Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 23,143,374 | 77,971 | 23,221,345 | |||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 34,195,325 | 36,045,580 | 42,889,391 | 44,540,505 | 44,809,897 | 202,480,698 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 57,338,699 | 36,123,551 | 42,889,391 | 44,540,505 | 44,809,897 | 225,702,043 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 6,481,514 | 11,975,904 | 12,428,245 | 4,608,987 | 14,041,095 | 49,535,745 |
| c | Add lines 7a and 7b.. | 6,481,514 | 11,975,904 | 12,428,245 | 4,608,987 | 14,041,095 | 49,535,745 |
| 8 | Public support. (Subtract line 7c from line 6.) | 176,166,298 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 57,338,699 | 36,123,551 | 42,889,391 | 44,540,505 | 44,809,897 | 225,702,043 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 120,539 | 259,591 | 405,680 | 360,449 | 329,290 | 1,475,549 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 14,565 | 14,565 | ||||
| c | Add lines 10a and 10b. | 120,539 | 259,591 | 405,680 | 360,449 | 343,855 | 1,490,114 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 2,994 | 6,308 | 2,092 | 11,394 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 57,462,232 | 36,389,450 | 43,297,163 | 44,900,954 | 45,153,752 | 227,203,551 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2019 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12, Explanation of Other Income: | Customer Finance Charges - 2013 Amount: $ 2,994. 2014 Amount: $ 6,308. 2015 Amount: $ 2,092. |
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Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Section A, line 8b | There are no committees with broad authority to act on behalf of the board. |
| Form 990, Part VI, Section B, line 11b | Prior to filing the Form 990, The CEO, CFO, and General Counsel conduct a review and then each member of the Board of Directors is provided a copy of the Form 990 to review. The directors are encouraged to ask any questions regarding the filing and are given the opportunity to contact the CEO, CFO and/or General Counsel. If a regular board meeting is not scheduled prior to the filing, then at the discretion of the board, if they deem it advisable, a special meeting may be called to discuss the Form 990. |
| Form 990, Part VI, Section B, line 12c | All directors and officers are required to comply with the Healthwise conflict of interest policy during their employment or service. Annually, they are required to sign a statement affirming: they have read and understand the Healthwise Conflict of Interest Policy regarding interested persons/financial interest, agree to comply with the Policy, understand that Healthwise is a charitable organization and, to maintain its Federal tax exemption, it must engage primarily in activities that accomplish one or more of its tax-exempt purposes. This statement also requires they specify if they do or not have an actual or possible conflict of interest (as defined in the Policy) and if so, that they disclose this information. The General Counsel reviews the completed statements and presents any disclosed actual or possible conflicts of interest to the Board and/or Audit, Finance and Compensation Committee for review and a determination of whether a conflict exists, and if so, address such conflict. In addition, the General Counsel annually reviews with the Board and/or Audit, Finance and Compensation Committee transactions between Healthwise and organizations, which have an affiliation with a director or officer involving a financial interest (based on their completed statements) for a determination of whether a conflict exists and to seek approval or ratification of the transaction and its related agreements, as necessary. |
| Form 990, Part VI, Section B, line 15 | The following procedures are in place for setting and reviewing CEO, officers and key employees' compensation: 1. Compensation is reviewed and approved by the Audit, Finance and Compensation Committee (AFC Committee). Persons with conflicts of interest for a particular position are not involved in review or approval for such position. 2. Compensation is reviewed and approved using comparable compensation data provided by an independent compensation company for similarly qualified persons in functionally comparable positions at similarly situated organizations. The source data used is based on multiple compensation surveys. 3. There is contemporaneous documentation and record keeping with respect to the deliberations and decisions regarding the compensation arrangements. The documentation includes terms of compensation, members of the Committee/Board present for the decision and discussion, comparable data used and the basis for the decision made. 4. The Board has access to all AFC Committee decisions regarding the results of this process and, in addition, the Board directly handled the setting of the compensation for the CEO. 5. Additionally, the AFC Committee periodically engages independent compensation consultants to review and analyze total compensation for specific officer positions, and the terms and compensation relating to retention and incentive compensation agreements and severance plans, against survey and/or peer group data and/or industry and comparable benchmark data. In connection with these engagements, the AFC Committee generally seeks an opinion from the independent compensation consultant on the reasonableness of the compensation package and/or terms relating to the retention and/or incentive agreement or severance plan. The review, deliberation and approval specified in items 1-4 above along with the analysis and opinion of the independent compensation consultant was used by the AFC Committee and Board with regard to Plan compensation matters and compensation of the CEO. |
| Form 990, Part VI, Section C, line 19 | A copy of any of these documents, such as but not limited to, the Form 990, Articles of Incorporation, Bylaws, Conflict of Interest Policy and Financial Statements are available upon request from the CEO, General Counsel or the CFO's office. |
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