DRISCOLL CHILDRENS HEALTH PLAN: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
DRISCOLL CHILDRENS HEALTH PLAN (EIN 74-2838488)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201243199349302079
Schema version
2011v1.3
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)
Timestamp2012-11-14T10:18:55-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12800 Post Oak Blvd Ste 3200AddressLine1
CityHOUSTONCity
StateTXState
ZIP Code77056ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742838488EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Driscoll Childrens Health PlanBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% RICK VILLARREALInCareOfName
Name ControlDRISNameControl
Phone3616944889Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 N Upper Broadway StAddressLine1
CityCorpus ChristiCity
StateTXState
ZIP Code784010746ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY D PETERSONName
TitleCEOTitle
Date Signed2012-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameM Paige GerichName
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDR MARY DALE PETERSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1615 N UPPER BROADWAY ST 1621AddressLine1
CityCORPUS CHRISTICity
StateTXState
ZIP Code784010746ZIPCode
FieldValueIRS element (for citing)
Gross Receipts151295523GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.DCHPKIDS.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionDriscoll Children's Health Plan is committed to providing efficient, cost-effective, quality care through a dedicated and compassionate health care team & respectful collaboration with its provider network.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees67TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year423224ContributionsGrantsPriorYear
Contributions Grants Current Year185751ContributionsGrantsCurrentYear
Program Service Revenue Prior Year152114133ProgramServiceRevenuePriorYear
Program Service Revenue CY150430135ProgramServiceRevenueCY
Investment Income Prior Year388164InvestmentIncomePriorYear
Investment Income Current Year679637InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year152925521TotalRevenuePriorYear
Total Revenue Current Year151295523TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3218625SalariesEtcPriorYear
Salaries Etc Current Year3751231SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year139470472OtherExpensePriorYear
Other Expenses Current Year143765392OtherExpensesCurrentYear
Total Expenses Prior Year142689097TotalExpensesPriorYear
Total Expenses Current Year147516623TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10236424RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3778900RevenuesLessExpensesCY
Total Assets BOY45253813TotalAssetsBOY
Total Assets EOY37384603TotalAssetsEOY
Total Liabilities BOY19923766TotalLiabilitiesBOY
Total Liabilities EOY17744195TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY25330047NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19640408NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionDRISCOLL CHILDREN'S HEALTH PLAN IS COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED & COMPASSIONATE HEALTHCARE TEAM & RESPECTFUL COLLABORATION WITH ITS PROVIDER NETWORK.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense133140755Expense
Revenue150430135Revenue
DescriptionSEE SCHEDULE O FOR FULL PROGRAM SERVICE DESCRIPTION.Description
Total Program Service Expense133140755TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees67NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRICK VILLARREALNamePerson
Telephone Number3616946781TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1615 N UPPER BROADWAY ST STE 1621AddressLine1
CityCorpus ChristiCity
StateTXState
ZIP Code78401ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationReportable Comp From OrganizationReportableCompFromOrganizationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
WILLIAM J STERETT
CHAIRMAN OF THE BOARD1.0XX
D ERIC HAMON
SECRETARY/TREASURER1.0XX207838403084
C IVAN WILSON
DIRECTOR1.0X1000000
JOE FULTON
DIRECTOR1.0X1000000
MARY D PETERSON
PRESIDENT/CEO40.0XX52136343557
STEVE WOERNER
DIRECTOR1.0X551082399033
S LOYD NEAL JR
DIRECTOR1.0X1000000
ERNEST BUCK
MEDICAL DIRECTOR40.0X
WILLIAM BRENDEL
ASSOCIATE MEDICAL DIRECTOR40.0X
RICARDO VILLARREAL
VICE PRESIDENT OF FINANCE40.018792167774X
MIGUEL PEREZ III
CHIEF INFORMATION OFFICER40.022763134950X
JUDITH KRAFT
EXECUTIVE DIRECTOR QUALITY IMP40.013076116718X
DON WELLS
CREDENTIAL PROVIDER RELATIONS40.02219118464X
HEATHER JOHNSON
DIRECTOR OF UTILIZATION MGMT40.012107105971X
FieldValueIRS element (for citing)
Total Reportable Comp From Org987434TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs788920TotalReportableCompFrmRltdOrgs
Total Other Compensation923210TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
VALENCE HEALTH
600 W JACKSON SUITE 800CHICAGOIL60661THIRD PARTY ADMIN7120355
EVERGREEN RE
