﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2019v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2020-11-05T07:54:27-06:00</ReturnTs>
    <TaxPeriodEndDt>2019-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>381357951</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PLANTE &amp; MORAN PLLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>2601 CAMBRIDGE COURT SUITE 500</AddressLine1Txt>
        <CityNm>AUBURN HILLS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48326</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2019-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>382018957</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>TOTAL HEALTH CARE INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>TOTA</BusinessNameControlTxt>
      <PhoneNum>3138712000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>3011 W GRAND BLVD NO 1600</AddressLine1Txt>
        <CityNm>DETROIT</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48202</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>RANDY NAROWITZ</PersonNm>
      <PersonTitleTxt>EXECUTIVE DIRECTOR</PersonTitleTxt>
      <PhoneNum>3138712000</PhoneNum>
      <SignatureDt>2020-10-27</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>LYNNE M HUISMANN</PreparerPersonNm>
      <PTIN>P00053811</PTIN>
      <PhoneNum>2483757100</PhoneNum>
      <PreparationDt>2020-10-26</PreparationDt>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>73.18.16.165</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2020-10-27</IPDt>
      <IPTm>15:00:56</IPTm>
      <IPTimezoneCd>ED</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>DA39A3EE5E6B4B0D3255BFEF95601890AFD80709</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>FA6B6BDBF4F55FC4B74C781E24C8D16A421CCE4E</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2019</TaxYr>
    <BuildTS>2021-04-22 16:20:28Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>RANDY NAROWITZ</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>3011 W GRAND BLVD NO 1600</AddressLine1Txt>
        <CityNm>DETROIT</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48202</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>191443767</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="4">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.THCMI.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1973</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>HEALTH MAINTENANCE ORGANIZATION PROVIDING COMPREHENSIVE MEDICAL SERVICES AND INSURANCE TO SUBSCRIBERS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>5</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>5</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>183424560</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>180666839</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>14461164</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>10776928</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>197885724</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>191443767</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>165447692</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>172251871</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1000</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1000</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>25738508</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>24643808</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>191187200</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>196896679</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>6698524</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-5452912</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>108837582</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>104297480</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>57556808</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>65222548</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>51280774</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>39074932</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TOTAL HEALTH CARE, INC. IS COMMITTED TO EXCELLENCE IN HEALTH CARE DELIVERY IN THE STATE OF MICHIGAN AND THE ASSURANCE THAT ITS MEMBERS HAVE ACCESS TO AND RECEIVE HIGH QUALITY HEALTH CARE AND THE APPROPRIATE PREVENTATIVE SERVICES THAT PROMOTE WELLNESS AND IMPROVED HEALTH STATUS WITHIN THE COMMUNITY. TOTAL HEALTH CARE, INC. SUPPORTS A CONTINUOUS QUALITY IMPROVEMENT PROCESS THAT CONTRIBUTES TO THE OVERALL IMPROVEMENT OF THE MAINSTREAM OF HEALTH CARE DELIVERY IN A COST EFFECTIVE MANNER. TOTAL HEALTH CARE, INC. MAINTAINS AN ORGANIZATIONAL SERVICE PHILOSOPHY OF BEING TOTALLY AVAILABLE AND TOTALLY HELPFUL.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>172251871</ExpenseAmt>
      <RevenueAmt>180666839</RevenueAmt>
