2020-11-12T15:46:36-06:00 2019-12-31 ERNST & YOUNG US LLP 2100 ONE PPG PLACE PITTSBURGH PA 15222 990 2019-01-01 042674079 TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION INC % UMESH KURPAD TUFT 6179729400 705 MOUNT AUBURN STREET WATERTOWN MA 024721508 ED TEXERIA VP, CONTROLLER 6179729400 2020-11-12 true EILEEN WEBB P01641852 4126447800 2020-11-11 73.186.87.208 04750420203175000032 2020-11-12 P A5F2FECDAE8DB169B1E75CE6C5EFBEE0D18B6ED7 A5F2FECDAE8DB169B1E75CE6C5EFBEE0D18B6ED7 2019 2021-04-22 16:20:28Z Thomas Croswell 705 Mount Auburn Street Watertown MA 02472 2922567602 false X www.tuftshealthplan.com X 1979 MA TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION INC.'S (TAHMO) MISSION IS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES WE SERVE. 11 9 474 0 8529 0 0 2581958897 2698353911 19940928 20538024 288589 274221 2602188414 2719166156 6235722 5563729 2195636765 2312355041 28172362 31899376 0 0 0 283020822 288127962 2513065671 2637946108 89122743 81220048 1085064306 1170000036 442607568 421676874 642456738 748323162 X SEE SCHEDULE O false false 965792557 2359141 1144160103 ONE OF TAHMO'S LARGEST PRODUCTS IS ITS COMMERCIAL HMO. IN 2019, THE HMO PROVIDED AFFORDABLE HEALTH COVERAGE TO APPROXIMATELY 173,573 MEMBERS. SEE SCHEDULE O. 1248682165 2855560 1384918476 TAHMO ALSO OFFERS PRODUCTS TO MEDICARE ELIGIBLE ENROLLEES. IN 2019, TUFTS HEALTH PLAN MEDICARE PREFERRED (TUFTS MEDICARE PREFERRED) PROVIDED AFFORDABLE HEALTH COVERAGE TO APPROXIMATELY 104,241 MEMBERS IN MASSACHUSETTS. SEE SCHEDULE O. 131041394 333849 161913479 THE ORGANIZATION PROVIDES ACCESS TO AFFORDABLE CARE THROUGH A DUAL-ELIGIBLE PROGRAM. SEE SCHEDULE O. 5916953 15179 7361853 Complement and Other 5916953 15179 7361853 2351433069 false false false false false false false false false true true false true true false true true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false true 13321 0 true 474 true true true false false false false false false false X 11 9 true true false false true true true true true false false true true true true true true true true false MA X UMESH KURPAD 6179729400 705 MOUNT AUBURN STREET WATERTOWN MA 02472 THOMAS CROSWELL PRESIDENT & CEO 17.5 32.5 X X 0 2439193 245158 MARC SPOONER EXEC VP 22.5 27.5 X 0 1028446 306565 UMESH KURPAD SVP & CFO 22.5 27.5 X 0 1158318 151182 PATRICIA TREBINO SVP, COO 25.0 25.0 X 0 946633 136447 PATRICIA BLAKE PRESIDENT SR PDTS 40.0 10.0 X 0 802117 213903 TRACEY CARTER SVP & CHIEF ACTUARY 22.5 27.5 X 0 752232 216661 Mary Mahoney Clerk, SVP, CHIEF LEGAL OFC 22.5 27.5 X 0 822715 108430 PAUL KASUBA SVP & CMO 25.0 25.0 X 0 767011 154067 Marc Backon PRESIDENT COM PRST 15.0 35.0 X 0 742185 122268 DEREK ABRUZZESE FORMER OFFICER (end 6/18) 22.5 27.5 X 0 581437 225981 JEAN YANG FORMER OFFICER (end 6/18) 0.0 50.0 X 0 660275 116147 LYDIA GREENE FORMER OFFICER (end 6/18) 22.5 27.5 X 0 679226 70833 KRISTIN LEWIS FORMER OFFICER (end 6/18) 23.5 26.5 X 0 575201 166619 ROLAND PRICE TREASURER & VP 23.5 26.5 X 0 490166 101405 CHRISTOPHER GORTON SVP (UNTIL 12/31/17) 0.0 0.0 X 0 220637 0 GREG TRANTER CHAIRMAN OF BOARD (BEG 5/19) 5.0 5.0 X X 0 98000 0 MICHAEL J MCCOLGAN DIRECTOR 2.5 2.5 X 0 77000 0 Bertram Scott DIRECTOR 3.0 3.0 X 0 73000 0 Irina Simmons DIRECTOR 2.0 2.0 X 0 72500 0 SUSAN WINDHAM-BANNISTE DIRECTOR & VICE CHAIRMAN 2.0 2.0 X 0 72500 0 THOMAS P O'NEILL III DIRECTOR & VICE CHAIRMAN 2.0 5.0 X 0 71500 0 TODD WHITBECK DIRECTOR 2.0 2.0 X 0 69000 0 CHARLOTTE GOLAR RICHIE DIRECTOR 2.0 2.0 X 0 67000 0 Eileen Auen DIRECTOR 2.5 2.5 X 0 65000 0 Frank Torti DIRECTOR 2.0 2.0 X 0 65000 0 ROBERT SPELLMAN Chairman OF BOARD (END 5/19) 2.5 2.5 X X 0 50000 0 MARY ANNA SULLIVAN DIRECTOR (END 3/19) 0.13 0.0 X 0 17000 0 0 13396292 2335666 0 true true false NTT Data Inc 100 City Square BOSTON MA 02129 Outside labor 8513698 CGI Technologies Solutions 11325 Randsom Hills Road FAIRFAX VA 22030 Outside labor 8784126 Deloitte Consulting LLP 200 Berkley Street BOSTON MA 02116 CONSULTING 4907738 PERFICIENT INC 555 MARYVILLE UNIVERSITY DR ST LOUIS MO 63141 OUTSIDE LABOR 2177835 MAGELLAN BEHAVORIAL HEALTH PO BOX 785341 PHILADELPHIA PA 19178 OUTSOURCING 1865415 50 0 COMMERCIAL 524114 1144160103 1144160103 MEDICARE 524114 1384918476 1384918476 MEDICAID 524114 161913479 161913479 MEDICARE COMPLEMENT 524114 7361853 7361853 2698353911 23495123 23495123 0 0 8529 8529 0 8529 8529 200444347 203401446 -2957099 -2957099 -2957099 0 0 0 0 0 0 0 0 0 OTHER INCOME 524114 265692 265692 265692 2719166156 2698619603 8529 20538024 5563729 5563729 0 0 2312355041 2312355041 0 0 24630372 24626372 4000 0 7269004 7269004 0 172982074 172982074 759711 607769 151942 479102 383282 95820 0 0 3757397 3757397 72378043 72378043 8660205 6928164 1732041 1610887 1610887 877363 701890 175473 0 3622869 3622869 518026 518026 0 275484 275484 0 0 29931012 29931012 0 LICENSING FEES -17375259 -13900207 -3475052 HEALTH ASSESSMENTS 1372872 1372872 OTHER EXPENSES 8278176 6622541 1655635 2637946108 2351433069 286513039 0 0 0 14260413 1010267 0 0 6541820 9962939 0 0 0 0 0 0 0 0 0 0 175669370 