DRISCOLL CHILDRENS HEALTH PLAN: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
DRISCOLL CHILDRENS HEALTH PLAN (EIN 74-2838488)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-01
IRS object ID
201103059349300625
Schema version
2010v3.4
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)
Timestamp2011-11-01T11:51:43-04:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

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 Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742838488EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Driscoll Childrens Health PlanBusinessNameLine1
FieldValueIRS element (for citing)
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 Signed2011-11-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameM Paige GerichName
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

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 1635AddressLine1
CityCORPUS CHRISTICity
StateTXState
ZIP Code784010746ZIPCode
FieldValueIRS element (for citing)
Gross Receipts166665096GrossReceipts
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 Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees43TotalNbrEmployees
Total Nbr Volunteers1TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year357701ContributionsGrantsPriorYear
Contributions Grants Current Year423224ContributionsGrantsCurrentYear
Program Service Revenue Prior Year134848007ProgramServiceRevenuePriorYear
Program Service Revenue CY152114133ProgramServiceRevenueCY
Investment Income Prior Year341242InvestmentIncomePriorYear
Investment Income Current Year388164InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year135546950TotalRevenuePriorYear
Total Revenue Current Year152925521TotalRevenueCurrentYear
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 Year1798502SalariesEtcPriorYear
Salaries Etc Current Year3218625SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year134023675OtherExpensePriorYear
Other Expenses Current Year139470472OtherExpensesCurrentYear
Total Expenses Prior Year135822177TotalExpensesPriorYear
Total Expenses Current Year142689097TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-275227RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10236424RevenuesLessExpensesCY
Total Assets BOY31042123TotalAssetsBOY
Total Assets EOY45253813TotalAssetsEOY
Total Liabilities BOY16185334TotalLiabilitiesBOY
Total Liabilities EOY19923766TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14856789NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY25330047NetAssetsOrFundBalancesEOY
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
Expense130946478Expense
Revenue152114133Revenue
DescriptionSEE SCHEDULE O FOR FULL PROGRAM SERVICE DESCRIPTION.Description
Total Program Service Expense130946478TotalProgramServiceExpense
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 Employees43NumberOfEmployees
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 Members7NbrVotingGoverningBodyMembers
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 (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
WILLIAM J STERETT
CHAIRMAN OF THE BOARD1.0XX000
D ERIC HAMON
SECRETARY/TREASURER1.0XX022661410285
C IVAN WILSON
DIRECTOR1.0X0100000
JOE FULTON
DIRECTOR1.0X0100000
MARY D PETERSON
PRESIDENT/CEO40.0XX32954608665
STEVE WOERNER
DIRECTOR1.0X055587218507
S LOYD NEAL JR
DIRECTOR1.0X0100000
RICARDO VILLARREAL
VICE PRESIDENT OF FINANCE40.016249906398X
MIGUEL PEREZ III
CHIEF INFORMATION OFFICER40.0126891010740X
JUDITH KRAFT
EXECUTIVE DIRECTOR QUALITY IMP40.011268006132X
FieldValueIRS element (for citing)
Total Reportable Comp From Org731616TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs812486TotalReportableCompFrmRltdOrgs
Total Other Compensation60727TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
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 ADMIN6510502
EVERGREEN RE
940 GOLF HOUSE RD W STE 300WHITSETTNC27377REINSURANCE BROKER1376287
CORPORATE PRINTING INC
3509 OAK FOREST DRHOUSTONTX77018PRINTING423539
HTMS AN EMDEON COMPANY
3055 LABANON PIKENASHVILLETN37214CONSULTING284963
ALLIED MANAGEMENT GROUP INC
825 N PARKCENTER DR STE 102SANTA ANACA92705SIU SERVICES273966
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Government Grants423224GovernmentGrants
Total Contributions423224TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Premium Revenue524292151789879151789879
Net Reinsurance524292-434418-434418
Other Income900099758672758672
FieldValueIRS element (for citing)
Total Program Service Revenue152114133TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column362081TotalRevenueColumn
Exclusion$362,081ExclusionAmount

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)
Securities13765658Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities13739575Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities26083Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column26083TotalRevenueColumn
Exclusion$26,083ExclusionAmount

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 Column152925521TotalRevenueColumn
Related Or Exempt Function Income152114133RelatedOrExemptFunctionIncome
Exclusion$388,164ExclusionAmount

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)
Total338211Total
Management And General338211ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2380700Total
Program Services1138303ProgramServices
Management And General1242397ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total105649Total
Program Services44373ProgramServices
Management And General61276ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total221176Total
Program Services96533ProgramServices
Management And General124643ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total172889Total
Program Services72613ProgramServices
Management And General100276ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total6306069Total
Program Services809369ProgramServices
Management And General5496700ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total74215Total
Management And General74215ManagementAndGeneral

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)
Total2038880Total
Management And General2038880ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total73311Total
Management And General73311ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total738948Total
Management And General738948ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total52501Total
Management And General52501ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total133992Total
Management And General133992ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total70980Total
Management And General70980ManagementAndGeneral

