2018-11-16T17:10:03-06:00 2017-12-31 ERNST & YOUNG LLP 5 TIMES SQUARE NEW YORK NY 100366530 990 2017-01-01 510609967 Healthfirst Health Plan of New Jersey Inc % CRAIG BARATTIN-VP CONTROLLER HEAL 2128016000 100 Church Street Floor 18 New York NY 100072601 JOHN BERMEL CFO 2128016000 2018-11-12 Laura Kielczewski P00740769 2127733000 2018-11-07 12.41.123.251 20404320183165000000 2018-11-12 P 48376AC60715834143EC7E8D06BB46C111BC8BCB E33A1571D2C37AC133723712033DBAF1EA8D7CD9 2017 2019-02-21 02:37:17Z HEALTHFIRST NJ PATRICIA J WANG 100 Church Street Floor 18 New York NY 100072601 999179 false X WWW.HEALTHFIRSTNJ.ORG X 2006 NJ TO PROMOTE THE HEALTH OF THE PEOPLE OF THE STATE OF NEW JERSEY BY ARRANGING FOR THE PROVISION OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID BENEFICIARIES. 17 15 0 0 0 0 0 0 0 955126 3837 44053 0 0 3837 999179 0 0 0 0 0 0 0 0 0 275216 1108759 275216 1108759 -271379 -109580 35375939 31784544 24757000 21011034 10618939 10773510 TO PROMOTE THE HEALTH OF THE COMMUNITY BY ARRANGING FOR THE PROVISION OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID BENEFICIARIES AND TO RELIEVE THE POOR AND DISTRESSED BY MEETING THE SPECIAL HEALTH CARE NEEDS OF MEDICARE AND MEDICAID BENEFICIARIES. false false 907800 955126 Medicare Healthfirst Health Plan of New Jersey, Inc. (HFNJ) provides affordable quality health plans to eligible medicare recipients. For the year ended December 31, 2017, premium revenue includes retroactive adjustments to amounts recorded in prior periods (none for the year ended December 31, 2016). There was no membership reported in 2017. As of 12/31/2014, the company ceased its Medicare operations. Effective December 1, 2014, the company no longer actively markets itself as an insurer and began liquidation activities to wind-down its operation. 1007 0 Medicaid/NJFamilycare Healthfirst Health Plan of New Jersey, Inc.(HFNJ) provides affordable quality health plans to eligible medicaid recipients. For 2017 there was no membership reported. As of June 2014 the company's Medicaid Membership was sold to a 3rd party and the company ceased its Medicaid operations. 908807 false false false false false false false false false false false false false true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false true 464 0 true 0 false false false false false false X 17 15 false true false false true true true true true false false true true true true true true false false false X CRAIG BARATTIN-VP CONTROLLER 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 GARY HORAN DIRECTOR 1.0 0.0 X 0 0 0 PETER A KELLY DIRECTOR 1.0 0.0 X 0 0 0 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 1.0 40.0 X 0 427750 16200 MICHAEL D D'AGNES DIRECTOR 1.0 0.0 X 0 0 0 ANTHONY T ORLANDO DIRECTOR 1.0 0.0 X 0 0 0 LESLIE D HIRSCH DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL MARON DIRECTOR 1.0 0.0 X 0 0 0 JOHN CALANDRIELLO DIRECTOR 1.0 0.0 X 0 0 0 RICHARD SMITH DIRECTOR 1.0 0.0 X 0 0 0 RONALD NAPIORSKI DIRECTOR 1.0 0.0 X 0 0 0 RONALD RAK DIRECTOR 1.0 0.0 X 0 0 0 EDWARD CONDIT DIRECTOR 1.0 0.0 X 0 0 0 TOM DALY DIRECTOR 1.0 0.0 X 0 0 0 PAUL E PORTSMORE SVP, GROWTH 1.0 40.0 X X 0 739095 111900 ROBERT PETERSON DIRECTOR 1.0 0.0 X 0 0 0 CHAD FORBES DIRECTOR 1.0 0.0 X 0 0 0 ALAN BEATTY DIRECTOR 1.0 0.0 X 0 0 0 LINDA TIANO CHIEF LGL OFFICER 1.0 40.0 X 0 537294 90000 PATRICIA J WANG CHIEF EXECUTIVE OFFICER 1.0 40.0 X 0 3105009 461430 JOHN J BERMEL CHIEF FINANCIAL OFFICER 1.0 40.0 X 0 1157812 32944 DANIEL P MCCARTHY-END 63017 PRESIDENT & COO 1.0 40.0 X 0 2369180 200442 JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 1.0 40.0 X 0 