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| Utah | 87-0285238 | |
| (State or other jurisdiction of incorporation or organization) | (I.R.S. Employer I.D. No.) | |
|
1201 Dove Street, Suite 300
Newport Beach, California
|
92660 | |
| (Address of principal executive offices) | (Zip Code) | |
| Registrant’s telephone number, including area code: (949) 721-8272 | ||
|
Large accelerated filer
|
o |
Accelerated filer
|
o |
|
Non-accelerated filer
|
o |
Smaller reporting company
|
x
|
|
(Do not check if smaller reporting company)
|
|||
|
Page
|
||
|
PART I
|
||
|
Item 1.
|
4
|
|
|
Item 1A.
|
12
|
|
|
Item 1B.
|
12
|
|
|
Item 2.
|
12
|
|
|
Item 3.
|
12
|
|
|
Item 4.
|
12
|
|
|
PART II
|
||
|
Item 5.
|
13
|
|
|
Item 6.
|
14
|
|
|
Item 7.
|
14
|
|
|
Item 7A.
|
19
|
|
|
Item 8.
|
20
|
|
|
Item 9.
|
36
|
|
|
Item 9A.
|
36
|
|
|
Item 9B.
|
36
|
|
|
PART III
|
||
|
Item 10.
|
37
|
|
|
Item 11.
|
43
|
|
|
Item 12.
|
47
|
|
|
Item 13.
|
48
|
|
|
Item 14.
|
49
|
|
|
PART IV
|
||
|
Item 15.
|
50
|
|
|
52
|
|
·
|
improving safety programs and having fewer injury and illness claims;
|
|
·
|
increasing access to quality medical providers and medical evaluators;
|
|
·
|
lowering costs of medical care;
|
|
·
|
reducing disputes;
|
|
·
|
improving collaboration between unions and employers;
|
|
·
|
increasing satisfaction of all parties; and
|
|
·
|
providing the opportunity for continuous improvement by renegotiating the terms of the carve-out on an as-needed basis.
|
|
·
|
an alternative dispute resolution process in place of most hearings before a workers’ compensation judge;
|
|
·
|
a mutually agreed upon list of medical providers and medical evaluators; and
|
|
·
|
a mutually agreed upon list of vocational rehabilitation providers.
|
|
·
|
that the carve-out process does not diminish compensation to injured workers; and
|
|
·
|
that the alternative dispute resolution process retain the right to appeal to the reconsideration unit of the Workers’ Compensation Appeals Board (“WCAB”) and, ultimately, to the state courts of appeal.
|
|
Year ended December 31,
|
||||||||
|
Customer:
|
2011
|
2010
|
||||||
|
Customer A
|
14 | % | 0 | % | ||||
|
Customer B
|
12 | % | 22 | % | ||||
|
Customer C
|
11 | % | 0 | % | ||||
|
Customer D
|
7 | % | 12 | % | ||||
|
High
|
Low
|
|||||||
|
Fiscal year ended December 31, 2011
|
||||||||
|
Fourth Quarter
|
$ | .87 | $ | .27 | ||||
|
Third Quarter
|
$ | .56 | $ | .26 | ||||
|
Second Quarter
|
$ | .53 | $ | .30 | ||||
|
First Quarter
|
$ | .30 | $ | .01 | ||||
|
Fiscal year ended December 31, 2010
|
||||||||
|
Fourth Quarter
|
$ | .22 | $ | .22 | ||||
|
Third Quarter
|
$ | .22 | $ | .214 | ||||
|
Second Quarter
|
$ | .45 | $ | .10 | ||||
|
First Quarter
|
$ | .45 | $ | .45 | ||||
|
December 31, 2011
|
December 31, 2010
|
|||||||
|
Net cash provided by (used in) operating activities
|
$ | 88,139 | $ | (248,736 | ) | |||
|
Net cash (used in) investing activities
|
(63,084 | ) | (25,543 | ) | ||||
|
Net cash provided by (used in) financing activities
|
(6,148 | ) | 19,809 | |||||
|
Net increase (decrease) in cash
|
$ | 18,907 | $ | (254,470 | ) | |||
|
Payments Due By Period
|
||||||||||||||||||||
|
Contractual obligations
|
Total
|
Less than 1 year
|
1-3 years
|
3-5 years
|
More than
5 years
|
|||||||||||||||
|
|
||||||||||||||||||||
|
Equipment Leases
(1)
|
$ | 21,011 | $ | 10,085 | $ | 10,926 | $ | - | $ | - | ||||||||||
|
Office Leases
(2)
|
591,113 | 133,563 | 432,800 | 24,750 | - | |||||||||||||||
|
Total
|
$ | 612,124 | $ | 143,648 | $ | 443,726 | $ | 24,750 | $ | - | ||||||||||
|
|
(1)
|
In January 2010 we entered into a capital lease arrangement whereby we leased an office copy machine for $25,543. The asset was recorded on our balance sheet under office equipment under capital lease and our liability incurred under the lease was recorded as current and noncurrent obligations under capital lease. The lease arrangement is for a term of 48 months at level operating rents with capital interest rate at 7%.
