HEALTHCARE IN ACTION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHCARE IN ACTION INC (EIN 87-1858798)
- Tax period
- 2021-07-20 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202203189349313380
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T15:05:22-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH SIXTH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-20 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 871858798 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90806 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL HOCHMAN | PersonNm |
| Person Title | CEO & PRESIDENT | PersonTitleTxt |
| Phone | 5629895100 | PhoneNum |
| Signature | 2022-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | HOCHMAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANNA KOLAKALURI | PreparerPersonNm |
| PTIN | P01275237 | PTIN |
| Phone | 6123974000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | MICHAEL HOCHMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,030,000 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HEALTHCAREINACTION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE LIVES OF PEOPLE EXPERIENCING HOMELESSNESS THROUGH WHOLISTIC CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $2,000,000 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $30,000 | CYOtherRevenueAmt |
| CY Total Revenue | $2,030,000 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $165,000 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $451,393 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $616,476 | CYOtherExpensesAmt |
| CY Total Expenses | $1,232,869 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $797,131 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $2,628,621 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $1,831,490 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $797,131 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE PATIENTS EXPERIENCING HOMELESSNESS THROUGH AN INNOVATIVE "STREET MEDICINE" APPROACH BY CONTRACTING WITH MEDICARE AND MEDICAID HEALTH PLANS AS WELL AS HOSPITALS AND HEALTH SYSTEMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $165,000 | ExpenseAmt |
| Grant | $165,000 | GrantAmt |
| Revenue | $30,000 | RevenueAmt |
| Desc | HEALTHCARE IN ACTION'S PRIMARY ACTIVITY IS TO FACILITATE ACCESS TO HEALTHCARE SERVICES FOR HOMELESS INDIVIDUALS AND TO SUPPORT THE DELIVERY OF THE MEDICAL CARE BY OFFERING SPECIALIZED CARE MANAGEMENT, SOCIAL WORK, AND NAVIGATION SERVICES TAILORED TO THE UNIQUE AND UNMET NEEDS OF THIS POPULATION, INCLUDING HEALTHCARE, HOUSING, FOOD, AND OTHER SOCIAL SERVICES. | Desc |
| Total Program Service Expenses | $165,000 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | 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 | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRGINIA HAVAI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 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 |
|---|---|---|---|---|---|---|---|
| SACHIN JAIN | |||||||
| DIRECTOR | 0.50 | 39.50 | Yes (X) | $0 | $2,232,612 | $1,655,096 | |
| ROMILLA BATRA | |||||||
| DIRECTOR | 0.50 | 39.50 | Yes (X) | $0 | $1,211,524 | $423,584 | |
| MICHAEL PLUMB | |||||||
| DIRECTOR | 0.50 | 39.50 | Yes (X) | $0 | $504,077 | $543,307 | |
| KEVIN KAPPEL | |||||||
| TREASURER AND COO | 20.00 | 20.00 | Yes (X) | $0 | $192,542 | $32,955 | Yes (X) |
| MICHAEL HOCHMAN | |||||||
| PRESIDENT & CEO | 20.00 | 20.00 | Yes (X) | $0 | $192,017 | $28,734 | Yes (X) |
| KEVIN KROEKER | |||||||
| SECRETARY | 0.50 | 39.50 | $0 | $411,087 | $257,578 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,743,859 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,941,254 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| IRVINE TECHNOLOGY COMPANY | |||||
| 2850 RED HILL AVENUE | SANTA ANA | CA | 92705 | IT CONSULTING | $304,530 |
| CROWELL & MORING LLC | |||||
| PO BOX 75509 | BALTIMORE | MD | 21275 | LEGAL | $122,982 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,000,000 | RelatedOrganizationsAmt |
| Total Contributions | $2,000,000 | TotalContributionsAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MANAGEMENT FEE REVENUE | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $30,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $30,000 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,030,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,000 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,000 | TotalAmt |
| Program Services | $165,000 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,800 | TotalAmt |
