2019-11-07T15:41:07-06:00 2018-12-31 743001153 PMB HELIN DONOVAN LLP 12301 RESEARCH BLVD BLDG 5 160 AUSTIN TX 78759 990 2018-01-01 473641754 C2C INNOVATIVE SOLUTIONS INC C2CI 5123341622 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 PAMELA HOERNIS TREASURER 5123341622 2019-11-07 1 KELLY LOGAN P00677048 5122589670 2019-11-06 45.20.197.35 2019-11-07 15:39:02 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 86DDA4CBC524EDB5EDF2E14CC3DB1269118CEBE7 2018 2020-03-31 21:24:44Z PAMELA HOERNIS 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 54356304 0 X WWW.C2CINC.COM X 2015 TX PROVIDE BEST VALUE ADMINISTRATIVE SERVICES AND QUALITY MANAGEMENT PRINCIPLES THAT PROMOTE CONTINUOUS IMPROVEMENT. 5 3 437 0 0 45555 54400904 54345416 0 0 4243 10796 0 0 54405147 54356212 13000000 0 0 0 30573582 27559985 0 0 0 20048326 15923636 63621908 43483621 -9216761 10872591 21788849 30115798 8359490 5845215 13429359 24270583 PROVIDE BEST VALUE ADMINISTRATIVE SERVICES AND QUALITY MANAGEMENT PRINCIPLES THAT PROMOTE CONTINUOUS IMPROVEMENT. 0 0 31723150 C2C INNOVATIVE SOLUTIONS INC. (C2C) SERVES AS A FEDERAL CONTRACTOR FOR THE MEDICARE PROGRAM SINCE THE INCEPTION OF THE SECOND-LEVEL APPEAL PROCESS IN SEPTEMBER 2004. AS A QUALIFIED INDEPENDENT CONTRACTOR (QIC), C2C ADJUDICATES SECOND-LEVEL MEDICARE APPEALS CALLED RECONSIDERATIONS FOR SEVERAL JURISDICTIONS WITH NATIONAL SCOPE. 31723150 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 437 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PAMELA L HOERNIS 5123341622 3107 OAK CREEK DRIVE NO 200 AUSTIN TX 78727 THOMAS MANLEY CHAIRMAN 1.60 44.00 X X 0 859772 73398 LOUIS POLISE BOARD OF TRUSTEES 1.70 X 11011 0 0 DONALD P FORGIONE BOARD OF TRUSTEES 1.70 X 10813 0 0 GARY CRAYTON BOARD OF TRUSTEES 1.60 X 10688 0 0 JEFF PETERSON PRESIDENT 46.90 X X 440692 0 73694 PAMELA HOERNIS TREASURER 1.60 45.60 X 0 412041 44929 BRIAN ANDREW STOTLER PROGRAM DIRECTOR 49.90 X 214167 0 61914 SHERI L SOUERS PROGRAM DIRECTOR 48.50 X 188874 0 61414 LISA HANSON GENERAL COUNSEL 43.70 X 194107 0 45830 NICHOLETTE WARNER PROGRAM DIRECTOR 44.50 X 182336 0 17963 FRANK A DELLI CARPINI MD MEDICAL DIRECTOR 53.50 X 400877 0 61807 JANET I LAWRENCE MD MEDICAL DIRECTOR 45.00 X 286613 0 52916 MICHAEL OWENS MD MEDICAL DIRECTOR 48.70 X 312154 0 71450 SHERRY ANNE KING MD MEDICAL DIRECTOR 44.50 X 304994 0 28520 CHARLOTTE STELLY-SEITZ MD ASSOCIATE MEDICAL DIRECTOR 44.90 X 244947 0 36139 2802273 1271813 629974 30 0 1 0 FEDERAL HEARINGS & APPEALS SERVICES INC 117 WEST MAIN STREET PLYMOUTH PA 18651 A CONTRACTOR PROCESSING QIC APPEALS 3438736 HM HEALTH SOLUTIONS INC 4800 DEERWOOD CAMPUS PARKWAY JACKSONVILLE FL 322466498 PRINTING AND MAILING SERVICES 896473 AMKIN WEST BAY LLC 301 WEST BAY STREET SUITE 210 JACKSONVILLE FL 32202 LEASING OF OFFICE SPACE 812179 DAVID BRODY & DONDERSHINE LLP 2100 RESTON PARKWAY STE 370 RESTON VA 20191 ATTORNEY SERVICES 214226 AMERICAN EXPRESS PO BOX 650448 DALLAS TX 752650448 CORPORATE CREDIT CARD PROVIDER 205244 6 54345416 54345416 10772 10772 116 92 24 24 24 54356212 10772 0 24 1252687 1174200 78487 20688721 19392470 1296251 1704190 1597414 106776 2295196 2151391 143805 1619191 1517741 101450 226715 1 226714 211575 205487 6088 488601 474542 14059 136119 55594 80525 8197 3348 4849 373985 366576 7409 INTERCOMPANY 9468953 6299 9462654 CONTRACTOR 3913673 3913673 0 POSTAGE 627703 609642 18061 MAINTENANCE AND REPAIRS 130775 127012 3763 337340 127760 209580 43483621 31723150 11760471 0 9992606 21247435 10082282 7568719 157748 