2014-11-14T09:00:52-06:00 2013-12-31 440160260 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2013-01-01 340922268 HEALTHSPAN INTEGRATED CARE HEAL 5139814199 1001 Lakeside Ave Cleveland OH 44114 DAVE NOWISKI CHIEF FINANCIAL OFFICER 2014-10-31 true Aaron Hershberger P00961884 5136218300 2013 2015-11-30 17:44:51Z X KENNETH C PAGE 1001 Lakeside Ave Cleveland OH 44114 497985100 false X X 1978 OH TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. 2 1 1795 1 19233 6132 12000 0 520792175 495204393 3413678 2772056 108998 0 524326851 497976449 770156 2851552 0 0 153849150 313125960 0 0 0 430063743 266393195 584683049 582370707 -60356198 -84394258 334654842 271065276 560428826 197235340 -225773984 73829936 TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. false false 517374809 2851552 495185160 HSIC PROVIDES MEDICAL AND SURGICAL CARE, INCLUDING URGENT CARE SERVICES, EXTENDED CARE AND HOME HEALTH CARE, FOR ITS MEMBERS WITHOUT REGARD TO AGE, SEX, RACE, RELIGION OR NATIONAL ORIGIN OR THE ABILITY TO PAY. HSIC EDUCATES AND TRAINS MEDICAL STUDENTS AND OTHER HEALTH CARE PROFESSIONALS AND PROMOTES SCIENTIFIC AND NURSING EDUCATION IN ORDER TO IMPROVE CARE. 517374809 true false false true false false false false false true false false false true true true true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false false true 807 0 true 1795 true true true false false false false false false false false false X 2 1 false false true false true true true true true false false true false false false false false false X Travis Crum 5136392800 615 Elsinore Place Cincinnati OH 45202 JEFFREY COPELAND Trustee 1.00 50.00 X 0 728371 39098 ROBERT CAMPBELL TRUSTEE 1.00 0 X 0 0 0 DANIEL J HOUNCHELL TREASURER and COO 25.00 25.00 X 0 201632 3417 DAVID NOWISKI HealthSpan Partners CFO 1.00 51.40 X 0 478327 78108 JUDY SISSON SECRETARY 1.00 51.00 X 0 198259 26769 KENNETH C PAGE PRESIDENT and CEO 25.00 25.00 X 0 389333 35148 FRED LEFTON Director, Asst Pharmacy 50.00 0 X 255773 0 24224 JOHN LANDRETH Director, Financial Planning 50.00 0 X 240005 0 20225 JOSIAH SUTTON Senior Director, Sales 50.00 0 X 256613 0 27106 KATHLEEN STEPHENS Senior Director, Acct Mgmt & Client Services 50.00 0 X 277494 0 22125 WILLIAM TREXLER Senior Director, Finance 50.00 0 X 265785 0 28826 1295670 1995922 305046 147 false true false OHIO PERMANENTE MEDICAL GROUP 1001 LAKESIDE AVENUE CLEVELAND OH 44114 MEDICAL SERVICES 123005334 AMERISOURCEBERGEN 27550 NETWORK PL CHICAGO IL 606731275 MEDICAL PRODUCTS/SERVICES 55127735 KAISER FOUNDATION HOSPITALS 1001 LAKESIDE AVENUE CLEVELAND OH 44114 HOSPITAL SERVICES 42787242 THE CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVENUE CLEVELAND OH 44195 HOSPITAL SERVICES 32689809 MARYMOUNT HOSPITAL 12300 MCCRACKEN ROAD GARFIELD HEIGHTS OH 44125 HOSPITAL SERVICES 9669869 208 0 MEMBER PREMIUMS 621400 353797811 353797811 MEDICARE REVENUE 621400 115419493 115419493 SUPP CHARGES/PHARM 621400 22554002 22534769 19233 NON-PLAN & IND REV 621400 269541 269541 OTHER PROGRAM REVENUE 621400 3163546 3163546 0 0 0 0 495204393 2166347 2166347 0 0 0 0 0 614360 0 8651 614360 -8651 605709 605709 0 0 0 0 0 0 0 0 0 0 0 497976449 495185160 19233 2772056 X 2851552 2851552 0 0 0 0 0 98659628 83860684 14798944 0 207605786 176464918 31140868 6860546 5831464 1029082 0 -271607 0 -271607 780971 0 780971 1883 1601 282 0 49088 0 49088 126752955 118018182 8734773 0 3916267 3328827 587440 28267214 24027132 4240082 0 0 10155123 8631855 1523268 760178 646151 114027 0 6402 5442 960 4788894 4070560 718334 0 7356326 6252877 1103449 325255 276467 48788 CLAIMS EXPENSE 29280681 29280681 0 LICENSES AND FEES 113103 96138 16965 PHARMACY 51575565 51575565 EDUCATION 312655 265757 46898 2222242 1888956 333286 0 582370707 517374809 64995898 0 0 21382567 144180997 11987483 37145212 0 0 6245064 6726655 568345 334654 78352578 