2017-11-13T09:36:47-06:00 2016-12-31 ERNST & YOUNG LLP 5 TIMES SQUARE NEW YORK NY 100366530 990 2016-01-01 510609967 Healthfirst Health Plan of New Jersey Inc % CRAIG BARATTIN-VP CONTROLLER HEAL 2128016000 100 Church Street Floor 18 New York NY 100072601 JOHN BERMEL CFO 2128016000 2017-11-08 Laura Kielczewski P00740769 2127733000 2017-11-07 12.41.123.251 20404320173175000000 2017-11-13 P 48376AC60715834143EC7E8D06BB46C111BC8BCB 69737C1B06B896110FDEC2C2D169A38C27D88D5E 2016 2017-02-10 21:41:12Z HEALTHFIRST NJ PATRICIA J WANG 100 Church Street Floor 18 New York NY 100072601 3837 false X WWW.HEALTHFIRSTNJ.ORG X 2006 NJ TO PROMOTE THE HEALTH OF THE PEOPLE OF THE STATE OF NEW JERSEY BY ARRANGING FOR THE PROVISION OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID BENEFICIARIES. 16 14 0 0 0 0 0 -199923 0 16003 3837 0 0 -183920 3837 0 0 0 0 0 0 0 0 0 -217418 275216 -217418 275216 33498 -271379 31204901 35375939 25100464 24757000 6104437 10618939 TO PROMOTE THE HEALTH OF THE COMMUNITY BY ARRANGING FOR THE PROVISION OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID BENEFICIARIES AND TO RELIEVE THE POOR AND DISTRESSED BY MEETING THE SPECIAL HEALTH CARE NEEDS OF MEDICARE AND MEDICAID BENEFICIARIES. false false -11481 0 Medicare Healthfirst Health Plan of New Jersey, Inc. (HFNJ) provides affordable quality health plans to eligible medicare recipients. For 2016 there was no membership reported. As of 12/31/2014, the company ceased its Medicare operations. -17151 0 Medicaid/NJFamilycare Healthfirst Health Plan of New Jersey, Inc.(HFNJ) provides affordable quality health plans to eligible medicaid recipients. For 2016 there was no membership reported. As of June 2014 the company's Medicaid Membership was sold to a 3rd party and the company ceased its Medicaid operations. -28632 false false false false false false false false false false false false true true true false true false false false false false false false false false false false true false false false false false false false true false false false false false true true false false true 35 0 0 false false false false false false X 16 14 false true false false true true true true true false false true true true true true true false false false X CRAIG BARATTIN-VP CONTROLLER 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 GARY HORAN DIRECTOR 1.0 0.0 X 0 0 0 PETER A KELLY DIRECTOR 1.0 0.0 X 0 0 0 DANIEL P MCCARTHY PRESIDENT & COO 1.0 40.0 X X 0 1482463 198420 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 1.0 40.0 X 0 436446 17234 MICHAEL D D'AGNES DIRECTOR 1.0 0.0 X 0 0 0 ANTHONY T ORLANDO DIRECTOR 1.0 0.0 X 0 0 0 LESLIE D HIRSCH DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL MARON DIRECTOR 1.0 0.0 X 0 0 0 JOHN CALANDRIELLO DIRECTOR 1.0 0.0 X 0 0 0 RICHARD SMITH DIRECTOR 1.0 0.0 X 0 0 0 RONALD NAPIORSKI DIRECTOR 1.0 0.0 X 0 0 0 RONALD RAK DIRECTOR 1.0 0.0 X 0 0 0 EDWARD CONDIT DIRECTOR 1.0 0.0 X 0 0 0 TOM DALY DIRECTOR 1.0 0.0 X 0 0 0 ROBERT PETERSON DIRECTOR 1.0 0.0 X 0 0 0 CHAD FORBES DIRECTOR 1.0 0.0 X 0 0 0 ELIZABETH R ST CLAIR CHIEF LGL OFFICER-END 9/30/16 1.0 40.0 X 0 879977 110029 PATRICIA J WANG CHIEF EXECUTIVE OFFICER 1.0 40.0 X 0 3263189 360296 JOHN J BERMEL CFO-BEG 2/1/16 1.0 40.0 X 0 621734 15873 JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 1.0 40.0 X 0 857313 125306 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUIS 1.0 40.0 X 0 646818 95926 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 1.0 40.0 X 0 870836 137731 SEAN KANE CHIEF HR OFFICER 1.0 40.0 X 0 652845 103072 REBECCA SCHWIETZ SVP CLINICAL SERVICES 1.0 40.0 X 0 542851 86462 MARYBETH A TITA SVP-CORP. FINANCE-END 3/31/15 0.0 0.0 X 0 212981 0 MICHAEL FEDYNA CFO-END 7/21/15 1.0 40.0 X 0 503800 23002 0 10971253 1273351 0 true true false 0 0 0 3837 3837 