Form 990 for tax year 2022
Filed by SIDNEY HILLMAN HEALTH CENTRE OF THE CHICAGO AND CENT ST JNT BRD UNION.
Totals
- Total revenue
- $3,390,564
- Total expenses
- $3,116,497
- Contributions and grants received
- $0
- Grants paid
- $0
- Program service revenue
- $3,050,980
- Investment income
- $186
- Other revenue
- $339,398
- Total assets, end of year
- $948,647
- Total liabilities, end of year
- $109,207
- Net assets or fund balances, end of year
- $839,440
- Program services expenses (Part IX)
- $2,580,258
- Management and general expenses
- $536,239
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $2,580,258
Program services were 82.8% 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: PREMIUMS
total $2,377,556 · related or exempt $2,377,556
-
2b · Program service revenue: INSURANCE CARRIER INCO
total $335,144 · related or exempt $335,144
-
2c · Program service revenue: DENTAL AND OPTICAL INC
total $159,291 · related or exempt $159,291
-
2d · Program service revenue: CAPITATION
total $142,211 · related or exempt $142,211
-
2e · Program service revenue: MEDICARE PAYMENTS
total $34,618 · related or exempt $34,618
-
2f · All other program service revenue
total $2,160 · related or exempt $2,160
-
3 · Investment income
total $186 · excluded $186
-
11a · Other revenue: RENT ABATEMENT
total $281,178 · excluded $281,178
-
11b · Other revenue: MISCELLANEOUS
total $58,220 · excluded $58,220
-
11e · Other revenue, total
$339,398
Functional expenses
Part IX, the statement of functional expenses.
-
5 · Compensation of officers, directors and key employees
total $158,938 · program services $158,938
-
7 · Other salaries and wages
total $1,016,764 · program services $761,834 · management and general $254,930
-
8 · Pension plan contributions
total $121,095 · program services $93,236 · management and general $27,859
-
9 · Other employee benefits
total $268,412 · program services $209,880 · management and general $58,532
-
10 · Payroll taxes
total $100,918 · program services $78,911 · management and general $22,007
-
11b · Fees: legal
total $2,604 · management and general $2,604
-
11c · Fees: accounting
total $23,000 · management and general $23,000
-
11g · Fees: other
total $209,042 · program services $99,782 · management and general $109,260
-
13 · Office expenses
total $18,277 · program services $12,538 · management and general $5,739
-
14 · Information technology
total $128,609 · program services $128,609
-
16 · Occupancy
total $682,356 · program services $682,356
-
22 · Depreciation, depletion and amortization
total $32,707 · program services $32,707
-
23 · Insurance
total $46,251 · program services $46,251
-
24a · Other expenses: LABORATORY EXPENSES
total $122,665 · program services $122,665
-
24b · Other expenses: MALPRACTICE INSURANCE
total $45,413 · program services $45,413
-
24c · Other expenses: OTHER MEDICAL EXPENSES
total $40,824 · program services $40,824
-
24d · Other expenses: DENTAL EXPENSES
total $37,742 · program services $37,742
-
24e · All other expenses
total $60,880 · program services $28,572 · management and general $32,308
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $135,537 · end of year $168,892
-
2 · Savings and temporary cash investments
beginning of year $151,959 · end of year $402,145
-
4 · Accounts receivable
beginning of year $233,691 · end of year $239,635
-
8 · Inventories for sale or use
beginning of year $4,266 · end of year $4,291
-
9 · Prepaid expenses and deferred charges
beginning of year $19,913 · end of year $16,992
-
10a · Land, buildings and equipment: cost or other basis
$1,091,922
-
10b · Land, buildings and equipment: accumulated depreciation
$975,230
-
10c · Land, buildings and equipment, net
beginning of year $133,136 · end of year $116,692
-
17 · Accounts payable and accrued expenses
beginning of year $111,614 · end of year $107,684
-
19 · Deferred revenue
beginning of year $1,515 · end of year $1,523
-
27 · Net assets without donor restrictions
beginning of year $565,373 · end of year $839,440
Mission and programs · 2022
Mission
TO ESTABLISH AND OPERATE A VOLUNTARY HEALTH SERVICES PLAN WITHIN THE MEANING OF THE VOLUNTARY HEALTH SERVICES PLAN ACT OF THE STATE OF ILLINOIS AND FURNISH HEALTH SERVICES OR BENEFITS TO THE PLAN SUBSCRIBERS.