2426487 61363436 75926091 213301628 400000 0 19806319 6351667 334654842 271065276 46912077 146039442 8331743 6404074 0 505185006 44791824 560428826 197235340 X 73829936 4886800 -230660784 -225773984 73829936 334654842 271065276 X -84394258 -4008016 -42196221 430202415 X false true X true false X 80601 262333 45581 12000 0 400515 595429126 587211818 558821465 520738804 495204393 2757405606 0 0 0 595509727 587474151 558867046 520750804 495204393 2757806121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2757806121 4393255 2079211 2548931 2515614 2166347 13703358 11220 11220 4393255 2079211 2548931 2526834 2166347 13714578 0 0 0 0 0 0 0 599902982 589553362 561415977 523277638 497370740 2771520699 0.99500 0.99410 0.00490 0.00590 X false true false false false false true 20289 true 0 true 25362 45651 false Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i HSIC CARRIED ON VARIOUS PERMITTED LOBBYING ACTIVITIES RELATED TO HEALTH CARE ISSUES. 0 61086750 1670366 59416384 5050760 181221 4869539 11829195 574900 11254295 385873 0 385873 75926091 0 CONTINGENT EARNOUT 43517000 OTHER LONG-TERM LIABILITIES 1274824 44791824 X 477268000 2541044 2541044 474726956 23249493 23249493 497976449 487285000 -74943026 -74943026 562228026 20142681 20142681 582370707 Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote THE COMPANY COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2013 AND 2012, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2013 OR 2012. Schedule D, Part XI, Line 2d, Other revenues in audited financial statements not in form 990 UNREALIZED LOSSES ON INVESTMENTS - -4008016; DONOR RESTRICTED CONTRIBUTIONS - -3265; PREMIUM REVENUE RECOGNITION - 5367187; OTHER STATUTORY BASIS - TAX BASIS DIFFERENCES - 1185138; Schedule D, Part XI, Line 4b, Other revenues in form 990 not in audited financial statements MEDICARE REVENUE RECOGNITION - 23249493; Schedule D, Part XII, Line 2d, Other expenses in audited financial statements not in form 990 IMPAIRMENT - -58552433; MEMBERSHIP TRANSFER EXPENSES - -16100000; OTHER STATUTORY BASIS - TAX BASIS DIFFERENCES - -290593; Schedule D, Part XII, Line 4b, Other expenses in form 990 not in audited financial statements CLAIMS EXPENSE - 20142681; true AKRON-CANTON REGIONAL FOODBANK 350 OPPORTUNITY PARKWAY AKRON OH 44307 341369388 501(C)(3) 15000 KID POWER PACK PROGRAM AMERICAN HEART ASSOCIATION INC 1689 EAST 115TH STREET CLEVELAND OH 44106 135613797 501(C)(3) 5000 KP COMMUNITY CARE FUND AMERICAN HEART ASSOCIATION INC 1689 EAST 115TH STREET CLEVELAND OH 44106 135613797 501(C)(3) 20000 HEART WALK CARE ALLIANCE 1530 ST CLAIR AVENUE CLEVELAND OH 44114 341748776 501(C)(3) 15000 ORGANIZATIONAL CAPACITY BUILDING CLEVELAND BOARD OF EDUCATION 1111 SUPERIOR AVENUE CLEVELAND OH 44114 346000662 GOVERNMENT 20649 IN-KIND DONATION OF 12 PASSENGER VAN CLEVELAND FOODBANK INC 15500 S WATERLOO ROAD CLEVELAND OH 44110 341292848 501(C)(3) 22000 KP COMMUNITY CARE FUND CLEVELAND FOODBANK INC 15500 S WATERLOO ROAD CLEVELAND OH 44110 341292848 501(C)(3) 25000 FRESH PRODUCE INITIATIVE CLEVELAND RAPE CRISIS CENTER 526 SUPERIOR AVENUE SUITE 1400 CLEVELAND OH 44114 510164315 501(C)(3) 5000 SPONSORSHIP: FACES OF CHANGE LUNCHEON CUYAHOGA VALLEY COUNTRYSIDE CONSERVANCY 2179 EVERETT ROAD PENINSULA OH 44264 341896395 501(C)(3) 5000 COUNTRYSIDE LOCAL FOOD MOVMENT CUYAHOGA VALLEY COUNTRYSIDE CONSERVANCY 2179 EVERETT ROAD PENINSULA OH 44264 341896395 501(C)(3) 10000 CARROT CASH INCENTIVE PROGRAM GREATER CLEVELAND COMMUNITY SHARES 3631 PERKINS AVENUE CLEVELAND OH 44114 341493880 501(C)(3) 6000 KP COMMUNITY CARE FUND HARVARD COMMUNITY SERVICES CENTER 18240 HARVARD CLEVELAND OH 44128 237098744 501(C)(3) 50000 CHI/HEAL - WARD 1 COMMUNITY HEALTH INITIATIVE INFO LINE INC 703 SOUTH MAIN STREET SUITE 211 AKRON OH 44311 341170391 501(C)(3) 10000 MEDASSIST DIABETIC CARE PROJECT KOINONIA