2012-12-14T10:18:20-06:00 2010-09-30 BEENE GARTER LLP 56 GRANDVILLE AVE SW SUITE 100 GRAND RAPIDS MI 495034036 990 2009-10-01 383609504 KENT HEALTH PLAN CORPORATION KENT 6167268204 620 CENTURY AVE SW No 210 GRAND RAPIDS MI 49503 JAMES TUINSTRA 6167268204 2012-12-13 1 MARGARET W BISHOP CPA 6162355200 2009 2016-02-24 21:20:13Z JAMES TUINSTRA 620 CENTURY AVENUE SW GRAND RAPIDS MI 49503 7639599 0 X WWW.KENTHEALTHPLAN.ORG X 2001 MI TO INSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW-INCOME PERSONS WITHOUT INSURANCE AND/OR INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS 9 9 0 11 0 0 25000 0 7460990 7586277 41137 53322 0 7527127 7639599 908807 1282759 0 0 240327 46880 0 0 6374376 5953657 7523510 7283296 3617 356303 3918810 4651201 2104748 2517852 1814062 2133349 TO INSURE THE DELIVERY OF BASIC PREVENTATIVE HEALTH CARE TO LOW INCOME PERSONS WITHOUT INSURANCE AND/OR ARE INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS IN AN INTEGRATED COMMUNITY BASED HEALTH IMPROVEMENT MODEL. 0 0 4121957 4250645 PLAN A ADMINISTERS HEALTH CARE BENEFITS TO RESIDENTS OF KENT COUNTY WHO DO NOT QUALIFY FOR ANY OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS. THE PLAN CONTRACTS WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH). BENEFITS AND ELIGIBILTY FOR THIS PLAN ARE ESTABLISHED BY MDCH. MDCH PAYS A SET PER MEMBER PER MONTH TO PLAN A. ON AVERAGE 2,757 MEMBERS WERE SERVED EACH MONTH. 2671487 3058780 PLAN B ADMINISTERS HEALTH CARE BENEFITS TO INDIVIDUALS WHOSE INCOMES ARE LESS THAN 150% OF POVERTY AND WHO ARE NOT ELIGIBLE FOR ANY GOVERNMENT SPONSORED HEALTH CARE PROGRAM. THE PROGRAM PROVIDES ACCESS TO BASIC COMMUNITY BASED PRIMARY CARE AND DIAGNOSTICS THAT ARE NOT FUNDED BY ANY OTHER MEANS. ON AVERAGE 1,881 MEMBERS ARE SERVED EACH MONTH. 148234 236808 THE MEDICATION ASSISTANCE PROGRAM PROVIDES COORDINATED ACCESS TO PRESCRIPTION MEDICATIONS FOR KENT COUNTY RESIDENTS WHOSE INCOMES ARE 200% OR LESS OF POVERTY AND WHO ARE NOT ELIGIBLE FOR ANY GOVERNMENT SPONSORED PROGRAMS. THE PROGRAM ALSO ASSISTS THE MEMBERS IN UTILIZING PHARMACY ASSISTANCE PROGRAMS PROVIDED BY PHARMACEUTICAL MANUFACTURERS. ON AVERAGE, 475 MEMBERS ARE SERVED EACH MONTH. 30587 40044 PLAN C ALLOWS FOR SMALL BUSINESS TO PROVIDE HEALTHCARE COVERAGE TO THEIR EMPLOYEES. THE COST OF PLAN C COVERAGE IS SHARED EQUALLY BY KENT HEALTH PLAN CORPORATION, ELIGIBLE EMPLOYERS AND THEIR ENROLLED EMPLOYEES. ON AVERAGE 12 MEMBERS ARE SERVED EACH MONTH. 30587 40044 6972265 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 188 0 1 0 0 0 0 0 0 0 0 0 0 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X X SUSAN COOPER 6167268204 620 CENTURY AVE GRAND RAPIDS MI 49503 CARL VERBEEK 1.00 X X 0 0 0 DAVID SMITH 1.00 X X 0 0 0 LINDA CONSTANTINO 1.00 X X 0 0 0 MARCIA MYERS 1.00 X X 0 0 0 KRISTA MATLOCK 1.00 X 0 0 0 TERRI WEEKLY 1.00 X 0 0 0 GERRI NAVARRE 1.00 X 0 0 0 ALISON DARK 1.00 X 0 0 0 LODEWYK ZWARENSTEYN 1.00 X 0 0 0 JAMES TUINSTRA 10.00 X 41600 0 0 41600 0 0 0 0 0 0 ACCESS HEALTH 1200 RANSOM STREET MUSKEGON MI 49442 CLAIMS AND PAYROLL ADMINISTRATION 271399 1 PLAN A PROGRAM FEES 524114 4250645 4250645 HOSPITAL CONTRACT REVE 524114 3335632 3335632 7586277 53322 53322 7639599 7586277 0 53322 1282759 1282759 46880 46880 558502 434602 123900 27172 27172 746 746 39385 21156 18229 7025 7025 29690 29690 3956 3956 39031 39031 1621 1621 8357 8357 15574 15574 HEALTH CARE CLAIMS 5201522 5201522 BAD DEBT EXPENSE 16823 16823 OTHER EXPENSES 