897 X CHORUS COMMUNITY HEALTH PLANS, INC. ("CCHP"), A SUBSIDIARY OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), IS A HEALTH MAINTENANCE ORGANIZATION DEDICATED TO PROVIDING ACCESS TO THE HIGHEST QUALITY HEALTH CARE AND SERVICES TO MEMBERS. 0 0 284757446 169745 317779300 CCHP'S PURPOSE IS TO PROMOTE ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME CHILDREN AND CERTAIN OTHER DISADVANTAGED RESIDENTS OF THE STATE OF WISCONSIN, AND TO PROMOTE OR SPONSOR PROGRAMS FURTHERING THE HEALTH OF ITS MEMBERS AND THE LARGER COMMUNITIES SERVED. CCHP IS AN HMO FOR WISCONSIN MEDICAID-ELIGIBLE INDIVIDUALS AND FAMILIES LIVING IN BROWN, CALUMET, DOOR, FOND DU LAC, FOREST, GREEN LAKE, JEFFERSON, KENOSHA, KEWAUNEE, LINCOLN, MANITOWOC, MARINETTE, MILWAUKEE, OCONTO, ONEIDA, OUTAGAMIE, OZAUKEE, RACINE, ROCK, SHAWANO, SHEBOYGAN, VILAS, WALWORTH, WASHINGTON, WAUKESHA, WAUPACA, WAUSHARA, AND WINNEBAGO COUNTIES IN WISCONSIN. THE MEDICAID ENROLLMENT AT THE END OF DECEMBER 2022 WAS 156,369 MEMBERS, AND THERE WERE 9,741 INPATIENT ADMISSIONS, 423,414 AMBULATORY ENCOUNTERS, AND 2,436 DELIVERIES IN 2022. THE PLAN ALLOWS MEMBERS TO CHOOSE FROM A LARGE NETWORK OF PROVIDERS, WHICH INCLUDED MORE THAN 9,700 PHYSICIANS, MORE THAN 10,900 NON PHYSICIANS, AND 71 HOSPITALS IN 2022. IN ADDITION, CCHP OFFERS HOME CARE, MEDICAL EQUIPMENT PROVIDERS AND THE CCHP NURSELINE FOR ITS MEMBERS. 115661898 120288752 CCHP SELLS INDIVIDUAL COMPREHENSIVE INSURANCE PLANS SUBJECT TO THE AFFORDABLE CARE ACT ON THE FEDERALLY FACILITATED MARKETPLACE AND OFF EXCHANGE DIRECTLY TO CONSUMERS. THERE WERE 13,046 MEMBERS ENROLLED AT THE END OF DECEMBER 2022. APPROXIMATELY 77 PERCENT OF THE POLICY HOLDERS RECEIVED AN ADVANCE PREMIUM TAX CREDIT (APTC), AND THESE CREDITS ACCOUNTED FOR 57 PERCENT OF THE PREMIUM REVENUE FROM MEMBERS. ADDITIONALLY, APPROXIMATELY 31 PERCENT OF THE ENROLLMENT MONTHS WERE ON SILVER PLANS THAT QUALIFIED FOR COST SUBSIDY REIMBURSEMENT (CSR), ALTHOUGH CMS NO LONGER PAYS THE SUBSIDY. BEGINNING IN 2022, CCHP ALSO STARTED TO SELL A STAND-ALONE DENTAL INSURANCE PLAN, WHICH HAD 79 MEMBERS ENROLLED AT THE END OF DECEMBER 2022. 22674235 22771537 CCHP RECORDED REVENUE AND EXPENSES FOR CHHS' FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS. CARE4KIDS IS A NON-RISK PREPAID INPATIENT HEALTH PLAN CONTRACT BETWEEN CHHS AND WISCONSIN MEDICAID THAT PROVIDES COMPREHENSIVE HEALTHCARE SERVICES FOR QUALIFYING FOSTER CHILDREN IN SOUTHEASTERN WISCONSIN. CCHP PROVIDES UTILIZATION MANAGEMENT AND A PROVIDER NETWORK, AND PROCESSES CLAIMS FOR THE PARTICIPANTS VIA A SUBCONTRACT AGREEMENT WITH CHHS. THERE WERE 2,915 FOSTER CHILDREN IN CARE4KIDS AT THE END OF DECEMBER 2022. 