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Nonprofiteer
← MOUNT CARMEL HEALTH INSURANCE COMPANY

Form 990 for tax year 2022

Filed by MOUNT CARMEL HEALTH INSURANCE COMPANY.

Totals

Total revenue
$9,948,719
Total expenses
$11,096,572
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$9,946,411
Investment income
$2,308
Other revenue
$0
Total assets, end of year
$8,608,222
Total liabilities, end of year
$3,443,776
Net assets or fund balances, end of year
$5,164,446
Program services expenses (Part IX)
$9,703,988
Management and general expenses
$1,392,584
Fundraising expenses
$0
Program service expenses (Part III)
$9,703,988

Program services were 87.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

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: PREMIUM REVENUE

    total $9,946,411 · related or exempt $9,946,411

  • 3 · Investment income

    total $13,679 · excluded $13,679

  • 7b · Less cost or other basis and sales expenses

    securities $11,371

  • 7c · Gain or loss

    securities -$11,371

  • 7d · Net gain or loss

    total -$11,371 · excluded -$11,371

Functional expenses

Part IX, the statement of functional expenses.

  • 11a · Fees: management

    total $1,329,667 · management and general $1,329,667

  • 11c · Fees: accounting

    total $55,023 · management and general $55,023

  • 11d · Fees: lobbying

    total $100 · management and general $100

  • 11f · Fees: investment management

    total $1,170 · management and general $1,170

  • 11g · Fees: other

    total $9,571,908 · program services $9,571,908

  • 24a · Other expenses: I/C PURCHASED SERVICES

    total $132,080 · program services $132,080

  • 24b · Other expenses: LICENSES, FEES, & OTHER

    total $6,624 · management and general $6,624

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $1,539,954 · end of year $1,485,847

  • 4 · Accounts receivable

    beginning of year $2,574,843 · end of year $2,025,184

  • 11 · Investments: publicly traded securities

    beginning of year $4,282,123 · end of year $4,641,626

  • 15 · Other assets

    beginning of year $254,370 · end of year $455,565

  • 17 · Accounts payable and accrued expenses

    beginning of year $207,546 · end of year $306,268

  • 19 · Deferred revenue

    beginning of year $1,459 · end of year $2,832

  • 25 · Other liabilities

    beginning of year $2,085,012 · end of year $3,134,676

  • 27 · Net assets without donor restrictions

    beginning of year $6,357,273 · end of year $5,164,446

Mission and programs · 2022

Mission

WE, MOUNT CARMEL AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES.MOUNT CARMEL HEALTH INSURANCE COMPANY (MCHIC) IS A MEMBER OF MOUNT CARMEL AND TRINITY HEALTH.

Activities or mission (Part I)

TO ASSIST MEDICARE-ELIGIBLE SENIORS OBTAIN ACCESS TO MEDICARE ADVANTAGE INSURANCE COVERAGE

  • MOUNT CARMEL HEALTH INSURANCE COMPANY (MCHIC) WAS FORMED IN 2007 FOR THE PURPOSE OF ASSISTING MEDICARE-ELIGIBLE SENIORS IN THE CENTRAL OHIO REGION TO OBTAIN ACCESS TO MEDICARE ADVANTAGE INSURANCE COVERAGE THAT PROVIDES COST-EFFECTIVE HEALTH BENEFITS, COMPASSIONATE CARE, AND SERVICE COUPLED WITH OUT-OF-NETWORK BENEFITS. MCHIC IS A WHOLLY-OWNED NONPROFIT SUBSIDIARY OF MOUNT CARMEL HEALTH SYSTEM, A TAX-EXEMPT HEALTH CARE SYSTEM UNDER IRC SECTION 501(C)(3). MCHIC OFFERS A PREFERRED PROVIDER ORGANIZATION PLAN IN ACCORDANCE WITH THE REQUIREMENTS OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THE PLAN IS AVAILABLE TO ALL RESIDENTS OF OHIO WITHIN MCHIC'S SERVICE AREA WHO ARE ELIGIBLE FOR MEDICARE PARTS A AND B. AS AN INTEGRAL PART OF MOUNT CARMEL HEALTH SYSTEM, MCHIC IS A COMMUNITY-BASED HEALTH CARE ORGANIZATION THAT WORKS IN COLLABORATION WITH EMPLOYERS, INDIVIDUAL MEMBERS, PHYSICIANS, HEALTH CARE PROVIDERS, AND COMMUNITY AND GOVERNMENTAL AGENCIES TO CONTINUALLY IMPROVE THE HEALTH OF ITS MEMBERS BY PROVIDING EXCEPTIONAL COVERAGE AND ACCESS TO HIGH QUALITY AND COST EFFECTIVE CARE. PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION: HTTP://WWW.MEDIGOLD.COM

