2013-08-14T12:48:29-05:00 2012-09-30 593214308 AVERETT WARMUS DURKEE PA 1417 E CONCORD STREET ORLANDO FL 32803 990 2011-10-01 650504316 HEALTH CHOICE NETWORK OF FLORIDA INC HEAL 3055991015 9064 NORTHWEST 13TH TERRACE MIAMI FL 33172 KEVIN KEARNS 3055991015 2013-08-02 1 EDWARD A HOFMA CPA P00735723 4078491569 2013-07-12 2011 2016-02-25 16:41:14Z KEVIN KEARNS 9064 NORTHWEST 13TH TERRACE MIAMI FL 33172 32087048 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. 14 14 190 0 0 0 13163533 14772109 13100968 14820367 49403 53324 5092861 2404620 31406765 32050420 0 0 0 0 12398141 10149066 0 0 106605 18984308 22489732 31382449 32638798 24316 -588378 12931294 12086156 7956595 7699835 4974699 4386321 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 8816790 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. 10094111 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. 4087755 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. 7282151 14820367 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. 1456228 HEALTH CARE INITIATIVES - THIS INCLUDES THE JESSIE TRICE CANCER PREVENTION PROJECT AND THE CARE MANAGEMENT MEDICAL HOME CENTER WHICH FOCUSES ON IMPROVING CARE FOR PATIENTS WITH DIABETES. MEMBER SERVICES - A SINGLE RESOURCE ON BEHALF OF ALL CENTERS FOR SERVICES SUCH AS EDUCATION ON CURRENT GRANTS, LEGISLATIVE ISSUES, BOARD TRAINING, ETC.ELECTRONIC HEALTH RECORDS - IMPLEMENT AND MAINTAIN INTEGRATED ELECTRONIC MEDICAL AND DENTAL HEALTH RECORDS. 8738379 14820367 31737035 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 0 1 31 0 1 190 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X RICK FRIEDFELD 3055991015 9064 NORTHWEST 13 TERRACE MIAMI FL 33172 BRODES HARTLEY JR 1.00 X X 0 0 0 ROSALYN FRAZIER 1.00 X X 0 0 0 BAKARI BURNS 1.00 X X 0 0 0 CHARLES BOTTOMS 1.00 X X 0 0 0 CALEB A DAVIS 1.00 X 0 0 0 CLAUDIO M PEREZ 1.00 X 0 0 0 RAYMOND KAYAL 1.00 X 0 0 0 KATHRYN ABBATE 1.00 X 0 0 0 FRANK MAZZEO 1.00 X 0 0 0 MARIO JARDON 1.00 X 0 0 0 PAT MABE 1.00 X 0 0 0 MARK RABINOWITZ 1.00 X 0 0 0 BOB LINDER 1.00 X 0 0 0 ANNIE NEASMAN 1.00 X 0 0 0 KEVIN S KEARNS 40.00 X X 232569 518310 13281 ALEJANDRO ROMILLO 40.00 X 377690 0 8119 RICK FRIEDFELD 40.00 X 178077 0 956 ROGELIO FERNANDEZ 40.00 X 140854 0 2095 THEODORE MAREFKA 40.00 X 149801 0 5348 TERISA A JAMES 40.00 X 158385 0 8543 AMY ROSA 40.00 X 156923 0 1309 LISA RAWLINS 40.00 X 267887 0 8377 BRIAN MORTON 40.00 X 163971 0 3024 1826157 518310 51052 8 0 1 0 CLAIMS REVIEW CORPORATION 9420 BUNSEN PARKWAY SUITE 204 LOUISVILLE KY 40220 MEDICAL CLAIMS BILLING 416292 TERREMARK NORTH AMERICAN INC PO BOX 864416 ORLANDO FL 32886 IT INFRASTRUCTURE SERVICES 242696 ALLZONE MANAGEMENT SOLUTIONS 3700 WILSHIRE BLVD SUITE 979 LOS ANGELES CA 90010 DATA PROCESSING & A/R SERVICES 232800 STRUCTURED CABLE SOLUTIONS 5632 NW 161 STREET MIAMI GARDENS FL 33014 NETWORK CABLING INSTALLATIONS 194622 ROBERTA PARILLO 13990 EAGLE RIDGE LAKES DR 102 FORT MYERS FL 33912 MEDICAL CLAIMS BILLING 136000 6 4944648 9827461 14772109 MEMBER SERVICES 561000 10606827 10606827 MANAGED CARE 524298 3727946 3727946 MEMBERSHIP DUES 561000 485594 485594 14820367 53324 53324 124350 36628 87722 87722 CONTRACT SERVICES 561000 1505679 1505679 ADMINISTRATIVE SERVICE 561000 1194163 1194163 EQUITY IN EARNINGS OF 900003 -382944 -382944 2316898 32050420 14820367 0 2457944 621590 497272 114453 9865 