MDWISE INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- MDWISE INC (EIN 35-1931354)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-08-13
- IRS object ID
- 202002269349301855
- Schema version
- 2019v5.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-13T13:00:08-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2601 CAMBRIDGE CT STE 500 | AddressLine1Txt |
| City | AUBURN HILLS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351931354 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MDWISE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MDWI | BusinessNameControlTxt |
| Phone | 3178227100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2955 N MERIDIAN STREET | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46208 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHERYL DIEHL | PersonNm |
| Person Title | INTERIM CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3178227100 | PhoneNum |
| Signature | 2020-08-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 2483757100 | PhoneNum |
| Preparation | 2020-08-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 24.127.213.245 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-07 | IPDt |
| IP Tm | 13:54:15 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D1A42FCEE5CBCA1835161BC59C75369F1B7E9248 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHERYL DIEHL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2955 N MERIDIAN STREET | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46208 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,350,463,560 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.MDWISE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | MDWISE IS A NOT-FOR-PROFIT HEALTH MAINTENANCE ORGANIZATION CONTRACTING WITH HEALTHCARE PROVIDERS TO PROVIDE SERVICES TO ITS MEMBERS FOR TWO STATE MEDICAID PROGRAMS: HOOSIER HEALTHWISE (HHW) AND HEALTHY INDIANA PLAN (HIP) | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 291 | 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 | $1,262,486,020 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,243,800,126 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,050,795 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,340,867 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,623,671 | PYOtherRevenueAmt |
| CY Other Revenue | $13,081,513 | CYOtherRevenueAmt |
| PY Total Revenue | $1,268,160,486 | PYTotalRevenueAmt |
| CY Total Revenue | $1,263,222,506 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $97,770 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $115,175 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,127,955 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,799,725 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,219,770,546 | PYOtherExpensesAmt |
| CY Other Expenses | $1,207,673,589 | CYOtherExpensesAmt |
| PY Total Expenses | $1,244,996,271 | PYTotalExpensesAmt |
| CY Total Expenses | $1,221,588,489 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $23,164,215 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $41,634,017 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $398,850,570 | TotalAssetsBOYAmt |
| Total Assets EOY | $368,555,855 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $288,652,627 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $224,203,249 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $110,197,943 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $144,352,606 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTHCARE AND IMPROVE THE WELL-BEING OF OUR MEMBERS BY ENGAGING EXCEPTIONAL ASSOCIATES, COMMUNITY LEADERS AND HEALTHCARE PROFESSIONALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,026,559,770 | ExpenseAmt |
| Grant | $115,175 | GrantAmt |
| Revenue | $1,256,881,639 | RevenueAmt |
| Desc | BEGINNING JANUARY 1, 2011, MDWISE WAS GRANTED A FOUR-YEAR CONTRACT WITH THE STATE OF INDIANA (THE "STATE"), THROUGH THE FAMILY AND SOCIAL SERVICE ADMINISTRATION ("FSSA") AND OFFICE OF MEDICAID POLICY AND PLANNING ("OMPP"), TO ARRANGE FOR AND ADMINISTER TWO RISK-BASED MANAGED CARE PROGRAMS ("HOOSIER HEALTHWISE AND "HEALTHY INDIANA PLAN") FOR CERTAIN INDIANA MEDICAID ENROLLEES. MDWISE CONTRACTS WITH VARIOUS DELIVERY NETWORKS INCLUDING THE AFFILIATED MDWISE MEDICAID NETWORK ("EXCEL"). EXCEL AND THE OTHER DELIVERY NETWORKS ACCEPT THE MEDICAL SERVICE RISK FOR ENROLLEES WHO CHOOSE A PRIMARY CARE PROVIDER AFTER SELECTING THE MDWISE NETWORK. ON JANUARY 1, 2017, THE CONTRACT WITH THE STATE OF INDIANA WAS RENEWED AND IS NOW SCHEDULED TO EXPIRE ON DECEMBER 31, 2022.AS A MEDICAID MANAGED CARE ENTITY, MDWISE PROVIDES A GOVERNMENT INSURANCE PROGRAM FOR PERSONS OF ALL AGES WHOSE INCOME AND RESOURCES ARE INSUFFICIENT TO PAY FOR HEALTH CARE. | Desc |
