2022-10-28T19:42:52-05:00 2021-12-31 111986323 MARCUM LLP 1899 L STREET NW SUITE 850 WASHINGTON DC 20036 990 2021-01-01 200413676 HEALTHWELL FOUNDATION HEAL 2406325305 20440 CENTURY BOULEVARD 250 GERMANTOWN MD 20874 STEPHEN M WEINER BOARD CHAIR 2406325305 2022-10-28 1 STEPHEN WEINER 999009999 AARON M FOX P01365820 2022274000 2022-10-28 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z STEPHEN M WEINER 20440 CENTURY BOULEVARD 250 GERMANTOWN MD 20874 597521136 0 X WWW.HEALTHWELLFOUNDATION.ORG X 2003 VA HELP ELIGIBLE PATIENTS WITH CHRONIC OR LIFE-ALTERING DISEASES AFFORD THEIR MEDICAL TREATMENTS. 8 8 151 0 0 0 546256983 538184808 0 0 12490776 16076471 0 0 558747759 554261279 437532753 610136983 0 0 9125591 13452033 313550 386661 871663 5186651 5967989 452158545 629943666 106589214 -75682387 604913332 529554117 22794136 25238410 582119196 504315707 X HEALTHWELL FOUNDATION (THE FOUNDATION) REDUCES FINANCIAL BARRIERS TO CARE FOR UNDERINSURED PATIENTS WITH CHRONIC OR LIFE-ALTERING DISEASES. HEALTHWELL'S VISION IS TO ENSURE THAT NO PATIENT - ADULT OR CHILD - GOES WITHOUT MEDICAL TREATMENTS BECAUSE THEY CANNOT AFFORD THEM. 0 0 168135449 164811865 MULTIPLE MYELOMA - MEDICARE ACCESS - PROVIDED DEDUCTIBLE, COINSURANCE, COPAYMENT AND PREMIUM ASSISTANCE TO 28,364 ELIGIBLE MEDICARE PATIENTS RECEIVING TREATMENT FOR MULTIPLE MYELOMA. 44379122 43636359 PROSTATE CANCER - MEDICARE ACCESS - PROVIDED DEDUCTIBLE, COINSURANCE, COPAYMENT AND PREMIUM ASSISTANCE TO 12,116 ELIGIBLE PATIENTS RECEIVING TREATMENT FOR PROSTATE CANCER. 43948488 43475341 PULMONARY FIBROSIS - PROVIDED DEDUCTIBLE, COINSURANCE, COPAYMENT AND PREMIUM ASSISTANCE TO 9,237 ELIGIBLE PATIENTS BEING TREATED FOR PULMONARY FIBROSIS. 369424630 358213418 HEPATITIS C, CHRONIC LYMPHOCYTIC LEUKEMIA, POST-MENOPAUSAL OSTEOPOROSIS - MEDICARE ACCESS, BREAST CANCER - MEDICARE ACCESS, HYPERCHOLESTEROLEMIA - MEDICARE ACCESS, ACUTE MYELOID LEUKEMIA, TARDIVE DYSKINESIA - MEDICARE ACCESS, CYSTIC FIBROSIS TREATMENTS, SECONDARY HYPERPARATHYROIDISM, RENAL CELL CARCINOMA - MEDICARE ACCESS, BONE METASTASES - MEDICARE ACCESS, SYSTEMIC LUPUS ERYTHEMATOSUS, CYSTIC FIBROSIS VITAMINS AND SUPPLEMENTS, NON-SMALL CELL LUNG CANCER - MEDICARE ACCESS, CHEMOTHERAPY-INDUCED NEUTROPENIA - MEDICARE ACCESS, MANTLE CELL LYMPHOMA, MELANOMA - MEDICARE ACCESS, COVID-19, MACULAR DEGENERATION (WET AND DRY), PEYRONIE'S DISEASE, SMALL CELL LUNG CANCER - MEDICARE ACCESS, OVARIAN CANCER - MEDICARE ACCESS, AMYOTROPHIC LATERAL SCLEROSIS, COLORECTAL CARCINOMA - MEDICARE ACCESS, DUPUYTREN'S DISEASE, URTICARIA, GOUT - MEDICARE ACCESS, CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY, HUNTINGTON'S DISEASE - MEDICARE ACCESS, PEDIATRIC ASSISTANCE, CHRONIC HEART FAILURE - MEDICARE ACCESS, ACROMEGALY, GIANT CELL ARTERITIS OR TEMPORAL ARTERITIS - MEDICARE ACCESS, AMYLOIDOSIS, BLADDER AND UROTHELIAL CANCER - MEDICARE ACCESS, HEAD AND NECK CANCER - MEDICARE ACCESS, ASTHMA, PROSTATE CANCER - MEDICARE ACCESS, ANCA - ASSOCIATED VASCULITIS, WEGENER'S AND GRANULOMATOSIS WITH POLYANGIITIS, LAMBERT-EATON MYASTHENIC SYNDROME, MOVEMENT DISORDERS - MEDICARE ACCESS, IMMUNOSUPPRESSIVE TREATMENT FOR SOLID ORGAN TRANSPLANT RECIPIENTS - MEDICARE ACCESS, CHRONIC MYELOID LEUKEMIA - MEDICARE ACCESS, MIGRAINE, OTHER, SICKLE CELL DISEASE, GASTRIC CANCER - MEDICARE ACCESS, CYTOMEGALOVIRUS DISEASE - PREVENTION AND