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← LAKELAND REGIONAL HEALTH SYSTEM ASSOCIATE BENEFIT PROGRAM TRUST

Form 990 for tax year 2022

Filed by LAKELAND REGIONAL HEALTH SYSTEM ASSOCIATE BENEFIT PROGRAM TRUST.

Totals

Total revenue
$335,204
Total expenses
$79,296
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$335,204
Other revenue
$0
Total assets, end of year
$15,883,794
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$15,883,794
Program services expenses (Part IX)
not reported
Management and general expenses
not reported
Fundraising expenses
not reported
Program service expenses (Part III)
$0

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 $331,023 · excluded $331,023

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $437,330

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

    securities $433,149

  • 7c · Gain or loss

    securities $4,181 · other assets $0

  • 7d · Net gain or loss

    total $4,181 · excluded $4,181

  • 11d · All other revenue

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

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 11c · Fees: accounting

    total $31,100

  • 11f · Fees: investment management

    total $17,166

  • 11g · Fees: other

    total $31,030

  • 24e · All other expenses

    total $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,753,485 · end of year $2,228,159

  • 5 · Loans and receivables from officers and key people

    end of year $0

  • 6 · Loans and receivables from disqualified persons

    end of year $0

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

    $0

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

    $0

  • 10c · Land, buildings and equipment, net

    end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $16,786,317 · end of year $13,655,635

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $18,539,802 · end of year $15,883,794

Mission and programs · 2022

Mission

THE TRUST WAS ESTABLISHED TO FUND THE POSTRETIREMENT OBLIGATION OF LAKELAND REGIONAL HEALTH SYSTEM, INC.

  • PAYMENT OF STIPEND TO ELIGIBLE RETIREES TOWARDS THE PURCHASE OF HEALTH INSURANCE OR TO PURCHASE THEIR OWN MEDICARE STOP LOSS INSURANCE COVERAGE. NUMBER OF ACTIVE MEMBERS IN THE PLAN IS 440. TOTAL EMPLOYEES THAT COULD BECOME ELIGIBLE TO RECEIVE FUTIRE BENEFITS UPON RETIREMENT IS 547.

As filed on the 2022 return.

Listed in Part VII

  • Norma Tirado-Kellenberger

    TRUSTEE

    Total calculated
    $569,532
    From this org
    $0
    From related orgs
    $466,826
    Other
    $102,706
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $243,447 related
    Bonus
    $0 + $105,181 related
    Other
    $0 + $118,198 related
    Deferred
    $0 + $46,475 related
    Nontaxable benefits
    $0 + $56,231 related
    Filer's total
    $0 + $569,532 related

  • Paul Konopacki

    TRUSTEE

    Total calculated
    $617,372
    From this org
    $0
    From related orgs
    $462,697
    Other
    $154,675
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $316,985 related
    Bonus
    $0 + $109,732 related
    Other
    $0 + $35,980 related
    Deferred
    $0 + $94,643 related
    Nontaxable benefits
    $0 + $60,032 related
    Filer's total
    $0 + $617,372 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement

The filer's explanations (Part III)

Schedule J, Part I, Line 4a Severance or change-of-control payment
DURING 2022 THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM A RELATED ORGANIZATION: NORMA TIRADO-KELLENBERGER - $68,257
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
SCHEDULE J, PART I, LINE 4B IS ANSWERED YES BECAUSE CERTAIN INDIVIDUALS, DO PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN(S) FOR A RELATED ORGANIZATION. SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN(S) BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR WHILE ALSO BEING REPORTED IN THE CURRENT 990 AS TOTAL COMPENSATION. THE NONQUALIFIED RETIREMENT PLANS ARE AN INDUSTRY STANDARD AND ARE SUBJECT TO THE FUNDING REQUIREMENTS OF NONQUALIFIED DEFERRED COMPENSATION PLANS UNDER ERISA AND FEDERAL TAX REGULATIONS. DISTRIBUTIONS PAID BY A RELATED ORGANIZATION ARE AS FOLLOWS: NORMA TIRADO-KELLENBERGER - $46,308 PAUL KONOPACKI - $35,248

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.

