2022-12-07T08:32:43-06:00 2021-12-31 FORVIS LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2021-01-01 760495152 Community Health Choice Inc % ANNA MATEJA COMM 7132952222 2636 S Loop West Ste 125 Houston TX 77054 Lisa Wright CEO 7132952222 2022-11-15 true Lisa Wright XXX-XX-XXXX Amanda Maya P01067777 7134994600 2022-11-15 2 2021 2022-09-23 18:48:47Z X LISA WRIGHT 2636 South Loop West Suite 125 Houston TX 77054 794944240 false X www.communityhealthchoice.org X 1996 TX THE OPERATION OF A HEALTH MAINTENANCE ORGANIZATION OFFERING HEALTH INSURANCE EXCHANGE THAT PROVIDES PRE-PAID MEDICAL & DENTAL CARE. 9 9 176 9 0 0 0 0 705949752 794938214 212002 6026 0 0 706161754 794944240 0 0 0 0 17382144 14047347 0 0 0 679240409 796488343 696622553 810535690 9539201 -15591450 220623046 271208373 128099944 194429938 92523102 76778435 X TO IMPROVE THE HEALTH OF THE UNDERSERVED RESIDENTS OF SOUTHEAST TEXAS BY PROVIDING ACCESS TO COORDINATED, HIGH QUALITY, AFFORDABLE, HEALTHCARE SERVICES. OUR MISSION IS ACHIEVED THROUGH: 1) COMMUNITY: COLLABORATING WITH COMMUNITY - BASED PROVIDERS & ORGANIZATIONS TO IMPROVE ACCESS, QUALITY, COORDINATION AND COST-EFFECTIVENESS OF SERVICES. 2) HEALTH: DEVELOPING PROGRAMS TO ESTABLISH MEDICAL HOMES, MANAGE HEALTH CONDITIONS, AND PROMOTE WELLNESS AND PREVENTIVE CARE. 3) CHOICE: ENCOURAGING PERSONAL ACCOUNTABILITY AND EDUCATED CHOICES FOR INDIVIDUAL AND FAMILY HEALTH. false false 780792320 794938214 COMMUNITY HEALTH CHOICE, INC. ISSUES HEALTH PLANS FOR NINE SOUTHEAST TEXAS COUNTIES IN THE FEDERALLY-FACILITATED HEALTHCARE INSURANCE MARKETPLACE FOR THE STATE OF TEXAS. PART OF CHCI'S MISSION IS TO SERVE THE UNINSURED POPULATION IN SOUTHEAST TEXAS. TEXAS HAS THE LARGEST NUMBER OF RESIDENTS WITHOUT MEDICAL COVERAGE IN THE ENTIRE COUNTRY. ONE OF CHCI'S MARKETING GOALS IS TO PROVIDE COVERAGE TO THE PARENTS OF THE CHILDREN ENROLLED IN CHCT'S CHIP PROGRAM THROUGH MARKETPLACE PLANS. THE HEALTHCARE INSURANCE MARKETPLACE HAD 84,090 COVERED LIVES AS OF DECEMBER 31, 2021. 780792320 false false false false false false false false false false false false true true false 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 true true false true X 134 0 true 176 true false false false false false false false false X 9 9 false true false false false true true true false false false true true true true true true true true false X ANNA MATEJA 7132954791 2636 SOUTH LOOP W SUITE 125 HOUSTON TX 77054 X LISA WRIGHT PRESIDENT & CEO 8.0 32.0 X 119571 478283 35718 VERNICKA PORTER-SALES CHIEF MED. OFC (THRU 12/29/21) 8.0 32.0 X 76832 307327 36052 LAURIE LEVERMANN CHIEF INFORMATION OFFICER 8.0 32.0 X 66353 265414 36380 PAMELA HELLSTROM CHIEF COMPLIANCE OFFICER 8.0 32.0 X 66188 264755 20716 VALERIE BAHAR ASSOCIATE MEDICAL DIRECTOR 8.0 32.0 X 61511 246050 19988 MARK VAN ELDEN CFO (THRU 09/24/2021) 8.0 32.0 X 57612 230448 28010 DAISY MORALES VP - COMMUNITY AFFAIRS 8.0 32.0 X 50918 203671 30711 SEBRINA ALLISON VP, MEDICAL