PRIORITY HEALTH CHOICE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PRIORITY HEALTH CHOICE INC (EIN 32-0016523)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-25
- IRS object ID
- 201742989349301594
- Schema version
- 2016v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-10-25T19:00:41-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9600 Brownsboro Road Suite 400 | AddressLine1Txt |
| City | Louisville | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402411122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320016523 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Priority Health Choice Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRIO | BusinessNameControlTxt |
| Phone | 6167745083 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 East Beltline NE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Anne Jones | PersonNm |
| Person Title | SVP, Finance | PersonTitleTxt |
| Signature | 2017-10-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rachel Spurlock | PreparerPersonNm |
| PTIN | P00520729 | PTIN |
| Phone | 5023263996 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joan A Budden | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 East Beltline NE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $595,139,447 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.priorityhealth.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH, AND THEREFORE THE LIVES, OF THE MEMBERS AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $452,045,980 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $484,530,294 | CYProgramServiceRevenueAmt |
| PY Investment Income | $718,936 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,425,564 | CYInvestmentIncomeAmt |
| CY Other Revenue | $950,700 | CYOtherRevenueAmt |
| PY Total Revenue | $452,764,916 | PYTotalRevenueAmt |
| CY Total Revenue | $486,906,558 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $386,402,388 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $419,859,650 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,013,685 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,195,605 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,183,949 | PYOtherExpensesAmt |
| CY Other Expenses | $46,313,612 | CYOtherExpensesAmt |
| PY Total Expenses | $437,600,022 | PYTotalExpensesAmt |
| CY Total Expenses | $476,368,867 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,164,894 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,537,691 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $122,787,215 | TotalAssetsBOYAmt |
| Total Assets EOY | $132,328,090 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $77,906,266 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $76,978,637 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $44,880,949 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $55,349,453 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH, AND THEREFORE THE LIVES, OF THE MEMBERS AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $462,631,890 | ExpenseAmt |
| Revenue | $485,480,994 | RevenueAmt |
| Desc | PRIORITY HEALTH CHOICE, INC. HAS A CONTRACT WITH THE STATE OF MICHIGAN TO OFFER HEALTH CARE COVERAGE TO MEDICAID RECIPIENTS WITHIN THE STATE OF MICHIGAN. MEDICAID MANAGED CARE HAS BEEN IN EXISTENCE SINCE THE LATE 1990'S AND HAS DEMONSTRATED SIGNIFICANT COST SAVINGS ALONG WITH BETTER HEALTH OUTCOMES FOR THEIR MEMBERS. PRIORITY HEALTH CHOICE, INC. PROVIDES MORE THAN 119,000 LOWER INCOME AND/OR DISABLED RESIDENTS IN 20 MICHIGAN COUNTIES (UP FROM 17 COUNTIES IN THE PRIOR YEAR) WITH ACCESS TO QUALITY AND AFFORDABLE HEALTH CARE SERVICES. IT PROMOTES AND INCENTIVIZES OPEN ACCESS TO PROVIDERS. PRIORITY HEALTH CHOICE, INC. HAS MAINTAINED ITS "EXCELLENT" ACCREDITATION STATUS FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) EVERY YEAR SINCE 1998 AND CONTINUES WITH ABOVE AVERAGE STATUS IN 2016. THIS RANKING IS THE RESULT OF EXCELLENT CLINICAL PERFORMANCE AND MEMBER SATISFACTION SCORES. PRIORITY HEALTH CHOICE, INC. TOPS THE NATION'S BENCHMARK IN THE AREAS OF CHILDHOOD IMMUNIZATIONS, DIABETES CARE AND THE MANAGEMENT OF ASTHMA. IN ADDITION TO THIS RECOGNITION FROM NCQA, THE 2016 MEDICAID HEALTH PLAN CONSUMER GUIDE IDENTIFIES PRIORITY HEALTH CHOICE, INC. AS THE ONLY MEDICAID PLAN IN THE STATE OF MICHIGAN TO RECEIVE THE HIGHEST RANKING IN ALL FIVE CATEGORIES. CHILDREN'S SPECIAL HEALTH CARE SERVICES (CSHCS) IS A SPECIALTY PROGRAM OFFERED BY THE STATE OF MICHIGAN TO PROVIDE CARE FOR CHILDREN AND SOME ADULTS WITH CHRONIC HEALTH CONDITIONS. IN ADDITION, THE CSHCS PROGRAM OFFERS SUPPORT TO THE FAMILIES AND CAREGIVERS OF THE MEMBER. CSHCS PROGRAM ELIGIBILITY IS BASED ON MORE THAN 2,700 MEDICAL DIAGNOSES. AS OF OCTOBER 1, 2012, THE MAJORITY OF THE CSHCS POPULATION TRANSITIONED INTO A MEDICAID HEALTH PLAN. IN RESPONSE TO THIS TRANSITION, PRIORITY HEALTH CHOICE, INC. IMPLEMENTED A SPECIALTY CARE MANAGEMENT PROGRAM FOR THIS UNIQUE POPULATION. A DEDICATED CARE MANAGEMENT TEAM ENSURES CSHCS MEMBERS ARE ESTABLISHED WITH A PRIMARY CARE MEDICAL HOME WHILE ALSO PROVIDING CARE COORDINATION BETWEEN THEIR PRIMARY CARE / SPECIALTY CARE PROVIDERS AND ANY ANCILLARY PROVIDERS. THIS TEAM INCLUDES CARE MANAGERS, COMMUNITY HEALTH WORKERS, FIELD SERVICE REPRESENTATIVES, AND OTHER KEY PARTNERS, INCLUDING COUNTY HEALTH DEPARTMENTS, EARLY ON, EARLY HEAD START, THE INTERMEDIATE SCHOOL DISTRICTS, SPECIALTY PROVIDERS, AND MEDICAL SUPPLIERS. THE CARE MANAGEMENT TEAM ALSO FACILITATES ACCESS FOR FAMILIES TO THE FAMILY CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, AND THE CHILDREN'S SPECIAL NEEDS FUNDS IN LANSING. AS OF DECEMBER 31, 2016, PRIORITY HEALTH CHOICE, INC. HAS APPROXIMATELY 1,600 MEMBERS ENROLLED IN THE CSHCS PROGRAM, UP FROM APPROXIMATELY 1,500 MEMBERS IN THE PRIOR YEAR. IN 2013, THE MICHIGAN ASSOCIATION OF HEALTH PLANS (MAHP) AWARDED PRIORITY HEALTH CHOICE, INC. WITH A PINNACLE AWARD FOR THE TRANSITION OF CSHCS MEMBERS INTO A MEDICAID MANAGED HEALTH PLAN. THE TRANSITION OF THIS POPULATION BEGAN WITH AN OUTREACH CALL BY FIELD SERVICE REPRESENTATIVES, WHO REVIEWED THE HEALTH PLAN BENEFITS WITH FAMILIES. THESE BENEFITS INCLUDE TRANSPORTATION, PRIMARY CARE ASSIGNMENT, USE OF URGENT CARE AND