2025-11-17T12:26:11+00:00 2024-12-31 346565596 ERNST & YOUNG US LLP 221 EAST 4TH STREET CINCINNATI OH 45202 990 2024-01-01 050477052 Neighborhood Health Plan of Rhode Island NEIG 4014596000 910 DOUGLAS PIKE SMITHFIELD RI 02917 PETER MARINO CEO 2025-11-17 true Julie L Sparks P01268401 5136121400 2025-11-17 2024 2025-03-06 01:10:19Z PETER MARINO 910 DOUGLAS PIKE SMITHFIELD RI 02917 2425232557 false X WWW.NHPRI.ORG X 1993 RI Neighborhood Health Plan of Rhode Island, an innovative health plan in partnership with the Community Health Centers, secures access to high quality, cost-effective health care for Rhode Island's at-risk populations. 16 15 776 15 1973677 0 0 1875967422 1935848322 7612611 8953088 0 1883580033 1944801410 0 1730787510 1785992679 49152581 53619320 0 0 100463451 103111269 1880403542 1942723268 3176491 2078142 578758475 471348536 446745371 342136840 132013104 129211696 Neighborhood Health Plan of Rhode Island, an innovative health plan in partnership with the Community Health Centers, secures access to high quality, cost-effective health care for Rhode Island's at-risk populations. false false 1831032659 0 1935848322 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION ("HMO") THAT PROVIDES HIGH-QUALITY, LOW-COST HEALTH CARE SERVICES ON A PREPAID BASIS PRINCIPALLY TO MEDICAID RECIPIENTS AND CERTAIN OTHER ELIGIBLE PERSONS UNDER STATE OF RHODE ISLAND MANAGED CARE PROGRAM, RITECARE. THE ORGANIZATION ALSO EXTENDS ITS SERVICE, BENEFITS AND VALUE TO INDIVIDUALS AND BUSINESSES THROUGH HEALTHSOURCE RI, THE STATE'S HEALTH INSURANCE EXCHANGE. AS OF DECEMBER 31, 2024, THE ORGANIZATION IS RESPONSIBLE FOR PROVIDING HEALTH CARE SERVICES TO OVER 218,540 MEMBERS. 1831032659 true false false true false false false false false false true 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 false false false false false false false true 2323 0 true 776 true true true false false false false false false false false false false false X 16 15 false false false false true true true true true false false false true true true true true true true true false false RI X PETER M MARINO CEO 4014596000 910 DOUGLAS PIKE SMITHFIELD RI 02917 ALISON CROKE VICE CHAIRPERSON 1.0 0.0 X X 0 0 0 BRENDA DOWLATSHAHI CHAIRPERSON 1.0 0.0 X X 0 0 0 KEITH OLIVEIRA SECRETARY 1.0 0.0 X X 0 0 0 MERRILL THOMAS TREASURER 1.0 0.0 X X 0 0 0 PETER MARINO PRESIDENT & CEO 38.0 0.0 X X 710375 0 49857 CHRISTINA PACHECO TRUSTEE (AS OF 6/4/2024) 1.0 0.0 X 0 0 0 CHUCK JONES TRUSTEE (AS OF 12/2/2024) 1.0 0.0 X 0 0 0 DANIEL DA PONTE TRUSTEE 1.0 0.0 X 0 0 0 DIOSCARIS GARCIA PHD TRUSTEE 1.0 0.0 X 0 0 0 ELENA NICOLELLA TRUSTEE 1.0 0.0 X 0 0 0 GARY FURTADO TRUSTEE 1.0 0.0 X 0 0 0 JEANNE LACHANCE TRUSTEE (TERM ENDED 9/3/2024) 1.0 0.0 X 0 0 0 LISA RANGLIN TRUSTEE 1.0 0.0 X 0 0 0 PABLO RODRIQUEZ MD TRUSTEE 1.0 0.0 X 0 0 0 PETER BANCROFT CPA TRUSTEE 1.0 0.0 X 0 0 0 RILWAN FEYISTAN TRUSTEE 1.0 0.0 X 0 0 0 WILLIAM HOCHSTRASSER-WALSH TRUSTEE (TERM ENDED 12/3/2024) 1.0 0.0 X 0 0 0 YAHAIRA PLACENCIA TRUSTEE 1.0 0.0 X 0 0 0 KAREN CARLSON CHIEF OPERATING OFFICER 38.0 0.0 X 419870 0 40068 KRISTEN RUSSELL CHIEF MEDICAL OFFICER 38.0 0.0 X 550554 0 49221 MICHELLE SEARS CHIEF FINANCIAL OFFICER-SVP 38.0 0.0 X 428704 0 22726 DAVID BURNETT CHIEF GROWTH OFFICER 38.0 0.0 