|
|
|
(2)
|
In March 2011 we commenced a new office lease agreement that runs to February 29, 2016. In October 2011 we amended our office lease agreement to include an additional 1,640 square feet for our subsidiary MMC. Following is our annual amended base rent for the new office space throughout the term of the lease:
|
|
Rent Period
|
Annual Rent Payments
|
|||
|
Jan. 1 to Dec. 31, 2012
|
$ | 133,563 | ||
|
Jan. 1 to Dec. 31, 2013
|
$ | 140,343 | ||
|
Jan. 1 to Dec. 31, 2014
|
$ | 144,508 | ||
|
Jan. 1 to Dec. 31, 2015
|
$ | 147,949 | ||
|
Jan. 1 to Feb. 29, 2016
|
$ | 24,750 | ||
|
Total
|
$ | 591,113 | ||
|
ASSETS
|
|||||||||
|
December 31,
|
December 31,
|
||||||||
|
2011
|
2010
|
||||||||
|
Current Assets
|
|||||||||
|
Cash
|
$ | 368,459 | $ | 349,552 | |||||
|
Accounts receivable, net of allowance of $20,000
|
523,864 | 239,205 | |||||||
|
Deferred tax asset
|
- | 10,582 | |||||||
|
Income tax receivable
|
3,998 | 35,100 | |||||||
|
Commission draw
|
29,853 | 24,000 | |||||||
|
Prepaid expenses
|
53,947 | 70,112 | |||||||
| Total current assets | 980,121 | 728,551 | |||||||
|
Property & Equipment, net
|
|||||||||
|
Computer equipment
|
80,963 | 60,922 | |||||||
|
Furniture & fixtures
|
56,471 | 28,839 | |||||||
|
Office equipment
|
12,537 | - | |||||||
|
Office equipment under capital lease
|
25,543 | 25,543 | |||||||
| Total property & equipment | 175,514 | 115,304 | |||||||
| Less: accumulated depreciation and amortization | (104,294 | ) | (92,009 | ) | |||||
| Net property & equipment | 71,220 | 23,295 | |||||||
| Other assets | 8,158 | 8,158 | |||||||
| Total assets | $ | 1,059,499 | $ | 760,004 | |||||
|
LIABILITIES AND STOCKHOLDERS' EQUITY
|
|||||||||
|
Current Liabilities
|
|||||||||
|
Accounts payable
|
$ | 86,482 | $ | 30,038 | |||||
|
Accrued expenses
|
126,770 | 100,392 | |||||||
|
Income tax payable
|
1,611 | 100 | |||||||
|
Current obligations under capital lease
|
6,592 | 6,148 | |||||||
|
Deferred rent expense
|
21,903 | - | |||||||
|
Deferred tax liabilities
|
5,404 | - | |||||||
|
Unearned revenue
|
7,803 | 12,035 | |||||||
| Total current liabilities | 256,565 | 148,713 | |||||||
|
Long term liabilities
Noncurrent obligation under capital lease
|
7,069 | 13,661 | |||||||
| Total liabilities | 263,634 | 162,374 | |||||||
|
Commitments and Contingencies
|
- | - | |||||||
|
Shareholder's Equity
|
|||||||||
|
Preferred stock; 5,000,000 shares
authorized at $0.001 par value;
|
- | - | |||||||
|
Common stock; 50,000,000 shares
authorized at $0.001 par value;
|
802 | 802 | |||||||
|
Additional paid-in capital
|
623,629 | 623,629 | |||||||
|
Retained earnings (deficit)
|
171,434 | (26,801 | ) | ||||||
| Total stockholders' equity | 795,865 | 597,630 | |||||||
