Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 75,000 | 441,875 | 516,875 | |||
| 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...... | 537,264 | 537,264 | ||||
| 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. | 75,000 | 979,139 | 1,054,139 | |||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 75,000 | 235,000 | 310,000 | |||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 75,000 | 235,000 | 310,000 | |||
| 8 | Public support (Subtract line 7c from line 6.) | 744,139 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 75,000 | 979,139 | 1,054,139 | |||
| 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 VI.) .. | 893 | 893 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 75,000 | 980,032 | 1,055,032 | |||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | THE MISSION OF YOUR HEALTH NETWORK INC. (YHN) IS TO PROVIDE PATIENT-CENTERED, HIGH QUALITY HEALTH AND WELLNESS SERVICES THAT DEEPLY ENGAGE AND EMPOWER MARYLANDERS TO BE STEWARDS OF THEIR OWN HEALTH, WITH THE DESIRED IMPACT OF HEALTHIER COMMUNITIES AND THE REDUCTION OF HEALTH DISPARITIES. TO ACCOMPLISH ITS MISSION, YHN HAS ESTABLISHED FOUR PRIMARY CARE HEALTH CENTERS THAT AIM TO SERVE SURROUNDING COMMUNITIES WITH CLINICAL CARE AND OTHER SUPPORTIVE HEALTH AND LIFESTYLE SERVICES. THE INITIAL FOUR CENTERS HAVE BEEN ESTABLISHED IN BALTIMORE CITY, COLUMBIA, WHITE MARSH, AND GREENBELT. THE CENTER LOCATIONS WERE SELECTED BASED ON A DESIRE TO EXTEND REACH BROADLY ACROSS MARYLAND, BUT IN PARTICULAR TO BE ACCESSIBLE WITHIN WORKING CLASS COMMUNITIES WHERE AN INVESTMENT IN PRIMARY CARE CAN IMPROVE POPULATION HEALTH FOR THE VULNERABLE (DEFINED AS LOW-INCOME, PREVIOUSLY UNINSURED, DISCONNECTED FROM THE HEALTH CARE SYSTEM, ETC.) THE WORK OF THE ORGANIZATION IS TO IMPLEMENT A PATIENT-CENTERED PRIMARY HEALTH CARE MODEL THAT IS MORE EFFECTIVE (BASED ON COST, QUALITY, AND EXPERIENCE) THAN THE PRIMARY MEDICAL CARE OFFERED BY THE TYPICAL PRIVATE PRACTICE HEALTH CARE GROUP OR LARGE HEALTH SYSTEM. WHEREAS MOST PRACTICES FOCUS ON ONLY REIMBURSABLE ACTIVITIES (I.E. MEDICAL TESTING AND TREATMENT), YHN ALSO PROVIDES (FREE OF CHARGE TO ITS PATIENTS) HEALTH COACHING AND CARE COORDINATION SERVICES TO EDUCATE PATIENTS ON DISEASE PREVENTION AND MANAGEMENT AND ASSIST PATIENTS IN IMPLEMENTING LIFESTYLE CHANGES THAT CAN IMPROVE THEIR OVERALL HEALTH. THUS, YHN'S SERVICES ARE NOT JUST 'SERVICES FOR HIRE' BUT RATHER OUTCOMES-ORIENTED, PROGRAMMATIC DECISIONS DESIGNED TO MAXIMIZE POPULATION HEALTH OUTCOMES. TO AFFORD A FOCUS ON ITS CHARITABLE MISSION, YHN IS COMMITTED TO UNIQUE INTERNAL DESIGN AS FAR AS POLICIES AND COMPENSATION, RELATIVE TO OTHER HEALTH CARE DELIVERY ENTITIES. THE STAFF ARE COMPENSATED BASED ON THE HEALTH OUTCOMES THEY HELP PATIENTS TO ACHIEVE, NOT THE REVENUE THEY GENERATE FOR THE ORGANIZATION. ADDITIONALLY, SERVICES ARE PROVIDED WITH PARITY ACROSS PATIENTS, REGARDLESS OF INCOME. DESPITE THESE INTERNAL DECISIONS AND A COMMITMENT TO REMAIN MISSION-FOCUSED, YHN MUST BUT BE SELECTIVE IN ITS PARTNERSHIPS GIVEN THE FOR-PROFIT INSURANCE REIMBURSEMENT LANDSCAPE THAT OFTEN PRESSURES HEALTH CARE PROVIDERS TO FOCUS ON REVENUE, NOT QUALITY OR COMMUNITY BENEFIT. TO RUN A SUSTAINABLE ORGANIZATION THAT IS FREE FROM THESE PROFIT-SEEKING PRESSURES, YHN PARTNERS WITH SELECT HEALTH INSURANCE PLANS THAT ARE PHILOSOPHICALLY ALIGNED WITH YHN'S