FURP.ORG / PUBLIC DATA EXPLORER

COMMON GROUND HEALTHCARE COOPERATIVE: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
COMMON GROUND HEALTHCARE COOPERATIVE (EIN 45-3309488)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-03
IRS object ID
201603089349301225
Schema version
2015v2.1
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

FieldValueIRS element (for citing)
Return2016-11-03T12:20:19-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Tilly Virchow Krause LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1777 E Wisconsin Avenue 32nd FloorAddressLine1Txt
CityMilwaukeeCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN453309488EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Common Ground Healthcare CooperativeBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone4144550500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 Bishops Way No 150AddressLine1Txt
CityBrookfieldCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCathy MahaffeyPersonNm
Person TitleCEOPersonTitleTxt
Phone4144550500PhoneNum
Signature2016-11-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTroy Marine CPAPreparerPersonNm
PTINP00187863PTIN
Phone4147775500PhoneNum
Preparation2016-10-13PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCathy MahaffeyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 Bishops Way No 150AddressLine1Txt
CityBrookfieldCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$170,168,779GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.commongroundhealthcare.orgWebsiteAddressTxt
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Other Organization DscCO-OPOtherOrganizationDsc
Formation2011FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionPROVIDE AFFORDABLE HEALTH INSURANCE SOLUTIONS TO SMALL BUS., INDIVIDUALS & NON-PROFITS IN WI.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee111TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$500PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$104,891,467PYProgramServiceRevenueAmt
CY Program Service Revenue$170,167,234CYProgramServiceRevenueAmt
PY Investment Income$1,061PYInvestmentIncomeAmt
CY Investment Income$1,545CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$104,893,028PYTotalRevenueAmt
CY Total Revenue$170,168,779CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,563,218PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,805,214CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$137,983,206PYOtherExpensesAmt
CY Other Expenses$192,677,709CYOtherExpensesAmt
PY Total Expenses$141,546,424PYTotalExpensesAmt
CY Total Expenses$199,482,923CYTotalExpensesAmt
PY Revenues Less Expenses-$36,653,396PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$29,314,144CYRevenuesLessExpensesAmt
Total Assets BOY$85,588,772TotalAssetsBOYAmt
Total Assets EOY$83,794,437TotalAssetsEOYAmt
Total Liabilities BOY$128,153,477TotalLiabilitiesBOYAmt
Total Liabilities EOY$155,673,286TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$42,564,705NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$71,878,849NetAssetsOrFundBalancesEOYAmt
MissionCommon Ground Healthcare Cooperative ("CGHC") is a non-profit member-governed health insurance company dedicated to providing affordable, innovative health insurance solutions to small businesses, non-profits, and individuals in Wisonsin.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescCommon Ground Healthcare Cooperative is a non-profit member-governed health insurance cooperative dedicated to delivering quality, comprehensive health insurance to small businesses and individuals in Wisconsin.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
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
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1974IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee111EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Licensed More Than One StateYes (1)LicensedMoreThanOneStateInd
State Required Reserves$20,040,509StateRequiredReservesAmt
Reserves Maintained$24,589,376ReservesMaintainedAmt
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
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 PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Brian LebenBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4144550500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 Bishops Way Suite 150AddressLine1Txt
CityBrookfieldCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Kristy Buus
Secretary/Treasurer1.00Yes (X)$950$0$0
Jiliane Hummel Bauer
Director1.00Yes (X)$900$0$0
Suzanne Garrity
Director1.00Yes (X)$0$0$0
Keisha Krumm
Board Vice-Chair1.00Yes (X)$1,550$0$0
John Magilo
Director1.00Yes (X)$900$0$0
Amy Murphy
Director1.00Yes (X)$0$0$0
Mary Rynders
Director1.00Yes (X)$700$0$0
James Wesp
Board Chair6.00Yes (X)$0$0$0
James Lazar
Director1.00Yes (X)$100$0$0
Cathy Mahaffey
CEO40.00$336,500$0$38,929Yes (X)
Shelly Johnson
COO40.00$209,331$0$20,329Yes (X)
Brian Leben
CFO40.00$64,042$0$3,695Yes (X)
Chris Meyer
VP-Provider Relations40.00$159,265$0$19,082Yes (X)
Melissa Duffy
CSO40.00$204,715$0$14,435Yes (X)
Michael Hillman
CMO40.00$270,672$0$16,706Yes (X)
Brenda Vechart
Executive VP-Human Resources40.00$112,650$0$23,288Yes (X)
Paul Will
BI Architect40.00$100,896$0$17,792Yes (X)
Scott Bergman
Controller40.00$117,710$0$25,927Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,580,881TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$180,183TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Xerox Care and Quality Solutions
PO Box 201322DallasTX753201322Medical Management$2,247,874
Xerox Business Services LLC
PO Box 201322DallasTX753201322Third Party Administrator$1,779,776
Milliman Inc
15800 W Bluemound Rd Suite 100BrookfieldWI53005Actuarial$811,790
Broadpath Healthcare Solutions
10501 E Seven Generations Way SuitTucsonAZ85747Claims Processing$699,109
Relevant Healthcare Cost Containment