940 GOLF HOUSE RD W STE 300WHITSETTNC27377REINSURANCE BROKER1383442
CORPORATE PRINTING INC
3509 OAK FOREST DRHOUSTONTX77018PRINTING603188
PORTER ROGERS DAHLMAN GORDON
800 N Shoreline Suite 800 SCORPUS CHRISTITX784013708Legal224416
ALLIED MANAGEMENT GROUP INC
825 N PARKCENTER DR STE 102SANTA ANACA92705SIU SERVICES377740
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Government Grants185751GovernmentGrants
Total Contributions185751TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Preimum Revenue524292149886214149886214
Net Reinsurance524292-839199-839199
Other Income90009913831201383120
FieldValueIRS element (for citing)
Total Program Service Revenue150430135TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column525837TotalRevenueColumn
Exclusion$525,837ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities153800Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities153800Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column153800TotalRevenueColumn
Exclusion$153,800ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column151295523TotalRevenueColumn
Related Or Exempt Function Income150430135RelatedOrExemptFunctionIncome
Exclusion$679,637ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total582258Total
Program Services582258ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2526113Total
Program Services723257ProgramServices
Management And General1802856ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total190165Total
Program Services79869ProgramServices
Management And General110296ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total245221Total
Program Services102993ProgramServices
Management And General142228ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total207474Total
Program Services87139ProgramServices
Management And General120335ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total6858319Total
Program Services735845ProgramServices
Management And General6122474ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total350159Total
Management And General350159ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total2000Total
Management And General2000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2979587Total
Management And General2979587ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total270175Total
Management And General270175ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total840216Total
Management And General840216ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total327142Total
Management And General327142ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total152849Total
Management And General152849ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total76892Total
Management And General76892ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total76971Total
Management And General76971ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total73022Total
Management And General73022ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Expenses128264930128264930
Premium Taxes27874612564464222997
Member Value Add Expense202733202733
SPECIAL FEES131050131050

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total371886Total
Management And General371886ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total147516623Total
Program Services133140755ProgramServices
Management And General14375868ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16098120BOY
EOY3331896EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6768108BOY
EOY6808484EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2930723BOY
EOY1766847EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2631534LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2461622LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY175865BOY
EOY169912EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY19280997BOY
EOY25307464EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY45253813BOY
EOY37384603EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17836492BOY
EOY13847875EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2087274BOY
EOY3896320EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY19923766BOY
EOY17744195EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY25330047BOY
EOY19640408EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY25330047BOY
EOY19640408EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY45253813BOY
EOY37384603EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3778900ReconcilationRevenueExpenses
Reconcilation Other Changes-9468539ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteefalseAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years103906CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years357701CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year423224CurrentTaxYearMinus1Year
Current Tax Year185751CurrentTaxYear
Total1070582Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years103906CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years357701CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year423224CurrentTaxYearMinus1Year
