2019-11-14T15:57:51-06:00 2018-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2018-01-01 463803873 INDIANA UNIVERSITY HEALTH PLANS NFP INC % CRAIG J JONES INDI 3179634842 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 GERALD C BRADFORD CFO 3179634842 2019-11-12 JENNIFER D RHODERICK P00395735 3176817000 162.1.129.128 35198520193185000005 2019-11-14 P E9BB99990D559D2579C16A2912A9ECE87B6779B9 B30082F924EC775D7FDD2A920EAE87EBC9BA4CEE 2018 2020-03-31 21:24:44Z MARK A LANTZY 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 349033692 false X https://www.iuhealthplans.org/ X 2013 IN An Indiana Medicare Advantage Plan that is passionate about helping our members achieve the wellbeing they desire by improving the way they experience health care. 7 3 0 0 0 0 0 0 162229441 157168131 56754 402959 0 0 162286195 157571090 1750 0 0 0 0 0 0 0 0 167743098 160664112 167744848 160664112 -5458653 -3093022 36107214 43900919 22409604 26282264 13697610 17618655 AN INDIANA MEDICARE ADVANTAGE PLAN THAT IS PASSIONATE ABOUT HELPING OUR MEMBERS ACHIEVE THE WELLBEING THEY DESIRE BY IMPROVING THE WAY THEY EXPERIENCE HEALTH CARE. false false 160308266 0 157168131 Indiana University Health Plans NFP, Inc. ("IU Health Plans NFP") operates as a health maintenance organization ("HMO") that holds a contract with the federal centers for Medicaid and Medicare Services, a division of the federal Department of Health and Human Services, to be a Medicare Advantage organization. Medicare Advantage organizations are required to provide adequate access to comprehensive health care services for Medicare beneficiaries through a contracted network of health care providers. To be considered adequate, the network must have a sufficient number of health care providers within an acceptable distance of the Medicare beneficiaries. The Corporation uses Indiana University Health, Inc. ("IU Health") as a health care delivery system to deliver and arrange for health care services to Medicare beneficiaries. IU Health maintains a network of providers throughout the state of Indiana. IU Health Plans NFP's HMO business is limited to the Medicare Advantage program. The corporation does not currently nor does it intend in the future to provide HMO coverage in the commercial, individual, or group health insurance markets. 160308266 false false false true false false false false false false false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false true 104 0 true 0 false false false false false false false false X 7 3 true false false false true true true true true false false false true true true true true false false false IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 MARK A LANTZY DIRECTOR/PRESIDENT 2.0 53.0 X X 0 788940 130514 RYAN C KITCHELL DIRECTOR/CHAIR 2.0 53.0 X X 0 1831685 237945 David A Ingram MD DIRECTOR (PARTIAL YEAR) 2.0 53.0 X 0 539320 111083 JOHN F FITZGERALD MD DIRECTOR 2.0 53.0 X 0 821518 130522 CYNTHIA S MILLER DIRECTOR 2.0 0.0 X 0 0 0 BEN H PARK MD DIRECTOR (Partial Year) 2.0 0.0 X 0 0 0 STEVEN L POLLACK DIRECTOR 2.0 0.0 X 0 0 0 ALFONSO W GATMAITAN DIRECTOR (Partial Year) 2.0 53.0 X 0 3058805 1037833 GERALD C BRADFORD TREASURER (Partial Year) 2.0 53.0 X 0 350937 42402 ROBERT W KOMULA TREASURER (Partial Year) 2.0 53.0 X 0 370963 38853 SUSAN M MANN SECRETARY (Partial Year) 2.0 53.0 X 0 181570 30678 Tina L Korty Secretary (Partial Year) 2.0 53.0 X 0 133664 14606 CAROLINE ABELEDA VP, OPERATIONS 0.0 55.0 X 0 341324 22819 0 8418726 1797255 0 true true false BLOOM INSURANCE AGENCY 1801 SOUTH LIBERTY DRIVE SUITE 200 BLOOMINGTON IN 47403 COMMISSIONS 580252 MILLIMAN INC 15800 W BLUEMOUND ROAD BROOKFIELD WI 53005 ACTUARIAL SERVICES 419879 HY Connect 340 W 10th Street INDIANAPOLIS IN 46202 Advertising 1863200 AMER SPECIALTY HEALTH FITNESS 10221 Wateridge Circle SAN DIEGO CA 92121 Health 270063 ATTAC CONSULTING GROUP LLC 301 East Liberty Suite 605 ANN ARBOR MI 48104 Consulting 871503 6 0 MEDICARE MEMBER SERVICE REVENUE 524298 157168131 157168131 0 0 157168131 262722 0 0 262722 0 0 0 0 0 191602839 191462602 140237 140237 0 0 140237 0 0 0 0 0 0 0 0 0 0 157571090 157168131 0 402959 X 0 0 0 0 0 0 0 0 0 0 0 9832 0 9832 0 156553 0 156553 0 0 0 0 17619379 17566352 53027 3524503 3524503 0 0 252839 212491 40348 0 116888 108558 8330 0 0 212299 212145 154 0 30945 30945 0 7489 7489 0 0 0 0 0 9536 0 9536 0 HEALTH CLAIMS PD. TO PROVIDERS 138423811 138423811 0 0 RECRUITMENT 97479 50603 46876 0 INSTITUTIONAL DUES/LICENSES 163028 163028 0 0 DRUGS & MEDICAL SUPPLIES 5449 5449 0 0 34082 2892 31190 160664112 160308266 355846 0 0 0 29753465 34375971 0 0 5428899 8802137 0 0 0 0 0 0 0 0 424029 220037 0 0 0 0 500821 502774 0 0 0 0 0 0 36107214 43900919 7606671 4041602 0 0 128313 218172 0 0 0 0 0 0 0 0 0 0 14674620 22022490 22409604 26282264 X 13697610 17618655 0 0 0 0 13697610 17618655 36107214 43900919 X -3093022 14067 7000000 X false true X true false true