PRIORITY HEALTH: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- PRIORITY HEALTH (EIN 38-2715520)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-10-12
- IRS object ID
- 202042869349301604
- Schema version
- 2019v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-10-12T12:30:33-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135381590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Ottawa Ave NW Suite 300 | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382715520 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Priority Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRIO | BusinessNameControlTxt |
| Phone | 6167745083 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 East Beltline NE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Anne Jones | PersonNm |
| Person Title | SVP, Finance | PersonTitleTxt |
| Signature | 2020-10-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jacob Cook | PreparerPersonNm |
| PTIN | P01240455 | PTIN |
| Phone | 6167747000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-04-22 16:20:28Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joan A Budden | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 East Beltline NE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,544,303,748 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | www.priorityhealth.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | To Improve Health, inspire hope and save lives. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $161,096 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $223,445 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,180,011,993 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,405,819,769 | CYProgramServiceRevenueAmt |
| PY Investment Income | $23,124,924 | PYInvestmentIncomeAmt |
| CY Investment Income | $62,940,052 | CYInvestmentIncomeAmt |
| PY Other Revenue | $614,581 | PYOtherRevenueAmt |
| CY Other Revenue | $453,011 | CYOtherRevenueAmt |
| PY Total Revenue | $3,203,751,498 | PYTotalRevenueAmt |
| CY Total Revenue | $3,469,212,832 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $2,707,334,596 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $2,967,243,296 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $166,534,034 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $178,322,518 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $205,984,437 | PYOtherExpensesAmt |
| CY Other Expenses | $178,932,603 | CYOtherExpensesAmt |
| PY Total Expenses | $3,079,853,067 | PYTotalExpensesAmt |
| CY Total Expenses | $3,324,498,417 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $123,898,431 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $144,714,415 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,276,184,676 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,507,787,414 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $516,041,187 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $542,944,400 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $760,143,489 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $964,843,014 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To Improve Health, inspire hope and save lives. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,651,921,797 | ExpenseAmt |
| Revenue | $1,776,677,621 | RevenueAmt |
| Desc | PRIORITY HEALTH HMO: SEE SCHEDULE O | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,522,112,277 | ExpenseAmt |
| Revenue | $1,628,290,848 | RevenueAmt |
| Desc | PRIORITY HEALTH SENIOR MARKETS (MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENT): SEE SCHEDULE O | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,401,561 | ExpenseAmt |
| Revenue | $2,230,224 | RevenueAmt |
| Desc | PRIORITY HEALTH WELLNESS: SEE SCHEDULE O | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,175,435,635 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 13609 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (true) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Anne Jones | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6164648695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 East Beltline NE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Joan A BUDDEN | ||||||||||
| PRESIDENT & CEO | 36.0 | 14.0 | Yes (X) | Yes (X) | $999,773 | $411,037 | $515,739 | |||
| MICHAEL SYTSMA | ||||||||||
| Chair | 1.0 | 1.0 | Yes (X) | Yes (X) | $15,000 | $15,000 | $0 | |||
| Ann Harten | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,087 | $9,087 | $0 | ||||
| BIRGIT KLOHS | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,000 | $9,000 | $0 | ||||
| Bruce Ullery | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,087 | $9,087 | $0 | ||||
| Christina Freese Decker | ||||||||||
| Director | 1.0 | 49.0 | Yes (X) | $0 | $2,364,268 | $967,786 | ||||
| EDWIN NESS | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $7,875 | $7,875 | $0 | ||||
| ELAINE WOOD | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $10,125 | $10,125 | $0 | ||||
| GARY TIMMER | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $7,500 | $7,500 | $0 | ||||
| Hilary Snell | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $10,125 | $10,125 | $0 | ||||
| Matthew Cox | ||||||||||
| Director | 1.0 | 49.0 | Yes (X) | $0 | $1,197,881 | $519,377 | ||||
| MICHAEL VERHULST | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,087 | $9,087 | $0 | ||||
| Michael Vredenburg | ||||||||||
| DIRECTOR | 1.0 | 49.0 | Yes (X) | $9,750 | $651,831 | $60,250 | ||||
| PAUL SAGINAW | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,750 | $9,750 | $0 | ||||
| RAJESH KOTHARI | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,750 | $9,750 | $0 | ||||
| RODRICK MILLER | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $6,750 | $6,750 | $0 | ||||
| WENDY WALKER MD | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $9,000 | $9,000 | $0 | ||||
| KIMBERLY L THOMAS | ||||||||||
| SECRETARY & SVP, General Counsel | 36.0 | 14.0 | Yes (X) | $404,178 | $166,169 | $167,409 | ||||
| Mary Anne Jones | ||||||||||
| Treasurer & SVP, Finance | 36.0 | 14.0 | Yes (X) | $477,302 | $196,234 | $205,751 | ||||
| BRIAN KRUPICZEWICZ | ||||||||||
| SVP, HUMAN RESOURCES | 36.0 | 14.0 | $282,036 | $115,953 | $129,578 | Yes (X) | ||||
| CHRISTOPHER CROOK | ||||||||||
| SVP, Information Services-Data & Analytics | 36.0 | 14.0 | $330,278 | $135,787 | $136,444 | Yes (X) | ||||
| JAMES FORSHEE MD | ||||||||||
| SVP, CHIEF MEDICAL OFFICER | 36.0 | 14.0 | $438,106 | $180,118 | $143,634 | Yes (X) | ||||
| MARTI LOLLI | ||||||||||
| SVP, CONS/GOVT MKT & CMO | 36.0 | 14.0 | $404,107 | $166,140 | $200,498 | Yes (X) | ||||
| MICHAEL KOZIARA | ||||||||||
| SVP, PROVIDER NETWORK | 36.0 | 14.0 | $437,300 | $179,787 | $168,530 | Yes (X) | ||||
| RICK MORRONE | ||||||||||
| SVP, EMPLOYER SOLUTIONS | 36.0 | 14.0 | $381,610 | $156,891 | $121,680 | Yes (X) | ||||
| CANDY DAVIS | ||||||||||
| SR. SALES EXECUTIVE | 36.0 | 14.0 | $290,622 | $119,484 | $28,283 | Yes (X) | ||||
| INES VIGIL | ||||||||||
| VP, ADVANCED ANALYTICS | 36.0 | 14.0 | $319,171 | $131,220 | $71,793 | Yes (X) | ||||
| JANIECE NICHOLS | ||||||||||
| Manager, Sales | 36.0 | 14.0 | $298,732 | $122,818 | $23,914 | Yes (X) | ||||
| JIANHUA YU | ||||||||||
| SVP, ADVANCED ANALYTICS/CHIEF ACTUARY | 36.0 | 14.0 | $435,829 | $179,182 | $172,308 | Yes (X) | ||||
| SHERWIN ROBINSON | ||||||||||
| VP, CHIEF UNDERWRITER | 36.0 | 14.0 | $347,448 | $142,846 | $58,952 | Yes (X) | ||||
| Pamela Ries | ||||||||||
| Former VP, System Total Value | 0.0 | 50.0 | $0 | $782,704 | $294,117 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,978,378 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,522,486 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,986,043 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Express Scripts | |||||
| 1 Express Way | St Louis | MO | 63121 | CLAIMS SERVICES | $702,913,257 |
| MUNSON MEDICAL CENTER | |||||
| 1105 6TH STREET | TRAVERSE CITY | MI | 49684 | CLAIMS SERVICES | $92,021,235 |
| REGENTS OF UNIVERSITY OF MICHIGAN | |||||
| 1500 EAST MEDICAL CENTER DRIVE | ANN ARBOR | MI | 48109 | CLAIMS SERVICES | $88,604,574 |
| SAINT MARYS HEALTH SERVICES | |||||
| 200 JEFFERSON STREET SE | GRAND RAPIDS | MI | 49503 | CLAIMS SERVICES | $81,630,353 |
| Metropolitan Hospital | |||||
| 5900 Byron Center Ave SW | Wyoming | MI | 49519 | Claims Services | $75,215,717 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1381 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Priority Health HMO | 524114 | $1,775,958,584 | $1,775,958,584 |
| PRIORITY HEALTH SENIOR MARKETS | 524114 | $1,627,631,864 | $1,627,631,864 |
