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ObjectId: 201943189349312759 - Submission: 2019-11-14
TIN: 46-3803873
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
18
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH PLANS NFP INC
Employer identification number
46-3803873
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Clarian Transplant Institute Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
13-4350599
Healthcare
IN
501(c)(3)
10
IUH
Yes
(2)
HealthLINC Incorporated
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
26-3571507
Healthcare
IN
501(c)(3)
10
IUHB
Yes
(3)
Indiana Health Info Exchange Inc
846 N Senate Ave
Indianapolis
,
IN
46202
36-4550324
Healthcare
IN
501(c)(3)
12 I
NA
No
(4)
Indiana University Health Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1955872
Healthcare
IN
501(c)(3)
3
NA
No
(5)
IU Health Arnett Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
26-3162145
Healthcare
IN
501(c)(3)
3
IUH
Yes
(6)
IU Health Ball Memorial Hospital Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-0867958
Healthcare
IN
501(c)(3)
3
IUH
Yes
(7)
IU Health Ball Memorial Physicians Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1925641
Healthcare
IN
501(c)(3)
10
IUHBMH
Yes
(8)
IU Health Bedford Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
23-7042323
Healthcare
IN
501(c)(3)
3
IUH
Yes
(9)
IU Health Blackford Hospital Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
01-0646166
Healthcare
IN
501(c)(3)
3
IUHBMH
Yes
(10)
IU Health Bloomington Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1720796
Healthcare
IN
501(c)(3)
3
IUH
Yes
(11)
IU Health BMH Foundation Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
31-1111784
Fundraising
IN
501(c)(3)
12 I
IUHBMH
Yes
(12)
IU Health Care Associates Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1747218
Healthcare
IN
501(c)(3)
10
IUH
Yes
(13)
IUHLP Liquidation Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
35-1125434
Healthcare
IN
501(c)(3)
10
IUH
Yes
(14)
IUHLP-P Liquidation Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
31-1070868
Healthcare
IN
501(c)(3)
10
IUHLP
Yes
(15)
IU Health Morgan Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
27-3533027
Healthcare
IN
501(c)(3)
10
IUH
Yes
(16)
IU Health North Hospital Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1932442
Healthcare
IN
501(c)(3)
3
IUH
Yes
(17)
IU Health Paoli Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-2090919
Healthcare
IN
501(c)(3)
3
IUHB
Yes
(18)
IU Health Tipton Hospital Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
26-2772226
Healthcare
IN
501(c)(3)
3
IUH
Yes
(19)
IU Health West Hospital Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1814660
Healthcare
IN
501(c)(3)
3
IUH
Yes
(20)
IU Health White Memorial Hospital Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
27-3532963
Healthcare
IN
501(c)(3)
3
IUH
Yes
(21)
IU Medical Group Foundation Inc
340 W 10th St No FS5100
Indianapolis
,
IN
46202
20-1093251
Fundraising
IN
501(c)(3)
12 II
NA
No
(22)
LaPorte Hospital Foundation Inc
PO Box 250
LaPorte
,
IN
46352
31-0952775
Fundraising
IN
501(c)(3)
12 I
NA
No
(23)
MDwise Marketplace Inc
1200 Madison Ave
Indianapolis
,
IN
46225
46-5270582
Insurance
IN
501(c)(4)
N/A
IUH
Yes
(24)
MDwise Network Inc
1200 Madison Ave
Indianapolis
,
IN
46225
47-2619552
Insurance
IN
501(c)(4)
N/A
IUH
Yes
(25)
Indiana University Health Foundation Inc
1800 N Capitol Ave
Indianapolis
,
IN
46202
35-6043086
Fundraising
IN
501(c)(3)
12 I
IUH
Yes
(26)
Methodist Health Group Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
35-0876390
Healthcare
IN
501(c)(3)
12 III-FI
NA
No
(27)
Methodist Occup Health Centers Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1844176
Healthcare
IN
501(c)(3)
3
IUH
Yes
(28)
Rehabilitation Hospital of Indiana Inc
4141 Shore Dr
Indianapolis
,
IN
46254
35-1786005
Healthcare
IN
501(c)(3)
3
MHH
Yes
(29)
RHI Foundation Inc
4141 Shore Dr
Indianapolis
,
IN
46254
35-1932349
Fundraising
IN
501(c)(3)
12 I
RHI
Yes
(30)
The Cheer Guild of Riley Hos for Child
705 Riley Hospital Dr
Indianapolis
,
IN
46202
35-6018517
Fundraising
IN
501(c)(3)
12 III-FI
NA
No
(31)
University Family Physicians Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
23-7427350
Healthcare
IN
501(c)(3)
10
IUHCA
Yes
(32)
IU Health Frankfort Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
81-5174295
Healthcare
IN
501(c)(3)
3
IUH
Yes
(33)
