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← REGIONAL WEST HEALTH SERVICES & AFFILIATED EMPLOYEE BENEFIT TRUST

Form 990 for tax year 2022

Filed by REGIONAL WEST HEALTH SERVICES & AFFILIATED EMPLOYEE BENEFIT TRUST.

Totals

Total revenue
$18,990,184
Total expenses
$28,131,972
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$18,960,533
Investment income
$29,651
Other revenue
$0
Total assets, end of year
$1,700,063
Total liabilities, end of year
$8,886,582
Net assets or fund balances, end of year
-$7,186,519
Program services expenses (Part IX)
not reported
Management and general expenses
not reported
Fundraising expenses
not reported
Program service expenses (Part III)
$28,131,972

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: EMPLOYER CONTRIBUTIONS

    total $15,418,206 · related or exempt $15,418,206

  • 2b · Program service revenue: EMPLOYEE CONTRIBUTIONS

    total $3,445,861 · related or exempt $3,445,861

  • 2f · All other program service revenue

    total $96,466 · related or exempt $96,466

  • 3 · Investment income

    total $29,651 · unrelated business $29,651

Functional expenses

Part IX, the statement of functional expenses.

  • 4 · Benefits paid to or for members

    total $27,707,773

  • 11g · Fees: other

    total $422,825

  • 24a · Other expenses: MISCELLANEOUS

    total $1,374

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $317,263 · end of year $281,973

  • 4 · Accounts receivable

    beginning of year $188,218 · end of year $188,218

  • 11 · Investments: publicly traded securities

    beginning of year $1,502,537 · end of year $1,229,872

  • 15 · Other assets

    beginning of year $3,361,107 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,000 · end of year $206,932

  • 25 · Other liabilities

    beginning of year $3,110,372 · end of year $8,679,650

  • 27 · Net assets without donor restrictions

    beginning of year $2,257,753 · end of year -$7,186,519

Mission and programs · 2022

Mission

NONE

Activities or mission (Part I)

SELF FUNDED EMPLOYEE BENEFIT PLAN.

  • THE PLAN PROVIDES MEDICAL (HOSPITAL, SURGICAL AND MAJOR MEDICAL) AND DENTAL BENEFITS TO ALL FULL-TIME AND PART-TIME (20 HOURS OR MORE PER WEEK) EMPLOYEES ENROLLED IN THE PLAN.

    Expenses $28,131,972 · Revenue $18,960,533

As filed on the 2022 return.

Listed in Part VII

  • Dennis Hadden

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Hod Kosman

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • John Mentgen

    CEO THRU 10/2022

    Total calculated
    $820,525
    From this org
    $0
    From related orgs
    $695,971
    Other
    $124,554
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $686,629 related
    Bonus
    $0
    Other
    $0 + $9,342 related
    Deferred
    $0 + $75,199 related
    Nontaxable benefits
    $0 + $49,355 related
    Filer's total
    $0 + $820,525 related

  • Michael Ickowski

    CFO

    Total calculated
    $415,299
    From this org
    $0
    From related orgs
    $369,241
    Other
    $46,058
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $358,860 related
    Bonus
    $0
    Other
    $0 + $10,381 related
    Deferred
    $0 + $45,300 related
    Nontaxable benefits
    $0 + $758 related
    Filer's total
    $0 + $415,299 related

  • Amanda Vick

    INTERIM CEO THRU 12/2022

    Total calculated
    $340,576
    From this org
    $0
    From related orgs
    $300,625
    Other
    $39,951
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $292,250 related
    Bonus
    $0
    Other
    $0 + $8,375 related
    Deferred
    $0 + $39,212 related
    Nontaxable benefits
    $0 + $739 related
    Filer's total
    $0 + $340,576 related

  • Mel McNea

    CEO

    Total calculated
    $8,654
    From this org
    $0
    From related orgs
    $8,654
    Other
    $0
    Hours/week
    1 + 45 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement

The filer's explanations (Part III)

PART I, LINE 3
THE CEO AND CFO ARE COMPENSATED BY REGIONAL WEST HEALTH SERVICES, A RELATED ORGANIZATION. METHODS USED TO ESTABLISH COMPENSATION FOR THESE INDIVIDUALS INCLUDE THE FOLLOWING: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JOHN MENTGEN 64,199 MICHAEL ICKOWSKI 33,700 AMANDA VICK 27,612

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • REGIONAL CARE INC

    C · TPA · NE

Provenance

Return type
form_990
Tax year
2022
Filed
14 November 2023
IRS schema version
2022v5.0
Source object
202323189349310232

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