CARE WISCONSIN FIRST INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CARE WISCONSIN FIRST INC (EIN 39-1245329)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201223189349300527
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)
Timestamp2012-11-13T10:02:55-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110000 INNOVATION DRIVE SUITE 250AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code532264837ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391245329EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CARE WISCONSIN FIRST INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCARENameControl
Phone6082400020Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 14017AddressLine1
CityMADISONCity
StateWIState
ZIP Code537080017ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKAREN MUSSERName
TitlePRESIDENT, CEOTitle
Phone6082400020Phone
Date Signed2012-11-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSON CPAName
PTINP01360892PTIN
Phone4144319300Phone
Date Prepared2012-11-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKAREN MUSSERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 14017AddressLine1
CityMADISONCity
StateWIState
ZIP Code537080017ZIPCode
FieldValueIRS element (for citing)
Gross Receipts175016775GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CAREWISC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH, SOCIAL, INFORMATIONAL AND RELATED SUPPORT SERVICES TO ELIGIBLE MEMBERS AND THEIR FAMILIES OR OTHER CARE GIVERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees616TotalNbrEmployees
Total Nbr Volunteers275TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year172328ContributionsGrantsPriorYear
Contributions Grants Current Year238072ContributionsGrantsCurrentYear
Program Service Revenue Prior Year144669755ProgramServiceRevenuePriorYear
Program Service Revenue CY171083766ProgramServiceRevenueCY
Investment Income Prior Year64951InvestmentIncomePriorYear
Investment Income Current Year118127InvestmentIncomeCurrentYear
Other Revenue Prior Year16023OtherRevenuePriorYear
Other Revenue Current Year3535616OtherRevenueCurrentYear
Total Revenue Prior Year144923057TotalRevenuePriorYear
Total Revenue Current Year174975581TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year104970241BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY127439801BenefitsPaidToMembersCY
Salaries Etc Prior Year29465230SalariesEtcPriorYear
Salaries Etc Current Year31435450SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9887300OtherExpensePriorYear
Other Expenses Current Year7957171OtherExpensesCurrentYear
Total Expenses Prior Year144322771TotalExpensesPriorYear
Total Expenses Current Year166832422TotalExpensesCurrentYear
Revenues Less Expenses Prior Year600286RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8143159RevenuesLessExpensesCY
Total Assets BOY53015414TotalAssetsBOY
Total Assets EOY26648111TotalAssetsEOY
Total Liabilities BOY55725152TotalLiabilitiesBOY
Total Liabilities EOY18216603TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-2709738NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8431508NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROVIDE HEALTH, SOCIAL, INFORMATIONAL AND RELATED SUPPORT SERVICES TO ELIGIBLE MEMBERS AND THEIR FAMILIES OR OTHER CARE GIVERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense136511381Expense
Revenue150588067Revenue
DescriptionFAMILY CARE PROGRAM - PROVIDES CARE MANAGEMENT AND A MEDICAID BENEFIT AND SERVICE PACKAGE. FOCUS IS ON ELIMINATING WAIT LISTS AND MEETING MEMBERS' DESIRED HEALTH AND LONG-TERM CARE OUTCOMES THROUGH EFFECTIVE AND COST-EFFECTIVE CARE PLANS. FAMILY CARE HAD 3,418 MEMBERS ENROLLED IN 2011.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense16752999Expense
Revenue20362106Revenue
DescriptionPARTNERSHIP PROGRAM - PROVIDES COORDINATED HEALTH CARE AND LONG-TERM SUPPORT SERVICES FOR MEDICAID ELIGIBLE MEMBERS WHO HAVE CONDITIONS REQUIRING NURSING HOME LEVEL OF CARE.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense820238Expense
Revenue117655Revenue
DescriptionADULT DAY CENTERS - BRIGHT AND VIBRANT PLACES WHERE OLDER PERSONS WITH MEDICAL, PHYSICAL OR COGNITIVE DISABILITIES CAN ACTIVELY AND ENJOYABLY SPEND THE DAYTIME.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense3006372Expense
Revenue3551554Revenue
DescriptionOTHER HEALTH AND LONG-TERM CARE SERVICES PROVIDED INCLUDE TRANSPORTATION, REHAB, AND DENTAL.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp3006372TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev3551554TotalOfOtherProgramServiceRev
Total Program Service Expense157090990TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
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 Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096404NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees616NumberOfEmployees
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 Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
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 FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTERRY METZGERNamePerson
Telephone Number6082453066TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 14017AddressLine1
CityMADISONCity
StateWIState
ZIP Code53708ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
KAREN MUSSER
PRESIDENT, CEO40.00XX247320021560
BRIAN HELLMER
CHAIR1.00XX000
DIANE KRUEGER
VICE CHAIR1.00XX000
ANNE SMITH
IMMEDIATE PAST CHAIR1.00XX000
IRIS CHRISTENSON
DIRECTOR1.00X000
MARY PAT WILLIAMS
DIRECTOR1.00X000
KAREN PAULSON
DIRECTOR1.00X000
MEL MCCARTNEY
DIRECTOR1.00X000
DAVID ZIMMERMAN
DIRECTOR1.00X000
MARSHA TESAR
DIRECTOR1.00X000
ELAINE TAYLOR
DIRECTOR1.00X000
BARB BOWERS
DIRECTOR1.00X000
STEVE CABLE
DIRECTOR1.00X000
TERRY SCHADEBERG
DIRECTOR1.00X000
KEN EIMERS
CHIEF OPERATING OFFICER40.00X186197019769
MICHAEL TEGLER FORMER
