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PRIORITY HEALTH CHOICE INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
PRIORITY HEALTH CHOICE INC (EIN 32-0016523)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-10-15
IRS object ID
202142889349300644
Schema version
2020v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-10-15T11:30:56-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135381590PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 Ottawa Ave NW Suite 300AddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49503ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN320016523EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Priority Health Choice IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPRIOBusinessNameControlTxt
Phone6167745083PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11231 East Beltline NEAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49525ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNick GatesPersonNm
Person TitleSVP, FinancePersonTitleTxt
Signature2021-10-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstNickPersonFirstNm
Person LastGatesPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJacob CookPreparerPersonNm
PTINP01240455PTIN
Phone6167747000PhoneNum
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Praveen ThadaniBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11231 East Beltline NEAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49525ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$961,093,751GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.priorityhealth.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionTo Improve Health, inspire hope and save lives.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$471,049,566PYProgramServiceRevenueAmt
CY Program Service Revenue$547,127,976CYProgramServiceRevenueAmt
PY Investment Income$4,781,603PYInvestmentIncomeAmt
CY Investment Income$4,803,940CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$475,831,169PYTotalRevenueAmt
CY Total Revenue$551,931,916CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$409,054,068PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$477,932,928CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,485,794PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,035,403CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$17,152,346PYOtherExpensesAmt
CY Other Expenses$24,884,632CYOtherExpensesAmt
PY Total Expenses$437,692,208PYTotalExpensesAmt
CY Total Expenses$518,852,963CYTotalExpensesAmt
PY Revenues Less Expenses$38,138,961PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$33,078,953CYRevenuesLessExpensesAmt
Total Assets BOY$199,832,508TotalAssetsBOYAmt
Total Assets EOY$270,572,304TotalAssetsEOYAmt
Total Liabilities BOY$82,548,285TotalLiabilitiesBOYAmt
Total Liabilities EOY$116,281,628TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$117,284,223NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$154,290,676NetAssetsOrFundBalancesEOYAmt
MissionTo Improve Health, inspire hope and save lives.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$500,386,616ExpenseAmt
Grant$0GrantAmt
Revenue$547,127,976RevenueAmt
DescPRIORITY HEALTH CHOICE, INC. HAS A CONTRACT WITH THE STATE OF MICHIGAN TO OFFER HEALTH CARE COVERAGE TO MEDICAID RECIPIENTS WITHIN THE STATE OF MICHIGAN. MEDICAID MANAGED CARE HAS BEEN IN EXISTENCE SINCE THE LATE 1990'S AND HAS DEMONSTRATED SIGNIFICANT COST SAVINGS ALONG WITH BETTER HEALTH OUTCOMES FOR THEIR MEMBERS. PRIORITY HEALTH CHOICE, INC. PROVIDES MORE THAN 154,000 LOWER INCOME AND/OR DISABLED RESIDENTS IN 20 MICHIGAN COUNTIES WITH ACCESS TO QUALITY AND AFFORDABLE HEALTH CARE SERVICES. IT PROMOTES AND INCENTIVIZES OPEN ACCESS TO PROVIDERS. IN A PRIOR YEAR, PRIORITY HEALTH CHOICE, INC. RECEIVED A RATING OF 4 OUT OF 5 FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). THE RATING WAS BASED ON CLINICAL QUALITY, MEMBER SATISFACTION AND NCQA ACCREDITATION SURVEY RESULTS WHICH WERE CONDUCTED ON MORE THAN 1,000 HEALTH INSURANCE PLANS. (CONTINUED ON SCHEDULE O)Desc
Total Program Service Expenses$500,386,616TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document2902IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (true)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Nick GatesBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6164648695PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11231 East Beltline NEAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMIStateAbbreviationCd
ZIP495254501ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOAN A BUDDEN
PRESIDENT & CEO4.046.0Yes (X)Yes (X)$130,018$1,383,583$455,711
KIMBERLY L THOMAS
SECRETARY & SVP, General Counsel4.046.0Yes (X)Yes (X)$44,944$478,271$169,452
MARY ANNE JONES
Treasurer & SVP, Finance4.046.0Yes (X)Yes (X)$53,438$568,662$213,866
Chelsee Stark
DIRECTOR1.00Yes (X)$2,250$0$0
JAMES FORSHEE MD
DIRECTOR - SVP, CHIEF MEDICAL OFFICER4.046.0Yes (X)$47,956$510,825$144,227
MARTI LOLLI
DIRECTOR - SVP, CONS/GOVT MKT & CMO4.046.0Yes (X)$45,520$484,401$206,768
Michael Jasperson
DIRECTOR - SVP, PROVIDER NETWORK4.046.0Yes (X)$36,263$360,631$73,765
MICHAEL KOZIARA
Director - SVP, PROVIDER NETWORK - PART YEAR4.046.0Yes (X)$52,552$559,230$171,626
BRIAN KRUPICZEWICZ
SVP, HUMAN RESOURCES4.046.0$34,034$338,466$132,803Yes (X)
CHRISTOPHER CROOK
SVP, Information Services-Data & Analytics4.046.0$43,023$427,856$140,768Yes (X)
BRIAN FEDORONKO
MEDICAL DIRECTOR4.046.0$31,775$315,999$45,156Yes (X)
ERIN SULLIVAN
VP, MARKETING - PART YEAR4.046.0$33,759$335,732$42,916Yes (X)
INES VIGIL
VP, ADVANCED ANALYTICS4.046.0$38,327$381,156$68,400Yes (X)
JIANHUA YU
SVP, ADVANCED ANALYTICS/CHIEF ACTUARY4.046.0$48,315$514,140$166,569Yes (X)
RICK MORRONE
SVP, EMPLOYER SOLUTIONS4.046.0$46,267$492,347$123,788Yes (X)
PAMELA RIES
Former VP, System Total Value0.050.0$0$859,029$256,482Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$688,441TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,010,328TotReportableCompRltdOrgAmt