| PRIORITY HEALTH WELLNESS | 900099 | $2,229,321 | $2,229,321 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,405,819,769 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,998,097 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $345,792 | UnrelatedBusinessRevenueAmt |
| Exclusion | $32,652,305 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,758,328 | RealAmt |
| Personal | $29,876 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,684,241 | RealAmt |
| Personal | $29,876 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$925,913 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$925,913 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$184,696 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$741,217 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,100,318,754 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,070,376,799 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,941,955 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,941,955 | TotalRevenueColumnAmt |
| Exclusion | $29,941,955 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Management Fee Revenue | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,378,924 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,378,924 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,378,924 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,469,212,832 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,407,198,693 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $161,096 | UnrelatedBusinessRevenueAmt |
| Exclusion | $61,853,043 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,967,243,296 | TotalAmt |
| Program Services | $2,967,243,296 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,554,540 | TotalAmt |
| Program Services | $3,054,997 | ProgramServicesAmt |
| Management And General | $2,499,543 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,076 | TotalAmt |
| Program Services | $34,142 | ProgramServicesAmt |
| Management And General | $27,934 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,889,792 | TotalAmt |
| Program Services | $74,739,386 | ProgramServicesAmt |
| Management And General | $61,150,406 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,234,061 | TotalAmt |
| Program Services | $11,678,734 | ProgramServicesAmt |
| Management And General | $9,555,327 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,582,049 | TotalAmt |
| Program Services | $8,570,127 | ProgramServicesAmt |
| Management And General | $7,011,922 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,603 | TotalAmt |
| Management And General | $131,603 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,321 | TotalAmt |
| Management And General | $31,321 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,845 | TotalAmt |
| Program Services | $36,845 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,234,813 | TotalAmt |
| Management And General | $1,234,813 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,359,125 | TotalAmt |
| Program Services | $22,197,519 | ProgramServicesAmt |
| Management And General | $18,161,606 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,816,183 | TotalAmt |
| Program Services | $5,948,901 | ProgramServicesAmt |
| Management And General | $4,867,282 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,614,233 | TotalAmt |
| Program Services | $4,187,828 | ProgramServicesAmt |
| Management And General | $3,426,405 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $482,931 | TotalAmt |
| Program Services | $265,612 | ProgramServicesAmt |
| Management And General | $217,319 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,555,616 | TotalAmt |
| Program Services | $3,055,589 | ProgramServicesAmt |
| Management And General | $2,500,027 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $730,357 | TotalAmt |
| Program Services | $401,696 | ProgramServicesAmt |
| Management And General | $328,661 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $597,491 | TotalAmt |
| Program Services | $328,620 | ProgramServicesAmt |
| Management And General | $268,871 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,274,869 | TotalAmt |
| Program Services | $1,274,869 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,044 | TotalAmt |
| Program Services | $424,074 | ProgramServicesAmt |
| Management And General | $346,970 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,832 | TotalAmt |
| Program Services | $202,308 | ProgramServicesAmt |
| Management And General | $165,524 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Shared Services/Management Fees | $66,604,140 | $36,632,277 | $29,971,863 |
| Taxes on Regulatory Fees | $24,159,533 | $24,159,533 | |
| Other Medical Management Programs | $2,241,593 | $2,241,593 | |
| Community Support & Outreach | $1,199,490 | $659,719 | $539,771 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,723,584 | TotalAmt |
| Program Services | $8,097,970 | ProgramServicesAmt |
| Management And General | $6,625,614 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,324,498,417 | TotalAmt |
| Program Services | $3,175,435,635 | ProgramServicesAmt |
| Management And General | $149,062,782 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$17,035,100 | BOYAmt |
| EOY | -$38,309,478 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,129,257 | BOYAmt |
| EOY | $454,490,446 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,074,467 | BOYAmt |
| EOY | $123,262,181 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,586 | BOYAmt |
| EOY | $3,549 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $465,399 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $36,854,747 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,011,351 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,504,173 | BOYAmt |
| EOY | $26,843,396 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $549,078,424 | BOYAmt |
| EOY | $625,598,260 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,843,787 | BOYAmt |
| EOY | $179,815,539 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,576,082 | BOYAmt |
| EOY | $135,618,122 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,276,184,676 | BOYAmt |
| EOY | $1,507,787,414 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $352,333,546 | BOYAmt |
| EOY | $357,620,954 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,052,774 | BOYAmt |
| EOY | $28,692,567 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,652,768 | BOYAmt |
| EOY | $19,407,375 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,002,099 | BOYAmt |
| EOY | $137,223,504 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $516,041,187 | BOYAmt |
| EOY | $542,944,400 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,524 | BOYAmt |
| EOY | $8,524 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,698,482 | BOYAmt |
| EOY | $186,065,280 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $687,436,483 | BOYAmt |
| EOY | $778,769,210 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $760,143,489 | BOYAmt |
| EOY | $964,843,014 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,276,184,676 | BOYAmt |
| EOY | $1,507,787,414 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $144,714,415 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,502,699 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $58,482,411 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,388,000 | OtherCostOrOtherBasisAmt |
| Book Value | $10,388,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,894,407 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,439,011 | DepreciationAmt |
| Book Value | $16,455,396 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $572,340 | OtherCostOrOtherBasisAmt |
| Depreciation | $572,340 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,843,396 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Investment in Affiliates | Desc |
| Book Value | $179,815,539 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $179,815,539 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from related entities | $21,594,714 |
| Interest receivable | $9,023,408 |
| other long term assets | $105,000,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $135,618,122 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to affiliates | $42,502,577 |
| Other Liabilities | $9,869,531 |
| PPACA Fee Payable | $84,851,396 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $137,223,504 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) Footnote | FormAndLineReferenceDesc |
| Explanation | Priority Health CONDUCTS AN ANALYSIS ANNUALLY TO DETERMINE THE ORGANIZATION'S LIABILITY WITH RESPECT TO UNCERTAIN TAX POSITIONS. FOR THE YEAR ENDED December 31, 2019 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joan A BUDDEN | ||||||||||||||
