Civic Intelligence

Provider Services Benefits Trust

990 • Fiscal year 2015 • EIN 26-6672281

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 04, 2016

Organization ProfileN/A
25000 Country Club Blvd No 255North Olmsted, OH 44070

(440) 793-2247

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

81st percentile

0.29x

Higher debt load relative to assets than 81% of similar nonprofits.

2015 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2015

Liabilities / Revenue

86th percentile

0.29x

Higher debt load relative to revenue than 86% of similar nonprofits.

2015 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2015

Net Margin

94th percentile

70%

Higher net margin than 94% of similar nonprofits.

2015 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2015

Top Officer Pay

53rd percentile

$0

Higher top officer pay than 53% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2015 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2015

Asset Growth

100th percentile

22636%

Faster asset growth than 100% of similar nonprofits.

2015 filings • 501(c)9 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Revenue Growth

1st percentile

-82%

Faster revenue growth than 1% of similar nonprofits.

2015 filings • 501(c)9 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Balance Sheet
Liabilities / Assets81st percentile

Assets

Up

$3,137,743

Up $3,123,942 (+22636%) from 2014

Net Assets

Up

$2,216,064

Up $2,202,263 (+15957%) from 2014

Liabilities

Up

$921,679

Up $921,679 from 2014

Revenue And Expenses
Liabilities / Revenue86th percentileNet Margin94th percentile

Revenue

Down

$3,130,942

Down $14,569,010 (-82%) from 2014

Expenses

Down

$928,679

Down $20,768,087 (-96%) from 2014

Net Income

Up

$2,202,263

Up $6,199,077 (+155%) from 2014

Historical Trend

Balance Sheet Trend

Asset Growth100th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$15M$10M$5.0M$0Assets 2010: $3,000,676Liabilities 2010: $0Net Assets 2010: $3,000,6762010Assets 2011: $6,250,395Liabilities 2011: $0Net Assets 2011: $6,250,3952011Assets 2012: $13,407,187Liabilities 2012: $0Net Assets 2012: $13,407,1872012Assets 2013: $4,010,615Liabilities 2013: $0Net Assets 2013: $4,010,6152013Assets 2014: $13,801Liabilities 2014: $0Net Assets 2014: $13,8012014Assets 2015: $3,137,743Liabilities 2015: $921,679Net Assets 2015: $2,216,0642015Assets 2016: $2,013,658Liabilities 2016: $44,615Net Assets 2016: $1,969,0432016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017

Highlighted filing

2015

Assets$3,137,743
Liabilities$921,679
Net Assets$2,216,064
Open 2015 Filing

Operations Trend

Revenue Growth1st percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$30M$20M$10M$0-$10MExpenses 2010: $15,987,1422010Expenses 2011: $17,854,5322011Expenses 2012: $26,421,5992012Revenue 2013: $19,710,275Expenses 2013: $28,885,298Net Income 2013: -$9,175,0232013Revenue 2014: $17,699,952Expenses 2014: $21,696,766Net Income 2014: -$3,996,8142014Revenue 2015: $3,130,942Expenses 2015: $928,679Net Income 2015: $2,202,2632015Revenue 2016: $37Expenses 2016: $247,058Net Income 2016: -$247,0212016Revenue 2017: $5,139Expenses 2017: $1,974,182Net Income 2017: -$1,969,0432017

Highlighted filing

2015

Revenue$3,130,942
Expenses$928,679
Net Income$2,202,263
Open 2015 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 4, 2016
Return Version
2015v2.1
Gross Receipts
$3,130,942
Mission and Program Overview

Mission

To fund health care and workers' compensation benefits to the eligible employees of the provider services companies.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$2$3,130,943▲ $3,130,941
Rtn Earn Endowment Incm Other Fnds$13,801$2,216,064▲ $2,202,263
Savings and Temporary Cash Investments$13,799$6,800▼ $6,999
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Cap Stk Tr Prin Current Funds$0$0→ $0
Total Assets$13,801$3,137,743▲ $3,123,942
Liabilities
Other Liabilities$0$921,679▲ $921,679
Total Liabilities$0$921,679▲ $921,679
Net Assets / Fund Balance
Total Net Assets Fund Balance$13,801$2,216,064▲ $2,202,263
Total Liabilities and Net Assets / Fund Balance$13,801$3,137,743▲ $3,123,942
Compensation and Service Providers
Top Officer Pay53rd percentile

