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← ALLEGIANCE HEALTH FOUNDATION

Form 990 for tax year 2022

Filed by ALLEGIANCE HEALTH FOUNDATION.

Totals

Total revenue
$0
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

Listed in Part VII

  • ANTHONY PARKER

    DIRECTOR-VICE CHAIRMAN

    Total calculated
    $0
    Hours/week
    2

  • KATHLEEN SCHMALTZ

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • SUSAN RILEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CHERYL SIMONETTI

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • SARAH ERMATINGER

    DIRECTOR-CHAIRMAN

    Total calculated
    $0
    Hours/week
    2

  • CARRIE GLICK

    DIRECTOR-SECRETARY/TREASUR

    Total calculated
    $0
    Hours/week
    2

  • JAMIE GRACE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • TERRY LANGSTON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • KELLY NARKIEWICZ

    DIRECTOR (THRU 4/2022)

    Total calculated
    $0
    Hours/week
    1

  • JAY ZIEMBA

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JOHN WALDRON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • BRIAN KIMMD

    DIRECTOR

    Total calculated
    $106,215
    From this org
    $0
    From related orgs
    $106,215
    Other
    $0
    Hours/week
    1

  • MARY SHIRKEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MUMTAZ MEMON MD

    DIRECTOR

    Total calculated
    $681,950
    From this org
    $0
    From related orgs
    $647,045
    Other
    $34,905
    Hours/week
    1 + 61 related

    Schedule J breakdown matched by us

    Base
    $0 + $466,333 related
    Bonus
    $0 + $101,891 related
    Other
    $0 + $78,821 related
    Deferred
    $0 + $5,338 related
    Nontaxable benefits
    $0 + $29,567 related
    Filer's total
    $0 + $681,950 related

  • EMILY MOORHEAD

    DIRECTOR (START 2/2022)

    Total calculated
    $513,732
    From this org
    $0
    From related orgs
    $507,762
    Other
    $5,970
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $304,242 related
    Bonus
    $0 + $145,023 related
    Other
    $0 + $58,497 related
    Deferred
    $0 + $4,575 related
    Nontaxable benefits
    $0 + $1,395 related
    Filer's total
    $0 + $513,732 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 — 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

  • 1a · Tax indemnification and gross-up payments
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 4B
CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN SUPPLEMENTAL RETIREMENT PROGRAMS THAT RESULT IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, AND/OR AS PAID. IT IS AN ELEMENT OF SOME PLAN DESIGNS TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. THE FOLLOWING PROVIDES THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS: CONTRIBUTIONS TO SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN- HENRY FORD HEALTH SYSTEM EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2022 CONTR. 2022 CONTR. TAX GROSS-UP W-2 AMOUNTS EMILY MOORHEAD 465 - - 465 SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - W.A. FOOTE MEMORIAL HOSPITAL EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2022 CONTR. 2022 CONTR. TAX GROSS-UP W-2 AMOUNTS EMILY MOORHEAD 11,160 - - 11,160 MUMTAZ MEMON, M.D. 13,675 6,825 164 20,664

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
10 November 2023
IRS schema version
2022v5.0
Source object
202303149349304135

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