2024-08-19T15:31:12-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 10401 W INNOVATION DR STE 300 WAUWATOSA WI 53226 990 2023-01-01 475607606 ORION HEALTH INSURANCE POOL INC ORIO 8443814790 333 E OSBORN ROAD 300 PHOENIX AZ 85012 DAWN ABBOTT PRESIDENT 8443814790 2024-08-14 1 1 KRISTEN DONLEVY P01670215 4144761880 2024-08-07 2023 2024-08-08 14:25:15Z DAWN ABBOTT 333 E OSBORN ROAD 300 PHOENIX AZ 85012 5456944 0 X WWW.ORIONHEALTHPOOL.ORG X 2016 AZ PROVIDES HEALTH BENEFITS AND SERVICES. 5 0 0 0 0 0 0 0 4777626 5238907 59264 218037 0 0 4836890 5456944 0 0 2270243 3251500 0 0 0 0 0 1565157 1598777 3835400 4850277 1001490 606667 4359290 5181509 721307 936859 3637983 4244650 SEE SCHEDULE O 0 0 COMPREHENSIVE HEALTH BENEFITS PROGRAM:ORION HEALTH INSURANCE POOL OFFERS A COMPREHENSIVE HEALTH BENEFITS PROGRAM TO NOT-FOR-PROFIT, CONTRACTORS AND SUBCONTRACTORS LICENSED TO DO WORK FOR THE STATE OF ARIZONA OR POLITICAL SUBDIVISION OF THE STATE OF ARIZONA. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 X 5 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 X RISK PROGRAM ADMINISTRATORS 8443814790 333 E OSBORN ROAD 300 PHOENIX AZ 85012 DAWN ABBOTT PRESIDENT 0.40 40.00 X X 0 354698 47248 ROBERT POSEY SECRETARY/TREASURER 0.40 40.00 X X 0 138161 28568 JEFF OAKES VICE PRESIDENT 0.40 40.00 X X 0 134611 19749 MELISSA DIXON DIRECTOR 0.40 40.00 X 0 84280 20357 PAULETT DAVIS DIRECTOR 0.40 40.00 X 0 122664 15448 0 834414 131370 0 0 1 0 RISK PROGRAM ADMINISTRATORS 333 E OSBORN ROAD SUITE 300 PHOENIX AZ 85012 POOL ADMINISTRATION 353900 3 EMPLOYER CONTRIBUTIONS 525100 4482702 4482702 EMPLOYEE CONTRIBUTIONS 525100 756205 756205 5238907 218037 218037 5456944 5238907 0 218037 3251500 353900 540 17325 13187 12914 3601 531788 TRANSFER TO HSA ACCOUNT 499756 CLAIM SERVICE FEES 165766 4850277 4245251 4393767 69234 68282 37249 711303 7556 8157 4359290 5181509 25993 22705 695314 914154 721307 936859 X 0 0 0 0 3637983 4244650 3637983 4244650 4359290 5181509 606667 0 X X 0 1 X 1 0 0 BENEFIT OBLIGATIONS 914154 914154 X 5456944 0 5456944 0 5456944 4629948 0 4629948 220329 220329 4850277 PART X, LINE 2: THE VEBA TRUST, WHICH FUNDS CERTAIN BENEFITS OF THE PLAN, RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED JUNE 23, 2016, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)9 OF THE INTERNAL REVENUE CODE (IRC). THE PLAN WAS ORGANIZED AS A NONPROFIT PURSUANT TO STATE OF ARIZONA STATUTE SECTION 41-621.01. THE PLAN IS CONSIDERED TO BE A NONPROFIT ORGANIZATION AND IS NOT SUBJECT TO FEDERAL OR STATE CORPORATE INCOME TAXES; THEREFORE, NO PROVISION FOR INCOME TAXES WAS RECORDED IN THESE FINANCIAL STATEMENTS. IN ADDITION, THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. AS OF DECEMBER 31, 2023 AND 2022, NO SUCH TAX LIABILITY OR ASSET WAS DEEMED NECESSARY. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS PAYABLE AND ESTIMATED CLAIMS INCURRED BUT NOT REPORTED RESERVE FOR LOSS ADJUSTMENT EXPENSES 220,329. 