2025-11-14T09:09:37-06:00 2024-12-31 363168081 SIKICH LLC 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2024-01-01 271494977 CHORUS COMMUNITY HEALTH PLANS INC CHOR 4142665420 PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 MARC A CADIEUX TREASURER 4142665420 2025-11-12 1 0 JILL M BOYLE CPA P01246734 2627549400 2025-11-12 2024 2025-03-06 01:10:19Z MARK RAKOWSKI PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 448750169 0 X HTTPS://CHORUSHEALTHPLANS.ORG X 2009 WI TO PROVIDE ACCESS TO QUALITY HEALTH CARE AND SERVICES TO ITS MEMBERS IN WI. 13 11 0 11 0 0 0 0 466998654 441042022 6578316 7667211 33974 30586 473610944 448739819 53500 16612 393653194 391298661 14222283 14346807 0 0 0 49259622 56040654 457188599 461702734 16422345 -12962915 268808395 258666022 87872465 90561578 180935930 168104444 X CHORUS COMMUNITY HEALTH PLANS, INC. ("CCHP"), A SUBSIDIARY OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), IS A HEALTH MAINTENANCE ORGANIZATION DEDICATED TO PROVIDING ACCESS TO THE HIGHEST QUALITY HEALTH CARE AND SERVICES TO MEMBERS. 0 0 286866934 16612 293278205 CCHP'S PURPOSE IS TO PROMOTE ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME CHILDREN AND CERTAIN OTHER DISADVANTAGED RESIDENTS OF THE STATE OF WISCONSIN, AND TO PROMOTE OR SPONSOR PROGRAMS FURTHERING THE HEALTH OF ITS MEMBERS AND THE LARGER COMMUNITIES SERVED. CCHP IS AN HMO FOR WISCONSIN MEDICAID-ELIGIBLE INDIVIDUALS AND FAMILIES LIVING IN BROWN, CALUMET, DODGE, DOOR, EAU CLAIRE, FOND DU LAC, GRANT, GREEN LAKE, JEFFERSON, KENOSHA, KEWAUNEE, MANITOWOC, MARINETTE, MILWAUKEE, OCONTO, OUTAGAMIE, OZAUKEE, RACINE, ROCK, SHAWANO, SHEBOYGAN, WALWORTH, WASHINGTON, WAUKESHA, WAUPACA, WAUSHARA, AND WINNEBAGO COUNTIES IN WISCONSIN. THE MEDICAID ENROLLMENT AT THE END OF DECEMBER 2024 WAS 117,950 MEMBERS, AND THERE WERE 8,435 INPATIENT ADMISSIONS, 402,726 AMBULATORY ENCOUNTERS, AND 2,213 DELIVERIES IN 2024. THE PLAN ALLOWS MEMBERS TO CHOOSE FROM A LARGE NETWORK OF PROVIDERS, WHICH INCLUDED MORE THAN 11,500 PHYSICIANS, MORE THAN 13,400 NON PHYSICIANS, AND 102 HOSPITALS IN 2024. IN ADDITION, CCHP OFFERS HOME CARE AND MEDICAL EQUIPMENT PROVIDERS. 142521848 130090679 CCHP SELLS INDIVIDUAL COMPREHENSIVE INSURANCE PLANS SUBJECT TO THE AFFORDABLE CARE ACT ON THE FEDERALLY FACILITATED MARKETPLACE AND OFF EXCHANGE DIRECTLY TO CONSUMERS. THERE WERE 13,391 MEMBERS ENROLLED AT THE END OF DECEMBER 2024. APPROXIMATELY 78 PERCENT OF THE POLICY HOLDERS RECEIVED AN ADVANCE PREMIUM TAX CREDIT (APTC), AND THESE CREDITS ACCOUNTED FOR 58 PERCENT OF THE PREMIUM REVENUE FROM MEMBERS. ADDITIONALLY, APPROXIMATELY 32 PERCENT OF THE ENROLLMENT MONTHS WERE ON SILVER PLANS THAT QUALIFIED FOR COST SUBSIDY REIMBURSEMENT (CSR), ALTHOUGH CMS NO LONGER PAYS THE SUBSIDY. CCHP ALSO STARTED TO SELL A STAND-ALONE DENTAL INSURANCE PLAN, WHICH HAD 174 MEMBERS ENROLLED AT THE END OF DECEMBER 2024. 