Hospital Sisters Health System Self Insurance Trust Fund in Springfield, Illinois (IL)

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Hospital Sisters Health System Self Insurance Trust Fund
Employer Identification Number (EIN)371120626
Name of OrganizationHospital Sisters Health System Self Insurance Trust Fund
In Care of NameMichael W Cottrell
Address4936 Laverna Rd, Springfield, IL 62707-9797
Activities"Unspecified"
SubsectionCharitable Organization
Ruling Date01/1985
DeductibilityContributions are deductible
FoundationOrganizations operated solely for the benefit of and in conjunction with organizations described in 10 through 16 above
OrganizationTrust
Exempt Organization StatusUnconditional Exemption
Tax Period06/2012
Assets$1 to $9,999
Income$0
Filing Requirement990 - Required to file Form 990-N - Income less than $25,000 per year
Asset Amount$1
Amount of Income$11,463,931
Form 990 Revenue Amount$11,463,931
National Taxonomy of Exempt Entities (NTEE)Mutual/Membership Benefit Organizations, Other: Insurance Providers, Services


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Amount of income in 2012: $11,463,931
Hospital Sisters Health System Self Insurance Trust Fund: 

 $11,463,931
Other organizations performing similar types of work: 

 $508,960

Assets in 2012: $1
This organization: 

 $1
Other organizations performing similar types of work: 

 $662,652

Expenses in 2007: $2,950,005
Hospital Sisters Health System Self Insurance Trust Fund: 

 $2,950,005
Other organizations performing similar types of work: 

 $32,569,791

Income to expenses ratio in 2007: 3.9
This organization: 

 3.9
Other organizations performing similar types of work: 

 1.1

Expenses allocated to program services in 2007: 99.7%
Hospital Sisters Health System Self Insurance Trust Fund: 

 99.7%
Other organizations performing similar types of work: 

 88.8%

Financial snapshot ($)

Revenue for 2007

Assets at end of 2007

Expenses for 2007

Functional Expenses for 2007 ($)