423093579 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2312 0 149 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MS SARAH KAFKA 4142661887 PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 MARGARET TROY DIRECTOR/PRESIDENT & CEO CHHS 0.00 40.00 X 0 1973534 58792 ROBERT DUNCAN END 12822 DIRECTOR/PRES CCHP & EVP CHHS 0.00 40.00 X X 0 257357 20692 JAMES PURKO DIRECTOR/CHAIR 1.00 0.00 X X 0 0 0 DAVID DRURY DIRECTOR 1.00 0.00 X 0 0 0 MARK HOGAN DIRECTOR 1.00 0.00 X 0 0 0 BEN MELSON DIRECTOR 1.00 0.00 X 0 0 0 THOMAS PRECIA DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL SILVER DIRECTOR 1.00 0.00 X 0 0 0 CLARK SLIPHER DIRECTOR 1.00 0.00 X 0 0 0 MARC CADIEUX TREASURER/CORP VP & CFO 0.00 40.00 X 0 993812 126962 MICHELLE METTNER END 123122 SECRETARY/CORP VP GOV & LEGAL AFFAIRS 0.00 40.00 X 0 703637 111779 MARK RAKOWSKI DIRECTOR/PRESIDENT OF CCHP 40.00 0.00 X 0 543242 120336 MICHAEL BOEDER COO CCHP 40.00 0.00 X 220275 0 31447 JAMES SLAWSON CHIEF MEDICAL OFFICER CCHP 40.00 0.00 X 327985 0 52526 LYNN MASKEL END 9222 MEDICAL DIR 28.00 0.00 X 211708 0 25163 KELLY HODGES ASSOCIATE CMO CCHO 40.00 0.00 X 260114 0 13847 LYNN KRYFKE END 102922 EXEC DIR HEALTH PLAN CLIN 40.00 0.00 X 166461 0 15411 DANIELLE COTEREL DIR COMMERCIAL PROD DEV SALES 40.00 0.00 X 155833 0 22877 1342376 4471582 599832 21 0 1 0 DENTAL PROFESSIONALS OF WI 3520 W OKLAHOMA AVE MILWAUKEE WI 53215 DENTAL SERVICES 24985232 DEAN HEALTH PLAN INC 1277 DEMING WAY MADISON WI 53717 CLAIM TPA FEES 15232246 UPMC BENEFIT MANAGEMENT SERVICES INC 600 GRANT ST 12TH FLOOR PITTSBURGH PA 15219 CLAIM AND BILLING TPA FEES 5483619 HERSLOF OPTICAL COMPANY INC 12000 W CARMEN AVE MILWAUKEE WI 53225 CAPITATED VISION SERVICES 1639976 LIBERTY INSURANCE 100 N CORPORATE DR STE 100 BROOKFIELD WI 53045 INSURANCE BROKER 1547042 26 PREMIUM REVENUE 524114 438038466 438038466 FOSTER CARE MEDICAL HOME PIHP 524298 22771537 22771537 460810003 1976008 1976008 15237 4571 222295 10666 -222295 -211629 -211629 OTHER REVENUE 900099 29586 29586 29586 462603968 460839589 0 1764379 169745 169745 358408920 358408920 251722 251722 10590457 7519329 3071128 552411 392217 160194 1428158 1014006 414152 753900 535276 218624 3617772 3617772 106774 106774 37629 37629 106059 106059 32737264 29331403 3405861 688407 60877 627530 1151736 95674 1056062 416190 416190 29182 17077 12105 14219 8503 5716 193361 193361 71350 71350 FOSTER CARE MEDICAL HOM 22159925 22159925 STATE INCOME TAX 2064298 2064298 PREMIUM RESERVE DEFICIE 2035000 2035000 OTHER EXPENSES 1126280 929437 196843 438710759 423093579 15617180 0 254049 283255 134812127 161310525 56303383 66226832 1445671 1266182 863098 469001 809753 394097 23682504 22819630 1802221 1300342 219109708 253600863 73887172 82956531 2061034 2108606 1759514 4504829 77707720 89569966 X 141401988 164030897 141401988 164030897 219109708 253600863 23893209 -1264300 0 X X 0 1 X 1 0 X 459573101 363681065 397955482 426477163 460810003 2108496814 459573101 363681065 397955482 426477163 460810003 2108496814 0 0 0 2108496814 689726 2040465 719514 273532 1976008 5699245 689726 2040465 719514 273532 1976008 5699245 675 8750 14445 27345 29586 80801 460263502 365730280 398689441 426778040 462815597 2114276860 0.99730 