2020-09-04T15:29:37-05:00 2019-12-31 351489521 GREENWALT CPAS INC 5342 W VERMONT STREET INDIANAPOLIS IN 46224 990 2019-01-01 350411650 INDIANA STATE MEDICAL ASSOCIATION INDI 3172612060 322 CANAL WALK INDIANAPOLIS IN 462023268 JULIE D REED EXECUTIVE VICE PRESIDENT 3172612060 2020-08-07 1 AMANDA MEKO CPA P01062615 3172412999 2020-08-07 50.222.35.158 2020-08-07 11:05:30 US P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 69FDE0FCA6B6959D707F5308BCB93833B6F76445 2019 2020-11-19 02:30:22Z JULIE D REED 322 CANAL WALK INDIANAPOLIS IN 462023268 5027479 0 X WWW.ISMANET.ORG X 1849 IN PHYSICIAN ORG IN INDIANA, ADVOCATING FOR THE WELL-BEING OF DOCTORS AND THEIR PATIENTS. 23 19 33 0 286420 0 1758004 2168897 219487 220162 2181468 676128 1420505 1550028 5579464 4615215 1023572 23524 0 0 2428084 2641577 0 0 0 1471643 1422056 4923299 4087157 656165 528058 19231204 19810835 3422014 1975955 15809190 17834880 THE INDIANA STATE MEDICAL ASSOCIATION EXISTS TO MAXIMIZE THE LEADERSHIP AND IMPACT OF PHYSICIANS. 0 0 THE ASSOCIATION CONDUCTS BUSINESS FOR THE PURPOSE OF IMPROVING THE KNOWLEDGE AND STANDARDS OF MEDICAL MATTERS IN INDIANA. ALL ACTIVITIES ARE CARRIED ON TO ACCOMPLISH THE OBJECTIVES OF THE ASSOCIATION. THIS IS DONE THROUGH SEMINARS AND PUBLICATIONS WHICH EXTEND MEMBERS' MEDICAL KNOWLEDGE AND ELEVATE STANDARDS OF MEDICAL EDUCATION, FIELD SERVICES WHICH KEEP MEMBERS ABREAST OF NEW DEVELOPMENTS IN AN EVER-CHANGING ENVIRONMENT, AND LEGISLATIVE SERVICES WHICH HELP MEMBERS PARTICIPATE IN GOVERNMENT TO HELP DERIVE THE BEST HEALTH CARE SYSTEM FOR THE COMMUNITY, AND PROVIDE BENEFITS TO MEMBERS. 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 33 0 1 33 1 1 1 0 0 0 1 1 0 0 0 X 23 19 0 0 0 0 1 1 0 1 1 0 1 1 0 1 1 1 1 1 1 1 0 IN X MARK INGOLD 3172612060 322 CANAL WALK INDIANAPOLIS IN 462023268 STACIE WENK DO IMMEDIATE PAST PRESIDENT 6.00 X X 44307 0 0 LISA HATCHER MD PRESIDENT 20.00 X X 12812 0 0 J ELIZABETH STRUBLE MD CHAIR BOARD OF TRUSTEES 12.00 X 4271 0 0 ANN PATTERSON MD TRUSTEE 1.00 X 0 0 0 SHALIN ARNETT DO TRUSTEE 1.00 X 0 0 0 HELEN BORGENHEIMER MD TRUSTEE 1.00 X 0 0 0 VIPUL BRAHMBHATT MD TRUSTEE 1.00 X 0 0 0 RUPESH SHAH DO TRUSTEE 1.00 X 0 0 0 NATALI BALOG MD TRUSTEE 1.00 X 0 0 0 ROBERTO DARROCA MD PRESIDENT-ELECT 6.00 X X 0 0 0 PARDEEP KUMAR MD TREASURER 1.00 X X 0 0 0 JOHN ELLIS MD TRUSTEE 1.00 X 0 0 0 DAVID DIAZ MD TRUSTEE 1.00 X 0 0 0 THOMAS ORMAN MD TRUSTEE 1.00 X 0 0 0 WILLIAM POND MD ASSISTANT TREASURER 1.00 X X 0 0 0 RYAN SINGERMAN DO TRUSTEE 1.00 X 0 0 0 TERESA LOVINS MD TRUSTEE 1.00 X 0 0 0 JACQUES DAOUD MD TRUSTEE 1.00 X 0 0 0 ANGELA WAGNER DO TRUSTEE 1.00 X 0 0 0 SVETLANA HAGAN MD TRUSTEE 1.00 X 0 0 0 DAVID SCOTT MD TRUSTEE 1.00 X 0 0 0 KIMBERLY CHERNOBY MD TRUSTEE 1.00 X 0 0 0 KELSEY QUIN TRUSTEE 1.00 X 0 0 0 ALEXANDER CHOI MD VICE SPEAKER 1.00 X 0 0 0 JULIE REED EXECUTIVE VICE PRESIDENT 50.00 X 317678 0 79176 ANDREW TROBRIDGE MD