2024-11-06T19:17:23-06:00 2023-12-31 990 2023-01-01 382018957 TOTAL HEALTH CARE INC TOTA 8669897999 100 COREWELL DR NW ATTN TAX MC6 GRAND RAPIDS MI 49503 NICHOLAS GATES SVP FINANCE 8669897999 2024-11-06 0 2023 2024-10-15 13:58:12Z X PRAVEEN THADANI 1231 E BELTLINE AVE NE GRAND RAPIDS MI 49525 1278025 0 X N/A X 1973 MI TO IMPROVE HEALTH, INSTILL HUMANITY AND INSPIRE HOPE. 6 0 0 0 0 0 0 0 245820 1017582 108892 260443 1062 0 355774 1278025 0 0 -1005411 -917911 0 0 0 0 0 2356193 919940 1350782 2029 -995008 1275996 12374285 13025231 2621957 1788555 9752328 11236676 X TO IMPROVE HEALTH, INSTILL HUMANITY AND INSPIRE HOPE. 0 1 -917911 0 1017582 SEE SCHEDULE OTHE ORGANIZATION WAS FORMED AS A HEALTH MAINTENANCE ORGANIZATION SERVING EXCLUSIVELY A POOR AND INDIGENT POPULATION UNDER THE STATE SPONSORED MEDICAID PROGRAM PROVIDING COMPREHENSIVE MEDICAL SERVICES AND INSURANCE.EFFECTIVE OCTOBER 1, 2021 THE ORGANIZATION'S MEMBERSHIP AND MEDICAID CONTRACT WERE TRANSFERRED TO PRIORITY HEALTH CHOICE, INC. (A RELATED TAX-EXEMPT ORGANIZATION). ALL REMAINING ACTIVITY IS OPERATING ON A RUN-OUT BASIS, WITH NO NEW MEMBERSHIP AGREEMENTS BEING WRITTEN.TOTAL HEALTH CARE, INC. WILL RETAIN ADEQUATE CASH AND INVESTMENTS TO MANAGE THE RUN-OUT OF ITS MEDICAID BUSINESS UNTIL FINAL DISSOLUTION IS APPROVED BY THE MICHIGAN DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES. TOTAL HEALTH CARE, INC. HAS RETAINED ITS HMO LICENSE. -917911 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 6 0 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X CORPORATE TAX 8669897999 100 COREWELL DR NW MC6481 GRAND RAPIDS MI 49503 PRAVEEN THADANI DIRECTOR/PRESIDENT 1.00 50.00 X X 0 2618588 577316 JAMES FORSHEE MD DIRECTOR 1.00 50.00 X 0 759706 149757 KIMBERLY THOMAS DIRECTOR/SECRETARY 1.00 50.00 X X 0 616801 177268 JOYCE CHAN RUSSELL DIRECTOR 1.00 50.00 X 0 671143 106424 MICHAEL JASPERSON DIRECTOR 1.00 50.00 X 0 579463 132583 NICHOLAS GATES DIRECTOR/TREASURER 1.00 50.00 X X 0 523507 127070 JIANHUA YU FORMER KEY EMPLOYEE 0.00 50.00 X 0 1434422 0 MICHAEL KOZIARA FORMER KEY EMPLOYEE 0.00 50.00 X 0 764843 0 NOEL UPFALL FORMER KEY EMPLOYEE 1.00 50.00 X 0 361353 43456 SUSAN RYAN FORMER HIGHEST COMPENSATED 1.00 50.00 X 0 211092 31750 SARA MCGLYNN FORMER HIGHEST COMPENSATED 1.00 50.00 X 0 151576 35992 0 8692494 1381616 0 1 1 0 0 MEDICAID CAPITATION 900099 1017582 1017582 1017582 260443 260443 1278025 1017582 0 260443 X -917911 -917911 919329 919329 -38629 -38629 44000 44000 -4760 -4760 2029 -917911 919940 0 6010453 7920753 1449602 0 846017 1146482 3993503 3952885 74710 5111 12374285 13025231 2620924 275355 1382854 1033 130346 2621957 1788555 X 0 0 0 0 9752328 11236676 9752328 11236676 12374285 13025231 1275996 208352 0 X X 0 1 X 1 0 0 OTHER SECURITIES 3952885 F 3952885 DUE TO AFFILIATES 130346 130346 1278025 0 1278025 0 1278025 2029 0 2029 0 2029 0 1 0 0 0 0 0 0 0 PRAVEEN THADANI DIRECTOR/PRESIDENT 0 1218900 0 1291995 0 107693 0 550170 0 27146 0 3195904 0 322002 JIANHUA YU FORMER KEY EMPLOYEE 0 0 0 0 0 1434422 0 0 0 0 0 1434422 0 1433583 JAMES FORSHEE MD DIRECTOR 0 456864 0 143456 0 159386 0 123008 0 26749 0 909463 0 54177 KIMBERLY THOMAS DIRECTOR/SECRETARY 0 442247 0 128738 0 45816 0 166153 0 11115 0 794069 0 0 JOYCE CHAN RUSSELL DIRECTOR 0 335060 0 322448 0 13635 0 82432 0 23992 0 777567 0 0 MICHAEL