EMERGENCY ROOM SERVICES, REFERRAL PROCESS, PHARMACY, THE BEHAVIORAL HEALTH BENEFIT, AND THE ROLE OF THE LOCAL HEALTH DEPARTMENT. IN ADDITION, CARE MANAGEMENT SERVICES WERE OFFERED, WHICH THE MAJORITY OF THE CSHCS MEMBERS UTILIZED. A CARE MANAGER CONTACTED EACH MEMBER/FAMILY, COMPLETED A COMPREHENSIVE ASSESSMENT TO IDENTIFY MEMBER NEEDS, AND DEVELOPED A CARE PLAN WITH MEMBER CENTRIC GOALS. IN ADDITION, APPROPRIATE EDUCATION WAS PROVIDED REGARDING THE CURRENT DISEASE PROCESS, PREVENTATIVE HEALTH, CHRONIC DISEASE MANAGEMENT, AND THE IMPORTANCE OF THE MEDICAL HOME. THE TEAM WORKS COLLABORATIVELY TO ENSURE ALL NEEDS ARE IDENTIFIED AND ADDRESSED UTILIZING IN NETWORK/IN STATE PROVIDERS WHENEVER POSSIBLE. THIS PROCESS CONTINUES TODAY WITH ALL NEWLY ENROLLED CSHCS MEMBERS. ON SEPTEMBER 16, 2013, THE MICHIGAN GOVERNOR SIGNED INTO LAW MICHIGAN PUBLIC ACT 107 OF 2013, WHICH DIRECTED THE CREATION OF THE HEALTHY MICHIGAN PLAN. THE HEALTHY MICHIGAN PLAN RECEIVED APPROVAL FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES ON DECEMBER 30, 2013. THE STATE OF MICHIGAN BEGAN TO MAKE HEALTH CARE BENEFITS AVAILABLE THROUGH THE HEALTHY MICHIGAN PLAN EFFECTIVE APRIL 1, 2014. THE HEALTHY MICHIGAN PLAN ENCOURAGES HEALTHY BEHAVIORS AND PERSONAL RESPONSIBILITY, HELPS LOW-INCOME MICHIGAN RESIDENT'S ACCESS AFFORDABLE HEALTH COVERAGE, AND REDUCES UNCOMPENSATED CARE THAT SHIFTS COSTS ONTO BUSINESSES AND TAXPAYERS. AS OF DECEMBER 31, 2016, PRIORITY HEALTH CHOICE, INC. HAD NEARLY 34,000 MEMBERS ENROLLED IN THE HEALTHY MICHIGAN PLAN. IN 2016, THE MAHP AWARDED PRIORITY HEALTH CHOICE, INC. WITH A PINNACLE AWARD RECOGNIZING THE INNOVATIVE MEDNOW APPROACH. PRIORITY HEALTH CHOICE, INC. PARTNERED WITH MEDNOW TO VIRTUALLY CONNECT MEDICAID RECIPIENTS AND PROVIDERS. MEDNOW PROVIDES MEDICAID RECIPIENTS WITH ACCESS TO A COMPUTER IN-HOME, REAL-TIME ACCESS TO PRIMARY CARE PROVIDERS FOR NON-LIFE-THREATENING CONDITIONS, INCLUDING VIDEO VISITS FOR THOSE WITH A WEBCAM AND A STRONG INTERNET CONNECTION. IT HAS PROVIDED EFFECTIVE HEALTH CARE SERVICES TO BENEFICIARIES AT MEASURABLE COST SAVINGS. THE VIDEO-ENABLED VIRTUAL VISITS USE DATA ANALYTICS TO MEASURE UTILIZATION AND SATISFACTION. IN 2016, PRIORITY HEALTH CHOICE, INC. HAD 570 MEDNOW ENCOUNTERS WITH THE MEDICAID POPULATION. PRIORITY HEALTH CHOICE, INC. PARTNERED WITH CARECALL TO MAKE OUTREACH CALLS TO EACH HEALTHY MICHIGAN MEMBER. DURING THAT CALL, MEMBERS ARE PROVIDED WITH BENEFIT EDUCATION AS WELL AS ASSISTANCE IN MAKING THEIR INITIAL PRIMARY CARE PROVIDER ("PCP") APPOINTMENT. DURING THAT INITIAL PCP APPOINTMENT, THE MEMBER COMPLETES A HEALTH RISK ASSESSMENT, WHICH IDENTIFIES CURRENT BEHAVIORS, A MEMBER'S READINESS TO CHANGE, KEY HEALTH METRICS, AND THE PCP ATTESTATION. ONCE COMPLETED, THE HEALTH RISK ASSESSMENT IS SENT TO PRIORITY HEALTH CHOICE, INC. WHERE THE ASSESSMENT IS REVIEWED FOR COMPLETENESS AND TRANSMITTED TO THE STATE OF MICHIGAN. SPECIFIC HEALTH INFORMATION IS SENT VIA U.S. MAIL TO THE MEMBER DEPENDING ON WHICH GOAL(S) THE MEMBER CHOOSES TO WORK ON. IN PURSUIT OF THE GOAL THAT 81% OF CONTINUOUSLY ENROLLED MEDICAID MEMBERS WILL HAVE AT LEAST ONE LEAD SCREENING TEST BY THEIR SECOND BIRTHDAY, PRIORITY HEALTH REDESIGNED THE MEDICAID LEAD SCREENING PROGRAM. AS SUCH, PRIORITY HEALTH DEVELOPED A PROGRESSIVE THREE-TOUCH MEMBER OUTREACH REMINDER/INCENTIVE, PURCHASED LAB EQUIPMENT ON BEHALF OF PROVIDER OFFICES AND PROVIDED EDUCATION TO BOTH MEMBERS AND PROVIDERS AROUND THE IMPORTANCE OF LEAD SCREENING. BASED ON 2016 DATA, THE PRIORITY HEALTH HEALTH CARE EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) RATE FOR LEAD SCREENING ROSE FROM 71% (2011) TO 86%, SURPASSING THE GOAL OF THE STATE STANDARD. THE COMMUNITY HEALTH CARE ACCESS PROGRAM (CHAP), FORMERLY KNOWN AS CHILDREN'S HEALTH CARE ACCESS PROGRAM, IS A COMMUNITY COLLABORATIVE THAT WAS INITIATED IN 2008 AND HAS SINCE EXPANDED TO SERVICE ADULT ENROLLEES. THE FOCUS OF THE COLLABORATIVE FOR THE FIRST SEVERAL YEARS WAS TO INCREASE ACCESS AND QUALITY HEALTH CARE TO MEDICAID PEDIATRIC MEMBERS. THE PRIMARY GOAL OF THE CHAP PROGRAM NOW IS TO IMPROVE HEALTH OUTCOMES AMONG CHILDREN ON MEDICAID WHILE BETTER UTILIZING EXISTING RESOURCES AND DECREASING COSTS. THIS PARTNERSHIP BETWEEN PRIORITY HEALTH CHOICE, INC., HELEN DEVOS CHILDREN'S HOSPITAL, CHERRY STREET HEALTH SERVICES, PRIVATE PEDIATRIC PRACTICES, NUMEROUS HUMAN SERVICE AGENCIES, AND PRIVATE FOUNDATIONS COVERS 15,000 CHILDREN IN KENT COUNTY. CHAP CONTRACTED WITH PCPS, PROVIDING CARE COORDINATION AND ASSISTANCE WITH KEY HEDIS METRICS. PCPS WERE REIMBURSED AT A HIGHER RATE IN EXCHANGE FOR THEIR WILLINGNESS TO OPEN UP ACCESS, ESPECIALLY SAME DAY ACCESS TO MEMBERS. CHAP PROVIDED SAME DAY TRANSPORTATION TO URGENT PCP APPOINTMENTS AS NEEDED. IN ADDITION, CHAP PROVIDED MEMBER/FAMILY EDUCATION REGARDING APPROPRIATE EMERGENCY ROOM AND URGENT CARE UTILIZATION. IN 2014, CHAP DEVELOPED ITS OWN IDENTITY AS HEALTH NET OF WEST MICHIGAN. AT THE SAME TIME, THE FOCUS OF INTERVENTION EXPANDED TO ADULTS AS WELL AS CHILDREN. HEALTH NET PARTNERED WITH ADULT PRIMARY CARE PRACTICES TO WORK WITH ADULT MEMBERS REGARDING EMERGENCY ROOM AND URGENT CARE USE, WHILE ALSO PROVIDING EDUCATION REGARDING SPECIFIC MEMBER INPATIENT UTILIZATION. IN ADDITION, HEALTH NET HAS PARTNERED WITH OB-GYN RESIDENCY CLINICS TO FACILITATE THE MATERNAL INFANT HEALTH PROGRAM (MIHP) ENROLLMENT FOR PREGNANT WOMEN. HEALTH NET REPORTS A 53% RETURN ON INVESTMENT; FOR EVERY $1 INVESTED IN CHAP SERVICES, $1.53 WAS SAVED IN HEALTH COSTS. THE CONSUMER ASSESSMENT OF HEALTH CARE PROVIDERS AND SYSTEMS (CAHPS) CONDUCTS AN ANNUAL SURVEY THAT ASKS CONSUMERS AND PATIENTS TO REPORT ON AND EVALUATE THEIR EXPERIENCES WITH HEALTH CARE . IN 2016, PRIORITY HEALTH CHOICE, INC. SCORED SIGNIFICANTLY HIGHER THAN THE MDHHS MEDICAID MANAGED CARE PROGRAM AVERAGE. | Desc |
| Total Program Service Expenses | $462,631,890 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1908 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Anne Jones | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6164648695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 East Beltline NE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 495254501 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Joan A BUDDEN | |||||||||
