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NEW YORK STATE CATHOLIC HEALTH PLAN INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
NEW YORK STATE CATHOLIC HEALTH PLAN INC (EIN 11-3153422)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-06-25
IRS object ID
201811769349300641
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2018-06-25T11:16:21-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1Txt
CityJERICHOCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11753ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN113153422EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLANBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlNEWYBusinessNameControlTxt
Phone7183936403PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICK J FRAWLEYPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone7183936403PhoneNum
Signature2018-06-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTINE KAWECKIPreparerPersonNm
PTINP00743140PTIN
Phone5169187000PhoneNum
Preparation2018-06-06PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1FIDELIS CARE NEW YORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerPATRICK J FRAWLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,901,776,524GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FIDELISCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE O.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee4468TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$896,865PYContributionsGrantsAmt
CY Contributions Grants$415,749CYContributionsGrantsAmt
PY Program Service Revenue$8,407,238,664PYProgramServiceRevenueAmt
CY Program Service Revenue$9,692,298,442CYProgramServiceRevenueAmt
PY Investment Income$15,301,767PYInvestmentIncomeAmt
CY Investment Income$55,522,502CYInvestmentIncomeAmt
PY Other Revenue$14,901,768PYOtherRevenueAmt
CY Other Revenue$25,519,534CYOtherRevenueAmt
PY Total Revenue$8,438,339,064PYTotalRevenueAmt
CY Total Revenue$9,773,756,227CYTotalRevenueAmt
PY Grants And Similar Paid$4,937,087PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,184,210CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$7,694,782,844PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$8,893,847,473CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$263,733,378PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$342,970,670CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$163,804,432PYOtherExpensesAmt
CY Other Expenses$219,978,558CYOtherExpensesAmt
PY Total Expenses$8,127,257,741PYTotalExpensesAmt
CY Total Expenses$9,461,980,911CYTotalExpensesAmt
PY Revenues Less Expenses$311,081,323PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$311,775,316CYRevenuesLessExpensesAmt
Total Assets BOY$3,370,300,258TotalAssetsBOYAmt
Total Assets EOY$4,275,726,392TotalAssetsEOYAmt
Total Liabilities BOY$1,600,301,484TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,154,215,164TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,769,998,774NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,121,511,228NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE O.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,476,254,260ExpenseAmt
Grant$3,399,926GrantAmt
Revenue$5,916,471,228RevenueAmt
DescMEDICAID MANAGED CARE PROGRAM ("MEDICAID") IS A NEW YORK STATE PROGRAM ADMINISTERED BY FIDELIS THAT PROVIDES FREE COMPREHENSIVE HEALTH COVERAGE FOR ELIGIBLE INDIVIDUALS AND FAMILIES WHO ARE RESIDENTS OF NEW YORK STATE AND HAVE LOW INCOME AND LIMITED RESOURCES.THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE.AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 1,207,300 MEDICAID BENEFICIARIES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$941,977,700ExpenseAmt
Grant$53,723GrantAmt
Revenue$1,082,402,987RevenueAmt
DescFIDELIS CARE AT HOME IS A MEDICAID LONG-TERM CARE CAPITATED PROGRAM WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES AN ARRAY OF HOME, COMMUNITY, AND INSTITUTIONALLY BASED, LONG-TERM CARE SERVICES TO PERSONS WHO ARE ELIGIBLE FOR MEDICAID AND WHO HAVE BEEN CERTIFIED AS APPROPRIATE CANDIDATES FOR NURSING HOME PLACEMENT. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 20,400 FIDELIS CARE AT HOME PROGRAM BENEFICIARIES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$892,676,786ExpenseAmt
Grant$183,213GrantAmt
Revenue$920,296,727RevenueAmt
DescMEDICARE ADVANTAGE PROGRAM IS A PROGRAM AVAILABLE TO ADULTS AGED 65 AND OVER WHO ARE ELIGIBLE UNDER MEDICARE. BENEFICIARIES MAY CHOOSE TO USE PRIVATE PAY OPTIONS, ESTABLISH MEDICAL SAVINGS ACCOUNT, USE MANAGED CARE PLANS SUCH AS FIDELIS, OR JOIN PROVIDER-SPONSORED PLAN.AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 67,000 MEDICARE ADVANTAGE PROGRAM BENEFICIARIES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$1,588,122,937ExpenseAmt
Grant$1,547,348GrantAmt
Revenue$1,798,647,034RevenueAmt
DescOTHER PROGRAMS ADMINISTERED BY THE PLAN INCLUDE THE CHILD HEALTH PLUS PROGRAM, MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM, MEDICAID ADVANTAGE PLUS PROGRAM, THE NEW YORK HEALTH BENEFIT EXCHANGE PROGRAM ("HEALTH BENEFIT EXCHANGE"), THE FULLY INTEGRATED DUALS ADVANTAGE ("FIDA") PROGRAM, HEALTH AND RECOVERY PLAN ("HARP") PROGRAM, AND THE ESSENTIAL PLAN PROGRAM. CHILD HEALTH PLUS PROGRAM IS A PROGRAM THAT COVERS UNINSURED CHILDREN UNDER THE AGE OF 19, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 113,800 CHILD HEALTH PLUS PROGRAM BENEFICIARIES.MEDICARE/MEDICAID DUAL ADVANTAGE IS A PROGRAM FOR THOSE WHO MEET ELIGIBILITY REQUIREMENTS FOR BOTH MEDICARE AND MEDICAID AND ARE ENROLLED IN BOTH PROGRAMS. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 1,400 MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM BENEFICIARIES.MEDICAID ADVANTAGE PLUS IS A FULL-RISK MANAGED LONG-TERM CARE PROGRAM FOR INDIVIDUALS 18 YEARS OF AGE AND OLDER WITH MEDICARE AND MEDICAID COVERAGE WHO HAVE A CHRONIC ILLNESS OR DISABILITY. MEMBERS MUST BE IN NEED OF LONG-TERM CARE SERVICES AND MAY NEED CARE TYPICALLY GIVEN IN A NURSING HOME. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 100 MEDICAID ADVANTAGE PLUS PROGRAM BENEFICIARIES. HEALTH BENEFIT EXCHANGE IS A PROGRAM PROVIDING HEALTH COVERAGE TO INDIVIDUALS UNDER THE HEALTH CARE REFORM ACT. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 69,600 HEALTH BENEFIT EXCHANGE BENEFICIARIES. FIDA PROGRAM IS A PLAN DESIGNED TO PROVIDE MANAGED CARE TO INDIVIDUALS WHO HAVE BOTH MEDICARE AND MEDICAID. THE FIDA PLAN ALLOWS THE INDIVIDUAL'S MEDICARE AND MEDICAID BENEFITS TO BE COVERED AND MANAGED UNDER ONE PLAN, INCLUDING LONG-TERM CARE NEEDS, SUPPORTS AND PRESCRIPTION DRUGS. THE FIDA PROGRAM ENDED ON DECEMBER 31, 2017 WITH 300 BENEFICIARIES.HARP PROGRAM IS A MEDICAID PROGRAM THAT PROVIDES CARE MANAGEMENT SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICAID REQUIRING BEHAVIORAL HEALTH SERVICES. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 27,000 HARP BENEFICIARIES.ESSENTIAL PLAN IS A PROGRAM THAT PROVIDES MINIMUM ESSENTIAL COVERAGE TO QUALIFIED INDIVIDUALS WHO ARE NOT ELIGIBLE FOR MEDICAID OR THE CHILD HEALTH PLUS PROGRAMS. AS OF DECEMBER 31, 2017, THE PLAN SERVED APPROXIMATELY 157,000 ESSENTIAL PLAN BENEFICIARIES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$1,588,122,937TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$1,547,348TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$1,798,647,034TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$8,899,031,683TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document17214IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee4468EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANNE C KONTOPOULOSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7183936403PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BLVDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
KARL P ADLER MD
DIRECTOR1.000.00Yes (X)$0$0$0
JACK BALINSKY
DIRECTOR1.000.00Yes (X)$0$0$0
M WILLIAM BENEDETTO
DIRECTOR1.000.00Yes (X)$0$0$0
SR PATRICIA BURKARD
DIRECTOR/SECRETARY1.000.00Yes (X)$0$0$0Yes (X)
JAMES M CORRIGAN
DIRECTOR1.000.00Yes (X)$0$0$0
REVEREND JOHN COUGHLIN
DIRECTOR1.000.00Yes (X)$0$0$0
THOMAS F DOODIAN
DIRECTOR1.000.00Yes (X)$0$0$0
REVEREND DONALD J HARRINGTON
CHAIRMAN OF THE BOARD1.000.00Yes (X)$0$0$0Yes (X)
JOHN J HURLEY
DIRECTOR1.000.00Yes (X)$0$0$0
THOMAS L KELLY
DIRECTOR1.000.00Yes (X)$0$0$0
DONNA O' BRIEN
DIRECTOR1.000.00Yes (X)$0$0$0
REVEREND LEO J O'DONOVAN
DIRECTOR1.000.00Yes (X)$0$0$0
GINO J PAZZAGLINI
DIRECTOR/VICE-CHAIRMAN1.000.00Yes (X)$0$0$0Yes (X)
JOHN RYDZEWSKI
DIRECTOR1.000.00Yes (X)$0$0$0
JOSEPH SLAVIK
DIRECTOR (THRU OCT. 2017)1.000.00Yes (X)$0$0$0
DEACON FRANK J THOMAS MD
DIRECTOR1.000.00Yes (X)$0$0$0
MARY THOMPSON
DIRECTOR1.000.00Yes (X)$0$0$0
MICHAEL J TOOLEY
DIRECTOR1.000.00Yes (X)$0$0$0
JOHN A WERWAISS
DIRECTOR/TREASURER1.000.00Yes (X)$0$0$0Yes (X)
PATRICK J FRAWLEY
CEO37.500.00$5,496,616$0$162,545Yes (X)
DAVID THOMAS
PRESIDENT & COO34.702.80$1,823,483$92,192$86,482Yes (X)
THOMAS HALLORAN
EVP & CHIEF FINANCIAL OFFICER33.753.75$761,088$85,736$363,173Yes (X)
PAMELA HASSEN
CHIEF MARKETING OFFICER37.500.00$4,275,328$0$61,599Yes (X)
MARTIN KREBS
CHIEF INFORMATION OFFICER37.500.00$562,888$0$230,133Yes (X)
SANTO RUSSO
CHIEF LEGAL OFFICER33.753.75$609,565$68,915$272,923Yes (X)
THOMAS BROWN
CHIEF ADMINISTRATIVE OFFICER37.500.00$575,638$0$182,858Yes (X)
ROBERT FAZZOLARI
SVP, GOV'T RELATIONS & CORP. COMP.37.500.00$515,193$0$29,762Yes (X)
SANJIV SHAH MD
FMR CHIEF MED. OFF. (THRU MAY 2017)32.804.70$275,432$39,356$31,639Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$14,895,231TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$286,199TotReportableCompRltdOrgAmt
Total Other Compensation$1,421,114TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K527IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COTIVITI DOMESTIC HOLDINGS INC
50 DANBURY ROADWILTONCT06897MEDICAL CLAIMS REVIEW$14,153,858
AARETE LLC
8574 SOLUTION CENTERCHICAGOIL606778005CONSULTING/COST SAVINGS$8,996,359
HEALTH MANAGEMENT SYSTEMS INC
PO BOX 27151NEW YORKNY10087COORDINATION OF BENEFITS REVIEW$4,713,163
DELOITTE CONSULTING LLP
4022 SELLS DRHERMITAGETN37076CONSULTING$4,696,043
NORTON ROSE FULBRIGHT US LLP
1301 MCKINNEY SUITE 5100HOUSTONTX770103095LEGAL$3,105,539
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K79CntrctRcvdGreaterThan100KCnt
Related Organizations$25,000RelatedOrganizationsAmt
Government Grants$293,706GovernmentGrantsAmt
All Other Contributions$97,043AllOtherContributionsAmt
Total Contributions$415,749TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID524114$5,916,471,228$5,916,471,228
FIDELIS CARE AT HOME524114$1,082,402,987$1,082,402,987
MEDICARE ADVANTAGE524114$920,296,727$920,296,727
ESSENTIAL PLAN524114$602,478,643$602,478,643
HARP524114$577,245,277$577,245,277

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$593,403,580TotalRevenueColumnAmt
Related Or Exempt Func Income$593,403,580RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$9,692,298,442TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,066,417TotalRevenueColumnAmt
Exclusion$34,066,417ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,149,476,382SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,128,020,297SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$21,456,085SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,456,085TotalRevenueColumnAmt
Exclusion$21,456,085ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
VBP QIP & OTHER ADMIN524298$25,345,370$25,345,370
EQUITY FROM SUBSIDIARY900099$131,496$131,496
PURCHASE REBATES524298$11,904$11,904

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,764TotalRevenueColumnAmt
Related Or Exempt Func Income$30,764RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$25,519,534OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,773,756,227TotalRevenueColumnAmt
Related Or Exempt Func Income$9,717,817,976RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$55,522,502ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,884,420TotalAmt
Program Services$4,884,420ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$299,790TotalAmt