KOZIARA FORMER KEY EMPLOYEE 0 0 0 0 0 764843 0 0 0 0 0 764843 0 762150 MICHAEL JASPERSON DIRECTOR 0 411914 0 129256 0 38293 0 104651 0 27932 0 712046 0 0 NICHOLAS GATES DIRECTOR/TREASURER 0 385520 0 113186 0 24801 0 102360 0 24710 0 650577 0 0 NOEL UPFALL FORMER KEY EMPLOYEE 0 276219 0 70410 0 14724 0 14867 0 28589 0 404809 0 0 SUSAN RYAN FORMER HIGHEST COMPENSATED 0 174522 0 34566 0 2004 0 24981 0 6769 0 242842 0 0 SARA MCGLYNN FORMER HIGHEST COMPENSATED 0 134181 0 16841 0 554 0 7390 0 28602 0 187568 0 0 Part I, Line 3 THE FILING ORGANIZATION RELIED UPON A RELATED ORGANIZATION WHO UTILIZED THE FOLLOWING PROCESS IN DETERMINATION OF THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. THE COREWELL HEALTH BOARD OF DIRECTORS (THROUGH ITS COMPENSATION COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIALS, OTHER OFFICERS, AND KEY EMPLOYEES AT COREWELL HEALTH. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON IN SETTING COMPENSATION LEVELS. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE COMPENSATION COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM. THE FOLLOWING SURVEYS, PREPARED BY INDEPENDENT FIRMS, WERE THE PRIMARY SOURCES REFERENCED TO OBTAIN COMPARABLE MARKET DATA FOR THE REVIEW: GALLAGHER: 2022 NATIONAL HEALTHCARE LEADERSHIP COMPENSATION SURVEY MERCER: 2023 IHN HEALTHCARE COMPENSATION SURVEY MERCER: 2023 IHP HEALTH PLAN COMPENSATION SURVEY SULLIVANCOTTER, INC: 2023 HEALTH CARE MANAGEMENT AND EXECUTIVE COMPENSATION SURVEY IN ADDITION, TWO GENERAL INDUSTRY SURVEYS WERE REFERENCED FOR SELECT POSITIONS: MERCER: 2023 US EXECUTIVE REMUNERATION SUITE WILLIS TOWERS WATSON: 2023 EXECUTIVE COMPENSATION SURVEY IN ADDITION TO THE ABOVE DATA SOURCES, THE COMPENSATION COMMITTEE APPROVED THE CREATION OF A CUSTOM PEER GROUP OF HIGH PERFORMING INTEGRATED HEALTH SYSTEMS TO ENSURE ROBUST DATA AND A RELEVANT COMPARATOR MARKET. THE PEER GROUP ORGANIZATIONS ARE APPROVED BY THE COMPENSATION COMMITTEE AND CONSISTS OF HEALTHCARE SYSTEMS SIMILAR IN REVENUE SIZE, TALENT MARKET COMPETITORS, HIGH PERFORMERS, FINANCIALLY STABLE AS INDICATED BY BOND RATING AND THAT FOLLOW A SIMILAR STRATEGY (MULTI-SITE SYSTEMS, HEALTH PLANS). COMPARABLE DATA FOR THE APPROVED PEER GROUP IS COMPILED BY THE INDEPENDENT EXECUTIVE COMPENSATION CONSULTING FIRM. COMPENSATION ADJUSTMENTS ARE APPROVED BY COMPENSATION COMMITTEE MEMBERS, CONSISTENT WITH THE COREWELL HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE COMPENSATION COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE COMPENSATION COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTH CARE AND/OR HEALTH INSURANCE ORGANIZATIONS. COREWELL HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTH CARE/HEALTH INSURANCE MARKET PRACTICES. THIS PROCESS IS INTENDED TO ASSIST COREWELL HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL COREWELL HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III). Part I, Line 4b THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JAMES FORSHEE MD $54,177 JIANHUA YU $1,433,583 MICHAEL KOZIARA $762,150 PRAVEEN THADANI $322,002 PART I, LINE 4B IS ANSWERED YES BECAUSE CERTAIN INDIVIDUALS DO PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN(S). SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN(S) BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR WHILE ALSO