56536044 117445315 119133326 714643274 799480003 155155959 149476392 0 0 0 0 77017525 90937109 1085064306 1170000036 102765985 96484865 0 0 27826870 26224541 0 0 0 0 0 0 0 0 67291675 58791670 244723038 240175798 442607568 421676874 X 642456738 748323162 0 0 642456738 748323162 1085064306 1170000036 X 81220048 37722000 -13075624 X false true X true false 0 130532125 30037240 100494885 0 75174485 56536044 18638441 119133326 INVESTMENT IN TAHP 58156357 C INVESTMENT IN INTEGRA 80522771 C COMMON STOCKS - INTEGRA 7788955 F INVESTMENT IN CP HOLDINGS 3008309 C 149476392 INTEREST RECEIVABLE 1633575 HEALTHCARE RECEIVABLES 55273700 OTHER RECEIVABLES 3460680 DUE FROM THPI 4013184 DUE FROM CAREPARTNERS 542087 DUE FROM TBA 12044378 DUE FROM TUFTS HEALTH PLAN FOU 69155 ACCRUED RETROSPECTIVE PREMIUMS 13900350 90937109 0 CLAIMS UNPAID 195311999 DUE TO HOLDING COMPANY 15295218 DUE TO THFIC 5032442 DUE TO TICO 15559779 DUE TO THPP 8976360 240175798 X 2715400229 2715400229 3757397 8529 3765926 2719166156 2634188711 2634188711 3757397 3757397 2637946108 FORM 990, Schedule D, Part X, Line 2 ASC 740 (FKA FIN 48) FOOTNOTE IN 2019, THE AUDITED FINANCIAL STATEMENTS FOR THE TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION DID NOT DISCLOSE AN ASC 740 FOOTNOTE. RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STMTS WITH REVENUE PER 990 SCHEDULE D, PART XI, LINE 4B RENTAL INCOME NOT INCLUDED IN FINANCIAL STATEMENTS $8,529 true Alzheimer's Disease & Related Disorders Assoc 309 Waverley Oaks Road Waltham MA 02452 133039601 501(C)(3) 25000 Hope on the Harbor ASSOCIATED INDUSTRIES OF MASSACHUSETTS 1 BEACON ST FL 16 BOSTON MA 021083119 041045830 501(C)(6) 6000 Mission Continues - Benefactor Level Congregation of THE Sisters of St Joseph 637 CAMBRIDGE ST BRIGHTON MA 021352801 042160625 501(C)(3) 10000 Retired Sisters & ministry ENHANCE ASIAN COMMUNITY ON HEALTH INC 1 Franklin ST Boston MA 02110 472130807 501(C)(3) 10000 EACH celebrates Five Year Anniversary Fenway Community Health Center 1340 BOYLSTON STREET BOSTON MA 022150000 042510564 501(C)(3) 6000 Fenway Health Sponsorship Family Festival FirstWorks 275 W-MINSTER ST PROVIDENCE RI 029033433 222597014 501(C)(3) 12500 PVDFest 2019 GREATER BOSTON CHAMBER OF COMMERCE 265 FRANKLIN ST BOSTON MA 021103121 041103090 501(C)(6) 10000 2019 Annual Meeting and Dinner Health Care For All Inc One Federal ST Boston MA 02110 043071598 501(C)(3) 17500 Together For The People Massachusetts Health Council Inc 200 Reservoir St Needham MA 02494 042296739 501(C)(3) 10000 Common Health for the Commonwealth: Report on Prev Massachusetts Women's Political Caucus Leadership 89 SOUTH ST BOSTON MA 021112746 042738443 501(C)(3) 10000 1st Annual MWPC Gala HEALTH FORUMS National Braille Press 88 SAINT STEPHEN ST BOSTON MA 021154302 042104740 501(C)(3) 10000 Million Laughs for Literacy Gala 2019 NEW ENGLAND COUNCIL INC 98 N WASHINGTON ST BOSTON MA 021141913 041661090 501(C)(6) 8000 Annual Dinner 2019 Operation ABLE of Greater Boston Inc 174 Portland STREET BOSTON MA 02114 042761871 501(C)(3) 10000 ABLE Spring Fundraiser Reliant Foundation Inc 311 Main St Worcester MA 016081543 222912515 501(C)(3) 10000 21st Annual Drive for a Difference The Family Pantry of Cape Cod 133 QUEEN ANNE RD HARWICH MA 026452406 223079904 501(C)(3) 25000 2019 Summer Family Pantry Gala The Greater Boston Food Bank Inc 70 SOUTH BAY AVENUE BOSTON MA 021182700 042717782 501(C)(3) 10000 FreshFest: Festival 2019 The Home for Little Wanderers 10 GUEST STREET STE 3 BOSTON MA 021352066 042104764 501(C)(3) 10000 Generous Masters Golf Tournament The Massachusetts General Hospital 100 Cambridge St Boston MA 02114 041564655 501(C)(3) 15000 The Schwartz Center Business Membership program VNA Care 97 Libbey Indl PRKWY Weymouth MA 02189 042105800 501(C)(3) 10000 Heroes in Health Care WATERTOWN POLICE EMPLOYEES ASSOCIATION 552 MAIN ST WATERTOWN MA 024722224 046063845 501(C)(5) 15000 WPD 6th Annual Road Race TUFTS HEALTH PLAN FOUNDATION INC 705 MOUNT AUBURN ST WATERTOWN MA 02472 261374263 501(C)(3) 5000000 GRANTS TO RELATED ORGANIZATION 17 4 Form 990, Schedule I, PART I, LINE 2 DESCRIPTION OF ORG'S PROCEDURES FOR MONITORING THE USE OF GRANTS THE ORGANIZATION ONLY CONTRIBUTES TO TAX-EXEMPT ORGANIZATIONS UNDER 501(C) AND CERTAIN GOVERNMENTAL UNITS AS WELL AS SPONSORS EVENTS THAT BENEFIT THESE TYPES OF ORGANIZATIONS. THE ORGANIZATION CONTRIBUTES TO WELL ESTABLISHED, NON-PROFIT ORGANIZATIONS THAT HAVE ESTABLISHED POLICIES AND PROCEDURES FOR MONITORING THE USE OF FUNDS. true true false false false false false false false THOMAS CROSWELL PRESIDENT & CEO 0 1113102 0 1162696 0 163395 0 238342 0 6816 0 2684351 0 159251 UMESH KURPAD SVP & CFO 0 550755 0 528691 0 78872 0 136853 0 14329 0 1309500 0 81531 PATRICIA TREBINO SVP, COO 0 452343 0 434222 0 60068 0 116097 0 20350 0 1083080 0 64997 PATRICIA BLAKE PRESIDENT SR PDTS 0 409719 0 344143 0 48255 0 193526 0 20377 0 1016020 0 56081 PAUL KASUBA SVP & CMO 0 392396 0 329591 0 45024 0 132519 0 21548 0 921078 0 53346 TRACEY CARTER SVP & CHIEF