2018-11-14T09:41:01-06:00 2017-12-31 BKD LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2017-01-01 760495152 Community Health Choice Inc % MARK VAN ELDEN - CONTROLLER COMM 7132952222 2636 South Loop West Suite 700 Houston TX 77054 BRIAN MAUDE CFO 7132952222 2018-11-15 true Amanda Maya P01067777 7134994600 73.32.10.96 76915820183185000001 2018-11-14 P 3C05F97901279AF0647DFC7D8771036E0E35E774 F163B7394A02593AB1D23FF5A4E129A361E2DE59 2017 2019-02-21 02:37:17Z Kenneth W Janda 2636 South Loop West Suite 700 Houston TX 77054 834206714 false X HTTPS://WWW.CHCHEALTH.ORG X 1996 TX THE OPERATION OF A MEDICAID/CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) HEALTH MAINTENANCE ORGANIZATION AND HEALTH INSURANCE EXCHANGE PROVIDING PRE-PAID MEDICAL & DENTAL CARE. 7 7 821 7 0 0 0 0 1126912764 832533744 1803947 1672970 0 0 1128716711 834206714 920823 0 1029052828 0 36299601 32493236 0 0 0 82539114 825060021 1148812366 857553257 -20095655 -23346543 305073571 259721828 223576925 204384776 81496646 55337052 X COMMUNITY HEALTH CHOICE'S MISSION IS TO IMPROVE THE HEALTH OF THE UNDERSERVED RESIDENTS OF SOUTHEAST TEXAS BY PROVIDING ACCESS TO COORDINATED, HIGH QUALITY, AFFORDABLE, HEALTHCARE SERVICES. OUR MISSION IS ACHIEVED THROUGH: 1) COMMUNITY: COLLABORATING WITH COMMUNITY - BASED PROVIDERS & ORGANIZATIONS TO IMPROVE ACCESS, QUALITY, COORDINATION AND COST-EFFECTIVENESS OF SERVICES. 2) HEALTH: DEVELOPING PROGRAMS TO ESTABLISH MEDICAL HOMES, MANAGE HEALTH CONDITIONS, AND PROMOTE WELLNESS AND PREVENTIVE CARE. 3) CHOICE: ENCOURAGING PERSONAL ACCOUNTABILITY AND EDUCATED CHOICES FOR INDIVIDUAL AND FAMILY HEALTH. false true 832329404 832533744 THE OPERATION OF A HEALTH MAINTENANCE ORGANIZATION PROVIDING PRE-PAID MEDICAL & DENTAL CARE TO ITS APPROXIMATELY 248,279 MEDICAID, 28,971 CHIP AND 4,156 CHIP PERINATAL MEMBERS WITHIN A PRIMARY SERVICE AREA OF HARRIS AND CONTIGUOUS COUNTRIES IN THE STATE OF TEXAS. COMMUNITY HEALTH CHOICE, INC. ALSO ISSUES HEALTH POLICIES FOR NINE SOUTHEAST TEXAS COUNTIES IN THE FEDERALLY-FACILITATED HEALTHCARE INSURANCE MARKETPLACE FOR THE STATE OF TEXAS. PART OF CHCI'S MISSION IS TO SERVE THE UNINSURED POPULATION IN SOUTHEAST TEXAS. TEXAS HAS THE LARGEST NUMBER OF RESIDENTS WITHOUT MEDICAL COVERAGE IN THE ENTIRE COUNTRY. ONE OF CHCI'S MARKETING GOALS IS TO PROVIDE COVERAGE TO THE PARENTS OF THE CHILDREN ENROLLED IN CHCI'S CHIP PROGRAM THROUGH MARKETPLACE POLICIES. THE HEALTHCARE INSURANCE MARKETPLACE HAD 126,039 COVERED LIVES AS OF DECEMBER 31, 2017. 