Program Services$299,790ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$8,893,847,473TotalAmt
Program Services$8,893,847,473ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$8,443,819TotalAmt
Management And General$8,443,819ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$270,891,360TotalAmt
Management And General$270,891,360ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,860,122TotalAmt
Management And General$7,860,122ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$36,072,287TotalAmt
Management And General$36,072,287ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$19,703,082TotalAmt
Management And General$19,703,082ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$3,884,414TotalAmt
Management And General$3,884,414ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,365,433TotalAmt
Management And General$1,365,433ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$88,869TotalAmt
Management And General$88,869ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$972,975TotalAmt
Management And General$972,975ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$30,916,122TotalAmt
Management And General$30,916,122ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$20,148,038TotalAmt
Management And General$20,148,038ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,364,020TotalAmt
Management And General$3,364,020ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$23,237,608TotalAmt
Management And General$23,237,608ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$11,518,794TotalAmt
Management And General$11,518,794ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,512,426TotalAmt
Management And General$4,512,426ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$965,798TotalAmt
Management And General$965,798ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,473,736TotalAmt
Management And General$2,473,736ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$34,570,481TotalAmt
Management And General$34,570,481ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,414,629TotalAmt
Management And General$1,414,629ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
CLAIMS PROCESSING$22,722,111$22,722,111
POSTAGE AND SHIPPING$9,400,852$9,400,852
TELEPHONE EXPENSE$5,550,777$5,550,777
PRINTING AND PUBLICATIO$4,784,764$4,784,764

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$38,086,711TotalAmt
Management And General$38,086,711ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,461,980,911TotalAmt
Program Services$8,899,031,683ProgramServicesAmt
Management And General$562,949,228ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$69,579,692BOYAmt
EOY$87,994,994EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,720,092,292BOYAmt
EOY$2,309,422,521EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$203,708,261BOYAmt
EOY$209,850,337EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$124,910,660BOYAmt
EOY$101,271,384EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$363,373,276LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$153,267,659LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$57,486,951BOYAmt
EOY$210,105,617EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$650,604,208BOYAmt
EOY$748,498,315EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$46,486,899BOYAmt
EOY$31,615,519EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$269,092BOYAmt
EOY$420,366EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$15,849,778BOYAmt
EOY$15,849,778EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$481,312,425BOYAmt
EOY$560,697,561EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,370,300,258BOYAmt
EOY$4,275,726,392EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$187,631,041BOYAmt
EOY$246,349,322EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$14,245,393BOYAmt
EOY$30,784,525EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$100,000,000BOYAmt
EOY$85,714,286EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,298,425,050BOYAmt
EOY$1,791,367,031EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,600,301,484BOYAmt
EOY$2,154,215,164EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,769,344,153BOYAmt
EOY$2,119,731,353EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$654,621BOYAmt
EOY$1,779,875EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,769,998,774BOYAmt
EOY$2,121,511,228EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,370,300,258BOYAmt
EOY$4,275,726,392EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$311,775,316ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$39,737,138NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$353,245CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$196,215CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$470,690CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$896,865CurrentTaxYearMinus1YearAmt
Current Tax Year$415,749CurrentTaxYearAmt
Total$2,332,764TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,086,015,198CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,282,714,979CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,469,839,473CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,422,090,289CurrentTaxYearMinus1YearAmt
Current Tax Year$9,717,643,812CurrentTaxYearAmt
Total$33,978,303,751TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,086,368,443CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,282,911,194CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,470,310,163CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,422,987,154CurrentTaxYearMinus1YearAmt
Current Tax Year$9,718,059,561CurrentTaxYearAmt
Total$33,980,636,515TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$33,980,636,515PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,866,741CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,001,330CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,525,457CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,015,784CurrentTaxYearMinus1YearAmt