Income-Producing Activities for 2007

Revenue, Expenses, and Changes in Net Assets or Fund Balances
20002001200220032004200520062007
Total revenue$8,697,484$5,863,589$9,440,765$12,703,180$15,113,561$12,974,579$19,586,446$11,463,931
Contributions, gifts, grants, and similar amounts received$0$0$0$0$0$0$0$0
Contributions to donor advised funds$0$0
Direct public support$0$0$0$0$0$0$0$0
Indirect public support$0$0$0$0$0$0$0$0
Government contributions (grants)$0$0$0$0$0$0$0$0
Program service revenue including government fees and contracts$5,704,920$5,816,220$5,482,476$8,380,752$10,571,808$11,243,820$11,276,820$8,193,816
Membership dues and assessments$0$0$0$0$0$0$0$0
Interest on savings and temporary cash investments$2,992,564$47,369$0$0$0$0$0$0
Dividends and interest from securities$0$0$3,958,289$4,322,428$4,541,753$1,730,759$8,309,626$3,270,115
Net rental income or (loss)$0$0$0$0$0$0$0$0
Gross rents$0$0$0$0$0$0$0$0
Less: rental expenses$0$0$0$0$0$0$0$0
Other investment income$0$0$0$0$0$0$0$0
Gain or (loss) from sales of assets other than inventory$0$0$0$0$0$0$0$0
Gross amount from sales of assets other than inventory$0$0$0$0$0$0$0$0
Less: cost or other basis and sales expenses$0$0$0$0$0$0$0$0
Net income or (loss) from special events and activities$0$0$0$0$0$0$0$0
Gross revenue$0$0$0$0$0$0$0$0
Less: direct expenses other than fundraising expenses$0$0$0$0$0$0$0$0
Gross profit or (loss) from sales of inventory$0$0$0$0$0$0$0$0
Gross sales of inventory, less returns and allowances$0$0$0$0$0$0$0$0
Less: cost of goods sold$0$0$0$0$0$0$0$0
Other revenue$0$0$0$0$0$0$0$0
Total expenses$7,438,921$6,935,644$8,231,360$11,953,711$13,828,306$7,891,217$6,095,158$2,950,005
Program services$7,345,012$6,924,665$8,220,125$11,938,512$13,814,452$7,882,016$6,085,694$2,940,677
Management and general$93,909$10,979$11,235$15,199$13,854$9,201$9,464$9,328
Fundraising$0$0$0$0$0$0$0$0
Payments to affiliates$0$0$0$0$0$0$0$0
Net assets or fund balances at end of year$10,287,198$9,215,142$10,424,547$11,174,016$0$0$0$0
Excess or (deficit) for the year$1,258,563$-1,072,055$1,209,405$749,469$1,285,255$5,083,362$13,491,288$8,513,926
Net assets or fund balances at beginning of year$7,504,442$10,287,198$9,215,142$10,424,547$11,174,016$0$0$0
Other changes in net assets or fund balances$1,524,193$-1$0$0$-12,459,271$-5,083,362$-13,491,288$-8,513,926
Statement of Functional Expenses (for 2007)
TotalProgram servicesManagement and generalFundraising
Total functional expenses$2,950,005$2,940,677$9,328$0
Grants paid from donor advised funds$0
Other grants and allocations$0
Specific assistance to individuals$0
Benefits paid to or for members$0
Compensation of current officers, directors, key employees, etc.$603$0$603$0
Compensation of former officers, directors, key employees, etc.$0$0$0$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0$0$0
Salaries and wages of employees not included above$0$0$0$0
Pension plan contributions not included above$0$0$0$0
Employee benefits not included above$0$0$0$0
Payroll taxes$0$0$0$0
Professional fundraising fees$0$0$0$0
Accounting fees$7,722$0$7,722$0
Legal fees$1,386,391$1,386,391$0$0
Supplies$0$0$0$0
Telephone$0$0$0$0
Postage and shipping$0$0$0$0
Occupancy$0$0$0$0
Equipment rental and maintenance$0$0$0$0
Printing and publications$0$0$0$0
Travel$0$0$0$0
Conferences, conventions, and meetings$0$0$0$0
Interest$0$0$0$0
Depreciation, depletion, etc.$0$0$0$0
Other expenses not covered above$1,555,289$1,554,286$1,003$0
Balance Sheets
20002001200220032004200520062007
Total assets$37,942,809$40,345,814$45,183,261$55,814,359$65,114,283$70,702,520$85,973,149$82,223,599
Cash - non-interest-bearing$216,287$616,165$1,525,130$7,879,405$0$0$0$8,928,553
Savings and temporary cash investments$0$0$0$0$4,727,658$3,817,034$11,123,652$0
Accounts receivable less allowance for doubtful accounts$0$0$0$0$0$0$0$0
Pledges receivable less allowance for doubtful accounts$0$0$0$0$0$0$0$0
Grants receivable$0$0$0$0$0$0$0$0
Receivables from current and former officers, directors, trustees, and key employees$0$0$0$0$0$0$0$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0
Other notes and loans receivable less allowance for doubtful accounts$0$0$0$0$0$0$0$0
Inventories for sale or use$0$0$0$0$0$0$0$0
Prepaid expenses and deferred charges$0$0$0$0$0$0$0$0
Investments - publicly-traded securities$0$0
Investments - other securities$37,724,610$39,729,371$43,656,876$0$0$0$0$0
Investments - land, buildings, and equipment less accumulated depreciation$0$0$0$0$0$0$0$0
Investments - other$0$0$0$47,928,609$60,375,151$66,872,201$74,803,544$73,276,099
Land, buildings, and equipment less accumulated depreciation$0$0$0$0$0$0$0$0
Other assets, including program-related investments$1,912$278$1,255$6,345$11,474$13,285$45,953$18,947
Total liabilities$27,655,611$31,130,672$34,758,714$44,640,343$65,114,283$70,702,520$85,973,149$82,223,599
Accounts payable and accrued expenses$0$1$0$0$0$158,352$54,939,227$47,036,543
Grants payable$0$0$0$0$0$0$0$0
Deferred revenue$0$0$0$0$0$0$0$0
Loans from officers, directors, trustees, and key employees$0$0$0$0$0$0$0$0
Tax-exempt bond liabilities$0$0$0$0$0$0$0$0
Mortgages and other notes payable$0$0$0$0$0$0$0$0