ACTUARY 0 384540 0 322993 0 44699 0 196290 0 20371 0 968893 0 51763 MARC SPOONER EXEC VP 0 495869 0 471543 0 61034 0 286169 0 20396 0 1335011 0 69174 CHRISTOPHER GORTON SVP (UNTIL 12/31/17) 0 0 0 0 0 220637 0 0 0 0 0 220637 0 0 ROLAND PRICE TREASURER & VP 0 272218 0 179653 0 38295 0 83715 0 17690 0 591571 0 31995 Marc Backon PRESIDENT COM PRST 0 393606 0 330609 0 17970 0 122160 0 108 0 864453 0 0 Mary Mahoney Clerk, SVP, CHIEF LEGAL OFC 0 422363 0 343914 0 56438 0 108315 0 115 0 931145 0 53414 LYDIA GREENE FORMER OFFICER (end 6/18) 0 344863 0 289667 0 44696 0 63616 0 7217 0 750059 0 0 JEAN YANG FORMER OFFICER (end 6/18) 0 366962 0 295330 0 -2017 0 108936 0 7211 0 776422 0 0 DEREK ABRUZZESE FORMER OFFICER (end 6/18) 0 300267 0 252209 0 28961 0 205630 0 20351 0 807418 0 38238 KRISTIN LEWIS FORMER OFFICER (end 6/18) 0 297341 0 249751 0 28109 0 146268 0 20351 0 741820 0 0 SCHEDULE J, PART I, LINE 3 THE COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS (THE "BOARD") OF TUFTS HEALTH PLAN, INC. (TUFTS HP OR THE "COMPANY") REVIEWS AND ADMINISTERS TOTAL REMUNERATION OPPORTUNITIES, POLICIES, PROGRAMS, AND MAJOR CHANGES IN TUFTS HP'S BENEFIT PLANS THAT ARE APPLICABLE TO THE OFFICERS AND EXECUTIVES OF THE COMPANY (THE "EXECUTIVES" - THESE INCLUDE THE CEO AND ALL SENIOR VICE PRESIDENTS), AS WELL AS TO THE GENERAL AUDITOR, CHIEF COMPLIANCE & ETHICS OFFICER, AND ANY OTHER INDIVIDUAL OR GROUPS THE COMMITTEE DEEMS APPROPRIATE BASED ON ITS INTERPRETATION OF THE DEFINITION OF "DISQUALIFIED PERSONS" IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986. THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS OF THE COMPANY. THE COMMITTEE REPORTS TO THE FULL BOARD OF DIRECTORS. FOR CEO COMPENSATION, THE COMMITTEE REVIEWS THE INFORMATION DESCRIBED BELOW AND RECOMMENDS THE CEO'S COMPENSATION TO THE FULL BOARD FOR ITS APPROVAL. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION RECOMMENDATIONS FROM THE CEO FOR OTHER EXECUTIVES, AND PROVIDES A REPORT TO THE FULL BOARD ON THIS INFORMATION. IT IS THE BOARD'S INTENTION THAT THE COMMITTEE WILL PERFORM ITS DUTIES IN A MANNER THAT WILL ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OFFERED TO EXECUTIVES AND OTHER "DISQUALIFIED PERSONS" ARE REASONABLE. COMPARABILITY DATA AND REASONABLENESS THE TOTAL REMUNERATION OPPORTUNITIES PROVIDED TO EXECUTIVES OF THE COMPANY ARE INTENDED TO BE COMPETITIVE WITH, AND IN REASONABLE COMPARISON TO, THOSE OPPORTUNITIES PROVIDED BY ORGANIZATIONS IN THOSE BUSINESS SECTORS WITH WHICH THE COMPANY COMPETES FOR EXECUTIVE TALENT. THE BOARD BELIEVES THAT SUCH COMPETITORS ARE NOT LIMITED TO OTHER HEALTHCARE INSTITUTIONS AND THAT COMPARISONS SHOULD BE MADE TO THE COMPENSATION PRACTICES OF A CROSS-SECTION OF BUSINESS SECTORS IN BOTH FOR-PROFIT AND NOT-FOR-PROFIT ORGANIZATIONS, WHEN APPROPRIATE. THE COMMITTEE RETAINS INDEPENDENT COMPENSATION CONSULTANTS TO PROVIDE DATA AS NECESSARY, AND ALSO USES AVAILABLE SOURCES OF INDEPENDENT DATA ON COMPENSATION. PEER ORGANIZATIONS AND PUBLISHED SURVEY SOURCES WILL BE APPROVED BY THE COMMITTEE BASED ON ITS REASONABLE DETERMINATION. THE COMMITTEE MAY ALSO RELY ON MEMBERS OF MANAGEMENT AND OUTSIDE ADVISORS, CONSULTANTS, AND COUNSEL TO PROVIDE MARKET DATA REPORTS, ANALYSIS, AND OPINIONS WITH RESPECT TO COMPENSATION-RELATED MATTERS. THE DATA REVIEWED CONSISTS OF COMPARABLE, RELEVANT MARKET DATA FOR THE COMPANY'S POSITIONS FROM PUBLISHED SURVEYS, AND OTHER AVAILABLE SOURCES, OF HEALTH AND MANAGED CARE INSTITUTIONS AND THE GENERAL INDUSTRY. OTHER SURVEYS OF SPECIALIZED SKILL SETS OR EMPLOYEE ATTRIBUTES CRITICAL TO THE SUCCESS OF THE COMPANY, E.G., ACTUARIAL, LEGAL, ETC., ARE ALSO INCORPORATED AS NEEDED, ALONG WITH GEOGRAPHIC REFERENCES TO THE BOSTON AND NEW ENGLAND LABOR MARKETS. THE COMMITTEE WILL RELY ON THIS MARKET DATA TO ASSESS, DETERMINE, AND VALIDATE COMPENSATION LEVELS FOR THE COMPANY'S EXECUTIVES. THE COMMITTEE USES THIS DATA IN ITS REVIEW OF: - SETTING BASE SALARIES - IN LIGHT OF MARKET DATA AND THE INDIVIDUAL'S PERFORMANCE, BACKGROUND, EXPERIENCES, AND PERSONAL SKILLS. BASE SALARY WILL BE SET SO THAT THE TARGETED POSITIONING OF AN EXECUTIVE IS AT THE 50TH PERCENTILE FOR EACH POSITION. ACTUAL BASE SALARY MAY VARY BASED ON SKILLS, BACKGROUND, AND EXPERIENCE. - ANNUAL INCENTIVE COMPENSATION - THE COMPANY'S GOAL IS TO PROVIDE COMPETITIVE AND REASONABLE OPPORTUNITIES UNDER THE TERMS OF AN EXECUTIVE ANNUAL INCENTIVE PLAN FOR THE SELECTED POSITIONS WHICH ARE RESPONSIBLE FOR ACHIEVING PERFORMANCE GOALS THAT REFLECT THE OVERALL MISSION OF THE COMPANY, AND THE STRATEGIC DIRECTION OF THE COMPANY FOR THE PERFORMANCE YEAR. THE COMMITTEE MAKES EVERY EFFORT TO ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OPPORTUNITIES PROVIDED TO EXECUTIVES ARE REASONABLE; AS SUCH PRESUMPTION IS CONTEMPLATED IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED FROM TIME TO TIME. IN ESTABLISHING THE PRESUMPTION OF REASONABLENESS, THE COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. TIMING EXECUTIVE BENCHMARKING IS COMPLETED EVERY TWO YEARS FOR THOSE