| PRESIDENT & CEO | 5.0 | 45.0 | Yes (X) | Yes (X) | $107,935 | $998,696 | $459,764 | ||
| MICHAEL P FREED | |||||||||
| PRESIDENT & CEO - Part Year | 5.0 | 45.0 | Yes (X) | Yes (X) | $23,485 | $217,302 | $440,965 | ||
| Mary Anne Jones | |||||||||
| Treasurer & SVP, Finance | 5.0 | 45.0 | Yes (X) | Yes (X) | $58,341 | $539,813 | $195,502 | ||
| JAMES FORSHEE | |||||||||
| DIRECTOR - SVP, CHIEF MEDICAL OFFICER | 5.0 | 45.0 | Yes (X) | $6,879 | $63,646 | $7,167 | |||
| JOHN L FOX | |||||||||
| DIRECTOR - PART YEAr - Sr. Dir MEDICAL Affairs | 5.0 | 45.0 | Yes (X) | $43,471 | $402,230 | $65,966 | |||
| NICOLE KARSIES | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL KOZIARA | |||||||||
| Director - SVP, CHIEF OPERATING OFFICER | 5.0 | 45.0 | Yes (X) | $55,439 | $512,963 | $168,461 | |||
| JAY LABINE | |||||||||
| Director - SVP, CHIEF MEDICAL OFFICER - Part Year | 3.0 | 47.0 | Yes (X) | $25,940 | $554,142 | $171,638 | |||
| Chelsee Stark | |||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $225 | $0 | $0 | |||
| KIMBERLY L THOMAS | |||||||||
| SECRETARY | 5.0 | 45.0 | Yes (X) | $51,527 | $476,770 | $167,092 | |||
| BRIAN KRUPICZEWICZ | |||||||||
| SVP, HUMAN RESOURCES | 5.0 | 45.0 | $15,879 | $146,923 | $30,906 | Yes (X) | |||
| PAMELA RIES | |||||||||
| VP, SYSTEM TOTAL VALUE - PART YEAR | 0.0 | 50.0 | $0 | $627,555 | $265,413 | Yes (X) | |||
| WAYNE WILSON | |||||||||
| SVP, GOVERNMENT MARKETS | 5.0 | 45.0 | $47,432 | $438,879 | $49,245 | Yes (X) | |||
| KRISCHA WINRIGHT | |||||||||
| SVP, Chief Marketing/Digital Officer | 4.0 | 46.0 | $36,029 | $477,202 | $173,069 | Yes (X) | |||
| RICHARD O'DONNELL | |||||||||
| VP, Prov Contract & Reimbursement | 5.0 | 45.0 | $32,916 | $304,564 | $66,430 | Yes (X) | |||
| JIANHUA YU | |||||||||
| SVP, CHIEF ACTUARY | 5.0 | 45.0 | $51,271 | $474,399 | $158,776 | Yes (X) | |||
| SCOTT NORMAN | |||||||||
| VP, Senior Markets | 5.0 | 45.0 | $41,701 | $385,848 | $75,648 | Yes (X) | |||
| MARTI LOLLI | |||||||||
| SVP, COMMERCIAL MARKETS | 5.0 | 45.0 | $40,752 | $377,067 | $75,404 | Yes (X) | |||
| EUGENE CRONIN | |||||||||
| VP, NEW GOVERNMENT MARKETS | 5.0 | 45.0 | $39,194 | $362,654 | $73,417 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $678,416 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,360,653 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,644,863 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EXPRESS SCRIPTS | |||||
| 1 EXPRESS WAY | ST LOUIS | MO | 63121 | CLAIMS SERVICES | $74,032,425 |
| MERCY HEALTH PARTNERS | |||||
| PO BOX 358 | MUSKEGON | MI | 49442 | CLAIMS SERVICES | $14,656,244 |
| METROPOLITAN HOSPITAL | |||||
| 5900 BYRON CENTER AVE SW | WYOMING | MI | 49519 | CLAIMS SERVICES | $13,141,247 |
| DELTA DENTAL | |||||
| 4100 OKEMOS RD | OKEMOS | MI | 48864 | CLAIMS SERVICES | $10,535,686 |
| HOLLAND HOSPITAL | |||||
| 602 MICHIGAN AVENUE | HOLLAND | MI | 49423 | CLAIMS SERVICES | $7,630,205 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 239 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Premium Income | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $484,530,294 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $484,530,294 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $484,530,294 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,276,292 | TotalRevenueColumnAmt |
| Exclusion | $1,276,292 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $108,382,161 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $108,232,889 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $149,272 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $149,272 | TotalRevenueColumnAmt |
| Exclusion | $149,272 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Income from Transferred Membership | Desc |
| Business | 524298 | BusinessCd |
| Total Revenue Column | $950,700 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $950,700 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $950,700 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $486,906,558 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $485,480,994 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,425,564 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $419,859,650 | TotalAmt |
| Program Services | $419,859,650 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $693,551 | TotalAmt |
| Program Services | $381,453 | ProgramServicesAmt |
| Management And General | $312,098 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,555,329 | TotalAmt |
| Program Services | $3,605,431 | ProgramServicesAmt |
| Management And General | $2,949,898 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,162,189 | TotalAmt |
| Program Services | $1,189,204 | ProgramServicesAmt |
| Management And General | $972,985 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $784,536 | TotalAmt |
| Program Services | $431,495 | ProgramServicesAmt |
| Management And General | $353,041 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,520 | TotalAmt |
| Management And General | $10,520 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,081 | TotalAmt |
| Management And General | $10,081 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,940 | TotalAmt |
| Management And General | $49,940 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,750,251 | TotalAmt |
| Program Services | $1,512,638 | ProgramServicesAmt |
| Management And General | $1,237,613 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,154,187 | TotalAmt |
| Program Services | $634,803 | ProgramServicesAmt |
| Management And General | $519,384 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $656,998 | TotalAmt |
| Program Services | $361,349 | ProgramServicesAmt |
| Management And General | $295,649 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,369 | TotalAmt |
| Program Services | $81,053 | ProgramServicesAmt |
| Management And General | $66,316 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,422 | TotalAmt |
| Program Services | $248,282 | ProgramServicesAmt |
| Management And General | $203,140 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,547 | TotalAmt |
| Program Services | $59,151 | ProgramServicesAmt |