0.99790 0.00270 0.00210 X SCHEDULE A, PART III, SECTION B, LINE 12, COLUMN E: 2016 OTHER REVENUE $ 750 2017 OTHER REVENUE $ 2,239 2018 OTHER REVENUE $ 675 2019 OTHER REVENUE $ 8,750 2020 OTHER REVENUE $14,445 2021 OTHER REVENUE $27,345 2022 OTHER REVENUE $29,586 0 0 0 0 0 0 1 0 1 37629 37629 0 PART II-B, LINE 1: SINCE CHORUS COMMUNITY HEALTH PLAN ("CCHP") IS A WISCONSIN MEDICAID HMO, CERTAIN OFFICERS OF CCHP AND CCHP'S PARENT, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (CHHS), MEET WITH OFFICIALS FROM THE STATE OF WISCONSIN DEPARTMENT OF HEALTH SERVICES TO DISCUSS THE MEDICAID PROGRAM IN WISCONSIN. THE EXPENSE FOR THE CHHS OFFICERS WERE NOT REPORTED AS EXPENSES ON CCHP'S PART IX. THE AMOUNT REPORTED ON SCHEDULE C PART II-B LINE 1I CONSISTS OF $24,000 PAID TO AN OUTSIDE CONSULTANT WHO IS A REGISTERED LOBBYIST WHO ADVISES CCHP MANAGEMENT. THE REMAINING $13,629 IS THE PORTION OF FEES PAID TO NATIONAL TRADE ASSOCIATIONS THAT WERE ATTRIBUTED TO NON-DEDUCTIBLE LOBBYING ACTIVITIES BY THE TRADE ASSOCIATIONS. 812598 442450 370148 50500 26551 23949 394097 DUE TO AFFILIATES 872239 OTHER LIABILITIES 3625778 LEASE LIABILITY 6812 4504829 X PART X, LINE 2: FOOTNOTE 2 INCOME TAXES: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021. 1 UNITED COMMUNITY CTR 1028 S 9TH STREET MILWAUKEE WI 53204 391146191 501(3) 10000 0 GENERAL SUPPORT VILLAGE OF BROWN DEER 4800 W GREEN BROOK DR BROWN DEER WI 53223 396021350 VILLAGE, BROWN D 11567 0 FARMER'S MARKET EBT MATCH MILWAUKEE HEALTH CARE PARTNERSHIP 400 W RIVER WOODS PARKWAY MILWAUKEE WI 53212 391834639 501(3) 10000 0 TO SUPPORT MILWAUKEE ENROLLMENT NETWORK CITY OF MILWAUKEE 841 N BORADWAY ROOM 315 MILWAUKEE WI 53202 396005532 CITY, MKE 10000 0 BACK TO SCHOOL CHILDREN'S WI FOUNDATION - FRC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500074 501(3) 70000 0 FAMILY RESOURCE CENTER 5 0 PART I, LINE 2: OCCASIONALLY, CCHP WILL MAKE CONTRIBUTIONS TO OTHER NOT-FOR-PROFIT OR GOVERNMENT ORGANIZATIONS. IN ORDER TO MONITOR THE USE OF THE FUNDS, CCHP LEADERSHIP WILL PERIODICALLY TOUCH BASE WITH THESE ORGANIZATIONS AND INQUIRE OR RECEIVE REPORTS ON HOW THE FUNDS WERE UTILIZED. 0 1 0 0 0 0 0 1 0 MARGARET TROY DIRECTOR/PRESIDENT & CEO CHHS 0 1134014 0 410825 0 428695 0 22450 0 36342 0 2032326 0 0 MARC CADIEUX TREASURER/CORP VP & CFO 0 635957 0 162297 0 195558 0 123257 0 3705 0 1120774 0 133747 MICHELLE METTNER END 123122 SECRETARY/CORP VP GOV & LEGAL AFFAIR 0 469771 0 92214 0 141652 0 82467 0 29312 0 815416 0 93242 MARK RAKOWSKI DIRECTOR/PRESIDENT OF CCHP 0 356478 0 71615 0 115149 0 83250 0 37086 0 663578 0 82132 JAMES SLAWSON CHIEF MEDICAL OFFICER CCHP 298338 0 16561 0 13086 0 16350 0 36176 0 380511 0 0 0 ROBERT DUNCAN END 12822 DIRECTOR/PRES CCHP & EVP CHHS 0 44161 0 131892 0 81304 0 17251 0 3441 0 278049 0 0 KELLY HODGES ASSOCIATE CMO CCHO 245922 0 13673 0 519 0 10250 0 3597 0 273961 0 0 0 MICHAEL BOEDER COO CCHP 205963 0 13282 0 1030 0 15734 0 15713 0 251722 