ASCENSION HEALTH PROFESSIONAL AND GENERAL LIABILITY SELF-INSURANCE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ASCENSION HEALTH PROFESSIONAL AND GENERAL LIABILITY SELF-INSURANCE (EIN 36-7046706)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201401359349306460
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-05-15T13:56:21-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 367046706 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ascension Health Alliance Professional & | BusinessNameLine1 |
| Business Name Line2 | General Liability Self-Insurance Trust | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ASCE | NameControl |
| Phone | 3147338000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4600 Edmundson Road | AddressLine1 |
| City | St Louis | City |
| State | MO | State |
| ZIP Code | 631343806 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Elizabeth Foshage | Name |
| Title | VP Finance | Title |
| Phone | 3147338672 | Phone |
| Date Signed | 2014-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Alicia Janisch | Name |
| PTIN | P00741382 | PTIN |
| Phone | 5137847100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Elizabeth Foshage | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4600 Edmundson Road | AddressLine1 |
| City | St Louis | City |
| State | MO | State |
| ZIP Code | 631343806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 87617894 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.ascensionhealth.org | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | Receive, hold and invest contributions and dispurse claims and expenses payable. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 0 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | -1257 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 60714976 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 65629127 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 29163941 | InvestmentIncomePriorYear |
| Investment Income Current Year | 18169277 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 70084 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 89878917 | TotalRevenuePriorYear |
| Total Revenue Current Year | 83868488 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 57851503 | OtherExpensePriorYear |
| Other Expenses Current Year | 69509674 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 57851503 | TotalExpensesPriorYear |
| Total Expenses Current Year | 69509674 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 32027414 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 14358814 | RevenuesLessExpensesCY |
| Total Assets BOY | 388471309 | TotalAssetsBOY |
| Total Assets EOY | 489501411 | TotalAssetsEOY |
| Total Liabilities BOY | 297179681 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 382022006 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 91291628 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 107479405 | NetAssetsOrFundBalancesEOY |
| Mission Description | To receive, hold and invest contributions for professional and general liabilities and to disburse claims and expenses payable under the program. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 69430773 | Expense |
| Grants | 0 | Grants |
| Revenue | 65699211 | Revenue |
| Description | Ascension Health Alliance Professional and General Liability Self Insurance Trust (hereinafter "Trust"), was formed to maintain the self-insurance funding for the payment of claims arising against liability coverage for the tax-exempt member organizations of the sponsors of Ascension Health Alliance. The trust receives participant contributions from covered entities and pays the claims and administrative expenses of the program. Ascension Health Alliance, a tax-exempt entity, is the sponsor of the self-insurance program; all beneficiaries of the trust are tax-exempt organizations related to the sponsors of Ascension Health Alliance. | Description |
| Total Program Service Expense | 69430773 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 656 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 0 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 0 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 1 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 0 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeanine Wescott | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3147338877 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11775 Borman Dr - Suite 200 | AddressLine1 |
| City | St Louis | City |
| State | MO | State |
| ZIP Code | 631464134 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | State St Bank Trust Co | NamePerson |
| Title | Trustee | Title |
| Average Hours Per Week | 1.00 | AverageHoursPerWeek |
| Average Hours Per Week Related | 0.00 | AverageHoursPerWeekRelated |
| Institutional Trustee | X | InstitutionalTrustee |
| Reportable Comp From Organization | 0 | ReportableCompFromOrganization |
| Reportable Comp From Related Orgs | 0 | ReportableCompFromRelatedOrgs |
| Other Compensation | 0 | OtherCompensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Towers Watson Pennsylvania Inc | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 Market Street | AddressLine1 |
| City | Philadelphia | City |
| State | PA | State |
| ZIP Code | 191024790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Actuarial Services | DescriptionOfServices |
| Compensation | 278000 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Participant Cont. | Description |
| Business Code | 525100 | BusinessCode |
| Total Revenue Column | 65629127 | TotalRevenueColumn |