| Management And General | $48,396 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,940 | TotalAmt |
| Program Services | $23,617 | ProgramServicesAmt |
| Management And General | $19,323 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,285 | TotalAmt |
| Program Services | $113,457 | ProgramServicesAmt |
| Management And General | $92,828 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,793 | TotalAmt |
| Program Services | $30,136 | ProgramServicesAmt |
| Management And General | $24,657 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,022 | TotalAmt |
| Program Services | $26,962 | ProgramServicesAmt |
| Management And General | $22,060 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Use Tax Expense | $29,582,494 | $26,624,245 | $2,958,249 |
| Shared Services & Management Fees | $7,450,520 | $4,097,786 | $3,352,734 |
| Claims Tax Expense | $3,060,212 | $3,060,212 | |
| Community Support & Outreach | $129,331 | $71,132 | $58,199 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $399,700 | TotalAmt |
| Program Services | $219,834 | ProgramServicesAmt |
| Management And General | $179,866 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $476,368,867 | TotalAmt |
| Program Services | $462,631,890 | ProgramServicesAmt |
| Management And General | $13,736,977 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,351,172 | BOYAmt |
| EOY | $29,994,792 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,795,760 | BOYAmt |
| EOY | $11,811,784 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,416,283 | BOYAmt |
| EOY | $84,321,317 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,224,000 | BOYAmt |
| EOY | $6,200,197 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,787,215 | BOYAmt |
| EOY | $132,328,090 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,727,806 | BOYAmt |
| EOY | $68,244,828 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,767,968 | BOYAmt |
| EOY | $6,857,023 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,410,492 | BOYAmt |
| EOY | $1,876,786 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,906,266 | BOYAmt |
| EOY | $76,978,637 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,326,877 | BOYAmt |
| EOY | $12,326,877 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,544,072 | BOYAmt |
| EOY | $43,012,576 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,880,949 | BOYAmt |
| EOY | $55,349,453 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,787,215 | BOYAmt |
| EOY | $132,328,090 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $10,537,691 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$22,960 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$46,227 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $192,615,762 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $231,486,741 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $341,051,363 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $452,045,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $484,530,294 | CurrentTaxYearAmt |
| Total | $1,701,730,140 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $192,615,762 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $231,486,741 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $341,051,363 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $452,045,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $484,530,294 | CurrentTaxYearAmt |
| Total | $1,701,730,140 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,701,730,140 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $135,907 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $420,975 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $646,606 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $681,872 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,276,292 | CurrentTaxYearAmt |
| Total | $3,161,652 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $135,907 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $420,975 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $646,606 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $681,872 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,276,292 | CurrentTaxYearAmt |
| Total | $3,161,652 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $950,700 | CurrentTaxYearAmt |
| Total | $950,700 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $192,751,669 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $231,907,716 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $341,697,969 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $452,727,852 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $486,757,286 | CurrentTaxYearAmt |
| Total | $1,705,842,492 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.9976 | PublicSupportCY509Pct |
| Public Support PY509 | 0.9986 | PublicSupportPY509Pct |
| Investment Income CY | 0.0019 | InvestmentIncomeCYPct |
| Investment Income PY | 0.0014 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - INCOME FROM TRANSFERRED MEMBERSHIP, COLUMN A - , COLUMN B - , COLUMN C - , COLUMN D - , COLUMN E - 950700.0, COLUMN F - 950700.0; | ExplanationTxt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| Amt | $1,876,786 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,876,786 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) Footnote | FormAndLineReferenceDesc |
| Explanation | PRIORITY HEALTH CHOICE, INC. CONDUCTS AN ANALYSIS ANNUALLY TO DETERMINE THE ORGANIZATION'S LIABILITY WITH RESPECT TO UNCERTAIN TAX POSITIONS. FOR THE YEAR ENDED DECEMBER 31, 2016 IT WAS DETERMINED THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS TO DISCLOSE. AS SUCH, THERE WAS NO FOOTNOTE ADDED TO THE AUDITED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joan A BUDDEN | ||||||||||||||
| PRESIDENT & CEO | $70,136 | $648,950 | $35,870 | $331,899 | $1,929 | $17,847 | $33,183 | $307,033 | $11,660 | $107,888 | $152,778 | $1,413,617 | $7,284 | $67,401 |
| MICHAEL P FREED | ||||||||||||||
| PRESIDENT & CEO - Part Year | $4,579 | $42,375 | $8,776 | $81,200 | $10,130 | $93,727 | $33,641 | $311,275 | $9,368 | $86,681 | $66,494 | $615,258 | $8,776 | $81,200 |
| Mary Anne Jones | ||||||||||||||
