COX HEALTH SYSTEMS INSURANCE COMPANY: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COX HEALTH SYSTEMS INSURANCE COMPANY (EIN 43-1684044)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202213159349304561
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T17:11:55-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431684044 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COX HEALTH SYSTEMS INSURANCE COMPANY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % LISA ODOM CFO | InCareOfNm |
| Business Name Control | COXH | BusinessNameControlTxt |
| Phone | 4172692900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5750 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65801 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LISA ODOM | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4172693000 | PhoneNum |
| Signature | 2022-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LISA | PersonFirstNm |
| Person Last | ODOM | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| 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) |
|---|---|---|
| Principal Officer | MATTHEW AUG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5750 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $149,493,194 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.COXHEALTHPLANS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | ENGAGED IN PROMOTING THE COMMON GOOD AND GENERAL WELFARE OF THE PEOPLE OF THE COMMUNITY BY PROVIDING LOW-COST, HIGH-QUALITY HEALTH PLANS TO AN UNDERSERVED POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 4 | 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 | $143,169,831 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $137,385,478 | CYProgramServiceRevenueAmt |
| PY Investment Income | $722,454 | PYInvestmentIncomeAmt |
| CY Investment Income | $519,249 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $143,892,285 | PYTotalRevenueAmt |
| CY Total Revenue | $137,904,727 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $127,313,415 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $127,312,178 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,701,224 | PYOtherExpensesAmt |
| CY Other Expenses | $12,006,631 | CYOtherExpensesAmt |
| PY Total Expenses | $140,014,639 | PYTotalExpensesAmt |
| CY Total Expenses | $139,318,809 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,877,646 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,414,082 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $54,553,162 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,773,938 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,091,106 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,724,487 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,462,056 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,049,451 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SUPPORT HEALTH IMPROVEMENT IN THE COMMUNITIES WE SERVE BY OFFERING COMPETITIVE INSURANCE PRODUCTS BASED ON QUALITY OUTCOMES AND EVIDENCED BASED HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $131,446,934 | ExpenseAmt |
| Revenue | $137,385,478 | RevenueAmt |
| Desc | THE COMPANY (CHSIC) PROVIDES GROUP AND INDIVIDUAL HEALTH INSURANCE POLICIES. IT HAS BEEN ARRANGING HEALTH CARE SERVICES THROUGH THE OPERATION OF HEALTH PLANS SINCE ITS INCEPTION IN 1994. CHSIC SERVES APPROXIMATELY 27,000 PEOPLE ACROSS THE STATE OF MISSOURI AND MOST ARE IN ITS PRIMARY SERVICE AREA, WHICH CONSISTS OF THE 26 COUNTIES IN SOUTHWEST MISSOURI. CHSIC'S HEALTH PLANS ARE EPO AND PPO PLANS, AND THEY PROVIDE A COMMUNITY BENEFIT DUE TO THEIR LOW COST, THEIR AVAILABILITY TO ALL IN THE COMMUNITY AND THEIR ROLE IN COX HEALTH SYSTEM'S IMPROVING OF THE HEALTH OF THE COMMUNITY. | Desc |
| Total Program Service Expenses | $131,446,934 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LISA ODOM CFO | PersonNm |
| Phone | 4172692900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5750 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| MR STEVEN D EDWARDS | |||||||