SPEAKER 1.00 X 0 0 0 CHELSEA KURTH GENERAL COUNSEL 50.00 X 133883 0 17076 MARK INGOLD VICE PRESIDENT OF FINANCE 50.00 X 121245 0 33549 634196 0 129801 3 0 1 0 CANAL SQUARE LIMITED PARTNERSHIP 359 NORTH WEST STREET INDIANAPOLIS IN 46202 RENT 211244 BARNES & THORNBURG LLP 11 S MERIDIAN ST STE 1313 INDIANAPOLIS IN 46204 ATTORNEY 145062 2 2168897 2168897 PROGRAM SEMINAR REVENU 611430 199067 199067 PUBLICATION REVENUE 611430 21095 21095 220162 642805 642805 612024 612024 445587 412264 33323 33323 33323 ADMINISTRATIVE SERVICE 561000 685734 409314 276420 GRANTS AND SPONSORSHIP 900099 174207 174207 ACCREDITATION CME 611430 67475 67475 10588 588 10000 938004 4615215 1483770 286420 676128 20524 3000 379068 1496571 179958 452158 133822 147845 39445 27602 19863 133705 99 225044 95324 236110 139921 202722 67519 26919 LICENSES AND FEES 35056 REPAIRS AND MAINTENANCE 21397 EMPLOYEE TRAINING AND D 2306 INCOME TAX EXPENSE 1179 4087157 1114107 906069 1303169 35475 181126 454246 110195 134084 645047 518469 146228 126578 16204200 17860585 1000 1000 171179 292798 19231204 19810835 756637 957430 2343759 880984 321618 137541 3422014 1975955 X 15614492 17814451 194698 20429 15809190 17834880 19231204 19810835 528058 1497632 0 X X 0 1 X 1 0 INDIANA MEDICAL POLITICAL ACTION COMMITTEE 322 CANAL WALK INDIANAPOLIS IN 46202 351485797 0 0 0 2168897 447580 447580 563914 -116334 PART I-A, LINE 1: THE INDIANA STATE MEDICAL ASSOCIATION (ISMA) DOES NOT CONTRIBUTE ANY OF ITS FUNDS FOR DIRECT OR INDIRECT POLITICAL CAMPAIGN ACTIVITIES. MEMBERS ARE ALLOWED TO MAKE CONTRIBUTIONS TO THE INDIANA MEDICAL POLITICAL ACTION COMMITTEE (IMPAC), A SEPERATELY ESTABLISHED ORGANIZATION. THESE FUNDS ARE COLLECTED FROM MEMBERS BY ISMA AND PROMPTLY REMITTED TO THE IMPAC. 2018 WAS THE LAST YEAR THAT ISMA COLLECTED AND REMITTED CONTRIBUTIONS ON BEHALF OF IMPAC. BEGINNING IN 2019, IMPAC IS NOW DIRECTLY COLLECTING ALL OF ITS CONTRIBUTIONS FROM ISMA MEMBERS. 150033 112016 38017 495014 406453 88561 126578 DUES COLLECTED FOR OTHER ORGANIZATION 137541 137541 6623948 1497632 1277520 2775152 3848796 766419 766419 4615215 4451739 1131001 1131001 3320738 766419 766419 4087157 PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE REPORTED AS EIN 23-7001672 229,325. REVENUE REPORTED AS EIN 35-1731389 1,048,195. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUE ELIMINATED IN CONSOLIDATION 756,419. RECLASS GRANT 10,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES REPORTED AS EIN 23-7001672 177,311. EXPENSES REPORTED AS EIN 35-1731389 953,619. OTHER ADJUSTMENT 71. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES ELIMINATED IN CONSOLIDATION 756,419. RECLASS GRANT 10,000. FORM 990, PART XII, LINE 4B INDIANA STATE MEDICAL ASSOCIATION'S AUDITED FINANCIAL STATEMENTS ARE PRESENTED ON A CONSOLIDATED BASIS. THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF THE ASSOCIATION AND ITS WHOLLY-OWNED FOR PROFIT SUBSIDIARY, INDIANA STATE MEDICAL ASSOCIATION INSURANCE AGENCY, INC. (ISMAIA), EIN NUMBER 35-1731389 AND CONTROLLED TAX EXEMPT ENTITY INDIANA MEDICAL FOUNDATION, INC. (IMF), EIN 23-7001672. THE PURPOSE OF THE ISMAIA IS TO MARKET INSURANCE PRODUCTS TO PHYSICIANS AND OTHER PROFESSIONAL PERSONS. THE ORGANIZATION'S SCHEDULE D HAS BEEN RECONCILED TO THE CONSOLIDATED FINANCIAL STATEMENTS. 1 INDIANA STATE MEDICAL ASSOCIATION ALLIANCE INC 322 CANAL WALK INDIANAPOLIS IN 46202 300199265 501(C)(3) 16620 OPERATIONAL SUPPORT 1 FORM 990, SCHEDULE I, PART IV CONTRIBUTIONS TO THE ISMA ALLIANCE ARE AUTHORIZED BY A RESOLUTION PASSED BY THE HOUSE OF DELEGATES, IS BASED ON ISMA MEMBERSHIP, AND IS FOR THE PURPOSE OF PROVIDING FINANCIAL SUPPORT FOR THE ALLIANCE ACTIVITIES. THE ALLIANCE PRESENTS PERIODIC REPORTS OF ITS ACTIVITIES TO THE BOARD OF TRUSTEES. X X X X X 0 0 0 JULIE REED EXECUTIVE VICE PRESIDENT 277438 0 40000 0 240 0 55763 0 23413 0 396854 0 0 0 CHELSEA KURTH GENERAL COUNSEL 113415 0 20372 0 96 0 16279 0 797 0 150959 0 0 0 MARK INGOLD VICE PRESIDENT OF FINANCE 115255 0 5750 0 240 0 14521 0 19028 0 154794 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 AS A MEMBERSHIP ORGANIZATION, INDIANA STATE MEDICAL ASSOCIATION IS COMPRISED OF A GROUP OF INDIVIDUALS WHO MEET SPECIFIC QUALIFICATIONS AS A MEMBER INTO ONE OF SEVEN DISTINCT MEMBERSHIP CATEGORIES. FORM 990, PART VI, SECTION A, LINE 7A WITH THE EXCEPTION OF HONORARY MEMBERS, ALL ISMA PHYSICIAN MEMBERS ARE ELIGIBLE TO VOTE AND HOLD OFFICE AS SPECIFIED IN THE BYLAWS. ISMA IS DIVIDED INTO THIRTEEN (13) REGIONAL DISTRICTS. ALL MEMBERS OF ISMA MAY ATTEND THEIR DISTRICT'S ANNUAL MEETING AND VOTE TO ELECT THE DISTRICT'S TRUSTEE AND ALTERNATE TRUSTEE. THESE DISTRICT TRUSTEES AND ALTERNATES MAKE UP ISMA'S BOARD OF TRUSTEES WHO ARE PART OF THE GOVERNING BODY. WITH THE EXCEPTION OF THE EXECUTIVE VICE PRESIDENT, THE OFFICERS OF THIS ASSOCIATION ARE ELECTED BY A MAJORITY VOTE OF THE HOUSE OF DELEGATES AT ISMA'S ANNUAL MEETING. PERSONS ENTITLED TO VOTE FOR OFFICERS AT THE HOUSE OF DELEGATES ARE: 1) DELEGATES OR THE DESIGNATED ALTERNATES, WHICH ARE SELECTED BY THEIR COUNTY MEDICAL SOCIETIES; 2) TRUSTEES OR THE DESIGNATED ALTERNATES; 3) SPEAKER; 4) VICE SPEAKER; AND 5) PAST PRESIDENTS. PERSONS WHO ARE NOT ENTITLED TO VOTE ARE: 1) PRESIDENT; 2) PRESIDENT-ELECT; 3) EXECUTIVE VICE PRESIDENT; 4) TREASURER; 5) ASSISTANT TREASURER; 6) DELEGATES AND ALTERNATE DELEGATES TO THE AMERICAN MEDICAL ASSOCIATION; AND 7) SECTION DELEGATES OR DESIGNATED ALTERNATE DELEGATES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS COMPLETED BY AN EXTERNAL CERTIFIED PUBLIC ACCOUNTING FIRM. THE FINANCIAL INFORMATION IS REVIEWED INTERNALLY AND TIED BACK TO AUDITED FINANCIAL STATEMENTS TO VERIFY ACCURACY. ALL OTHER INFORMATION IS REVIEWED FOR ACCURACY PRIOR TO SIGNING AND SUBMISSION. THE FORM 990 IS PROVIDED TO ALL MEMBERS