true false 0 INTERCOMPANY PAYABLES (NET) 22022490 22022490 X SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE IU Health Plans NFP is a subsidiary in Indiana University Health, Inc.'s ("IU Health") Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that Indiana University Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). Indiana University Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provisions of IRC Section 511. The Tax Cuts and Jobs Act (TCJA) was enacted on December 22, 2017. For tax-exempt entities, TCJA requires organizations to categorize certain fringe benefit expenses as a source of unrelated business income subject to tax, pay an excise tax on compensation above certain thresholds, and record income or losses for tax determination purposes from unrelated business activities on an activity-by-activity basis, among other provisions. Regulations necessary to implement certain aspects of TCJA are expected to be promulgated by the IRS in 2019. As of and for the year ended December 31, 2018, Indiana University Health has made reasonable estimates of the provision for income taxes, the compensation excise tax, and the effects, if any, on existing deferred tax balances based on accounting guidance included in Accounting Standards Codification (ASC) 740, Income Taxes. Indiana University Health will continue to refine its calculations in future periods, as additional regulations and guidance are issued by the IRS. Deferred income taxes which, as of December 31, 2018 and 2017, have no net carrying value, reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2018 and 2017, the Indiana University Health System had gross deferred tax assets of $119,965 and $93,794, respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2018 and 2017 was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. ASC Topic 740-10-50-3, Income Taxes: Disclosure, requires a valuation allowance to reduce the deferred tax assets reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The change in the valuation allowance for the current year is $26,171. At December 31, 2018, the Indiana University Health System has available net operating loss carryforwards of $482,349. Net operating losses generated from 1999 through 2017 will expire between 2019 and 2037. Net operating losses generated during 2018 do not expire. Certain subsidiaries of Indiana University Health are taxable entities. The tax expense and liabilities of these subsidiaries are not material to the consolidated financial statements. true true false false false false false false false MARK A LANTZY DIRECTOR/PRESIDENT 0 516838 0 247506 0 24596 0 103702 0 26812 0 919454 0 0 RYAN C KITCHELL DIRECTOR/CHAIR 0 958723 0 851710 0 21252 0 214270 0 23675 0 2069630 0 0 David A Ingram MD DIRECTOR (PARTIAL YEAR) 0 457117 0 79034 0 3169 0 111083 0 0 0 650403 0 0 JOHN F FITZGERALD MD DIRECTOR 0 346540 0 349441 0 125537 0 129837 0 685 0 952040 0 116473 ALFONSO W GATMAITAN DIRECTOR (Partial Year) 0 853829 0 504450 0 1700526 0 1012983 0 24850 0 4096638 0 1654573 GERALD C BRADFORD TREASURER (Partial Year) 0 295049 0 51566 0 4322 0 14715 0 27687 0 393339 0 0 ROBERT W KOMULA TREASURER (Partial Year) 0 297082 0 70317 0 3564 0 14807 0 24046 0 409816 0 0 SUSAN M MANN SECRETARY (Partial Year) 0 180046 0 0 0 1524 0 9272 0 21406 0 212248 0 0 CAROLINE ABELEDA VP, OPERATIONS 0 116921 0 38588 0 185815 0 8961 0 13858 0 364143 0 0 SCHEDULE J, PART I, LINE 3 - COMP. OF THE ORG'S CEO/EXECUTIVE DIRECTOR IU Health Plans NFP's President is employed by IU Health. IU Health's process for determining compensation includes the use of a compensation survey/study conducted by an independent compensation consultant with review and approval by the Committee on Personnel and Compensation and the Board of Directors. Please see Schedule O for additional details. SCHEDULE J, PART I, LINE 4A - SEVERANCE Caroline Abeleda entered into a severance agreement with IU Health during 2018. Severance of $143,738 that was received during 2018 is included in column B(III), other reportable compensation. Alfonso W. Gatmaitan entered into a severance agreement with IU Health during 2018. Severance of $17,530 that was received during 2018 is included in column B(III), other reportable compensation. Deferred severance of $999,283 included in column C, retirement and other deferred compensation. