2023-11-13T09:35:20-06:00 2022-12-31 BDO USA 200 PARK AVENUE 38TH FLOOR NEW YORK NY 10166 990 2022-01-01 461496685 PARTNERS HEALTH PLAN INC % CHRISTOPHER MASI PART 6468444020 2500 Halsey Street Bronx NY 10461 CHRISTOPHER MASI CFO 6468834171 2023-11-11 true CHRISTOPHER MASI 999009999 Paul Hammerschmidt P01384178 2128858000 2 2022 2023-04-26 12:10:37Z KERRY ANN DELANEY-MASAWI 2500 Halsey Street Bronx NY 10461 302386327 false X WWW.PHPCARES.ORG X 2012 NY PARTNERS HEALTH PLAN, INC. IS A MISSION-DRIVEN, PERSON-CENTERED ORGANIZATION DEDICATED TO ASSISTING INDIVIDUALS IN PURSUING THE LIVES THEY CHOOSE. 11 11 0 12 0 0 0 0 286906906 302378949 536 653 523736 0 287431178 302379602 0 0 0 0 11294781 11823312 0 0 0 300557102 281299513 311851883 293122825 -24420705 9256777 49889991 76215193 128634399 145703286 -78744408 -69488093 X PARTNERS HEALTH PLAN ("PHP") IS A MANAGED CARE ORGANIZATION DEDICATED SOLELY TO PROVIDING SUPPORT AND SERVICES FOR ADULTS AGE 21 AND OLDER WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. PHP IS COMMITTED TO KEEPING MEMBERS AS HEALTHY AND AS INDEPENDENT AS POSSIBLE, SO THEY CAN LIVE THE LIFE THEY CHOOSE. PHP PROMOTES THE WELLNESS, SUPPORTS THE CHOICES, INTEGRATES THE SERVICES, RESPECTS THE DIVERSITY OF AND IMPROVES THE LIFE OF PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. false false 281699034 0 302378949 Effective April 1, 2016, The New York State Department of Health (NYDOH) Issued a Health Maintenance Organization Certificate of Authority, licensing Partners Health Plan (PHP) to operate a FIDA-IDD Plan in the five boroughs of New York City and Nassau, Suffolk, Westchester and Rockland Counties. In 2022 PHP provided a wide range of support services, including Medicaid, Medicare, Personal Care and those offered by the Office for People with Developmental Disabilities for approximately 1,690 dual Medicaid and Medicare eligible adults, age 21 and older, with intellectual and other developmental disabilities. 281699034 false false false false false false false false false false false false true true true true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false true 27 0 true 0 true false false false false false false false false false false false false X 11 11 false true false false true true true true true false false true true true true true true true true false NY X CHRISTOPHER MASI 6468834171 2500 HALSEY STREET BRONX NY 10461 X Kerry Ann Delaney-Masawi Chief Executive Officer 45.0 0.0 X 484072 0 30400 Christopher Masi Chief Financial Officer 45.0 0.0 X 244184 0 44167 Karleen Haines CHIEF-COMM. RELATIONS&OUTREACH 45.0 0.0 X 177109 0 48089 Tracy Corraro VP of Analytics 45.0 0.0 X 174625 0 40166 Diane Marrone Chief of Care Coordination 45.0 0.0 X 194983 0 11151 Premila Kumar VP- QUALITY PROG & INITIATIVES 45.0 0.0 X 195631 0 8566 Scott Doolan Asst. VP of Health Care Mgmt. 45.0 0.0 X 156279 0 17356 Michael Mascari Chairman of the Board 2.0 0.0 X X 0 0 0 Martin Boorstein Director and Treasurer 2.0 0.0 X X 0 0 0 Howard Jurist Director and Secretary 2.0 0.0 X X 0 0 0 Kevin Conroy Director 2.0 0.0 X 0 0 0 Howard Gold Director 2.0 0.0 X 0 0 0 Joshua Hirsch Director (thru 08/2022) 2.0 0.0 X 0 0 0 Alden Kaplan Director 2.0 0.0 X 0 0 0 Steve Logan Director 2.0 0.0 X 0 0 0 Robert Norris Director 2.0 0.0 X 0 0 0 John Sardelis Director 2.0 0.0 X 0 0 0 Tim Sullivan Director 2.0 0.0 X 0 0 0 Arthur Webb Director 2.0 0.0 X 0 