Board Members and Trustees

NameTitle
-Trustee
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$3,130,942
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$2,202,263

Audited Revenue Reconciliation

Revenue per Audited Statements
$3,130,942
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$0
Total Revenue per Audited Statements
$3,130,942
Total Revenue per Form 990
$3,130,942
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$7,000
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members---$921,679
Fees for Service Investment Mgmnt Fees---$7,000
Total Functional Expenses$0$0$0$928,679

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$928,679
Total Expenses per Audited Statements$928,679
Total Expenses per Form 990$928,679
Expenses Not Reported on Financial Statements$0
Expenses Not Reported on Form 990$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Claims Payable$921,679
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Audit committee
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
No
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11

“All members of the governing body review and approve the 990 before it is filed.”

Form 990, Part VI, Section C, Line 19

“The 990 is available upon request.”

Filing and Contact Details

Filer

Filer Name
Provider Services Benefits Trust
EIN
26-6672281
Phone
4407932247
Address
25000 COUNTRY CLUB BLVD NO 255, NORTH OLMSTED, OH 44070

Signing Officer

Name
John Krystowski
Title
Officer
Phone
4407932247
Signed
2016-11-04
Discuss with paid preparer
Yes

Organization Details

Principal Officer
John Krystowski
Formed
2008
Legal Domicile
Oh
Voting Board Members
1
Independent Board Members
1
Employees
0
Volunteers
0

Preparer

Firm
Corrigan Krause
Address
2055 CROCKER RD SUITE 300, WESTLAKE, OH 44145-1964
Preparer
Thomas L Harrison CPA
Phone
4404710800
Raw XML Appendix284 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