INDIVIDUALS UNDER THE COMPENSATION COMMITTEE'S PURVIEW BY THE EXTERNAL CONSULTANT ENGAGED BY THE COMPENSATION COMMITTEE. TO COMPLETE THE ANALYSIS, THE CONSULTANT: - COLLECTED RELEVANT INFORMATION REGARDING THE COMPANY'S OPERATIONS, COMPLEXITY, STRUCTURE, SIZE, AND SCOPE, AS WELL AS RELEVANT BACKGROUND ON THE EXECUTIVES' DUTIES AND SCOPE OF RESPONSIBILITIES; - DETERMINED THE SURVEY SOURCES TO USE IN THE ANALYSIS, BASED ON THE COMPANY'S COMPETITIVE MARKET FOR EXECUTIVE POSITIONS (AS DESCRIBED ABOVE); - MATCHED THE COMPANY'S EXECUTIVE POSITIONS IN THE SURVEYS BASED ON THE COMPANY'S SIZE COMPLEXITY, AND SCOPE, AS WELL AS ACCORDING TO SPECIFIC POSITION RESPONSIBILITIES AND REPORTING RELATIONSHIPS; - VALIDATED THE SURVEY SOURCES AND MARKET MATCHES WITH THE INTERNAL COMPENSATION TEAM TO ENSURE CONSISTENCY; - REVIEWED, COMPILED, AND SUMMARIZED THE DATA IN REPORT FORM. THE REPORT SUMMARIZING THE RESULTS OF THE ANALYSIS WAS PRESENTED TO THE COMPENSATION COMMITTEE FOR DISCUSSION AND DELIBERATION. DOCUMENTATION A SUMMARY OF THE DISCUSSIONS AND DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN THE MEETING MINUTES, WHICH ARE REVIEWED AND APPROVED BY THE COMMITTEE. COPIES OF ALL MEETING MATERIALS DISTRIBUTED PRIOR TO AND DURING THE MEETING ARE MAINTAINED IN THE CORPORATE RECORDS ALONG WITH MEETING MINUTES. SCHEDULE J, PART I, LINE 4A CHRISTOPHER GORTON RECEIVED $220,637 IN SEVERANCE. SCHEDULE J, PART I, LINE 4B THE RELATED ORGANIZATION MAINTAINS AN EXECUTIVE SAVINGS PLAN (ESP) FOR ITS SENIOR MANAGERS WITH THE TITLE DIRECTOR AND ABOVE. THE NUMBERs LISTED ON SCHEDULE J PART II COLUMN C REFLECT BOTH THE EMPLOYEE DEFERRALS AS WELL AS THE EMPLOYER CONTRIBUTIONS TO THE ESP. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION STATEMENT TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC.'S (TAHMO) MISSION IS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES IT SERVES. TAHMO IS RESPONSIBLE FOR ARRANGING THE DELIVERY OF COMPREHENSIVE, PREVENTIVE AND THERAPEUTIC HEALTH CARE SERVICES TO SUBSCRIBING INDIVIDUALS IN RETURN FOR A FIXED MONTHLY PAYMENT. SERVICES ARE PROVIDED THROUGH A CONTRACTED NETWORK OF INDEPENDENT PROVIDER GROUPS AND HOSPITALS WITHIN THE SERVICE AREA. TAHMO PRODUCTS ARE AVAILABLE TO ALL SIZE EMPLOYER GROUPS, INCLUDING A MERGED SMALL GROUP AND INDIVIDUAL MARKET, AND ARE BASED ON COMMUNITY RATING METHODOLOGIES.TAHMO ALSO OFFERS PRODUCTS TO INDIVIDUALS WHO ARE MEDICARE AND/ OR MEDICAID ELIGIBLE. TAHMO PROVIDES A BROAD RANGE OF PROGRAMS DESIGNED TO EDUCATE ITS MEMBERS IN HEALTH MAINTENANCE AND DISEASE PREVENTION. TAHMO IS DEDICATED TO OFFERING A VARIETY OF QUALITY, INNOVATIVE HEALTH COVERAGE OPTIONS AT THE LOWEST COST, AND TO IMPROVING ACCESS TO AFFORDABLE HEALTH CARE BY DEVELOPING AND EMPLOYING STRATEGIES THAT IMPROVE THE ALLOCATION OF HEALTH CARE RESOURCES. IN ADDITION TO PROVIDING THESE SERVICES TO ITS MEMBERS, TAHMO IS DEDICATED TO PROVIDING AND FUNDING HEALTH PROGRAMS THAT BENEFIT THE COMMUNITY TAHMO SERVES. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A HMO ONE OF TAHMO'S LARGEST PRODUCTS IS ITS COMMERCIAL HMO. IN 2019, THE HMO PROVIDED AFFORDABLE HEALTH COVERAGE TO APPROXIMATELY 173,573 MEMBERS . TAHMO STRIVES TO PROVIDE HMO COVERAGE THAT IS AFFORDABLE, AND PROVIDES ACCESS TO TOP QUALITY HEALTH CARE SERVICES. TAHMO ALSO PROVIDES PROGRAMS THAT TARGET THE IMPROVEMENT OF THE HEALTH OF ITS MEMBERS, AS WELL AS THE COMMUNITY AT LARGE. QUALITY: IN THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) 2019-2020 RATINGS, TAHMO WAS RATED 5 OUT OF 5 FOR ITS EXCELLENCE IN PROVIDING INNOVATIVE, HIGH-QUALITY HEALTH CARE COVERAGE TO ITS HMO AND POS MEMBERS. TAHMO HAS ATTAINED TOP NCQA RATINGS SINCE 1996. TAHMO HAS ALSO IMPLEMENTED PROGRAMS WITH PROVIDERS THAT FOCUS ON THE QUALITY OF HEALTH CARE SERVICES PROVIDED AND, IN SOME INSTANCES, WHICH TAILOR REIMBURSEMENT FOR SERVICES BASED IN PART ON QUALITY STANDARDS. TAHMO PROVIDES SPECIALTY CARE MANAGEMENT SERVICES FOR ITS MEMBERS WITH COMPLEX MEDICAL AND BEHAVIORAL HEALTH CONDITIONS. TAHMO MEMBERS RECEIVE TARGETED HEALTH REMINDERS TO ENCOURAGE PREVENTIVE HEALTH CARE, SUCH AS FOR FLU VACCINES AND PNEUMOVAX. TAHMO'S CARE MANAGERS ASSIST MEMBERS WHO ARE ILL OR DISABLED IN NAVIGATING THE HEALTH CARE SYSTEM AND PROVIDE REFERRALS TO COMMUNITY RESOURCES. OUR ONLINE HEALTH AND WELLNESS RESOURCE CENTER, AVAILABLE TO THE COMMUNITY AT LARGE, INCLUDES A LIBRARY OF TOOLS AND READY-MADE PRINT AND ELECTRONIC MATERIALS. THESE RESOURCES HELP TO ENCOURAGE HEALTHY BEHAVIORS, INCREASE DEMAND FOR PREVENTIVE HEALTH, AND DRIVE ENGAGEMENT IN PROGRAMS THAT EDUCATE AND EMPOWER HEALTHIER LIFESTYLES AND REDUCE HEALTH RISKS. TOPICS INCLUDE PREVENTIVE CARE BENEFITS, HEALTHY EATING AND WEIGHT CONTROL, EXERCISE AND FITNESS, MANAGING STRESS AND HEART HEALTH, CANCER PREVENTION, AND TOBACCO CESSATION. WE ALSO OFFER A VARIETY OF WELLNESS PROGRAMS AT THE WORKSITE SUCH AS FLU SHOTS, CHOLESTEROL SCREENINGS,STRESS MANAGEMENT, AND MORE. OUR CERTIFIED WELLNESS CONSULTANTS CAN HELP EMPLOYERS FORM A WELLNESS COMMITTEE, ASSESS THE NEEDS