4253 2536 1717 7283296 6972265 311031 0 3604871 3109191 285086 5775 6275 38211 16688 23078 21523 1514212 3918810 4651201 215841 675677 1888907 1842175 2104748 2517852 X 1814062 2133349 1814062 2133349 3918810 4651201 X 0 0 0 X 25000 25000 7558556 7518015 7071664 7460990 7586277 37195502 7558556 7518015 7071664 7485990 7586277 37220502 0 0 0 37220502 117074 136400 88496 41137 53322 436429 117074 136400 88496 41137 53322 436429 7675630 7654415 7160160 7527127 7639599 37656931 0.98840 0.98880 0.01160 0.01120 X 13064 2717 10347 25147 13971 11176 21523 HEALTH CARE CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 1842175 1842175 0 CATHOLIC CHARITIES OF WEST MICHIGAN 360 DIVISION SUITE 3A GRAND RAPIDS MI 49503 383012473 501(C)(3) 101958 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE ITS TAX EXEMPT MISSION FAMILY OUTREACH CENTER 1919 SOUTH DIVISION GRAND RAPIDS MI 49507 382272711 501(C)(3) 93820 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE ITS TAX EXEMPT MISSION VISITING NURSES OF WEST MICHIGAN 1401 CEDAR NE GRAND RAPIDS MI 49503 381359195 501(C)(3) 159981 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE ITS TAX EXEMPT MISSION YWCA WEST CENTRAL MICHIGAN 25 SHELDON BLVD SE GRAND RAPIDS MI 49503 381359578 501(C)(3) 40000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE ITS TAX EXEMPT MISSION PLANNED PARENTHOOD OF KENT COUNTY 425 CHERRY STREET GRAND RAPIDS MI 49503 381782520 501(C)(3) 50000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE ITS TAX EXEMPT MISSION KENT COUNTY 300 MONROE AVE NE GRAND RAPIDS MI 49503 386004862 777000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE GOVERNMENT PROGRAMMING CLINICA SANTA MARIA 730 GRANDVILLE SW GRAND RAPIDS MI 49503 204108960 501(C)(3) 60000 SERVICE AGREEMENT - PROVIDED WORKING CAPITAL FOR ORGANIZATION TO PURSUE ITS TAX EXEMPT MISSION 6 1 Form 990, Part VI, Section B, line 11 THE COMPLETED FORM 990 IS REVIEWED BY MANAGEMENT AND THE FINANCE COMMITTEE. THE COMPLETED FORM 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING. Form 990, Part VI, Section B, line 12c THE CONFLICT OF INTEREST POLICY IS MONITORED BY A REVIEW OF ALL FINANCIAL TRANSACTIONS BY TOP MANAGEMENT; BOARD MEMBERS ARE REQUIRED TO REFRAIN FROM VOTING ON MATTERS THAT RELATE TO CONTRACTS BETWEEN KENT HEALTH PLAN AND THEIR EMPLOYER. ANNUAL CONFLICT OF INTEREST DISCLOSURES ARE REQUIRED BY ALL BOARD MEMBERS, SENIOR MANAGEMENT, ALL EMPLOYEES AND CONTRACTORS. EACH PARTY IS ALSO REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST. Form 990, Part VI, Section B, line 15 THE BOARD OF DIRECTORS DETERMINES THE CONTRACT AMOUNT TO PAY AND THE NUMBER OF HOURS REQUIRED FOR THE SERVICES OF THE PRESIDENT. THE PRESIDENT PROPOSES COMPENSATION FOR ALL EMPLOYEES AND CONTRACTORS AND THE BOARD OF DIRECTORS APPROVES. THE BOARD OF DIRECTORS ALSO REVIEWS AND APPROVES EACH YEAR'S ANNUAL BUSINESS RELATIONSHIPS AND ALL SIGNIFICANT CONTRACTS OF THE ORGANIZATION. Form 990, Part VI, Section C, line 18 THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. CONTACT INFORMATION IS PROVIDED ON THE ORGANIZATION'S WEBSITE. THE FORM 990 IS ALSO AVAILABLE TO VIEW AT WWW2.GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CONTACT INFORMATION IS PROVIDED ON THE ORGANIZATION'S WEBSITE. IN ADDITION THE ARTICLES OF NONPROFIT INCORPORATION AND ANNUAL REPORTS ARE AVAILABLE FROM THE MICHIGAN DEPARTMENT OF ENERGY, LABOR AND ECONOMIC GROWTH AT WWW.DLEG.STATE.MI.US/BCS CORP.