| Total Program Service Expenses | $1,026,559,770 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5993 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 291 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHERYL DIEHL | PersonNm |
| Phone | 3178227115 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2955 N MERIDIAN STREET | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46208 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KEVIN B TOMPKINS | |||||||||
| CHAIRMAN | 1.00 | 48.30 | Yes (X) | Yes (X) | $0 | $1,039,243 | $129,985 | ||
| DAVID E MAZURKIEWICZ | |||||||||
| TREASURER | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $1,591,411 | $30,379 | ||
| KATHLEEN KENDALL | |||||||||
| PRESIDENT AND CEO | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $1,203,500 | $211,566 | ||
| CAROL SOLOMON | |||||||||
| ASSISTANT TREASURER | 1.00 | 41.00 | Yes (X) | Yes (X) | $0 | $490,728 | $23,800 | ||
| BRUCE HAYES | |||||||||
| PRESIDENT AND CEO (PART YEAR) | 40.00 | 1.00 | Yes (X) | Yes (X) | $0 | $503,564 | $15,454 | ||
| JAMES MAGUIRE | |||||||||
| CFO | 40.00 | 1.00 | Yes (X) | Yes (X) | $404,782 | $0 | $29,218 | ||
| LINDSEY LUX KLEMAN | |||||||||
| SVP OPERATIONS (PART YEAR) | 40.00 | 0.00 | $293,360 | $0 | $19,000 | Yes (X) | |||
| PATRICIA HEBENSTREIT | |||||||||
| SVP GENERAL COUNSEL | 40.00 | 0.00 | $287,707 | $0 | $25,000 | Yes (X) | |||
| BRIAN ARROWWOOD | |||||||||
| VP BUSINESS OPERATIONS | 40.00 | 0.00 | $274,350 | $0 | $19,000 | Yes (X) | |||
| DANIEL SPITZBERG | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $221,041 | $0 | $0 | Yes (X) | |||
| CHRISTOPHER CALLAHAN | |||||||||
| VP PHARMACY AND MED ECON (PART YEAR) | 40.00 | 0.00 | $211,516 | $0 | $2,200 | Yes (X) | |||
| WENDI POWELL | |||||||||
| DIRECTOR CLINICAL PHARMACY | 40.00 | 0.00 | $172,112 | $0 | $19,000 | Yes (X) | |||
| BRIAN MUSIAL | |||||||||
| DIRECTOR PHARMACY ANALYTICS | 40.00 | 0.00 | $157,965 | $0 | $14,529 | Yes (X) | |||
| ERIC ESSLEY | |||||||||
| DIRECTOR LEGAL SERVICES | 40.00 | 0.00 | $149,634 | $0 | $19,000 | Yes (X) | |||
| JASON THACKER | |||||||||
| DIRECTOR BUSINESS OPERATIONS | 40.00 | 0.00 | $148,601 | $0 | $17,116 | Yes (X) | |||
| MARCIA SHIVELY | |||||||||
| DIRECTOR BUSINESS SERVICES | 40.00 | 0.00 | $141,574 | $0 | $4,466 | Yes (X) | |||
| MARK IVORY | |||||||||
| MANAGER FINANCE | 40.00 | 0.00 | $140,136 | $0 | $9,212 | Yes (X) | |||
| REBECCA COBB | |||||||||
| DIRECTOR CUSTOMER SERVICE | 40.00 | 0.00 | $124,896 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,727,674 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,828,446 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $588,925 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AI KING | |||||
| 8604 ALLISONVILLE ROAD | INDIANAPOLIS | IN | 46250 | REINSURANCE PROVIDER | $7,707,856 |
| MCLAREN INTEGRATED INSURANCE GROUP | |||||
| ONE MCLAREN PARKWAY | GRAND BLANC | MI | 48439 | INTERCOMPANY SERVICE AGREEMENT | $6,956,214 |
| EVOLENT HEALTH LLC | |||||
| 800 N GLEBE ROAD | ARLINGTON | VA | 22203 | MEDICAL CLAIMS PAYMENT PROVIDER | $6,419,651 |
| SOUTHEASTRANS INC | |||||
| 4751 BEST ROAD | ATLANTA | GA | 30337 | TRANSPORTATION PROVIDER | $3,600,545 |
| DENTAQUEST | |||||
| 12121 NORTH CORPORATE PKWY | MEQUON | WI | 53092 | DENTAL CLAIMS PAYMENT PROVIDER | $2,073,169 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HEALTHY INDIANA PLAN | 900000 | $762,331,219 | $762,331,219 |
| HOOSIER HEALTHWISE | 900000 | $481,468,907 | $481,468,907 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,243,800,126 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,060,060 | TotalRevenueColumnAmt |
| Exclusion | $6,060,060 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $87,521,861 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $87,217,289 | SecuritiesAmt |
| Other | $23,765 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $304,572 | SecuritiesAmt |