1642737 126038 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 1.0 40.0 X 0 814400 140156 SEAN KANE CHIEF HR OFFICER 1.0 40.0 X 0 815602 106863 REBECCA SCHWIETZ SVP CLINICAL SERVICES 1.0 40.0 X 0 596083 92197 THOMAS E MEIXNER SVP Deliver System Engagement 1.0 40.0 X 0 542852 79190 ELIZABETH R ST CLAIR CHIEF LEGAL OFFICER 0.0 0.0 X 0 822455 278162 0 13570269 1735522 0 true true false PALISADES MEDICAL CENTER 7600 RIVER ROAD NORTH BERGEN NJ 07047 MEDICAL/HOSPITAL 552831 RARITAN BAY MEDICAL CENTER 530 NEW BRUNSWICK AVENUE PERTH AMBORY NJ 08861 MEDICAL/HOSPITAL 341138 TRINITAS REGIONAL MEDICAL CENTER 750 WALNUT AVENUE CRANFORD NJ 07016 MEDICAL/HOSPITAL 291253 EAST ORANGE GENERAL HOSPTIAL 300 CENTRAL AVENUE EAST ORANGE NJ 07019 MEDICAL/HOSPITAL 266645 ST MICHAEL'S MEDICAL CENTER 1160 RAYMOND BLVD NEWARK NJ 07012 MEDICAL/HOSPITAL 215153 10 0 MEDICARE PART D - FINAL SETTLEMENT 524114 955126 955126 955126 44053 44053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 999179 955126 44053 0 0 0 0 0 0 0 0 0 0 143269 95990 47279 0 0 0 0 0 2000 2000 0 8587 8587 0 0 0 0 0 0 142086 142086 0 0 0 CLAIMS ADJUSTMENT EXPENSE 960 960 0 0 HEALTHCARE SERVICE COSTS 811857 811857 0 0 1108759 908807 199952 0 0 0 27819618 30311346 0 0 1079231 40730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6477090 1432468 35375939 31784544 3403077 1508942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21353923 19502092 24757000 21011034 X 10618939 10773510 0 0 0 0 10618939 10773510 35375939 31784544 X -109580 264151 X X false true X true false 0 NOTES PAYABLE TO AFFILIATE 4728342 DUE TO HEALTHFIRST HEALTH PLAN 23431 DUE TO STATE OF NJ 12123 UPCAE/UNPAID VENDOR PAYABLE 238093 DUE TO AFFILIATE 14500000 DUE TO SHP 103 19502092 X 999179 999179 999179 1108759 1108759 1108759 Schedule D - Part X, LINE 2 THE FOLLOWING IS DISCLOSED IN THE AUDITED FINANCIAL STATEMENTS OF HF MANAGEMENT SERVICES, LLC, THE PARENT COMPANY OF HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.: It is the Companys policy to provide for uncertain tax positions and the related interest and penalties based upon managements assessment of whether a tax benefit is more likely than not to be sustained upon examination by tax authorities. At December 31, 2017, the Company believes it has appropriately accounted for any unrecognized tax benefits. To the extent the Company prevails in matters for which a liability for an unrecognized tax benefit is established or is required to pay amounts in excess of the liability, the Company's effective tax rate in a given financial statement period may be affected. true true false false false false false false false JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 446321 329148 867268 0 109860 0 16288 0 1768885 0 202731 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 304486 118946 4318 0 4512 0 11819 0 444081 0 0 LINDA TIANO CHIEF LGL OFFICER 435865 95900 5529 0 90000 0 131 0 627425 0 0 PATRICIA J WANG CHIEF EXECUTIVE OFFICER 1243960 1005888 855161 0 456010 0 5532 0 3566551 0 389469 PAUL E PORTSMORE SVP, GROWTH 444537 239570 54988 0 111900 0 131 0 851126 0 54004 JOHN J BERMEL CHIEF FINANCIAL OFFICER 611778 461625 84409 0 16200 0 16880 0 1190892 0 0 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 481668 304657 28075 0 122768 0 17528 0 954696 0 26564 SEAN KANE CHIEF HR OFFICER 427914 297433 90255 0 106863 0 138 0 922603 0 89271 REBECCA SCHWIETZ SVP CLINICAL SERVICES 381493 198443 16147 0 73950 0 18378 0 688411 0 15207 DANIEL P MCCARTHY-END 63017 PRESIDENT & COO 422404 965941 980835 0 195758 0 4836 0 2569774 0 461775 THOMAS E MEIXNER SVP Deliver