| Total liabilities and stockholders' equity | $ | 1,059,499 | $ | 760,004 | |||||
|
December 31,
2011
|
December 31,
2010
|
|||||||
|
Revenues
|
||||||||
|
HCO fees
|
$ | 770,303 | $ | 607,450 | ||||
| MPN fees | 627,341 | 605,238 | ||||||
| Other | 1,434,149 | 402,971 | ||||||
|
Total revenues
|
2,831,793 | 1,615,659 | ||||||
|
Expenses
|
||||||||
|
Depreciation
|
13,595 | 5,691 | ||||||
|
Consulting fees
|
358,996 | 273,684 | ||||||
|
Salaries & wages
|
1,132,351 | 692,337 | ||||||
|
Professional fees
|
212,572 | 190,519 | ||||||
|
Insurance
|
151,227 | 105,495 | ||||||
|
Outsource service fees
|
190,917 | 24,302 | ||||||
|
Data maintenance
|
57,445 | 75,325 | ||||||
|
General & administrative
|
392,407 | 329,535 | ||||||
|
Total expenses
|
2,509,510 | 1,696,888 | ||||||
|
Income (loss) from operations
|
322,283 | (81,229 | ) | |||||
|
Other income (expense)
|
||||||||
|
Loss on disposal of assets
|
(1,564 | ) | - | |||||
|
Interest income
|
957 | 1,712 | ||||||
|
Rental income
|
250 | - | ||||||
|
Interest (expense)
|
(1,192 | ) | (1,606 | ) | ||||
|
Total other income (expense)
|
(1,549 | ) | 106 | |||||
|
Income (loss) before income tax provision
|
320,734 | (81,123 | ) | |||||
|
Income tax provision (benefit)
|
122,499 | (21,190 | ) | |||||
|
Net income (loss)
|
$ | 198,235 | $ | (59,933 | ) | |||
|
Basic and fully diluted earnings per share:
|
||||||||
|
Earnings per share amount
|
$ | .25 | $ | (0.08 | ) | |||
|
Weighted average common shares outstanding
|
802,424 | 802,424 | ||||||
|
Preferred Stock
|
Common Stock
|
Paid in |
Retained
Earnings
|
|||||||||||||||||||||
|
Shares
|
Amount
|
Shares
|
Amount
|
Capital
|
(Deficit)
|
|||||||||||||||||||
|
Balance,
January 1, 2010
|
- | $ | - | 802,424 | $ | 802 | $ | 623,629 | $ | 33,132 | ||||||||||||||
|
Net loss for the
year ended
|
- | - | - | - | - | (59,933 | ) | |||||||||||||||||
|
Balance,
December 31, 2010
|
- | $ | - | 802,424 | $ | 802 | $ | 623,629 | $ | (26,801 | ) | |||||||||||||
|
Net income for the
year ended
|
- | - | - | - | - | 198,235 | ||||||||||||||||||
|
Balance,
December 31, 2011
|
- | $ | - | 802,424 | $ | 802 | $ | 623,629 | $ | 171,434 | ||||||||||||||
|
2011
|
2010
|
|||||||
|
Cash Flows from Operating Activities
|
||||||||
|
Net income (loss)
|
$ | 198,235 | $ | (59,933 | ) | |||
|
Adjustments to reconcile net income to net cash:
|
||||||||
|
Depreciation
|
13,595 | 5,691 | ||||||
|
Loss on disposition of assets
|
1,564 | - | ||||||
|
Changes in operating assets & liabilities:
|
||||||||
|
(Increase) in accounts receivable
|
(284,659 | ) | (84,139 | ) | ||||
|
Decrease (increase) in income tax receivable
|
31,102 | (23,577 | ) | |||||
|
(Increase) in commission draw
|
(5,853 | ) | (24,000 | ) | ||||
