2020-10-21T13:54:30-05:00 2019-12-31 ERNST & YOUNG LLP 5 TIMES SQUARE NEW YORK NY 100366530 990 2019-01-01 113029569 Healthfirst Health Plan Inc % CRAIG BARATTIN-VP CONTROLLER HEAL 2128016000 100 CHURCH ST FL 18 New York NY 100072601 JOHN BERMEL CFO 2128016000 2020-10-20 NICOLE M SOKOLOWSKI P01683199 2127733000 2020-10-01 12.41.123.251 26528220202955000000 2020-10-21 P 9B904A396C3243A57879A4FFD4CB314CD3B74F97 69737C1B06B896110FDEC2C2D169A38C27D88D5E 2019 2021-04-22 16:20:28Z PATRICIA J WANG 100 CHURCH ST FL 18 NEW YORK NY 100072601 3519795768 false X www.healthfirst.org X 1990 NY IMPROVE THE HEALTH AND WELL-BEING OF UN DERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE,COMPLETE CARE,FIDA&COMMERCIAL INSURANCE RECIPIENTS. 4 2 0 0 0 0 0 0 2615768739 3034004843 14363863 18517333 0 0 2630132602 3052522176 0 0 0 0 0 0 0 0 0 2601432167 3027160070 2601432167 3027160070 28700435 25362106 798683966 927107027 448217619 521921401 350466347 405185626 X IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE, COMPLETE CARE, FIDA & COMMERCIAL INSURANCE RECIPIENTS. false false 1947324476 2017242604 MEDICARE: HEALTHFIRST HEALTH PLAN, INC. (HFHP), IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. HFHP PROVIDES HEALTH CARE SERVICES TO MEDICARE ADVANTAGE MEMBERS WHO ARE INDIGENT, AGED, DISABLED AND/OR MEDICALLY UNDERSERVED. IN 2019, HFHP SERVED 178,687 MEDICARE MEMBERS. 868506099 921706305 COMPLETECARE: HEALTHFIRST HEALTH PLAN, INC. (HFHP), IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. HFHP PROVIDES HEALTH CARE SERVICES TO COMPLETE CARE MEMBERS. COMPLETECARE IS A MEDICAID ADVANTAGE PLUS SPECIAL NEEDS PLAN THAT COMBINES MEDICARE AND MEDICAID BENEFITS, WITH ADDED LONG-TERM CARE SERVICES FOR QUALIFIED DUAL-ELIGIBLE MEMBERS. IN 2019, HFHP SERVED 13,253 COMPLETE CARE MEMBERS. 93602256 94946049 Fully Integrated Duals Advantage Programs (FIDA): HEALTHFIRST HEALTH PLAN, INC. (HFHP), IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. HFHP PROVIDES HEALTH CARE SERVICES TO FIDA MEMBERS, WHOSE BENEFIT CAN BE INTEGRATED AND CARE ACROSS THE MEDICARE AND MEDICAID PROGRAMS. IN 2019, HFHP SERVED 1,224 FIDA MEMBERS. HEALTHY NEW YORK : IN 2019, HEALTHY NEW YORK SERVED 7 MEMBERS. A PROGRAM OVERSEEN BY NY STATE DEPT. OF FINANCIAL SERVICES TO PROVIDE AFFORDABLE HEALTH CARE. 28576 109885 2909461407 false false false false false false false false false false false false false true false 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 true false true X 1372 0 true 0 false false false false false false true false X 4 2 false true false false true true true true true false false true true true true true true false false false NY X CRAIG BARATTIN-VP CONTROLLER 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 PATRICIA J WANG PRESIDENT AND CEO 1.0 40.0 X 0 3395186 482844 JOHN J BERMEL CHIEF FINANCIAL OFFICER 1.0 40.0 X 0 1896305 39437 STEVEN H BLACK CHIEF OPERATING OFFICER 1.0 40.0 X 0 1341124 156642 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 1.0 40.0 X 0 1193488 155911 JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 1.0 40.0 X 0 1022145 138801 LINDA TIANO CHIEF LEGAL OFFICER/SECRETARY 1.0 40.0 X X 0 974359 126894 SEAN KANE CHIEF HR OFFICER 1.0 40.0 X 0 962737 112065 THOMAS E MEIXNER SVP Delivery System Innovation 1.0 40.0 X 0 983539 87629 REBECCA SCHWIETZ END 9 SVP Clinical Services 1.0 40.0 X 0 967454 95770 PAUL E PORTSMORE JR SVP, GROWTH 1.0 40.0 X 0 939516 118328 KEVIN BARTH SVP Operations 1.0 40.0 X 0 771863 45300 ROBERT P BLANCHARD Treasurer 1.0 40.0 X 0 281623 34051 STEPHEN ROSENTHAL BOARD DIRECTOR 1.0 0.0 X 0 0 0 ERIC SCALETTAR BOARD DIRECTOR 1.0 0.0 X 0 0 0 0 14729339 1593672 0 false true false CAREMARK LLC ONE CVS DRIVE WOONSOCKET RI 