| VICE CHAIRMAN/DIRECTOR | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $1,973,321 | $323,705 |
| DR TIMOTHY JONES | |||||||
| DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $562,697 | $93,303 | |
| MR MATTHEW AUG | |||||||
| CHIEF EXECUTIVE OFFICER | 20.0 | 20.0 | Yes (X) | $0 | $394,021 | $23,101 | |
| DR NORMAN J MECHLIN | |||||||
| DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $372,407 | $16,468 | |
| MRS LISA ODOM | |||||||
| CHIEF FINANCIAL OFFICER | 20.0 | 20.0 | Yes (X) | $0 | $178,173 | $25,004 | |
| MS SUSAN BUTTS | |||||||
| CHIEF INFORMATION OFFICER | 20.0 | 20.0 | Yes (X) | $0 | $157,453 | $9,123 | |
| MS LOREE LINES | |||||||
| SECRETARY | 20.0 | 20.0 | Yes (X) | $0 | $57,752 | $10,492 | |
| DR MARK COSTLEY | |||||||
| CHAIRMAN/DIRCTOR | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $47,018 | $20,219 |
| MR JERRY G JARED | |||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| MR JOHN BRENT SINGLETON | |||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| MR ROBERT MCDOWELL | |||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| MS RITA M NEEDHAM | |||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,742,842 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $521,415 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CONNELL INSURANCE | |||||
| 511 BEE CREEK RD | BRANSON | MO | 65616 | BROKER COMMISSIONS | $806,207 |
| MULTIPLAN | |||||
| 115 FIFTH AVENUE | NEW YORK | NY | 10003 | NEGOTIATING SAVINGS | $777,160 |
| BARKER PHILLIPS JACKSON | |||||
| PO BOX 4207 | SPRINGFIELD | MO | 65808 | BROKER COMMISSIONS | $702,578 |
| FIRST HEALTH | |||||
| 3200 HIGHLAND AVE | DOWNERS GROVE | IL | 60515 | SAVINGS FEES | $624,439 |
| OLLIS AND COMPANY | |||||
| PO BOX 10346 | SPRINGFIELD | MO | 65808 | BROKER COMMISSIONS | $409,614 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PREMIUM INCOME | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $137,385,478 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $137,385,478 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $137,385,478 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $515,087 | TotalRevenueColumnAmt |
| Exclusion | $515,087 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,592,629 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,588,467 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,162 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,162 | TotalRevenueColumnAmt |
| Exclusion | $4,162 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,904,727 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $137,385,478 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $519,249 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,312,178 | TotalAmt |
| Program Services | $127,312,178 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,868,923 | TotalAmt |
| Management And General | $7,868,923 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,522,560 | TotalAmt |
| Program Services | $3,522,560 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,952 | TotalAmt |
| Management And General | $2,952 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PREMIUM TAX | $535,577 | $535,577 |
| PCORI FEE | $76,619 | $76,619 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,318,809 | TotalAmt |
| Program Services | $131,446,934 | ProgramServicesAmt |
| Management And General | $7,871,875 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $859 | BOYAmt |
| EOY | $202 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,219,216 | BOYAmt |
| EOY | $26,959,382 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,176,893 | BOYAmt |
| EOY | $3,576,103 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,156,194 | BOYAmt |
| EOY | $22,238,251 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,553,162 | BOYAmt |
| EOY | $52,773,938 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,587 | BOYAmt |
| EOY | $295,088 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,274,279 | BOYAmt |
| EOY | $2,928,965 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,389,240 | BOYAmt |
