2014-06-18T12:32:00-05:00 2013-09-30 382088116 BRICKLEY DELONG PC PO BOX 999 MUSKEGON MI 494430999 990 2012-10-01 383609504 KENT HEALTH PLAN CORPORATION KENT 6167268204 620 CENTURY AVE SW SUITE 210 GRAND RAPIDS MI 49503 JAMES TUINSTRA 6167268204 2014-06-18 1 BRENDA K JACOBS P00691360 2317265800 2014-06-02 2012 2015-11-30 17:44:51Z JAMES TUINSTRA 620 CENTURY AVE SW SUITE 210 GRAND RAPIDS MI 49503 5604426 0 X WWW.KENTHEALTHPLAN.ORG X 2001 MI KENT HEALTH PLAN CORPORATION (ORGANIZATION) IS A NONPROFIT ORGANIZATION WHOSE PURPOSE IS TO EMPOWER COMMUNITY MEMBERS TO EFFECTIVELY USE THE LOCAL HEALTHCARE SYSTEM AND OTHER RESOURCES BY PROVIDING HEALTH COVERAGE, EDUCATION AND SUPPORT SERVICES TO ELIGIBLE RESIDENTS OF KENT COUNTY. 9 9 0 4 0 0 0 0 6172826 5079251 38601 9701 0 0 6211427 5088952 1177678 782781 0 0 62000 60000 0 0 0 4534081 4039410 5773759 4882191 437668 206761 4785091 5071393 639818 718834 4145273 4352559 X KENT HEALTH PLAN CORPORATION (ORGANIZATION) IS A NONPROFIT ORGANIZATION WHOSE PURPOSE IS TO EMPOWER COMMUNITY MEMBERS TO EFFECTIVELY USE THE LOCAL HEALTHCARE SYSTEM AND OTHER RESOURCES BY PROVIDING HEALTH COVERAGE, EDUCATION AND SUPPORT SERVICES TO ELIGIBLE RESIDENTS OF KENT COUNTY. 0 0 2540924 2847794 PLAN A ADMINISTERS HEALTHCARE BENEFITS TO RESIDENTS OF KENT COUNTY WHO DO NOT QUALIFY FOR ANY OTHER GOVERNMENT SPONSORED HEALTHCARE PROGRAMS. THE ORGANIZATION CONTRACTS DIRECTLY WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH). BENEFITS UNDER THIS PLAN ARE ESTABLISHED BY MDCH. THE PROGRAM IS FUNDED THROUGH A MONTHLY AMOUNT FOR EACH ELIGIBLE PROGRAM PARTICIPANT, BASED UPON THE BEGINNING-OF-THE-MONTH CENSUS. THE CONTRACT IS SUBJECT TO RENEWAL AND RENEGOTIATION THROUGH SEPTEMBER 30, 2013. APPROXIMATELY 1,700 MEMBERS WERE SERVED EACH MONTH. 1618508 710599 2019481 PLAN B ADMINISTERS HEALTH CARE BENEFITS TO INDIVIDUALS WHOSE INCOMES ARE 150% OR LESS OF POVERTY AND WHO ARE NOT ELIGIBLE FOR ANY GOVERNMENT SPONSORED HEALTHCARE PROGRAM. THE PROGRAM PROVIDES ACCESS TO BASIC COMMUNITY-BASED HEALTHCARE SERVICES THAT ARE NOT FUNDED BY ANY OTHER MEANS. THE PROGRAM IS FUNDED BY SUPPORT FROM THE COMMUNITY, MAINLY FROM LOCAL HOSPITALS. APPROXIMATELY 1,500 MEMBERS WERE SERVED EACH MONTH. 117055 48000 96000 THE MEDICATION ASSISTANCE PROGRAM PROVIDES COORDINATED ACCESS TO PRESCRIPTION MEDICATIONS FOR KENT COUNTY RESIDENTS WHOSE INCOMES ARE 200% OR LESS OF POVERTY AND WHO ARE NOT ELIGIBLE FOR ANY GOVERNMENT SPONSORED PRESCRIPTION PROGRAM. THE PROGRAM ALSO ASSISTS THE MEMBERS IN UTILIZING PHARMACY ASSISTANCE PROGRAMS PROVIDED BY PHARMACEUTICAL MANUFACTURERS. APPROXIMATELY 440 MEMBERS WERE SERVED EACH MONTH. 73853 24182 115976 SHARED CARE OF KENT COUNTY IS AN AFFORDABLE HEALTHCARE OPTION FOR SMALL BUSINESS TO PROVIDE HEALTH CARE COVERAGE TO THEIR EMPLOYEES. THE MONTHLY COST OF SHARED CARE COVERAGE IS SHARED BY ELIGIBLE EMPLOYERS, THEIR ENROLLED EMPLOYEES AND THE ORGANIZATION. APPROXIMATELY 40 MEMBERS WERE SERVED EACH MONTH.THE HOSPITAL SUPPORT REPRESENTS APPROXIMATELY 43% OF THE FUNDING FOR ALL PLANS FOR THE YEAR ENDED SEPTEMBER 30, 2013. THE HOSPITALS RECEIVE DISPROPORTIONATE SHARE (DSH) PROGRAM