2016-11-15T14:42:09-06:00 2015-12-31 KPMG LLP 210 Park Ave Suite 2850 Oklahoma City OK 73102 990 2015-01-01 760495152 COMMUNITY HEALTH CHOICE INC % RICHARD LEE CPA COMM 7132952222 2636 SOUTH LOOP WEST Suite 700 HOUSTON TX 77054 RICHARD LEE SR VP - FINANCE 7132952222 2016-11-15 true DEBRA C COOK P00031689 4052396411 2015 2017-02-10 21:41:12Z KENNETH W JANDA 2636 SOUTH LOOP WEST STE 700 HOUSTON TX 77054 851462290 false X https://www.chchealth.org X 1996 TX THE OPERATION OF A MEDICAID/CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) HEALTH MAINTENANCE ORGANIZATION PROVIDING PRE-PAID MEDICAL & DENTAL CARE. (SEE SCH. O, GENERAL STMT 1) 8 8 516 8 0 0 0 0 720197037 850625457 881516 836833 0 0 721078553 851462290 0 25521 642520958 771434924 25389125 28585265 0 0 0 36610262 50181666 704520345 850227376 16558208 1234914 192137284 239892454 91779897 138300153 100357387 101592301 X SEE SCHEDULE O, GENERAL STATEMENT 2 false false 833136893 25521 850625457 SEE SCHEDULE O, GENERAL STATEMENT 3 833136893 false false false false false false false false false false false false false true false true false false false false false false false false false false true false true false false false false false false false false false false false false false true false false true X 2625 0 516 false false false false false false X 8 8 true false false false false true true true true false false false true true true true true true true false X RICHARD LEE CPA 7132952222 2636 SOUTH LOOP WEST STE 700 HOUSTON TX 77054 VICKI KEISER CHAIRMAN OF THE BOARD 8.0 0.0 X X 0 0 0 JOSE GARCIA JR SECRETARY OF THE BOARD 4.0 0.0 X X 0 0 0 RAYMOND J KHOURY VICE CHAIRMAN OF THE BOARD 8.0 0.0 X X 0 0 0 CHARLES A MOORE BOARD MEMBER 8.0 0.0 X 0 0 0 DAISY A STINER BOARD MEMBER 2.0 0.0 X 0 0 0 MARGO HILLARD BOARD MEMBER THRU 03/15 2.0 0.0 X 0 0 0 STEPHEN MCKERNAN BOARD MEMBER 2.0 X 0 0 0 ELANA M MARKS BOARD MEMBER 4.0 0.0 X 0 0 0 VIVIAN HO BOARD MEMBER 2.0 0.0 X 0 0 0 KENNETH JANDA PRESIDENT/CEO 40.0 0.0 X 0 548332 21234 RICHARD LEE SR. VP - FINANCE 40.0 0.0 X 0 272376 29721 ALFONSO RUBIO SR. VP-INFORMATION TECHNOLOGY 40.0 0.0 X 0 292579 30636 DAISY MORALES VP - SALES & MARKETING 40.0 0.0 X 0 205964 15057 ERNEST MENDEZ SR. VP - OPERATIONS 40.0 0.0 X 0 290218 17737 FRED BUCKWOLD SR. MEDICAL DIRECTOR 40.0 0.0 X 0 374944 27922 JEFFREY ALLEN VP - NETWORK MANAGEMENT 40.0 0.0 X 0 230585 16514 KAREN LOVE EXECUTIVE VICE PRESIDENT 40.0 0.0 X 0 291660 14929 PAMELA HELLSTROM VP - QUALITY MANAGEMENT 40.0 0.0 X 0 213150 591 TANYA NGUYEN VP - OPERATIONS 40.0 0.0 X 0 204484 14519 THOMAS NGUYEN DIRECTOR-MANAGED CARE SYSTEMS 40.0 0.0 X 0 211243 15550 CHARLOTTE WOODS VP - ADMINISTRATION 40.0 0.0 X 0 183026 7627 LISA FULLER ASSOCIATE MEDICAL DIRECTOR 40.0 0.0 X 0 159077 7897 OLUBURMI OTUYELU VP - COMPLIANCE & RISK MGMT 40.0 0.0 X 0 166027 17503 SAIRA SHAH VP - ADMIN & LEGAL AFFAIRS 40.0 0.0 X 0 208364 24017 ANDREA HENRY DIRECTOR - PHARMACY ANALYTICS 40.0 0.0 X 0 191690 19064 JOHN