Civic Intelligence

Cox Health Systems Hmo Inc

990 • Fiscal year 2017 • EIN 43-1757075

Jan 01, 2017 to Dec 31, 2017 • Filed on Sep 04, 2018

PO Box 5750Springfield, MO 65801

(417) 269-2900

Siviq Scores

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

Liabilities / Assets

53rd percentile

0.18x

Higher debt load relative to assets than 53% of similar nonprofits.

2017 filings • 501(c)4 • $25M-$50M nonprofits • Source year 2017

Liabilities / Revenue

48th percentile

0.33x

Higher debt load relative to revenue than 48% of similar nonprofits.

2017 filings • 501(c)4 • $25M-$50M nonprofits • Source year 2017

Net Margin

81st percentile

32%

Higher net margin than 81% of similar nonprofits.

2017 filings • 501(c)4 • $25M-$50M nonprofits • Source year 2017

Top Officer Pay

98th percentile

$1,931,697

Higher top officer pay than 98% of similar nonprofits.

Top officer pay equals 13.6% of source-year revenue.

2017 filings • $25M-$50M nonprofits • Source year 2017

Asset Growth

14th percentile

-10%

Faster asset growth than 14% of similar nonprofits.

2017 filings • 501(c)4 • $25M-$50M nonprofits • Annualized from 2016 to 2017

Revenue Growth

56th percentile

5.5%

Faster revenue growth than 56% of similar nonprofits.

2017 filings • 501(c)4 • $25M-$50M nonprofits • Annualized from 2016 to 2017

Assets

Down

$26,717,827

Down $3,104,024 (-10%) from 2016

Net Assets

Down

$22,028,071

Down $6,085,038 (-22%) from 2016

Liabilities

Up

$4,689,756

Up $2,981,014 (+174%) from 2016

Revenue

Up

$14,199,068

Up $735,615 (+5.5%) from 2016

Expenses

Up

$9,678,548

Up $344,244 (+3.7%) from 2016

Net Income

Up

$4,520,520

Up $391,371 (+9.5%) from 2016

Historical Trend

Balance Sheet Trend

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

$80M$60M$40M$20M$0Assets 2015: $31,495,025Liabilities 2015: $1,758,822Net Assets 2015: $29,736,2032015Assets 2016: $29,821,851Liabilities 2016: $1,708,742Net Assets 2016: $28,113,1092016Assets 2017: $26,717,827Liabilities 2017: $4,689,756Net Assets 2017: $22,028,0712017Assets 2018: $24,147,687Liabilities 2018: $1,527,601Net Assets 2018: $22,620,0862018Assets 2019: $27,531,072Liabilities 2019: $1,371,694Net Assets 2019: $26,159,3782019Assets 2020: $38,030,084Liabilities 2020: $4,075,083Net Assets 2020: $33,955,0012020Assets 2021: $37,618,692Liabilities 2021: $2,491,837Net Assets 2021: $35,126,8552021Assets 2022: $44,488,230Liabilities 2022: $9,393,707Net Assets 2022: $35,094,5232022Assets 2023: $60,085,046Liabilities 2023: $15,054,692Net Assets 2023: $45,030,3542023Assets 2024: $63,956,103Liabilities 2024: $14,998,507Net Assets 2024: $48,957,5962024

Highlighted filing

2017

Assets$26,717,827
Liabilities$4,689,756
Net Assets$22,028,071

Operations Trend

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

$80M$60M$40M$20M$0Revenue 2015: $14,273,719Expenses 2015: $11,031,823Net Income 2015: $3,241,8962015Revenue 2016: $13,463,453Expenses 2016: $9,334,304Net Income 2016: $4,129,1492016Revenue 2017: $14,199,068Expenses 2017: $9,678,548Net Income 2017: $4,520,5202017Revenue 2018: $14,377,297Expenses 2018: $8,904,001Net Income 2018: $5,473,2962018Revenue 2019: $12,281,314Expenses 2019: $9,106,257Net Income 2019: $3,175,0572019Revenue 2020: $13,048,850Expenses 2020: $9,132,065Net Income 2020: $3,916,7852020Revenue 2021: $12,571,299Expenses 2021: $9,986,839Net Income 2021: $2,584,4602021Revenue 2022: $12,608,683Expenses 2022: $11,084,783Net Income 2022: $1,523,9002022Revenue 2023: $57,413,695Expenses 2023: $56,528,810Net Income 2023: $884,8852023Revenue 2024: $60,268,895Expenses 2024: $58,186,333Net Income 2024: $2,082,5622024

Highlighted filing

2017

Revenue$14,199,068
Expenses$9,678,548
Net Income$4,520,520
Jump To
Filing Snapshot
Filing Period
Jan 1, 2017 to Dec 31, 2017
Signed
Sep 4, 2018
Return Version
2017v2.3
Gross Receipts
$14,199,068
Mission and Program Overview

Mission

To support health improvement in the communities we serve by offering competitive insurance products based on quality outcomes and evidenced based healthcare.

