Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Altarum Supporting Organization
Employer identification number
38-3580694
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
Altarum Institute
381983442
09
Yes
Yes
Yes
0
Total
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Altarum Supporting Organization
Employer identification number
38-3580694
Identifier
Return Reference
Explanation
MEMBERS WHO MAY ELECT ONE OR MORE OF THE GOVERNING BODY
PART VI, SECTION A, LN 7a
THE MEMBERS OF THE BOARD OF DIRECTORS FOR ALTARUM SUPPORTING ORGANIZATION ARE APPOINTED BY ALTARUM INSTITUTE, THE SHAREHOLDER.
DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS
Form 990, Part VI, LN 7B
ALTARUM INSTITUTE IS THE SOLE SHAREHOLDER OF ALTARUM SUPPORTING ORGANIZATION. ALTARUM INSTITUTE'S RESPONSIBILITIES INCLUDE LONG TERM PLANNING, ESTABLISHING POLICIES AND PROCEDURES AND ASSISTING ALTARUM SUPPORTING ORGANIZATION IN CARRYING OUT ITS EXEMPT PURPOSE. ALTARUM INSTITUTE LIMITS ITS POWER OF APPROVAL PRIMARILY TO MEMBERSHIP AND THE ORGANIZATION'S ANNUAL BUDGET.
Process for review of Form 990 by organization
PART VI, SECTION A, LN 11a
1. IRS Form 990 is prepared externally by Altarums tax accounting firm. The process is managed by the office of the Chief Financial Officer for Altarum Institute. With appropriate guidance from the tax accountants, information gathering and reporting is primarily conducted by the Controller of Altarum Institute. As part of the information gathering process, the Controller works with Altarum Supporting Organization Officers and other managers as necessary. 2. The Chief Financial Officer, also a Trustee of Altarum Institute, presents the completed draft Form 990 to the Chair of the Board of Trustees of Altarum Supporting Organization. The Board reviews the Form 990 to either approve as written or make suggested modifications, drawing upon whatever Board Committees or individual Trustees it deems necessary. 3. Once reviewed and approved for submission, the Chair of the Board of Trustees notifies the Chief Financial Officer that the Form is ready for submission to the IRS. 4. The Chief Financial Officer provides a copy of the form 990 to each member of the board of trustees prior to filing. 5. The Chief Financial Officer instructs the external tax accountants to finalize the IRS Form 990 and present it for signature and filing with the IRS.
Description of Process to Monitor Transactions for Conflicts of Interest
Form 990, Part VI, Question 12c
The Conflict of interest policy for Altarum Supporting Organization is maintained and administered by the parent organization, Altarum Institute, EIN 38-1983442. Altarum Institute establishes various policies and procedures that must then be adopted by the subsidiary organizations. One such policy is the Conflict of Interest. The explanation provided below describes the process in which the parent organization monitors for potential conflicts of interest. The Officers, Directors, Trustees and Key Employees of Altarum Supporting Organization are subject to this monitoring process as well. Annually, each member of the Board of Trustees and every officer must complete and submit a disclosure form to the Director of Legal Affairs. Included in the disclosure is any employment, board membership, compensatory arrangements, material interests, etc. with other entities. The Director of Legal Affairs inputs all of the information into a database so that material transactions can be checked against all of the data provided in the disclosure forms. Also, pursuant to policy, the board members and officers have to disclose any interests in or relationship with an entity that Altarum is pursuing a transaction with (at the time of the board member or officer becoming aware of the potential Altarum relationship). In the event of a potential conflict of interest, the interested person must disclose all material facts, and the disinterested board members (in the absence of the interested person) discuss and vote upon whether or not an actual conflict of interest exists. If a conflict of interest exists, then alternative transactions or arrangements will be sought out and considered. If no alternative transaction is suitable, the disinterested members of the board determine whether or not the conflicted transaction is in Altarum Supporting Organization's best interests and determine if the terms of the transaction are fair and reasonable without the participation or vote by the party involved in the conflict of interest. Upon a conflict of interest occurring that was not disclosed, the interested person must explain the failure to disclose the alleged conflict. After hearing the explanation and conducting any necessary further investigation, the board will take appropriate disciplinary and corrective action.
Offices & Positions for Which Process was Used, & Year Process was Begun
Form 990, Part VI, Question 15a & 15b
The Compensation determination policy for Altarum Supporting Organization is maintained and administered by the parent organization, Altarum Institute, EIN 38-1983442. Altarum Institute establishes various policies and procedures that must then be adopted by the subsidiary organizations. One such process is the determination of compensation. The explanation provided below describes the process in which the parent organization determines and approves the compensation for Officers, Directors, Trustees and Key Employees. The Officers, Directors, Trustees and Key Employees of Altarum Supporting Organization are subject to this monitoring process as well. The Altarum Institute Compensation Committee meets every year for the purpose of reviewing, determining and approving compensation for the executive employees of Altarum Institute. The committee meets in February to evaluate the reasonableness of the amount and conformity with Altarum Institute policies and prior Committee approvals. Review of prior year's total compensation also occurs at the February meeting. Executive Positions included in review are: 1. President & CEO 2. Chief Financial Officer 3. Chief Operations Officer 4. Chief HR Officer 5. Chief Development Officer 6. Group Operations Director(s) 7. Business Development Officer The following information is considered as part of the determination of compensation: 1. Independent and current Salary Survey information compiled by Mercer Human Resource Consulting. 2. Independent and current Salary Survey information compiled by Watson Wyatt Worldwide. 3. Independent and current Salary Survey information compiled by Economic Research Institute. 4. Review of employee performance evaluation data summarized by the President and CEO. After discussion, all members of the Compensation Committee vote on the compensation presented. The compensation packages presented are approved as reasonable and in conformity with Altarum Institute policies, and that the Compensation Committee submitted the compensation provisions outlined for approval by the Board of Trustees. After reviewing the recommendation of the Compensation Committee, the Board of Trustees votes on the recommendations.
Avail of gov docs, conflict of interest policy, & fin stmts to gen public
Part VI, Section C., Line 19
All Available Upon Request Explanation of other changes in net assets or fund balances Part XI, Line 5 Loss from Subsidiaries ($1,847,455) Unrealized Gain on Investments $ 498,246 Total ($1,349,209)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.