Current Tax Year$34,066,417CurrentTaxYearAmt
Total$101,475,729TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,866,741CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,001,330CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,525,457CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,015,784CurrentTaxYearMinus1YearAmt
Current Tax Year$34,066,417CurrentTaxYearAmt
Total$101,475,729TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$153,519CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$209,418CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years-$10,983CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,142CurrentTaxYearMinus1YearAmt
Current Tax Year$174,164CurrentTaxYearAmt
Total$576,260TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,098,388,703CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,301,121,942CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,486,824,637CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,444,053,080CurrentTaxYearMinus1YearAmt
Current Tax Year$9,752,300,142CurrentTaxYearAmt
Total$34,082,688,504TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99700PublicSupportCY509Pct
Public Support PY5090.99720PublicSupportPY509Pct
Investment Income CY0.00300InvestmentIncomeCYPct
Investment Income PY0.00280InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$88,869OtherActivitiesAmt
Total Lobbying Expenditures$88,869TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationFIDELIS IS A MEMBER OF CERTAIN ASSOCIATIONS, TO WHICH IT PAYS ANNUAL DUES. A PORTION OF THOSE DUES ARE DETERMINED TO BE EXPENDITURES FOR LOBBYING PURPOSES. IN 2017, THAT PORTION WAS $88,869.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,562,244OtherCostOrOtherBasisAmt
Book Value$26,562,244BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$113,716,659OtherCostOrOtherBasisAmt
Depreciation$2,186,769DepreciationAmt
Book Value$111,529,890BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,423,581OtherCostOrOtherBasisAmt
Depreciation$12,817,708DepreciationAmt
Book Value$13,605,873BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,226,098OtherCostOrOtherBasisAmt
Depreciation$13,723,578DepreciationAmt
Book Value$2,502,520BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$180,444,694OtherCostOrOtherBasisAmt
Depreciation$124,539,604DepreciationAmt
Book Value$55,905,090BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$210,105,617TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$14,818,996
PHARMACY RECEIVABLES$96,398,183
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS) - CURRENT$33,160
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS)$449,447,222
FieldValueIRS element (for citing)
Total Book Value Other Assets$560,697,561TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
CAPITAL LEASE PAYABLE$1
CLAIMS PAYABLE$1,361,667,109
DUE TO THIRD PARTIES$429,699,921
FieldValueIRS element (for citing)
Total Liability$1,791,367,031TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$9,813,070,603TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$39,737,138NetUnrealizedGainsInvstAmt
Other Revenue-$422,762OtherRevenueAmt
Revenue Not Reported$39,314,376RevenueNotReportedAmt
Revenue Subtotal$9,773,756,227RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,773,756,227TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$9,461,558,149TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$422,762OtherExpensesIncludedAmt
Expenses Not Reported-$422,762ExpensesNotReportedAmt
Expenses Subtotal$9,461,980,911ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$9,461,980,911TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS") -131,496. SALUS CONTRIBUTION ELIMINATED IN CONSOLIDATION -25,000. GOVERNMENT GRANTS -293,706. SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 27,440.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS") -131,496. SALUS CONTRIBUTION ELIMINATED IN CONSOLIDATION -25,000. GOVERNMENT GRANTS -293,706. SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 27,440.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (53 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxtAddress Line2USAddress/AddressLine2Txt
1199SEIU HOME CARE INDUSTRY EDUCATION
330 WEST 42ND STREETNEW YORKNY10036711028611501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
ALICE HYDE MEDICAL CENTER
133 PARK STREETMALONENY12953150346515501(C)(3)$2,500CASHPART IV, SUPPLEMENTAL INFORMATION
AMAUS HEALTH SERVICES AT THE CATHEDRAL OF THE IMMACULATE CONCEPTION
259 EAST ONONDAGA STREETSYRACUSENY13202611548780501(C)(3)$30,000CASHPART IV, SUPPLEMENTAL INFORMATION
CARDINAL EDWARD M EGAN PAVILION OF THE ST JOHN VIANNEY CLERGY RESIDENCE
5655 ARLINGTON AVENUEBRONXNY10471133089351501(C)(3)$950,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES DIOCESE OF OGDENSBURG
6866 STATE HIGHWAY 37OGDENSBURGNY13669150614025501(C)(3)$200,500CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF BUFFALO
741 DELAWARE AVENUEBUFFALONY14209160743251501(C)(3)$413,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF FULTON & MONTGOMERY
55 EAST MAIN STREETJOHNSTOWNNY12095141340033501(C)(3)$6,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF LIVINGSTON COUNTY
34 EAST STATE STREETMT MORRISNY14510205493091501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF STEUBEN COUNTY
23 LIBERTY STREETBATHNY14810300553416501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF TEXAS
2900 LOUISIANA STREETHOUSTONTX77006741109733501(C)(3)$13,340CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF ALBANY
40 NORTH MAIN AVENUEALBANYNY12203141340033501(C)(3)$380,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF BROOKLYN
191 JORALEMON ST 4TH FLOORBROOKLYNNY11201112047151501(C)(3)$361,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
1150 BUFFALO RDROCHESTERNY14624160743944501(C)(3)$235,500CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
90 CHERRY LANEHICKSVILLENY11801111843801501(C)(3)$386,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF SYRACUSE
