2016-11-14T15:06:24-06:00 2015-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD 1000 ATLANTA GA 30308 990 2015-01-01 050477052 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND % PETER MARINO CEO NEIG 4014596000 910 Douglas Pike Smithfield RI 02917 Frank Meaney CFO 2016-11-14 true MICHAEL KUCZYNSKI P01226533 4048748300 2015 2017-02-10 21:41:12Z X Peter Marino CEO 910 Douglas Pike Smithfield RI 02917 1037610339 false X www.nhpri.org X 2000 RI NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND, SECURES ACCESS TO HIGH QUALITY, COST-EFFECTIVE HEALTH CARE FOR RHODE ISLAND'S AT-RISK POPULATIONS. 16 15 502 1 1069525 0 35400 0 848055027 980546905 1142995 1624627 0 0 849233422 982171532 8129 5506 750666267 849673019 33672071 38714520 0 0 0 43755321 65201245 828101788 953594290 21131634 28577242 251986845 369480153 194871536 283924104 57115309 85556049 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND, AN INNOVATIVE HEALTH PLAN IN PARTNERSHIP WITH THE COMMUNITY HEALTH CENTERS, SECURES ACCESS TO HIGH QUALITY, COST-EFFECTIVE HEALTH CARE FOR RHODE ISLAND'S AT-RISK POPULATIONS. false false 890043481 5506 980546905 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND IS A HEALTH MAINTENANCE ORGANIZATION (HMO) THAT PROVIDES COMPREHENSIVE HEALTH CARE SERVICES ON A PREPAID BASIS PRINCIPALLY TO MEDICAID RECIPIENTS AND CERTAIN OTHER ELIGIBLE PERSONS UNDER THE STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS MANAGED CARE PROGRAM, RITECARE. AS OF DECEMBER 31, 2015, THE ORGANIZATION IS RESPONSIBLE FOR PROVIDING HEALTH CARE SERVICES TO OVER 178,000 MEMBERS. 890043481 true false false true false false false false false false true false false false true false true false false false false false false false false false false false true true false false false false false false false false false false false false false false false false false true 2302 0 true 502 true true true false false false false false false false false false X 16 15 true false false false true true false true true false false true false false false true true false X PETER MARINO CEO 4014596000 910 DOUGLAS PIKE SMITHFIELD RI 02917 X MERRILL THOMAS BOARD CHAIR 1.0 0.0 X 0 0 0 JANE HAYWARD VICE CHAIR 1.0 0.0 X 0 0 0 PETER WALSH TREASURER 1.0 0.0 X 0 0 0 BRENDA DOWLATSHAHI SECRETARY 1.0 0.0 X 0 0 0 RAYMOND LAVOIE TRUSTEE 1.0 0.0 X 0 0 0 PABLO RODRIGUEZ MD TRUSTEE 1.0 0.0 X 0 0 0 PATRICIA MARTINEZ TRUSTEE 1.0 0.0 X 0 0 0 PETER BANCROFT TRUSTEE 1.0 0.0 X 0 0 0 DORIS DELOS SANTOS TRUSTEE 1.0 0.0 X 0 0 0 WILLIAM HOCHSTRASSER-WALSH TRUSTEE 1.0 0.0 X 0 0 0 CHARLES JONES TRUSTEE 1.0 0.0 X 0 0 0 CHRISTOPHER LITTLE TRUSTEE 1.0 0.0 X 0 0 0 DENNIS ROY TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL LICHENSTEIN TRUSTEE 1.0 0.0 X 0 0 0 RICHARD BESDINE MD TRUSTEE 1.0 0.0 X 0 0 0 PETER MARINO