2025-10-30T11:00:40-05:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2024-01-01 272367522 MANIFEST MEDEX MANI 5106831333 3993 JURUPA AVE RIVERSIDE CA 92506 FAY JI CFO 5106831309 2025-10-28 1 0 LESLIE VAN P01294411 4159561500 2025-10-28 2024 2025-03-06 01:10:19Z ERICA GALVEZ 3993 JURUPA AVE RIVERSIDE CA 92506 48912338 0 X HTTPS://WWW.MANIFESTMEDEX.ORG/ X 2010 CA MANIFEST MEDEX FACILITATES THE COLLECTION OF ELECTRONIC CLINICAL RECORDS FROM HEALTHCARE PROVIDERS AND CLAIMS DATA FROM HEALTH INSURERS. THE CLINICAL AND CLAIMS DATA IS AGGREGATED TO PROVIDE COMPREHENSIVE LONGITUDINAL PATIENT RECORDS THAT EMPOWER MANIFEST MEDEX PARTICIPANTS WITH POWERFUL DATA TO EFFECTIVELY MANAGE THE CONTINUUM OF CARE AND DRIVE HIGHER QUALITY CARE AT A LOWER COST. 9 9 91 9 0 0 34504986 27882081 16440282 20559226 125886 471031 0 0 51071154 48912338 0 500000 0 0 16791839 18830122 0 0 0 33911346 24795162 50703185 44125284 367969 4787054 34884476 39254773 12660018 12243261 22224458 27011512 BE THE SMART GRID FOR HEALTH INFORMATION - DELIVER DATA-DRIVEN INSIGHT TO INDIVIDUALS AND HEALTH TEAMS WHEN AND WHERE THEY NEED IT SO THEY CAN IMPROVE CARE, LOWER COSTS AND ENHANCE HEALTH. 0 0 31849240 500000 20559226 AGGREGATING HEALTH CARE INFORMATION FROM DISPARATE PROVIDERS AND PAYERS TO ENABLE THEM TO PROVIDE MORE TIMELY, COMPLETE AND HIGHER QUALITY PATIENT-CENTERED CARE. 31849240 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 29 0 1 91 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X FAY JI 5106831309 3993 JURUPA AVE RIVERSIDE CA 92506 PETER LONG MEMBER (THRU 6/24) 2.50 X 0 0 0 KERRY HEINRICH MEMBER 2.50 X 0 0 0 J MARC OVERHAGE MEMBER (THRU 11/24) 2.50 X 0 0 0 DOLORES GREEN MEMBER 2.50 X 0 0 0 DEVEN MCGRAW MEMBER 2.50 X 0 0 0 ABNER MASON MEMBER 2.50 X 0 0 0 MARK SAVAGE VICE CHAIR 2.50 X 0 0 0 JARROD B MCNAUGHTON CHAIR 2.50 X 0 0 0 FRANCISCO J SILVA ESQ MEMBER 2.50 X 0 0 0 KRISHNA RAMACHANDRAN MEMBER 2.50 X 0 0 0 JEFFERY EATON MEMBER 2.50 X 0 0 0 SARITA CHOY CHIEF MARKETING OFFICER 40.00 X 356992 0 24866 ADAM HARRISON CHIEF BUS. DEV. OFFICER 40.00 X 556352 0 31044 JASON BUCKNER CHIEF INFORMATION OFFICER 40.00 X 385758 0 27857 PATRICIA GROBECK CHIEF FINANCIAL OFFICER (THRU 8/24) 40.00 X 295847 0 17520 ERICA GALVEZ CHIEF EXECUTIVE OFFICER 40.00 X 516208 0 13280 ELIZABETH KILLINGSWORTH CHIEF PRIVACY OFFICER 40.00 X 439099 0 14312 ROBERT JAKO CHIEF PEOPLE OFFICER 8.00 X 142932 0 14775 FAY JI CHIEF FINANCIAL OFFICER (START 8/24) 20.00 X 97500 0 0 BRITTANY HARNOIS CHIEF OF STAFF 40.00 X 256543 0 22730 JOSEPH HIBBITT INFRASTRUCTURE TEAM LEAD 40.00 X 266293 0 24066 DEIRDRE LAMBERTON SENIOR MANAGING DIRECTOR 40.00 X 279952 0 21207 NICHOLAS YARKER MANAGING DIRECTOR 40.00 X 288858 0 24700 HEIDI PALANCA PROJECT DIRECTOR - SAPHIRE 40.00 X 251025 0 9877 AAIRON LAI DIRECTOR, DATA & ANALYTICS 40.00 X 244431 0 17195 4377790 0 263429 82 0 1 0 INTERSYSTEMS CORPORATION PO BOX 84-5809 BOSTON MA 022845809 SAAS LICENSE FEES 6800842 LOGICWORKS SYSTEM CORPORATION 155 AVENUE OF THE AMERICAS 8TH FL NEW