OF EMPLOYEES, ASSIST WITH A PERSONAL HEALTH ASSESSMENT CAMPAIGN, AND PROVIDE GUIDANCE ON SUPPORTING A CULTURE OF WELLNESS. TAHMO'S ONLINE MEMBER PORTAL SERVES AS A CENTRAL HUB FOR LIFESTYLE MANAGEMENT PROGRAM COMPONENTS, HEALTH AND WELLNESS CONTENT, AND TOOLS. THE PORTAL OFFERS A PERSONAL HEALTH ASSESSMENT AND RESOURCES DESIGNED TO ENCOURAGE INDIVIDUALS TO LEAD HEALTHIER LIVES BASED ON THEIR INTERESTS, OVERALL HEALTH CONDITION, AND MANY OTHER PERSONAL ATTRIBUTES. TAHMO ALSO PUBLISHES WELL! MAGAZINE ONCE A YEAR, AND UPDATES ARTICLES ONLINE THROUGHOUT THE YEAR. THE MAGAZINE IS AN EDUCATIONAL RESOURCE ON TOPICS PERTAINING TO ACCESS TO CARE, PREVENTIVE CARE, HEALTH INFORMATION AND HEALTH CARE REMINDERS. IT ALSO PROVIDES INFORMATION FOR MEMBERS ON HOW TO GET THE MOST OF TUFTS HEALTH PLAN'S BENEFITS. WELL IS MAILED TO COMMERCIAL MEMBERS' HOMES AND IS AVAILABLE TO THE PUBLIC ON THE PUBLIC WEBSITE HTTPS://TUFTSHEALTHPLAN.COM/WELL. ACCESS: TAHMO'S MEMBERS HAVE ACCESS TO MORE THAN 109 HOSPITALS, 44,000 PRIMARY CARE PROVIDERS AND SPECIALISTS, AND 13,600 ALLIED HEALTH PROFESSIONALS, AS WELL AS CONDITION MANAGEMENT PROGRAMS, PREVENTION AND WELLNESS PROGRAMS. AFFORDABILITY: TAHMO'S GOAL IS TO PROVIDE THE HIGHEST QUALITY HEALTH CARE SERVICES AT THE LOWEST COST TO AS MANY MASSACHUSETTS AND RHODE ISLAND RESIDENTS AS POSSIBLE. UNDER THE DIRECTION OF ITS CHIEF MEDICAL DIRECTOR, TAHMO HAS DESIGNED HEALTH MANAGEMENT PROGRAMS TO SIMULTANEOUSLY LOWER MEDICAL COSTS AND IMPROVE QUALITY AND OUTCOMES. BY LOWERING MEDICAL COSTS, TAHMO IS ABLE TO OFFER COMPETITIVE PREMIUM RATES AND PROVIDE COVERAGE TO MORE PEOPLE. TAHMO MEMBERS RECEIVE DISCOUNTS ON A VARIETY OF SERVICES TO MAINTAIN A HEALTHY LIFESTYLE, AND ONLINE TOOLS TO MAXIMIZE BENEFITS OFFERED AND TO MAKE INFORMED HEALTH CARE DECISIONS. EXAMPLES INCLUDE DISCOUNTS ON MEMBERSHIPS IN PARTICIPATING FITNESS CLUBS, NUTRITIONAL COUNSELING VISITS, WEIGHT LOSS PROGRAMS. RECOGNIZING THAT STRESS IS A UNIQUE CONTRIBUTOR TO POOR HEALTH, TAHMO ALSO PROVIDES DISCOUNTS TO MEMBERS FOR A MINDFULNESS AND STRESS REDUCTION PROGRAM, MASSAGE THERAPY, ACUPUNCTURE, AND OTHER SERVICES AND PRODUCTS RELATED TO STRESS RELIEF. TAHMO IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY AS WELL AS THAT OF ITS MEMBERS. THE ORGANIZATION TAKES THIS COMMITMENT SERIOUSLY AND HAS A DEDICATED COMMUNITY PARTNERSHIP PROGRAM THAT PROVIDES IN-KIND AND FINANCIAL SUPPORT TO NOT-FOR-PROFIT PROGRAMS THROUGHOUT MASSACHUSETTS. SUPPORT IS BROAD BASED AND REFLECTS DIVERSE SPONSORSHIP OF ORGANIZATIONS THAT PROMOTE IMPROVED COMMUNITY HEALTH. SOME EXAMPLES OF PHILANTHROPY INCLUDE FUNDING TO HEALTH CARE FOR ALL, THE ALZHEIMER'S ASSOCIATION, AND THE MASSACHUSETTS ASSOCIATION FOR MENTAL HEALTH. TUFTS HEALTH PLAN FOUNDATION, INC: TO PROVIDE COMMUNITY BENEFITS ABOVE AND BEYOND ITS REGULAR LINES OF BUSINESS, TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO) ESTABLISHED THE TUFTS HEALTH PLAN FOUNDATION, A 501(C)(3) CHARITABLE AND SUPPORTING ORGANIZATION OF TAHMO. THE FOUNDATION LEVERAGES THE PLAN'S GREATEST ASSET-ITS PEOPLE-IN A MORE DELIBERATE WAY ON BEHALF OF COMMUNITY. ITS MISSION IS ALIGNED WITH THAT OF TUFTS HEALTH PLAN: TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES WE SERVE. THE FOUNDATION ACHIEVES THIS MISSION PRIMARILY THROUGH COMMUNITY INVESTMENTS, COMMUNITY ENGAGEMENT AT KEY STAKEHOLDER "TABLESCONVENING ACTIVITIES FOCUSED ON HEALTHY LIVING WITH AN EMPHASIS ON OLDER PEOPLE, PARTICULARLY THOSE IN UNDER-RESOURCED COMMUNITIES. TUFTS HEALTH PLAN FOUNDATION COLLABORATES WITH OLDER PEOPLE, CIVIC LEADERS AND NONPROFIT ORGANIZATIONS TO SUPPORT COMMUNITIES WORKING TO BE GREAT PLACES TO GROW UP AND GROW OLD. IN 2019, THE FOUNDATION MADE 134 GRANTS TOTALING NEARLY $4.3 MILLION TO NONPROFITS; THE GRANTS ENGAGE MORE THAN COMMUNITY-BASED ORGANIZATIONS. SUMMARY: IN SUMMARY, TAHMO IS DEDICATED TO OFFERING A VARIETY OF QUALITY, INNOVATIVE HEALTH COVERAGE OPTIONS AT THE LOWEST COST AND TO IMPROVING ACCESS TO AFFORDABLE HEALTH CARE BY DEVELOPING AND EMPLOYING STRATEGIES THAT IMPROVE THE ALLOCATION OF HEALTH CARE RESOURCES. IN ADDITION TO PROVIDING THESE SERVICES TO ITS MEMBERS, TAHMO IS DEDICATED TO PROVIDING AND FUNDING HEALTH PROGRAMS THAT BENEFIT THE COMMUNITY TAHMO SERVES. MEDICARE ADVANTAGE FORM 990, PART III, LINE 4B TAHMO ALSO OFFERS PRODUCTS TO MEDICARE ELIGIBLE ENROLLEES. IN 2019, TUFTS HEALTH PLAN MEDICARE PREFERRED (TUFTS MEDICARE PREFERRED) PROVIDED AFFORDABLE HEALTH COVERAGE TO APPROXIMATELY 104,241 MEMBERS IN MASSACHUSETTS. TUFTS MEDICARE PREFERRED STRIVES TO PROVIDE COVERAGE OPTIONS THAT ARE AFFORDABLE AND PROVIDE ACCESS TO TOP QUALITY HEALTH CARE SERVICES FOR SENIORS. TUFTS MEDICARE PREFERRED ALSO OFFERS PROGRAMS THAT TARGET THE IMPROVEMENT OF THE HEALTH OF ITS MEMBERS, AS WELL AS THE COMMUNITY AT LARGE. WITHIN THE MASSACHUSETTS MEDICARE ADVANTAGE MARKET, TUFTS MEDICARE PREFERRED IS THE MARKET LEADER WITH 37% MARKET SHARE - COVERING MORE INDIVIDUALS THROUGH MEDICARE ADVANTAGE PRODUCTS THAN ANY OTHER CARRIER. TUFTS MEDICARE PREFERRED ALSO OFFERS CARE