2025-04-07T12:40:34-05:00 2024-05-31 331889858 HM&M ADVISORY LLC 5005 LYNDON B JOHNSON FWY STE 1200 DALLAS TX 75244 990 2023-06-01 202464129 FOURSQUARE HEALTHCARE LTD BENEFITS TRUST FOUR 9723039000 1309 RIDGE RD 300 ROCKWALL TX 75087 KOLBY CLARK CHIEF ACCOUNTING OFFICER 9723039000 2025-04-06 1 0 PEARL BALSARA P01238984 9724041010 2025-04-05 2023 2025-03-06 01:10:19Z KOLBY CLARK 1309 RIDGE RD 300 ROCKWALL TX 75087 3285809 0 X N/A X 2005 TX EMPLOYEE INSURANCE BENEFITS 2 0 0 0 0 0 0 0 0 3285809 0 0 0 0 0 3285809 0 0 1874281 1676273 0 0 0 0 0 1390904 1436990 3265185 3113263 -3265185 172546 752642 981179 208615 264606 544027 716573 TO PROVIDE HEALTH INSURANCE BENEFITS TO EMPLOYEES OF FOURSQUARE HEALTHCARE, LTD. AND AFFILIATED COMPANIES AND THEIR DEPENDENTS. 0 0 3113263 PROVIDED HEALTH INSURANCE BENEFITS, DENTAL INSURANCE BENEFITS AND VISION INSURANCE BENEFITS TO EMPLOYEES OF FOURSQUARE HEALTHCARE, LTD. AND AFFILIATED COMPANIES AND THEIR DEPENDENTS. 3113263 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 X FOURSQUARE HEALTHCARE LTD 9723039000 1309 RIDGE RD 300 ROCKWALL TX 75087 SHANE LEWIS VP/CFO 1.00 39.00 X 0 232907 25513 DON MILLER PRESIDENT 1.00 39.00 X 0 212198 25513 JEFF PATEL IT MANAGER 1.00 40.00 X 0 179766 2980 HEATHER M BURCHETT ADMINISTRATOR 1.00 40.00 X 0 173225 426 KOLBY CLARK CHIEF ACCOUNTING OFFICER 1.00 40.00 X 0 162604 12249 EDWARD BLACK ASST. DIRECTOR OF OPERATIO 1.00 40.00 X 0 186660 628 DANIEL MARICK DIRECTOR OF OPERATIONS 1.00 40.00 X 0 154949 23095 PAMELA FITZSIMMONS DIRECTOR OF CLINICAL REIMB 1.00 40.00 X 0 192757 3395 RICHARD MILLER ADMINISTRATOR 1.00 40.00 X 0 143501 12149 JON LAUKHUF ADMINISTRATOR 1.00 40.00 X 0 153569 12464 WILLIAM T GREEN ADMINISTRATOR 1.00 40.00 X 0 187296 12130 REBECCA MCNEELY DIRECTOR OF CASE MANAGEMEN 1.00 40.00 X 0 179177 1586 CLAYTON T CHESSER ADMINISTRATOR 1.00 40.00 X 0 154271 12133 0 2312880 144261 0 0 1 0 0 EMPLOYER CONTRIBUTIONS 525100 1966801 1966801 EMPLOYEE CONTRIBUTION 525100 1319008 1319008 3285809 3285809 3285809 0 0 1676273 1676273 369740 369740 33345 33345 9711 9711 1024194 1024194 3113263 3113263 0 0 247912 414853 504730 566326 752642 981179 201906 259604 6709 5002 208615 264606 X 0 0 0 0 544027 716573 544027 716573 752642 981179 172546 0 X X 0 1 X 0 0 0 OTHER PAYABLES 5002 5002 3285809 0 3285809 0 3285809 3113263 0 3113263 0 3113263 0 0 0 SHANE LEWIS VP/CFO 0 232907 0 0 0 0 0 0 0 25513 0 258420 0 0 DON MILLER PRESIDENT 0 212198 0 0 0 0 0 0 0 25513 0 237711 0 0 WILLIAM T GREEN ADMINISTRATOR 0 187296 0 0 0 0 0 0 0 12130 0 199426 0 0 PAMELA FITZSIMMONS DIRECTOR OF CLINICAL REIMB 0 192757 0 0 0 0 0 0 0 3395 0 196152 0 0 EDWARD BLACK ASST. DIRECTOR OF OPERATIO 0 186660 0 0 0 0 0 0 0 628 0 187288 0 0 JEFF PATEL IT MANAGER 0 179766 0 0 0 0 0 0 0 2980 0 182746 0 0 REBECCA MCNEELY DIRECTOR OF CASE MANAGEMEN 0 179177 0 0 0 0 0 0 0 1586 0 180763 0 0 DANIEL MARICK DIRECTOR OF OPERATIONS 0 154949 0 0 0 0 0 0 0 23095 0 178044 0 0 KOLBY CLARK CHIEF ACCOUNTING OFFICER 0 162604 0 0 0 0 0 0 0 12249 0 174853 0 0 HEATHER M BURCHETT ADMINISTRATOR 0 173225 0 0 0 0 0 0 0 426 0 173651 0 0 CLAYTON T CHESSER ADMINISTRATOR 0 154271 0 0 0 0 0 0 0 12133 0 166404 0 0 JON LAUKHUF ADMINISTRATOR 0 153569 0 0 0 0 0 0 0 12464 0 166033 0 0 RICHARD MILLER ADMINISTRATOR 0 143501 0 0 0 0 0 0 0 12149 0 155650 0 0 FORM 990, PART VI, SECTION A, LINE 2 A TRUSTEE HAS A BUSINESS RELATIONSHIP WITH ANOTHER TRUSTEE. FORM 990, PART VI, SECTION A, LINE 8A THE ORGANIZATION HAS NOT HISTORICALLY DOCUMENTED MEETINGS OR WRITTEN ACTIONS TAKEN BY THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NOT HISTORICALLY DOCUMENTED MEETINGS OR WRITTEN ACTIONS TAKEN BY EACH COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B AN ELECTRONIC COPY OF THE FORM 990 WAS SENT TO THE BOARD MEMBERS FOR REVIEW PRIOR TO FILING FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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