| Other | -$23,765 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $280,807 | TotalRevenueColumnAmt |
| Exclusion | $280,807 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $9,086,712 | $9,086,712 |
| TRANSPORTATION, NET | 900000 | $3,994,801 | $3,994,801 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,081,513 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,263,222,506 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,256,881,639 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,340,867 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,175 | TotalAmt |
| Program Services | $115,175 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,957,831 | TotalAmt |
| Management And General | $2,957,831 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,498,680 | TotalAmt |
| Program Services | $6,373,878 | ProgramServicesAmt |
| Management And General | $1,124,802 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,502 | TotalAmt |
| Program Services | $354,877 | ProgramServicesAmt |
| Management And General | $62,625 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,140,100 | TotalAmt |
| Program Services | $1,819,085 | ProgramServicesAmt |
| Management And General | $321,015 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $785,612 | TotalAmt |
| Program Services | $667,770 | ProgramServicesAmt |
| Management And General | $117,842 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,739 | TotalAmt |
| Program Services | $6,578 | ProgramServicesAmt |
| Management And General | $1,161 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,175 | TotalAmt |
| Program Services | $391,149 | ProgramServicesAmt |
| Management And General | $69,026 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,000 | TotalAmt |
| Program Services | $51,000 | ProgramServicesAmt |
| Management And General | $9,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,744 | TotalAmt |
| Program Services | $82,232 | ProgramServicesAmt |
| Management And General | $14,512 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $882,583 | TotalAmt |
| Program Services | $750,196 | ProgramServicesAmt |
| Management And General | $132,387 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,195,847 | TotalAmt |
| Program Services | $1,016,470 | ProgramServicesAmt |
| Management And General | $179,377 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,033,244 | TotalAmt |
| Program Services | $878,257 | ProgramServicesAmt |
| Management And General | $154,987 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,957,732 | TotalAmt |
| Program Services | $4,214,072 | ProgramServicesAmt |
| Management And General | $743,660 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,387,025 | TotalAmt |
| Program Services | $2,028,971 | ProgramServicesAmt |
| Management And General | $358,054 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,231 | TotalAmt |
| Program Services | $139,596 | ProgramServicesAmt |
| Management And General | $24,635 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,792 | TotalAmt |
| Program Services | $117,973 | ProgramServicesAmt |
| Management And General | $20,819 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,933,605 | TotalAmt |
| Management And General | $10,933,605 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,702,371 | TotalAmt |
| Program Services | $1,447,015 | ProgramServicesAmt |
| Management And General | $255,356 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,521 | TotalAmt |
| Program Services | $154,293 | ProgramServicesAmt |
| Management And General | $27,228 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DELIVERY SYSTEM PAYMENT | $1,179,537,707 | $1,002,607,051 | $176,930,656 |
| PURCHASED SERVICES | $3,752,689 | $3,189,786 | $562,903 |
| SUSPENSE | $181,584 | $154,346 | $27,238 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,221,588,489 | TotalAmt |
| Program Services | $1,026,559,770 | ProgramServicesAmt |
| Management And General | $195,028,719 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,062,662 | BOYAmt |
| EOY | $168,471,834 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,780,453 | BOYAmt |
| EOY | $136,624,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $574,513 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $418,487 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $186,078 | BOYAmt |