| Management And General | $384,800 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,660 | TotalAmt |
| Management And General | $15,660 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,384 | TotalAmt |
| Management And General | $23,384 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,549 | TotalAmt |
| Management And General | $27,549 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,131 | TotalAmt |
| Management And General | $129,131 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,438 | TotalAmt |
| Management And General | $60,438 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,148 | TotalAmt |
| Management And General | $3,148 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,243 | TotalAmt |
| Management And General | $16,243 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,666 | TotalAmt |
| Management And General | $398,666 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49 | TotalAmt |
| Management And General | $49 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,172 | TotalAmt |
| Management And General | $4,172 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $734 | TotalAmt |
| Management And General | $734 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $978 | TotalAmt |
| Management And General | $978 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER | Desc |
| Total | $2,917 | TotalAmt |
| Management And General | $2,917 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,232,869 | TotalAmt |
| Program Services | $165,000 | ProgramServicesAmt |
| Management And General | $1,067,869 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,433,623 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $79,686 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,484 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $118,766 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,938 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $112,828 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,628,621 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,221,490 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $610,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,831,490 | 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) |
|---|---|---|
| EOY | $797,131 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $797,131 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,628,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $797,131 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,000,000 | CurrentTaxYearAmt |
| Total | $2,000,000 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $30,000 | CurrentTaxYearAmt |
| Total | $30,000 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,030,000 | CurrentTaxYearAmt |
| Total | $2,030,000 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,000,000 | CurrentTaxYearAmt |
| Total | $2,000,000 | 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) |
|---|---|---|
| Current Tax Year | $2,000,000 | CurrentTaxYearAmt |
| Total | $2,000,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $30,000 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,030,000 | CurrentTaxYearAmt |
| Total | $2,030,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, SHORT YEAR EXPLANATION: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATIONS INITIAL YEAR WAS A SHORT YEAR BEGINNING ON JULY 20, 2021 AND ENDING ON DECEMBER 31, 2021. THE ORGANIZATION'S TAX YEAR END IS DECEMBER 31. | ExplanationTxt |
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
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $118,766 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,938 | DepreciationAmt |
| Book Value | $112,828 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $112,828 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | UNDER FASB ASC 740, INCOME TAXES, THE COMPANY IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES AS OF DECEMBER 31, 2021. THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION MEDICAL GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 871942811 | RecipientEIN |
| Cash Grant | $165,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | TO SUPPORT OPERATIONS OF HEALTHCARE IN ACTION, MEDICAL GROUP. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | HIA, INC MADE A RESTRICTED GRANT TO A RELATED ORGANIZATION SUBJECT TO A WRITTEN GRANT AGREEMENT. PER THE TERMS OF THE AGREEMENT, THE GRANTEE IS REQUIRED TO PROVIDE AN ANNUAL REPORT TO HIA DETAILING ALL EXPENDITURES MADE FROM THE GRANT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SACHIN JAIN | ||||||||||||||