| PRESIDENT & CEO | $602,317 | $247,632 | $383,442 | $157,644 | $14,014 | $5,761 | $282,095 | $115,978 | $83,384 | $34,282 | $1,365,252 | $561,297 | $62,410 | $25,658 |
| Christina Freese Decker | ||||||||||||||
| Director | $0 | $1,339,915 | $0 | $996,180 | $0 | $28,173 | $0 | $748,731 | $0 | $219,055 | $0 | $3,332,054 | $0 | $104,436 |
| Matthew Cox | ||||||||||||||
| Director | $0 | $753,759 | $0 | $411,704 | $0 | $32,418 | $0 | $393,507 | $0 | $125,870 | $0 | $1,717,258 | $0 | $0 |
| Michael Vredenburg | ||||||||||||||
| DIRECTOR | $9,750 | $633,305 | $0 | $500 | $0 | $18,026 | $0 | $28,000 | $0 | $32,250 | $9,750 | $712,081 | $0 | $0 |
| Mary Anne Jones | ||||||||||||||
| Treasurer & SVP, Finance | $323,772 | $133,114 | $149,204 | $61,342 | $4,326 | $1,778 | $83,814 | $34,458 | $61,992 | $25,487 | $623,108 | $256,179 | $40,459 | $16,633 |
| KIMBERLY L THOMAS | ||||||||||||||
| SECRETARY & SVP, General Counsel | $280,031 | $115,128 | $122,958 | $50,552 | $1,189 | $489 | $79,138 | $32,536 | $39,497 | $16,238 | $522,813 | $214,943 | $28,951 | $11,902 |
| Pamela Ries | ||||||||||||||
| Former VP, System Total Value | $0 | $469,239 | $0 | $294,862 | $0 | $18,603 | $0 | $223,071 | $0 | $71,046 | $0 | $1,076,821 | $0 | $42,838 |
| MICHAEL KOZIARA | ||||||||||||||
| SVP, PROVIDER NETWORK | $301,914 | $124,126 | $122,626 | $50,415 | $12,760 | $5,246 | $67,137 | $27,602 | $52,292 | $21,499 | $556,729 | $228,888 | $28,828 | $11,853 |
| MARTI LOLLI | ||||||||||||||
| SVP, CONS/GOVT MKT & CMO | $280,917 | $115,492 | $120,850 | $49,685 | $2,340 | $963 | $90,693 | $37,286 | $51,391 | $21,128 | $546,191 | $224,554 | $25,541 | $10,501 |
| JAMES FORSHEE MD | ||||||||||||||
| SVP, CHIEF MEDICAL OFFICER | $293,925 | $120,841 | $133,392 | $54,842 | $10,789 | $4,435 | $52,282 | $21,495 | $49,504 | $20,353 | $539,892 | $221,966 | $33,530 | $13,785 |
| RICK MORRONE | ||||||||||||||
| SVP, EMPLOYER SOLUTIONS | $283,650 | $116,617 | $93,854 | $38,586 | $4,106 | $1,688 | $53,177 | $21,863 | $33,051 | $13,589 | $467,838 | $192,343 | $0 | $0 |
| CHRISTOPHER CROOK | ||||||||||||||
| SVP, Information Services-Data & Analytics | $218,333 | $89,764 | $109,887 | $45,177 | $2,058 | $846 | $54,393 | $22,363 | $42,298 | $17,390 | $426,969 | $175,540 | $18,779 | $7,721 |
| BRIAN KRUPICZEWICZ | ||||||||||||||
| SVP, HUMAN RESOURCES | $193,272 | $79,459 | $82,570 | $33,947 | $6,194 | $2,547 | $50,117 | $20,604 | $41,709 | $17,148 | $373,862 | $153,705 | $17,298 | $7,112 |
| JIANHUA YU | ||||||||||||||
| SVP, ADVANCED ANALYTICS/CHIEF ACTUARY | $297,268 | $122,216 | $131,906 | $54,230 | $6,655 | $2,736 | $82,749 | $34,021 | $39,357 | $16,181 | $557,935 | $229,384 | $33,727 | $13,866 |
| SHERWIN ROBINSON | ||||||||||||||
| VP, CHIEF UNDERWRITER | $137,692 | $56,609 | $111,658 | $45,906 | $98,098 | $40,331 | $5,421 | $2,228 | $36,356 | $14,947 | $389,225 | $160,021 | $66,391 | $27,295 |
| INES VIGIL | ||||||||||||||
| VP, ADVANCED ANALYTICS | $219,143 | $90,095 | $99,044 | $40,720 | $984 | $405 | $7,937 | $3,263 | $42,939 | $17,654 | $370,047 | $152,137 | $23,776 | $9,775 |
| JANIECE NICHOLS | ||||||||||||||
| Manager, Sales | $62,343 | $25,632 | $9,858 | $4,053 | $226,531 | $93,133 | $6,745 | $2,773 | $10,202 | $4,194 | $315,679 | $129,785 | $0 | $0 |
| CANDY DAVIS | ||||||||||||||
| SR. SALES EXECUTIVE | $48,696 | $20,022 | $354 | $145 | $241,572 | $99,317 | $6,466 | $2,659 | $13,576 | $5,582 | $310,664 | $127,725 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part II, Column (F) DEFERRED COMPENSATION | THE 2019 "BONUS & INCENTIVE COMPENSATION" INCLUDES CERTAIN DEFERRED COMPENSATION ARRANGEMENTS THAT WERE REPORTED IN PREVIOUS YEARS BUT PAID IN 2019. 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 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 1a Health or social club dues or initiation fees | The organization provided health club dues for seven executive employees. These amounts were treated as taxable compensation and included in Form W-2. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | SEE EXPLANATION PROVIDED ON SCHEDULE O FOR FORM 990, PART VI, LINE 15A. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | Sherwin Robinson - $77,800 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | $ 88,069 Joan Budden $ 26,500 Christopher Crook $ 47,316 James Forshee $ 104,436 Christina Freese Decker $ 57,092 Mary Anne Jones $ 40,680 Michael Koziara $ 24,409 Brian Krupiczewicz $ 36,042 Marti Lolli $ 42,838 Pamela Ries $ 93,687 Sherwin Robinson $ 40,853 Kimberly Thomas $ 33,551 Inis Vigil $ 47,593 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 L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL VREDENBURG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship With Org | DIRECTOR | RelationshipWithOrgTxt |
| Loan Purpose | TUITION ASSIST | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $27,000 | OriginalPrincipalAmt |
| Balance Due | $3,549 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | false | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $3,549 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Wendy Walker MD | |||
| Board member owning more than 35% of entity doing business with Priority Health. | $244,794 | BUSINESS RELATIONSHIP | false |
| Matthew Koziara | |||
| Son of Mr. Michael Koziara, a Key Employee of the organization. | $62,076 | Employment | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part IV, Column (b) Relationship Between the interested Person and the Organization | FormAndLineReferenceDesc |
| Explanation | MS. WENDY WALKER, A MEMBER OF THE BOARD OF DIRECTORS, HAS OWNERSHIP IN PHYSICIAN SUPPORT SERVICES, LLC. PHYSICIAN SUPPORT SERVICES LLC. PURCHASES HEALTH INSURANCE FROM PRIORITY HEALTH. THE AMOUNT REPORTED IN SCHEDULE L, PART IV REPRESENTS THE HEALTH INSURANCE PREMIUMS PAID TO PRIORITY HEALTH ON BEHALF OF PHYSICIAN SUPPORT SERVICES, LLC EMPLOYEES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
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| Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PRIORITY HEALTH HMO | PRIORITY HEALTH IS AN INTEGRAL PART OF THE SPECTRUM HEALTH SYSTEM, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM SERVING COMMUNITIES THROUGHOUT MICHIGAN. PRIORITY HEALTH'S MISSION, LED BY ITS COMMUNITY BOARD, STRIVES TO RETURN VALUE TO THE COMMUNITIES SERVED BEYOND THE PROVISION OF HEALTH CARE TO ITS MEMBERS. PRIORITY HEALTH HAS BUILT A LONG HISTORY OF OFFERING MICHIGAN EMPLOYERS AND INDIVIDUALS PROGRESSIVE PRODUCTS AND INNOVATIVE PROGRAMS INTENDED TO KEEP COSTS DOWN AND MEMBERS HEALTHY. ITS BROAD PORTFOLIO OF PRODUCTS AND SERVICES INCLUDES TRADITIONAL MEDICAL PLANS AS WELL AS HSA'S, HRA'S AND OTHER CONSUMER-DRIVEN PRODUCTS. PRIORITY HEALTH CURRENTLY HAS A "COMMENDABLE" ACCREDITATION FOR ITS HMO PRODUCTS FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA), AN INDEPENDENT MANAGED CARE ACCREDITING BODY. PRIORITY HEALTH HAS EARNED EITHER A "COMMENDABLE" OR "EXCELLENT" RATING EVERY YEAR SINCE 1998. PRIORITY HEALTH HAS ALSO MAINTAINED AN "A" (EXCELLENT) FINANCIAL RATING FOR FOUR CONSECUTIVE YEARS FROM A.M. BEST, A HEALTH INSURANCE RATINGS AGENCY, RECOGNIZING THE FINANCIAL STRENGTH OF THE ORGANIZATION AND FOCUS ON MANAGING THE COST OF HEALTH CARE FOR ITS COMMUNITY. PRIORITY HEALTH'S MAJORITY SHAREHOLDER, SPECTRUM HEALTH IS A NOT-FOR-PROFIT HEALTH SYSTEM, BASED IN WEST MICHIGAN, OFFERING A FULL CONTINUUM OF CARE THROUGH THE SPECTRUM HEALTH HOSPITAL GROUP, WHICH IS COMPRISED OF 14 HOSPITALS; 150 AMBULATORY AND SERVICE SITES; 4,500 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS; AND PRIORITY HEALTH, A HEALTH PLAN WITH MORE THAN 840,000 MEMBERS. SPECTRUM HEALTH IS WEST MICHIGAN'S LARGEST EMPLOYER, WITH OVER 31,000 EMPLOYEES. THE ORGANIZATION PROVIDED $585 MILLION IN COMMUNITY BENEFIT DURING ITS 2019 FISCAL YEAR AND ANOTHER $271 MILLION DURING ITS SHORT TAX YEAR COVERING JULY 1 - DECEMBER 31, 2019 SPECTRUM HEALTH REMAINS ONE OF THE TOP HEALTH SYSTEMS IN THE COUNTRY IN THE COUNTRY AND EXPANDED ITS FOOTPRINT WITH THE 2018 INTEGRATION OF LAKELAND REGIONAL HEALTH SYSTEM IN SOUTHWEST MICHIGAN. THE AFFORDABLE CARE ACT (ACA) ADDED NEW REQUIREMENTS THAT HOSPITAL ORGANIZATIONS MUST SATISFY IN ORDER TO MAINTAIN TAX EXEMPT STATUS UNDER IRC SECTION 501(C)(3). ONE OF THE REQUIREMENTS UNDER THIS ACT IS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY AT LEAST ONCE EVERY THREE YEARS. SPECTRUM HEALTH COMPLETED SEVERAL IMPLEMENTATION PLANS IDENTIFYING THE COMMUNITY HEALTH NEEDS AND IMPLEMENTATION PLAN GOALS FOR EACH SPECTRUM HEALTH HOSPITAL. ONE NEED IDENTIFIED IN THE CHNA'S IS ACCESS TO HEALTH CARE, WHICH INCLUDES IMPROVING ACCESS TO AFFORDABLE HEALTH CARE FOR ALL COMMUNITY MEMBERS. IN ADDITION, ALL COMMUNITY MEMBERS SHOULD HAVE ACCESS TO PREVENTIVE CARE AND MEDICAL HOME CARE, INCLUDING THE UNINSURED AND LOW-INCOME WORKING INDIVIDUALS. SPECTRUM