| EOY | $156,026 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,759,190 | BOYAmt |
| EOY | $63,303,289 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,187 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,850,570 | BOYAmt |
| EOY | $368,555,855 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,267,059 | BOYAmt |
| EOY | $218,790,670 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,385,568 | BOYAmt |
| EOY | $5,412,579 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $288,652,627 | BOYAmt |
| EOY | $224,203,249 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,197,943 | BOYAmt |
| EOY | $144,352,606 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,197,943 | BOYAmt |
| EOY | $144,352,606 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,850,570 | BOYAmt |
| EOY | $368,555,855 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $41,634,017 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,595,463 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$8,304,855 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$769,962 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Other | Yes (X) | MethodOfAccountingOtherInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $574,513 | OtherCostOrOtherBasisAmt |
| Depreciation | $418,487 | DepreciationAmt |
| Book Value | $156,026 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $156,026 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TPL RECOVERY- THIRD PARTY LIABILITY | Desc |
| Amt | $5,412,579 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,412,579 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $1,254,135,792 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,254,135,792 | RevenueSubtotalAmt |
| Other Revenues Not Included | $9,086,714 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $9,086,714 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,263,222,506 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,212,501,775 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,212,501,775 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $9,086,714 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $9,086,714 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,221,588,489 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REVENUE NET WITH EXPENSES FOR FINANCIAL STATEMENT REPORTING 9,086,714. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | REVENUE NET WITH EXPENSES FOR FINANCIAL STATEMENT REPORTING 9,086,714. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|
| COVERING KIDS AND FAMILIES OF INDIANA | |||||||||
| 3838 N RURAL AVE | INDIANAPOLIS | IN | 46208 | 611520892 | 501(C)(3) | $55,000 | N/A | N/A | GENERAL SUPPORT |
| SHALOM HEALTH CARE CENTER INC | |||||||||
| 3400 LAFAYETTE ROAD SUITE 200 | INDIANAPOLIS | IN | 46222 | 061645027 | 501(C)(3) | $10,750 | N/A | N/A | GENERAL SUPPORT |
| MINORITY HEALTH COALITION OF MARION COUNTY | |||||||||
| 1100 W 42ND STREET SUITE 215 | INDIANAPOLIS | IN | 46205 | 351938965 | 501(C)(3) | $9,000 | N/A | N/A | GENERAL SUPPORT |
| INDIANA STATE DEPARTMENT OF HEALTH | |||||||||
| 2 NORTH MERIDAN ST SUITE 6-C | INDIANAPOLIS | IN | 46204 | 356000158 | GOVERNMENT | $7,000 | N/A | N/A | GENERAL SUPPORT |
| MENTAL HEALTH OF AMERICA OF INDIANA | |||||||||
| 1431 N DELAWARE STREET | INDIANAPOLIS | IN | 46202 | 350896905 | 501(C)(3) | $6,000 | N/A | N/A | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MDWISE HAS A CORPORATE GIVING COMMITTEE THAT REQUESTS CERTAIN INFORMATION FROM EACH GRANTEE ORGANIZATION IN ORDER TO EVALUATE AND MEASURE IMPACT TO SEE HOW MEMBERS OF MDWISE BENEFIT FROM THE GRANTEE ORGANIZATION. MDWISE DOES NOT HAVE A FORMAL PROCEDURE TO FOLLOW-UP WITH THE GRANTEE ORGANIZATIONS AFTER FUNDS ARE AWARDED BUT USES INFORMAL COMMUNICATIONS TO UNDERSTAND HOW CONTRIBUTIONS ARE USED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN B TOMPKINS | ||||||||||||||
| CHAIRMAN | $0 | $498,692 | $0 | $186,896 | $0 | $353,655 | $0 | $114,499 | $0 | $15,486 | $0 | $1,169,228 | $0 | $0 |
| DAVID E MAZURKIEWICZ | ||||||||||||||
| TREASURER | $0 | $921,718 | $0 | $281,529 | $0 | $388,164 | $0 | $14,000 | $0 | $16,379 | $0 | $1,621,790 | $0 | $0 |
| KATHLEEN KENDALL | ||||||||||||||
| PRESIDENT AND CEO | $0 | $591,065 | $0 | $226,125 | $0 | $386,310 | $0 | $195,684 | $0 | $15,882 | $0 | $1,415,066 | $0 | $0 |
| CAROL SOLOMON | ||||||||||||||
| ASSISTANT TREASURER | $0 | $432,958 | $0 | $54,206 | $0 | $3,564 | $0 | $23,800 | $0 | $0 | $0 | $514,528 | $0 | $0 |
| BRUCE HAYES | ||||||||||||||
| PRESIDENT AND CEO (PART YEAR) | $0 | $231,143 | $0 | $61,075 | $0 | $211,346 | $0 | $6,207 | $0 | $9,247 | $0 | $519,018 | $0 | $0 |
| JAMES MAGUIRE | ||||||||||||||
| CFO | $314,782 | $0 | $90,000 | $0 | $0 | $0 | $19,000 | $0 | $10,218 | $0 | $434,000 | $0 | $0 | $0 |
| LINDSEY LUX KLEMAN | ||||||||||||||
| SVP OPERATIONS (PART YEAR) | $258,356 | $0 | $35,004 | $0 | $0 | $0 | $19,000 | $0 | $0 | $0 | $312,360 | $0 | $0 | $0 |
| PATRICIA HEBENSTREIT | ||||||||||||||
| SVP GENERAL COUNSEL | $252,703 | $0 | $35,004 | $0 | $0 | $0 | $25,000 | $0 | $0 | $0 | $312,707 | $0 | $0 | $0 |
| BRIAN ARROWWOOD | ||||||||||||||
| VP BUSINESS OPERATIONS | $240,457 | $0 | $33,893 | $0 | $0 | $0 | $19,000 | $0 | $0 | $0 | $293,350 | $0 | $0 | $0 |
| DANIEL SPITZBERG | ||||||||||||||
| MEDICAL DIRECTOR | $221,041 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $221,041 | $0 | $0 | $0 |
| CHRISTOPHER CALLAHAN | ||||||||||||||
| VP PHARMACY AND MED ECON (PART YEAR) | $180,178 | $0 | $31,338 | $0 | $0 | $0 | $2,200 | $0 | $0 | $0 | $213,716 | $0 | $0 | $0 |
| WENDI POWELL | ||||||||||||||
| DIRECTOR CLINICAL PHARMACY | $158,323 | $0 | $13,789 | $0 | $0 | $0 | $19,000 | $0 | $0 | $0 | $191,112 | $0 | $0 | $0 |
| BRIAN MUSIAL | ||||||||||||||
| DIRECTOR PHARMACY ANALYTICS | $145,348 | $0 | $12,617 | $0 | $0 | $0 | $14,529 | $0 | $0 | $0 | $172,494 | $0 | $0 | $0 |
| ERIC ESSLEY | ||||||||||||||
| DIRECTOR LEGAL SERVICES | $137,255 | $0 | $12,379 | $0 | $0 | $0 | $19,000 | $0 | $0 | $0 | $168,634 | $0 | $0 | $0 |
| JASON THACKER | ||||||||||||||
| DIRECTOR BUSINESS OPERATIONS | $136,654 | $0 | $11,947 | $0 | $0 | $0 | $17,116 | $0 | $0 | $0 | $165,717 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 1 BOXES HAVE BEEN CHECKED. THE CORPORATE CEO, SUBSIDIARY CEOS AND CORPORATE EXECUTIVE & SENIOR VICE-PRESIDENTS IN SOME INSTANCES HAVE RECEIVED TAX INDEMNIFICATION FOR THE FOLLOWING BENEFITS: VEHICLE COSTS, GROUP TERM LIFE INSURANCE, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS, AND HEALTH CLUB OR SOCIAL DUES. THESE BENEFITS HAVE BEEN INCLUDED IN TAXABLE COMPENSATION. |
| PART I, LINE 3 | THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 3 BOXES HAVE BEEN CHECKED. THE RELATED ORGANIZATION USED THE FOLLOWING METHODOLOGIES TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINES 4A-B | PART I, LINE 4A: BRUCE HAYES RECEIVED SEVERANCE PAYMENTS TOTALING $192,480 DURING THE TAX YEAR. PAYMENTS ARE MADE IN BIWEEKLY INSTALLMENTS OVER A 20 WEEK PERIOD PER THE AGREEMENT SIGNED BY THE PARTIES. PART I, LINE 4B: MDWISE MAINTAINS TWO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES (THE "SERPS"). THE OLD SERP WAS CLOSED TO NEW PARTICIPANTS ON OCTOBER 1, 2006, AND THE NEW SERP BECAME EFFECTIVE AS OF JANUARY 1, 2007. NO EMPLOYEE MAY PARTICIPATE IN BOTH OF THE SERPS. THE OLD SERP IS STRUCTURED AS A DEFINED BENEFIT PLAN THAT ESSENTIALLY REPLACES THE BENEFITS THE PARTICIPANT IS NOT PERMITTED TO RECEIVE UNDER MDWISE'S QUALIFIED RETIREMENT PLAN DUE TO IRS LIMITATIONS APPLICABLE TO QUALIFIED PLANS. THE BENEFIT UNDER THE OLD SERP IS PAYABLE IN EITHER THE FORM OF A LUMP SUM DISTRIBUTION OR IN MONTHLY PAYMENTS EQUAL TO THE ACTUARIAL EQUIVALENT OF THE PARTICIPANT'S ACCRUED BENEFIT. THE BENEFIT IS PAID AT AGE 55, AND IF THE PARTICIPANT REMAINS EMPLOYED, THE BENEFIT IS PAID UPON TERMINATION OF EMPLOYMENT, REDUCED TO TAKE INTO ACCOUNT THE BENEFIT PREVIOUSLY PAID. THE NEW SERP IS STRUCTURED AS A DEFINED CONTRIBUTION PLAN, AND MDWISE CONTRIBUTES 15 PERCENT OF EACH PARTICIPANT'S COMPENSATION TO THE PLAN EACH YEAR FOR ALLOCATION TO THE PARTICIPANT'S ACCOUNT. PARTICIPANTS IN THE NEW SERP BECOME VESTED IN THEIR ACCOUNTS UPON THE EARLIER OF FIVE YEARS OF PARTICIPATION IN THE PLAN OR ATTAINMENT OF AGE 60. PARTICIPANTS IN THE NEW SERP SELF-DIRECT THE INVESTMENT OF THEIR ACCOUNTS AND HAVE THE ACTUAL INVESTMENT RETURN CREDITED OR DEBITED TO THEIR ACCOUNTS. THE BENEFIT UNDER THE NEW SERP IS EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE, AND THE BENEFIT IS PAID IN A SINGLE SUM WITHIN 60 DAYS OF THE PARTICIPANT'S TERMINATION DATE. BENEFITS UNDER BOTH SERPS ARE PROVIDED ON A TAX-NEUTRAL BASIS. BOTH SERPS ARE DESIGNED TO COMPLY WITH INTERNAL REVENUE CODE SECTIONS 457(F) AND 409A. |
