2024-05-06T14:01:53-05:00 2023-12-31 910189318 MOSS ADAMS LLP 6565 AMERICAS PARKWAY NE STE 600 ALBUQUERQUE NM 87110 990 2023-01-01 270093845 OSMA HEALTH - HEALTH PLAN OSMA 4058439571 313 NE 50TH OKLAHOMA CITY OK 73105 JACK J BELLER MD PRESIDENT 4058439571 2024-05-03 1 JACK BELLER MD 999009999 1 PAMELA ALEXANDERSON P01218925 5058787200 2024-05-03 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z JACK J BELLER MD 313 NE 50TH OKLAHOMA CITY OK 73105 18612542 0 X N/A X 2004 OK THE CORPORATION'S SPECIFIC PURPOSES ARE TO (1) ACT AS A SPONSOR OF A HEALTH BENEFIT PROGRAM AND ANY OTHER WELFARE BENEFIT PROGRAMS AS DIRECTED BY THE OSMA HOUSE OF DELEGATES AND/OR BOARD OF TRUSTEES; AND (2) ESTABLISH A TRUST(S) THROUGH WHICH THE HEALTH AND WELFARE BENEFIT PLANS WILL BE OFFERED. 13 11 0 11 359308 0 0 0 14235997 18253234 315432 359308 0 0 14551429 18612542 0 0 11268808 17301465 82358 80451 0 0 0 3203015 4507213 14554181 21889129 -2752 -3276587 11959151 10424113 2134033 4410084 9825118 6014029 X THE CORPORATION'S SPECIFIC PURPOSES ARE TO (1) ACT AS A SPONSOR OF A HEALTH BENEFIT PROGRAM AND ANY OTHER WELFARE BENEFIT PROGRAMS AS DIRECTED BY THE OSMA HOUSE OF DELEGATES AND/OR BOARD OF TRUSTEES; AND (2) ESTABLISH A TRUST(S) THROUGH WHICH THE HEALTH AND WELFARE BENEFIT PLANS WILL BE OFFERED. 0 0 THE CORPORATION'S SPECIFIC PURPOSES ARE TO (1) ACT AS A SPONSOR OF A HEALTH BENEFIT PROGRAM AND ANY OTHER WELFARE BENEFIT PROGRAMS AS DIRECTED BY THE OSMA HOUSE OF DELEGATES AND/OR BOARD OF TRUSTEES; AND (2) ESTABLISH A TRUST(S) THROUGH WHICH THE HEALTH AND WELFARE BENEFIT PLANS WILL BE OFFERED. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 59 0 1 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 0 0 0 OK X RICK FRANKLIN 4052905744 13439 BROADWAY EXT SUITE 110 OKLAHOMA CITY OK 73114 JACK BELLER PRESIDENT 15.00 X X 24160 0 0 JOHN ROBINSON TREASURER 2.00 X X 6152 0 0 AUDRA HARDIN-LINCK DIRECTOR 2.00 X 3988 0 0 DIANE HEATON DIRECTOR 2.00 X 5083 0 0 DALE NEIKIRK DIRECTOR 2.00 X 13003 0 0 WILLIAM OEHLERT DIRECTOR 2.00 X 5874 0 0 LEE SCHOEFFLER DIRECTOR 2.00 X 4920 0 0 BASEL HASSOUN DIRECTOR 2.00 X 2900 0 0 DANA STONE DIRECTOR 2.00 X 4725 0 0 DARYLE VOSS DIRECTOR 2.00 X 6250 0 0 DAVID SEIGLER DIRECTOR 2.00 X 725 0 0 GREG RATLIFF DIRECTOR 2.00 X 2671 0 0 MICHAEL HAUGH VICE PRESIDENT (THROUGH FEB 2023) 2.00 X X 0 0 0 WES GLINSMANN DIRECTOR 2.00 X 0 0 0 DAVID HOLDEN DIRECTOR (THROUGH APRIL 2023) 2.00 X 0 0 0 80451 0 0 0 0 0 0 ASSURED BENEFITS ADMINISTRATORS 12221 MERIT DRIVE STE 1800 DALLAS TX 75251 BENEFIT ADMINISTRATION 1406715 UNITED