HOMES 6161 OAK TREE BLVD SUITE 400 INDEPENDENCE OH 44131 237412318 501(C)(3) 18668 ADVANCING HEALTHCARE FOR PEOPLE WITH I/DD THROUGH TELEMEDICINE LAKE COUNTY FREE MEDICAL CLINIC INC 54 SOUTH STATE STREET SUITE 302 PAINESVILLE OH 44077 341081191 501(C)(3) 15000 ORGANIZATIONAL CAPACITY BUILDING NORTH COAST HEALTH MINISTRY 16110 DETROIT AVE LAKEWOOD OH 44107 341536257 501(C)(3) 20000 GENERAL OPERATING SUPPORT OPPORTUNITY PARISH ECUMENICAL NEIGHBORHOOD-MINISTRY 941 PRINCETON STREET AKRON OH 44311 341046107 501(C)(3) 7500 OPEN M FREE MEDICAL CLINIC SISTERS OF CHARITY HEALTH SYSTEM 2475 EAST 22ND STREET 4TH FLOOR CLEVELAND OH 44115 530196617 501(C)(3) 7500 BUILDING HEALTHY COMMUNITIES - THE RAIN BARREL & EDUCATION CENTER PROJECT STELLA MARIS INC 1320 WASHINGTON AVENUE CLEVELAND OH 44113 340896181 501(C)(3) 10000 KEYLESS SECURITY SYSTEM UNITED STATES CONFERENCE OF CATHOLIC BISHOPS 1228 EUCLID AVENUE SUITE 330 CLEVELAND OH 44115 530196617 501(C)(3) 7500 OHIO REGIONAL CONVERGENCE PARTNERSHIP UNITED WAY OF GREATER CLEVELAND 1331 EUCLID AVENUE CLEVELAND OH 44115 346516654 501(C)(3) 10000 KP COMMUNITY CARE FUND WEST CREEK PRESERVATION COMMITTEE PO BOX 347113 PARMA OH 44134 341859064 501(C)(3) 12000 THE DENTZLER TRAILHEAD FOR AN ACTIVE NEIGHBORHOOD YOUNG MENS CHRISTIAN ASSOCIATION OF CLEVELAND OHIO INC 2200 PROSPECT AVENUE SUITE 900 CLEVELAND OH 44115 340714728 501(C)(3) 10000 WE RUN THIS CITY YOUTH MARATHON PROGRAM 20 0 Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds GRANTEES ARE REQUIRED TO SIGN A MEMORANDUM OF UNDERSTANDING PRIOR TO GRANT FUNDS DISBURSAL. GRANTEES ARE REQUIRED TO SUBMIT A FINAL REPORT WHICH DELINEATES ACCOMPLISHMENTS, RELATED TO STATED OBJECTIVES, AND DESCRIBE THE EVALUATION METHOD USED TO ACCESS ACCOMPLISHMENTS. false true false false false false false true false JEFFREY COPELAND TRUSTEE 0 431718 0 168006 0 128647 0 10200 0 28898 0 767469 0 0 DAVID NOWISKI HEALTHSPAN PARTNERS CFO 0 331035 0 113870 0 33422 0 46187 0 31921 0 556435 0 0 JUDY SISSON SECRETARY 0 147335 0 26409 0 24515 0 6270 0 20499 0 225028 0 0 KENNETH C PAGE PRESIDENT AND CEO 0 283993 0 66973 0 38367 0 7266 0 27882 0 424481 0 0 DANIEL J HOUNCHELL TREASURER AND COO 0 173502 0 25866 0 2264 0 912 0 2505 0 205049 0 0 KATHLEEN STEPHENS SENIOR DIRECTOR, ACCT MGMT & CLIENT SERVICES 265515 0 0 0 11979 0 0 0 22125 0 299619 0 0 0 WILLIAM TREXLER SENIOR DIRECTOR, FINANCE 237497 0 15769 0 12519 0 0 0 28826 0 294611 0 0 0 JOSIAH SUTTON SENIOR DIRECTOR, SALES 244443 0 0 0 12170 0 170 0 26936 0 283719 0 0 0 FRED LEFTON DIRECTOR, ASST PHARMACY 222985 0 18826 0 13962 0 0 0 24224 0 279997 0 0 0 JOHN LANDRETH DIRECTOR, FINANCIAL PLANNING 201580 0 21293 0 17132 0 941 0 19284 0 260230 0 0 0 Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation THE COMPENSATION OF KENNETH C. PAGE, PRESIDENT AND CEO, IS DETERMINED BY A RELATED TAX-EXEMPT ORGANIZATION. Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan THE CHP SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTIVELY. VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMINATION. PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDING. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDABLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JEFFREY COPELAND $93,946. SCHEDULE J, PART I, LINE 4B, TERMS AND CONDITIONS OF THE CHP EXECUTIVE RETENTION PLAN THE CHP EXECUTIVE RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDABLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: KENNETH C. PAGE $0; DAVID NOWISKI $0. Schedule J, Part I, Line 7, Non-fixed payments THE ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION FOR LISTED INDIVIDUALS. THE ORGANIZATION'S BOARD OF TRUSTEES ESTABLISHES OBJECTIVE THRESHOLDS FOR QUALITY, COMMUNITY BENEFIT, AND FINANCIAL PERFORMANCE WHICH MUST BE ACHIEVED FOR INCENTIVES TO BE AWARDED. THE BOARD ALSO