Engaged in promoting the common good and general welfare of the community by providing a low-cost,high-quality hmo option to all individuals, including an underserved population.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments Other Securities$14,716,588$18,104,018▲ $3,387,430
Cap Stk Tr Prin Current Funds$14,092,409$14,099,422▲ $7,013
Pd in Cap Srpls Land Bldg Eqp Fund$8,268,000$10,601,073▲ $2,333,073
Savings and Temporary Cash Investments$10,603,227$4,396,196▼ $6,207,031
Cash and Non-Interest-Bearing Accounts$1,699,938$1,465,947▼ $233,991
Accounts Receivable$858,727$926,983▲ $68,256
Prepaid Expenses and Deferred Charges$587,108$591,449▲ $4,341
Land, Buildings, and Equipment, Net$416,112$230,143▼ $185,969
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Rtn Earn Endowment Incm Other Fnds$5,752,700$-2,672,424▼ $8,425,124
Total Assets$29,821,851$26,717,827▼ $3,104,024
Other Assets Total$940,151$1,003,091▲ $62,940
Liabilities
Other Liabilities$826,961$4,027,537▲ $3,200,576
Accounts Payable and Accrued Expenses$881,781$662,219▼ $219,562
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$1,708,742$4,689,756▲ $2,981,014
Net Assets / Fund Balance
Total Net Assets Fund Balance$28,113,109$22,028,071▼ $6,085,038
Total Liabilities and Net Assets / Fund Balance$29,821,851$26,717,827▼ $3,104,024

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$217,944$7,234,868$7,452,812
Leasehold Improvements$12,199$131,832$144,031
Other Securities$18,104,018--
Compensation and Service Providers

Employees

NameTitleFull / Part TimeOtherTotal
Susan ButtsChief Information OfficerPT$143,316$143,316

Board Members and Trustees

NameTitle
Dr Mark CostleyChairman/director
Mr Steven D EdwardsVice Chairman/director
Dr James H CeaserDirector
Mr Chris W NattingerDirector
Mr Jerry G JaredDirector
Mr Joseph W TurnerDirector
Mr Kenneth E MeyerDirector
Ms Rita M NeedhamDirector
Mr Larry SchmittDirector - Resigned March 2017
Matthew AugChief Executive Officer
Lisa OdomChief Financial Officer

Highest Paid Contractors

ContractorServicesLocationCompensation
Trizetto Group INCHealthcare It Svc12250 WEBER HILL ROAD SUITE 100, St Louis, MO 63127$512,074
Envision Pharmaceutical SolutionsPharm. Benefits Mgr2181 E AURORA RD SUITE 201, Twinsburg, OH 44087$322,447
MillimanConsulting500 NORTH BROADWAY SUITE 1750, St Louis, MO 63102$280,205
Ozark Mailing Service LLCMailing2804 NORTH OAK GROVE AVENUE, Springfield, MO 65803$254,080
Lg Iii LLCBuilding Lease1675 E SEMINOLE, Springfield, MO 65804$218,400
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$14,156,048
Investment Income
$43,020
Other Revenue
$0
Change in Net Assets
$4,520,520

Audited Revenue Reconciliation

Revenue Not Reported on Financial Statements
$14,199,068
Other Revenue Adjustments
$14,199,068
Total Revenue per Form 990
$14,199,068
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$5,581,892
Other Expenses$4,096,656
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$3,572,039$580,995-$4,153,034
Information Technology$849,659$138,198-$987,857
Other Employee Benefits$811,073$131,921-$942,994
Fees for Services Other$847,632$86,199-$933,831
Office Expenses$614,581$87,800-$702,381
Fees for Service Investment Mgmnt Fees$450,326--$450,326
Occupancy$251,881$40,969-$292,850
Payroll Taxes$242,881$39,505-$282,386
Depreciation Depletion$189,370$30,801-$220,171
Pension Plan Contributions$175,012$28,466-$203,478
Advertising$141,269$22,977-$164,246
Fees for Services Accounting-$123,016-$123,016
Other Expenses$63,670$10,355-$74,025
Insurance$45,719$7,436-$53,155
Travel$28,194$4,586-$32,780
Conferences and Meetings$4,355$708-$5,063
Fees for Services Legal-$2,060-$2,060
Total Functional Expenses$8,334,876$1,343,672$0$9,678,548

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$9,678,548
Expenses Not Reported on Financial Statements$9,678,349
Other Expense Adjustments$9,678,349
Total Expenses per Audited Statements$6,331
Expenses Not Reported on Form 990$6,132
Expenses per Audited Statements$199
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Related Parties$4,027,537
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
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
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 2

Family and business relationships: steven edwards serves as the president and ceo, and james ceaser, mark costley, matthew aug, lisa odom, and susan butts are all employed by lester e. Cox medical centers, a related organization. No compensation was provided for responsibilities associated with being a board director. Compensation reported for board members listed on form 990, part vii, and schedule j represents employee or independent contractor compensation unrelated to service as a board member.