BEING REPORTED IN THE CURRENT 990 AS TOTAL COMPENSATION. THE NONQUALIFIED RETIREMENT PLANS ARE AN INDUSTRY STANDARD AND ARE SUBJECT TO THE FUNDING REQUIREMENTS OF NONQUALIFIED DEFERRED COMPENSATION PLANS UNDER ERISA AND FEDERAL TAX REGULATIONS. Form 990, Part III, line 3 EFFECTIVE OCTOBER 1, 2021 THE ORGANIZATION'S MEMBERSHIP AND MEDICAID CONTRACT WERE TRANSFERRED TO PRIORITY HEALTH CHOICE, INC. (A RELATED TAX-EXEMPT ORGANIZATION). ALL REMAINING ACTIVITY IS OPERATING ON A RUN-OUT BASIS, WITH NO NEW MEMBERSHIP AGREEMENTS BEING WRITTEN. TOTAL HEALTH CARE, INC. WILL RETAIN ADEQUATE CASH AND INVESTMENTS TO MANAGE THE RUN-OUT OF ITS MEDICAID BUSINESS UNTIL FINAL DISSOLUTION IS APPROVED BY THE MICHIGAN DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES. TOTAL HEALTH CARE, INC. HAS RETAINED ITS HMO LICENSE. Form 990, Part VI, Section A, line 2 KIMBERLY THOMAS NICHOLAS GATES PRAVEEN THADANI HAVE A BUSINESS RELATIONSHIP AS THEY SERVE AS AN OFFICER OR DIRECTOR OF PRIORITY HEALTH MANAGED BENEFITS, INC. A RELATED TAXABLE ENTITY. Form 990, Part VI, Section A, line 3 DELEGATION OF MANAGEMENT DUTIES THE FILING ORGANIZATION ENTERED INTO AN AGREEMENT WITH PRIORITY HEALTH MANAGED BENEFITS, INC., A WHOLLY OWNED SUBSIDIARY OF COREWELL HEALTH, TO PROVIDE PERSONNEL, OFFICE SPACE, AND SUPPLIES NECESSARY TO CARRY OUT BUSINESS OPERATIONS. PRIORITY HEALTH MANAGED BENEFITS, INC. FACILITATES PAYMENT OF MOST MANAGEMENT, OPERATIONAL, AND ADMINISTRATIVE EXPENSES ON BEHALF OF THE FILING ORGANIZATION. Form 990, Part VI, Section A, line 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE SOLE MEMBER IS PRIORITY HEALTH, INC. (EIN 38-2715520), A TAX-EXEMPT 501(C)(4) ORGANIZATION. PRIORITY HEALTH CONTROLS 100% OF THE ORGANIZATION. Form 990, Part VI, Section A, line 7a MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY PRIORITY HEALTH, INC., A RELATED 501(C)(4) ORGANIZATION, IS ABLE TO APPOINT THE BOARD OF TOTAL HEALTH CARE, INC. Form 990, Part VI, Section B, line 11b THE FORM 990 IS PREPARED BY COREWELL HEALTH CORPORATE TAX. THE TAX RETURN IS REVIEWED BY THE CORPORATE TAX MANAGER AND THE VP TAX. IT IS THEN REVIEWED BY THE ORGANIZATION'S FINANCE AND LEGAL DEPARTMENTS. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE GOVERNING BODY. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. Form 990, Part VI, Section B, line 12c CONFLICT OF INTEREST POLICY BOARD OF DIRECTORS 1. CONFLICTS OF INTEREST MUST BE DISCLOSED, VIA AN ANNUAL ELECTRONIC DISCLOSURE PROCESS AND VERBALLY AT EACH BOARD AND BOARD COMMITTEE MEETING AS PART OF THE DECLARATION OF CONFLICT OF INTEREST PRIOR TO DISCUSSION OF ANY AGENDA ITEMS. 2. A PERSON HAVING A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT MAY MAKE A PRESENTATION AT A MEETING OF THE BOARD OR COMMITTEE WHICH IS CONSIDERING THAT TRANSACTION OR ARRANGEMENT, BUT AFTER THAT PRESENTATION HE/SHE SHALL LEAVE THE MEETING BEFORE DISCUSSION AND VOTING ON THAT PROPOSED TRANSACTION OR ARRANGEMENT. THE PERSON HAVING THE FINANCIAL INTEREST SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM IS PRESENT. 3. THE CHAIRPERSON OF THE BOARD OR THE COMMITTEE CHAIR SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE (INCLUDING OUTSIDE ADVISORS) TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND TO ADVISE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST. 4. THE BOARD OR COMMITTEE SHALL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER THE ORGANIZATION CAN, WITH REASONABLE EFFORTS, OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO ACONFLICT OF INTEREST. 5. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS AND MEMBERS WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 6. THE MINUTES OF THE MEETINGS OF THE BOARD AND ALL OF THE ORGANIZATION'S COMMITTEES SHALL SET FORTH: A) THE NAMES OF THE PERSONS WHO DISCLOSED A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING THE ORGANIZATION OR ANY OF ITS SUBSIDIARIES AND THE NATURE OF THE FINANCIAL INTEREST; AND B) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO SUCH TRANSACTION OR ARRANGEMENT, INCLUDING ANY DISCUSSION OF ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THAT MATTER. THE VOTES OF INDIVIDUAL MEMBERS NEED NOT BE RECORDED UNLESS OTHERWISE DIRECTED BY THE BOARD OFDIRECTORS OR COMMITTEE. 7. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF THE BOARD AND BOARD COMMITTEES UPDATE THEIR ANNUAL DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER TENURE ON THE BOARD OF DIRECTORS WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. MANAGEMENT 1. UPON ACCEPTANCE OF AN EMPLOYMENT OFFER, EACH MEMBER OF MANAGEMENT (DIRECTORS AND ABOVE) COMPLETE A CONFLICT-OF-INTEREST DISCLOSURE QUESTIONNAIRE. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE QUESTIONNAIRE IS SENT TO THE ORGANIZATION'S SYSTEM COMPLIANCE DEPARTMENT. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE IS REVIEWED BY THE ORGANIZATION'S COMPLIANCE OPERATIONS ANALYST AND ESCALATED TO THE APPROPRIATE EXECUTIVE LEADERSHIP TEAM, IF NECESSARY. 2. ANNUALLY, EACH MEMBER OF MANAGEMENT (DIRECTORS AND ABOVE) COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE ELECTRONICALLY. IF THERE IS AN AFFIRMATIVE DISCLOSURE, THE QUESTIONNAIRE IS REVIEWED BY THE APPROPRIATE EXECUTIVE LEADERSHIP TEAM. 3. THERE IS AN ONGOING REQUIREMENT TO UPDATE THE DISCLOSURE QUESTIONNAIRE WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. UPDATED DISCLOSURES FOLLOW THE SAME PROCESS AS INITIAL DISCLOSURES DESCRIBED ABOVE. 4. THE COMPLIANCE OFFICER, IN CONSULTATION WITH EXECUTIVE MANAGEMENT,DETERMINES HOW REPORTED CONFLICTS SHOULD BE MANAGED. MANAGEMENT OF A CONFLICT MAY TAKE A VARIETY OF DIFFERENT FORMS FROM IMPLEMENTATION OF A MANAGEMENT PLAN TO REQUIRING THAT THE MEMBER OF MANAGEMENT CEASE THE ACTIVITY CREATING THE CONFLICT OR, IN EXTREME CASES, LEAVE THE ORGANIZATION'S EMPLOYMENT. MANAGEMENT OF A CONFLICT IS DETERMINED ON AN INDIVIDUAL BASIS BASED UPON THE FACTS AND CIRCUMSTANCES SURROUNDING THE DISCLOSURE. THE PURPOSE OF CONFLICT MANAGEMENT IS TO PROVIDE TRANSPARENCY WITHIN THE ORGANIZATION AND TO ENSURE THAT THE ORGANIZATION'S EMPLOYEES ARE ALWAYS ACTING IN THE BEST INTEREST OF THE ORGANIZATION. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION AND STATUTORY FINANCIAL STATEMENTS ARE ON FILE WITH THE STATE OF MICHIGAN AND AVAILABLE TO THE PUBLIC ON THE STATE'S WEBSITE. THE ORGANIZATION'S BYLAWS AND INTERNAL POLICIES ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. Form 990, Part IX, line 11g OTHER PURCHASED SERVICES: Program service expenses 0. Management and general expenses 917,860. Fundraising expenses 0. Total expenses 917,860. NONCLINICAL PURCHASED SERVICES: Program service expenses 0. Management and general expenses 1,469. Fundraising expenses 0. Total expenses 1,469. FORM 990, PART XII, LINE 2B THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AUDITED ANNUALLY BY AN INDEPENDENT ACCOUNTING FIRM. THE PARENT ORGANIZATION ISSUES GAAP BASIS FINANCIAL STATEMENTS WHICH ARE PREPARED ON A CONSOLIDATED BASIS AND NOT ON A STANDALONE BASIS. THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS AUDITED ANNUALLY ON A STAND ALONE BASIS AND ISSUES FINANCIAL STATEMENTS ON A STAND ALONE BASIS WHICH ARE PREPARED IN ACCORDANCE WITH SAP (STATUTORY ACCOUNTING PRINCIPLES), AS REQUIRED BY REGULATORY AUTHORITIES. THE AMOUNTS IN THIS FORM 990 RECONCILE TO THE FINANCIAL STATEMENTS PREPARED UNDER STATUTORY ACCOUNTING PRINCIPLES AS SUBMITTED TO THE STATE OF MICHIGAN AND THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC). Form 990, Part XII, Line 2c: NO CHANGE IN OVERSIGHT FROM PRIOR YEAR BEAUMONT HEALTH 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 465718220 SUPPORTING ORGANIZATION MI 501(c)(3) Line 12c, III-FI COREWELL HEALTH 0 BEAUMONT HEALTH FOUNDATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 364852171 FUNDRAISING FOUNDATION MI 501(c)(3) Line 7 BEAUMONT HEALTH 0 BEAUMONT MEDICAL GROUP-HOSPITAL-BASED SERVICES 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 822768899 PHYSICIAN SUPPORT SERVICES MI 501(c)(3) Line 10 BEAUMONT HEALTH 0 BEAUMONT MEDICAL GROUP-PRIMARY CARE SERVICES 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 822796539 PHYSICIAN SUPPORT SERVICES MI 501(c)(3) Line 10 BEAUMONT HEALTH 0 BEAUMONT MEDICAL GROUP-SPECIALTY SERVICES 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 822784244 PHYSICIAN SUPPORT SERVICES MI 501(c)(3) Line 10 BEAUMONT HEALTH 0 BEAUMONT MEDICAL TRANSPORTATION SERVICES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 260203703 MEDICAL TRANSPORTATIONAL SERVICES MI 501(c)(3) Line 10 BH GRAND RIVER SOUTHFIELD INC 0 BH GRAND RIVER SOUTHFIELD INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382410823 EMERGENCY MEDICAL SERVICES MI 501(c)(3) Line 10 BOTSFORD GENERAL HOSPITAL 0 BOTSFORD CONTINUING CARE CORPORATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382549505 REHABILITATION & NURSING CENTER MI 501(c)(3) Line 10 BOTSFORD GENERAL HOSPITAL 0 BOTSFORD GENERAL HOSPITAL 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381426919 HOSPITAL MI 501(c)(3) Line 3 BEAUMONT HEALTH 0 COREWELL HEALTH 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383382353 SUPPORTING ORGANIZATION MI 501(c)(3) Line 12c, III-FI N/A 0 COREWELL HEALTH FOUNDATION WEST MICHIGAN 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382752328 FUNDRAISING FOUNDATION MI 501(c)(3) Line 7 SPECTRUM HEALTH HOSPITALS 0 HOSPICE AT HOME INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382416086 HOSPICE AND PALLIATIVE CARE MI 501(c)(3) Line 7 LAKELAND REGIONAL HEALTH SYSTEM 0 LAKELAND COMMUNITY HOSPITAL WATERVLIET 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381368745 HOSPITAL MI 501(c)(3) Line 3 LAKELAND REGIONAL HEALTH SYSTEM 0 LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382539929 FUNDRAISING FOUNDATION MI 501(c)(3) Line 7 LAKELAND REGIONAL HEALTH SYSTEM 0 LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382156872 HOSPITAL MI 