17610633 17703724 CCHP RECORDED REVENUE AND EXPENSES FOR CHHS' FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS. CARE4KIDS IS A NON-RISK PREPAID INPATIENT HEALTH PLAN CONTRACT BETWEEN CHHS AND WISCONSIN MEDICAID THAT PROVIDES COMPREHENSIVE HEALTHCARE SERVICES FOR QUALIFYING FOSTER CHILDREN IN SOUTHEASTERN WISCONSIN. CCHP PROVIDES UTILIZATION MANAGEMENT AND A PROVIDER NETWORK, AND PROCESSES CLAIMS FOR THE PARTICIPANTS VIA A SUBCONTRACT AGREEMENT WITH CHHS. THERE WERE 2,803 FOSTER CHILDREN IN CARE4KIDS AT THE END OF DECEMBER 2024. 446999415 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 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 0 0 0 1 X 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MS SARAH KAFKA 4142668976 PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 MARGARET TROYTHROUGH AUG 2024 DIRECTOR/PRESIDENT & CEO CHHS 1.00 40.00 X 0 2589483 68848 GIL PERIBEGINNING AUG 2024 DIRECTOR/PRESIDENT & CEO CHHS 1.00 40.00 X 0 743059 170491 MARK RAKOWSKI DIRECTOR/PRESIDENT CCHP AND SVP CHHS 1.00 40.00 X X 0 727724 173951 JAMES PURKO DIRECTOR/CHAIR 1.00 X 0 0 0 MARY HANNES DIRECTOR 1.00 X 0 0 0 MARK HOGAN DIRECTOR 1.00 X 0 0 0 DANI MACHATA DIRECTOR 1.00 X 0 0 0 BEN MELSON DIRECTOR 1.00 X 0 0 0 THOMAS PRECIA DIRECTOR 1.00 X 0 0 0 MICHAEL SILVER DIRECTOR 1.00 X 0 0 0 CLARK SLIPHER DIRECTOR 1.00 X 0 0 0 RALPH WEBER DIRECTOR 1.00 X 0 0 0 MARC CADIEUX TREASURER/SVP & CFO 1.00 40.00 X 0 1134229 138345 LESLIE TECTOR SECRETARY/SVP & CHIEF LEGAL OFFICER 1.00 40.00 X 0 694284 106972 MICHAEL BOEDER VICE PRESIDENT/COO CCHP 40.00 X 350598 0 30282 JULIE ANTHOLINE DIR HEALTH PLAN OPERATIONS 40.00 X 181207 0 82973 KELLY HODGES MD ASSOCIATE CHIEF MEDICAL OFFICER 40.00 X 331932 0 22208 MICHAEL PELYHES HEALTH PLAN PHARMACY DIRECTOR 40.00 X 197668 0 67227 JAMES SLAWSON MD CHIEF MEDICAL OFFICER 40.00 X 424218 0 72758 JACQUELINE WHELAN VP QUALITY AND ANALYTICS 40.00 X 218456 0 77616 MICHELLE METTNER FORMER OFFICER 0.00 40.00 X 0 173846 26 1704079 6062625 1011697 24 1 1 0 DENTAL PROFESSIONALS OF WI 3520 W OKLAHOMA AVE MILWAUKEE WI 53215 DENTAL SERVICES 27906366 DEAN HEALTH PLAN INC 1277 DEMING WAY MADISON WI 53717 CLAIM TPA FEES 13210768 UPMC BENEFIT MANAGEMENT SERVICES INC 600 GRANT ST 12TH FLOOR PITTSBURGH PA 15219 CLAIM AND BILLING TPA FEES 6225471 LIBERTY INSURANCE 100 N CORPORATE DR STE 100 BROOKFIELD WI 53045 INSURANCE BROKER 1511642 HERSLOF OPTICAL COMPANY INC 12000 W CARMEN AVE MILWAUKEE WI 53225 CAPITATED VISION SERVICES 1509592 24 PREMIUM REVENUE 524114 423338298 423338298 FOSTER CARE MEDICAL HOME PIHP 524298 17703724 17703724 441042022 7667561 7667561 10000 10350 -350 -350 -350 OTHER REVENUE 900099 30586 30586 30586 448739819 441072608 0 7667211 16612 16612 391298661 391298661 380879 380879 11187702 7242856 3944846 546390 358755 187635 1437242 902869 534373 794594 514416 280178 3091408 3091408 78527 78527 38950 38950 137331 137331 29931073 24440380 5490693 142965 142965 9054 3443 5611 1287779 39185 1248594 11970 11970 23470 9823 13647 2232 589 1643 89660 89660 FOSTER CARE MEDICAL HOM 17053658 17053658 PREMIUM RESERVE DEFICIE 4283000 4283000 OTHER EXPENSES 1049991 823198 226793 DEF ST INC TAX BENEFIT -1190414 -1190414 461702734 446999415 14703319 0 507966 745410 176234454 160481671 65138170 67063381 1274925 1198783 448301 313811 224150 