Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
Community Health Network of
Connecticut Inc
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
11 FAIRFIELD BOULEVARD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WALLINGFORD, CT06492
D Employer identification number

06-1429341
E Telephone number

G Gross receipts $ 98,665,894
F Name and address of principal officer:
IBRAHIM BENITEZ
11 FAIRFIELD BOULEVARD
WALLINGFORD,CT06492
I
Tax-exempt status: ( 4 ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHNCT.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1995
M State of legal domicile: CT
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION IMPROVES THE HEALTH OF THE RESIDENTS OF CONNECTICUT AND PROMOTES THE AVAILABILITY OF HIGH-QUALITY, COMPREHENSIVE, COST-EFFECTIVE HEALTH CARE SERVICES TO A CHARITABLE POPULATION OF OVER 700,000 CONNECTICUT RESIDENTS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 5
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 4
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 597
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 78,710,814 82,426,603
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 94,663 232,746
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 73,517 54,000
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 78,878,994 82,713,349
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,168,580 1,281,056
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 41,982,470 46,557,285
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 34,265,976 34,050,069
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 77,417,026 81,888,410
19 Revenue less expenses. Subtract line 18 from line 12....... 1,461,968 824,939
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 50,694,179 41,844,119
21 Total liabilities (Part X, line 26)............. 16,136,431 6,868,318
22 Net assets or fund balances. Subtract line 21 from line 20..... 34,557,748 34,975,801
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE ORGANIZATION IMPROVES THE HEALTH OF THE RESIDENTS OF CONNECTICUT AND PROMOTES THE AVAILABILITY OF HIGH-QUALITY, COMPREHENSIVE, COST-EFFECTIVE HEALTH CARE SERVICES TO A CHARITABLE POPULATION OF OVER 700,000 CONNECTICUT RESIDENTS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ -174,963 including grants of $   ) (Revenue $ 0 )
HEALTH CARE PROGRAMS, GENERAL/OTHER:IN 2015, CHNCT CONTINUED TO RECEIVE FUNDS DIRECTLY RELATED TO THIRD PARTY LIABILITY CLAIMS OVERPAYMENT RECOVERY AUDIT WORK CONDUCTED BY HEALTH MANAGEMENT SYSTEMS (HMS) AND FIRST RECOVERY (FR). SINCE CHNCT ENTERED INTO THE AGREEMENT WITH CT DSS AS THE MEDICAID PROGRAM'S MEDICAL ADMINISTRATIVE SERVICES ORGANIZATION EFFECTIVE JANUARY 1, 2012, CHNCT IS NO LONGER AT RISK FOR MEDICAID CLAIMS PAYMENTS AND AUDIT RECOVERY RESULTS HAVE DECREASED CONSIDERABLY. HOWEVER, HMS AND FR CONTINUE TO CONDUCT RECOVERY AUDIT WORK SOLELY ON CLAIMS PAID THAT HAD A MEDICAL SERVICE PROVIDED PRIOR TO 2012.
4b (Code:   ) (Expenses $ 79,974,782 including grants of $ 231,056 ) (Revenue $ 82,480,603 )
CONNECTICUT MEDICAID MEDICAL ADMINISTRATIVE SERVICES PROGRAM: THROUGH ITS MEDICAID MEDICAL ADMINISTRATIVE SERVICES PROGRAM, CHNCT PROVIDES MEDICAL ADMINISTRATIVE SERVICES TO OVER 700,000 UNDERSERVED AND VULNERABLE MEMBERS OF CONNECTICUT'S MEDICAID POPULATION WHO PARTICIPATE IN THE CONNECTICUT DEPARTMENT OF SOCIAL SERVICES' HUSKY HEALTH PROGRAM. THIS PROGRAM PROMOTES AND IMPROVES THE HEALTH OF MEMBERS OF CONNECTICUT'S MOST VULNERABLE AND UNDERSERVED POPULATIONS. THROUGH THIS PROGRAM, CHNCT PROVIDES A COMPREHENSIVE ARRAY OF SERVICES IN MANAGING CHRONIC CONDITIONS, PROMOTING WELL CARE/PREVENTION, PROVIDING DIRECT SUPPORT TO INDIVIDUALS AND FAMILIES AND PROVIDERS, AND INTEGRATING AND ANALYZING DATA FROM MULTIPLE SOURCES.KEY OBJECTIVES OF THIS PROGRAM INCLUDE:IMPROVING QUALITY OF CARE AND HEALTH CARE OUTCOME FOR INDIVIDUALS SERVED BY CONNECTICUT'S MEDICAID PROGRAM WHILE DRIVING DOWN THE COST OF CARE THROUGH BETTER MANAGEMENT OF SERVICE UTILIZATION;PROVIDING UNINTERRUPTED AND SEAMLESS SERVICES TO MEMBERS OF CONNECTICUT'S MEDICAID POPULATION AND THE NETWORK OF HEALTH CARE PROVIDERS WHO SERVE SUCH POPULATION; ANDDERIVING INTELLIGENCE FROM OUR COMPREHENSIVE REPOSITORY OF CLAIMS AND CLINICAL INFORMATION TO OPTIMALLY MANAGE MEDICAL EXPENSES AND UTILIZATION.CHNCT IS DEDICATED TO SERVING MEMBERS OF THIS VULNERABLE AND UNDERSERVED POPULATION WITH THEIR DESIRE TO IMPROVE HEALTH OUTCOMES, DEVELOP MEDICAL SELF-MANAGEMENT SKILLS AND IMPROVE MEDICATION MANAGEMENT.
4c (Code:   ) (Expenses $ 1,050,000 including grants of $ 1,050,000 ) (Revenue $   )
