UNIVERSITY OF LOUISVILLE BOARD OF TRUSTEES CONFLICT OF INTEREST STATEMENT
YEAR 7/1/2015 6/30/2016

Organization UNIVERSITY OF LOUISVILLE
Name oflndividual Laurencen .Benz

Signature

 

 

Business Transaction with UofL

1. Other than an employment relationship, do you or a family member conduct business with the UofL?
Business transactions include, but are not limited to contracts of sale, lease, license and performance
of services, whether initiated during the UofL tax year or ongoing from a prior year. Business
transactions also includejoint ventures in which either the profits or capital interest of the UofL and
of the interested person exceeds 10%.

As an owner of freestanding outpatient physical therapy locations, ProRehab Louisville Confluent Health
contract with 3rd party payors Anthem, Humana) and 3rd party administrators AO N, Gallagher
Bassett) who in turn may or may not have a direct relationship to University of Louisville health, worker?s
comp insured, or disease management recipients. There is no direct relationship with UL and ProRehab
Louisville or Confluent Health.

1. Do you or a family member own 35% of an entity (C?corporation, S-corporation, Partnership, LLC or
other entity type(s), directly or indirectly, that conducts business with the UofL?

If ?Yes,? describe your business transaction(s) with the UofL:

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2.

Do you or a family member, in combination with other "interested person(s)" own 35% of an
entity (C-corporation, S-corporation, Partnership, LLC or other entity type), directly or indirectly,
that conducts business with the UofL?

If ?Yes,? describe your business transaction(s) with the UofL:

Do you or a family member, serve as an officer, director, trustee, or key employee or an entity
that does business with the UofL?

- If ?Yes,? describe your business transaction(s) with the UofL:

Do you or a family member serve as a partner, member, or shareholder of an entity (with
ownership interest in excess of 5% of a partnership or professional corporation) that conducts
business with the UofL?

If ?Yes,? describe your business transactionls) with the UofL:

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5. Did a family member receive a compensation payment in excess of $10,000 from the UofL? 

If ?Yes," explain:

6. Did you or a family member receive grants or other assistance, including provision of goods,
services, or use of facilities from the UofL? Grants include scholarships, fellowships, internships,
prizes, and awards. 

*My daughter is currently a graduate student in MAT program but she receives no scholarships

7. Do you have 35% control in an entity that received grants or other assistance, including provision 
of goods, services, or use of facilities from the UofL?

If "Yes," explain:

8. Do you have any loans to or from the UofL? l:l

If "Yes," explain.

9. Are you aware of any excess benefit transactions to report? An excess benefit transaction is 
where the UofL directly or indirectly provided an economic benefit where the value of the
benefit exceeds the value of the consideration received by the UofL.

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 If "Yes," explain.

Busineg and Family Relationships with Interested Persons

 

10. Do you have a family or business relationship with any other officer, director, trustee, or key
employee of the UofL?

For each family and business relationship, identify the persons and indicate family or business
relationship.

Building partnership at an Elizabethtown healthcare center with multiple partners including Trustee Dr.
Jody Prather

Through one of my I am a small investor in TNG Pharmaceuticals which I believe ULF is an investor
through one of their holdings

PT Development LLC which I wholly own is a member of an aviation partnership, LNB Sky LLC. LNB Sky is a
member of a syndicate of companies that may have some very small overlapping ownership with
principles of 21C.

Confluent Health is an owner of Evidence in Motion who is a minority partner and provides management
services to NeuroRecovery Training Institute (NRTI) which provides training to physical therapists and
other in activity based therapy. To the extent that either are considered ?key em ployees? of UL, Dr. Susie
Harkema and Dr. Andrea Behrman have an LLC (with others) that is also a minority investor in
NeuroRecovery Training Institute. There is no business relationship between NRTI and UL.

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