Other liabilities$27,655,611$31,130,671$34,758,714$44,640,343$65,114,283$70,544,168$31,033,922$35,187,056
Total liabilities and net assets/fund balances$37,942,809$40,345,814$45,183,261$55,814,359$65,114,283$70,702,520$85,973,149$82,223,599
Total net assets or fund balances$10,287,198$9,215,142$10,424,547$11,174,016$0$0$0$0
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
20002001200220032004200520062007
Total revenue$8,697,484$5,863,589$9,440,765$12,703,180$15,113,561$12,974,579$19,586,446$11,463,931
Total revenue, gains, and other support per audited financial statements$8,697,484$5,863,589$9,440,765$12,703,180$15,113,561$12,974,579$19,586,446$7,103,139
Other expenses$0$0$0$0$0$0$0$-4,360,792
Net unrealized gains on investments$0$0$0$0$0$0$0$-4,360,792
Donated services and use of facilities$0$0$0$0$0$0$0$0
Recoveries of prior year grants$0$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0$0
Other revenue$0$0$0$0$0$0$0$0
Investment expenses$0$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0$0
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
20002001200220032004200520062007
Total expenses$7,438,921$6,935,644$8,231,360$11,953,711$13,828,306$7,891,217$6,095,158$2,950,005
Total expenses and losses per audited financial statements$7,438,921$6,935,644$8,231,360$11,953,711$13,828,306$7,891,217$6,095,158$2,950,005
Other revenue$0$0$0$0$0$0$0$0
Donated services and use of facilities$0$0$0$0$0$0$0$0
Prior year adjustments$0$0$0$0$0$0$0$0
Losses$0$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0$0
Other expenses$0$0$0$0$0$0$0$0
Investment expenses$0$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0$0
Current Officers, Directors, Trustees, and Key Employees
Total number of officers, directors, and trustees permitted to vote on organization business at board meetings10
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?No
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?Yes
Does the organization have a written conflict of interest policy?Yes
Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?Yes
Direct and indirect political expenditures$0
Did the organization file Form 1120-POL for this year?No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members$0
Section 162(e) lobbying and political expenditures$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices$0
Taxable amount of lobbying and political expenditures$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?No
Amount of tax imposed on the organization during the year under: section 4911$0
Amount of tax imposed on the organization during the year under: section 4912$0
Amount of tax imposed on the organization during the year under: section 4955$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958$0
Amount of tax above, reimbursed by the organization$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?No
Number of employees employed in the pay period that includes March 12, 20060
Analysis of Income-Producing Activities (for 2007)
Unrelated business incomeExcluded by section 512, 513, or 514Related or exempt function income
Business codeAmountExclusion codeAmount
Total$0$3,270,115$8,193,816
Program service revenue
Program service revenue 1000000$000$0$8,193,816
Program service revenue 2000000$000$0$0
Program service revenue 3000000$000$0$0
Program service revenue 4000000$000$0$0
Program service revenue 5000000$000$0$0
Medicare/Medicaid payments000000$000$0$0
Fees and contracts from government agencies000000$000$0$0
Membership dues and assessments000000$000$0$0
Interest on savings and temporary cash investments000000$000$0$0
Dividends and interest from securities000000$0Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)$3,270,115$0
Net rental income or (loss) from real estate
debt-financed property000000$000$0$0
not debt-financed property000000$000$0$0
Net rental income or (loss) from personal property000000$000$0$0
Other investment income000000$000$0$0
Gain or (loss) from sales of assets other than inventory000000$000$0$0
Net income or (loss) from special events000000$000$0$0
Gross profit or (loss) from sales of inventory000000$000$0$0
Other revenue000000$000$0$0
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2007)
EIN of corporation, partnership, or disregarded entityPercentage of ownership interestTotal incomeEnd-of-year assets
0000000000%$0$0
0000000000%$0$0
0000000000%$0$0
0000000000%$0$0
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2007)
CompensationContributions to employee benefit plans & deferred compensationExpense account and other allowances
$0$0$0
$0$0$0
$0$0$0
$0$0$0
$0$0$0
Total number of other employees paid over $50,0000
Statements About Activities (for 2007)
Expenses paid or incurred in connection with the lobbying activities$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?No
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?No
Did the organization maintain any donor advised funds?No
Did the organization make any taxable distributions under section 4966?No
Did the organization make a distribution to a donor, donor advisor, or related person?No
Enter the total number of donor advised funds owned at the end of the tax year$0
Enter the aggregate value of assets held in all donor advised funds owned at the end of the tax year$0