      <Desc>HEALTH MAINTENANCE ORGANIZATION PROVIDING COMPREHENSIVE MEDICAL SERVICES AND INSURANCE TO APPROXIMATELY 48,919 SUBSCRIBERS. THE ORGANIZATION ALSO: - ENCOURAGES PARTICIPATION IN A SUPERVISED WEIGHT LOSS PROGRAM FOR ADULTS AND ADOLESCENTS BY PAYING FOR THE WEIGHT WATCHERS PLAN.- ASSISTS WITH COMMUNITY, CHURCH AND EMPLOYER SPONSORED HEALTH FAIRS WHICH INCLUDE MANY HEALTH SCREENINGS. PROVIDES MATERIALS TO ATTENDEES FOR VARIOUS HEALTH CONDITIONS AND DISEASES TO ASSIST IN HEALTHIER LIFESTYLES. - EDUCATES INDIVIDUALS ON NUMEROUS DISEASES TO ENABLE MEMBERS TO BETTER CARE FOR THEMSELVES AND IMPROVE THE MANAGEMENT OF THEIR CONDITION.- DISTRIBUTES HEALTH BROCHURES TO COMMUNITY HEALTH FAIRS, EMPLOYER GROUPS AND PHYSICIAN OFFICES.- ENCOURAGES SMOKING CESSATION THROUGH VARIOUS MEANS AND PARTICIPATION IN PROGRAMS OFFERED BY THE STATE. PROVIDES PAYMENT FOR MEDICATIONS TO ASSIST IN THE BREAKING OF ADDICTION.- PUBLISHES THE GOOD HEALTH GAZZETTE ON QUARTERLY BASIS TO THE MEMBERSHIP AND PHYSICIANS CONTAINING ARTICLES ON NUTRITION, WEIGHT LOSS, HEALTH SCREENINGS AND OTHER HEALTHCARE MATTERS.- EDUCATES EXPECTANT MOTHERS RELATED TO THEIR PREGNANCY AND THE CARE AND DEVELOPMENT OF THEIR NEWBORN.- OFFERS MEDICAL INTERNSHIP FOR HIGH SCHOOL STUDENTS TO ENCOURAGE CAREERS IN THE HEALTHCARE PROFESSION, IN COOPERATION WITH WAYNE STATE SCHOOL OF MEDICINE.</Desc>
      <TotalProgramServiceExpensesAmt>172251871</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind>0</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">0</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>1</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>1928</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>5</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>5</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>1</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>1</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>RANDY NAROWITZ</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>3138712000</PhoneNum>
        <USAddress>
          <AddressLine1Txt>3011 W GRAND BLVD SUITE 1600</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48202</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>RANDY NAROWITZ</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1422586</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>79024</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBYN J ARRINGTONJRMD</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>1067390</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22339</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NICOLE ROUSH</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>306517</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>53528</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NOEL UPFALL</PersonNm>
        <TitleTxt>ASSOC MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>285517</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35528</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NOAH MONRO</PersonNm>
        <TitleTxt>CHIEF INFORMATION OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>210757</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26617</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN RYAN</PersonNm>
        <TitleTxt>PROVIDER RELATIONS/CONTRACTING MANAGER</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>155919</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24785</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SARA MCGLYNN</PersonNm>
        <TitleTxt>CONTROLLER</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>145624</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23052</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KANU PATEL</PersonNm>
        <TitleTxt>ADMINISTRATION</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>142142</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22921</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY KOWAL</PersonNm>
        <TitleTxt>CHIEF COMPLIANCE OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>134805</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16495</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLI KRUEGER</PersonNm>
        <TitleTxt>SENIOR ANALYST</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>141240</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7804</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOUGLAS P BAKER</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>56000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>269</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RUBY O COLE</PersonNm>
        <TitleTxt>VICE-CHAIRPERSON &amp; SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>56000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>81</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEANETTE ABBOTT</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>56000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>81</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELIZABETH PRATCHER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>3500</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTA POOLE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>1000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOREEN CARTER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>500</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4013497</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>174000</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>312524</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>24</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>1</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ENVISION PHARMACEUTICAL SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2181 E AURORA RD STE 201</AddressLine1Txt>