OF THE EXECUTIVE COMMITTEE FOR REVIEW AND COMMENTS PRIOR TO SIGNING AND SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C ISMA ANNUALLY SENDS OUT REQUESTS FOR DISCLOSURES OR UPDATES OF DISCLOSURES OF CONFLICTS OF INTEREST TO ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. IF RESPONSES ARE NOT RECEIVED, ISMA SENDS OUT ADDITIONAL REQUESTS. ONCE THOSE DISCLOSURES ARE RECEIVED, ISMA LEGAL COUNSEL TRACKS ALL RESPONSES AND MONITORS FOR ANY POTENTIAL CONFLICT SITUATION. OTHER ISMA MANAGERS ARE ALSO GENERALLY AWARE OF POTENTIAL CONFLICTS OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES AND CAN ALSO ASSIST WITH MONITORING FOR POTENTIAL CONFLICT SITUATIONS DURING MEETINGS AND ACTIVITIES. IF A CONFLICT OR POTENTIAL CONFLICT IS IDENTIFIED, ISMA STAFF WILL REMIND THE PHYSICIAN OF THE CONFLICT OR POTENTIAL CONFLICT IF THE PHYSICIAN DOES NOT DISCLOSE IT OR RECUSE HIMSELF/HERSELF. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE, EXECUTIVE COMMITTEE, AND BOARD OF TRUSTEES ALL APPROVE COMPENSATION, WHICH IS DOCUMENTED IN AN EMPLOYMENT CONTRACT, WITH THE ULTIMATE DECISION BASED ON PERFORMANCE, EXPERIENCE, AND OTHER RELATED FACTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART XI, LINE 2C THE AUDIT COMMITTEE REVIEW PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PART VI, SECTION A, LINE 9A THE INDIANA STATE MEDICAL ASSOCIATION (ISMA) HAS AFFILIATED COUNTY SOCIETIES. ISMA'S CONSTITUTION & BYLAWS ADDRESS THE RELATIONSHIP AND INTERACTIONS WITH THOSE AFFILIATED SOCIETIES. THE ISMA CONSTITUTION & BYLAWS REQUIRE THE AFFILIATED SOCIETIES TO HAVE AND SUBMIT TO ISMA CONSTITUTION & BYLAWS WHICH DO NOT CONFLICT WITH THE ISMA. ADDITIONALLY, THE AFFILIATED SOCIETIES CANNOT ENGAGE IN CONDUCT WHICH VIOLATES ISMA'S CONSTITUTION & BYLAWS. THE ISMA CONSTITUTION & BYLAWS ARE ANNUALLY PROVIDED TO THE AFFILIATED SOCIETIES (AND OTHERS), AND ARE ALSO AVAILABLE UPON REQUEST. ADDITIONALLY, THE AREAS WHICH PRESENT THE MOST POTENTIAL FOR INCONSISTENCY ARE DUES AND MEMBERSHIP. BECAUSE ALL AFFILIATE DUES AND MEMBERSHIP ARE PROCESSED BY ISMA, ANY INCONSISTENCIES WOULD BE IDENTIFIED IMMEDIATELY BY ISMA AND RESOLVED PER ISMA'S CONSTITUTION & BYLAWS. INDIANA MEDICAL FOUNDATION INC 322 CANAL WALK INDIANAPOLIS IN 46202 237001672 EDUCATION FOR MEDICAL PROFESSIONALS IN 501(C)(3) LINE 7 INDIANA STATE MEDICAL ASSOCIATION 1 INDIANA MEDICAL POLITICAL ACTION COMMITTEE 322 CANAL WALK INDIANAPOLIS IN 46202 351485797 IMPROVEMENT OF MEDICAL COMMUNITY THROUGH POLITICAL ACTION IN 527 INDIANA MEDICAL POLITICAL ACTION COMMITTEE 0 INDIANA STATE MEDICAL ASSOCIATION INSURANCE AGENCY INC 322 CANAL WALK INDIANAPOLIS IN 46202 351731389 INSURANCE AGENCY IN N/A C 219576 1208718 1.00000 1 1 0 1 0 0 1 0 0 0 0 0 1 0 1 1 0 1 0 0 INDIANA STATE MEDICAL ASSOCIATION INSURANCE AGENCY INC L 353176 FMV INDIANA STATE MEDICAL ASSOCIATION INSURANCE AGENCY INC F 125000 DIVIDENDS PAID