ESTABLISHES THRESHOLD, TARGET AND MAXIMUM LEVELS FOR INCENTIVE AWARDS. WITHIN THESE ESTABLISHED PARAMETERS, THE BOARD DETERMINES THE CEO'S INCENTIVE AWARD AND INCENTIVE AWARDS FOR OTHER LISTED INDIVIDUALS ARE DETERMINED BY THE LISTED INDIVIDUAL'S SUPERVISOR AND DISCLOSED TO THE BOARD. THE BOARD MAY AUTHORIZE MODIFIED INCENTIVE AWARDS WHEN APPROPRIATE IN ITS JUDGMENT. Form 990, Part VI, Sec A, Line 4, Significant changes to organizational documents THE CODE OF REGULATIONS WAS AMENDED FOR THE FOLLOWING SIGNIFICANT CHANGES: UNDER SECTION 1.1 THE SOLE MEMBER WAS CHANGED TO HEALTHSPAN PARTNERS (HSP). UNDER SECTION 1.2 HSP SHALL HAVE THE DUTIES AND SHALL EXERCISE ALL THE RIGHTS AND PRIVILEGES CONFERRED UPON MEMBERS OF NONPROFIT CORPORATIONS BY CHAPTER 1702 OF THE OHIO REVISED CODE. SECTION 1.6 DESCRIBES HOW HSP SHALL EXERCISE ITS POWERS AND SECTION 1.7 DESCRIBES THE RESERVED POWERS OF HSP. SECTION 2.3 STATES THE BOARD SHALL AT ALL TIMES CONSIST OF AT LEAST THREE MEMBERS AND SECTION 2.4 PROVIDES FOR A TERM OF THREE YEARS. A TRUSTEE MAY SERVE NO MORE THAN THREE SUCCESSIVE TERMS ON THE BOARD. SECTION 3.1 STATES THE OFFICERS OF HSIC SHALL BE A CHAIRPERSON, VICE CHAIRPERSON, PRESIDENT, SECRETARY, TREASURER AND SUCH OTHER OFFICERS AND ASSISTANT OFFICERS AS THE BOARD MAY FROM TIME TO TIME DETERMINE. SECTION 3.2 OUTLINES THE POWERS AND DUTIES OF THE OFFICERS. Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders HEALTHSPAN PARTNERS IS THE SOLE MEMBER AND HAS ALL RIGHTS AND PRIVILEGES AS ALLOWED UNDER CHAPTER 1702 OF THE OHIO REVISED CODE. Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body HEALTHSPAN PARTNERS APPOINTS ALL MEMBERS OF THE GOVERNING BODY AND HAS THE AUTHORITY TO FILL VACANCIES AND REMOVE MEMBERS OF THE GOVERNING BODY. Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders THE FOLLOWING ACTIONS REQUIRE APPROVAL OF THE MEMBER: TO ADOPT, CHANGE AND INTERPRET THE MISSION, VISION AND VALUES OF THE CORPORATION AND ITS STATEMENT OF VALUES; TO ELECT AND REMOVE TRUSTEES OF THE CORPORATION; TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS OF THE CORPORATION; TO APPROVE THE DISSOLUTION OR TERMINATION OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH DISSOLUTION OR TERMINATION; TO APPROVER ANY MERGER OF THE CORPORATION OR ANY TRANSFER OF SUBSTANTIALLY ALL OF ITS ASSETS; TO APPROVE THE ANNUAL CONSOLIDATED STRATEGIC PLAN AND THE ANNUAL CONSOLIDATED FINANCIAL PLAN OF THE CORPORATION AND ANY BORROWINGS BY THE CORPORATION IN EXCESS OF THE AMOUNT CONTEMPLATED BY EITHER OF THOSE PLANS; TO APPROVE (I) ANY CAPITAL OR OTHER EXTRAORDINARY EXPENDITURES BY THE CORPORATION THAT ARE NOT INCLUDED IN THE ANNUAL CONSOLIDATED BUDGET FOR THE CORPORATION THAT EXCEED $15 MILLION IN THE AGGREGATE AND (II) ANY INCREASE IN TOTAL EXPENSES OF THE CORPORATION THAT EXCEEDS 10% OF THE ANNUAL CONSOLIDATED BUDGETED EXPENSES; TO CAUSE THE APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; TO APPOINT THE INDEPENDENT AUDITORS FOR THE CORPORATION'S CONSOLIDATED FINANCIAL STATEMENTS AND THE COMPENSATION CONSULTANT REVIEWING THE CORPORATION'S EXECUTIVE COMPENSATION; TO ADOPT POLICIES GOVERNING THE ACTIVITIES OF THE CORPORATION AND ANY SUBSIDIARIES OR AFFILIATES OF THE CORPORATION THAT WILL FURTHER THE MISSION, VISION AND VALUES ESTABLISHED BY THE GOVERNING BODY AND THE STATEMENT OF COMMON VALUES. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body THE FORM 990 IS REVIEWED BY THE INDEPENDENT ACCOUNTING FIRM OF BKD AND BY MANAGEMENT. THE FORM IS THEN REVIEWED BY THE HEALTHSPAN PARTNERS AUDIT & CORPORATE RESPONSIBILITY COMMITTEE FOR APPROVAL. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. Form 990, Part VI, Sec C, Line 19, Required documents available to the public GOVERNING DOCUMENTS ARE AVAILABLE FROM THE OHIO DEPARTMENT OF INSURANCE AND MAINTAINED ON THE THE STATE AGENCY WEBSITE OR UPON REQUEST. FINANCIAL STATEMENTS ARE ON FILE WITH THE OHIO DEPARTMENT OF INSURANCE ON A STATUTORY BASIS (STAND ALONE ENTITY). AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE ISSUED AND ARE AVAILABLE UPON REQUEST. Form 990, Part IX, Line 11g, Other Expenses MEDICAL PROFESSIONAL FEES - TOTAL EXPENSE: 68521132, PROGRAM SERVICE EXPENSE: 68521132, MANAGEMENT AND GENERAL EXPENSES: 0, FUNDRAISING EXPENSES: ; OTHER PURCHASED SERVICES - TOTAL EXPENSE: 10722960, PROGRAM SERVICE EXPENSE: 9114516, MANAGEMENT AND GENERAL EXPENSES: 1608444, FUNDRAISING EXPENSES: ; INTERCOMPANY ASSESSMENTS - TOTAL EXPENSE: 47508863, PROGRAM SERVICE EXPENSE: 40382534, MANAGEMENT AND GENERAL EXPENSES: 7126329, FUNDRAISING EXPENSES: ; Form 990 , Part XI, Line 9, Other changes in net assets or fund balances DONOR RESTRICTED CONTRIBUTIONS - -3265; CAPITAL TRANSFER - 21812114; OCI PENSION - 4997252; OCI PRB - -11315976; LIABILITIES TRANSFERRED - XXX-XX-XXXX; CAPITAL CONTRIBUTION - 40000000; IMPAIRMENT - -58552431; MISCELLANEOUS - -275; CATHOLIC HEALTH PARTNERS 615 ELSINORE PLACE CINCINNATI OH 45202 311161086 HEALTHCARE SYSTEM PARENT OH 501(C)(3) 11 - Type III - FI NA false CATHOLIC HEALTH PARTNERS FOUNDATION 615 ELSINORE PLACE CINCINNATI OH 45202 201072726 FUNDRAISING OH 501(C)(3) 7 CATHOLIC HEALTH PARTNERS false CATHOLIC HEALTHCARE PARTNERS HOUSING DEVELOPMENT 615 ELSINORE PLACE CINCINNATI OH 45202 208943658 HUD PARENT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS false CATHOLIC HEALTHCARE PARTNERS RETIREMENT TRUST 615 ELSINORE PLACE CINCINNATI OH 45202 316046304 RETIREMENT TRUST OH 501(C)(3) 8 CATHOLIC HEALTH PARTNERS false COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM 3700 KOLBE ROAD LORAIN OH 44053 270071694 MARKET PARENT OH 501(C)(3) 11 - Type II CATHOLIC HEALTH PARTNERS false COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER 3700 KOLBE ROAD LORAIN OH 44053 340714704 HOSPITAL OH 501(C)(3) 3 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM false ALLEN MEDICAL CENTER 200 WEST LORAIN ST OBERLIN OH 44074 340864230 HOSPITAL OH 501(C)(3) 3 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM false COMMUNITY HEALTH PARTNERS REGIONAL FOUNDATION 3700 KOLBE ROAD LORAIN OH 44053 341504558 FOUNDATION OH 501(C)(3) 11 - Type III - FI COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER false COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS 3700 KOLBE ROAD LORAIN OH 44053 341268828 MEDICAL OFFICE RENTAL OH 501(C)(3) 9 COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER false ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING 200 WEST LORAIN ST OBERLIN OH 44074 364504991 MEDICAL OFFICE RENTAL OH 501(C)(3) 11 - Type II ALLEN MEDICAL CENTER false MERCY HEALTH PARTNERS OF SOUTHWEST OHIO 4600 MCAULEY PLACE CINCINNATI OH 45242 311063783 MARKET PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS false MERCY HEALTH PARTNERS OF SOUTHWEST OHIO FOUNDATION 4600 MCAULEY PLACE CINCINNATI OH 45242 311217563 FOUNDATION OH 501(C)(3) 7 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY HOSPITALS WEST 2446 KIPLING AVENUE CINCINNATI OH 45239 311091597 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY HOSPITAL ANDERSON 7500 STATE ROAD CINCINNATI OH 45255 310537085 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false THE SISTERS OF MERCY OF HAMILTON OHIO (DBA MERCY FAIRFIELD HOSPITAL) 3000 MACK ROAD FAIRFIELD OH 45014 310538532 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false THE SISTERS OF MERCY OF CLERMONT COUNTY OHIO (DBA MERCY CLERMONT HOSPITAL) 3000 HOSPITAL DRIVE BATAVIA OH 45103 310830955 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC 7010 ROWAN HILLS DR CINCINNATI OH 45227 311308729 RETIREMENT HOME OH 501(C)(3) 9 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY SACRED HEART INC 2120 PAYNE STREET LOUISVILLE KY 40206 