TREATMENT, B-CELL LYMPHOMA - MEDICARE ACCESS, NON HODGKINS LYMPHOMA - MEDICARE ACCESS, DIABETIC FOOT ULCERS, GLIOBALSTOMA MULTIFORME/ANAPLASTIC ASTROCYTOMA, HEALTH ACCESS, NONTUBERCULOUS MYCOBACTERIUM - MEDICARE ACCESS, CANCER - RELATED BEHAVIORAL HEALTH, HOMOCYSTINURIA, NEUROCOGNITIVE DISEASE WITH PSYCHOSIS - MEDICARE ACCESS, PORPHYRIAS, HYPEROXALURIA 369424630 358213418 625887689 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 20 0 1 151 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AK AZ AR CA CT FL GA HI IL KS KY LA ME MD MA MI MN MS NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VT VA WA WV WI CO DE ID IN IA MO MT NE NV SD TX WY X X X KRISTA ZODET 2406325305 20440 CENTURY BLVD STE 250 GERMANTOWN MD 20874 JERRI SCARZELLA BSN VICE CHAIR & TREASURER 1.00 X X 12000 0 0 DAVID L KNOWLTON VICE CHAIR & SECRETARY 1.00 X X 32156 0 0 STEPHEN M WEINER BOARD CHAIR 2.00 X X 20563 0 0 CATHLEEN BENNETT ESQ BOARD MEMBER 1.00 X 12000 0 0 NANCY CARTERON MD FACR BOARD MEMBER 1.00 X 13313 0 0 DAVID F ERTEL BOARD MEMBER 1.00 X 9000 0 0 DON LISS MD BOARD MEMBER 1.00 X 0 0 0 SUZANNE M MILLER PHD BOARD MEMBER 1.00 X 12000 0 0 ALAN KLEIN CHIEF DEVELOPMENT OFFICER 40.00 X 329342 0 25276 KRISTA ZODET PRESIDENT 40.00 X 314819 0 23593 SHELA HALPER SENIOR FOUNDATION PROGRAM OFFICER 40.00 X 215361 0 32695 COLLIN ALEXANDER DIRECTOR OF FINANCE 40.00 X 177079 0 41257 FRED ASIEDU LARBI DIRECTOR OF OPERATIONS 40.00 X 198980 0 18039 VIRGINIA DUNN SR. ASSOCIATE DIRECTOR, COMM. & MKT 40.00 X 129521 0 41786 ERICA MATA ASSOCIATE DIRECTOR OF OPERATIONS 40.00 X 104155 0 42731 TIM VAWTER ASSOCIATE DIRECTOR OF IT 40.00 X 104805 0 33815 CESAR MARTINEZ SOLUTIONS ARCHITECT 40.00 X 105774 0 32020 LORRIN ROSEN SENIOR MANAGER, HUMAN RESOURCES 40.00 X 104155 0 30723 1895023 0 321935 10 0 1 0 PHARMACY DATA MANAGEMENT INC 8530 CROSSROADS DR POLAND OH 44514 PHARMACY CLAIMS PROCESSING 913806 AB DATA COMPENSATION 600 A B DATA DRIVE MILWAUKEE WI 53217 DIRECT MAIL SERVICES 364451 BAKER DONELSON 901 K STREET NW WASHINGTON DC 20005 LEGAL SERVICES 282083 EXPERIAN HEALTH INC 720 COOL SPRINGS BLVD 200 FRANKLIN TN 37067 VERIFICATION SVCS FOR APPLICANTS 238694 SALESFORCEORG 50 FREMONT SUITE 300 SAN FRANSISCO CA 94105 GRANT MANAGEMENT SYSTEM 233803 8 538184808 538184808 9540057 9540057 49796271 43259857 6536414 6536414 6536414 554261279 0 0 16076471 610136983 610136983 1523599 404952 854305 264342 9152694 8536267 570183 46244 279463 248243 28918 2302 1694038 1495967 161428 36643 802239 698611 83451 20177 738588 487441 251147 215887 147114 68773 74990 74990 386661 386661 241178 241178 2073842 1928123 130610 15109 825377 423345 378170 23862 867915 800514 67401 590848 509290 64136 17422 44422 1428 13576 29418 50501 1696 42510 6295 12228 6707 5521 102699 51081 48136 3482 72357 72357 DUES & SUBS 57157 9927 27524 19706 629943666 625887689 3184314 871663 69909065 64073571 73009100 65861781 70378438 29995974 410493 628317 2348249 1716012 488837 632237 390675195 368288033 42204 74204 604913332 529554117 15320049 17901541 1198512 6275575 7336869 22794136 25238410 X 52046936 59689288 530072260 444626419 582119196 504315707 604913332 529554117 -75682387 -2121102 0 X X 0 1 X 1 0 X 350046179 427570435 481424153 546256983 538184808 2343482558 350046179 427570435 481424153 546256983 538184808 2343482558 1575305185 768177373 3017353 7058197 7173067 7417028 