02895 PHARMACY 1116190380 NEW YORK CITY HEALTH AND HOSPITAL C 125 WORTH STREET ROOM 514 NEW YORK NY 10013 MEDICAL/HOSPITAL 249022020 MONTEFIORE MEDICAL CENTER PO BOX 4296 CHURCH STREET STATION NEW YORK NY 10261 MEDICAL/HOSPITAL 185440090 NY PRESBYTERIAN HOSP-COLUMBIA PO BOX 6154 NEW YORK NY 10249 MEDICAL/HOSPITAL 114543688 INTERACTIVE COMMUNICATIONS INTERNAT 250 WILLIAMS STREET NW SUITE M 100 ATLANTA GA 30303 MEDICAL/HOSPITAL 98728568 1284 0 MEDICARE (INCLUDES PART D) 524114 2017242604 2017242604 COMPLETECARE (INCLUDES PART D) 524114 921706305 921706305 FIDA 524114 94946049 94946049 HEALTHY NY 524114 109885 109885 3034004843 18366421 18366421 0 0 0 0 0 467424504 467273592 150912 150912 150912 0 0 0 0 0 0 0 0 0 0 3052522176 3034004843 18517333 0 0 0 0 0 0 0 0 0 0 350101964 234104086 115997878 0 0 0 0 0 0 5077844 3502495 1575349 7637817 7637817 0 0 372797 247361 125436 0 0 0 0 0 0 0 0 0 0 0 HEALTHCARE SERVICE COSTS 2611937073 2611937073 MEDICAL ADMINISTRATIVE 52032575 52032575 3027160070 2909461407 117698663 0 0 0 5070553 50826077 0 0 291130254 360232423 0 0 0 0 0 0 0 0 0 0 0 0 494877932 508159007 0 0 0 0 0 0 7605227 7889520 798683966 927107027 397843426 476189365 0 0 16909285 0 0 0 0 0 0 0 0 0 0 0 33464908 45732036 448217619 521921401 X 350466347 405185626 0 0 350466347 405185626 798683966 927107027 X 25362106 8640828 20716345 X X false true X true false 0 DUE TO CMS 6040526 DUE TO STATE - CURRENT 16155813 PASS THRU PROGRAM LIABILITIES 4217254 MEDICARE PART D DEPOSIT LIABILITIES 19318443 45732036 3081879349 8640828 20716345 29357173 3052522176 3052522176 3027160070 3027160070 3027160070 PART XI, LINE 2D - OTHER ADJUSTMENTS ADMINISTRATIVE CHARGES: $20,432,053. The health care services agreements with certain hospitals require that a portion of the premiums are retained in order to fun the capital requirement by Healthfirst Health Plan (HFHP). EQUITY GAIN FROM INVESTMENT IN AFFILIATE: $284,292 represents 50% share of gain in Healthfirst Insurance Co. Inc. true true false false false false false false false JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 493696 418020 110429 0 116164 0 24067 0 1162376 0 107120 LINDA TIANO CHIEF LEGAL OFFICER/SECRETARY 518707 418800 36852 0 118800 0 9527 0 1102686 0 32027 PATRICIA J WANG PRESIDENT AND CEO 1276724 1576600 541862 0 474378 0 10088 0 3879652 0 447762 PAUL E PORTSMORE JR SVP, GROWTH 483872 361600 94044 0 118328 0 1425 0 1059269 0 93054 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 501335 542891 149262 0 132307 0 25042 0 1350837 0 120990 SEAN KANE CHIEF HR OFFICER 452816 408100 101821 0 112065 0 1420 0 1076222 0 100831 STEVEN H BLACK CHIEF OPERATING OFFICER 731816 606100 3208 0 148800 0 9327 0 1499251 0 0 JOHN J BERMEL CHIEF FINANCIAL OFFICER 709111 1115589 71605 0 16800 0 24117 0 1937222 0 0 ROBERT P BLANCHARD Treasurer 219343 60438 1842 0 10447 0 24619 0 316689 0 0 THOMAS E MEIXNER SVP Delivery System Innovation 385496 549558 48485 0 74112 0 14919 0 1072570 0 42334 REBECCA SCHWIETZ END 93019 SVP Clinical Services 350086 272541 344827 0 78067 0 18694 0 1064215 0 256549 KEVIN BARTH SVP Operations 244036 422300 105527 45300 0 701 0 817864 0 103182 SCHEDULE J, PART 1, LINE 3 THE COMPENSATION OF THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO HFHP (A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY OF HFMS MEMBER HOSPITAL EXECUTIVES (WHO ARE NOT EMPLOYED NOR COMPENSATED BY HFMS OR ANY OF ITS AFFILIATES). THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEE'S CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUALS ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - AN AFFILIATE ORGANIZATION OF HEALTHFIRST. REBECCA SCHWIETZ - TOTAL SEVERANCE: $416,000, SEVERANCE PAID IN 2019: $102,548 SEVERANCE DEFERRED: $313,452. SCHEDULE J, PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS TO THE PLAN SPONSOR FOR 2019: PATRICIA J. WANG $457,578, JAY A. SCHECHTMAN $99,364, GERALD T. SWEENEY $115,507, SEAN KANE $95,265, PAUL PORTSMORE $101,528, LINDA TIANO $102,000, STEVE BLACK $132,000, REBECCA SCHWIETZ $61,267, THOMAS E. MEIXNER $57,312, KEVIN BARTH $28,500. FORM 990, PART V, LINE 1A IN JULY 2018, WE STARTED PROCESSING SOME OF OUR PAYMENTS TO PROVIDER VIA BY CARD. THESE PAYMENTS ARE REPORTED ON 1099K BY THE PROVIDER'S MERCHANT SERVICE. IN 2019, THE NUMBER OF 1099S ISSUED BY HEALTHFIRST PHSP, INC. WAS REDUCED SIGNIFICANTLY SINCE IT WAS THE FIRST FULL YEAR PROCESSING CARD PAYMENTS FROM MERCHANT SERVICE (VPAY). FORM 990, PART VI, SECTION A, LINE 3 HEALTHFIRST HEALTH PLAN INC. (HFHP), CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS), A RELATED ORGANIZATION, TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE; THESE ARE PROVIDED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUMS ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY STATE REGULATORS. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR, HFMS A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM HFHP. FORM 990, PART VI, SECTION A, LINE 6 Healthfirst, Inc. has the right to appoint the members of the Board of Directors of Healthfirst Health Plan, inc. FORM 990, PART VI, SECTION A, LINE 7A HEALTHFIRST, INC., A RELATED NOT-FOR-PROFIT ORGANIZATION, HAS THE RIGHT TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS OF HEALTHFIRST HEALTH PLAN, INC. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY OTHER ENTITIES: * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS REQUIRES STATE REGULATORY APPROVAL * CERTAIN CHANGES TO PREMIUM RATES ARE SUBJECT TO FEDERAL OR STATE REGULATORY APPROVAL * EXPANSION TO OTHER MANAGED CARE BUSINESSES REQUIRES STATE LICENSURE * MANAGEMENT FEE RATE CHANGES REQUIRE APPROVAL FROM THE MANAGEMENT COMPANY AND STATE REGULATORS FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS VICE PRESIDENT CONTROLLER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS CHIEF LEGAL OFFICER AND CHIEF FINANCIAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. A NOMINATED BOARD MEMBER WHO DOES NOT COMPLETE THE STATEMENT WITHIN THE CALENDAR YEAR WILL NOT BE PERMITTED TO CARRY OUT DUTIES. THE SAME APPLIES TO AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE APPROPRIATE DISCLOSURES. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. GUIDANCE IS PROVIDED TO THE NECESSARY PARTIES AND ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION-MAKING, MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICERS OR EMPLOYEES, THE ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO HFHP (A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY OF HFMS MEMBER HOSPITAL EXECUTIVES (WHO ARE NOT EMPLOYED NOR COMPENSATED BY HFMS OR ANY OF ITS AFFILIATES). THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEE'S CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XI, LINE 5 $704,950 UNREALIZED GAIN RELATED TO EQUITY INVESTMENT WAS INCLUDED IN NET INCOME ACCORDING TO ACCOUNTING STANDARDS UPDATE ("ASU") 2016-01 IN AUDITED FINANCIAL STATEMENT AND THIS AMOUNT WAS REPORTED AND INCLUDED IN CHANGE OF NET ASSETS IN 990. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS - ADMINISTRATIVE CHARGES: $20,432,053 AND EQUITY GAIN IN INVESTMENT IN HEALTHFIRST INSURANCE CO. INC. - A 50% OWNED SUBSIDIARY: $284,292. TOTAL OTHER CHANGES IN NET ASSETS -$20,716,345. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT RISK AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC. (A RELATED ORGANIZATION). 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