HEALTH WORKS CLOSELY WITH PRIORITY HEALTH TO ACHIEVE THE IDENTIFIED NEEDS AND GOALS. PRIORITY HEALTH PURSUES INITIATIVES THAT WILL IMPROVE PATIENT OUTCOMES WHILE HELPING TO REDUCE THE OVERALL COST TO THE MEMBER. IN 2019, PRIORITY HEALTH LOWERED HEALTH COSTS ACROSS ALL LINES OF BUSINESS BY $11.5 MILLION IN INCREMENTAL SAVINGS THROUGH NEW OR EXPANDED MANAGED CARE INITIATIVES AND CHRONIC DISEASE MANAGEMENT PROGRAMS. THESE PROGRAMS INFLUENCE PHYSICIAN PRACTICES, PROMOTE APPROPRIATE HEALTH CARE UTILIZATION AND INCREASE QUALITY, WHICH EXTENDS BEYOND PRIORITY HEALTH'S MEMBERS. IN ADDITION TO THE MANAGED CARE SAVINGS ABOVE, PRIORITY HEALTH PURSUES INITIATIVES TO PREVENT INDIVIDUALS FROM DEVELOPING CHRONIC DISEASES, AS WELL AS INITIATIVES TO BETTER MANAGE INDIVIDUALS WHO ALREADY HAVE CHRONIC DISEASES. IN 2019, PRIORITY HEALTH ENROLLED OVER 78,000 MEMBERS IN MANAGED CARE AND CHRONIC DISEASE MANAGEMENT PROGRAMS. PRIORITY HEALTH MEASURES EACH ACCOUNTABLE CARE NETWORK'S USE OF RATES FOR PREFERENCE SENSITIVE CONDITIONS AND DISTRIBUTES THIS BENCHMARK DATA UN-BLINDED TO HIGHLIGHT OUTLIERS IN STANDARDS OF CARE. CONSUMER DECISION MAKING TOOLS HAVE ALSO BEEN DEVELOPED TO PROVIDE PATIENTS WITH ALTERNATIVES TO TREATMENT WITH RELATED EVIDENCE BASED OUTCOMES. PHARMACEUTICAL FORMULARY ASSESSMENTS GUIDE PHYSICIAN PRESCRIPTION ORDERING BEHAVIORS TOWARD THE LOWEST COST DRUGS THAT ARE PROVEN EFFECTIVE. QUALITY AND INCENTIVE PROGRAMS DESIGNED TO MONITOR AND REDUCE HIGH COST HEALTH CARE AREAS SUCH AS EMERGENCY ROOM (ER) VISITS, HIGH DIAGNOSTIC IMAGING, AND UNNECESSARY ADMISSIONS HAVE BEEN IMPLEMENTED ACROSS THE STATE OF MICHIGAN. OTHER EXAMPLES OF INITIATIVES INCLUDE IMPLEMENTATION OF ELECTRONIC MEDICAL RECORDS, WHICH BENEFIT NON-PRIORITY HEALTH PATIENTS; DEVELOPING AND PUBLISHING PREVENTIVE HEALTH CARE GUIDELINES AVAILABLE TO THE GENERAL PUBLIC ON ITS WEBSITE; AND USING COMMUNITY RATING WHICH MINIMIZES THE ECONOMIC IMPACT OF SEVERE ILLNESS ON A GIVEN INDIVIDUAL OR GROUP. PRIORITY HEALTH SERVES WHAT THE IRS HAS DEFINED AS THE "MOST IN NEED" POPULATION WITH INDIVIDUALS, SMALL GROUPS AND ELDERLY MAKING UP 63% OF THE MEMBERSHIP BASE. PRIORITY HEALTH PROVIDED COMMUNITY-RATED AFFORDABLE HEALTH INSURANCE TO OVER 451,000 MEMBERS WHO ARE INDIVIDUALS, SMALL GROUPS AND ELDERLY IN 2019. PRIORITY HEALTH ALSO SUPPORTS ITS WHOLLY-OWNED SUBSIDIARY, PRIORITY HEALTH CHOICE, INC., WHICH PROVIDES ACCESS TO EXCELLENT HEALTH CARE TO OVER 125,000 MEDICAID MEMBERS OF THE 451,000 MEMBERS MENTIONED PREVIOUSLY. |
| Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PRIORITY HEALTH HMO (CONTINUED) | IN 2016, PRIORITY HEALTH WAS SELECTED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) TO PARTICIPATE IN A FEDERAL COMPREHENSIVE PRIMARY CARE PLUS (CPC+) INITIATIVE, A NATIONAL ADVANCED PRIMARY CARE MEDICAL HOME MODEL THAT AIMS TO STRENGTHEN PRIMARY CARE THROUGH REGIONALLY-BASED MULTI-PAYER PAYMENT REFORM AND CARE DELIVERY TRANSFORMATION. THE GOALS OF CPC+ ARE TO IMPROVE THE QUALITY OF CARE PATIENTS RECEIVE, IMPROVE PATIENTS' HEALTH, AND SPEND HEALTH CARE DOLLARS WISELY. CPC+ WILL BRING TOGETHER CMS, COMMERCIAL INSURANCE PLANS, PRIORITY HEALTH CHOICE, AND PRIORITY HEALTH MEDICARE TO PROVIDE THE FINANCIAL SUPPORT NECESSARY FOR PRACTICES TO MAKE FUNDAMENTAL CHANGES IN THEIR CARE DELIVERY. THE CPC+ PILOT BEGAN IN JANUARY 2017 AND TESTS A 5-YEAR MODEL. PRIORITY HEALTH HAS BEEN A LEADER IN PATIENT-CENTERED CARE AND HAS A PROVEN RECORD OF WORKING WITH PHYSICIANS TO IMPROVE HEALTH OUTCOMES. THROUGH ITS PARTNERS IN PERFORMANCE PROGRAM, PRIORITY HEALTH ENCOURAGES AND REWARDS THE QUALITY CARE OF PRIMARY CARE PHYSICIANS. THE PHYSICIANS AND PRACTICES SELECTED FOR THE PRIORITY HEALTH QUALITY AWARDS HAVE ACHIEVED THE HIGHEST OVERALL SCORES FOR ENSURING PATIENTS RECEIVE PREVENTIVE CARE, CONTROL CHRONIC DISEASE AND HAVE A GOOD EXPERIENCE. EACH AWARD RECIPIENT IS SELECTED BY ANALYZING THE RESULTS OF THE PRIORITY HEALTH PRIMARY CARE PROVIDER INCENTIVE PROGRAM, A PROGRAM THAT TRACKS CLINICAL QUALITY MEASURES AGAINST NATIONAL STANDARDS AND EVIDENCE-BASED MEDICINE. PRIORITY HEALTH PAID PHYSICIANS MORE THAN $30 MILLION IN 2020 BASED ON THEIR PERFORMANCE IN 2019. THE PROGRAM'S SUCCESS IS CLEARLY DEMONSTRATED BY THE NUMBER OF PRIORITY HEALTH MEMBERS WHO RECEIVED PREVENTIVE SCREENINGS. IN THE LAST YEAR, MORE THAN 75% OF PRIORITY HEALTH MEMBERS RECEIVED ROUTINE COLORECTAL CANCER SCREENING EXAMS COMPARED TO A NATIONAL AVERAGE OF 62% AND 81% OF MEMBERS RECEIVED RECOMMENDED BREAST CANCER SCREENING COMPARED TO THE NATIONAL AVERAGE OF 72%. ADDITIONALLY, 82% OF MEMBERS RECEIVED CHILDHOOD IMMUNIZATIONS COMPARED TO THE NATIONAL AVERAGE OF 74%. PRIORITY HEALTH SHARES RISK WITH PROVIDERS AND EMPLOYERS BY OFFERING THESE INCENTIVES AND OTHER RISK SHARING ARRANGEMENTS. THIS PROMOTES LOWER OVERALL HEALTH CARE COSTS AND IMPROVED QUALITY TO THE COMMUNITY. IN 2015, PRIORITY HEALTH LAUNCHED A COST ESTIMATOR TOOL TO HELP MEMBERS CALCULATE THEIR OUT-OF-POCKET COSTS TO FIND THE MOST AFFORDABLE SERVICES. THE ONLINE COST ESTIMATOR TOOL DISPLAYS PRIORITY HEALTH SPECIFIC FEES FOR 300 COMMON HEALTH CARE PROCEDURES. THE COST ESTIMATOR RECOMMENDS LOWER-COST DOCTOR/FACILITY OPTIONS TO HELP ENSURE MEMBERS GET THE HIGHEST-QUALITY CARE AT THE BEST PRICE. THIS INNOVATIVE TOOL SUPPORTS PRIORITY HEALTH'S CONTINUED MARKET LEADERSHIP IN TRANSPARENCY AND LOWERS THE COST OF CARE TO THE COMMUNITY. SINCE LAUNCHING IN 2015, THE COST ESTIMATOR HAS RESULTED IN SHARED SAVINGS OF MORE THAN $11 MILLION. THE PRIORITY HEALTH THIRD PARTY LIABILITY (TPL) TEAM HAS CONSISTENTLY IMPROVED OUTCOMES BY INCREASING SAVINGS THROUGH AUDIT, ANALYSIS, AND THOROUGH ACCOUNT EVALUATION. WITH EMPHASIS ON IMPROVING BOTH MEMBER AND PROVIDER SATISFACTION, PROGRAM IMPROVEMENTS WERE MADE AT THE END OF 2019 TO EXPEDITE LIABILITY DETERMINATIONS BY FOCUSING ON COST CONTAINMENT EFFORTS AND DRIVING CONTINUOUS IMPROVEMENT IN ALL AREAS OF THE DEPARTMENT, THE TPL TEAM HAS BEEN ABLE TO CREATE EFFICIENCIES WHILE REALIZING PROGRAM SAVINGS OF OVER $36 MILLION. . THE MICHIGAN DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS) ADOPTED THE OBAMA ADMINISTRATION'S EXTENSION OF THE TRANSITIONAL "AS IS" POLICY. THIS DECISION ALLOWS INSURERS TO DECIDE WHETHER THEY WOULD CONTINUE OFFERING POLICIES THAT ARE NOT COMPLIANT WITH THE ACA, WHICH BECAME PERMISSIBLE WHEN THE FEDERAL GOVERNMENT DELAYED THE REQUIRED SHIFT TO ACA-APPROVED INSURANCE COVERAGE. WHILE MAJOR COMPETITORS HAVE SHUT DOWN PLANS, PRIORITY HEALTH CONTINUES TO OFFER AN EXTENSION OF ITS PRE-ACA INDIVIDUAL AND GROUP HEALTH PLANS TO SUBSCRIBERS AS LONG AS PERMITTED BY REGULATORY GUIDANCE. THE DECISION TO EXTEND PLANS IS CONSISTENT WITH PRIORITY HEALTH'S COMMITMENT TO PROVIDE INDIVIDUALS WITH FLEXIBILITY AND CHOICE. AT A TIME WHEN NATIONAL CARRIERS ARE EXITING THE INDIVIDUAL ACA MARKET, PRIORITY HEALTH REMAINS COMMITTED TO SERVING THIS POPULATION. |
| Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PRIORITY HEALTH HMO (CONTINUED) | AS A REQUIREMENT OF THE ACA, EACH STATE SELECTS AN ESSENTIAL HEALTH BENEFITS "BENCHMARK PLAN" THAT SERVES AS A REFERENCE FOR ALL OTHER HEALTH PLANS TO FOLLOW (INDIVIDUAL AND SMALL BUSINESS), WHEN DESIGNING THE SCOPE AND LIMITATIONS SURROUNDING COVERED SERVICES. A BENCHMARK PLAN IS CHOSEN BY EACH STATE EVERY FIVE YEARS. PRIORITY HEALTH WAS SELECTED AS THE STATE'S BENCHMARK PLAN IN 2012 AND IS THE ONLY HEALTH PLAN IN MICHIGAN TO EVER EARN THIS DESIGNATION. STARTING IN 2017 (CONTINUING IN 2018 AND FORWARD), THE MICHIGAN DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS) HAS RECOMMENDED THE PRIORITY HEALTH HMO PLAN TO CONTINUE TO SERVE AS THE ESSENTIAL HEALTH BENEFITS BENCHMARK FOR THE STATE. THE RECOMMENDATION UNDERSCORES PRIORITY HEALTH'S ABILITY TO DELIVER INCREDIBLE VALUE AND CREATE INNOVATIVE SOLUTIONS THAT IMPACT HEALTH CARE COSTS WHILE MAXIMIZING CUSTOMER EXPERIENCE. PRIORITY HEALTH'S HMO PLAN WAS SELECTED BECAUSE DIFS BELIEVES IT ACHIEVES THE BEST BALANCE BETWEEN COMPREHENSIVENESS AND COST-EFFECTIVENESS FOR MICHIGAN CONSUMERS. THE MICHIGAN ASSOCIATION OF HEALTH PLANS (MAHP), AN INDUSTRY VOICE FOR THE STATE'S HEALTH CARE PLANS, RECOGNIZES BEST PRACTICES IN HEALTH PLANS BY SPONSORING THE PINNACLE AWARDS. HEALTH PLANS ARE RECOGNIZED FOR ACHIEVEMENTS IN ADDRESSING THE CHALLENGES OF A SHIFTING HEALTHCARE ENVIRONMENT THROUGH IMPROVEMENTS IN OPERATIONS, CLINICAL SERVICES, DISEASE MANAGEMENT AND COMMUNITY OUTREACH. THE PINNACLE AWARD CONTINUES TO SERVE AS AN EMBLEM OF EXCELLENCE TO THE MEMBER PLANS THAT ARE RECOGNIZED. THE 2018 PINNACLE AWARDS CONTINUE PRIORITY HEALTH'S HISTORY OF BEING RECOGNIZED FOR ITS FOCUS ON IMPROVING HEALTH WHILE LOWERING COST. DURING 2019, 9 MICHIGAN HEALTH PLANS FROM ACROSS THE STATE SUBMITTED 28 PROGRAMS DEMONSTRATING CREATIVE APPROACHES TO SOLVING PROBLEMS AND IMPROVING SERVICES