ENVIRONMENTAL SUPPORT CHARITABLE GRANT PROGRAM: THROUGH ITS ENVIRONMENTAL SUPPORT CHARITABLE GRANT PROGRAM, CHNCT MAKES CHARITABLE GRANTS TO ORGANIZATIONS THAT ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.THE ENVIRONMENTAL SUPPORT CHARITABLE GRANT PROGRAM IS DESIGNED TO AFFORD CHNCT'S FOUNDING FEDERALLY QUALIFIED HEALTH CENTER (FQHC) SITES AN OPPORTUNITY TO REQUEST FUNDING FROM CHNCT FOR PROJECT AND/OR FACILITY IMPROVEMENTS THAT WOULD EXPAND ACCESS TO HEALTHCARE, ENHANCE ACCESS TO SPECIALTY CARE, ASSIST WITH MEDICAL HOME MODEL INITIATIVES, IMPLEMENT ELECTRONIC HEALTH RECORD MEANINGFUL USE INITIATIVES, AND/OR HELP PROVIDE CARE ALTERNATIVES WHEN HOSPITAL EMERGENCY ROOM SERVICES ARE NOT A NECESSITY.DURING 2015, CHNCT MADE GRANTS OF $150,000 TO EACH OF ITS SEVEN FOUNDING TAX-EXEMPT 501(C)(3) FQHCS FOR A TOTAL OF $1,050,000 IN CHARITABLE GRANTS.
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet80,849,819
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II..............
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV ........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
70
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
597
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
5
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
4
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletIBRAHIM BENITEZ11 FAIRFIELD BOULEVARD   WALLINGFORD,CT06492 (203) 949-4000
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Antoinette D'Almeida......................................................................
Board Member
 0.50
.................
  		X           0 0 0
(2) Carl A Mikolowsky DDS......................................................................
Treasurer/Secretary
 0.50
.................
  		X   X       1,914 0 0
(3) John H Senechal MD......................................................................
board Member
 0.50
.................
  		X           1,914 0 0
(4) Ludwig Spinelli......................................................................
chair
 0.50
.................
  		X   X       0 0 0
(5) SYLVIA B KELLY......................................................................
President, CEO and Vice Chair
 40.00
.................
3.00 		X   X       503,847 0 34,304
(6) ibrahim Benitez......................................................................
sr. VP and Chief Financial Officer
 40.00
.................
2.00 		    X       359,986 0 40,231
(7) waldemar Rosario......................................................................
sr. vp and chief medical OFFICER
 40.00
.................
2.00 		    X       342,755 0 21,959
(8) mary ann cyr......................................................................
SR. VP, health services
 40.00
.................
  		    X       319,981 0 12,766
(9) john kaukas......................................................................
vp and chief information officer
 40.00
.................
  		    X       239,870 0 37,816
(10) gail digioia......................................................................
vp, member and provider services
 40.00
.................
  		    X       232,648 0 38,652
(11) joseph j karl......................................................................
vp, human resources
 40.00
.................
  		    X       227,719 0 30,986
(12) cory ludington......................................................................
vp for government affairs and compliance
 40.00
.................
  		    X       226,436 0 18,311
(13) steven bartolotta......................................................................
vp and chief information security officer
 40.00
.................
  		    X       193,143 0 17,584
(14) tressa spears......................................................................
vp, comm. affairs and Exec. Dir. CHNCT Foundation
 4.00
.................
36.00 		    X       149,852 0 27,892
(15) venice francis-Churilov......................................................................
director of intensive care management
 40.00
.................
  		      X     188,076 0 16,319
(16) attilio granata......................................................................
medical reviewer
 40.00
.................
2.00 		        X   257,768 0 28,628
(17) richard cowett......................................................................
medical reviewer
 40.00
.................
  		        X   233,445 0 29,731
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) aidINHA BLANEY........................................................................
director of Finance
 40.00
.......................   		        X   185,064 0 40,131
(19) gregory barbiero........................................................................
director of medical economics and network mgmt
 40.00
.......................   		        X   184,698 0 8,950
(20) annise caro........................................................................
director of utilization management
 40.00
.......................   		        X   181,312 0 27,516




















