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WASHTENAW HEALTH PLAN CORPORATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
WASHTENAW HEALTH PLAN CORPORATION (EIN 02-0585175)
Tax period
2014-10-01 to 2015-09-30
Filed
2016-02-26
IRS object ID
201640579349300349
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-02-26T16:45:24-06:00ReturnTs
Tax Period End2015-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN382157642PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MANER COSTERISAN PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12425 E GRAND RIVER SUITE 1AddressLine1Txt
CityLANSINGCityNm
State AbbreviationMIStateAbbreviationCd
ZIP489123291ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020585175EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WASHTENAW HEALTH PLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWASHBusinessNameControlTxt
Phone7345446858PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1555 TOWNERAddressLine1Txt
CityYPSILANTICityNm
State AbbreviationMIStateAbbreviationCd
ZIP48917ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonELLEN RABINOWITZPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone7345446858PhoneNum
Signature2016-02-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJAMES A MC NEELEY CPAPreparerPersonNm
PTINP00364811PTIN
Phone5173237500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerELLEN RABINOWITZPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1555 TOWNERAddressLine1Txt
CityYPSILANTICityNm
State AbbreviationMIStateAbbreviationCd
ZIP48917ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,729,840GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EWASHTENAW.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionTO ENSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$55,559PYContributionsGrantsAmt
CY Contributions Grants$54,688CYContributionsGrantsAmt
PY Program Service Revenue$8,646,753PYProgramServiceRevenueAmt
CY Program Service Revenue$1,597,133CYProgramServiceRevenueAmt
PY Investment Income$15,383PYInvestmentIncomeAmt
CY Investment Income$78,019CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,717,695PYTotalRevenueAmt
CY Total Revenue$1,729,840CYTotalRevenueAmt
PY Grants And Similar Paid$335,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$200,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,702,254PYOtherExpensesAmt
CY Other Expenses$1,543,613CYOtherExpensesAmt
PY Total Expenses$7,037,254PYTotalExpensesAmt
CY Total Expenses$1,743,613CYTotalExpensesAmt
PY Revenues Less Expenses$1,680,441PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$13,773CYRevenuesLessExpensesAmt
Total Assets BOY$7,552,243TotalAssetsBOYAmt
Total Assets EOY$7,129,211TotalAssetsEOYAmt
Total Liabilities BOY$593,741TotalLiabilitiesBOYAmt
Total Liabilities EOY$184,482TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,958,502NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,944,729NetAssetsOrFundBalancesEOYAmt
MissionTO ENSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS WITHOUT INSURANCE AND/OR PERSONS INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,000,460ExpenseAmt
Revenue$1,596,911RevenueAmt
DescPLAN B: TO PROVIDE LOW-INCOME WORKING INDIVIDUALS WHO DON'T QUALIFY FOR ANY OTHER GOVERNMENT-SPONSORED HEALTH COVERAGE PROGRAMS. AT 9/30/15 THERE ARE 1,454 MEMBERS ENROLLED.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$200,000ExpenseAmt
Grant$200,000GrantAmt
DescGRANTS TO LOCAL HEALTH PROGRAMS INCLUDING CORNER HEALTH CENTER, PACKARD COMMUNITY CLINIC, SHELTER ASSOCIATION HEALTH CLINIC, BARRIER BUSTER DENTAL EMERGENCY FUND, FLINN FOUNDATION, LIVINGSTON COUNTY HEALTH DEPARTMENT, WHI CARE NAVIGATION PROJECT, WHI DENTAL PROJECT, AND WHI BLUE CROSS COMPLETE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,200,460TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document41IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ELLEN RABINOWITZBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7345446858PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1555 TOWNER STREETAddressLine1Txt
CityYPSILANTICityNm
State AbbreviationMIStateAbbreviationCd
ZIP48197ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
JEFFREY SANFIELD MD
DIRECTOR1.00Yes (X)$0$0$0
VERNA MCDANIEL
DIRECTOR1.00Yes (X)$0$0$0
ROBERT E GUENZEL
DIRECTOR1.00Yes (X)$0$0$0
ROBERT LAVERTY
DIRECTOR (10/1/14-5/1/15)1.00Yes (X)$0$0$0
CHARO LEDON
DIRECTOR1.00Yes (X)$0$0$0
DAVID SHARE
DIRECTOR1.00Yes (X)$0$0$0
THOMAS BIGGS
DIRECTOR1.00Yes (X)$0$0$0
ROBERT F GILLETT
PRESIDENT1.50Yes (X)$0$0$0Yes (X)
TOM CAMPBELL
V.P./TREASURER1.50Yes (X)$0$0$0Yes (X)
ROBIN DAMSCHRODER
SECRETARY1.00Yes (X)$0$0$0Yes (X)
ELLEN RABINOWITZ
