CHORUS COMMUNITY HEALTH PLANS INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CHORUS COMMUNITY HEALTH PLANS INC (EIN 27-1494977)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-09
- IRS object ID
- 201603149349302570
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-09T14:12:50-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363168081 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIKICH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13400 BISHOPS LANE SUITE 300 | AddressLine1Txt |
| City | BROOKFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53005 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271494977 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S COMMUNITY HEALTH PLAN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHIL | BusinessNameControlTxt |
| Phone | 4142665420 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1997 MS 900 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532011997 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARC A CADIEUX | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 4142665420 | PhoneNum |
| Signature | 2016-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRYAN L PAUTSCH CPA | PreparerPersonNm |
| PTIN | P00034913 | PTIN |
| Phone | 2627549400 | PhoneNum |
| Preparation | 2016-10-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT DUNCAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1997 MS 900 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532011997 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $250,809,419 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHILDRENSCHP.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESS TO QUALITY HEALTH CARE AND SERVICE TO MEDICAID BENEFICIARIES IN WI. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 77 | TotalEmployeeCnt |
| Total Volunteers | 5 | 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 | $228,470,477 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $237,847,920 | CYProgramServiceRevenueAmt |
| PY Investment Income | $113,896 | PYInvestmentIncomeAmt |
| CY Investment Income | $159,557 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,180 | PYOtherRevenueAmt |
| CY Other Revenue | $540 | CYOtherRevenueAmt |
| PY Total Revenue | $228,588,553 | PYTotalRevenueAmt |
| CY Total Revenue | $238,008,017 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $38,117 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $31,175 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $200,999,184 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $207,190,673 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,362,067 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,340,909 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,051,953 | PYOtherExpensesAmt |
| CY Other Expenses | $16,239,132 | CYOtherExpensesAmt |
| PY Total Expenses | $218,451,321 | PYTotalExpensesAmt |
| CY Total Expenses | $227,801,889 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,137,232 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,206,128 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $64,171,920 | TotalAssetsBOYAmt |
| Total Assets EOY | $73,877,192 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,216,325 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $32,765,840 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,955,595 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,111,352 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CHILDREN'S COMMUNITY HEALTH PLAN, INC. ("CCHP"), A SUBSIDIARY OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), IS A HEALTH MAINTENANCE ORGANIZATION DEDICATED TO PROVIDING ACCESS TO THE HIGHEST QUALITY HEALTH CARE AND SERVICES TO MEDICAID BENEFICIARIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $221,351,498 | ExpenseAmt |
| Grant | $31,175 | GrantAmt |
| Revenue | $237,847,584 | RevenueAmt |
| Desc | CCHP'S PURPOSE IS TO PROMOTE ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME CHILDREN AND CERTAIN OTHER DISADVANTAGED RESIDENTS OF THE STATE OF WISCONSIN, AND TO PROMOTE OR SPONSOR PROGRAMS FURTHERING THE HEALTH OF ITS MEMBERS AND THE LARGER COMMUNITIES SERVED. CCHP IS AN HMO FOR WISCONSIN MEDICAID-ELIGIBLE INDIVIDUALS AND FAMILIES LIVING IN BROWN, CALUMET, KENOSHA, MILWAUKEE, OUTAGAMIE, OZAUKEE, RACINE, SHEBOYGAN, WALWORTH, WASHINGTON, WAUKESHA, WAUPACA AND WINNEBAGO COUNTIES IN WISCONSIN. THE ENROLLMENT AT THE END OF DECEMBER 2015 WAS 132,932 MEMBERS, AND THERE WERE 12,824 INPATIENT ADMISSIONS, 471,061 AMBULATORY ENCOUNTERS, AND 4,103 DELIVERIES IN 2015. THE PLAN ALLOWS MEMBERS TO CHOOSE FROM A LARGE NETWORK OF PROVIDERS, WHICH INCLUDED MORE THAN 6,900 PHYSICIANS, 5,500 NON PHYSICIANS AND 55 HOSPITALS IN 2015, HOME CARE, MEDICAL EQUIPMENT PROVIDERS AND THE CCHP NURSELINE. | Desc |
