Skip to content
Nonprofiteer
← MOUNT CARMEL HEALTH PLAN OF IDAHO INC

Form 990 for tax year 2023

Filed by MOUNT CARMEL HEALTH PLAN OF IDAHO INC.

Totals

Total revenue
$20,263,330
Total expenses
$20,104,773
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$18,149,485
Management and general expenses
$1,955,288
Fundraising expenses
$0
Program service expenses (Part III)
$18,149,485

Program services were 90.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JACK RANDOLPH

    DIRECTOR; CHAIR; PRESIDENT & CEO

    Total calculated
    $957,338
    From this org
    $0
    From related orgs
    $767,255
    Other
    $190,083
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $543,556 related
    Bonus
    $0 + $191,227 related
    Other
    $0 + $32,472 related
    Deferred
    $0 + $146,797 related
    Nontaxable benefits
    $0 + $43,286 related
    Filer's total
    $0 + $957,338 related

  • ANDY PRIDAY

    MOUNT CARMEL CFO

    Total calculated
    $580,062
    From this org
    $0
    From related orgs
    $506,911
    Other
    $73,151
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $414,548 related
    Bonus
    $0 + $87,000 related
    Other
    $0 + $5,363 related
    Deferred
    $0 + $54,892 related
    Nontaxable benefits
    $0 + $18,259 related
    Filer's total
    $0 + $580,062 related

  • GREG WISE MD

    MEDICAL DIRECTOR MCHP

    Total calculated
    $447,867
    From this org
    $0
    From related orgs
    $415,213
    Other
    $32,654
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $357,911 related
    Bonus
    $0 + $54,817 related
    Other
    $0 + $2,485 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $22,754 related
    Filer's total
    $0 + $447,867 related

  • DAVID VIS

    SECRETARY; TREAS; MCHP VP FINANCE

    Total calculated
    $388,049
    From this org
    $0
    From related orgs
    $369,635
    Other
    $18,414
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $318,396 related
    Bonus
    $0 + $47,121 related
    Other
    $0 + $4,118 related
    Deferred
    $0 + $14,850 related
    Nontaxable benefits
    $0 + $3,564 related
    Filer's total
    $0 + $388,049 related

  • CARLOS ALVARADO

    CHIEF ADMINISTRATIVE OFFICER MCHP

    Total calculated
    $347,604
    From this org
    $0
    From related orgs
    $303,036
    Other
    $44,568
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $261,822 related
    Bonus
    $0 + $40,466 related
    Other
    $0 + $748 related
    Deferred
    $0 + $11,191 related
    Nontaxable benefits
    $0 + $33,377 related
    Filer's total
    $0 + $347,604 related

  • TRISHA WHETSTONE

    ASST SECRETARY; MCHS ASSOC COUNSEL

    Total calculated
    $242,559
    From this org
    $0
    From related orgs
    $198,615
    Other
    $43,944
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $179,354 related
    Bonus
    $0 + $19,106 related
    Other
    $0 + $155 related
    Deferred
    $0 + $9,524 related
    Nontaxable benefits
    $0 + $34,420 related
    Filer's total
    $0 + $242,559 related

  • FATOU NDOYE

    ASST TREASURER; MCHP CONTROLLER

    Total calculated
    $227,171
    From this org
    $0
    From related orgs
    $182,722
    Other
    $44,449
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $164,965 related
    Bonus
    $0 + $17,591 related
    Other
    $0 + $166 related
    Deferred
    $0 + $8,753 related
    Nontaxable benefits
    $0 + $35,696 related
    Filer's total
    $0 + $227,171 related

  • DEBBIE DAVIS

    SALES MANAGER

    Total calculated
    $159,384
    From this org
    $0
    From related orgs
    $140,201
    Other
    $19,183
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $133,333 related
    Bonus
    $0 + $6,313 related
    Other
    $0 + $555 related
    Deferred
    $0 + $5,043 related
    Nontaxable benefits
    $0 + $14,140 related
    Filer's total
    $0 + $159,384 related

  • LORI KAMINS

    PROVIDER RELATIONS NETWORK MANAGER

    Total calculated
    $131,639
    From this org
    $0
    From related orgs
    $114,811
    Other
    $16,828
    Hours/week
    50

  • CHARLES CHODROFF MD

    DIRECTOR AS OF 10/23

    Total calculated
    $0
    Hours/week
    2

  • JENNIFER GUDAPATI

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • CHRIS HOYD

    DIRECTOR THROUGH 4/23

    Total calculated
    $0
    Hours/week
    2

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 — 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 PLAN OF IDAHO IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL HEALTH PLAN OF IDAHO'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 PLAN OF IDAHO'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 2023. 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 2023, AND THEIR NON-VESTED BENEFITS FOR 2023 WERE ACCRUED. THE FOLLOWING PAYOUT FOR 2023 FOR THE PLAN IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JACK RANDOLPH - $7,595 THE FOLLOWING ACCRUALS FOR 2023 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: ANDY PRIDAY - $40,042 JACK RANDOLPH - $131,947 THE FOLLOWING IS A PARTICIPANT IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($330,000 FOR 2023). ANDY PRIDAY THERE WAS NO PAYOUT FOR 2023 FOR THIS PARTICIPANT.

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
2023
Filed
14 November 2024
IRS schema version
2023v5.1
Source object
202433199349301668

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.