HEALTHCARE SHARED SERVICES PO BOX 30783 SALT LAKE CITY UT 84130 HOSPITAL CLAIMS PRICING 408023 VERUS RX LLC 5800 GRANITE PARKWAY STE 450 PLANO TX 75024 PHARMACY BENEFITS MANAGER 324751 FRATES IRWIN RISK MANAGEMENT SOLUTIONS 103 DEAN A MCGEE AVE 700 OKLAHOMA CITY OK 73102 BENEFIT ADMINISTRATION 107660 4 PLAN CONTRIBUTIONS 900099 18253234 18253234 18253234 359308 359308 18612542 18253234 359308 0 17301465 80451 1406715 7300 39635 18740 121835 12605 6186 438718 16940 654303 ADMINISTRATIVE FEES 1611678 TRANSITIONAL REINSURANC 87574 INCOME TAX EXPENSE - UB 84984 21889129 375748 6373370 4695903 175819 285824 4992117 5401636 42097 40750 11959151 10424113 351039 1113673 103179 214012 1679815 3082399 2134033 4410084 X 0 0 0 0 9825118 6014029 9825118 6014029 11959151 10424113 X -3276587 316008 -850510 X 0 1 X 1 0 0 19906 BENEFITS CLAIMS LIABILITIES 2489032 OUTSTANDING CHECKS IN EXCESS OF CASH BALANCE 573461 3082399 X 18928550 316008 316008 18612542 0 18612542 21889129 0 21889129 0 21889129 PART X, LINE 2: THE PLAN IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C) (9) OF THE INTERNAL REVENUE CODE (IRC) AND IS, THEREFORE, NOT SUBJECT TO FEDERAL INCOME TAXES UNDER PRESENT INCOME TAX LAWS. THE PLAN HAS BEEN APPROVED BY THE INTERNAL REVENUE SERVICE (IRS) FOR TAX-EXEMPT STATUS. HOWEVER, PER CODE SECTION 512(A)(3)(E)(I), TO THE EXTENT THAT A SET-ASIDE FOR ANY GIVEN YEAR CAUSES THE PLAN ASSETS AT YEAR END, TO EXCEED THE ACCOUNT LIMIT AS DESCRIBED BY CODE SECTION 419A, THE EXCESS AMOUNT IS CONSIDERED TO BE UNRELATED BUSINESS TAXABLE INCOME (TO THE EXTENT OF INVESTMENT INCOME). THE PLAN INCURRED INCOME TAX EXPENSE OF $84,984 AND $73,347 DURING THE YEARS ENDED DECEMBER 31, 2023 AND 2022, RESPECTIVELY. IN ACCORDANCE WITH GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, MANAGEMENT EVALUATED THE PLAN'S TAX POSITIONS AND DOES NOT BELIEVE THE PLAN HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION B, LINE 11B THE PRESIDENT OF THE ORGANIZATION PERFORMS A DETAILED REVIEW OF THE FORM 990 BEFORE IT IS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO FORMALLY ACKNOWLEDGE THEIR COMPLIANCE WITH THE CONFLICT-OF-INTEREST POLICY ON AN ANNUAL BASIS. IF A CONFLICT ARISES, THE BOARD MEMBER CANNOT TAKE PART IN THE DISCUSSION OR VOTE ON THE ISSUE. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: ESTIMATED LIABILITY FOR CLAIMS INCURRED BUT NOT PAID -850,510. OKLAHOMA STATE MEDICAL ASSOCIATION 313 NE 50TH STREET OKLAHOMA CITY OK 73105 730384245 TRADE ASSOCIATION OK 501(C)(6) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0