240 EAST ONONDAGA STREETSYRACUSENY13202150532085501(C)(3)$315,280CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE FINGER LAKES
94 EXCHANGE STREETGENEVANY14456142005241501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF TOMPKINSTIOGA
324 WEST BUFFALO STREETITHACANY14850510621633501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF WAYNE COUNTY
1141 EAST UNION STREETNEWARKNY14513204649120501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC MEDICAL MISSION BOARD INC
100 WALL STREET 9TH FLOORNEW YORKNY10005135602319501(C)(3)$40,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC MIGRATION SERVICES
191 JORALEMON ST 4TH FLOORBROOKLYNNY11201112634818501(C)(3)$500,000CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC SCHOOLS IN THE ARCHDIOCESE OF NEW YORK
1011 FIRST AVENUENEW YORKNY10022530196617501(C)(3)$90,000CASHPART IV, SUPPLEMENTAL INFORMATION
CHARLES B WANG COMMUNITY HEALTH CENTER
268 CANAL STREETNEW YORKNY10013132739694501(C)(3)$10,000CASHPART IV, SUPPLEMENTAL INFORMATION
COLUMBIA MEMORIAL HOSPITAL
71 PROSPECT AVENUEHUDSONNY12534141338373501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
COMMUNITY ENRICHMENT NETWORK TOWARDS EMPOWERMENT
50 WEST BROAD STREETHAVERSTRAWNY10927455233944501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
CORTLAND CHENANGO RURAL SERVICES INC
2704 LOWER CINCINNATUS RD PO BOX 57CINCINNATUSNY13040455599324501(C)(3)$16,000CASHPART IV, SUPPLEMENTAL INFORMATION57
DIOCESE OF BUFFALO
795 MAIN STREETBUFFALONY14203160743984501(C)(3)$60,000CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF OGDENSBURG
100 ELIZABETH STREETOGDENSBURGNY13669150532120501(C)(3)$60,000CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF ROCHESTER- DEPARTMENT OF CATHOLIC SCHOOLS
1150 BUFFALO ROADROCHESTERNY14624160743944501(C)(3)$60,000CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF ROCKVILLE CENTRE
128 CHERRY LANEHICKSVILLENY11801300868138501(C)(3)$60,000CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF SYRACUSE CATHOLIC SCHOOLS
240 E ONONDAGA STREETSYRACUSENY13207150532137501(C)(3)$60,000CASHPART IV, SUPPLEMENTAL INFORMATION
FOOD BANK OF WESTERN NEW YORK INC
91 HOLT STREETBUFFALONY14206222470820501(C)(3)$44,000CASHPART IV, SUPPLEMENTAL INFORMATION
FRANCISCAN NORTHSIDE MINISTRIES
812 NORTH SALINA STREETSYRACUSENY13208150532104501(C)(3)$28,720CASHPART IV, SUPPLEMENTAL INFORMATION
LONG ISLAND HEADSTART
98 AUSTIN STREETPATCHOGUENY11772112771919501(C)(3)$15,000CASHPART IV, SUPPLEMENTAL INFORMATION
MATERNITY & EARLY CHILDHOOD FOUNDATION INC
40 NORTH MAIN AVENUEALBANYNY12203141650131501(C)(3)$50,000CASHPART IV, SUPPLEMENTAL INFORMATION
MORRIS HEIGHTS HEALTH CENTER
85 WEST BURNSIDE AVENUEBRONXNY10453061081232501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
PS 130 M PARENTS ASSOCIATION
143 BAXTER STREETNEW YORKNY10013200766928501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
REGIONAL FOOD BANK
965 ALBANY - SHAKER RDLATHAMNY12110222470885501(C)(3)$44,000CASHPART IV, SUPPLEMENTAL INFORMATION
ROMAN CATHOLIC DIOCESE OF BROOKLYN
310 PROSPECT PARK WESTBROOKLYNNY11215111631807501(C)(3)$90,000CASHPART IV, SUPPLEMENTAL INFORMATION
SCHENECTADY FAMILY HEALTH SERVICES INC
1044 STATE STREETSCHENECTADYNY12307141636222501(C)(3)$7,500CASHPART IV, SUPPLEMENTAL INFORMATION
SCHOOLS OF THE ROMAN CATHOLIC CHARITIES DIOCESE OF ALBANY
40 NORTH MAIN AVENUEALBANYNY12203141605502501(C)(3)$60,000CASHPART IV, SUPPLEMENTAL INFORMATION
SEAMEN'S SOCIETY FOR CHILDREN & FAMILIES
50 BAY STREETSTATEN ISLANDNY10301135563010501(C)(3)$12,000CASHPART IV, SUPPLEMENTAL INFORMATION
ST ELIZABETH MEDICAL FOUNDATION
2209 GENESEE STREETUTICANY13501222562170501(C)(3)$7,580CASHPART IV, SUPPLEMENTAL INFORMATION
ST JOSEPH'S HOME
950 LINDEN STREETOGDENSBURGNY13669150532217501(C)(3)$69,000CASHPART IV, SUPPLEMENTAL INFORMATION
THE ALFRED E SMITH MEMORIAL FOUNDATION
1011 FIRST AVE SUITE 1400NEW YORKNY10022131553263501(C)(3)$30,000CASHPART IV, SUPPLEMENTAL INFORMATION
THE CHILDREN'S FOUNDATION OF ASTOR
6339 MILL STREETRHINEBECKNY12572223056183501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
THE DOOR - A CENTER OF ALTERNATIVES INC
121 AVENUE OF THE AMERICASNEW YORKNY10013136127348501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
THE FOUNDATION FOR ELLIS MEDICINE
1101 NOTT STREETSCHENECTADYNY12308141638957501(C)(3)$7,500CASHPART IV, SUPPLEMENTAL INFORMATION
THE POINT COMMUNITY DEVELOPMENT
940 GARRISON AVENUEBRONXNY10474133765140501(C)(3)$10,000CASHPART IV, SUPPLEMENTAL INFORMATION
UNITED HOSPITAL FUND OF NEW YORK INC
1411 BROADWAY 12TH FLOORNEW YORKNY10018131562656501(C)(3)$10,000CASHPART IV, SUPPLEMENTAL INFORMATION
WESTHAB INC
8 BASHFORD STREETYONKERSNY10701061064281501(C)(3)$10,000CASHPART IV, SUPPLEMENTAL INFORMATION
WHITNEY M YOUNG JR HEALTH CENTER INC
920 LARK DRIVEALBANYNY12207132922147501(C)(3)$10,000CASHPART IV, SUPPLEMENTAL INFORMATION
WILLIAM F RYAN COMMUNITY HEALTH CENTER
110 WEST 97TH STREETNEW YORKNY10025132884976501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
YOUNG MEN'S CHRISTIAN ASSOCIATION OF CORTLAND
22 TOMPKINS STREETCORTLANDNY13045150533570501(C)(3)$5,000CASHPART IV, SUPPLEMENTAL INFORMATION
FieldValueIRS element (for citing)
Total501c3 Org53Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeHEALTHY KIDS FUNDGrantTypeTxt
Recipient31553RecipientCnt
Cash Grant$299,790CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedCASH PAIDValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2:RECIPIENTS OF GRANT AWARDS UNDER THE COMMUNITY GRANT FUND ARE REQUIRED TO PROVIDE PERIODIC UPDATES ON THE ACCOMPLISHMENTS OF THE GRANT AND DISBURSEMENTS. IT IS THE RESPONSIBILITY OF THE GRANT RECIPIENT TO ENSURE THAT THE GRANT IS USED FOR THE PURPOSE(S) STATED IN THE ORIGINAL APPLICATION. FIDELIS MONITORS GRANT USAGE BY CORRESPONDENCE, TELEPHONE OR SITE VISITS. AN EVALUATION OF THE PROJECT IS REQUIRED UPON THE GRANTEE'S COMPLETION. NON-COMPLIANCE WITH THESE GUIDELINES MAY RESULT IN A REQUEST FOR RETURN OF THE FUNDS IN QUESTION OR INELLIGIBILITY OF THE ORGANIZATION FOR FUTURE GRANTS FROM FIDELIS.