9540057 34205702 2377688260 0.32310 0.28460 X THE HEALTHWELL FOUNDATION (THE "FOUNDATION") OFFERS THE FOLLOWING FACTS AND CIRCUMSTANCES IN SUPPORT OF ITS ONGOING CLASSIFICATION AS A PUBLIC CHARITY AND NOT A PRIVATE FOUNDATION.GENERAL BACKGROUND - THE FOUNDATION PROVIDES NEED-BASED FINANCIAL ASSISTANCE TO UNDERINSURED INDIVIDUALS LIVING WITH CHRONIC AND/OR LIFE-ALTERING DISEASES SUCH AS MULTIPLE SCLEROSIS, CYSTIC FIBROSIS, MULTIPLE MYELOMA AND MANY OTHER TYPES OF CANCER. THROUGH 2021, THE FOUNDATION HAS HELPED 727,986 PATIENTS AFFORD THEIR PRESCRIPTION DRUG COPAYMENTS, PREMIUMS AND OTHER OUT-OF-POCKET HEALTH CARE COSTS.THE FOUNDATION GRANTS FUNDS TO PATIENTS WHO HAVE PRIVATE OR GOVERNMENT-SPONSORED INSURANCE BUT WHO ARE STILL UNABLE TO AFFORD THEIR INSURANCE COPAYMENTS OR PREMIUMS TO OBTAIN COVERAGE FOR THEIR CONDITIONS. THE FOUNDATION AWARDS GRANTS BASED ON THE OBJECTIVE CONSIDERATION OF FINANCIAL AND MEDICAL CRITERIA AND THE ADEQUACY OF THE RECIPIENT'S INSURANCE COVERAGE. GRANTS ARE AWARDED TO RECIPIENTS FOR A 12 MONTH CYCLE. THE FOUNDATION DOES NOT PLACE RESTRICTIONS ON THE MEDICATIONS WITHIN EACH DISEASE FUND ITS GRANT RECIPIENTS USE. THE DECISION AS TO WHICH MEDICATIONS ARE PRESCRIBED IS A MEDICAL JUDGMENT. FURTHER, THE FOUNDATION DOES NOT LIMIT THE PROVIDERS OR PHARMACIES ITS GRANT RECIPIENTS MAY USE TO OBTAIN THEIR MEDICATIONS.PUBLIC SUPPORT PERCENTAGE - THE FOUNDATION'S CUMULATIVE PUBLIC SUPPORT PERCENTAGE THROUGH DECEMBER 31, 2021 IS 32.31%, WHICH IS ABOVE THE MINIMUM AMOUNT AT WHICH FACTS AND CIRCUMSTANCES WILL BE CONSIDERED BY THE SERVICE IN DETERMINING THE FOUNDATION'S ONGOING QUALIFICATION AS A PUBLICLY SUPPORTED CHARITY. THE FOUNDATION'S PUBLIC SUPPORT PERCENTAGE HAS GENERALLY MAINTAINED AN UPWARD TRAJECTORY SINCE 2004, WITH A SMALL FLUCTUATION DOWN IN 2018; THE FACTS AND CIRCUMSTANCES RELATING TO THE FOUNDATION'S STRUCTURE AND OPERATIONS PRESENT AN EXCEPTIONALLY STRONG CASE IN SUPPORT OF ITS ONGOING CLASSIFICATION AS A PUBLIC CHARITY AND NOT AS A PRIVATE FOUNDATION. THESE FACTS AND CIRCUMSTANCES, WHICH ARE DISCUSSED IN MORE DETAIL LATER, INCLUDE THE FOLLOWING:1. THE FOUNDATION IS NOT CONTROLLED BY ITS CONTRIBUTORS AND HAS NO ENDOWMENT FUND, CHARACTERISTICS WHICH DISTINGUISH IT FROM VIRTUALLY ALL PRIVATE FOUNDATIONS.2. THE FOUNDATION'S BOARD REPRESENTS MANY DIVERSE ASPECTS OF THE HEALTH CARE COMMUNITY, DEMONSTRATING THE FOUNDATION'S COMMITMENT TO THE BROAD PUBLIC BENEFIT AND THE FOUNDATION'S COMMITMENT TO OPERATE AN OUTSTANDING ORGANIZATION THAT WILL ATTRACT FUTURE PUBLIC SUPPORT.3. THE FOUNDATION'S ACTIVITIES BROADLY BENEFIT THE GENERAL PUBLIC AS WELL AS OTHER CHARITABLE ORGANIZATIONS THAT ARE ATTEMPTING TO HELP PATIENTS COPE WITH A VARIETY OF ILLNESSES AND CONDITIONS.FACTS AND CIRCUMSTANCES SUPPORTING QUALIFICATION AS A PUBLICLY SUPPORTED ORGANIZATION1. ATTRACTION OF PUBLIC SUPPORT. THE FOUNDATION'S POLICY IS TO ACCEPT CONTRIBUTIONS FROM DONORS AND TO DISBURSE THE CONTRIBUTIONS IN THE FORM OF GRANTS AS SOON AS PRACTICABLE. THE FOUNDATION DOES NOT HAVE AN ENDOWMENT FUND, AND ITS ABILITY TO FULFILL ITS FUTURE MISSION IS ENTIRELY DEPENDENT ON ITS ABILITY TO ATTRACT FUTURE SUPPORT FROM DONORS ON A CONTINUOUS BASIS. NONE OF THE FOUNDATION'S HISTORICAL SUBSTANTIAL CONTRIBUTORS HAVE PLEDGED OR OTHERWISE COMMITTED TO CONTINUE TO SUPPORT THE FOUNDATION IN FUTURE YEARS. THEREFORE, THE FOUNDATION MUST CONTINUALLY SEEK NEW DONORS TO SUSTAIN ITS FUNDS, AND IT HAS DONE SO. SPECIFICALLY:- THE FOUNDATION EMPLOYS 151 PERSONS WHO, IN ADDITION TO THEIR PRIMARY TASKS, MAY ALSO WORK ON FUNDRAISING PROJECTS AS NEEDED.