9500 Bormet DriveMokenaIL60448Dialysis Claim Repricing$554,282
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K20CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPremiums EarnedDesc
Business525100BusinessCd
Total Revenue Column$170,167,234TotalRevenueColumnAmt
Related Or Exempt Func Income$170,167,234RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$170,167,234TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,545TotalRevenueColumnAmt
Exclusion$1,545ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$170,168,779TotalRevenueColumnAmt
Related Or Exempt Func Income$170,167,234RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,545ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,755,965TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,758,015TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$186,553TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$674,185TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$430,496TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$30,184TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,174,921TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,906,876TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$178,969TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,167,561TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$334,383TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$194,039TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$45,053TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$48,945TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$315,066TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$174,319TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$136,880TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
Claims Expense$186,055,939
CMS Exchange User Fee E$5,296,023
Commissions$2,105,375
Insurance Fees Expense$954,438

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total-$14,441,262TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$199,482,923TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,021,177BOYAmt
EOY$13,373,857EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$15,200,041BOYAmt
EOY$10,107,927EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,053,538BOYAmt
EOY$1,578,232EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$106,840BOYAmt
EOY$326,743EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$983,890LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$326,185LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$538,279BOYAmt
EOY$657,705EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$62,668,897BOYAmt
EOY$57,749,973EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$85,588,772BOYAmt
EOY$83,794,437EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,634,885BOYAmt
EOY$4,020,298EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,074,391BOYAmt
EOY$3,016,461EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$67,833,010BOYAmt
EOY$107,739,354EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$55,611,191BOYAmt
EOY$40,897,173EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$128,153,477BOYAmt
EOY$155,673,286EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$42,564,705BOYAmt
EOY-$71,878,849EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$42,564,705BOYAmt
EOY-$71,878,849EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$85,588,772BOYAmt
EOY$83,794,437EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$29,314,144ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$983,890OtherCostOrOtherBasisAmt
Depreciation$326,185DepreciationAmt
Book Value$657,705BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$657,705TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
accrued retrospective premiums$12,199,789
reinsurance recoverables$29,090,117
health care receivable$662,335
advanced premium tax credit receivable$621,867
cost sharing reduction receivable$15,175,865
FieldValueIRS element (for citing)
Total Book Value Other Assets$57,749,973TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Interest Payable$456,796
claims unpaid$36,328,417
premium deficiency reserve$3,717,554
risk adjustment transfer payable$250,000
insurance fees payable$130,883
Accrued Lease Payable$13,523
FieldValueIRS element (for citing)
Total Liability$40,897,173TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$170,168,779TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$170,168,779RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$170,168,779TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$199,482,923TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$199,482,923ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$199,482,923TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe Organization received notification that it qualifies as a tax-exempt organization under Section 501(c)(29) of the U.S. Internal Revenue Code on August 19, 2013 and corresponding provisions of State law and, accordingly, is not subject to federal and state income taxes.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Cathy Mahaffey
CEO$336,500$0$0$0$0$0$17,985$0$20,944$0$375,429$0$0$0
Shelly Johnson
COO$209,331$0$0$0$0$0$12,298$0$8,031$0$229,660$0$0$0
Chris Meyer
VP-Provider Relations$159,265$0$0$0$0$0$7,865$0$11,217$0$178,347$0$0$0
Melissa Duffy
CSO$204,715$0$0$0$0$0$6,865$0$7,570$0$219,150$0$0$0
Michael Hillman
CMO$270,672$0$0$0$0$0$2,585$0$14,121$0$287,378$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 13aWI
Form 990, Part VI, Section A, line 6On January 1, 2014 Common Ground Healthcare Cooperative began issuing health insurance to individuals and small groups. Any active policyholder is considered a member of the cooperative. In December of 2014 there was an election from the members of an operational board of directors replacing the formative board of directors at that time.
