2020-11-11T14:39:14-06:00 2019-12-31 ERNST & YOUNG US LLP 101 E WASHINGTON ST STE 910 PHOENIX AZ 85004 990 2019-01-01 742838488 Driscoll Children's Health Plan % GREGORY WARD DRIS 3616946432 615 N Upper Broadway St Suite 1621 CORPUS CHRISTI TX 78401 GREGORY WARD CFO 3616946432 2020-11-11 true PATRICK SHIELDS P01508556 6023223000 2020-11-11 98.179.115.73 75306120203165000010 2020-11-11 P 0EDFC99EEA59013BB9022CB1D7B1AB2A7301ADC1 61426FAB2135B2C3C11C549A0C4C4AD617697A57 2019 2021-01-29 14:40:06Z MIKE MINOR SAME AS C ABOVE CORPUS CHRISTI TX 78401 711675223 false X www.DCHPKIDS.COM X 1997 TX COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED AND COMPASSIONATE HEALTH CARE TEAM & RESPECTFUL COLLABORATION WITH ITS PROVIDER NETWORK. 9 8 535 1 0 0 644 0 669262700 709268025 2346291 2407198 0 0 671609635 711675223 0 0 0 0 35169542 40441788 0 0 0 649537132 730424136 684706674 770865924 -13097039 -59190701 150783770 183126283 75552232 97538098 75231538 85588185 X DRISCOLL CHILDREN'S HEALTH PLAN IS COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED AND COMPASSIONATE HEALTH CARE TEAM AND RESPECTFUL COORDINATION WITH ITS PROVIDER NETWORK. false false 716227183 0 709268025 SEE SCHEDULE O. 716227183 true false false true false false false false false false true false false false true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 0 0 535 true false false false false false false false false false false false false X 9 8 false false true false true true true true true false false true true true true true true false false false X GREGORY WARD 3616946781 615 N UPPER BROADWAY ST STE 1621 CORPUS CHRISTI TX 78401 ERIC HAMON SECRETARY/TREASURER 10.0 40.0 X X 0 909422 169821 MARY DAHLEN PETERSON PRESIDENT (OUTGOING) 39.0 1.0 X 0 628897 107322 ERNEST DALE BUCK CHIEF MED DIR (THRU 1/27/19) 39.0 1.0 X 0 358103 40129 KARL SERRAO CHIEF Medical Director 40.0 0.0 X 0 318912 46200 WILLIAM BRENDEL MEDICAL DIRECTOR 40.0 0.0 X 0 310871 46636 STEPHEN P COLLINS COO 40.0 0.0 X 0 297271 54745 FREDRICK McCURDY Medical Director 40.0 0.0 X 0 284994 43869 MICHAEL PIERCE LANCE VICE PRESIDENT 40.0 0.0 X 0 243488 39803 RICK VILLARREAL VICE PRESIDENT 40.0 0.0 X 0 224542 55192 JOSEPH CECIL Vice President, STAR Kids 40.0 0.0 X 0 257098 20145 JENNIFER S BROOKS SENIOR DIRECTOR OF OPERATIONS 40.0 0.0 X 0 200133 34740 LISA D SPRENGER PHARMACY PROGRAM DIRECTOR 40.0 0.0 X 0 181595 42388 MIKE MINOR PRESIDENT/CEO (AS OF 11/18/19) 40.0 0.0 X 0 120620 1988 S LOYD NEAL JR BOARD MEMBER 10.0 1.0 X 0 0 0 SAM L SUSSER BOARD MEMBER 10.0 4.0 X 0 0 0 BOB PARKER BOARD CHAIR 10.0 1.0 X X 0 0 0 JULIE BUCKLEY BOARD MEMBER 10.0 1.0 X 0 0 0 PAUL DANIEL CHAPA BOARD MEMBER 10.0 1.0 X 0 0 0 JIM DEVLIN BOARD MEMBER 10.0 1.0 X 0 0 0 ROBERT FURGASON BOARD MEMBER 10.0 1.0 X 0 0 0 MIKE CARRELL BOARD MEMBER 10.0 1.0 X 0 0 0 0 4335946 702978 0 false true false EVOLENT HEALTH 540 WEST MADISON SUITE 1500 CHICAGO IL 60661 CLAIM ADMINISTRATION 5110405 NAVITUS HEALTH 2601 W BELTLINE HWY 600 MADISON WI 53713 PHARMACY BENEFIT MGT 3292591 RISK STRATEGIES CO PO BOX 970069 