Current Tax Year185751CurrentTaxYear
Total1070582Total
FieldValueIRS element (for citing)
Public Support Total1701070582PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years336324CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years254370CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year362081CurrentTaxYearMinus1Year
Current Tax Year525837CurrentTaxYear
Total1478612Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years56299110CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years134848007CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year152114133CurrentTaxYearMinus1Year
Current Tax Year150430135CurrentTaxYear
Total493691385Total
FieldValueIRS element (for citing)
Total Support496240579TotalSupport
Gross Receipts From Admissions Etc491300955GrossReceiptsFromAdmissionsEtc
First5 Years170XFirst5Years170

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)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$77,899GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB77899TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2631534OtherCostOrOtherBasis
Depreciation2461622Depreciation
Book Value169912BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings169912TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionVANGUARD- MUTUAL FUNDSDescription
Book Value25307464BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities25307464TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Rebate Liability$3,545,036
Due to CPSST$21,960
Due to Affiliate$329,324
FieldValueIRS element (for citing)
Total Of Amounts3896320TotalOfAmounts
Total Revenue151295523TotalRevenue
Total Expenses147516623TotalExpenses
Excess Or Deficit For Year3778900ExcessOrDeficitForYear
Excess Or Deficit Per FS3778900ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt149694765TotRevenueEtcAuditedFinclStmt
Revenue Subtotal149694765RevenueSubtotal
Other Revenues Not Included1600758OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1600758RevenueNotRptdOnFinStmt
Total Revenue Per Form990151295523TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt145915866TotExpensesEtcAuditedFinclStmt
Expenses Subtotal145915866ExpensesSubtotal
Other Expenses Not Included1600757OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1600757ExpensesNotRptdOnFinStmt
Total Expenses Per Form990147516623TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF AUDIT REPORT REVENUE/EXPENSES TO FORM 990SCH D, PARTS XII & XIII LINE 4BINCOME ON RETURN, NOT ON BOOKS: AUDIT EXPENSES NETTED WITH INCOME ON 990 $1,600,758 EXPENSE ON RETURN, NOT ON BOOKS: AUDIT EXPENSES NETTED WITH INCOME ON 990 $1,600,757
FIN 48SCHEDULE D, PART X, LINE 2MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
D ERIC HAMON
970109432816500391319117656109220
MARY D PETERSON
2708506760051074577463623956930
STEVE WOERNER
3555121790701650038939496399501150
RICARDO VILLARREAL
1317863182641621243663561865660
MIGUEL PEREZ III
11722617724011899108641577130

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPARTICIPANTS IN/PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANIdentifier
Return ReferencePART I, QUESTION 4BReturnReference
ExplanationTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: NAME DEFERRAL AMOUNT D. ERIC HAMON $329,904 STEVE WOERNER $310,284 NO PAYMENTS WERE RECEIVED.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (21 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTFORM 990, PART III, QUESTION 4ADRISCOLL CHILDREN'S HEALTH PLAN IS THE CONTRACTOR FOR THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) THIS SERVICE AREA INCLUDES 14 COUNTIES COMPRISED OF ARANSAS, BEE, BROOKS, CALHOUN, GOLIAD, JIM WELLS, KARNES, KENEDY, KLEBERG, LIVE OAK, NUECES, REFUGIO, SAN PATRICIO, AND VICTORIA. THE PLAN ALSO PROVIDES HEALTH BENEFITS FOR CHILDREN ENROLLED IN THE STATE OF TEXAS ACCESS REFORM (STAR) PROGRAM FOR 24 COUNTIES. THE PLAN IS A HEALTH MAINTENANCE ORGANIZATION (HMO) COMMITTED TO PROVIDING ITS MEMBERS A NETWORK OF HEALTH SERVICE PROVIDERS. ITS AFFILIATION WITH DRISCOLL CHILDREN'S HOSPITAL (DCH), THE SOLE CORPORATE MEMBER, LENDS TO THE PLAN'S SUCCESS BY OFFERING ITS MEMBERS DCH'S EXTENSIVE NETWORK INCLUDING PHYSICIANS, HOSPITAL, AND SERVICES IN ITS TOTAL EXPANDED SERVICE AREA, THUS OFFERING CHIP AND STAR MEMBERS WHO LIVE IN THE ADJACENT COUNTIES A FULL CONTINUUM OF QUALITY SERVICES TAILORED TO MEET THE NEEDS OF THE CHIP AND STAR POPULATION. THE PLAN'S ENROLLMENT WAS 58,721 AND 56,216 AT DECEMBER 31, 2011 AND 2010, RESPECTIVELY.
CLASSES OF MEMBERS OR STOCKHOLDERSForm 990, Part IV, Question 6Driscoll Children's Hospital is the sole member of Driscoll Children's Health Plan.
CLASS OF PERSONS AND NATURE OF THEIR RIGHTSForm 990, Part IV, Question 7aAny vacancy occurring in the board of directors shall be filled in accordance with the following procedure: the Member shall elect and appoint a candidate to fill the vacancy.
