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Nonprofiteer
← INDEPENDENT CARE HEALTH BENEFIT TR

Form 990 for tax year 2022

Filed by INDEPENDENT CARE HEALTH BENEFIT TR.

Totals

Total revenue
$8,591,721
Total expenses
$8,296,196
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$8,591,721
Investment income
$0
Other revenue
$0
Total assets, end of year
$4,657,865
Total liabilities, end of year
$4,362,340
Net assets or fund balances, end of year
$295,525
Program services expenses (Part IX)
not reported
Management and general expenses
not reported
Fundraising expenses
not reported
Program service expenses (Part III)
not reported

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: MEDICAL PREMIUMS

    total $8,591,721 · related or exempt $8,591,721

Functional expenses

Part IX, the statement of functional expenses.

  • 4 · Benefits paid to or for members

    total $7,142,645

  • 11b · Fees: legal

    total $285

  • 11g · Fees: other

    total $758,262

  • 20 · Interest

    total $79,375

  • 23 · Insurance

    total $314,869

  • 24a · Other expenses: BANK FEES

    total $760

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    end of year $3,730,181

  • 4 · Accounts receivable

    end of year $927,684

  • 17 · Accounts payable and accrued expenses

    end of year $282,965

  • 25 · Other liabilities

    beginning of year $0 · end of year $4,079,375

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $0 · end of year $295,525

Mission and programs · 2022

Mission

THE ORGANIZATION IS A MULTIPLE EMPLOYER WELFARE ARRANGEMENT (MEWA) WHICH PROVIDES MEDICAL AND PRESCRIPTION DRUG BENEFITS FOR ITS MEMBERS AND THEIR DEPENDENTS.

  • ALL FUNDS ARE USED FOR THE PURPOSE OF PROVIDING BENEFITS TO MEMBERS AND THEIR DEPENDENTS.

As filed on the 2022 return.

Listed in Part VII

  • L ALLEN DOBSON JR

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • CONRAD FLICK

    TRUSTEE

    Total calculated
    $108,000
    From this org
    $0
    From related orgs
    $108,000
    Other
    $0
    Hours/week
    0.5 + 39.5 related

  • JOSEPH MOOSE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • CHRISTOPHER WOODFIN

    TRUSTEE

    Total calculated
    $563,393
    From this org
    $0
    From related orgs
    $522,463
    Other
    $40,930
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $397,099 related
    Bonus
    $0 + $124,137 related
    Other
    $0 + $1,227 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $25,680 related
    Filer's total
    $0 + $563,393 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

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement

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.

Provenance

Return type
form_990
Tax year
2022
Filed
31 July 2024
IRS schema version
2022v5.0
Source object
202402139349301455

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