X 461682 0 46095 MARK COOPER VICE PRESIDENT OF MEDICARE/MEDICAID INTEGRATION 38.0 0.0 X 351088 0 32816 MELISSA HUSBAND CHIEF OF STAFF 38.0 0.0 X 407109 0 46657 TALIA A MARK CHIEF DIVERSITY OFFICER 38.0 0.0 X 409282 0 49499 VENT R JACKSON VICE PRESIDENT OF CLINICAL OPERATIONS 38.0 0.0 X 354773 0 29424 CRISTOPHER OTTIANO FORMER OFFICER 0.0 0.0 X 330990 0 62404 4424427 0 428767 245 false true false CVS Pharmacy Inc 9501 E Shea Blvd MC 019 Scottsdale AZ 86260 Healthcare services 404231783 Rhode Island Hospital 167 Point St Suite 3A Providence RI 02903 Healthcare services 319490779 United Behavioral Health dba Optum Dept 175897 PO Box 39000 San Francisco CA 94139 Healthcare services 283937709 Women & Infants Hospital 101 Dudley Street Providence RI 02905 Healthcare Services 112679643 The Miriam Hosptial PO Box 1202 Providence RI 029011202 Healthcare Services 84459732 538 0 0 0 0 0 0 0 0 PREMIUM EARNED 524114 1931882058 1931882058 0 0 EOHHS INCENTIVES 524114 1992587 1992587 0 0 PPC ADMINISTRATION 524114 1973677 0 1973677 0 0 0 0 0 0 0 0 0 0 0 0 0 1935848322 9512004 0 0 9512004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479872231 480431147 -558916 0 -558916 0 0 -558916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1944801410 1933874645 1973677 8953088 0 0 0 0 0 0 1785992679 1785992679 1409936 0 1409936 0 0 0 0 0 35565265 13329933 22235332 0 2224915 833903 1391012 0 11144147 4176849 6967298 0 3275057 1227498 2047559 0 0 0 0 0 513431 192435 320996 0 1397220 523681 873539 0 90000 0 90000 0 0 0 0 0 0 0 33912920 12710549 21202371 0 2311305 866282 1445023 0 2707599 1014814 1692785 0 10645726 3990040 6655686 0 0 0 0 0 2562747 960523 1602224 0 189876 71166 118710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3326663 1246840 2079823 0 1161243 435236 726007 0 PREMIUM TAX 35060382 0 35060382 STATE & LOCAL TAXES PAID 8164054 3059904 5104150 TEMPORARY HELP 873907 327542 546365 OTHER EXPENSE - TRAINING 194196 72785 121411 0 0 0 0 1942723268 1831032659 111690609 0 0 0 0 0 183674493 153116385 0 0 0 0 60547974 67771724 0 0 0 0 0 0 0 0 0 0 4690952 3978730 811261 712222 161086191 154411003 0 0 0 0 172638556 95337202 578758475 471348536 145574523 91501351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301170848 250635489 446745371 342136840 X 132013104 129211696 0 0 0 0 0 0 0 0 132013104 129211696 578758475 471348536 X 2078142 -53902 -4825648 X false true true false X 0 1394307685 1520834669 1636540955 1875967422 1935848322 8363499053 0 0 0 1394307685 1520834669 1636540955 1875967422 1935848322 8363499053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8363499053 1540580 974533 2610232 7792172 9512004 22429521 0 1540580 974533 2610232 7792172 9512004 22429521 0 7189 0 0 0 0 7189 1395855454 1521809202 1639151187 1883759594 1945360326 8385935763 0.99732 0.99798 0 0.0 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - INSURANCE DIVIDENDS, COLUMN A - 7189.0, COLUMN B - , COLUMN C - , COLUMN D - , COLUMN E - , COLUMN F - 7189.0; false false false false false false true 90000 false false 90000 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND DOES NOT DIRECTLY ENGAGE IN ANY LOBBYING ACTIVITES BUT RETAINS A GOVERNMENT RELATIONS COMPANY, PLDO STRATEGIES LLC, TO ADVOCATE THAT FUNDING FOR THE MEDICAID PROGRAM NOT BE REDUCED. FOR THE YEAR ENDED DECEMBER 31, 2024, THE ORGANIZATION PAID PLDO STRATEGIES LLC $90,000. 