MANAGEMENT AND CONDITION MANAGEMENT SERVICES TO MEMBERS AND PUBLISHES WELL! MAGAZINE FOR ITS MEDICARE POPULATION ONCE A YEAR. THE MAGAZINE IS AN EDUCATIONAL RESOURCE ON TOPICS PERTAINING TO SAFETY, ACCESS TO CARE, PREVENTIVE CARE, HEALTH INFORMATION AND HEALTH CARE REMINDERS, TARGETED TO ITS SPECIFIC POPULATION. IT ALSO PROVIDES INFORMATION FOR MEMBERS ON HOW TO GET THE MOST OF TUFTS HEALTH PLAN'S BENEFITS. WELL IS MAILED TO MEMBERS' HOMES AND IS AVAILABLE TO THE PUBLIC ON THE TUFTS MEDICARE PREFERRED WEBSITE. FORM 990, PART III, LINE 4C DUAL-ELIGIBLE PROGRAM THE ORGANIZATION ALSO PROVIDES ACCESS TO AFFORDABLE CARE THROUGH A DUAL-ELIGIBLE PROGRAM. TAHMO PROVIDES COVERAGE FOR PEOPLE AGE 65 OR OLDER WHO ARE ELIGIBLE FOR MASSHEALTH STANDARD, HAVE BOTH MEDICARE PART A AND B, AND HAVE NOT BEEN DIAGNOSED AS HAVING END STAGE RENAL DISEASE. THIS PROGRAM, CALLED SENIOR CARE OPTIONS, INTEGRATES MEDICAID AND MEDICARE BENEFITS AND SERVICES, PROVIDING THOSE ELIGIBLE WITH COORDINATED HIGH-QUALITY AND COST-EFFECTIVE HEALTH CARE. FORM 990, PART III, LINE 4D MEDICARE COMPLEMENT TAHMO PROVIDES COVERAGE FOR MEMBERS OF ELIGIBLE EMPLOYER GROUPS WHO ARE ENROLLED IN MEDICARE PARTS A AND B. THIS PROGRAM IS CALLED TUFTS MEDICARE COMPLEMENT (TMC) PLAN AND IS A MANAGED CARE PLAN THAT COMPLEMENTS A MEMBER'S EXISTING MEDICARE COVERAGE. IT IS OFFERED TO TUFTS HEALTH PLAN MEMBERS IN ELIGIBLE EMPLOYER GROUPS WHO ARE ENROLLED IN MEDICARE PARTS A AND B. THE TMC PLAN REQUIRES MEMBERS TO CHOOSE A PRIMARY CARE PHYSICIAN(PCP) WHO IS RESPONSIBLE FOR MANAGING OR PROVIDING THE MEMBER'S CARE. FAMILY OR BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS ASSOCIATED HEALTH PLANS, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE ROBERT SPELLMAN Through May 6, 2019 GREG TRANTER As of May 7, 2019 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TOTAL HEALTH PLAN, INC: THOMAS CROSWELL UMESH KURPAD MARY MAHONEY ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS INSURANCE COMPANY: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE ROBERT SPELLMAN Through May 6, 2019 Tracey Carter GREG TRANTER As of May 7, 2019 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS BENEFIT ADMINISTRATORS, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER FOR INTEGRA PARTNERS HOLDINGS, INC.: THOMAS CROSWELL UMESH KURPAD GREG TRANTOR Through May 6, 2019 FORM 990, PART VI, LINE 3 DELEGATION OF CONTROL OF MANAGEMENT DUTIES TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. IS MANAGED BY TUFTS ASSOCIATED HEALTH PLANS, INC. (TAHP), ITS WHOLLY OWNED SUBSIDIARY. TAHP PERFORMS MANAGEMENT, ADMINISTRATIVE, AND MARKETING SERVICES FOR TAHMO, INCLUDING EMPLOYEE DECISIONS AND SUPERVISING AND PLANNING AND EXECUTING BUDGETS AND FINANCIAL OPERATIONS. ALL OF THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A ARE EMPLOYEES OF TAHP. THEIR COMPENSATION IS LISTED IN PART VII, SECTION A AND SCHEDULE J. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 TUFTS HEALTH PLAN, INC.(THPI) IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. POWER TO ELECT OR APPOINT MEMBERS FORM 990, PART VI, LINE 7A THPI, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 7B THPI, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE RIGHT TO MAKE CERTAIN DECISIONS REGARDING THE ORGANIZATION, AND IS REQUIRED TO APPROVE ANY CHANGES TO THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, LINE 8B FOR A MAJORITY OF THE TIME, THE ORGANIZATION CONTEMPORANEOUSLY DOCUMENTS MEETINGS HELD AND WRITTEN ACTIONS UNDERTAKEN BY ITS COMMITTEES. HOWEVER, ON LIMITED OCCASIONS, A COMMITTEE MAY HAVE A SERIES OF CONFERENCE CALLS AND MINUTES FOR THOSE CALLS ARE NOT APPROVED UNTIL THE NEXT IN-PERSON MEETING, WHICH MAY BE MORE THAN SIXTY DAYS LATER. FORM 990, PART VI, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED IN OUR FINANCE DEPARTMENT, WITH ASSISTANCE FROM OUR EXTERNAL ACCOUNTANTS, ERNST & YOUNG. INFORMATION IS PROVIDED BY OUR FINANCE DEPARTMENT, GOVERNANCE MANAGER, COMPLIANCE & PRIVACY OFFICER, AND INTERNAL LEGAL COUNSEL. CERTAIN SECTIONS OF THE FORM ARE REVIEWED BY A NUMBER OF SENIOR MANAGERS; OUR CHIEF FINANCIAL OFFICER REVIEWS THE FORM IN ITS ENTIRETY. ONCE THE FORM IS COMPLETE, IN NOVEMBER 2020, IT IS FORWARDED ON TO OUR BOARD OF DIRECTORS AND IT IS THEN SUBMITTED FOR FILING. FORM 990, PART VI, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE TUFTS HEALTH PLAN (THP) CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND REVISED AS NEEDED. THE POLICY REQUIRES MANAGERS, DIRECTORS, AVPS, VPS, SVPS, EVPS,THE PRESIDENT AND CEO, AND THE BOARD OF DIRECTORS TO ATTEST ANNUALLY THAT THEY WILL ABIDE BY THE POLICY. IT ALSO REQUIRES THEM TO SUBMIT AN ANNUAL DISCLOSURE STATEMENT TO THE CORPORATE COMPLIANCE OFFICER, LISTING ANY OUTSIDE RELATIONSHIPS, INCLUDING FINANCIAL AND/OR BOARD RELATIONSHIPS, THAT THEY OR A FAMILY MEMBER HAVE WITH THP'S SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. THERE IS A PROTOCOL TO REVIEW ANY DISCLOSURE THAT MIGHT BE A POTENTIAL CONFLICT OF INTEREST. ALSO, ALL EMPLOYEES ARE REQUIRED