| Related Or Exempt Function Income | 65629127 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 65629127 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17647314 | TotalRevenueColumn |
| Unrelated Business Revenue | -1257 | UnrelatedBusinessRevenue |
| Exclusion | $17,648,571 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4271369 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3749406 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 521963 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 521963 | TotalRevenueColumn |
| Exclusion | $521,963 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Miscellaneous Income | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 70084 | TotalRevenueColumn |
| Related Or Exempt Function Income | 70084 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 70084 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 83868488 | TotalRevenueColumn |
| Related Or Exempt Function Income | 65699211 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -1257 | UnrelatedBusinessRevenue |
| Exclusion | $18,170,534 | ExclusionAmount |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14800 | Total |
| Program Services | 14800 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78901 | Total |
| Management And General | 78901 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 631444 | Total |
| Program Services | 631444 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223518 | Total |
| Program Services | 223518 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83253 | Total |
| Program Services | 83253 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59961 | Total |
| Program Services | 59961 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 271078 | Total |
| Program Services | 271078 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50415 | Total |
| Program Services | 50415 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Claim Payments | 61642729 | 61642729 | 0 | 0 |
| Patient Comp Fund Exp | 4774084 | 4774084 | 0 | 0 |
| Service Fees | 4012360 | 4012360 | 0 | 0 |
| Reserve for Losses | -3608430 | -3608430 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1275561 | Total |
| Program Services | 1275561 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69509674 | Total |
| Program Services | 69430773 | ProgramServices |
| Management And General | 78901 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6792533 | BOY |
| EOY | 27068694 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46308230 | BOY |
| EOY | 31238062 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161721 | BOY |
| EOY | 139153 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 335208825 | BOY |
| EOY | 431055502 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 388471309 | BOY |
| EOY | 489501411 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6599656 | BOY |
| EOY | 1937930 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 290580025 | BOY |
| EOY | 380084076 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 297179681 | BOY |
| EOY | 382022006 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91291628 | BOY |
| EOY | 107479405 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91291628 | BOY |
| EOY | 107479405 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 388471309 | BOY |
| EOY | 489501411 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 14358814 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 2467019 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -638056 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | See Part IV | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453358926 | EIN |
| Type Of Organization | See Part IV | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
| General Explanation | Schedule A, Part IV, Supplemental Information: Part I, Line 11 h (i) - Name of Supported Organizations: Ascension Health Alliance Professional and General Liability Self-Insurance Trust is organized and at all times shall be operated exclusively for the benefit of, to perform the functions of, and to carry out the purposes of the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, and the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province, and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province by and through Ascension Health Ministries. Ascension Health Ministries is the Canonical sponsor which was formed by the founding sponsors and which has been conferred public juridic personality by decree of The Congregation for Institutes of Consecrated Life and Societies of Apostolic Life of the Roman Catholic Church. | GeneralExplanation |
| General Explanation | Schedule A, Part IV, Supplemental Information: Part I, Line 11 h (vii) - Amount of Monetary Support: Ascension Health Alliance Professional & General Liabilities Self-Insurance Trust provides support through the payment of claims arising against liability coverage for the tax-exempt member organizations of the sponsors of Ascension Health Alliance. | GeneralExplanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Ascension Alpha Fund, LLC | 414104446 | F |
| Claim Payment Funds | 14356446 | F |
| Investment - M&T Bank | 2594610 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 431055502 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Reserve for Losses | Description |
| Amount | $380,084,076 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 380084076 | TotalOfAmounts |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 7a | Ascension Health Alliance is the plan sponsor of Ascension Health Alliance Professional and General Liability Self-Insurance Trust, and as plan sponsor reserved the right to amend the Trust. The reserved right to amend the Trust includes the ability to appoint a new trustee. | |