PART II, COLUMN H:SINCE 2004, THE PURPOSE OF THE FIDELIS CARE COMMUNITY GRANT FUND IS TO OFFER SUPPORT ANNUALLY THROUGH CHARITABLE CONTRIBUTIONS TO SELECTED TAX-EXEMPT NONPROFIT ORGANIZATIONS THAT SHARE SIMILAR MISSIONS AND VALUES OF SERVICE TO LOW-INCOME VULNERABLE INDIVIDUALS. PROPOSALS ARE EVALUATED ON THEIR RELEVANCE TO FIDELIS' MISSION OF CARING FOR THE NEEDS AND CONCERNS OF THE POOR AND MEDICALLY UNDERSERVED IN CONSULTATION WITH FIDELIS' MEMBERS. THE TOTAL AMOUNT TO BE DISTRIBUTED EACH YEAR IS APPROVED BY THE BOARD OF DIRECTORS AND DISTRIBUTED IN ACCORDANCE WITH THE APPROVED BOARD POLICY. IN ADDITION TO THE GRANTS MADE THROUGH ITS COMMUNITY GRANT FUND, FIDELIS PROVIDES SUPPORT THROUGH CHARITABLE CONTRIBUTIONS THROUGH ITS CATHOLIC SCHOOLS GRANT INITIATIVE TO SELECTED CATHOLIC SCHOOLS OR DIOCESAN SCHOOL SYSTEMS IN THEIR EFFORT TO IMPROVE THE HEALTH STATUS OF CHILDREN AND THEIR FAMILIES. LASTLY, FIDELIS MAKES CHARITABLE DONATIONS TO ORGANIZATIONS CLASSIFIED AS TAX-EXEMPT NONPROFIT ORGANIZATIONS UNDER STATE AND FEDERAL LAW THAT WORK WITH FIDELIS TO SUPPORT THE PLAN'S MISSION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PATRICK J FRAWLEY
CEO$1,356,097$0$0$0$4,140,519$0$18,576$0$143,969$0$5,659,161$0$0$0
DAVID THOMAS
PRESIDENT & COO$593,775$51,000$314,500$25,500$915,208$15,692$17,183$1,393$63,683$4,223$1,904,349$97,808$0$0
THOMAS HALLORAN
EVP & CHIEF FINANCIAL OFFICER$486,775$58,000$182,700$20,300$91,613$7,436$309,789$1,858$47,534$3,992$1,118,411$91,586$0$0
PAMELA HASSEN
CHIEF MARKETING OFFICER$439,711$0$175,780$0$3,659,837$0$18,576$0$43,023$0$4,336,927$0$0$0
MARTIN KREBS
CHIEF INFORMATION OFFICER$384,082$0$143,500$0$35,306$0$189,033$0$41,100$0$793,021$0$0$0
SANTO RUSSO
CHIEF LEGAL OFFICER$383,386$44,327$183,600$20,400$42,579$4,188$219,025$1,858$47,986$4,054$876,576$74,827$0$0
THOMAS BROWN
CHIEF ADMINISTRATIVE OFFICER$372,328$0$175,500$0$27,810$0$172,712$0$10,146$0$758,496$0$0$0
ROBERT FAZZOLARI
SVP, GOV'T RELATIONS & CORP. COMP.$295,903$0$194,000$0$25,290$0$18,576$0$11,186$0$544,955$0$0$0
SANJIV SHAH MD
FMR CHIEF MED. OFF. (THRU MAY 2017)$152,099$25,207$99,041$14,149$24,292$0$16,254$2,322$11,262$1,801$302,948$43,479$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BSERP COMPENSATION OF OFFICERS AND HIGHEST COMPENSATED EMPLOYEES: PATRICK J. FRAWLEY - $4,112,709*; DAVID THOMAS - $696,979*; PAMELA HASSEN - $3,642,070*; THOMAS HALLORAN - $293,071**; MARTIN KREBS - $170,457**; SANTO RUSSO - $202,307**; THOMAS BROWN - $154,136** *THE ABOVE AMOUNTS INCLUDE GROSS-UP TAXES PAID ON BEHALF OF THE PARTICIPANTS (LINE 1A). **THESE REPRESENT NON-VESTED SERP BENEFITS.
PART I, LINE 7PERFORMANCE-BASED INCENTIVES ARE PAID AS PART OF THE PLAN'S ANNUAL INCENTIVE PROGRAM. THE CHIEF EXECUTIVE OFFICER DOES NOT PARTICIPATE IN ANY INCENTIVE PROGRAM.
PART II, COLUMN (B)(III):IN 2017, THE PLAN PAID GRANDFATHERED PAID TIME OFF BALANCES TO ELIGIBLE EMPLOYEES INCLUDING EXECUTIVES.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SUBSTANTIAL CONTRIBUTORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionSUBSTANTIAL CONTRIBUTORRelationshipDescriptionTxt
Transaction$30,960,112TransactionAmt
TransactionBUSINESS TRANSACTIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1:TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES TO THE COMMUNITY, ESPECIALLY TO THE POOR AND UNDERSERVED; TO PROMOTE HEALTH EDUCATION AND PREVENTATIVE MEDICINE.
FORM 990, PART III, LINE 1:THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("FIDELIS OR THE "PLAN") STRIVES TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES FOR ALL; TO JOIN IN PARTNERSHIP WITH HEALTH PROFESSIONALS TO ASSIST THEM IN THEIR HEALING WORK; TO ACT AS A FACILITATOR TO BUILD LINKAGES AND SYSTEMS FOR THE COORDINATION OF CARE AND SERVICES AMONG HEALTHCARE, BEHAVIORAL AND SOCIAL SERVICES, AS WELL AS EDUCATORS AND RELIGIOUS LEADERS, TO ADDRESS THE SPIRITUAL, EMOTIONAL AND PHYSICAL NEEDS OF THOSE IT SERVES; TO ADVOCATE FOR A HEALTH POLICY THAT ACCORDS TRUE DIGNITY AND RESPECT FOR ALL HUMAN PERSONS, ESPECIALLY THE POOR AND UNDERSERVED.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ORGANIZATION SHALL BE LIMITED TO THE DIOCESAN BISHOPS OF THE STATE AND THE ECCLESIASTICAL PROVINCE OF NEW YORK.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION IS A MEMBERSHIP CORPORATION UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW (THE "N-PCL"). THE ORGANIZATION'S MEMBERS ELECT ITS BOARD OF DIRECTORS AND, AS MEMBERS OF A NEW YORK NOT-FOR-PROFIT CORPORATION, POSSESS CERTAIN OTHER POWERS UNDER THE N-PCL. FURTHERMORE, THE ORGANIZATION'S BY-LAWS, WHICH ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYSDOH"), DEFINE THE FOLLOWING RESERVED POWERS OF THE MEMBERS: (I) THE INTERPRETATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES TO WHICH THE ORGANIZATION, AS A FAITH-BASED ORGANIZATION, IS SUBJECT; (II) APPROVAL OF THE MISSION STATEMENT; (III) STANDING TO ENSURE THE ORGANIZATION'S COMPLIANCE WITH ITS PHILOSOPHY AND MISSION STATEMENT; (IV) APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S CERTIFICATE OF INCORPORATION AND BY-LAWS; (V) APPROVAL OF CERTAIN TRANSACTIONS INVOLVING REAL PROPERTY; (VI) APPROVAL OF CERTAIN ACTIONS BY THE ORGANIZATION WHEN ACTING AS A SHAREHOLDER OR MEMBER OF ANOTHER ENTITY; (VII) APPROVAL OF THE ACCEPTANCE AND ISSUANCE OF SUBVENTIONS; (VIII) APPROVAL OF ANY MERGER, DISSOLUTION OR CONSOLIDATION; (IX) REMOVAL OF DIRECTORS AND CERTAIN OFFICERS OF THE CORPORATION; (X) APPROVAL OF THE ELECTION OF THE CHIEF EXECUTIVE OFFICER; AND (XI) REVIEW OF THE AUDITED FINANCIAL STATEMENTS. CERTAIN OF THESE POWERS ALREADY EXIST BY VIRTUE OF THE N-PCL (I.E., THE POWER TO APPROVE ANY MERGER, DISSOLUTION OR CONSOLIDATION UNDER N-PCL 903(A)(2) & 1002(A)).