            <CityNm>MINNEAPOLIS</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>55401</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHARMACY BENEFITS MANAGEMENT</ServicesDesc>
        <CompensationAmt>29194578</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>UNIVERSL HEALTH MANAGEMENT</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>20836 HALL RD STE 317</AddressLine1Txt>
            <CityNm>CLINTON TWP</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48038</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ADMINISTRATIVE SERVICES COMPANY</ServicesDesc>
        <CompensationAmt>24073155</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PARTNERS FOR HEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>882 OAKMAN BLVD</AddressLine1Txt>
            <CityNm>DETROIT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48238</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEMBERS ASSISTANCE</ServicesDesc>
        <CompensationAmt>775530</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HUMAN ARC CORPORATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 637901</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45263</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CLAIMS RECOVERY</ServicesDesc>
        <CompensationAmt>208000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SVS VISION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>140 MACOMB PL</AddressLine1Txt>
            <CityNm>MOUNT CLEMENS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48043</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>VISION</ServicesDesc>
        <CompensationAmt>178989</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>96</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID CAPITATION</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>180666839</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>180666839</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>180666839</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>10776928</TotalRevenueColumnAmt>
        <ExclusionAmt>10776928</ExclusionAmt>
      </InvestmentIncomeGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>191443767</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>180666839</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>10776928</ExclusionAmt>
      </TotalRevenueGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>172251871</TotalAmt>
        <ProgramServicesAmt>172251871</ProgramServicesAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1000</TotalAmt>
        <ManagementAndGeneralAmt>1000</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>174000</TotalAmt>
        <ManagementAndGeneralAmt>174000</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>45000</TotalAmt>
        <ManagementAndGeneralAmt>45000</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <InsuranceGrp>
        <TotalAmt>223632</TotalAmt>
        <ManagementAndGeneralAmt>223632</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>ADMINISTRATIVE EXPENSES</Desc>
        <TotalAmt>24073155</TotalAmt>
        <ManagementAndGeneralAmt>24073155</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CLAIMS TAX EXPENSE</Desc>
        <TotalAmt>123782</TotalAmt>
        <ManagementAndGeneralAmt>123782</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER ADMINSTRAVE COSTS</Desc>
        <TotalAmt>4239</TotalAmt>
        <ManagementAndGeneralAmt>4239</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>196896679</TotalAmt>
        <ProgramServicesAmt>172251871</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24644808</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>18644260</BOYAmt>
        <EOYAmt>34345944</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>39863691</BOYAmt>
        <EOYAmt>30761818</EOYAmt>
      </AccountsReceivableGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>6382299</BOYAmt>
        <EOYAmt>1962487</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>43871028</BOYAmt>
        <EOYAmt>37153573</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>76304</BOYAmt>
        <EOYAmt>73658</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>108837582</BOYAmt>
        <EOYAmt>104297480</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>57556808</BOYAmt>
        <EOYAmt>65222548</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>57556808</BOYAmt>
        <EOYAmt>65222548</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PdInCapSrplsLandBldgEqpFundGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>51280774</BOYAmt>
        <EOYAmt>39074932</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>51280774</BOYAmt>
        <EOYAmt>39074932</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>108837582</BOYAmt>
        <EOYAmt>104297480</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-5452912</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-6752930</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>MAINTAINED UNDER STATUTORY REQUIREMENTS</Desc>
        <BookValueAmt>1056905</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>INVESTMENT IN SUBSIDIARIES</Desc>
        <BookValueAmt>36096668</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>37153573</TotalBookValueSecuritiesAmt>
