BLUE ENVELOPE HEALTH FUND INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
BLUE ENVELOPE HEALTH FUND INC (EIN 83-6006173)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-08-24
IRS object ID
201822369349300847
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2018-08-24T16:47:16-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN836006173EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE ENVELOPE HEALTH FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBLUEBusinessNameControlTxt
Phone3072378649PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2177AddressLine1Txt
CityCASPERCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82602ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDEANNA PICKERINGPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3073336977PhoneNum
Signature2018-08-23SignatureDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDEANNA PICKERINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2177AddressLine1Txt
CityCASPERCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82602ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$360,862GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressBLUEENVELOPE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1954FormationYr
Legal Domicile StateWYLegalDomicileStateCd
Activity Or MissionFINANCIAL MEDICAL ASSISTANCEActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent20VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$91,786PYContributionsGrantsAmt
CY Contributions Grants$43,634CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$165,441PYInvestmentIncomeAmt
CY Investment Income$303,109CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$14,119CYOtherRevenueAmt
PY Total Revenue$257,227PYTotalRevenueAmt
CY Total Revenue$360,862CYTotalRevenueAmt
PY Grants And Similar Paid$214,209PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$166,942CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$29,587PYOtherExpensesAmt
CY Other Expenses$18,079CYOtherExpensesAmt
PY Total Expenses$243,796PYTotalExpensesAmt
CY Total Expenses$185,021CYTotalExpensesAmt
PY Revenues Less Expenses$13,431PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$175,841CYRevenuesLessExpensesAmt
Total Assets BOY$2,033,443TotalAssetsBOYAmt
Total Assets EOY$2,163,796TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,033,443NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,163,796NetAssetsOrFundBalancesEOYAmt
MissionFINANCIAL MEDICAL ASSISTANCEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$166,942ExpenseAmt
Grant$166,942GrantAmt
DescTHE ORGANIZATION SPONSORS A COMMUNITY HEALTH PROGRAM WHICH INCLUDES AID TO THOSE PEOPLE IN NEED OF ASSISTANCE IN PAYING MEDICAL BILLS.Desc
Total Program Service Expenses$166,942TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member20IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDEANNA PICKERINGPersonNm
Phone3073336977PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1330 S CENTER ST STE 420AddressLine1Txt
CityCASPERCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82601ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
KEVYN MORGAREIDGE
DIRECTOR1.000.00Yes (X)$0$0$0
VAL LATHROP
DIRECTOR1.000.00Yes (X)$0$0$0
LORRAINE HEIDE
DIRECTOR1.000.00Yes (X)$0$0$0
AUDREY GRAY
DIRECTOR1.000.00Yes (X)$0$0$0
ELAINE HOUGH
DIRECTOR1.000.00Yes (X)$0$0$0
NADIA FRIES
DIRECTOR1.000.00Yes (X)$0$0$0
DEBORAH O'BRIEN
DIRECTOR1.000.00Yes (X)$0$0$0
MARK BOWER
DIRECTOR1.000.00Yes (X)$0$0$0
JEROD LEVIN
DIRECTOR1.000.00Yes (X)$0$0$0
RYEA O'NEILL
DIRECTOR1.000.00Yes (X)$0$0$0
DARIN PEPPLE
DIRECTOR1.000.00Yes (X)$0$0$0
VICTORIA ZITON
DIRECTOR1.000.00Yes (X)$0$0$0
JUDY AURELIUS
PARLIAMENTARIAN1.000.00Yes (X)$0$0$0
KAREN FARMER
PAST PRESIDENT1.000.00Yes (X)$0$0$0
RUBY ZIEHL
DIRECTOR1.000.00Yes (X)$0$0$0
JOHN MASTERSON
DIRECTOR1.000.00Yes (X)$0$0$0
KEN MORSE
PRESIDENT5.000.00$0$0$0Yes (X)
SUE HOAG
VICE PRESIDENT5.000.00$0$0$0Yes (X)
RITA WALSH
SECRETARY5.000.00$0$0$0Yes (X)
DEANNA PICKERING
TREASURER7.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$43,634AllOtherContributionsAmt