832329404 false false false false false false false false false false false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false false true true true false true X 4359 0 true 821 true true true false false false false false X 7 7 true false false false false true true true false false false true true true true true true true true false X MARK VAN ELDEN - CONTROLLER 7132952238 2636 SOUTH LOOP W SUITE 125 HOUSTON TX 77054 X RAYMOND J KHOURY VICE CHAIRMAN OF THE BOARD 4.0 4.0 X X 0 0 0 JOSE GARCIA JR SECRETARY OF THE BOARD 2.0 2.0 X X 0 0 0 DAISY A STINER BOARD MEMBER 2.0 0.0 X 0 0 0 ELANA M MARKS BOARD MEMBER 2.0 2.0 X 0 0 0 VIVIAN HO BOARD MEMBER 1.0 1.0 X 0 0 0 STEPHEN MCKERNAN BOARD MEMBER 1.0 1.0 X 0 0 0 VICKI KEISER CHAIRMAN OF THE BOARD 4.0 4.0 X X 0 0 0 ANNE CLUTTERBACK BOARD MEMBER 1.0 1.0 X 0 0 0 KENNETH JANDA PRESIDENT/CEO 20.0 20.0 X 230991 230990 32811 RICHARD LEE SVP - FINANCE 20.0 20.0 X 118456 118454 43561 BRIAN MAUDE CHIEF FINANCIAL OFFICER 20.0 20.0 X 131768 131767 46567 FRED BUCKWOLD SVP - CLIN POLICY & PRTNRSHP 20.0 20.0 X 168761 168759 39647 ALFONSO RUBIO CHIEF INFORMATION OFFICER 20.0 20.0 X 132291 132289 32137 TANYA NGUYEN DIRECTOR-IS SYSTEM APPLICATION 20.0 20.0 X 95726 95725 50384 KAREN LOVE EXECUTIVE VICE PRESIDENT 20.0 20.0 X 143427 143427 36946 DAISY MORALES VP - COMMUNITY AFFAIRS 20.0 20.0 X 93186 93184 11282 PAMELA HELLSTROM VP - QUALITY MANAGEMENT 20.0 20.0 X 105650 105649 52237 OLUBUNMI OTUYELU CHIEF COMPLIANCE OFFICER 20.0 20.0 X 94249 94249 12039 LISA FULLER ASSOCIATE MEDICAL DIRECTOR 20.0 20.0 X 123556 123556 24089 VALERIE BAHAR ASSOCIATE MEDICAL DIRECTOR 20.0 20.0 X 126977 126975 22251 THOMAS NGUYEN DIRECTOR-MANAGED CARE SYSTEMS 20.0 20.0 X 98813 98813 52103 KAREN HILL SVP - MEDICAL AFFAIRS 20.0 20.0 X 112417 112417 7000 LAURIE LEVERMANN VP - INFORMATION SYSTEMS 20.0 20.0 X 70527 70527 13443 ANGELA WALTMAN VP - SALES & MEMBER OPERATIONS 20.0 20.0 X 118909 118908 2545 JANET WOODSON DIRECTOR - UTILIZATION MGMT 20.0 20.0 X 75102 75101 9880 CLAUDIA MEADOWS DIRECTOR-CONTRACTING & PROV R 20.0 20.0 X 77535 77534 9240 NANCY EDGAR CHIEF HR/ADMIN OFFICER 20.0 20.0 X 83891 83890 47122 2202232 2202214 545284 43 false true false NAVITUS HEALTH SOLUTIONS 2601 W BELTLINE HWY STE 600 MADISON WI 53713 PHARMACY BENEFITS 165647925 MEMORIAL HERMANN HEALTH SYSTEM 921 GESSNER RD HOUSTON TX 77024 HOSPITAL SERVICES 121885771 TEXAS CHILDREN'S HOSPITAL 6621 FANNIN ST HOUSTON TX 77030 HOSPITAL SERVICES 34251545 UTMB GALVESTON HOSPITAL 301 UNIVERSITY BLVD HOUSTON TX 77555 HOSPITAL SERVICES 26998927 CHI ST LUKE'S MEDICAL CENTER 6720 BERTNER AVE HOUSTON TX 77030 HOSPITAL SERVICES 20540056 494 0 Net Premium Revenue 524114 825055103 825055103 OTHER REVENUE 900099 7478641 7478641 832533744 1672970 1672970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834206714 832533744 1672970 0 0 0 0 2007800 1606240 401560 0 23302350 18641880 4660470 1086023 868819 217204 4384664 3507732 876932 1712399 1369919 342480 0 172963 172963 296618 296618 0 0 190250 190250 22610749 18726973 3883776 275457 275457 4484385 4484385 2476333 2476333 0 1640017 1640017 146343 146343 0 124825 124825 0 0 0 89030 89030 Medical Claims Expense 734525645 734525645 CMS User Fees 21297293 21297293 PREMIUM & MAINTENANCE TAXES 15119886 15119886 COMMISSIONS EXPENSE 8308580 