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN Mark A. Lantzy, Ryan C. Kitchell, John F. Fitzgerald M.D., David A. Ingram M.D. and Alfonso W. Gatmaitan participate in an IU Health supplemental executive retirement plan, provisions of which are designed to retain its critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Each of the executives listed above, with the exception of Alfonso W. Gatmaitan and John F. Fitzgerald, have amounts included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. These amounts were not paid to the executives during the year. The following executives have an amount included in column b(iii), other reportable compensation, representing the current year vested amounts received under the supplemental executive retirement plan: - Alfonso W. Gatmaitan ($1,654,573) - John F. Fitzgerald ($116,473) PART VI, SECTION A, LINE 2 - FAMILY OR BUSINESS RELATIONSHIP Certain officers, directors or key employees of Indiana University Health, Inc. (IU Health) may also serve on the boards or as officers of other related or unrelated organizations. As noted below, no additional compensation was provided to these individuals for their service to related organizations. Related for-profit organization: IU Health ACO, Inc. Type of Relationship: Business Director or Officer: Alfonso W. Gatmaitan, David A. Ingram PART VI, SECTION A, LINES 6, 7A AND 7B - MEMBERS OR STOCKHOLDERS Line 6: The sole member of IU Health Plans NFP is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: Subject to the powers reserved to the Member in the Corporation's Articles of Incorporation, the business and affairs of the Corporation shall be managed under the direction of a Board of Directors. The number of Directors comprising the Board of Directors shall be between three (3) and seven (7), as determined from time to time by the Board of Directors. Line 7B: Notwithstanding any other provisions of the Articles of Incorporation or any provision of IU Health Plans NFP's Bylaws, the following matters require the approval of IU Health, as the sole member, prior to implementation: - Any amendment of the Articles of Incorporation or Bylaws of IU Health Plans NFP; - Adoption or revision of any operating or capital budget of IU Health Plans NFP; - A merger or consolidation of IU Health Plans NFP; - Any sale, lease, exchange, conveyance, mortgage, pledge or other disposition of a substantial portion of the property, assets or interests of IU Health Plans NFP, other than pursuant to a budget approved by IU Health, as sole member; - Any incurrence of debt by, or the creation of any lien upon the property or revenues of, IU Health Plans NFP other than in the ordinary course of business or pursuant to a budget approved by IU Health, as sole member. Notwithstanding any other provisions of the Articles of Incorporation, or any provision of IU Health Plans NFP's Bylaws, IU Health, as the sole member, shall have the power to direct the Board of IU Health Plans NFP to do any of the following: - Transfer property of IU Health Plans NFP in amounts sufficient to pay the principal and interest of any obligation of IU Health, as sole member; and - Take such actions as are required in order for IU Health Plans NFP to comply with the covenants contained in any financing document to which IU Health, as sole member, is a party or under which IU Health is bound. PART VI, SECTION B, LINE 11B - REVIEW OF FORM 990 The CFO reviewed and approved the Form 990 prior to its filing. PART VI, SECTION B, LINES 12, 13, AND 14 - POLICIES IU Health Plans NFP is part of the IU Health system. As the sole member and controlling parent of IU Health Plans NFP, IU Health and its board of directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health Plans NFP's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries. PART VI, SECTION B, LINE 12C - CONFLICT OF INTEREST POLICY IU Health Plans NFP follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (1) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (2) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (3) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (4) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (5) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (6) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy. PART VI, SECTION B, LINE 15 - PROCESS FOR DETERMINING COMP. IU Health Plans NFP's Chairman of the Board, President, Secretary, Treasurer as well as a board member are all employed by IU Health. IU Health's process for determining compensation is as follows: (1) The Board of Directors has established a Committee on Personnel and Compensation. The individuals on this Committee are made up of individuals who are on the Board and who do not have a conflict of interest with IU Health. There are no physicians or employees on this Committee. This Committee develops and reviews annually the executive compensation philosophy, market analysis as to comparability and reasonableness. One of the purposes of this Committee is to review, approve and make recommendations regarding executive compensation and benefits to the IU Health Board. As deemed appropriate, this Committee also reviews the same detail with the Committee on Finance. The Committee on Finance is represented by certain members of the Board as well. (2) Each year the Committee on Personnel and Compensation engages an outside compensation consulting firm to conduct