COMMON GROUND HEALTHCARE COOPERATIVE: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COMMON GROUND HEALTHCARE COOPERATIVE (EIN 45-3309488)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-10-28
IRS object ID
202123019349302552
Schema version
2020v4.1
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

FieldValueIRS element (for citing)
Return2021-10-28T16:05:21-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1777 E WISCONSIN AVENUE 32ND FLOORAddressLine1Txt
CityMILWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN453309488EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMON GROUND HEALTHCARE COOPERATIVEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone4144550500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 BISHOPS WAY NO 150AddressLine1Txt
CityBROOKFIELDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCATHY MAHAFFEYPersonNm
Person TitleCEOPersonTitleTxt
Phone4144550500PhoneNum
Signature2021-10-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstCATHYPersonFirstNm
Person LastMAHAFFEYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTROY MARINE CPAPreparerPersonNm
PTINP00187863PTIN
Phone4147775500PhoneNum
Preparation2021-10-20PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCATHY MAHAFFEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 BISHOPS WAY NO 150AddressLine1Txt
CityBROOKFIELDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$482,539,179GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.COMMONGROUNDHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Other Organization DscCO-OPOtherOrganizationDsc
Formation2011FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionPROVIDE AFFORDABLE HEALTH INSURANCE SOLUTIONS TO SMALL BUS., INDIVIDUALS & NON-PROFITS IN WI.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee127TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$513,508,101PYProgramServiceRevenueAmt
CY Program Service Revenue$478,995,791CYProgramServiceRevenueAmt
PY Investment Income$5,201,792PYInvestmentIncomeAmt
CY Investment Income$3,543,388CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$518,709,893PYTotalRevenueAmt
CY Total Revenue$482,539,179CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,185,600PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,832,359CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$433,800,311PYOtherExpensesAmt
CY Other Expenses$432,485,672CYOtherExpensesAmt
PY Total Expenses$444,985,911PYTotalExpensesAmt
CY Total Expenses$444,318,031CYTotalExpensesAmt
PY Revenues Less Expenses$73,723,982PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$38,221,148CYRevenuesLessExpensesAmt
Total Assets BOY$361,426,459TotalAssetsBOYAmt
Total Assets EOY$366,280,384TotalAssetsEOYAmt
Total Liabilities BOY$241,534,354TotalLiabilitiesBOYAmt
Total Liabilities EOY$237,111,559TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$119,892,105NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$129,168,825NetAssetsOrFundBalancesEOYAmt
MissionCOMMON GROUND HEALTHCARE COOPERATIVE ("CGHC") IS A NON-PROFIT MEMBER-GOVERNED HEALTH INSURANCE COMPANY DEDICATED TO PROVIDING AFFORDABLE, INNOVATIVE HEALTH INSURANCE SOLUTIONS TO SMALL BUSINESSES, NON-PROFITS, AND INDIVIDUALS IN WISCONSIN.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescCOMMON GROUND HEALTHCARE COOPERATIVE IS A NON-PROFIT MEMBER-GOVERNED HEALTH INSURANCE COOPERATIVE DEDICATED TO DELIVERING QUALITY, COMPREHENSIVE HEALTH INSURANCE TO SMALL BUSINESSES AND INDIVIDUALS IN WISCONSIN.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document1839IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee127EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Licensed More Than One State0LicensedMoreThanOneStateInd
State Required Reserves$86,302,188StateRequiredReservesAmt
Reserves Maintained$218,025,657ReservesMaintainedAmt
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TOM LAWLESSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4144550500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 BISHOPS WAY SUITE 150AddressLine1Txt
CityBROOKFIELDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CHRISTOPHER MARTIN