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 4,030,428 0 431,776
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet66
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
care to care

485 madison ave 2nd floor
new york,NY10022 		imaging radiology benefit managment 2,044,450
nesco resource llc

po box 901372
clevelande,OH44190 		temporary help services 313,156
htms - ebs masters llc

po box 572490
salt lake city,UT841572490 		it consulting 279,384
shipman & Goodwin llp

one constitution plaza
hartford,CT06103 		legal 277,843
cervalis llc

6 norden place
norwalk,CT06855 		disaster recovery services 272,808
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet10
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a aso revenue 561000 80,756,954 80,756,954    
b grant funds - rewards to quit 561000 1,276,494 1,276,494    
c grant funds - AQG 561000 340,746 340,746    
d grant funds - HCCN 561000 52,409 52,409    
e
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 82,426,603
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 247,430     247,430
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss)......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   15,937,861
b Less: cost or other basis and sales expenses   15,952,545
c Gain or (loss)   -14,684
d Net gain or (loss).....MediumBullet -14,684     -14,684
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a other income 900099 54,000 54,000    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 54,000
12 Total revenue. See Instructions......MediumBullet 82,713,349 82,480,603 0 232,746
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 1,093,680 1,093,680
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 187,376 187,376
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,284,961 3,284,961    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 33,575,789 33,178,406 397,383  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 897,802 887,817 9,985  
9 Other employee benefits ....... 5,900,599 5,771,692 128,907  
10 Payroll taxes ........... 2,898,134 2,856,827 41,307  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 447,831 150,949 296,882  
c Accounting ........... 110,044 110,044    
d Lobbying ........... 30,000   30,000  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 5,828,845 5,772,697 56,148  
12 Advertising and promotion .... 2,359   2,359  
13 Office expenses ....... 3,954,625 3,948,713 5,912  
14 Information technology ...... 9,063,958 9,063,640 318  
15 Royalties ..        
16 Occupancy ........... 1,586,108 1,586,108    
17 Travel ............ 123,221 121,019 2,202  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 203,840 182,596 21,244  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 3,100,352 3,100,352    
23 Insurance ... 491,560 491,560    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a mckesson 4,905,593 4,905,593    
b care to care 2,069,319 2,069,319    
c value options 1,784,355 1,784,355    
d other 523,022 477,078 45,944  
e All other expenses -174,963 -174,963    
25 Total functional expenses. Add lines 1 through 24e 81,888,410 80,849,819 1,038,591 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 30,291,950 2 19,532,802
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 3,626,928 4 3,160,052
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........   8  
9 Prepaid expenses and deferred charges ......   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 21,800,180
b Less: accumulated depreciation 10b 15,137,145 8,153,079 10c 6,663,035
11 Investments—publicly traded securities . 6,361,732 11 9,309,714
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 2,260,490 15 3,178,516
16 Total assets. Add lines 1 through 15 (must equal line 34)... 50,694,179 16 41,844,119
Liabilities 17 Accounts payable and accrued expenses ..... 8,672,489 17 5,715,688
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 7,463,942 25 1,152,630
26 Total liabilities. Add lines 17 through 25.. 16,136,431 26 6,868,318
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets   27  
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 748,984 30 748,984
31 Paid-in or capital surplus, or land, building or equipment fund ... 0 31 0
32 Retained earnings, endowment, accumulated income, or other funds 33,808,764 32 34,226,817
33 Total net assets or fund balances ........... 34,557,748 33 34,975,801
34 Total liabilities and net assets/fund balances ........ 50,694,179 34 41,844,119
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
82,713,349
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
81,888,410
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
824,939
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
34,557,748
5
Net unrealized gains (losses) on investments ...............
5
-406,886
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
34,975,801
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
Community Health Network of
Connecticut Inc
Employer identification number