| EOY | $26,500,434 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,091,106 | BOYAmt |
| EOY | $29,724,487 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $800,000 | BOYAmt |
| EOY | $800,000 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,189,682 | BOYAmt |
| EOY | $39,189,682 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$15,527,626 | BOYAmt |
| EOY | -$16,940,231 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,462,056 | BOYAmt |
| EOY | $23,049,451 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,553,162 | BOYAmt |
| EOY | $52,773,938 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,414,082 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,477 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS AND CLAIMS PAYABLE | $25,290,739 |
| DUE TO RELATED PARTIES | $1,209,695 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,500,434 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $137,904,727 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $137,904,727 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $137,904,727 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $139,318,809 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $139,318,809 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $139,318,809 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | UNCERTAIN TAX POSITIONS: EFFECTIVE JANUARY 1, 2015, THE COMPANY ELECTED 501(C) NONPROFIT TAX-EXEMPT STATUS. AS A RESULT OF THIS ELECTION, THE COMPANY IS NO LONGER SUBJECT TO INCOME TAXES AT THE ENTITY LEVEL. THE COMPANY IS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2021 AND 2020. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR NORMAN J MECHLIN | ||||||||||||||
| DIRECTOR | $0 | $372,407 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $16,468 | $0 | $388,875 | $0 | $0 |
| DR TIMOTHY JONES | ||||||||||||||
| DIRECTOR | $0 | $526,181 | $0 | $35,826 | $0 | $690 | $0 | $75,750 | $0 | $17,553 | $0 | $656,000 | $0 | $0 |
| MR MATTHEW AUG | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $0 | $319,654 | $0 | $73,917 | $0 | $450 | $0 | $14,100 | $0 | $9,001 | $0 | $417,122 | $0 | $0 |
| MR STEVEN D EDWARDS | ||||||||||||||
| VICE CHAIRMAN/DIRECTOR | $0 | $1,232,639 | $0 | $441,501 | $0 | $299,181 | $0 | $301,267 | $0 | $22,438 | $0 | $2,297,026 | $0 | $284,930 |
| MRS LISA ODOM | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $144,540 | $0 | $32,943 | $0 | $690 | $0 | $9,580 | $0 | $15,424 | $0 | $203,177 | $0 | $0 |
| MS SUSAN BUTTS | ||||||||||||||
| CHIEF INFORMATION OFFICER | $0 | $156,163 | $0 | $0 | $0 | $1,290 | $0 | $0 | $0 | $9,123 | $0 | $166,576 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | ESTABLISHMENT OF TOP MANAGEMENT OFFICIAL COMPENSATION: LESTER E. COX MEDICAL CENTERS, A RELATED PARTY OF THE ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE COX HEALTH SYSTEMS INSURANCE COMPANY TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| SCHEDULE J, PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS PARTICIPATES IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS ("COX"). HE RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $286,767, AND AN EXECUTIVE DISTRIBUTION OF $284,930, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. |
| SCHEDULE J, PART II, COLUMN F | COMPENSATION REPORTED ON PRIOR FORM 990: AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN F, WERE REPORTED ON A PRIOR FORM 990 OF LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION. COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. DURING CALENDAR YEAR 2021, THERE WERE NO AMOUNTS REQUIRED TO BE REPORTED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY AND BUSINESS RELATIONSHIPS: STEVEN EDWARDS SERVES AS THE PRESIDENT AND CEO, AND MARK COSTLEY, LOREE LINES, MATTHEW AUG, LISA ODOM, SUSAN BUTTS, NORMAN MECHLIN, AND TIMOTHY JONES ARE ALL EMPLOYED BY LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION. NO COMPENSATION WAS PROVIDED FOR RESPONSIBILITIES ASSOCIATED WITH BEING A BOARD DIRECTOR. COMPENSATION REPORTED FOR BOARD MEMBERS LISTED