YORK NY 10013 PLATFORM MAINTENANCE 3410940 J2 INTERACTIVE LLC 2 THIRTEENTH STREET CHARLESTOWN MA 02129 CONTRACTOR 3038431 AVAILITY LLC 10 EXECUTIVE DRIVE FARMINGTON CT 06032 SAAS LICENSE FEES 1744657 VERATO INC 1751 PINNACLE DR SUITE 1700 MCLEAN VA 22102 SAAS LICENSE FEES 923797 22 26719026 1163055 27882081 HIE SERVICES REVENUE 541900 20559226 20559226 20559226 471031 471031 48912338 20559226 0 471031 500000 500000 2802749 917706 1885043 12910623 7758420 5152203 409064 253812 155252 2707686 1592540 1115146 33930 33930 110850 110850 3936914 3533300 403614 11647 11647 131583 36188 95395 637666 467480 170186 367417 367417 469789 18865 450924 206490 80118 126372 154536 154536 611391 611391 398436 398436 SAAS FEES 12801721 12801721 PLATFORM MAINTENANCE 3889090 3889090 NEW INITIATIVES 695050 695050 HIO CONTRIBUTION EXPENS 111000 111000 227652 227652 44125284 31849240 12276044 0 10002 10004 24341152 30650029 4055922 4885387 1678956 2451609 3474682 685355 8751638 8666685 723134 84953 600628 487436 34884476 39254773 6856010 6102152 125000 610083 5000000 5000000 679008 531026 12660018 12243261 X 22224458 27011512 22224458 27011512 34884476 39254773 4787054 0 X 0 1 X 1 0 X 23323957 27316877 23346838 34504986 27882081 136374739 23323957 27316877 23346838 34504986 27882081 136374739 52273695 84101044 88459 1521 125886 471031 686897 3627 3627 137065263 73332275 0.61360 0.46330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 500000 1 150000 0 0 650000 0 PART II-B, LINE 1: LOBBYING FOR A STATEWIDE HEALTHCARE DATA EXCHANGE INFRASTRUCTURE FOR KEY MEDI-CAL PROGRAM AND STATE FUNCTIONS, INCLUDING THE RESPONSE TO COVID-19, FUNDED WITH FEDERAL MEDICAID MATCH, AND WITH A STATEWIDE MANDATE FOR PARTICIPATION. THERE ARE NO ACTIVE BILLS IN THE LEGISLATURE, BUT WE HAVE MET THE GOVERNOR'S OFFICE, SENATE, AND ASSEMBLY HEALTH COMMITTEES, AND MULTIPLE STATE AGENCIES. 134050 133354 696 8592726 8508469 84257 24862 24862 0 84953 OPERATING LEASE LIABILITY 531026 531026 X 48920795 8457 8457 48912338 0 48912338 44133741 8457 8457 44125284 0 44125284 PART X, LINE 2: MANAGEMENT HAS DETERMINED THAT THE COMPANY HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. ANY FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES WOULD BE RECOGNIZED IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 0 PROTECT OUR HEALTHCARE 2350 KERNER BLVD STE 250 SAN RAFAEL CA 94901 921017935 500000 0 CONTRIBUTION TO YES ON 35 COMMITTEE - FORMED TO QUALIFY AND SUPPORT THE PROTECT ACCESS TO HEALTHCARE ACT OF 2024 ON THE NOVEMBER 2024 STATEWIDE CA BALLOT. 1 X X X X 1 0 0 0 0 0 0 1 0 ADAM HARRISON CHIEF BUS. DEV. OFFICER 263711 0 292641 0 0 0 13800 0 17244 0 587396 0 0 0 ERICA GALVEZ CHIEF EXECUTIVE OFFICER 416108 0 100100 0 0 0 13280 0 0 0 529488 0 0 0 ELIZABETH KILLINGSWORTH CHIEF PRIVACY OFFICER 358285 0 80814 0 0 0 13800 0 512 0 453411 0 0 0 JASON BUCKNER CHIEF INFORMATION OFFICER 311299 0 74459 0 0 0 13800 0 14057 0 413615 0 0 0 SARITA CHOY CHIEF MARKETING OFFICER 293459 0 63533 0 0 0 13800 0 11066 0 381858 