06-1429341
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ....    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ...   412,300 412,300
b Buildings   2,764,984 1,056,024 1,708,960
c Leasehold improvements   4,472,074 2,681,286 1,790,788
d Equipment ...   12,175,232 9,848,741 2,326,491
e Other ...   1,975,590 1,551,094 424,496
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 6,663,035
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c)Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) prepaid expenses 3,178,516
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 3,178,516
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
accounts payable - dss aso 1,079,738
funds held for r2q program 72,892
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,152,630
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 83,038,051
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 324,702
e Add lines 2a through 2d ..................... 2e 324,702
3 Subtract line 2e from line 1.................. 3 82,713,349
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c 0
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 82,713,349
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 82,172,849
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 284,439
e Add lines 2a through 2d.................... 2e 284,439
3 Subtract line 2e from line 1................... 3 81,888,410
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 81,888,410

Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part X, Line 2: THE COMPANY FOLLOWS THE GUIDANCE OF ACCOUNTING STANDARDS CODIFICATION (ASC) 740, ACCOUNTING FOR INCOME TAXES (ASC 740), RELATED TO UNCERTAINTIES IN INCOME TAXES, WHICH PRESCRIBES A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE COMPANY BELIEVES IT HAS TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS.
Part XI, Line 2d - Other Adjustments: Community Health Network of Connecticut Foundation Inc. Revenue included in consolidated financial statements, net of in-kind contributions from CHN for inter-company expenses of $554,075; CHN Foundation Form 990 filed separately under ein: 20-0395748 324,702.
Part XII, Line 2d - Other Adjustments: Community Health Network of Connecticut Foundation Inc. expenses included in consolidated financial statements, net of in-kind contributions from CHN for inter-company expenses of $554,075; CHN Foundation Form 990 filed separately under ein: 20-0395748 284,439.
Schedule D (Form 990) 2015