IN THE COMMERCIAL, MEDICARE, AND MEDICAID SECTORS. THESE 28 GROUND-BREAKING PROGRAMS CONSIDERED FOR MAHP'S ANNUAL PINNACLE AWARDS, SHOW AN ENTREPRENEURIAL SPIRIT AND AN INTEREST IN SERVING MEMBERS AS WELL AS TO INCREASE EFFICIENCY AND IMPROVE PATIENT HEALTH CARE WHILE LOWERING COSTS AND INCREASING SERVICE TO MICHIGAN CITIZENS. PRIORITY HEALTH RECEIVED 1 PINNACLE AWARD IN 2019. PRIORITY HEALTH WON A 2019 PINNACLE AWARD FOR COMMUNITY OUTREACH BY A SINGLE PLAN. PRIORITY HEALTH, WHILE WORKING CLOSELY WITH MAHP'S CHILDREN'S SPECIAL HEALTH CARE SERVICES ("CSHCS") AND THEIR FAMILIES,WAS QUICK TO IDENTIFY NEEDS AND GAPS IN KNOWLEDGE RELATED TO CARE COORDINATION BETWEEN THESE FAMILIES AND THE COMMUNITY PROVIDERS THEY RELY ON TO SERVE THEM. IN RESPONSE TO THESE FINDINGS, PRIORITY HEALTH LAUNCHED THE MEDICALLY COMPLEX CHILDREN'S INFORMATION SHARING EVENTS. THESE EVENTS ARE HELD QUARTERLY TO PROVIDE A VENUE FOR HEALTH CARE PROVIDERS AND COMMUNITY PARTNERS WHO WORK WITH THE CSHCS POPULATION TO NETWORK, SHARE INFORMATION, ESTABLISH A MORE ROBUST REFERRAL PROCESS AND TO COLLABORATE MORE. THE RESULT IS GREATER CARE COORDINATION AND AVAILABILITY OF RESOURCES, WHICH ARE AVAILABLE BUT OFTEN UNDERUTILIZED IN THESE COMMUNITIES. IN 2018, PRIORITY HEALTH RECEIVED A PINNACLE AWARE FOR ITS COMMUNICATION AND PUBLIC RELATIONS CAMPAIGN , "KNOW YOUR HEALTH CARE COSTS". PRIORITY HEALTH'S PUBLIC RELATIONS TEAM EXECUTED AN INTEGRATED COMMUNICATIONS PLAN TO SUPPORT THE WORK DONE TOWARDS HEALTH CARE PRICE TRANSPARENCY. THE GOAL WAS POSITIONING PRIORITY HEALTH AS A HEALTH CARE TRANSPARENCY AND INNOVATION LEADER, WHILE EDUCATING AND ENGAGING CUSTOMERS ABOUT THE IMPORTANCE OF UNDERSTANDING THEIR HEALTH CARE COSTS. CONSUMERS AREN'T ACCUSTOMED TO SHOPPING FOR HEALTH CARE PROCEDURES, SO FOCUSING ON EDUCATION AND PRICE TRANSPARENCY WAS CRUCIAL. THE OVERALL OBJECTIVES OF THE CAMPAIGN WERE TO INCREASE AWARENESS OF PRICE TRANSPARENCY THROUGH THE PRIORITY HEALTH SHOPPING TOOL, COST ESTIMATOR. THE FOCUS WAS ON PROVISION OF EDUCATION BY INFORMING CONSUMERS ABOUT THE IMPORTANCE OF UNDERSTANDING HEALTH CARE COSTS. THIS INCLUDED ADDING 80 NEW SERVICES AND SHARING UPDATES ON TOTAL HEALTH CARE COSTS SAVED WITH THIS TOOL. ALSO THE ADDITION OF SHOPPING PHARMACY COSTS WITH THE TOOL WAS HIGHLIGHTED FOR CONSUMERS. |
| Form 990, Part III, Line 4c PROGRAM SERVICE DESCRIPTION - PRIORITY HEALTH WELLNESS | PREVENTION AND WELLNESS HAVE BEEN THE FOUNDATION OF PRIORITY HEALTH'S APPROACH TO HEALTH CARE. PRIORITY HEALTH PROVIDES WELLNESS PROGRAMS WITHIN ITS STANDARD HEALTH PLANS, WHILE ALSO OFFERING CUSTOMIZED, STAND-ALONE WELLNESS PROGRAMS TO EMPLOYER GROUPS TO EMPOWER THEIR EMPLOYEES TO PURSUE HEALTHIER LIFESTYLES. IN ADDITION TO HEALTH PLAN OFFERINGS, PRIORITY HEALTH PARTICIPATES IN, AND SPONSORS, WELLNESS PROGRAMS FOR THE COMMUNITY AT LARGE TO IMPROVE THE HEALTH OF ALL PEOPLE, NOT JUST MEMBERS. IN ADDITION, APPROXIMATELY 84 STAFF HOURS OF WELLNESS CLASSES AND HEALTH FAIRS WERE PROVIDED TO THE COMMUNITY TO PROMOTE HEALTHY LIVING. PRIORITY HEALTH'S WELLNESS PROGRAMS ADDRESS THE OVERALL WELLBEING OF ITS MEMBERS. EMPLOYERS ARE ABLE TO SUPPORT THE OVERALL WELLBEING OF THEIR EMPLOYEES AND IMPROVE ENGAGEMENT, SATISFACTION AND PRODUCTIVITY, ULTIMATELY RESULTING IN IMPROVED TALENT RETENTION AND A HEALTHIER WORKFORCE. PRIORITY HEALTH PARTNERS WITH EMPLOYERS TO HELP THEM DELIVER TARGETED, SMART PROGRAMS THAT EFFECTIVELY IMPROVE EMPLOYEE PHYSICAL AND EMOTIONAL HEALTH WHILE ALSO IMPROVING WORKPLACE MORALE AND REDUCING OVERALL HEALTH COSTS WITH A PERSONALIZED WELLBEING APPROACH. PRIORITY HEALTH OFFERS A WELLBEING HUB, WHICH OFFERS A PERSONALIZED ONLINE WELLNESS EXPERIENCE TAILORED TO EACH EMPLOYEE'S INDIVIDUAL NEEDS. THE WELLBEING HUB, AVAILABLE TO ALL PRIORITY HEALTH MEMBERS, OFFERS MEMBERS ACCESS TO CONTENT AND TOOLS CENTERED ON SUPPORTING STRESS MANAGEMENT, NUTRITION, WEIGHT LOSS, QUITTING TOBACCO, CHRONIC CONDITION MANAGEMENT, FINANCIAL SUPPORT, SLEEP HEALTH AND MORE. IN RECENT YEARS PRIORITY HEALTH HAS SPONSORED MANY COMMUNITY EDUCATION PROGRAMS, HEALTH FAIRS, WALKS/RUNS/TRIATHLONS AND NEWSLETTERS. DURING 2019, PRIORITY HEALTH CONTRIBUTED OVER $64,500 BY OFFERING DISCOUNT CODES TO PROMOTE WELLNESS AND SPONSOR WALKS/RUNS ACROSS THE STATE. ONE OF THE MORE SIGNIFICANT CONTRIBUTIONS WAS TO THE MSU GRAN FONDO, A CYCLING EVENT TO ACTIVELY ENGAGE THE COMMUNITY WHILE ACCELERATING SKIN CANCER AWARENESS, PREVENTION AND RESEARCH. THE SEVENTH ANNUAL RIDE IN JUNE 2019 DREW MORE THAN 2,000 CYCLISTS FROM TWENTY ONE STATES AND THREE COUNTRIES AND REMAINS ONE OF AMERICA'S TOP GRAN FONDO'S RAISING $141,000 IN 2019. RIDERS PEDALED BETWEEN 10 MILES AND 80 MILES ACROSS THE ROLLING SCENIC TERRAIN OF WEST MICHIGAN. IN ITS FIRST SEVEN YEARS, THE MSU GRAN FONDO HAS RAISED OVER $1.1 MILLION WITH 100% OF EVERY DOLLAR RAISED BENEFITING SKIN CANCER AWARENESS, PREVENTION AND RESEARCH. PRIORITY HEALTH HAD 75 REPRESENTATIVES PARTICIPATE IN THE EVENT RAISING MORE THAN $8,700 IN SUPPORT OF HEALTHY LIVING AND CANCER RESEARCH IN ADDITION TO PRIORITY HEALTH'S $25,000 CONTRIBUTION. IN ADDITION TO THE GRAN FONDO, PRIORITY HEALTH SPONSORED THE MOVE TO THE BEATS RUN/WALK BENEFITING THE LIFETIME FOUNDATION, AUTISM ALLIANCE OF MICHIGAN & ROCK CF, A NONPROFIT DEDICATED TO INCREASING THE QUALITY OF LIFE FOR PEOPLE WITH CYSTIC FIBROSIS. THIS RACE IS PART OF THE LONGSTANDING ARTS, BEATS & EATS FESTIVAL AND HIGHLIGHTS THE IMPORTANCE OF HEALTHY LIVING WITHIN THE COMMUNITY. IN 2019, OVER 343,000 VISITORS ATTENDED THE FESTIVAL AND OVER $200,000 WAS RAISED FOR LOCAL CHARITIES. . AN ANNUAL PART OF THE ARTS, BEATS & EATS FESTIVAL, THE PRIORITY HEALTH ZUMBATHON HAD MORE THAN 1,600 PARTICIPANTS AND RAISED $20,000 IN DONATIONS BENEFITING ORGANIZATIONS IN SOUTHEAST MICHIGAN. IN ADDITION TO THE ZUMBATHON, PRIORITY HEALTH ALSO SPONSORS HEALTHY OPTIONS AT THE ARTS, BEATS AND EATS FESTIVAL. PARTICIPATING RESTAURANTS ARE ENCOURAGED TO PREPARE, PRESENT, AND IDENTIFY HEALTHY FOOD ITEMS IN THE FOLLOWING CATEGORIES: LOW CARB, VEGAN, LOW FAT, GLUTEN-FREE OR SUGAR FREE. EACH PARTICIPATING RESTAURANT DISPLAYS A SIGN THAT INDICATES WHICH HEALTHY OPTIONS THEY ARE FEATURING, MAKING IT EASY FOR THOSE WHO WANT TO MAKE GOOD FOOD CHOICES, AS WELL AS THOSE NEEDING SPECIAL ACCOMMODATIONS DUE TO FOOD SENSITIVITIES AND SPECIAL DIETS. NEW IN 2019 WAS A "SMART OPTIONS" FOOD LABELING PROGRAM THAT EDUCATED ATTENDEES ON HEALTHIER FOOD CHOICES. PRIORITY HEALTH PARTICIPATES IN PARTNERSHIP WITH MARANDA, A WEST MICHIGAN NEWS PERSONALITY, DIRECTING MESSAGES TO CHILDREN ON HEALTH AND OTHER POSITIVE MESSAGING. MARANDA PRESENTS A TV SERIES CALLED "WHERE YOU LIVE" AND BRINGS IN EXPERTS TO TALK TO KIDS ABOUT HEALTHY LIVING. THIS PARTNERSHIP ALSO SPONSORS EVENTS THROUGHOUT WEST MICHIGAN REACHING OUT TO KIDS IN AT-RISK COMMUNITIES. PRIORITY HEALTH IS ONE OF THE LONGEST RUNNING SUPPORTERS OF THE MARANDA PARK PARTIES (IN 2019 OVER $77,000 WAS CONTRIBUTED), WHICH PROVIDE FREE FOOD, HEALTH AND FITNESS ACTIVITIES FOR CHILDREN AT INNER CITY PUBLIC PARKS THROUGHOUT WEST MICHIGAN. THE PARK PARTIES HAVE BEEN RECOGNIZED BY THE USDA AS ONE OF THE NATION'S LARGEST SUMMER FEEDING PROGRAMS, IN 2019, MORE THAN 28,900 PEOPLE ATTENDED PARK PARTIES FOR FREE FUN. THE PRIORITY HEALTH TEAM DISTRIBUTED 9,000 PEDOMETERS AT 6 SUMMER EVENTS IN 2019. PRIORITY HEALTH ALSO BROUGHT BACK THE WALK THE ZOO WITH MARANDA EVENT TO JOHN BALL ZOO IN 2019. THIS EVENT ALLOWED KIDS AND FAMILIES TO GET OUT AND EXERCISE WHILE WALKING THE ZOO WITH MARANDA AND OTHER COMMUNITIES MEMBERS WHILE ENJOYING HEALTHY SNACK OPTIONS . |