Total Other Compensation$2,412,297TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
EXPRESS SCRIPTS
1 EXPRESS WAYST LOUISMO63121CLAIMS SERVICES$78,684,108
METROPOLITAN HOSPITAL
5900 BYRON CENTER AVE SWWYOMINGMI49519CLAIMS SERVICES$15,009,788
MERCY HEALTH PARTNERS
PO BOX 358MUSKEGONMI49442CLAIMS SERVICES$13,448,923
BRONSON METHODIST HOSPITAL
601 JOHN STKALAMAZOOMI49007CLAIMS SERVICES$9,034,626
HOLLAND HOSPITAL
602 MICHIGAN AVEHOLLANDMI49423CLAIMS SERVICES$6,478,861
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K229CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet Premium IncomeDesc
Business524114BusinessCd
Total Revenue Column$547,127,976TotalRevenueColumnAmt
Related Or Exempt Func Income$547,127,976RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$547,127,976TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,089,372TotalRevenueColumnAmt
Exclusion$4,089,372ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$409,876,403SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$409,161,835SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$714,568SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$714,568TotalRevenueColumnAmt
Exclusion$714,568ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$551,931,916TotalRevenueColumnAmt
Related Or Exempt Func Income$547,127,976RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,803,940ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$477,932,928TotalAmt
Program Services$477,932,928ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$638,700TotalAmt
Program Services$351,285ProgramServicesAmt
Management And General$287,415ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,767,644TotalAmt
Program Services$5,922,205ProgramServicesAmt
Management And General$4,845,439ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,378,210TotalAmt
Program Services$1,858,016ProgramServicesAmt
Management And General$1,520,194ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,250,849TotalAmt
Program Services$687,967ProgramServicesAmt
Management And General$562,882ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$16,551TotalAmt
Management And General$16,551ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,807TotalAmt
Management And General$5,807ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$72,789TotalAmt
Management And General$72,789ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,585,391TotalAmt
Program Services$4,171,965ProgramServicesAmt
Management And General$3,413,426ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,924,848TotalAmt
Program Services$1,058,666ProgramServicesAmt
Management And General$866,182ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,230,756TotalAmt
Program Services$676,916ProgramServicesAmt
Management And General$553,840ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$404,924TotalAmt
Program Services$222,708ProgramServicesAmt
Management And General$182,216ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$522,815TotalAmt
Program Services$287,548ProgramServicesAmt
Management And General$235,267ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$33,837TotalAmt
Program Services$18,610ProgramServicesAmt
Management And General$15,227ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$40,556TotalAmt
Program Services$22,306ProgramServicesAmt
Management And General$18,250ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,817TotalAmt
Program Services$2,649ProgramServicesAmt
Management And General$2,168ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$73,879TotalAmt
Program Services$40,633ProgramServicesAmt
Management And General$33,246ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Shared Services & Management Fees$10,248,260$5,636,543$4,611,717
DIFS Regulatory Fee$140,770$77,424$63,346
Community Support & Outreach$130,228$71,625$58,603
Meals and Entertainment$57,064$31,385$25,679

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,391,340TotalAmt
Program Services$1,315,237ProgramServicesAmt
Management And General$1,076,103ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$518,852,963TotalAmt
Program Services$500,386,616ProgramServicesAmt
Management And General$18,466,347ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$43,101,300BOYAmt
EOY$54,572,961EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$41,705,266BOYAmt
EOY$47,350,051EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$114,299,935BOYAmt
EOY$167,352,341EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$726,007BOYAmt
EOY$1,296,951EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$199,832,508BOYAmt
EOY$270,572,304EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$70,002,610BOYAmt
EOY$103,123,370EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,105,937BOYAmt
EOY$2,841,252EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,439,738BOYAmt
EOY$10,317,006EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$82,548,285BOYAmt
EOY$116,281,628EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$10,000BOYAmt
EOY$10,000EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$12,326,877BOYAmt
EOY$12,326,877EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$104,947,346BOYAmt
EOY$141,953,799EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$117,284,223BOYAmt
EOY$154,290,676EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$199,832,508BOYAmt
EOY$270,572,304EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$33,078,953ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,001,670NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$74,170OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$484,530,294CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$517,463,814CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$396,476,442CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$471,049,566CurrentTaxYearMinus1YearAmt
Current Tax Year$547,127,976CurrentTaxYearAmt
Total$2,416,648,092TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