- THE FOUNDATION'S CORPORATE CUMULATIVE DONOR BASE HAS INCREASED EACH YEAR FROM ONE CORPORATE DONOR IN 2004 TO 66 CORPORATE DONORS.- THE FOUNDATION'S CHIEF DEVELOPMENT OFFICER WORKS WITH THE PRESIDENT AND BOARD TO IDENTIFY AND PURSUE NEW CORPORATE FUNDRAISING OPPORTUNITIES.- THE FOUNDATION'S SENIOR FOUNDATION PROGRAM OFFICER WORKS TO IDENTIFY AND SECURE PARTNERS AND SPONSORS FOR THE FOUNDATION'S BROAD-BASED SPECIAL INITIATIVES, INCLUDING ITS PEDIATRIC ASSISTANCE AND CANCER-RELATED BEHAVIORAL HEALTH FUNDS.- THE FOUNDATION'S SENIOR FOUNDATION PROGRAM OFFICER ALSO ENGAGES A LARGE NETWORK OF DISEASE-ALIGNED NON-PROFITS TO PROMOTE THE FOUNDATION PROGRAM AND SPECIFIC DISEASE AREA FUNDS TO THEIR NETWORKS.- THE FOUNDATION REGULARLY SOLICITS SUPPORT FROM PRIVATE INDIVIDUALS, WHICH HAS RESULTED IN DONATIONS FROM MORE THAN 63,580 INDIVIDUAL DONORS. 2. REPRESENTATIVE GOVERNING BODY. THE FOUNDATION'S BOARD CONSISTS ENTIRELY OF NATIONALLY-RECOGNIZED HEALTH CARE EXPERTS WITH DEEP EXPERIENCE IN THE FIELDS OF HEALTH CARE ADMINISTRATION, ACADEMIC (TEACHING, TRAINING AND RESEARCH), CLINICAL PRACTICE AND RESEARCH, DIRECT PATIENT CARE, PATIENT ADVOCACY AND HEALTH LAW. THE COMPOSITION OF THE BOARD EXEMPLIFIES THE FOUNDATION'S COMMITMENT TO REPRESENT THE BROAD INTERESTS OF THE GENERAL PUBLIC AND TO OPERATE IN A MANNER THAT WILL ATTRACT ATTENTION - AND SUPPORT - FROM A BROAD RANGE OF POTENTIAL DONORS.GIVEN THEIR DIVERSE EXPERTISE, THE FOUNDATION'S BOARD MEMBERS BRING FORWARD A VARIETY OF IMPORTANT ISSUES TO ENCOURAGE DISCUSSION ABOUT HOW THE FOUNDATION'S PROGRAMS AND SERVICES WILL DIRECTLY IMPACT THE GENERAL PUBLIC. THEIR WIDE-RANGING OPINIONS HELP TO EXPAND THE FOUNDATION'S VIEWPOINT AND RESULT IN AN ORGANIZATION THAT CAN RESPOND SUCCESSFULLY TO IMPORTANT CHANGES IN THE HEALTH CARE ENVIRONMENT.SIGNIFICANTLY, NONE OF THE FOUNDATION'S BOARD MEMBERS ARE AFFILIATED WITH ANY CONTRIBUTOR TO THE FOUNDATION AND IT IS THE FOUNDATION'S STRICT POLICY THAT THERE NOT BE SUCH AFFILIATIONS. MOREOVER, NO CONTRIBUTOR HAS THE POWER TO APPOINT DIRECTORS TO THE FOUNDATION'S BOARD. IN THIS REGARD, THE FOUNDATION DIFFERS MARKEDLY FROM A PRIVATE FOUNDATION, WHERE THE GOVERNING BODY IS TYPICALLY COMPOSED OF SUBSTANTIAL CONTRIBUTORS AND/OR MEMBERS CHOSEN BY SUBSTANTIAL CONTRIBUTORS. 3. AVAILABILITY OF PUBLIC FACILITIES OR SERVICES; PUBLIC PARTICIPATION IN PROGRAMS OR POLICIES. THE FOUNDATION PUTS FORTH SIGNIFICANT EFFORTS TO MAKE THE AVAILABILITY OF ITS PROGRAMS AND SERVICES KNOWN TO THE GENERAL PUBLIC THROUGH AVENUES SUCH AS ITS WEBSITE (WWW.HEALTHWELLFOUNDATION.ORG), WHERE PATIENTS, PROVIDERS, PHARMACIES AND ADVOCATES CAN OBTAIN INFORMATION ON THE FOUNDATION'S PROGRAM, APPLY ONLINE AND, THROUGH INTERACTIVE PORTALS, MANAGE A PATIENT'S PORTFOLIO OF GRANTS (PROVIDERS AND PHARMACIES) OR MONITOR THEIR OWN GRANT (PATIENTS). THESE AVENUES ARE UPDATED CONTINUOUSLY AND MONITORED CLOSELY THROUGHOUT THE YEAR. THE FOUNDATION ENGAGES IN A WIDE RANGE OF PROMOTIONAL OUTREACH ACTIVITIES, INCLUDING MEDIA RELATIONS AND OUR REAL WORLD HEALTH CARE BLOG ACTIVITIES (HEALTHWELLFOUNDATION.ORG/REALWORLDHEALTHCARE) IN ADDITION TO TARGETED