Additional Data


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Community Health Network of
Connecticut Inc
Employer identification number
06-1429341
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) southwest community health center inc
46 albion street
bridgeport,CT06605 		06-1023013 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(2) fair haven community health center
374 grand avenue
new haven,CT06513 		06-0883545 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(3) CORNELL SCOTT-HILL HEALTH CORP
400 columbus avenue
new haven,CT06519 		06-0870990 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(4) charter oak health center
21 grand street
hartford,CT06106 		06-0986747 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(5) optimus health care inc
982 east main street
bridgeport,CT06608 		06-0972166 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(6) staywell health care inc
80 phoenix avenue
waterbury,CT06702 		22-3160873 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(7) generations family health center inc
40 mansfield avenue
willimantic,CT06226 		22-3158253 501(c)(3) 150,000       THE ENVIRONMENTAL SUPPORT PROGRAM HAS AS ITS PRIMARY FOCUS, THE ENHANCEMENT OF HEALTH CARE DELIVERY PROVIDED TO CHNCT MEMBERS AND THEIR FAMILIES WHO ARE DEPENDENT UPON THESE SITES AS THEIR MEDICAL HOME.
(8) community health center
635 main street
middletown,CT06457 		06-0897105 501(c)(3) 5,145       A STIPEND IS PAID TO HEALTH CENTERS FOR EACH MEMBER THAT ENROLLS IN THE REWARDS TO QUIT PROGRAM WHICH ASSISTS MEMBERS IN QUITTING SMOKING. THEY ARE PAID $35 PER MEMBER ENROLLED.
(9) community health resources
995 day hill road
windsor,CT06095 		06-6082527 501(c)(3) 5,215       A STIPEND IS PAID TO a local mental health authority FOR EACH MEMBER THAT ENROLLS IN THE REWARDS TO QUIT PROGRAM WHICH ASSISTS MEMBERS IN QUITTING SMOKING. THEY ARE PAID $35 PER MEMBER ENROLLED.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
9
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
non-cash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of non-cash assistance
(1) prepaid debit cards issued to members when they sign up for rewards to quit 2055 187,376   FMV  
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, Line 2: ENVIRONMENTAL SUPPORT CHARITABLE GRANT PROGRAM: THROUGH ITS ENVIRONMENTAL SUPPORT CHARITABLE GRANT PROGRAM, CHNCT MAKES CHARITABLE GRANTS TO ORGANIZATIONS THAT ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ENVIRONMENTAL SUPPORT CHARITABLE GRANT PROGRAM IS DESIGNED TO AFFORD CHNCT'S FOUNDING FEDERALLY QUALIFIED HEALTH CENTER (FQHC) SITES AN OPPORTUNITY TO REQUEST FUNDING FOR PROJECT AND/OR FACILITY IMPROVEMENTS THAT WOULD ENHANCE ACCESS TO CARE AT THESE LOCATIONS. EACH OF THESE FQHCS IS A TAX-EXEMPT CHARITABLE ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE INITIATIVES THAT QUALIFY FOR AN ENVIRONMENTAL SUPPORT CHARITABLE GRANT MUST BE RELATED TO: EXPANDING ACCESS TO HEALTHCARE; EMERGENCY ROOM DIVERSION; SPECIALTY SERVICE/ACCESS TO SPECIALTY CARE; HELPING WITH MEDICAL HOME MODEL INITIATIVES; IMPLEMENTING ELECTRONIC HEALTH RECORD MEANINGFUL USE INITIATIVES; AND/OR FQHC FACILITY IMPROVEMENTS. DURING 2015, CHNCT MADE GRANTS OF $150,000 TO EACH OF ITS SEVEN FOUNDING TAX-EXEMPT 501(C)(3) FQHCS FOR A TOTAL OF $1,050,000 IN CHARITABLE GRANTS.
Schedule I (Form 990) 2015



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
Community Health Network of
Connecticut Inc
Employer identification number

06-1429341
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
No
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1SYLVIA B KELLYPresident, CEO and Vice Chair (i)

(ii)		 382,487
-------------
0 		67,075
-------------
0 		54,285
-------------
0 		9,275
-------------
0 		25,029
-------------
0 		538,151
-------------
0 		0
-------------
0
2ibrahim Benitezsr. VP and Chief Financial Officer (i)

(ii)		 293,418
-------------
0 		30,000
-------------
0 		36,568
-------------
0 		9,275
-------------
0 		30,956
-------------
0 		400,217
-------------
0 		0
-------------
0
3waldemar Rosariosr. vp and chief medical OFFICER (i)

(ii)		 325,046
-------------
0 		10,000
-------------
0 		7,709
-------------
0 		9,275
-------------
0 		12,684
-------------
0 		364,714
-------------
0 		0
-------------
0
4mary ann cyrSR. VP, health services (i)

(ii)		 262,065
-------------
0 		25,000
-------------
0 		32,916
-------------
0 		9,275
-------------
0 		3,491
-------------
0 		332,747
-------------
0 		0
-------------
0
5john kaukasvp and chief information officer (i)

(ii)		 214,199
-------------
0 		15,000
-------------
0 		10,671
-------------
0 		7,737
-------------
0 		30,079
-------------
0 		277,686
-------------
0 		0
-------------
0
6gail digioiavp, member and provider services (i)

(ii)		 191,133
-------------
0 		20,000
-------------
0 		21,515
-------------
0 		6,441
-------------
0 		32,211
-------------
0 		271,300
-------------
0 		0
-------------
0
7joseph j karlvp, human resources (i)