611318326 RETIREMENT HOME KY 501(C)(3) 9 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY LONG TERM CARE INITIATIVE 4915 CHARLESTOWN RD NEW ALBANY IN 47150 311332491 RETIREMENT HOME IN 501(C)(3) 9 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY FRANCISCAN SOCIAL MINISTRIES INC 1800 LOGAN STREET CINCINNATI OH 45210 311222942 LOW INCOME HOUSING OH 501(C)(3) 7 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false MERCY FRANCISCAN AT ST RAPHAEL INC 610 HIGH STREET HAMILTON OH 45011 202934871 SERVICES TO THE POOR OH 501(C)(3) 7 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO false COMMUNITY MERCY HEALTH SYSTEM ONE S LIMESTONE ST SPRINGFIELD OH 45502 300272454 MARKET PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS false COMMUNITY MERCY HEALTH PARTNERS ONE S LIMESTONE ST SPRINGFIELD OH 45502 310785684 HOSPITAL OH 501(C)(3) 3 COMMUNITY MERCY HEALTH SYSTEM false THE COMMUNITY MERCY FOUNDATION 1343 N FOUNTAIN BLVD SPRINGFIELD OH 45504 311443778 FOUNDATION OH 501(C)(3) 7 COMMUNITY MERCY HEALTH SYSTEM false C H HEALTH SERVICES COMPANY ONE S LIMESTONE ST SPRINGFIELD OH 45502 311181984 HOSPITAL OH 501(C)(3) 3 COMMUNITY MERCY HEALTH SYSTEM false CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE 1150 E HOME ROAD SPRINGFIELD OH 45503 260698515 MEDICAL INFORMATION EXCHANGE OH 501(C)(3) 9 COMMUNITY MERCY HEALTH SYSTEM false THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST ONE S LIMESTONE ST SPRINGFIELD OH 45502 346827136 INDIGENT MEDICAL CARE OH 501(C)(3) 11 - Type I NA false MERCY HEALTH SYSTEM - NORTHERN REGION 2200 JEFFERSON AVENUE TOLEDO OH 43604 341344482 MARKET PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS false MERCY PROPERTY HOLDINGS 2200 JEFFERSON AVENUE TOLEDO OH 43604 300699825 TITLE HOLDING COMPANY OH 501(C)(2) N/A MERCY HEALTH SYSTEM - NORTHERN REGION false ST CHARLES MERCY HOSPITAL OF OREGON OHIO 2600 NAVARRE AVENUE OREGON OH 43616 344445373 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION false RIVERSIDE MERCY HOSPITAL 3404 W SYLVANIA AVE TOLEDO OH 43623 311556401 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION false MERCY HOME CARE INC 2200 JEFFERSON AVENUE TOLEDO OH 43604 341587572 HOME HEALTHCARE OH 501(C)(3) 9 MERCY HEALTH SYSTEM - NORTHERN REGION false MERCY COLLEGE OF OHIO 2221 MADISON AVENUE TOLEDO OH 43604 341726619 MEDICAL COLLEGE OH 501(C)(3) 2 MERCY HEALTH SYSTEM - NORTHERN REGION false MERCY COLLEGE OF OHIO FOUNDATION INC 2221 MADISON AVENUE TOLEDO OH 43604 141963204 FOUNDATION OH 501(C)(3) 11 - Type I MERCY COLLEGE OF OHIO false MERCY HOSPITAL OF TIFFIN OHIO 45 ST LAWRENCE DRIVE TIFFIN OH 44883 344431174 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION false MERCY TIFFIN HEALTH FOUNDATION 45 ST LAWRENCE DRIVE TIFFIN OH 44883 341499894 FOUNDATION OH 501(C)(3) 11 - Type III - FI MERCY HOSPITAL OF TIFFIN OHIO false THE SISTERS OF MERCY OF WILLARD OHIO (MERCY WILLARD HOSPITAL) 110 EAST HOWARD ST WILLARD OH 44890 341577110 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION false MERCY HOSPITAL OF WILLARD FOUNDATION 110 EAST HOWARD ST WILLARD OH 44890 113742347 FOUNDATION OH 501(C)(3) 11 - Type III - FI THE SISTERS OF MERCY OF WILLARD OHIO false ST VINCENT MERCY MEDICAL CENTER 2213 CHERRY STREET TOLEDO OH 43608 344428250 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION false MERCY FOUNDATION 2213 CHERRY STREET TOLEDO OH 43608 237393213 FOUNDATION OH 501(C)(3) 11 - Type III - FI ST VINCENT MERCY MEDICAL CENTER false LIFESTAR AMBULANCE INC 2200 JEFFERSON AVENUE TOLEDO OH 43604 341354653 MEDICAL TRANSPORTATION OH 501(C)(3) 11 - Type II MERCY HEALTH SYSTEM - NORTHERN REGION false RSM MEDICAL FOUNDATION 2200 JEFFERSON AVENUE TOLEDO OH 43624 341693671 HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION false SIMON OUTREACH SERVICES 2600 NAVARRE AVENUE OREGON OH 43616 