| Form 990, Part III, Line 4c PROGRAM SERVICE DESCRIPTION - PRIORITY HEALTH WELLNESS (CONTINUED) | PRIORITY HEALTH CONDUCTS FREE WELLNESS CLASSES THROUGHOUT THE STATE. THE BROADER COMMUNITY IS WELCOME TO ATTEND CLASSES THAT EDUCATE THE COMMUNITY IN TOPICS SUCH AS NUTRITION, FITNESS AND PREVENTION. PRIORITY HEALTH PARTNERED WITH AM YOGA TO PROVIDE MONTHLY COMMUNITY YOGA AT THE GRAND RAPIDS ART MUSEUM (GRAM). PRIORITY HEALTH SPONSORS THIS PROGRAM AND CONTRIBUTED $5,000 IN 2019. THIS SPONSORSHIP PROVIDES ACCESS TO HEALTH AND WELLNESS THAT PEOPLE MAY NOT NORMALLY BE ABLE TO AFFORD. THE DONATIONS FROM EACH CLASS ARE THEN TURNED AROUND TO PROVIDE YOGA TO OTHER AREAS AND COMMUNITIES THAT MAY NOT HAVE ACCESS AND REACHES OVER 1,200 YOGIS PER YEAR. IN 2019, PRIORITY HEALTH CONTRIBUTED $20,000 TO THE AMERICAN HEART ASSOCIATION (AHA). A PORTION WENT TO THE PROGRAM CALLED GO RED FOR WOMEN DESIGNED TO CREATE AWARENESS OF THE ISSUE OF WOMEN AND HEART DISEASE. FINANCIAL SUPPORT HELPS FUND THE AHA PROGRAMS AND INITIATIVES THAT ADVANCE THE MISSION TO BUILD HEALTHIER LIVES, FREE OF CARDIOVASCULAR DISEASES AND STROKE. PRIORITY HEALTH SUPPORTS THE AHA'S GOAL OF SEEKING WAYS TO INCREASE COMMUNICATION WITH THE PUBLIC AND TO CREATE TOOLS AND RESOURCES TO HELP THEM MANAGE AND PREVENT HEART DISEASE . THE REMAINDER WENT TO THE AHA HEART WALK, WHICH IS THEIR PREMIER EVENT RAISING FUNDS TO SAVE LIVES FROM THE COUNTRY'S NUMBER 1 AND NUMBER 5 KILLERS - HEART DISEASE AND STROKE. IN 2019 PRIORITY HEALTH CONTINUED IT'S PARTNERSHIP WITH THE DETROIT RED WINGS TO PROMOTE HEALTHLY LIFESTYLES INCLUDING A PROMOTIONAL CAMPAIGN TO REACH RED WINGS FANS TO ENCOURAGE THEM TO STAY HEALTHY AND ACTIVE. SOCIAL MEDIA FOLLOWERS OF THE RED WINGS WERE ENCOURAGED TO TAKE PICTURES OF THEMSELVES BEING ACTIVE WITH THE OPPORTUNITY TO EARN FREE TICKETS TO FUTURE GAMES . TOGETHER, PRIORITY HEALTH AND THE DETROIT RED WINGS WERE ABLE TO REACH COUNTLESS LOYAL FANS WHILE PROMOTING HEALTH AND WELLNESS. IN 2019, PRIORITY HEALTH ALSO CONTINUED ITS PARTNERSHIP WITH THE DETROIT LIONS. THIS SPONSORSHIP HELPS SUPPORT THE TEAM'S EFFORTS TO SERVE AS COMMUNITY ADVOCATES BY PARTICIPATING IN VARIOUS COMMUNITY EVENTS THROUGHOUT THE YEAR WHICH FOCUS ON SUSTAINABLE HEALTH AND WELLNESS INITIATIVES AND COMMUNITY WELL-BEING. IN 2019, PRIORITY HEALTH PARTNERED WITH THE DETROIT PISTONS TO SUPPORT VARIOUS YOUTH ACTIVITIES THAT SUPPORTED LEADERSHIP, EMPOWERMENT, MAKING SMART CHOICES AND HEALTH AND WELLNESS INCLUDING A 3 ON 3 BASKETBALL TOURNAMENT, THE GIRLS DREAM BIG SUMMIT AND THE PISTONS ACADEMY AWARDS FOR YOUTH. IN THE SUMMER OF 2019, PRIORITY HEALTH LAUNCHED AN EXPERIENTIAL CAMPAIGN CALLED SUN SMART TO REMIND MICHIGANDERS TO STAY SAFE DURING THE SUMMER AND TAKE APPROPRIATE PRECAUTIONS TO PROTECT THEMSELVES FROM THE SUN'S HARMFUL UV RAYS. THE CAMPAIGN INCLUDED THE DISTRIBUTION OF MORE THAN 80,000 FREE UV ACTIVATED SUN BURN ALERT STICKERS, THE DEVELOPMENT AND DISTRIBUTION OF EDUCATIONAL MATERIALS AND A SOCIAL MEDIA CAMPAIGN THAT RESULTED IN A $10,000 DONATION TO THE AMERICAN CANCER SOCIETY. PRIORITY HEALTH IS ALSO A $10,000 SPONSOR OF FORGOTTEN HARVEST'S HEALTHY FOOD, HEALTHY KIDS PROGRAM WHICH HAS PROVIDES ENOUGH FOOD FOR 200,000 STRUGGLING CHILDREN IN WAYNE, MACOMB AND OAKLAND COUNTIES. IN ADDITION, PRIORITY HEALTH SPONSORS THE UNITED SPORTS PROFESSIONAL BASEBALL LEAGUE DANCE TEAM IN SOUTHEAST MICHIGAN. THIS PROGRAM GIVES AN INCLUSIVE HEALTHY ACTIVITY FOR NEARLY 100 KIDS AND ADULTS AGES 6-23 DURING THE BASEBALL SEASON. THEY ALSO CONTRIBUTED $20,000 TO THE WEST MICHIGAN PROSTATE HEALTH ALLIANCE - SUPPORTING EDUCATION, SCREENING AND MENTOR/SUPPORT GROUPS FOR MEN DIAGNOSED WITH PROSTATE CANCER AND THEIR FAMILIES AND $30,000 TO THE BUILDING OF THE PORTAGE SENIOR CENTER IN 2019. THE CONTRIBUTION HELPED BUILD AN ACTIVITY ROOM FOR SENIORS TO STAY SOCIAL AND ACTIVE. PRIORITY HEALTH CONTRIBUTES OVER $200,000 ANNUALLY TO PROVIDE HEALTH AND WELLNESS COMMUNICATION TO INDIVIDUALS ACROSS MICHIGAN. THINK-HEALTH, A DIGITAL MAGAZINE, IS RELEASED BY PRIORITY HEALTH TO SUPPORT CONSUMERS AND BUSINESS OWNERS AS THEY MAKE HEALTH CARE DECISIONS. THINK HEALTH FEATURES PRIORITY HEALTH EXPERTS AS WELL AS OTHER THOUGHT LEADERS AND THIRD-PARTY ORGANIZATIONS ACROSS THE HEALTH INSURANCE, HEALTH CARE TECHNOLOGY AND FITNESS INDUSTRIES. THE SITE ALSO HIGHLIGHTS PERSONAL STORIES FROM INDIVIDUALS LOOKING TO IMPROVE THEIR HEALTH AND INSPIRE OTHERS, AS WELL AS INSIDER TIPS ON HOW TO GET INVOLVED IN ACTIVITY-RELATED EVENTS ACROSS MICHIGAN. IN TOTAL, PRIORITY HEALTH SUPPORTED HEALTH AND SOCIAL WELFARE ACTIVITIES VIA CONTRIBUTIONS OF NEARLY $1,400,000 IN 2019 IN AN EFFORT TO IMPROVE HEALTH SERVICES AND CONDITIONS IN NEIGHBORHOODS, WORKPLACES, AND SCHOOLS THROUGHOUT THE COMMUNITIES IT SERVES. |
| Form 990, Part III, Line 4b PRIORITY HEALTH SENIOR MARKETS | PRIORITY HEALTH BEGAN OFFERING MEDICARE ADVANTAGE PLANS IN JULY 2005 AND MEDICARE ADVANTAGE PLANS WITH PRESCRIPTION DRUG COVERAGE IN JANUARY 2006. ITS MEDICARE ADVANTAGE PLANS VARY IN PRICE BASED ON WHERE MEMBERS LIVE AND WHAT BENEFITS THEY NEED. MORE THAN 156,000 MICHIGANDERS HAVE A PRIORITY HEALTH MEDICARE ADVANTAGE PLAN, AND MORE THAN 16,000 CHOSE A PRIORITY HEALTH MEDICARE SUPPLEMENT PLAN, ALSO KNOWN AS MEDIGAP. PRIORITY HEALTH STRIVES TO WORK WITH THE COMMUNITY AND MAKE MEDICARE SIMPLE TO UNDERSTAND. THAT IS WHY IT WROTE AND PUBLISHED "MEDICARE ADVANTAGE FOR DUMMIES." IT WAS WRITTEN IN COOPERATION WITH WILEY PUBLISHING, OWNERS OF THE DUMMIES SERIES. THE BOOK HAS BEEN DISTRIBUTED FREE TO OVER 255,000 PEOPLE ACROSS MICHIGAN AND DOWNLOADED COUNTLESS TIMES AS IT IS NOW AVAILABLE ELECTRONICALLY AS AN E-BOOK. AS A RESULT OF PRIORITY HEALTH'S WORK WITH THE COMMUNITY AND DEDICATION TO OFFERING PLANS THAT DELIVER HIGH QUALITY, ITS MEDICARE ADVANTAGE PLANS HAVE RECEIVED NCQA ACCREDITATION STATUS OF "COMMENDABLE." PRIORITY HEALTH'S HMO-POS MEDICARE ADVANTAGE PLANS WITH PRESCRIPTION DRUG COVERAGE WERE AWARDED 4.5 OUT OF 5 STARS IN 2019 BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). PRIORITY HEALTH'S PPO MEDICARE ADVANTAGE PLANS WITH PRESCRIPTION DRUG COVERAGE WERE AWARDED 4 OUT OF 5 STARS IN 2019 BY CMS. THE MEDICARE STAR RATINGS INDICATE HOW WELL A HEALTH PLAN PERFORMS OVERALL; THE BETTER THE STAR RATING, THE HIGHER QUALITY CARE AND EXPERIENCE IS DELIVERED. OF THE 44 QUALITY AND IMPROVEMENTS METRICS USED TO DETERMINE OUR OVERALL QUALITY RATING OF 4.5, APPROXIMATELY 80% OF THE METRICS WERE EITHER 4 OR 5 STARS. PRIORITY HEALTH IS ABLE TO PROVIDE ITS MEMBERS HIGH QUALITY MEDICARE ADVANTAGE PLANS WHILE REMAINING AMONG THE LOWEST COST PLANS IN THE COUNTRY. MEDICARE ADVANTAGE MEMBERS CAN ENROLL EITHER INDIVIDUALLY, OR THROUGH AN EMPLOYER GROUP. DURING THE 2019 MEDICARE ANNUAL ENROLLMENT PERIOD (AEP), PRIORITY HEALTH ENROLLED 19% OF THE INDIVIDUALS WHO PURCHASED A MAPD PLAN IN MICHIGAN FROM OCTOBER 15 - DECEMBER 7, 2018. PRIORITY HEALTH'S MEDICARE ADVANTAGE ENROLLMENT INCLUDES ABOUT 130,000 INDIVIDUAL ADVANTAGE MEMBERS, OR JUST OVER 32% OF THE TOTAL INDIVIDUAL MEDICARE ADVANTAGE MARKET, MAKING PRIORITY HEALTH THE LEADER IN MICHIGAN. INDIVIDUAL MEDICARE ADVANTAGE IS OFFERED IN ALL 68 COUNTIES IN MICHIGAN'S LOWER PENINSULA, WITH 98% OF PROVIDERS, INCLUDING ALL MAJOR HOSPITAL SYSTEMS, IN OUR NETWORK. PRIORITY HEALTH'S NETWORK HAS MORE THAN 41,000 PROVIDERS. IN 2012, PRIORITY HEALTH LAUNCHED HOME BASED PRIMARY CARE (HBPC) AS A PILOT WITH OUR AFFILIATE, SPECTRUM HEALTH MEDICAL GROUP (SHMG). HBPC BRINGS THE CARE TEAM INTO THE HOME OF PATIENTS THAT ARE AT THE FAR END OF THE POPULATION HEALTH CONTINUUM, THE ADVANCED CHRONICALLY ILL, WHOSE MULTIPLE MEDICAL CONDITIONS ARE COMPLICATED BY FUNCTIONAL AND/OR COGNITIVE LIMITATIONS THAT MAKE IT DIFFICULT FOR THEM TO ADEQUATELY ACCESS THE TRADITIONAL AMBULATORY PHYSICIAN OFFICE. IN ADDITION TO PRIORITY HEALTH CHANGING HOW THE PATIENT ACCESSES THEIR CARE, THERE IS NOW A TEAM BASED MODEL OF CARE TO MEET ALL THE NEEDS OF THE PATIENT. IN 2019, PRIORITY HEALTH CONTINUED ITS ENGAGEMENT WITH PATIENTS HAVING ADVANCED ILLNESS WHICH RESULTED IN AN ESTIMATED $11.2 MILLION IN TOTAL SAVINGS BY REACHING MEMBERS ENROLLED IN HBPC PROGRAMS . CHRONIC CONDITIONS ARE LEADING CONTRIBUTORS TO RISING HEALTH CARE COSTS NATIONWIDE. TO ADDRESS THIS, PRIORITY HEALTH LAUNCHED THE MEDICATION THERAPY MANAGEMENT (MTM) PILOT PROGRAM WITH ITS MEDICARE MEMBERS. THE MTM PILOT PROGRAM OFFERED PRIORITY HEALTH MEDICARE MEMBERS THE OPPORTUNITY TO MEET ONE-ON-ONE WITH PHARMACISTS TO REVIEW ALL OF THEIR MEDICATIONS INCLUDING PRESCRIPTIONS, OVER-THE-COUNTER DRUGS, AND HERBAL AND VITAMIN SUPPLEMENTS. COMPLEX MEDICATION REGIMENS CREATE SIGNIFICANT CHALLENGES FOR PATIENTS LIVING WITH CHRONIC ILLNESS, THEIR CAREGIVERS, HEALTH CARE PROVIDERS AND THE HEALTH CARE SYSTEM AS A WHOLE. THE IMPACT OF MEDICATION-RELATED PROBLEMS CAN BE MINIMIZED THROUGH A STRUCTURED MTM PROGRAM THAT USES PHARMACISTS WORKING COLLABORATIVELY WITH THE PATIENT AND THE PATIENT'S HEALTH CARE PROVIDERS. RETAIL AND OFFICE-BASED PHARMACISTS WILL WORK WITH PATIENTS AND PROVIDERS TO ADDRESS DRUG-RELATED PROBLEMS AND COMPLETE COMPREHENSIVE MEDICATION REVIEWS. IN 2015, PRIORITY HEALTH EXPANDED ITS MTM PROGRAM TO COMMERCIAL AND MEDICAID MEMBERS. WITH THIS MOVE, PRIORITY HEALTH BECAME THE FIRST HEALTH PLAN IN THE STATE TO EXPAND THE PROGRAM TO BOTH ITS MEDICARE AND EMPLOYER-SPONSORED HEALTH PLANS. IN 2019, PRIORITY HEALTH ENGAGED OVER 54,000 MEDICARE MEMBERS IN THE MTM PROGRAM AND REDUCED THE COST OF CARE FOR ENGAGED MEDICARE MEMBERS BY AN ESTIMATED $1,218 PER YEAR. IN ADDITION, PRIORITY HEALTH ENGAGED OVER 45,000 COMMERCIAL AND MEDICAID MEMBERS IN PHARMACY MANAGEMENT PROGRAMS. PRIORITY HEALTH WAS ABLE TO LOWER THE ANNUAL COST OF CARE FOR COMMERCIAL AND MEDICAID MEMBERS $645 AND $479, RESPECTIVELY. IN 2017, PRIORITY HEALTH RECEIVED A PINNACLE AWARD FOR ITS MEDICARE CARE MANAGEMENT HYBRID PROGRAM. THE CARE MANAGEMENT TEAM UNDERSTANDS AND ACKNOWLEDGES THAT SOCIAL DETERMINANTS OF HEALTH IMPACT DISEASE MANAGEMENT. WHILE DATA SCIENCE CONTINUES TO EVOLVE AND IMPROVE IN ITS ABILITY TO IDENTIFY THESE NON-CLAIMS DRIVEN INDICATORS OF RISK, IT IS DIFFICULT FOR THE USUAL METHODS OF CARE MANAGEMENT TO IDENTIFY AND ADDRESS THEM. |
