HEALTHWELL FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HEALTHWELL FOUNDATION (EIN 20-0413676)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-13
IRS object ID
201222269349302357
Schema version
2011v1.2
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)
Timestamp2012-08-13T15:03:08-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN521511275EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1RAFFA PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11899 L STREET NW SUITE 900AddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20036ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN200413676EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HEALTHWELL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHEALNameControl
Phone2406325311Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 WASHINGTONIAN BLVD 9TH FLOORAddressLine1
CityGAITHERSBURGCity
StateMDState
ZIP Code208785355ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY SUNDEENName
TitlePRESIDENTTitle
Phone2406325311Phone
Date Signed2012-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameFRANK H SMITHName
PTINP00639053PTIN
Phone2028225000Phone
Date Prepared2012-08-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARY P SUNDEENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line19801 WASHINGTONIAN BLVD 9TH FLOORAddressLine1
CityGAITHERSBURGCity
StateMDState
ZIP Code208785355ZIPCode
FieldValueIRS element (for citing)
Gross Receipts63537188GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HEALTHWELLFOUNDATION.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2003YearFormation
State Legal DomicileDCStateLegalDomicile
Activity Or Mission DescriptionADDRESSING THE NEEDS OF PEOPLE WITH INSURANCE WHO CANNOT AFFORD NECESSARY MEDICATIONS.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees9TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year77404453ContributionsGrantsPriorYear
Contributions Grants Current Year52749627ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year1195776InvestmentIncomePriorYear
Investment Income Current Year1092568InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year78600229TotalRevenuePriorYear
Total Revenue Current Year53842195TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year84233714GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY49521777GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1044019SalariesEtcPriorYear
Salaries Etc Current Year1200720SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year203238TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY186388TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year332738TotalFundrsngExpCurrentYear
Other Expense Prior Year14823574OtherExpensePriorYear
Other Expenses Current Year14609716OtherExpensesCurrentYear
Total Expenses Prior Year100304545TotalExpensesPriorYear
Total Expenses Current Year65518601TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-21704316RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-11676406RevenuesLessExpensesCY
Total Assets BOY87086973TotalAssetsBOY
Total Assets EOY66318603TotalAssetsEOY
Total Liabilities BOY35480778TotalLiabilitiesBOY
Total Liabilities EOY4719259TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY51606195NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY61599344NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionASSIST INCOME ELIGIBLE INSURED INDIVIDUALS IN OBTAINING NECESSARY MEDICATIONS. THE INDIVIDUALS ASSISTED BY THE FOUNDATION ARE AWARDED GRANTS ON A NONDISCRIMINATORY, OBJECTIVE AND FIRST-COME, FIRST-SERVED BASIS. THE FOUNDATION PROVIDES ASSISTANCE TO ELIGIBLE INDIVIDUALS ONLY FOR THE USE OF PRODUCTS THAT ARE APPROVED BY THE FOOD AND DRUG ADMINISTRATION, OR ARE COMPENDIA-LISTED FOR A SPECIFIC DISEASE INDICATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense13984808Expense
Grants10147619Grants
DescriptionAUTOIMMUNE FUND - ASSISTED 8,180 ELIGIBLE MEDICARE BENEFICIARIES WITH DEDUCTIBLE, COINSURANCE, AND COPAYMENT EXPENSES RELATED TO THE TREATMENT OF RHEUMATOID ARTHRITIS, PSORIASIS, PSORIATIC ARTHRITIS, AND ANKYLOSING SPONDYLITIS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8663613Expense
Grants5849760Grants