0 0 0 LYNN MASKEL END 9222 MEDICAL DIR 103996 0 8460 0 99252 0 12863 0 12300 0 236871 0 0 0 LYNN KRYFKE END 102922 EXEC DIR HEALTH PLAN CLIN 137025 0 8473 0 20963 0 13138 0 2273 0 181872 0 0 0 DANIELLE COTEREL DIR COMMERCIAL PROD DEV SALES 132065 0 18706 0 5062 0 11015 0 11862 0 178710 0 0 0 PART I, LINE 3 CCHP RELIED UPON CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE CORPORATE MEMBER OF CCHP, TO ESTABLISH THE COMPENSATION OF CCHP'S PRESIDENT. CHHS USED ITS INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, A COMPENSATION SURVEY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION. PART I, LINE 4B IN 2022, THERE WAS A CHHS EXECUTIVE FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2022 WERE AS FOLLOWS: M. CADIEUX, $100,807; M. METTNER, $60,017; AND M. RAKOWSKI $57,750. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2022 WERE: M. CADIEUX, $133,747, M. METTNER, $93,242 AND M. RAKOWSKI, $82,132. PART I, LINE 7 CERTAIN EXECUTIVES PARTICIPATE IN AN ANNUAL BONUS PLAN THAT PROVIDES COMPENSATION BASED ON ACHIEVING SPECIFIC PRE-DEFINED GOALS. BONUS CRITERIA ARE COMPRISED OF BOTH SYSTEM LEVEL AND EXECUTIVE SPECIFIC COMPONENTS. SUCH CRITERIA PERTAIN TO MATTERS WITHIN THE EXECUTIVE'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF THE ORGANIZATION AND ITS AFFILIATES IN ALIGNMENT WITH SYSTEM-WIDE BALANCED MEASURES. FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. ROBERT DUNCAN, FORMER PRESIDENT AND DIRECTOR OF CCHP AND EXECUTIVE VICE PRESIDENT - COMMUNITY SERVICES OF CHHS, MARGARET TROY, DIRECTOR OF CCHP AND PRESIDENT & CEO OF CHHS, MARC CADIEUX, TREASURER OF CCHP AND TREASURER & CFO OF CHHS, MICHELLE METTNER, SECRETARY OF CCHP AND CORP VP GOV & LEGAL AFFAIRS, AND MARK RAKOWSKI, PRESIDENT AND DIRECTOR, CCHP - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY MS. TROY, MR. DUNCAN AND MR. RAKOWSKI AS MEMBERS OF THE BOARD OF DIRECTORS OF CCHP WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. FORM 990, PART VI, SECTION A, LINE 4 ARTICLES: - ARTICLE I, NAME: NAME CHANGE FROM CHILDREN'S COMMUNITY HEALTH PLAN, INC. TO CHORUS COMMUNITY HEALTH PLANS, INC BYLAWS: - CHANGE OF TITLE FROM CHILDREN'S COMMUNITY HEALTH PLAN, INC. TO CHORUS COMMUNITY HEALTH PLANS, INC. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SOLE CORPORATE MEMBER WHICH IS CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (CHHS). FORM 990, PART VI, SECTION A, LINE 7A CHHS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER, CHHS, HAS CERTAIN RESERVE POWERS OVER THE CORPORATION, INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; APPROVAL OF MERGER, CONSOLIDATION OR THE CREATION OF ANY SUBSIDIARIES BY THE CORPORATION; APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT; AND SELECTION OF THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CCHP. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE DIRECTOR OF CORPORATE COMPLIANCE. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, TREASURER, AND SECRETARY WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF CHHS (THE ORGANIZATION'S CORPORATE MEMBER). WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF THE COO WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CCHP ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. FORM 990, PART XII LINE 2 & PART IV, LINE 12A: CCHP WAS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHHS. THE CONSOLIDATED FINANCIAL STATEMENTS OF CHHS WERE PREPARED IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA AND WERE AUDITED BY AN INDEPENDENT ACCOUNTANT. ADDITIONALLY, CCHP WAS REQUIRED TO PREPARE STATUTORY FINANCIAL STATEMENTS IN ACCORDANCE WITH ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE OFFICE OF THE COMMISSIONER OF INSURANCE OF THE STATE OF WISCONSIN, WHICH IS A BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. THE STATUTORY FINANCIAL STATEMENTS WERE ALSO AUDITED BY AN INDEPENDENT ACCOUNTANT, BUT WERE NOT USED TO PREPARE THE FORM 990 SINCE THE STATUTORY STATEMENTS WERE PREPARED USING A BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. FORM 990, PART I LINE 4 & PART VI LINE 1B: CCHP IS A WISCONSIN NONSTOCK CORPORATION AND IS AN AFFILIATE OF CHHS, A TAX-EXEMPT WISCONSIN CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH CARE NEEDS OF CHILDREN IN SOUTHEASTERN WISCONSIN, NORTHERN ILLINOIS AND SURROUNDING AREAS. AS THE CORPORATE MEMBER OF CCHP, CHHS HOLDS VARIOUS RESERVE POWERS IN RELATION TO CCHP, INCLUDING AUTHORITY TO APPOINT CCHP'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF CCHP CONSISTS OF REPRESENTATIVES OF CHHS'S EXECUTIVE LEADERSHIP IN ADDITION TO SEVEN EXTERNAL DIRECTORS. THESE EMPLOYED DIRECTORS MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS CPE TEXT FOR FISCAL YEAR 1997, IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. CCHP MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF CHHS, AND CHHS'S GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. CHILDREN'S HOSPITAL & HEALTH SYSTEM INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500074 AMBULATORY SURGERY CTR, URGENT CARE, & OPERATIONAL SUPPT SVCS WI 501(C)(3) LINE 3 N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500075 FUND DEVELOPMENT WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S MEDICAL GROUP INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391789197 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 390806380 CHILD WELFARE SERVICES WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SPECIALTY GROUP INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391990012 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 12A, I N/A 0 WEST ALLIS PRESCRIPTION CENTER INC 6737 W WASHINGTON ST STE 1100 WEST ALLIS WI 53214 463421597 PHARMACY WI N/A C 0 WAUWATOSA PRESCRIPTION CENTER INC SKYWALK PHARMACY 9000 W WISCONSIN AVE WAUWATOSA WI 53226 061654484 PHARMACY WI N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0