2014-07-15T14:51:12-05:00 2013-09-30 593214308 AVERETT WARMUS DURKEE PA 1417 E CONCORD STREET ORLANDO FL 32803 990 2012-10-01 650504316 HEALTH CHOICE NETWORK OF FLORIDA INC HEAL 3055991015 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 KEVIN KEARNS 3055991015 2014-07-15 1 EDWARD A HOFMA CPA P00735723 4078491569 2014-07-15 2012 2015-11-30 17:44:51Z KEVIN KEARNS 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 37664341 0 X WWW.HCNETWORK.ORG X 1994 FL TO PROVIDE HIGH QUALITY SERVICE, SUPPORT, AND EXPERTISE TO MEMBER ORGANIZATIONS... AND TO ACT AS A VEHICLE FOR STRATEGIC EFFORTS THAT STRENGTHEN OUR COMMUNITY HEALTH PARTNERS. 12 12 190 0 0 0 14772109 15949716 14820367 15532105 53324 36183 2404620 6098812 32050420 37616816 0 0 0 0 10149066 10922110 0 0 123511 22489732 23239319 32638798 34161429 -588378 3455387 12086156 13713323 7699835 5871615 4386321 7841708 X TO PROVIDE HIGH QUALITY, SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS AND TO ACT AS A VEHICLE FOR STRATEGIC EFFORTS THAT STRENGTHEN OUR COMMUNITY HEALTH PARTNERS. 0 0 8328364 HEALTH CONNECT IN OUR SCHOOLS - THE CHILDREN'S TRUST SUBCONTRACTS WITH HCN AND FOUR (4) OF MIAMI-DADE FEDERALLY QUALIFIED HEALTH CENTERS TO IMPLEMENT THE HEALTH CONNECT IN OUR SCHOOLS PROGRAM TO PROVIDE MIAMI DADE COUNTY PUBLIC SCHOOL STUDENTS WITH BOTH BASIC AND PRIMARY CARE ALONG WITH SCREENINGS AND BEHAVIORAL HEALTH SERVICES IN 93 SCHOOLS. 7984296 FISCAL/MIS INTEGRATION - PROVIDES FISCAL AND MANAGEMENT INFORMATION SYSTEM SERVICES FOR MEMBER CENTERS. PRIMARY SERVICES INCLUDE OPERATING A CENTRALIZED MIS DEPARTMENT (HARDWARE AND SOFTWARE), AND SHARING OF CHIEF FINANCIAL OFFICER AND CHIEF INFORMATION OFFICER SERVICES THROUGH INTEGRATED ACTIVITIES OF THE CENTERS FINANCE AND IT DEPARTMENTS. 4556681 CENTRALIZED BILLING - PROVIDES BILLING AND PAYMENT POSTING SERVICES FOR THE MEMBER CENTERS THAT HAVE ELECTED TO PARTICIPATE. THE CENTRAL BILLING OFFICE IS RESPONSIBLE FOR LIMITED CREDENTIALING SERVICES AND MOST ASPECTS OF THE BILLING AND COLLECTION OF PATIENT CHARGES ON BEHALF OF THE CENTERS, WHICH INCLUDES FOLLOW-UP ON ACCOUNTS RECEIVABLE. 11998344 21451492 MANAGED CARE - PROVIDES HEALTH CARE MANAGEMENT TO THE HMO ASSIGNED MEMBERS AND MANAGED MEDICAID PREPAID OUTPATIENT MENTAL HEALTH SERVICES FOR PARTICIPATING MEMBER CENTERS TO ENSURE PROPER UTILIZATION OF HEALTH CARE IN THE MANAGED CARE ENVIRONMENT. THIS PROGRAM INCLUDES CREDENTIALING, CENTRALIZED REFERRALS FOR CENTER HMO CONTRACTS, PROVIDER RELATIONS, AND MANAGEMENT OF AT-RISK CONTRACTS. THE MANAGED CARE UNIT ALSO PROVIDES SUPPORT TO SHARED CLINICAL COMMITTEE COLLABORATIVE SERVICES. ELECTRONIC HEALTH RECORDS - IMPLEMENT AND MAINTAIN INTEGRATED