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Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
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FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$517,463,814CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$396,476,442CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$471,049,566CurrentTaxYearMinus1YearAmt
Current Tax Year$547,127,976CurrentTaxYearAmt
Total$2,416,648,092TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
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FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,416,648,092PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$1,802,889CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,671,828CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,938,531CurrentTaxYearMinus1YearAmt
Current Tax Year$4,089,372CurrentTaxYearAmt
Total$13,778,912TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
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Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$1,802,889CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,671,828CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,938,531CurrentTaxYearMinus1YearAmt
Current Tax Year$4,089,372CurrentTaxYearAmt
Total$13,778,912TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$950,700TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$486,757,286CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$519,266,703CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$399,148,270CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$474,988,097CurrentTaxYearMinus1YearAmt
Current Tax Year$551,217,348CurrentTaxYearAmt
Total$2,431,377,704TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9939PublicSupportCY509Pct
Public Support PY5090.9951PublicSupportPY509Pct
Investment Income CY0.01InvestmentIncomeCYPct
Investment Income PY0.0044InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - INCOME FROM TRANSFERRED MEMBERSHIP, COLUMN A - 950700.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 950700.0;ExplanationTxt

Schedule D IRS990ScheduleD

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to AffiliatesDesc
Amt$10,317,006Amt
FieldValueIRS element (for citing)
Total Liability$10,317,006TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) FootnoteFormAndLineReferenceDesc
ExplanationPRIORITY HEALTH CHOICE, INC. CONDUCTS AN ANALYSIS ANNUALLY TO DETERMINE THE ORGANIZATION'S LIABILITY WITH RESPECT TO UNCERTAIN TAX POSITIONS. FOR THE YEAR ENDED DECEMBER 31, 2020 IT WAS DETERMINED THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS TO DISCLOSE. AS SUCH, THERE WAS NO FOOTNOTE ADDED TO THE AUDITED FINANCIAL STATEMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KIMBERLY L THOMAS
SECRETARY & SVP, General Counsel$34,853$370,879$9,952$105,909$139$1,483$9,616$102,332$4,940$52,564$59,500$633,167$3,673$39,089
MARY ANNE JONES
Treasurer & SVP, Finance$40,140$427,148$11,789$125,451$1,509$16,063$10,434$111,037$7,937$84,458$71,809$764,157$4,462$47,484
JOAN A BUDDEN
PRESIDENT & CEO$76,006$808,819$53,206$566,183$806$8,581$28,272$300,853$10,874$115,712$169,164$1,800,148$30,113$320,447
MICHAEL KOZIARA
Director - SVP, PROVIDER NETWORK - PART YEAR$37,371$397,686$13,609$144,819$1,572$16,725$8,177$87,012$6,566$69,871$67,295$716,113$6,828$72,657
JAMES FORSHEE MD
DIRECTOR - SVP, CHIEF MEDICAL OFFICER$36,408$387,935$10,201$108,554$1,347$14,336$5,579$59,371$6,810$72,467$60,345$642,663$3,598$38,285
MARTI LOLLI
DIRECTOR - SVP, CONS/GOVT MKT & CMO$35,339$376,067$9,842$104,729$339$3,605$11,384$121,145$6,377$67,862$63,281$673,408$3,415$36,337
Michael Jasperson
DIRECTOR - SVP, PROVIDER NETWORK$28,318$281,618$7,214$71,744$731$7,269$1,432$14,242$5,308$52,783$43,003$427,656$2,536$25,219
PAMELA RIES
Former VP, System Total Value$0$494,360$0$353,239$0$11,430$0$187,220$0$69,262$0$1,115,511$0$203,544
BRIAN KRUPICZEWICZ
SVP, HUMAN RESOURCES$25,957$258,148$7,212$71,719$865$8,599$6,487$64,510$5,647$56,159$46,168$459,135$2,426$24,128
CHRISTOPHER CROOK
SVP, Information Services-Data & Analytics$31,554$313,795$11,156$110,946$313$3,115$7,038$69,992$5,824$57,914$55,885$555,762$3,497$34,777
JIANHUA YU
SVP, ADVANCED ANALYTICS/CHIEF ACTUARY$37,164$395,475$10,943$116,447$208$2,218$10,054$106,990$4,254$45,271$62,623$666,401$4,324$46,011
INES VIGIL
VP, ADVANCED ANALYTICS$29,395$292,323$8,788$87,400$144$1,433$1,042$10,358$5,208$51,792$44,577$443,306$3,483$34,640
RICK MORRONE
SVP, EMPLOYER SOLUTIONS$35,463$377,373$10,290$109,503$514$5,471$6,476$68,914$4,157$44,241$56,900$605,502$3,961$42,147
BRIAN FEDORONKO
MEDICAL DIRECTOR$26,358$262,131$4,989$49,612$428$4,256$1,432$14,242$2,694$26,788$35,901$357,029$0$0
ERIN SULLIVAN
VP, MARKETING - PART YEAR$9,546$94,944$8,218$81,725$15,995$159,063$157$1,560$3,764$37,435$37,680$374,727$4,006$39,842

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part II, Column (F) DEFERRED COMPENSATIONTHE 2020 "BONUS & INCENTIVE COMPENSATION" INCLUDES CERTAIN DEFERRED COMPENSATION ARRANGEMENTS THAT WERE REPORTED IN PREVIOUS YEARS BUT PAID IN 2020. THIS RESULTS IN A CERTAIN AMOUNT OF WAGES BEING REPORTED IN THE FORM 990 TWICE. AMOUNTS REPORTED IN PART II COLUMN F REPRESENT COMPENSATION THAT WAS ALSO REPORTED IN A PREVIOUS YEAR'S FORM 990 WHILE ALSO BEING REPORTED IN THE CURRENT FORM 990 AS TOTAL COMPENSATION.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationSEE EXPLANATION PROVIDED ON SCHEDULE O FOR FORM 990, PART VI, LINE 15A.