FAMILYCARE HEALTH PLANS INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- FAMILYCARE HEALTH PLANS INC (EIN 91-1829317)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201943189349310874
- Schema version
- 2018v3.1
- 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 | 2019-11-14T15:17:59-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930928924 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERKINS & COMPANY PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 SW FIFTH AVE SUITE 1000 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 972043710 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911829317 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILYCARE HEALTH PLANS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAMI | BusinessNameControlTxt |
| Phone | 5034712103 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2121 SW BROADWAY SUITE 115 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT K CARUS | PersonNm |
| Person Title | SECRETARY | PersonTitleTxt |
| Phone | 5034712103 | PhoneNum |
| Signature | 2019-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CYNTHIA P BARTHOLOMEW | PreparerPersonNm |
| PTIN | P01313965 | PTIN |
| Phone | 5032210336 | PhoneNum |
| Preparation | 2019-11-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 52.183.24.237 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-13 | IPDt |
| IP Tm | 13:09:57 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 107EDC9825E31507E2C414B50C50019CDA1077BD | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D2C01C9AB4B0B15F4225B95C8306F5C5D0622163 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | ROBERT K CARUS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2121 SW BROADWAY SUITE 115 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,786,338 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PROGRAMS OF COOPERATIVE AND COMPREHENSIVE HEALTHCARE TO THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 326 | TotalEmployeeCnt |
| Total Volunteers | 0 | 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 | $41,635,232 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,717,658 | CYProgramServiceRevenueAmt |
| PY Investment Income | $312,359 | PYInvestmentIncomeAmt |
| CY Investment Income | $708,806 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $41,947,591 | PYTotalRevenueAmt |
| CY Total Revenue | $26,426,464 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $664,147 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $388,796 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $51,092,094 | PYOtherExpensesAmt |
| CY Other Expenses | $22,678,382 | CYOtherExpensesAmt |
| PY Total Expenses | $51,756,241 | PYTotalExpensesAmt |
| CY Total Expenses | $23,067,178 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,808,650 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,359,286 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,806,864 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,100,183 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,897,635 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $393,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,909,229 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,706,816 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE PROGRAMS OF COOPERATIVE AND COMPREHENSIVE HEALTHCARE TO THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,345,301 | ExpenseAmt |
| Revenue | $25,717,658 | RevenueAmt |
| Desc | DURING 2018, FAMILYCARE HEALTH PLANS, INC. (THE ORGANIZATION) CONTINUED TO PROVIDE COMPREHENSIVE AND COOPERATIVE HEALTH CARE TO MEMBERS ACCORDING TO THE TERMS OF A CONTRACT WITH CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THE ORGANIZATION SERVED APPROXIMATELY 4,058 MEMBERS MONTHLY UNTIL THE ORGANIZATION'S CONTRACT WITH CMS ENDED JULY 1, 2018. THE ORGANIZATION HAS BEGUN WINDING DOWN OPERATIONS AS IT SATISFIES THE REMAINING OBLIGATIONS UNDER THE CMS CONTRACT. THE WIND DOWN OF OPERATIONS WILL CONTINUE THROUGH AT LEAST THE END OF 2019; ONCE COMPLETED AND NO OTHER BUSINESS OPERATIONS ARE CONTINUING THE RESULTING NET ASSETS WILL BE DISTRIBUTED IN ACCORDANCE WITH THE ORGANIZATION'S BYLAWS. MANAGEMENT FOR THE ORGANIZATION BELIEVES THE ORGANIZATION HAS AN APPROPRIATE LEVEL OF CAPITAL AND SURPLUS TO MEET ALL REMAINING CLAIMS AND OTHER OBLIGATIONS UNDER THE CMS CONTRACT. | Desc |