|
Decrease in deferred tax asset
|
10,582 | 1,887 | ||||||
|
Decrease (increase) in prepaid expenses
|
16,165 | (3,712 | ) | |||||
|
Increase in accounts payable
|
56,444 | 23,366 | ||||||
|
(Decrease) increase in accrued expenses
|
26,378 | (68,662 | ) | |||||
|
Increase in income tax payable
|
1,511 | - | ||||||
|
Increase in deferred rent expense
|
21,903 | - | ||||||
|
Increase in deferred tax liabilities
|
5,404 | - | ||||||
|
(Decrease) in unearned revenue
|
(4,232 | ) | (7,499 | ) | ||||
|
(Increase) in other assets
|
- | (8,158 | ) | |||||
|
Net cash provided by (used in) operating activities
|
88,139 | (248,736 | ) | |||||
|
Cash Flows from Investing Activities
|
||||||||
|
Purchase of furniture& equipment
|
(63,084 | ) | - | |||||
|
Purchase equipment under capital lease
|
- | (25,543 | ) | |||||
|
Net cash used by investing activities
|
(63,084 | ) | (25,543 | ) | ||||
|
Cash Flows from Financing Activities
|
||||||||
|
Increase in obligation under capital lease
|
- | 25,543 | ||||||
|
Payment of obligations under capital lease
|
(6,148 | ) | (5,734 | ) | ||||
|
Net cash provided by (used in) financing activities
|
(6,148 | ) | 19,809 | |||||
|
Increase (decrease) in cash
|
18,907 | (254,470 | ) | |||||
|
Cash at beginning of period
|
349,552 | 604,022 | ||||||
|
Cash at end of period
|
$ | 368,459 | $ | 349,552 | ||||
|
Supplemental Cash Flow Information
|
||||||||
|
Cash paid (refunded) for:
|
||||||||
|
Interest
|
$ | 1,191 | $ | 1,488 | ||||
|
Income taxes refunded
|
$ | (38,718 | ) | - | ||||
|
Income taxes paid
|
$ | (107,346 | ) | $ | 57,200 | |||
|
|
For the Years Ended December 31,
|
|||||||
|
2011
|
2010
|
|||||||
|
Basic Earnings per share:
|
||||||||
|
Income (loss) (numerator)
|
$ | 198,235 | $ | (59,933 | ) | |||
|
Shares (denominator)
|
802,424 | 802,424 | ||||||
|
Per share amount
|
$ | .25 | $ | (.08 | ) | |||
|
Fully Diluted Earnings per share:
|
||||||||
|
Income (Loss) (numerator)
|
$ | 198,235 | $ | (59,933 | ) | |||
|
Shares (denominator)
|
802,424 | 802,424 | ||||||
|
Per share amount
|
$ | .25 | $ | (.08 | ) | |||
|
•
|
Level 1 inputs to the valuation methodology are quoted prices (unadjusted) for identical assets or liabilities in active markets.
|
|
|
|
•
|
Level 2 inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument.
|
|
•
|
Level 3 inputs to valuation methodology are unobservable and significant to the fair measurement.
|
|
12/31/11
|
12/31/10
|
|||||||
|
Customer A
|
6 | % | 20 | % | ||||
|
Customer B
|
12 | % | - | |||||
|
Customer C
|
3 | % | 13 | % | ||||
|
Customer D
|
15 | % | - | |||||
|
Customer E
|
12 | % | - | |||||
|
Customer F
|
13 | % | - | |||||
|
|
Cost
|
Depreciation Exp. & Amort
|
Accum. Depre. & Amort.