BOARD CHAIR6.00Yes (X)$7,435$0$0
AMY MURPHY
BOARD VICE-CHAIR1.00Yes (X)$7,435$0$0
MARY REHBERG
SECRETARY/TREASURER1.00Yes (X)$7,435$0$0
BRETT REMINGTON
DIRECTOR1.00Yes (X)$7,435$0$0
ERIN KENNEKE
DIRECTOR1.00Yes (X)$7,435$0$0
JAMES WESP
NON-VOTING DIRECTOR1.00Yes (X)$7,435$0$0
JOHN MAGLIO
NON-VOTING DIRECTOR1.00Yes (X)$7,435$0$0
ROBERT CONNOLLY
NON-VOTING DIRECTOR1.00Yes (X)$7,435$0$0
TERESA PISZCOR
DIRECTOR1.00Yes (X)$7,435$0$0
WILLIAM KORT
DIRECTOR1.00Yes (X)$7,435$0$0
CLIFFORD PUKEL
DIRECTOR1.00Yes (X)$6,196$0$0
MICHAEL BRAUN
DIRECTOR1.00Yes (X)$6,000$0$0
RACHAEL BUSH
DIRECTOR1.00Yes (X)$1,239$0$0
CATHY MAHAFFEY
CEO40.00$532,951$0$23,520Yes (X)
BRIAN MCDONALD
CHIEF BUS DEV OFFICER40.00$327,974$0$51,214Yes (X)
SCOTT ANDERSON
CMO - CHIEF MEDICAL OFFICER40.00$296,354$0$49,742Yes (X)
TOM LAWLESS
CFO40.00$287,339$0$47,455Yes (X)
MELISSA HENDERSON
COO40.00$268,195$0$18,255Yes (X)
SCOTT BERGMAN
CONTROLLER40.00$217,568$0$48,106Yes (X)
SHELLY JOHNSON
VP OF NETWORK OPTIMIZATION & HEALTHC40.00$228,750$0$16,917Yes (X)
JESSICA KOTTWITZ
VP OF OPERATIONS40.00$226,016$0$19,739Yes (X)
ROBET PLESHA
CHIEF ACTUARY40.00$219,273$0$13,533Yes (X)
AARON JACKSON
VP PROVIDER CONTRACTING & STRATEGY40.00$180,812$0$15,157Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,873,017TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$303,638TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
OPTUM HEALTH CARE SOLUTIONS INC
11000 OPTUM CIRCLE MN101W400MINNEAPOLISMN55344MEDICAL MANAGEMENT$3,232,347
MILLIMAN INC
15800 W BLUEMOUND RD SUITE 100BROOKFIELDWI53005ACTUARIAL$985,346
EVOLENT HEALTH LLC
PO BOX 505384ST LOUISMO631505384CLAIMS PROCESSING PLATFORM$745,242
MPX
2301 CONGRESS STPORTLANDME04102PRINTING AND POSTAGE$706,993
CHARTFAST
45 N MAIN STREETHATFIELDPA19440RA CHART RETRIEVAL$394,256
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPREMIUMS EARNEDDesc
Business525100BusinessCd
Total Revenue Column$478,995,791TotalRevenueColumnAmt
Related Or Exempt Func Income$478,995,791RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$478,995,791TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,543,388TotalRevenueColumnAmt
Exclusion$3,543,388ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$482,539,179TotalRevenueColumnAmt
Related Or Exempt Func Income$478,995,791RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,543,388ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,990,784TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,332,626TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$426,256TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,472,346TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$610,347TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,859,021TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,785,599TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$22,230TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,430,766TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$283,827TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,006,412TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,162,675TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$261,817TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$9,748TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$108,706TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$30,285,514TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$246,910TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$241,242TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
CLAIMS EXPENSE$315,039,688
MLR PREMIUM REFUNDS$44,503,250
CMS EXCHANGE USER FEE E$10,914,537
STATE INCOME TAX EXPENS$3,468,565

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,855,165TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$444,318,031TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$41,799,407BOYAmt
EOY$84,990,660EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$216,802,690BOYAmt
EOY$200,608,332EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,102,273BOYAmt
EOY$4,093,167EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$436,779BOYAmt