Path#Value
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IRS990/ActivitiesConductedPrtshpInd00
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IRS990/AuditCommitteeInd00
IRS990/BenefitsToMembersGrp/TotalAmt0921679
IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt0JOHN KRYSTOWSKI
IRS990/BooksInCareOfDetail/PhoneNum04407932247
IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt025000 COUNTRY CLUB BLVD 255
IRS990/BooksInCareOfDetail/USAddress/CityNm0NORTH OLMSTED
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IRS990/FSAuditedInd01
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IRS990/GrantsToIndividualsInd00
IRS990/GrantsToOrganizationsInd00
IRS990/GrantToRelatedPersonInd00
IRS990/GrossReceiptsAmt03130942
IRS990/GroupReturnForAffiliatesInd00
IRS990/IncludeFIN48FootnoteInd00
IRS990/IndependentAuditFinclStmtInd01
IRS990/IndependentVotingMemberCnt01
IRS990/IndivRcvdGreaterThan100KCnt00
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InvestmentInJointVentureInd00
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LegalDomicileStateCd0OH
IRS990/LoanOutstandingInd00
IRS990/LocalChaptersInd00
IRS990/MaterialDiversionOrMisuseInd00
IRS990/MembersOrStockholdersInd00
IRS990/MethodOfAccountingCashInd0X
IRS990/MinutesOfCommitteesInd01
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IRS990/MoreThan5000KToIndividualsInd00
IRS990/MoreThan5000KToOrgInd00
IRS990/NetAssetsOrFundBalancesBOYAmt013801
IRS990/NetAssetsOrFundBalancesEOYAmt02216064
IRS990/NetUnrelatedBusTxblIncmAmt00
IRS990/NoListedPersonsCompensatedInd0X
IRS990/NondeductibleContributionsInd00
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IRS990/PartialLiquidationInd00
IRS990/PayPremiumsPrsnlBnftCntrctInd00
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IRS990/PoliticalCampaignActyInd00
IRS990/PrincipalOfficerNm0JOHN KRYSTOWSKI
IRS990/ProfessionalFundraisingInd00
IRS990/ProgramServiceRevenueGrp/BusinessCd0525100
IRS990/ProgramServiceRevenueGrp/Desc0EMPLOYER CONTRIBUTIONS
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt03130942
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt03130942
IRS990/ProhibitedTaxShelterTransInd00
IRS990/PYBenefitsPaidToMembersAmt021688016
IRS990/PYContributionsGrantsAmt00
IRS990/PYGrantsAndSimilarPaidAmt00
IRS990/PYInvestmentIncomeAmt0959
IRS990/PYOtherExpensesAmt08750
IRS990/PYOtherRevenueAmt00
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IRS990/PYRevenuesLessExpensesAmt0-3996814
IRS990/PYSalariesCompEmpBnftPaidAmt00
IRS990/PYTotalExpensesAmt021696766
IRS990/PYTotalProfFndrsngExpnsAmt00
IRS990/PYTotalRevenueAmt017699952
IRS990/QuidProQuoContributionsInd00
IRS990/RcvFndsToPayPrsnlBnftCntrctInd00
IRS990/ReconcilationRevenueExpnssAmt02202263
IRS990/RelatedEntityInd01
IRS990/RelatedOrganizationCtrlEntInd00
IRS990/ReportInvestmentsOtherSecInd00
IRS990/ReportLandBuildingEquipmentInd00
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IRS990/ReportProgramRelatedInvstInd00
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IRS990/SavingsAndTempCashInvstGrp/BOYAmt013799
IRS990/SavingsAndTempCashInvstGrp/EOYAmt06800
IRS990/ScheduleBRequiredInd00
IRS990ScheduleD/ExpensesNotReportedAmt00
IRS990ScheduleD/ExpensesNotRptFinclStmtAmt00
IRS990ScheduleD/ExpensesSubtotalAmt0928679
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt0921679
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0CLAIMS PAYABLE
IRS990ScheduleD/RevenueNotReportedAmt00
IRS990ScheduleD/RevenueNotReportedFinclStmtAmt00
IRS990ScheduleD/RevenueSubtotalAmt03130942
IRS990ScheduleD/TotalBookValueLandBuildingsAmt00
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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0ALL MEMBERS OF THE GOVERNING BODY REVIEW AND APPROVE THE 990 BEFORE IT IS FILED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE 990 IS AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11
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IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd00
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd00
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingNACd0N/A
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EIN0810681796
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EntityTypeTxt0C
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd0OH
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/PrimaryActivitiesTxt0LT CARE FACILITIES
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IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd01
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsBOYAmt013801
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IRS990/UponRequestInd0X
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IRS990/USAddress/ZIPCd044070
IRS990/VotingMembersGoverningBodyCnt01
IRS990/VotingMembersIndependentCnt01
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0JOHN KRYSTOWSKI
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0OFFICER
ReturnHeader/BusinessOfficerGrp/PhoneNum04407932247
ReturnHeader/BusinessOfficerGrp/SignatureDt02016-11-04
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0PROVIDER SERVICES BENEFITS TRUST
ReturnHeader/Filer/BusinessNameControlTxt0PROV
ReturnHeader/Filer/EIN0266672281
ReturnHeader/Filer/PhoneNum04407932247
ReturnHeader/Filer/USAddress/AddressLine1Txt025000 COUNTRY CLUB BLVD NO 255
ReturnHeader/Filer/USAddress/CityNm0NORTH OLMSTED
ReturnHeader/Filer/USAddress/StateAbbreviationCd0OH
ReturnHeader/Filer/USAddress/ZIPCd044070
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0371574855
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0CORRIGAN KRAUSE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt02055 CROCKER RD SUITE 300
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0WESTLAKE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0OH
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0441451964
ReturnHeader/PreparerPersonGrp/PhoneNum04404710800
ReturnHeader/PreparerPersonGrp/PreparationDt02016-11-04
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0THOMAS L HARRISON CPA
ReturnHeader/ReturnTs02016-11-15T13:01:25-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02015-01-01
ReturnHeader/TaxPeriodEndDt02015-12-31
ReturnHeader/TaxYr02015

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2015 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$3,137,743
Liabilities
$921,679
Net assets
$2,216,064
Revenue
$3,130,942
Expenses
$928,679
Net income
$2,202,263
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.01$1.97$1.97
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.01$0.04$1.97$0.00$0.25$0.25
2015Detailed filing. Detailed filing data is available for this year.$3.14$0.92$2.22$3.13$0.93$2.20
2014Detailed filing. Detailed filing data is available for this year.$0.01$0.00$0.01$17.7$21.7$4.00
2013Detailed filing. Detailed filing data is available for this year.$4.01$0.00$4.01$19.7$28.9$9.18
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$13.4$0.00$13.4$26.4
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$6.25$0.00$6.25$17.9
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.00$0.00$3.00$16.0
Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2015 filings • 501(c)9 • $1M-$5M nonprofits