|
|||||||||||||||||||||
|
Assets
|
December 31, 2011
|
December 31, 2010
|
December 31, 2011
|
December 31, 2010
|
December 31, 2011
|
December 31, 2010
|
||||||||||||||||||
|
Computer equipment
|
$ | 80,963 | $ | 60,922 | $ | 2,342 | $ | - | $ | 63,264 | $ | 60,922 | ||||||||||||
|
Furniture & fixtures
|
60,544 | 28,839 | 4,678 | 582 | 30,656 | 25,978 | ||||||||||||||||||
|
Disposal of furniture
|
(4,073 | ) | (1,309 | ) | ||||||||||||||||||||
|
Office equipment
|
12,537 | 1,465 | - | 1,465 | ||||||||||||||||||||
|
Office equipment
under capital lease
|
25,543 | 25,543 | 5,109 | 5,109 | 10,218 | 5,109 | ||||||||||||||||||
|
Totals
|
$ | 175,514 | $ | 115,304 | $ | 13,594 | $ | 5,691 | $ | 104,294 | $ | 92,009 | ||||||||||||
|
2011
|
2010
|
|||||||
|
Current:
|
||||||||
|
Federal
|
$ | 86,511 | $ | (25,758 | ) | |||
|
State
|
20,002 | 2,681 | ||||||
|
Deferred
|
||||||||
|
Federal
|
12,389 | 1,463 | ||||||
|
State
|
3,597 | 424 | ||||||
|
Total tax provision (benefit)
|
$ | 122,499 | $ | (21,190 | ) | |||
|
2011
|
2010
|
|||||||
|
Depreciation
|
||||||||
|
Federal
|
$ | (20,178 | ) | (4,054 | ) | |||
|
State
|
(5,858 | ) | (1,177 | ) | ||||
|
Reserve for bad debts
|
||||||||
|
Federal
|
6,200 | 6,200 | ||||||
|
State
|
1,800 | 1,800 | ||||||
|
Vacation accrual
|
||||||||
|
Federal
|
9,790 | 6,055 | ||||||
|
State
|
2,842 | 1,758 | ||||||
|
Deferred tax asset (liability)
|
$ | (5,404 | ) | $ | 10,582 | |||
| 2011 | 2010 | |||||||
|
Expense at federal statutory rate
|
$ | 101,905 | $ | (31,078 | ) | |||
|
State tax effects
|
24,281 | 2,549 | ||||||
|
Non deductible expenses
|
16,270 | 5,876 | ||||||
|
Taxable temporary differences
|
6,247 | - | ||||||
|
Deductible temporary differences
|
(26,204 | ) | 1,463 | |||||
|
Deferred tax asset valuation allowance
|
- | - | ||||||
|
Income tax provision (benefit)
|
$ | 122,499 | $ | (21,190 | ) | |||
|
Rent Period
|
Annual Rent Payments
|
|||
|
Jan. 1 to Dec. 31, 2012
|
$ | 133,563 | ||
|
Jan. 1 to Dec. 31, 2013
|
$ | 140,343 | ||
|
Jan. 1 to Dec. 31, 2014
|
$ | 144,508 | ||
|
Jan. 1 to Dec. 31, 2015
|
$ | 147,949 | ||
|
Jan. 1 to Feb. 29, 2016
|
$ | 24,750 | ||
|
Total
|
$ | 591,113 | ||
|
Payments Due By Period
|
||||||||||||||||||||
|
Contractual obligations
|
Total
|
Less than 1 year
|
1-3 years
|
3-5 years
|
More than
5 years
|
|||||||||||||||
|
|
||||||||||||||||||||
|
Equipment Leases
(1)
|
$ | 21,011 | $ | 10,085 | $ | 10,926 | $ | - | $ | - | ||||||||||
|
Office Leases
(2)
|
591,113 | 133,563 | 432,800 | 24,750 | - | |||||||||||||||
|
Total
|
$ | 612,124 | $ | 143,648 | $ | 443,726 | $ | 24,750 | $ | - | ||||||||||
|
Year ended December 31,
|
||||||||
|
Customer:
|
2011
|
2010
|
||||||
|
Customer A
|
14 | % | 0 | % | ||||
|
Customer B
|
12 | % | 22 | % | ||||
|
Customer C
|
11 | % | 0 | % | ||||
|
Customer D
|
7 | % | 12 | % | ||||
|
2011
|
2010
|
|||||||
|
Employment enrollment fee
|
- | 372 | ||||||
|
Compensated absences
|
29,287 | 18,755 | ||||||
|
Legal fees
|
52,000 | 16,000 | ||||||
|
Accounting fees
|
43,812 | 46,922 | ||||||
|
Sales commissions
|
930 | 18,025 | ||||||
|
Other
|
741 | 318 | ||||||
|
Total
|
$ | 126,770 | $ | 100,392 | ||||
|
·
|
pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company;
|
|
·
|
provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and
|
|
·
|
provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the company’s assets that could have a material effect on the financial statements.
