2016-05-02T09:23:33-05:00 2015-09-30 222027092 WITHUMSMITHBROWN PC 1417 E CONCORD STREET ORLANDO FL 32803 990 2014-10-01 650504316 HEALTH CHOICE NETWORK OF FLORIDA INC HEAL 3055991015 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 ALEJANDRO ROMILLO PRESIDENT AND CEO 3055991015 2016-03-14 1 EDWARD A HOFMA CPA P00735723 4078491569 2016-03-14 2014 2016-08-17 19:52:53Z ALEJANDRO ROMILLO 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 40778190 0 X WWW.HCNETWORK.ORG X 1994 FL TO PROVIDE HIGH QUALITY SERVICE, SUPPORT, AND EXPERTISE TO MEMBER ORGANIZATIONS... AND TO ACT AS A VEHICLE FOR STRATEGIC EFFORTS THAT STRENGTHEN OUR COMMUNITY HEALTH PARTNERS. 11 11 139 0 0 0 11354750 8834333 22357025 29515136 9700 391213 7969290 2037508 41690765 40778190 0 0 0 0 9138482 7631694 0 0 27925 26245863 31430176 35384345 39061870 6306420 1716320 17856989 19337601 3708861 3473153 14148128 15864448 X TO PROVIDE HIGH QUALITY, SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS AND TO ACT AS A VEHICLE FOR STRATEGIC EFFORTS THAT STRENGTHEN OUR COMMUNITY HEALTH PARTNERS. 0 0 6177739 HEALTH CONNECT IN OUR SCHOOLS - THE CHILDREN'S TRUST SUBCONTRACTS WITH HCN AND FOUR (4) OF MIAMI-DADE FEDERALLY QUALIFIED HEALTH CENTERS TO IMPLEMENT THE HEALTH CONNECT IN OUR SCHOOLS PROGRAM TO PROVIDE MIAMI DADE COUNTY PUBLIC SCHOOL STUDENTS WITH BOTH BASIC AND PRIMARY CARE ALONG WITH SCREENINGS AND BEHAVIORAL HEALTH SERVICES IN 93 SCHOOLS. 8541383 FISCAL/MIS INTEGRATION - PROVIDES FISCAL AND MANAGEMENT INFORMATION SYSTEM SERVICES FOR MEMBER CENTERS. PRIMARY SERVICES INCLUDE OPERATING A CENTRALIZED MIS DEPARTMENT (HARDWARE AND SOFTWARE), AND SHARING OF CHIEF FINANCIAL OFFICER AND CHIEF INFORMATION OFFICER SERVICES THROUGH INTEGRATED ACTIVITIES OF THE CENTERS FINANCE AND IT DEPARTMENTS. 3736514 CENTRALIZED BILLING - PROVIDES BILLING AND PAYMENT POSTING SERVICES FOR THE MEMBER CENTERS THAT HAVE ELECTED TO PARTICIPATE. THE CENTRAL BILLING OFFICE IS RESPONSIBLE FOR LIMITED CREDENTIALING SERVICES AND MOST ASPECTS OF THE BILLING AND COLLECTION OF PATIENT CHARGES ON BEHALF OF THE CENTERS, WHICH INCLUDES FOLLOW-UP ON ACCOUNTS RECEIVABLE. 16707966 31060143 MANAGED CARE - PROVIDES HEALTH CARE MANAGEMENT TO THE HMO ASSIGNED MEMBERS AND MANAGED MEDICAID PREPAID OUTPATIENT MENTAL HEALTH SERVICES FOR PARTICIPATING MEMBER CENTERS TO ENSURE PROPER UTILIZATION OF HEALTH CARE IN THE MANAGED CARE ENVIRONMENT. THIS PROGRAM INCLUDES CREDENTIALING, CENTRALIZED REFERRALS FOR CENTER HMO CONTRACTS, PROVIDER RELATIONS, AND MANAGEMENT OF AT-RISK CONTRACTS. THE MANAGED CARE UNIT ALSO PROVIDES SUPPORT TO SHARED CLINICAL COMMITTEE COLLABORATIVE SERVICES. 36672 SOUTH FLORIDA REGIONAL EXTENSION CENTER PROJECT- IMPLEMENT AND MAINTAIN INTEGRATED ELECTRONIC MEDICAL AND DENTAL HEALTH RECORDS IN PARTICIPATING MEMBER CENTERS TO ENHANCE THE ABILITY TO PROVIDE HIGH QUALITY PREVENTIVE AND PRIMARY CARE, AND IMPROVE PATIENT OUTCOMES. 