a compensation and benefits study for all senior vice presidents and above. The current compensation advisor is the SullivanCotter. SullivanCotter performs an independent compensation survey. The relevant comparability data includes: compensation and benefit levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. The Committee reviews the entire compensation package including: base compensation, short term and long term incentive plans, basic health and welfare benefits, qualified and nonqualified plans as well as any additional fringe benefits. Further, SullivanCotter will provide recommendations based upon the reasonable compensation information as it relates to salary increases, bonuses and benefits that are consistent with the compensation philosophy of the Committee. A separate analysis using the same methodology is done for the Chief Executive Officer. (3) The Committee reviews the salary survey and, if appropriate, makes recommendations on increases in salary and any changes in bonuses or benefits.The Committee's goal is to ensure that the total compensation and benefits package is reasonable based upon the independent data provided by SullivanCotter. The Committee votes on any changes in compensation or benefits. This review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval of compensation. (4) The Board reviews the report prepared by the SullivanCotter as well as the recommendations of the Committee on Personnel and Compensation as to changes in compensation approved by the Committee. As requested, the Committee on Finance also provides its review of recommendations on changes in executive compensation and benefits. This review, discussion and vote are documented in the minutes. (5) The Board then reviews the recommendations provided by the Committee on Personnel and Compensation and votes on the changes as well. No additional compensation or benefits are paid to the executives until the changes have been approved by the Committee and the Board. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval of compensation. The General Counsel prepares a formal written opinion reviewing the compensation and benefits approval process, comparing that process to the Intermediate Sanctions Test of IRC Section 4958 and, if the facts warrant, provides comments regarding the compensation and benefits approval process as this relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. (6) After the end of each year, the Committee and Board also reviews the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executive and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals and the compensation survey. The discussion and vote of the Committee and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. (7) The Committee on Personnel and Compensation and Audit Committee also review the required Form 990 disclosures related to executive compensation and benefits as well as compensation practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. PART VI, SECTION C, LINE 19 - PUBLIC DISCLOSURE IU Health Plans NFP's Articles of Incorporation are available for public inspection through the Indiana Secretary of State's website. IU Health Plans NFP's conflict of interest procedures are disclosed on Form 990, Schedule O. IU Health Plans NFP is a subsidiary in IU Health's Consolidated Audited Financial Statements. IU Health's Consolidated Audited Financial Statements are available for public inspection through its bond filings and as an attachment to IU Health's Form 990. PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS OR FUND BALANCES During 2018, IU Health Plans NFP recorded the following other changes in net assets or fund balances: Net Asset Transfer from IU Health: $7,000,000 Total Other Changes: $7,000,000 FORM 990 PART IX LINE 11G DESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:17619379 Clarian Transplant Institute Inc 950 N Meridian St Ste 800 Indianapolis IN 46204 134350599 Healthcare IN 501(c)(3) 10 IUH true HealthLINC Incorporated 950 N Meridian St Ste 800 Indianapolis IN 46204 263571507 Healthcare IN 501(c)(3) 10 IUHB true Indiana Health Info Exchange Inc 846 N Senate Ave Indianapolis IN 46202 364550324 Healthcare IN 501(c)(3) 12 I NA false Indiana University Health Inc 950 N Meridian St Ste 300 Indianapolis IN 46204 351955872 Healthcare IN 501(c)(3) 3 NA false IU Health Arnett Inc 950 N Meridian St Ste 300 Indianapolis IN 46204 263162145 Healthcare IN 501(c)(3) 3 IUH true IU Health Ball Memorial Hospital Inc 950 N Meridian St Ste 300 Indianapolis IN 46204 350867958 Healthcare IN 501(c)(3) 3 IUH true IU Health Ball Memorial Physicians Inc 950 N Meridian St Ste 300 Indianapolis IN 46204 351925641 Healthcare IN 501(c)(3) 10 IUHBMH true IU Health Bedford Inc 950 N Meridian St Ste 300 Indianapolis IN 46204 237042323 Healthcare IN 501(c)(3) 3 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