|
|
Name
|
Age
|
Positions with
the Company
|
Director Since
|
Executive
Officer Since
|
||||
|
Tom Kubota
|
72
|
Chief Executive Officer, President and Chairman of the Board of Directors
|
Sept. 2000
|
Sept. 2000
|
||||
|
Fred Odaka
|
75
|
Chief Financial Officer and Secretary
|
Aug. 2008
|
|||||
|
David Wang
|
49
|
Independent Director
|
Nov. 2007
|
|||||
|
Thomas Iwanski
|
54
|
Independent Director
|
Nov. 2004
|
|||||
|
Lester L. Sacks
|
80
|
President, Medex Healthcare, Inc
|
||||||
|
Donald P. Balzano
|
66
|
President, Industrial Resolutions Coalition, Inc., President Medex Legal Support, Inc.
|
||||||
|
David Kim
|
38
|
Executive Vice President, Medex Healthcare, Inc.
|
||||||
|
Geri Plotzke
|
69
|
Vice President, Managed Care Services, Medex Healthcare, Inc.
|
||||||
|
Kathy Torres
|
62
|
Executive Vice President, Medex Managed Care, Inc.
|
| (i) Acting as a futures commission merchant, introducing broker, commodity trading advisor, commodity poll operator, floor broker, leverage transaction merchant, and other person regulated by the Commodity Futures Trading Commission (“CFTC”), or an associated person of any of the foregoing, or as an investment adviser, underwriter, broker or dealer in securities, or as an affiliate person, director or employee of any investment company, bank savings and loan association or insurance company, or engaging in or continuing any conduct or practice in connection with such activity; | |
| (ii) Engaging in any type of business practice; or | |
| (iii) Engaging in any activity in connection with the purchase or sale of any security or commodity or in connection with any violation of Federal or State securities laws or Federal commodities laws; |
|
(i) Any Federal or State securities or commodities law or regulations; or
|
|
|
(ii) Any law or regulation respecting financial institutions or insurance companies including, but not limited to, a temporary or permanent injunction, order of disgorgement or restitution, civil money penalty or temporary or permanent cease-and-desist order, or removal or prohibition order; or
|
|
|
(iii) Any law or regulation prohibiting mail or wire fraud or fraud in connection with any business entity; or
|
|
·
|
a statement that the writer is a shareholder (providing evidence if the person’s shares are held in street name) and is proposing a candidate for consideration;
|
|
·
|
the name and contact information for the candidate;
|
|
·
|
a statement of the candidate’s business and educational experience;
|
|
·
|
information regarding the candidate’s qualifications to be director, including but not limited to an evaluation of the factors discussed above which the board would consider in evaluating a candidate;
|
|
·
|
information regarding any relationship or understanding between the proposing shareholder and the candidate;
|
|
·
|
information regarding potential conflicts of interest; and
|
|
·
|
a statement that the candidate is willing to be considered and willing to serve as a director if nominated and elected.