Enter the total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts$0
Enter the aggregate value of assets held in all funds or accounts included above at the end of the tax year$0
Reason for Non-Private Foundation Status
The organization is not a private foundation because it isNot controlled by disqualified persons/supports non private foundation
Type of supporting organizationType I
Information about the supported organizations
Employer identification number (EIN)Name of organizationType of organizationIs the supported organization listed in the supporting organization's governing documents?Amount of support
370663567St Elizabeths Hospital Sisters Of The Third Order Of St FrancisYes$0
371208459St Josephs Hosp Of The Hosp Sisters Of The 3rd Order Of St FrancisYes$0
370661233St Anthonys Memorial Hospital Sis Of Third Order Of St FrancisYes$0
370663568St Josephs Hospital Of The Hospital Sisters Of The Thrid Order Of St FYes$0
370661236St Francis Hospital Sisters Of The Third Order Of St FrancisYes$0
370661238St Johns Hospital Of The Hospital Sisters Of The Third Order Of St FYes$0
362169181St Marys Hospital Streator Hospital Sisters Of The 3rd Ordr St FrancisYes$0
390810545St Josephs Hospital Of The Hospital Sisters Of The Third Order Of St FYes$0
390807060Sacred Heart Hospital Of The Hospit Al Sisters-3rd Order Of St FrancisYes$0
390818682St Marys Hospital Medical Center Of Green Bay Inc-Hospital SistersYes$0
390817529St Vincent Hospital-Hospital Sisters-Third Order Of St FrancisYes$0
390808480St Nicholas Hospital-Sisters Of The Third Order Of St FrancisYes$0
371163402Hospital Sisters Services IncYes$0
371058692Hospital Sisters Health SystemYes$0
371137724Hospital Sisters Health System Health Care Plan Trust FundYes$0
371186514Hospital Sisters Of St Francis Foundation IncYes$0
510157933Hospital Sisters Healthcare-West IncYes$0
370661244St Marys Hospital Sisters Of The Third Order Of St FrancisYes$0
Total$0
Support Schedule
19992000200120022003200420052006
Total$0$0$0$0$0$0$0$0
Gifts, grants, and contributions received$0$0$0$0$0$0$0$0
Membership fees received$0$0$0$0$0$0$0$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose$0$0$0$0$0$0$0$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975$0$0$0$0$0$0$0$0
Net income from unrelated business activities not included above$0$0$0$0$0$0$0$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf$0$0$0$0$0$0$0$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge$0$0$0$0$0$0$0$0
Other income$0$0$0$0$0$0$0$0
Lobbying Expenditures by Electing Public Charities (for 2007)
Total exempt purpose expenditures$0
Total lobbying expenditures$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)$0
Total lobbying expenditures to influence a legislative body (direct lobbying)$0
Other exempt purpose expenditures$0
Lobbying nontaxable amount$0
Grassroots nontaxable amount$0
Statements Regarding Other IRS Filings and Tax Compliance (for 2011)
Did the organization have unrelated business gross income of $1,000 or more during the year?No
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities $0
Gross income from members or shareholders$0
Gross income from other sources$0
Statement of Revenue (for 2011)
Total revenue$1,164,067
Contributions, Gifts, Grants and Other Similar Amounts$0
Program Service Revenue$472,296
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$161,156
Income from investment of tax-exempt bond proceeds$0
Royalties$0
Net rental income$0
Net loss from sales of assets other than inventory$-124,129
Gross amount from sales of assets other than inventory (Securities / Other)$0 / $0
Less: cost or other basis and sales expenses (Securities / Other)$124,129 / $0
Gain or (loss) (Securities / Other)$-124,129 / $0
Net income from fundraising events$0
Net income from gaming activities$0
Net income from sales of inventory$0
Miscellaneous Revenue$654,744
Statement of Functional Expenses (for 2011)
Total functional expenses$1,164,067
Compensation of current officers, directors, trustees, and key employees$0
Other salaries and wages$0
Payroll taxes$0
Professional fundraising services$0
Other$1,164,067
Balance Sheet (for 2011)
Total assets$474,552
Total liabilities$474,552
Tax-exempt bond liabilities$0
Secured mortgages and notes payable to unrelated third parties$0
Unsecured notes and loans payable to unrelated third parties$0
Other$474,552
Total net assets or fund balances$0
Reason for Public Charity Status (for 2011)
The organization is not a private foundation because it is:An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2)
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Number of organizations performing similar types of work
Alabama3
Arkansas2
Arizona11
California23
Colorado1
Connecticut7
District of Columbia2
Florida8
Georgia6
Hawaii4
Idaho4
Illinois12
Indiana5
Kansas1
Kentucky6
Louisiana4
Massachusetts2
Maryland2
Maine1
Michigan5
Minnesota14
Missouri5
Montana1
North Carolina6
North Dakota2
Nebraska2
New Hampshire1
New Jersey1
New Mexico3
Nevada4
New York9
Ohio6
Oklahoma4
Oregon3
Pennsylvania13
Rhode Island1
South Carolina3
Tennessee5
Texas10
Utah1
Virginia4
Vermont2
Washington5
Wisconsin6
International5
Total225

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