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)
Total99150Total
Management And General99150ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total74966Total
Management And General74966ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Expenses126307413126307413
Premium Taxes26933412477874215467
Member Value Add Expense308686308686
ALLOCATED COSTS112485112485
Special Fees137531137531

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total246004Total
Management And General246004ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total142689097Total
Program Services130946478ProgramServices
Management And General11742619ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12450540BOY
EOY16098120EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY6768108EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2291796BOY
EOY2930723EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2560515LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2384650LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY251294BOY
EOY175865EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY14342858BOY
EOY19280997EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1705635BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY31042123BOY
EOY45253813EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15556907BOY
EOY17836492EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY628427BOY
EOY2087274EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY16185334BOY
EOY19923766EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY14856789BOY
EOY25330047EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14856789BOY
EOY25330047EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31042123BOY
EOY45253813EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10236424ReconcilationRevenueExpenses
Reconcilation Other Changes236834ReconcilationOtherChanges
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 Minus2 Years103906CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year357701CurrentTaxYearMinus1Year
Current Tax Year423224CurrentTaxYear
Total884831Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years103906CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year357701CurrentTaxYearMinus1Year
Current Tax Year423224CurrentTaxYear
Total884831Total
FieldValueIRS element (for citing)
Public Support Total170884831PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years336324CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year254370CurrentTaxYearMinus1Year
Current Tax Year362081CurrentTaxYear
Total952775Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years56299110CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year134848007CurrentTaxYearMinus1Year
Current Tax Year152114133CurrentTaxYear
Total343261250Total
FieldValueIRS element (for citing)
Total Support345098856TotalSupport
Gross Receipts From Admissions Etc340870820GrossReceiptsFromAdmissionsEtc
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$73,127GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB73127TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

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

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2560515OtherCostOrOtherBasis
Depreciation2384650Depreciation
Book Value175865BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings175865TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionVANGUARD - MUTUAL FUNDSDescription
Book Value19280997BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities19280997TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Rebate Liability$1,786,527
Due to CPSST$19,451
Due to DM&FPG$19,475
Due to Affiliates$261,821
FieldValueIRS element (for citing)
Total Of Amounts2087274TotalOfAmounts
Total Revenue152925521TotalRevenue
Total Expenses142689097TotalExpenses
Excess Or Deficit For Year10236424ExcessOrDeficitForYear
Excess Or Deficit Per FS10236424ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt150882153TotRevenueEtcAuditedFinclStmt
Revenue Subtotal150882153RevenueSubtotal
Other Revenues Not Included2043368OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2043368RevenueNotRptdOnFinStmt
Total Revenue Per Form990152925521TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt140645729TotExpensesEtcAuditedFinclStmt
Expenses Subtotal140645729ExpensesSubtotal
Other Expenses Not Included2043368OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2043368ExpensesNotRptdOnFinStmt
Total Expenses Per Form990142689097TotalExpensesPerForm990

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 $2,043,368 EXPENSE ON RETURN, NOT ON BOOKS: AUDIT EXPENSES NETTED WITH INCOME ON 990 $2,043,368
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 (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 OrgsTotalCompensationRelatedOrgs
D ERIC HAMON
0122874080263023477000102850236899
MARY D PETERSON
251110067600010836000866503382110
STEVE WOERNER
03725390173250010083000185070574379
RICARDO VILLARREAL
12577703182604896000639801688970

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 AMOUNT D. ERIC HAMON $256,759 STEVE WOERNER $233,779Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (18 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) FOR CHIP SERVICE AREA 8; THIS SERVICE AREA INCLUDES 15 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. 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 56,216 AND 50,785 AT DECEMBER 31, 2010 AND 2009, 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 5UNREALIZED GAIN/LOSS $ 236,831 ROUNDING $ 3 ----------- OTHER CHANGES TOTAL $ 236,834
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:D. ERIC HAMON TITLE:SECRETARY/TREASURER HOURS:60
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:C. IVAN WILSON TITLE:DIRECTOR HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOE FULTON TITLE:DIRECTOR HOURS:10
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:10
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 (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Driscoll Children's Hospital
3533 South AlamedaCorpus ChristiTX78411742577746HospitalTX501(C)(3)3na
DCH Holding Company
3533 South AlamedaCorpus ChristiTX78411743011381Holding Co.TX501(C)(2)N/ANA
Driscoll Physician's Group
3533 South AlamedaCorpus ChristiTX78411742988134HospitalTX501(C)(3)3NA
Driscoll Valley Physicians Group
3533 South AlamedaCorpus ChristiTX78411201234322HospitalTX501(C)(3)3NA
Driscoll Maternal & Fetal Physician's Gr
3533 South AlamedaCorpus ChristiTX78411201234461Health CareTX501(C)(3)7NA
Childrens Physician Services of South TX
3533 South AlamedaCorpus ChristiTX78411742620408HospitalTX501(C)(3)3NA
Driscoll Foundation
615 North Upper Broadway ste 1635Corpus ChristiTX78401741170270Char. TrustTX501(C)(3)11aNA
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 OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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