SOCIAL MEDIA CAMPAIGNS TO EDUCATE THE PUBLIC, PROVIDERS, PHARMACIES AND OTHER HEALTH-RELATED ORGANIZATIONS ABOUT ITS WORK. NEWS ABOUT THE FOUNDATION'S PROGRAMS REGULARLY APPEARS IN LOCAL AND NATIONAL PUBLICATIONS, INCLUDING MEDICAL JOURNALS, NEWSPAPERS, MAGAZINES, BLOGS AND HEALTH CARE WEBSITES. TYPICALLY, REPRESENTATIVES OF THE FOUNDATION REGULARLY ATTEND NATIONAL AND LOCAL CONFERENCES INCLUDING THOSE OF SUCH ENTITIES AS INFORMA'S PATIENT ASSISTANCE AND ACCESS PROGRAMS (PAP), THE LIVER MEETING, AMERICAN SOCIETY OF CLINICAL ONCOLOGY, NORTH AMERICAN CYSTIC FIBROSIS CONFERENCE, ASEMBIA SPECIALTY PHARMACY SUMMIT, AND AMERICAN SOCIETY OF HEMATOLOGY. COVID-19 AND TRAVEL RESTRICTIONS PREVENTED REPRESENTATIVES FROM PARTICIPATING IN LIVE EVENTS THROUGHOUT MUCH OF 2021, BUT OPERATIONS SLOWLY BEGAN TO RETURN TO NORMAL DURING THE THIRD AND FOURTH QUARTERS. THE FOUNDATION WAS ABLE TO MAKE APPEARANCES AT HEALTHCARE ADVOCATE SUMMIT, AMERICAN SOCIETY OF HEMATOLOGY (ASH) ANNUAL MEETING, ASEMBIA SPECIALTY PHARMACY SUMMIT, AND THE COUPON AND COPAY CONFERENCE. ADDITIONALLY, WHEN THE FOUNDATION ESTABLISHES A NEW FUND WITH RESPECT TO A PARTICULAR DISEASE OR CONDITION, THE FOUNDATION:- IDENTIFIES KEY NATIONAL PATIENT SUPPORT AND HEALTH CARE ORGANIZATIONS THAT ARE ABLE TO REACH OUT TO PATIENTS IN THE NEW FUND AREA.- IDENTIFIES APPROPRIATE CONTACTS IN EACH ORGANIZATION THAT FOCUS ON PATIENT ADVOCACY AND/OR REIMBURSEMENT ISSUES. - INVITES THESE ORGANIZATIONS TO EDUCATE PATIENTS, PROVIDERS, ADVOCATES AND THEIR BROADER NETWORKS ABOUT THE FOUNDATION'S PROGRAMS BY POSTING A LINK TO WWW.HEALTHWELLFOUNDATION.ORG ON THEIR WEBSITES, PROMOTING VIA SOCIAL MEDIA AND/OR INCLUDING INFORMATION ABOUT THE FOUNDATION'S SERVICES IN THEIR MARKETING AND EDUCATIONAL MATERIALS AS WELL AS THEIR WEBINARS AND CONFERENCES. - ISSUES A PRESS RELEASE TO ANNOUNCE A NEW FUND TO THE MEDIA, PATIENT ADVOCACY GROUPS AND THE BROADER HEALTH CARE COMMUNITY.- REACHES OUT TO PROSPECTIVE DONORS TO SOLICIT ADDITIONAL SUPPORT FOR THE DISEASE AREA.- PROMOTES THE NEW FUND IN ITS NEWSLETTER, "THE PULSE," WHICH REACHES APPROXIMATELY 111,000 INDIVIDUALS 2 TO 4 TIMES A YEAR, AND THROUGH SOCIAL MEDIA. PART II, SECTION C, LINE 17A, FACTS AND CIRCUMSTANCES TEST: FURTHERMORE, THE FOUNDATION IS REFERENCED BY, OR IS LINKED TO, THE WEBSITES OF A NUMBER OF ORGANIZATIONS THAT DIRECT PATIENTS FOR COPAYMENT AND PREMIUM ASSISTANCE. SUCH ORGANIZATIONS INCLUDE PARTNERSHIP FOR PRESCRIPTION ASSISTANCE, AMERICAN CANCER SOCIETY, CMS, BONE HEALTH & OSTEOPOROSIS FOUNDATION, INTERNATIONAL MYELOMA FOUNDATION, NATIONAL MS SOCIETY, COMMUNITY LIVER ALLIANCE, LUPUS FOUNDATION OF AMERICA, CANCERCARE, ANXIETY AND DEPRESSION ASSOCIATION OF AMERICA, ASSOCIATION OF COMMUNITY CANCER CENTERS AND NEEDYMEDS, AMONG OTHERS. CONCLUSION IN SUMMARY, THE HEALTHWELL FOUNDATION HAS THE CHARACTERISTICS OF A "PUBLICLY SUPPORTED ORGANIZATION, BASED ON THE FACTS AND CIRCUMSTANCES TEST DESCRIBED IN SECTION 1.170A-9(E)(3) OF THE TREASURY REGULATIONS. SPECIFICALLY, A SMALL NUMBER OF DONORS DO NOT CONTROL HEALTHWELL; RATHER HEALTHWELL IS A GROWING INSTITUTION THAT BEARS MANY OF THE INDICIA OF A "PUBLICLY SUPPORTED ORGANIZATION, INCLUDING PUBLIC SUPPORT FROM A WIDE CROSS-SECTION OF DONORS WITH A REPRESENTATIVE GOVERNING BODY. MOREOVER, HEALTHWELL IS CONTINUING TO SEEK NEW SOURCES OF SUPPORT FROM THE GENERAL PUBLIC