| Total Program Service Expenses | $20,345,301 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 457 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 326 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | Yes (1) | 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 | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM MURRAY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5037343147 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2121 SW BROADWAY SUITE 115 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|---|---|
| ROBIN RICHARDSON DO | |||||||||
| CHAIR & BOARD MEMBER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $8,250 | $0 | ||
| MATT DASKALOS | |||||||||
| VICE CHAIR & BOARD MEMBER | 0.00 | 1.00 | Yes (X) | Yes (X) | $0 | $1,250 | $0 | ||
| PATRICIA PARKER | |||||||||
| SECRETARY (PART YEAR) & BOARD MEMBER | 0.00 | 1.00 | Yes (X) | Yes (X) | $0 | $750 | $0 | ||
| JEFFREY PAWLOWSKI | |||||||||
| TREASURER & BOARD MEMBER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $6,250 | $0 | ||
| ROBERT CARUS | |||||||||
| SECRETARY (PART YEAR) & BOARD MEMBER | 0.00 | 1.00 | Yes (X) | Yes (X) | $0 | $2,000 | $0 | ||
| RICHARD BARSOTTI | |||||||||
| BOARD MEMBER | 0.00 | 1.00 | Yes (X) | $0 | $2,750 | $0 | |||
| JOE HROMCO | |||||||||
| BOARD MEMBER | 0.00 | 1.00 | Yes (X) | $0 | $1,000 | $0 | |||
| MICHAEL RILEY | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $1,250 | $0 | |||
| CARL ERICKSON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $393 | $0 | |||
| ROYAL E HARRIS | |||||||||
| BOARD MEMBER | 0.00 | 1.00 | Yes (X) | $0 | $1,000 | $0 | |||
| JEFFREY HEATHERINGTON | |||||||||
| PRESIDENT & CEO | 15.00 | 25.00 | Yes (X) | $0 | $510,181 | $32,684 | |||
| WILLIAM MURRAY | |||||||||
| COO | 10.00 | 30.00 | $0 | $372,474 | $24,806 | Yes (X) | |||
| KEVIN CLANCY | |||||||||
| VP FINANCE | 10.00 | 30.00 | $0 | $217,956 | $10,942 | Yes (X) | |||
| OSCAR CLARK | |||||||||
| VP COMMUNITY & HEALTH SERV | 10.00 | 30.00 | $0 | $224,214 | $13,930 | Yes (X) | |||
| CHRIS JACOBSEN | |||||||||
| VP INFORMATION TECHNOLOGY | 10.00 | 30.00 | $0 | $221,794 | $15,185 | Yes (X) | |||
| CHERI PFANNES | |||||||||
| VP CORPORATE COMPLIANCE | 10.00 | 30.00 | $0 | $192,661 | $5,746 | Yes (X) | |||
| ANA JIMENEZ | |||||||||
| DIRECTOR | 10.00 | 30.00 | $0 | $305,480 | $16,949 | Yes (X) | |||
| KARIN VILLIARIMO | |||||||||
| DIRECTOR | 10.00 | 30.00 | $0 | $256,546 | $14,052 | Yes (X) | |||
| MICHELLE NARDONE | |||||||||
| ANALYST | 10.00 | 30.00 | $0 | $218,519 | $8,486 | Yes (X) | |||
| SHANNON NOEL | |||||||||
| PHARMACIST | 10.00 | 30.00 | $0 | $198,923 | $13,509 | Yes (X) | |||
| CHRISTINE PRICE | |||||||||
| ANALYST | 10.00 | 30.00 | $0 | $181,240 | $6,849 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,924,881 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $163,138 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | 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 |
|---|---|---|---|---|---|
| CVS CAREMARK PHARMACY | |||||
| PO BOX 99794 | CHICAGO | IL | 60696 | MEDICAL SERVICES | $8,238,496 |
| LEGACY EMANUEL HOSPITAL AND HEALTH | |||||
| 2801 N GANTENBEIN AVE | PORTLAND | OR | 97227 | MEDICAL SERVICES | $2,331,918 |
| PROVIDENCE HEALTH SYSTEM OREGON | |||||
| PO BOX 3395 | PORTLAND | OR | 97208 | MEDICAL SERVICES | $1,577,712 |
| COLUMBIA LUTHERAN CHARITIES | |||||
| 2111 EXCHANGE ST | ASTORIA | OR | 97103 | MEDICAL SERVICES | $1,495,080 |
| PORTLAND ADVENTIST MEDICAL CENTER | |||||
| PO BOX 92900 | PORTLAND | OR | 97292 | MEDICAL SERVICES | $1,421,912 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE PREMIUMS, NET | 624100 | $20,269,404 | $20,269,404 |
| BAD DEBT RECOVERY | 624100 | $5,448,254 | $5,448,254 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,717,658 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $868,964 | TotalRevenueColumnAmt |
| Exclusion | $868,964 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,199,716 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,359,874 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$160,158 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$160,158 | TotalRevenueColumnAmt |
| Exclusion | -$160,158 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,426,464 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,717,658 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $708,806 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,381 | TotalAmt |
| Program Services | $294,705 | ProgramServicesAmt |
| Management And General | $73,676 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,588 | TotalAmt |
