Civic Intelligence

Provider Services Benefits Trust

990 • Fiscal year 2016 • EIN 26-6672281

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 01, 2017

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

56th percentile

0.02x

Higher debt load relative to assets than 56% of similar nonprofits.

2016 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2016

Liabilities / Revenue

100th percentile

1205.81x

Higher debt load relative to revenue than 100% of similar nonprofits.

2016 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2016

Net Margin

1st percentile

-667624%

Higher net margin than 1% of similar nonprofits.

2016 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2016

Top Officer Pay

52nd percentile

$0

Higher top officer pay than 52% of similar nonprofits.

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

2016 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2016

Asset Growth

10th percentile

-36%

Faster asset growth than 10% of similar nonprofits.

2016 filings • 501(c)9 • $1M-$5M nonprofits • Annualized from 2015 to 2016

Revenue Growth

1st percentile

-100%

Faster revenue growth than 1% of similar nonprofits.

2016 filings • 501(c)9 • $1M-$5M nonprofits • Annualized from 2015 to 2016

Balance Sheet
Liabilities / Assets56th percentile

Assets

Down

$2,013,658

Down $1,124,085 (-36%) from 2015

Net Assets

Down

$1,969,043

Down $247,021 (-11%) from 2015

Liabilities

Down

$44,615

Down $877,064 (-95%) from 2015

Revenue And Expenses
Liabilities / Revenue100th percentileNet Margin1st percentile

Revenue

Down

$37

Down $3,130,905 (-100%) from 2015

Expenses

Down

$247,058

Down $681,621 (-73%) from 2015

Net Income

Down

-$247,021

Down $2,449,284 (-111%) from 2015

Historical Trend

Balance Sheet Trend

Asset Growth10th 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

2016

Assets$2,013,658
Liabilities$44,615
Net Assets$1,969,043
Open 2016 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

2016

Revenue$37
Expenses$247,058
Net Income-$247,021
Open 2016 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 1, 2017
Return Version
2016v3.0
Gross Receipts
$37
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
Savings and Temporary Cash Investments$6,800$2,013,656▲ $2,006,856
Rtn Earn Endowment Incm Other Fnds$2,216,064$1,969,043▼ $247,021
Cash and Non-Interest-Bearing Accounts$3,130,943$2▼ $3,130,941
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Cap Stk Tr Prin Current Funds$0$0→ $0
Total Assets$3,137,743$2,013,658▼ $1,124,085
Liabilities
Other Liabilities$921,679$44,615▼ $877,064
Total Liabilities$921,679$44,615▼ $877,064
Net Assets / Fund Balance
Total Net Assets Fund Balance$2,216,064$1,969,043▼ $247,021
Total Liabilities and Net Assets / Fund Balance$3,137,743$2,013,658▼ $1,124,085
Compensation and Service Providers
Top Officer Pay52nd percentile

Board Members and Trustees

NameTitle
-Trustee
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$37
Other Revenue
$0
Change in Net Assets
$-247,021

Audited Revenue Reconciliation

Revenue per Audited Statements
$37
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$0
Total Revenue per Audited Statements
$37
Total Revenue per Form 990
$37
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$7,070
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---$239,988
Fees for Service Investment Mgmnt Fees---$7,070
Total Functional Expenses$0$0$0$247,058

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$247,058
Total Expenses per Audited Statements$247,058
Total Expenses per Form 990$247,058
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$42,865
Accrued Operating Expenses$1,750
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 11B

“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
2017-11-01
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
Sheri Terens CPA
Phone
4404710800
Raw XML Appendix281 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/MoreThan5000KToIndividualsInd00
IRS990/MoreThan5000KToOrgInd00
IRS990/NetAssetsOrFundBalancesBOYAmt02216064
IRS990/NetAssetsOrFundBalancesEOYAmt01969043
IRS990/NetUnrelatedBusTxblIncmAmt00
IRS990/NoListedPersonsCompensatedInd0X
IRS990/NondeductibleContributionsInd00
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IRS990/QuidProQuoContributionsInd00
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IRS990/ReconcilationRevenueExpnssAmt0-247021
IRS990/RelatedEntityInd01
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IRS990/ScheduleBRequiredInd00
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IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc1ACCRUED OPERATING EXPENSES
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ReturnHeader/BusinessOfficerGrp/PhoneNum04407932247
ReturnHeader/BusinessOfficerGrp/SignatureDt02017-11-01
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ReturnHeader/Filer/EIN0266672281
ReturnHeader/Filer/PhoneNum04407932247
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ReturnHeader/FilingSecurityInformation/IPTm013:40:39
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0371574855
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ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0WESTLAKE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0OH
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0441451964
ReturnHeader/PreparerPersonGrp/PhoneNum04404710800
ReturnHeader/PreparerPersonGrp/PreparationDt02017-11-01
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0SHERI TERENS CPA
ReturnHeader/ReturnTs02017-11-07T13:26:38-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02016-01-01
ReturnHeader/TaxPeriodEndDt02016-12-31
ReturnHeader/TaxYr02016

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2016 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$2,013,658
Liabilities
$44,615
Net assets
$1,969,043
Revenue
$37
Expenses
$247,058
Net income
-$247,021
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
2016Detailed filing. Detailed filing data is available for this year.$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