2023-11-14T15:57:22-06:00 2022-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2022-01-01 462602391 ICIRCLE SERVICES OF THE FINGER LAKES INC ICIR 8444247253 860 HARD RD WEBSTER NY 14580 ANDREW SEWNAUTH PRESIDENT/CEO 8444247253 2023-11-14 1 ANDREW SEWNAUTH 999009999 1 THOMAS J GIUFRE P00841958 3154463600 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ANDREW SEWNAUTH 860 HARD RD WEBSTER NY 14580 141611993 0 X WWW.ICIRCLECNY.ORG X 2013 NY TO PROVIDE MEMBERS WITH HIGH-QUALITY HEALTH AND SOCIAL SERVICES THAT ARE CULTURALLY-APPROPRIATE, COMMUNITY-INTEGRATED, AND TAILORED TO THEIR INDIVIDUAL NEEDS, ENSURING A POSITIVE IMPACT ON THEIR PERSONAL HEALTH, LIFESTYLE, AND INDEPENDENCE. 11 11 151 11 0 0 2595000 0 156555887 141459017 50177 140182 90000 12794 159291064 141611993 7500 0 0 0 14196222 14021420 0 0 0 112533230 127875276 126736952 141896696 32554112 -284703 40072798 46115258 36172473 42499636 3900325 3615622 TO PROVIDE MEMBERS WITH HIGH-QUALITY HEALTH AND SOCIAL SERVICES THAT ARE CULTURALLY-APPROPRIATE, COMMUNITY-INTEGRATED, AND TAILORED TO THEIR INDIVIDUAL NEEDS, ENSURING A POSITIVE IMPACT ON THEIR PERSONAL HEALTH, LIFESTYLE, AND INDEPENDENCE. 0 0 139087675 141471811 MANAGED LONG TERM CARE INSURANCE - 3,491 INDIVIDUALS SERVED IN 2022. 139087675 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 427 0 1 151 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X THE ORGANIZATION 8444247253 860 HARD RD WEBSTER NY 14580 GREGORY GRIBBEN TREASURER 1.00 X X 0 0 0 JENNIFER CARLSON BOARD MEMBER 1.00 X 0 0 0 RICHARD YARMEL SECRETARY 1.00 X X 0 0 0 MARK PETERSON BOARD CHAIR 1.00 X X 0 0 0 TIM THANEY VICE CHAIR 1.00 X X 0 0 0 PIERRE GIRGIS MD BOARD MEMBER 1.00 X 0 0 0 EDWARD MYERS HAYES BOARD MEMBER 1.00 X 0 0 0 ANDY LOPEZ-WILLIAMS BOARD MEMBER 1.00 X 0 0 0 RENE SNYDER BOARD MEMBER 1.00 X 0 0 0 SYLVESTER ZIELINSKI BOARD MEMBER 1.00 X 0 0 0 DARYL TIFFIN BOARD MEMBER 1.00 X 0 0 0 SHARON MARBLE COO 40.00 X 292280 0 18100 SANKAR SEWNAUTH CEO 27.00 13.00 X 0 846237 19954 RICHARD FERRARI CFO 0.00 40.00 X 0 375544 16441 DR JOEL HAAS CHIEF MEDICAL OFFICER 40.00 X 334148 0 1115 HUI CAI MEDICAL DIRECTOR 40.00 X 153492 0 25867 ANDREA VALK VP OF GOVERNMENT RELATIONS 40.00 X 166722 0 10333 DIANE FREDERICO VP OF QUALITY & COMPLIANCE 40.00 X 131633 0 20046 REBECCA HENDERSON VP OF FINANCE 34.00 6.00 X 153907 27876 10342 JENNIFER GRANGER DIRECTOR OF CONTRACTING AND NETWORK MGMT 40.00 X 117713 0 17407 1349895 1249657 139605 10 0 1 0 FREEDOM CARE LLC 1979 MARCUS AVENUE SUITE C-115 LAKE SUCCESS NY 11042 PROVIDER OF SERVICES TO MEMBERS 13353383 ELITE CHOICE LLC 1967 MCDONALD AVENUE BROOKLYN NY 112231805 PROVIDER OF SERVICES TO MEMBERS 9845724 CENTER FOR DISABILITY RIGHTS 497 STATE ST ROCHESTER NY 14608 PROVIDER OF SERVICES TO MEMBERS 7354911 COMMITTED HOME CARE INC 222 NY 59 STE 302 SUFFERN NY 10901 PROVIDER OF SERVICES TO MEMBERS 5581916 BURD HOME HEALTH LLC 274 N GOODMAN STREET SUITE A403 ROCHESTER NY 14607 PROVIDER OF SERVICES TO MEMBERS 4772961 122 MEDICAID PREMIUM REVENUE 524114 139224216 139224216 SPENDDOWN AND NAMI 524114 2234801 2234801 141459017 140182 140182 OTHER REVENUE 900099 12794 12794 12794 141611993 141471811 0 140182 808236 790212 18024 10615488 10568582 46906 176832 171527 5305 1588301 1538691 49610 832563 