0 0 0 DAWN ABBOTT PRESIDENT 0 354698 0 0 0 0 0 33000 0 14248 0 401946 0 0 ROBERT POSEY SECRETARY/TREASURER 0 138161 0 0 0 0 0 13241 0 15327 0 166729 0 0 JEFF OAKES VICE PRESIDENT 0 134611 0 0 0 0 0 5501 0 14248 0 154360 0 0 FORM 990, PART I, LINE 1 ORION HEALTH INSURANCE POOL (ORION) WAS ESTABLISHED JANUARY 1, 2016 PURSUANT TO ARS 41-621.01, AND IS A SELF-INSURED EMPLOYEE BENEFITS POOL. ORION PROVIDES HEALTH BENEFITS AND SERVICES TO NOT-FOR-PROFIT, CONTRACTORS AND SUBCONTRACTORS LICENSED TO DO WORK FOR THE STATE OF ARIZONA OR POLITICAL SUBDIVISION OF THE STATE OF ARIZONA. THE POOL OFFERS A COMPREHENSIVE HEALTH BENEFITS PROGRAM, INCLUDING MEDICAL, DENTAL, PRESCRIPTION, BASIC AND SUPPLEMENTAL LIFE, LTD AND A VOLUNTARY VISION PLAN. IN ADDITION, THE POOL OFFERS SUPPLEMENTAL PROGRAMS SUCH AS HEALTH SAVINGS ACCOUNTS (HSA) AND PHARMACY BENEFIT PROGRAMS. FORM 990, PART VI, SECTION A, LINE 3 RISK PROGRAM ADMINISTRATORS IS THE ADMINISTRATOR OF THE POOL. ADMINISTRATOR IS RESPONSIBLE FOR THE PREPARATION OF BOARD MATERIALS, WILL PREPARE, REVIEW, AND MAINTAIN ALL APPROPRIATE DOCUMENTS, (I.E., SERVICE AGREEMENTS, ARTICLES OF INCORPORATION, BYLAWS, MEMBERSHIP AGREEMENT AND ADMINISTRATIVE PROCEDURES), AND WILL SERVE AS THE PRIMARY CONTACT FOR THE REPRESENTATIVE(S) OF EACH OF THE ORION'S MEMBERS. ADMINISTRATOR WILL ACT AS A LIAISON TO ALL OUTSIDE AGENCIES AND PREPARE, FILE, AND MAINTAIN COPIES OF REQUIRED REPORTS AND WILL IMPLEMENT THE CLIENT'S FINANCIAL PLANS, POLICIES, AND ACCOUNTING PRACTICES IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE POOL CONSIST OF CONTRACTORS AND SUB CONTRACTORS THAT PROVIDE BEHAVIORAL HEALTH SERVICES TO THE STATE OF ARIZONA OR ANY OTHER POLITICAL SUBDIVISION OF THE STATE. FOR 2023, THE POOL HAD TWO MEMBERS. THERE ARE NOT SEPARATE CLASSES. ONE OF THE MEMBERS HAS THREE DIRECTORS AND THE OTHER MEMBER HAS TWO DIRECTORS ON THE BOARD OF DIRECTORS. THIS IS BASED ON THE RELATIVE PERCENTAGE OF CONTRIBUTIONS TO THE POOL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE POOL ELECT THE SLATE OF THE BOARD OF DIRECTORS. EACH MEMBER HAS EQUAL VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAD NO COMMITTESS WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B EXECUTIVE DIRECTOR AND BOARD PRESIDENT WILL REVIEW BEFORE FILING, AND THE BOARD WILL REVIEW AFTER FILING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE POOL DOES NOT HAVE A SEPARATE AUDIT COMMITTEE. INSTEAD, THE ENTIRE BOARD FUNCTIONS AS AN AUDIT COMMITTEE BY SELECTING THE AUDIT FIRM AND APPROVING THE AUDIT. THERE HAVE BEEN NO CHANGES IN EITHER THE OVERSIGHT PROCESS OR THE SELECTION PROCESS DURING THE TAX YEAR. CHANGEPOINT INTEGRATED HEALTH 1801 W DEUCE OF CLUBS SUITE 100 SHOW LOW AZ 85901 860215065 BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES SERVICES AZ 501(C)(3) LINE 7 N/A 0 MOHAVE MENTAL HEALTH CLINIC INC 3707 N STOCKTON HILL RD STE B KINGMAN AZ 86409 860214457 MENTAL HEALTH, CRISIS INTERVENTION AZ 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1