| Program Services | $5,270 | ProgramServicesAmt |
| Management And General | $1,318 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,827 | TotalAmt |
| Program Services | $11,062 | ProgramServicesAmt |
| Management And General | $2,765 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,741,267 | TotalAmt |
| Program Services | $8,918,033 | ProgramServicesAmt |
| Management And General | $1,823,234 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294 | TotalAmt |
| Management And General | $294 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,804 | TotalAmt |
| Management And General | $27,804 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| INPATIENT HOSPITAL | $6,460,189 | $6,460,189 | |
| OTHER MEDICAL AND HOSPI | $2,890,933 | $2,890,933 | |
| EMERGENCY ROOM AND OUT- | $1,765,109 | $1,765,109 | |
| ADMIN FEE | $436,981 | $436,981 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,805 | TotalAmt |
| Management And General | $355,805 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,067,178 | TotalAmt |
| Program Services | $20,345,301 | ProgramServicesAmt |
| Management And General | $2,721,877 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,151,521 | BOYAmt |
| EOY | $2,140,076 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,805,482 | BOYAmt |
| EOY | $14,419,497 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,165,611 | BOYAmt |
| EOY | $1,200,852 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,678 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,055,336 | BOYAmt |
| EOY | $1,166,486 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,342,236 | BOYAmt |
| EOY | $1,173,272 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,806,864 | BOYAmt |
| EOY | $20,100,183 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $376,925 | BOYAmt |
| EOY | $1,767 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,520,710 | BOYAmt |
| EOY | $391,600 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,897,635 | BOYAmt |
| EOY | $393,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,909,229 | BOYAmt |
| EOY | $19,706,816 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,909,229 | BOYAmt |
| EOY | $19,706,816 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,806,864 | BOYAmt |
| EOY | $20,100,183 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,359,286 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$561,699 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER CURRENT ASSETS, NET | $887,490 |
| RESTRICTED SHORT-TERM INVESTMENTS | $285,782 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,173,272 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER POLICY LIABILITIES | $145,164 |
| DUE TO AFFILIATES | $53,562 |
| CLAIMS PAYABLE AND UNPAID CLAIMS ADJUDICATION EXPENSES | $192,874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $391,600 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY HEATHERINGTON | ||||||||||||||
| PRESIDENT & CEO | $0 | $504,000 | $0 | $0 | $0 | $6,181 | $0 | $24,750 | $0 | $7,934 | $0 | $542,865 | $0 | $0 |
| WILLIAM MURRAY | ||||||||||||||
| COO | $0 | $370,494 | $0 | $0 | $0 | $1,980 | $0 | $8,250 | $0 | $16,556 | $0 | $397,280 | $0 | $0 |
| KEVIN CLANCY | ||||||||||||||
| VP FINANCE | $0 | $217,498 | $0 | $0 | $0 | $458 | $0 | $4,188 | $0 | $6,754 | $0 | $228,898 | $0 | $0 |
| OSCAR CLARK | ||||||||||||||
| VP COMMUNITY & HEALTH SERV | $0 | $224,029 | $0 | $0 | $0 | $185 | $0 | $6,721 | $0 | $7,209 | $0 | $238,144 | $0 | $0 |
| CHRIS JACOBSEN | ||||||||||||||
| VP INFORMATION TECHNOLOGY | $0 | $221,372 | $0 | $0 | $0 | $422 | $0 | $5,204 | $0 | $9,981 | $0 | $236,979 | $0 | $0 |
| CHERI PFANNES | ||||||||||||||
| VP CORPORATE COMPLIANCE | $0 | $191,535 | $0 | $0 | $0 | $1,126 | $0 | $5,746 | $0 | $0 | $0 | $198,407 | $0 | $0 |
| ANA JIMENEZ | ||||||||||||||
| DIRECTOR | $0 | $304,380 | $0 | $0 | $0 | $1,100 | $0 | $7,333 | $0 | $9,616 | $0 | $322,429 | $0 | $0 |
| KARIN VILLIARIMO | ||||||||||||||
| DIRECTOR | $0 | $256,482 | $0 | $0 | $0 | $64 | $0 | $3,897 | $0 | $10,155 | $0 | $270,598 | $0 | $0 |
| MICHELLE NARDONE | ||||||||||||||
| ANALYST | $0 | $218,479 | $0 | $0 | $0 | $40 | $0 | $1,732 | $0 | $6,754 | $0 | $227,005 | $0 | $0 |
| SHANNON NOEL | ||||||||||||||
| PHARMACIST | $0 | $198,813 | $0 | $0 | $0 | $110 | $0 | $3,893 | $0 | $9,616 | $0 | $212,432 | $0 | $0 |
| CHRISTINE PRICE | ||||||||||||||
