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ObjectId: 202112249349301211 - Submission: 2021-08-12
TIN: 87-0807914
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
19
Open to Public Inspection
Name of the organization
Core Physicians LLC
Employer identification number
87-0807914
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax idemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
.........
1b
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a?
..
2
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Written employment contract
Independent compensation consultant
Compensation survey or study
Form 990 of other organizations
Approval by the board or compensation committee
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment?
.............
4a
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
.........
4b
Yes
c
Participate in, or receive payment from, an equity-based compensation arrangement?
.........
4c
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization?
....................
5a
No
b
Any related organization?
.......................
5b
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
..................
6a
No
b
Any related organization?
......................
6b
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
Yes
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III
..........................
8
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?
.........................
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019
Page 2
Schedule J (Form 990) 2019
Page
2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A)
Name and Title
(B)
Breakdown of W-2 and/or 1099-MISC compensation
(C)
Retirement and other deferred compensation
(D)
Nontaxable
benefits
(E)
Total of columns
(B)(i)-(D)
(F)
Compensation in column (B) reported as deferred on prior Form 990
(i)
Base
compensation
(ii)
Bonus & incentive
compensation
(iii)
Other
reportable compensation
1
Kevin J O'Leary
Treasurer/System Manager
(i)
(ii)
0
-------------
438,060
0
-------------
192,640
0
-------------
1,034,325
0
-------------
8,400
0
-------------
20,111
0
-------------
1,693,536
0
-------------
748,000
2
Avnish Clerk MD
Physician
(i)
(ii)
589,814
-------------
0
648,627
-------------
0
56,548
-------------
0
8,400
-------------
0
27,035
-------------
0
1,330,424
-------------
0
0
-------------
0
3
Kevin J Callahan
System Manager
(i)
(ii)
0
-------------
675,611
0
-------------
435,000
0
-------------
82,213
0
-------------
8,400
0
-------------
20,111
0
-------------
1,221,335
0
-------------
0
4
Thomas McGovern MD
Physician
(i)
(ii)
590,145
-------------
0
425,784
-------------
0
24,945
-------------
0
8,400
-------------
0
20,738
-------------
0
1,070,012
-------------
0
0
-------------
0
5
Roger Nowak MD
Physician
(i)
(ii)
591,710
-------------
0
396,694
-------------
0
21,374
-------------
0
8,400
-------------
0
13,940
-------------
0
1,032,118
-------------
0
0
-------------
0
6
Aaron Colman MD
Physician
(i)
(ii)
589,151
-------------
0
225,600
-------------
0
630
-------------
0
8,400
-------------
0
26,472
-------------
0
850,253
-------------
0
0
-------------
0
7
Arthur Yan MD
Clinician Manager
(i)
(ii)
534,679
-------------
0
274,384
-------------
0
395
-------------
0
8,400
-------------
0
20,341
-------------
0
838,199
-------------
0
0
-------------
0
8
Kimberly Marble MD
Physician
(i)
(ii)
528,497
-------------
0
271,515
-------------
0
1,806
-------------
0
8,400
-------------
0
23,946
-------------
0
834,164
-------------
0
0
-------------
0
9
Jessica Peelman MD
Clinician Manager
(i)
(ii)
583,564
-------------
0
90,360
-------------
0
63,134
-------------
0
8,400
-------------
0
27,265
-------------
0
772,723
-------------
0
0
-------------
0
10
Debra Cresta
CEO/President, System Manager
(i)
(ii)
0
-------------
369,672
0
-------------
171,185
0
-------------
14,295
0
-------------
16,800
0
-------------
19,839
0
-------------
591,791
0
-------------
0
11
Jessica Sutherland MD
Clinician Manager (ended 3/20)
(i)
(ii)
413,830
-------------
0
116,519
-------------
0
420
-------------
0
8,400
-------------
0
20,341
-------------
0
559,510
-------------
0
0
-------------
0
12
Melanie Lanier DO
Clinician Manager
(i)
(ii)
0
-------------
336,280
0
-------------
159,112
0
-------------
8,032
0
-------------
16,800
0
-------------
24,636
0
-------------
544,860
0
-------------
0
13
Ernest Podrasky MD
Clinician Manager
(i)
(ii)
407,644
-------------
0
65,224
-------------
0
26,971
-------------
0
8,400
-------------
0
20,738
-------------
0
528,977
-------------
0
0
-------------
0
14
Constance D Sprauer Esq
Secretary
(i)
(ii)
0
-------------
303,989
0
-------------
120,199
0
-------------
9,558
0
-------------
16,800
0
-------------
19,960
0
-------------
470,506
0
-------------
0
15
Michael Pangan MD
Clinician Manager (as of 4/20)
(i)
(ii)
224,612
-------------
0
161,064
-------------
0
940
-------------
0
8,400
-------------
0