| Form 990, Part VI, Section A, line 7b | Ascension Health Alliance is the plan sponsor of the Ascension Health Alliance Professional and General Liability Self-Insurance Trust. As plan sponsor, Ascension Health Alliance holds certain rights as provided in the trust agreement. | |
| Form 990, Part VI, Section A, line 8a | Ascension Health Alliance Professional and General Liability Self-Insurance Trust did not hold meetings of the governing body during the year. All decisions of the organization were made by the plan sponsor, Ascension Health Alliance. | |
| Form 990, Part VI, Section A, line 8b | There are no committees with authority to act on behalf of the governing body. This question is more appropriately answered as not applicable. | |
| Form 990, Part VI, Section B, line 11 | Ascension Health Alliance Management works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, the Plan Sponsor is provided the Form 990 to review. | |
| Form 990, Part VI, Section B, line 12 | Ascension Health Alliance Professional and General Liability Self Insurance Trust does not have officers, directors, trustees or key employees; therefore, these questions are more appropriately answered not applicable. | |
| Ascension Health Alliance Professional and General Liability Self Insurance Trust does not have a CEO, Executive Director, top management official, or any other officers or key employees; therefore, these questions are more appropriately answered not applicable. | ||
| Form 990, Part VI, Section C, line 19 | The organization will provide any documents open to public inspection upon request. | |
| Form 990, Part VII, Line 9: | State Street Bank and Trust Company - #1 Lincoln Center, Boston, MA 02111 | Alternate Mailing Address: |
| Form 990, Part XI, line 9: | Transfer to Ascension Health Alliance -638,056. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health Alliance | |||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 453358926 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | N/A | 0 | |
| Ascension Health | |||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | 1 | Ascension Health Alliance | |
| Catholic Healthcare Investment Management Company | |||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 273174701 | Supporting Organization | MO | Section 501(c)(3) | Schedule A, Line 11a | 1 | Ascension Health Alliance | |
| Ascension Health Global Mission | |||||||||||
| 101 South Hanley Suite 450 | St Louis | MO | 63105 | 651205990 | Supporting Organization | MO | Section 501(c)(3) | Schedule A, Line 11a | 1 | Ascension Health Alliance | |
| Ascension Health-IS Inc | |||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 651257719 | Supporting Organization | MO | Section 501(c)(3) | Schedule A, Line 11a | 1 | Ascension Health Alliance | |
| Ascension Health Welfare Benefits Trust | |||||||||||
| PO Box 46944 | St Louis | MO | 63146 | 431601369 | Trust | MO | Section 501(c)(9) | N/A | 1 | Ascension Health | |
| The TriMedx Foundation | |||||||||||
| 5451 Lakeview Parkway S Drive | Indianapolis | IN | 46268 | 201643383 | Supporting Organization | IN | Section 501(c)(3) | Schedule A, Line 7 | 1 | MedXcel LLC | |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHV II LLC | |||||||||||||||
| 101 South Hanley Rd Ste 200 | Clayton | MO | 63105 | 360534243 | Investing | MO | N/A | ||||||||
| CHV III LLC | |||||||||||||||
| 101 South Hanley Rd Ste 200 | Clayton | MO | 63105 | Investing | MO | N/A | |||||||||
| Ascension Alpha Fund LLC | |||||||||||||||
| 101 South Hanley Rd Ste 200 | St Louis | MO | 63141 | 900786464 | Investing | DE | Ascension Health Alliance | Excluded | 19852875 | 488736816 | 0 | -$1,257 | 0 | 0.03570 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Clinical Holdings Corp | |||||||||||||
| 101 South Hanley Rd Ste 200 | Clayton | MO | 63105 | 453802297 | Holding Company | MO | N/A | C | 0 | ||||
| Ascension Health Master Pension Trust | |||||||||||||
| 11775 Borman Drive Ste 200 | St Louis | MO | 63146 | 366891022 | Trust | MO | N/A | T | 0 | ||||
| Ascension Health Worker's Compensation Self-Insurance Trust | |||||||||||||
| 11775 Borman Drive Ste 200 | St Louis | MO | 63146 | Trust | MO | N/A | T | 0 | |||||
| Ascension Health Insurance Limited | |||||||||||||
| Insurance | N/A | C | 0 | PO Box 1159 | Grand Cayman BWI | CJ | CJ | ||||||
| Ascension Health Risk Purchasing Group | |||||||||||||
| 101 South Hanley Rd Ste 450 | St Louis | MO | 63105 | 274176480 | Supporting Organization | MO | N/A | C | 0 | ||||
| Travel Services Corporation | |||||||||||||
| PO Box 45998 | St Louis | MO | 631455998 | 263764978 | Travel Services | MO | N/A | C | 0 | ||||
| AH Incubations Accelerator Inc | |||||||||||||
| 101 South Hanley Rd Ste 450 | St Louis | MO | 63105 | 455078523 | Medical Service | MO | N/A | C | 0 | ||||
| TriMedx Inc | |||||||||||||
| 5451 Lakeview Parkway South Dr | Indianapolis | IN | 46268 | 460563336 | Medical Equipment | IN | N/A | C | 0 | ||||
| TriMedx India Pvt Ltd | |||||||||||||
| 5451 Lakeview Parkway South Dr | Indianapolis | IN | 46268 | Trust | N/A | T | 0 | IN | |||||
| Smart Health Inc | |||||||||||||
| 101 South Hanley Rd Ste 200 | Clayton | MO | 63105 | 454413419 | Medical Service | MO | N/A | C | 0 | ||||
| Health City Cayman Islands Ltd | |||||||||||||
| Hospitals | N/A | C | 0 | 1283 Sea View Rd PO Box 10590 | Grand Cayman BWI | CJ | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Ascension Health Alliance | ||
| P | 4012360 | Services Fees |
| Ascension Health Alliance | ||
| R | 638056 | Net Asset Transfer |
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