134490 24116212 25351002 1312518 3691285 268808395 258666022 78861954 84705849 1826599 1769326 7183912 4086403 87872465 90561578 X 180935930 168104444 180935930 168104444 268808395 258666022 X -12962915 131429 X X 0 1 X 1 0 X 397955482 426477163 460810003 466998654 441042022 2193283324 397955482 426477163 460810003 466998654 441042022 2193283324 0 0 0 2193283324 719514 273532 1976008 6619237 7667561 17255852 719514 273532 1976008 6619237 7667561 17255852 14445 27345 29586 33974 30586 135936 398689441 426778040 462815597 473651865 448740169 2210675112 0.99210 0.99450 0.00780 0.00550 X SCHEDULE A, PART III, SECTION B, LINE 12, COLUMN E: 2020 OTHER REVENUE $14,445 2021 OTHER REVENUE $27,345 2022 OTHER REVENUE $29,586 2023 OTHER REVENUE $33,974 2024 OTHER REVENUE $30,586 0 0 0 0 0 0 1 0 1 38950 38950 0 PART II-B, LINE 1: SINCE CHORUS COMMUNITY HEALTH PLANS ("CCHP") IS A WISCONSIN MEDICAID HMO, CERTAIN OFFICERS OF CCHP AND CCHP'S PARENT, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (CHHS), MEET WITH OFFICIALS FROM THE STATE OF WISCONSIN DEPARTMENT OF HEALTH SERVICES TO DISCUSS THE MEDICAID PROGRAM IN WISCONSIN. THE EXPENSE FOR THE CCHP OFFICERS WAS NOT REPORTED AS LOBBYING ON CCHP'S PART IX. THE AMOUNT REPORTED ON SCHEDULE C PART II-B LINE 1I CONSISTS OF $24,000 PAID TO AN OUTSIDE CONSULTANT WHO IS A REGISTERED LOBBYIST WHO ADVISES CCHP MANAGEMENT. THE REMAINING $14,950 IS THE PORTION OF FEES PAID TO NATIONAL TRADE ASSOCIATIONS THAT WERE ATTRIBUTED TO NON-DEDUCTIBLE LOBBYING ACTIVITIES BY THE TRADE ASSOCIATIONS. 448301 313811 134490 134490 DUE TO AFFILIATES 404636 OTHER LIABILITIES 3681767 4086403 X 428953363 -2046065 -2046065 430999428 6082 17734309 17740391 448739819 443108210 -16542377 -16542377 459650587 6082 2046065 2052147 461702734 PART X, LINE 2: FOOTNOTE 2 INCOME TAXES: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2024 AND 2023. PART XI, LINE 2D - OTHER ADJUSTMENTS: REINSURANCE PREMIUMS -1,914,816. BANK FEES -131,249. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER REVENUE 30,585. FOSTER CARE MEDICAL HOME PIHP 17,703,724. PART XII, LINE 2D - OTHER ADJUSTMENTS: STATUTORY ACCOUNTING DIFFERENCES 1,191,929. FOSTER CARE MEDICAL HOME PIHP -17,703,724. OTHER REVENUE -30,582. PART XII, LINE 4B - OTHER ADJUSTMENTS: REINSURANCE PREMIUMS 1,914,816. BANK FEES 131,249. 0 1 0 0 0 0 0 1 0 MARGARET TROYTHROUGH AUG 2024 DIRECTOR/PRESIDENT & CEO CHHS 0 1409156 0 610262 0 570065 0 25300 0 43548 0 2658331 0 0 MARC CADIEUX TREASURER/SVP & CFO 0 713591 0 215665 0 204973 0 137499 0 846 0 1272574 0 90953 GIL PERIBEGINNING AUG 2024 DIRECTOR/PRESIDENT & CEO CHHS 0 447226 0 150000 0 145833 0 145833 0 24658 0 913550 0 0 MARK RAKOWSKI DIRECTOR/PRESIDENT CCHP AND SVP CHHS 0 498494 0 125426 0 103804 0 111766 0 62185 0 901675 0 41719 LESLIE TECTOR SECRETARY/SVP & CHIEF LEGAL OFFICER 0 519906 0 108594 0 65784 0 85450 0 21522 0 801256 0 0 JAMES SLAWSON MD CHIEF MEDICAL OFFICER 354240 0 55138 0 14840 0 21850 0 50908 0 496976 0 0 0 MICHAEL BOEDER VICE PRESIDENT/COO CCHP 263725 0 50978 0 35895 0 25300 0 4982 0 380880 0 0 0 KELLY HODGES MD ASSOCIATE CHIEF