| DIRECTOR | $0 | $1,021,772 | $0 | $1,190,500 | $0 | $20,340 | $0 | $1,636,862 | $0 | $18,234 | $0 | $3,887,708 | $0 | $905,500 |
| ROMILLA BATRA | ||||||||||||||
| DIRECTOR | $0 | $483,434 | $0 | $340,998 | $0 | $387,092 | $0 | $414,183 | $0 | $9,401 | $0 | $1,635,108 | $0 | $706,558 |
| MICHAEL PLUMB | ||||||||||||||
| DIRECTOR | $0 | $482,645 | $0 | $0 | $0 | $21,432 | $0 | $516,706 | $0 | $26,601 | $0 | $1,047,384 | $0 | $0 |
| KEVIN KROEKER | ||||||||||||||
| SECRETARY | $0 | $239,277 | $0 | $150,000 | $0 | $21,810 | $0 | $236,641 | $0 | $20,937 | $0 | $668,665 | $0 | $0 |
| KEVIN KAPPEL | ||||||||||||||
| TREASURER AND COO | $0 | $157,300 | $0 | $26,250 | $0 | $8,992 | $0 | $12,849 | $0 | $20,106 | $0 | $225,497 | $0 | $0 |
| MICHAEL HOCHMAN | ||||||||||||||
| PRESIDENT & CEO | $0 | $182,260 | $0 | $0 | $0 | $9,757 | $0 | $12,758 | $0 | $15,976 | $0 | $220,751 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR MICHAEL HOCHMAN (CHIEF EXECUTIVE OFFICER AND PRESIDENT- HEALTHCARE IN ACTION, INC) WAS ESTABLISHED BY A RELATED ORGANIZATION, SCAN GROUP, AND PAID BY SCAN HEALTH PLAN. THE RELATED ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; 4) APPROVAL BY THE SCAN GROUP BOARD OF DIRECTORS. |
| PART I, LINE 4B | SCAN GROUP AND SCAN HEALTH PLAN PROVIDE A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO OFFICERS AND SENIOR VICE PRESIDENTS VIA ITS SECTION 457(F) PLAN. FOR CONTRIBUTIONS MADE PRIOR TO DECEMBER 31, 2017, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN UPON COMPLETION OF ONE OF THE CHOSEN VESTING OPTIONS: 1) FIVE YEARS OF SERVICE AND 62 YEARS OF AGE OR 2) 10 YEARS OF SERVICE. ON JANUARY 1, 2018, A NEW PLAN WAS ADOPTED, FOR CONTRIBUTIONS MADE ON OR AFTER THAT DATE, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN FOLLOWING A 4 YEAR CLASS VESTING CYCLE. DEFERRED COMPENSATION FOR 2021, REPORTED ON SCHEDULE J, PART II, COLUMN B AND COLUMN C CONSISTS OF THE FOLLOWING: 1)457(F) EMPLOYER CONTRIBUTIONS ARE SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED THE PLAN DOCUMENTS. BASED ON THESE VESTING TERMS AND CONDITIONS, THERE IS SUBSTANTIAL RISK OF FORFEITURE. 2) 457(B) IS A DEFERRED COMPENSATION PLAN THAT THE EMPLOYER AND EMPLOYEE CONTRIBUTE TO, UP TO THE SCAN GROUP AND SCAN HEALTH PLAN'S DEFINED AND IRS ANNUAL LIMITS. 3) 403(B) QUALIFIED RETIREMENT PLAN CONTRIBUTIONS (EMPLOYER MATCH AND SAFE HARBOR) UP TO THE IRS ANNUAL LIMITS. 4) SCAN GROUP AND SCAN HEALTH PLAN PROVIDE AN INCENTIVE PLAN TO VICE PRESIDENTS AND ABOVE. THE INCENTIVE PLAN IS BASED ON ORGANIZATION AND INDIVIDUAL PERFORMANCE METRICS. PAYMENTS ARE MADE ON OR AROUND APRIL 1 OF THE SUBSEQUENT CALENDAR YEAR. 5) IN 2017, UPON RECOMMENDATION BY SCAN'S COMPENSATION CONSULTANT, SULLIVAN COTTER, THE COMPENSATION COMMITTEE APPROVED THE ELIMINATION OF THE DEFERRAL PORTION OF THE INCENTIVE COMPENSATION PLAN EFFECTIVE JANUARY 1, 2018. THE RECOMMENDATION BY SULLIVAN COTTER TO DISCONTINUE THE DEFERRAL COMPONENT OF THE PLAN WAS BASED ON BEST PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS. THE ELIMINATION OF THE DEFERRAL COMPONENT RESULTED IN DISTRIBUTION TO ALL PARTICIPANTS OF ANY PREVIOUSLY UNPAID CONTRIBUTIONS IN 2017, EXCEPT IN CERTAIN INDIVIDUAL CIRCUMSTANCES THAT ARE GOVERNED BY THE LAW, IN WHICH CASE SCAN ADHERED TO THE GOVERNING PRACTICES. |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION MEDICAL GROUP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship With Org | CONTROLLED ENTITY OF HIA INC. OFFICERS | RelationshipWithOrgTxt |
| Cash Grant | $165,000 | CashGrantAmt |
| Type Of Assistance | GRANT | TypeOfAssistanceTxt |
| Assistance Purpose | SUPPORT HIAMG DELIVERY OF MEDICAL SERVICES TO NEEDY INDIVIDUALS | AssistancePurposeTxt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION MEDICAL GROUP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CONTROLLED ENTITY OF HIA INC. OFFICERS | RelationshipDescriptionTxt |
| Transaction | $30,000 | TransactionAmt |
| Transaction | MANAGEMENT FEE | TransactionDesc |