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3837 3837 0 0 0 0 0 0 0 0 0 0 0 168694 168694 0 0 0 0 1000 0 1000 0 11856 11856 0 0 0 0 0 0 122268 122268 0 0 0 CLAIMS ADJUSTMENT EXPENSE -28632 -28632 MISC. EXPENSE 30 30 275216 -28632 303848 0 0 0 23671703 27819618 0 0 1079232 1079231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6453966 6477090 31204901 35375939 3820858 3403077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21279606 21353923 25100464 24757000 X 6104437 10618939 0 0 0 0 6104437 10618939 31204901 35375939 X -271379 4785881 X X false true X true false OTHER RECEIVABLES 1460703 MEDICARE PART D PLAN DEP.REC. 5016387 6477090 0 NOTES PAYABLE TO AFFILIATE 4586256 DUE TO HEALTHFIRST HEALTH PLAN INC. 9400 DUE TO STATE OF NJ 1391414 UPCAE/UNPAID VENDOR PAYABLE 354617 DUE TO AFFILIATE 14500000 MEDICARE PART D PLAN DEPOSIT L 16758 DUE TO CMS 495478 21353923 X Schedule D - Part X, LINE 2 THE FOLLOWING IS DISCLOSED IN THE AUDITED FINANCIAL STATEMENTS OF HF MANAGEMENT SERVICES, LLC, THE PARENT COMPANY OF HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.: It is the Companys policy to provide for uncertain tax positions and the related interest and penalties based upon managements assessment of whether a tax benefit is more likely than not to be sustained upon examination by tax authorities. At December 31, 2016, the Company believes it has appropriately accounted for any unrecognized tax benefits. To the extent the Company prevails in matters for which a liability for an unrecognized tax benefit is established or is required to pay amounts in excess of the liability, the Company's effective tax rate in a given financial statement period may be affected. true true false false false false false false false JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 434310 309736 113267 0 106830 0 18622 0 982765 0 93963 DANIEL P MCCARTHY PRESIDENT & COO 698258 607037 177168 0 186111 0 12421 0 1680995 0 157287 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 294524 137773 4149 0 4318 0 13009 0 453773 0 0 MARYBETH A TITA SVP-CORP. FINANCE-END 3/31/15 0 0 212981 0 0 0 0 0 212981 0 0 ELIZABETH R ST CLAIR CHIEF LGL OFFICER-END 9/30/16 407339 336888 135750 0 100613 0 9567 0 990157 0 0 PATRICIA J WANG CHIEF EXECUTIVE OFFICER 1147767 979693 1135729 0 354219 0 6228 0 3623636 0 1088131 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUIS 396319 248312 2187 0 95926 0 140 0 742884 0 0 JOHN J BERMEL CFO-BEG 2/1/16 522697 99037 0 0 0 16025 0 637759 0 0 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 442296 427020 1520 0 119335 0 18506 0 1008677 0 0 SEAN KANE CHIEF HR OFFICER 396551 244556 11738 0 103072 0 138 0 756055 0 9878 REBECCA SCHWIETZ SVP CLINICAL SERVICES 340655 201601 595 0 67040 0 19553 0 629444 0 0 MICHAEL FEDYNA CFO-END 7/21/15 221431 277971 4398 0 15900 0 7102 0 526802 0 0 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUALS ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - AN AFFILIATE ORGANIZATION OF HEALTHFIRST. ELIZABETH ST. CLAIR - TOTAL SEVERANCE: $759,575, SEVERANCE PAID IN 2016: $107,120 SEVERANCE DEFERRED: $652,455. MARYBETH TITA, SEVERANCE PAID IN 2016: $135,635. SCHEDULE J, PART 1, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS FROM THE PLAN SPONSOR FOR 2016: PATRICIA J. WANG $338,319 [Col. C] DANIEL P. McCARTHY $176,344 [Col. C] ELIZABETH R. ST CLAIR $84,713 [Col. C] JAY A. SCHECHTMAN $90,930 [Col. C] GERALD T. SWEENEY $103,455 [Col. C] SEAN KANE $87,172 [Col. C] PAUL PORTSMORE $80,026 [Col. C] REBECCA SCHWIETZ $51,140 [Col. C] MARYBETH TITA $77,346 [Col. C] HF MANAGEMENT SERVICES LLC SOLE CORPORATE MEMBER 4586256 SURPLUS NOTES OUTSTANDING false HF MANAGEMENT SERVICES LLC SOLE CORPORATE MEMBER 14500000 OTHER MGMT & ADMIN SVCS LIAB false FORM 990, PART VI, SECTION A, LINE 3 HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.