COX HEALTH SYSTEMS HMO INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COX HEALTH SYSTEMS HMO INC (EIN 43-1757075)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201633199349305573
- 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 | 2016-11-14T12:10:07-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E Main St Suite 700 | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | 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 | 431757075 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COX HEALTH SYSTEMS HMO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % LISA ODOM CFO | InCareOfNm |
| Business Name Control | COXH | BusinessNameControlTxt |
| Phone | 4172692900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5750 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65801 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATTHEW AUG | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4172693000 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joyce A Dulworth | PreparerPersonNm |
| PTIN | P00151125 | PTIN |
| Phone | 2604604000 | PhoneNum |
| 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) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | MATTHEW AUG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5750 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65807 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,273,719 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.COXHEALTHPLANS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | ENGAGED IN PROMOTING THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY BY PROVIDING A LOW-COST, HIGH-QUALITY HMO OPTION TO ALL INDIVIDUALS, INCLUDING AN UNDERSERVED POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 6 | 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 | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,243,941 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $29,778 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $14,273,719 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $1,319,013 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,105,229 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $4,607,581 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $11,031,823 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,241,896 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,622,694 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,495,025 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,864,609 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,758,822 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,758,085 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,736,203 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SUPPORT HEALTH IMPROVEMENT IN THE COMMUNITIES WE SERVE BY OFFERING COMPETITIVE INSURANCE PRODUCTS BASED ON QUALITY OUTCOMES AND EVIDENCED BASED HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $1,170,055 | ExpenseAmt |
| Revenue | $1,503,163 | RevenueAmt |
| Desc | COX HMO'S PRIMARY ACTIVITY HAS BEEN ARRANGING HEALTH CARE SERVICES THROUGH THE OPERATION OF AN HMO SINCE 1997. COX HMO HAS SERVED UP TO 400 PEOPLE IN ITS SERVICE AREA WHICH CONSISTS OF 26 COUNTIES IN THE STATE OF MISSOURI. COX HMO IS NO LONGER WRITING BUSINESS AND ALL ACTIVITIES AND PLAN OFFERINGS WILL BE CONDUCTED OUT OF THE RELATED COMPANY, COX HEALTH SYSTEMS INSURANCE COMPANY (CHSIC). AS OF DECEMBER 2015, MEMBERSHIP CONSISTED OF 88 PEOPLE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,157,547 | ExpenseAmt |
| Revenue | $9,700,139 | RevenueAmt |
| Desc | COX HMO PROVIDES OPERATIONAL SUPPORT SERVICES TO ITS WHOLLY OWNED SUBSIDIARY CHSIC. SUCH ADMINISTRATIVE SERVICES PROVIDED TO CHSIC INCLUDE COMPREHENSIVE ADMINISTRATIVE SERVICES, FINANCIAL AND MANAGERIAL SERVICES, PREMIUM PROCESSING, CLAIMS MANAGEMENT AND PROVIDER NETWORK ADMINISTRATION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,015,377 | ExpenseAmt |
| Revenue | $3,040,639 | RevenueAmt |
| Desc | COX HMO SERVES AS THE THIRD PARTY ADMINISTRATOR (TPA) FOR COX HEALTH SYSTEMS HOSPITALS' SELF-FUNDED EMPLOYEE HEALTH PLAN. THE CHS HOSPITALS' SELF-FUNDED PLAN COVERS APPROXIMATELY 12,500 MEMBERS INCLUDING EMPLOYEES AND DEPENDENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $8,342,979 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1757 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MO | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LISA ODOM CFO | PersonNm |