DescriptionSECONDARY HYPERPARATHYROIDISM (SHPT) FUND - ASSISTED 6,103 ELIGIBLE PATIENTS WITH DEDUCTIBLE AND COINSURANCE, COPAYMENT, OR PREMIUM OUT OF POCKET EXPENSES ENABLING THEM TO ACCESS TREATMENT FOR SHPT.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6594147Expense
Grants6761361Grants
DescriptionRHEUMATOID ARTHRITIS FUND - ASSISTED 2,442 ELIGIBLE PATIENTS WITH DEDUCTIBLE AND COINSURANCE, COPAYMENT, OR PREMIUM EXPENSES ALLOWING THEM TO BEGIN OR CONTINUE TREATMENT OF MODERATELY TO SEVERELY ACTIVE RHEUMATOID ARTHRITIS.Description

Activity Other ActivityOther (32 entries)

ExpenseExpenseGrantsGrantsDescriptionDescription
58252084291029CHEMOTHERAPY-INDUCED NEUTROPENIA
42852022684504COLORECTAL CARCINOMA
40596183235543ASTHMA, MODERATE TO SEVERE
33062562159275ANEMIA ASSOCIATED WITH CHRONIC RENAL INSUFFICIENCY/FAILURE
27966971782836IMMUNOSUPPRESSIVE THERAPY
21402842383657BREAST CANCER
16539631800263NON-HODGKIN'S LYMPHOMA
15070721627730PSORIASIS
1244166939297AGE-RELATED MACULAR DEGENERATION
870327551225HEAD AND NECK CANCER
786509895812PSORIATIC ARTHRITIS
665199250022CHEMOTHERAPY-INDUCED ANEMIA/NEUTROPENIA
623669373393CROHN'S DISEASE
616780587902CARCINOID TUMORS
517179318058OSTEOPOROSIS
494614403937BONE METASTASES
475167340403CHRONIC MYELOID LEUKEMIA
413278341083METASTIC MELANOMA
382011315931IDIOPATHIC THROMBOCYTOPENIC PURPURA
32837687726LUPUS
299478339580ANKYLOSING SPONDYLITIS
219002334559IRON OVERLOAD DUE TO MULTIPLE TRANSFUSIONS
194988251581CHEMOTHERAPY-INDUCED ANEMIA
18240411061CHRONIC MYELOID LEUKEMIA - MEDICARE ACCESS
14887488443HEPATITIS
13375999529DUPUYTREN'S DISEASE
12912249949GOUT
12668030420ASSOCIATED VASCULITIS AND WEGENERS
11643275182NON-SMALL CELL LUNG CANCER
4071031458CYTOMEGALOVIRUS
3237732377SPECIAL DONATIONS
1549849272OTHER
FieldValueIRS element (for citing)
Total Of Other Program Service Exp34630899TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt26763037TotalOfOtherProgramServiceGrnt
Total Program Service Expense63873467TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees9NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledALStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledAKStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledARStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledHIStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledKSStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledKYStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledLAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMDStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMSStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNJStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNMStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNDStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledOKStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledRIStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledSCStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledTNStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledUTStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledVTStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWVStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BASKARAN VELLANDURAIBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2406325311TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19801 WASHINGTONIAN BLVD 9TH FLOORAddressLine1
CityGAITHERSBURGCity
StateMDState
ZIP Code208785355ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
STEPHEN WEINER
BOARD CHAIR2.00XX000
JERRI SCARZELLA
VICE CHAIR & TREASURER1.00XX900000
NANCY CARTERON
VICE CHAIR & SECRETARY1.00XX900000
DAVID KNOWLTON
BOARD MEMBER1.00X900000
DON LISS
BOARD MEMBER1.00X000
SUZANNE MILLER
BOARD MEMBER1.00X600000
MARY P SUNDEEN
PRESIDENT40.00X272837041714
SHELA HALPER
DIR. - STRAT. DEVELOP. & MARKETING40.00165748020097X
BASKARAN VELLANDURAI
DIRECTOR OF FINANCE & IT40.00163941020210X
KRISTA ZODET
DIRECTOR OF OPERATIONS32.00140279015349X
FieldValueIRS element (for citing)
Total Reportable Comp From Org775805TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation97370TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
COVANCE MARKET ACCESS