4690952 3978730 712222 712222 RETROSPECTIVE PREMIUM REINSURANCE 7577553 ACCOUNTS RECEIVABLE UNINSURED PLANS 12215794 HEALTHCARE AND OTHER ACCTS RECEIVABLES 31876069 Other Receivables - Miscellaneous 1602564 Other Receivables - APM LTSS Pass-Thru Program Other Receivable - AE Incentive Pass-Thru Program 542378 Other Receivable - Hospitals Directed Premiums 41522844 95337202 Federal Income Taxes CLAIMS UNPAID 128159897 ACCRUED MEDICAL INCENTIVES 5999998 UNCLAIMED PROPERTY PAYABLE 28276 PREMIUMS RECEIVED IN ADVANCE 116447318 LIABILITY FOR AMOUNTS HELD UNDER UNINSURED PLANS 250635489 1933874645 0 0 1933874645 10926765 10926765 1944801410 1940749591 -1973677 -1973677 1942723268 0 0 1942723268 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements PPC INCOME - 1973677 NET INVESTMENT INCOME - 9512004 NET CAPITAL LOSS - -558916 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 PPC INCOME INCLUDED IN REVENUE - -1973677 X X X X false false false false false false false true false PETER MARINO PRESIDENT & CEO 562442 0 143860 0 4073 0 13800 0 36057 0 760232 0 0 0 CRISTOPHER OTTIANO FORMER OFFICER 277275 0 50400 0 3315 0 27047 0 35357 0 393394 0 13524 0 KAREN CARLSON CHIEF OPERATING OFFICER 340631 0 75375 0 3864 0 13800 0 26268 0 459938 0 0 0 MICHELLE SEARS CHIEF FINANCIAL OFFICER-SVP 349917 0 76500 0 2287 0 13800 0 8926 0 451430 0 0 0 KRISTEN RUSSELL CHIEF MEDICAL OFFICER 447500 0 100838 0 2216 0 13164 0 36057 0 599775 0 0 0 DAVID BURNETT CHIEF GROWTH OFFICER 352387 0 107625 0 1670 0 13238 0 32857 0 507777 0 0 0 TALIA A MARK CHIEF DIVERSITY OFFICER 324938 0 83125 0 1219 0 8642 0 40857 0 458781 0 0 0 MELISSA HUSBAND CHIEF OF STAFF 332386 0 73125 0 1598 0 13800 0 32857 0 453766 0 0 0 VENT R JACKSON VICE PRESIDENT OF CLINICAL OPERATIONS 281932 0 35000 0 37841 0 7454 0 21970 0 384197 0 0 0 MARK COOPER VICE PRESIDENT OF MEDICARE/MEDICAID INTEGRATION 274721 0 74500 0 1867 0 10846 0 21970 0 383904 0 0 0 Schedule J, Part I, Line 7 Non-fixed payments PURPOSE: NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND'S (NHPRI) PERFORMANCE INCENTIVE PLAN (THE PLAN) HAS BEEN IMPLEMENTED TO OFFER A PERFORMANCE-BASED INCENTIVE AWARD OPPORTUNITY TO ELIGIBLE NHPRI EMPLOYEES BASED ON ACHIEVEMENT OF THE ORGANIZATION'S ANNUAL BUSINESS OBJECTIVES AS WELL AS THEIR OWN JOB PERFORMANCE. THE PLAN ALLOWS A PORTION OF NHPRI'S ANNUAL COMPENSATION COSTS TO BE VARIABLE IN RELATION TO THE ORGANIZATION'S PERFORMANCE. AMOUNTS PAID IN 2024 UNDER THE PLAN ARE INCLUDED IN PART II COLUMN (B) (II). OTHER OBJECTIVES THE PLAN IS EXPECTED TO PROMOTE INCLUDE THE FOLLOWING: A) FOCUS THE ATTENTION, EFFORT, AND TEAMWORK OF PLAN PARTICIPANTS ON THE ACCOMPLISHMENT OF NHPRI'S KEY BUSINESS OBJECTIVES; B) ENABLE NHPRI TO OFFER A COMPENSATION PROGRAM WITH METHODS AND LEVELS OF PAY THAT ARE COMPETITIVE WITH OTHER ORGANIZATIONS SEEKING COMPARABLE EMPLOYEE RESOURCES; C) REINFORCE NHPRI'S COMMITMENT TO A PERFORMANCE-BASED CULTURE FOR ITS EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION; D) ASSIST NHPRI'S EFFORTS TO RETAIN ITS VALUED EMPLOYEES. Form 990, Part VI, Line 6 Classes of members or stockholders THE ORGANIZATION IS A 