  • WEST MICHIGAN ACCOUNTABLE CARE ORGANIZATION LLC

    N/A · ACCOUNTABLE CARE ORGANIZATION · MI

    Directly controlled by NA

  • DEARBORN SCHAEFFER OFFICE COMPANY LLC

    N/A · REAL ESTATE · MI

    Directly controlled by NA

  • OAKMED LLC

    N/A · PRIVATE DUTY NURSING · MI

    Directly controlled by NA

Related corporations and trusts

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

  • PRIORITY HEALTH MANAGED BENEFITS

    C Corporation · THIRD PARTY ADMINISTRATOR · MI

    Directly controlled by NA

  • SPECTRUM HEALTH PHYSICIAN ALLIANCE

    C Corporation · PHYSICIANS · MI

    Directly controlled by NA

  • WEST MICHIGAN HEART

    C Corporation · PHYSICIANS · MI

    Directly controlled by NA

  • HELEN DEVOS WOMEN'S AND CHILDREN'S HEALTH PAVILION ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • LEMMEN-HOLTON CANCER PAVILION CONDOMINIUM ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • MUSCULOSKELETAL CENTER CONDOMINIUM ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • PRIORITY HEALTH INSURANCE COMPANY

    C Corporation · INSURANCE · MI

    Directly controlled by NA

  • THE MICHIGAN STREET PARKING CONDOMINIUM ASSOCATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • 25 MICHIGAN STREET CONDOMINIUM ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • 35 MICHIGAN STREET CONDOMINIUM ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • PENNOCK VENTURES INC

    C Corporation · Healthcare · MI

    Directly controlled by NA

  • LAKELAND HEALTH ENTERPRISES INC

    C Corporation · ACCOUNTING AND BILLING · MI

    Directly controlled by NA

  • PHARMACY SHOPPE INC

    C Corporation · PHARMACEUTICALS · MI

    Directly controlled by NA

  • LAKELAND MEDICAL PRACTICES

    C Corporation · MEDICAL ADMINISTRATIVE SERVICES · MI

    Directly controlled by NA

  • SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC

    C Corporation · PHYSICIAN OFFICE · MI

    Directly controlled by NA

  • FOUR FLAGS PROPERTIES INC

    C Corporation · PROPERTY MANAGEMENT/RENTAL · MI

    Directly controlled by NA

  • LAKELAND HEALTH VENTURES INC

    C Corporation · HOLDING COMPANY · MI

    Directly controlled by NA

  • LAKELAND PHYSICIAN CARE NETWORK

    C Corporation · MEDICAL SERVICES · MI

    Directly controlled by NA

  • LAKELAND PERSONAL CARE SERVICES INC

    C Corporation · HEALTHCARE SERVICES · MI

    Directly controlled by NA

  • 1697 MICHIGAN STREET PROPERTY

    C Corporation · MGMT · MI

    Directly controlled by NA

  • BLUE STAR PROFESSIONAL BUILDING CONDO ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • PHMB CAMADS TRUST

    Trust · TRUST · MI

    Directly controlled by NA

  • PENNOCK PROFESSIONAL BUILDING CONDOMINIUM ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • COREWELL HEALTH INDEMNITY COMPANY

    C Corporation · PREMIUM DEPOSITS · CJ

    Directly controlled by NA

  • BEAUMONT NURSING HOME SERVICES INC

    C Corporation · ASSISTED CARE LIVING · MI

    Directly controlled by NA

  • BEAUMONT PHYSICIANS INSURANCE COMPANY INC

    C Corporation · PROFESSIONAL INSURANCE · MI

    Directly controlled by NA

  • BOTSFORD COMMONS PROPERTY ASSOCIATION

    C Corporation · PROPERTY MANAGEMENT · MI

    Directly controlled by NA

  • OAKWOOD AFFILIATED VENTURES INC AND SUBSIDIARIES

    C Corporation · OFFICE OF PHYSICIANS / NON-RESIDENTIAL RENTAL · MI

    Directly controlled by NA

  • BH SOUTHFIELD BILLING INC

    C Corporation · MANAGEMENT AND DISPATCH SERVICES · MI

    Directly controlled by NA

  • MIDWEST MEDICAL CENTER

    C Corporation · OFFICE OF PHYSICIANS · MI

    Directly controlled by NA

  • OAKWOOD ENTERPRISES INC

    C Corporation · NON RESIDENTIAL RENTAL · MI

    Directly controlled by NA

  • MICHIGAN STREET PROJECT CONDOMINIUM ASSOCIATION

    C Corporation · MGMT · MI

    Directly controlled by NA

  • GRAND RIVER ABSOLUTE RETURN FUND LTD

    POOLED INVESTMENT FUND · CJ

    Directly controlled by COREWELL HEALTH

Provenance

Return type
form_990
Tax year
2022
Filed
6 November 2023
IRS schema version
2022v5.0
Source object
202303109349303655

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