| PART I, LINE 7 | MDWISE'S PARENT COMPANY, MCLAREN HEALTH CARE (MHC), HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION, SUBSIDIARY EXECUTIVES AND DIRECTORS, MANAGERS AND SUPERVISORS. THE PURPOSE OF THE PLAN IS TO ENHANCE THE ORGANIZATION'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING TOP OFFICIALS AND THE BOARD OF DIRECTORS WITH A TOOL FOR (A) CLEARLY COMMUNICATING PERFORMANCE ON THE PART OF KEY LEADERS, (B) STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE ON THE PART OF KEY LEADERS WHICH WILL ULTIMATELY BENEFIT THE COMMUNITIES MHC SERVES, AND (C) PROTECTING MHC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS MCLAREN INTEGRATED HMO GROUP. |
| FORM 990, PART VI, SECTION A, LINE 7A | MCLAREN INTEGRATED HMO GROUP, MDWISE'S SOLE MEMBER HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED BY MDWISE'S PRESIDENT & CEO AND ALSO BY THE CFO PRIOR TO FILING. AS PART OF AN INTEGRATED HEALTH SYSTEM, THE PARENT BOARD ALSO REVIEWS THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH MDWISE BOARD MEMBER, OFFICER AND SENIOR MANAGEMENT EXECUTIVE COMPLETES THE MDWISE CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. THE BOARD CHAIR AND PRESIDENT/CEO REVIEW ALL COMPLETED FORMS TO IDENTIFY ANY POTENTIAL CONFLICTS. ANY IDENTIFIED POTENTIAL CONFLICT IS INVESTIGATED AND RAISED WITH THE INDIVIDUAL, AS APPROPRIATE, TO RESOLVE THE CONFLICT OR DETERMINE IF ANY ACTION IS NEEDED, UP TO AND INCLUDING, POSSIBLE REMOVAL FROM THE BOARD, OR OFFICER/SENIOR MANAGEMENT POSITION. ANY IDENTIFIED CONFLICTS ARE REPORTED TO THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | TO ENSURE A FAIR, COMPETITIVE AND LEGALLY COMPLIANT METHOD OF ADMINISTERING COMPENSATION, MDWISE USES INDEPENDENT COMPENSATION STUDIES AND SURVEY DATA TO ESTABLISH THE COMPENSATION STRUCTURE FOR THE MDWISE CEO AND OFFICERS. COMPENSATION FOR THE CEO AND OFFICERS ARE REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE PROVIDED UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN NONADMITTED ASSET -769,962. |
| PART XII, LINE 1: | MDWISE, INC. USES THE STATUTORY METHOD OF ACCOUNTING. |
| PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN PROCESS FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (44 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MCLAREN BAY REGION FOUNDATION | |||||||||||
| 1900 COLUMBUS AVE | BAY CITY | MI | 48708 | 382156534 | FOUNDATION | MI | 501(C)(3) | LINE 12A, I | MCLAREN BAY REGION | Yes (1) | |
| MCLAREN BAY REGION | |||||||||||
| 1900 COLUMBUS AVE | BAY CITY | MI | 48708 | 381976271 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| BAY REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||
| 1908 COLUMBUS AVENUE | BAY CITY | MI | 48708 | 386081235 | SUPPORTING ORGANIZATION | MI | 501(C)(3) | LINE 12A, I | MCLAREN BAY REGION | Yes (1) | |
| MCLAREN BAY SPECIAL CARE | |||||||||||
| 3250 E MIDLAND ROAD STE 1 | BAY CITY | MI | 48706 | 383161753 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN BAY REGION | Yes (1) | |
| MCLAREN CENTRAL MICHIGAN | |||||||||||
| 1221 SOUTH DRIVE | MT PLEASANT | MI | 48858 | 381420304 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| CHARLEVOIX NURSING HOME CORPORATION DBA BOULDER PARK TERRACE | |||||||||||
| 14676 WEST UPRIGHT | CHARLEVOIX | MI | 49720 | 383038683 | SKILLED NURSING FACILITY | MI | 501(C)(3) | LINE 10 | MCLAREN NORTHERN MICHIGAN | Yes (1) | |
| KARMANOS CANCER FOUNDATION | |||||||||||
| 4100 JOHN R ST | DETROIT | MI | 48532 | 383584572 | CANCER CARE CENTER | MI | 501(C)(3) | LINE 7 | BARBARA ANN KARMANOS CANCER INSTITUTE | Yes (1) | |
| MCLAREN GREATER LANSING FOUNDATION | |||||||||||
| 401 W GREENLAWN AVE | LANSING | MI | 48910 | 382463637 | FOUNDATION | MI | 501(C)(3) | LINE 7 | MCLAREN GREATER LANSING | Yes (1) | |
| MCLAREN GREATER LANSING | |||||||||||
| 401 W GREENLAWN AVE | LANSING | MI | 48910 | 381434090 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| BARBARA ANN KARMANOS CANCER HOSPITAL | |||||||||||
| 4100 JOHN R ST | DETROIT | MI | 48201 | 201649466 | HOSPITAL | MI | 501(C)(3) | LINE 3 | BARBARA ANN KARMANOS CANCER INSTITUTE | Yes (1) | |