AFFAIRS 8.0 32.0 X 49321 197284 19723 TAYLOR COOPER VP & GENERAL COUNSEL 8.0 32.0 X 44899 179595 15577 RACHAEL ROBERTS ASSOC MEDICAL DIRECTOR 8.0 32.0 X 42881 171523 12432 WILLIAM GIBULA ACTUARY DIRECTOR 8.0 32.0 X 38534 154134 28340 ANDREA LOPEZ DIR SPECIAL INVESTIGATION UNIT 8.0 32.0 X 40190 160757 19140 TREVAN ROSS CHIEF HR (THRU 03/01/2021) 8.0 32.0 X 40795 163182 4708 VERNISHA SAVOY DIR. COMPLIANCE, FED PROGRAMS 8.0 32.0 X 34715 138862 26650 JOHN HALEY CHIEF OPERATIONS OFFICER 8.0 32.0 X 36715 146862 8811 RAY MCCOMB CHIEF HR/ADMIN OFFICER 8.0 32.0 X 34715 138862 11361 SONYA MADDOX CHIEF GROWTH OFFICER 8.0 32.0 X 14615 58462 3781 RAYMOND J KHOURY BOARD MEMBER 1.0 1.0 X 0 0 0 JOSE GARCIA JR SECRETARY OF THE BOARD 1.0 3.0 X X 0 0 0 ELENA M MARKS BOARD MEMBER 1.0 1.0 X 0 0 0 VIVIAN HO BOARD MEMBER 1.0 1.0 X 0 0 0 STEPHEN MCKERNAN BOARD MEMBER 1.0 1.0 X 0 0 0 VICKI KEISER CHAIRMAN OF THE BOARD 2.0 6.0 X X 0 0 0 ANNE CLUTTERBUCK VICE CHAIRMAN OF THE BOARD 1.0 3.0 X X 0 0 0 DR ARTHUR BRACEY BOARD MEMBER 1.0 1.0 X 0 0 0 RODNEY LENFANT BOARD MEMBER (APPT 5/19/21) 1.0 1.0 X 0 0 0 876365 3505471 358098 23 false true false MEMORIAL HERMANN HEALTH SYSTEM 929 Gessner Rd 2700 HOUSTON TX 77024 MEDICAL SERVICES 100126307 THE METHODIST HOSPITAL 6565 Fannin St HOUSTON TX 77030 MEDICAL SERVICES 63132423 NAVITUS HEALTH SOLUTIONS 12301 Research Blvd Plaza V Suite AUSTIN TX 78759 PHARMACY SERVICES 151306193 HARRIS HEALTH 4800 Fournace Place BELLAIRE TX 77401 MEDICAL SERVICES 83313593 ST LUKES EPISCOPAL HOSPITAL 1101 BATES AVE HOUSTON TX 77030 MEDICAL SERVICES 21746862 387 0 Net Premium Revenue 524114 794444553 794444553 Other revenue 900099 493661 493661 794938214 6026 6026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 794944240 794938214 6026 0 0 0 0 708845 567076 141769 0 9942071 7953657 1988414 601679 481343 120336 2029498 1623598 405900 765254 612203 153051 0 1702058 1702058 66746 66746 0 0 0 22433465 7274342 15159123 169885 169885 1366667 1366667 3010242 3010242 0 433906 433906 11142 11142 0 6518 6518 1153851 1153851 0 0 99322 99322 Medical Claims Expense 716396428 716396428 CMS User Fees 19064173 19064173 COMMISION EXPENSE 13688407 13688407 Premium & Maintenance Taxes 10056474 10056474 6829059 3074619 3754440 810535690 780792320 29743370 0 0 0 79853459 47542290 0 0 116954321 198459631 0 0 0 0 0 0 0 0 0 295397 0 0 0 0 0 0 0 0 0 0 23815266 24911055 220623046 271208373 8242142 4778044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119857802 189651894 128099944 194429938 X 0 0 15000000 15000000 77523102 61778435 92523102 76778435 220623046 271208373 X -15591450 -14547 -138670 X X false true X true false Reinsurance Receivable 211636 Interest receivable 26 Health Care receivable 24699393 24911055 0 Health Policy Reserve 13225562 Intercompany payables 75338660 Deferred Premium Revenue 15110376 Medical Claims Payable 73503024 Affordable Care Act Liabilities 11320421 Interest Payable 1153851 189651894 