| Form 990, Part III, Line 4b PRIORITY HEALTH SENIOR MARKETS (CONTINUED) | PRIORITY HEALTH LAUNCHED ITS HYBRID PROGRAM AS AN AT-HOME CARE MANAGEMENT PROGRAM TO ADDRESS THE FULL BURDEN OF ILLNESS AND SOCIO-DEMOGRAPHIC RISK FACTORS FOR MEDICARE MEMBERS. AS A RESULT, PRIORITY HEALTH HAS OBSERVED LOWER ADMISSION RATES THAN STATE AND NATIONAL AVERAGES THANKS IN PART TO INTERDISCIPLINARY TEAMS THAT PROVIDE A QUICK RESPONSE TO CONDITION DESTABILIZATION. IN 2018, PRIORITY HEALTH ADDED ADDITIONAL FUNCTIONALITY TO ITS COST ESTIMATOR TOOL ENABLING MEDICARE ADVANTAGE MEMBERS TO ACCESS REAL-TIME COST INFORMATION ON PRESCRIPTION DRUGS, HELPING MEMBERS PAY LESS BY SWITCHING TO A LOWER PRICED ALTERNATIVE, USING A PREFERRED PHARMACY, OR OPTING FOR MAIL ORDER. MORE THAN 6,000 PRESCRIPTIONS ARE AVAILABLE VIA THE COST ESTIMATOR TOOL INCLUDING PILLS, CHEWABLES, AND CAPSULE DRUGS. WHEN A MEDICATION IS PRICED THROUGH THE TOOL, MEMBERS HAVE THE OPTION TO VIEW MORE AFFORDABLE ALTERNATIVES AND SEE EXACT COSTS AT THEIR PREFERRED PHARMACIES, WHICH FOR COULD PROVIDE SIGNIFICANT SAVINGS TO THOSE MEMBERS WHO REQUIRE SOME OF THE MOST EXPENSIVE DRUGS IN THE MARKET. |
| Form 990, Part IV, Line 12a Audited Financial Statements | The organization's financial statements are audited annually by an independent accounting firm. The "No" response to these questions 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-3 | ALL EMPLOYEES OF PRIORITY HEALTH WERE EMPLOYED DURING THE YEAR BY SPECTRUM HEALTH SYSTEM (38-3382353) AND LEASED BACK TO PRIORITY HEALTH. SALARIES AND WAGES, EMPLOYEE BENEFITS AND PAYROLL TAXES ARE ALLOCATED TO PRIORITY HEALTH VIA A MANAGEMENT FEE. THE SALARIES AND WAGES REPORTED IN PART IX STATEMENT OF FUNCTIONAL EXPENSES REFLECTS THE PORTION OF SALARIES AND WAGES ALLOCATED TO PRIORITY HEALTH. SPECTRUM HEALTH SYSTEM FILED ALL APPLICABLE IRS TAX FILINGS INCLUDING FORMS W-2 AND W-3 ON BEHALF OF PRIORITY HEALTH. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | Committees - The Chair of the Board of Directors may establish such standing or special committees from time to time as he or she will deem appropriate to conduct the activities of the corporation, and will define the powers and responsibilities of such committees. Persons who are not members of the Board of Directors will be eligible to serve on committees other than the Executive Committee. The members and chair of all committees will be appointed by the Chair of the Board of Directors for a one (1) year term or until their successors are duly elected, but will be subject to removal at any time by the Chair of the Board of Directors. A committee will have the specific powers and responsibilities as determined by the Board of Directors excluding those powers and responsibilities retained by the shareholders or Board of Directors pursuant to the Articles of Incorporation or Bylaws of the corporation. Executive Committee - The Chair of the Board of Directors may appoint an Executive Committee consisting of the Chair of the Board of Directors, the Vice Chair, and such additional directors as the Chair of the Board of Directors may determine from time to time. The Executive Committee may exercise all powers and authority of the Board of Directors in managing the corporation between meetings of the Board of Directors (within the limits prescribed by the Articles of Incorporation or Bylaws of the corporation or by law) or may have such specific powers and responsibilities as determined by the Chair of the Board of Directors. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | CERTAIN 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 stockholders | The Organization 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 - 0.6% 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 body | Election of Members and Their Rights From Priority Health bylaws: 6.2 Number and Class of Directors. The Board of Directors will be composed of not less than fifteen (15) and not more than twenty-one (21) members, which will be divided into the following classes: 6.2.1 One-third (1/3) of the directors will be adult enrollees as specified under MCL Section 500.3511(1) and elected pursuant to Section 6.3 below. At least one (1) of such adult enrollee directors will be from the corporation's Northern service area that is also served by the Class B Shareholders (the Northern Shareholders). 6.2.2 Two (2) of the directors will be appointed jointly by the Class B Shareholders. Of such directors, one (1) will be a physician. 6.2.3 The remainder of the directors (not less than eight (8)) will be appointed by the Class A Shareholder. 6.3 Election of Adult Enrollee Members. The Governance Committee or similarly delegated committee of the Board of Directors will solicit names of potential candidates from the members, shareholders, directors and community. The Committee will submit to the Board of Directors a list of nominees for election to the Board of Directors as adult enrollee representatives. At least one (1) member will be nominated for each directorship to be filled at such annual meeting. No more than two (2) persons employed by or affiliated with any one (1) employer or other group may be nominated. 6.4 Term. The adult enrollee members will be divided into three (3) classes, which will be as evenly divided as possible. The terms of office of the classes will expire in three (3) successive years, with one (1) class expiring each year. Each elected director will be elected for a term of three (3) years (except for the directors elected immediately after adoption of this Section 6.4 who will serve the terms designated by the Board of Directors). The directors appointed by the Class A and Class B Shareholders will serve one (1) year terms or until such time as their successor is appointed. 6.5 Vacancies. Any vacancy in a Board of Director position designated by the Class A and Class B Shareholders will be filled by the Class A and Class B Shareholders, respectively. Any vacancy in a position for an adult enrollee will be filled by the remaining adult enrollees on the Board of Directors. Each person appointed to fill a vacancy will complete the unexpired portion of the original term of the director being replaced or such term as designated by the shareholder, following non-binding consultation with the Chairperson of the corporation's Board; or (ii) allow the seat to remain vacant until an individual is appointed by the shareholder pursuant to Section 6.4 of these Bylaws. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Decisions Subject to Approval of shareholders (Not Members) Certain decisions are subject to approval of shareholders. From Priority Health bylaws: 2.2 Class A Shareholder's Reserved Powers. The Class A Shareholder shall have the reserved powers set forth in this Section 2.2. The corporation's Board of Directors may recommend action to the Class A Shareholder with respect to the reserved powers set forth in this Section 2.2. The actions listed below may, notwithstanding any other provision of these Bylaws or the Articles, be unilaterally caused and/or taken by the Class A Shareholder, within its sole and exclusive power and discretion, and shall not be deemed authorized unless and until approved by the Class A Shareholder: 2.2.1 Amendment of the Articles of Incorporation or Bylaws of the corporation as provided in Section 13.1 of these Bylaws; 2.2.2 Election and/or removal of the Class A Shareholder-appointed members of the corporation's Board of Directors pursuant to Article VI of these Bylaws; 2.2.3 Election and/or removal of the corporation's Chairperson of the Board of Directors; 2.2.4 Hiring, discharge, and evaluation of the corporation's President following consultation with the corporation's Board of Directors pursuant to Section 7.3; 2.2.5 Adoption of the corporation's strategic plan(s); 2.2.6 Adoption of the corporation's annual operating and capital budgets, and any amendments to such budgets in excess of the Authority Matrix Amount; 2.2.7 All capital expenditures by the corporation in excess of that amount (the "Authority Matrix Amount") set forth in the Authority Matrix for Capital Expenditures and Loans to Non-Spectrum Health Entities (the "Expenditure Authority Matrix"), a current copy of which is attached hereto as Exhibit A and which may be amended from time to time by Spectrum Health System ("Spectrum Health"); 2.2.8 All borrowings or guarantees of indebtedness by the corporation (or any entity controlled by the corporation), including any operating lease in an amount greater than one million dollars ($1,000,000.00) during the