84812 492501 MEMBER SERVICES - A SINGLE RESOURCE ON BEHALF OF ALL CENTERS FOR SERVICES SUCH AS EDUCATION ON CURRENT GRANTS, LEGISLATIVE ISSUES, BOARD TRAINING, ETC. 16829450 31552644 35285086 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 24 0 1 139 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X RICK FRIEDFELD 3055991015 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 BRODES HARTLEY JR IMMEDIATE PAST CHAIR 1.00 X 0 0 0 ROSALYN FRAZIER CHAIR 1.00 X X 0 0 0 BAKARI BURNS VICE-CHAIR 1.00 X X 0 0 0 CHARLES BOTTOMS TREASURER 1.00 X X 0 0 0 CLAUDIO M PEREZ SECRETARY 1.00 X 0 0 0 FRANK MAZZEO DIRECTOR 1.00 X 0 0 0 MARIO JARDON DIRECTOR 1.00 X 0 0 0 PAT MABE DIRECTOR 1.00 X 0 0 0 MARK RABINOWITZ DIRECTOR 1.00 X 0 0 0 BOB LINDER DIRECTOR 1.00 X 0 0 0 ANNIE NEASMAN DIRECTOR 1.00 X 0 0 0 KEVIN S KEARNS CHIEF EXECUTIVE OFFICER 40.00 X X 271541 541615 14110 ALEJANDRO ROMILLO SR. VP & COO 40.00 X 473448 0 13211 RICK FRIEDFELD CFO 40.00 X 327720 0 1860 THEODORE MAREFKA DIRECTOR OF OPERATIONS & H 40.00 X 196145 0 6524 TERISA A JAMES VP OF COMMUNITY INITIATIVE 40.00 X 169494 0 9691 BLANCA MARGARITA OLLET SVP ADMINISTRATION SERVICE 40.00 X 268726 0 4146 MICHELLE RUSSELL VP BUSINESS DEVELOPMENT 40.00 X 0 181923 8018 ANDREW BRICKMAN SR. DIRECTOR OF STRATEGIC 40.00 X 184552 0 10797 MICHAEL BIRDSONG CHIEF INFORMATION OFFICER 40.00 X 0 180902 1078 GEORGE KARNEGIS SR. DIRECTOR OF INFORMATIO 40.00 X 0 150881 6971 MEREDITH HUGHES MARSH INTERIM SFREC DIRECTOR 40.00 X 135678 0 5581 COLLETTE REECE SR. DIRECTOR OF FINANCE/CFO SERVICES 40.00 X 131517 0 1849 VICTOR RODRIGUEZ DIRECTOR OF NETWORK OPERATIONS 40.00 X 0 136234 556 RICARDO GOMEZ SR. DIRECTOR OF INFORMATIO 40.00 X 0 140470 1217 PATRICE TULLOCH SR. DIRECTOR OF PMO 40.00 X 0 130512 1404 2158821 1462537 87013 13 0 1 0 CLAIMS REVIEW CORPORATION 9420 BUNSEN PARKWAY SUITE 204 LOUISVILLE KY 40220 MEDICAL CLAIMS BILLING 889983 ADSS GLOBAL SOUTHEAST LLC 3276 BUFORD DRIVE SUITE 104-113 BUFORD GA 30519 SAGE 300 IMPLEMENTATION AND TRAINING 228053 CNI CONCEPT ENTERPRISES INC 13611 S DIXIE HWY UNIT 566 MIAMI FL 33176 BUILDING CONTRACTORS 180215 CONNECT C3 INC 12915 SW 132 STREET SUITE 4 MIAMI FL 33186 ETHERNET AND FIBEROPTIC CABLING INSTALLA 150829 4 841907 7992426 8834333 MANAGED CARE 524298 15491554 15491554 MEMBER SERVICES 561000 13531081 13531081 MEMBERSHIP DUES 561000 492501 492501 29515136 391213 391213 CONTRACT SERVICES 561000 1196904 1196904 ADMINISTRATIVE SERVICES FOR AFFIL 561000 712276 712276 EQUITY IN EARNINGS OF AFFILIATED 900003 128328 128328 2037508 40778190 31552644 0 391213 986814 789451 184064 13299 5463828 3449449 2000456 13923 273033 170168 102375 490 451618 395475 56143 456401 335923 120265 213 30095 