Activities or mission (Part I)
TO OPERATE A VOLUNTARY HEALTH SERVICES PLAN
-
PROVIDE COMPREHENSIVE DIAGNOSTIC AND SPECIALIST MEDICAL SERVICES FOR PLAN SUBSCRIBERS.
Expenses $2,580,258 · Revenue $3,050,980
As filed on the 2022 return.
Listed in Part VII
-
Naomi K HanshewNAOMI K HANSHEW
CHAIRMAN/PRESIDENT
- Total calculated
- $200,761
- From this org
- $0
- From related orgs
- $151,298
- Other
- $49,463
- Hours/week
- 1 + 39 related
Schedule J breakdown matched by us
- Base
- $0 + $151,298 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $23,250 related
- Nontaxable benefits
- $0 + $26,213 related
- Filer's total
- $0 + $200,761 related
-
Douglas WarrenDOUGLAS WARREN
DIRECTOR
- Total calculated
- $165,800
- From this org
- $0
- From related orgs
- $122,606
- Other
- $43,194
- Hours/week
- 1 + 39 related
Schedule J breakdown matched by us
- Base
- $0 + $122,606 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $17,438 related
- Nontaxable benefits
- $0 + $25,756 related
- Filer's total
- $0 + $165,800 related
-
Carlos GinardCARLOS GINARD
DIRECTOR
- Total calculated
- $157,471
- From this org
- $0
- From related orgs
- $114,277
- Other
- $43,194
- Hours/week
- 1 + 39 related
Schedule J breakdown matched by us
- Base
- $0 + $114,277 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $17,438 related
- Nontaxable benefits
- $0 + $25,756 related
- Filer's total
- $0 + $157,471 related
-
James E SkonickiJAMES E SKONICKI
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Chris RoseCHRIS ROSE
DIRECTOR - PAST
- Total calculated
- $0
- Hours/week
- 1
-
Charles ScherbaumCHARLES SCHERBAUM
DIRECTOR/SECRETARY TREASURER
- Total calculated
- $152,778
- From this org
- $0
- From related orgs
- $110,000
- Other
- $42,778
- Hours/week
- 1 + 39 related
Schedule J breakdown matched by us
- Base
- $0 + $110,000 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $17,050 related
- Nontaxable benefits
- $0 + $25,728 related
- Filer's total
- $0 + $152,778 related
-
Antonio DiazANTONIO DIAZ
DIRECTOR
- Total calculated
- $113,964
- From this org
- $0
- From related orgs
- $77,592
- Other
- $36,372
- Hours/week
- 1 + 39 related
-
Jose CastellanosJOSE CASTELLANOS
MEDICAL DIRECTOR
- Total calculated
- $158,938
- From this org
- $152,277
- From related orgs
- $0
- Other
- $6,661
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $152,277
- Bonus
- $0
- Other
- $0
- Deferred
- $6,661
- Nontaxable benefits
- $0
- Filer's total
- $158,938
-
Dr Seit J WongDR SEIT J WONG
PHYSICIAN
- Total calculated
- $146,917
- From this org
- $135,292
- From related orgs
- $0
- Other
- $11,625
- Hours/week
- 40
-
Adriana MedinaADRIANA MEDINA
EXECUTIVE DIRECTOR
- Total calculated
- $206,287
- From this org
- $158,980
- From related orgs
- $0
- Other
- $47,307
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $158,980
- Bonus
- $0
- Other
- $0
- Deferred
- $23,717
- Nontaxable benefits
- $23,590
- Filer's total
- $206,287
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
- 3 · Written employment contract
Answered no
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 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
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.
-
AMALGAMATED SOCIAL BENEFITS ADMINISTRATION
501(C)(9) · BENEFITS TRUST · IL
-
CHICAGO & MIDWEST REGIONAL JOINT BOARD
501(C)(5) · LABOR UNION · IL
-
AMALGAMATED LIFE & HEALTH INSURANCE
501(C)(9) · LIFE AND HEALTH INSURANCE · IL
Directly controlled by CHICAGO & MIDWEST REGIONAL JOINT BOARD
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 6 September 2023
- IRS schema version
- 2022v5.0
- Source object
- 202332499349301143
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