2024-08-13T09:42:16-05:00 2023-09-30 990 2022-10-01 222779421 Connecticut Health System Inc CONN 8606963563 80 Seymour Street Hartford CT 06102 Mark A Keise Authorized Signer 8606966282 2024-08-13 0 2022 2024-08-08 14:25:15Z Mark A Keise 80 Seymour Street Hartford CT 06102 0 0 X n/a X 1986 CT Coordination of Health Care Delivery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 None 0 0 Connecticut Health System, Inc (CHS) is currently a dormant entity - pending dissolution. 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 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X Carol Wardell 8606963563 9 Farm Springs Road Farmington CT 06032 Gerald Boisvert SVP, Financial Operations 1.00 59.00 X 0 861012 65730 0 861012 65730 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 0 0 0 0 0 X 0 0 0 X X 2 Hartford Hospital 060646668 3 1 0 0 MidState Medical Center 060646715 3 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 0 0 Part IV, Section D, Line 2: CHS is currently a dormant entity - pending dissolution. Supported Organization Information Connecticut Health System, Inc. was established to provide management services for the benefit of supported organizations. CHS is currently a dormant entity - pending dissolution. 0 1 0 0 0 0 0 1 0 Gerald Boisvert SVP, Financial Operations 0 530323 0 246119 0 84570 0 21350 0 44380 0 926742 0 0 Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by Connecticut Health System, Inc. on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurrence of a change in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2022 SERP Payout was made on behalf of the following individual: Gerald Boisvert $49,532* *For this individual, vesting occurred, causing taxable income. This portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Form 990, Part VI, Section A, line 8a CHS is currently a dormant entity and does not have a governing body that meets on a regular basis. Form 990, Part VI, Section A, line 8b CHS is currently a dormant entity and does not have a governing body that meets on a regular basis. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare Corporation's Tax Department. There was no board review of this Form. CHS is currently a dormant entity - pending dissolution. Form 990, Part VI, Section C, line 18 The Organization's financial statements, Form 990, Form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 CHS is currently a dormant entity - pending dissolution. Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Supporting Organization CT 501(c)(3) 12 (a) Hartford HealthCare Corporation 1 Hartford HealthCare ACO Inc 1290 Silas Deane Hwy 2nd Floor Wethersfield CT 06109 460886367 Government Contracts CT 501(c)(3) 7 Hartford HealthCare Medical Group Inc 1 Hartford HealthCare at Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 060646938 Home Healthcare CT 501(c)(3) 10 Hartford HealthCare Corporation 1 Hartford HealthCare Corporation 100 Pearl Street Hartford CT 06103 222672834 Support & Management Svcs. 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061432692 Supporting Organization CT 501(c)(3) 12 (a) Rushford Center Inc 1 St Vincent's Development Inc 95 Merritt Boulevard Trumbull CT 06611 222554128 Holding Company CT 501(c)(25) St Vincent's Health Services Corp 1 St Vincent's Health Services Corp 2800 Main Street Bridgeport CT 06606 222558134 Supporting Organization CT 501(c)(3) 12 (a) SVMC Holdings Inc dba St Vincent's Medical Center 1 St Vincent's Multispecialty Group Inc 2800 Main Street Bridgeport CT 06606 800458769 Healthcare Services CT 501(c)(3) 12 (a) SVMC Holdings Inc dba St Vincent's Medical Center 1 St Vincent's Medical Center Foundation Inc 2800 Main Street Bridgeport CT 06606 222558132 Fundraising CT 501(c)(3) 7 SVMC Holdings Inc dba St Vincent's Medical Center 1 St Vincent's Special Needs Center Inc 95 Merritt Boulevard Trumbull CT 06611 060702617 Residential Services for Handicapped CT 501(c)(3) 10 St Vincent's Health Services Corp 1 SVMC Holdings Inc dba St Vincent's Medical Center 2800 Main