FORM 990, PART VI, SECTION A, LINE 7BPLEASE SEE LINE 11B NARRATIVE.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE FORM 990 PREPARED BY THE ORGANIZATION'S FINANCE DEPARTMENT IS REVIEWED BY THE ORGANIZATION'S EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER, IN COLLABORATION WITH THE ORGANIZATION'S OUTSIDE INDEPENDENT TAX ADVISORS. THEREAFTER, THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER AND PRESIDENT & CHIEF OPERATING OFFICER REVIEW THE DRAFT FORM 990 WITH THE EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AUTHORIZED THE EXECUTIVE COMMITTEE OF THE BOARD TO REVIEW AND ACCEPT THE DRAFT FORM 990 BEFORE ITS FILING WITH THE IRS. ACCORDINGLY, AFTER THE ORGANIZATION'S MANAGEMENT HAS COMPLETED ITS REVIEW OF THE DRAFT FORM 990, IT IS CIRCULATED IN DRAFT FOR REVIEW, COMMENT AND APPROVAL TO THE MEMBERS OF THE EXECUTIVE COMMITTEE. ONCE ANY COMMENTS HAVE BEEN INCORPORATED AND THE FORM 990 HAS BEEN ACCEPTED BY THE EXECUTIVE COMMITTEE, A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE ORGANIZATION'S OFFICERS, DIRECTORS AND SENIOR EXECUTIVES ARE PROVIDED WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND AN ACKNOWLEDGEMENT FORM. THESE INDIVIDUALS ARE INSTRUCTED TO SIGN AND RETURN THE FORM, (A) TO ACKNOWLEDGE THAT THEY HAVE REVIEWED THE POLICY AND (B) TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS. THE CONFLICTS OF INTEREST POLICY DEFINES "DISCLOSABLE INTERESTS", I.E., THOSE INTERESTS THAT AN INDIVIDUAL COVERED BY THE POLICY MUST HAVE IN ANOTHER ENTITY IN ORDER FOR A TRANSACTION BETWEEN THE ORGANIZATION AND THAT ENTITY TO BE COVERED BY THE POLICY. THE POLICY ALSO DEFINES THE TYPES OF TRANSACTIONS BETWEEN THE ORGANIZATION AND ANOTHER ENTITY INVOLVING AN INDIVIDUAL COVERED BY THE POLICY THAT IS SUBJECT TO BY THE POLICY. THE POLICY REQUIRES DISCLOSURE TO THE BOARD OF DIRECTORS AND/OR THE EXECUTIVE COMMITTEE BY ANY PERSON WITH A DISCLOSABLE INTEREST IN A TRANSACTION AS DEFINED IN THE POLICY OF ALL CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. INITIALLY, AFTER THE INTERESTED INDIVIDUAL HAS RECUSED HIMSELF, THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE DETERMINES WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE DECIDES WHETHER TO ENTER INTO THE TRANSACTION BASED ON ITS DETERMINATION OF WHETHER (A) A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, (B) THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND (C) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15OUTSIDE COUNSEL FOR THE ORGANIZATION, A NATIONAL LAW FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, HAS ADVISED FIDELIS AS TO WHICH EMPLOYEES ARE DISQUALIFIED PERSONS WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EMPLOYS A COMPENSATION CONSULTANT FIRM, A NATIONAL HUMAN RESOURCES CONSULTING FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, TO PREPARE ANNUALLY A DETAILED REPORT ON THE PROPOSED COMPENSATION FOR THE ORGANIZATION'S DISQUALIFIED PERSONS THAT INCLUDES DATA AS TO COMPARABLE COMPENSATION FOR SIMILAR QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY-SITUATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH HAS BEEN AUTHORIZED BY THE BOARD TO REVIEW AND APPROVE ALL MATTERS CONCERNING EXECUTIVE COMPENSATION, IS PROVIDED WITH THE COMPENSATION CONSULTANT'S DETAILED EXECUTIVE COMPENSATION REPORT. THE REVIEW AND APPROVAL OF THE COMPENSATION OF THE ORGANIZATION'S DISQUALIFIED PERSONS IS ACCOMPLISHED IN TWO PHASES: FIRST WITH RESPECT TO THE CHIEF EXECUTIVE OFFICER AND THEN WITH RESPECT TO ALL OTHER DISQUALIFIED PERSONS, NAMELY, (I) THE PRESIDENT & CHIEF OPERATING OFFICER, (II) THE EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER, (III) THE CHIEF LEGAL OFFICER, (IV) THE CHIEF MEDICAL OFFICER, (V) CHIEF MARKETING OFFICER, (VI) CHIEF INFORMATION OFFICER AND (VII) CHIEF ADMINISTRATIVE OFFICER. FIRST, THE AFOREMENTIONED OUTSIDE COUNSEL AND HUMAN RESOURCES CONSULTING FIRM, AT THE INVITATION OF THE EXECUTIVE COMMITTEE, REVIEW WITH THE COMMITTEE THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO RETAINS THE SERVICES OF A SECOND HUMAN RESOURCES CONSULTING FIRM TO ASSIST IN ITS EVALUATION OF THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER. THE FULL REVIEW OF THE COMPENSATION AND PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER IS PERFORMED BY THE EXECUTIVE COMMITTEE AT LEAST BI-ANNUALLY. AFTER ESTABLISHING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, THE EXECUTIVE COMMITTEE REPORTS ON ITS DELIBERATIONS AND DETERMINATIONS TO THE ORGANIZATION'S BOARD OF DIRECTORS. SECOND, THE EXECUTIVE COMMITTEE REVIEWS THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS WITH THE ASSISTANCE OF THE SAME OUTSIDE COUNSEL AND COMPENSATION CONSULTANTS PARTICIPATING IN THE REVIEW OF THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE DETERMINES WHETHER TO APPROVE THE COMPENSATION ANALYSIS AND CONCLUSIONS CONTAINED IN THE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS. AFTER CONSULTING WITH OUTSIDE COUNSEL, THE EXECUTIVE COMMITTEE HAS DESIGNATED THE CHIEF EXECUTIVE OFFICER TO SERVE AS AN "AUTHORIZED BODY" AS CONTEMPLATED BY THE EXCESS BENEFIT TRANSACTION REGULATIONS FOR THE PURPOSE OF SETTING THE COMPENSATION OF THOSE DISQUALIFIED PERSONS WITHIN AN APPROVED RANGE. