2025-11-17T16:07:55-06:00 2024-12-31 420714325 RSM US LLP 80 CITY SQUARE BOSTON MA 02129 990 2024-01-01 562382058 COMMONWEALTH CLINICAL ALLIANCE INC COMM 6174260600 30 WINTER STREET BOSTON MA 02108 LARRY SMART TREASURER 6174260600 2025-11-17 1 0 KAREN LO P01434915 6179129000 2024 2025-03-06 01:10:19Z BILJANA SIMIKIC 30 WINTER STREET BOSTON MA 02108 85736825 0 X N/A X 2004 MA SERVES AS A PRIMARY CARE SITE WITH NUMEROUS LOCATIONS IN MASSACHUSETTS, FOR THE COMMONWEALTH CARE ALLIANCE'S SENIOR CARE AND ONE CARE OPTIONS PROGRAMS. 6 4 0 5 0 0 0 0 63051921 85736825 -44450 0 0 0 63007471 85736825 0 0 0 0 60324363 80784469 0 0 0 2739572 4958742 63063935 85743211 -56464 -6386 278657228 9668984 263703343 448221 14953885 9220763 SERVES AS A PRIMARY CARE SITE WITH NUMEROUS LOCATIONS IN MASSACHUSETTS, FOR THE COMMONWEALTH CARE ALLIANCE'S SENIOR CARE AND ONE CARE OPTIONS PROGRAMS. 0 0 85743211 85736825 PROVIDES CARE MANAGEMENT SERVICES TO CHRONICALLY ILL ADULTS. 85743211 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X EDWARD L STUBBERS SECRETARY 6174260600 30 WINTER STREET BOSTON MA 02108 CHRISTOPHER D PALMIERI PRESIDENT & CEO, DIRECTOR 10.00 30.00 X X 0 1623372 1129181 HANY ABDELAAL DIRECTOR 1.00 39.00 X 0 911545 260319 DANIEL HENDERSON DIRECTOR (UNTIL MAY 2024) 1.00 1.00 X 0 0 0 BILJANA SIMIKIC DIRECTOR 1.00 2.00 X 0 0 0 SUSAN WOOD DIRECTOR 1.00 2.00 X 0 0 0 CHRISTY AMITAY DIRECTOR (AS OF MAY 2024) 1.00 1.00 X 0 0 0 NAZLIM HAGMANN DIRECTOR 1.00 2.00 X 0 0 0 ELIZABETH GOODMAN SEC CLERK CHIEF LEGAL OFFICER 10.00 30.00 X 0 748500 224165 FRANK SCALISE TREASURER CFO (UNTIL JUNE 2024) 10.00 30.00 X 0 410855 17273 MIHIR SHAH TREASURER CFO (AS OF OCTOBER 2024) 10.00 30.00 X 0 125039 82745 0 3819311 1713683 0 0 1 0 0 ENROLLEE REVENUE 621610 85736825 85736825 85736825 85736825 85736825 0 0 61598160 61598160 19182318 19182318 3991 3991 1132 1132 867244 867244 1673 1673 747527 747527 156827 156827 714377 714377 523196 523196 12306 12306 43688 43688 MEDICAL EXPENSES 1427306 1427306 DUES & SUBSCRIPTIONS 320339 320339 EDUCATION & TRAINING 133908 133908 MEALS & ENTERTAINMENT 8663 8663 556 556 85743211 85743211 0 0 879 16875 27800 19300 800249 799461 12291 788 278617137 9631142 278657228 9668984 153305 339462 263550038 108759 263703343 448221 X 14953885 9220763 14953885 9220763 278657228 9668984 X -6386 -5726736 X 0 1 X 1 0 X 89879060 101479734 121448867 63051921 85736825 461596407 89879060 101479734 121448867 63051921 85736825 461596407 0 0 0 461596407 89879060 101479734 121448867 63051921 85736825 461596407 1.00000 1.00000 0.00000 X 241638 240850 788 106428 106428 0 452183 452183 0 788 DUE FROM COMMONWEALTH COMMUNITY CARE, INC. 1013882 DUE FROM COMMONWEALTH CARE ALLIANCE, INC. 8500305 RIGHT OF USE ASSET-SHORT TERM 116955 9631142 RIGHT OF USE LIABILITY-SHORT TERM 108759 108759 X PART X, LINE 2: THE ORGANIZATION IS REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 0 0 CHRISTOPHER D PALMIERI PRESIDENT & CEO, DIRECTOR 0 1213752 0 358102 0 51518 0 1106329 0 22852 0 2752553 0 0 HANY ABDELAAL DIRECTOR 0 728906 0 179801 0 2838 0 255527 0 4792 0 1171864 0 0 ELIZABETH GOODMAN SEC CLERK CHIEF LEGAL OFFICER 0 559004 0 186658 0 2838 0 198567 0 25598 0 972665 0 0 FRANK SCALISE TREASURER CFO (UNTIL JUNE 2024) 0 318092 0 90585 0 2178 0 14850 0 2423 0 428128 0 0 MIHIR SHAH TREASURER CFO (AS OF OCTOBER 2024) 0 124811 0 0 0 228 0 82502 0 243 