System Engagement 361847 176118 4887 0 69821 0 9499 0 622172 0 0 ELIZABETH R ST CLAIR CHIEF LEGAL OFFICER 0 243212 579243 0 278162 0 151 0 1100768 0 0 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUALS ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - AN AFFILIATE ORGANIZATION OF HEALTHFIRST. ELIZABETH ST. CLAIR - TOTAL SEVERANCE: $759,575, SEVERANCE PAID IN 2016: $107,120 SEVERANCE PAID IN 2017: $506,383 SEVERANCE DEFERRED: $146,072. DAN MCCARTHY - TOTAL SEVERANCE: $1,106,248, SEVERANCE PAID IN 2017: $340,384 SEVERANCE DEFERRED: $765,864 SCHEDULE J, PART 1, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT DISTRIBUTIONS FROM THE PLAN SPONSOR FOR 2017: PATRICIA J. WANG $850,820 DANIEL P. MCCARTHY $739,116 JAY A. SCHECHTMAN $865,756 GERALD T. SWEENEY $26,564 SEAN KANE $90,138 PAUL PORTSMORE $54,005 REBECCA SCHWIETZ $15,207 ELIZABETH R ST CLAIR $325,086. FORM 990, PART VI, SECTION A, LINE 3 HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.(HFNJ) CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS) TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE, THESE ARE SUPPLIED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUM ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY RESOLUTION OF THE BOARD OF DIRECTORS. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR HFMS, A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM HFNJ. FORM 990, PART VI, SECTION A, LINE 6 HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. IS A NEW JERSEY NOT-FOR-PROFIT CORPORATION WITH ONE CORPORATE MEMBER, HF MANAGEMENT SERVICES, LLC. FORM 990, PART VI, SECTION A, LINES 7A AND 7B 7A: HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. IS A NEW JERSEY NOT FOR PROFIT CORPORATION WITH ONE CORPORATE MEMBER, HF MANAGEMENT SERVICES, LLC. THE CORPORATE MEMBER HAS THE RIGHT TO APPOINT THE BOARD OF DIRECTORS OF HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. 7B: AMENDMENTS TO THE GOVERNING DOCUMENTS REQUIRE APPROVAL OF THE SOLE CORPORATE MEMBER, HF MANAGEMENT SERVICES, LLC. CERTAIN DECISIONS OF THE BOARD OF DIRECTORS RELATING TO PRODUCTS OFFERED, RELATED PARTY TRANSACTIONS AND REPAYMENT OF SURPLUS NOTES REQUIRE APPROVAL OF THE NEW JERSEY DEPARTMENT OF BANKING AND INSURANCE. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS VICE PRESIDENT, CONTROLLER AND TREASURER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS CHIEF LEGAL OFFICER AND CHIEF FINANCIAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. A NOMINATED BOARD MEMBER WHO DOES NOT COMPLETE THE STATEMENT WITHIN THE CALENDAR YEAR WILL NOT BE PERMITTED TO CARRY OUT DUTIES. THE SAME APPLIES TO AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE APPROPRIATE DISCLOSURES. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. A REPORT OF ANY CONFLICTS IS PREPARED FOR DISCUSSION WITH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HF MANAGEMENT SERVICES, LLC, THE PARENT COMPANY, AS WELL AS THE FULL BOARD OF DIRECTORS OF HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. AS APPROPRIATE. GUIDANCE IS PROVIDED TO THE NECESSARY PARTIES AND ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION-MAKING, MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICER OR EMPLOYEE, THE REPORTING ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE PRESIDENT, CEO, OTHER OFFICERS AND CERTAIN KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY OF HFMS MEMBER HOSPITAL DIRECTORS (WHO ARE NOT EMPLOYED NOR COMPENSATED BY HFMS OR ANY OF ITS AFFILIATES). THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEES CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XI, LINE 