      <TotalRevEtcAuditedFinclStmtAmt>225903869</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>34460102</OtherRevenueAmt>
      <RevenueNotReportedAmt>34460102</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>191443767</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>191443767</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>231356781</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>34460102</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>34460102</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>196896679</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>196896679</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>INSURANCE PROVIDER ASSESSMENT 34,460,102.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>INSURANCE PROVIDER ASSESSMENT 34,460,102.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RANDY NAROWITZ</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>670086</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>752500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14000</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23024</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>42000</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1459610</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>42000</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBYN J ARRINGTONJRMD</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>533695</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>533695</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14000</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8339</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1089729</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NICOLE ROUSH</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>239017</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>67500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14000</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21528</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>18000</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>342045</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>18000</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NOEL UPFALL</PersonNm>
        <TitleTxt>ASSOC MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>263017</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>22500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14000</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21528</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>321045</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NOAH MONRO</PersonNm>
        <TitleTxt>CHIEF INFORMATION OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>183257</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>27500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10538</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16079</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>237374</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUSAN RYAN</PersonNm>
        <TitleTxt>PROVIDER RELATIONS/CONTRACTING MANAG</TitleTxt>
        <BaseCompensationFilingOrgAmt>128419</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>27500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7796</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16989</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>180704</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SARA MCGLYNN</PersonNm>
        <TitleTxt>CONTROLLER</TitleTxt>
        <BaseCompensationFilingOrgAmt>138124</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>7500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7281</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15771</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>168676</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KANU PATEL</PersonNm>
        <TitleTxt>ADMINISTRATION</TitleTxt>
        <BaseCompensationFilingOrgAmt>119642</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>22500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7107</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15814</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>165063</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NANCY KOWAL</PersonNm>
        <TitleTxt>CHIEF COMPLIANCE OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>79805</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>55000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6740</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9755</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>151300</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SEE SCHEDULE O FOR ADDITIONAL REPORTING.</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE SCHEDULE O FOR ADDITIONAL REPORTING. THE COMPENSATION FOR THE FOLLOWING INDIVIDUALS REPORTED ON PART VII, COLUMN D IS FROM UNIVERSAL HEALTH MANAGEMENT, LLC., AN UNRELATED COMPANY. NOAH MONRO, SUSAN RYAN, ROBYN J. ARRINGTON, JR., MD, RANDY NAROWITZ, NICOLE ROUSH, KELLI KRUEGER, NANCY KOWAL, SARA MCGLYNN, KANU PATEL AND NOEL UPFALL MD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SEE SCHEDULE O FOR ADDITIONAL REPORTING.</FormAndLineReferenceDesc>