791500297 -14547 -2935735 -2950282 794450579 493661 493661 794944240 807106294 -493661 -493661 807599955 2935735 2935735 810535690 SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Reinsurance expense included in audit revenue ($ 2,935,735) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Operating revenue included in audit expense $ 493,661 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Operating revenue included in audit expense ($ 493,661) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Reinsurance expense included in audit revenue $ 2,935,735 SCHEDULE D, PART X, LINE 2 INCOME TAX LIABILITIES THE COMPANY IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE COMPANY IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. X X true false false false false false false false false DAISY MORALES VP - COMMUNITY AFFAIRS 42686 170742 8232 32929 0 0 2134 8537 4008 16032 57060 228240 0 0 PAMELA HELLSTROM CHIEF COMPLIANCE OFFICER 51736 206946 13940 55762 512 2047 1675 6702 2468 9871 70331 281328 0 0 LAURIE LEVERMANN CHIEF INFORMATION OFFICER 54286 217144 12067 48270 0 0 2714 10858 4562 18246 73629 294518 0 0 VALERIE BAHAR ASSOCIATE MEDICAL DIRECTOR 52999 211998 7905 31622 607 2430 1642 6566 2356 9424 65509 262040 0 0 TAYLOR COOPER VP & GENERAL COUNSEL 36506 146025 8393 33570 0 0 1825 7302 1290 5160 48014 192057 0 0 LISA WRIGHT PRESIDENT & CEO 101077 404307 16934 67736 1560 6240 2785 11142 4358 17433 126714 506858 0 0 VERNICKA PORTER-SALES CHIEF MED. OFC (THRU 12/29/21) 70806 283224 6026 24103 0 0 2900 11600 4310 17242 84042 336169 0 0 SEBRINA ALLISON VP, MEDICAL AFFAIRS 39002 156008 10319 41276 0 0 1950 7800 1995 7978 53266 213062 0 0 MARK VAN ELDEN CFO (THRU 09/24/2021) 49748 198991 7864 31457 0 0 2403 9613 3199 12795 63214 252856 0 0 JOHN HALEY CHIEF OPERATIONS OFFICER 36615 146462 100 400 0 0 0 0 1762 7049 38477 153911 0 0 RAY MCCOMB CHIEF HR/ADMIN OFFICER 34615 138462 100 400 0 0 935 3738 1338 5350 36988 147950 0 0 TREVAN ROSS CHIEF HR (THRU 03/01/2021) 10290 41160 10005 40022 20500 82000 515 2058 427 1708 41737 166948 0 0 WILLIAM GIBULA ACTUARY DIRECTOR 32827 131306 5707 22828 0 0 1642 6566 4026 16106 44202 176806 0 0 ANDREA LOPEZ DIR SPECIAL INVESTIGATION UNIT 35485 141938 4705 18819 0 0 1774 7097 2054 8215 44018 176069 0 0 RACHAEL ROBERTS ASSOC MEDICAL DIRECTOR 42404 169615 100 400 377 1508 1170 4681 1316 5265 45367 181469 0 0 VERNISHA SAVOY DIR. COMPLIANCE, FED PROGRAMS 34615 138462 100 400 0 0 1592 6369 3738 14951 40045 160182 0 0 SCHEDULE J, PART I, LINE 3 THE COMPENSATION OF THE PRESIDENT/CEO OF THE ORGANIZATION IS REVIEWED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH CHOICE AND HCHD ANNUALLY. THE COMPENSATION OF ALL OTHER EXECUTIVE EMPLOYEES IS SUBJECT TO THE GUIDELINES AND MERIT RAISE PROCESS OF COMMUNITY HEALTH CHOICE. IN EARLY 2022, AN EXTERNAL COMPENSATION CONSULTING FIRM ASSISTED CHC IN EVALUATING EXECUTIVE EMPLOYEE COMPENSATION AGAINST MARKET BENCHMARKING FOR HEALTH INSURANCE PLAN COMPANIES. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENT: TREVAN ROSS RECEIVED A SEVERANCE PAYMENT TOTALLING $102,500 IN CALENDAR YEAR 2021 FROM BOTH CHCI AND CHCT. FORM 990, PART V, LINES 1A & 2A SALARIES REFLECTED ON FORM 990, PART IX, LINES 5 AND 7 WERE ALLOCATED TO CHCI BY THE HARRIS COUNTY HOSPITAL DISTRICT (HCHD) (FEIN: 76-0408224) AND THEY ARE REFLECTED ON THE FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, OF HCHD. CHCI REIMBURSED HCHD FOR THE SALARIES, AND ALL OTHER EXPENSES INCURRED ON BEHALF OF CHCI. THE NUMBER OF FORMS 1099 AND FORMS W-2 FILED FOR THE YEAR IS REPORTED AS 134 AND 176, RESPECTIVELY. FORM 990, PART VI, SECTION A, LINES 7A & 7B HARRIS COUNTY HOSPITAL DISTRICT (HCHD) HAS CERTAIN ENUMERATED RESERVED POWERS OVER THE GOVERNING BOARD OF COMMUNITY HEALTH CHOICE, INC. (CHCI). THE GOVERNING BODY IS PROHIBITED FROM TAKING FINAL ACTION ON THE FOLLOWING WITHOUT THE APPROVAL BY RESOLUTION OF THE HCHD BOARD OF MANAGERS: 1. ADOPTION, AMENDMENT, OR REVOCATION OF THE BYLAWS OF CHCI; 2. ADOPTION, AMENDMENT, OR REVOCATION OF THE ARTICLES OF INCORPORATION OF CHCI; 3. APPOINTMENT OR REMOVAL OF DIRECTORS OF CHCI; 4. ADOPTION, AMENDMENT, OR REVOCATION OF CHCI'S PURCHASING MANUAL; 5. ADOPTION, AMENDMENT, OR REVOCATION OF CHCI'S PERSONNEL POLICIES; 6. ADOPTION, AMENDMENT, OR REVOCATION OF CHCI'S FINANCIAL POLICIES; 7. ADOPTION OF CHCI'S ANNUAL OPERATING AND CAPITAL BUDGETS; 8. ANY DEVIATION OF 10% OR MORE FROM CHCI'S ANNUAL OPERATING BUDGET OR $50,000 FROM CHCI'S ANNUAL CAPITAL BUDGET; 9. ANY TRANSACTION INVOLVING REAL PROPERTY; 10. ANY MORTGAGE, ENCUMBRANCES, OR DEBT OF CHCI IN EXCESS OF $50,000; 11. THE SALE OR OTHER DISPOSITION OF PROPERTY OF ANY KIND EXCEEDING $25,000; 12. THE PURCHASE OR ACQUISITION OF PROPERTY OF ANY KIND BY CHCI EXCEEDING $200,000 AND NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHCI'S ANNUAL OPERATING AND CAPITAL BUDGET; 13. ALL PAYMENTS OTHER THAN PURCHASES, INCLUDING GUARANTEES AND GRANTS THAT ARE NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHCI'S ANNUAL OPERATING AND CAPITAL BUDGETS; 14. ANY ACTION TO AMEND OR ENLARGE THE SERVICE AREA OF CHCI'S CERTIFICATE OF AUTHORITY TO DO BUSINESS AS A HEALTH MAINTENANCE ORGANIZATION IN THE STATE OF TEXAS; 15. ANY MERGER, AFFILIATION, DISSOLUTION, OR OTHER DISPOSITION OF CHCI. FORM 990, PART VI, SECTION A, LINE 8B COMMUNITY HEALTH CHOICE, INC. DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THEREFORE, NO DOCUMENTATION OF COMMITTEE MEETINGS WAS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGES A PAID PREPARER, EXPERIENCED IN THE PREPARATION OF THE FORM 990, TO PREPARE THE FORM. MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO HELP COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. ONCE PREPARED, IT IS REVIEWED BY THE ORGANIZATION'S CONTROLLER AND THEN AGAIN BY THE CHIEF FINANCIAL OFFICER. A COPY OF THE RETURN IS THEN MAILED OR