8308580 13301647 8356437 4945210 857553257 832329404 25223853 0 177452323 3636325 0 225515899 0 0 15419231 8823852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93020687 8093212 0 0 0 0 19181330 13652540 305073571 259721828 19430947 13275319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204145978 191109457 223576925 204384776 X 0 0 0 45500000 81496646 9837052 81496646 55337052 305073571 259721828 X -23346543 -298894 -2514157 X false true X true false Reinsurance Receivable 2496571 INTEREST RECEIVABLE 57244 PRESCRIPTION REBATE RECEIVABLE 11098725 13652540 0 DUE TO CHCT 41256374 Due to District 11472204 Deferred Premium Revenue 19550001 Medical Claims Payable 62659000 Affordable Care Act Liabilities 53889166 Provider Incentive Payable 2282712 191109457 821580454 -298894 -4452137 -4751031 826331485 396588 7478641 7875229 834206714 845225891 -7478641 -7478641 852704532 396588 4452137 4848725 857553257 SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Reinsurance expense included in audit revenue ($ 4,452,137) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Operating revenue included in audit expense $ 7,478,641 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Operating revenue included in audit expense ($ 7,478,641) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: Reinsurance expense included in audit revenue $ 4,452,137 X X false false false false false false false false false KENNETH JANDA PRESIDENT/CEO 230991 230990 0 0 0 0 12000 12000 4406 4405 247397 247395 0 0 RICHARD LEE SVP - FINANCE 109862 109861 8594 8593 0 0 8852 8852 12929 12928 140237 140234 0 0 FRED BUCKWOLD SVP - CLIN POLICY & PRTNRSHP 156647 156646 12114 12113 0 0 12000 12000 7824 7823 188585 188582 0 0 ALFONSO RUBIO CHIEF INFORMATION OFFICER 122919 122918 9372 9371 0 0 6340 6339 9729 9729 148360 148357 0 0 TANYA NGUYEN DIRECTOR-IS SYSTEM APPLICATION 88822 88822 6904 6903 0 0 12000 12000 13192 13192 120918 120917 0 0 KAREN LOVE EXECUTIVE VICE PRESIDENT 132900 132900 10527 10527 0 0 9941 9941 8532 8532 161900 161900 0 0 DAISY MORALES VP - COMMUNITY AFFAIRS 86103 86102 7083 7082 0 0 4259 4259 1382 1382 98827 98825 0 0 PAMELA HELLSTROM VP - QUALITY MANAGEMENT 99149 99148 6501 6501 0 0 12000 12000 14119 14118 131769 131767 0 0 OLUBUNMI OTUYELU CHIEF COMPLIANCE OFFICER 87332 87332 6917 6917 0 0 1379 1378 4641 4641 100269 100268 0 0 LAURIE LEVERMANN VP - INFORMATION SYSTEMS 70527 70527 0 0 0 0 3471 3471 3251 3250 77249 77248 0 0 LISA FULLER ASSOCIATE MEDICAL DIRECTOR 114702 114702 8854 8854 0 0 6873 6873 5172 5171 135601 135600 0 0 VALERIE BAHAR ASSOCIATE MEDICAL DIRECTOR 118050 118049 8927 8926 0 0 9000 9000 2126 2125 138103 138100 0 0 THOMAS NGUYEN DIRECTOR-MANAGED CARE SYSTEMS 91690 91690 7123 7123 0 0 12000 12000 14052 14051 124865 124864 0 0 ANGELA WALTMAN VP - SALES & MEMBER OPERATIONS 113732 113731 5177 5177 0 0 0 0 1273 1272 120182 120180 0 0 JANET WOODSON