COAKLEY DIRECTOR - INFORMATION SYSTEMS 40.0 0.0 X 0 147831 14487 JANET WOODSON DIRECTOR - UTILIZATION MGMT 40.0 0.0 X 0 141347 10376 TRACY MADDOX DIRECTOR - QUALITY & OUTCOMES 40.0 0.0 X 0 161062 639 DARRELL PERRY MANAGER - TELECOM & SUPPORT 40.0 0.0 X 0 131886 20999 0 4625845 327019 72 false true false SEE SCHEDULE O GENERAL STATEMENT 1 343542223 558 0 NET PREMIUM REVENUE 524114 850544684 850544684 TX HEALTH 3-SHARE PROGRAM FEES 524298 60000 60000 HARRIS HEALTH EXT NETWORK FEES 524298 13272 13272 BAXTER GRANT FEES 524298 7501 7501 850625457 836833 836833 0 0 0 0 0 0 0 0 0 0 851462290 851462290 25521 25521 0 0 771434924 771434924 5080445 508044 4572401 0 16215080 12972064 3243016 1647918 1318334 329584 4144892 3315914 828978 1496930 1282146 214784 0 88542 70834 17708 183594 146875 36719 0 0 0 13479463 10898384 2581079 851586 681269 170317 3391609 2713288 678321 3197801 2558241 639560 0 1699608 1359686 339922 247259 197807 49452 0 0 0 0 0 121737 97390 24347 TAXES & LICENSES 15859650 12687720 3171930 UBI TAXES PAID 50000 50000 PROVIDER INCENTIVES 4670950 4670950 CMS USER FEES 3949815 3949815 2390052 2247687 142365 850227376 833136893 17090483 0 28883358 70175501 101591728 68212282 0 0 11999944 15500388 0 0 0 0 0 0 0 0 0 0 0 47747438 79998751 0 0 0 0 0 0 1914816 6005532 192137284 239892454 13121559 9641940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78658338 128658213 91779897 138300153 X 100357387 101592301 0 0 0 0 100357387 101592301 192137284 239892454 1234914 X false true X true false 0 MEDICAL CLAIMS PAYABLE 77345572 PROVIDER INCENTIVE PAYABLE 2791749 PREMIUM DEFICIENCY RESERVE 6891645 DEFERRED PREMIUM REVENUE 3843623 AMOUNTS DUE TO DISTRICT 6481277 AFFORDABLE CARE ACT LIABILITIES 31304347 128658213 851462290 851462290 851462290 849566938 849566938 660438 660438 850227376 SUPPLEMENTAL INFORMATION 1 RECLASS OF CHANGE IN NON-ADMITTED ASSETS $660,438 true PASADENA INDEPENDENT SCHOOL DISTRICT 1515 CHERRYBROOK LANE PASADENA TX 77502 746001850 GOVT 20000 APPLICATION ASSISTANCE 1 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE I, PART I, LINE 2: AS PART OF ITS CHARITABLE PURPOSE, COMMUNITY HEALTH CHOICE, INC. MAKES GRANTS TO COMMUNITY-BASED ORGANIZATIONS AND INITIATIVES THAT ARE COMPATIBLE WITH CHCS MISSION TO IMPROVE THE HEALTH OF UNDERSERVED RESIDENTS OF SOUTHEAST TEXAS. GRANTS ARE AVAILABLE TO PUBLIC CHARITY ORGANIZATIONS EXPANDING ACCESS TO HEALTH CARE OR EDUCATING THE COMMUNITY ABOUT IMPROVING HEALTH AND/OR REDUCING POVERTY THROUGH EDUCATION. CHCS BOARD APPOINTS A COMMUNITY BENEFIT COMMITTEE TO EVALUATE PROPOSALS FOR COMMUNITY BENEFIT PROGRAM FUNDING AND MAKES FUNDING RECOMMENDATIONS FOR APPROVAL BY THE BOARD OF DIRECTORS. CHC REQUESTS A REPORT FROM THE GRANTEE REGARDING THE USE OF THE FUNDS AND THE RESULTS ACHIEVED SIX MONTHS AND TWELVE MONTHS AFTER THE GRANT HAS BEEN EXPENDED. false false false false false false false false false KENNETH JANDA PRESIDENT/CEO 0 464412 0 60957 0 22963 0 12489 0 8745 0 