ELECTRONIC MEDICAL AND DENTAL HEALTH RECORDS IN PARTICIPATING MEMBER CENTERS TO ENHANCE THE ABILITY TO PROVIDE HIGH QUALITY PREVENTIVE AND PRIMARY CARE, AND IMPROVE PATIENT OUTCOMES. MEMBER SERVICES - A SINGLE RESOURCE ON BEHALF OF ALL CENTERS FOR SERVICES SUCH AS EDUCATION ON CURRENT GRANTS, LEGISLATIVE ISSUES, BOARD TRAINING, ETC. 11998344 21451492 32867685 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 190 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 FL X RICK FRIEDFELD 3055991015 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 BRODES HARTLEY JR 1.00 1.00 X X 0 0 0 ROSALYN FRAZIER 1.00 1.00 X X 0 0 0 BAKARI BURNS 1.00 0.00 X X 0 0 0 CHARLES BOTTOMS 1.00 1.00 X X 0 0 0 PAUL AHR 1.00 0.00 X 0 0 0 CLAUDIO M PEREZ 1.00 0.00 X 0 0 0 FRANK MAZZEO 1.00 0.00 X 0 0 0 MARIO JARDON 1.00 0.00 X 0 0 0 PAT MABE 1.00 0.00 X 0 0 0 MARK RABINOWITZ 1.00 0.00 X 0 0 0 BOB LINDER 1.00 0.00 X 0 0 0 ANNIE NEASMAN 1.00 0.00 X 0 0 0 KEVIN KEARNS 40.00 1.00 X X 232569 180000 13281 ALEJANDRO ROMILLO 40.00 0.00 X 377690 0 8119 RICK FRIEDFELD 40.00 0.00 X 178077 0 956 TERISA A JAMES 40.00 0.00 X 158385 0 8543 BLANCA MARGARITA OLLET 40.00 0.00 X 193978 0 3129 MICHAEL BIRDSONG 0.00 40.00 X 0 183888 1686 ROGELIO FERNANDEZ 40.00 0.00 X 140854 0 2095 THEODORE MAREFKA 40.00 0.00 X 149801 0 5348 GARY ROBINSON 0.00 40.00 X 0 132541 3895 MICHELLE RUSSELL 0.00 40.00 X 0 146754 7242 JEFFREY URKEVICH 0.00 40.00 X 0 120360 1544 1431354 763543 55838 9 0 1 0 CLAIMS REVIEW CORPORATION 9420 BUNSEN PARKWAY SUITE 204 LOUISVILLE KY 40220 MEDICAL CLAIMS BILLING 395760 ALLZONE MANAGEMENT SOLUTIONS 3700 WILSHIRE BLVD SUITE 979 LOS ANGELES CA 90010 DATA PROCESSING & A/R SERVICES 232800 ROBERTA PARILLO 13990 EAGLE RIDGE LAKES DR 102 FORT MYERS FL 33912 MEDICAL CLAIMS BILLING 196000 WAX & COMPANY INC 261 NE 1ST STREET SUITE 600 MIAMI FL 33172 MARKETING AND ADVERTISING SERVICES 112569 4 10136895 5812821 15949716 MEMBER SERVICES 561000 10763159 10763159 MANAGED CARE 524298 4047688 4047688 MEMBERSHIP DUES 561000 721258 721258 15532105 36183 36183 226950 47525 179425 179425 EQUITY IN EARNINGS OF AFFILIATED 900003 3137883 3137883 ADMINISTRATIVE SERVICES FOR AFFIL 561000 2020617 2020617 CONTRACT SERVICES 561000 760887 760887 5919387 37616816 21451492 0 215608 977119 781695 179850 15574 8337785 7825475 484003 28307 335082 307507 26636 939 567698 548979 14538 4181 704426 661110 39760 3556 20597 16183 4414 60688 40335 20353 504648 456792 47856 99126 92475 6651 120413 80030 40383 180302 169702 10600 210263 148458 27910 33895 128655 86195 42460 1318170 1220472 97698 53225 35375 17850 CONTRACTED SERVICES 18536944 18423755 77837 35352 CAPITATION 1555540 1555540 AMALGA HOSTING & SUPPOR 354959 354959 PAYROLL SERVICES - ADP 79717 52982 26735 16072 9666 4699 1707 34161429 32867685 1170233 123511 2375907 5969799 1440714 1025213 2031816 1692797 934931 63232 119937 91080 11558505 7508040 5033315 4050465 0 635679 149536 185058 12086156 13713323 4602667 2980612 587804 787995 1957559 1712904 551805 390104 7699835 5871615 X 4386321 7841708 4386321 7841708 12086156 13713323 3455387 0 X X 0 1 X 1 1 1 X 10418021 11523933 13649734 14772109 15949716 66313513 10418021 11523933 13649734 14772109 15949716 66313513 66313513 9361 20254 49403 53324 36183 168525 464209 1276975 4913999 2316898 5919387 14891468 81373506 68531636 0.81490 0.86760 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CONTRACT SERVICES - 2008 AMOUNT: $ 464,209. 2009 AMOUNT: $ 1,276,975. 2010 AMOUNT: $ 4,274,406. 2011 AMOUNT: $ 1,505,679. 2012 AMOUNT: $ 3,137,883. ADMISTRATIVE SERVICE - 2010 AMOUNT: $ 849,342. 2011 AMOUNT: $ 1,194,163. 2012 AMOUNT: $ 2,020,617. EQUITY IN EARNINGS OF AFFILIATE - 2010 AMOUNT: $ -209,749. 2011 AMOUNT: $ -382,944. 2012 AMOUNT: $ 760,887. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3033435 838311 2195124 780657 360087 420570 3247855 2657679 590176 4496558 3651963 844595 4050465 CURRENT OBLIGATIONS UNDER CAPITAL LEASE 390104 390104 X 37682810 18469 18469 37664341 -47525 -47525 37616816 34227423 18469 47525 65994 34161429 0 34161429 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE NETWORK IS A NONPROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PRESCRIBE REQUIREMENTS FOR THE RECOGNITION OF INCOME TAXES IN FINANCIAL STATEMENTS, AND THE AMOUNTS RECOGNIZED ARE AFFECTED BY INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS. THE NETWORK'S STATUS AS AN EXEMPT ORGANIZATION IS DEFINED AS AN INCOME TAX POSITION UNDER THESE REQUIREMENTS. WHILE MANAGEMENT BELIEVES IT HAS COMPLIED WITH THE INTERNAL REVENUE CODE, THE SUSTAINABILITY OF SOME INCOME TAX POSITIONS TAKEN BY THE NETWORK IN ITS TAX RETURNS MAY BE UNCERTAIN. THERE ARE MINIMUM THRESHOLDS OF LIKELIHOOD THAT UNCERTAIN TAX POSITIONS ARE REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THAT THE NETWORK HAS ANY MATERIAL UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2013. IN THE EVENT INTEREST AND PENALTIES WERE DUE RELATING TO AN UNSUSTAINABLE TAX POSITION, THEY WOULD BE TREATED AS A COMPONENT OF INCOME TAX EXPENSE. THE NETWORK'S FEDERAL INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. AT SEPTEMBER 30, 2013, THE FISCAL YEARS 2010 THROUGH 2013 FEDERAL TAX RETURNS ARE SUBJECT TO EXAMINATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -47,525. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 47,525. JESSIE TRICE HEALTH BENEFIT DINNER 226950 226950 1697 39230 1105 5493 226950 226950 1697 39230 1105 5493 47525 179425 X X 0 0 0 0 0 0 0 0 0 KEVIN KEARNS 202569 180000 30000 0 0 0 0 0 13281 0 245850 180000 0 0 ALEJANDRO ROMILLO 299990 0 77700 0 0 0 0 0 8119 0 385809 0 0 0 RICK FRIEDFELD 168077 0 10000 0 0 0 0 0 956 0 179033 0 0 0 TERISA A JAMES 150843 0 7542 0 0 0 0 0 8543 0 166928 0 0 0 BLANCA MARGARITA OLLET 133441 0 60537 0 0 0 0 0 3129 0 197107 0 0 0 MICHAEL BIRDSONG 0 183888 0 0 0 0 0 0 0 1686 0 185574 0 0 THEODORE MAREFKA 136551 0 13250 0 0 0 0 0 5348 0 155149 0 0 0 MICHELLE RUSSELL 0 146754 0 0 0 0 0 0 0 7242 0 153996 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE NETWORK IS MANAGED BY THREE CATEGORIES OF MEMBERS: FOUNDING MEMBERS, AFFILATED MEMBERS AND PARTICIPATING MEMBERS. THE MEMBERS OF THE BOARD OF DIRECTORS MUST BE EMPLOYED BY OR SERVE ON THE BOARD OF DIRECTORS OF CORPORATIONS WHICH ARE EITHER FOUNDING PARTICIPATING MEMBERS OR PARTICIPATING NETWORK MEMBERS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS SHALL BE LIMITED TO FOUNDING, AFFILIATED MEMBERS AND PARTICIPATING MEMBERS. THE DIRECTORS OF THE NETWORK (REFERRED TO IN THESE BYLAWS AS THE "BOARD") SHALL CONSIST OF AS MANY INDIVIDUALS AS THE BOARD MAY, FROM TIME TO TIME, DETERMINE, PROVIDED THAT AT A MINIMUM THE BOARD SHALL CONSIST OF: THE CEO (OR TOP EXECUTIVE POSITION) OF EACH FOUNDING AND AFFILIATED MEMBER; THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE NETWORK (EX-OFFICIO AND NON-VOTING MEMBER); A CLINICAL REPRESENTATIVE OF THE NETWORK WHO SHALL BE SELECTED ANNUALLY BY THE NETWORK BOARD OF DIRECTORS. AT SUCH TIME AS AN ORGANIZATION BECOMES AN AFFILIATED MEMBER, THE MEMBER SHALL HAVE THE RIGHT TO NOMINATE AN INDIVIDUAL MEETING QUALIFICATION CRITERIA SET FORTH HEREIN TO THE BOARD OF DIRECTORS. PRIOR TO EACH ANNUAL MEETING OF THE BOARD OF DIRECTORS, EACH MEMBER ENTITLED TO APPOINT A DIRECTOR SHALL INFORM THE BOARD, IN WRITING, OF ANY CHANGES IN THE PERSON OR PERSONS THAT IT HAS APPOINTED TO SERVE ON THE BOARD OF DIRECTORS FOR THE TERM THAT BEGINS UPON ADJOURNMENT OF THAT ANNUAL MEETING. DIRECTORS SO APPOINTED AND POSSESSING THE QUALIFICATION SET FORTH IN THESE BYLAWS SHALL BE CONFIRMED BY THE BOARD AT THE ANNUAL BOARD MEETING, OR IN THE CASE OF AN APPOINTMENT TO FILL A VACANCY ON THE BOARD AT ANY DULY CALLED MEETING OF THE BOARD. IF A PERSON DULY APPOINTED BY A MEMBER IS FOUND NOT TO MEET THE CRITERIA FOR MEMBERSHIP ESTABLISHED BY THE BYLAWS, THE MEMBER THAT APPOINTED SUCH A PERSON SHALL HAVE THE RIGHT TO APPOINT A QUALIFIED PERSON FOR CONFIRMATION BY THE BOARD FORM 990, PART VI, SECTION A, LINE 7B ALL THE POWERS OF THE NETWORK SHALL BE EXERCISED BY OR UNDER THE CONTROL OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS REVIEWED IN DRAFT FORM AND APPROVED BY THE FINANCE COMMITTEE. A COPY WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE NETWORK HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT EVERY EMPLOYEE IS REQUIRED TO READ AND SIGN. THE NETWORK'S BYLAWS ALSO REQUIRE ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT TO ADHERE TO THE STANDARDS OF CONDUCT PERTAINING TO THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE NETWORK'S BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION AND ESTABLISHES THE COMPENSATION WITH A WRITTEN EMPLOYEMENT CONTRACT. THE CEO ESTABLISHES THE PROCESSES FOR DETERMINATION OF THE COMPENSATION OF OTHER OFFICERS. FORM 990, PART VI, SECTION C, LINE 18 THE NETWORK MAKES THESE FORMS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT CURRENTLY MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS AND REPORTING FORM 990, PART XII, LINE 2C THE NETWORK HAS A FINANCE COMMITTEE ESTABLISHED BY THE BOARD OF DIRECTORS THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT, REVIEWING OF ITS FINANCIAL STATEMENTS, AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, SCHEDULE J, PART II, LINE 1 COMPENSATION FOR KEVIN KEARNS INCLUDES AMOUNTS FROM HEALTH CHOICE NETWORK OF FLORIDA AND PRESTIGE HEALTH CHOICE, A RELATED COMPANY. THESE AMOUNTS ARE BROKEN DOWN AS FOLLOWS: BASE COMPENSATION INCENTIVE COMPENSATION TOTAL HCN OF FLORIDA $202,569 $ 30,000 $232,569 PRESTIGE HEALTH 180,000 180,000 TOTAL $382,569 $ 30,000 $412,569 HEALTH CHOICE NETWORK INC 9064 NORTHWEST 13TH TERRACE DORAL FL 33172 900525658 TO PROVIDE SERVICE, SUPPORT AND EXPERTISE TO MEMBER ORGANIZATIONS FL 501(C)(3) LINE 9 N/A 0 PRESTIGE HEALTH CHOICE LLC 9064 NW 13TH TERRACE MIAMI FL 33172 450563075 MANAGED HEALTH CARE ACTIVITIES FL NO MEDICAID FUNDING -5300 3655100 1 0 0.13330 HEALTH CHOICE CARE LLC 9064 NW 13TH TERRACE MIAMI FL 33172 462807961 OWN, MAINTAIN, MANAGE, AND OPERATE AN ACCOUNTABLE CARE ORGANIZATION FL NO NONE -64321 449842 1 0 0.33330 0 0 0 1 0 0 0 0 0 1 0 1 1 0 1 0 0 1 0 HEALTH CHOICE NETWORK INC L 1440420 ADMIN REVENUE RECEIVED FROM HCN HEALTH CHOICE NETWORK INC D 171699 REDUCTION OF NOTE REC. BALANCE HEALTH CHOICE NETWORK INC M 7323668 MEMBERSHIP FEES PAID TO HCN HEALTH CHOICE NETWORK INC O 245850 DIRECTOR SALARY HEALTH CHOICE NETWORK INC J 120086 RENT INCOME RECEIVED FROM HCN PRESTIGE HEALTH CHOICE LLC L 2020617 ADMIN REVENUE REC'D FROM PRESTIGE PRESTIGE HEALTH CHOICE LLC D 700000 PAYOFF OF ISSUED LOAN PRESTIGE HEALTH CHOICE LLC J 120086 RENT INCOME REC'D FROM PRESTIGE PRESTIGE HEALTH CHOICE LLC O 180000 OFFICER SALARY HEALTH CHOICE CARE LLC R 700000 INVESTMENT IN ENTITY