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Object ID: 202102779349300805 - Rendered 2024-04-29
TIN: 20-1072726
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
20
Open to Public Inspection
Name of the organization
Bon Secours Mercy Health Foundation
Employer identification number
20-1072726
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) 2020
Schedule J (Form 990) 2020
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
Timothy Koder
Board Member, Foundation President
(i)
(ii)
266,137
-------------
0
194,518
-------------
0
63,688
-------------
0
22,047
-------------
0
19,938
-------------
0
566,328
-------------
0
0
-------------
0
2
MICHAEL BEZNEY JD
Board Member, Chief Legal Officer & General Counsel
(i)
(ii)
0
-------------
715,920
0
-------------
440,664
0
-------------
1,280,298
0
-------------
216,439
0
-------------
35,243
0
-------------
2,688,564
0
-------------
699,749
3
TRAVIS CRUM
Former Treasurer, SVP Finance - BSMH
(i)
(ii)
0
-------------
369,957
0
-------------
180,000
0
-------------
180,629
0
-------------
102,191
0
-------------
34,139
0
-------------
866,916
0
-------------
129,911
4
JONATHAN LABBE
Former Board President, Cincinnati Foundation President
(i)
(ii)
155,209
-------------
0
42,512
-------------
0
27,468
-------------
0
19,594
-------------
0
24,975
-------------
0
269,758
-------------
0
7,839
-------------
0
5
Michael McQueary
Former Secretary, Staff Counsel/Government Relations
(i)
(ii)
0
-------------
84,624
0
-------------
10,454
0
-------------
16,909
0
-------------
4,038
0
-------------
15,356
0
-------------
131,381
0
-------------
0
6
Becky Sittason
Former Secretary, System Director Donor Engagement
(i)
(ii)
135,199
-------------
0
39,256
-------------
0
39,772
-------------
0
5,905
-------------
0
17,821
-------------
0
237,953
-------------
0
0
-------------
0
7
SCOTT PEMBER
Lorain Foundation President
(i)
(ii)
159,577
-------------
0
46,585
-------------
0
25,189
-------------
0
19,615
-------------
0
20,203
-------------
0
271,169
-------------
0
8,898
-------------
0
8
PAUL HOMICK
Youngstown Foundation President
(i)
(ii)
191,391
-------------
0
61,535
-------------
0
38,215
-------------
0
23,767
-------------
0
9,704
-------------
0
324,612
-------------
0
8,919
-------------
0
9
Julie MERcer
Baltimore Foundation President
(i)
(ii)
153,724
-------------
0
36,496
-------------
0
43,113
-------------
0
5,840
-------------
0
173
-------------
0
239,346
-------------
0
0
-------------
0
10
Erik Whaley
St. Francis Foundation President
(i)
(ii)
171,198
-------------
0
52,410
-------------
0
28,768
-------------
0
22,388
-------------
0
30,918
-------------
0
305,682
-------------
0
0
-------------
0
11
Eric Lemen
VP, Foundation Solutions
(i)
(ii)
171,186
-------------
0
55,076
-------------
0
23,523
-------------
0
20,854
-------------
0
282
-------------
0
270,921
-------------
0
0
-------------
0
Schedule J (Form 990) 2020
Schedule J (Form 990) 2020
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
Schedule J, Part I, Line 4b Terms and conditions of the Bon Secours Mercy Health System SERP
The Bon Secours Mercy Health System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Travis Crum $89,526; Timothy Koder $29,971; Scott Pember $9,997; Jonathan Labbe $8,354; Paul Homick $10,022; Michael Bezney $375,497; Eric Lemen, $0; Julie Mercer, $13,536.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
Bon Secours Mercy Health Foundation relies upon Bon Secours Mercy Health to establish compensation of the organization's President. Bon Secours Mercy Health utilized a compensation committee, an independent compensation consultant, a compensation survey or study, and approval by board or compensation committee to establish the top management official's compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE MERCY HEALTH SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATES. IT PROVIDES ANNUAL CREDITS OF A SPECIFICED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTFULLY. VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHNAGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMIATION. PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: MICHAEL BEZNEY $0.
Schedule J, Part I, Line 7 Non-fixed payments
The organization provides annual incentive compensation for listed individuals. The organization's Board of Trustees establishes objective thresholds for quality, community benefit, and financial performance which must be achieved for incentives to be awarded. The Board also establishes threshold, target and maximum levels for incentive awards. Within these established parameters, the Board determines the CEO's incentive award and incentive awards for other listed individuals are determined by the listed individual's supervisor and disclosed to the Board. The Board may authorize modified incentive awards when appropriate in its judgment.
Schedule J (Form 990) 2020
Additional Data
Software ID:
20011424
Software Version:
2020v4.0