2019-08-21T15:44:51-05:00 2018-12-31 351489521 GREENWALT CPAS INC 5342 W VERMONT STREET INDIANAPOLIS IN 46224 990 2018-01-01 350411650 INDIANA STATE MEDICAL ASSOCIATION INDI 3172612060 322 CANAL WALK INDIANAPOLIS IN 462023268 JULIE D REED EXECUTIVE VICE PRESIDENT 3172612060 2019-08-13 1 ANITA W SHERMAN CPA P01395184 3172412999 2019-08-13 75.149.79.53 2019-08-13 14:57:52 US P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3E5012E62A6315800EC95514F8D2FD196A43967B 2018 2019-02-21 02:37:17Z JULIE D REED 322 CANAL WALK INDIANAPOLIS IN 462023268 7708827 0 X WWW.ISMANET.ORG X 1849 IN PHYSICIAN ORG IN INDIANA, ADVOCATING FOR THE WELL-BEING OF DOCTORS AND THEIR PATIENTS. 19 15 28 0 383653 35418 1810271 1758004 232606 219487 403059 2181468 1215707 1420505 3661643 5579464 57839 1023572 0 0 2408998 2428084 0 0 0 1155847 1471643 3622684 4923299 38959 656165 20290555 19231204 2937607 3422014 17352948 15809190 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 25 0 1 28 1 1 1 0 0 0 1 1 0 0 0 X 19 15 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 JOHN MCGOFF MD IMMEDIATE PAST PRESIDENT 6.00 X X 41828 0 0 STACIE WENK DO PRESIDENT 20.00 X X 26492 0 0 LISA HATCHER MD PRESIDENT-ELECT 6.00 X X 8367 0 0 ALEXANDER CHOI MD ASSISTANT TREASURER 1.00 X X 0 0 0 J ELIZABETH STRUBLE MD CHAIR BOARD OF TRUSTEES 12.00 X 1395 0 0 ANN PATTERSON MD TRUSTEE 1.00 X 0 0 0 SHALIN ARNETT DO TRUSTEE 1.00 X 0 0 0 DAVID RAU MD 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 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 SEMYON FAYNBOYM MD TRUSTEE 1.00 X 0 0 0 DOUG MORRELL MD TRUSTEE 1.00 X 0 0 0 CHRISTOPHER AREEPHANTHU MD TRUSTEE 1.00 X 0 0 0 MICHAEL KELLER TRUSTEE 1.00 X 0 0 0 THOMAS WHITEMAN MD FORMER PAST PRESIDENT 1.00 X X 3500 0 0 JULIE REED EXECUTIVE VICE PRESIDENT 50.00 X 318761 0 74222 ROBERTO DARROCA MD SPEAKER 1.00 X 0 0 0 ANDREW TROBRIDGE MD VICE SPEAKER 1.00 X 0 0 0 MARK INGOLD VICE PRESIDENT OF FINANCE 50.00 X 105726 0 25116 506069 0 99338 2 0 1 0 CANAL SQUARE LIMITED PARTNERSHIP 359 NORTH WEST STREET INDIANAPOLIS IN 46202 RENT 209889 BARNES & THORNBURG LLP 11 S MERIDIAN ST STE 1313 INDIANAPOLIS IN 46204 ATTORNEY 111865 2 1758004 1758004 PROGRAM SEMINAR REVENUE 611430 198215 198215 PUBLICATION REVENUE 611430 21272 21272 219487 856426 856426 546191 546191 3454405 2129363 1325042 1325042 1325042 ADMINISTRATIVE SERVICES 561000 694165 319862 374303 GRANTS AND SPONSORSHIPS 900099 99213 99213 ACCREDITATION CME 611430 70800 70800 10136 786 9350 874314 5579464 1256339 383653 2181468 1020572 3000 396842 1362614 157939 383881 126808 212811 39035 17500 47406 175728 500 202400 78391 239788 139050 159290 49021 26653 LICENSES AND FEES 41941 REPAIRS AND MAINTENANCE 16877 INCOME TAX EXPENSE 12110 EMPLOYEE TRAINING AND D 8342 4800 4923299 553563 1114107 995454 1303169 155954 181126 157020 110195 688834 542606 160083 146228 17585033 16204200 1000 1000 682448 171179 20290555 19231204 775569 756637 1879826 2343759 282212 321618 2937607 3422014 X 17324606 15614492 28342 194698 17352948 15809190 20290555 19231204 656165 -2199923 0 X X 0 1 X 1 0 INDIANA MEDICAL POLITICAL ACTION COMMITTEE 322 CANAL WALK INDIANAPOLIS IN 46202 351485797 11150 0 0 0 1758004 386105 386105 421921 -35816 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 99174 50859 538801 443432 95369 146228 DUES COLLECTED FOR OTHER ORGANIZATION 321618 321618 4502738 -2199923 1703059 -496864 4999602 579862 579862 5579464 5470743 877305 877305 4593438 329861 329861 4923299 PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE REPORTED AS EIN 23-7001672 389,300. REVENUE REPORTED AS EIN 35-1731389 1,313,759. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUE ELIMINATED IN CONSOLIDATION 579,862. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES REPORTED AS EIN 23-7001672 166,207. EXPENSES REPORTED AS EIN 35-1731389 711,028. OTHER ADJUSTMENT 70. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES ELIMINATED IN CONSOLIDATION 329,861. 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) 21072 OPERATIONAL SUPPORT INDIANA UNIVERSITY SCHOOL OF MEDICINE CO TRUSTEES OF INDIANA UNIVERSITY PO BOX 66271 INDIANAPOLIS IN 462666271 356001673 501(C)(3) 500000 MEDICAL STUDENT ENDOWED SCHOLARSHIP FUND THE HAHN FOUNDATION 500 N MERIDIAN ST STE 250 INDIANAPOLIS IN 46204 356020062 501(C)(3) 25000 OPERATIONAL SUPPORT TO THE ALLIANCE FOR A HEALTHIER INDIANA IN ITS EFFORTS TO RAISE AWARENESS OF INDIANA'S POOR HEALTH RANKINGS AND GROW GRASSROOTS SUPPORT FOR A HEALTHIER STATE. MARIAN UNIVERSITY - COLLEGE OF OSTEOPATHIC MEDICINE 3200 COLD SPRING RD INDIANAPOLIS IN 46222 350868175 501(C)(3) 473500 MEDICAL STUDENT ENDOWED SCHOLARSHIP FUND 4 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. CONTRIBUTIONS TO THE IU SCHOOL OF MEDICINE AND THE MARIAN COLLEGE OF OSTEOPATHIC MEDICNE WERE AUTHORIZED BY A RESOLUTION PASSED BY THE HOUSE OF DELEGATES, AND ARE FOR THE PURPOSE OF ESTABLISHING ENDOWED MEDICAL STUDENT SCHOLARSHIP FUNDS AT EACH INSTITUTION. 1 X X X X 0 0 0 JULIE REED EXECUTIVE VICE PRESIDENT 263549 0 30000 0 25212 0 55625 0 18597 0 392983 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 AND DISTRICT MEDICAL 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 735131 852378 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 166583 FMV INDIANA STATE MEDICAL ASSOCIATION INSURANCE AGENCY INC F 250000 DIVIDENDS PAID