8021585 7720087 296717 4781 309245 290112 18282 851 505531 487210 17410 911 691115 658692 31004 1419 86849 79938 6911 45938 34018 11920 826343 771250 55093 150305 142262 7002 1041 111717 82729 28988 262427 254068 8359 192240 156201 14911 21128 162142 123827 38315 1361748 1287434 74314 74978 55523 19455 CONTRACTED EXPENSES 17417300 17323338 27805 66157 CAPITATION 1067362 1067362 AMALGA HOSTING & SUPPOR 340000 340000 SHARED RISK - CENTERS 291070 291070 99313 74642 24219 452 32638798 31737035 795158 106605 2830352 2375907 1400110 1440714 2009385 2031816 500000 934931 783338 119937 11223185 6189870 5016179 5033315 278944 0 112986 149536 12931294 12086156 4706154 4602667 366774 587804 2232719 1957559 650948 551805 7956595 7699835 X 4974699 4386321 4974699 4386321 12931294 12086156 -588378 0 X X 0 1 1 X 1 1 X 9536383 10418021 11523933 13649734 14772109 59900180 9536383 10418021 11523933 13649734 14772109 59900180 59900180 9361 20254 49403 53324 132342 38704 464209 1276975 4913999 2316898 9010785 69043307 65090278 0.86760 0.88510 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CONTRACT SERVICES ADMISTRATIVE SERVICE EQUITY IN EARNINGS OF AFFILIATE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2991435 724480 2266955 780658 192777 587881 3075970 2103259 972711 4375122 3169354 1205768 5033315 CURRENT OBLIGATIONS UNDER CAPITAL LEASE 551805 551805 32050420 32638798 -588378 -588378 32153455 66407 66407 32087048 -36628 -36628 32050420 32741833 66407 36628 103035 32638798 0 32638798 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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, 2012. 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, 2012, THE FISCAL YEARS 2009 THROUGH 2012 FEDERAL TAX RETURNS ARE SUBJECT TO EXAMINATION. PART XII, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -36,628. PART XIII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 36,628. JESSIE TRICE HEALTH BENEFIT DINNER 124350 124350 2586 29164 631 4247 124350 124350 2586 29164 631 4247 36628 87722 X X X 0 0 0 0 0 0 0 0 0 KEVIN S KEARNS 202569 180000 30000 338310 0 0 0 0 13281 0 245850 518310 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 THEODORE MAREFKA 136551 0 13250 0 0 0 0 0 5348 0 155149 0 0 0 TERISA A JAMES 150843 0 7542 0 0 0 0 0 8543 0 166928 0 0 0 AMY ROSA 136923 0 20000 0 0 0 0 0 1309 0 158232 0 0 0 LISA RAWLINS 247887 0 20000 0 0 0 0 0 8377 0 276264 0 0 0 BRIAN MORTON 163971 0 0 0 0 0 0 0 3024 0 166995 0 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 19 THE ORGANIZATION DOES NOT CURRENTLY MAKE ITS 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 180,000 338,310 518,310 TOTAL $382,569 $368,310 $750,879 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 -625436 3397764 1 0 0.22000 0 0 0 1 0 0 0 0 1 0 1 1 0 1 0 0 0 0 HEALTH CHOICE NETWORK INC K 2440950 ADMIN REVENUE RECEIVED FROM HCN HEALTH CHOICE NETWORK INC D 265069 REDUCTION OF NOTE REC. BALANCE HEALTH CHOICE NETWORK INC L 6778508 MEMBERSHIP FEES PAID TO HCN HEALTH CHOICE NETWORK INC N 245850 DIRECTOR SALARY HEALTH CHOICE NETWORK INC I 116755 RENT INCOME RECEIVED FROM HCN PRESTIGE HEALTH CHOICE LLC K 1194163 ADMIN REVENUE REC'D FROM PRESTIGE PRESTIGE HEALTH CHOICE LLC D 700000 LOAN ISSUED TO PRESTIGE PRESTIGE HEALTH CHOICE LLC I 115467 RENT INCOME REC'D FROM PRESTIGE PRESTIGE HEALTH CHOICE LLC N 518310 OFFICER SALARY