        <ExplanationTxt>TOTAL HEALTH CARE USA, INC PAID CLUB DUES FOR RANDY NAROWITZ AND NICOLE ROUSH.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>UNIVERSAL HEALTH MANAGEMENT LLC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>ROBYN J. ARRINGTON, JR., MD INDIRECTLY OWNS MORE THAN 35% OF UHM, LLC.</RelationshipDescriptionTxt>
        <TransactionAmt>24073155</TransactionAmt>
        <TransactionDesc>ADMINISTRATIVE SERVICES COMPANY</TransactionDesc>
        <SharingOfRevenuesInd>1</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP: RANDY NAROWITZ, NICOLE ROUSH, ROBYN ARRINGTON, NOEL UPFALL, NANCY KOWAL, NOAH MONRO, SARA MCGLYNN, KELLI KRUEGER, AND KANU PATEL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THC HAS CONTRACTED WITH AN ADMINISTRATIVE SERVICES COMPANY, UNIVERSAL HEALTH MANAGEMENT LLC, TO PERFORM THESE FUNCTIONS, SUCH AS HIRING THE NECESSARY EMPLOYEES. THE PERFORMANCE OF THESE SERVICES BY UHM IS SUBJECT TO OVERSIGHT BY THE BOARD OF TOTAL HEALTH CARE, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>AS OF 12/30/19, THE ARTICLES WERE AMENDED TO REFLECT TOTAL HEALTH CARE FOUNDATION AS THE SOLE MEMBER OF TOTAL HEALTH CARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER IS THE TOTAL HEALTH CARE FOUNDATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TAX RETURN IS REVIEWED BY ITS CHIEF FINANCIAL OFFICER AND EXECUTIVE DIRECTOR BEFORE FILING. THE TAX RETURN IS PROVIDED AT THE BOARD MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>TOTAL HEALTH CARE, INC. HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES, WHICH REQUIRES NOTIFICATION TO THE COO OR CEO OF ANY POTENTIAL CONFLICTS. FAILURE TO DO SO PUTS THE EMPLOYEE AT RISK OF TERMINATION. OFFICERS AND BOARD MEMBERS ARE REQUIRED TO ANNUALLY CERTIFY THE CONFLICT OF INTEREST STATEMENT, WHICH ALSO REQUIRES NOTIFICATION TO THE BOARD OF DIRECTORS IF ANY POTENTIAL CONFLICTS ARISE DURING THE YEAR. THE ANNUAL STATEMENTS ARE REVIEWED BY THE EXECUTIVE AND BOARD CHAIR IF THERE ARE CONCERNS ABOUT POTENTIAL CONFLICTS. IF ANY CONFLICT EXISTS, THE INDIVIDUAL WOULD ABSTAIN FROM ANY ACTION OR INVOLVEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL COMPENSATION IS PAID BY AN ADMINISTRATIVE SERVICES COMPANY, UNIVERSAL HEALTH MANAGEMENT LLC. HOWEVER, BEGINNING IN 2017, COMPENSATION FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IS DISCUSSED AND APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION FOR OTHER OFFICERS OR KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE TOP MANAGEMENT OFFICIALS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATIONAL DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>INCOME FROM SUBSIDIARY EQUITY INVESTMENT - TOTAL HEALTHCARE USA -6,752,930.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE HAVE BEEN NO CHANGES FROM PRIOR YEAR TO THE OVERSIGHT RESPONSIBILITIES OF THE AUDIT COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>990 PART IV, LINE 12:</FormAndLineReferenceDesc>
        <ExplanationTxt>TOTAL HEALTH CARE, INC. HAS ITS FINANCIAL STATEMENTS AUDITED UNDER THE STATUTORY BASIS OF ACCOUNTING, AS OPPOSED TO UNDER THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) BASIS OF ACCOUNTING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, COLUMN (D) &amp; SCHEDULE J, PART II, ROW (I):</FormAndLineReferenceDesc>
        <ExplanationTxt>TOTAL HEALTH CARE INC., HAS ENTERED INTO AN ADMINISTRATIVE SERVICES CONTRACT WITH AN ADMINISTRATIVE SERVICES COMPANY, UNIVERSAL HEALTH MANAGEMENT, LLC. ALL SALARIES AND BENEFITS ARE PAID BY THE ADMINISTRATIVE SERVICES COMPANY TO ITS EMPLOYEES WHO PROVIDE SERVICES TO TOTAL HEALTH CARE, INC. THE AMOUNTS SHOWN AS COMPENSATION FOR THE OFFICERS AND EMPLOYEES ON SCHEDULE J ARE THE TOTAL W-2 COMPENSATION FOR THE YEAR. ONLY A PORTION OF THIS COMPENSATION IS ATTRIBUTABLE TO THEIR SERVICES FOR TOTAL HEALTH CARE, INC. THE REMAINING SERVICES ARE ATTRIBUTABLE TO A RELATED ENTITY, TOTAL HEALTH CARE USA, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TOTAL HEALTH CARE USA INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3011 W GRAND BLVD SUITE 1600</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48202</ZIPCd>
        </USAddress>
        <EIN>383240485</EIN>
        <PrimaryActivitiesTxt>HMO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>IRC CODE 501(C)(4)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TOTAL HEALTH CARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TOTAL HEALTH CARE FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3011 W GRAND BLVD SUITE 1600</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48202</ZIPCd>
        </USAddress>
        <EIN>842310771</EIN>
        <PrimaryActivitiesTxt>FOUNDATION SUPPORTING HEALTH CARE ACTIVITIES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>IRC CODE 501(C)(4)</ExemptCodeSectionTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>1</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TOTAL HEALTH CARE USA INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>34009767</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COSTS</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TOTAL HEALTH CARE USA INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>F</TransactionTypeTxt>
        <InvolvedAmt>10000000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL RECEIVED</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>