BOSTON MA 02297 REINSURANCE 2714072 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 IT SERVICES 1950778 WELLS FARGO BANK TOWER 3003 ENGLISH CREEK AVE SUITE D13A EGG HARBOR TOWNSHIP NJ 08234 OFFICE LESSOR 1111354 34 0 PREMIUM REVENUE 524292 709268025 709268025 0 0 709268025 2407198 2407198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 711675223 709268025 0 2407198 0 0 0 0 0 0 0 0 1192284 0 1192284 0 0 0 0 0 29924769 12194435 17730334 0 1850432 512848 1337584 0 5299668 2117059 3182609 0 2174635 913346 1261289 0 6270520 684326 5586194 0 9406 0 9406 0 127313 0 127313 0 130886 0 130886 0 0 0 40913 0 40913 0 4651049 0 4651049 0 533434 0 533434 0 1707126 0 1707126 0 4225145 0 4225145 0 0 0 0 0 2577566 0 2577566 0 215029 0 215029 0 0 0 0 0 59268 0 59268 0 0 0 0 0 0 0 0 0 1376498 0 1376498 0 115250 0 115250 0 MEDICAL EXPENSES 687341091 687341091 0 0 PREMIUM TAXES 12464078 12464078 0 0 MEMBER VALUE ADD EXPENSE 3590322 0 3590322 0 ALLOCATED COSTS 3639384 0 3639384 0 1349858 1349858 770865924 716227183 54638741 0 0 72711201 55213081 15744713 16590483 0 0 5377419 11040630 0 0 0 0 0 0 0 0 29644 4980 9904915 2762876 8190745 7142039 47465048 91870070 0 0 0 0 0 0 1265000 1265000 150783770 183126283 60162595 77492692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15389637 20045406 75552232 97538098 X 0 0 0 0 75231538 85588185 75231538 85588185 150783770 183126283 X -59190701 -643630 0 0 0 70190978 X false true X false false X 0 0 8194 644 0 8838 436170194 523498054 663466548 669262700 709268025 3001665521 0 0 0 436170194 523498054 663474742 669263344 709268025 3001674359 0 0 0 3001674359 327076 562737 1722784 2346291 2407198 7366086 0 327076 562737 1722784 2346291 2407198 7366086 0 0 436497270 524060791 665197526 671609635 711675223 3009040445 0.99755 0.99800 0.00245 0.00200 X false false false 0 false 0 false 0 false 0 false 0 false 0 true 130886 130886 false SCHEDULE C, PART II-B, LINE 11I PAYMENTS MADE TO VARIOUS ORGANIZATIONS FOR THE PURPOSE OF MEETING WITH AND CALLING GOVERNMENT OFFICIALS OR LEGISLATORS AND SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS AND LEGISLATORS REGARDING ISSUES THAT HAVE AN IMPACT ON THE EXEMPT PURPOSE OF THE HOSPITAL. DCHP PAYS MEMBERSHIP DUES TO CERTAIN MEDICAL ASSOCIATIONS. A PORTION OF THESE DUES, $29,686, IS ATTRIBUTABLE TO LOBBYING EXPENSES FOR HEALTHCARE ISSUES AND INCLUDED IN THE AMOUNT REPORTED ON LINE 1I. 0 0 2287213 1036576 1250637 0 7617702 1726300 5891402 7142039 0 DUE TO AFFILIATES 20045406 20045406 X 710990680 -643630 -643630 711634310 40913 0 40913 711675223 770865924 0 0 770865924 0 0 770865924 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X X X X false true false false false false false false false WILLIAM BRENDEL MEDICAL DIRECTOR 0 291818 0 19053 0 0 0 24250 0 22386 0 357507 0 0 STEPHEN P COLLINS COO 0 267139 0 26691 0 3441 0 32701 0 22044 0 352016 0 0 ERNEST DALE BUCK CHIEF MED DIR (THRU 1/27/19) 0 311345 0 21621 0 25137 0 21005 0 19124 0 398232 0 0 JOSEPH CECIL Vice President, STAR Kids 0 241201 0 15699 0 198 0 0 0 20145 0 277243 0 0 MICHAEL