Sanford Heart of America Health Plan: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- Sanford Heart of America Health Plan (EIN 45-0346132)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-09
- IRS object ID
- 201103139349302500
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-09T13:50:21-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1 |
| City | FARGO | City |
| State | ND | State |
| ZIP Code | 581082545 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450346132 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEART OF AMERICA HEALTH PLAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HEAR | NameControl |
| Phone | 7017765848 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 SOUTH MAIN | AddressLine1 |
| City | RUGBY | City |
| State | ND | State |
| ZIP Code | 58368 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Mary Ann Jaeger | Name |
| Title | Executive Director | Title |
| Phone | 7017765848 | Phone |
| Date Signed | 2011-11-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA CHAFFEE CPA | Name |
| Phone | 7012398500 | Phone |
| Date Prepared | 2011-11-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Mary Ann Jaeger | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 SOUTH MAIN | AddressLine1 |
| City | RUGBY | City |
| State | ND | State |
| ZIP Code | 58368 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4784065 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.HOAHP.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1978 | YearFormation |
| State Legal Domicile | ND | StateLegalDomicile |
| Activity Or Mission Description | To coordinate effective and efficient delivery of high-quality health care in a cost effective manner. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 9 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4845406 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4717701 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 61908 | InvestmentIncomePriorYear |
| Investment Income Current Year | 66364 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4907314 | TotalRevenuePriorYear |
| Total Revenue Current Year | 4784065 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 246685 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 237881 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4705679 | OtherExpensePriorYear |
| Other Expenses Current Year | 4712819 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4952364 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4950700 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -45050 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -166635 | RevenuesLessExpensesCY |
| Total Assets BOY | 2073969 | TotalAssetsBOY |
| Total Assets EOY | 2123735 | TotalAssetsEOY |
| Total Liabilities BOY | 572905 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 782360 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1501064 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1341375 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The Heart of America Health Plan is a rural, member-owned managed health care system. Our mission is to coordinate effective and efficient delivery of high-quality health care in a cost effective manner. Member service is our priority. We are committed to the development of personal responsibility for a healthy lifestyle.We believe that member education and active participation will lead to pride and satisfaction in our health plan. Our vision is to be a national model for rural managed care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4825787 | Expense |
| Revenue | 4717701 | Revenue |
| Description | Heart Of America Health Plan was incorporated for the purpose of providing comprehensive health care services on a prepaid basis and for the purpose of establishing and operating organized health maintenance and health care delivery systems.Heart Of America Health Plan (HAHP) served 449 Medicare members during 2010 and 881 commercial members. During 2010, the following community services were provided:A "fun walk" was open to anyone willing to walk a 3-mile course. T-shirts were given away to all walkers. Approximately 255 walkers joined the walk in 2010 to promote health and exercise. Total expenses -- $1,843.The Pierce County Fair was held for the second year in a row in Rugby after an eleven year absence. The fair provides free shows, contests, talent show, farm animals and exhibits and is open to the public. Total expenses -- $400.A "Turkey Trot" was also open to anyone willing to do a 5K walk/run to promote a healthy lifestyle. Total expenses -- $300.Pierce County's annual relay for life was held which is an all-night walk in support of cancer victims and survivors. The event is open to the public and participants of all ages. Total expenses -- $300.Other miscellaneous items involved support of youth events including a bike marathon, Easter egg hunt, 4-H activities and other youth activities. Total expenses -- $450. | Description |
| Total Program Service Expense | 4825787 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 9 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Ann Jaeger | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7017765848 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 South Main | AddressLine1 |
| City | Rugby | City |
| State | ND | State |
| ZIP Code | 58368 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Rob St Michel | ||||||
| President | 0.50 | X | X | 0 | 0 | 0 |
| Rob Hovland | ||||||
| Vice President | 0.50 | X | X | 0 | 0 | 0 |
| Dave Kraft Jan-April | ||||||
| Vice President | 0.50 | X | X | 0 | 0 | 0 |
| Denise Myhre | ||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 |
| Cynthia Tastad | ||||||
| Director | 0.50 | X | 0 | 0 | 0 | |
| Wayne Judkins | ||||||
| Director | 0.50 | X | 0 | 0 | 0 | |
| Rod Wurgler | ||||||
| Director | 0.50 | X | 0 | 0 | 0 | |
| Philip Backstrom | ||||||
| Director | 0.50 | X | 0 | 0 | 0 | |
| Dr Teri Hurly | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Tim McKay | ||||||
| Director | 0.50 | X | 0 | 0 | 0 | |
| Mary Ann Jaeger | ||||||
| Executive Director | 40.00 | X | 64440 | 0 | 11537 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 64440 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 11537 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Premiums | 524114 | 3050350 | 3050350 |
| Medicare Reimbursement | 524114 | 1389867 | 1389867 |
| Reinsurance Recoveries | 524114 | 277484 | 277484 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4717701 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 66364 | TotalRevenueColumn |
| Exclusion | $66,364 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4784065 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4717701 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $66,364 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75977 | Total |
| Management And General | 75977 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108637 | Total |
| Program Services | 108637 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39476 | Total |
| Program Services | 39476 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13791 | Total |
| Program Services | 8115 | ProgramServices |