IU Health Jay Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
82-2736786
Healthcare
IN
501(c)(3)
3
IUH
Yes
(34)
IU Health Jay Foundation Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
35-1809127
FUNDRAISING
IN
501(c)(3)
12 I
IUH
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Page 2
Schedule R (Form 990) 2018
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
Ball Outpatient Sur Ctr LLC
569 Brookwood Village Ste 901
Birmingham
,
AL
35244
27-0275794
Healthcare
IN
NA
(2)
Beltway Surgery Centers LLC
569 Brookwood Village Ste 901
Birmingham
,
AL
35244
35-2072586
Healthcare
IN
NA
(3)
Bloomington Endo Center LLC
PO Box 550
Bloomington
,
IN
47402
35-2117943
Healthcare
IN
NA
(4)
BOSC Holdings LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-4147343
Healthcare
IN
NA
(5)
BSC Holdings LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-2314634
Healthcare
IN
NA
(6)
CHV Fund I LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
26-2523206
Venture Capital
IN
NA
(7)
CHV Fund II Management LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
37-1717823
Venture Capital
IN
NA
(8)
CHV Fund II LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
80-0902337
Venture Capital
IN
NA
(9)
CHV Fund Management LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
26-2523151
Venture Capital
IN
NA
(10)
IEC Holdings LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-4148032
Healthcare
IN
NA
(11)
Indiana Endoscopy Centers LLC
569 Brookwood Village Ste 901
Birmingham
,
AL
35244
20-8398421
Healthcare
IN
NA
(12)
ROC Surgery LLC
569 Brookwood Village Ste 901
Birmingham
,
AL
35244
27-1497960
Healthcare
IN
NA
(13)
ROCS Holdings LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-4148369
Healthcare
IN
NA
(14)
Senate St Surgery Center LLC
569 Brookwood Village Ste 901
Birmingham
,
AL
35244
42-1709357
Healthcare
IN
NA
(15)
SSSC Holdings LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-4148167
Healthcare
IN
NA
(16)
IU Health Fort Wayne LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
83-1224627
Healthcare
IN
N/A
(17)
Health Venture Management LLC
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
20-5740218
Management
IN
NA
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
BMH Medical Pavilion Association Inc
2525 W University Ave
Muncie
,
IN
47303
35-1858408
Condo Mgmt
IN
NA
C
Yes
(2)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
35-1611424
Management
IN
NA
C
Yes
(3)
CHV Capital Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
26-0752507
Venture Capital
IN
NA
C
Yes
(4)
IU Health 457(B) Plan
1100 N Market St
Wilmington
,
DE
19890
47-6948347
Investments
IN
NA
T
Yes
(5)
IU Health ACO Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-4421020
Healthcare
IN
NA
C
Yes
(6)
IU Health Board Designated Trust
400 Howard St
San Francisco
,
CA
94105
30-6309021
Investments
IN
NA
T
Yes
(7)
IU Health NTGI S&P500 Fund CF
PO Box 804358
Chicago
,
IL
60680
30-6298263
Investments
IN
NA
T
Yes
(8)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
46-3794815
Insurance
IN
NA
C
Yes
(9)
IU Health Plans Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
26-2127080
HMO
IN
NA
C
Yes
(10)
IU Health Risk Purchasing Group Inc
151 Meeting St Ste 301
Charleston
,
SC
29401
26-0202446
Insurance
IN
NA
C
Yes
(11)
IU Health Risk Retention Group Inc
151 Meeting St Ste 301
Charleston
,
SC
29401
20-1107674
Insurance
SC
NA
C
Yes
(12)
IU Health Southern IN Physicians Inc
950 N Meridian St Ste 300
Indianapolis
,
IN
46204
35-1913875
Healthcare
IN
NA
C
Yes
(13)
IUH Assurance SPC Ltd
PO BOX 69 94 SOLARIS AVE
CAMANA BAY
,
GRAND CAYMAN
CJ
98-0395429
Insurance
CJ
NA
C
Yes
(14)
Proteuo Fund LP
PO BOX 31106 89 NEXUS WAY
CAMANA BAY
,
GRAND CAYMAN
CJ
98-1075227
Investments
CJ
NA
C
Yes
(15)
SCANS Inc
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
45-3080392
Healthcare
IN
NA
C
Yes
(16)
IU Health Plans Insurance Company
950 N Meridian St Ste 800
Indianapolis
,
IN
46204
81-1097218
Insurance
IN
NA
C
Yes
Schedule R (Form 990) 2018
Page 3
Schedule R (Form 990) 2018
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
No
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2018
Page 4
Schedule R (Form 990) 2018
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2018
Page 5
Schedule R (Form 990) 2018
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2018
Additional Data
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