| BARBARA ANN KARMANOS CANCER INSTITUTE | |||||||||||
| 4100 JOHN R ST | DETROIT | MI | 48201 | 381613280 | CANCER RESEARCH & CARE CENTER | MI | 501(C)(3) | LINE 7 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MCLAREN LAPEER REGION | |||||||||||
| 1375 N MAIN ST | LAPEER | MI | 48446 | 382689033 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MCLAREN LAPEER REGION FOUNDATION | |||||||||||
| 1375 N MAIN ST | LAPEER | MI | 48446 | 382689603 | FOUNDATION | MI | 501(C)(3) | LINE 12A, I | MCLAREN LAPEER REGION | Yes (1) | |
| MARWOOD MANOR NURSING HOME | |||||||||||
| PO BOX 5011 | PORT HURON | MI | 48060 | 382683251 | NURSING HOME | MI | 501(C)(3) | LINE 10 | PORT HURON HOSPITAL | Yes (1) | |
| MCLAREN HEALTH CARE CORPORATION | |||||||||||
| ONE MCLAREN PARKWAY | GRAND BLANC | MI | 48439 | 382397643 | SUPPORTING ORG | MI | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| MCLAREN HEALTH CARE VILLAGE FOUNDATION | |||||||||||
| 401 S BALLENGER HIGHWAY | FLINT | MI | 48532 | 262693350 | SUPPORTING ORG | MI | 501(C)(3) | LINE 12A, I | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MCLAREN HEALTH PLAN COMMUNITY | |||||||||||
| G-3245 BEECHER ROAD SUITE 200 | FLINT | MI | 48532 | 272204037 | INSURANCE | MI | 501(C)(4) | MCLAREN HEALTH PLAN | Yes (1) | ||
| MCLAREN HEALTH PLAN INC | |||||||||||
| G-3245 BEECHER ROAD | FLINT | MI | 48532 | 383252216 | HEALTH CARE SERVICES | MI | 501(C)(4) | MCLAREN INTEGRTAED HMO GROUP | Yes (1) | ||
| MCLAREN HOSPICE AND HOME CARE FOUNDATION | |||||||||||
| 1515 CAL DR | DAVISON | MI | 48423 | 463643089 | FOUNDATION | MI | 501(C)(3) | LINE 12A, I | MCLAREN HEALTH MANAGEMENT GROUP | Yes (1) | |
| MCLAREN MEDICAL GROUP | |||||||||||
| 401 S BALLENGER HWY | FLINT | MI | 48532 | 382988086 | MANAGEMENT COMPANY | MI | 501(C)(3) | LINE 12A, I | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MCLAREN NORTHERN MICHIGAN | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 382146751 | ACUTE CARE HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MCLAREN NORTHERN MICHIGAN FOUNDATION | |||||||||||
| 360 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 382445611 | FOUNDATION | MI | 501(C)(3) | LINE 7 | MCLAREN NORTHERN MICHIGAN | Yes (1) | |
| MCLAREN PORT HURON | |||||||||||
| 1221 PINE GROVE AVENUE | PORT HURON | MI | 48060 | 381369611 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MCLAREN FLINT | |||||||||||
| 401 S BALLENGER HWY | FLINT | MI | 48532 | 382383119 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| MICHIGAN CANCER SOCIETY | |||||||||||
| 4100 JOHN R ST | DETROIT | MI | 48201 | 382823451 | CANCER RESEARCH | MI | 501(C)(3) | LINE 7 | BARBARA ANN KARMANOS CANCER INSTITUTE | Yes (1) | |
| MOUNT CLEMENS REGIONAL HEALTHCARE FOUNDATION | |||||||||||
| PO BOX 326 | MOUNT CLEMENS | MI | 48046 | 382578873 | FOUNDATION | MI | 501(C)(3) | LINE 10 | MCLAREN MACOMB | Yes (1) | |
| MCLAREN MACOMB | |||||||||||
| 1000 HARRINGTON | MOUNT CLEMENS | MI | 48043 | 381218516 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| NORTH OAKLAND NORTH MACOMB IMAGING INC | |||||||||||
| 50 NORTH PERRY STREET | PONTIAC | MI | 48342 | 382807040 | MRI IMAGING | MI | 501(C)(3) | LINE 3 | MCLAREN OAKLAND | Yes (1) | |
| NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 320020293 | PHYSICIAN PRACTICE | MI | 501(C)(3) | LINE 3 | MCLAREN NORTHERN MICHIGAN | Yes (1) | |
| NORTHERN MICHIGAN MEDICAL MANAGEMENT | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 208458840 | PHYSICIAN PRACTICE | MI | 501(C)(3) | LINE 3 | MCLAREN NORTHERN MICHIGAN | Yes (1) | |
| MCLAREN OAKLAND FOUNDATION | |||||||||||
| 50 NORTH PERRY STREET | PONTIAC | MI | 48342 | 200442217 | FOUNDATION | MI | 501(C)(3) | LINE 12C, III-FI | MCLAREN OAKLAND | Yes (1) | |
| MCLAREN OAKLAND | |||||||||||
| 50 NORTH PERRY STREET | PONTIAC | MI | 48342 | 381428164 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| PORT HURON HOSPITAL FOUNDATION | |||||||||||
| PO BOX 5011 | PORT HURON | MI | 48060 | 382777750 | FOUNDATION | MI | 501(C)(3) | LINE 12A, I | PORT HURON HOSPITAL | Yes (1) | |
| REGIONAL EMERGENCY MEDICAL SERVICE INC | |||||||||||
| 25400 W 8 MILE ROAD | SOUTHFIELD | MI | 48034 | 383255499 | AMBULANCE SERVICE | MI | 501(C)(3) | LINE 10 | MCLAREN MEDICAL MANAGEMENT INC | Yes (1) | |