| Phone | 4172692900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3200 S NATIONAL BUILDING B | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65807 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| MR STEVEN D EDWARDS | |||||||||
| VICE CHAIRMAN/DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $1,355,943 | $259,919 | |||
| DR JAMES H CEASER | |||||||||
| DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $380,008 | $14,153 | |||
| DR MARK COSTLEY | |||||||||
| CHAIRMAN/DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $293,850 | $45,753 | |||
| MS RITA M NEEDHAM | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MR JOSEPH W TURNER | |||||||||
| DIRECTOR | 1.0 | 5.0 | Yes (X) | $0 | $0 | $0 | |||
| MR JERRY G JARED | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| MR KENNETH E MEYER | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MR CHRIS W NATTINGER | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MR LARRY SCHMITT | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MATTHEW AUG | |||||||||
| CHIEF EXECUTIVE OFFICER | 20.0 | 20.0 | $0 | $307,936 | $19,979 | Yes (X) | |||
| JOHN D GAMBLE | |||||||||
| CHIEF FINANCIAL OFFICER | 20.0 | 20.0 | $0 | $155,258 | $17,501 | Yes (X) | |||
| SUSAN BUTTS | |||||||||
| CHIEF INFORMATION OFFICER | 20.0 | 20.0 | $0 | $132,145 | $7,171 | Yes (X) | |||
| DANIEL O'CONNELL | |||||||||
| DIRECTOR OF MEDICAL MANAGEMENT | 20.0 | 20.0 | $0 | $91,924 | $17,178 | Yes (X) | |||
| JEFF BOND | |||||||||
| RETIRED CEO | 1.0 | 0.0 | $0 | $127,708 | $6,493 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,844,772 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $388,147 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TRIZETTO GROUP INC | |||||
| 12250 WEBER HILL ROAD SUITE 100 | ST LOUIS | MO | 63127 | HEALTHCARE IT SVC | $409,549 |
| CATAMARAN | |||||
| 1600 MCCONNOR PARKWAY FLOOR 1 | SCHAUMBURG | IL | 60173 | PHARMACY SERVICES | $379,601 |
| MILLIMAN | |||||
| 500 NORTH BROADWAY SUITE 1750 | ST LOUIS | MO | 63102 | CONSULTING | $232,643 |
| ERNST YOUNG US LLP | |||||
| 190 CARONDELET PLAZA DRIVE | ST LOUIS | MO | 63105 | TAX CONSULTING | $171,385 |
| OZARK MAILING SERVICE LLC | |||||
| 2804 NORTH OAK GROVE AVENUE | SPRINGFIELD | MO | 65803 | MAILING | $251,143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PREMIUM REVENUE | 524114 | $1,718,311 | $1,718,311 |
| ADMINISTRATIVE SERVICES | 561000 | $12,525,630 | $12,525,630 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,243,941 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,778 | TotalRevenueColumnAmt |
| Exclusion | $29,778 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,273,719 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,243,941 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $29,778 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,319,013 | TotalAmt |
| Program Services | $1,319,013 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,941,709 | TotalAmt |
| Program Services | $3,153,367 | ProgramServicesAmt |
| Management And General | $788,342 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,163,520 | TotalAmt |
| Program Services | $930,816 | ProgramServicesAmt |
| Management And General | $232,704 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,084 | TotalAmt |
| Management And General | $53,084 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,724 | TotalAmt |
| Management And General | $375,724 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $681,347 | TotalAmt |
| Program Services | $52,131 | ProgramServicesAmt |
| Management And General | $629,216 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,138 | TotalAmt |
| Program Services | $128,910 | ProgramServicesAmt |
| Management And General | $32,228 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,810 | TotalAmt |
| Program Services | $483,848 | ProgramServicesAmt |
| Management And General | $120,962 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,030,501 | TotalAmt |
| Program Services | $824,401 | ProgramServicesAmt |
| Management And General | $206,100 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,589 | TotalAmt |
| Program Services | $288,471 | ProgramServicesAmt |