569566 0 0 RICHARD LEE SR. VP - FINANCE 213393 29262 29721 0 10693 0 19028 0 302097 ALFONSO RUBIO SR. VP-INFORMATION TECHNOLOGY 230950 30993 30636 0 11533 0 19103 0 323215 DAISY MORALES VP - SALES & MARKETING 164680 23028 18256 0 7835 0 7222 0 221021 ERNEST MENDEZ SR. VP - OPERATIONS 244068 28413 17737 0 6186 0 11551 0 307955 FRED BUCKWOLD SR. MEDICAL DIRECTOR 304857 41698 28389 0 14719 0 13203 0 402866 JEFFREY ALLEN VP - NETWORK MANAGEMENT 187701 26370 16514 0 8892 0 7622 0 247099 KAREN LOVE EXECUTIVE VICE PRESIDENT 239254 29828 22578 0 3495 0 11434 0 306589 PAMELA HELLSTROM VP - QUALITY MANAGEMENT 174980 23825 14345 0 301 0 290 0 213741 TANYA NGUYEN VP - OPERATIONS 164714 25218 14552 0 0 0 14519 0 219003 THOMAS NGUYEN DIRECTOR-MANAGED CARE SYSTEMS 175923 19770 15550 0 7905 0 7645 0 226793 CHARLOTTE WOODS VP - ADMINISTRATION 154169 21177 7680 0 0 0 7627 0 190653 LISA FULLER ASSOCIATE MEDICAL DIRECTOR 151180 0 7897 0 7531 0 366 0 166974 OLUBURMI OTUYELU VP - COMPLIANCE & RISK MGMT 146563 10662 8802 0 0 0 17503 0 183530 SAIRA SHAH VP - ADMIN & LEGAL AFFAIRS 171509 12837 24018 0 9134 0 14883 0 232381 ANDREA HENRY DIRECTOR - PHARMACY ANALYTICS 160679 11947 19064 0 0 0 19064 0 210754 JOHN COAKLEY DIRECTOR - INFORMATION SYSTEMS 120505 12827 14499 0 0 0 14487 0 162318 JANET WOODSON DIRECTOR - UTILIZATION MGMT 125538 5310 10499 0 2872 0 7504 0 151723 TRACY MADDOX DIRECTOR - QUALITY & OUTCOMES 145009 15414 639 0 0 0 639 0 161701 DARRELL PERRY MANAGER - TELECOM & SUPPORT 98941 11946 20999 0 5400 0 15599 0 152885 PART I, LINE 3: COMPENSATION FOR KENNETH W. JANDA IS DETERMINED THROUGH NEGOTIATIONS WITH THE HARRIS COUNTY HOSPITAL DISTRICT (HCHD), A RELATED ORGANIZATION, AND IS THEN SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF HCHD. FOR ALL OTHER EXECUTIVES, COMPENSATION IS DETERMINED BY THE BOARD OF HCHD UTILIZING MARKET SURVEYS FOR EXECUTIVES IN SIMILAR ORGANIZATIONS AND IN SIMILAR POSITIONS. MARKET ADJUSTMENTS ARE MADE ANNUALLY TO ACCOUNT FOR ANY CHANGES IN COMPENSATION. GENERAL STATEMENT 1 FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION'S MISSION: THE OPERATION OF A MEDICAID/CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) HEALTH MAINTENANCE ORGANIZATION PROVIDING PRE-PAID MEDICAL & DENTAL CARE TO ITS APPROXIMATELY 233,885 MEDICAID, 23,374 CHIP AND 3,678 CHIP PERINATAL MEMBERS WITHIN A PRIMARY SERVICE AREA OF HARRIS AND CONTIGUOUS COUNTIES IN THE STATE OF TEXAS. GENERAL STATEMENT 2 FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION'S MISSION: COMMUNITY HEALTH CHOICE'S MISSION IS TO IMPROVE THE HEALTH OF THE UNDERSERVED RESIDENTS OF SOUTHEAST TEXAS BY PROVIDING ACCESS TO COORDINATED, HIGH QUALITY, AFFORDABLE, HEALTHCARE SERVICES. OUR MISSION IS ACHIEVED THROUGH: 1) COMMUNITY: COLLABORATING WITH COMMUNITY-BASED PROVIDERS & ORGANIZATIONS TO IMPROVE ACCESS, QUALITY, COORDINATION AND COST-EFFECTIVENESS OF SERVICES. 