    Expenses $9,703,988 · Revenue $9,946,411

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • LORRAINE LUTTON

    DIRECTOR & MOUNT CARMEL CEO

    Total calculated
    $1,566,664
    From this org
    $0
    From related orgs
    $1,277,941
    Other
    $288,723
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $862,896 related
    Bonus
    $0 + $391,500 related
    Other
    $0 + $23,545 related
    Deferred
    $0 + $238,294 related
    Nontaxable benefits
    $0 + $50,429 related
    Filer's total
    $0 + $1,566,664 related

  • JACK RANDOLPH

    DIRECTOR; PRESIDENT & CEO

    Total calculated
    $919,569
    From this org
    $0
    From related orgs
    $737,128
    Other
    $182,441
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $527,875 related
    Bonus
    $0 + $185,657 related
    Other
    $0 + $23,596 related
    Deferred
    $0 + $141,829 related
    Nontaxable benefits
    $0 + $40,612 related
    Filer's total
    $0 + $919,569 related

  • DANIEL WENDORFF MD

    DIRECTOR; CHAIR; PRES, HLTH PARTNERS

    Total calculated
    $553,542
    From this org
    $0
    From related orgs
    $510,056
    Other
    $43,486
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $437,932 related
    Bonus
    $0 + $66,116 related
    Other
    $0 + $6,008 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $25,186 related
    Filer's total
    $0 + $553,542 related

  • ANDY PRIDAY

    MOUNT CARMEL CFO AS OF 7/22

    Total calculated
    $459,294
    From this org
    $0
    From related orgs
    $405,211
    Other
    $54,083
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $346,480 related
    Bonus
    $0 + $55,888 related
    Other
    $0 + $2,843 related
    Deferred
    $0 + $37,378 related
    Nontaxable benefits
    $0 + $16,705 related
    Filer's total
    $0 + $459,294 related

  • GREG WISE MD

    MEDICAL DIRECTOR MCHP

    Total calculated
    $443,543
    From this org
    $0
    From related orgs
    $412,420
    Other
    $31,123
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $358,370 related
    Bonus
    $0 + $51,714 related
    Other
    $0 + $2,336 related
    Deferred
    $0 + $9,150 related
    Nontaxable benefits
    $0 + $21,973 related
    Filer's total
    $0 + $443,543 related

  • KIMBERLY HODGKINSON

    MOUNT CARMEL CFO THROUGH 6/22

    Total calculated
    $432,817
    From this org
    $0
    From related orgs
    $405,351
    Other
    $27,466
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $266,007 related
    Bonus
    $0 + $131,250 related
    Other
    $0 + $8,094 related
    Deferred
    $0 + $3,748 related
    Nontaxable benefits
    $0 + $23,718 related
    Filer's total
    $0 + $432,817 related

  • DAVID VIS

    ASST TREASURER;VP FINANCE OPERATIONS

    Total calculated
    $361,044
    From this org
    $0
    From related orgs
    $345,335
    Other
    $15,709
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $307,103 related
    Bonus
    $0 + $34,311 related
    Other
    $0 + $3,921 related
    Deferred
    $0 + $13,725 related
    Nontaxable benefits
    $0 + $1,984 related
    Filer's total
    $0 + $361,044 related

  • CARLOS ALVARADO

    CHIEF ADMINISTRATIVE OFFICER

    Total calculated
    $335,257
    From this org
    $0
    From related orgs
    $293,929
    Other
    $41,328
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $254,052 related
    Bonus
    $0 + $39,287 related
    Other
    $0 + $590 related
    Deferred
    $0 + $9,090 related
    Nontaxable benefits
    $0 + $32,238 related
    Filer's total
    $0 + $335,257 related

  • TRISHA WHETSTONE

    ASST SECRETARY; MCHS ASSOC COUNSEL

    Total calculated
    $234,444
    From this org
    $0
    From related orgs
    $192,972
    Other
    $41,472
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $174,337 related
    Bonus
    $0 + $18,487 related
    Other
    $0 + $148 related
    Deferred
    $0 + $9,215 related
    Nontaxable benefits
    $0 + $32,257 related
    Filer's total
    $0 + $234,444 related

  • JOSEPH PATRICK JR

    DIRECTOR; TREASURER; SECRETARY

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • CYNTHIA DELLECKER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • TODD FOX

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • STEVE LUNDREGAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 2 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
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
MOUNT CARMEL HEALTH INSURANCE COMPANY IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL HEALTH INSURANCE COMPANY'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MOUNT CARMEL HEALTH INSURANCE COMPANY'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2022, AND THEIR NON-VESTED BENEFITS FOR 2022 WERE ACCRUED. THE FOLLOWING ACCRUALS FOR 2022 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: LORRAINE LUTTON - $224,569 ANDY PRIDAY - $23,653 JACK RANDOLPH - $128,104

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 partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
14 November 2023
IRS schema version
2022v5.0
Source object
202333189349313898

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