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan$ 350,561 Joan Budden $ 38,273 Christopher Crook $ 41,883 James Forshee $ 27,756 Michael Jasperson $ 51,946 Mary Anne Jones $ 79,485 Michael Koziara $ 26,554 Brian Krupiczewicz $ 39,753 Marti Lolli $ 46,108 Rick Morrone $ 203,544 Pamela Ries $ 43,849 Erin Sullivan $ 42,763 Kimberly Thomas $ 38,123 Inis Vigil $ 50,335 Jianhua Yu Schedule J, Part I, Line 4b is answered "yes" because individuals, whose salary and benefits are allocated to this organization, do "participate in" a supplemental nonqualified retirement plan. Some individuals received distributions during the year (as reported on this line) whereas others participated in the plan but did not receive distributions. Distributions reported on this line are also included in Schedule J, Part II, Column F as compensation reported in a prior year. The nonqualified retirement plans are an industry standard and are subject to the funding requirements of nonqualified deferred compensation plans under ERISA and federal tax regulations.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a Part III - Program Service DescriptionIN ADDITION TO THIS RECOGNITION FROM NCQA, THE 2019 MEDICAID HEALTH PLAN CONSUMER GUIDE HAS AWARDED PRIORITY HEALTH CHOICE, INC. WITH AN ABOVE AVERAGE OVERALL RATING. THE OVERALL RATING INCLUDES ALL 5 CATEGORIES IN ADDITION TO HOW THE MEMBERS FEEL ABOUT THEIR PLAN AND THE HELP THE MEMBERS RECEIVE FROM THEIR PLAN. CHILDREN'S SPECIAL HEALTH CARE SERVICES (CSHCS) IS A SPECIALTY PROGRAM OFFERED BY THE STATE OF MICHIGAN TO PROVIDE CARE FOR CHILDREN AND SOME ADULTS WITH CHRONIC HEALTH CONDITIONS. IN ADDITION, THE CSHCS PROGRAM OFFERS SUPPORT TO THE FAMILIES AND CAREGIVERS OF THE MEMBER. CSHCS PROGRAM ELIGIBILITY IS BASED ON MORE THAN 2,600 MEDICAL DIAGNOSES. AS OF OCTOBER 1, 2012, THE MAJORITY OF THE CSHCS POPULATION TRANSITIONED INTO A MEDICAID HEALTH PLAN. IN RESPONSE TO THIS TRANSITION, PRIORITY HEALTH CHOICE, INC. IMPLEMENTED A SPECIALTY CARE MANAGEMENT PROGRAM FOR THIS UNIQUE POPULATION. A DEDICATED CARE MANAGEMENT TEAM ENSURES CSHCS MEMBERS ARE ESTABLISHED WITH A PRIMARY CARE MEDICAL HOME WHILE ALSO PROVIDING CARE COORDINATION BETWEEN THEIR PRIMARY CARE / SPECIALTY CARE PROVIDERS AND ANY ANCILLARY PROVIDERS. THIS TEAM INCLUDES CARE MANAGERS, COMMUNITY HEALTH WORKERS, FIELD SERVICE REPRESENTATIVES, AND OTHER KEY PARTNERS, INCLUDING COUNTY HEALTH DEPARTMENTS, EARLY ON, EARLY HEAD START, THE INTERMEDIATE SCHOOL DISTRICTS, SPECIALTY PROVIDERS, AND MEDICAL SUPPLIERS. THE CARE MANAGEMENT TEAM ALSO FACILITATES ACCESS FOR FAMILIES TO THE FAMILY CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, AND THE CHILDREN'S SPECIAL NEEDS FUNDS IN LANSING. AS OF DECEMBER 31, 2020, PRIORITY HEALTH CHOICE, INC. HAS MORE THAN 3,300 MEMBERS ENROLLED IN THE CSHCS PROGRAM, UP FROM APPROXIMATELY 2,700 MEMBERS IN THE PRIOR YEAR. ON SEPTEMBER 16, 2013, THE MICHIGAN GOVERNOR SIGNED INTO LAW MICHIGAN PUBLIC ACT 107 OF 2013, WHICH DIRECTED THE CREATION OF THE HEALTHY MICHIGAN PLAN. THE HEALTHY MICHIGAN PLAN RECEIVED APPROVAL FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES ON DECEMBER 30, 2013. THE STATE OF MICHIGAN BEGAN TO MAKE HEALTH CARE BENEFITS AVAILABLE THROUGH THE HEALTHY MICHIGAN PLAN EFFECTIVE APRIL 1, 2014. THE HEALTHY MICHIGAN PLAN ENCOURAGES HEALTHY BEHAVIORS AND PERSONAL RESPONSIBILITY, HELPS LOW-INCOME MICHIGAN RESIDENTS ACCESS AFFORDABLE HEALTH COVERAGE, AND REDUCES UNCOMPENSATED CARE THAT SHIFTS COSTS ONTO BUSINESSES AND TAXPAYERS. AS OF DECEMBER 31, 2020, PRIORITY HEALTH CHOICE, INC. HAD MORE THAN 46,000 MEMBERS ENROLLED IN THE HEALTHY MICHIGAN PLAN . PRIORITY HEALTH CHOICE, INC. MAKES OUTREACH CALLS TO EACH HEALTHY MICHIGAN MEMBER. DURING THE CALL, MEMBERS ARE PROVIDED WITH BENEFIT EDUCATION AS WELL AS ASSISTANCE IN MAKING THEIR INITIAL PRIMARY CARE PROVIDER ("PCP") APPOINTMENT. DURING THAT INITIAL PCP APPOINTMENT, THE MEMBER COMPLETES A HEALTH RISK ASSESSMENT, WHICH IDENTIFIES CURRENT BEHAVIORS, A MEMBER'S READINESS TO CHANGE, KEY HEALTH METRICS, AND THE PCP ATTESTATION. IN PURSUIT OF THE GOAL THAT 81% OF CONTINUOUSLY ENROLLED MEDICAID MEMBERS WILL HAVE AT LEAST ONE LEAD SCREENING TEST BY THEIR SECOND BIRTHDAY, PRIORITY HEALTH REDESIGNED THE MEDICAID LEAD SCREENING PROGRAM . AS SUCH, PRIORITY HEALTH DEVELOPED A PROGRESSIVE THREE-TOUCH MEMBER OUTREACH REMINDER/INCENTIVE, PURCHASED LAB EQUIPMENT ON BEHALF OF PROVIDER OFFICES AND PROVIDED EDUCATION TO BOTH MEMBERS AND PROVIDERS AROUND THE IMPORTANCE OF LEAD SCREENING. BASED ON 2020 DATA, THE PRIORITY HEALTH CARE EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) RATE FOR LEAD SCREENING ROSE FROM 71% (2011) TO 78% . THE COMMUNITY HEALTH CARE ACCESS PROGRAM (CHAP), FORMERLY KNOWN AS CHILDREN'S HEALTH CARE ACCESS PROGRAM, IS A COMMUNITY COLLABORATIVE THAT WAS INITIATED IN 2008 AND HAS SINCE EXPANDED TO SERVICE ADULT ENROLLEES. THE FOCUS OF THE COLLABORATIVE FOR THE FIRST SEVERAL YEARS WAS TO INCREASE ACCESS AND QUALITY HEALTH CARE TO MEDICAID PEDIATRIC MEMBERS. THE PRIMARY GOAL OF THE CHAP PROGRAM NOW IS TO IMPROVE HEALTH OUTCOMES AMONG CHILDREN ON MEDICAID WHILE BETTER UTILIZING EXISTING RESOURCES AND DECREASING COSTS. THIS PARTNERSHIP BETWEEN PRIORITY HEALTH CHOICE, INC., HELEN DEVOS CHILDREN'S HOSPITAL, CHERRY STREET HEALTH SERVICES, PRIVATE PEDIATRIC PRACTICES, NUMEROUS HUMAN SERVICE AGENCIES, AND PRIVATE FOUNDATIONS COVERS MORE THAN 14,000 CHILDREN IN KENT COUNTY . CHAP CONTRACTED WITH PCP'S, PROVIDING CARE COORDINATION AND ASSISTANCE WITH KEY HEDIS METRICS. PCP'S WERE REIMBURSED AT A HIGHER RATE IN EXCHANGE FOR THEIR WILLINGNESS TO OPEN UP ACCESS, ESPECIALLY SAME DAY ACCESS TO MEMBERS. CHAP PROVIDED SAME DAY TRANSPORTATION TO URGENT PCP APPOINTMENTS AS NEEDED. IN ADDITION, CHAP PROVIDED MEMBER/FAMILY EDUCATION REGARDING APPROPRIATE EMERGENCY ROOM AND URGENT CARE UTILIZATION. IN 2014, CHAP DEVELOPED ITS OWN IDENTITY AS HEALTH NET OF WEST MICHIGAN. AT THE SAME TIME, THE FOCUS OF INTERVENTION EXPANDED TO ADULTS AS WELL AS CHILDREN. HEALTH NET PARTNERED WITH ADULT PRIMARY CARE PRACTICES TO WORK WITH ADULT MEMBERS REGARDING EMERGENCY ROOM AND URGENT CARE USE, WHILE ALSO PROVIDING EDUCATION REGARDING SPECIFIC MEMBER INPATIENT UTILIZATION. IN ADDITION, HEALTH NET HAS PARTNERED WITH OB-GYN RESIDENCY CLINICS TO FACILITATE THE MATERNAL INFANT HEALTH PROGRAM (MIHP) ENROLLMENT FOR PREGNANT WOMEN. HEALTH NET REPORTS A 50% RETURN ON INVESTMENT; FOR EVERY $1 INVESTED IN CHAP SERVICES, $1.50 WAS SAVED IN HEALTH COSTS.