CHIEF FINANCIAL OFFICER40.00X130394018201
SCOTT JOHNSON
EXECUTIVE VICE PRESIDENT40.00X172347014696
REBECCA DORSCHEID
INTERIM CHIEF FINANCIAL OFFICER40.00X11030204283
PATRICIA NEELY
AVP-PARTNERSHIP40.00129711013693X
MYRA ENLOE
AVP-QI & MEMBER SERVICES40.00126390013494X
KRISTIN JEFFRIES
VICE PRESIDENT PLANNING & COMMUNICATION40.00122635016268X
JOHN DEAN
AVP PROVIDER SERVICES & PAYMENTS40.00111281011886X
RITA SEAVER
DIRECTOR OF IS AND CLAIMS40.00105764012792X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1442341TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation146642TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
OCONOMOWOC RESIDENTIAL PROGRAMS INC
PO BOX 3090MILWAUKEEWI53201LONG TERM CARE SERVICES6175775
BETHESDA LUTHERAN COMMUNITIES INC
600 HOFFMAN DRIVEWATERTOWNWI53094LONG TERM CARE SERVICES5669702
ST COLETTA OF WISCONSIN DAC
N4637 COUNTY ROAD YJEFFERSONWI53549LONG TERM CARE SERVICES4387312
REM WISCONSIN III INC
2005 W BELTLINE HWY SUITE 203MADISONWI53713LONG TERM CARE SERVICES3969180
CREATIVE COMMUNITY LIVING SERVICES INC
314 E MAIN STWATERTOWNWI53094LONG TERM CARE SERVICES3924339
FieldValueIRS element (for citing)
Number Of Contractors GT100 K229NumberOfContractorsGT100K
Federated Campaigns52477FederatedCampaigns
Government Grants172049GovernmentGrants
All Other Contributions13546AllOtherContributions
Total Contributions238072TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE PREMIUMS624100134680962134680962
ELDER CARE HEALTH PLAN6241002036210620362106
FAMILY CARE6241001590710515907105
ADULT DAY CENTER624100117655117655
TRANSPORTATION6241001593815938
FieldValueIRS element (for citing)
Total Program Service Revenue171083766TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column56925TotalRevenueColumn
Exclusion$56,925ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities30538Securities
Other71858Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities29883Securities
Other11311Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities655Securities
Other60547Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column61202TotalRevenueColumn
Exclusion$61,202ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionINTERDEPARTMENTAL REVEDescription
Business Code624100BusinessCode
Total Revenue Column3535616TotalRevenueColumn
Related Or Exempt Function Income3535616RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue3535616TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column174975581TotalRevenueColumn
Related Or Exempt Function Income174619382RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$118,127ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total127439801Total
Program Services127439801ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1442342Total
Management And General1442342ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total24010981Total
Program Services17666937ProgramServices
Management And General6344044ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total296143Total
Program Services290891ProgramServices
Management And General5252ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3448784Total
Program Services2524896ProgramServices
Management And General923888ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2237200Total
Program Services1580923ProgramServices
Management And General656277ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total27739Total
Management And General27739ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total51649Total
Management And General51649ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total10050Total
Management And General10050ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total539Total
Management And General539ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total293783Total
Program Services140ProgramServices
Management And General293643ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total10222Total
Program Services243ProgramServices
Management And General9979ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total994519Total
Program Services442529ProgramServices
Management And General551990ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2009832Total
Program Services1114ProgramServices
Management And General2008718ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1054317Total
Program Services953696ProgramServices
Management And General100621ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total10900Total
Program Services2999ProgramServices
Management And General7901ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total22712Total
Management And General22712ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1454476Total
Program Services553387ProgramServices
Management And General901089ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total330496Total
Program Services62472ProgramServices
Management And General268024ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIPMENT MAINTENANCE &1022288270591751697
OTHER EXPENSES6168735300371-4683498
BAD DEBT EXPENSE4677646776

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total166832422Total
Program Services157090990ProgramServices
Management And General9741432ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1700BOY
EOY1700EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY43061918BOY
EOY14083596EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2947628BOY
EOY4669845EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY510995BOY
EOY473762EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13037735LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8840971LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4435734BOY
EOY4196764EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2057439BOY
EOY3222444EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY53015414BOY
EOY26648111EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2984847BOY