FUNDS FROM THE FEDERAL GOVERNMENT THROUGH STATE ALLOCATION IN ORDER TO HELP THEM COVER THE COST OF UNCOMPENSATED CARE THEY PROVIDE. IF THE HOSPITALS WERE TO CEASE RECEIVING DSH FUNDS, IT COULD PUT THE PLANS' FUNDING AT RISK. 73853 24182 115976 4350340 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 0 0 0 0 0 0 1 138 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X THE ORGANIZATION 6167268204 620 CENTURY AVE SW SUITE 210 GRAND RAPIDS MI 49503 CARL VERBEEK 1.00 X X 0 0 0 DAVID SMITH 1.00 X X 0 0 0 DR LARRY ROBSON 1.00 X 0 0 0 MARGO SCHLEWITZ 1.00 X X 0 0 0 TERRI WEEKLEY 1.00 X 0 0 0 ERIN INMAN 1.00 X X 0 0 0 MIKE REAGAN 1.00 X 0 0 0 LODEWYK ZWARENSTEYN 1.00 X 0 0 0 MICHAEL GRANT 1.00 X 0 0 0 JAMES TUINSTRA 15.00 X 60000 0 0 60000 0 0 0 0 0 0 AH SERVICES INC 1200 RANSOM MUSKEGON MI 49442 CONSULTING, CLAIMS PROCESSING AND ADMINI 308900 1 PLAN A PROGRAM FEES 524114 2835559 2835559 HOSPITAL CONTRACT REVE 524114 2183803 2183803 SHARED CARE OF KENT CO 524114 47269 47269 OTHER PROGRAM REVENUES 524114 12620 12620 5079251 24309 24309 500866 515474 -14608 -14608 -14608 5088952 5079251 0 9701 782781 782781 60000 60000 18487 18487 1726 1726 242170 189059 53111 4446 4446 30846 30846 2910 2910 50413 50413 6326 6326 3275 3275 10118 10118 16074 16074 HEALTH CARE CLAIMS 3191021 3191021 LEASED EMPLOYEE EXPENSE 274130 274130 LEASED EMPLOYEE EXPENSE 159852 159852 MICHIGAN CLAIMS TAX 27593 27593 23 34 -11 4882191 4350340 531851 0 388 2117 2938249 3506487 281579 624 61120 52461 16086 8659 1548789 1553506 4785091 5071393 254556 58816 385262 660018 639818 718834 X 4145273 4352559 4145273 4352559 4785091 5071393 206761 525 0 X X 1 X 0 1 0 X 25000 15000 3500 43500 7460990 7586277 8496624 6169326 5079251 34792468 7485990 7586277 8511624 6172826 5079251 34835968 0 0 0 34835968 41137 53322 61287 40458 9701 205905 41137 53322 61287 40458 9701 205905 7527127 7639599 8572911 6213284 5088952 35041873 0.99410 0.99230 0.00590 0.00770 X 17490 8831 8659 43630 43630 0 8659 HEALTH CARE CLAIMS PAYABLE & INCURRED BUT NOT REPORTED 660018 660018 X 5087751 525 525 5087226 1726 1726 5088952 4880466 1 1 4880465 1726 1726 4882191 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION ADOPTED ACCOUNTING STANDARDS CODIFICATION ("ASC") 740-10 AS IT RELATES TO UNCERTAIN TAX POSITIONS. ANY INTEREST AND PENALTIES RECOGNIZED ASSOCIATED WITH A TAX PROVISION ARE CLASSIFIED AS CURRENT IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION HAS EVALUATED ITS TAX POSITIONS TAKEN FOR ALL OPEN TAX YEARS. FEDERAL, STATE AND LOCAL TAX RETURNS GENERALLY REMAIN OPEN FOR EXAMINATION BY THE VARIOUS TAXING AUTHORITIES FOR A PERIOD OF THREE OR FOUR YEARS. THE ORGANIZATION IS NOT CURRENTLY UNDER AUDIT NOR HAS IT BEEN CONTACTED BY ANY OF THESE JURISDICTIONS. BASED ON THE EVALUATION OF THE ORGANIZATION'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER EXAMINATION. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED FOR THE YEAR ENDED SEPTEMBER 30, 2013. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 1. 