ON FORM 990, PART VII, AND SCHEDULE J REPRESENTS EMPLOYEE OR INDEPENDENT CONTRACTOR COMPENSATION UNRELATED TO SERVICE AS A BOARD MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 6 | STOCKHOLDERS: THE STOCKHOLDER IS COX HEALTH SYSTEMS HMO, INC., A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION/APPOINTMENT OF BOARD MEMBERS: THE BOARD SHALL CONSIST OF NO LESS THAN EIGHT (8) AND NO MORE THAN TWENTY-ONE (21) DIRECTORS, WHO SHALL BE ELECTED AT THE ANNUAL MEETING OF THE STOCKHOLDER, COX HEALTH SYSTEMS HMO, INC. ONE (1) DIRECTOR SHALL RESIDE IN THE BRANSON, MISSOURI AREA, WHICH IS DEFINED AS THE SKAGGS COMMUNITY HOSPITAL ASSOCIATION D/B/A COX MEDICAL CENTER BRANSON (CMCB) SERVICE AREA INCLUDING STONE AND TANEY COUNTIES (CMCB DIRECTOR). THE BOARD SHALL RECEIVE NOMINATIONS FROM THE CMCB BOARD PRIOR TO THE ANNUAL MEETING FOR ELECTION AS DIRECTOR. THE BOARD OF DIRECTORS OF COX MEDICAL GROUP (CMG) SHALL NOMINATE TWO (2) PHYSICIANS TO SERVE ON THE BOARD (EACH A CMG DIRECTOR). ONE CMG DIRECTOR SHALL BE EMPLOYED BY FERRELL-DUNCAN CLINIC, INC. AND THE OTHER SHALL BE EMPLOYED BY LESTER E. COX MEDICAL CENTERS (MEMBER), EMPLOYED BY CMG, OR EMPLOYED BY MEMBER AND LEASED TO CMG. THE BOARD SHALL RECEIVE NOMINATIONS FROM THE CMG BOARD PRIOR TO THE ANNUAL MEETING AT WHICH DIRECTORS ARE ELECTED. |
| FORM 990, PART VI, SECTION A, LINE 7B | STOCKHOLDER POWERS: ALTERATIONS, AMENDMENTS, OR REPEALS OF THE BYLAWS MAY BE MADE BY A MAJORITY OF THE STOCKHOLDERS ENTITLED TO VOTE AT ANY MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ORGANIZATION. THE FORM 990 IS PROVIDED TO THE DIRECTOR OF ACCOUNTING AND CFO FOR A DETAILED REVIEW TO ENSURE ACCURACY. A COPY IS THEN PROVIDED TO THE CEO AND GOVERNING BODY FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: COXHEALTH OFFICERS, DIRECTORS AND KEY EMPLOYEES, AS WELL AS OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE COXHEALTH AFFILIATES AND/OR COMMITTEES WITH DELEGATED AUTHORITY TO MAKE DECISIONS, ARE ANNUALLY REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST FOLLOWING THE POLICY SET FORTH BELOW. THE POLICY REQUIRES THAT BOARD MEMBERS MAKE DECISIONS THAT ARE CONFLICT FREE, OR IF A CONFLICT IS PRESENT, THAT IT IS FULLY DISCLOSED FOR THE BOARD'S CONSIDERATION. COXHEALTH'S EMPLOYEES AND BOARD MEMBERS MUST AVOID ALL ACTIVITIES, ASSOCIATIONS OR INTERESTS THAT CREATE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST FOR EMPLOYEES MUST BE REPORTED TO THE CORPORATE INTEGRITY DEPARTMENT. A FILE WILL BE MAINTAINED OF ALL REPORTED CONFLICTS OF INTEREST. FOR MEDICAL STAFF MEMBERS, THE CONFLICT OF INTEREST PROCESS MAY BE ACCESSED THROUGH THE MEDICAL STAFF OFFICE. FOR BOARD MEMBERS, THE CONFLICT OF INTEREST PROCESS IS HANDLED THROUGH THE GOVERNANCE SUB-COMMITTEE OF THE BOARD WITH THE ASSISTANCE OF THE EXECUTIVE OFFICE AND IS DEFINED IN THE CHARTER OF THE GOVERNANCE SUB-COMMITTEE. IF ANY OFFICER OR DIRECTOR IS FOUND TO HAVE A CONFLICT OF INTEREST, SUCH PERSON SHALL NEITHER VOTE NOR USE HIS OR HER INFLUENCE TO AFFECT ANY DECISION RELATING TO THE CONFLICT, AND SUCH PERSON SHOULD NOT BE INCLUDED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION. SUCH PERSON IS PERMITTED TO BRIEFLY STATE HIS OR HER POSITION ON THE MATTER, AND ANSWER PERTINENT QUESTIONS ABOUT IT, IF HIS OR HER KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. FOR VENDORS, THE POLICY IS DISTRIBUTED WITH THEIR INITIAL CONTRACT WITH COXHEALTH. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION REVIEW: COXHEALTH EMPLOYS A DEFINED GOVERNANCE STRUCTURE AROUND EXECUTIVE COMPENSATION. THE BOARD OF DIRECTORS MAINTAINS A COMPENSATION COMMITTEE THAT IS CHARGED WITH CARRYING OUT THE FUNCTIONS OF EVALUATING AND SETTING EXECUTIVE COMPENSATION THROUGH FORMAL DOCUMENTED MEETINGS THAT OCCUR SEVERAL TIMES DURING THE YEAR. THE COMPENSATION COMMITTEE UTILIZES A WELL RESPECTED INDEPENDENT EXTERNAL ADVISOR TO PROVIDE THIRD PARTY ASSESSMENTS AND RECOMMENDATIONS REGARDING COMPENSATION LEVELS AND BENEFIT PROGRAMS FOR THE TOP EXECUTIVES OF THE ORGANIZATION TO ENSURE THE COMPENSATION PROGRAM IS COMPETITIVE