16100 13995 49850 49850 452998 204916 248082 32271 19728 12543 124916 124916 95271 47252 48019 180739 33444 147295 673025 401349 271676 71265 71265 CONTRACTED SERVICES 16490024 16248132 241892 CAPITATION 12935081 12935081 AMALGA HOSTING & SUPPOR 238265 238265 PAYROLL SERVICES - ADP 37890 108 37782 18486 245 18241 39061870 35285086 3748859 27925 5026087 2174936 846266 361122 1440681 1710304 2236368 7399050 440990 744983 11907684 9143055 3154940 2764629 4346363 3869549 365294 313028 17856989 19337601 2206564 1752711 1502297 1720442 3708861 3473153 X 14148128 15864448 14148128 15864448 17856989 19337601 1716320 0 X X 0 1 X 1 1 1 X 13649734 14772109 15949716 11354750 8834333 64560642 13649734 14772109 15949716 11354750 8834333 64560642 64560642 49403 53324 36183 9700 391213 539823 4913999 2316898 5919387 7852398 2037508 23040190 88140655 94839400 0.73250 0.74970 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CONTRACT SERVICES - 2010 AMOUNT: $ 4,274,406. 2011 AMOUNT: $ 1,505,679. 2012 AMOUNT: $ 760,887. 2013 AMOUNT: $ 1,229,375. 2014 AMOUNT: $ 1,196,904. ADMISTRATIVE SERVICE - 2010 AMOUNT: $ 849,342. 2011 AMOUNT: $ 1,194,163. 2012 AMOUNT: $ 2,020,617. 2013 AMOUNT: $ 1,744,564. 2014 AMOUNT: $ 712,276. EQUITY IN EARNINGS OF AFFILIATE - 2010 AMOUNT: $ -209,749. 2011 AMOUNT: $ -382,944. 2012 AMOUNT: $ 3,137,883. 2013 AMOUNT: $ 4,878,459. 2014 AMOUNT: $ 128,328. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3342150 1102240 2239910 780657 647923 132734 3285916 3226636 59280 4498961 4166256 332705 2764629 INVESTMENT IN LIMITED LIABILITY COMPANIES 1127836 F CERTIFICATES OF DEPOSIT 498708 F MUTUAL FUNDS 2054213 F COMMON STOCKS 188792 F 3869549 X 40778190 0 40778190 0 40778190 39061870 0 39061870 0 39061870 PART X, LINE 2: THE NETWORK IS A NONPROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PRESCRIBE REQUIREMENTS FOR THE RECOGNITION OF INCOME TAXES IN FINANCIAL STATEMENTS, AND THE AMOUNTS RECOGNIZED ARE AFFECTED BY INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS. THE NETWORK'S STATUS AS AN EXEMPT ORGANIZATION IS DEFINED AS AN INCOME TAX POSITION UNDER THESE REQUIREMENTS. WHILE MANAGEMENT BELIEVES IT HAS COMPLIED WITH THE INTERNAL REVENUE CODE, THE SUSTAINABILITY OF SOME INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS MAY BE UNCERTAIN. THERE ARE MINIMUM THRESHOLDS OF LIKELIHOOD THAT UNCERTAIN TAX POSITIONS ARE REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THAT THE NETWORK HAS ANY MATERIAL UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2015. IN THE EVENT INTEREST AND PENALTIES WERE DUE RELATING TO AN UNSUSTAINABLE TAX POSITION, THEY WOULD BE TREATED AS A COMPONENT OF INCOME TAX EXPENSE. THE NETWORK'S FEDERAL INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. AT SEPTEMBER 30, 2015, THE FISCAL YEARS 2012 THROUGH 2015 