1 ARBOR CIRCLE CORPORATION 1115 BALL AVENUE GRAND RAPIDS MI 49505 383263853 501(C)(3) 148500 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. CATHERINE'S HEALTH CENTER 1211 LAFAYETTE AVE NE GRAND RAPIDS MI 49505 203572418 501(C)(3) 20000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. CATHOLIC CHARITIES WEST MICHIGAN 360 DIVISION SUITE 3A GRAND RAPIDS MI 49503 383012473 501(C)(3) 28875 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. CHERRY STREET HEALTH SERVICES 3351 CLAYSTONE SUITE 212 GRAND RAPIDS MI 49546 382853534 501(C)(3) 22439 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. FAMILY OUTREACH CENTER INC 1919 S DIVISION GRAND RAPIDS MI 49507 382272711 501(C)(3) 77584 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. GERONTOLOGY NETWORK 500 CHERRY STREET SE GRAND RAPIDS MI 49503 382774701 501(C)(3) 25000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. KENT COUNTY 300 MONROE AVE NE GRAND RAPIDS MI 49503 386004862 385259 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. VISITING NURSE SERVICES OF WESTERN MICHGIAN 1401 CEDAR NE GRAND RAPIDS MI 49503 381359195 501(C)(3) 34125 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. YWCA WEST CENTRAL MICHIGAN 25 SHELDON BLVD SE GRAND RAPIDS MI 49503 381359578 501(C)(3) 40000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE IT TAX EXEMPT MISSION. PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION HAS A REVIEW WITH EACH AGENCY AND REVIEWS THEIR REPORTED SPENDING UPON THE SERVICES SUPPORTED IN THE GRANT. IN EACH CASE THE AGENCY'S SPENDING ON THE SERVICES IS SIGNIFICANTLY HIGHER THAN THE AMOUNT OF THE GRANT. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 990 IS REVIEWED BY MANAGEMENT AND THE FINANCE COMMITTEE, AND THEN PRESENTED TO THE ENTIRE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST IS MONITORED BY A REVIEW OF ALL FINANCIAL TRANSACTIONS BY TOP MANAGEMENT; BOARD MEMBERS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON MATTERS THAT RELATE TO CONTRACTS BETWEEN KENT HEALTH PLAN AND THEIR EMPLOYER. ANNUAL CONFLICT OF INTEREST DISCLOSURES ARE REQUIRED BY ALL BOARD MEMBERS AND SENIOR MANAGEMENT AND EACH EMPLOYEE AND CONTRACTOR IS REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST OR TO NOT ENGAGE IN ANY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DETERMINES THE CONTRACT AMOUNT TO PAY AND THE NUMBER OF HOURS REQUIRED FOR THE SERVICES FO THE PRESIDENT. THE PRESIDENT PROPOSES COMPENSATION FOR ALL EMPLOYEES AND CONTRACTORS AND THE BOARD OF DIRECTORS APPROVES. THE BOARD OF DIRECTORS ALSO REVIEWS AND APPROVES EACH YEAR'S ANNUAL BUSINESS RELATIONSHIPS AND ALL SIGNIFICANT CONTRACTS OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 1023 AND 990 ARE AVAILABLE UPON REQUEST. CONTACT INFORMATION IS PROVIDED ON THE ORGANIZATION'S WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CONTACT INFORMATION IS PROVIDED ON THE ORGANIZATION'S WEBSITE. ADDITIONALLY, THE ARTICLES OF NONPROFIT INCORPORATION AND ANNUAL REPORTS ARE AVAILABLE FROM MICHIGAN DEPT OF ENERGY, LABOR & ECONOMIC GROWTH AT WWW.CIS.STATE.MI.US/BCS_CORP/SR_CORP.ASP. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A FINANCE COMMITTEE THAT OVERSEES THE REVIEW OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT.