FURP.ORG / PUBLIC DATA EXPLORER

LIONS INSURANCE COMPANY: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LIONS INSURANCE COMPANY (EIN 20-4372643)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-03
IRS object ID
201143079349300429
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)
Timestamp2011-11-03T11:44:25-04:00Timestamp
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 Line1201 N Illinois StreetAddressLine1
CityIndianapolisCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204372643EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LIONS INSURANCE COMPANY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLIONNameControl
Phone3172212309Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13838 NORTH RURAL STREETAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46205ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDANIEL E SELLERSName
TitleTREASURERTitle
Phone3172212309Phone
Date Signed2011-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNICOLE B FISHBACKName
Phone3173834000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonNORMAN ARANDANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13838 NORTH RURAL STREETAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46205ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3544086GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2005YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE INSURANCE COVERING THE PROFESSIONAL (MALPRACTICE) AND GENERAL LIABILITY EXPOSURES OF THE NURSING HOMES OPERATED BY HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY (HHC).ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees1TotalNbrEmployees
Total Nbr Volunteers4TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3183442ProgramServiceRevenuePriorYear
Program Service Revenue CY3491648ProgramServiceRevenueCY
Investment Income Prior Year62914InvestmentIncomePriorYear
Investment Income Current Year52438InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year3246356TotalRevenuePriorYear
Total Revenue Current Year3544086TotalRevenueCurrentYear
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 Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2487109OtherExpensePriorYear
Other Expenses Current Year3098446OtherExpensesCurrentYear
Total Expenses Prior Year2487109TotalExpensesPriorYear
Total Expenses Current Year3098446TotalExpensesCurrentYear
Revenues Less Expenses Prior Year759247RevenuesLessExpensesPriorYear
Revenues Less Expenses CY445640RevenuesLessExpensesCY
Total Assets BOY16104813TotalAssetsBOY
Total Assets EOY14344824TotalAssetsEOY
Total Liabilities BOY12410990TotalLiabilitiesBOY
Total Liabilities EOY10205361TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3693823NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4139463NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE INSURANCE COVERING THE PROFESSIONAL (MALPRACTICE) AND GENERAL LIABILITY EXPOSURES OF THE NURSING HOMES OPERATED BY HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY (HHC); TO PROVIDE TAIL COVERAGE RELATING TO POTENTIAL EXPOSURE FOR PROFESSIONAL AND GENERAL CLAIMS INCURRED PRIOR TO THE INCEPTION OF LIONS INSURANCE COMPANY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2768678Expense
Revenue3491648Revenue
DescriptionLIONS INSURANCE COMPANY IS A WHOLLY OWNED ENTITY OF HEALTH & HOSPITAL CORPORATION OF MARION COUNTY (HHC). HHC IS A MUNICIPAL ENTITY CREATED BY STATE STATUTE, INDIANA CODE SECTION 16-22-8 ET SEQ. LIONS INSURANCE COMPANY IS PURE CAPTIVE INSURER ORGANIZED AS A NONPROFIT CORPORATION THAT PROVIDES INSURANCE AND REINSURANCE COVERAGE FOR HHC'S NURSING HOMES. DURING 2010 LIONS INSURANCE COMPANY CLOSED 14 CLAIMS MADE BY OR ON BEHALF OF HHC NURSING HOME RESIDENTS. LIONS INSURANCE PAID $271,000 IN CLAIMS DURING 2010.Description
Total Program Service Expense2768678TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
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 Employees0NumberOfEmployees
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 Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
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 PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDANIEL SELLERSNamePerson
Telephone Number3172212309TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13838 N RURAL STAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46205ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
NORMAN ARANDA
PRESIDENT20.0XX012436621440
DANIEL E SELLERS
VP, SECRETARY AND TREASURER10.0XX014278812152
JEFF WEBSTER
BOARD MEMBER1.0X000
JAMES MINER MD
BOARD MEMBER1.0X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs267154TotalReportableCompFrmRltdOrgs
Total Other Compensation33592TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
RILEY BENNETT EGLOFF LLP
141 E WASHINGTON ST 4TH FLOORINDIANAPOLISIN46204LEGAL SERVICES528640
BAKER DANIELS LLP
1050 K ST NW STE 400WASHINGTONDC20001LEGAL SERVICES321340
CROWE HORWATH LLP
PO BOX 145415CINCINNATIOH45250OVERSIGHT SERVICES226000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
All Other Contributions0AllOtherContributions
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPREMIUMS COLLECTEDDescription
Business Code524298BusinessCode
Total Revenue Column3491648TotalRevenueColumn
Related Or Exempt Function Income3491648RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3491648TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column52438TotalRevenueColumn
Exclusion$52,438ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 Column3544086TotalRevenueColumn
Related Or Exempt Function Income3491648RelatedOrExemptFunctionIncome
Exclusion$52,438ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total379563Total
Program Services56265ProgramServices
Management And General323298ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30000Total
Program Services30000ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1025Total
Program Services0ProgramServices
Management And General1025ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total445Total
Program Services0ProgramServices
Management And General445ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
CLAIMS EXPENSE2682413268241300
AWARDS5000050000