| Sharing Of Revenues | Yes (1) | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM OF DELOITTE TAX, LLP WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE VICE PRESIDENT AND CONTROLLER OF SCAN HEALTH PLAN. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY FOR AND/OR KNOWLEDGE REGARDING THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 FOR ACCURACY AND COMPLETENESS. THE FORM 990 IS PROVIDED TO THE HEALTHCARE IN ACTION'S BOARD FOR REVIEW AFTER IT IS PREPARED, BUT PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING COMPENSATION FOR MICHAEL HOCHMAN (CHIEF EXECUTIVE OFFICER AND PRESIDENT -HEALTHCARE IN ACTION, INC), OFFICERS AND SENIOR VICE PRESIDENT OF HEALTHCARE IN ACTION, INC IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF SCAN GROUP AND CHIEF EXECUTIVE OFFICER (CEO) OF SCAN HEALTH PLAN, WITH THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP. ALL OF THE VOTING MEMBERS OF THE COMPENSATION COMMITTEE ARE INDEPENDENT DIRECTORS. IN DETERMINING EACH EMPLOYEE'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WORK WITH AND RELY UPON THE COUNSEL AND EXPERTISE OF AN OUTSIDE COMPENSATION CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT HEALTH CARE ORGANIZATIONS, EXECUTIVE COMPENSATION, AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. THE COMPENSATION CONSULTANT PROVIDES AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT EACH YEAR WHICH FURNISHES THE BASIS FOR THE DETERMINATION OF EACH EMPLOYEE'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS CONSIDERED COMPARABLE TO SCAN HEALTH PLAN BASED ON VARIOUS METRICS. THE CHIEF EXECUTIVE OFFICER (CEO) MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE WITH RESPECT TO EACH EMPLOYEE'S COMPENSATION PACKAGE IN LIGHT OF THE EXECUTIVE COMPENSATION REPORT. AT THE COMPENSATION COMMITTEE MEETING ADDRESSING SUCH MATTERS, QUESTIONS ARE ASKED OF, AND ANSWERED BY, THE COMPENSATION CONSULTANT, REGARDING THEIR REPORT AND OTHER MATTERS RELEVANT TO THE COMPENSATION PACKAGE; PURSUANT TO THEIR DELIBERATIONS, THE COMPENSATION COMMITTEE MAKES A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR. THE MINUTES OF THE COMPENSATION COMMITTEE FOR THIS MEETING ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIVE SUCH DELIBERATION AND DECISIONS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDING THE EXECUTIVE COMPENSATION REPORT AND GUIDANCE RELATED TO THE 2021 SALARY PACKAGE WAS SULLIVAN COTTER. |
| FORM 990, PART VI, SECTION C, LINE 19 | HEALTHCARE IN ACTION, INC'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. HEALTHCARE IN ACTION MAKES ITS FORM 990, WHICH CONTAINS FINANCIAL INFORMATION, AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART VI, SECTION B, LINES 12, 13 AND 14 | IN 2021, HIA CURRENTLY OPERATES UNDER THE POLICIES THAT ARE MAINTAINED BY ITS SOLE MEMBER, SCAN GROUP. ONCE OPERATIONAL, HIA PLANS TO ADOPT THE FOLLOWING POLICIES OF SCAN GROUP: WHISTLEBLOWER POLICY, DOCUMENT RETENTION AND DESTRUCTION POLICY, AND CONFLICT OF INTEREST POLICY. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SCAN GROUP | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 953826037 | ADMIN SUPPORT | CA | 501(C)(3) | 12B, II | N/A | 0 | |
| THE SCAN FOUNDATION | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 450552845 | GRANT MAKING | CA | 501(C)(3) | 12B, II | Yes (1) | SCAN GROUP | |
| SCAN HEALTH NEVADA PLAN INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 854288083 | MEDICARE ADVANTAGE | NV | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN HEALTH PLAN | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 953858259 | MEDICARE ADVANTAGE | CA | 501(C)(3) | 10 | Yes (1) | SCAN GROUP | |
| SCAN DESERT HEALTH PLAN INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 854275186 | MEDICARE ADVANTAGE | AZ | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN HEALTH PLAN TEXAS INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872944493 | MEDICARE ADVANTAGE | TX | 501(C)(4) | Yes (1) | SCAN GROUP | ||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SCAN HEALTHCHECK ASSESSMENT CENTERS INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462962358 | HEALTHCARE | CA | N/A | C | Yes (1) |
| SCAN CALIFORNIA MANAGEMENT COMPANY | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462951831 | MANAGEMENT | CA | N/A | C | Yes (1) |
| ALIVE VENTURES INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 852381604 | VENTURE STUDIO | CA | N/A | C | Yes (1) |
| HEALTHCARE IN ACTION MEDICAL GROUP | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 871942811 | HEALTHCARE | CA | N/A | C | Yes (1) |
| WELCOME HEALTH INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 863730275 | HEALTHCARE | CA | N/A | C | Yes (1) |
| WELCOME HEALTH MEDICAL GROUP | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872705807 | HEALTHCARE | CA | N/A | C | Yes (1) |
| PROSPER SERVICES LLC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872979343 | HEALTHCARE | CA | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SCAN HEALTH PLAN | ||
| C | $2,000,000 | BOOK VALUE |
| SCAN GROUP | ||
| P | $1,101,326 | BOOK VALUE |
| SCAN HEALTH PLAN | ||
| P | $118,766 | BOOK VALUE |
| HEALTHCARE IN ACTION MEDICAL GROUP | ||
| B | $165,000 | BOOK VALUE |
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