EXECUTIVE DIRECTOR40.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WASHTENAW COUNTY PUBLIC HEALTH
555 TOWNER STYPSILANTIMI48198HEALTH SERVICES$827,320
UNIVERSITY OF MICHIGAN HEALTH SYSTEM
700 KMS PLACEANN ARBORMI48108HEALTH SERVICES$333,636
PACKARD HEALTH INC
3174 PACKARD RDANN ARBORMI48108HEALTH SERVICES$128,428
4D PHARMACY MANAGEMENT SYSTEMS INC
2520 INDUSTRIAL ROW DRIVETROYMI48084HEALTH SERVICES$117,910
JP FARLEY CORPORATION
29055 CLEMENS RDNORTH RIDGEVILLEOH44039HEALTH SERVICES$109,261
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$54,688AllOtherContributionsAmt
Total Contributions$54,688TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTH & PHARMACY SVSDesc
Business621300BusinessCd
Total Revenue Column$1,596,911TotalRevenueColumnAmt
Related Or Exempt Func Income$1,596,911RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$222TotalRevenueColumnAmt
Exclusion$222ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,597,133TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$78,019TotalRevenueColumnAmt
Exclusion$78,019ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,729,840TotalRevenueColumnAmt
Related Or Exempt Func Income$1,596,911RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$78,241ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$200,000TotalAmt
Program Services$200,000ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$42,749TotalAmt
Management And General$42,749ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,642TotalAmt
Management And General$1,642ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$33,364TotalAmt
Management And General$33,364ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,822TotalAmt
Management And General$5,822ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
HEALTH & PHARMACY SVS$678,964$678,964
EXECUTIVE SERVICES$452,277$452,277
ADMINISTRATIVE SERVICES$315,414$315,414
MISCELLANEOUS$7,299$7,299

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,082TotalAmt
Program Services$6,082ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,743,613TotalAmt
Program Services$1,200,460ProgramServicesAmt
Management And General$543,153ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$175,548BOYAmt
EOY$51,681EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,687BOYAmt
EOY$24,662EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,794BOYAmt
EOY$5,141EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$7,328,214BOYAmt
EOY$7,047,727EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$25,000BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,552,243BOYAmt
EOY$7,129,211EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$572,966BOYAmt
EOY$184,482EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$20,775BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$593,741BOYAmt
EOY$184,482EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,891,500BOYAmt
EOY$6,934,729EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$67,002BOYAmt
EOY$10,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,958,502BOYAmt
EOY$6,944,729EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,552,243BOYAmt
EOY$7,129,211EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$13,773ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,407CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$55,559CurrentTaxYearMinus1YearAmt
Current Tax Year$54,688CurrentTaxYearAmt
Total$182,654TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,481,449CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,794,188CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,117,936CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,646,637CurrentTaxYearMinus1YearAmt
Current Tax Year$1,596,911CurrentTaxYearAmt
Total$40,637,121TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,506,449CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,809,188CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,150,343CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,702,196CurrentTaxYearMinus1YearAmt
Current Tax Year$1,651,599CurrentTaxYearAmt
Total$40,819,775TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$40,819,775PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,476CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,697CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,705CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,383CurrentTaxYearMinus1YearAmt
Current Tax Year$78,019CurrentTaxYearAmt
Total$144,280TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,476CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,697CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,705CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,383CurrentTaxYearMinus1YearAmt