initial lease term, not including renewals and/or extensions; 2.2.9 All lending by the corporation (or any entity controlled by the corporation) to persons other than Spectrum Health or an entity controlled by Spectrum Health in excess of the Authority Matrix Amount; 2.2.10 The corporation's investments of cash and/or reserves, whether on an individual basis or as part of a pooled investment strategy; 2.2.11 Any merger or consolidation of the corporation (or any entity controlled by the corporation), or any other change in ownership percentages, control, or capital structure of the corporation (or any entity controlled by the corporation); 2.2.12 The purchase of all, or a majority of, another corporation, limited liability company, partnership or other legal entity's stock, membership interest, partnership interest, other ownership interest, or assets; 2.2.13 The creation of any entity controlled, directly or indirectly, by the corporation; 2.2.14 The sale or transfer of more than ten percent (10%) of the assets of the corporation (or any entity controlled by the corporation) to any person or entity not controlled by Spectrum Health; 2.2.15 Dissolution of the corporation; 2.2.16 The selection, retention, and oversight of the outside auditors for the corporation (or any entity controlled by the corporation) and 2.2.17 In other cases when required by law or as otherwise provided in these Bylaws. The Class A Shareholder, prior to exercising any of the reserved powers set forth above, shall notify the Class B Shareholder (provided such action is not taken at a duly called meeting of the shareholders, Board of Directors or any designated committee). 2.3 Class B Shareholders' Reserved Powers. The Class B Shareholders shall have the reserved powers set forth in this Section 2.3. The corporation's Board of Directors may recommend action to the Class B Shareholders with respect to the reserved powers set forth in this Section 2.3. The Class B Shareholders may, notwithstanding any other provision of these Bylaws or the Articles, act jointly, within their sole and exclusive powers and discretion, elect and/or remove the Class B Shareholder-appointed members of the corporation's Board of Directors pursuant to Article VI of these Bylaws. 2.4 Compliance with Spectrum Health Policies. Notwithstanding anything contained in these Bylaws to the contrary, the corporation and its subsidiaries shall at all times comply with and implement Spectrum Health policies and procedures approved by the President and Chief Executive Officer of Spectrum Health, or his/her designee as being specifically applicable to the corporation, except to the extent that such compliance and/or implementation would (a) materially and negatively impact the rights, powers, or preferences of the Class B Shareholders; or (b) be noncompliant with applicable laws and/or regulations. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The 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 by 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 policy | BOARD OF DIRECTORS 1. Conflicts of interest must be disclosed, BOTH VIA AN ANNUAL ELECTRONIC DISCLOSURE PROCESS as well as verbally at a board meeting prior to discussion of any agenda item with regard to which a board member has a conflict. 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 official | The 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. 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 2019 (1/1/19-12/31/19), three health care executive compensation surveys, two medical group surveys, two pediatric hospital surveys 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 employees | See explanation provided for Form 990, Part VI, Line 15a. |
| Form 990, Part VI, Line 19 Required documents available to the public | The 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 $100,000 | THERE 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 DIRECTORS | BASED ON EXTERNAL OPINION BY SULLIVAN COTTER AND ASSOCIATES, INC., PRIORITY HEALTH 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 balances | Change in nonadmitted assets - -70189341; Change in surplus notes - -6000000; Net Unrealized Gain(Loss) on Subsidiaries - 47971752; Contributed Capital for Future Acquisition - 86700000; |
| Form 990, Part XII, Line 2b Audited Financial Statements | The 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 Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHMB PROPERTIES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 EAST BELTLINE NE | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382715520 | EIN |
| Primary Activities | PROP. MGMT | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Total Income | $3,773,843 | TotalIncomeAmt |
| End Of Year Assets | $107,393,740 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRIORITY HEALTH | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SPECTRUM HEALTH SYSTEM | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 383382353 | MANAGEMENT | MI | 501(c)(3) | Type III-FI | NA | false |
| SPECTRUM HEALTH HOSPITALS | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 381360529 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH PRIMARY CARE PTNRS | ||||||||||
| 1840 WEALTHY STREET SE | GRAND RAPIDS | MI | 49506 | 381358164 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH FOUNDATION | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 382752328 | PHILANTHROPY | MI | 501(c)(3) | 7 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH CONTINUING CARE | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 383242232 | REHAB/CARE | MI | 501(c)(3) | 10 | SPECTRUM HEALTH SYSTEM | false |
| TRINITY HEALTH PLANS | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382663747 | HMO MGMT | MI | 501(c)(4) | PRIORITY HEALTH | Yes (true) | |
| PRIORITY HEALTH CHOICE INC | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 320016523 | HMO (MEDICAID) | MI | 501(c)(3) | 10 | PRIORITY HEALTH | Yes (true) |
| REED CITY HOSPITAL CORPORATION | ||||||||||
| 300 N PATTERSON RD | REED CITY | MI | 49677 | 382770076 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION | ||||||||||
| 212 S SULLIVAN AVENUE | FREMONT | MI | 49412 | 381359517 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| ZEELAND COMMUNITY HOSPITAL | ||||||||||
| 8333 FELCH STREET | ZEELAND | MI | 49464 | 381411184 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH UNITED | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 381358412 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| MECOSTA COUNTY MEDICAL CENTER | ||||||||||
| 605 OAK STREET | BIG RAPIDS | MI | 49307 | 381368744 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| MEMORIAL MEDICAL CENTER OF WEST MICHIGAN | ||||||||||
| 1 N ATKINSON DR | LUDINGTON | MI | 49431 | 381359266 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| PENNOCK HOSPITAL | ||||||||||
| 1009 West Green Street | Hastings | MI | 49058 | 381360562 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| LAKELAND REGIONAL HEALTH SYSTEM INC | ||||||||||
| 1234 NAPIER AVENUE | SAINT JOSEPH | MI | 49085 | 382609624 | HEALTH CARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST MICHIGAN ACCOUNTABLE CARE ORGANIZATION LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 221 MICHIGAN ST NE STE 501 | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 833153113 | EIN |
| Primary Activities | ACCOUNTABLE CARE ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Related | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PRIORITY HEALTH INSURANCE COMPANY | ||||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 201529553 | INSURANCE | MI | PRIORITY HEALTH | C Corporation | $297,801,488 | $137,250,020 | 0.01 | Yes (true) |
| PRIORITY HEALTH MANAGED BENEFITS | ||||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 383085182 | THIRD PARTY ADMINISTRATOR | MI | NA | C Corporation | false | |||
| WEST MICHIGAN HEART | ||||||||||||
| 1840 Wealthy Street | GRAND RAPIDS | MI | 49506 | 382125186 | PHYSICIANS | MI | NA | C Corporation | false | |||
| SPECTRUM HEALTH PHYSICIAN ALLIANCE | ||||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 371655728 | PHYSICIANS | MI | NA | C Corporation | false | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PRIORITY HEALTH INSURANCE COMPANY | ||
| A | $262,985 | GAAP, CASH, OR FMV |
| PRIORITY HEALTH INSURANCE COMPANY | ||
| L | $496,281 | GAAP, CASH, OR FMV |
| PRIORITY HEALTH INSURANCE COMPANY | ||
| R | $9,666,079 | GAAP, CASH, OR FMV |
| PRIORITY HEALTH CHOICE | ||
| R | $2,825,683 | GAAP, CASH, OR FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part II, Column (g) SECTION 512(B)(13) CONTROLLED ENTITY | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, SPECTRUM HEALTH SYSTEM. | ExplanationTxt |