|
|
Name and
Principal Position
|
Year
|
Salary
($)
|
Bonus
($)
|
All Other
Compensation
($)
|
Total
($)
|
||||||||||||||
|
Tom Kubota
|
2011
|
135,450 | -0- | 4,493 | (1) | 139,943 | |||||||||||||
|
Chief Executive Officer,
|
2010
|
111,150 | -0- | -0- | 111,150 | ||||||||||||||
|
President and Director, PHCO
|
|||||||||||||||||||
|
Fred Odaka
|
2011
|
86,250 | 10,000 | 5,264 | (1) | 101,514 | |||||||||||||
|
Chief Financial Officer, PHCO
|
2010
|
67,500 | -0- | -0- | 67,500 | ||||||||||||||
|
Dr. Lester Sacks
|
2011
|
96,000 | 20,000 | -0- | 116,000 | ||||||||||||||
|
President, Medex and MMC
|
2010
|
80,000 | -0- | -0- | 80,000 | ||||||||||||||
|
Donald Balzano
|
2011
|
-0- | 6,000 | 151,600 | (2) | 157,600 | |||||||||||||
|
President, IRC
|
2010
|
-0- | -0- | 153,664 | (2) | 153,664 | |||||||||||||
|
David Kim
|
2011
|
92,622 | 10,000 | 21,968 | (3) | 124,590 | |||||||||||||
|
Executive Vice President,
|
2010
|
90,364 | -0- | 8,000 | 98,364 | ||||||||||||||
|
Medex
|
|||||||||||||||||||
|
·
|
Mr. Kubota from $10,000 per month to $12,000 per month; and
|
|
·
|
Mr. Odaka from $5,400 per month to $7,700 per month.
|
|
·
|
Mr. Odaka - $10,000;
|
|
·
|
Dr. Sacks - $20,000;
|
|
·
|
Mr. Balzano - $6,000; and
|
|
·
|
Mr. Kim - $10,000.
|
|
Name
|
Fees Earned or Paid in Cash ($)
|
All Other
Compensation($)
|
Total
($)
|
|||||||||
|
Thomas Iwanski
|
3,450
|
(1)
|
1,000
|
(2)
|
4,450
|
|||||||
|
David Wang
|
3,450
|
(1)
|
1,000
|
(2)
|
4,450
|
|||||||
|
Type of Security
|
Name and Address
|
Amount & Nature of
Beneficial Ownership
|
% of Class
|
|||||||
|
Common
|
Tom Kubota(1)(2)
1201 Dove Street, Suite 300
Newport Beach, CA 92660
|
469,704 | 58.5 | % | ||||||
|
Common
|
Fred Odaka(1)
1201 Dove Street, Suite 300
Newport Beach, CA 92660
|
-0- | * | |||||||
|
|
||||||||||
|
Common
|
Lester Sacks(1)
1201 Dove Street, Suite 300
Newport Beach, CA 92660
|
-0- | * | |||||||
|
|
||||||||||
|
Common
|
Thomas Iwanksi(1)
1541 Amberwood Drive
Santa Ana, CA 92705
|
-0- | * | |||||||
|
|
||||||||||
|
Common
|
David Wang(1)
138 Ocean Way
Santa Monica, CA 90402
|
-0- | * | |||||||
|
|
||||||||||
|
Common
|
Donald P. Balzano(1) (3)
5422 Michelle Drive
Torrance, CA90503
|
54,165 | 6.8 | % | ||||||
|
|
||||||||||
|
Common
|
David Kim(1)
1201 Dove Street, Suite 300
Newport Beach, CA 92660
|
-0- | * | |||||||
|
Common
|
Nanko Investments, Inc.(2)
1280 Bison, Suite B9-596
Newport Beach, CA 92660
|
432,626 | 53.9 | % | ||||||
|
All executive officers and directors as a group (4 persons)
|
469,704 | 58.5 | % | |||||||
|
|
||||||||||
|
TOTAL
|
523,869 | 65.3 | % | |||||||
|
Plan category
|
Number of securities to be issued upon exercise of outstanding options, warrants and rights
|
Weighted-average exercise price of outstanding options, warrants and rights
|
Number of securities remaining available for future issuance under equity compensation plans (excluding securities reflected in column (a))
|
|||||||||
|
(a)
|
(b)
|
(c)
|
||||||||||
|
Equity compensation plans approved by security holders
|
0 | $ | 0.00 | 95,750 | ||||||||
|
Equity compensation
plans not approved by security holders
|
0 | $ | 0.00 | -0- | ||||||||
|
Total
|
0 | $ | 0.00 | 95,750 | ||||||||
|
2011
|
2010
|
|||||||
|
Audit
|
$
|
43,043
|
$
|
41,271
|
||||
|
Audit related
|
-0-
|
-0-
|
||||||
|
Tax
|
-0-
|
-0-
|
||||||
|
All other
|
-0-
|
900
|
||||||
|
Total
|
$
|
43,043
|
42,171
|
|||||
|
Exhibit No.