2) HEALTH: DEVELOPING PROGRAMS TO ESTABLISH MEDICAL HOMES, MANAGE HEALTH CONDITIONS, AND PROMOTE WELLNESS AND PREVENTIVE CARE. 3) CHOICE: ENCOURAGING PERSONAL ACCOUNTABILITY AND EDUCATED CHOICES FOR INDIVIDUAL AND FAMILY HEALTH. GENERAL STATEMENT 3 FORM 990, PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS THE OPERATION OF A HEALTH MAINTENANCE ORGANIZATION PROVIDING PRE-PAID MEDICAL & DENTAL CARE TO ITS APPROXIMATELY 233,885 MEDICAID, 23,374 CHIP AND 3,678 CHIP PERINATAL MEMBERS WITHIN A PRIMARY SERVICE AREA OF HARRIS AND CONTIGUOUS COUNTIES IN THE STATE OF TEXAS. Community Health Choice, Inc. also issues health policies for nine southeast Texas counties in the Federally-Facilitated Healthcare Insurance Marketplace for the State of Texas. Part of CHC's mission is to serve the uninsured population in Southeast Texas. Texas has the largest number of residents without medical coverage in the entire country. One of CHC's marketing goals is to provide coverage to the parents of the children enrolled in CHC's CHIP programs through Marketplace policies. The Healthcare Insurance Marketplace had 31,856 covered lives as of December 31, 2015. GENERAL STATEMENT 4 FORM 990, PART V, LINE 2A: NUMBER OF EMPLOYEES THE NUMBER OF EMPLOYEES REPORTED IN PART V, LINE 2A IS 516. THE SALARIES REFLECTED ON FORM 990, PART IX, LINES 5 AND 7 WERE ALLOCATED TO CHC BY THE HARRIS COUNTY HOSPITAL DISTRICT (HCHD) (FEIN: 76-0408224) AND THEY ARE REFLECTED ON THE FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, OF HCHD. CHC REIMBURSED HCHD FOR THE SALARIES, AND ALL OTHER EXPENSES INCURRED ON BEHALF OF CHC. GENERAL STATEMENT 5 FORM 990, PART VI, LINE 2: FAMILY OR BUSINESS RELATIONSHIP CHC IS AWARE OF THE FAMILY RELATIONSHIP BETWEEN THE FOLLOWING KEY EMPLOYEES: THOMAS NGUYEN AND TANYA NGUYEN GENERAL STATEMENT 6 FORM 990, PART VI, SECTION A, LINE 7A & 7B: HARRIS COUNTY HOSPITAL DISTRICT (HCHD) HAS CERTAIN ENUMERATED RESERVED POWERS OVER THE GOVERNING BOARD OF COMMUNITY HEALTH CHOICE, INC. (CHC). THE GOVERNING BODY IS PROHIBITED FROM TAKING FINAL ACTION ON THE FOLLOWING WITHOUT THE APPROVAL BY RESOLUTION OF THE HCHD BOARD OF MANAGERS: 1. ADOPTION, AMENDMENT, OR REVOCATION OF THE BYLAWS OF CHC; 2. ADOPTION, AMENDMENT, OR REVOCATION OF THE ARTICLES OF INCORPORATION OF CHC; 3. APPOINTMENT OR REMOVAL OF DIRECTORS OF CHC; 4. ADOPTION, AMENDMENT, OR REVOCATION OF CHC'S PURCHASING MANUAL; 5. ADOPTION, AMENDMENT, OR REVOCATION OF CHC'S PERSONNEL POLICIES; 6. ADOPTION, AMENDMENT, OR REVOCATION OF CHC'S FINANCIAL POLICIES; 7. ADOPTION OF CHC'S ANNUAL OPERATING AND CAPITAL BUDGETS; 8. ANY DEVIATION OF 10% OR MORE FROM CHC'S ANNUAL OPERATING BUDGET OR $50,000 FROM CHC'S ANNUAL CAPITAL BUDGET; 9. ANY TRANSACTION INVOLVING REAL PROPERTY; 10. ANY MORTGAGE, ENCUMBRANCE, OR DEBT OF CHC IN EXCESS OF $50,000; 11. THE SALE OR OTHER DISPOSITION OF PROPERTY OF ANY KIND EXCEEDING $25,000; 12. THE PURCHASE OR ACQUISITION OF PROPERTY OF ANY KIND BY CHC EXCEEDING $200,000 AND NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHC'S ANNUAL OPERATING