EOY$356,358EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,997,875LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,266,085LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$815,893BOYAmt
EOY$731,790EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$96,469,417BOYAmt
EOY$75,500,077EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$361,426,459BOYAmt
EOY$366,280,384EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,738,403BOYAmt
EOY$5,457,522EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$40,041,820BOYAmt
EOY$44,770,544EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$100,104,199BOYAmt
EOY$97,893,003EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$93,649,932BOYAmt
EOY$88,990,490EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$241,534,354BOYAmt
EOY$237,111,559EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$119,892,105BOYAmt
EOY$129,168,825EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$119,892,105BOYAmt
EOY$129,168,825EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$361,426,459BOYAmt
EOY$366,280,384EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$38,221,148ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,055,572NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$30,000,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$356,298OtherCostOrOtherBasisAmt
Depreciation$264,934DepreciationAmt
Book Value$91,364BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,049,939OtherCostOrOtherBasisAmt
Depreciation$772,706DepreciationAmt
Book Value$277,233BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$591,638OtherCostOrOtherBasisAmt
Depreciation$228,445DepreciationAmt
Book Value$363,193BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$731,790TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
REINSURANCE RECOVERABLES$47,618,582
HEALTH CARE RECEIVABLE$8,850,011
ADVANCED PREMIUM TAX CREDIT RECEIVABLE$18,173,846
PROVIDER RECEIVABLE$857,638
FieldValueIRS element (for citing)
Total Book Value Other Assets$75,500,077TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
INTEREST PAYABLE$57,497
UNEARNED PREMIUM$27,024,524
INSURANCE FEES PAYABLE$16,883,804
MLR PAYABLE TO MEMBERS$45,024,665
FieldValueIRS element (for citing)
Total Liability$88,990,490TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$482,539,179TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$482,539,179RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$482,539,179TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$444,318,031TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$444,318,031ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$444,318,031TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ACA ESTABLISHED SECTION 501(C) (29) OF THE INTERNAL REVENUE CODE AS A NEW TAX-EXEMPT CATEGORY SPECIFICALLY FOR QUALIFIED NON-PROFIT HEALTH INSURANCE ISSUERS THAT HAVE RECEIVED A LOAN OR GRANT UNDER THE CMS CO-OP PROGRAM FOR PERIODS THAT THEY MEET BOTH THE REQUIREMENTS OF SECTION 1322 OF THE ACA AND ANY LOAN AGREEMENT WITH CMS. THE COMPANY RECEIVED AN APPROVAL LETTER FROM THE INTERNAL REVENUE SERVICE STATING THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C) (29).ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CATHY MAHAFFEY
CEO$476,228$0$48,375$0$8,348$0$15,426$0$8,094$0$556,471$0$0$0
BRIAN MCDONALD
CHIEF BUS DEV OFFICER$284,243$0$35,750$0$7,981$0$15,793$0$35,421$0$379,188$0$0$0
SCOTT ANDERSON
CMO - CHIEF MEDICAL OFFICER$289,008$0$0$0$7,346$0$9,952$0$39,790$0$346,096$0$0$0
TOM LAWLESS
CFO$253,714$0$33,017$0$608$0$16,110$0$31,345$0$334,794$0$0$0
MELISSA HENDERSON
COO$247,627$0$20,000$0$568$0$15,567$0$2,688$0$286,450$0$0$0
SCOTT BERGMAN
CONTROLLER$192,566$0$24,575$0$427$0$12,681$0$35,425$0$265,674$0$0$0
JESSICA KOTTWITZ
VP OF OPERATIONS$207,883$0$17,760$0$373$0$13,151$0$6,588$0$245,755$0$0$0
SHELLY JOHNSON
VP OF NETWORK OPTIMIZATION & HEALTHC$204,010$0$24,375$0$365$0$13,085$0$3,832$0$245,667$0$0$0
ROBET PLESHA
CHIEF ACTUARY$214,118$0$0$0$5,155$0$9,725$0$3,808$0$232,806$0$0$0
AARON JACKSON
VP PROVIDER CONTRACTING & STRATEGY$166,522$0$14,167$0$123$0$5,637$0$9,520$0$195,969$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ACOMMON GROUND MADE A GROSS-UP PAYMENTS OF $500 FOR ITS FIVE YEAR ANNIVERSARY.