501(c)(3) Line 3 LAKELAND REGIONAL HEALTH SYSTEM 0 LAKELAND REGIONAL HEALTH SYSTEM 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382609624 SUPPORTING ORGANIZATION MI 501(c)(3) Line 12c, III-FI COREWELL HEALTH 0 LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383452303 FACILITY LEASING MI 501(c)(3) Line 3 LAKELAND REGIONAL HEALTH SYSTEM 0 LAKESHORE AREA RADIATION ONCOLOGY CENTER 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383067954 RADIATION SERVICES MI 501(c)(3) Line 3 SPECTRUM HEALTH HOSPITALS 0 MECOSTA COUNTY MEDICAL CENTER 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381368744 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 MEMORIAL MEDICAL CENTER OF WEST MICHIGAN 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381359266 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 MERCY-MEMORIAL HEALTH SERVICES INCORPORATED 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382748035 REHABILITATION & NURSING CENTER MI 501(c)(3) Line 10 LAKELAND REGIONAL HEALTH SYSTEM 0 MICHIGAN MOBILE PET IMAGING 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 331086165 MOBILE PET SCANNING MI 501(c)(3) Line 12a, I OAKWOOD HEALTHCARE INC 0 NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381359517 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 OAKWOOD HEALTH PROMOTIONS INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382601965 REHABILITATION & NURSING CENTER MI 501(c)(3) Line 10 OAKWOOD HEALTHCARE INC 0 OAKWOOD HEALTHCARE INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381405141 HOSPITAL MI 501(c)(3) Line 3 BEAUMONT HEALTH 0 OAKWOOD HOME CARE SERVICES 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382877338 HOME HEALTH SERVICES MI 501(c)(3) Line 10 OAKWOOD HEALTHCARE INC 0 OAKWOOD UNITED HOSPITALS INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382837961 FACILITY LEASING MI 501(c)(3) Line 12a, I OAKWOOD HEALTHCARE INC 0 PENNOCK HOSPITAL 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381360562 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 PRIORITY HEALTH 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382715520 HMO MANAGEMENT MI 501(c)(4) COREWELL HEALTH 0 PRIORITY HEALTH CHOICE INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 320016523 HMO MANAGEMENT MI 501(c)(3) Line 10 PRIORITY HEALTH 0 REED CITY HOSPITAL CORPORATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382770076 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 SPECTRUM HEALTH - LEFFINGWELL AVENUE 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 854390483 REHABILITATION & NURSING CENTER MI 501(c)(3) Line 10 SPECTRUM HEALTH CONTINUING CARE 0 SPECTRUM HEALTH CONTINUING CARE 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383242232 HOSPICE AND PALLIATIVE CARE MI 501(c)(3) Line 10 COREWELL HEALTH 0 SPECTRUM HEALTH CONTINUING CARE CENTER INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382415333 REHABILITATION & NURSING CENTER MI 501(c)(3) Line 10 SPECTRUM HEALTH CONTINUING CARE 0 SPECTRUM HEALTH HOSPITALS 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381360529 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 SPECTRUM HEALTH KELSEY 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381297435 HOSPITAL MI 501(c)(3) Line 3 SPECTRUM HEALTH UNITED 0 SPECTRUM HEALTH PRIMARY CARE