Current Tax Year$78,019CurrentTaxYearAmt
Total$144,280TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$231CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$116CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$116CurrentTaxYearMinus1YearAmt
Current Tax Year$222CurrentTaxYearAmt
Total$685TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,516,925CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,839,116CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,161,164CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,717,695CurrentTaxYearMinus1YearAmt
Current Tax Year$1,729,840CurrentTaxYearAmt
Total$40,964,740TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99650PublicSupportCY509Pct
Public Support PY5090.99840PublicSupportPY509Pct
Investment Income CY0.00350InvestmentIncomeCYPct
Investment Income PY0.00160InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENTSDesc
Book Value$7,047,727BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$7,047,727TotalBookValueSecuritiesAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,786,842TotalRevEtcAuditedFinclStmtAmt
Other Revenue$57,002OtherRevenueAmt
Revenue Not Reported$57,002RevenueNotReportedAmt
Revenue Subtotal$1,729,840RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,729,840TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,743,613TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,743,613ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,743,613TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE PLAN ANALYZES ITS INCOME TAX FILING POSITIONS IN THE FEDERAL AND STATE JURISDICTIONS WHERE IT IS REQUIRED TO FILE INCOME TAX RETURNS, AS WELL AS OPEN TAX YEARS IN THESE JURISDICTIONS, TO IDENTIFY POTENTIAL UNCERTAIN TAX POSITIONS. THE PLAN TREATS INTEREST AND PENALTIES ATTRIBUTABLE TO INCOME TAXES, AND RELFECTS ANY CHARGES FOR SUCH, TO THE EXTENT THEY ARISE, AS A COMPONENT OF ITS MANAGMENET AND GENERAL EXPENSES. THE PLAN HAS EVALUATED ITS INCOME TAX FILING POSITIONS FOR FISCAL YEARS 2011 THROUGH 2015, THE YEARS WHICH REMAIN SUBJECT TO EXAMINATION AS OF SEPTEMBER 30, 2015. THE PLAN CONCLUDED THAT THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS REQUIRING RECOGNITITION IN THE PLAN'S FINANCIAL STATEMENTS. THE PLAN DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS ("UTB") (E.G. TAX DEDUCTIONS, EXCLUSIONS, OR CREDITS CLAIMED OR EXPECTED TO BE CLAIMED) TO SIGNIFICANTLY CHANGE IN THE NEXT TWELVE MONTHS. THE PLAN DOES NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES RELATED TO UTB AT SEPTEMBER 30, 2015, AND IT IS NOT AWARE OF ANY CLAIMS FOR SUCH AMOUNTS BY FEDERAL OR STATE INCOME TAX AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTIONS SATISFIED BY PERFORMANCE 57,002.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
PACKARD HEALTH
3174 PACKARD RDANN ARBORMI48108382269817501(C)(3)$87,500HEALTH SERVICES
SHELTER ASSOCIATION OF WASHTENAW COUNTY
312 WEST HURONANN ARBORMI48107382533030501(C)(3)$45,000HEALTH SERVICES
CORNER HEALTH CENTER
47 NORTH HURON STREETYPSILANTIMI48197382329742501(C)(3)$17,500HEALTH SERVICES
MICHIGAN COMMUNITY DENTAL CLINICS INC
ONE WATER ST SUITE 200BOYNE CITYMI49712300393232501(C)(3)$50,000HEALTH SERVICES

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE PURPOSE OF THE GRANT FUNDING IS TO PROVIDE ADDITIONAL HEALTH CARE SERVICES TO LOW-INCOME UNINSURED COUNTY RESIDENTS. IN THE CASE OF THE NON-PROFIT HEALTH CLINICS, THE FUNDING ALSO ENHANCES THEIR ABILITY TO PROVIDE WHP SERVICES TO WHP MEMBERS. EACH OF THE GRANT RECIPIENTS IS REQUIRED TO REPORT TO THE WHP ON A QUARTERLY BASIS. THE WHP BOARD OF DIRECTORS REVIEWS THE REPORTS ON A REGULAR BASIS. WHP STAFF CONDUCT ANNUAL EVALUATIONS OF THE FUNDED GRANT PROGRAMS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS RECEIVED BY THE ORGANIZATION'S EXECUTIVE DIRECTOR WHO REVIEWS THE RETURN FOR ACCURACY. UPON THE EXECUTIVE DIRECTOR'S REVIEW, THE 990 IS MADE AVAILABLE TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IN ELECTRONIC FORMAT FOR FURTHER REVIEW. UPON THE EXECUTIVE COMMITTEE'S REVIEW, THE 990 IS DISTRIBUTED TO THE FULL BOARD OF DIRECTORS. AFTER ANY CONCERNS PRESENTED BY THE BOARD ARE ADDRESSED, THE EXECUTIVE DIRECTOR SIGNS AND FILES THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CEACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY, INDICATING ANY CONFLICTS. THE BOARD REVIEWS AND APPROVES THESE STATEMENTS ANNUALLY AT THE SEPTEMBER BOARD MEETING.
FORM 990, PART VI, SECTION C, LINE 19ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990 IS ALSO POSTED ANNUALLY ON GUIDESTAR'S WEBSITE. THE 990 IS PUBLIC INFORMATION THROUGH THE MICHIGAN ATTORNEY GENERAL'S OFFICE.

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