Civic Intelligence

Cobb Medical Associates LLC

EIN 58-2617089 • 501(c)3 • Altamonte Springs, FL

Profile

Adventist health system sunbelt healthcare corporation and all of its subsidiary organizations were established by the seventh-day adventist church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of christ.

900 Hope WayAltamonte Springs, FL 32714

n/A

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2015

Liabilities / Revenue

62nd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • <$500k nonprofits • Source year 2015

Net Margin

7th percentile

-161%

Higher net margin than 7% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2015

Top Officer Pay

100th percentile

$1,409,107

Higher top officer pay than 100% of similar nonprofits.

Top officer pay equals 3122.0% of source-year revenue.

501(c)3 • <$500k nonprofits • Source year 2015

Asset Growth

10th percentile

-100%

Faster asset growth than 10% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2014 to 2015

Revenue Growth

4th percentile

-99%

Faster revenue growth than 4% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2014 to 2015

Assets

Down

$0

Down $203,772 (-100%) from 2014

Liabilities

Down

$0

Down $409,692 (-100%) from 2014

Net Assets

Up

$0

Up $205,920 (+100%) from 2014

Revenue

Down

$45,135

Down $5,957,256 (-99%) from 2014

Expenses

Down

$117,860

Down $7,314,751 (-98%) from 2014

Net Income

Up

-$72,725

Up $1,357,495 (+95%) from 2014

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$1.0M$500K$0-$500KAssets 2010: $390,090Liabilities 2010: $387,845Net Assets 2010: $2,2452010Assets 2011: $324,177Liabilities 2011: $527,508Net Assets 2011: -$203,3312011Assets 2012: $520,983Liabilities 2012: $598,073Net Assets 2012: -$77,0902012Assets 2013: $497,789Liabilities 2013: $532,024Net Assets 2013: -$34,2352013Assets 2014: $203,772Liabilities 2014: $409,692Net Assets 2014: -$205,9202014Assets 2015: $0Liabilities 2015: $0Net Assets 2015: $02015

Highlighted filing

2015

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$10M$5.0M$0-$5.0MExpenses 2010: $7,929,9172010Expenses 2011: $7,859,0882011Expenses 2012: $8,502,6622012Revenue 2013: $6,898,112Expenses 2013: $8,181,755Net Income 2013: -$1,283,6432013Revenue 2014: $6,002,391Expenses 2014: $7,432,611Net Income 2014: -$1,430,2202014Revenue 2015: $45,135Expenses 2015: $117,860Net Income 2015: -$72,7252015

Highlighted filing

2015

Revenue$45,135
Expenses$117,860
Net Income-$72,725

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 15, 2016
Return Version
2015v2.1
Gross Receipts
$45,135
Mission and Program Overview

Mission

Adventist health system sunbelt healthcare corporation and all of its subsidiary organizations were established by the seventh-day adventist church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of christ.

Operation of physician practices and provision of related medical services.

Balance Sheet Detail
LineBeginningEndChange
Assets
Accounts Receivable$138,120$0▼ $138,120
Savings and Temporary Cash Investments$63,315$0▼ $63,315
Land, Buildings, and Equipment, Net$2,330$0▼ $2,330
Cash and Non-Interest-Bearing Accounts$248$0▼ $248
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Total Assets$203,772$0▼ $203,772
Other Assets Total$-241$0▲ $241
Liabilities
Accounts Payable and Accrued Expenses$281,931--
Other Liabilities$127,761$0▼ $127,761
Total Liabilities$409,692$0▼ $409,692
Net Assets / Fund Balance
Unrestricted Net Assets$-205,920$0▲ $205,920
Total Net Assets Fund Balance$-205,920$0▲ $205,920
Total Liabilities and Net Assets / Fund Balance$203,772$0▼ $203,772
Compensation and Service Providers

Board Members and Trustees

NameTitle
Snyder Brent GChairman
Kiley Dennis JDirector/president
Evans DavidDirector
Hammonds PaulDirector
Peterson DaneDirector
Stiltz Bryan JDirector
Hazen Carol JCFO
Moyer Harry EdwardFormer COO
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$92
Other Revenue
$45,043
Change in Net Assets
$-72,725
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$88,549
Salaries, Compensation, and Employee Benefits$29,311
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$45,182$5,794-$50,976
Office Expenses$37,259$3,811-$41,070
Other Salaries and Wages$20,773--$20,773
Payroll Taxes$12,793--$12,793
Information Technology$2,516--$2,516
Occupancy$516--$516
Pension Plan Contributions$293--$293
Travel-$30-$30
Other Expenses$-4,182$-2,377-$-4,182
Other Employee Benefits$-4,548--$-4,548
Total Functional Expenses$110,602$7,258$0$117,860
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
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
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