9801 WASHINGTONIAN BLVD 9TH FLGAITHERSBURGMD20878OPERATIONS OF PATIENT SERVICES12675869
ACCOUNTING SEED LLC
4717 WIGGLESWORTH CTELLICOTT CITYMD21043SYSTEM DEVELOPMENT444823
COVANCE SPECIALTY PHARMACY
500 EAGLES LANDING WAYLAKES LANDFL33810MANAGEMENT OF PHARMACY CARDS429863
TRIAL CARD
6501 WESTON PKWY 370CARYNC27513MANAGEMENT OF PHARMACY CARDS341868
AB DATA GROUP
600 A B DATA DRIVEMILWAUKEEWI53217PROFESSIONAL FUNDRAISING186388
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
All Other Contributions52749627AllOtherContributions
Total Contributions52749627TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1419587TotalRevenueColumn
Exclusion$1,419,587ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities9367974Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9694993Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-327019Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-327019TotalRevenueColumn
Exclusion-$327,019ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column53842195TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,092,568ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total49521777Total
Program Services49521777ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total706547Total
Program Services243852ProgramServices
Management And General366194ManagementAndGeneral
Fundraising96501Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total334678Total
Program Services106347ProgramServices
Management And General212681ManagementAndGeneral
Fundraising15650Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total13893Total
Program Services2793ProgramServices
Management And General10256ManagementAndGeneral
Fundraising844Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total84359Total
Program Services26224ProgramServices
Management And General50438ManagementAndGeneral
Fundraising7697Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total61243Total
Program Services19710ProgramServices
Management And General34388ManagementAndGeneral
Fundraising7145Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total11329502Total
Program Services11329502ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total186733Total
Program Services112040ProgramServices
Management And General74693ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total62773Total
Program Services62773ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total186388Total
Fundraising186388Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total133275Total
Management And General133275ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1119284Total
Program Services874993ProgramServices
Management And General231703ManagementAndGeneral
Fundraising12588Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total30321Total
Management And General30321ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1407725Total
Program Services1359588ProgramServices
Management And General42725ManagementAndGeneral
Fundraising5412Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total126351Total
Program Services99766ProgramServices
Management And General26585ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total36528Total
Management And General36528ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total26681Total
Program Services4917ProgramServices
Management And General21251ManagementAndGeneral
Fundraising513Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5740Total
Management And General5740ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total137287Total
Program Services109185ProgramServices
Management And General28102ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3009Total
Management And General3009ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
STATE REG. FEES38593859
TRAINING648648

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total65518601Total
Program Services63873467ProgramServices
Management And General1312396ManagementAndGeneral
Fundraising332738Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY76996BOY
EOY45599EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY47663707BOY
EOY17360043EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2000000BOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis798309LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec329810LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY109863BOY