CEO (HIRED 9/1/14) 38.0 0.0 X X 322609 0 11302 SHANTA DIAZ CHIEF OPERATING OFFICER 38.0 0.0 X 255166 0 29735 FRANCISCO TRILLA MD CHIEF MEDICAL OFFICER 38.0 0.0 X 308414 0 10600 MICHELLE TETREAULT-INTERIM CFO (EFF 11/15/14-5/8/15) 38.0 0.0 X 91005 0 4770 FRANK MEANEY CFO (EFF 9/21/15) 38.0 0.0 X 128820 0 0 LISA WHITING CHR - VP HUMAN RESOURCES 38.0 0.0 X 168875 0 32902 CRAIG MCANAUGH - INTERIM CFO (EFF 5/8/15-9/21/15) 38.0 0.0 X 180866 0 16188 NANCY HERMIZ VICE PRESIDENT MEDICAID 38.0 0.0 X 197387 0 17782 JEFFREY MEYER VP/CHIEF INFORMATION OFFICER 38.0 0.0 X 195424 0 8841 BRENDA SEAGRAVE-WHITTLE CHIEF MARKETING OFF/VP EXCH 38.0 0.0 X 180472 0 27028 LOUISE POVALL VICE PRESIDENT MEDICARE 38.0 0.0 X 179642 0 0 MICHELLE LUPOLI VP MEDICAL MANAGEMENT 38.0 0.0 X 173940 0 37055 2382620 0 196203 65 false true false ARGUS HEALTH SYSTEMS 1300 WASHINGTON KANSAS CITY MO 64105 HEALTHCARE SERVICES 107037476 ACCENTURE 161 NORTH CLARK STREET CHICAGO IL 60601 CONSULTING 3859713 WRIGHT FILIPPIS INC 2845 CROOKS ROAD ROCHESTER HILLS MI 48309 HEALTHCARE SERVICES 3596696 PERFORM RX LLC 200 STEVENS DR BLDG 1 2ND FLOOR A PHILADELPHIA PA 19113 HEALTHCARE SERVICES 3410705 HEALTHEDGE SOFTWARE INC 30 CORPORATE DRIVE BURLINGTON MA 01803 SOFTWARE CONSULTING 3292082 51 0 0 0 PREMIUMS EARNED 524114 971678088 971678088 0 0 REINSURANCE RECOVERIES 2010475 2010475 0 PPC ADMIN SERVICES 524114 1069525 0 1069525 0 PHARMACY DIVIDENDS 524114 3843120 3843120 0 0 All other program service revenue 524114 1945697 1945697 0 0 980546905 1479588 1479588 0 0 0 0 0 55583846 55438807 145039 145039 145039 0 0 0 0 982171532 979477380 1069525 1624627 0 0 5506 5506 0 0 849673019 849673019 2008540 0 2008540 0 0 0 0 0 28776801 17548093 11228708 0 902744 565091 337653 0 4548876 2727275 1821601 0 2477559 1550878 926681 0 0 0 0 0 147288 147288 0 1192960 1192960 0 86400 86400 0 0 0 653790 653790 0 20476743 14178402 6298341 1878490 94011 1784479 0 2298492 13945 2284547 0 7981995 7981995 0 0 0 0 0 2494057 1271969 1222088 0 92648 59740 32908 0 0 0 0 0 0 0 69109 0 69109 0 0 0 0 0 712083 363162 348921 0 527825 94660 433165 0 STATE PREMIUM TAX 20652160 0 20652160 0 TEMPORARY HELP 2205225 1399146 806079 0 OTHER EXPENSES 322353 91309 231044 0 STATE AND LOCAL TAXES PAID 2246806 2246806 1162821 407275 755546 953594290 890043481 63550809 0 0 0 0 34212227 104324476 0 0 13435469 18975798 0 0 0 0 0 0 0 0 0 0 2816610 1859180 401059 957430 203825483 245222449 0 0 0 0 0 0 112607 0 251986845 369480153 21053227 18181715 0 0 0 0 0 0 0 0 0 0 1000000 0 0 0 172818309 265742389 194871536 283924104 X 57115309 85556049 0 0 0 0 57115309 85556049 251986845 369480153 X 28577242 -68348 0 0 0 -68154 X X false true X true false X 0 0 0 35400 0 35400 415427897 423570696 430147979 848055027 1042135899 3159337498 0 0 0 415427897 423570696 430147979 