Dennis kiley and dane peterson - business relationship dane peterson and paul hammonds - business relationship

Form 990, Part VI, Section A, Line 6

Cobb medical associates, llc (the filing organization) has one member. The sole member of the filing organization is emory-adventist, inc. Emory-adventist, inc. (ea) is a georgia, not-for-profit corporation that is exempt from federal income tax under internal revenue code (irc) section 501(c)(3). There are no other classes of membership in the filing organization.

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

The sole member of the filing organization is ea. The board of directors of the filing organization are appointed by the sole member, ea, who has the right to elect, appoint or remove any member of the board of directors of the filing organization.

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

Ea, as the sole member of the filing organization, has certain reserved powers as set forth in the bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization; b) to adopt, amend, restate, and repeal the articles of organization or operating agreement of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove the annual operating and capital budgets of the filing organization; e) to approve or disapprove of any transaction which is not provided for or in the capital or operating budget in excess of ten thousand dollars; f) organize or acquire any subsidiary; g) merge the filing organization with or into any other entity; h) sell, assign or otherwise transfer all or substantially all of the filing organization's assets; and i) enter into any business other than the offering of one or more medical clinics.

Form 990, Part VI, Section B, Line 11

The filing organization's current year form 990 was reviewed by the board chairman and ceo prior to its filing with the irs. The review conducted by the board chairman and ceo did not include the review of any supporting workpapers that were used in preparation of the current year form 990, but did include a review of the entire form 990 and all supporting schedules.

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

The conflict of interest policy of the filing organization applies to members of its board of directors and its principal officers (to be known as interested persons). In connection with any actual or possible conflict of interests, any member of the board of directors of the filing organization or any principal officer of the filing organization (i.e. Interested persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the board of directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant board member or principal officer, the remaining members of the board of directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's conflict of interest policy, an interested person may make a presentation to the board of directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each interested person, as defined under the filing organization's conflict of interest policy, shall annually sign a statement which affirms that such person has received a copy of the conflict of interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's conflict of interest policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.

Form 990, Part VI, Section B, Line 15

The filing organization's ceo, other officers and certain key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to schedule j, line 3.

Form 990, Part VI, Section C, Line 19

The filing organization is a part of the system of healthcare organizations known as adventist health system (ahs). Each year, ahs publishes an annual report document that includes a financial report for the relevant year as well as a community benefit report. The financial report and community benefit report are presented on a consolidated basis and represent all of the activities, results of operations, and financial position at year-end of the entire ahs system. In addition, the audited consolidated financial statements of ahs and of the ahs "obligated group" are filed annually with the municipal securities rulemaking board (msrb). The "obligated group" is a group of ahsshc subsidiaries that are jointly and severally liable under a master trust indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with generally accepted accounting principles (gaap) are also filed with msrb for ahs on a consolidated basis and for the grouping of ahs subsidiaries comprising the "obligated group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.

Part VII, Section A, Column (E) & (F)

For those board of director members, officer(s) who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (b) on page 7 of the return) the compensation amounts shown in columns (e) and (f) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within adventist health system.

Filing and Contact Details

Filer

Filer Name
Cobb Medical Associates LLC
EIN
58-2617089
Phone
4073572352
Address
900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714

Signing Officer

Name
Lynn C Addiscott
Title
Asst. Secretary
Phone
7704363162
Signed
2016-11-15

Organization Details

Principal Officer
Dennis Kiley
Formed
2001
Legal Domicile
Ga
Voting Board Members
6
Independent Board Members
2
Employees
10
Volunteers
2
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Payments to healthcare professional : program service expenses 247. Management and general expenses 0. Fundraising expenses 0. Total expenses 247. Professional fees : program service expenses 45,919. Management and general expenses 0. Fundraising expenses 0. Total expenses 45,919. Purchased medical services : program service expenses -956. Management and general expenses 0. Fundraising expenses 0. Total expenses -956. Environmental services : program service expenses -28. Management and general expenses 0. Fundraising expenses 0. Total expenses -28. Billing & collection services : program service expenses 0. Management and general expenses 5,794. Fundraising expenses 0. Total expenses 5,794.