| Treasurer & SVP, Finance | $39,979 | $369,923 | $17,791 | $164,612 | $571 | $5,278 | $11,866 | $109,792 | $7,202 | $66,642 | $77,409 | $716,247 | $4,616 | $42,713 |
| JOHN L FOX | ||||||||||||||
| DIRECTOR - PART YEAr - Sr. Dir MEDICAL Affairs | $30,661 | $283,710 | $12,631 | $116,868 | $179 | $1,652 | $1,809 | $16,741 | $4,625 | $42,791 | $49,905 | $461,762 | $3,359 | $31,077 |
| MICHAEL KOZIARA | ||||||||||||||
| Director - SVP, CHIEF OPERATING OFFICER | $38,684 | $357,928 | $15,179 | $140,452 | $1,576 | $14,583 | $9,583 | $88,669 | $6,848 | $63,361 | $71,870 | $664,993 | $2,415 | $22,347 |
| JAY LABINE | ||||||||||||||
| Director - SVP, CHIEF MEDICAL OFFICER - Part Year | $16,222 | $382,938 | $9,607 | $168,576 | $111 | $2,628 | $9,719 | $98,434 | $5,104 | $58,381 | $40,763 | $710,957 | $4,056 | $37,525 |
| KIMBERLY L THOMAS | ||||||||||||||
| SECRETARY | $35,383 | $327,391 | $16,074 | $148,732 | $70 | $647 | $11,204 | $103,671 | $5,093 | $47,124 | $67,824 | $627,565 | $4,545 | $42,058 |
| BRIAN KRUPICZEWICZ | ||||||||||||||
| SVP, HUMAN RESOURCES | $12,777 | $118,223 | $2,926 | $27,074 | $176 | $1,626 | $262 | $2,421 | $2,753 | $25,470 | $18,894 | $174,814 | $0 | $0 |
| PAMELA RIES | ||||||||||||||
| VP, SYSTEM TOTAL VALUE - PART YEAR | $0 | $414,388 | $0 | $193,397 | $0 | $19,770 | $0 | $197,922 | $0 | $67,491 | $0 | $892,968 | $0 | $25,632 |
| WAYNE WILSON | ||||||||||||||
| SVP, GOVERNMENT MARKETS | $30,463 | $281,870 | $15,322 | $141,774 | $1,647 | $15,235 | $1,422 | $13,153 | $3,382 | $31,288 | $52,236 | $483,320 | $5,241 | $48,490 |
| KRISCHA WINRIGHT | ||||||||||||||
| SVP, Chief Marketing/Digital Officer | $24,452 | $323,865 | $11,409 | $151,117 | $168 | $2,220 | $7,686 | $101,799 | $4,464 | $59,120 | $48,179 | $638,121 | $3,199 | $42,366 |
| RICHARD O'DONNELL | ||||||||||||||
| VP, Prov Contract & Reimbursement | $23,816 | $220,363 | $7,992 | $73,949 | $1,108 | $10,252 | $1,731 | $16,017 | $4,748 | $43,934 | $39,395 | $364,515 | $0 | $0 |
| JIANHUA YU | ||||||||||||||
| SVP, CHIEF ACTUARY | $35,343 | $327,025 | $15,696 | $145,231 | $232 | $2,143 | $10,846 | $100,356 | $4,640 | $42,934 | $66,757 | $617,689 | $4,437 | $41,052 |
| SCOTT NORMAN | ||||||||||||||
| VP, Senior Markets | $24,681 | $228,375 | $10,837 | $100,268 | $6,183 | $57,205 | $1,420 | $13,142 | $5,958 | $55,128 | $49,079 | $454,118 | $2,723 | $25,192 |
| MARTI LOLLI | ||||||||||||||
| SVP, COMMERCIAL MARKETS | $30,115 | $278,646 | $10,401 | $96,240 | $236 | $2,181 | $1,422 | $13,153 | $5,933 | $54,896 | $48,107 | $445,116 | $0 | $0 |
| EUGENE CRONIN | ||||||||||||||
| VP, NEW GOVERNMENT MARKETS | $26,887 | $248,781 | $12,130 | $112,235 | $177 | $1,638 | $1,422 | $13,153 | $5,739 | $53,103 | $46,355 | $428,910 | $3,241 | $29,989 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part II, Column (F) DEFERRED COMPENSATION | THE 2016 "BONUS & INCENTIVE COMPENSATION" INCLUDES CERTAIN DEFERRED COMPENSATION ARRANGEMENTS THAT WERE REPORTED IN PREVIOUS YEARS BUT PAID IN 2016. THIS RESULTS IN A CERTAIN AMOUNT OF WAGES BEING REPORTED IN THE FORM 990 TWICE. AMOUNTS REPORTED IN PART II COLUMN F REPRESENT COMPENSATION THAT WAS ALSO REPORTED IN A PREVIOUS YEAR'S FORM 990 WHILE ALSO BEING REPORTED IN THE CURRENT FORM 990 AS TOTAL COMPENSATION. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | SEE EXPLANATION PROVIDED ON SCHEDULE O FOR FORM 990, PART VI, LINE 15A. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | $ 74,685 Joan Budden $ 33,230 Eugene Cronin $ 34,435 John Fox $ 89,976 Michael P. Freed $ 47,329 Mary Anne Jones $ 24,762 Michael Koziara $ 4,056 Jay Labine $ 27,915 Scott Norman $ 25,632 Pamela Ries $ 46,603 Kimberly Thomas $ 53,731 Wayne Wilson $ 45,565 Krischa Winright $ 45,488 Jianhu Yu Schedule J, Part I, Line 4b is answered "yes" because individuals, whose salary and benefits are allocated to this organization, do "participate in" a supplemental nonqualified retirement plan. Some individuals received distributions during the year (as reported on this line) whereas others participated in the plan but did not receive distributions. Distributions reported on this line are also included in Schedule J, Part II, Column F as compensation reported in a prior year. The nonqualified retirement plans are an industry standard and are subject to the funding requirements of nonqualified deferred compensation plans under ERISA and federal tax regulations. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 3 Significant changes in program services | The Michigan Department of Health & Human Services no longer has a separate contract for MI Child. On January 1, 2016, MI Child became a Medicaid expansion program through the State of Michigan. Priority Health Choice, Inc. has a contract with the State of Michigan to provide coverage to Medicaid recipients that expires September 2020. At December 31, 2016, Priority Health Choice, Inc. had 119,500 Medicaid members and 0 MI Child members. The MI Child Members are now reported as Medicaid members. |
| Form 990, Part IV, Line 12a Audited Financial Statements | The organization's financial statements are audited annually by an independent accounting firm. The "No" response to this question relates to the fact that the GAAP basis financial statements were prepared on a consolidated basis and not on a stand alone basis. The organization is audited annually on a stand alone basis and issued financial statements on a stand alone basis which are prepared in accordance with SAP (Statutory Accounting Principles), as required by regulatory authorities. The figures in this Form 990 reconcile to the financial statements prepared under statutory accounting principles as submitted to the State of Michigan and the National Association of Insurance Commissioners (NAIC). |
| Form 990, Part V, Line 2a NUMBER OF EMPLOYEES REPORTED ON FORM W-3 | ALL EMPLOYEES OF PRIORITY HEALTH CHOICE, INC. WERE EMPLOYED DURING THE YEAR BY SPECTRUM HEALTH SYSTEM (38-3382353) AND LEASED BACK TO PRIORITY HEALTH CHOICE, INC. SALARIES AND WAGES, EMPLOYEE BENEFITS AND PAYROLL TAXES ARE ALLOCATED TO PRIORITY HEALTH CHOICE, INC. VIA A MANAGEMENT FEE. THE SALARIES AND WAGES REPORTED IN PART IX STATEMENT OF FUNCTIONAL EXPENSES REFLECT THE PORTION OF SALARIES AND WAGES ALLOCATED TO PRIORITY HEALTH CHOICE, INC. SPECTRUM HEALTH SYSTEM FILED ALL APPLICABLE IRS TAX FILINGS INCLUDING FORMS W-2 AND W-3 ON BEHALF OF PRIORITY HEALTH CHOICE, INC. |