Form 990, Part VI, Section A, Line 6

Members: the member is lester e. Cox medical centers (member), a related organization and subsidiary of coxhealth (parent), another related organization.

Form 990, Part VI, Section A, Line 7A

Election/appointment of board members: the board shall consist of no less than eight (8) and no more than twenty-one (21) directors, each of whom shall be appointed by coxhealth (parent). One (1) director shall reside in the branson, missouri area, which is defined as the skaggs community hospital association d/b/a cox medical center branson (cmcb) service area including stone and taney counties (cmcb director). The board shall receive nominations from the cmcb board prior to the annual meeting for election as director. The board of directors of cox medical group (cmg) shall nominate two (2) physicians to serve on the board (each a cmg director). One cmg director shall be employed by ferrell-duncan clinic, inc. And the other shall be employed by lester e. Cox medical centers (member), employed by cmg, or employed by member and leased to cmg. The parent shall receive nominations from the cmg board prior to the annual meeting at which directors are elected.

Form 990, Part VI, Section A, Line 7B

Member powers: the bylaws are reviewed by the president and ceo of coxhealth (parent) or his/her designee together with the general counsel, at least every three (3) years. The parent may adopt, amend and repeal the bylaws, subject to any limitations set forth in the bylaws, at any meeting, provided that a copy of the bylaws to be considered at the meeting accompanies the notice thereof. Except as specified below or as set forth elsewhere in the bylaws, the following reserved powers may be exercised by the parent without prior action by the board. Said reserved powers are: (a) to establish and change the business purposes, mission, vision or values of the corporation; (b) to approve amendments to the articles of acceptance of the corporation as provided therein; (c) to approve amendments to the bylaws of the corporation; (d) to approve the adoption of and any revision to the charters for all committees established by the board; (e) to appoint and remove the directors of the corporation, subject to the requirements of article five, and to appoint and remove the officers of the board and the corporation; (f) to approve the appointment and removal of the president of the corporation; (g) to appoint the auditor and the corporate counsel for the corporation and its controlled subsidiaries or remotely controlled subsidiaries so long as such appointment is consistent with all applicable laws and regulations, including missouri department of insurance regulations and guidelines; (h) to establish centralized employee benefit, insurance, investment, financing, marketing, legal, corporate compliance, performance assessment and improvement and other operational and support programs; to require the participation of the corporation in such programs; and to authorize the opening and closing of bank accounts and investment accounts in the name of the corporation; (i) to approve the merger, consolidation or dissolution of the corporation or the sale of all or substantially all of the assets of the corporation; (j) to approve the formation of a controlled subsidiary or a remotely controlled subsidiary; (k) to approve the acquisition or disposition by the corporation of another legal entity or an interest in another legal entity; (l) to approve the strategic plan and the operating and capital budgets of the corporation; (m) approval of the corporation's unbudgeted debt and capital expenditures of one hundred thousand dollars ($100,000) or greater; (n) to authorize or approve the acquisition or disposition by the corporation of real property or any interest in real property having a value of one hundred thousand dollars ($100,000) or greater; (o) to approve the sale or purchase of any property of the corporation having a value of one hundred thousand dollars ($100,000) or greater; (p) to authorize and approve borrowing money or entering into financial guaranties by the corporation, including actions relating to the formation, joining, operation, withdrawal from and termination of a credit group or an obligated group and the granting of security interests in the property of the corporation; (q) to approve the transfer of assets by the corporation to any entity other than the member and/ or parent, other than transfers made in the ordinary course of operations of the corporation which will not require approval of the parent; (r) to determine the extent to which and the manner in which the powers described in this section which are reserved to the parent with respect to the corporation are to be included in the governing documents of any controlled subsidiary or remotely controlled subsidiary and exercised with respect to any controlled subsidiary or any remotely controlled subsidiary.

Form 990, Part VI, Section B, Line 11B

Form 990 review: the form 990 is prepared by an independent accounting firm based on the audited financial statements and information provided by the organization. The form 990 is provided to the director of accounting and cfo for a detailed review to ensure accuracy. A copy is then provided to the ceo and governing body for review prior to filing.