| Total Program Service Expenses | $221,351,498 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| 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 | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1702 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 77 | 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 |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MS SARAH KAFKA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4142661887 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1997 MS 900 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532011997 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MARK J BACKE | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LARRY A RAMBO | |||||||||
| DIRECTOR (THROUGH JUNE 2015) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID J DRURY | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES PURKO | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS PRECIA | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT DUNCAN | |||||||||
| DIRECTOR/PRESIDENT | 0.00 | 40.00 | Yes (X) | $0 | $531,735 | $90,075 | Yes (X) | ||
| WELDON GAGE | |||||||||
| DIRECTOR/TREASURER(THROUGH JAN.2015) | 0.00 | 40.00 | Yes (X) | $0 | $181,445 | $951 | Yes (X) | ||
| MARGARET TROY | |||||||||
| DIRECTOR/CHAIR/CHHS PRESIDENT | 0.00 | 40.00 | Yes (X) | $0 | $1,376,051 | $280,989 | Yes (X) | ||
| MARC CADIEUX | |||||||||
| DIRECTOR/TREASURER | 0.00 | 40.00 | Yes (X) | $0 | $443,414 | $52,167 | Yes (X) | ||
| SHEILA REYNOLDS | |||||||||
| SECRETARY | 0.00 | 40.00 | $0 | $437,468 | $87,457 | Yes (X) | |||
| MARK RAKOWSKI | |||||||||
| VICE PRESIDENT, CCHP | 40.00 | 0.00 | $0 | $294,658 | $49,420 | Yes (X) | |||
| LYNN KRYFKE | |||||||||
| DIR, HEALTH PLAN CLINICAL SVCS | 40.00 | 0.00 | $115,365 | $0 | $10,727 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $115,365 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,264,771 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $571,786 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | 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 |
|---|---|---|---|---|---|
| DENTAL PROFESSIONALS OF WI | |||||
| 3520 W OKLAHOMA AVE | MILWAUKEE | WI | 53215 | CAPITATED DENTAL SERVICES | $11,685,624 |
| DEAN HEALTH PLAN INC | |||||
| 1277 DEMING WAY | MADISON | WI | 53717 | CLAIMS ADMINISTRATION/PROCESSOR | $11,004,422 |
| HERSLOF OPTICAL COMPANY INC | |||||
| 12000 W CARMEN AVE | MILWAUKEE | WI | 53225 | CAPITATED VISION SERVICES | $1,147,216 |
| MCG HEALTH LLC | |||||
| PO BOX 742350 | ATLANTA | GA | 303742350 | LICENSING FEES | $998,703 |
| MEDICAL COLLEGE OF WISCONSIN INC | |||||
| 8701 WATERTOWN PLANK RD | MILWAUKEE | WI | 53226 | MEDICAL LEADERSHIP | $369,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PREMIUM REVENUE | 524114 | $237,745,221 | $237,745,221 |
| PRENATAL CARE COORDINATION REV | 624100 | $102,699 | $102,699 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $237,847,920 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $167,631 | TotalRevenueColumnAmt |
| Exclusion | $167,631 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,793,328 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,801,066 | SecuritiesAmt |
| Other | $336 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$7,738 | SecuritiesAmt |
| Other | -$336 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,074 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$336 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$7,738 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $540 | TotalRevenueColumnAmt |
| Exclusion | $540 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $540 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $238,008,017 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $237,847,584 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $160,433 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,175 | TotalAmt |
| Program Services | $31,175 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,190,673 | TotalAmt |
| Program Services | $207,190,673 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,093 | TotalAmt |
| Program Services | $126,093 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,236,730 | TotalAmt |
| Program Services | $1,914,083 | ProgramServicesAmt |
| Management And General | $1,322,647 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,383 | TotalAmt |
| Program Services | $120,552 | ProgramServicesAmt |
| Management And General | $83,831 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530,840 | TotalAmt |
| Program Services | $320,453 | ProgramServicesAmt |
| Management And General | $210,387 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,863 | TotalAmt |
| Program Services | $147,043 | ProgramServicesAmt |
| Management And General | $95,820 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000,000 | TotalAmt |
| Management And General | $1,000,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,051 | TotalAmt |
| Management And General | $28,051 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,501 | TotalAmt |