AND WITHIN FAIR MARKET VALUE. AFTER A FULL REVIEW OF THE DATA AND THOROUGH DISCUSSION THE COMMITTEE MAKES A SELF DETERMINATION OF COMPENSATION LEVELS SET JANUARY 1 OF EACH YEAR. ANNUALLY THE STEPS NECESSARY TO DOCUMENT REBUTTABLE PRESUMPTION ARE TAKEN AND RECORDED. ADDITIONALLY, COMPENSATION LEVELS FOR THE VICE PRESIDENT TIER OF MANAGEMENT IS OVERSEEN BY THE CEO USING EXTERNAL COMPARABLE DATA FOR ASSESSMENT AND IS PROVIDED TO THE COMPENSATION COMMITTEE FOR REVIEW ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: COX HEALTH SYSTEMS INSURANCE COMPANY'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FOR PUBLIC INSPECTION AS AN ATTACHMENT TO THE APPLICATION FOR RECOGNITION OF EXEMPTION. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $ 1,477 CHANGE IN NONADMITTED ASSETS |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| COX HEALTH SYSTEMS HMO INC | ||||||||||
| PO BOX 5750 | SPRINGFIELD | MO | 65801 | 431757075 | INSURANCE | MO | 501(C)4 | COXHEALTH | false | |
| LESTER E COX MEDICAL CENTERS | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 440577118 | HOSPITAL | MO | 501(C)3 | COXHEALTH | false | 3 |
| COXHEALTH FOUNDATION | ||||||||||
| 3525 S NATIONAL SUITE 204 | SPRINGFIELD | MO | 65807 | 436810485 | FUNDRAISING | MO | 501(C)(3) | LESTER E COX | false | 12AI |
| COX HPS OF THE OZARKS INC | ||||||||||
| 2220 W SUNSET | SPRINGFIELD | MO | 65807 | 431641927 | HOME HEALTH | MO | 501(C)(3) | LESTER E COX | false | 10 |
| COX-MONETT HOSPITAL INC | ||||||||||
| 801 N LINCOLN AVE | MONETT | MO | 65708 | 431656689 | HOSPITAL | MO | 501(C)(3) | LESTER E COX | false | 3 |
| HEALTH ENRICHMENT SERVICERS INC | ||||||||||
| 3801 S NATIONAL | SPRINGFIELD | MO | 65807 | 363263313 | MED SERVICES | MO | 501(C)(3) | LESTER E COX | false | 7 |
| HC SVCS OZARKS INC DBA COXHEALTH AT HOME | ||||||||||
| PO BOX 10939 | SPRINGFIELD | MO | 65808 | 431641928 | HOME HEALTH | MO | 501(C)(3) | LESTER E COX | false | 10 |
| PRIMROSE PLACE | ||||||||||
| 1115 E PRIMROSE | SPRINGFIELD | MO | 65807 | 431641928 | SUPPORT | MO | 501 (C)(3) | LESTER E COX | false | 12AI |
| COX MEDICAL CTR GENPROF LIAB LOSS FUND | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 366668576 | SELF-INSURANC | MO | 501(C)(3) | LESTER E COX | false | 12AI |
| SKAGGS COMM HOSP ASSOC (COX MC BRANSON) | ||||||||||
| 525 BRANSON LANDING BLVD | BRANSON | MO | 65616 | 440584290 | HOSPITAL | MO | 501(C)(3) | LESTER E COX | false | 3 |
| COX COLLEGE | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 475148345 | EDUCATION | MO | 501(C)(3) | LESTER E COX | false | 2 |
| COXHEALTH | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 471087427 | HOLDING CO | MO | 501(C)(3) | NA | false | 12B |
| COX MEDICAL GROUP | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 471087566 | PHYSCIANS | MO | 501(C)(3) | COXHEALTH | false | 10 |
| COX MEDICAL GROUP CLINICS | ||||||||||
| 3801 S NATIONAL | SPRINGFIELD | MO | 65807 | 371830627 | HEALTHCARE | MO | 501(C)(3) | COXHEALTH | false | 10 |
| COX BARTON COUNTY HOSPITAL | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 823300758 | HOSPITAL | MO | 501(C)(3) | COXHEALTH | false | 3 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 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 | Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL DEVELOPMENTS | ||||||||||||||
| 1423 N JEFFERSON AVE | SPRINGFIELD | MO | 65802 | 431622182 | PHARMACY | MO | LESTER E COX | C CORP | false | |||||
| INSURANCE COMPANY OF SPRINGFIELD INC | ||||||||||||||
| CAPTIVE INSUR | LESTER E COX | C CORP | false | GRAND PAVILLION CORPORATE CENTRE | GRAND CAYMAN | CJ | KY1-11 | CJ | ||||||
| COX TAXABLE CLOSE CORPORATION | ||||||||||||||
| 1423 N JEFFERSON AVE | SPRINGFIELD | MO | 65802 | 472573263 | MEDICAL CLINI | MO | COX MED GROUP | C CORP | false | |||||
| FERRELL-DUNCAN CLINIC INC | ||||||||||||||
| 1001 E PRIMROSE | SPRINGFIELD | MO | 65808 | 430991578 | PHYSICIANS | MO | CTCC | C CORP | false | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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