| Management And General | 5676 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1570 | Total |
| Management And General | 1570 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13050 | Total |
| Management And General | 13050 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25135 | Total |
| Program Services | 25135 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14678 | Total |
| Management And General | 14678 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32914 | Total |
| Program Services | 20907 | ProgramServices |
| Management And General | 12007 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4321 | Total |
| Program Services | 4321 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26577 | Total |
| Program Services | 26577 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1466 | Total |
| Management And General | 1466 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2618 | Total |
| Program Services | 2129 | ProgramServices |
| Management And General | 489 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3667 | Total |
| Program Services | 3667 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23615 | Total |
| Program Services | 23615 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Claims | 3476840 | 3476840 |
| Capitation Services | 1017923 | 1017923 |
| Premium Tax | 64757 | 64757 |
| Community Services | 3293 | 3293 |
| Quality Assurance | 344 | 344 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51 | Total |
| Program Services | 51 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4950700 | Total |
| Program Services | 4825787 | ProgramServices |
| Management And General | 124913 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 430976 | BOY |
| EOY | 590314 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118020 | BOY |
| EOY | 73356 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 17948 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 17406 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 429 | BOY |
| EOY | 542 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1475408 | BOY |
| EOY | 1323967 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49136 | BOY |
| EOY | 135556 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2073969 | BOY |
| EOY | 2123735 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 266491 | BOY |
| EOY | 437136 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2066 | BOY |
| EOY | 5665 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 304348 | BOY |
| EOY | 339559 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 572905 | BOY |
| EOY | 782360 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1501064 | BOY |
| EOY | 1341375 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1501064 | BOY |
| EOY | 1341375 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2073969 | BOY |
| EOY | 2123735 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -166635 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 6946 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17948 | OtherCostOrOtherBasis |
| Depreciation | 17406 | Depreciation |
| Book Value | 542 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 542 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Estimated Third Party Settlement | 124300 |
| Accrued Interest Receivable | 11256 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 135556 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Estimated Incomplete and Unreported Claims | $310,295 |
| Unpaid Claims Adjustment | $29,264 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 339559 | TotalOfAmounts |
| Total Revenue | 4784065 | TotalRevenue |
| Total Expenses | 4950700 | TotalExpenses |
| Excess Or Deficit For Year | -166635 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 11975 | NetUnrealizedGLOnInvestments |
| Other | -$5,029 | OtherAmount |
| Total Adjustments | 6946 | TotalAdjustments |
| Excess Or Deficit Per FS | -159689 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 3116235 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -479 | OtherRevenues |
| Revenue Not Rptd F990 | -479 | RevenueNotRptdF990 |
| Revenue Subtotal | 3116714 | RevenueSubtotal |
| Other Revenues Not Included | 1667351 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1667351 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 4784065 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 3282870 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -1667351 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -1667351 | ExpensesNotRptdF990 |
| Expenses Subtotal | 4950221 | ExpensesSubtotal |
| Other Expenses Not Included | 479 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 479 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 4950700 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | Change in Nonadmitted Assets -5,029. |
| Part XII, Line 2d - Other Adjustments: | Bond Amortization of Premium -479. |
| Part XII, Line 4b - Other Adjustments: | Medicare Reimbursement 1,389,867. Reinsurance Recoveries Incurred 277,484. |
| Part XIII, Line 2d - Other Adjustments: | Medicare Reimbursement -1,389,867. Reinsurance Recoveries Incurred -277,484. |
| Part XIII, Line 4b - Other Adjustments: | Bond Amortization of Premium 479. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 1 | The total number of voting members including the board president is 9; however the board president only votes if there is a tie. There is an executive committee made up of the president, vice president, and secretary. All members of the executive committee are on the full board. Executive committee members have the authority to act on matters requiring immediate attention in the interim between board meetings. | |
| Form 990, Part VI, Section A, line 2 | Rob Hovland and Rob St. Michel - Business relationship Dave Kraft and Tim McKay - Business relationship | |
| Form 990, Part VI, Section B, line 11 | The Executive Director will review the draft. The board was mailed a copy of the Form 990 prior to it being filed. | |
| Board Members, the Executive Directors, and Assistant Medical Director sign disclosures annually. The Executive Director reviews the disclosures to determine if there is a conflict. Anyone with a conflict refrains from voting on the issue. | Form 990, Part VI, Section B, line 12c | |
| Comparison with the North Dakota Job Service salary survey, North Central Region, was done for all positions during mid-year 2008, with revisions made to all positions based on the findings at that time. Compensation is also reviewed by the Executive Committee in October/November when working with the annual budget. Any cost of living increases proposed by the committee are then approved by HAHP's Board of Directors. There are not other officer or key employees at HAHP. | Form 990, Part VI, Section B, line 15a | |
| Financial statements are provided at the annual meeting. Governing documents and the conflict of interest policy are available upon request. | Form 990, Part VI, Section C, line 19 | |
| Changes in Net Assets or Fund Balances: | Net unrealized gains on investments: 11,975. Change in Nonadmitted Assets -5,029. Total to Form 990, Part XI, Line 5: 6,946. | Form 990, Part XI, line 5: |
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