(ii)		 186,274
-------------
0 		20,000
-------------
0 		21,445
-------------
0 		6,702
-------------
0 		24,284
-------------
0 		258,705
-------------
0 		0
-------------
0
8cory ludingtonvp for government affairs and compli (i)

(ii)		 193,275
-------------
0 		20,000
-------------
0 		13,161
-------------
0 		6,835
-------------
0 		11,476
-------------
0 		244,747
-------------
0 		0
-------------
0
9steven bartolottavp and chief information security of (i)

(ii)		 186,931
-------------
0 		5,000
-------------
0 		1,212
-------------
0 		3,333
-------------
0 		14,251
-------------
0 		210,727
-------------
0 		0
-------------
0
10tressa spearsvp, comm. affairs and Exec. Dir. CHN (i)

(ii)		 129,981
-------------
0 		8,000
-------------
0 		11,871
-------------
0 		2,700
-------------
0 		25,192
-------------
0 		177,744
-------------
0 		0
-------------
0
11venice francis-Churilovdirector of intensive care managemen (i)

(ii)		 161,583
-------------
0 		10,000
-------------
0 		16,493
-------------
0 		4,030
-------------
0 		12,289
-------------
0 		204,395
-------------
0 		0
-------------
0
12attilio granatamedical reviewer (i)

(ii)		 200,350
-------------
0 		0
-------------
0 		57,418
-------------
0 		7,679
-------------
0 		20,949
-------------
0 		286,396
-------------
0 		0
-------------
0
13richard cowettmedical reviewer (i)

(ii)		 228,558
-------------
0 		0
-------------
0 		4,887
-------------
0 		4,924
-------------
0 		24,807
-------------
0 		263,176
-------------
0 		0
-------------
0
14aidINHA BLANEYdirector of Finance (i)

(ii)		 135,077
-------------
0 		10,000
-------------
0 		39,987
-------------
0 		4,815
-------------
0 		35,316
-------------
0 		225,195
-------------
0 		0
-------------
0
15gregory barbierodirector of medical economics and ne (i)

(ii)		 163,716
-------------
0 		10,000
-------------
0 		10,982
-------------
0 		5,897
-------------
0 		3,053
-------------
0 		193,648
-------------
0 		0
-------------
0
16annise carodirector of utilization management (i)

(ii)		 163,474
-------------
0 		7,000
-------------
0 		10,838
-------------
0 		5,839
-------------
0 		21,677
-------------
0 		208,828
-------------
0 		0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A: CERTAIN GROUPS OF EMPLOYEES RECEIVED GROSSED UP PAYMENTS AS A COMPONENT OF A PERFORMANCE BONUS PAID OUT DURING THE YEAR. THOSE GROUPS OF EMPLOYEES THAT RECEIVED THIS BENEFIT WERE EXECUTIVE MANAGEMENT, SENIOR AND MIDDLE MANAGEMENT, AND GENERAL EMPLOYEES WHOSE WORK WERE INSTRUMENTAL IN ACHIEVING OUR GOALS AND OBJECTIVES. INCLUDED IN THE GROUPS OF EMPLOYEES WHO RECEIVED THE GROSS UP BONUS BENEFIT WERE THE FOLLOWING INDIVIDUALS LISTED ON SCHEDULE J: S. KELLY - $19,464 I. BENITEZ - $19,464 W. Rosario - $ 6,488 M. Cyr - $16,220 j. kaukus - $ 9,732 g. digioia - $12,976 j. karl - $12,976 c. ludington - $12,976 T. spears - $ 5,040 V. FRANCIS-CHURILOV $ 6,300 A. BLANEY - $ 6,488 g. barbiero - $ 6,300 a. caro - $ 4,410 IN EACH CASE, THE ENTIRE AMOUNT OF THE GROSS UP BENEFIT WAS TREATED AS TAXABLE COMPENSATION TO THE LISTED INDIVIDUAL, PROPERLY REPORTED ON AN IRS FORM W-2 AND INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN THIS FORM 990.
PART I, LINE 1B: THE FILING ORGANIZATION DOES NOT HAVE A WRITTEN POLICY REGARDING GROSSED-UP PAYMENTS. THE FILING ORGANIZATION HAS TERMINATED THE PRACTICE OF PROVIDING GROSSED-UP BONUS PAYMENTS.
PART I, LINE 2: THE CORPORATION REQUIRES ALL EMPLOYEES TO SUBMIT SUBSTANTIATION IN ACCORDANCE WITH THE IRS ACCOUNTABLE PLAN RULES PRIOR TO REIMBURSING EMPLOYEE EXPENSES. HOWEVER, THE SUBSTANTIATION/ACCOUNTABLE PLAN RULES DO NOT (AND CANNOT) APPLY TO THE GROSS-UP PAYMENTS IDENTIFIED IN LINE 1A AS the amounts of the bonus benefits that were grossed up and paid to the EMPLOYEES WERE DETERMINED BY THE CORPORATION.
PART I, LINE 7: during calendar year 2015, the organization paid discretionary bonuses to certain of the individuals listed in Part II.
Schedule J (Form 990) 2015
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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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Community Health Network of
Connecticut Inc
Employer identification number