EOY468499EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY36059719BOY
EOY48247233EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1176688BOY
EOY197229EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY87086973BOY
EOY66318603EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1363916BOY
EOY2171355EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY34116862BOY
EOY2547904EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY35480778BOY
EOY4719259EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2152091BOY
EOY3381943EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY49454104BOY
EOY58217401EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY51606195BOY
EOY61599344EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87086973BOY
EOY66318603EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-11676406ReconcilationRevenueExpenses
Reconcilation Other Changes21669555ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years56218602CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years62065378CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years67538322CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year77404453CurrentTaxYearMinus1Year
Current Tax Year52749627CurrentTaxYear
Total315976382Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years56218602CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years62065378CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years67538322CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year77404453CurrentTaxYearMinus1Year
Current Tax Year52749627CurrentTaxYear
Total315976382Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total262861413AmountsSubstContributorsTotal
Public Support Total17053114969PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4608767CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3529018CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2102642CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1195776CurrentTaxYearMinus1Year
Current Tax Year1419587CurrentTaxYear
Total12855790Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years2373CurrentTaxYearMinus2Years
Total2373Total
FieldValueIRS element (for citing)
Total Support328834545TotalSupport
Public Support Pertcentage1700.16150PublicSupportPertcentage170
Public Support Pertcent Prior Year0.12250PublicSupportPertcentPriorYear
Ten Percent Test Current YearXTenPercentTestCurrentYear
Facts And Circumstances TestHEALTHWELL FOUNDATION (THE "FOUNDATION") OFFERS THE FOLLOWING FACTS AND CIRCUMSTANCES IN SUPPORT OF ITS ONGOING CLASSIFICATION AS A PUBLIC CHARITY AND NOT A PRIVATE FOUNDATION.GENERAL BACKGROUND - THE FOUNDATION PROVIDES NEED-BASED FINANCIAL ASSISTANCE TO UNDERINSURED INDIVIDUALS LIVING WITH CHRONIC AND/OR LIFE-THREATENING ILLNESSES SUCH AS ASTHMA, CANCER AND AUTOIMMUNE DISORDERS. THROUGH 2011, THE FOUNDATION HAS HELPED ABOUT 152,000 PATIENTS AFFORD THEIR PRESCRIPTION DRUG CO-PAYMENTS, PREMIUMS AND OTHER OUT-OF-POCKET HEALTH CARE COSTS.THE FOUNDATION PROVIDES GRANTS TO PATIENTS WHO HAVE PRIVATE OR GOVERNMENT-SPONSORED INSURANCE BUT WHO ARE STILL UNABLE TO AFFORD THEIR INSURANCE CO-PAYMENTS OR THE PREMIUMS TO CONTINUE COVERAGE FOR THEIR CONDITIONS. THE FOUNDATION MAKES ITS AWARDS BASED ON THE OBJECTIVE CONSIDERATION OF FINANCIAL AND MEDICAL CRITERIA AND THE ADEQUACY OF THE RECIPIENT'S INSURANCE COVERAGE. GRANTS ARE GIVEN TO RECIPIENTS FOR ONE YEAR. THE FOUNDATION ONLY COVERS FDA-APPROVED OR COMPENDIA-LISTED MEDICATIONS. THE DECISION AS TO WHICH MEDICATIONS ARE PRESCRIBED IS A MEDICAL JUDGMENT. FURTHER, THE FOUNDATION DOES NOT LIMIT THE PROVIDERS OR PHARMACIES ITS RECIPIENTS MAY USE TO OBTAIN THEIR MEDICATIONS.PUBLIC SUPPORT PERCENTAGE - THE FOUNDATION'S CUMULATIVE PUBLIC SUPPORT PERCENTAGE THROUGH DECEMBER 31, 2011 IS AT 16.15%, WHICH IS THE ABOVE THE MINIMUM AMOUNT AT WHICH FACTS AND CIRCUMSTANCES WILL BE CONSIDERED BY THE SERVICE IN DETERMINING THE FOUNDATION'S ONGOING QUALIFICATION AS A PUBLICLY-SUPPORTED CHARITY. NOTWITHSTANDING THIS RELATIVELY LOW PERCENTAGE, THE FACTS AND CIRCUMSTANCES RELATING TO THE FOUNDATION'S STRUCTURE AND