PARTNERS 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381358164 PHYSICIAN SUPPORT SERVICES MI 501(c)(3) Line 3 COREWELL HEALTH 0 SPECTRUM HEALTH UNITED 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381358412 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 SPECTRUM HEALTH WORTH SERVICES 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382786617 REHABILITATION SERVICES MI 501(c)(3) Line 10 SPECTRUM HEALTH CONTINUING CARE 0 TOTAL HEALTH CARE USA INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383240485 HMO MANAGEMENT MI 501(c)(4) TOTAL HEALTH CARE INC 1 TRINITY HEALTH PLANS 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382663747 HOLDING COMPANY MI 501(c)(4) PRIORITY HEALTH 0 VISITING NURSE SERVICES OF WESTERN MICHIGAN 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381359195 HOME HEALTH SERVICES MI 501(c)(3) Line 10 SPECTRUM HEALTH CONTINUING CARE 0 WILLIAM BEAUMONT HOSPITAL 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381459362 HOSPITAL MI 501(c)(3) Line 3 BEAUMONT HEALTH 0 ZEELAND COMMUNITY HOSPITAL 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 381411184 HOSPITAL MI 501(c)(3) Line 3 COREWELL HEALTH 0 CHCC TAYLOR LLC 2355 E CAMELBACK RD STE 700 PHOENIX AZ 85016 923588577 MANAGEMENT MI N/A N/A 0 0 CHCC TROY LLC 2355 E CAMELBACK RD STE 700 PHOENIX AZ 85016 923960104 MANAGEMENT MI N/A N/A 0 0 CHEC 1 LLC 2355 E CAMELBACK RD STE 700 PHOENIX AZ 85016 990525515 MANAGEMENT MI N/A N/A 0 0 DEARBORN SCHAEFFER OFFICE CO LLC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 262448025 REAL ESTATE MI N/A N/A 0 0 OAKMED LLC 1938 WOODSLEE DRIVE TROY MI 48084 461459737 PRIVATE DUTY NURSING MI N/A N/A 0 0 SPECTRUM ATLAS JV LLC 2355 E CAMELBACK RD STE 700 PHOENIX AZ 85016 874265336 MANAGEMENT MI N/A N/A 0 0 WEST MICHIGAN ACCOUNTABLE CARE ORGANIZATION LLC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 833153113 ACCOUNTABLE CARE ORGANIZATION MI N/A N/A 0 0 1697 MICHIGAN STREET PROPERTY 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 831721239 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 25 MICHIGAN STREET CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 161734157 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 35 MICHIGAN STREET CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 272193084 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 BEAUMONT NURSING HOME SERVICES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382799842 ASSISTED CARE LIVING MI WILLIAM BEAUMONT HOSPITAL C 0 BH SOUTHFIELD BILLING INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382755982 MANAGEMENT AND DISPATCH SERVICES MI BH GRAND RIVER SOUTHFIELD INC C 0 BLUE STAR PROFESSIONAL BUILDING CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 208313519 PROPERTY MANAGEMENT MI HOSPICE AT HOME INC C 0 BOTSFORD COMMONS PROPERTY ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383203663 PROPERTY MANAGEMENT MI BOTSFORD CONTINUING CARE CORPORATION C 0 COREWELL HEALTH INDEMNITY COMPANY LTD 23 LIME TREE BAY AVENUE GRAND CAYMAN CJ 980512415 PREMIUM DEPOSITS CJ COREWELL HEALTH C 0 COREWELL HEALTH PHYSICIANS INSURANCE COMPANY 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 274261262 PROFESSIONAL INSURANCE MI COREWELL HEALTH C 0 FOUR FLAGS PROPERTIES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 