| Management And General | $38,501 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,334,530 | TotalAmt |
| Program Services | $11,123,391 | ProgramServicesAmt |
| Management And General | $2,211,139 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,512 | TotalAmt |
| Management And General | $65,512 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,117 | TotalAmt |
| Management And General | $4,117 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,444 | TotalAmt |
| Program Services | $266,444 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,904 | TotalAmt |
| Management And General | $65,904 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,527 | TotalAmt |
| Management And General | $25,527 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,820 | TotalAmt |
| Management And General | $78,820 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,759 | TotalAmt |
| Management And General | $50,759 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| STATE INCOME TAX | $883,604 | $883,604 | |
| OTHER EXPENSES | $397,363 | $285,772 | $111,591 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,801,889 | TotalAmt |
| Program Services | $221,351,498 | ProgramServicesAmt |
| Management And General | $6,450,391 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,836,441 | BOYAmt |
| EOY | $39,042,757 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,572,461 | BOYAmt |
| EOY | $11,880,758 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,801 | BOYAmt |
| EOY | $689,536 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $573,589 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $179,302 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $335,885 | BOYAmt |
| EOY | $394,287 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,680,857 | BOYAmt |
| EOY | $21,750,689 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $512,475 | BOYAmt |
| EOY | $119,165 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,171,920 | BOYAmt |
| EOY | $73,877,192 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,392,986 | BOYAmt |
| EOY | $32,209,413 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,823,339 | BOYAmt |
| EOY | $556,427 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,216,325 | BOYAmt |
| EOY | $32,765,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,955,595 | BOYAmt |
| EOY | $41,111,352 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,955,595 | BOYAmt |
| EOY | $41,111,352 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,171,920 | BOYAmt |
| EOY | $73,877,192 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $10,206,128 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$50,371 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,232,162 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $74,613,944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $200,793,464 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $228,470,477 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $237,847,920 | CurrentTaxYearAmt |
| Total | $809,957,967 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,232,162 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $74,613,944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $200,793,464 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $228,470,477 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $237,847,920 | CurrentTaxYearAmt |
| Total | $809,957,967 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $809,957,967 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $137,398 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $97,999 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $83,640 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $106,229 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,763 | CurrentTaxYearAmt |
| Total | $442,029 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $137,398 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $97,999 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $83,640 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $106,229 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,763 | CurrentTaxYearAmt |
| Total | $442,029 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,800 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $540 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $450 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,180 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $540 | CurrentTaxYearAmt |
| Total | $7,510 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,371,360 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $74,712,483 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $200,877,554 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $228,580,886 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $237,865,223 | CurrentTaxYearAmt |