Form 990, Part VI, Section A, line 7aIn December of 2014 there was an election from the members of an operational board of directors replacing the formative board of directors at that time.
Form 990, Part VI, Section B, line 11The board members are given a copy of the return before it is filed.
Form 990, Part VI, Section B, line 12cTHE POLICY SETS FORTH CLEAR EXPECTATIONS AND GUIDANCE THAT IS TO BE FOLLOWED BY ALL DIRECTORS, OFFICERS, EMPLOYEES AND THIRD PARTY REPRESENTATIVES. THE COOPERATIVE WILL EVALUATE ITS ADHERENCE AND COMPLIANCE TO THIS POLICY BY REQUESTING FEEDBACK ON A REGULAR BASIS FROM OUR MEMBERS, EMPLOYEES, DIRECTORS AND THIRD PARTY REPRESENTATIVES. IF ANY INDIVIDUAL HAS QUESTIONS OR CONCERNS ABOUT COMPLIANCE WITH THE SUBJECTS DESCRIBED IN THIS POLICY, ARE UNSURE ABOUT WHAT IS THE "RIGHT THING" TO DO, OR REASONABLY BELIEVES THAT SOME POLICY, PRACTICE OR ACTIVITY OF THE COOPERATIVE IS IN VIOLATION OF THE ETHICS POLICY OR CODE, THIS INDIVIDUAL SHOULD SHARE THEIR QUESTIONS, CONCERNS, SUGGESTIONS OR COMPLAINTS WITH SOMEONE WHO CAN ADDRESS THEM PROPERLY. IN MOST CASES, AN INDIVIDUAL'S SUPERVISOR IS IN THE BEST POSITION TO ADDRESS AN AREA OF CONCERN. HOWEVER, IF THE INDIVIDUAL IS NOT COMFORTABLE SPEAKING WITH HIS OR HER SUPERVISOR OR IS NOT SATISFIED WITH THE SUPERVISOR'S RESPONSE, THE INDIVIDUAL IS ENCOURAGED TO SPEAK WITH THE COMPLIANCE OFFICER, OR ANYONE IN MANAGEMENT WHOM THE INDIVIDUAL IS COMFORTABLE IN APPROACHING. THE COOPERATIVE PROVIDES ALL INDIVIDUALS AN ADDITIONAL MECHANISM TO REPORT UNETHICAL CONDUCT WHICH IS DISCUSSED FURTHER IN THE EMPLOYEE PROTECTION AND NON-RETALIATION POLICY.
Form 990, Part VI, Section B, line 15THE EMPLOYMENT AGREEMENTS FOR THE CEO, COO, CSO, CMO AND CFO INCLUDING COMPENSATION, WERE REVIEWED AND APPROVED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES IN ACCORDANCE WITH TERMS OF THE COOPERATIVE'S LOAN AGREEMENT.
Form 990, Part VI, Section C, line 19The documents are available upon request.