9 ADMINISTRATIVE CHARGES: $264,151 - The health care service agreements with Healthfirst Health Plan of New Jersey, Inc (HFNJ) Sponsors provide a portion of the premium revenue allocated to each Sponsor, as health care provider to HFNJ plan members, is retained by HFNJ as additional capital contributions for the purpose of providing applicable statutory financial reserves and other administrative charges. The portion may be subject to periodic adjustment by HFNJ's Board of Directors. FORM 990, PART XII, LINE 2B The filing organization does not publish stand-alone financial statements for general disclosure and use. Stand-alone financial statements are prepared solely for the New Jersey Department of Banking and Insurance and New Jersey Department of Human Services and are restricted as to their use. Such financial statements are prepared in conformity with accounting practices prescribed or permitted by the New Jersey Department of Banking and Insurance, which is a comprehensive basis of accounting other than accounting principles generally accepted in the United States. The statutory-basis financial statements are audited by an independent accountant. For purposes of general disclosure and use, including the Form 990, the filing organization is included in the consolidated financial statements of HF Management Services, LLC, a related organization, which are prepared in accordance with US GAAP and audited by an independent accountant. Other financial information included in the consolidated financial statements contains the GAAP-Basis balance sheet and income statement of the filing organization. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF MANAGERS OF HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION). HEALTHFIRST INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501(C)(3) 12 Type I NA false HEALTHFIRST HEALTH PLAN INC 100 CHURCH ST FL 18 NEW YORK NY 10007 113029569 MANAGED CARE NY 501(C)(4) HEALTHFIRST true HEALTHFIRST PHSP INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133783732 MANAGED CARE NY 501(C)(3) 10 HEALTHFIRST true SENIOR HEALTH PARTNERS INC 100 CHURCH STREET 18FL NEW YORK NY 10007 134103882 MGD LT CARE NY 501(C)(3) 10 HF MGMT SVCS true HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM SCVS NY NA false 0 HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM SCVS NY MF MGMT SVCS C CORP true HEALTHFIRST INSURANCE COMPANY INC 100 Church Street FL 18 NEW YORK NY 100072601 464545744 INSUR. PROVIDER NY NA C CORP false false false false false true false false false false false false false true false false false false false false HF MANAGEMENT SERVICES LLC E 4728342 SURPLUS NOTE HF MANAGEMENT SERVICES LLC M 14500000 Liab.-cost FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (1): The amount represents Surplus Note Payable which was monies borrowed from HF Management Services, LLC (HFMS) to fund Healthfirst Health Plan of New Jersey, Inc (HFNJ). It represents two 7 year note payables to HFMS. Interest is calculated and is adjusted at the prime rate. FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (2): In 2014, subsequent to the closing of the sale transaction to Wellcare, Healthfirst Health Plan of New Jersey (HFNJ) recorded a liability due to HF Management Services, LLC (HFMS) in the amount of $14.5 million for the system configuration and programming, marketing and vendor costs that HFMS previously provided to HFNJ, as a component of its administrative services agreement with HFMS. The payment of these costs was contingent upon the closing of a sale transaction between HFNJ and Wellcare.