AS WELL AS OTHER ORGANIZATIONS. ACCORDINGLY, THE FOUNDATION QUALIFIES AS A "PUBLICLY SUPPORTED ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(VI). RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 121560 43282 78278 435187 164503 270684 1791502 1508227 283275 632237 COPAYMENTS AND PREMIUM ASSISTANCE PAYABLE 7178295 DEFERRED RENT 158574 7336869 X 551898999 -2121102 -2121102 554020101 241178 241178 554261279 629702488 0 629702488 241178 241178 629943666 PART X, LINE 2: THE FOUNDATION EVALUATED ITS UNCERTAINTY IN INCOME TAXES FOR THE YEAR ENDED DECEMBER 31, 2021, AND DETERMINED THAT THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OR THAT MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS. X X 1 AB DATA GROUP 600 A B DATA DRIVE MILWAUKEE WI 53217 DIRECT MAIL CAMPAIGN 0 1410540 364451 1046089 1410540 364451 1046089 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE FOUNDATION PAID IN TOTAL $364,451 TO A.B. DATA GROUP OF WHICH $193,766 WAS FOR EXPENSE REIMBURSEMENTS. 1 MULTIPLE MYELOMA - MEDICARE ACCESS 28364 168135449 PROSTATE CANCER - MEDICARE ACCESS 12116 44379122 PULMONARY FIBROSIS 9237 43948488 MULTIPLE SCLEROSIS - MEDICARE ACCESS 9580 43006616 HYPERCHOLESTEROLEMIA - MEDICARE ACCESS 36786 39732005 HEPATITIS C 5896 36563752 PULMONARY HYPERTENSION - MEDICARE ACCESS 7078 36147726 RENAL CELL CARCINOMA - MEDICARE ACCESS 6367 34731653 CHRONIC LYMPHOCYTIC LEUKEMIA 5753 22357875 TARDIVE DYSKINESIA - MEDICARE ACCESS 4530 19642593 ACUTE MYELOID LEUKEMIA 5511 19079067 POST MENOPAUSAL OSTEOPOROSIS - MEDICARE ACCESS 32601 16564927 CYSTIC FIBROSIS TREATMENTS 7825 15274243 BREAST CANCER - MEDICARE ACCESS 3063 14336306 MYELODYSPLASTIC SYNDROMES - MEDICARE ACCESS 2795 9668607 MANTLE CELL LYMPHOMA 1461 6183039 CYSTIC FIBROSIS VITAMINS AND SUPPLEMENTS 7470 5279724 SYSTEMIC LUPUS ERYTHEMATOSUS 1377 4260272 PEYRONIE'S DISEASE 1592 3985951 DUPUYTREN'S DISEASE 2183 3380137 AMYOTROPHIC LATERAL SCLEROSIS 897 3245743 AMYLOIDOSIS 552 3165815 SMALL CELL LUNG CANCER - MEDICARE ACCESS 1039 3156367 COLORECTAL CARCINOMA - MEDICARE ACCESS 1053 2749419 NON-SMALL CELL LUNG CANCER - MEDICARE ACCESS 864 2533376 CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY 613 2437036 BONE METASTASES - MEDICARE ACCESS 1618 2399475 MELANOMA - MEDICARE ACCESS 442 2309016 GOUT - MEDICARE ACCESS 1223 2145568 OVARIAN CANCER - MEDICARE ACCESS 892 2051630 MACULAR DEGENERATION (WET AND DRY) 1099 1374621 SECONDARY HYPERPARATHYROIDISM 1241 813748 HEAD AND NECK CANCER - MEDICARE ACCESS 379 787226 URTICARIA 412 773673 LAMBERT-EATON MYASTHENIC SYNDROME 115 765142 SICKLE CELL DISEASE 196 568416 CHRONIC MYELOID LEUKEMIA - MEDICARE ACCESS 99 424143 CHEMOTHERAPY INDUCED NEUTROPENIA - MEDICARE ACCESS 267 400561 ASTHMA 205 400497 GIANT CELL ARTERITIS OR TEMPORAL ARTERITIS - MEDICARE ACCESS 143 381414 PANCREATIC CANCER - MEDICARE ACCESS 152 320780 NEUROCOGNITIVE DISEASE WITH PSYCHOSIS - MEDICARE ACCESS 225 286344 ANCA-ASSOC VASCULITIS, AND GRANULOMATOSIS WITH POLYANGIITIS (FORMERLY WEGENERS) 80 206112 ADRENAL INSUFFICIENCY 79 192514 ACROMEGALY 64 185547 MOVEMENT DISORDERS - MEDICARE ACCESS 70 127983 CANCER-RELATED BEHAVIORAL HEALTH 89 109244 CYTOMEGALOVIRUS DISEASE - PREVENTION AND TREATMENT 125 102871 NONTUBERCULOUS MYCOBACTERIUM - MEDICARE ACCESS 95 81529 HOMOCYSTINURIA 46 77350 COVID-19 FRONTLINE HEALTH CARE WORKERS