FEDERAL TAX RETURNS ARE SUBJECT TO EXAMINATION. X X 0 0 0 0 0 0 0 0 0 KEVIN S KEARNS CHIEF EXECUTIVE OFFICER 231541 200226 40000 341389 0 0 0 0 14110 0 285651 541615 0 0 ALEJANDRO ROMILLO SR. VP & COO 330240 0 143208 0 0 0 0 0 13211 0 486659 0 0 0 RICK FRIEDFELD CFO 258723 0 68997 0 0 0 0 0 1860 0 329580 0 0 0 THEODORE MAREFKA DIRECTOR OF OPERATIONS & H 185695 0 10450 0 0 0 0 0 6524 0 202669 0 0 0 TERISA A JAMES VP OF COMMUNITY INITIATIVE 160494 0 9000 0 0 0 0 0 9691 0 179185 0 0 0 BLANCA MARGARITA OLLET SVP ADMINISTRATION SERVICE 171346 0 97380 0 0 0 0 0 4146 0 272872 0 0 0 MICHELLE RUSSELL VP BUSINESS DEVELOPMENT 0 171864 0 10059 0 0 0 0 0 8018 0 189941 0 0 ANDREW BRICKMAN SR. DIRECTOR OF STRATEGIC 179141 0 5411 0 0 0 0 0 10797 0 195349 0 0 0 MICHAEL BIRDSONG CHIEF INFORMATION OFFICER 0 180902 0 0 0 0 0 0 0 1078 0 181980 0 0 GEORGE KARNEGIS SR. DIRECTOR OF INFORMATIO 0 148012 0 2869 0 0 0 0 0 6971 0 157852 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE NETWORK IS MANAGED BY THREE CATEGORIES OF MEMBERS: FOUNDING MEMBERS, AFFILATED MEMBERS AND PARTICIPATING MEMBERS. THE MEMBERS OF THE BOARD OF DIRECTORS MUST BE EMPLOYED BY OR SERVE ON THE BOARD OF DIRECTORS OF CORPORATIONS WHICH ARE EITHER FOUNDING PARTICIPATING MEMBERS OR PARTICIPATING NETWORK MEMBERS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS SHALL BE LIMITED TO FOUNDING, AFFILIATED MEMBERS AND PARTICIPATING MEMBERS. THE DIRECTORS OF THE NETWORK (REFERRED TO IN THESE BYLAWS AS THE "BOARD") SHALL CONSIST OF AS MANY INDIVIDUALS AS THE BOARD MAY, FROM TIME TO TIME, DETERMINE, PROVIDED THAT AT A MINIMUM THE BOARD SHALL CONSIST OF: THE CEO (OR TOP EXECUTIVE POSITION) OF EACH FOUNDING AND AFFILIATED MEMBER; THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE NETWORK (EX-OFFICIAL AND NON-VOTING MEMBER); A CLINICAL REPRESENTATIVE OF THE NETWORK WHO SHALL BE SELECTED ANNUALLY BY THE NETWORK BOARD OF DIRECTORS. AT SUCH TIME AS AN ORGANIZATION BECOMES AN AFFILIATED MEMBER, THE MEMBER SHALL HAVE THE RIGHT TO NOMINATE AN INDIVIDUAL MEETING QUALIFICATION CRITERIA SET FORTH HEREIN TO THE BOARD OF DIRECTORS. PRIOR TO EACH ANNUAL MEETING OF THE BOARD OF DIRECTORS, EACH MEMBER ENTITLED TO APPOINT A DIRECTOR SHALL INFORM THE BOARD, IN WRITING, OF ANY CHANGES IN THE PERSON OR PERSONS THAT IT HAS APPOINTED TO SERVE ON THE BOARD OF DIRECTORS FOR THE TERM THAT BEGINS UPON ADJOURNMENT OF THAT ANNUAL MEETING. DIRECTORS SO APPOINTED AND POSSESSING THE QUALIFICATION SET FORTH IN THESE BYLAWS SHALL BE CONFIRMED BY THE BOARD AT THE ANNUAL BOARD MEETING, OR IN THE CASE OF AN APPOINTMENT TO FILL A VACANCY ON THE BOARD AT ANY DULY CALLED MEETING OF THE BOARD. IF A PERSON DULY APPOINTED BY A MEMBER IS FOUND NOT TO MEET THE CRITERIA FOR MEMBERSHIP ESTABLISHED BY THE BYLAWS, THE MEMBER THAT APPOINTED SUCH A PERSON SHALL