Street Bridgeport CT 06606 832550272 Hospital CT 501(c)(3) 3 Hartford HealthCare Corporation 1 The Charlotte Hungerford Hospital 540 Litchfield Street PO Box 988 Torrington CT 06790 060646678 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 The Hospital of Central CT and Bradley Memorial 100 Grand Street New Britian CT 06052 060646768 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 The Orchards of Southington 34 Hobart Street Southington CT 06489 061490803 Residential Services for Senior Citizens CT 501(c)(3) 10 Hartford HealthCare Senior Services Inc 1 The William W Backus Hospital 326 Washington Street Norwich CT 06360 060250773 Hospital CT 501(c)(3) 3 Hartford HealthCare Corporation 1 WCMH Women's Auxiliary Inc 112 Mansfield Avenue Willimantic CT 06226 060677728 Fundraising CT 501(c)(3) 12 (a) Windham Community Memorial Hospital 1 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 060646966 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 Windham Hospital Foundation Inc 112 Mansfield Avenue Willimantic CT 06226 562546632 Supporting Organization CT 501(c)(3) 12 (a) Windham Community Memorial Hospital 1 Advanced Medical Imaging of NW CT LLC 57 Commercial Blvd Torrington CT 06790 061594854 Magnetic Resonance Imaging CT N/A 0 0 Ambulance Service of Manchester LLC PO Box 300 Manchester CT 06450 061557358 Ambulatory Service CT N/A 0 0 Central Connecticut Endoscopy Center 440 New Britain Avenue Plainville CT 06062 141855010 Endoscopy Svcs CT N/A 0 0 Connecticut Imaging Partners LLC 1500 Concord Terrace Sunrise FL 33323 134298940 Imaging Services CT N/A 0 0 Connecticut Orthopaedic Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 832570191 Surgery Svcs CT N/A 0 0 Connecticut Proton Therapy Center LLC 789 Howard Ave Suite CB 230 New Haven CT 06519 871371777 Proton Therapy Services CT N/A 0 0 Constitution Surgery Center East LLC 174 Cross Road Waterford CT 06385 061574704 Surgery Svcs CT N/A 0 0 CT GI 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resonance imaging CT N/A 0 0 Rocky Hill Surgery Center LLC 1111 Cromwell Avenue Building 1 Rocky Hill CT 06067 833096156 Surgery Svcs CT N/A 0 0 The Endoscopy Center of Northwest Connecticut LLC 245 Alvord Park Road Torrington CT 06790 061609993 Endoscopy Svcs CT N/A 0 0 Wallingford Endoscopy Center LLC 863 North Main Street Ext Suite 300 Wallingford CT 06492 824601730 Endoscopy Svcs CT N/A 0 0 Aetna Ambulance Service Inc PO Box 1150 Manchester CT 06045 060795431 Ambulance Services CT N/A C 1 American Ambulance Services Inc One American Way Norwich CT CT 06360 061028857 Ambulance Services CT N/A S 1 American Professional Educational Services Inc One American Way Norwich CT CT 06360 061459930 Educational Services CT N/A S 1 Backus Medical Center Condo Assoc Inc 330 Washington Street Norwich CT 06360 061542647 Condo Association CT N/A C 1 CenConn Services Inc 100 Grand Street New Britain CT 06050 222836001 Billing Services CT N/A C 1 ConnCare Inc 326 Washington Street Norwich CT 06360 061387598 Health Care Services CT N/A C 1 HHMOB Corporation 80 Seymour Street PO Box 5037 Hartford CT 06102 061140244 Real Estate & Parking CT N/A C 1 Hartford HealthCare Indemnity Services Ltd FB Perry Bld 40 Church Street Hamilton BD Captive Insurance BD N/A C 1 Hartford Physician Services PC 80 Seymour Street Hartford CT 06102 061254082 Medical Services CT N/A C 1 Hunter's Ambulance Service Inc 450 West Main Street Meriden CT 06451 060789464 Ambulance Services CT N/A S 1 Meriden Imaging Center Inc 101 North Plains Industrial Road Meriden CT 06429 061541468 Imaging CT N/A S 1 Metro Wheelchair Service Inc PO Box 300 Manchester CT 06045 060878432 Wheelchair Services CT N/A C 1 The Cancer Care Fund Of The Litchfield Hills Inc 200 Kennedy Drive Torrington CT 06790 510474072 Cancer Care Fund CT N/A C 1 Windham Professional Office Condo Assoc 112 Mansfield Avenue Willimantic CT 06226 061090041 Condo Association CT N/A C 1 WWB Corporation 326 Washington Street Norwich CT 06360 061094838 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