| Management And General | $72,118 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,752 | TotalAmt |
| Program Services | $32,602 | ProgramServicesAmt |
| Management And General | $8,150 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,256 | TotalAmt |
| Program Services | $6,605 | ProgramServicesAmt |
| Management And General | $1,651 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,059 | TotalAmt |
| Management And General | $2,059 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,412 | TotalAmt |
| Program Services | $294,730 | ProgramServicesAmt |
| Management And General | $73,682 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,794 | TotalAmt |
| Program Services | $319,035 | ProgramServicesAmt |
| Management And General | $79,759 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| FEDERAL INCOME TAXES | $455,380 | $455,380 | |
| OTHER EXPENSES | $1,406 | $1,406 | |
| PROPERTY TAXES | $7,827 | $6,262 | $1,565 |
| SALES TAXES | $2,130 | $1,704 | $426 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,372 | TotalAmt |
| Program Services | $44,298 | ProgramServicesAmt |
| Management And General | $11,074 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,031,823 | TotalAmt |
| Program Services | $8,342,979 | ProgramServicesAmt |
| Management And General | $2,688,844 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,940,857 | BOYAmt |
| EOY | $5,659,068 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,568,275 | BOYAmt |
| EOY | $5,568,674 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,361,885 | BOYAmt |
| EOY | $1,651,895 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $528,058 | BOYAmt |
| EOY | $529,283 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,362,045 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,774,010 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $589,279 | BOYAmt |
| EOY | $588,035 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,634,340 | BOYAmt |
| EOY | $17,498,070 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,622,694 | BOYAmt |
| EOY | $31,495,025 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,381,914 | BOYAmt |
| EOY | $1,536,644 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,767 | BOYAmt |
| EOY | $439 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $414,928 | BOYAmt |
| EOY | $221,739 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,864,609 | BOYAmt |
| EOY | $1,758,822 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,421,532 | BOYAmt |
| EOY | $14,063,160 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,356,113 | BOYAmt |
| EOY | $20,605,010 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,980,440 | BOYAmt |
| EOY | -$4,931,967 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,758,085 | BOYAmt |
| EOY | $29,736,203 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,622,694 | BOYAmt |
| EOY | $31,495,025 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,241,896 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$263,778 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,203 | OtherCostOrOtherBasisAmt |
| Book Value | $139,203 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,222,842 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,774,010 | DepreciationAmt |
| Book Value | $448,832 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $588,035 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS IN AFFILIATES | Desc |
| Book Value | $17,498,070 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $17,498,070 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CLAIMS AND CLAIMS PAYABLE | Desc |
| Amt | $221,739 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $221,739 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $14,271,696 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $14,271,696 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,023 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,023 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,273,719 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,029,800 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $11,029,800 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,023 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,023 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,031,823 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASC 740 FOOTNOTE | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| PART XI, LINE 4B | INTEREST EXPENSE $ 2,023 |