| THE CARDIAC INSTITUTE DBA MICHIGAN HEART & VASCULAR SPECIALISTS | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 262774689 | PHYSICIAN PRACTICE | MI | 501(C)(3) | LINE 3 | MCLAREN NORTHERN MICHIGAN | Yes (1) | |
| MCLAREN HEALTH MANAGEMENT GROUP | |||||||||||
| 1515 CAL DRIVE | DAVISON | MI | 48423 | 383491714 | HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 10 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| VITALCARE INC | |||||||||||
| 761 LAFAYETTE AVENUE | CHEBOYGAN | MI | 49721 | 382527255 | HOSPICE CARE/HOME HEALTH SERVICES | MI | 501(C)(3) | LINE 10 | MCLAREN NORTHERN MICHIGAN | Yes (1) | |
| MCLAREN FLINT FOUNDATION | |||||||||||
| 401 S BALLENGER HIGHWAY | FLINT | MI | 48532 | 381358053 | SUPPORTING ORGANIZATION | MI | 501(C)(3) | LINE 12A, I | MCLAREN FLINT | Yes (1) | |
| CARO COMMUNITY HOSPITAL | |||||||||||
| 410 N HOOPER ST | CARO | MI | 48723 | 383426063 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| CARO COMMUNITY HOSPITAL ENDOWMENT FOUNDATION | |||||||||||
| 410 N HOOPER ST | CARO | MI | 48724 | 382422995 | FOUNDATION | MI | 501(C)(3) | LINE 12C, III-FI | CARO COMMUNITY HOSPITAL | Yes (1) | |
| MDWISE MEDICAID NETWORK INC | |||||||||||
| 2955 N MERIDIAN STREET SUITE 201 | INDIANAPOLIS | IN | 46208 | 473192307 | INSURANCE | IN | 501(C)(4) | MCLAREN INTEGRTAED HMO GROUP | Yes (1) | ||
| HURON MEMORIAL HOSPITAL | |||||||||||
| 1100 S VAN DYKE ROAD | BAD AXE | MI | 48413 | 381474929 | HOSPITAL | MI | 501(C)(3) | LINE 3 | MCLAREN HEALTH CARE CORPORATION | Yes (1) | |
| HURON MEMORIAL FOUNDATION | |||||||||||
| 1100 S VAN DYKE ROAD | BAD AXE | MI | 48413 | 382717147 | FOUNDATION | MI | 501(C)(3) | LINE 7 | HURON MEMORIAL HOSPITAL | Yes (1) | |
| MCLAREN INTEGRATED HMO GROUP | |||||||||||
| G-3245 BEECHER ROAD | FLINT | MI | 48532 | 824449304 | HEALTH CARE SERVICES | MI | 501(C)(4) | MCLAREN HEALTH CARE CORPORATION | Yes (1) | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MCLAREN - NORTHERN EQUITIES CANCER CENTER PROJECT LLC | |||||||
| 39000 COUNTRY CLUB DRIVE | FARMINGTON HILLS | MI | 48331 | 263112935 | RENTAL REAL ESTATE | MI | N/A |
| MOUNT CLEMENS REGIONAL HEALTH BUILDING HEALTH PARTNERS | |||||||
| 1000 HARRINGTON ST | MOUNT CLEMENS | MI | 48043 | 262524717 | BUILDING MANAGEMENT | MI | N/A |
| SOUTH VAN DYKE MEDICAL COMPLEX-A | |||||||
| 125 N HANSELMAN ST | BAD AXE | MI | 48413 | 383372174 | VARIOUS HEALTHCARE ACTIVITIES | MI | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLARKSTON PROPERTY ASSOCIATES | |||||||||||||
| 50 NORTH PERRY STREET | PONTIAC | MI | 48342 | 432006072 | REAL ESTATE | MI | N/A | C | 0 | ||||
| DELPHINUS INVESTMENT INC | |||||||||||||
| 4100 JOHN R ST | DETROIT | MI | 48075 | 454758176 | HOLD PASSIVE INVESTMENT | MI | N/A | C | Yes (1) | ||||
| HEALTH ADVANTAGE INC | |||||||||||||
| G3245 BEECHER ROAD | FLINT | MI | 48532 | 912141720 | INSURANCE | MI | N/A | C | Yes (1) | ||||
| MCLAREN INSURANCE COMPANY LTD | |||||||||||||
| INSURANCE | N/A | C | Yes (1) | 10 MAIN ST | GRAND CAYMAN | CJ | CJ | ||||||
| MID-MICHIGAN PHYSICIANS PC | |||||||||||||
| 2510 KERRY STREET SUITE 200 | LANSING | MI | 48912 | 383267121 | PHYSICIAN PRACTICE | MI | N/A | C | Yes (1) | ||||
| MCLAREN PHYSICIAN PARTNERS | |||||||||||||
| ONE MCLAREN PARKWAY | GRAND BLANC | MI | 48439 | 383136458 | MANAGED CARE | MI | N/A | C | 0 | ||||
| RAPIN & RAPIN INC DBA PRESCRIPTION SERVICES PHARMACY | |||||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 383465261 | RETAIL PHARMACY | MI | N/A | C | Yes (1) | ||||
| VITALCARE HOME MEDICAL EQUIPMENT INC | |||||||||||||
| 761 LAFAYETTE AVENUE | CHEBOYGAN | MI | 49721 | 382662954 | SALE AND RENTAL OF DURABLE MEDICAL EQUIPMENT | MI | N/A | C | Yes (1) | ||||
| HURON CLINIC CONDOMINIUMS OWNERS | |||||||||||||
| 125 N HANSELMAN ST | BAD AXE | MI | 48413 | 412144341 | VARIOUS HEALTHCARE ACTIVITIES | MI | N/A | C | Yes (1) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MDWISE MEDICAID NETWORK INC | ||
| S | $1,128,329,819 | CASH |
| MDWISE MEDICAID NETWORK INC | ||
| R | $1,194,691,407 | CASH |
| MDWISE MEDICAID NETWORK INC | ||
| Q | $1,009,535 | ALLOCATION OF ACTUAL COST |
| MDWISE MEDICAID NETWORK INC | ||
| O | $7,903,191 | ALLOCATION OF ACTUAL COST |
| MCLAREN INTEGRATED HMO GROUP | ||
| Q | $325,109 | ALLOCATION OF ACTUAL COST |
| MCLAREN INTEGRATED HMO GROUP | ||
| P | $19,308,216 | ALLOCATION OF ACTUAL COST |