29482 2561585 1922567 1015284 639018 175665 265880 365264 365264 21788849 30115798 4197014 3645588 479713 110094 3682763 2089533 8359490 5845215 X 13429359 24270583 13429359 24270583 21788849 30115798 X 10872591 -24536 -6831 X X 1 X 1 X 1 0 X 11368425 57629565 54400904 54345416 177744310 11368425 57629565 54400904 54345416 177744310 177744310 1462 4224 10772 16458 177760768 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1715027 1138879 576148 846558 783688 62870 639018 PAYABLE TO TMF HEALTH QUALITY INSTITUTE 1267907 DEFERRED LEASES 821626 2089533 X 54331676 -24536 -24536 54356212 0 54356212 43490452 6831 6831 43483621 0 43483621 PART X, LINE 2: PRIOR TO 2015, THE COMPANY WAS A C-CORPORATION AND SUBJECT TO FEDERAL AND STATE INCOME TAXES. DURING 2015, THE COMPANY CONVERTED TO A NON-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. UNRELATED BUSINESS TAXABLE INCOME WAS NOMINAL FOR C2C AS OF DECEMBER 31, 2018 AND 2017. THE COMPANY IS GENERALLY NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR RETURNS SUBMITTED PAST THREE YEARS. THE COMPANY ASSESSES UNCERTAINTIES IN INCOME TAX RECOGNITION IN ITS FINANCIAL STATEMENTS AND USES A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION AND DERECOGNITION OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN. THE COMPANY HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2018 OR 2017. PART XII, LINE 2D - OTHER ADJUSTMENTS: PRIOR YEAR FEDERAL INCOME TAX BENEFIT 6,831. X X X X 0 1 0 1 1 1 1 1 0 THOMAS MANLEY CHAIRMAN 0 548928 0 288986 0 21858 0 27864 0 45534 0 933170 0 0 JEFF PETERSON PRESIDENT 325193 0 115499 0 0 0 27864 0 45830 0 514386 0 0 0 PAMELA HOERNIS TREASURER 0 297700 0 114341 0 0 0 27864 0 17065 0 456970 0 0 BRIAN ANDREW STOTLER PROGRAM DIRECTOR 163598 0 43928 0 6641 0 21798 0 40116 0 276081 0 0 0 SHERI L SOUERS PROGRAM DIRECTOR 147060 0 35720 0 6094 0 18925 0 42489 0 250288 0 0 0 LISA HANSON GENERAL COUNSEL 154301 0 33666 0 6140 0 18828 0 27002 0 239937 0 0 0 NICHOLETTE WARNER PROGRAM DIRECTOR 156079 0 26257 0 0 0 16681 0 1282 0 200299 0 0 0 FRANK A DELLI CARPINI MD MEDICAL DIRECTOR 325122 0 69546 0 6209 0 27864 0 33943 0 462684 0 0 0 JANET I LAWRENCE MD MEDICAL DIRECTOR 224042 0 62571 0 0 0 27864 0 25052 0 339529 0 0 0 MICHAEL OWENS MD MEDICAL DIRECTOR 253032 0 59122 0 0 0 27864 0 43586 0 383604 0 0 0 SHERRY ANNE KING MD MEDICAL DIRECTOR 250799 0 54195 0 0 0 27864 0 656 0 333514 0 0 0 CHARLOTTE STELLY-SEITZ MD ASSOCIATE MEDICAL DIRECTOR 216038 0 28909 0 0 0 24051 0 12088 0 281086 0 0 0 PART I, LINE 4B JEFF PETERSON: $70,781 TOM MANLEY: $81,187 PAMELA HOERNIS: $14,976 PART I, LINE 5 TMF HEALTH QUALITY INSTITUTE HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE REVENUES OF THE ORGANIZATION AND IT'S SUBSIDIARY, C2C INNOVATIVE SOLUTIONS, INC. C2C INNOVATIVE SOLUTIONS, INC. HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE REVENUES OF THE ORGANIZATION. PART I, LINE 6 TMF HEALTH QUALITY INSTITUTE HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION AND IT'S SUBSIDIARY, C2C INNOVATIVE SOLUTIONS, INC.C2C INNOVATIVE SOLUTIONS, INC. HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION. PART I, LINE 7 TMF HEALTH QUALITY INSTITUTE HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON OTHER PERFORMANCE INCLUDING BUT NOT LIMITED TO NEW BUSINESS GOALS, PROFIT MARGIN, AND COMPLIANCE REQUIREMENTS OF THE ORGANIZATION AND IT'S SUBSIDIARY, C2C INNOVATIVE SOLUTIONS, INC. C2C INNOVATIVE SOLUTIONS, INC. HAS AN EXECUTIVE INCENTIVE COMPENSATION PLAN WHERE THE PAYMENT