PART I, LINE 6LEADERSHIP INCENTIVE BONUSES ARE ACCRUED DURING THE PREVIOUS YEAR BASED ON A SERIES OF METRICS, ONE OF THE METRICS BEING THE COOPERATIVE MUST BE PROFITABLE FOR THE PREVIOUS YEAR.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MELISSA DUFFYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionFORMER OFFICERRelationshipDescriptionTxt
Transaction$241,800TransactionAmt
TransactionINDEPENDENT CONTRACTORTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 13AWI
FORM 990, PART VI, SECTION A, LINE 6ON JANUARY 1, 2014 COMMON GROUND HEALTHCARE COOPERATIVE BEGAN ISSUING HEALTH INSURANCE TO INDIVIDUALS AND SMALL GROUPS. ANY ACTIVE POLICYHOLDER IS CONSIDERED A MEMBER OF THE COOPERATIVE. IN DECEMBER OF 2014 THERE WAS AN ELECTION FROM THE MEMBERS OF AN OPERATIONAL BOARD OF DIRECTORS REPLACING THE FORMATIVE BOARD OF DIRECTORS AT THAT TIME.
FORM 990, PART VI, SECTION A, LINE 7AIN DECEMBER OF 2014 THERE WAS AN ELECTION FROM THE MEMBERS OF AN OPERATIONAL BOARD OF DIRECTORS REPLACING THE FORMATIVE BOARD OF DIRECTORS AT THAT TIME.
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD MEMBERS ARE GIVEN A COPY OF THE RETURN BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE POLICY SETS FORTH CLEAR EXPECTATIONS AND GUIDANCE THAT IS TO BE FOLLOWED BY ALL DIRECTORS, OFFICERS, EMPLOYEES AND THIRD PARTY REPRESENTATIVES. THE COOPERATIVE WILL EVALUATE ITS ADHERENCE AND COMPLIANCE TO THIS POLICY BY REQUESTING FEEDBACK ON A REGULAR BASIS FROM OUR MEMBERS, EMPLOYEES, DIRECTORS AND THIRD PARTY REPRESENTATIVES. IF ANY INDIVIDUAL HAS QUESTIONS OR CONCERNS ABOUT COMPLIANCE WITH THE SUBJECTS DESCRIBED IN THIS POLICY, ARE UNSURE ABOUT WHAT IS THE "RIGHT THING" TO DO, OR REASONABLY BELIEVES THAT SOME POLICY, PRACTICE OR ACTIVITY OF THE COOPERATIVE IS IN VIOLATION OF THE ETHICS POLICY OR CODE, THIS INDIVIDUAL SHOULD SHARE THEIR QUESTIONS, CONCERNS, SUGGESTIONS OR COMPLAINTS WITH SOMEONE WHO CAN ADDRESS THEM PROPERLY. IN MOST CASES, AN INDIVIDUAL'S SUPERVISOR IS IN THE BEST POSITION TO ADDRESS AN AREA OF CONCERN. HOWEVER, IF THE INDIVIDUAL IS NOT COMFORTABLE SPEAKING WITH HIS OR HER SUPERVISOR OR IS NOT SATISFIED WITH THE SUPERVISOR'S RESPONSE, THE INDIVIDUAL IS ENCOURAGED TO SPEAK WITH THE COMPLIANCE OFFICER, OR ANYONE IN MANAGEMENT WHOM THE INDIVIDUAL IS COMFORTABLE IN APPROACHING. THE COOPERATIVE PROVIDES ALL INDIVIDUALS AN ADDITIONAL MECHANISM TO REPORT UNETHICAL CONDUCT WHICH IS DISCUSSED FURTHER IN THE EMPLOYEE PROTECTION AND NON-RETALIATION POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE EMPLOYMENT AGREEMENTS FOR THE CEO, COO, CBDO, CMO AND CFO INCLUDING COMPENSATION, WERE REVIEWED AND APPROVED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES IN ACCORDANCE WITH TERMS OF THE COOPERATIVE'S LOAN AGREEMENT.
FORM 990, PART VI, SECTION C, LINE 19THE DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:REDUCTION IN PAID-IN-CAPITAL -30,000,000.

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