CLASS OF THE PERSON, DECISIONS THAT REQUIRE APPROVAL, AND VOTING RIGHTSForm 990, Part IV, Question 7bThe following matters are reserved to the member and shall require the affirmative action of the member to be effective: A. annual operating & capital budgets of the corporation; B. Merger, acquisition or consolidation of the corporation; c. borrowing or lending of money or the creation of indebtedness through the guarantee of another debt or similar action; and d. appointment & removal of directors in accordance with the by-laws.
FORM 990 PROVIDED TO GOVERNING BODYform 990, part VI, question 11THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING.
COMPENSATION REVIEW OF CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIALFORM 990, PART VI, QUESTION 15ABOARD OF DIRECTORS REVIEW THE APPLICABLE MARKETING DATA PROVIDED BY A THRID PARTY COMPENSATION FIRM AND MATCHES THE PRESIDENT/CEO SALARY TO THE APPROPRIATE MARKET RATE FOR THE DUTIES. SULLIVAN COTTER REVIEWED 2011.
COMPENSATION REVIEW OF OFFICERS OR KEY EMPLOYEESFORM 990, PART VI, QUESTION 15BMANAGEMENT REVIEWS APPLICABLE MARKET DATA AND SLOTS THE SALARY ACCORDING TO APPROPRIATE MARKET DATA.
Organizational documents made available to publicform 990, part VI, question 19The organization does not make its governing documents, policies, and financial statements available to the public.
ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE WITH POLICYFORM 990, PART VI, QUESTION 12CANNUALLY, ALL DIRECTORS, OFFICERS, AND KEY PERSONNEL FILL OUT A CONFLICT OF INTEREST FORM. STAFF MAKES SURE ALL CONFLICT OF INTEREST FORMS ARE TURNED IN AND REVIEWED ANNUALLY.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5Transfer to Driscoll Children's Hospital $ (10,000,000) Unrealized Gain/Loss $ 531,462 ---------- OTHER CHANGES TOTAL $ (9,468,539)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:WILLIAM J STERETT TITLE:CHAIRMAN OF THE BOARD HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:D. ERIC HAMON TITLE:SECRETARY/TREASURER HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:C. IVAN WILSON TITLE:DIRECTOR HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOE FULTON TITLE:DIRECTOR HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MARY D PETERSON TITLE:PRESIDENT/CEO HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEVE WOERNER TITLE:DIRECTOR HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:S LOYD NEAL JR TITLE:DIRECTOR HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ERNEST BUCK TITLE:MEDICAL DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:WILLIAM BRENDEL TITLE:ASSOCIATE MEDICAL DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RICARDO VILLARREAL TITLE:VICE PRESIDENT OF FINANCE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MIGUEL PEREZ III TITLE:CHIEF INFORMATION OFFICER HOURS:1

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Driscoll Children's Hospital
3533 South AlamedaCorpus ChristiTX78411742577746HospitalTX501(c)(3)3nafalse
DCH Holding Company
3533 South AlamedaCorpus ChristiTX78411743011381Holding Co.TX501(c)(3)N/ADCHfalse
Driscoll Physician's Group
3533 South AlamedaCorpus ChristiTX78411742988134HospitalTX501(c)(3)3DCHfalse
Driscoll Valley Physicians Group
3533 South AlamedaCorpus ChristiTX78411201234322HospitalTX501(c)(3)3DCHfalse
Driscoll Maternal & Fetal Physician's Gr
3533 South AlamedaCorpus ChristiTX78411201234461Health CareTX501(c)(3)7DCHfalse
Childrens Physician Services of South TX
3533 South AlamedaCorpus ChristiTX78411742620408HospitalTX501(c)(3)3DCHfalse
Driscoll Foundation
615 North Upper Broadway ste 1635Corpus ChristiTX78401741170270Char. TrustTX501(c)(3)11aNAfalse
Driscoll Healthcare Services
3533 south alamedacorpus christiTX78411010962276health careTX501(c)(3)11adchfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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