501(C)(3) CORPORATION AND HAS MEMBERS BUT DOES NOT HAVE ANY STOCKHOLDERS. THE ORGANIZATION HAS A BOARD OF DIRECTORS WHO ARE MEMBERS OF THE ORGANIZATION THAT MEET ON A REGULAR BASIS AND FUNCTION AS THE GOVERNING BODY OF THE ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE MEMBERS OF THE ORGANIZATION ARE RHODE ISLAND COMMUNITY HEALTH CENTERS THAT HAVE THE AUTHORITY TO APPOINT A PORTION OF THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ALSO APPROVES THE HIRING OF THE CHIEF EXECUTIVE OFFICER WHO IS A VOTING MEMBER OF THE BOARD. Form 990, Part VI, Line 11b Review of form 990 by governing body THE ORGANIZATION'S FISCAL OPERATIONS DEPARTMENT ACCUMULATES THE INFORMATION AND DATA NECESSARY TO COMPLETE THE FEDERAL FORM 990. AUDITED FINANCIAL STATEMENTS AND APPROVED POLICIES AND PROCEDURES ARE USED AS INPUT TO COMPLETE THE 990. A DRAFT RETURN IS PREPARED AND REVIEWED BY THE ORGANIZATION'S INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS. AFTER THE REVIEW PROCESS IS COMPLETED BY THE INDEPENDENT ACCOUNTANTS, THE FINANCE STAFF REVIEW THE RETURN PRIOR TO FILING WITH THE IRS. THE FINANCE AND AUDIT COMMITTEE AND BOARD OF DIRECTORS ARE PROVIDED A DRAFT COPY OF THE RETURN FOR APPROVAL PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy Consistent with the organization's compliance plan, THE ORGANIZATION'S DIRECTOR OF COMPLIANCE IS ALSO THE ORGANIZATION'S CHIEF PRIVACY OFFICIAL. ALL BOARD MEMBERS, COMMITTEE MEMBERS AND EMPLOYEES MUST DISCLOSE ALL CONFLICTS ON A SIGNED DISCLOSURE FORM ON A YEARLY BASIS. IF A POTENTIAL CONFLICT OF INTEREST IS REPORTED, THE PRIVACY OFFICIAL REVIEWS THE CIRCUMSTANCES TO DETERMINE IF A POSSIBLE CONFLICT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE PRIVACY OFFICIAL WILL MONITOR THE CONFLICT OF INTEREST AS NECESSARY AND/OR REFER THE APPROPRIATE ITEMS TO THE CHIEF EXECUTIVE OFFICER FOR A RESOLUTION/DECISION. BOARD AND COMMITTEE MEMBERS REFRAIN FROM VOTING ON ISSUES WHERE THERE IS AN APPEARANCE OF A CONFLICT INVOLVING THESE MEMBERS. Form 990, Part VI, Line 19 Required documents available to the public THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S LOCATION AT 910 DOUGLAS PIKE, SMITHFIELD, RI 02917. Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN NET ASSETS - -4825648; Total - -4825648; Form 990, Part XII, Line 1 ACCOUNTING METHOD USED TO PREPARE THE FORM 990 NEIGHBORHOOD'S STATUTORY FINANCIAL STATEMENTS ARE PRESENTED ON THE BASIS OF ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE DEPARTMENT OF BUSINESS REGULATION (DBR). THE DBR HAS ADOPTED THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' STATUTORY ACCOUNTING PRATICES (NAIC SAP) AS THE BASIS OF ITS STATUTORY ACCOUNTING PRATICES (SAP). FORM 990, PART VI, LINE 15A & 15B PROCESS TO ESTABLISH COMPENSATION OF TOP MGMT OFFICIALS AND OTHERS THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CONTRACT OF THE CEO AND ANY CHANGES TO THE CONTRACT. THE VICE PRESIDENT OF HUMAN RESOURCES REVIEWS THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER BASED ON COMPENSATION SURVEYS. NEIGHBORHOOD SUBSCRIBES TO THREE OR FOUR SALARY SURVEYS THAT LIST SALARY AND SALARY INCREASES BY POSITION, GEOGRAPHY, PLAN SIZE AND PROFIT VS. NON-PROFIT ORGANIZATIONS. THESE SURVEYS ARE USED TO SET COMPENSATION ANNUALLY.