Noncash Contributions$1,628NoncashContributionsAmt
Total Contributions$43,634TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$41,549TotalRevenueColumnAmt
Exclusion$41,549ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,119TotalRevenueColumnAmt
Exclusion$2,119ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$12,000RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$12,000RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,000TotalRevenueColumnAmt
Exclusion$12,000ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$261,560SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$261,560SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$261,560TotalRevenueColumnAmt
Related Or Exempt Func Income$261,560RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$360,862TotalRevenueColumnAmt
Related Or Exempt Func Income$261,560RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$55,668ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$161,167TotalAmt
Program Services$161,167ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$5,775TotalAmt
Program Services$5,775ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$9,989TotalAmt
Management And General$9,989ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,722TotalAmt
Management And General$1,722ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
POSTAGE & PRINTING$2,985$2,985
BLOOD DRAW EXPENSE$2,612$2,612
TELEPHONE$430$430
WEB SITE$290$290

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$51TotalAmt
Management And General$51ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$185,021TotalAmt
Program Services$166,942ProgramServicesAmt
Management And General$18,079ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$4,440EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$443,496BOYAmt
EOY$15,516EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,589,947BOYAmt
EOY$2,143,840EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,033,443BOYAmt
EOY$2,163,796EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,021,397BOYAmt
EOY$2,146,305EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,046BOYAmt
EOY$17,491EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,033,443BOYAmt
EOY$2,163,796EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,033,443BOYAmt
EOY$2,163,796EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$175,841ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$45,488NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
CENTRAL WYOMING COUNSELING CENTER
1430 WILKINS CIRCLECASPERWY82601830186967501(C)(3)$31,199ASSIST WITH PROGRAM EXPENSES
CAMP HOPE
3920 W 45TH STCASPERWY82604830322643501(C)(3)$5,000SUMMER DIABETES CAMP
CENTRAL WYOMING HOSPICE
319 S WILSON STCASPERWY82601830249753501(C)(3)$5,000ROOF REPAIRS
EVANSVILLE FIRE DEPARTMENT
P O BOX 158EVANSVILLEWY82636$6,760WATER RESCUE SUITS AND LIFE VESTS
IRIS CLUB HOUSE
615 S DAVIDCASPERWY82609814865384501(C)(3)$10,000MENTAL HEALTH REHAB CENTER ASSISTANCE
MILLS FIRE DEPARTMENT
300 LAKEVIEW DRMILLSWY82604$24,018STRYKER COT
NATRONA COUNTY LIBRARY
307 E 2ND STCASPERWY82601237248551501(C)(3)$5,3564 AUTOMATED EXTERNAL DEFIBRILLATORS AND SUPPLIES
NICOLAYSEN ART MUSEUM
400 E COLLINS DRCASPERWY82601830230592501(C)(3)$5,000SUPPLIES FOR VA ART PROJECT
REVEILLE ROTARY
1831 E 4TH STREETCASPERWY82601$17,000SMOKE DETECTOR PROGRAM ASSISTANCE
WYOMING MEDICAL CENTER FOUNDATION
1233 E SECOND STCASPERWY82601830230808501(C)(3)$13,648SUPPLIES AND EMERGENCY ROOM CONSTRUCTION ASSISTANCE
YOUTH CRISIS CENTER
1656 EAST 12TH STCASPERWY82601830270428501(C)(3)$15,000OPERATING EXPENSES AND AFTER CARE PROGRAM
FieldValueIRS element (for citing)
Total501c3 Org8Total501c3OrgCnt
Total Other Org11TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypePATIENT ASSISTANCEGrantTypeTxt
Recipient22RecipientCnt
Cash Grant$5,775CashGrantAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PART VI, SECTION C, LINE 19NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.

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