06-1429341
Return Reference Explanation
Form 990, Part VI, Section A, line 6 THE ORGANIZATION HAS A SINGLE CLASS OF MEMBERS. THE SOLE MEMBER IN THAT CLASS IS COMMUNITY HEALTH NETWORK OF CONNECTICUT HOLDINGS, INC., A CONNECTICUT NONSTOCK CORPORATION ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3).
Form 990, Part VI, Section A, line 7a THE ORGANIZATION'S MEMBER HAS THE POWER TO ELECT THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. MORE SPECIFICALLY, COMMUNITY HEALTH NETWORK OF CONNECTICUT HOLDINGS, INC., THE ORGANIZATION'S SOLE MEMBER, HAS THE POWER TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE ORGANIZATION.
Form 990, Part VI, Section A, line 7b CERTAIN GOVERNANCE DECISIONS OF THE ORGANIZATION ARE RESERVED TO THE MEMBER. MORE SPECIFICALLY, COMMUNITY HEALTH NETWORK OF CONNECTICUT HOLDINGS, INC., THE ORGANIZATION'S SOLE MEMBER, HAS THE EXCLUSIVE POWER TO AMEND THE BYLAWS OF THE ORGANIZATION. IN ADDITION, IN ACCORDANCE WITH SUCH BYLAWS, THE ORGANIZATION'S SOLE MEMBER HAS APPROVAL RIGHT WITH RESPECT TO THE ORGANIZATION'S ABILITY TO (I) ADOPT OR MODIFY THE ORGANIZATION'S MISSION STATEMENT, (II) ADOPT OR MODIFY THE ORGANIZATION'S BUDGETS, (III) APPROVE SIGNIFICANT BORROWINGS, (IV) HIRE THE ORGANIZATION'S PRESIDENT, (V) APPROVE SIGNIFICANT CHANGES IN THE ORGANIZATION'S ACTIVITIES, (VI) ACQUIRE OR DISPOSE OF SIGNIFICANT ASSETS, (VII) FILE FOR BANKRUPTCY, AND (VIII) AMEND THE CERTIFICATE OF INCORPORATION.
Form 990, Part VI, Section B, line 11 ONCE PREPARED BY OUR THIRD PARTY ACCOUNTANTS, THE 990 FORM IS REVIEWED BY CHNCT'S DIRECTOR OF FINANCE, CHIEF FINANCIAL OFFICER, CHIEF EXECUTIVE OFFICER, VICE PRESIDENT OF COMPLIANCE, AND VICE PRESIDENT OF HUMAN RESOURCES. AFTER THIS REVIEW PROCESS IS COMPLETED, THE 990 FORM IS DISTRIBUTED TO EACH MEMBER OF THE CHNCT BOARD OF DIRECTORS, AND EACH MEMBER OF THE CHNCT HOLDINGS BOARD OF DIRECTORS (CHNCT HOLDINGS IS THE SOLE MEMBER OF CHNCT) PRIOR TO THE FILING OF THE DOCUMENT WITH THE IRS.
Form 990, Part VI, Section B, line 12c OFFICERS (EXECUTIVE MANAGEMENT) AND KEY EMPLOYEES (SENIOR MANAGERS) ARE REQUIRED TO DISCLOSE ANNUAL INTERESTS THAT COULD GIVE RISE TO CONFLICTS TO THE COMPLIANCE OFFICER.
Form 990, Part VI, Section B, line 15 FOR THE CEO, THE BOARD'S EXECUTIVE COMMITTEE DETERMINES ANNUAL COMPENSATION BASED ON MARKET DATA OBTAINED FROM CHNCT'S PRIMARY SURVEY SOURCES; THE WARREN SURVEY, THE ACAP EXECUTIVE SALARY SURVEY, AND THE ECONOMIC RESEARCH INSTITUTE'S EXECUTIVE SALARY ASSESSOR. EXCERPTED DATA INCLUDED THE SURVEY MEDIAN (50TH PERCENTILE) FOR THE CEO POSITION, BOTH FOR BASE SALARY AND TOTAL COMPENSATION (BASE PLUS ANNUAL BONUS). THE EXECUTIVE COMMITTEE MEETS AND APPROVES ANY ADJUSTMENT TO BASE SALARY AND/OR BONUS AMOUNTS TO BE PAID. FOR THE KEY EXECUTIVES, BASE SALARY LEVELS, ADJUSTMENTS AND BONUS AWARDS WERE AT THE DISCRETION OF THE CEO. SURVEY DATA AT THE SAME REFERENCE POINTS FROM THE SAME SURVEYS IS PROVIDED, ALONG WITH RECOMMENDED SALARY RANGES, SUBJECT TO CEO APPROVAL. AS WITH THE CEO DATA, THE REFERENCE POINTS USED ARE THE 50TH PERCENTILE. ANY ADJUSTMENT AWARDED ARE AT THE CEO'S DISCRETION, WITHIN THE CONTEXT AND LIMITS OF THE COMPANY'S OVERALL SALARY BUDGET and ASO contract performance. DURING 2016, THE BOARD ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM (SULLIVAN COTTER) TO CONDUCT A MARKET STUDY AND COMPARISON OF BASE COMPENSATION, BONUS PAY, BENEFITS, AND TOTAL CASH COMPENSATION FOR THE CEO AND MOST OF THE OFFICERS/VP'S (NINE POSITIONS IN ALL). THEY ALSO UTILIZED THE WARREN AND ACAP SURVEYS, BUT SUPPLEMENTED THAT DATA WITH OTHER SOURCES. THEY COMPARED THE NINE POSITIONS TO AN EQUALLY WEIGHTED BLEND OF HEALTH PLAN, NOT-FOR-PROFIT, AND GENERAL INDUSTRY MARKETS. IN COMPARING TO THE NOT-FOR-PROFIT AND GENERAL INDUSTRY MARKETS, THEY UTILIZED ANNUAL REVENUE SIZE AS SCOPE DATA. THE BOARD HAS ALSO FORMED A COMPENSATION AND PERSONNEL COMMITTEE WHOSE RESPONSIBILITY IT WILL BE TO REVIEW AND APPROVE EXECUTIVE COMPENSATION.
Form 990, Part VI, Section C, line 19 UPON REQUEST, THESE DOCUMENTS WOULD BE MADE AVAILABLE ON THE PREMISES OF THE COMPANY'S CORPORATE LOCATION FOR REVIEW BY THE PUBLIC.
Form 990, Part XII, Line 2c: There were no changes to the organization's oversight or selection processes during the tax year.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
Community Health Network of
Connecticut Inc
Employer identification number

06-1429341
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)community health network of connecticut foundation inc
11 fairfield avenue

wallingford,CT06492
20-0395748 		supports nonprofit activities of community health centers and nonprofit orgs CT 501(c)(3) Line 7 community health network of connecticut inc
 
Yes
 
(2)community health network of connecticut holdings inc
11 fairfield avenue

wallingford,CT06492
45-5239655 		supports the t/e activities of CHNCT thru strategic plng & facility maint. CT 501(c)(3) Line 11c, III-FI N/A
 
No










For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) community health network of connecticut foundation inc

 O 614,005 fair value





Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2015

Additional Data


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