HAVE THE RIGHT TO APPOINT A QUALIFIED PERSON FOR CONFIRMATION BY THE BOARD FORM 990, PART VI, SECTION A, LINE 7B ALL THE POWERS OF THE NETWORK SHALL BE EXERCISED BY OR UNDER THE CONTROL OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS REVIEWED IN DRAFT FORM AND APPROVED BY THE FINANCE COMMITTEE. A COPY WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE NETWORK HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT EVERY EMPLOYEE IS REQUIRED TO READ AND SIGN. THE NETWORK'S BYLAWS ALSO REQUIRE ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT TO ADHERE TO THE STANDARDS OF CONDUCT PERTAINING TO THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE NETWORK'S BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION AND ESTABLISHES THE COMPENSATION WITH A WRITTEN EMPLOYMENT CONTRACT. THE CEO ESTABLISHES THE PROCESSES FOR DETERMINATION OF THE COMPENSATION OF OTHER OFFICERS. FORM 990, PART VI, SECTION C, LINE 18 THE NETWORK MAKES THESE FORMS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT CURRENTLY MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C THE NETWORK HAS A FINANCE COMMITTEE ESTABLISHED BY THE BOARD OF DIRECTORS THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT, REVIEWING OF ITS FINANCIAL STATEMENTS, AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, SCHEDULE J, PART II, LINE 1 COMPENSATION FOR KEVIN KEARNS INCLUDES AMOUNTS FROM HEALTH CHOICE NETWORK OF FLORIDA AND PRESTIGE HEALTH CHOICE, A RELATED COMPANY. THESE AMOUNTS ARE BROKEN DOWN AS FOLLOWS: BASE COMPENSATION INCENTIVE COMPENSATION TOTAL HCN OF FLORIDA $ 231,541 $ 40,000 $ 271,541 PRESTIGE HEALTH 200,226 341,389 541,615 TOTAL $ 431,767 $ 381,389 $ 813,156 HEALTH CHOICE NETWORK INC 9064 NORTHWEST 13TH TERRACE DORAL FL 33172 900525658 TO PROVIDE SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS FL 501(C)(3) LINE 9 N/A 0 PRESTIGE HEALTH CHOICE LLC 9064 NW 13TH TERRACE MIAMI FL 33172 450563075 MANAGED HEALTH CARE ACTIVITIES FL NO MEDICAID FUNDING -1008114 8177260 1 0 0.05000 HEALTH CHOICE CARE LLC 9064 NW 13TH TERRACE MIAMI FL 33172 462807961 OWN, MAINTAIN, MANAGE, AND OPERATE AN ACCOUNTABLE CARE ORGANIZATION FL NO NONE 192957 1575927 1 0 0.33330 0 0 0 1 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 HEALTH CHOICE NETWORK INC L 1196904 ADMIN REVENUE REC'D FROM HCN HEALTH CHOICE NETWORK INC M 9720316 MEMBERSHIP FEES PAID TO HCN HEALTH CHOICE NETWORK INC O 285651 DIRECTOR SALARY HEALTH CHOICE NETWORK INC J 170449 RENT INCOME RECEIVED FROM HCN PRESTIGE HEALTH CHOICE LLC L 712276 ADMIN REVENUE REC'D FROM PRESTIGE PRESTIGE HEALTH CHOICE LLC D 7399050 LOAN ISSUED TO PRESTIGE PRESTIGE HEALTH CHOICE LLC J 170449 RENT INCOME REC'D FROM PRESTIGE PRESTIGE HEALTH CHOICE LLC O 541616 OFFICER SALARY HEALTH CHOICE CARE LLC L 470922 ADMIN REVENUE REC'D FROM HCC