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← Children's Medical Center Health Plan

Form 990 for tax year 2022

Filed by Children's Medical Center Health Plan.

Totals

Total revenue
$139,757
Total expenses
$790,638
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$27,236
Other revenue
$112,521
Total assets, end of year
$0
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$662,860
Management and general expenses
$127,778
Fundraising expenses
$0
Program service expenses (Part III)
$662,860

Program services were 83.8% 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.

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $27,236 · excluded $27,236

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11a · Other revenue: Refund of medical claims

    total $112,521 · related or exempt $112,521

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $112,521

Functional expenses

Part IX, the statement of functional expenses.

  • 11g · Fees: other

    total $6,309 · program services $112 · management and general $6,197 · fundraising $0

  • 13 · Office expenses

    total $9,961 · program services $8,416 · management and general $1,545

  • 14 · Information technology

    total $773,867 · program services $653,831 · management and general $120,036

  • 24a · Other expenses: Premium Taxes

    total $501 · program services $501

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $41,908,755 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $2,118,280 · end of year $0

  • 4 · Accounts receivable

    beginning of year $0

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $8,528 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $187,382

  • 10b · Land, buildings and equipment: accumulated depreciation

    $187,382

  • 10c · Land, buildings and equipment, net

    beginning of year $1,829,562 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $1,018,051 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $295,558 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $522,114 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $46,065,504 · end of year $0

Mission and programs · 2022

Mission

TO INSURE HEALTH COVERAGE FOR POOR, DISTRESSED, OR UNDERPRIVILEGED CHILDREN & ADULTS IN THE STATE OF TEXAS.

Activities or mission (Part I)

TO INSURE HEALTH COVERAGE FOR POOR, DISTRESSED, OR UNDERPRIVILEGED CHILDREN & ADULTS.

  • To insure poor, distressed, or underprivileged children or adults enrolled in Texas Medicaid (STAR), Children's Health Insurance Program (CHIP), Medicaid recipients on Social Security Administration's Supplemental Security Income (STAR Kids and STAR+PLUS), Medicaid for foster children (STAR health), and Medicare Advantage (covering only those patients that have dual eligibility for Medicaid and Medicare benefits) in the State of Texas.

    Expenses $662,860 · Revenue $112,521

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

Listed in Part VII

  • Doris E Hunt

    Dir. and VP/Executive Director

    Total calculated
    $1,036,345
    From this org
    $0
    From related orgs
    $829,876
    Other
    $206,469
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $488,609 related
    Bonus
    $0 + $194,388 related
    Other
    $0 + $146,879 related
    Deferred
    $0 + $173,853 related
    Nontaxable benefits
    $0 + $32,616 related
    Filer's total
    $0 + $1,036,345 related

  • Peter C Perialas Jr

    Director & President

    Total calculated
    $2,185,693
    From this org
    $0
    From related orgs
    $1,825,216
    Other
    $360,477
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,048,454 related
    Bonus
    $0 + $504,726 related
    Other
    $0 + $272,036 related
    Deferred
    $0 + $334,779 related
    Nontaxable benefits
    $0 + $25,698 related
    Filer's total
    $0 + $2,185,693 related

  • Christopher J Durovich

    Chairman

    Total calculated
    $3,975,862
    From this org
    $0
    From related orgs
    $3,912,737
    Other
    $63,125
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,715,978 related
    Bonus
    $0 + $2,128,783 related
    Other
    $0 + $67,976 related
    Deferred
    $0 + $20,500 related
    Nontaxable benefits
    $0 + $42,625 related
    Filer's total
    $0 + $3,975,862 related

  • Amy Yeager

    Secretary

    Total calculated
    $1,171,405
    From this org
    $0
    From related orgs
    $953,089
    Other
    $218,316
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $486,033 related
    Bonus
    $0 + $281,010 related
    Other
    $0 + $186,046 related
    Deferred
    $0 + $170,098 related
    Nontaxable benefits
    $0 + $48,218 related
    Filer's total
    $0 + $1,171,405 related

  • Jeremiah Radandt

    Former Officer

    Total calculated
    $409,238
    From this org
    $0
    From related orgs
    $409,238
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $409,238 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $409,238 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)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
Children's Medical Center Health Plan (The "Corporation") has no employees. Certain individuals identified herein as Director or Officers of the Corporation are employed and compensated by a related organization, Children's Health System of Texas (CHST). The Individuals perform services for the Corporation, and in some cases other related organizations, by arrangement between CHST and such organization(s). Therefore, Compensation decisions for the officers were determined by the related organization following CHST compensation's policy. In their duties as Officers of the Corporation, they have no influence over the compensation process performed by CHST. The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. The HR Committee engages the services of an independent compensation consultant for executive compensation. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is dinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Peter Perialas - $261,558 Doris Hunt - $118,918 Amy Yeager - $155,196 Employees who participated in and have contributions to the EDCRP include: Peter Perialas - $316,479 Doris Hunt - $157,096 Amy Yeager - $157,898

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.

  • ALTERNATIVE CARE SYSTEMS

    C Corporation · OTHER MEDICAL SERVICES · TX

    Directly controlled by NA

  • NTPSS INC

    C Corporation · PHYSICIAN SOLUTIONS · TX

    Directly controlled by NA

  • Texas Bluebonnet Insurance Company

    C Corporation · Insurance Company · TX

    Directly controlled by NA

  • Texas Trinity River Assurance Company

    C Corporation · Self-insurance · CJ

    Directly controlled by NA

  • Children's Health

    C Corporation · Other Medical Services · TX

    Directly controlled by NA

  • CHFH Inc

    C Corporation · OTHER MEDICAL SERVICES · TX

    Directly controlled by NA

  • CHILDREN'S HEALTH CARE NETWORK

    C Corporation · OTHER MEDICAL SERVICES · TX

    Directly controlled by NA

Assets distributed on this return

Schedule N, as filed: what the organization did with its assets when it liquidated or dissolved, or disposed of more than a quarter of them, and who received them. A recipient with an EIN is usually a successor organization; filers also list expenses such as legal fees here.

4 distributions to recipients named as people, $47,070,558 in total. Counted where the filer named the recipient as a person, as filed. Who received them, and what, are not published.

Provenance

Return type
form_990
Tax year
2022
Filed
14 November 2023
IRS schema version
2022v5.0
Source object
202323179349311837

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