2015-08-13T15:19:36-05:00 2014-09-30 382157642 MANER COSTERISAN PC 2425 E GRAND RIVER SUITE 1 LANSING MI 489123291 990 2013-10-01 202717744 COMMUNITY HEALTHCARE CONNECTIONS COMM 2699696461 62 EAST MICHIGAN AVENUE BATTLE CREEK MI 49017 RUTH CLARK PRESIDENT 2699696461 2015-08-10 1 JAMES A MC NEELEY CPA P00364811 5173237500 2013 2016-02-25 16:41:14Z X RUTH CLARK 62 EAST MICHIGAN AVENUE BATTLE CREEK MI 49017 6336527 0 X WWW.CHCCONNECTIONS.COM X 2005 MI TO ENSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS. 7 7 34 70 0 0 1043534 2244061 3701058 4080466 0 0 0 12000 4744592 6336527 0 0 0 0 1044489 1192002 0 0 18859 2873645 3195928 3918134 4387930 826458 1948597 1158947 3139582 304345 336383 854602 2803199 TO ENSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS WITHOUT INSURANCE AND/OR INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS. 0 0 3766225 4080466 TO PROVIDE DIRECT MEDICAL SERVICES FOR LOW-INCOME, UNINSURED PEOPLE WITHOUT ACCESS TO OTHER GOVERNMENT HEALTH CARE PROGRAMS. AN AVERAGE OF 1,000 PEOPLE RECEIVED MEDICAL SERVICES UNDER THE PLAN DURING THE FIRST 6 MONTHS OF THE PLAN YEAR. 3766225 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16 0 1 34 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 MI X X X BARBARA TRAVIS 2699696461 62 EAST MICHIGAN AVENUE BATTLE CREEK MI 49017 BETH GREEN DIRECTOR 0.50 X 0 0 0 MARK BOOTH MD DIRECTOR 0.50 X 0 0 0 PASTOR RALPH CATES DIRECTOR 0.50 X 0 0 0 RUTH CLARK PRESIDENT 1.00 X X 0 0 0 JAMES MORENO VICE PRESIDENT 1.00 X X 0 0 0 ELAINE HUNSICKER TREASURER 1.00 X X 0 0 0 NIDIA WOLF SECRETARY 1.00 X X 0 0 0 SAMANTHA PEARL EXECUTIVE DIRECTOR 40.00 X 70618 0 17797 70618 0 17797 0 0 0 0 CALHOUN COUNTY HEALTH DEPARTMENT 190 E MICHIGAN AVE SUITE A-100 BATTLE CREEK MI 49014 MEDICAL SERVICES 1218406 BLUE CROSS BLUE SHIELD 1403 S CREYTS RD LANSING MI 48917 HEALTH INSURANCE 183292 2 2244061 2244061 HEALTH & PHARMACY SRVC 621300 4080466 4080466 4080466 12000 0 12000 12000 12000 6336527 4080466 0 12000 110218 71642 38576 1081784 703160 378624 8270 992 7278 64744 7789 56955 30117 1351 9907 18859 4874 4874 44315 34141 10174 199801 151344 48457 35926 19290 16636 21780 21780 MEDICAL SERVICES 2481850 2481850 PHARMACY SERVICES 211603 211603 CLAIMS PROCESSING AND A 75680 75680 OTHER EXPENSES 16968 7383 9585 4387930 3766225 602846 18859 849386 1902947 183412 373183 6307 5460 979046 121054 119842 857992 1158947 3139582 93287 256104 96058 74279 115000 6000 304345 336383 X 854602 2803199 854602 2803199 1158947 3139582 1948597 0 X X 0 1 X 1 0 X 670427 796621 1165793 1043534 21780 3698155 3000919 3555933 2902924 3701058 6302747 19463581 3671346 4352554 4068717 4744592 6324527 23161736 0 0 0 23161736 12000 12000 12000 12000 3671346 4352554 4068717 4744592 6336527 23173736 0.99950 0.99990 0.00050 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 122350 36704 85646 96768 84350 12418 759928 759928 857992 CLAIMS INCURRED BUT NOT REPORTED 6000 6000 X 6336527 0 6336527 0 6336527 4387930 0 4387930 0 4387930 PART X, LINE 2: THE ORGANIZATION HAS EVALUATED ITS INCOME TAX FILING POSITIONS FOR FISCAL YEARS 2011 THROUGH 2014, THE YEARS WHICH REMAIN SUBJECT TO EXAMINATION AS OF SEPTEMBER 30, 2014. THE ORGANIZATION CONCLUDED THAT THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS REQUIRING RECOGNITION IN THE ORGANIZATIONS FINANCIAL STATEMENTS. THE ORGANIZATION 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 ORGANIZATION DOES NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES RELATED TO UTB AT SEPTEMBER 30, 2014, AND IS NOT AWARE OF ANY CLAIMS FOR SUCH AMOUNTS BY FEDERAL OR STATE INCOME TAX AUTHORITIES. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS RECEIVED BY THE ORGANIZATION'S EXECUTIVE DIRECTOR WHO REVIEWS THE RETURN FOR ACCURACY. UPON THE EXECUTIVE DIRECTOR'S APPROVAL, THE 990 IS MADE AVAILABLE TO THE PRESIDENT AND TREASURER. AFTER ANY CONCERNS PRESENTED ARE ADDRESSED, THE PRESIDENT SIGNS AND FILES THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS VERBALLY REPORT CONFLICTS OF INTEREST AS THEY ARISE AT BOARD MEETINGS. SUCH CONFLICTS ARE THEN DISCUSSED BY THE BOARD BEFORE THE NECESSARY ACTION IS DECIDED UPON. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS MEETS TO REVIEW THE PERFORMANCE OF THE EXECUTIVE DIRECTOR ANNUALLY AND DETERMINE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. A RECORD OF THE MEETING AND DECISION BY THE BOARD OF DIRECTORS IS RETAINED BY THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990 IS ALSO POSTED ANNUALLY ON GUIDESTAR'S WEBSITE. CALHOUN HEALTH PLAN IS LICENSED TO SOLICIT IN THE STATE OF MICHIGAN AND PROVIDES FORM 990 AND AUDITED FINANCIAL STATEMENTS TO THE MICHIGAN ATTORNEY GENERAL'S OFFICE WHERE IT IS PUBLIC INFORMATION. FORM 990, PART XII, LINE 2C COMMUNITY HEALTHCARE CONNECTIONS HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.