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, Line 15a Compensation paid to officers | No has been answered to lines 15a & 15 b, as the filing organization reimburses MDWise for officers' compensation pursuant to a management services agreement. All officers of MDWISE Marketplace, Inc. are employees of an affiliated entity MDWISE, Inc. |
| Form 990, Part VI, Line 1a Material differences in voting rights | MDwise Medicaid Network, Inc., a not-for- profit entity, was formed by Health and Hospital Corporation of Marion County who contributed 50%, and Indiana University Health who contributed 50% of the capital required for MDwise Medicaid Network to meet all of its obligations as a licensed Indiana domestic Health Maintenance Organization. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Indiana University Health ("IU Health") and The Health and Hospital Corporation of Marion County ("HHC") shall each appoint 50% of the board. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The CFO of MDwise reviewed a final draft of the form 990 before filing with the IRS. A final copy of the form 990 is sent to every member of the governing body after it is filed with the IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization REQUIRES THAT ALL BOARD MEMBERS and OFFICERS SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE COMPLIANCE OFFICER OF MDWISE, INC. REVIEWS EACH COMPLETED STATEMENT AND IS PRESENT AT BOARD MEETINGS TO ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF AN ISSUE WITH A POTENTIAL CONFLICT IS BROUGHT TO THE TABLE AT A BOARD MEETING, THE PERSON WITH THE POTENTIAL CONFLICT ABSTAINS FROM VOTING ON THE ISSUES. |
| Form 990, Part VI, Line 19 Required documents available to the public | All required documents will be made available upon authorized request. |
| Software ID: | 15000238 |
| Software Version: | 2015v2.1 |