| Form 990, Part VI, Line 3 Management Services | Priority Health Managed Benefits, Inc. (PHMB), an entity related through common ownership, provides contracted management services to Priority Health Choice, Inc. and its affiliates. Priority Health, a 501(c)(4), is the parent company to the organization. Priority Health's governing body retains control of the activities of PHMB as the governing bodies of Priority Health and PHMB are comprised of the same directors and officers. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | CERTAIN MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS OF THE ORGANIZATION ALSO SERVE ON THE BOARD OF DIRECTORS AND/OR AS OFFICERS OF RELATED TAXABLE ENTITIES - Business relationship |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The parent organization is Priority Health (EIN 38-2715520), a tax-exempt 501(c)(4) organization. Priority Health controls 100% of the Organization. Priority Health has three shareholders as follows: Spectrum Health System (EIN 38-3382353), Class A Shareholder - 93.9% Munson Healthcare (EIN 38-2640544), Class B Shareholder - 5.5% McLaren Northern Michigan (EIN 38-2146751), Class B Shareholder - .6% All Shareholders are tax-exempt Internal Revenue Code Section 501(c)(3) organizations. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Election of Members and Their Rights from Priority Health Choice, Inc. bylaws: Article V Section 2. Number and Class of Directors. The Board of Directors will be comprised of six (6) members as follows: a. One (1) member will be the President and Chief Executive Officer of Priority Health. b. One (1) member will be the Chief Financial Officer of Priority Health. c. One (1) member will be the Chief Medical Officer of Priority Health. d. One (1) member will be the Chief Operations officer of Priority Health. e. Two (2) members will be Adult Enrollee Members of Priority Health Choice, Inc. Section 3. Election of Adult Enrollee Members. The Board of Directors will solicit names of potential candidates from the members, shareholders, directors and community. The Priority Health Choice, Inc. Board of Directors will submit a list of nominees for election to the Board of Directors as adult enrollee representatives. At least one (1) member will be nominated for each directorship to be filled at such annual meeting. In addition, any group of adult enrollees in the corporation's health maintenance plan, upon filing a petition with more than one hundred (100) legitimate signatures of current members with the Secretary of the Board of Directors at least ninety (90) days prior to the annual meeting, may nominate a candidate for election to the Board of Directors. Eligible members will be given the opportunity to vote on the candidates for election to the Board of Directors. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | From Priority Health Choice, Inc. bylaws: Section 1. Votes. Each shareholder of record as determined in accordance with Section 2 of this Article will, at every meeting of shareholders, be entitled to one (1) vote in person or by proxy for each share of capital voting stock of the corporation held by the shareholder. A vote may be cast either verbally or in writing. Unless the Articles of Incorporation or Bylaws state otherwise, all matters will be determined by the vote of the holders of a majority of the issued and outstanding stock in the corporation. Section 2. Record Date for Determination of Shareholders. For the purpose of determining shareholders entitled to notice of, and to vote at, a meeting of shareholders, or any adjourned meeting, or to express consent to or dissent from a proposal without a meeting, or for the purpose of any other action, the Board of Directors may fix in advance a date, not more than sixty (60) days nor less than twenty-one (21) days before the date of the meeting or other action, as the record date for the determination of shareholders. Section 3. Proxies. A shareholder entitled to vote at a meeting of shareholders or to express consent or dissent without a meeting may authorize other persons to act for the shareholder by proxy. No proxy will be deemed operative unless and until signed by the shareholder or the shareholder's authorized agent or representative and filed with the corporation. Unless otherwise provided in the proxy, a proxy is valid only for three (3) years from its date. Section 4. Annual Budget and Strategic Plan. At the first meeting of the Board of Directors during each fiscal year, the Board of Directors will approve the annual budget and strategic plan for the Corporation. At the first meeting of the Board of Directors of the Shareholder during each fiscal year, the Shareholder will approve the annual budget and strategic plan for the Corporation. Section 5. Power to Elect President. The shareholders will select a President from the Board of Directors. Section 6. Removal of Officers and Agents. Any officer or agent may be removed by the shareholders whenever, in their judgment, the business interests of the corporation will be served by the removal. Section 7. Delegation of Powers. For any reason they deem sufficient, whether occasioned by absence or otherwise, the shareholders may delegate all or any of the powers and duties of any officer to any other officer or director. Section 8. Power to Require Bonds. The shareholders may require any officer or agent to file with the corporation a satisfactory bond conditioned for faithful performance of the officer's or agent's duties. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The review process for this Form 990 is as follows: 1. Preparation of the return is supervised and reviewed by the organization's Corporate Tax Manager. 2. A second review is performed by an external CPA firm with expertise in tax-exempt return preparation. 3. The return is reviewed by the organization's finance and legal departments (Including the SVP, Finance; SVP, General Counsel; VP, Controller) and shared with the members of the finance committee and board of directors. 4. The organization's SVP, Finance reviews comments or questions received by members of the Board of Directors, if any, to address or to incorporate, as appropriate, into the return prior to filing. |