OPERATIONS PRESENT AN EXCEPTIONALLY STRONG CASE IN SUPPORT OF ITS ONGOING CLASSIFICATION AS A PUBLIC CHARITY AND NOT AS A PRIVATE FOUNDATION. THESE FACTS AND CIRCUMSTANCES, WHICH ARE DISCUSSED IN MORE DETAIL LATER, INCLUDE THE FOLLOWING:1. THE FOUNDATION IS NOT CONTROLLED BY ITS CONTRIBUTORS AND HAS NO ENDOWMENT FUND, CHARACTERISTICS WHICH DISTINGUISH IT FROM VIRTUALLY ALL PRIVATE FOUNDATIONS.2. THE FOUNDATION'S BOARD OF DIRECTORS REPRESENTS MANY DIVERSE ASPECTS OF THE HEALTH CARE COMMUNITY, DEMONSTRATING THE FOUNDATION'S COMMITMENT TO THE BROAD PUBLIC BENEFIT AND THE FOUNDATION'S COMMITMENT TO OPERATE AN OUTSTANDING ORGANIZATION THAT WILL ATTRACT FUTURE PUBLIC SUPPORT.3. THE FOUNDATION'S ACTIVITIES BROADLY BENEFIT THE GENERAL PUBLIC AS WELL AS OTHER CHARITABLE ORGANIZATIONS THAT ARE ATTEMPTING TO HELP PATIENTS COPE WITH MANY DIFFERENT TYPES OF ILLNESSES AND CONDITIONS.FACTS AND CIRCUMSTANCES SUPPORTING QUALIFICATION AS A PUBLICLY-SUPPORTED ORGANIZATION1. ATTRACTION OF PUBLIC SUPPORT. THE FOUNDATION'S POLICY IS TO ACCEPT CONTRIBUTIONS FROM DONORS AND TO DISBURSE THE CONTRIBUTIONS IN THE FORM OF GRANTS AS SOON AS PRACTICABLE. THE FOUNDATION DOES NOT HAVE AN ENDOWMENT FUND, AND ITS ABILITY TO FULFILL ITS FUTURE MISSION IS ENTIRELY DEPENDENT ON ITS ABILITY TO ATTRACT FUTURE SUPPORT FROM DONORS ON A CONTINUOUS BASIS. NONE OF THE FOUNDATION'S HISTORICAL SUBSTANTIAL CONTRIBUTORS HAS PLEDGED OR OTHERWISE COMMITTED TO CONTINUE TO SUPPORT THE FOUNDATION IN FUTURE YEARS. THEREFORE, THE FOUNDATION MUST CONTINUALLY SEEK NEW DONORS TO SUSTAIN ITS FUNDS, AND IT HAS DONE SO. SPECIFICALLY:THE FOUNDATION EMPLOYS NINE PERSONS WHO, IN ADDITION TO THEIR PRIMARY TASKS, MAY ALSO WORK ON FUNDRAISING PROJECTS AS NEEDED.THE FOUNDATION'S CORPORATE DONOR BASE HAS INCREASED FROM ONE CORPORATE DONOR IN 2004 TO THIRTEEN CORPORATE DONORS IN 2011.IN ADDITION TO THE DIRECTOR OF DEVELOPMENT, THE FOUNDATION WORKS WITH A DEVELOPMENT CONSULTING FIRM TO RESEARCH, IDENTIFY AND HELP PURSUE NEW FUNDRAISING OPPORTUNITIES.2. REPRESENTATIVE GOVERNING BODY. THE FOUNDATION'S BOARD CONSISTS ENTIRELY OF NATIONALLY-RECOGNIZED HEALTH CARE EXPERTS WITH DEEP EXPERIENCE IN THE FIELDS OF HEALTH CARE ADMINISTRATION, CLINICAL PRACTICE AND RESEARCH, DIRECT PATIENT CARE, PATIENT ADVOCACY AND HEALTH LAW. THE COMPOSITION OF THE BOARD EXEMPLIFIES THE FOUNDATION'S COMMITMENT TO REPRESENT THE BROAD INTERESTS OF THE GENERAL PUBLIC AND TO OPERATE IN A MANNER THAT WILL ATTRACT ATTENTION - AND SUPPORT - FROM A BROAD RANGE OF POTENTIAL DONORS.GIVEN THEIR DIVERSE EXPERIENCES, THE FOUNDATION'S BOARD MEMBERS BRING FORWARD A VARIETY OF IMPORTANT ISSUES TO ENCOURAGE DISCUSSION ABOUT HOW THE FOUNDATION'S PROGRAMS AND SERVICES WILL DIRECTLY IMPACT THE GENERAL PUBLIC. THEIR WIDE-RANGING OPINIONS HELP TO EXPAND THE FOUNDATION'S VIEWPOINT AND RESULT IN AN ORGANIZATION THAT CAN RESPOND SUCCESSFULLY TO IMPORTANT CHANGES IN THE HEALTH CARE ENVIRONMENT.SIGNIFICANTLY, NONE OF THE FOUNDATION'S BOARD MEMBERS IS AFFILIATED WITH ANY CONTRIBUTOR TO THE FOUNDATION, AND IT IS THE FOUNDATION'S STRICT POLICY THAT THERE NOT BE SUCH AFFILIATIONS. MOREOVER, NO CONTRIBUTOR HAS THE POWER TO APPOINT DIRECTORS TO THE FOUNDATION'S BOARD. IN THIS REGARD, THE FOUNDATION DIFFERS MARKEDLY FROM A PRIVATE FOUNDATION, WHERE THE GOVERNING BODY IS TYPICALLY COMPOSED OF SUBSTANTIAL CONTRIBUTORS AND/OR MEMBERS CHOSEN BY SUBSTANTIAL CONTRIBUTORS. 3. AVAILABILITY OF PUBLIC FACILITIES OR SERVICES; PUBLIC PARTICIPATION IN PROGRAMS OR POLICIES. THE FOUNDATION PUTS FORTH SIGNIFICANT EFFORTS TO MAKE THE AVAILABILITY OF ITS PROGRAMS AND SERVICES KNOWN TO THE GENERAL PUBLIC THROUGH AVENUES SUCH AS ITS WEBSITE (WWW.HEALTHWELLFOUNDATION.ORG), WHERE PATIENTS CAN APPLY ON-LINE FOR ASSISTANCE, FREE MEDIA, CONFERENCES AND OUTREACH TO THOUGHT LEADERS. THESE AVENUES ARE UPDATED CONTINUOUSLY AND MONITORED CLOSELY THROUGHOUT THE YEAR. THROUGH THE EFFORTS OF INTERNAL STAFF, AS WELL AS A DEVELOPMENT CONSULTING FIRM, NEWS ABOUT THE FOUNDATION'S PROGRAMS APPEARS IN LOCAL AND NATIONAL PUBLICATIONS, INCLUDING MEDICAL JOURNALS, NEWSPAPERS, RADIO SHOWS, MAGAZINES, AND HEALTHCARE WEBSITES.REPRESENTATIVES OF THE FOUNDATION REGULARLY ATTEND NATIONAL AND LOCAL HEALTHCARE