DIRECTOR - UTILIZATION MGMT 64664 64664 10438 10437 0 0 3323 3323 1617 1617 80042 80041 0 0 KAREN HILL SVP - MEDICAL AFFAIRS 112417 112417 0 0 0 0 0 0 3500 3500 115917 115917 0 0 CLAUDIA MEADOWS DIRECTOR-CONTRACTING & PROV R 72243 72242 5292 5292 0 0 4327 4326 294 293 82156 82153 0 0 BRIAN MAUDE CHIEF FINANCIAL OFFICER 131768 131767 0 0 0 0 9000 9000 14284 14283 155052 155050 0 0 NANCY EDGAR CHIEF HR/ADMIN OFFICER 83891 83890 0 0 0 0 11927 11927 11634 11634 107452 107451 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION FOR KENNETH W. JANDA IS DETERMINED THROUGH NEGOTIATIONS WITH THE HARRIS COUNTY HOSPITAL DISTRICT (HCHD), A RELATED ORGANIZATION, AND IS THEN SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF HCHD FOR ALL OTHER EXECUTIVES, COMPENSATION IS DETERMINED BY THE BOARD OF HCHD UTILIZING MARKET SURVEYS FOR EXECUTIVES IN SIMILAR ORGANIZATIONS AND IN SIMILAR POSITIONS. MARKET ADJUSTMENTS ARE MADE ANNUALLY TO ACCOUNT FOR ANY CHANGES IN COMPENSATION. FORM 990, PART V, LINES 1A & 2A SALARIES REFLECTED ON FORM 990, PART IX, LINES 5 AND 7 WERE ALLOCATED TO CHCI BY THE HARRIS COUNTY HOSPITAL DISTRICT (HCHD) (FEIN: 76-0408224) AND THEY ARE REFLECTED ON THE FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, OF HCHD. CHCI REIMBURSED HCHD FOR THE SALARIES, AND ALL OTHER EXPENSES INCURRED ON BEHALF OF CHCI. THE NUMBER OF FORMS 1099 AND FORMS W-2 FILED FOR THE YEAR IS REPORTED AS 4,359 AND 821, RESPECTIVELY. THIS TOTAL ALSO INCLUDES FORMS FILED FOR CHCT, A RELATED ORGANIZATION. THE RELATED PAYROLL EXPENSES ARE ALLOCATED AND REPORTED ON FORM 990, PART IX, LINES 5 AND 7 OF CHCT. FORM 990, PART VI, LINE 2 FAMILY OR BUSINESS RELATIONSHIP CHCI IS AWARE OF THE FAMILY RELATIONSHIP BETWEEN THE FOLLOWING KEY EMPLOYEES: THOMAS NGUYEN AND TANYA NGUYEN FORM 990, PART VI, SECTION A, LINES 7A & 7B HARRIS COUNTY HOSPITAL DISTRICT (HCHD) HAS CERTAIN ENUMERATED RESERVED POWERS OVER THE GOVERNING BOARD OF COMMUNITY HEALTH CHOICE, INC. (CHCI). THE GOVERNING BODY IS PROHIBITED FROM TAKING FINAL ACTION ON THE FOLLOWING WITHOUT THE APPROVAL BY RESOLUTION OF THE HCHD BOARD OF MANAGERS: 1. ADOPTION, AMENDMENT, OR REVOCATION OF THE BYLAWS OF CHCI; 2. ADOPTION, AMENDMENT, OR REVOCATION OF THE ARTICLES OF INCORPORATION OF CHCI; 3. APPOINTMENT OR REMOVAL OF DIRECTORS OF CHCI; 4. ADOPTION, AMENDMENT, OR REVOCATION OF CHCI'S PURCHASING MANUAL; 5. ADOPTION, AMENDMENT, OR REVOCATION OF CHCI'S PERSONNEL POLICIES; 6. ADOPTION, AMENDMENT, OR REVOCATION OF CHCI'S FINANCIAL POLICIES; 7. ADOPTION OF CHCI'S ANNUAL OPERATING AND CAPITAL BUDGETS; 8. ANY DEVIATION OF 10% OR MORE FROM CHCI'S ANNUAL OPERATING BUDGET OR $50,000 FROM CHCI'S ANNUAL CAPITAL BUDGET; 9. ANY TRANSACTION INVOLVING REAL PROPERTY; 10. ANY MORTGAGE, ENCUMBRANCES, OR DEBT OF CHCI IN EXCESS OF $50,000; 11. THE SALE OR OTHER DISPOSITION OF PROPERTY OF ANY KIND EXCEEDING $25,000; 12. THE PURCHASE OR ACQUISITION