0 0 1626883 0 199895 24 false true false HEALTHSMART BENEFIT SOLUTIONS 222 WEST LAS COLINAS BLVD SUITE 5 IRVING TX 75039 HEALTH PLAN MGMT 4675140 hMetrix 150 Monument Road Suite 600 BALA CYNWYD PA 19004 Data Analytics 735000 Care Design New York LLC 8 Southwoods Boulevard Suite 110 ALBANY NY 12211 ADMINISTRATIVE SVCS 705783 MEDIMPACT HEALTHCARE SYSTEMS INC 10181 SCRIPPS GATEWAY COURT SAN DIEGO CA 92131 PHARMACY BENEFIT MGT 381889 MEDISKED 850 UNIVERSITY AVENUE ROCHESTER NY 14607 CARE MGMT PLATFORM 222006 8 0 MEDICARE/MEDICAID 624200 302378949 302378949 302378949 718 718 0 0 0 0 0 6660 6725 -65 -65 -65 0 0 0 0 0 0 0 0 0 0 302379602 302378949 653 0 0 0 0 802823 120423 682400 0 0 8695804 5378263 3317541 305276 176722 128554 1313648 760461 553187 705761 408560 297201 6013923 116342 5897581 102227 102227 204172 204172 0 0 504 504 1075001 1075001 12658 12658 190427 93260 97167 3595 1761 1834 0 275095 134728 140367 30032 30032 0 6443 3730 2713 1156777 1156777 0 26103 26103 479833 52782 427051 MEDICAL CLAIMS 264124912 264124912 PHARMACY CLAIMS 9209399 9209399 PREMIUM DEFICIENCY RESERVE -1769000 -1769000 HIRING & RECRUITMENT 4661 4661 152751 152751 293122825 281699034 11423791 0 -24293561 10193329 15751 22412 0 0 33907216 24606647 0 0 0 0 0 0 0 0 400923 718555 0 0 90843 0 8339544 9098229 0 0 0 0 0 0 31429275 31576021 49889991 76215193 7750517 7055875 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120883882 138647411 128634399 145703286 X -78744408 -69488093 0 0 -78744408 -69488093 49889991 76215193 9256777 -462 X false true X true false RISK CORRIDOR RECEIVABLE 31575490 SECURITY DEPOSITS 531 31576021 0 MEDICAL CLAIMS PAYABLE 64748406 SUBORDINATED SURPLUS NOTES 66899005 PREMIUM DEFICIENCY RESERVES 7000000 138647411 X 302378636 -462 -462 302379098 504 504 302379602 293122321 293122321 504 504 293122825 PART X, LINE 2: AN ORGANIZATION MUST RECOGNIZE THE TAX BENEFIT ASSOCIATED WITH THE TAX POSITIONS TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. PARTNERS HEALTH PLAN, INC. DOES NOT BELIEVE IT HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, IT HAS NOT RECORDED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. PHP HAS FILED FOR AND RECEIVED INCOME TAX EXEMPTIONS IN THE JURISDICTIONS WHERE IT IS REQUIRED TO DO SO. ADDITIONALLY, PHP FILED INTERNAL REVENUE SERVICE FORM 990 INFORMATION RETURNS, AS REQUIRED, AND ALL OTHER APPLICABLE RETURNS IN JURISDICTIONS WHERE SO REQUIRED. AS OF DECEMBER 31, 2022, PHP WAS NOT SUBJECT TO ANY EXAMINATION BY A TAXING AUTHORITY. PART XI & PART XII: IN 2018 PARTNERS HEALTH PLAN, INC. BEGAN FINANCIAL STATEMENT REPORTING ON THE STATUTORY BASIS, CONSISTENT WITH ITS OPERATIONS AS AN INSURANCE COMPANY AND DESIRED BY INSURANCE INDUSTRY REGULATORS. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES ("GAAP") BASIS AUDITED FINANCIAL STATEMENTS WERE DISCONTINUED BEGINNING IN 2018. AT THIS TIME PARTNERS HEALTH PLAN, INC. WILL CONTINUE TO REPORT FORM 990 UNDER GAAP WITH NO CHANGE IN ACCOUNTING METHOD FOR TAX REPORTING. FORM 990, SCHEDULE D, PARTS XI AND XII, RECONCILIATION OF INCOME AND EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH FORM 990 WERE PREPARED ON GAAP BASIS. X X X false false false false false false false true false Kerry Ann Delaney-Masawi Chief Executive Officer 409072 0 75000 0 0 0 26502 0 3898 0 514472 0 0 0 Christopher Masi Chief Financial Officer 242184 0 2000 0 0 0 10293 0 33874 0 288351 