EOY3238503EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY38449620BOY
EOY604321EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY621734BOY
EOY477742EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY13668951BOY
EOY13896037EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY55725152BOY
EOY18216603EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2828962BOY
EOY8418738EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY115194BOY
EOY8740EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4030BOY
EOY4030EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-2709738BOY
EOY8431508EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY53015414BOY
EOY26648111EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses8143159ReconcilationRevenueExpenses
Reconcilation Other Changes2998087ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years230769CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years238618CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years149371CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year172328CurrentTaxYearMinus1Year
Current Tax Year238072CurrentTaxYear
Total1029158Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18702172CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years56816726CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years139314898CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year144685778CurrentTaxYearMinus1Year
Current Tax Year174619382CurrentTaxYear
Total534138956Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18932941CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years57055344CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years139464269CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year144858106CurrentTaxYearMinus1Year
Current Tax Year174857454CurrentTaxYear
Total535168114Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509535168114PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years176160CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years45372CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years31460CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32381CurrentTaxYearMinus1Year
Current Tax Year56925CurrentTaxYear
Total342298Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years176160CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years45372CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years31460CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32381CurrentTaxYearMinus1Year
Current Tax Year56925CurrentTaxYear
Total342298Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19109101CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years57100716CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years139495729CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year144890487CurrentTaxYearMinus1Year
Current Tax Year174914379CurrentTaxYear
Total535510412Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99940PublicSupportPercentage509
Investment Income Percentage0.00060InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: THE ORGANIZATION HAS DETERMINED BASED ON FACTS AND CIRCUMSTANCES THAT ITS PUBLIC CHARITY STATUS SHOULD BE 509(A)(2) ON A GO FORWARD BASIS.GeneralExplanation

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$10,050OtherActivitiesAmount
Total Lobbying Expenditures IIB10050TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationAMOUNT PAID TO BLUMENFELD & ASSOCIATES.Explanation

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3346505OtherCostOrOtherBasis
Depreciation1412390Depreciation
Book Value1934115BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis638584OtherCostOrOtherBasis
Depreciation311938Depreciation
Book Value326646BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2359186OtherCostOrOtherBasis
Depreciation1752956Depreciation
Book Value606230BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6693460OtherCostOrOtherBasis
Depreciation5363687Depreciation
Book Value1329773BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4196764TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
SECURITY FUND DEPOSITS & OTHER DEPOSITS762017
TRUSTS2460427
FieldValueIRS element (for citing)
Total Book Value Other Assets3222444TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionMEDICAL CLAIMS PAYABLEDescription
Amount$13,896,037Amount
FieldValueIRS element (for citing)
Total Of Amounts13896037TotalOfAmounts
Total Revenue174975581TotalRevenue
Total Expenses166832422TotalExpenses
Excess Or Deficit For Year8143159ExcessOrDeficitForYear
Net Unrealized GL On Investments-1913NetUnrealizedGLOnInvestments
Other$3,000,000OtherAmount
Total Adjustments2998087TotalAdjustments
Excess Or Deficit Per FS11141246ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt231266891TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-1913NetUnrealizedGainsInvestments
Other Revenues59830256OtherRevenues
Revenue Not Rptd F99059828343RevenueNotRptdF990
Revenue Subtotal171438548RevenueSubtotal
Investment Expenses Not Included539InvestmentExpensesNotIncluded
Other Revenues Not Included3536494OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3537033RevenueNotRptdOnFinStmt
Total Revenue Per Form990174975581TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt225847913TotExpensesEtcAuditedFinclStmt
Other Expenses Included62552522OtherExpensesIncluded
Expenses Not Rptd F99062552522ExpensesNotRptdF990
Expenses Subtotal163295391ExpensesSubtotal
Investment Expenses Not Included2539InvestmentExpensesNotIncluded2
Other Expenses Not Included3536492OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt3537031ExpensesNotRptdOnFinStmt
Total Expenses Per Form990166832422TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE COMPANY DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY RECORED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2011 OR 2010.