Form 990, Part VI, Section B, Line 12C

Conflict of interest policy: coxhealth officers, directors and key employees, as well as officers, directors and key employees of the coxhealth affiliates and/or committees with delegated authority to make decisions, are annually required to disclose potential conflicts of interest following the policy set forth below. The policy requires that board members make decisions that are conflict free, or if a conflict is present, that it is fully disclosed for the board's consideration. Coxhealth's employees and board members must avoid all activities, associations or interests that create a conflict of interest. Conflicts of interest for employees must be reported to the corporate integrity department. A file will be maintained of all reported conflicts of interest. For medical staff members, the conflict of interest process may be accessed through the medical staff office. For board members, the conflict of interest process is handled through the governance sub-committee of the board with the assistance of the executive office and is defined in the charter of the governance sub-committee. If any officer or director is found to have a conflict of interest, such person shall neither vote nor use his or her influence to affect any decision relating to the conflict, and such person should not be included in determining whether a quorum participated in the decision. Such person is permitted to briefly state his or her position on the matter, and answer pertinent questions about it, if his or her knowledge or expertise could assist those participating in the decision. For vendors, the policy is distributed with their initial contract with coxhealth.

Form 990, Part VI, Section B, Lines 15A & 15B

Compensation review: coxhealth employs a defined governance structure around executive compensation. The board of directors maintains a compensation committee that is charged with carrying out the functions of evaluating and setting executive compensation through formal documented meetings that occur several times during the year. The compensation committee utilizes a well respected independent external advisor to provide third party assessment and recommendations regarding compensation levels and benefit programs for the top executives of the organization to ensure the compensation program is competitive and within fair market value. After a full review of the data and thorough discussion the committee makes a self determination of compensation levels set january 1 of each year. Annually the steps necessary to document rebuttable presumption are taken and recorded. Additionally, compensation levels for the vice president tier of management is overseen by the ceo using external comparable data for assessment and is provided to the compensation committee for review on an annual basis.

Form 990, Part VI, Section C, Line 19

Document disclosure: cox health systems hmo's governing documents and conflict of interest policy are available for public inspection as an attachment to the application for recognition of exemption.

Filing and Contact Details

Filer

Filer Name
Cox Health Systems Hmo Inc
EIN
43-1757075
In Care Of
% LISA ODOM CFO
Phone
4172692900
Address
PO BOX 5750, SPRINGFIELD, MO 65801

Signing Officer

Name
Matthew Aug
Title
President
Phone
4172693000
Signed
2018-09-04
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Matthew Aug
Formed
1996
Legal Domicile
Mo
Voting Board Members
8
Independent Board Members
5
Employees
0
Volunteers
5

Preparer

Firm
Bkd Llp
Address
910 E ST LOUIS 200/PO BOX 1190, SPRINGFIELD, MO 65806-2523
Preparer
Brian D Todd
Phone
4178658701
Supplemental Narrative

Additional Explanations

Form 990, Part XI, Line 9

Other changes in net assets: $ 7,013 capital contributions 22,189 change in nonadmitted assets (10,634,760) change in equity of affiliates ------------ $(10,605,558)

Financial Statement Notes

Schedule D, Part X, Line 2

Uncertain tax positions: effective january 1, 2015, the company elected 501(c) nonprofit tax-exempt status. As a result of this election, the company is no longer subject to income taxes at the entity level. The company files a consolidated informational tax return (990) with its subsidiary, cox healthplans, llc. The company is not aware of any uncertain tax positions at december 31, 2017 or 2016.

Schedule D, Part XI, Line 4B

Other amounts included on form 990, part viii, line 12, but not line 1: $ 14,200,754 cox healthplans, llc revenue ( 12,000) eliminated revenue of cox healthplans, llc 5,868 health claims revenue 4,446 interest income ----------- $ 14,199,068

Schedule D, Part XII, Line 2D

Other amounts included on line 1, but not form 990, part ix, line 25: $ 12,000 eliminated fees paid to llc from hmo (5,868) health claims reimbursements ------------ $ 6,132

Schedule D, Part XII, Line 4B

Other amounts included on form 990, part ix, line 25, but not line 1: $ 9,678,349 cox healthplans, llc expenses

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IRS990/Form990PartVIISectionAGrp/PersonNm0DR JAMES H CEASER
IRS990/Form990PartVIISectionAGrp/PersonNm1DR MARK COSTLEY
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IRS990/Form990PartVIISectionAGrp/TitleTxt5DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt6DIRECTOR - RESIGNED MARCH 2017
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IRS990/ProgSrvcAccomActy2Grp/Desc0COX HMO SERVES AS THE THIRD PARTY ADMINISTRATOR (TPA) FOR COX HEALTH SYSTEMS HOSPITALS' SELF-FUNDED EMPLOYEE HEALTH PLAN. THE CHS HOSPITALS' SELF-FUNDED PLAN COVERS APPROXIMATELY 13,600 MEMBERS INCLUDING EMPLOYEES AND DEPENDENTS.
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