IS ACCRUED AND PAID THAT IS CONTINGENT ON OTHER PERFORMANCE INCLUDING BUT NOT LIMITED TO NEW BUSINESS GOALS, PROFIT MARGIN AND COMPLIANCE REQUIREMENTS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 TMF HEALTH QUALITY INSTITUTE IS THE ONLY MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ELECT TRUSTEES FROM A SLATE OF CANDIDATES CHOSEN BY THE NOMINATING COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B THE APPOINTED BOARD MEMBER OF C2C INNOVATIVE SOLUTIONS, INC.'S BOARD OF TRUSTEES WILL RECEIVE A REDACTED COPY OF THE IRS FORM 990 TAX RETURN PRIOR TO ITS FILING WITH THE IRS. THE APPOINTED BOARD MEMBER AND THE CFO WILL REVIEW THE FORM. THE REVIEW WILL INCLUDE THE FOLLOWING: * DISCUSSION OF NEW IRS REQUIREMENTS AND REVISIONS TO THE FORM 990 FROM THE PREVIOUS YEAR. * A BRIEF DESCRIPTION OF SCHEDULES AND RELATED ATTACHMENTS ALL MEMBERS OF THE BOARD OF TRUSTEES WILL RECEIVE A PRINTED OR ELECTRONIC COPY OF THE COMPLETED FORM 990 PRIOR TO FILING OF THE IRS FORM 990. DURING THE NEXT SCHEDULED BOARD MEETING, THE BOARD WILL DISCUSS THE IRS FORM 990. THERE WILL BE AN OPPORTUNITY FOR ALL BOARD MEMBERS TO ASK QUESTIONS REGARDING THE TAX RETURN. ANY DISCUSSIONS OF THE COMPLETED IRS FORM 990 WILL BE DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO PROVIDE C2C WITH A DISCLOSURE OF ENTITIES AND RELATIONSHIPS THAT COULD GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST. THIS INFORMATION IS PROVIDED TO AND REVIEWED BY C2C'S COMPLIANCE OFFICER. BEFORE C2C ENTERS INTO A CONTRACT OR OTHER FINANCIAL RELATIONSHIP WITH A THIRD PARTY, THE CONTRACT OR SUBSTANCE OF THE FINANCIAL RELATIONSHIP IS SUBMITTED TO C2C'S COMPLIANCE OFFICER WHO CONDUCTS A CONFLICTS OF INTEREST ASSESSMENT. IF C2C'S COMPLIANCE OFFICER IS SATISFIED THAT THE CONTRACT OR OTHER RELATIONSHIP WOULD NOT RESULT IN A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST, C2C WILL PROCEED WITH THE CONTRACT OR RELATIONSHIP. IF A CONFLICT OR THE APPEARANCE OF A CONFLICT IS DETERMINED, C2C WILL NOT PROCEED WITH THE CONTRACT OR RELATIONSHIP UNLESS AN ACCEPTABLE MITIGATION PLAN CAN BE DEVELOPED AND IMPLEMENTED. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES OBTAINS INFORMATION FROM SOURCES IT DEEMS RELEVANT AND NECESSARY TO DETERMINE REASONABLE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. IN ADDITION TO C2C'S HR DIRECTOR, AN INDEPENDENT CONSULTANT IS OBTAINED PERIODICALLY, TO REVIEW APPROPRIATE LEVELS OF COMPENSATION FOR ALL THESE PEOPLE AND MAKE RECOMMENDATIONS TO THE BOARD. THE CONSULTANT WAS LAST OBTAINED IN 2018. THE PRESIDENT REVIEWS THE RECOMMENDATIONS OF THE HR DIRECTOR AND ANY INDEPENDENT CONSULTANT AND ADVISES THE BOARD OF THE DETERMINATION CONCERNING THE COMPENSATION OF ALL OFFICERS AND KEY EMPLOYEES OTHER THAN THE PRESIDENT. THE BOARD MAY ACCEPT THE PRESIDENTS'S DETERMINATION OR MODIFY IT. THE BOARD SETS WHAT IT DETERMINES TO BE APPROPRIATE COMPENSATION FOR THE PRESIDENT. THE PROCESS AND INFORMATION REVIEWED IN MAKING THESE DETERMINATIONS IS DOCUMENTED CONTEMPORANEOUSLY. FORM 990, PART VI, SECTION C, LINE 18 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: FEDERAL INCOME TAX EXPENSE -6,831. FORM 990, PART XII, LINE 2C: THE PROCESS OF OVERSEEING THE AUDIT OF THE FINANACIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. TMF HEALTH QUALITY INSTITUTE 3107 OAK CREEK DRIVE STE 200 AUSTIN TX 78727 521002260 HEALTH CARE TX 501(C)3 170(B)(1)(A)(VI) 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 TMF HEALTH QUALITY INSTITUTE O 9431197 FMV