MEDICAL OFFICER 269575 0 30026 0 32331 0 18186 0 4022 0 354140 0 0 0 JACQUELINE WHELAN VP QUALITY AND ANALYTICS 180337 0 23831 0 14288 0 16802 0 60814 0 296072 0 0 0 MICHAEL PELYHES HEALTH PLAN PHARMACY DIRECTOR 178635 0 18809 0 224 0 8299 0 58928 0 264895 0 0 0 JULIE ANTHOLINE DIR HEALTH PLAN OPERATIONS 162875 0 17155 0 1177 0 15139 0 67834 0 264180 0 0 0 MICHELLE METTNER FORMER OFFICER 0 173846 0 0 0 0 0 0 0 26 0 173872 0 0 PART I, LINE 3 CCHP RELIED UPON CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE CORPORATE MEMBER OF CCHP, TO ESTABLISH THE COMPENSATION OF CCHP'S PRESIDENT. CHHS USED ITS INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, A COMPENSATION SURVEY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION. PART I, LINE 4B IN 2024, THERE WAS A CHHS EXECUTIVE FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2024 WERE AS FOLLOWS: G. PERI, $145,833; M. CADIEUX, $112,199; L. TECTOR, $63,600; AND M. RAKOWSKI $83,016. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2024 WERE: M. CADIEUX, $90,953, AND M. RAKOWSKI, $41,719. PART I, LINE 7 CERTAIN LEADERS PARTICIPATE IN AN ANNUAL INCENTIVE PLAN THAT PROVIDES COMPENSATION BASED ON ACHIEVING SPECIFIC PRE-DEFINED GOALS. INCENTIVE CRITERIA ARE COMPRISED OF BOTH SYSTEM LEVEL AND LEADER SPECIFIC COMPONENTS. SUCH CRITERIA PERTAIN TO MATTERS WITHIN THE LEADER'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF THE ORGANIZATION AND ITS AFFILIATES IN ALIGNMENT WITH SYSTEM-WIDE BALANCED MEASURES. FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. GIL PERI, DIRECTOR OF CCHP AND PRESIDENT & CEO OF CHHS (BEGINNING IN AUGUST 2024), MARGARET TROY, DIRECTOR OF CCHP AND PRESIDENT & CEO OF CHHS (THROUGH AUGUST 2024), MARK RAKOWSKI, PRESIDENT AND DIRECTOR OF CCHP AND SVP OF CHHS, MARC CADIEUX, TREASURER OF CCHP AND SVP & CFO OF CHHS, LESLIE TECTOR, SECRETARY OF CCHP AND SVP & CHIEF LEGAL OFFICER OF CHHS, AND MICHELLE METTNER, FORMER SECRETARY OF CCHP - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY MS. TROY, MR. PERI, AND MR. RAKOWSKI AS MEMBERS OF THE BOARD OF DIRECTORS OF CCHP WERE PROVIDED AS PART OF THEIR POSITIONS OF CHHS. FORM 990, PART V, LINE 1A THE ORGANIZATION FILED FORM 1099S DURING THE TAXABLE YEAR FOR MEDICAL PAYMENTS IT MADE FROM ITS BANK ACCOUNTS. DUE TO CYBER ATTACKS THAT OCCURRED IN 2024, SOME OF THE ORGANIZATION'S MEDICAL PAYMENTS WERE INCLUDED ON THE ORGANIZATION'S THIRD PARTY ADMINISTRATOR'S (TPA) FORM 1099S SINCE THE CASH WAS DISBURSED VIA THE TPA'S BANK ACCOUNT. ADDITIONALLY, COMPENSATION AMOUNTS OWED TO INDEPENDENT CONTRACTORS AND HEALTH CARE PROVIDERS WERE PROCESSED AND PAID BY A RELATED ENTITY, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (CHHS), WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHHS. THE FORMS 1099 FOR SUCH PAYMENTS WERE ISSUED BY CHHS, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS. FORM 990, PART V, LINE 2A THE ORGANIZATION DID NOT FILE FORM W-3 DURING THE TAXABLE YEAR. ALTHOUGH THE ORGANIZATION DID RETAIN EMPLOYEES AND REPORTED SALARIES ON PART IX OF THE FORM 990, THE COMPENSATION AMOUNTS PAID TO