CONFERENCES TO PROMOTE THE FOUNDATION'S PROGRAM, INCLUDING THOSE OF SUCH ENTITIES AS THE NATIONAL KIDNEY FUND, THE AMERICAN COLLEGE OF RHEUMATOLOGY, THE AMERICAN ACADEMY OF PEDIATRICS, CBI-PAP (PATIENT ASSISTANCE PROGRAMS), BIO, AND THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY.ADDITIONALLY, WHEN THE FOUNDATION ESTABLISHES A NEW FUND WITH RESPECT TO A PARTICULAR DISEASE OR CONDITION, THE FOUNDATION:IDENTIFIES KEY NATIONAL PATIENT ORGANIZATIONS AND MEDICAL SPECIALTY SOCIETIES THAT ARE ABLE TO REACH OUT TO PATIENTS IN THE NEW FUND AREA.REACHES OUT TO PROSPECTIVE DONORS TO SOLICIT ADDITIONAL SUPPORT FOR THE DISEASE AREA.PROMOTES THE NEW FUND IN ITS NEWSLETTER "THE PULSE" WHICH REACHES OVER 32,000 INDIVIDUALS FOUR TIMES A YEAR.FURTHERMORE, THE FOUNDATION IS REFERENCED BY, OR IS LINKED TO, THE WEBSITES OF A NUMBER OF ORGANIZATIONS THAT DIRECT PATIENTS FOR CO-PAYMENT AND PREMIUM ASSISTANCE, INCLUDING NATIONAL PHARMACY CLAIMS, PATIENT ASSISTANCE PROGRAMS, PATIENT ADVOCACY GROUPS, AND OTHER COPAYMENT ASSISTANCE ORGANIZATIONS.CONCLUSIONIN SUMMARY, HEALTHWELL FOUNDATION HAS THE CHARACTERISTICS OF A "PUBLICLY SUPPORTED" ORGANIZATION, BASED ON THE FACTS AND CIRCUMSTANCES TEST DESCRIBED IN SECTION 1.170A-9(E)(3) OF THE TREASURY REGULATIONS. SPECIFICALLY, A SMALL NUMBER OF DONORS DO NOT CONTROL HEALTHWELL; RATHER HEALTHWELL IS A GROWING INSTITUTION THAT BEARS MANY OF THE INDICIA OF A "PUBLICLY SUPPORTED" ORGANIZATION, INCLUDING PUBLIC SUPPORT FROM A WIDE CROSS-SECTION OF DONORS, WITH A REPRESENTATIVE GOVERNING BODY. MOREOVER, HEALTHWELL IS CONTINUING TO SEEK NEW SOURCES OF SUPPORT FROM THE GENERAL PUBLIC AS WELL AS OTHER ORGANIZATIONS. ACCORDINGLY, THE FOUNDATION QUALIFIES AS A "PUBLICLY SUPPORTED" ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(VI).FactsAndCircumstancesTest

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis57994OtherCostOrOtherBasis
Depreciation43318Depreciation
Book Value14676BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis740315OtherCostOrOtherBasis
Depreciation286492Depreciation
Book Value453823BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings468499TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCO-PAYMENTS AND PREMIUM ASSISTANCE PAYABLEDescription
Amount$2,547,904Amount
FieldValueIRS element (for citing)
Total Of Amounts2547904TotalOfAmounts
Total Revenue53842195TotalRevenue
Total Expenses65518601TotalExpenses
Excess Or Deficit For Year-11676406ExcessOrDeficitForYear
Net Unrealized GL On Investments-361968NetUnrealizedGLOnInvestments
Other$22,031,523OtherAmount
Total Adjustments21669555TotalAdjustments
Excess Or Deficit Per FS9993149ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt53346952TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-361968NetUnrealizedGainsInvestments
Revenue Not Rptd F990-361968RevenueNotRptdF990
Revenue Subtotal53708920RevenueSubtotal
Investment Expenses Not Included133275InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt133275RevenueNotRptdOnFinStmt
Total Revenue Per Form99053842195TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt65385326TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal65385326ExpensesSubtotal
Investment Expenses Not Included2133275InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt133275ExpensesNotRptdOnFinStmt
Total Expenses Per Form99065518601TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED DECEMBER 31, 2011, AND DETERMINED THAT THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE FINANCIAL STATEMENTS OR THAT MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PRIOR PERIOD ADJ. - CHANGE IN METHOD OF RECOGNIZING PATIENT GRANT EXPENSE 22,031,523.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
In Person SolicitationsXInPersonSolicitations
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1AB DATA GROUPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 A B DATA DRIVEAddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53217ZIPCode
FieldValueIRS element (for citing)
ActivityDIRECT MAIL CAMPAIGNActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts249714GrossReceipts
Amount Retained By Contractor186388AmountRetainedByContractor
Net To Organization63326NetToOrganization