807586 24977 2474264 964963 1509301 121548 121548 97617 97617 753089 106054 647035 1350 1350 460146 450943 9203 1588276 1588276 233070 230739 2331 86967 85598 1369 179801 179801 81984 81412 572 94317 94317 MEDICAL EXPENSES 120508990 120508990 BAD DEBT EXPENSE 793253 793253 OTHER 186951 119432 67519 EQUIPMENT RENTAL AND MA 59625 59625 154028 40641 113387 141896696 139087675 2809021 0 26592602 33089573 5735166 5220710 55864 181181 723060 691949 113095 31111 7576071 7592683 40072798 46115258 21997068 23239526 14175405 19260110 36172473 42499636 X 3900325 3615622 3900325 3615622 40072798 46115258 -284703 0 X X 0 1 X 1 0 X 100000 145349 1100759 2685000 0 4031108 128898858 186540970 204435096 156555887 141611993 818042804 128998858 186686319 205535855 159240887 141611993 822073912 0 0 0 822073912 90000 90000 128998858 186686319 205535855 159330887 141611993 822163912 0.99990 0.99990 0.00000 X 181627 178563 3064 203254 194193 9061 338179 319193 18986 31111 RESTRICTED DEPOSITS 7592683 7592683 UNSECURED NOTE PAYABLE TO RELATED PARTY 8990040 DUE TO RELATED PARTIES, NET 134379 DUE TO NEW YORK STATE 10135691 19260110 X 141611993 0 141611993 0 141611993 141896696 0 141896696 0 141896696 PART X, LINE 2: ICIRCLE IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS OF DECEMBER 31, 2022 AND 2021, ICIRCLE DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES ARE 2019 THROUGH 2022. ICIRCLE DOES NOT ANTICIPATE ANY UNRECOGNIZED TAX BENEFITS TO CHANGE IN THE NEXT TWELVE MONTHS. 0 1 0 0 0 0 0 0 0 SANKAR SEWNAUTH CEO 0 522636 0 246300 0 77301 0 1394 0 18560 0 866191 0 0 RICHARD FERRARI CFO 0 286296 0 79100 0 10148 0 1394 0 15047 0 391985 0 0 DR JOEL HAAS CHIEF MEDICAL OFFICER 245272 0 73535 0 15341 0 1115 0 0 0 335263 0 0 0 SHARON MARBLE COO 223304 0 52040 0 16936 0 1394 0 16706 0 310380 0 0 0 REBECCA HENDERSON VP OF FINANCE 137418 20045 9720 6600 6769 1231 1185 209 7501 1447 162593 29532 0 0 HUI CAI MEDICAL DIRECTOR 152921 0 200 0 371 0 697 0 25170 0 179359 0 0 0 ANDREA VALK VP OF GOVERNMENT RELATIONS 145152 0 13252 0 8318 0 1394 0 8939 0 177055 0 0 0 DIANE FREDERICO VP OF QUALITY & COMPLIANCE 110813 0 12650 0 8170 0 1394 0 18652 0 151679 0 0 0 PART I, LINE 4B SANKAR SEWNAUTH, CEO, PARTICIPATES IN A SUPPLEMENTAL, NON-QUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F). FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE ORGANIZATION'S FINAL FORM 990 WAS PROVIDED IN ELECTRONIC FORM TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING THE FORM. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS WRITTEN CONFLICT OF INTEREST POLICY BY REQUIRING ALL EMPLOYEES, VOLUNTEERS, CONSULTANTS, AND BOARD MEMBERS UPON JOINING THE ORGANIZATION AND ANNUALLY THEREAFTER TO REVIEW, COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT TO REPORT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. REPORTS OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE REPORTED TO THE DIRECTOR OF QA, THE EXECUTIVE TEAM, OR TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR RESOLUTION, AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE PROCESS BY WHICH THE ORGANIZATION OVERSEES ITS AUDIT OR THE PROCESS BY WHICH THE ORGANIZATION SELECTS ITS INDEPENDENT ACCOUNTANT. 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