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)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 367,153 | 12,133,598 | 6,628,017 | 6,896,168 | 26,024,936 | |
| 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 | 367,153 | 12,133,598 | 6,628,017 | 6,896,168 | 26,024,936 | |
| 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. | 26,024,936 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 367,153 | 12,133,598 | 6,628,017 | 6,896,168 | 26,024,936 | |
| 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 | 26,024,936 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | ||||||
| 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on 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.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | SECTION 3.3 OF THE BYLAWS DEFINES THE COMPOSITION OF THE BOARD OF DIRECTORS AS FOLLOWS: THE BOARD SHALL BE COMPRISED OF THE FOLLOWING EIGHT MEMBERS: (I) ONE MEMBER WHO SHALL HAVE EXPERTISE AS AN ADVOCATE FOR CONSUMERS OF HEALTH CARE, APPOINTED BY THE GOVERNOR; (II) ONE MEMBER WHO SHALL HAVE EXPERTISE AS A CLINICAL MEDICAL DOCTOR, APPOINTED BY THE PRESIDENT PRO TEMPORE OF THE SENATE; (III) ONE MEMBER WHO SHALL HAVE EXPERTISE IN THE AREA OF HOSPITAL ADMINISTRATION, APPOINTED BY THE SPEAKER OF THE HOUSE OF REPRESENTATIVES; (IV) ONE MEMBER WHO SHALL HAVE EXPERTISE IN THE AREA OF CORPORATE LAW OR FINANCE, APPOINTED BY THE MINORITY LEADER OF THE SENATE; (V) ONE MEMBER WHO SHALL HAVE EXPERTISE IN GROUP HEALTH INSURANCE COVERAGE, APPOINTED BY THE MINORITY LEADER OF THE HOUSE OF REPRESENTATIVES; (VI) THE CHIEF INFORMATION OFFICER AND THE SECRETARY OF THE OFFICE OF POLICY AND MANAGEMENT, OR THEIR DESIGNEES, WHO SHALL SERVE AS EX OFFICIO, VOTING MEMBERS OF THE BOARD; (VII) THE HEALTH INFORMATION TECHNOLOGY OFFICER, DESIGNATED IN ACCORDANCE WITH SECTION 19A-754A OF THE CONNECTICUT GENERAL STATUTES, WHO SHALL SERVE AS CHAIRPERSON OF THE BOARD; AND (VIII) THE COMMISSIONER OF THE DEPARTMENT OF SOCIAL SERVICES, OR THE COMMISSIONER'S DESIGNEE, WHO SHALL SERVE AS EX-OFFICIO, VOTING MEMBER OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | HIA'S FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY MANAGMENT PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | HIA HAS A CONFLICT OF INTEREST POLICY DESIGNED TO SUPPLEMENT, BUT NOT REPLACE, THE CODE OF ETHICS FOR PUBLIC OFFICIALS OF THE STATE OF CONNECTICUT SET FORTH IN CHAPTER 10, SECTIONS 1-79 ET, SEQ. OF THE CONNECTICUT GENERAL STATUES, INCLUDING BUT NOT LIMITED TO SECTIONS 1-84 & 1-85 REGARDING INTERESTS IN CONFLICT WITH DISCHARGE OF A PUBLIC OFFICIAL'S DUTIES, AS WELL AS ANY OTHER APPLICABLE FEDERAL OR STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLCIABLE TO NON PROFIT OR ALL TYPES OF CORPORATIONS. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE CORPORATION'S DIRECTORS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IF AN INTERESTED PERSON BELIEVE THAT HE OR SHE HAS A CONFLICT OF INTEREST, SUCH PERSON SHALL RECUSE HIMSELF OR HERSELF FROM ALL FURTHER DISCUSSIONS WITH RESPECT TO THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST AND SHALL NOT VOTE ON ANY MATTERS WITH RESPECT THERETO. AN INTERESTED PERSON IS UNCERTAIN AS TO WHETHER HE OR SHE HAS A CONFLICT OF INTEREST, HE OR SHE SHALL SEEK A DETERMINATION BY THE BOARD OF DIRECTORS AS TO WHETHER A CONFLICT OF INTEREST EXISTS. SUCH INTERESTED PERSON SHALL BE BOUND BY A DECISION OF THE BOARD OF DIRECTORS WITH RESPECT TO THE EXISTENCE OF A CONFLICT OF INTEREST. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS SHALL DECIDE A CONFLICT OF INTEREST EXISTS. THE FOLLOWING PROCEDURES EXIST REGARDING POSSIBLE CONFLICTS OF INTEREST: A. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD MEETING, BUT AFTER SUCH PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT GIVES RISE TO THE CONFLICT OF INTEREST. B. THE REMAINING DIRECTORS SHALL, THEY, IN THEIR SOLE DISCRETION DETERMINE APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. THE MINUTES OF THE MEETING OF THE BOARD OF DIRECTORS SHALL DOCUMENT THE MEETING REGARDING A POTENTIAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | EMPLOYEE COMPENSATION IS GOVERNED BY BOARD POLICY. EMPLOYEES COMPENSATED BY THE ORGANIZATION ARE EVALUATED ANNUALLY FOR THEIR PERFORMANCE, SEEK INPUT ON MATTERS OF PERFORMANCE AND COMPENSATION, AND HAVE A REASONABLENESS DETERMINATION CONDUCTED WITH RESPECT TO PROPOSED COMPENSATION. RESEARCH AND INFORMATION TO MAKE RECOMMENDATIONS FOR COMPENSATION BASED ON A REVIEW OF COMPARABILITY DATA ARE OBTAINED DURING THIS PROCESS AND HOW CONCLUSIONS ARE REACHED, INCLUDING THE DATA RELIED UPON, ARE DOCUMENTED. DECISIONS REGARDING REASONABLENESS OF THE COMPENSATION ARRANGEMENTS ARE ARRIVED AT INDEPENDENTLY WITHOUT UNDUE INFLUENCE FROM ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS BEING DETERMINED. |
| FORM 990, PART VI, SECTION C, LINE 19 | HIA WILL MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| 990 PART VII, SECTION B, LINE 1: | PAYMENTS TO CRISP, LISTED AS AN INDEPENDENT CONTRACTOR, INCLUDE AMOUNTS PAID FOR THE STAFF OF HEALTH INFORMATION ALLIANCE. THESE INDIVIDUALS RECEIVE THEIR W-2S FROM CRISP, PAID BY HEALTH INFORMATION ALLIANCE AS A PASS-THROUGH AMOUNT. HEALTH INFORMATION ALLIANCE TREATS THE STAFF FROM CRISP AS ITS OWN EMPLOYEES IN EVERY OTHER WAY, AND SO THESE COMPENSATION AMOUNTS ARE INCLUDED AS SALARY EXPENSE ON THE STATEMENT OF FUNCTIONAL EXPENSES AND ALSO INCLUDED ON PART VII, SECTION B FOR THE CALENDAR YEAR ENDING WITHIN THE FISCAL YEAR OF HEALTH INFORMATION ALLIANCE. |
| FORM 990, PART IX, LINE 11G | BUCKNER CONSULTING GROUP: PROGRAM SERVICE EXPENSES 56,375. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 56,375. CASTLEMARK CONSULTING: PROGRAM SERVICE EXPENSES 80,450. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,450. COMMUNICATEHEALTH: PROGRAM SERVICE EXPENSES 96,673. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,673. CRISP SHARED SERVICES (CSS): PROGRAM SERVICE EXPENSES 2,385,384. MANAGEMENT AND GENERAL EXPENSES 34,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,419,384. DEFINITIVE HEALTHCARE: PROGRAM SERVICE EXPENSES 54,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,000. DELLA HUGHES CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,000. EPLUS: PROGRAM SERVICE EXPENSES 38,001. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,001. HES ADVISORS, LLC: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 43,141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,141. INNSENA: PROGRAM SERVICE EXPENSES 69,575. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,575. IMAJ ASSOCIATES: PROGRAM SERVICE EXPENSES 15,000. MANAGEMENT AND GENERAL EXPENSES 15,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,000. ITHP: PROGRAM SERVICE EXPENSES 147,225. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,225. MICHAEL MATTHEWS: PROGRAM SERVICE EXPENSES 8,938. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,938. NOVUS INSIGHT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 14,670. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,670. SECURE EXCHANGE SOLUTIONS: PROGRAM SERVICE EXPENSES 217,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 217,500. UCONN HEALTH: PROGRAM SERVICE EXPENSES 256,931. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 256,931. WTW: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 27,979. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,979. |
| FORM 990, PART XII, LINE 2C: | THE FINANCE AND AUDIT COMMITTEE ARE RESPONSIBLE FOR SELECTING AN INDEPENDENT AUDIT FIRM AND OVERSEEING THE FINANCIAL STATEMENT PREPARATION PROCESS. THE FINANCE AND AUDIT COMMITTEE PROVIDES THE STATUS OF FINANCIAL REPORTING AND OBTAINS BOARD APPROVAL FOR DESIGNATION OF AN AUDIT FIRM DURING THE BOARD MEETINGS. |
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| Software Version: |