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS FOR ALL DISQUALIFIED PERSONS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION IS A NEW YORK NOT-FOR-PROFIT CORPORATION. ITS CERTIFICATE OF INCORPORATION IS READILY AVAILABLE TO THE GENERAL PUBLIC FROM THE NEW YORK STATE DEPARTMENT OF STATE UNDER THE NEW YORK FREEDOM OF INFORMATION LAW ("FOIL"). ITS CERTIFICATE OF INCORPORATION AND BY-LAWS ARE ALSO ON FILE WITH THE NYSDOH AND LIKEWISE AVAILABLE TO THE GENERAL PUBLIC UNDER FOIL. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO ENROLLEES IN ITS MEDICAID PROGRAM AND TO INDIVIDUALS CONSIDERING BECOMING ENROLLEES BY INCLUDING IN THE MEMBER HANDBOOKS, WHICH ARE PROVIDED TO ENROLLEES AND ARE ACCESSIBLE ON THE ORGANIZATION'S WEB SITE, A STATEMENT THAT THE FINANCIAL STATEMENTS (AS WELL AS OTHER INFORMATION DESCRIBED IN THE HANDBOOKS) ARE AVAILABLE UPON REQUEST BY CALLING A TOLL-FREE NUMBER PROVIDED IN THE HANDBOOKS.
FORM 990, PART VII, SECTION A, COLUMN B:AVG. HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: THE FOLLOWING INDIVIDUALS DEVOTE A PERCENTAGE OF THEIR TIME TO SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED ORGANIZATION, AS DETAILED BELOW: DAVID THOMAS, PRESIDENT & CHIEF OPERATING OFFICER - 7.5% THOMAS HALLORAN, EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER - 10% SANJIV SHAH, MD, CHIEF MEDICAL OFFICER (THRU MAY 2017) - 12.5% SANTO RUSSO, CHIEF LEGAL OFFICER - 10% THIS ARRANGEMENT IS COVERED BY AN EMPLOYEE SERVICE AGREEMENT BETWEEN FIDELIS AND SALUS.
FORM 990, PART IX, LINE 12:THE ORGANIZATION'S PART IX, LINE 12, ADVERTISING AND PROMOTION EXPENSES INCLUDE PAYMENTS TO OTHER EXEMPT ORGANIZATIONS IN SUPPORT OF THEIR CHARITABLE PURPOSES, TO BENEFIT THE COMMUNITY, OR IN SPONSORSHIP OF THEIR FUNDRAISING EVENTS. THE EXPENDITURES INCLUDE THE AMOUNTS PAID TO THE FOLLOWING: THANKSGIVING CONTRIBUTION TO NEEDY - $185,341
SCHEDULE O, NOT APPLICABLE QUESTIONS:TO THE EXTENT THAT A QUESTION ON THE FORM 990 HAS BEEN LEFT BLANK, THE RESPONSE TO THIS QUESTION SHOULD BE NOT APPLICABLE. DUE TO SOFTWARE LIMITATIONS, FIDELIS COULD NOT PROPERLY RESPOND TO THE RESPECTIVE QUESTION AS N/A.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1REGO PARK OFFICE TOWER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BLVD 8TH FLOORAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11374ZIPCd
FieldValueIRS element (for citing)
EIN815473320EIN
Primary ActivitiesREAL PROPERTY OWNERPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Total Income$8,570,252TotalIncomeAmt
End Of Year Assets$144,769,329EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLAN INCBusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SALUS ADMINISTRATIVE SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11374ZIPCd
FieldValueIRS element (for citing)
EIN550878053EIN
Primary ActivitiesTHIRD PARTY ADMINISTRATORPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLAN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$15,640,024ShareOfTotalIncomeAmt
Share Of EOY Assets$111,402,727ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
SALUS ADMINISTRATIVE SERVICES INC
M$15,612,584
SALUS ADMINISTRATIVE SERVICES INC
N$1,037,408
SALUS ADMINISTRATIVE SERVICES INC
O$14,310,120

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART V:FormAndLineReferenceDesc
ExplanationSCHEDULE R, PART V RELATED PARTY TRANSACTIONS: FIDELIS REPORTS CERTAIN RELATED PARTY TRANSACTIONS BETWEEN ITSELF AND SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED PARTY, ON SCHEDULE R, PART V. THE METHODS USED FOR DETERMINING THE AMOUNTS REPORTED DIFFER BASED ON THE TYPE OF TRANSACTION BUT ARE ALL CONTAINED IN WRITTEN CONTRACTS BETWEEN THE TWO PARTIES. SALUS REPORTS A PERFORMANCE OF SERVICES TO FIDELIS. THE WRITTEN AGREEMENT SPECIFIES A FIXED DISPENSING FEE PER PHARMACY CLAIM PROCESSED. THE FEE IS AN ESTIMATE DESIGNED TO COVER DIRECT AND INDIRECT COSTS AS WELL AS A MODEST AMOUNT OF PROFIT. THE AMOUNT IS DEEMED CONSISTENT WITH AN INDEPENDENT THIRD PARTY TRANSACTION. FIDELIS REPORTS A SHARING OF FACILITIES, EQUIPMENT, AND OTHER ASSETS. THE OVERHEAD AND ADMINISTRATIVE COSTS ARE ALLOCATED BASED ON THE SHARE OF FACILITIES AND ASSETS SALUS IS DEEMED TO USE. FIDELIS SHARES PAID EMPLOYEES WITH SALUS. FIDELIS ALLOCATES SALARIES FOR EACH EMPLOYEE BASED ON THE PERCENTAGE OF TOTAL HOURS SPENT PROVIDING SERVICES TO SALUS.ExplanationTxt