OF PROPERTY OF ANY KIND BY CHCI EXCEEDING $200,000 AND NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHCI'S ANNUAL OPERATING AND CAPITAL BUDGET; 13. ALL PAYMENTS OTHER THAN PURCHASES, INCLUDING GUARANTEES AND GRANTS THAT ARE NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHCI'S ANNUAL OPERATING AND CAPITAL BUDGETS; 14. ANY ACTION TO AMEND OR ENLARGE THE SERVICE AREA OF CHCI'S CERTIFICATE OF AUTHORITY TO DO BUSINESS AS A HEALTH MAINTENANCE ORGANIZATION IN THE STATE OF TEXAS; 15. ANY MERGER, AFFILIATION, DISSOLUTION, OR OTHER DISPOSITION OF CHCI. FORM 990, PART VI, SECTION A, LINE 8B COMMUNITY HEALTH CHOICE, INC. DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THEREFORE, NO DOCUMENTATION OF COMMITTEE MEETINGS WAS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGES A PAID PREPARER, EXPERIENCED IN THE PREPARATION OF THE FORM 990, TO PREPARE THE FORM. MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO HELP COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. ONCE PREPARED, IT IS REVIEWED BY THE ORGANIZATION'S CONTROLLER AND THEN AGAIN BY THE CHIEF FINANCIAL OFFICER. A COPY OF THE RETURN IS THEN MAILED OR EMAILED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS IN ANNUAL STATEMENTS. THE VICE PRESIDENT FOR COMPLIANCE OF THE ORGANIZATION THEN REVIEWS THE ANNUAL STATEMENTS BEFORE SENDING TO THE HARRIS COUNTY HOSPITAL DISTRICT CORPORATE COMPLIANCE DEPARTMENT FOR FURTHER REVIEW OF THE ANNUAL CONFLICT OF INTEREST STATEMENTS. FORM 990, PART VI, SECTION B, LINES 15A & 15B THE COMPENSATION OF THE PRESIDENT/CEO OF THE ORGANIZATION IS REVIEWED BY THE BOARD OF DIRECTORS OF HCHD. THE COMPENSATION OF ALL OTHER EMPLOYEES IS SUBJECT TO THE GUIDELINES AND MERIT RAISE PROCESSING OF THE HARRIS COUNTY HOSPITAL DISTRICT. FORM 990, PART VI, SECTION C, LINE 19 AS A SUBSIDIARY OF THE HARRIS COUNTY HOSPITAL DISTRICT (A SUBSIDIARY OF HARRIS COUNTY, TEXAS), ALL DOCUMENTS AND POLICIES ARE PART OF THE PUBLIC RECORD AND ARE THEREFORE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 RECONCILIATION OF NET ASSETS OTHER CHANGES IN NET ASSETS: CAPITAL CONTRIBUTION TO CHCT $ (44,204,155) CAPITAL CONTRIBUTION FROM HCHD 45,500,000 CHANGE IN NONADMITTED ASSETS (3,810,002) ------------ $ (2,514,157) FORM 990, PART III, LINE 3 THE ORGANIZATION'S MEDICAID AND CHIP SERVICES WERE TRANSFERRED TO NEW RELATED ORGANIZATION, COMMUNITY HEALTH CHOICE TEXAS, INC, AS OF MARCH 2017. HARRIS COUNTY HOSPITAL DISTRICT 2525 HOLLY HALL HOUSTON TX 77054 741536936 HEALTH CARE TX NA false COMMUNITY HEALTH CHOICE TEXAS INC 2636 S LOOP WEST SUITE 125 HOUSTON TX 77054 814077507 INSURANCE TX 501(C)(4) HCHD true false true true false false false false false false false false false true true true true true true false COMMUNITY HEALTH CHOICE TEXAS INC R 44204155 BOOK VALUE COMMUNITY HEALTH CHOICE TEXAS INC R 80921000 BOOK VALUE COMMUNITY HEALTH CHOICE TEXAS INC Q 39036912 BOOK VALUE