|
Exhibit Description
|
|
|
3.1
|
Articles of Incorporation and Amendments thereto
(1)
|
|
|
3.2
|
Bylaws
(1)
|
|
|
3.3
|
Bylaws
(2)
|
|
|
3.4
|
Articles of Amendment to Articles of Incorporation to effect 1 share for 50 shares reverse split
(3)
|
|
|
3.5
|
Articles of Amendment to Articles of Incorporation to effect 2.5 shares for 1 share forward split
(3)
|
|
|
4.1
|
Pacific Health Care Organization, Inc., 2002 Stock Option Plan
(1)
|
|
|
4.2
|
Pacific Health Care Organization, Inc., 2005 Stock Option Plan
(4)
|
|
|
14.1
|
Code of Ethics
(5)
|
|
|
21.1
|
||
|
31.1
|
||
|
31.2
|
||
|
32.1
|
||
|
32.2
|
||
| 101.INS | XBRL Instance Document** | |
| 101.SCH |
XBRL Taxonomy Extension Schema Document**
|
|
| 101.CAL |
XBRL Taxonomy Extension Calculation Linkbase Document**
|
|
| 101.DEF |
XBRL Taxonomy Definition Linkbase Document**
|
|
| 101.LAB |
XBRL Taxonomy Extension Label Linkbase Document**
|
|
| 101.PRE |
XBRL Taxonomy Extension Presentation Linkbase Document**
|
| * | Filed herewith |
| ** | Pursuant to Rule 406T of Regulation S-T, the Interactive Data Files on Exhibit 101 hereto are deemed not filed or part of a registration statement or prospectus for purposes of Section 11 or 12 of the Securities Act of 1933, as amended, are not deemed not filed for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and otherwise are not subject to liability under those sections. |
|
(1)
|
Incorporated by reference to Registrant’s Registration Statement on Form 10-SB as filed with the Commission on September 19, 2002.
|
|
|
(2)
|
Incorporated by reference to Registrant’s Registration Statement on Form 10-SB/A-2 as filed with the Commission on July 13, 2004.
|
|
|
(3)
|
Incorporated by reference to Registrant’s Proxy Statement on Schedule 14A as filed with the Commission on May 15, 2008.
|
|
|
(4)
|
Incorporated by reference to Registrant’s Proxy Statement on Schedule 14A as filed with the Commission on October 21, 2005.
|
|
|
(5)
|
Incorporated by reference to Registrant’s Annual Report on Form 10-KSB as filed with the Commission on April 17, 2007.
|
| PACIFIC HEALTH CARE ORGANIZATION, INC. | |||
|
Date: March 30, 2012
|
By:
|
/s/ Tom Kubota
|
|
|
Tom Kubota
|
|||
| Chief Executive Officer and President | |||
|
Signatures
|
Title
|
Date
|
||
|
/s/ Tom Kubota
|
Chief Executive Officer, President
|
March 30, 2012
|
||
|
Tom Kubota
|
and Director
|
|||
|
/s/ Fred U. Odaka
|
Chief Financial Officer
|
March 30, 2012
|
||
|
Fred U. Odaka
|
||||
|
/s/ Thomas Iwanski
|
Director
|
March 30, 2012
|
||
|
Thomas Iwanski
|
||||
|
/s/ David Wang
|
Director
|
March 30, 2012
|
||
|
David Wang
|
No information found
* THE VALUE IS THE MARKET VALUE AS OF THE LAST DAY OF THE QUARTER FOR WHICH THE 13F WAS FILED.
| FUND | NUMBER OF SHARES | VALUE ($) | PUT OR CALL |
|---|
| DIRECTORS | AGE | BIO | OTHER DIRECTOR MEMBERSHIPS |
|---|
No information found
No Customers Found
No Suppliers Found
Price
Yield
| Owner | Position | Direct Shares | Indirect Shares |
|---|