(HFNJ) CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS) TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE, THESE ARE SUPPLIED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUM ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY RESOLUTION OF THE BOARD OF DIRECTORS. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR HFMS, A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM HFNJ. FORM 990, PART VI, SECTION A, LINE 6 HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. IS A NEW JERSEY NOT-FOR-PROFIT CORPORATION WITH ONE CORPORATE MEMBER, HF MANAGEMENT SERVICES, LLC. FORM 990, PART VI, SECTION A, LINES 7A AND 7B 7A: HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. IS A NEW JERSEY NOT FOR PROFIT CORPORATION WITH ONE CORPORATE MEMBER, HF MANAGEMENT SERVICES, LLC. THE CORPORATE MEMBER HAS THE RIGHT TO APPOINT THE BOARD OF DIRECTORS OF HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. 7B: AMENDMENTS TO THE GOVERNING DOCUMENTS REQUIRE APPROVAL OF THE SOLE CORPORATE MEMBER, HF MANAGEMENT SERVICES, LLC. CERTAIN DECISIONS OF THE BOARD OF DIRECTORS RELATING TO PRODUCTS OFFERED, RELATED PARTY TRANSACTIONS AND REPAYMENT OF SURPLUS NOTES REQUIRE APPROVAL OF THE NEW JERSEY DEPARTMENT OF BANKING AND INSURANCE. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS VICE PRESIDENT, CONTROLLER AND TREASURER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS CHIEF LEGAL OFFICER AND CHIEF FINANCIAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEW IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. A NOMINATED BOARD MEMBER WHO DOES NOT COMPLETE THE STATEMENT WITHIN THE CALENDAR YEAR WILL NOT BE PERMITTED TO CARRY OUT DUTIES. THE SAME APPLIES TO AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE APPROPRIATE DISCLOSURES. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. A REPORT OF ANY CONFLICTS IS PREPARED FOR DISCUSSION WITH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HF MANAGEMENT SERVICES, LLC, THE PARENT COMPANY, AS WELL AS THE FULL BOARD OF DIRECTORS OF HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. AS APPROPRIATE. GUIDANCE IS PROVIDED TO THE NECESSARY PARTIES AND ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION-MAKING, MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICER OR EMPLOYEE, THE REPORTING ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE PRESIDENT, CEO, OTHER OFFICERS AND CERTAIN KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY OF HFMS MEMBER HOSPITAL DIRECTORS (WHO ARE NOT EMPLOYED NOR COMPENSATED BY HFMS OR ANY OF ITS AFFILIATES). THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEES CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XI, LINE 9 ADMINISTRATIVE CHARGES: $337,651 - The health care service agreements with Healthfirst Health Plan of New Jersey, Inc (HFNJ) Sponsors provide a portion of the premium revenue allocated to each Sponsor, as health care provider to HFNJ plan members, is retained by HFNJ as additional capital contributions for the purpose of providing applicable statutory financial reserves and other administrative charges. The portion may be subject to periodic adjustment by HFNJ's Board of Directors. PROCEEDS FROM THE SALE OF MEDICAID BUSINESS: $4,448,230 - In September 2013, HFNJ entered into an asset purchase agreement with WellCare Health Plans of New Jersey, Inc. (WellCare) to sell certain non-financial assets owned by HFNJ which were used in operation of HFNJs Medicare and Medicaid business. In June 2014, HFNJ sold these non-financial assets relating to the Medicaid business to WellCare for approximately $27.0 million, of which approximately $2.7 million was placed in escrow as required by the asset purchase agreement. The sale