BEHAVIORAL HEALTH 64 69588 CHRONIC HEART FAILURE - MEDICARE ACCESS 54 63774 BLADDER AND UROTHELIAL CANCER - MEDICARE ACCESS 31 55824 CUSHING'S DISEASE 12 47343 B-CELL LYMPHOMA - MEDICARE ACCESS 10 40921 PORPHYRIAS 11 32991 COVID-19 ANCILLARY COSTS 184 25000 GOUT TRAVEL FUND 14 19500 HYPEROXALURIA 14 16350 MIGRAINE 45 14895 PEDIATRIC ASSISTANCE 1128 12125 UREA CYCLE DISORDERS 2 6370 PART I, LINE 2: EACH PATIENT SEEKING ASSISTANCE IS SCREENED FOR ELIGIBILITY EITHER BY A SPECIALIST THROUGH THE FOUNDATION HOTLINE OR THROUGH THE FOUNDATION'S ONLINE APPLICATION TOOL. CRITERIA ARE STATIC ACROSS ALL OF THE FOUNDATION FUNDS: DEPENDING ON THE PARTICULAR FUND FROM WHICH THE GRANT ISSUES, THE PATIENT'S HOUSEHOLD INCOME MAY BE UP TO 500% OF THE FEDERAL POVERTY LEVEL, ADJUSTED FOR HOUSEHOLD SIZE AND HIGH COST OF LIVING AREAS; THE PATIENT MUST HAVE A DIAGNOSIS THAT THE FOUNDATION CURRENTLY SUPPORTS; THE PATIENT MUST HAVE INSURANCE COVERAGE FOR THE TREATMENT FOR WHICH THEY ARE SEEKING ASSISTANCE; THAT TREATMENT MUST BE AN ELIGIBLE TREATMENT UNDER THE HEALTHWELL FUND; AND THE TREATMENT MUST BE DISPENSED IN THE UNITED STATES. IN ADDITION, DURING THE APPROVAL PROCESS, A SOFT CREDIT CHECK IS RUN ON THE APPLICANT TO DETERMINE THAT THEY MEET THE INCOME REQUIREMENTS FOR THE PROGRAM. IF THE SOFT CREDIT CHECK DOES NOT RETURN A SATISFACTORY RESULT, THE PATIENT IS REQUIRED TO SUBMIT A FULL INCOME DOCUMENT REVIEW IN ORDER TO RECEIVE ASSISTANCE THROUGH THE PROGRAM. OTHERWISE, PATIENTS ARE APPROVED IF ALL CRITERIA ARE MET DURING SCREENING. PATIENTS RECEIVE A PHARMACY CARD TO USE AT THE LOCAL RETAIL PHARMACY, THROUGH MAIL ORDER PHARMACY, OR THROUGH SPECIALTY PHARMACY. THE PHARMACY CARD CANNOT BE USED FOR PRIMARY PAYMENT AND PROVIDES ELECTRONIC POINT OF SALE REIMBURSEMENT FOR THE PHARMACY. IN CASES WHERE THE PHARMACY CARD CANNOT BE USED, THE FOUNDATION REQUIRES THE SUBMISSION OF A COMPLETED REIMBURSEMENT REQUEST FORM ALONG WITH ADDITIONAL INFORMATION AS OUTLINED ON THE FORM. UPON RECEIPT, THE REQUEST IS REVIEWED: A FOUNDATION PAYMENT SPECIALIST ENTERS THE RECEIVED INFORMATION INTO THE SYSTEM AND THE SYSTEM VALIDATES THE DATE OF SERVICE, AN INSURER PAID FIRST, THE PRODUCT IS AN ELIGIBLE TREATMENT UNDER THE HEALTHWELL FUND, AND THE PATIENT HAS AN ACTIVE, FULLY APPROVED GRANT. ONLY IF ALL SYSTEMATIC CHECKS PASS, THE PAYMENT SPECIALIST PROCESSES THE PAYMENT. X X X X X 0 0 0 0 0 0 0 1 0 ALAN KLEIN CHIEF DEVELOPMENT OFFICER 246147 0 83195 0 0 0 17400 0 7876 0 354618 0 0 0 KRISTA ZODET PRESIDENT 275779 0 39040 0 0 0 15508 0 8085 0 338412 0 0 0 SHELA HALPER SENIOR FOUNDATION PROGRAM OFFICER 192778 0 22583 0 0 0 13202 0 19493 0 248056 0 0 0 COLLIN ALEXANDER DIRECTOR OF FINANCE 158629 0 18450 0 0 0 9049 0 32208 0 218336 0 0 0 FRED ASIEDU LARBI DIRECTOR OF OPERATIONS 178685 0 20295 0 0 0 11939 0 6100 0 217019 0 0 0 VIRGINIA DUNN SR. ASSOCIATE DIRECTOR, COMM. & MKT 118020 0 11501 0 0 0 7936 0 33850 0 171307 0 0 0 PART I, LINE 3 DATE OF LAST STUDY 12/31/2021 PART I, LINE 7 ALL BONUS PAYMENTS RECEIVED BY OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES LISTED IN FORM 990, PART VII ARE BASED ON AN APPRAISAL OF HIS/HER PERFORMANCE. FORM 990, PART VII, LINE 5: THE BOARD CHAIR OF THE FOUNDATION, STEPHEN WEINER, IS ALSO A PARTNER AT MINTZ, LEVIN, COHN, FERRIS, GLOVSKY, AND POPEO, PC, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2021, THE