0 0 0 NICHOLAS YARKER MANAGING DIRECTOR 241564 0 47294 0 0 0 10393 0 14307 0 313558 0 0 0 PATRICIA GROBECK CHIEF FINANCIAL OFFICER (THRU 8/24) 180327 0 53296 0 62224 0 9610 0 7910 0 313367 0 0 0 DEIRDRE LAMBERTON SENIOR MANAGING DIRECTOR 233827 0 46125 0 0 0 11198 0 10009 0 301159 0 0 0 JOSEPH HIBBITT INFRASTRUCTURE TEAM LEAD 225503 0 40790 0 0 0 10897 0 13169 0 290359 0 0 0 BRITTANY HARNOIS CHIEF OF STAFF 217602 0 38941 0 0 0 10537 0 12193 0 279273 0 0 0 AAIRON LAI DIRECTOR, DATA & ANALYTICS 207651 0 36780 0 0 0 2777 0 14418 0 261626 0 0 0 HEIDI PALANCA PROJECT DIRECTOR - SAPHIRE 216865 0 34160 0 0 0 9365 0 512 0 260902 0 0 0 ROBERT JAKO CHIEF PEOPLE OFFICER 115008 0 27924 0 0 0 5717 0 9058 0 157707 0 0 0 PART I, LINE 4A TRISHA GROBECK RECEIVED A SEVERANCE PAYMENT OF $62,224 DURING THE YEAR. PART I, LINE 7 THE NON-FIXED PAYMENTS ARE CONTRACTUALLY DRIVEN BY THE TERMS OF EMPLOYEE EMPLOYMENT AGREEMENTS. THESE ARE AWARDED AND ARE BASED UPON ACCOMPLISHMENT OF KEY DEPARTMENTAL OBJECTIVES AND ARE NOT BASED ON REVENUE OR NET INCOME METRICS. BLUE SHIELD OF CALIFORNIA FOUNDER & SUBSTANTIAL CONTRIBUTOR OPERATING CASH FLOW X 5000000 5000000 0 1 1 5000000 FORM 990, PART VI, SECTION B, LINE 11B PROCESS SUMMARY 1-MANIFEST MEDEX'S AUDITORS COMPLETE AN AUDIT OF THE FINANCIAL STATEMENTS FOR THE APPLICABLE YEAR. 2-MANIFEST MEDEX'S TAX PREPARER USES INFORMATION FROM (I) THE AUDITED FINANCIAL STATEMENTS AND (II) MANIFEST MEDEX AND COMPLETES A DRAFT OF THE FORM 990. 3-INTERNAL STAFF, INCLUDING THE AVP OF FINANCE, CFO AND CEO REVIEW THE DRAFT FORM 990 AND MAKE ANY REQUIRED ADJUSTMENTS TO IT. 4-THE MANIFEST MEDEX BOARD IS PROVIDED A COPY OF THE FINAL DRAFT OF THE FORM 990 AND PROVIDED A REASONABLE PERIOD OF TIME TO REVIEW IT AND ASK ANY QUESTIONS OF MANAGEMENT BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH "INSIDER" IS RESPONSIBLE FOR KNOWING AND FOLLOWING THE POLICY INCLUDING HAVING A DUTY TO DISCOVER AND DISCLOSE A CONFLICT. ALSO, EACH INSIDER, AND OTHER PERSONS THAT MX'S BOARD MAY IDENTIFY FROM TIME TO TIME, SHALL ANNUALLY SIGN A DISCLOSURE STATEMENT IN THE FORM ATTACHED HERETO, THAT: 1. AFFIRMS THAT THE PERSON HAS RECEIVED, READ AND UNDERSTANDS THIS POLICY, AND AGREES TO COMPLY WITH THE POLICY; AND 2. DISCLOSES THE PERSON'S INTERESTS AND FAMILY RELATIONSHIPS THAT COULD GIVE RISE TO A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPANY'S BOARD ADOPTED AN EMPLOYEE COMPENSATION POLICY AND ESTABLISHED A COMPENSATION COMMITTEE. THIS COMMITTEE REVIEWS AND RECOMMENDS TO THE BOARD ALL COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES, EXCEPT FOR THE CEO WHICH THE BOARD AS A WHOLE ANALYZES AND APPROVES. THE REVIEW PROCESS INCLUDES A REVIEW OF BACKGROUND INFORMATION (E.G. EDUCATION, EXPERIENCE, ETC.) AND COMPARABILITY DATA (E.G. COMPENSATION SURVEYS). THE BOARD THEN DETERMINES WHETHER TO APPROVE THE COMPENSATION OF THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES BASED ON THE INFORMATION COMPILED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST.