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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 245,800 | 607,865 | 50,200 | 15,500 | 15,500 | 934,865 |
| 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 | 409,991 | 530,366 | 822,192 | 102,136 | 326,070 | 2,190,755 |
| 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 | 655,791 | 1,138,231 | 872,392 | 117,636 | 341,570 | 3,125,620 |
| 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. | 214,942 | 95,552 | 119,421 | 91,480 | 96,504 | 617,899 |
| c | Add lines 7a and 7b.. | 214,942 | 95,552 | 119,421 | 91,480 | 96,504 | 617,899 |
| 8 | Public support. (Subtract line 7c from line 6.) | 2,507,721 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 655,791 | 1,138,231 | 872,392 | 117,636 | 341,570 | 3,125,620 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 103 | 145 | 323 | 571 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 103 | 145 | 323 | 571 | ||
| 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.).. | 655,894 | 1,138,376 | 872,715 | 117,636 | 341,570 | 3,126,191 |
| 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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | PEAK HEALTH ALLIANCE IS ORGANIZED FOR THE PURPOSE OF ARRANGING FOR MORE COST-EFFECTIVE HEALTH INSURANCE AND HEALTH INSURANCE ADMINISTRATIVE SERVICES FOR EMPLOYERS WITH A PHYSICAL PRESENCE IN RURAL COLORADO AND THEIR EMPLOYEES AND INDIVIDUALS WHO RESIDE WITHIN COMMUNITIES WHO HAVE JOINED PEAK HEALTH ALLIANCE. |
| FORM 990, PAGE 2, PART III, LINE 4A | PEAK HEALTH ALLIANCE USES THE PURCHASING POWER OF THE COMMUNITIES WE REPRESENT TO NEGOTIATE LOWER HEALTH INSURANCE PREMIUMS. WE OFFER HEALTH INSURANCE PLANS THROUGH AN INSURANCE CARRIER SELECTED BASED ON THEIR ABILITY TO OFFER THE MOST COMPETITIVE RATES AND COMPREHENSIVE PLANS. WHILE OUR ABILITY TO OPERATE AND OFFER PLANS IS GRANTED UNDER COLORADO LAW AND ENFORCED BY THE DIVISION OF INSURANCE, WE ARE NOT A STATE AGENCY. THE KEY TO OUR SUCCESS IS A COLLABORATIVE APPROACH THAT INCLUDES LOCAL LEADERS AND PROVIDERS IN DEVELOPING INNOVATIVE HEALTHCARE SOLUTIONS. PHA HAS EXPANDED ITS SERVICE AREA TO INCLUDE NEARBY GRAND, LAKE, AND PARK COUNTIES. IN SOUTHWEST COLORADO, PEAK PARTNERS WITH THE LOCAL FIRST FOUNDATION TO SERVE DOLORES, LA PLATA, MONTEZUMA, AND SAN JUAN COUNTIES. ARCHULETA COUNTY IS NEW FOR 2024. IN ITS BRIEF EXISTENCE, PEAK HEALTH ALLIANCE HAS SAVED MEMBERS MORE THAN 18.9 MILLION DOLLARS ACROSS THE COMMUNITIES IT SERVES. THESE SAVINGS MEAN MONEY THAT WOULD HAVE BEEN SPENT ON INSURANCE PREMIUMS REMAINED IN THE LOCAL ECONOMY. |
| FORM 990, PAGE 6, PART VI, LINE 4 | EFFECTIVE DECEMBER 12, 2024, PHA AMENDED ITS BYLAWS. THESE ARE THE SIGNIFICANT CHANGES: NUMBER: THE NUMBER OF DIRECTORS WAS CHANGED FROM A MINIMUM OF TEN (10) TO A MINIMUM OF FIVE(5). THE MAXIMUM OF SEVENTEEN (17) REMAINED UNCHANGED. TERM AND ELECTION: DIRECTOR'S TERM IN OFFICE REMAINED UNCHANGED AT TWO YEARS. THE ELECTION PROCEDURES WERE CHANGED TO THE FOLLOWING: ONCE THE MAXIMUM NUMBER OF TERMS HAS BEEN REACHED, A DIRECTOR MUST REMAIN OFF THE BOARD FOR ONE YEAR, AND THEN CAN BE RE-APPOINTED TO THE BOARD. ONCE A YEAR THE CURRENT SLATE OF ALL DIRECTORS IS PRESENTED TO THE MEMBERS FOR APPROVAL OR DISAPPROVAL. THE ELECTIONS FOR MEMBERS WILL BE CONDUCTED VIA AN ONLINE BALLOT, WITH NOTICE TO ALL KNOWN MEMBERS WITH KNOWN CONTACT INFORMATION VIA EMAIL, LETTER, OR ANY OTHER METHOD PERMITTED BY APPLICABLE LAW. IF ACCEPTED, THAT BOARD WILL LEAD PEAK DECISIONS FOR THE NEXT YEAR. IF REJECTED, A NEW ELECTION WILL BE HELD WITHIN 6 MONTHS. A QUORUM OF THE MOST RECENT ACTIVE BOARD MEMBERS WILL CHOOSE AT LEAST 10 CANDIDATES FOR THE MEMBERSHIP TO CHOOSE FROM, THIS CHOICE OF VOLUNTEER BOARD MEMBERS WILL BE PRESENTED TO MEMBERSHIP FOR CONSIDERATION AND VOTE, AND THE TOP 9 BOARD CANDIDATES WHO GET THE MOST VOTES WILL BE SEATED AS THE NEW PEAK BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 6 | "MEMBER" SHALL MEAN (1) ANY PUBLIC OR PRIVATE EMPLOYER THAT HAS EMPLOYEES COVERED FOR HEALTH BENEFITS THROUGH A CORPORATION-SPONSORED HEALTH PLAN ("EMPLOYER MEMBERS"); (2) ANY INDIVIDUAL WHO PURCHASES COVERAGE THROUGH A CORPORATION-SPONSORED HEALTH PLAN ("INDIVIDUAL MEMBERS"), AND (3) ANY EMPLOYER OR RESIDENT OF A JUNSDICTION WHERE THE CORPORATION OFFERS HEALTH BENEFITS THROUGH A CORPORATION-SPONSORED HEALTH PLAN WHO ELECTS TO BECOME A MEMBER OF THE CORPORATION, BUT HAS NOT ELECTED TO ENROLL IN A CORPORATION- SPONSORED HEALTH PLAN (OR, IN THE CASE OF EMPLOYERS, OFFER SUCH BENEFIT PLANS TO THEIR EMPLOYEES). EMPLOYER AND INDIVIDUAL MEMBERS MEETING THE DEFINITIONS IN CLAUSES (1) AND (2) SHALL CONSTITUTE A CLASS OF "VOTING MEMBERS- AND SHALL BE GIVEN VOTING RIGHTS IN ELECTIONS CONDUCTED BY THE CORPORATION IN ACCORDANCE WITH POLICIES AND PROCEDURES FOR ELECTIONS ESTABLISHED BY THE BOARD OF DIRECTORS. MEMBERS WHO MEET THE DEFINITION IN CLAUSE (3) SHALL CONSTITUTE A CLASS OF "NON-VOTING MEMBERS" WITHOUT VOTING RIGHTS IN ANY ELECTIONS CONDUCTED BY THE CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE VOTING MEMBERS OF PEAK ELECT THE MEMBERS OF THE GOVERNING BODY AT THE ANNUAL MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 11B | DRAFT COPY OF THE 990 IS EMAILED TO ALL EXECUTIVE BOARD MEMBERS AND APPROVED BY THE FULL BOARD BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: (I) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; (II) HAS READ AND UNDERSTANDS THE POLICY; (III) HAS AGREED TO COMPLY WITH THE POLICY; AND (IV) UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE EXECUTIVE DIRECTOR'S SALARY AND APPROVES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | PEAK'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DURING REGULAR BUSINESS HOURS. |
| FORM 990, PART IX, LINE 11G | NEGOTIATION 20,004 0 0 DATA ANALYSIS 2,478 0 0 SOUTHWEST COLORADO ADVOCATE 5,750 0 0 MARKETING 0 0 58,800 OTHER CONTRACT SERVICES 20,200 0 0 TOTAL 48,432 0 58,800 |
| Software ID: | |
| Software Version: |