Form 990, Part III, Line 4a Part III - Program Service DescriptionPRIORITY HEALTH CHOICE, INC. CONTINUES TO BE RECOGNIZED FOR THEIR DEVELOPMENT OF PROGRAMS THAT HAVE LED TO INCREASED EFFICIENCY AND PATIENT CARE, HELPING LOWER COSTS, AND INCREASE SERVICE TO IT'S MICHIGAN PATIENTS BY THE MICHIGAN ASSOCIATION OF HEALTH PLANS. PRIORITY HEALTH CHOICE, INC. WAS AWARDED A PINNACLE AWARD IN 2017 FOR ITS CENTERINGPREGNANCY PROGRAM. THE GOAL WAS TO CREATE A COLLABORATIVE MODEL OF SUPPORT FOR MEDICAID MEMBERS WHICH RESULTS IN IMPROVED HEALTH OUTCOMES FOR MOTHERS AND THEIR BABIES, ENHANCED HEALTH EXPERIENCES, AND LOWER COSTS. PRIORITY HEALTH PARTNERED WITH SPECTRUM HEALTH IN SUPPORT OF THE CENTERINGPREGNANCY PROGRAM FOR EXPECTANT MEDICAID MEMBERS AND THEIR BABIES. THROUGH THIS PARTICULAR COLLABORATION, FOCUS WAS PLACED ON MEDICAID MOTHERS AND BABIES; HOWEVER, THE MODEL IS SCALABLE TO OTHER PRODUCTS AND PROVIDERS WITHIN THE PRIORITY HEALTH NETWORK. THE COLLABORATIVE TEAM'S EFFORT RESULTED IN A NEW METHOD OF ENHANCED REIMBURSEMENT TIED TO EACH MEMBER AND EACH VISIT. THE PROGRAM IS AN ADDED BENEFIT TO PRIORITY HEALTH MEDICAID MEMBERS, PROVIDES A PRIORITY HEALTH CARE MANAGER AT THE CLINIC SITE WHO WORKS CLOSELY WITH HIGH-RISK PATIENTS AND REINFORCES CENTERING EDUCATION, AND SUPPORTS AND ENCOURAGES PARTICIPATION IN THE MATERNAL INFANT HEALTH PROGRAM. IN 2016, THE MAHP AWARDED PRIORITY HEALTH CHOICE, INC. WITH A PINNACLE AWARD RECOGNIZING THE INNOVATIVE MEDNOW APPROACH. PRIORITY HEALTH CHOICE, INC. PARTNERED WITH MEDNOW TO VIRTUALLY CONNECT MEDICAID RECIPIENTS AND PROVIDERS. MEDNOW PROVIDES MEDICAID RECIPIENTS WITH ACCESS TO A COMPUTER IN-HOME, REAL-TIME ACCESS TO PRIMARY CARE PROVIDERS FOR NON-LIFE-THREATENING CONDITIONS, INCLUDING VIDEO VISITS FOR THOSE WITH A WEBCAM AND A STRONG INTERNET CONNECTION. IT HAS PROVIDED EFFECTIVE HEALTH CARE SERVICES TO BENEFICIARIES AT MEASURABLE COST SAVINGS. VIDEO-ENABLED VIRTUAL VISITS USE DATA ANALYTICS TO MEASURE UTILIZATION AND SATISFACTION. IN 2020, PRIORITY HEALTH CHOICE, INC. HAD 4,382 MEDNOW ENCOUNTERS WITH THE MEDICAID POPULATION . IN 2019, PRIORITY HEALTH'S MEDICAID CARE MANAGEMENT TEAM WAS AWARDED THE PINNACLE AWARD IN THE COMMUNITY OUTREACH CATEGORY FOR THEIR MEDICALLY COMPLEX CHILDREN INFORMATION SHARING EVENTS PROJECT FROM THE MICHIGAN ASSOCIATION OF HEALTH PLANS (MAHP). BY WORKING CLOSELY WITH MEDICALLY COMPLEX CHILDREN (CSHCS - CHILDREN'S SPECIAL HEALTH CARE SERVICES) AND THEIR FAMILIES, THEY WERE ABLE TO QUICKLY IDENTIFY THE NEEDS AND GAPS IN KNOWLEDGE RELATED TO CARE COORDINATION BETWEEN THESE FAMILIES AND THE COMMUNITY PROVIDERS THAT SERVE THEM. IN RESPONSE, PRIORITY HEALTH LAUNCHED QUARTERLY MEDICALLY COMPLEX CHILDREN'S INFORMATION SHARING EVENTS. THOSE EVENTS WERE CREATED TO PROVIDE A VENUE FOR HEALTH CARE PROVIDERS AND COMMUNITY PARTNERS THAT SPECIFICALLY WORK WITH THE CSHCS POPULATION, TO NETWORK, SHARE INFORMATION, ESTABLISH REFERRAL PATHWAYS AND WORK COLLABORATIVELY. IN 2019, PRIORITY HEALTH LAUNCHED THEIR NEW DUAL ELIGIBLE SPECIAL NEEDS PLAN (D-SNP) NAMED PRIORITYMEDICARE D-SNP WHICH WENT INTO EFFECT ON JANUARY 01, 2020. PRIORITY HEALTH IS THE ONLY HEALTH PLAN TO OFFER A D-SNP THROUGHOUT THE ENTIRE LOWER PENINSULA. THIS PLAN WILL SERVE INDIVIDUALS WHO ARE 21 YEARS OF AGE AND OLDER, WHO ARE ALSO FULL BENEFIT DUAL ELIGIBLE BENEFICIARIES. THE D-SNP IS MEANT FOR INDIVIDUALS WITH HIGH RATES OF MULTIPLE CHRONIC CONDITIONS AND DISABILITIES INCLUDING MEDICAL CONDITIONS, BEHAVIORAL HEALTH DIAGNOSIS, PHYSICAL DISABILITIES, INTELLECTUAL OR DEVELOPMENTAL DISABILITIES, AS WELL AS FUNCTIONAL AND/OR COGNITIVE LIMITATIONS. THIS PARTICULAR POPULATION FACES MANY SOCIAL RISK FACTORS THAT CONTRIBUTE TO POOR HEALTH AND OTHER OUTCOMES SUCH AS HOUSING INSTABILITY AND HOMELESSNESS, FOOD INSECURITY, ISOLATION, INADEQUATE OR NO ACCESS TO TRANSPORTATION, AND DISPARITIES IN OTHER SOCIAL DETERMINANTS TO HEALTH. AS OF DECEMBER 31, 2020, PRIORITY HEALTH CHOICE, INC. HAD MORE THAN 3,600 MEMBERS ENROLLED IN THE DUAL ELIGIBLE SPECIAL NEEDS PLAN.