FOUNDATION PAID A TOTAL OF $24,563 TO THE UNRELATED ORGANIZATION FOR THE TIME INCURRED BY MR. WEINER. DR. JEFFREY PEPPERCORN SERVES AS THE SCIENTIFIC AND ETHICS ADVISOR TO THE HEALTHWELL FOUNDATION BOARD OF DIRECTORS. IN THIS CAPACITY, DR. PEPPERCORN, ALONG WITH THE OTHER BOARD PHYSICIANS, DEFINES THE DISEASE STATE FUNDS HEALTHWELL SUPPORTS AND PROVIDES GUIDANCE TO STAFF, AS NEEDED, RELATED TO DISEASE FUND PARAMETERS, INCLUSIONS, AND MANAGEMENT. IN ADDITION, DR. PEPPERCORN, IN COLLABORATION WITH DR. SUZANNE MILLER, OVERSEES HEALTHWELL-FUNDED RESEARCH GRANTS INCLUDING DESIGN, SELECTION, AND OVERSIGHT. THIS ADVISORY POSITION IS NON-VOTING DR. PEPPERCORN WAS COMPENSATED $12,750 IN 2021. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF THE INTERNAL REVIEWS, THE FOUNDATION'S FINANCE DEPARTMENT PROVIDES EACH BOARD MEMBER A COPY FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. ONCE THE BOARD HAS REVIEWED AND APPROVED THE FILING, THE BOARD CHAIR AUTHORIZES THE FEDERAL FORM 990 TO BE E-FILED. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S PRESIDENT AND THE BOARD COMPLIANCE OFFICER WORK TOGETHER TO ENSURE ADHERENCE TO THE FOUNDATION'S COMPLIANCE PROGRAM. INCLUDED IN THIS COMPLIANCE PROGRAM ARE THE FOLLOWING ELEMENTS: STAFF AND BOARD OF DIRECTORS ARE REQUIRED TO FOLLOW A CODE OF CONDUCT; STAFF MUST SIGN A CONFIDENTIALITY AND CONFLICT OF INTEREST AGREEMENT UPON HIRE; MEMBERS OF THE BOARD OF DIRECTORS AND SENIOR STAFF ARE PROVIDED A COMPLIANCE MANUAL AND MUST SIGN A CONFLICT OF INTEREST DISCLOSURE ANNUALLY (BOARD MEMBERS THAT ARE DEEMED TO HAVE A CONFLICT OF INTEREST BASED ON THIS DISCLOSURE ARE RECUSED FROM PARTICIPATING IN A VOTE WITHIN THAT AREA OF CONFLICT); AND SENIOR STAFF AND BOARD ALSO ATTEST TO UNDERSTANDING AND ADHERING TO THE POLICIES AND PRACTICES OF THE HEALTHWELL FOUNDATION. THE SENIOR STAFF AND BOARD CANNOT REFER PATIENTS TO APPLY FOR ASSISTANCE FROM THE FOUNDATION, OR RECOMMEND A PARTICULAR PROVIDER, SUPPLIER, OR PRODUCT FOR AN APPLICANT OR PATIENT, OR DISCLOSE THE IDENTITY ANY PROGRAM DONOR. THE COMPLIANCE OFFICER PROVIDES ANNUAL COMPLIANCE TRAINING TO ALL STAFF. FORM 990, PART VI, SECTION B, LINE 15 HEALTHWELL BOARD OF DIRECTORS CONDUCTED A COMPENSATION REVIEW IN 2021 FOR THE PRESIDENT. THE BOARD ENGAGED AN INDEPENDENT CONSULTANT, MARSH MCLENNAN, TO CONDUCT THE ANALYSIS. THE BOARD CHAIR, TREASURER, AND A BOARD DIRECTOR REVIEWED AND APPROVED THE PRESIDENT'S COMPENSATION. HEALTHWELL WILL ENGAGE MARSH MCLENNAN TO CONDUCT A COMPENSATION REVIEW FOR ALL POSITIONS AT HEALTHWELL BASED ON UPDATED JOB DESCRIPTIONS IN 2022 (THE LAST PRIOR ONE WAS UNDERTAKEN IN 2018). THE BOARD CHAIR, TREASURER, A BOARD DIRECTOR, AND THE PRESIDENT WILL REVIEW AND APPROVE ALL COMPENSATION FOR THE REMAINING FOUNDATION STAFF. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND THE FEDERAL FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FEDERAL FORM 990, THE FOUNDATION'S FINANCIALS, AND ANNUAL REPORT ARE ALSO AVAILABLE AT WWW.HEALTHWELLFOUNDATION.ORG. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES FROM THE PRIOR YEAR. HWF DIRECT LLC 5280 CORPORATE DRIVE SUITE 250B FREDERICK MD 21073 832192839 CONTACT CENTER VA 11873184 24112882 HEALTHWELL FOUNDATION 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 HWF DIRECT LLC A 135000 HWF DIRECT LLC M 11873184 HWF DIRECT LLC P 1197498