PIERCE LANCE VICE PRESIDENT 0 226639 0 15370 0 1479 0 18888 0 20915 0 283291 0 0 RICK VILLARREAL VICE PRESIDENT 0 221342 0 0 0 3200 0 37916 0 17276 0 279734 0 0 FREDRICK McCURDY Medical Director 0 243267 0 17452 0 24275 0 20741 0 23128 0 328863 0 0 KARL SERRAO CHIEF Medical Director 0 297303 0 20640 0 969 0 20346 0 25854 0 365112 0 0 LISA D SPRENGER PHARMACY PROGRAM DIRECTOR 0 162890 0 11268 0 7437 0 13635 0 28753 0 223983 0 0 JENNIFER S BROOKS SENIOR DIRECTOR OF OPERATIONS 0 174904 0 16960 0 8269 0 14579 0 20161 0 234873 0 0 MARY DAHLEN PETERSON PRESIDENT (OUTGOING) 0 553722 0 56175 0 19000 0 82145 0 25177 0 736219 0 0 ERIC HAMON SECRETARY/TREASURER 0 716652 0 110536 0 82234 0 138792 0 31029 0 1079243 0 0 SCHEDULE J, PART I, LINES 1-3 THE FILING ORGANIZATION, DRISCOLL CHILDREN'S HEALTH PLAN, DOES NOT COMPENSATE OR PROVIDE BENEFITS. ALL COMPENSATION AND BENEFITS ARE DETERMINED AND PAID BY DRISCOLL CHILDREN'S HOSPITAL, A RELATED TAX EXEMPT ORGANIZATION. SCHEDULE J, PART I, LINE 4B THE NONQUALIFIED 457(F) PLAN COVERED THE EXECUTIVE LEADERSHIP TEAM DURING 2019. VESTING OCCURS WHEN EMPLOYEES MEET A PRESELECTED DATE THEY CHOOSE AT THE TIME OF ENROLLMENT. THERE WERE NO TAXABLE DISTRIBUTIONS FROM THE PLAN IN 2019. Schedule J, Part I, Line 7 CERTAIN EXECUTIVES AND MANAGEMENT TEAM MEMBERS ARE ELIGIBLE FOR DISCRETIONARY INCENTIVE BONUSES DETERMINED THROUGH A REVIEW OF SYSTEM AND INDIVIDUAL ACCOMPLISHED GOALS. ALL BONUSES REQUIRE BOARD APPROVAL. FORM 990, PART III, LINE 4A DRISCOLL CHILDREN'S HEALTH PLAN IS THE CONTRACTOR FOR THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). THIS SERVICE AREA INCLUDES 14 COUNTIES COMPRISED OF ARANSAS, BEE, BROOKS, CALHOUN, GOLIAD, JIM WELLS, KARNES, KENEDY, KLEBERG, LIVE OAK, NUECES, REFUGIO, SAN PATRICIO AND VICTORIA. THE PLAN ALSO PROVIDES HEALTH BENEFITS FOR CHILDREN ENROLLED IN THE STATE OF TEXAS ACCESS REFORM (STAR) PROGRAM FOR 24 COUNTIES. THE PLAN IS A HEALTH MAINTENANCE ORGANIZATION (HMO) COMMITTED TO PROVIDING ITS MEMBERS A NETWORK OF HEALTH SERVICE PROVIDERS. ITS AFFILIATION WITH DRISCOLL CHILDREN'S HOSPITAL (DCH), THE SOLE CORPORATE MEMBER, LENDS TO THE PLAN'S SUCCESS BY OFFERING ITS MEMBERS DCH'S EXTENSIVE NETWORK INCLUDING PHYSICIANS, HOSPITAL AND SERVICES IN ITS TOTAL EXPANDED SERVICE AREA, THUS OFFERING CHIP AND STAR MEMBERS WHO LIVE IN THE ADJACENT COUNTIES A FULL CONTINUUM OF QUALITY SERVICES TAILORED TO MEET THE NEEDS OF THE CHIP AND STAR POPULATION. IN ADDITION TO STAR AND CHIP LINES OF BUSINESS, DRISCOLL HEALTH PLAN ENTERED INTO STAR KIDS ON NOVEMBER 1, 2016. STAR KIDS IS A NEW LINE OF BUSINESS PRIMARILY RELATED TO CHILDREN WITH DISABILITIES AND IT RESIDES WITHIN THE SAME COUNTIES AS SERVICE AREA AS DESCRIBED ABOVE WITH STAR AND CHIP. THE PLAN'S ENROLLMENT WAS 175,769 AND 176,697 AT DECEMBER 31, 2019 AND 2018 RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO GOVERNING DOCUMENTS THE BYLAWS FOR DRISCOLL CHILDRENS HEALTH PLAN WERE AMENDED FEBRUARY 11, 2019 TO REVISE THE BOARD/OFFICER COMPOSITION AND THE NUMBER OF BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS DRISCOLL CHILDREN'S HOSPITAL IS THE SOLE MEMBER OF DRISCOLL CHILDREN'S HEALTH PLAN. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF GOVERNING BODY THE MEMBER SHALL ELECT AND APPOINT A CANDIDATE TO FILL ANY VACANCY OCCURRING ON THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL THE FOLLOWING MATTERS ARE RESERVED TO THE MEMBER AND SHALL REQUIRE THE AFFIRMATIVE ACTION OF THE MEMBER TO EFFECTIVE: (A) ANNUAL OPERATING & CAPITAL BUDGETS OF THE CORPORATION, (B) MERGER, ACQUISITION OR CONSOLIDATION OF THE CORPORATION, (C) BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTEE OF ANOTHER DEBT OR SIMILAR ACTION AND, (D) APPOINTMENT & REMOVAL OF DIRECTORS IN ACCORDANCE WITH THE BY-LAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990 THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY ANNUALLY, ALL DIRECTORS, OFFICERS AND KEY PERSONNEL FILL OUT A CONFLICT OF INTEREST FORM. THE COMPLIANCE OFFICER MAKES SURE ALL CONFLICT OF INTEREST FORMS ARE TURNED IN AND REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINES 15A AND 15B PROCESS FOR DETERMINING COMPENSATION THE FILING ORGANIZATION DOES NOT DETERMINE COMPENSATION FOR OFFICERS OR KEY EMPLOYEES. THE PROCESSES IS THAT OF DRISCOLL CHILDREN'S HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION. THE ORGANIZATION USES MGMA AND SULLIVAN COTTER PERCENTILES TO SET BASE COMPENSATION AND SKILL LEVELS. IF COMPENSATION LEVELS EXCEED CERTAIN PERCENTILES, A THIRD OUTSIDE CONSULTING FIRM IS USED TO VALUE THE MARKET VALUE FOR SERVICES RENDERED AND FOR GROUP COVERAGE AGREEMENTS. FOR CERTAIN COVERAGE AGREEMENTS, A FOURTH CONSULTING FIRM ASSISTS IN DETERMINING MARKET VALUE. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY WITH THE DELIBERATION AND DECISION DOCUMENTED CONTEMPORANEOUSLY. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2019. FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 OTHER CHANGES TO NET ASSETS EQUITY TRANSFER FROM DRISCOLL CHILDREN'S HOSPITAL $70,190,978 DRISCOLL CHILDREN'S HOSPITAL 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742577746 HOSPITAL TX 501(c)(3) 3 NA false DRISCOLL PHYSICIANS GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742988134 HEALTHCARE TX 501(c)(3) 3 DCH true DRISCOLL VALLEY PHYSICIANS GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 201234322 HEALTHCARE TX 501(c)(3) 3 DCH true DRISCOLL MATERNAL AND FETAL PHYS GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 201234461 HEALTHCARE TX 501(c)(3) 10 DCH true CHILDREN'S PHYS SERVICES OF SOUTH TEXAS 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742620408 HEALTHCARE TX 501(c)(3) 3 DCH true DRISCOLL HEALTHCARE SERVICES 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 010962276 AVIATION TX 501(c)(3) 12a-I DCH true DCH DEVELOPMENT FOUNDATION 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742358461 CHARITABLE TX 501(c)(3) 7 DCH true ALLEGRA INSURANCE COMPANY LTD PO BOX 105GT WEST BAY ROAD GRAND CAYMAN CJ KY1-1109 980704641 CAPTIVE INS. 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