341383325 MEDICAL OFFICE RENTAL OH 501(C)(3) 11 - Type II ST CHARLES MERCY HOSPITAL OF OREGON OHIO false FARLEY HEALTHCARE CORPORATION 2200 JEFFERSON AVENUE TOLEDO OH 43604 341363204 HEALTH SERVICES OH 501(C)(3) 9 MERCY HEALTH SYSTEM - NORTHERN REGION false ST RITA'S MEDICAL CENTER 730 W MARKET STREET LIMA OH 45801 341105619 HOSPITAL OH 501(C)(3) 3 CATHOLIC HEALTH PARTNERS false SRHC FOUNDATION 730 W MARKET STREET LIMA OH 45801 341368429 FOUNDATION OH 501(C)(3) 11 - Type III - FI ST RITA'S MEDICAL CENTER false NEW VISION MEDICAL LABORATORIES INC 750 W HIGH ST STE 400 LIMA OH 45801 341937267 MEDICAL LAB SERVICES OH 501(C)(3) 11 - Type III - FI ST RITA'S MEDICAL CENTER false HUMILITY OF MARY HEALTH PARTNERS 1044 BELMONT AVENUE YOUNGSTOWN OH 44501 340505560 HOSPITAL OH 501(C)(3) 3 CATHOLIC HEALTH PARTNERS false THE ASSUMPTION VILLAGE 9800 N MARKET STREET NORTH LIMA OH 44452 341013695 NURSING HOME OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS false HOSPICE OF THE VALLEY 5190 MARKET STREET YOUNGSTOWN OH 44512 341288745 HOSPICE SERVICES OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS false HUMILITY OF MARY DEVELOPMENT FOUNDATION 1044 BELMONT AVENUE YOUNGSTOWN OH 44501 341826978 FOUNDATION OH 501(C)(3) 11 - Type III - FI HUMILITY OF MARY HEALTH PARTNERS false HUMILITY HOUSE 755 OHLTOWN ROAD AUSTINTOWN OH 44515 341894783 NURSING HOME OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS false ST JOSEPH HEALTH CENTER AUXILIARY 677 EASTLAND SE WARREN OH 44484 346556121 FUNDRAISING OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS false MERCY HEALTH PARTNERS - LOURDES INC 1530 LONE OAK ROAD PADUCAH KY 42003 610600313 HOSPITAL KY 501(C)(3) 3 CATHOLIC HEALTH PARTNERS false LOURDES FOUNDATION INC 1530 LONE OAK ROAD PADUCAH KY 42003 611258960 FOUNDATION KY 501(C)(3) 7 MERCY HEALTH PARTNERS - LOURDES INC false LOURDES HOSPITAL AUXILIARY GIFT SHOP 1530 LONE OAK ROAD PADUCAH KY 42003 610927805 FUNDRAISING KY 501(C)(3) 11 - Type III - FI LOURDES FOUNDATION INC false MARCUM AND WALLACE MEMORIAL HOSPITAL INC 60 MERCY COURT IRVINE KY 40336 610927491 HOSPITAL KY 501(C)(3) 3 MERCY HEALTH PARTNERS - LOURDES INC false MARCUM AND WALLACE HOSPITAL FOUNDATION INC 60 MERCY COURT IRVINE KY 40336 320026557 FOUNDATION KY 501(C)(3) 11 - Type III - FI MARCUM AND WALLACE MEMORIAL HOSPITAL INC false MERCY HEALTH PARTNERS INC 615 ELSINORE PLACE CINCINNATI OH 45202 731627534 MARKET PARENT TN 501(C)(3) 11 - Type I CATHOLIC HEALTH PARTNERS false MERCY HEALTH PARTNERS - NORTHEAST REGION INC 615 ELSINORE PLACE CINCINNATI OH 45202 232813196 MARKET PARENT PA 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS false MERCY HOSPITAL OF WILKES-BARRE 746 JEFFERSON AVENUE SCRANTON PA 18510 240795625 HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC false MERCY HEALTH CARE CENTER 746 JEFFERSON AVENUE SCRANTON PA 18510 232322809 HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC false HEALTHSPAN PARTNERS 615 ELSINORE PLACE CINCINNATI OH 45202 463055925 MARKET PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS false HEALTHSPAN INTEGRATED CARE 1001 LAKESIDE AVE SUITE 1200 CLEVELAND OH 44114 340922268 HMO OH 501(C)(3) 9 HEALTHSPAN PARTNERS false NWO INTEGRATED LABORATORIES MERCY LLC 2200 JEFFERSON AVENUE TOLEDO OH 43624 341898285 LABORATORY SERVICES OH NA N/A TIFFIN AMBULATORY SURGICAL ASSOCIATES 45 ST LAWRENCE DRIVE TIFFIN OH 44833 371567866 AMBULATORY SURGERY CENTER OH NA N/A NEW VISION MEDICAL LAB LLC 750 W HIGH STREET LIMA OH 45801 341913433 LAB SERVICES OH NA N/A WEST CENTRAL OHIO GROUP LTD 801 MEDICAL DRIVE LIMA OH 45804 341848147 ORTHOPEDIC HOSPITAL OH NA N/A KIDNEY SERVICES OF WEST CENTRAL OHIO 750 W HIGH STREET SUITE 100 LIMA OH 45801 061644264 DIALYSIS CENTER OH NA N/A WEST CENTRAL OHIO REGIONAL HEALTHCARE ALLIANCE LTD 2615 FORT AMANDA ROAD LIMA OH 45805 341817078 HEALTHCARE