0 0 0 Karleen Haines CHIEF-COMM. RELATIONS&OUTREACH 175109 0 2000 0 0 0 5584 0 42505 0 225198 0 0 0 Diane Marrone Chief of Care Coordination 192983 0 2000 0 0 0 7850 0 3301 0 206134 0 0 0 Premila Kumar VP- QUALITY PROG & INITIATIVES 193631 0 2000 0 0 0 7119 0 1447 0 204197 0 0 0 Tracy Corraro VP of Analytics 172625 0 2000 0 0 0 7512 0 32654 0 214791 0 0 0 Scott Doolan Asst. VP of Health Care Mgmt. 154279 0 2000 0 0 0 6277 0 11079 0 173635 0 0 0 PART I, LINE 7: SCHEDULE J, PART II, COLUMN (B)(II) REPORTS DISCRETIONARY INCENTIVE AMOUNTS THAT WERE APPROVED BY THE BOARD BASED UPON PERFORMANCE. Form 990, Part I, Line 5 and Part V, Line 2a: Effective January 1, 2022 payroll and benefits were paid by Care Design New York LLC ("CDNY") (EIN 36-4875879) on behalf of Partners Health Plan, Inc. CDNY is a not-for-profit public charity organized and operating under Internal Revenue Code section 501(c)(3) that provides care coordination organization/health home (CCO/HH), whose mission is to help individuals with Intellectual/Developmental Disabilities lead a quality life. See Schedule O explanation to Form 990, Part VI, Line 3 for additional detail. Form 990, Part VI, Section A, Line 3: In March 2021, Partnerships for Healthcare Solutions, Inc. (Partnerships), the sole member of PHP, formed Partners in Management and Administrative Solutions, Inc. (PMAS). PMAS is a for-profit management services organization of which Partnerships is the sole shareholder. Among other business purposes, PMAS was organized to perform administrative functions for both PHP and Care Design New York LLC (CDNY). In conjunction with the establishment of PMAS in 2021, effective January 1, 2022 PHP staff responsible for the performance of PHP administrative functions were migrated to the employment by PMAS. Concurrent with that transition, PHP staff responsible for delivering care management services to PHP members migrated to the employment by CDNY. Accordingly, contractual arrangements were established with each respective affiliate to govern the services and payment terms associated with staff formerly employed directly by PHP as of December 31, 2021. FORM 990, PART VI, SECTION A, LINE 6: PARTNERS HEALTH PLAN, INC. HAS ONE SOLE CORPORATE MEMBER WHICH IS PARTNERSHIPS FOR HEALTHCARE SOLUTIONS, INC. PARTNERSHIPS FOR HEALTHCARE SOLUTIONS, INC. IS A NEW YORK NOT-FOR-PROFIT CORPORATION WHICH HAS THREE CORPORATE MEMBERS, PHSI, INC., ADAPT COMMUNITY NETWORK (FORMERLY KNOWN AS UNITED CEREBRAL PALSY OF NEW YORK CITY), AND BUILDING SOLUTIONS FOR TOMORROW, INC., ALL NEW YORK NON-PROFIT ORGANIZATIONS. IN NOVEMBER 2019, PARTNERSHIPS FOR HEALTHCARE SOLUTIONS, INC. BECAME THE SOLE MEMBER OF CARE DESIGN NY, LLC, A NEW YORK NON-PROFIT ORGANIZATION. IN CONJUNCTION WITH THIS TRANSACTION, BUILDING SOLUTIONS FOR TOMORROW, INC. ACQUIRED CERTAIN PARTNERS HEALTH PLAN, INC. AND PARTNERSHIPS FOR HEALTHCARE SOLUTION, INC. GOVERNANCE AND FINANCIAL RIGHTS AND OBLIGATIONS. BUILDING SOLUTIONS FOR TOMORROW, INC. ALSO ACQUIRED THE RIGHT TO APPOINT ONE DIRECTOR TO THE PARTNERS HEALTH PLAN, INC. BOARD. FORM 990, PART VI, SECTION A, LINE 7A: THE BOARD MEMBERS OF PARTNERS HEALTH PLAN, INC. ARE APPOINTED BY ITS PARENT, PARTNERSHIPS FOR HEALTHCARE SOLUTIONS, INC. FORM 990, PART VI, SECTION A, LINE 7B: AMENDMENTS TO ORGANIZATION BY-LAWS AND RESTRUCTURING OF DEBT ARE SUBJECT TO APPROVAL BY MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B: FORM 990 IS PREPARED BY A NATIONALLY RECOGNIZED ACCOUNTING FIRM IN CONJUNCTION WITH THE ORGANIZATION'S FINANCIAL DEPARTMENT. DRAFT FORM 990 IS REVIEWED BY THE ORGANIZATION'S CFO AND THEN PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS IN DRAFT VIA ELECTRONIC MAIL, WITH AN OPPORTUNITY FOR THEM TO COMMENT OR MAKE INQUIRY BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C: EACH DIRECTOR AND OFFICER OF THE ORGANIZATION SHALL ANNUALLY SIGN A CERTIFICATE SETTING FORTH ANY INTERESTS OR RELATIONSHIPS THAT EXIST WITH ANY PARTY WITH WHICH THE ORGANIZATION IS, OR IS CONTEMPLATING, TRANSACTING BUSINESS, AND CERTIFYING THAT NO OTHERS EXIST. SUCH PROCEDURE IS ALSO PERFORMED WHEN ENTERING THE INITIAL EMPLOYMENT WITH THE ORGANIZATION. FURTHERMORE, EACH SUCH PERSON WILL BE UNDER A CONTINUING OBLIGATION TO DISCLOSE TO THE CHAIR OF THE ORGANIZATION IN WRITING ANY SUCH INTERESTS OR RELATIONSHIPS THAT MAY ARISE AND HAVE NOT YET BEEN DISCLOSED IN THE ANNUAL CERTIFICATE. THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15: IN CONJUNCTION WITH THE FULL BOARD, A REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION IS PERFORMED BY THE COMPENSATION COMMITTEE OF THE BOARD. INPUT IS ACQUIRED BY INDEPENDENT BOARD MEMBERS WITH SPECIFIC INDUSTRY EXPERIENCE AND KNOWLEDGE. IN ADDITION, MARKET-BASED MAY BE ACQUIRED AND UTILIZED BY THE COMPENSATION COMMITTEE DURING THE REVIEW PROCESS TO VALIDATE COMPENSATION AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PARTNERSHIPS FOR HEALTHCARE SOLUTIONS 655 THIRD AVENUE FL 2 NEW YORK NY 10017 463808560 HEALTHCARE NY 501(C)(4) N/A PHSI INC false PHSI INC 655 THIRD AVENUE FL 2 NEW YORK NY 10017 463311164 HEALTHCARE NY 501(C)(4) N/A NA false ADAPT COMMUNITY NETWORK 80 MAIDEN LANE 8TH FLOOR NEW YORK NY 10038 135654532 HEALTHCARE NY 501(C)(3) 7 NA false CARE DESIGN NY LLC 8 Southwoods Blvd Ste 110 ALBANY NY 12211 364875879 HEALTHCARE NY 501(C)(3) 7 PARTNERSHIPS false Building Solutions for Tomorrow Inc 8 Southwoods Blvd Ste 110 Albany NY 12211 000000000 HEALTHCARE NY 501(c)(3) 7 NA false Partners in Management and Administrativ 2500 HALSEY STREET BRONX NY 10461 870999291 administrative NY PARTNERSHIPS C corp 0 0 0.00000 false false false false false false false false false false false true false false true true false false false false CARE DESIGN NY LLC k, N, 705783 COST Form 990, Schedule R, Part V, Line 1N and O: PARTNERS HEALTH PLAN, INC. AND CARE DESIGN NY, LLC NEGOTIATED AN ADMINISTRATIVE SERVICES AGREEMENT (ASA) THAT GOVERNS THE RELATIONSHIP AND SHARED RESOURCES BETWEEN THEM, AS WELL AS ESTABLISH PRICING AND PAYMENT TERMS. THE ASA WILL COVER PROVIDING EXECUTIVE EXPERTISE, ASSISTANCE WITH FUNCTIONAL PLAN OPERATIONS, ADMINISTRATIVE SERVICES AND SHARED WORKSPACE AND LEASED PROPERTY. THE ASA MAY ALSO COVER PROVIDING CARE MANAGEMENT SERVICES, AND ANY ACTIVITIES ASSOCIATED WITH PROVIDING SUCH SERVICE, IN ACCORDANCE WITH THE REQUIREMENTS OF BOTH THE FEDERAL AND STATE MANAGED CARE PROGRAM. COSTS FOR PERSONNEL SERVICES WILL BE CHARGED FOR THE DIRECT COST OF SALARY AND FRINGE BENEFIT EXPENSES BASED ON ACTUAL HOURS FURNISHED AND OTHER THAN PERSONNEL SERVICES OF CDNY USED IN CONNECTION WITH PERFORMANCE OF THE SERVICES UNDER THIS AGREEMENT SHALL BE CHARGED TO PHP AT COST. GIVEN THE NATURE OF THE THEIR RELATIONSHIP THE NEGOTIATED ASA WAS SUBMITTED TO NEW YORK STATE DEPARTMENT OF HEALTH AND APPROVED.