364501639 PROPERTY MANAGEMENT MI LAKELAND HEALTH VENTURES INC C 0 GRAND RIVER ABSOLUTE RETURN FUND LTD PO BOX 852 GRAND CAYMAN CJ KY1-1103 POOLED INVESTMENT FUND CJ COREWELL HEALTH 0 HELEN DE VOS WOMEN AND CHILDREN'S HEALTH PAVILION ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383264184 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 LAKELAND HEALTH ENTERPRISES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382669798 ACCOUNTING AND BILLING MI LAKELAND REGIONAL HEALTH SYSTEM INC C 0 LAKELAND HEALTH VENTURES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 272313790 HOLDING COMPANY MI LAKELAND HEALTH ENTERPRISES INC C 0 LAKELAND MEDICAL PRACTICES 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 270381199 MEDICAL ADMINISTRATIVE SERVICES MI LAKELAND HEALTH ENTERPRISES INC C 0 LAKELAND PERSONAL CARE SERVICES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 272990797 HEALTHCARE SERVICES MI LAKELAND HEALTH VENTURES INC C 0 LAKELAND PHYSICIAN CARE NETWORK 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 208513031 HEALTHCARE SERVICES MI LAKELAND HEALTH ENTERPRISES INC C 0 LEMMEN-HOLTON CANCER PAVILION CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 161734150 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 MICHIGAN STREET PARKING CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 161734145 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 MICHIGAN STREET PROJECT CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 364873152 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 MIDWEST MEDICAL CENTER 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 263683446 PHYSICIANS OFFICE MI OAKWOOD AFFILIATED VENTURES INC C 0 MUSCULO-SKELETAL CENTER CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383180086 PROPERTY MANAGEMENT MI SPECTRUM HEALTH HOSPITALS C 0 OAKWOOD AFFILIATED VENTURES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 371753159 HOLDING COMPANY MI OAKWOOD HEALTHCARE INC C 0 OAKWOOD ENTERPRISES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382601930 PROPERTY MANAGEMENT MI OAKWOOD AFFILIATED VENTURES INC C 0 PENNOCK PROFESSIONAL BUILDING CONDOMINIUM ASSOCIATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 384056359 PROPERTY MANAGEMENT MI PENNOCK HOSPITAL C 0 PENNOCK VENTURES INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382712819 PROPERTY MANAGEMENT MI PENNOCK HOSPITAL C 0 PRIORITY HEALTH INSURANCE COMPANY 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 201529553 INSURANCE MI PRIORITY HEALTH C 0 PRIORITY HEALTH MANAGED BENEFITS INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 383085182 THIRD PARTY ADMINISTRATOR MI COREWELL HEALTH C 0 SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 272589359 PHYSICIANS OFFICE MI LAKELAND HEALTH ENTERPRISES INC C 0 SPECTRUM HEALTH PHYSICIAN ALLIANCE 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 371655728 PHYSICIANS OFFICE MI COREWELL HEALTH C 0 THE PHARMACY SHOPPE INC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382929090 PHARMACEUTICALS MI LAKELAND HEALTH VENTURES INC C 0 WMHTC 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 382125186 PHYSICIANS MI COREWELL HEALTH C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 PRIORITY HEALTH B 78851 GAAP TOTAL HEALTH CARE USA INC C 1750343 GAAP