GOAL OF IMPROVED POPULATION HEALTH AND SUPPORTIVE SERVICES TO THE WORKING CLASS POPULATION. ONE SUCH MISSION-FOCUSED INSURANCE CARRIER IS EVERGREEN HEALTH COOPERATIVE (EHC). AS A SECTION 501(C)(29) ORGANIZATION, A NEW CATEGORY OF TAX-EXEMPT ORGANIZATION CREATED UNDER THE AFFORDABLE CARE ACT AND FUNDED THROUGH A FEDERAL LOAN PROGRAM ADMINISTERED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, EHC OPERATES TO FURTHER A PRIMARY PURPOSE OF THE AFFORDABLE CARE ACT, THE PROVISION OF HEALTH INSURANCE TO THE SUBSTANTIAL NUMBER OF PREVIOUSLY UNINSURED OR UNDERINSURED INDIVIDUALS IN THIS COUNTRY. MOST OF THE MEMBERS OF EHC ARE EXPECTED TO BE INDIVIDUALS ELIGIBLE FOR A FULL OR PARTIAL GOVERNMENTAL SUBSIDY OF THE COST OF THEIR HEALTH CARE COVERAGE. THE IMPROVEMENT OF THE DELIVERY OF HEALTH CARE TO INDIVIDUALS IN THIS CLASS HAS BEEN DETERMINED BY CONGRESS TO BE A CRITICAL NATIONAL OBJECTIVE. EHC IS ANTICIPATED TO BE A PRINCIPAL SOURCE OF PATIENTS FOR THE YHN HEALTH CENTERS. TOGETHER THE INSURANCE COMPANY AND THE HEALTH CENTERS WILL WORK TO MAXIMIZE QUALITY OF CARE AND SERVICE, NOT TO MAXIMIZE REVENUE. IN ADDITION TO SERVING A WORKING CLASS AND SUBSIDY-ELIGIBLE POPULATION, YHN IS ALSO DESIGNED TO SERVE THE MEDICAID POPULATION THROUGH RELATIONSHIPS WITH MEDICAID MANAGED CARE ORGANIZATIONS (MCOS). THESE ARE PATIENTS WHO HAVE BEEN DETERMINED BY THE FEDERAL GOVERNMENT TO CONSTITUTE A CLASS FOR WHOM THE DELIVERY OF HEALTH CARE IS AN IMPORTANT COMMUNITY CONCERN. YHN AIMS TO PROVIDE HIGHER QUALITY CARE TO THESE ENROLLEES RELATIVE TO THEIR OTHER OPTIONS, SUCH AS FEDERALLY QUALIFIED HEALTH CENTERS THAT RELY ON FEDERAL FUNDING AND ARE OFTEN UNDER-RESOURCED AND THUS UNABLE TO PROVIDE THE LEVEL OF PERSONALIZED, HIGH-INTENSITY SERVICES THAT YHN AIMS TO PROVIDE. TO ACCOMPLISH THESE ACTIVITIES, YHN WILL RELY ON THE PARTNERSHIP OF HEALTH INSURANCE PARTNERS AS WELL AS OTHER STAKEHOLDERS IN THE HEALTH OF MARYLANDERS. MANY STAKEHOLDERS IN MARYLAND, AND ACROSS THE COUNTRY, ARE ENGAGED IN WORK TO ADDRESS A SET OF RELATED HEALTH POLICY CONCERNS: POOR ACCESS TO PRIMARY CARE, INAPPROPRIATE USAGE OF HOSPITAL-BASED CARE, HIGH RATES OF UNINSURED, POOR MANAGEMENT OF CHRONIC DISEASE, LACK OF INTERVENTIONS THAT ADDRESS LIFESTYLE AND SOCIAL COMPONENTS OF HEALTH CARE. YHN HAS MADE KEY PLAYERS IN THE PUBLIC HEALTH AND PRIVATE / FOUNDATION FUNDING COMMUNITIES AWARE OF ITS MODEL, AND YHN IS NOW WORKING COLLABORATIVELY WITH THESE ENTITIES TO ADDRESS THESE SHARED CONCERNS. YHN HAS ALREADY RECEIVED EXPLICIT SUPPORT FROM SEVERAL PRIVATE FOUNDATIONS TO BUILD AND OPERATE ITS MODEL FOR THE COMMUNITY BENEFIT. YHN WILL CONTINUE TO RELY ON THE NONPROFIT FUNDING COMMUNITY TO ENABLE ITS INVESTMENT IN VULNERABLE POPULATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED BY THE CEO AND THE COO. THE FORM IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT. IF AN INTERESTED PERSON HAS AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE PERSON MUST DISCLOSE THE EXISTENCE AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15A | IN 2014, THE COMPENSATION OF THE EXECUTIVE DIRECTOR WAS DETERMINED BY THE INDEPENDENT BOARD OF DIRECTORS. MARKET SURVEYS WERE USED TO DETERMINE REASONABLE COMPENSATION. THE APPROVAL OF THE EMPLOYMENT CONTRACT WAS DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
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