PART XI, LINE 8 - OTHER ADJUSTMENTS:EQUITY CONTRIBUTIONS 3,000,000.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RELATED ORGANIZATION REVENUE 59,830,256.
PART XII, LINE 4B - OTHER ADJUSTMENTS:INTERDEPARTMENT REVENUE INCLUDED IN EXPENSES 3,536,494.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RELATED ORGANIZATION EXPENSES 62,552,522.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:INTERDEPARTMENT REVENUE INCLUDED IN EXPENSES 3,536,492.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
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 Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 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
KAREN MUSSER
2462800001040075530140070268880000
KEN EIMERS
185476000721056910140780205966000
SCOTT JOHNSON
171702000645039950107010187043000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE CHIEF FINANCIAL OFFICER PERFORMS AN EXTENSIVE REVIEW PRIOR TO FILING FORM 990 WITH THE INTERNAL REVENUE SERVICE. PRIOR TO THE 990 FILING WITH THE IRS, THE FORM IS MADE AVAILABLE TO THE MEMBERS OF THE BOARD. AT THE NEXT BOARD MEETING, KEY COMPONENTS OF THE 990 RETURN ARE DISCUSSED.
FORM 990, PART VI, SECTION B, LINE 12CEACH YEAR, ALL BOARD MEMBERS AND EXECTIVE TEAM MEMBERS MUST SIGN THE CONFLICT OF INTEREST DOCUMENT TO CERTIFY THAT THEY ARE IN COMPLIANCE.
FORM 990, PART VI, SECTION B, LINE 15FOR THE EXECUTIVE TEAM, A CONSULTANT HELPS WITH REVIEWING THE MARKET DATA FROM SIMILAR ORGANIZATIONS FOR DETERMINING THE APPROPRIATE PAY RANGES AND PAY RATES FOR THE INCUMBENTS. THE CONSULTANT WILL MAKE THE RECOMMENDATION FOR THE COMPENSATION TO THE CEO FOR THE EXECUTIVE TEAM MEMBERS WHO THEN REVIEWS AND APPROVES. FOR THE CEO'S COMPENSATION, THE BOARD RECEIVES THE RECOMMENDATION FROM THE CONSULTANT AND WILL REVIEW AND APPROVE.
FORM 990, PART VI, SECTION C, LINE 19RECORDS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST BY MAILING TO CARE WISCIONSIN, INC. C/O TERRY METZGER PO BOX 14017, MADISON, WI 53708-0017.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -1,913. EQUITY CONTRIBUTIONS 3,000,000. TOTAL TO FORM 990, PART XI, LINE 5: 2,998,087.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CARE WISCONSIN HEALTH PLANBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12802 INTERNATIONAL LANEAddressLine1
CityMADISONCity
StateWIState
ZIP Code53704ZIPCode
FieldValueIRS element (for citing)
EIN240093404EIN
Primary ActivitiesHEALTH CAREPrimaryActivities
Legal Domicile StateWILegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 9PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CARE WISCONSIN HEALTH PLAN INC
C3000000INTERCOMPANY ACCOUNT
CARE WISCONSIN HEALTH PLAN INC
K7170912DIRECT COST
CARE WISCONSIN HEALTH PLAN INC
M3202853DIRECT COST
CARE WISCONSIN HEALTH PLAN INC
N9988341DIRECT COST

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