0 207784 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON COMMONWEALTH CARE ALLIANCE, A RELATED ORGANIZATION, THAT USED ONE OR MORE OF THE METHODS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. PART I, LINE 4B THE CEO PARTICIPATES IN THE COMMONWEALTH CARE ALLIANCE SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP), A NONQUALIFIED DEFERRED COMPENSATION PLAN EFFECTIVE JANUARY 1, 2022. $157,804 WAS CONTRIBUTED TO THE PLAN IN 2024 AND HAS BEEN REPORTED IN PART II, COLUMN (C) AS DEFERRED COMPENSATION. THE CEO ALSO PARTICIPATES IN AN DEFINED BENEFIT PLAN IN WHICH $933,000 WAS CONTRIBUTED IN 2024 WHICH IS REPORTED IN PART II, COLUMN C. CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATE IN THE COMMONWEALTH CARE ALLIANCE EXECUTIVE RETENTION PLAN, A NONQUALIFIED DEFERRED COMPENSATION PLAN WHICH WAS OFFERED TO CERTAIN MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM AND SUBSEQUENTLY OFFERED TO NEWER EMPLOYEES. PAYMENTS WILL BE MADE TO THE EXECUTIVE ONLY IF THE EXECUTIVE STAYS WITH THE ORGANIZATION THROUGH THE FIVE-YEAR VESTING PERIOD AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION OF THE PARTICIPANTS. THE MARKET FOR EXECUTIVE TALENT IN THIS COUNTRY IS FIERCELY COMPETITIVE AND WE RECRUIT INDIVIDUALS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE SUCCESSFULLY. PAYMENTS WILL BE MADE AT THE END OF A FIVE-YEAR PERIOD BASED ON ROLLING EFFECTIVE DATES IN AN AMOUNT EQUAL TO 100% OF THE EXECUTIVE'S BASE SALARY AS OF THE END OF THE YEAR PRIOR TO PAYOUT. ELIGIBLE PARTICIPANTS HAVE 18% OF THEIR SALARY ACCRUED FOR EACH YEAR FOR THE FIVE-YEAR PERIOD. IN 2024, 18% OF BASE SALARY FOR ELIZABETH GOODMAN AND HANY ABDELAAL WAS ACCRUED AND HAS BEEN INCLUDED AS DEFERRED COMPENSATION IN (SCHEDULE J, PART II, COLUMN C). AMOUNTS WILL BE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). CERTAIN EXECUTIVES PARTICIPATE IN THE EXECUTIVE SERP PLAN. ELIGIBLE PARTICIPANTS HAVE 15% OF THEIR SALARY ACCRUED FOR EACH YEAR. IN 2024, 15% OF BASE SALARY FOR HANY ABDELAAL, MIHIR SHAH AND ELIZABETH GOODMAN WAS ACCRUED AND HAS BEEN INCLUDED AS DEFERRED COMPENSATION IN (SCHEDULE J, PART II, COLUMN C). FORM 990, PART VI, SECTION A, LINE 6 COMMONWEALTH CLINICAL ALLIANCE HAS ONE CORPORATE MEMBER WHICH IS COMMONWEALTH CARE ALLIANCE, INC. FORM 990, PART VI, SECTION A, LINE 7A IN ACCORDANCE WITH THE CLINICAL ALLIANCE'S BYLAWS, THE CORPORATE MEMBER HAS THE POWERS AND AUTHORITY TO APPOINT ADDITIONAL MEMBERS AND ELECT CLINICAL ALLIANCE'S DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B IN ACCORDANCE WITH THE CLINICAL ALLIANCE'S BYLAWS, THE CORPORATE MEMBER HAS THE POWERS AND AUTHORITY TO ADOPT AND APPROVE BYLAWS AND AMENDMENTS TO THE ARTICLES OF ORGANIZATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. THE BOARD ALSO REVIEWS THE FINANCIAL STATEMENTS ON A QUARTERLY BASIS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF COMMONWEALTH CLINICAL ALLIANCE, INC. FOLLOWS THE CONFLICT OF INTEREST POLICY OF COMMONWEALTH CARE ALLIANCE ("CCA"), A RELATED ORGANIZATION. THE FOLLOWING ARE THE PROCEDURES THAT CCA TAKES TO MONITOR AND ENFORCE COMPLIANCE WITH THE POLICY. THE ANNUAL COMPLIANCE POLICY AND CONFLICT OF INTEREST FORMS ARE DISTRIBUTED TO THE BOARD AND OFFICERS AND THE COMPLIANCE DEPARTMENT MONITORS FOR COMPLETION ANNUALLY. THE BOARD AND OFFICERS ALSO RECEIVE ANNUAL TRAINING ON CONFLICT OF INTEREST. THE