QUALITY OH NA N/A ST ELIZABETH SOUTHWOODS IMAGING 250 DEBARTOLO PLACE BLDG B YOUNGSTOWN OH 44512 261626482 DIAGNOSTIC IMAGING OH NA N/A ST ELIZABETH CARDIAC CATH LAB LLC P O BOX 16008 PITTSBURGH PA 15242 300023795 LAB SERVICES PA NA N/A UROLOGIC ONCOLOGY OF MAHONING VALLEY LLC 1044 BELMONT AVE YOUNGSTOWN OH 44501 262989686 RADIATION THERAPY OH NA N/A HMHPUSP SURGERY CENTERS LLC 15305 DALLAS PKWY STE 1600 ADDISON TX 75001 271953122 SURGERY CENTER TX NA N/A OSC-HMHP LLC 6505 MARKET ST BLDG B STE 101 BOARDMAN OH 44512 010724836 ORTHOPEDIC SURGERY CENTER OH NA N/A LOURDES AMBULATORY SURGERY CENTER 225 MEDICAL CENTER DRIVE PADUCAH KY 42003 611258960 SURGERY CENTER KY NA N/A CHP INSURANCE LTD 615 ELSINORE PLACE CINCINNATI OH 45202 980621978 INSURANCE CJ NA C CORPORATION SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST 615 ELSINORE PLACE CINCINNATI OH 45202 310990309 WORKERS COMPENSATION TRUST MA NA TRUST MHSWO HEALTH VENTURES INC 1 S LIMESTONE ST SPRINGFIELD OH 45502 311072139 PHYSICIAN PRACTICES OH NA C CORPORATION NORTHPARKE MEDICAL COMMONS CONDO ASSN 333 N LIMESTONE ST SPRINGFIELD OH 45503 311391230 REAL PROPERTY MGMNT OH NA C CORPORATION MERCY HEALTH AFFILIATES INC 2200 JEFFERSON AVENUE TOLEDO OH 43604 341372633 PHYSICIAN SERVICES OH NA C CORPORATION PHYSICIAN'S HEALTH COLLABORATIVE 2200 JEFFERSON AVENUE TOLEDO OH 43604 203986844 MEDICAL & HOSPITAL SERVICES OH NA C CORPORATION NORTHSIDE CORPORATION 2200 JEFFERSON AVENUE TOLEDO OH 43604 341318438 RESIDENT RENTALS OH NA C CORPORATION MERCY WORK SOLUTIONS 2200 JEFFERSON AVENUE TOLEDO OH 43604 300066340 WORKERS COMPENSATION OH NA C CORPORATION MERCY HEALTH SYSTEM PHO 2200 JEFFERSON AVENUE TOLEDO OH 43604 341778321 MEDICAL SERVICES OH NA C CORPORATION PHYSICIAN MANAGED CARE INC 2200 JEFFERSON AVENUE TOLEDO OH 43604 341565320 HEALTH SERVICES OH NA C CORPORATION MCAULEY MANAGEMENT SERVICES INC 730 W MARKET STREET LIMA OH 45801 341379037 PROPERTY RENTAL OH NA C CORPORATION LIMA MEDICAL SUPPLIES INC 730 W MARKET STREET LIMA OH 45801 340944477 MEDICAL EQUIPMENT OH NA C CORPORATION COMMUNITY HEALTH PARTNERS ENTERPRISES INC 3700 KOLBE ROAD LORAIN OH 44053 341455525 HOLDING COMPANY OH NA C CORPORATION COMMUNITY HEALTH PARTNERS PHYSICIANS INC 3700 KOLBE ROAD LORAIN OH 44053 341803352 PHYSICIAN PRACTICES OH NA C CORPORATION AMC PHYSICIANS INC 200 W LORAIN STREET OBERLIN OH 44074 371439554 PHYSICIAN SERVICES OH NA C CORPORATION MERCY HEALTH VENTURES INC 4600 MCAULEY PLACE CINCINNATI OH 45242 311185477 DIVERSIFIED ACTIVITIES OH NA C CORPORATION MERCY FRANCISCAN MEDICAL MANAGEMENT SERVICES 4600 MCAULEY PLACE CINCINNATI OH 45242 311640789 DIVERSIFIED ACTIVITIES OH NA C CORPORATION MERCY FRANCISCAN AT WINTON WOODS I INC 10290 MILL ROAD CINCINNATI OH 45231 311658668 LOW-INCOME HOUSING OH NA C CORPORATION MERCY HEALTH MANAGEMENT INC 1530 LONE OAK ROAD PADUCAH KY 42003 611086762 MEDICAL OFFICES KY NA C CORPORATION HEALTH DYNAMICS INC 900 E OAK HILL AVENUE KNOXVILLE TN 37917 621247729 MEDICAL EQUIPMENT SALES TN NA C CORPORATION HEALTH VENTURES INC & SUBSIDIARIES P O BOX 1788 KNOXVILLE TN 37901 621175587 MEDICAL SERVICES TN NA C CORPORATION ANNE KILCAWLEY CHRISTMAN FOUNDATION 100 FEDERAL PLAZA EAST YOUNGSTOWN OH 44503 356735706 BENEFICIAL TRUST OH NA TRUST RALPH EWE TRUST 270 PARK AVENUE NEW YORK NY 10017 346866422 BENEFICIAL TRUST NY NA TRUST ELIZABETH HINES CATES TRUST PNC 1900 E 9TH ST CLEVELAND OH 44114 346515678 BENEFICIAL TRUST OH NA TRUST WILLIS PARK TRUST PNC 1900 E 9TH ST CLEVELAND OH 44114 346519904 BENEFICIAL TRUST OH NA TRUST ERMA GIBSON BALDWIN TRUST PNC 1900 E 9TH ST CLEVELAND OH 44114 346515566 BENEFICIAL TRUST OH NA TRUST HEALTHSPAN INC 225 PICTORIA DR CINCINNATI OH 45246 311431434 INSURANCE OH NA C CORPORATION false false false false false false false false false false false true true false true true true true false