EMAILED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS IN ANNUAL STATEMENTS. THE CHIEF COMPLIANCE OFFICER OF THE ORGANIZATION THEN REVIEWS THE ANNUAL STATEMENTS BEFORE SENDING TO THE HARRIS COUNTY HOSPITAL DISTRICT CORPORATE COMPLIANCE DEPARTMENT FOR FURTHER REVIEW OF THE ANNUAL CONFLICT OF INTEREST STATEMENTS. IF AT THE CONCLUSION OF THE INVESTIGATION IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THE CHIEF COMPLIANCE OFFICER, THE CHIEF LEGAL OFFICER, AND APPROPRIATE MEMBERS OF CHC ADMINISTRATION WILL DETERMINE HOW BEST TO ADDRESS OR MANAGE THE COI AND DETERMINE WHETHER MITIGATING STRATEGIES MAY BE IMPLEMENTED. FORM 990, PART VI, SECTION B, LINES 15A & 15B THE COMPENSATION OF THE PRESIDENT/CEO OF THE ORGANIZATION IS REVIEWED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH CHOICE AND HCHD ANNUALLY. THE COMPENSATION OF ALL OTHER EXECUTIVE EMPLOYEES IS SUBJECT TO THE GUIDELINES AND MERIT RAISE PROCESS OF COMMUNITY HEALTH CHOICE. IN EARLY 2022, AN EXTERNAL COMPENSATION CONSULTING FIRM ASSISTED CHC IN EVALUATING EXECUTIVE EMPLOYEE COMPENSATION AGAINST MARKET BENCHMARKING FOR HEALTH INSURANCE PLAN COMPANIES. FORM 990, PART VI, SECTION C, LINE 19 AS A SUBSIDIARY OF THE HARRIS COUNTY HOSPITAL DISTRICT (A SUBSIDIARY OF HARRIS COUNTY, TEXAS), ALL DOCUMENTS AND POLICIES ARE PART OF THE PUBLIC RECORD AND ARE THEREFORE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 RECONCILIATION OF NET ASSETS OTHER CHANGES IN NET ASSETS: CHANGE IN NONADMITTED ASSETS $ (138,670) FORM 990, PART VII, SECTION A The organization's payroll is processed by and reported on Forms W-2 & W-3 of related organization Harris County Hospital District (HCHD). CHCI reimburses HCHD for salaries and expenses incurred on behalf of CHCI and related organization CHCT and then allocates the related portion of payroll expenses to CHCT. Part VII compensation is therefore reported 20% paid by CHCI and 80% paid by CHCT in an effort to report according to the related salary expense. FORM 990, PART VI, LINE 3 THE CFO AND ACCOUNTING MANAGER ROLES WERE OUTSOURCED TO AN OUTSIDE FINANCE FIRM, BODWELL VASEK WELLS DESIMONE, WHILE THESE ROLES WERE IN TRANSITION. THE AMOUNT PAID FOR THESE SERVICES DURING THE YEAR WAS $86,572 FOR SERVICES TO BOTH CHCI AND RELATED ORGANIZATION, CHCT. FORM 990, ITEM B FORM 990 ITEM B AMENDED RETURN THE ORGANIZATION IS AMENDING FORM 990 TO UPDATE A COMPENSATION DISCLOSURE. THE FOLLOWING ITEM HAS BEEN CHANGED FROM THE ORIGINALLY FILED RETURN: - SCHEDULE J, PART III, SUPPLEMENTAL INFORMATION FOR PART I, LINE 3 HARRIS COUNTY HOSPITAL DISTRICT 2525 HOLLY HALL HOUSTON TX 77054 741536936 HEALTH CARE TX NA false COMMUNITY HEALTH CHOICE TEXAS INC 2636 S LOOP WEST SUITE 125 HOUSTON TX 77054 814077507 INSURANCE TX 501(C)(4) HCHD true false false false false true false false false false false false false true true true true true true false COMMUNITY HEALTH CHOICE TEXAS INC P 386169 BOOK VALUE COMMUNITY HEALTH CHOICE TEXAS INC E 62679133 BOOK VALUE