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3098446Total
Program Services2768678ProgramServices
Management And General329768ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15446070BOY
EOY14067606EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY277218EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY658743BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY16104813BOY
EOY14344824EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY73642BOY
EOY77228EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY4021078BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8316270BOY
EOY10128133EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY12410990BOY
EOY10205361EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3693823BOY
EOY4139463EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3693823BOY
EOY4139463EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16104813BOY
EOY14344824EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses445640ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1HEALTH & HOSPITAL CORPORATION OF MARION COUNTYBusinessNameLine1
FieldValueIRS element (for citing)
EIN356005697EIN
Type Of Organization06TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCLAIMS PAYABLEDescription
Amount$10,128,133Amount
FieldValueIRS element (for citing)
Total Of Amounts10128133TotalOfAmounts
Total Revenue3544086TotalRevenue
Total Expenses3098446TotalExpenses
Excess Or Deficit For Year445640ExcessOrDeficitForYear
Excess Or Deficit Per FS445640ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt3544086TotRevenueEtcAuditedFinclStmt
Revenue Subtotal3544086RevenueSubtotal
Total Revenue Per Form9903544086TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3098446TotExpensesEtcAuditedFinclStmt
Expenses Subtotal3098446ExpensesSubtotal
Total Expenses Per Form9903098446TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 DISCLOSUREIdentifier
Return ReferenceSCHEDULE D, PART XReturnReference
ExplanationMANAGEMENT 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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

FieldValueIRS element (for citing)
Name PersonDANIEL E SELLERSNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs142788CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs12152NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs154940TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierDEFERRED COMPENSATIONIdentifier
Return ReferenceSCH J, PART IIReturnReference
ExplanationDEFERRED COMPENSATION IS INCLUDED IN DANIEL E SELLERS' BASE COMPENSATION OF $142,788.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROCESS TO REVIEW THE FORM 990FORM 990, PART VI, QUESTION 11BA COPY IS SENT TO EACH BOARD MEMBER PRIOR TO FILING AND THEY ARE GIVEN A WEEK TO RESPOND WITH QUESTIONS AND COMMENTS. A DETAIL REVIEW IS DONE BY MARY KITCHEN, THE ASSISTANT TREASURER OF HEALTH & HOSPITAL CORPORATION, PRIOR TO THE REPORT BEING FILED.
PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICYFORM 990, PART VI, QUESTION 12CTHE CONFLICT OF INTEREST STATEMENT IS SIGNED BY THE BOARD MEMBERS ONCE A YEAR AT THE ANNUAL BOARD MEETING. IT IS REVIEWED BY THE CAPTIVE MANAGER FROM THE ORGANIZATION'S LAW FIRM. THERE HAVE BEEN NO CONFLICTS YET. WE WOULD ASK FOR ABSTENTION FOR THE SPECIFIC TOPIC. IF THE CONFLICT WAS LARGE, WE WOULD ASK THE MEMBER TO REMOVE HIMSELF FROM THE BOARD.
PROCESS TO DETERMINE CEO, OFFICE, & KEY EMPLOYEE COMPENSATIONFORM 990, PART VI, QUESTIONS 15A & 15BTHE ABOVE-REFERENCED QUESTIONS ARE ANSWERED NO BECAUSE THE ORGANIZATION DID NOT COMPENSATE ANYONE.
AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FSFORM 990, PART VI, QUESTION 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:NORMAN ARANDA TITLE:PRESIDENT HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DANIEL E. SELLERS TITLE:VP, SECRETARY AND TREASURER HOURS:30

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HEALTH & HOSPITAL CORP OF MARION COUNTYBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13838 N RURAL STAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46205ZIPCode
FieldValueIRS element (for citing)
EIN356005697EIN
Primary ActivitiesHEALTH CAREPrimaryActivities
Legal Domicile StateINLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status6PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
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 OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
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