| PART XII, LINE 4B | INTEREST EXPENSE $ 2,023 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATTHEW AUG | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $0 | $256,424 | $0 | $44,970 | $0 | $6,542 | $0 | $12,985 | $0 | $6,994 | $0 | $327,915 | $0 | $0 |
| JOHN D GAMBLE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $131,612 | $0 | $19,463 | $0 | $4,183 | $0 | $3,305 | $0 | $14,196 | $0 | $172,759 | $0 | $0 |
| JEFF BOND | ||||||||||||||
| RETIRED CEO | $0 | $61,098 | $0 | $66,262 | $0 | $348 | $0 | $3,756 | $0 | $2,737 | $0 | $134,201 | $0 | $0 |
| MR STEVEN D EDWARDS | ||||||||||||||
| VICE CHAIRMAN/DIRECTOR | $0 | $936,242 | $0 | $265,782 | $0 | $153,919 | $0 | $245,648 | $0 | $14,271 | $0 | $1,615,862 | $0 | $147,034 |
| DR JAMES H CEASER | ||||||||||||||
| DIRECTOR | $0 | $360,683 | $0 | $0 | $0 | $19,325 | $0 | $0 | $0 | $14,153 | $0 | $394,161 | $0 | $0 |
| DR MARK COSTLEY | ||||||||||||||
| CHAIRMAN/DIRECTOR | $0 | $291,794 | $0 | $0 | $0 | $2,056 | $0 | $31,250 | $0 | $14,503 | $0 | $339,603 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | ESTABLISHMENT OF TOP MANAGEMENT OFFICIAL COMPENSATION: LESTER E. COX MEDICAL CENTERS, A RELATED PARTY OF THE ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE COX HEALTH SYSTEMS HMO TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| SCHEDULE J, PART I, QUESTION 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS PARTICIPATES IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS. HE RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $232,398 AND A 457(F) DISTRIBUTION OF $147,034, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990 OF THE PARENT. |
| SCHEDULE J, PART II; AND FORM 990, PART VII | BOARD MEMBER COMPENSATION: NO COMPENSATION WAS PROVIDED FOR RESPONSIBILITIES ASSOCIATED WITH BEING A BOARD DIRECTOR. COMPENSATION REPORTED FOR SEVERAL BOARD MEMBERS LISTED ON SCHEDULE J REPRESENTS EMPLOYEE OR INDEPENDENT CONTRACTOR COMPENSATION UNRELATED TO SERVICE AS A BOARD MEMBER. |
| SCHEDULE J, PART II, COLUMN F | COMPENSATION REPORTED ON PRIOR FORM 990 OF THE PARENT: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | INSURED LIVES WITH HMO PLANS WERE TRANSFERRED THROUGHOUT THE YEAR UPON CONTRACT RENEWAL TO CHSIC PLANS TO CLOSE DOWN THE HMO PLANS. AS OF 1/1/16 ALL REMAINING MEMBERS WITH HMO PLANS WERE TRANSFERRED TO NEW PLANS IN CHSIC. |
| FORM 990, PART VI, SECTION A, LINE 6 | 2000 SHARES CLASS H COMMON STOCK - ONE MEMBER WHICH IS COX HEALTH SYSTEMS |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PROVIDED TO THE DIRECTOR OF ACCOUNTING AND CFO FOR A DETAILED REVIEW. THE FORM INFORMATION IS CROSS-CHECKED WITH COMPANY FINANCIAL RECORDS TO ENSURE ACCURACY. A COPY IS ALSO PROVIDED TO THE CEO AND GOVERNING BODY FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS AND BOARD MEMBERS ARE REQUIRED ANNUALLY TO REVIEW AND SIGN CONFLICT OF INTEREST DISCLOSURES. |
| FORM 990, PART VI, SECTION B, LINE 15A | REVIEWED BY THE CFO OF COX HEALTH SYSTEMS ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15B REVIEWED BY THE PRESIDENT OF COX HEALTHPLANS ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 18 | THESE DOCUMENTS WILL BE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | COX HEALTH SYSTEMS HMO'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FOR PUBLIC INSPECTION AS AN ATTACHMENT TO THE APPLICATION FOR RECOGNITION OF EXEMPTION. |
| FORM 990, PART X | Effective January 1, 2015, the Company elected 501(c) nonprofit tax-exempt status. The balance sheet is being presented with the amounts that would have been entered on the 2014 Form 990 according to the IRS instructions. |
| FORM 990, PART XI, LINE 9 | ISSUANCE OF SHARES $ 641,628 CHANGES IN DEFERRED TAXES $ (5,731) CHANGES IN NONADMITTED ASSETS $(949,217) CHANGES IN EQUITY OF AFFILIATES $ 628,276 DIVIDENDS PAID $(114,586) DIFFERENCE IN ELIMINATION ENTRIES $(464,148) TOTAL $(263,778) |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| COX HEALTHPLANS LLC | |||||||||
| 3200 S NATIONAL BLDG B | SPRINGFIELD | MO | 65807 | 431754751 | MANAGEMENT | MO | $3,469,855 | $11,528,528 | COX HMO |
| FERRELL-DUNCAN CLINIC | |||||||||
| 1001 E PRIMROSE | SPRINGFIELD | MO | 65807 | 542183221 | PHYSICIANS | MO | COXHEALTH | ||
