Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION DID HAVE MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD DOES HAVE THE ABILITY TO ADD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND PRESIDENT BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONSUMERS' CHOICE HEALTH INSURANCE COMPANY DOES REGULARLY MONITOR THE CONFLICT OF INTEREST POLICY. IT IS PART OF THE CODE OF CONDUCT. EACH BOARD MEMBER AND MEMBER OF SR. MANAGEMENT MUST SIGN A CONFLICT OF INTEREST STATEMENT AND DISCLOSE ANY CONFLICTS AT LEAST ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | CONSUMERS' CHOICE HEALTH INSURANCE COMPANY DOES HAVE A GOVERNANCE AND COMPENSATION COMMITTEE THAT MEETS AND DETERMINES A REASONABLE COMPENSATION. THE COMMITTEE IS MADE OF INDEPENDENT PERSONS, REVIEWS COMPARABLE DATA, AND MAKES A PRESENTATION TO THE DIRECTORS WHICH IS INCLUDED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | CONSUMERS' CHOICE HEALTH INSURANCE COMPANY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| ALLOCATION OF SHARED SERVICES: | OFFICERS LISTED ON PART VII, SECTION A REPORT SALARY AT 100% PER W-2 ISSUED. HOWEVER, AVERAGE HOURS LISTED PER WEEK IS REPORTED AT 50%, AS THESE POSITIONS ARE SHARED EQUALLY PER A SHARED SERVICE AGREEMENT WITH COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY. HIGHLY COMPENSATED EMPLOYEES LISTED ON PART VII, SECTION A WITH 20 AVERAGE HOURS PER WEEK ARE ALSO SHARED WITH COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY. THE AVERAGE HOURS PER WEEK IS REPORTED AT 50% WHILE SALARY IS REPORTED AT 100% PER W-2 ISSUED. HIGHLY COMPENSATED EMPLOYEES LISTED ON PART VII, SECTION A WITH 40 AVERAGE HOURS PER WEEK ARE NOT SHARED EMPLOYEES AND THEREFORE REPORT BOTH HOURS AND SALARY AT 100%. INCLUDED IN PAGE 10, PART IX - STATEMENT OF FUNCTIONAL EXPENSES, LINE 11A OF MANAGEMENT FEES ARE A PORTION OF THE FOLLOWING EMPLOYEES' SALARIES: JERRY BURGESS - CEO ($279,633) (REPORTED ON CONSUMERS' CHOICE HEALTH INSURANCE COMPANY 990) DAVID YOUNG - CFO $182,864 (REPORTED ON COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY 990) JUDY SLAGLE - COO ($228,592) (REPORTED ON CONSUMERS' CHOICE HEALTH INSURANCE COMPANY 990) RALPH PARKER - CHIEF INFORMATION OFFICER ($169,663) (REPORTED ON CONSUMERS' CHOICE HEALTH INSURANCE COMPANY 990) KATHI WILLIS - GENERAL COUNSEL $72,511 (REPORTED ON COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY 990) ERIC QUIVERS - HIGHLY COMPENSATED EMPLOYEE ($142,222) (REPORTED ON CONSUMERS' CHOICE HEALTH INSURANCE COMPANY 990) LYNDA JOHNSON - HIGHLY COMPENSATED EMPLOYEE ($162,124) (REPORTED ON CONSUMERS' CHOICE HEALTH INSURANCE COMPANY 990) JAMES MITCHELL - HIGHLY COMPENSATED EMPLOYEE $71,001 (REPORTED ON COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY 990) SAMUEL ORRISON - HIGHLY COMPENSATED EMPLOYEE $118,787 (REPORTED ON COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY 990) WESLEY NELLIS - HIGHLY COMPENSATED EMPLOYEE $71,909 (REPORTED ON COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY 990) |
| FORM 990, PART XI, LINE 9: | NONADMITTED ASSETS - FURNITURE AND FIXTURES, NET OF A/D -300,712. NONADMITTED ASSETS - PREPAID EXPENSES -225,629. NONADMITTED ASSETS - REFUNDABLE DEPOSITS -20,892. NONADMITTED ASSETS - CASH 1,354,142. PROCEEDS FROM SURPLUS NOTE 0. NONADMITTED ASSETS - ACCOUNTS RECEIVABLE 28,637,473. NONADMITTED ASSETS - NOTES AND LOAN RECEIVABLE -36,460,296. NONADMITTED ASSETS - ACCOUNTS PAYABLE -1,353,666. |
| FORM 990, PART XII, LINE 1: | THE ORGANIZATION USES THE STATUTORY-BASIS METHOD OF ACCOUNTING IN CONFORMITY WITH THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' (NAIC) ACCOUNTING PRACTICES AND PROCEDURES MANUAL, EXCEPT TO THE EXTENT THAT THE LAWS OF SOUTH CAROLINA DIFFER FROM THESE RULES. |
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