27,021
-------------
0
422,037
-------------
0
0
-------------
0
16
Alexandra Bonesho MD
Chairman/Clinician Manager
(i)
(ii)
233,081
-------------
0
105,499
-------------
0
600
-------------
0
8,400
-------------
0
26,348
-------------
0
373,928
-------------
0
0
-------------
0
17
David Buono MD
Clinician Manager (as of 4/20)
(i)
(ii)
195,001
-------------
0
85,665
-------------
0
36,194
-------------
0
8,400
-------------
0
27,033
-------------
0
352,293
-------------
0
0
-------------
0
18
Jennifer Jones MD
Clinician Manager (ended 3/20)
(i)
(ii)
135,827
-------------
0
47,730
-------------
0
72,166
-------------
0
7,981
-------------
0
26,637
-------------
0
290,341
-------------
0
0
-------------
0
19
Apara Dave MD
Clinician Manager (as of 4/20)
(i)
(ii)
213,849
-------------
0
40,174
-------------
0
232
-------------
0
7,947
-------------
0
26,832
-------------
0
289,034
-------------
0
0
-------------
0
20
Allison Casassa
Assistant Treasurer
(i)
(ii)
0
-------------
180,073
0
-------------
78,071
0
-------------
10,558
0
-------------
15,972
0
-------------
341
0
-------------
285,015
0
-------------
0
Schedule J (Form 990) 2019
Page 3
Schedule J (Form 990) 2019
Page
3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference
Explanation
Part I, Line 3
The CEO of Core Physicians, LLC is compensated by a related organization, Exeter Health Resources, Inc. Exeter Health Resources, Inc. uses a compensation committee, an independent compensation consultant, a compensation survey and approval by the Board or compensation committee.
Part I, Line 4b
The organization's parent (Exeter Health Resources, Inc.) maintains a split dollar supplemental retirement plan for two executives (listed below with amounts) selected by the Exeter Health Resources Board of Trustees. The plan is closed to future participants. The Plan provides for annual payments of premiums for life insurance policies insuring the listed individuals. Those life insurance premiums are collaterally assigned to the corporation and any excess accumulated value in the policies (net of accumulated premium payments which are returned to the organization upon the executive attaining the age of 70 or at the death of the participant) is available to be paid to the participant once vested at age 62 and upon retirement from the organization. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance provided. Life insurance premium payments during tax year: Kevin J. Callahan $313,241 Kevin J. O'Leary $136,191 Excess Accumulated Value: Kevin J. Callahan $3,506,002 Kevin J. O'Leary $1,448,487 Certain of the listed employees participate in a nonqualified deferred compensation plan as described in Internal Revenue Code Section 457(f) sponsored by Exeter Health Resources, Inc. In the calendar year ended December 31, 2019 the contribution to the plan for the vested benefit of Kevin J. O'Leary was $68,000. The contribution is intended to provide a forfeitable supplemental retirement benefit. Participants in the 457(f) plan do not vest until age 62 when it is payable to the participant. During the calendar year ended December 31, 2019, Kevin O'Leary reached the age of 62 and received $1,002,727 payment from the 457(f) plan, which includes $748,000 of contributions reported on Form 990, Part VII-A and Schedule J, Part II, Column (C) in prior years.
Part I, Line 7
Core Physicians, LLC has a compensation plan that is based upon competitive market rates relative to a physician's specialty. The organization utilizes the services of an outside compensation consultant to determine market benchmarks. Total compensation consists of a base salary, a potential for a productivity bonus, an on-call stipend (if applicable), a medical directorship stipend (if applicable), a citizenship and quality payment that is earned based upon the achievement of objectives set in advance. The productivity bonus is based on work relative value units (WRVU) production and would be eligible to anyone who produces WRVU's above his or her base salary WRVU level. Base compensation is also adjusted if work relative value units fall below the base salary WRVU equivalency level. The physicians' compensation is approved by Core Physicians, LLC's Compensation Committee which is comprised of system managers who are approved by the Exeter Health Resources Board of Trustees.
Schedule J, Part II:
Kevin J. Callahan, Kevin J. O'Leary and Debra Cresta, who serve as System Managers, and Constance Sprauer, Esq. and Allison Casassa, who serve as Secretary and Assistant Treasurer respectively for Core Physicians, LLC are compensated by a related organization, Exeter Health Resources, Inc. Their compensation is based on their roles as CEO, CFO, President Core Physicians, LLC, Senior VP Legal Affairs and VP of Finance respectively, of the consolidated Exeter Health Resources, Inc. system.
Schedule J (Form 990) 2019
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