| ANALYST | $0 | $181,074 | $0 | $0 | $0 | $166 | $0 | $2,662 | $0 | $4,187 | $0 | $188,089 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | RELATED ORGANIZATION COMPENSATION: FAMILYCARE, INC. AND FAMILYCARE HEALTH PLANS, INC. ARE RELATED TAX-EXEMPT ORGANIZATIONS. THE COMPENSATION METHODOLOGY OF FAMILYCARE, INC. IS NOTED IN SCHEDULE O. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JEFFREY PAWLOWSKI, BOARD MEMBER, AND MICHAEL RILEY, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | SEE THE DESCRIPTION PROVIDED FOR PART VI, SECTION A, LINE 7B, BELOW. |
| FORM 990, PART VI, SECTION A, LINE 7A | FAMILYCARE, INC. IS THE ORGANIZATION'S SOLE MEMBER. FAMILYCARE, INC. HAS 8 CORPORATE MEMBERS. THE CORPORATE MEMBERS ELECT THE BOARD MEMBERS THAT GOVERN BOTH ORGANIZATIONS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE POWERS RESERVED TO THE MEMBERS OF FAMILYCARE, INC. ARE THE FOLLOWING: (A) AMENDING THE ARTICLES OF INCORPORATION; (B) AMENDING THE BYLAWS (C) APPOINTING MEMBERS; (D) ELECTING THE BOARD OF DIRECTORS; (E) APPROVING EXPENDITURES OF MORE THAN 5% OF THE RESERVES OF THE CORPORATION; AND (F) APPROVING THE SALE, TRANSFER, MERGER, OR DISSOLUTION OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF FORM 990 IS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING THE OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO: THE LEVEL AND ADEQUACY OF CEO TOTAL COMPENSATION IS DETERMINED AND APPROVED BY THE BOARD OF DIRECTORS. THE CEO PERFORMS UNDER AN EXECUTIVE EMPLOYMENT CONTRACT WHICH IS NEGOTIATED AND UPDATED BY THE BOARD. ONLY INDEPENDENT MEMBERS OF THE BOARD CONDUCT THE REVIEW AND MAKE DECISIONS REGARDING THE CEO'S SALARY. THE BOARD USES AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO REVIEW AND ESTABLISH THE CEO'S TOTAL COMPENSATION. THE TWO MOST RECENT REVIEWS COMPLETED BY THE CONSULTANT WERE IN MAY 2015 AND APRIL 2017. KEY EMPLOYEES: THE LEVEL AND ADEQUACY OF KEY EMPLOYEES TOTAL COMPENSATION IS DETERMINED BY THE CEO, WITH INPUT FROM THE VICE PRESIDENT OF HUMAN RESOURCES. THE CEO AND VICE PRESIDENT OF HUMAN RESOURCES USE AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO REVIEW AND ESTABLISH KEY EMPLOYEES TOTAL COMPENSATION. THE TWO MOST RECENT REVIEWS COMPLETED BY THE CONSULTANT WERE IN MAY 2015 AND APRIL 2017. OTHER EMPLOYEES: THE VICE PRESIDENT OF HUMAN RESOURCES IS ACCOUNTABLE TO USE PUBLISHED, REPUTABLE DATA FOR COMPARISONS OF JOB ACCOUNTABILITIES AND COMPENSATION RANGES, INCLUDING DATA PROVIDED BY INDEPENDENT COMPENSATION CONSULTANTS. BASED ON THE DATA, THE VICE PRESIDENT OF HUMAN RESOURCES ESTABLISHES AND UPDATES THE COMPENSATION RANGES, AND RESPONDS TO ANY INQUIRIES RELATED TO FAIRNESS, EQUITY AND PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | FAMILYCARE HEALTH PLANS, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990, PART IX, LINE 11G | MEDICAL PROFESSIONAL SERVICES : PROGRAM SERVICE EXPENSES 3,769,811. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,769,811. PHYSICIAN SERVICES : PROGRAM SERVICE EXPENSES 4,951,263. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,951,263. OTHER PROFESSIONAL SERVICES : PROGRAM SERVICE EXPENSES 196,959. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 196,959. CONSULTING & CLAIMS PROCESSING : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,823,234. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,823,234. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS FOR OVERSEEING THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FAMILYCARE INC | |||||||||||
| 2121 SW BROADWAY SUITE 115 | PORTLAND | OR | 97201 | 930878074 | TO PROVIDE COMMUNITY HEALTH CARE | OR | 501(C)(4) | FAMILYCARE HEALTH PLANS INC | Yes (1) | ||
| HEATHERINGTON FOUND FOR INNOVATION AND EDUCATION IN HEALTH CARE | |||||||||||
| 2121 SW BROADWAY SUITE 115 | PORTLAND | OR | 97201 | 930988354 | TO SUPPORT INNOVATION AND FUND HEALTHCARE EDUCATION | OR | 501(C)(3) | 0 | PF | N/A | |
| 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FAMILYCARE INC | ||
| N | $113,006 | CASH - U.S. CURRENCY |
| FAMILYCARE INC | ||
| O | $388,796 | CASH - U.S. CURRENCY |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II | FormAndLineReferenceDesc |
| Explanation | FAMILYCARE HEALTH PLANS, INC. IS RELATED TO FAMILYCARE, INC. AND TO HEATHERINGTON FOUNDATION FOR INNOVATION AND EDUCATION IN HEALTH CARE, BOTH TAX-EXEMPT ORGANIZATIONS, BY VIRTUE OF ITS BOARD MEMBERS SERVING ON THE BOARDS OF BOTH RELATED ORGANIZATIONS. | ExplanationTxt |
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