TO REPORT THE OFFER BY AN OUTSIDE ENTITY OF GIFTS OVER $100, HONORARIA OR COVERAGE OF BUSINESS EXPENSES TO THE CORPORATE COMPLIANCE OFFICER AND A SENIOR LEADER. BOTH MUST APPROVE BEFORE ACCEPTANCE IS ALLOWED. THE LEVELS OF REVIEW ARE: - FOR BOARD MEMBERS, THE BOARD CHAIR, CEO, AND BOARD AUDIT & COMPLIANCE COMMITTEE CHAIR - ONCE DISCLOSURES ARE REVIEWED AND APPROVED, THEY ARE COMMUNICATED TO THE GOVERNANCE MANAGER AND TO THE CORPORATE COMPLIANCE - FOR TUFTS HEALTH PLAN MANAGEMENT, THE CORPORATE COMPLIANCE OFFICER, CHIEF COMPLIANCE & ETHICS OFFICER, AND CHIEF LEGAL OFFICER. DISCLOSURES THAT NEED FURTHER REVIEW ARE BROUGHT TO THE BOARD AUDIT & COMPLIANCE COMMITTEE CHAIR. IF A CONFLICT OF INTEREST DOES EXIST, A TRANSACTION WITH THE ENTITY WITH WHICH THERE IS A CONFLICT MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST IS FULLY DISCLOSED; 2. THE PERSON WITH THE CONFLICT OF INTEREST MAY PRESENT INFORMATION, BUT THEN SHALL BE EXCUSED FROM FURTHER DISCUSSION AND FROM THE DECISION REGARDING APPROVING SUCH TRANSACTION; 3. IF PRACTICAL, A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND 4. THE BOARD (OR A DULY CONSTITUTED COMMITTEE THEREOF OR BOARD APPOINTEE) OR THE CHIEF COMPLIANCE & ETHICS OFFICER HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. ALL NEW HIRES, AND ALL EMPLOYEES ON AN ANNUAL BASIS, COMPLETE COMPLIANCE TRAINING THAT ADDRESSES CONFLICT OF INTEREST AND REQUIRES THE EMPLOYEE TO ATTEST THAT THEY DO NOT HAVE ANY POTENTIAL CONFLICTING RELATIONSHIPS THAT THEY HAVE NOT DISCLOSED TO THE PROPER LEVEL OF MANAGEMENT AND TO CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, LINES 15A & 15B PROCESS FOR DETERMINING COMPENSATION THE COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS (THE "BOARD") OF TUFTS HEALTH PLAN, INC. (TUFTS HP OR THE "COMPANY") REVIEWS AND ADMINISTERS TOTAL REMUNERATION OPPORTUNITIES, POLICIES, PROGRAMS, AND MAJOR CHANGES IN TUFTS HP'S BENEFIT PLANS THAT ARE APPLICABLE TO THE OFFICERS AND EXECUTIVES OF THE COMPANY (THE "EXECUTIVES" - THESE INCLUDE THE CEO AND ALL SENIOR VICE PRESIDENTS), AS WELL AS TO THE GENERAL AUDITOR, CHIEF COMPLIANCE & ETHICS OFFICER, AND ANY OTHER INDIVIDUAL OR GROUPS THE COMMITTEE DEEMS APPROPRIATE BASED ON ITS INTERPRETATION OF THE DEFINITION OF "DISQUALIFIED PERSONS" IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986. THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS OF THE COMPANY. THE COMMITTEE REPORTS TO THE FULL BOARD OF DIRECTORS. FOR CEO COMPENSATION, THE COMMITTEE REVIEWS THE INFORMATION DESCRIBED BELOW AND RECOMMENDS THE CEO'S COMPENSATION TO THE FULL BOARD FOR ITS APPROVAL. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION RECOMMENDATIONS FROM THE CEO FOR OTHER EXECUTIVES, AND PROVIDES A REPORT TO THE FULL BOARD ON THIS INFORMATION. IT IS THE BOARD'S INTENTION THAT THE COMMITTEE WILL PERFORM ITS DUTIES IN A MANNER THAT WILL ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OFFERED TO EXECUTIVES AND OTHER "DISQUALIFIED PERSONS" ARE REASONABLE. COMPARABILITY DATA AND REASONABLENESS THE TOTAL COMPENSATION OPPORTUNITIES PROVIDED TO EXECUTIVES OF THE COMPANY ARE INTENDED TO BE COMPETITIVE WITH, AND IN REASONABLE COMPARISON TO, THOSE OPPORTUNITIES PROVIDED BY ORGANIZATIONS IN THOSE BUSINESS SECTORS WITH WHICH THE COMPANY COMPETES FOR EXECUTIVE TALENT. THE BOARD BELIEVES THAT SUCH COMPETITORS ARE NOT LIMITED TO OTHER HEALTHCARE INSTITUTIONS AND THAT COMPARISONS SHOULD BE MADE TO THE COMPENSATION PRACTICES OF A CROSS-SECTION OF BUSINESS SECTORS IN BOTH FOR-PROFIT AND NOT-FOR-PROFIT ORGANIZATIONS, WHEN APPROPRIATE. THE COMMITTEE RETAINS INDEPENDENT COMPENSATION CONSULTANTS TO PROVIDE DATA AS NECESSARY, AND ALSO USES AVAILABLE SOURCES OF INDEPENDENT DATA ON COMPENSATION. PEER ORGANIZATIONS AND PUBLISHED SURVEY SOURCES WILL BE APPROVED BY THE COMMITTEE BASED ON ITS REASONABLE DETERMINATION. THE COMMITTEE MAY ALSO RELY ON MEMBERS OF MANAGEMENT AND OUTSIDE ADVISORS, CONSULTANTS, AND COUNSEL TO PROVIDE MARKET DATA REPORTS, ANALYSIS, AND OPINIONS WITH RESPECT TO COMPENSATION-RELATED MATTERS. THE DATA REVIEWED CONSISTS OF COMPARABLE, RELEVANT MARKET DATA FOR THE COMPANY'S POSITIONS FROM PUBLISHED SURVEYS, AND OTHER AVAILABLE SOURCES, OF HEALTH AND MANAGED CARE INSTITUTIONS AND THE GENERAL INDUSTRY. OTHER SURVEYS OF SPECIALIZED SKILL SETS OR EMPLOYEE ATTRIBUTES CRITICAL TO THE SUCCESS OF THE COMPANY, E.G., ACTUARIAL, LEGAL, ETC., ARE ALSO INCORPORATED AS NEEDED, ALONG WITH GEOGRAPHIC REFERENCES TO THE BOSTON AND NEW ENGLAND LABOR MARKETS. THE COMMITTEE WILL RELY ON THIS MARKET DATA TO ASSESS, DETERMINE, AND VALIDATE COMPENSATION LEVELS FOR THE COMPANY'S EXECUTIVES. THE COMMITTEE USES THIS DATA IN ITS REVIEW OF: - SETTING BASE SALARIES - IN LIGHT OF MARKET DATA AND THE INDIVIDUAL'S PERFORMANCE, BACKGROUND, EXPERIENCES, AND PERSONAL SKILLS. BASE SALARY WILL BE SET SO THAT THE TARGETED POSITIONING OF AN EXECUTIVE IS AT THE 50TH PERCENTILE FOR EACH POSITION. ACTUAL BASE SALARY MAY VARY BASED ON SKILLS, BACKGROUND, AND EXPERIENCE. - ANNUAL INCENTIVE COMPENSATION - THE COMPANY'S GOAL IS TO PROVIDE COMPETITIVE AND REASONABLE OPPORTUNITIES UNDER THE TERMS OF AN EXECUTIVE ANNUAL INCENTIVE PLAN FOR THE SELECTED POSITIONS WHICH ARE RESPONSIBLE FOR ACHIEVING PERFORMANCE GOALS THAT REFLECT THE OVERALL MISSION OF THE COMPANY, AND THE STRATEGIC DIRECTION OF THE COMPANY FOR THE PERFORMANCE YEAR. THE COMMITTEE MAKES EVERY EFFORT TO ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OPPORTUNITIES PROVIDED TO EXECUTIVES ARE REASONABLE; AS SUCH PRESUMPTION IS CONTEMPLATED IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED FROM TIME TO TIME. IN ESTABLISHING THE PRESUMPTION OF REASONABLENESS, THE COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. TIMING EXECUTIVE BENCHMARKING IS COMPLETED EVERY TWO YEARS FOR THOSE INDIVIDUALS UNDER THE COMPENSATION COMMITTEE'S PURVIEW BY THE EXTERNAL CONSULTANT ENGAGED BY THE COMPENSATION COMMITTEE. TO COMPLETE THE ANALYSIS, THE CONSULTANT: - COLLECTED RELEVANT INFORMATION REGARDING THE COMPANY'S OPERATIONS, COMPLEXITY, STRUCTURE, SIZE, AND SCOPE, AS WELL AS RELEVANT BACKGROUND ON THE EXECUTIVES' DUTIES AND SCOPE OF RESPONSIBILITIES; - DETERMINED THE SURVEY SOURCES TO USE IN THE ANALYSIS, BASED ON THE COMPANY'S COMPETITIVE MARKET FOR EXECUTIVE POSITIONS (AS DESCRIBED ABOVE); - MATCHED THE COMPANY'S EXECUTIVE POSITIONS IN THE SURVEYS BASED ON THE COMPANY'S SIZE COMPLEXITY, AND SCOPE, AS WELL AS ACCORDING TO SPECIFIC POSITION RESPONSIBILITIES AND REPORTING RELATIONSHIPS; - VALIDATED THE SURVEY SOURCES AND MARKET MATCHES WITH THE INTERNAL COMPENSATION TEAM TO ENSURE CONSISTENCY; - REVIEWED, COMPILED, AND SUMMARIZED THE DATA IN REPORT FORM. THE REPORT SUMMARIZING THE RESULTS OF THE ANALYSIS WAS PRESENTED TO THE COMPENSATION COMMITTEE FOR DISCUSSION AND DELIBERATION. DOCUMENTATION A SUMMARY OF THE DISCUSSIONS AND DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN THE MEETING MINUTES, WHICH ARE REVIEWED AND APPROVED BY THE COMMITTEE. COPIES OF ALL MEETING MATERIALS DISTRIBUTED PRIOR TO AND DURING THE MEETING ARE MAINTAINED IN THE CORPORATE RECORDS ALONG WITH MEETING MINUTES. FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC OUR GOVERNING DOCUMENTS ARE PUBLICLY FILED AND AVAILABLE UPON REQUEST. OUR CONFLICTS OF INTEREST POLICY IS ALSO AVAILABLE UPON REQUEST. OUR ANNUAL FINANCIAL REPORT AND QUARTERLY FINANCIAL UPDATES ARE POSTED ON OUR PUBLIC WEBSITE AND ARE ALSO AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 RENTAL INCOME NOT INCLUDED IN FINANCIAL STATEMENTS -8,529 CHANGE IN NONADMITTED ASSETS -13,067,095 _____________ TOTAL -13,075,624 Tufts Health Plan Foundation Inc 705 Mount Auburn St Watertown MA 02472 261374263 Grant Making MA 501(c)(3) 12a TAHMO true Tufts Health Public Plans Inc 705 Mount Auburn St Watertown MA 02472 800721489 HMO MA 501(c)(4) N/A THPI false Tufts Health Plan Inc 705 Mount Auburn St Watertown MA 02472 814089215 Healthcare MA 501(c)(4) N/A NA false Carepartners of Connecticut Inc 705 Mount Auburn St Watertown MA 02472 822604728 HMO CT 501(c)(4) N/A TAHMO true Carepartners of CT Holdings LLC 705 Mount Auburn St Watertown MA 02472 823129930 Holding Compa CT TAHMO RELATED 0 10695216 false true 0.51000 Kaiser Permanente Ventures LLC 1 Kaiser Pl Oakland CA 94612 Healthcare CA NA Tufts Associated Health Plans Inc 705 Mount Auburn St Watertown MA 02472 042985923 Management SV DE TAHMO C Corp 410870374 222840875 1.00000 true Tufts Insurance Company 705 Mount Auburn St Watertown MA 02472 043319729 Insurance MA TAHP C Corp 315520552 135907151 1.00000 true Tufts Benefit Administrators Inc 705 Mount Auburn St Watertown MA 02472 043270923 TPA MA TAHP C Corp 62192967 22428147 1.00000 true Total Health Plan Inc 705 Mount Auburn St Watertown MA 02742 042918943 TPA MA TAHP C Corp 60734522 45541567 1.00000 true TAHp Brokerage Corporation 705 Mount Auburn St Watertown MA 02472 043072692 Brokerage Com MA TAHP C Corp 0 196210 1.00000 true Integra Partners Holdings Inc 100 Wall St Ste 2502 New York NY 10005 453032233 Med eqUPT & s NY Tahmo C Corp 164523741 128539322 0.92000 true Tufts Health Freedom Plans Inc 705 Mount Auburn St Watertown MA 02472 300858646 Joint Venture MA TAHP C Corp 0 20415795 0.51000 true Tufts Health Freedom Insurance Company 11 South Main St Ste 600 Concord NH 03301 473788473 Insurance NH THFP C Corp 121704139 47480123 1.00000 true false true false false false false false false false false false false false false false true true true true Tufts Associated Health Plans Inc p 172070000 Accrual Tufts Insurance Company p 151220000 Accrual Total Health Plan Inc r 11740000 Accrual Tufts Benefit Administrators r 123320000 Accrual Tufts Health Plan Foundation Inc p 832000 Accrual Tufts Health Public Plans Inc r 9920000 Accrual Tufts Health Freedom Insurance Company s 43830000 Accrual Carepartners of Connecticut holdings llc r 10101226 Accrual Carepartners of Connecticut HOLDINGS LLC q 6865000 Accrual Tufts Health Plan Foundation Inc b 5000000 Accrual Tufts Associated Health Plans Inc b 15000000 Accrual Total Health Plan Inc S 1400000 Accrual