Form 990, Part IV, Line 12a Audited Financial StatementsThe organization's financial statements are audited annually by an independent accounting firm. The "No" response to this question relates to the fact that the GAAP basis financial statements were prepared on a consolidated basis and not on a stand alone basis. The organization is audited annually on a stand alone basis and issued financial statements on a stand alone basis which are prepared in accordance with SAP (Statutory Accounting Principles), as required by regulatory authorities. The figures in this Form 990 reconcile to the financial statements prepared under statutory accounting principles as submitted to the State of Michigan and the National Association of Insurance Commissioners (NAIC).
Form 990, Part V, Line 2a NUMBER OF EMPLOYEES REPORTED ON FORM W-3ALL EMPLOYEES OF PRIORITY HEALTH CHOICE, INC. WERE EMPLOYED DURING THE YEAR BY SPECTRUM HEALTH SYSTEM (38-3382353) AND LEASED BACK TO PRIORITY HEALTH CHOICE, INC. SALARIES AND WAGES, EMPLOYEE BENEFITS AND PAYROLL TAXES ARE ALLOCATED TO PRIORITY HEALTH CHOICE, INC. VIA A MANAGEMENT FEE. THE SALARIES AND WAGES REPORTED IN PART IX STATEMENT OF FUNCTIONAL EXPENSES REFLECT THE PORTION OF SALARIES AND WAGES ALLOCATED TO PRIORITY HEALTH CHOICE, INC. SPECTRUM HEALTH SYSTEM FILED ALL APPLICABLE IRS TAX FILINGS INCLUDING FORMS W-2 AND W-3 ON BEHALF OF PRIORITY HEALTH CHOICE, INC.
Form 990, Part VI, Line 3 Management ServicesPriority Health Managed Benefits, Inc. (PHMB), an entity related through common ownership, provides contracted management services to Priority Health Choice, Inc. and its affiliates. Priority Health, a 501(c)(4), is the parent company to the organization. Priority Health's governing body retains control of the activities of PHMB as the governing bodies of Priority Health and PHMB are comprised of the same directors and officers.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsCERTAIN MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS OF THE ORGANIZATION ALSO SERVE ON THE BOARD OF DIRECTORS AND/OR AS OFFICERS OF RELATED TAXABLE ENTITIES - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersThe parent organization is Priority Health (EIN 38-2715520), a tax-exempt 501(c)(4) organization. Priority Health controls 100% of the Organization. Priority Health has three shareholders as follows: Spectrum Health System (EIN 38-3382353), Class A Shareholder - 93.9% Munson Healthcare (EIN 38-2640544), Class B Shareholder - 5.5% McLaren Northern Michigan (EIN 38-2146751), Class B Shareholder - .6% All Shareholders are tax-exempt Internal Revenue Code Section 501(c)(3) organizations.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyElection of Members and Their Rights from Priority Health Choice, Inc. bylaws: Article V Section 2. Number and Class of Directors. The Board of Directors will be comprised of no less than three (3) and no more than nine (9) directors.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersFrom Priority Health Choice, Inc. bylaws: Section 1. Votes. Each shareholder of record as determined in accordance with Section 2 of this Article will, at every meeting of shareholders, be entitled to one (1) vote in person or by proxy for each share of capital voting stock of the corporation held by the shareholder. A vote may be cast either verbally or in writing. Unless the Articles of Incorporation or Bylaws state otherwise, all matters will be determined by the vote of the holders of a majority of the issued and outstanding stock in the corporation. Section 2. Record Date for Determination of Shareholders. For the purpose of determining shareholders entitled to notice of, and to vote at, a meeting of shareholders, or any adjourned meeting, or to express consent to or dissent from a proposal without a meeting, or for the purpose of any other action, the Board of Directors may fix in advance a date, not more than sixty (60) days nor less than twenty-one (21) days before the date of the meeting or other action, as the record date for the determination of shareholders. Section 3. Proxies. A shareholder entitled to vote at a meeting of shareholders or to express consent or dissent without a meeting may authorize other persons to act for the shareholder by proxy. No proxy will be deemed operative unless and until signed by the shareholder or the shareholder's authorized agent or representative and filed with the corporation. Unless otherwise provided in the proxy, a proxy is valid only for three (3) years from its date. Section 4. Annual Budget and Strategic Plan. The shareholders will approve the annual budget and strategic plan for the corporation. Section 5. Power to Elect President. The shareholders will select the President of the corporation who may be someone who is not a member of the Board of Directors. Section 6. Removal of Officers and Agents. Any officer or agent may be removed by the shareholders whenever, in their judgment, the business interests of the corporation will be served by the removal. Section 7. Delegation of Powers. For any reason they deem sufficient, whether occasioned by absence or otherwise, the shareholders may delegate all or any of the powers and duties of any officer to any other officer or director. Section 8. Power to Require Bonds. The shareholders may require any officer or agent to file with the corporation a satisfactory bond conditioned for faithful performance of the officer's or agent's duties.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyThe review process for this Form 990 is as follows: 1. Preparation of the return is supervised and reviewed by the organization's Corporate Tax Manager. 2. A second review is performed by an external CPA firm with expertise in tax-exempt return preparation. 3. The return is reviewed by the organization's finance and legal departments (Including the SVP, Finance; SVP, General Counsel; VP, Controller) and shared with the members of the finance committee and board of directors. 4. The organization's SVP, Finance reviews comments or questions received from members of the Board of Directors, if any, to address or to incorporate, as appropriate, into the return prior to filing.
