2011-08-10T14:13:54-05:00 2010-09-30 Maner Costerisan PC 2425 E Grand River Suite 1 Lansing MI 489123291 990 2009-10-01 383625439 GENESEE HEALTH PLAN GENE 8102327740 G-3169 BEECHER ROAD No 204 FLINT MI 485323644 Linda Hamacher 8102327740 2011-07-21 1 David M Raeck CPA 5173237500 2009 2016-02-24 21:20:13Z LINDA HAMACHER G-3169 BEECHER ROAD No 204 FLINT MI 485323644 26495809 0 X WWW.COUNTYHEALTHPLANS.ORG/ghp.aspx X 2001 MI TO PROVIDE HEALTH CARE COVERAGE FOR LOW-INCOME, UNINSURED RESIDENTS OF GENESEE COUNTY. 11 11 22 11 0 0 560470 673786 25249048 25797823 113076 24200 0 25922594 26495809 110312 101091 0 725270 782246 0 0 24486734 26706623 25322316 27589960 600278 -1094151 4784588 3171980 1940444 1421987 2844144 1749993 TO PROVIDE HEALTH CARE COVERAGE FOR LOW-INCOME, UNINSURED RESIDENTS OF GENESEE COUNTY WHO ARE NOT ELIGIBLE FOR MAINSTREAM MEDICAL ASSISTANCE PROGRAMS. 0 0 19498512 101091 18874807 SERVES LOW-INCOME, UNINSURED GENESEE COUNTY RESIDENTS WHO ARE NOT ELIGIBLE FOR OTHER PUBLICLY FUNDED INSURANCE PROGRAMS SUCH AS MEDICAID AND MEDICARE, AND WHO HAVE INCOMES UP TO 175% OF THE FEDERAL POVERTY LEVEL. THE PROGRAM COVERS PRIMARY CARE SERVICES AND OTHER MEDICALLY NECESSARY SERVICES INCLUDING SPECIALTY CARE, DIAGNOSTIC SERVICES AND PRESCRIPTION DRUGS. AS OF 9/30/10, THE PLAN HAD 20,202 MEMBERS ENROLLED. 6655102 6923016 PROVIDES HEALTH CARE COVERAGE FOR STATE OF MICHIGAN ADULT BENEFIT WAIVER PROGRAM PARTICIPANTS FOR UNINSURED ADULTS. THE PROGRAM COVERS BASIC OUTPATIENT HEALTH CARE SERVICES INCLUDING PHYSICIAN, DIAGNOSTIC, PRESCRIPTION DRUGS, EMERGENCY ROOM AND AMBULANCE SERVICES. AS OF 9/30/10, THE PLAN HAD 3,001 MEMBERS ENROLLED. 26153614 1 1 0 0 0 0 0 0 0 1 1 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 17 0 22 1 0 0 0 0 0 0 0 0 0 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MI X X JIM MILANOWSKI 8102327740 G-3169 BEECHER RD STE 204 FLINT MI 48532 JEAN CONYERS 0.30 X 0 0 0 MICHAEL JAGGI 0.30 X 0 0 0 YVONNE LEWIS 0.30 X 0 0 0 DANIEL DULIN 0.30 X 0 0 0 NANCY HAYWOOD 0.30 X 0 0 0 BARBARA L KORNBLAU 0.30 X 0 0 0 TRISSA TORRES 0.30 X 0 0 0 RICK WYLES 0.50 X X 0 0 0 LINDA HAMACHER 0.50 X X 0 0 0 JOSEPH LEONARD 0.80 X X 0 0 0 KEVIN MURPHY 0.50 X X 0 0 0 JAMES MILANOWSKI 40.00 X 80580 0 18942 80580 0 18942 0 0 0 0 HEALTHPLUS OPTIONS INC PO BOX 1700 FLINT MI 48501 3RD PARTY ADMIN. 1964303 UNIVERSITY OF MICHIGAN - FLINT 303 E KEARSLEY ST FLINT MI 48502 HEALTH SERVICES 655236 HEALTH MANAGEMENT ASSOCIATES ONE MICHIGAN AVE BLDG 120 N WASHING LANSING MI 48933 SYSTEMS/DATA MGMT 310963 AUBURN COUNSELING ASSOCIATES 3600 S DORT HWY STE 44 FLINT MI 48507 HEALTH SERVICES 229675 FAMILY CARE PLUS PHYSICAL THERAPY G2037 CENTER RD STE A BURTON MI 48519 HEALTH SERVICES 153583 10 621504 52282 673786 HEALTH SERVICES 621300 20445761 20445761 FEES FROM GOV'T AGENCY 900099 5352062 5352062 25797823 24200 24200 26495809 25797823 0 24200 101091 101091 100731 100731 516411 516411 165104 165104 21565 21565 25535 25535 440 440 11553 11553 DIRECT PROVIDER PAYMENT 12662838 12662838 HEALTH SERVICES 11425003 11425003 HEALTHPLUS ADMIN SERVIC 1964303 1964303 SUPPORT SERVICES 563392 563392 MISCELLANEOUS EXPENSE 31994 379 31615 27589960 26153614 1436346 0 3937408 2687143 288675 113759 25483 20409 8178 7337 1281 841 531741 349828 4784588 3171980 320444 243487 1620000 1178500 1940444 1421987 X 2844144 1749993 2844144 1749993 4784588 3171980 X 1 1 1 X 0 X 22123349 468030 560470 673786 23825635 21325666 18925907 19661588 20445761 80358922 3694998 5329961 5587460 5352062 19964481 22123349 25488694 24255868 25809518 26471609 124149038 0 0 0 124149038 274321 226059 171491 113076 24200 809147 274321 226059 171491 113076 24200 809147 22397670 25714753 24427359 25922594 26495809 124958185 0.99350 0.99250 0.00650 0.00750 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8178 7337 841 841 DEPOSITS 349828 349828 CLAIMS INCURRED BUT NOT REPORTED 1178500 1178500 26495809 27589960 -1094151 0 -1094151 26495809 0 26495809 0 26495809 27589960 0 27589960 0 27589960 