FieldValueIRS element (for citing)
Total Gross Receipts249714TotalGrossReceipts
Total Retained By Contractors186388TotalRetainedByContractors
Total Net To Organization63326TotalNetToOrganization
Licensed StatesALLicensedStates
Licensed StatesAKLicensedStates
Licensed StatesAZLicensedStates
Licensed StatesARLicensedStates
Licensed StatesCALicensedStates
Licensed StatesCOLicensedStates
Licensed StatesCTLicensedStates
Licensed StatesDELicensedStates
Licensed StatesFLLicensedStates
Licensed StatesGALicensedStates
Licensed StatesHILicensedStates
Licensed StatesIDLicensedStates
Licensed StatesILLicensedStates
Licensed StatesINLicensedStates
Licensed StatesIALicensedStates
Licensed StatesKSLicensedStates
Licensed StatesKYLicensedStates
Licensed StatesLALicensedStates
Licensed StatesMELicensedStates
Licensed StatesMDLicensedStates
Licensed StatesMALicensedStates
Licensed StatesMILicensedStates
Licensed StatesMNLicensedStates
Licensed StatesMSLicensedStates
Licensed StatesMOLicensedStates
Licensed StatesMTLicensedStates
Licensed StatesNELicensedStates
Licensed StatesNVLicensedStates
Licensed StatesNHLicensedStates
Licensed StatesNJLicensedStates
Licensed StatesNMLicensedStates
Licensed StatesNYLicensedStates
Licensed StatesNCLicensedStates
Licensed StatesNDLicensedStates
Licensed StatesOHLicensedStates
Licensed StatesOKLicensedStates
Licensed StatesORLicensedStates
Licensed StatesPALicensedStates
Licensed StatesRILicensedStates
Licensed StatesSCLicensedStates
Licensed StatesSDLicensedStates
Licensed StatesTNLicensedStates
Licensed StatesTXLicensedStates
Licensed StatesUTLicensedStates
Licensed StatesVTLicensedStates
Licensed StatesVALicensedStates
Licensed StatesWALicensedStates
Licensed StatesWVLicensedStates
Licensed StatesWILicensedStates
Licensed StatesWYLicensedStates
Licensed StatesDCLicensedStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII (39 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
ACUTE PORPHYRIAS (AP)25799
AGE-RELATED MACULAR DEGENERATION (AMD)472939297
ANCA-ASSOCIATED VASCULITIS AND WEGENERS (AAV)4230420
ANEMIA ASSOCIATED WITH CHRONIC RENAL INSUFFICIENCY/FAILURE (CRICRF)13622159275
ANKYLOSING SPONDYLITIS (AS)132339580
ASTHMA - MODERATE TO SEVERE (ASTHMA)37803235543
AUTOIMMUNE MEDICARE ACCESS (AI)818010147619
BONE METASTASES (BM)1320403937
BREAST CANCER (BC)6232383657
CARCINOID TUMORS AND ASSOCIATED SYMPTOMS (CARCINOID)151587902
CHEMOTHERAPY INDUCED ANEMIA (CIA)501251581
CHEMOTHERAPY INDUCED NEUTROPENIA (CIN)56664541051
CHRONIC GOUT (CG)9849949
CHRONIC MYELOID LEUKEMIA - MEDICARE ACCESS (CML-MA)5111061
CHRONIC MYELOID LEUKEMIA (CML)234340403
COLORECTAL CARCINOMA (CC)5572684504
CROHN'S DISEASE - MEDICARE ACCESS (CD)323373393
CUTANEOUS T-CELL LYMPHOMA (CTCL)3832349
CYTOMEGALOVIRUS DISEASE (CMV)1431458
DUPUYTREN'S DISEASE (DD)21599529
HEAD AND NECK CANCER (HNC)648551225
HEPATITIS B AND C (HBC)1288443
IDIOPATHIC THROMBOCYTOPENIC PUPURA (ITP)391315931
IMMUNOSUPPRESSIVE TREATMENT FOR SOLID ORGAN TRANSPLANT RECIPIENTS (ITSOTP)23031782836
IRON OVERLOAD AS A RESULT OF BLOOD TRANSFUSIONS (IO)65334559
METASTATIC MELANOMA (METMEL)331341083
MULTIPLE MYELOMA (MM)16279
NON-HODGKINS LYMPHOMA (NHL)10101800263
NON-SMALL CELL LUNG CANCER (NSCLC)2575182
POST MENOPAUSAL OSTEOPOROSIS (PMO)1889318058
PSORIASIS (PSO)5071627730
PSORIATIC ARTHRITIS (PSA)313895812
RHEUMATOID ARTHRITIS (RA)24426761361
SECONDARY HYPERPARATHYROIDISM (SHPT)61035849760
SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)22487726
MYELODYSPLASTIC SYNDROMES (MDS)1590
HODGKINS (HD)120
GLIOBLASTOMA MULTIFORME/ANAPLASTIC ASTROCYTOMA (GBMAA)14235
SPECIAL DONATIONS832377