Form 990, Part VI, Line 12c Conflict of interest policyBOARD OF DIRECTORS 1. Conflicts of interest must be disclosed to other members of the Board of Directors and Board of Directors members must not vote or use personal influence on any matter in which the director has a conflict of interest. 2. A person having a financial interest in a proposed transaction or arrangement may make a presentation at a meeting of the Board of Directors or committee considering that transaction or arrangement, but after that presentation he or she shall leave the meeting during discussion and voting on that proposed transaction or arrangement. The person having the financial interest shall not be counted in determining whether a quorum is present. 3. The chairperson of the Board of Directors or committee shall, if appropriate, appoint a disinterested person or committee (including outside advisors) to investigate alternatives to the proposed transaction or arrangement, and to advise whether the proposed transaction or arrangement is in the organization's best interest. 4. The Board of Directors or committee shall exercise due diligence to determine whether the organization can, with reasonable efforts, obtain a more advantageous transaction or arrangement that would not give rise to a conflict of interest. 5. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board of Directors or committee shall determine by a majority vote of the disinterested directors and members whether the proposed transaction or arrangement is in the organization's best interest and for its own benefit and whether the transaction is fair and reasonable to the organization, and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 6. The minutes of the meetings of the Board of Directors and all of the organization's committees shall set forth: a)The names of the persons who disclosed a financial interest in a proposed transaction or arrangement involving the organization or any of its subsidiaries and the nature of the financial interest; and b)The names of the persons who were present for discussions and votes relating to such transaction or arrangement, including any discussion of alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection with that matter. The votes of individual members need not be recorded unless otherwise directed by the Board of Directors or committee. 7. There is an ongoing requirement that members of the board of directors complete another disclosure questionnaire at any point during his/her tenure on the board of directors when a new potential conflict of interest arises. If a member of the board of directors completes a disclosure questionnaire as a result of a new potential conflict of interest, that disclosure questionnaire is submitted to the legal, organizational integrity, internal audit, and human resources departments for review. MANAGEMENT 1. UPON ACCEPTANCE OF AN EMPLOYMENT OFFER, EACH MEMBER OF MANAGEMENT COMPLETES A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE QUESTIONNAIRE IS SENT TO THE ORGANIZATIONAL INTEGRITY DEPARTMENT. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE IS REVIEWED BY THE ORGANIZATION'S COI COORDINATOR AND ESCALATED TO THE COI COMMITTEE IF NECESSARY. 2. ANNUALLY, EACH MEMBER OF MANAGEMENT COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE ELECTRONICALLY. THE DISCLOSURE QUESTIONNAIRE IS REVIEWED BY THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS. 3. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF MANAGEMENT COMPLETE ANOTHER DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER EMPLOYMENT WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. IF A MEMBER OF MANAGEMENT COMPLETES A DISCLOSURE QUESTIONNAIRE AS A RESULT OF A NEW POTENTIAL CONFLICT OF INTEREST, THAT DISCLOSURE QUESTIONNAIRE IS SUBMITTED TO THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS. 4. THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS, IN CONSULTATION WITH EXECUTIVE MANAGEMENT, DETERMINE HOW ANY REPORTED CONFLICTS SHOULD BE MANAGED. MANAGEMENT OF A CONFLICT MAY TAKE A VARIETY OF DIFFERENT FORMS FROM IMPLEMENTATION OF A MANAGEMENT PLAN TO REQUIRING THAT THE MEMBER OF MANAGEMENT CEASE THE ACTIVITY CREATING THE CONFLICT OR, IN EXTREME CASES, LEAVE THE ORGANIZATION'S EMPLOYMENT. MANAGEMENT IS DETERMINED ON AN INDIVIDUAL BASIS BASED UPON THE FACTS AND CIRCUMSTANCES SURROUNDING THE DISCLOSURE. THE PURPOSE OF CONFLICT MANAGEMENT IS TO PROVIDE TRANSPARENCY WITHIN THE ORGANIZATION AND TO ENSURE THAT THE ORGANIZATION'S EMPLOYEES ARE ALWAYS ACTING IN THE BEST INTEREST OF THE ORGANIZATION.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialThe Spectrum Health System Board of Directors (through its Executive Committee) uses the following process for determining compensation of the top management official, other officers, and key employees at Priority Health Choice, Inc. Labor market data reflecting comparable organizations and jobs (prepared by independent firms) are relied upon. Competitive assessment reports are provided to the Executive Committee in advance of meetings. The competitive assessment report is prepared by a nationally known independent executive compensation firm. For Calendar Year 2020 (1/1/20-12/31/20), three health care executive compensation surveys, two medical group surveys, on pediatric hospital survey, and one health plan survey prepared by independent firms, were the primary sources referenced to obtain market data for the review: * Sullivan, Cotter and Associates: 2018 Survey of Manager and Executive Compensation in Hospitals and Health Systems * Integrated Healthcare Strategies: 2018 HealthCare Executive Compensation Survey * Mercer: 2018 Integrated Health Networks Compensation Survey, also provides data for health plans * Medical Group Management Association: 2018 Management Compensation Survey * Sullivan, Cotter and Associates: 2018 Physician Compensation and Productivity Survey Report * Sullivan, Cotter and Associates: 2018 Custom Survey of Manager and Executive Compensation in Children's Hospitals * Warren: Fall 2018 HMO Salary Survey In addition, four general industry surveys were referenced: * Mercer: 2018 Executive Compensation Survey * Mercer: 2018 Information Technology Survey * Mercer: 2018 Human Resources Survey * Towers Watson: 2018 Top Management Compensation Report In addition to the above data sources, the Executive Committee approved the creation of a custom peer group of high performing integrated health systems to ensure robust data and a relevant comparator universe. The peer group organizations are approved by the Executive Committee and consist of double A bond rated and / or Truven top quintile organizations. Data for the peer group organizations is compiled by the independent executive compensation firm. Compensation adjustments are approved by Executive Committee members, consistent with the Spectrum Health compensation philosophy described below. Minutes of Committee discussions and decisions are prepared to memorialize Executive Committee decisions based upon the above data. Cash compensation data relied upon by the Executive Committee is national and reflects the compensation paid to executives in comparable jobs in comparably-sized health care and / or health insurance organizations. Spectrum Health recruits nationally for its executives. Benefits data reflect national health care / health insurance market practices. Geographic pay differential and cost of living data indicates consistency with national data. This process is intended to assist Spectrum Health in qualifying for the rebuttable presumption of reasonableness (Intermediate Sanctions Regulations) and complying with the potential Spectrum Health Excess Benefit Transaction Policy for those individuals in the group who are disqualified persons. The opinion submitted from the third party independent consulting firm is in accordance with the provisions of Treasury Regulations Section 53.4958-6(c)(2) and is also intended to satisfy the professional advice requirement of Treasury Regulations Section 53.4958-1(d)(4)(iii).