Part X: Description of Uncertain Tax Positions Under FIN 48: IN JULY 2006, THE FASB ISSUED A NEW STANDARD RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, NOW CODIFIED AS ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740. ASC TOPIC 740 SEEKS TO REDUCE THE SIGNIFICANT DIVERSITY IN PRACTICE ASSOCIATED WITH FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT IN ACCOUNTING FOR INCOME TAXES AND PRESCRIBES THE RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR DISCLOSURES OF TAX POSITIONS PREVIOUSLY TAKEN OR EXPECTED TO BE TAKEN ON AN INCOME TAX RETURN. NOT-FOR-PROFIT ENTITIES ARE ALSO WITHIN THE SCOPE OF ASC TOPIC 740. AN ORGANIZATION MUST CONSIDER WHETHER IT HAS ENGAGED IN ACTIVITIES THAT JEOPARDIZE THEIR CURRENT TAX-EXEMPT STATUS WITH THE INTERNAL REVENUE SERVICE. FURTHERMORE, THE ORGANIZATION MUST DETERMINE WHETHER THEY HAVE ANY UNRELATED BUSINESS INCOME, WHICH MAY BE SUBJECT TO US FEDERAL INCOME TAX. THE ORGANIZATION ADOPTED THE PROVISIONS OF ASC TOPIC 740 EFFECTIVE JULY 1, 2009, AND, ACCORDINGLY, ANALYZED ITS FILING POSITIONS IN THE FEDERAL AND STATE JURISDICTIONS WHERE IT IS REQUIRED TO FILE INCOME TAX RETURNS, AS WELL AS ALL OPEN TAX YEARS IN THESE JURISDICTIONS. THE ORGANIZATION HAS ALSO ELECTED TO RETAIN ITS EXISTING ACCOUNTING POLICY WITH RESPECT TO THE TREATMENT OF INTEREST AND PENALTIES ATTRIBUTABLE TO INCOME TAXES, AND CONTINUES TO REFLECT ANY CHANGES FOR SUCH, TO THE EXTENT THEY ARISE, AS A COMPONENT OF ITS SUPPORTING SERVICE EXPENSE. THE ADOPTION OF ASC TOPIC 740 HAD NO SIGNIFICANT IMPACT ON THE PLAN'S FINANCIAL STATEMENTS. THE ORGANIZATION HAS EVALUATED THE PROVISIONS OF ASC TOPIC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE EVALUATION WAS PERFORMED FOR THE YEARS 2006 THROUGH 2010, THE YEARS WHICH REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTION AS OF SEPTEMBER 30, 2010. THE ORGANIZATION CONCLUDED THAT THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS REQUIRING RECOGNITION IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS ("UTB") (E.G., TAX DEDUCTIONS, EXCLUSIONS, OR CREDITS CLAIMED OR EXPECTED TO BE CLAIMED) TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION DOES NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST PENALTIES RELATED TO UTBS AT SEPTEMBER 30, 2010, AND IT IS NOT AWARE OF ANY CLAIMS FOR SUCH AMOUNTS BY FEDERAL OR STATE INCOME TAX AUTHORITIES. 0 GENESEE COUNTY FREE CLINIC G2437 WELCH BLVD FLINT MI 48504 382995700 501(C)(3) 54995 TO PROVIDE HEALTH CARE BENEFITS TO LOW INCOME PERSONS IN GENESEE COUNTY. GENESEE COUNTY LEGAL AID SOCIETY DBA CENTER FOR CIVIL JUSTICE 320 S WASHINGTON 2ND FLOOR SAGINAW MI 48607 381859780 501(C)(3) 45000 TO PROVIDE LEGAL SERVICES FOR THOSE UNABLE TO AFFORD LEGAL ASSISTANCE. 2 0 Form 990, Part VI, Section B, line 11 Annually, the Genesee Health Plan Operations and Executive Committee will review the tax form 990, prepared by the contracted certified public accountant. Upon their approval, the 990 will be distributed to the Board of Directors with a report from the Operations and Executive Committee. After any concerns presented by the board are addressed, the Executive Director signs and files the return. Form 990, Part VI, Section B, line 12c Each Interested Person is required to disclose on the Organization's Annual Conflict of Interest Disclosure Statement the existence and nature of his or her financial interest, and must be given the opportunity to disclose all material facts to the board and members of committees with board delegated powers considering the proposed transaction or arrangement. Form 990, Part VI, Section B, line 15a Independent persons review comparison data from similar organization's of persons holding similar positions. Form 990, Part VI, Section C, line 19 ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990 IS ALSO POSTED ANNUALLY ON GUIDESTAR'S WEBSITE. FORM 990, PART XI, LINE 2C OVERSIGHT OF AUDIT GENESEE HEALTH PLAN HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.