AND CAPITAL BUDGETS; 13. ALL PAYMENTS OTHER THAN PURCHASES, INCLUDING GUARANTEES AND GRANTS, THAT ARE NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHC'S ANNUAL OPERATING AND CAPITAL BUDGETS; 14. ANY ACTION TO AMEND OR ENLARGE THE SERVICE AREA OF CHC'S CERTIFICATE OF AUTHORITY TO DO BUSINESS AS A HEALTH MAINTENANCE ORGANIZATION IN THE STATE OF TEXAS; 15. ANY MERGER, AFFILIATION, DISSOLUTION, OR OTHER DISPOSITION OF CHC. GENERAL STATEMENT 7 FORM 990, PART VI, SECTION A, LINE 8B: COMMUNITY HEALTH CHOICE, INC. DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THEREFORE, NO DOCUMENTATION OF COMMITTEE MEETINGS WAS REQUIRED. GENERAL STATEMENT 8 FORM 990, PART VI, SECTION B, LINE 11B: THE ORGANIZATION ENGAGES A PAID PREPARER EXPERIENCED IN THE PREPARATION OF THE FORM 990 TO PREPARE THE FORM. MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO HELP COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. ONCE PREPARED, IT IS REVIEWED BY THE ORGANIZATION'S CONTROLLER AND THEN AGAIN BY THE SENIOR VICE PRESIDENT OF FINANCE. A COPY OF THE RETURN IS THEN MAILED OR EMAILED TO THE BOARD OF DIRECTORS. GENERAL STATEMENT 9 FORM 990, PART VI, SECTION B, LINE 12C: THE ORGANIZATION REQUIRES OFFICERS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS IN ANNUAL STATEMENTS. THE VICE PRESIDENT FOR COMPLIANCE OF THE ORGANIZATION THEN REVIEWS THE ANNUAL STATEMENTS BEFORE SENDING TO THE HARRIS COUNTY HOSPITAL DISTRICT CORPORATE COMPLIANCE DEPARTMENT FOR FURTHER REVIEW OF THE ANNUAL CONFLICT OF INTEREST STATEMENTS. GENERAL STATEMENT 10 FORM 990, PART VI, SECTION B, LINE 15A & 15B: THE COMPENSATION OF THE PRESIDENT/CEO OF THE ORGANIZATION IS REVIEWED BY THE BOARD OF DIRECTORS OF HCHD. THE COMPENSATION OF ALL OTHER EMPLOYEES IS SUBJECT TO THE GUIDELINES AND MERIT RAISE PROCESSING OF THE HARRIS COUNTY HOSPITAL DISTRICT. GENERAL STATEMENT 11 FORM 990, PART VI, SECTION C, LINE 19: AS A SUBSIDIARY OF THE HARRIS COUNTY HOSPITAL DISTRICT (A SUBSIDIARY OF HARRIS COUNTY, TEXAS), ALL DOCUMENTS AND POLICIES ARE PART OF THE PUBLIC RECORD AND ARE THEREFORE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. GENERAL STATEMENT 12 FORM 990, PART VII, SECTION B: INDEPENDENT CONTRACTORS NAVITUS HEALTH SOLUTIONS PHARMACY BENEFIT $109,620,674 2601 WEST BELTLINE HWY., STE. 600 MADISON, WI 53713 TEXAS CHILDREN'S HOSPITAL CONTRACT HOSPITAL SVCS $92,423,629 6621 FANNIN ST. HOUSTON, TX 77030 MEMORIAL HERMANN HEALTH SYSTEM CONTRACT HOSPITAL SVCS $77,869,232 929 GESSNER DR., STE. 2600 HOUSTON, TX 77024 UTMB GALVESTON HOSPITAL CONTRACT HOSPITAL SVCS $42,523,249 301 UNIVERSITY BLVD. GALVESTON, TX 77555 CLEAR LAKE REGIONAL MEDICAL CENTER CONTRACT HOSPITAL SVCS $21,105,439 500 W. MEDICAL CENTER BLVD. WEBSTER, TX 77598 ============ TOTAL $343,542,223 HARRIS COUNTY HOSPITAL DISTRICT 2525 HOLLY HALL HOUSTON TX 77054 741536936 HEALTH CARE TX NA false false false false false false false false false false false false false true true true true false false false