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: EACH PATIENT SEEKING ASSISTANCE IS SCREENED FOR ELIGIBILITY EITHER BY A HEALTHWELL REPRESENTATIVE OR THROUGH OUR ONLINE APPLICATION TOOL. CRITERIA IS STATIC ACROSS ALL HEALTHWELL FUNDS: THE PATIENT'S HOUSEHOLD INCOME MAY BE UP TO 400% OF THE FEDERAL POVERTY LIMIT, ADJUSTED FOR HOUSEHOLD SIZE AND HIGH COST OF LIVING AREAS; THE PATIENT MUST HAVE A DIAGNOSIS THAT HEALTHWELL CURRENTLY SUPPORTS; THE PATIENT MUST HAVE INSURANCE COVERAGE FOR THE TREATMENT FOR WHICH THEY ARE SEEKING ASSISTANCE AND THAT TREATMENT MUST BE AN ELIGIBLE TREATMENT UNDER THE HEALTHWELL FUND; THE PATIENT'S PHYSICIAN, NURSE PRACTITIONER OR PHYSICIAN'S ASSISTANT MUST VERIFY THE PATIENT'S DIAGNOSIS AND TREATMENT VIA THE STATEMENT OF TREATMENT FORM; AND TREATMENT MUST BE DISPENSED IN THE UNITED STATES. ONCE A PATIENT IS PRE-QUALIFIED FOR A GRANT, THEY HAVE 30 DAYS DURING WHICH TIME THEY MUST SUBMIT TO HEALTHWELL A COMPLETED AND SIGNED STATEMENT OF TREATMENT FORM AND COPIES OF THEIR MEDICAL INSURANCE AND PRESCRIPTION CARDS - FRONT AND BACK. UNTIL HEALTHWELL RECEIVES THESE DOCUMENTS, NO PAYMENTS WILL BE CONSIDERED OR REVIEWED FOR REIMBURSEMENT. UPON RECEIPT AND REVIEW OF THE STATEMENT OF TREATMENT AND INSURANCE AND PRESCRIPTION CARD COPIES, IF THE DOCUMENTATION IS COMPLETE, THE PATIENT BECOMES FULLY APPROVED. FOR SOME FUNDS, PATIENTS RECEIVE A PHARMACY CARD TO USE AT THE LOCAL RETAIL PHARMACY, THROUGH MAIL ORDER PHARMACY, OR THROUGH SPECIALTY PHARMACY. THE PHARMACY CARD CANNOT BE USED FOR PRIMARY PAYMENT AND PROVIDES ELECTRONIC POINT OF SALE REIMBURSEMENT FOR THE PHARMACY. FOR OTHER FUNDS, HEALTHWELL REQUIRES THE SUBMISSION OF A COMPLETED REIMBURSEMENT REQUEST FORM ALONG WITH ADDITIONAL INFORMATION AS OUTLINED ON THE FORM. UPON RECEIPT, THE REQUEST IS REVIEWED: A HEALTHWELL REPRESENTATIVE ENTERS THE RECEIVED INFORMATION INTO THE SYSTEM AND THE SYSTEM VALIDATES THE DATE OF SERVICE, AN INSURER PAID FIRST, THE PRODUCT IS AN ELIGIBLE TREATMENT UNDER THE HEALTHWELL FUND, AND THE PATIENT HAS AN ACTIVE, FULLY APPROVED GRANT. ONLY IF ALL SYSTEMATIC CHECKS PASS, THE REPRESENTATIVE PROCESSES THE PAYMENT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARY P SUNDEEN
238680034157000168280248860314551000
SHELA HALPER
1602400550800085210115760185845000
BASKARAN VELLANDURAI
1587410520000079860122240184151000
KRISTA ZODET
136148041310006380089690155628000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 7ALL BONUS PAYMENTS RECEIVED BY OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN FORM 990, PART VII ARE BASED ON AN APPRAISAL OF HIS/HER PERFORMANCE.
PART IIIFORM 990, PART VII, LINE 5: THE BOARD CHAIR OF THE FOUNDATION, STEPHEN WEINER, IS ALSO A PARTNER AT MINTZ, LEVIN, COHN, FERRIS, GLOVSKY, AND POPEO, PC, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2011, THE FOUNDATION PAID A TOTAL OF $17,825 TO THE UNRELATED ORGANIZATION FOR THE TIME INCURRED BY MR. WEINER.SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGES IN PROGRAM SERVICESFORM 990, PART III, LINE 3THE HEALTHWELL FOUNDATION ENHANCED THE GRANTS MANAGEMENT SYSTEM, CONTRACTED WITH A NEW PHARMACY CARD VENDOR, STREAMLINED THE GRANT APPLICATION PROCESS, AND INSTITUTED A FRAUD AUDIT PROCESS.
FORM 990, PART VI, SECTION B, LINE 11THE PRESIDENT, HEALTHWELL DIRECTORS, AND THE ACCOUNTING MANAGER REVIEW THE FEDERAL FORM 990 AND THEN FORWARD IT TO THE TREASURER FOR REVIEW. UPON COMPLETION OF REVIEW, THE PRESIDENT SIGNS THE FEDERAL FORM 990 AND RETURNS IT TO THE DIRECTOR OF FINANCE. REVIEW CONSISTS OF TRACING ALL FIGURES FROM AUDITED FINANCIAL STATEMENTS TO THE PREPARED FEDERAL FORM 990, AND REVIEWING ANY DISCREPANCIES WITH THE TAX PREPARERS. THE DIRECTOR OF FINANCE PROVIDES EACH BOARD MEMBER A COPY FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CTHE STAFF AND BOARD OF DIRECTORS FOLLOW A CODE OF CONDUCT. THE MEMBERS OF THE BOARD OF DIRECTORS SIGN A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. MEMBERS THAT ARE DEEMED TO HAVE A CONFLICT OF INTEREST BASED ON THE ABOVE PROCESS ARE RECUSED FROM PARTICIPATING IN A VOTE WITHIN THAT AREA OF CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15GUIDESTAR NONPROFIT EXECUTIVE COMPENSATION MARKET ANALYSIS DATA WAS USED TO DETERMINE COMPENSATION FOR THE PRESIDENT AND DIRECTORS. THIS MARKET ANALYSIS WAS FURTHER REVIEWED BY KORN-FERRY.
FORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND THE FEDERAL FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FEDERAL FORM 990 AND ANNUAL REPORT ARE ALSO AVAILABLE AT WWW.HEALTHWELLFOUNDATION.ORG.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -361,968. PRIOR PERIOD ADJ. - CHANGE IN METHOD OF RECOGNIZING PATIENT GRANT EXPENSE 22,031,523. TOTAL TO FORM 990, PART XI, LINE 5: 21,669,555.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.