INDEPENDENT SCHOOL DISTRICT NO 535 HEALTH & DENTAL CARE: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
INDEPENDENT SCHOOL DISTRICT NO 535 HEALTH & DENTAL CARE (EIN 41-6255919)
Tax period
2013-07-01 to 2014-06-30
Filed
2014-10-15
IRS object ID
201422899349300317
Schema version
2013v3.0
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)
Return2014-10-15T08:48:52-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 217AddressLine1
CityAUSTINCity
StateMNState
ZIP Code55912ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN416255919EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ISD #535 HEALTH AND DENTAL CARE TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlISD5BusinessNameControlTxt
Phone5073284225PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 SEVENTH STREET SWAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55902ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBROOKE BASSPersonNm
Person TitleEXECUTIVE DIRECTOR OF HRPersonTitleTxt
Phone5073284225PhoneNum
Signature2014-10-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHERRI WESSELSPreparerPersonNm
PTINP00888088PTIN
Phone5074347000PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBROOKE BASSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 SEVENTH STREET SWAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55902ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$23,913,282GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1982FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE SELF-INSURED HEALTH AND DENTAL INSURANCE FOR DISTRICT EMPLOYEES AND RETIREES.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$21,790,905PYProgramServiceRevenueAmt
CY Program Service Revenue$23,888,282CYProgramServiceRevenueAmt
PY Investment Income$8,074PYInvestmentIncomeAmt
CY Investment Income$25,000CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$21,798,979PYTotalRevenueAmt
CY Total Revenue$23,913,282CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$389,767PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$413,208CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,052,790PYOtherExpensesAmt
CY Other Expenses$20,708,117CYOtherExpensesAmt
PY Total Expenses$22,442,557PYTotalExpensesAmt
CY Total Expenses$21,121,325CYTotalExpensesAmt
PY Revenues Less Expenses-$643,578PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,791,957CYRevenuesLessExpensesAmt
Total Assets BOY$8,046,031TotalAssetsBOYAmt
Total Assets EOY$10,725,855TotalAssetsEOYAmt
Total Liabilities BOY$3,251,848TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,139,715TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,794,183NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,586,140NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE SELF-INSURED HEALTH AND DENTAL INSURANCE FOR DISTRICT EMPLOYEES AND RETIREES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE TRUST PROVIDES FOR EMPLOYER GROUP HEALTH AND DENTAL BENEFITS TO ELIGIBLE EMPLOYEES AND RETIREES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescESTABLISHED A HIGH DEDUCTIBLE HEALTH PLAN WITH AN HRA COMPONENTDesc
FieldValueIRS element (for citing)
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
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 Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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 EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document272IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
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 AddressYes (1)OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1REBECCA PERLICHBusinessNameLine1
FieldValueIRS element (for citing)
Phone5073284225PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 9 1/2 STREET SEAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55904ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BART GRAFSTROM
TRUSTEE0.20Yes (X)$0$71,210$25,837
STEVE GIFFORD
TRUSTEE0.20Yes (X)$0$0$0
WAYNE WOXLAND
TRUSTEE0.20Yes (X)$0$0$0
GARY SMITH
TRUSTEE0.20Yes (X)$0$7,200$0
BROOKE BASS
TRUSTEE/PLAN ADMINISTRATOR0.20Yes (X)$0$90,108$24,886
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$168,518TotReportableCompRltdOrgAmt
Total Other Compensation$50,723TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
MAYO CLINIC
PO BOX 1658MINNEAPOLISMN554801658MEDICAL CLAIMS$5,774,992
COMPREHENSIVE CARE SERVICES
1200 YANKEE DOODLE ROADEAGANMN55121CLAIMS PROCESSING CPU SYSTEMS$3,029,061
MAYO
PO BOX 1820MINNEAPOLISMN554801658MEDICAL CLAIMS$2,526,299
OLMSTED MEDICAL CENTER HOSPITAL
PO BOX 4300ROCHESTERMN55903MEDICAL CLAIMS$329,469
SUN LIFE FINANCIAL
1 SUN LIFE EXECUTIVE PARKWELLESLEY HILLSMA02481STOP LOSS CLAIMS$325,606
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPREMIUM CHARGESDesc
Business525100BusinessCd
Total Revenue Column$23,888,282TotalRevenueColumnAmt
Related Or Exempt Func Income$23,888,282RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$23,888,282TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,000TotalRevenueColumnAmt
Exclusion$25,000ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,913,282TotalRevenueColumnAmt
Related Or Exempt Func Income$23,888,282RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$25,000ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$284,115TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$111,927TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$17,166TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$650TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,547TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,997TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
CLAIM EXPENSES$20,692,219
SOFTWARE EXPENSE$2,157
DUES & SUBSCRIPTIONS$786
REPAIRS & MAINTENANCE$607

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$154TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,121,325TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,428,981BOYAmt
EOY$8,225,514EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,069BOYAmt
EOY$134EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,961BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,595,020BOYAmt
EOY$2,500,207EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,046,031BOYAmt
EOY$10,725,855EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$835,088BOYAmt
EOY$722,955EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,416,760BOYAmt
EOY$2,416,760EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,251,848BOYAmt
EOY$3,139,715EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,794,183BOYAmt
EOY$7,586,140EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,794,183BOYAmt
EOY$7,586,140EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,046,031BOYAmt
EOY$10,725,855EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,791,957ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule D IRS990ScheduleD

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

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescSELF-INSURANCE CLAIMS PAYABLEDesc
Amt$2,416,760Amt
FieldValueIRS element (for citing)
Total Liability$2,416,760TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE COMPLETED FORM 990 IS REVIEWED BY THE PLAN ADMINISTRATOR PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION C, LINE 19THE TRUST MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2CTHE ROCHESTER PUBLIC SCHOOLS (INDEPENDENT SCHOOL DISTRICT #535) BOARD OF EDUCATION ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART VI, LINE 9:TRUSTEES WHO CANNOT BE REACHED AT THE ORGANIZATION'S ADDRESS: STEVE GIFFORD WELLS FARGO FINANCIAL CENTER ROCHESTER 4368 SHETLAND PLACE NW ROCHESTER, MN 55902 WAYNE WOXLAND BCBS OF MN 1301 SOPPA DR. ST. CHARLES, MN 55972
FORM 990, PART VI, SECTION B, LINE 15ISD #535 HEALTH AND DENTAL CARE TRUST DOES NOT HAVE ANY EMPLOYEES. THE SALARY, BENEFITS, AND PAYROLL TAX EXPENSE ON PAGE 10 OF THE FORM 990 ARE AMOUNTS THAT ARE ALLOCATED TO THE TRUST FROM ISD #535 FOR THE TRUST'S PORTION OF THE EXPENSES.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1INDEPENDENT SCHOOL DISTRICT #535BusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 7TH STREET SWAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55902ZIPCode
FieldValueIRS element (for citing)
EIN416002803EIN
Primary ActivitiesPUBLIC SCHOOLPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Exempt Code SectionGOVERNMENTALExemptCodeSectionTxt
Public Charity StatusGOVERNMENTALPublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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