FORM 990, PART XI, LINE 9:

Transfer to/from affiliate 295,202. Transfer to tax-exempt affiliate -16,557.

Part X, Line 2

The amounts shown on line 2 of part x of this return include the filing organization's interest in a central investment pool maintained by adventist health system sunbelt healthcare corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.

Financial Statement Notes

PART X, LINE 2:

The filing organization is a subsidiary organization within adventist health system (ahs). The consolidated financial statements of ahs contain the following fin 48 footnote: please note that dollar amounts are in thousands. Healthcare corporation and its affiliated organizations, other than north american health services, inc. And its subsidiary (nahs), are exempt from state and federal income taxes. Accordingly, healthcare corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. Nahs is a wholly owned, for-profit subsidiary of healthcare corporation. Nahs and its subsidiary are subject to federal and state income taxes. Nahs files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended december 31, 2015 and 2014. Nahs also has temporary deductible differences of approximately $62,700 and $63,600 at december 31, 2015 and 2014, respectively, primarily as a result of net operating loss carryforwards. At december 31, 2015, nahs had net operating loss carryforwards of approximately $62,500, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $23,800 and $24,200 at december 31, 2015 and 2014, respectively. A full valuation allowance has been provided at december 31, 2015 and 2014 to offset the deferred tax asset since healthcare corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. The income taxes topic of the asc (asc 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. Asc 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of december 31, 2015 and 2014.

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IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTIST HEALTH SYSTEM (AHS). THE CONSOLIDATED FINANCIAL STATEMENTS OF AHS CONTAIN THE FOLLOWING FIN 48 FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARY (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARY ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. ALL TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES; AS SUCH, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $62,700 AND $63,600 AT DECEMBER 31, 2015 AND 2014, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2015, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $62,500, EXPIRING BEGINNING IN 2022 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $23,800 AND $24,200 AT DECEMBER 31, 2015 AND 2014, RESPECTIVELY. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2015 AND 2014 TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ASC (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2015 AND 2014.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0PART X, LINE 2:
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IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO AHS AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF AHS WILL NOT EXCEED THE 40TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt1DURING THE YEAR ENDING DECEMBER 31, 2015, HARRY EDWARD MOYER, DENNIS J. KILEY, AND CAROL J. HAZEN RECEIVED SEVERANCE PAYMENTS IN THE AMOUNTS OF $138,703, $79,413, AND $89,246 RESPECTIVELY. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH AHS. EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE ANNUAL PRE-DETERMINED BENEFITS ALLOWANCE ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF AHS ENTITIES AND VICE PRESIDENTS OF ALL AHS ENTITIES WHOSE BASE SALARY IS AT LEAST $230,000. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT IS FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. IN ADDITION TO THE PLAN, AHS HAS INSTITUTED A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO AHS AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. PARTICIPATION IN THE PLAN IS OFFERED TO AHS EXECUTIVES ON A PRORATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF AHS AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM AHS ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF EN
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IRS990ScheduleN/ReceiveCompensationInd00
IRS990ScheduleN/RequiredToNotifyAGInd01
IRS990ScheduleN/SupplementalInformationDetail/ExplanationTxt0EXPLANATION OF INVOLVEMENT: EMORY-ADVENTIST, INC. (EA) IS THE SOLE CORPORATE MEMBER OF COBB MEDICAL ASSOCIATES, LLC. (COBB). DANE PETERSON AND BRENT SNYDER ARE CURRENT MEMBERS OF THE BOARD OF EA. MR. PETERSON HAS BEEN A MEMBER OF THE EA BOARD SINCE 2010 AND MR. SYNDER SINCE 1995. DENNIS KILEY THE PRESIDENT OF COBB IS ALSO THE PRESIDENT OF EA. CAROL HAZEN, THE CFO OF COBB, IS THE SECRETARY/TREASURER OF EA. BOTH MR. KILEY AND MS HAZEN WERE APPOINTED TO THEIR POSITIONS IN EA IN 2008.
IRS990ScheduleN/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 2E:
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0DENNIS KILEY AND DANE PETERSON - BUSINESS RELATIONSHIP DANE PETERSON AND PAUL HAMMONDS - BUSINESS RELATIONSHIP

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