| REGIONAL SERVICES | |||||||||
| 3800 S NATIONAL SUITE 540 | SPRINGFIELD | MO | 65807 | 542183222 | HEALTHCARE | MO | COXHEALTH | ||
| OXFORD HEALTHCARE HOME HEALTH AGENCY | |||||||||
| 3550 S NATIONAL | SPRINGFIELD | MO | 65807 | 770700975 | HOME HEALTH | MO | COXHEALTH | ||
| COXHEALTH HOME SUPPORT SYSTEMS | |||||||||
| 2224 W SUNSET | SPRINGFIELD | MO | 65807 | 542183216 | HOME HEALTH | MO | COXHEALTH | ||
| OB GYN FERRELL-DUNCAN CLINIC | |||||||||
| 1000 E PRIMROSE | SPRINGFIELD | MO | 65807 | 431878984 | PHYSICIANS | MO | COXHEALTH | ||
| COXHEALTH ALLIANCE LLC | |||||||||
| 3850 S NATIONAL AVE | SPRINGFIELD | MO | 65807 | 271117213 | MANAGEMENT | MO | COXHEALTH | ||
| SPRINGFIELD NEUROLOGICAL AND SPINE INSTI | |||||||||
| 2900 S NATIONAL AVE | SPRINGFIELD | MO | 65807 | 274296628 | PHYSICIANS | MO | COXHEALTH | ||
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| COX HEALTH SYSTEMS INSURANCE COMPANY | ||||||||||
| 3200 S NATIONAL BLDG B | SPRINGFIELD | MO | 65807 | 431684044 | INSURANCE | MO | 501(C)(4) | COX HMO | Yes (true) | |
| LESTER E COX MEDICAL CENTERS | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 440577118 | HOSPITAL | MO | 501(C)(3) | NA | false | 3 |
| COX ALTERNATIVE CARE OF THE OZARKS INC | ||||||||||
| PO BOX 10939 | SPRINGFIELD | MO | 65808 | 431641925 | HOME HEALTH | MO | 501(C)(3) | COXHEALTH | false | 9 |
| COXHEALTH FOUNDATION | ||||||||||
| 3525 S NATIONAL SUITE 204 | SPRINGFIELD | MO | 65807 | 436810485 | FUNDRAISING | MO | 501(C)(3) | COXHEALTH | false | 11AI |
| COXHEALTH HME CRE SVCS OF THE MDWST INC | ||||||||||
| 3850 S NATIONAL | SPRINGFIELD | MO | 65807 | 264781194 | HOME HEALTH | MO | 501(C)(3) | COXHEALTH | false | 9 |
| COX HPS OF THE OZARKS INC | ||||||||||
| 2220 W SUNSET | SPRINGFIELD | MO | 65807 | 431641927 | HOME HEALTH | MO | 501(C)(3) | COXHEALTH | false | 9 |
| COX-MONETT HOSPITAL INC | ||||||||||
| 801 N LINCOLN AVE | MONETT | MO | 65708 | 431656689 | HOSPITAL | MO | 501(C)(3) | COXHEALTH | false | 3 |
| COX-MONETT HOSPITAL AUXILIARY | ||||||||||
| 801 N LINCOLN AVE | MONETT | MO | 65708 | 431852817 | SUPPORT | MO | 501(C)(3) | COXHEALTH | false | 9 |
| HEALTH ENRICHMENT SERVICES INC | ||||||||||
| 3801 S NATIONAL | SPRINGFIELD | MO | 65807 | 363263313 | MED SVC | MO | 501(C)(3) | COXHEALTH | false | 7 |
| HEALTHCARE SERVICES OF THE OZARKS INC | ||||||||||
| PO BOX 10939 | SPRINGFIELD | MO | 65808 | 431641928 | HOME HEALTH | MO | 501(C)(3) | COXHEALTH | false | 9 |
| PRIMROSE PLACE INC | ||||||||||
| 1115 E PRIMROSE | SPRINGFIELD | MO | 65807 | 431183783 | NURSING HOME | MO | 501(C)(3) | COXHEALTH | false | 11AI |
| COXHEALTH AUXILIARY | ||||||||||
| 3801 S NATIONAL | SPRINGFIELD | MO | 65807 | 431090590 | SUPPORT | MO | 501(C)(3) | COXHEALTH | false | 9 |
| COX MEDICAL CTR GENPROF LIAB LOSS FUND | ||||||||||
| 1423 N JEFFERSON | SPRINGFIELD | MO | 65802 | 366668576 | SELF-INSURANC | MO | 501(C)(3) | COXHEALTH | false | 11AI |
| SKAGGS REGIONAL MEDICAL CENTER | ||||||||||
| D/B/A COX MEDICAL CTR BRANSON | BRANSON | MO | 65616 | 440584290 | HOSPITAL | MO | 501(C)(3) | COXHEALTH | false | 3 |
| COX COLLEGE | ||||||||||
| 1423 NORTH JEFFERSON | SPRINGFIELD | MO | 65802 | 475148345 | EDUCATION | MO | 501(C)(3) | COXHEALTH | false | 2 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SKAGGS-COXHEALTH ALLIANCE LLC | |||||||||||
| SFD MO 65807 | SPRINGFIELD | MO | 65807 | 271117343 | HEALTHCARE | MO | COXHLTH ALLI | RELATED | false | false | 0.00000 |
| PCRMC-COXHEALTH ALLIANCE LLC | |||||||||||
| SFD MO 65807 | SPRINGFIELD | MO | 65807 | 300649009 | HEALTHCARE | MO | COXHLTH ALLI | RELATED | false | false | 0.00000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL DEVELOPMENTS | |||||||||||||||||
| 1423 N JEFFERSON AVE | SPRINGFIELD | MO | 65802 | 431622182 | PHARMACY | MO | COXHEALTH | C CORP | $0 | $0 | 0.00000 | false | |||||
| INSURANCE COMPANY OF SPRINGFIELD INC | |||||||||||||||||
| INSURANCE | COXHEALTH | C CORP | $0 | $0 | 0.00000 | false | GRAND PAVILLION CORPORATE CENTRE | GRAND CAYMAN | CJ | KY1-110 | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| LESTER E COX MEDICAL CENTERS | ||
| C | $641,628 | COST |
| COX HEALTH SYSTEMS INSURANCE COMPANY | ||
| N | $196,258 | COST |
| COX HEALTHPLANS LLC | ||
| P | $118,029 | COST |
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