EMPLOYEES OF CCHP WERE PROCESSED AND PAID BY A RELATED ENTITY, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (CHHS), WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHHS. THE FORM W-3 WAS ISSUED BY CHHS, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE EMPLOYEES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SOLE CORPORATE MEMBER WHICH IS CHHS. FORM 990, PART VI, SECTION A, LINE 7A CHHS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER, CHHS, HAS CERTAIN RESERVE POWERS OVER THE CORPORATION, INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; APPROVAL OF MERGER, CONSOLIDATION OR THE CREATION OF ANY SUBSIDIARIES BY THE CORPORATION; APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT; AND SELECTION OF THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CCHP. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE DIRECTOR OF CORPORATE COMPLIANCE. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, TREASURER, AND SECRETARY WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF CHHS (THE ORGANIZATION'S CORPORATE MEMBER). WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF THE COO WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CCHP ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. FORM 990, PART XI, LINE 9: BANK FEES 131,429. FORM 990, PART XII LINE 2 & PART IV, LINE 12A: CCHP WAS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHHS. THE CONSOLIDATED FINANCIAL STATEMENTS OF CHHS WERE PREPARED IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA AND WERE AUDITED BY AN INDEPENDENT ACCOUNTANT. ADDITIONALLY, CCHP WAS REQUIRED TO PREPARE STATUTORY FINANCIAL STATEMENTS IN ACCORDANCE WITH ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE OFFICE OF THE COMMISSIONER OF INSURANCE OF THE STATE OF WISCONSIN, WHICH IS A BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. THE STATUTORY FINANCIAL STATEMENTS WERE ALSO AUDITED BY AN INDEPENDENT ACCOUNTANT, BUT WERE NOT USED TO PREPARE THE FORM 990 SINCE THE STATUTORY STATEMENTS WERE PREPARED USING A BASIS OF ACCOUNTING OTHER THAN ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. CHILDREN'S HOSPITAL & HEALTH SYSTEM INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500074 AMBULATORY SURGERY CTR, URGENT CARE, & OPERATIONAL SUPPT SVCS WI 501(C)(3) LINE 3 N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500075 FUND DEVELOPMENT WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S MEDICAL GROUP INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391789197 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 390806380 CHILD WELFARE SERVICES WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SPECIALTY GROUP INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391990012 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 12A, I N/A 0 WEST ALLIS PRESCRIPTION CENTER INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 463421597 PHARMACY WI N/A C 0 WAUWATOSA PRESCRIPTION CENTER INC SKYWALK PHARMACY PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 061654484 PHARMACY WI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0