COMPANY'S CONFLICT OF INTEREST POLICY COVERS CCA EMPLOYEES, OFFICERS AND DIRECTORS. THE POLICY CALLS FOR CONFLICT OF INTEREST ANALYSIS AND ACTUAL CONFLICTS ARE REVIEWED AND CONFLICTS DETERMINATIONS ARE MADE FOR EMPLOYEES OF DIRECTOR LEVEL AND ABOVE (DIRECTOR, SENIOR DIRECTOR, VICE PRESIDENT, SENIOR VICE PRESIDENT). WHERE AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST INVOLVING A TRANSACTION IS DETERMINED, THE EMPLOYEE IS PROHIBITED FROM PARTICIPATING IN EITHER MANAGEMENT'S OR THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IN ADDITION, THE FORM 990 WITHOUT SCHEDULE B IS AVAILABLE VIA CANDID FORMERLY KNOWN AS GUIDESTAR AND THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART XI, LINE 9: DISTRIBUTION TO MEMBER -5,726,736. COMMONWEALTH CARE ALLIANCEINC 30 WINTER STREET BOSTON MA 02108 043756900 SUPPORT FOR CARE DELIVERANCY MA 501(C)(3) LINE 10 N/A 0 BOSTON'S COMMUNITY MEDICAL GROUP INC 30 NORTHAMPTON STREET BOSTON MA 02118 260100022 MEDICAL SERVICESS MA 501(C)(3) LINE 3 COMMONWEALTH CARE ALLIANCE INC 0 THE CENTER TO ADVANCE CONSUMER PARTNERSHIP INC(CEASED CONTROL 3824) 30 WINTER STREET BOSTON MA 02108 822810261 NATIONAL INNOVATION HUB FOR DEVELOPMENT IN QUALITY OF CARE AND HEALTH MA 501(C)(3) LINE 12A, I COMMONWEALTH CARE ALLIANCE INC 0 COMMUNITY INTENSIVE CARE INC 30 WINTER STREET BOSTON MA 02108 933780796 MEDICAL SERVICES MA 501(C)(3) LINE 10 COMMONWEALTH CARE ALLIANCE INC 0 CCA FOUNDATION INC 30 WINTER STREET BOSTON MA 02108 934772832 INACTIVE MA 501(C)(3) LINE 12A, I COMMONWEALTH CARE ALLIANCE INC 0 CCA HOLDING COMPANY INC (FORMED ON 122624) 30 WINTER STREET BOSTON MA 02108 332663201 INACTIVE MA 501(C)(4) 0 CCA CLINICAL HOLDING COMPANY INC (FORMED ON 121724) 30 WINTER STREET BOSTON MA 02108 332709766 INACTIVE MA 501(C)(4) CCA HOLDING COMPANY INC 0 VOICE CARE TECH HOLDINGS LLC 30 WINTER STREET BOSTON MA 02108 882835914 HOLDING COMPANY MA N/A 0 0 CCA ACO LLC 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 461262045 MEDICARE SHARED SAVINGS PROGRAM ACO MI N/A 0 0 RELIANCE NEXT GEN ACO LLC 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 812185714 MEDICARE FEE FOR SERVICE NEXGEN ACO MI N/A 0 0 COMMONWEALTH CARE ALLIANCE MASSACHUSETTS INC 30 WINTER STREET BOSTON MA 02108 854228186 MEDICARE ADVANTAGE PRODUCTS MA N/A C 0 COMMONWEALTH CARE ALLIANCE RHODE ISLAND INC 30 WINTER STREET BOSTON MA 02108 854310885 MEDICARE ADVANTAGE PRODUCTS MA N/A C 0 COMMONWEALTH CARE ALLIANCE INDIANA LLC 30 WINTER STREET BOSTON MA 02108 873317576 MEDICARE ADVANTAGE PRODUCTS IN N/A C 0 COMMONWEALTH CARE ALLIANCE MICHIGAN LLC 30 WINTER STREET BOSTON MA 02108 872560730 HOLDING COMPANY MI N/A C 0 CCA HEALTH MICHIGAN INC 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 814977640 MEDICAL SERVICES TO PERSONS IN MICHIGAN MI N/A C 0 CCA PO INC 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 813685900 PHYSICIAN CONTRACTING ORGANIZATION MI N/A C 0 COMMONWEALTH CARE ALLIANCE CALIFORNIA LLC 30 WINTER STREET BOSTON MA 02108 873361607 HOLDING COMPANY CA N/A C 0 CCA HEALTH PLANS OF CALIFORNIA (FKA VITALITY HEALTH PLAN OF CALIFORNIA INC) 18000 STUDEBAKER RD STE 150 CERRITOS CA 90703 814822508 ARRANGES FOR HEALTHCARE SERVICES TO MEDICARE BENEFICIARIES CA N/A C 0 INSTED HOLDCO LLC (FORMED ON 121724) 30 WINTER STREET BOSTON MA 02108 333183161 HOLDING COMPANY DE N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1