of the Medicare non-financial assets was unable to be completed as planned in 2014, and HFNJ did not renew its Medicare contract with CMS, terminating its contract effective December 31, 2014. During 2015, a full reserve was placed against the escrow amount of approximately $2.7 million, as a result of a related claim asserted by WellCare prior to the escrow release date. In 2016, final settlement was reached with Wellcare and HFNJ received a cash settlement of approximately $4.4 million for all remaining amounts due related to the asset purchase agreement. FORM 990, PART XII, LINE 2B The filing organization does not publish stand-alone financial statements for general disclosure and use. Stand-alone financial statements are prepared solely for the New Jersey Department of Banking and Insurance and New Jersey Department of Human Services and are restricted as to their use. Such financial statements are prepared in conformity with accounting practices prescribed or permitted by the New Jersey Department of Banking and Insurance, which is a comprehensive basis of accounting other than accounting principles generally accepted in the United States. The statutory-basis financial statements are audited by an independent accountant. For purposes of general disclosure and use, including the Form 990, the filing organization is included in the consolidated financial statements of HF Management Services, LLC, a related organization, which are prepared in accordance with US GAAP and audited by an independent accountant. Other financial information included in the consolidated financial statements contains the GAAP-Basis balance sheet and income statement of the filing organization. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF MANAGERS OF HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION). HEALTHFIRST INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501(C)(3) 12 Type I NA false HEALTHFIRST HEALTH PLAN INC 100 CHURCH ST FL 18 NEW YORK NY 10007 113029569 MANAGED CARE NY 501(C)(4) HEALTHFIRST true HEALTHFIRST PHSP INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133783732 MANAGED CARE NY 501(C)(3) 10 HEALTHFIRST true SENIOR HEALTH PARTNERS INC 100 CHURCH STREET 18FL NEW YORK NY 10007 134103882 MGD LT CARE NY 501(C)(3) 10 HF MGMT SVCS true NEIGHBORHOOD HEALTH PROVIDERS INC 100 CHURCH ST FL 18 NEW YORK NY 10007 943474115 MANAGED CARE NY 501(C)(3) 10 HEALTHFIRST true HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA false 0 HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY MF MGMT SVCS C CORP true HEALTHFIRST INSURANCE COMPANY INC 100 Church Street FL 18 NEW YORK NY 100072601 464545744 INSUR. PROVID NY NA C CORP false false false false false true false false false false false false false true false false false false false false HF MANAGEMENT SERVICES LLC E 4586256 SURPLUS NOTE HF MANAGEMENT SERVICES LLC M 14500000 Liab.-cost FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (1): The amount represents Surplus Note Payable which was monies borrowed from HF Management Services, LLC (HFMS) to fund Healthfirst Health Plan of New Jersey, Inc (HFNJ). It represents two 7 year note payables to HFMS. Interest is calculated and is adjusted at the prime rate. FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (2): In 2014, subsequent to the closing of the sale transaction to Wellcare, Healthfirst Health Plan of New Jersey (HFNJ) recorded a liability due to HF Management Services, LLC (HFMS) in the amount of $14.5 million for the system configuration and programming, marketing and vendor costs that HFMS previously provided to HFNJ, as a component of its administrative services agreement with HFMS. The payment of these costs was contingent upon the closing of a sale transaction between HFNJ and Wellcare.