2016-11-10T13:56:24-06:00 2015-12-31 383133790 ANDREWS HOOPER PAVLIK PLC 4295 OKEMOS RD STE 200 OKEMOS MI 488646201 990 2015-01-01 364497604 SPARROW PHP SPAR 5173648400 PO BOX 30377 LANSING MI 48909 DENNIS REESE PRESIDENT/CEO - PHP 5173648400 2016-11-02 true MARK E HOOPER P00039887 5177060800 2016-11-02 2015 2017-02-10 21:41:12Z DENNIS SWAN 1215 E MICHIGAN AVENUE LANSING MI 48912 94927311 false X WWW.PHPMICHIGAN.COM X 2002 MI SPARROW PHP'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, AND COST EFFECTIVE HEALTHCARE. 3 2 0 0 0 66823246 92432304 442394 470088 220469 2024919 67486109 94927311 0 45626632 60119785 1934763 2666712 0 0 19071413 29246794 66632808 92033291 853301 2894020 21285488 24790567 12621042 13728566 8664446 11062001 X SPARROW PHP'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, AND COST EFFECTIVE HEALTHCARE. false true 89144102 94457223 SPARROW PHP (SPHP)IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO). SPHP USES A PRIMARY CARE CONCEPT FOR DELIVERING HEALTH CARE IN A HEALTH DELIVERY NETWORK (HDN) STRUCTURE. IT ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS AND THEIR QUALIFIED DEPENDENTS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER OR QUALIFIED DEPENDENT. SPHP CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. SPHP'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. SPHP'S SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW SPHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. SPHP MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY A HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY THE HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. SPHP OFFERS A VARIETY OF HEALTH CARE PROGRAMS. SPHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE SPHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO- PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO PAYOR NEEDS. SPARROW PHP IS OWNED BY PHYSICIAN HEALTH PLAN (PHP). PHYSICIANS HEALTH PLAN (PHP) IS OWNED BY SPARROW HEALTH SYSTEM (SHS) AND HOLDS A CERTIFICATE OF AUTHORITY AS AN HMO IN THE STATE OF MICHIGAN. PHP IS PRIMARILY A COMMERCIAL HMO AND ALSO OPERATES THREE SUBSIDIARIES, PHP INSURANCE COMPANY (PHPIC), A COMMERCIAL INSURANCE COMPANY, SPHP, AND PHP SERVICE COMPANY (TPA) A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHP. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHP APPLY TO PHP, PHPIC, SPHP, AND TPA. PHP'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE, PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. PHPIC OFFERS PRODUCTS ACROSS MICHIGAN. THE SPARROW PHP PRODUCT IS AVAILABLE TO MEDICAID ENROLLEES IN EATON, CLINTON, INGHAM, IONIA, MONTCALM, ISABELLA, AND SHIAWASSEE COUNTIES. AS OF DECEMBER 31, 2015, THERE WERE APPROXIMATELY 34,000 ENROLLEES IN PHP'S COMMERCIAL HMO, 14,700 IN TPA, 9,000 IN PHPIC, AND 21,600 ENROLLEES IN SPHP. PHP AND SPHP CONTRACTS DIRECTLY WITH PHYSICIANS HEALTH NETWORK (PHN), A WHOLLY OWNED SUBSIDIARY OF SHS. THE PHP NETWORK IS APPROXIMATELY 1,030 PRIMARY CARE PHYSICIANS, 1,860 SPECIALTY CARE PHYSICIANS, 800 ALLIED HEALTH PROFESSIONALS, AND 1,180 ORGANIZATIONAL PROVIDERS THAT INCLUDE 45 HOSPITALS. PHP MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: - DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES, - QUALITY OF CARE CONCERNS, AND - HEDIS MEASURES: THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLAN PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHP USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: DIABETES, ASTHMA, DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, BREAST AND CERVICAL CANCER SCREENINGS, USE OF BETA- BLOCKERS AFTER HEART ATTACKS, CHILD AND ADOLESCENT IMMUNIZATIONS, CHOLESTEROL MANAGEMENT, CONTROLLING HIGH BLOOD PRESSURE, SMOKING CESSATION, PRENATAL AND POSTPARTUM CARE, AND TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHP MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT. THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS EXPECTATIONS. THE PHP QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2015 PHP RECEIVED "FULL ACCREDITATION" STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. PHP HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. 89144102 false false false false false false false false true false false false true true false true true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false true 0 0 0 false false false false false false X 3 2 false false false false true true true true true false false true true true true true true true true false MI X DENNIS REESE 5173648400 1400 E MICHIGAN AVENUE LANSING MI 48909 DENNIS SWAN PRES/CEO - S 1.00 40.00 X 0 1489796 70224 JAMES BUTLER III DIRECTOR 1.00 1.00 X 0 1350 0 GWEN HALL DIRECTOR 1.00 1.00 X 0 0 0 DENNIS REESE PRESIDENT/CE 5.00 40.00 X 0 420841 46788 GEORGE SCHNEIDER CFO/COO - PH 5.00 40.00 X 0 220226 20399 KEVIN KAPLAN VP SALES 5.00 40.00 X 0 214619 33786 ANN HUNT-FUGATE RPH MGR CLINICAL 5.00 40.00 X 0 156351 25761 LINDA DICKINSON DIR OF MED R 5.00 40.00 X 0 155672 27469 KEVIN ESSENMACHER CONTROLLER 5.00 40.00 X 0 153275 27184 PAULA HOWARD SENIOR SALES 5.00 40.00 X 0 142681 25057 SCOTT WILKERSON FORMER PRES/ 0.00 0.00 X 0 40243 3094 2995054 279762 true true false TRIZETTO 1085 MORRIS AVENUE UNION NJ 07083 HEALTHCARE IT 1252693 GLOBALCARE INC 6875 SHILOH RD E ALPHARETTA GA 300058403 HEALTH 368409 MILLIMAN 15800 BLUEMOUND DR STE 100 BROOKFIELD WI 53005 CONSULTING 304422 THE ADVISORY BOARD COMPANY 227 WEST MONROE STREET SUITE 5100 CHICAGO IL 60606 CONSULTING 277835 HIGHPOINT SOLUTIONS 301 E GERMANTOWN PIKE EAST NORRITON PA 19401 HEALTH 269542 6 MEDICAID PAYMENTS 621990 92432304 92432304 92432304 440362 440362 29726 29726 29726 29726 NET MBRSHIP TRANSFER 900099 1837000 1837000 OTHER REVENUE 900099 187919 187919 2024919 94927311 94457223 470088 60119785 60119785 2087461 1580208 507253 120462 91190 29272 329098 249127 79971 129691 98176 31515 1425246 1425246 26630 26630 81298 81298 24662 24662 811214 614089 197125 21475 21475 236554 179071 57483 308774 233742 75032 34263 34263 23379 23379 383 383 20380 20380 GME EXPENSE 25806297 25806297 OTHER 199391 150942 48449 CORPORATE ALLOCATION 194057 194057 BANKING FEES 32791 32791 92033291 89144102 2889189 0 15157538 15296673 1271181 937750 4775056 4638209 81713 3917935 21285488 24790567 11734761 12612193 886281 1116373 12621042 13728566 X 8664446 11062001 8664446 11062001 21285488 24790567 2894020 -496465 X false true X true false 3411165 361583 -49824 15000 3707924 3184706 200567 40893 15000 3411165 2926676 82387 187643 12000 3184706 2641860 147795 149021 12000 2926676 1779759 796243 97691 30000 1833 2641860 1.00000 false true true MBRSHIP TRANSFER RECEIVABLE 3000000 RELATED PARTY RECEIVABLE 917935 PREPAID MAINTENANCE AGREEMENT 3917935 STATE REFUNDABLE 627000 RELATED PARTY PAYABLE 489373 1116373 91818912 -496465 1163000 666535 91152377 3774934 3774934 94927311 89421357 1163000 1163000 88258357 3774934 3774934 92033291 SCHEDULE D, PAGE 2, PART V, LINE 4 SPARROW PHP DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHYSICIANS HEALTH PLAN, SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. PHYSICIANS HEALTH PLAN IS THE SOLE MEMBER OF SPARROW PHP. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE ESTABLISHED BY THE ENDOWMENT. SCHEDULE D, PAGE 4, PART XI, LINE 2D MEMBERSHIP TRANSFER 1,163,000 SCHEDULE D, PAGE 4, PART XI, LINE 4B STATUTORY RECLASS FROM REVENUE TO EXPENSE 3,486,825 CEDED REINSURANCE 263,446 INVESTMENT EXPENSES 24,663 SCHEDULE D, PAGE 4, PART XII, LINE 2D MEMBERSHIP TRANSFER 1,163,000 SCHEDULE D, PAGE 4, PART XII, LINE 4B STATUTORY RECLASS FROM REVENUE TO EXPENSE 3,486,825 INVESTMENT EXPENSES 24,663 CEDED REINSURANCE 263,446 X X X X X X true false false true true true true false false DENNIS SWAN PRES/CEO - SHS 829199 623169 37428 19610 50614 1560020 DENNIS REESE PRESIDENT/CEO - PHP 315720 102981 2140 23700 23088 467629 GEORGE SCHNEIDER CFO/COO - PHP 199951 20000 275 5360 15039 240625 KEVIN KAPLAN VP SALES 150013 64484 122 18139 15647 248405 ANN HUNT-FUGATE RPH MGR CLINICAL PHARM 119402 17604 19345 11494 14267 182112 LINDA DICKINSON DIR OF MED RES MGMT 128969 26289 414 13314 14155 183141 KEVIN ESSENMACHER CONTROLLER 127090 26100 85 8689 18495 180459 PAULA HOWARD SENIOR SALES REP 89915 52668 98 12674 12383 167738 SCOTT WILKERSON FORMER PRES/CEO/SEC 40243 3094 43337 SCHEDULE J, PAGE 1, PART I, LINE 3 SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHYSICAN HEALTH PLAN, AND PHP IS THE SOLE MEMBER OF SPARROW PHP. SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGANIZATION THAT INCLUDES A NUMBER OF NON-PROFIT ENTITIES. THE METHODS SELECTED FOR DETERMINING THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR ARE METHODS WHICH ARE BEING USED BY ALL SPARROW HEALTH SYSTEM RELATED ENTITIES. SCHEDULE J, PAGE 1, PART I, LINE 4 SCOTT WILKERSON 43,337 0 0 SCHEDULE J, PAGE 1, PART I, LINE 5A THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 5B THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 6A THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 6B THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES. FORM 990 ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. FORM 990, PAGE 2, PART III, LINE 3 DURING THE YEAR ENDED DECEMBER 31, 2015 SPARROW PHP WAS NOT RECOMMENDED BY THE STATE OF MICHIGAN AS AN APPROVED CARRIER OF MICHIGAN MEDICAID INSURANCE FOR THE PROSPERITY REGION IN WHICH THE COMPANY OPERATES. AS A RESULT EFFECTIVE DECEMBER 31, 2015, SPARROW PHP SOLD 100 PERCENT OF THE MEMBERSHIP TO AN UNAFFILIATED HEALTH PLAN. THE MEMBERSHIP WAS SOLD FOR AN AGREED UPON SUM THAT WAS COLLECTED SUBSEQUENT TO YEAR END. FORM 990, PAGE 2, PART III, LINE 4A SPHP'S SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW SPHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. SPHP MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY A HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY THE HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. SPHP OFFERS A VARIETY OF HEALTH CARE PROGRAMS. SPHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE SPHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO- PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO PAYOR NEEDS. SPARROW PHP IS OWNED BY PHYSICIAN HEALTH PLAN (PHP). PHYSICIANS HEALTH PLAN (PHP) IS OWNED BY SPARROW HEALTH SYSTEM (SHS) AND HOLDS A CERTIFICATE OF AUTHORITY AS AN HMO IN THE STATE OF MICHIGAN. PHP IS PRIMARILY A COMMERCIAL HMO AND ALSO OPERATES THREE SUBSIDIARIES, PHP INSURANCE COMPANY (PHPIC), A COMMERCIAL INSURANCE COMPANY, SPHP, AND PHP SERVICE COMPANY (TPA) A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHP. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHP APPLY TO PHP, PHPIC, SPHP, AND TPA. PHP'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE, PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. PHPIC OFFERS PRODUCTS ACROSS MICHIGAN. THE SPARROW PHP PRODUCT IS AVAILABLE TO MEDICAID ENROLLEES IN EATON, CLINTON, INGHAM, IONIA, MONTCALM, ISABELLA, AND SHIAWASSEE COUNTIES. AS OF DECEMBER 31, 2015, THERE WERE APPROXIMATELY 34,000 ENROLLEES IN PHP'S COMMERCIAL HMO, 14,700 IN TPA, 9,000 IN PHPIC, AND 21,600 ENROLLEES IN SPHP. PHP AND SPHP CONTRACTS DIRECTLY WITH PHYSICIANS HEALTH NETWORK (PHN), A WHOLLY OWNED SUBSIDIARY OF SHS. THE PHP NETWORK IS APPROXIMATELY 1,030 PRIMARY CARE PHYSICIANS, 1,860 SPECIALTY CARE PHYSICIANS, 800 ALLIED HEALTH PROFESSIONALS, AND 1,180 ORGANIZATIONAL PROVIDERS THAT INCLUDE 45 HOSPITALS. PHP MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: - DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES, - QUALITY OF CARE CONCERNS, AND - HEDIS MEASURES: THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLAN PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHP USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: DIABETES, ASTHMA, DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, BREAST AND CERVICAL CANCER SCREENINGS, USE OF BETA- BLOCKERS AFTER HEART ATTACKS, CHILD AND ADOLESCENT IMMUNIZATIONS, CHOLESTEROL MANAGEMENT, CONTROLLING HIGH BLOOD PRESSURE, SMOKING CESSATION, PRENATAL AND POSTPARTUM CARE, AND TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHP MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT. THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS EXPECTATIONS. THE PHP QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2015 PHP RECEIVED "FULL ACCREDITATION" STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. PHP HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. FORM 990, PAGE 6, PART VI, LINE 6 PHYSICIANS HEALTH PLAN (PHP) IS THE SOLE MEMBER OF SPARROW PHP (SPHP) AND SPARROW HEALTH SYSTEM IS THE PARENT AND SOLE MEMBER OF PHP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE SPARROW HEALTH SYSTEM BOARD OF DIRECTORS. DECISIONS OF THE SPHP BOARD OF DIRECTORS MAY BE SUBJECT TO APPROVAL BY THE SPARROW HEALTH SYSTEM BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7A PHYSICIANS HEALTH PLAN (PHP) IS THE SOLE MEMBER OF SPARROW PHP (SPHP) AND SPARROW HEALTH SYSTEM IS THE PARENT AND SOLE MEMBER OF PHP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE SPARROW HEALTH SYSTEM BOARD OF DIRECTORS. DECISIONS OF THE SPHP BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE SPARROW HEALTH SYSTEM BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7B PHYSICIANS HEALTH PLAN (PHP) IS THE SOLE MEMBER OF SPARROW PHP (SPHP) AND SPARROW HEALTH SYSTEM IS THE PARENT AND SOLE MEMBER OF PHP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE SPARROW HEALTH SYSTEM BOARD OF DIRECTORS. DECISIONS OF THE SPHP BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE SPARROW HEALTH SYSTEM BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 11B COPIES OF THE 2015 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT COMPLETED ITS REVIEW OF THE FORM 990 COPIES WERE PROVIDED AT THE SEPTEMBER 2016 BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON. FORM 990, PAGE 6, PART VI, LINE 12C 1) CORPORATE COMPLIANCE SENDS OUT THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON). FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PAGE 6, PART VI, LINE 15B THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS FOLLOWS: THE GOVERNING DOCUMENTS OF SPARROW PHP ARE SUBMITTED TO DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS). THOSE ARE PUBLICLY AVAILABLE TO INTERESTED PARTIES. THE CONFLICT OF INTEREST IS AVAILABLE THROUGH SPARROW HEALTH SYSTEM BY REQUEST TO THE SPARROW COMPLIANCE OFFICER. FORM 990, PART XI, LINE 9 MEMBERSHIP TRANSFER 1,163,000 STATUTORY RECLASS FROM REVENUE TO EXPENSE -3,486,825 CEDED REINSURANCE -263,446 INVESTMENT EXPENSES -24,663 MEMBERSHIP TRANSFER -1,163,000 STATUTORY RECLASS FROM REVENUE TO EXPENSE 3,486,825 INVESTMENT EXPENSES 24,663 CEDED REINSURANCE 263,446 EDWARD W SPARROW HOSPITAL 1215 E MICHIGAN AVENUE LANSING MI 48912 381360584 HLTH CARE MI 501C3 3 SHS true SPARROW COMMUNITY CARE 3315 E MICHIGAN AVENUE STE 4 LANSING MI 48912 382543305 HOME HLTH MI 501C3 9 SHS true SPARROW HEALTH SYSTEM 1215 E MICHIGAN AVENUE LANSING MI 48912 382542859 PARENT MI 501C3 11A NA false PHYSICIANS HEALTH PLAN 1400 E MICHIGAN AVENUE LANSING MI 48912 382356288 INSURANCE MI 501C4 SHS false PHYSICIANS HEALTH NETWORK 1400 E MICHIGAN AVENUE LANSING MI 48912 382594856 HMO MI 501C4 SHS true SPARROW FOUNDATION 1215 E MICHIGAN AVENUE LANSING MI 48912 386100687 FUNDRAISE MI 501C3 11B SHS true SPARROW CLINTON HOSPITAL 805 S OAKLAND STREET ST JOHNS MI 48879 381358172 HLTH CARE MI 501C3 3 SHS true SPARROW SPECIALTY HOSPITAL 1215 E MICH AVE 8W SPARROW TOWER LANSING MI 48912 141885340 LT ACUTE MI 501C3 3 SHS true SPARROW IONIA HOSPITAL 3565 S STATE RD IONIA MI 48846 383218134 HLTH CARE MI 501C3 3 SHS true SPARROW CLINICAL RESEARCH INSTITUTE 1200 E MICHIGAN AVENUE LANSING MI 48912 383075242 RESEARCH MI 501C3 4 SHS true SPARROW CARSON HOSPITAL 406 E ELM ST PO BOX 879 CARSON CITY MI 48811 381490180 HLTH CARE MI 501C3 3 SHS true CARSON CITY FOUNDATION 406 E ELM ST PO BOX 879 CARSON CITY MI 48811 460877509 FUNDRAISE MI 501C3 11A CCH true SPARROW DEVELOPMENT INC 1215 E MICHIGAN AVENUE LANSING MI 48912 382595963 RENTAL PRO MI N/A true PHP INSURANCE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 205565219 INSURANCE MI N/A true PHP SERVICE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 383344741 MED SVS MI N/A true EAST LANSING ATHLETIC CLUB 2900 HANNAH BLVD EAST LANSING MI 48823 382886420 HLTH CLUB MI N/A true MAC RESTAURANT LLC 2900 HANNAH BLVD EAST LANSING MI 48823 205120690 RESTAURANT MI N/A true MEDICAL CENTER WEST CONDO ASSOC 1322 E MICHIGAN AVENUE LANSING MI 48912 382635630 CONOD ASSO MI N/A true CLINTON SERVICES CORPORATION 805 S OAKLAND ST JOHNS MI 48879 382494110 SERVICES MI N/A true false false false false false false false false false false false false true true true true false false false PHYSICIANS HEALTH NETWORK M 58044512 COST