| Form 990, Part VI, Line 12c Conflict of interest policy | BOARD OF DIRECTORS 1. Conflicts of interest must be disclosed, BOTH VIA AN ANNUAL ELECTRONIC DISCLOSURE PROCESS as well as verbally at a board meeting prior to discussion of any agenda item with regard to which a board member has a conflict. 2. A person having a financial interest in a proposed transaction or arrangement may make a presentation at a meeting of the Board of Directors or committee considering that transaction or arrangement, but after that presentation he or she shall leave the meeting during discussion and voting on that proposed transaction or arrangement. The person having the financial interest shall not be counted in determining whether a quorum is present. 3. The chairperson of the Board of Directors or committee shall, if appropriate, appoint a disinterested person or committee (including outside advisors) to investigate alternatives to the proposed transaction or arrangement, and to advise whether the proposed transaction or arrangement is in the organization's best interest. 4. The Board of Directors or committee shall exercise due diligence to determine whether the organization can, with reasonable efforts, obtain a more advantageous transaction or arrangement that would not give rise to a conflict of interest. 5. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board of Directors or committee shall determine by a majority vote of the disinterested directors and members whether the proposed transaction or arrangement is in the organization's best interest and for its own benefit and whether the transaction is fair and reasonable to the organization, and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 6. The minutes of the meetings of the Board of Directors and all of the organization's committees shall set forth: a)The names of the persons who disclosed a financial interest in a proposed transaction or arrangement involving the organization or any of its subsidiaries and the nature of the financial interest; and b)The names of the persons who were present for discussions and votes relating to such transaction or arrangement, including any discussion of alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection with that matter. The votes of individual members need not be recorded unless otherwise directed by the Board of Directors or committee. 7. There is an ongoing requirement that members of the board of directors complete another disclosure questionnaire at any point during his/her tenure on the board of directors when a new potential conflict of interest arises. If a member of the board of directors completes a disclosure questionnaire as a result of a new potential conflict of interest, that disclosure questionnaire is submitted to the legal, organizational integrity, internal audit, and human resources departments for review. MANAGEMENT 1. UPON ACCEPTANCE OF AN EMPLOYMENT OFFER, EACH MEMBER OF MANAGEMENT COMPLETES A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE QUESTIONNAIRE IS SENT TO THE ORGANIZATIONAL INTEGRITY DEPARTMENT. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE IS REVIEWED BY THE ORGANIZATION'S COI COORDINATOR AND ESCALATED TO THE COI COMMITTEE IF NECESSARY. 2. ANNUALLY, EACH MEMBER OF MANAGEMENT COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE ELECTRONICALLY. THE DISCLOSURE QUESTIONNAIRE IS REVIEWED BY THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS. 3. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF MANAGEMENT COMPLETE ANOTHER DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER EMPLOYMENT WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. IF A MEMBER OF MANAGEMENT COMPLETES A DISCLOSURE QUESTIONNAIRE AS A RESULT OF A NEW POTENTIAL CONFLICT OF INTEREST, THAT DISCLOSURE QUESTIONNAIRE IS SUBMITTED TO THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS. 4. THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS, IN CONSULTATION WITH EXECUTIVE MANAGEMENT, DETERMINE HOW ANY REPORTED CONFLICTS SHOULD BE MANAGED. MANAGEMENT OF A CONFLICT MAY TAKE A VARIETY OF DIFFERENT FORMS FROM IMPLEMENTATION OF A MANAGEMENT PLAN TO REQUIRING THAT THE MEMBER OF MANAGEMENT CEASE THE ACTIVITY CREATING THE CONFLICT OR, IN EXTREME CASES, LEAVE THE ORGANIZATION'S EMPLOYMENT. MANAGEMENT IS DETERMINED ON AN INDIVIDUAL BASIS BASED UPON THE FACTS AND CIRCUMSTANCES SURROUNDING THE DISCLOSURE. THE PURPOSE OF CONFLICT MANAGEMENT IS TO PROVIDE TRANSPARENCY WITHIN THE ORGANIZATION AND TO ENSURE THAT THE ORGANIZATION'S EMPLOYEES ARE ALWAYS ACTING IN THE BEST INTEREST OF THE ORGANIZATION. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The Spectrum Health System Board of Directors (through its Executive Committee) uses the following process for determining compensation of the top management official, other officers, and key employees at Priority Health Choice, Inc. Labor market data reflecting comparable organizations and jobs (prepared by independent firms) are relied upon. Competitive assessment reports are provided to the Executive Committee in advance of meetings. The competitive assessment report is prepared by a nationally known independent executive compensation firm. For calendar 2016 (1/1/16-12/31/16), four health care executive compensation surveys, three medical group surveys, two pediatric hospital surveys and one health plan survey prepared by independent firms were the primary sources referenced to obtain market data for the review: * American Medical Group Association: 2015 Medical Group Compensation & Financial Survey * Integrated Healthcare Strategies: 2015 Children's Hospitals Executive Compensation Survey * Integrated Healthcare Strategies: 2015 Health Care Executive Compensation Survey * Mercer Human Resources Consulting: 2015 Integrated Health Networks Compensation Survey * Medical Group Management Association: 2015 Management Compensation Survey * Sullivan, Cotter and Associates: 2015 Survey of Manager and Executive Compensation in Hospitals and Health Systems * Sullivan, Cotter and Associates: 