| Total | $810,407,506 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99900 | PublicSupportPY509Pct |
| Investment Income CY | 0.00050 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00100 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, SECTION B, LINE 12, COLUMN E: | FormAndLineReferenceDesc |
| Explanation | 2011 OTHER REVENUE $1,800 2012 OTHER REVENUE $ 540 2013 OTHER REVENUE $ 450 2014 OTHER REVENUE $4,180 2015 OTHER REVENUE $ 540 | ExplanationTxt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $28,052 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $28,052 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | SINCE CHILDREN'S COMMUNITY HEALTH PLAN IS A WISCONSIN MEDICAID HMO, CERTAIN OFFICERS OF CCHP AND CCHP'S PARENT, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC., MEET WITH OFFICIALS FROM THE STATE OF WISCONSIN DEPARTMENT OF HEALTH SERVICES TO DISCUSS THE MEDICAID PROGRAM IN WISCONSIN. THESE OFFICERS ARE EMPLOYEES OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM AND THUS WERE NOT REPORTED AS EXPENSES ON CCHP'S PART IX. THE AMOUNT REPORTED ON SCHEDULE C PART II-B LINE 1I CONSISTS OF $24,074 PAID TO AN OUTSIDE CONSULTANT WHO IS A REGISTERED LOBBYIST WHO ADVISES CCHP MANAGEMENT. THE REMAINING $3,978 IS THE PORTION OF FEES PAID TO A NATIONAL TRADE ASSOCIATION THAT WERE ATTRIBUTED TO NON DEDUCTIBLE LOBBYING ACTIVITIES BY THE TRADE ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $152,014 | OtherCostOrOtherBasisAmt |
| Depreciation | $109,213 | DepreciationAmt |
| Book Value | $42,801 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $71,248 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,078 | DepreciationAmt |
| Book Value | $50,170 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $350,327 | OtherCostOrOtherBasisAmt |
| Depreciation | $49,011 | DepreciationAmt |
| Book Value | $301,316 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $394,287 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $424,649 |
| PATIENT PROTECTION AND AFFORDABLE CARE ACT PASSTHROUGH | $19,595 |
| MEDICAL HOME PILOT OUTCOME INCENTIVE PROGRAM | $108,000 |
| UNCASHED CHECKS | $4,183 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $556,427 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FOOTNOTE 2 INCOME TAXES: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT DUNCAN | ||||||||||||||
| DIRECTOR/PRESIDENT | $0 | $332,715 | $0 | $126,102 | $0 | $72,918 | $0 | $53,188 | $0 | $36,887 | $0 | $621,810 | $0 | $44,984 |
| WELDON GAGE | ||||||||||||||
| DIRECTOR/TREASURER(THROUGH JAN.2015) | $0 | $53,541 | $0 | $127,883 | $0 | $21 | $0 | $0 | $0 | $951 | $0 | $182,396 | $0 | $0 |
| MARGARET TROY | ||||||||||||||
| DIRECTOR/CHAIR/CHHS PRESIDENT | $0 | $813,770 | $0 | $446,931 | $0 | $115,350 | $0 | $232,659 | $0 | $48,330 | $0 | $1,657,040 | $0 | $0 |
| MARC CADIEUX | ||||||||||||||
| DIRECTOR/TREASURER | $0 | $273,307 | $0 | $95,252 | $0 | $74,855 | $0 | $47,350 | $0 | $4,817 | $0 | $495,581 | $0 | $0 |
| SHEILA REYNOLDS | ||||||||||||||
| SECRETARY | $0 | $287,272 | $0 | $93,546 | $0 | $56,650 | $0 | $51,224 | $0 | $36,233 | $0 | $524,925 | $0 | $35,371 |
| MARK RAKOWSKI | ||||||||||||||
| VICE PRESIDENT, CCHP | $0 | $224,299 | $0 | $69,219 | $0 | $1,140 | $0 | $19,600 | $0 | $29,820 | $0 | $344,078 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | CCHP RELIED UPON CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE CORPORATE MEMBER OF CCHP, TO ESTABLISH THE COMPENSATION OF CCHP'S PRESIDENT. CHHS USED ITS INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, A COMPENSATION SURVEY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION. |
| PART I, LINE 4B | IN 2015, THERE WAS A CHHS EXECUTIVE FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2015 WERE AS FOLLOWS: M. CADIEUX, $27,750; R. DUNCAN, $36,238; AND S. REYNOLDS, $31,624. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2015 WERE: R. DUNCAN, $44,984; AND S. REYNOLDS, $35,371. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT AND CEO. THE AMOUNT SET ASIDE IN 2015 WAS $274,540 AND OF THAT, $58,831 WAS PAID AS A VESTED DISTRIBUTION UNDER THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN) MENTIONED ABOVE AND IS INCLUDED IN PART II, COLUMN (B)(III). |
| PART I, LINE 7 | CERTAIN EXECUTIVES PARTICIPATE IN AN ANNUAL BONUS PLAN THAT PROVIDES COMPENSATION BASED ON ACHIEVING SPECIFIC PRE-DEFINED GOALS. BONUS CRITERIA ARE COMPRISED OF BOTH SYSTEM LEVEL AND EXECUTIVE SPECIFIC COMPONENTS. SUCH CRITERIA PERTAIN TO MATTERS WITHIN THE EXECUTIVE'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF THE ORGANIZATION AND ITS AFFILIATES IN ALIGNMENT WITH SYSTEM-WIDE BALANCED MEASURES. |
| FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: | SALARIES PAID BY RELATED ORGANIZATIONS: 1. MARGARET TROY, BOARD CHAIR OF CCHP AND PRESIDENT & CEO OF CHHS, MARC CADIEUX, TREASURER OF CCHP AND TREASURER & CFO OF CHHS, WELDON GAGE, TREASURER OF CCHP (THROUGH JANUARY 2015) AND TREASURER & CFO OF CHHS (THROUGH JANUARY 2015), ROBERT DUNCAN, DIRECTOR & PRESIDENT OF CCHP AND EXECUTIVE VICE PRESIDENT OF COMMUNITY SERVICES OF CHHS, SHEILA REYNOLDS, SECRETARY OF CCHP AND CORPORATE VICE PRESIDENT & GENERAL COUNSEL OF CHHS, AND MARK RAKOWSKI, VICE PRESIDENT, CCHP - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY MS. TROY, MR. CADIEUX, AND MR. DUNCAN AS MEMBERS OF THE BOARD OF DIRECTORS OF CCHP WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: DRURY AND BACKE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS A SOLE CORPORATE MEMBER WHICH IS CHHS. |
| FORM 990, PART VI, SECTION A, LINE 7A | CHHS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE ORGANIZATION'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE CORPORATE MEMBER, CHHS, HAS CERTAIN RESERVE POWERS OVER THE CORPORATION, INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; APPROVAL OF MERGER, CONSOLIDATION OR THE CREATION OF ANY SUBSIDIARIES BY THE CORPORATION; APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT; AND SELECTION OF THE PRESIDENT. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CCHP. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CORPORATE VICE PRESIDENT AND GENERAL COUNSEL. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE AT EACH BOARD AND COMMITTEE MEETING. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, CHAIR, TREASURER, AND SECRETARY WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF CHHS (THE ORGANIZATION'S CORPORATE MEMBER). WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF THE VICE PRESIDENT WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CCHP ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. |
| FORM 990, PART XII LINE 2: | CCHP WAS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHHS. THE CONSOLIDATED FINANCIAL STATEMENTS OF CHHS WERE PREPARED IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA AND WERE AUDITED BY AN INDEPENDENT ACCOUNTANT. ADDITIONALLY, CCHP WAS REQUIRED TO PREPARE STATUTORY FINANCIAL STATEMENTS IN ACCORDANCE WITH ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE OFFICE OF THE COMMISSIONER OF INSURANCE OF THE STATE OF WISCONSIN, WHICH IS A BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. THE STATUTORY FINANCIAL STATEMENTS WERE ALSO AUDITED BY AN INDEPENDENT ACCOUNTANT, BUT WERE NOT USED TO PREPARE THE FORM 990 SINCE THE STATUTORY STATEMENTS WERE PREPARED USING A BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. |
| FORM 990, PART I LINE 4 & PART VI LINE 1B: | CCHP IS A WISCONSIN NONSTOCK CORPORATION AND IS AN AFFILIATE OF CHHS, A TAX-EXEMPT WISCONSIN CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH CARE NEEDS OF CHILDREN IN SOUTHEASTERN WISCONSIN AND SURROUNDING AREAS. AS THE CORPORATE MEMBER OF CCHP, CHHS HOLDS VARIOUS RESERVE POWERS IN RELATION TO CCHP, INCLUDING AUTHORITY TO APPOINT CCHP'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF CCHP CONSISTS OF REPRESENTATIVES OF CHHS'S EXECUTIVE LEADERSHIP IN ADDITION TO FOUR EXTERNAL DIRECTORS. THESE EMPLOYED DIRECTORS MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS CPE TEXT FOR FISCAL YEAR 1997, IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. CCHP MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF CHHS, AND CHHS'S GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 391500074 | OPERATIONAL SUPPORT SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 | |
| CHILDREN'S HOSPITAL OF WISCONSIN INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 390812532 | PEDIATRIC HOSPITAL | WI | 501(C)(3) | LINE 3 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 391500075 | FUND DEVELOPMENT | WI | 501(C)(3) | LINE 7 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S MEDICAL GROUP INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 391789197 | PEDIATRIC PHYSICIAN SERVICES | WI | 501(C)(3) | LINE 3 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S PHYSICIAN GROUP PC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 364303682 | PEDIATRIC PHYSICIAN SERVICES | IL | 501(C)(3) | LINE 9 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S SERVICE SOCIETY OF WISCONSIN | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 390806380 | CHILD WELLBEING SERVICES | WI | 501(C)(3) | LINE 7 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRTUAL PICU SYSTEMS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 WYTHE STREET SUITE 101 | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22314 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201414664 | EIN |
| Primary Activities | QUALITY/OUTCOMES ANALYSIS | PrimaryActivitiesTxt |
| Legal Domicile State | DE | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL & HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| 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 | 0 | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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