Form 990, Part VI, Line 15b Process to establish compensation of other employeesSee explanation provided for Form 990, Part VI, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the publicThe organization's Articles of Incorporation and Statutory Financial Statements are on file with the State of Michigan and available to the public on the State's website. The organization's bylaws and internal policies are generally not made available to the public. The overall system consolidated financial statements are provided at www.spectrumhealth.org in the section titled "about us." Financial performance is discussed at an annual public meeting held and posted to www.spectrumhealth.org annually (under the section titled "about us").
Form 990, Part VII, Section A, Line 2 Individuals Compensated more than $100,000THERE ARE NO INDIVIDUALS REPORTED AS ALL ARE EMPLOYED BY THE PARENT ORGANIZATION SPECTRUM HEALTH SYSTEM. REFER TO THE DISCLOSURE FOR FORM 990, PART V, LINE 2A FOR FURTHER DETAIL.
Form 990, Part VII, Section A COMPENSATION OF DIRECTORSBASED ON EXTERNAL OPINION BY SULLIVAN, COTTER AND ASSOCIATES, INC., PRIORITY HEALTH CHOICE, INC. COMPENSATES BOARD MEMBERS IN A MANNER THAT IS REASONABLE IN RELATION TO MARKET DATA. BOARD OF DIRECTORS COMPENSATION IS REVIEWED ANNUALLY BY INTERNAL STAFF TO CONFIRM COMPENSATION FALLS WITHIN REASONABLE LIMITS. ANY COMPENSATION AMOUNT IS TREATED AS TAXABLE TO THE BOARD MEMBER AND IS REPORTED AND PROVIDED TO THEM ON FORM 1099, AS REQUIRED ACCORDING TO THE REPORTING THRESHOLDS. CERTAIN BOARD MEMBERS ARE EMPLOYED BY A RELATED ORGANIZATION. COMPENSATION REPORTED IN PART VII, SECTION A, COLUMN E IS FOR SERVICES PERFORMED FOR THE RELATED ORGANIZATION, NOT THE FILING ORGANIZATION.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesCHANGE IN NONADMITTED ASSETS - -74170;
Form 990, Part XII, Line 2b Audited Financial StatementsThe organization's financial statements are audited annually by an independent accounting firm. The organization issued GAAP basis financial statements which are prepared on a consolidated basis and not on a stand alone basis. The organization is audited annually on a stand alone basis and issued financial statements on a stand alone basis which are prepared in accordance with SAP (Statutory Accounting Principles), as required by regulatory authorities. The figures in this Form 990 reconcile to the financial statements prepared under statutory accounting principles as submitted to the State of Michigan and the National Association of Insurance Commissioners (NAIC).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
SPECTRUM HEALTH SYSTEM
100 MICHIGAN AVE NEGRAND RAPIDSMI49503383382353MANAGEMENTMI501(c)(3)Type III-FINAfalse
PRIORITY HEALTH
1231 EAST BELTLINE NEGRAND RAPIDSMI49525382715520HMOMI501(c)(4)SPECTRUM HEALTH SYSTEMfalse
TRINITY HEALTH PLANS
1231 EAST BELTLINE NEGRAND RAPIDSMI49525382663747HMO MGMTMI501(c)(4)PRIORITY HEALTHfalse
TOTAL HEALTH CARE INC
3011 W GRAND BLVD SUITE 1600DETROITMI48202382018957HMOMI501(c)(4)PRIORITY HEALTHfalse
TOTAL HEALTH CARE USA INC
3011 W GRAND BLVD SUITE 1600DetroitMI48202383240485HMOMI501(c)(4)TOTAL HEALTH CARE INCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PRIORITY HEALTH INSURANCE COMPANYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11231 EAST BELTLINE NEAddressLine1Txt
CityGRAND RAPIDSCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49525ZIPCd
FieldValueIRS element (for citing)
EIN201529553EIN
Primary ActivitiesINSURANCEPrimaryActivitiesTxt
Legal Domicile StateMILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CorporationEntityTypeTxt
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Priority HealthBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeSTransactionTypeTxt
Involved$4,766,681InvolvedAmt
Method Of Amount DeterminationGAAP, Cash or FMVMethodOfAmountDeterminationTxt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule R, Part II, Column (g) SECTION 512(B)(13) CONTROLLED ENTITYFormAndLineReferenceDesc
ExplanationTAXPAYER IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, SPECTRUM HEALTH SYSTEM.ExplanationTxt