2015 Custom Survey of Manager and Executive Compensation in Children's Hospitals * Sullivan, Cotter and Associates: 2015 Physician Compensation and Productivity Survey Report * Towers Watson: 2015 Hospital and Health Care Management Compensation Survey Report * Warren: Fall 2015 HMO Salary Survey In addition, one retirement community survey and four general industry surveys were referenced: * Rodeghero Consulting Group, Inc.: 2015 AAHA-CEMO Leadership Compensation Survey * Mercer: 2015 Executive Compensation Survey * Mercer: 2015 Information Technology Survey * Mercer: 2015 Human Resources Survey * Towers Watson: 2015 Top Management Compensation Report In addition to the above data sources, the Executive Committee approved the creation of a custom peer group of high performing integrated health systems to ensure robust data and a relevant comparator universe. The peer group organizations are approved by the Executive Committee and consist of double A bond rated and / or Truven top quintile organizations. Data for the peer group organizations is compiled by the independent executive compensation firm. Compensation adjustments are approved by Executive Committee members, consistent with the Spectrum Health compensation philosophy described below. Minutes of Committee discussions and decisions are prepared to memorialize Executive Committee decisions based upon the above data. Cash compensation data relied upon by the Executive Committee is national and reflects the compensation paid to executives in comparable jobs in comparably-sized health care and / or health insurance organizations. Spectrum Health recruits nationally for its executives. Benefits data reflect national health care / health insurance market practices. Geographic pay differential and cost of living data indicates consistency with national data. This process is intended to assist Spectrum Health in qualifying for the rebuttable presumption of reasonableness (Intermediate Sanctions Regulations) and complying with the potential Spectrum Health Excess Benefit Transaction Policy for those individuals in the group who are disqualified persons. The opinion submitted from the third party independent consulting firm is in accordance with the provisions of Treasury Regulations Section 53.4958-6(c)(2) and is also intended to satisfy the professional advice requirement of Treasury Regulations Section 53.4958-1(d)(4)(iii). |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | See explanation provided for Form 990, Part VI, Line 15a. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization's Articles of Incorporation and Statutory Financial Statements are on file with the State of Michigan and available to the public on the State's website. The organization's bylaws and internal policies are generally not made available to the public. The overall system consolidated financial statements are provided at www.spectrumhealth.org in the section titled "about us." Financial performance is discussed at an annual public meeting held and posted to www.spectrumhealth.org annually (under the section titled "about us"). |
| Form 990, Part VII, Section A, Line 2 Individuals Compensated more than $100,000 | There are no individuals reported due to the integration with Spectrum Health System. Refer to the disclosure for Form 990, Part V, Line 2a for further detail. |
| Form 990, Part VII, Section A COMPENSATION OF DIRECTORS | BASED ON EXTERNAL OPINION BY SULLIVAN, COTTER AND ASSOCIATES, INC., PRIORITY HEALTH CHOICE, INC. COMPENSATES BOARD MEMBERS IN A MANNER THAT IS REASONABLE IN RELATION TO MARKET DATA. BOARD OF DIRECTORS COMPENSATION IS REVIEWED ANNUALLY BY INTERNAL STAFF TO CONFIRM COMPENSATION FALLS WITHIN REASONABLE LIMITS. ANY COMPENSATION AMOUNT IS TREATED AS TAXABLE TO THE BOARD MEMBER AND IS REPORTED AND PROVIDED TO THEM ON FORM 1099, AS REQUIRED ACCORDING TO THE REPORTING THRESHOLDS. CERTAIN BOARD MEMBERS ARE EMPLOYED BY A RELATED ORGANIZATION. COMPENSATION REPORTED IN PART VII, SECTION A, COLUMN E IS FOR SERVICES PERFORMED FOR THE RELATED ORGANIZATION, NOT THE FILING ORGANIZATION. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | CHANGE IN NONADMITTED ASSETS - -46227; |
| Form 990, Part XII, Line 2b Audited Financial Statements | The organization's financial statements are audited annually by an independent accounting firm. The organization issued GAAP basis financial statements which are prepared on a consolidated basis and not on a stand alone basis. The organization is audited annually on a stand alone basis and issued financial statements on a stand alone basis which are prepared in accordance with SAP (Statutory Accounting Principles), as required by regulatory authorities. The figures in this Form 990 reconcile to the financial statements prepared under statutory accounting principles as submitted to the State of Michigan and the National Association of Insurance Commissioners (NAIC). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SPECTRUM HEALTH SYSTEM | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 383382353 | MANAGEMENT | MI | 501(c)(3) | Type III-FI | NA | false |
| PRIORITY HEALTH | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382715520 | HMO | MI | 501(c)(4) | SPECTRUM HEALTH SYSTEM | false | |
| TRINITY HEALTH PLANS | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382663747 | HMO MGMT | MI | 501(c)(4) | PRIORITY HEALTH | false | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRIORITY HEALTH INSURANCE COMPANY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 EAST BELTLINE NE | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49525 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201529553 | EIN |
| Primary Activities | INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corporation | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Priority Health | ||
| M | $267,610 | GAAP, CASH OR FMV |
| Priority Health | ||
| S | $2,062,856 | GAAP, Cash or FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part II, Column (g) SECTION 512(B)(13) CONTROLLED ENTITY | FormAndLineReferenceDesc |
| Explanation | TAXPAYER IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, SPECTRUM HEALTH SYSTEM. | ExplanationTxt |