848090427 1042135899 3159372898 0 0 0 3159372898 1160371 756428 518891 1005897 1477997 4919584 0 1160371 756428 518891 1005897 1477997 4919584 0 0 416588268 424327124 430666870 849096324 1043613896 3164292482 0.99845 0.99823 0.00156 0.00176 X SCHEDULE A, PART III, SECTION B, LINE 1, COLUMN (E) 2015 THERE WERE NO CONTRIBUTIONS FOR THE YEAR ENDED DECEMBER 31, 2015. false false false false false false true 86400 false false 86400 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1G NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND DOES NOT DIRECTLY ENGAGE IN ANY LOBBYING ACTIVITIES BUT RETAINS A GOVERNMENT RELATIONS COMPANY, CAPITOL CITY GROUP TO ADVOCATE THAT FUNDING FOR THE MEDICAID PROGRAM NOT BE REDUCED. FOR THE YEAR ENDED DECEMBER 31, 2015, THE ORGANIZATION PAID CAPITOL CITY GROUP $86,400. 0 0 0 2816610 1859180 957430 0 0 957430 0 IBNR LIABILITIES 81473582 UNEARNED PREMIUMS 79950116 RISK SHARE GAIN/LIABILITY 104318691 265742389 1012312000 -5431336 -5431336 1017743336 -35571804 -35571804 982171532 983736000 35571804 35571804 948164196 5430094 5430094 953594290 FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART X, LINE 2 THERE WAS NO FIN 48 (ASC 740) FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS. RECONCILIATION OF EXPENSES ON AFS TO TAX RETURN SCHEDULE D, PART XI, LINE 2D AND LINE 4B LINE 2D RECLASS OF REINSURANCE PREMIUMS ($5,431,336) LINE 4B RECLASS OF PHARMACY DIVIDENDS $3,843,120 RECLASS OF REINSURANCE RECOVERIES $2,010,475 RECLASS OF RISK SHARE SETTLEMENTS ($61,496,546) RECLASS STOP LOSS RECOVERY $12,886,155 RECLASS OF STOP LOSS RECOVERY $5,814,529 RECLASS OF INVESTMENT INCOME $687,563 RECLASS OF PPC ADMIN SERVICES $1,069,525 RECLASS OF BAD DEBT EXPENSE ($386,625) ------------ TOTAL ($35,571,804) SCHEDULE D, PART XII, LINE 2D AND LINE 4B LINE 2D RECLASS OF PHARMACY DIVIDEND ($3,843,120) RECLASS OF REINSURANCE RECOVERIES ($2,010,475) RECLASS OF RISK SHARE SETTLEMENT $61,496,546 RECLASS OF STOP LOSS RECOVERY ($12,886,155) RECLASS OF COST SHARING RECOVERIES ($5,814,629) RECLASS OF INVESTMENT INCOME ($687,563) RECLASS OF PPC ADMIN SERVICES ($1,069,525) RECLASS OF BAD DEBT EXPENSE $386,625 ----------- TOTAL $35,571,804 LINE 4B RECLASS OF REINSURANCE PREMIUMS $5,431,336 RECLASS OF MISCELLANEOUS EXPENSE ($1,242) ----------- TOTAL $5,430,094 true FAMILY EMERGENCY FUND (FEF) 11 5025 FMV SCHEDULE I, PART I, LINE 2 THE FAMILY EMERGENCY FUND ("FUND") RECEIVES CONTRIBUTIONS FROM THE NHPRI EXECUTIVE BUDGET AS WELL AS FROM COMMUNITY CONTRIBUTORS. CASH HELD BY THE FUND IS ELIGIBLE FOR DISBURSEMENT TO A NHPRI MEMBER IN NEED OF ASSISTANCE, ONCE PER YEAR, AND APPROVED BY A DESIGNATED FUND COORDINATOR. THE MEMBER MUST BE ENROLLED IN CARE COORDINATION AND ASSIGNED A CASE MANAGER AND/OR CARE COORDINATOR. PAYMENTS ARE MADE DIRECTLY TO THE 3RD PARTY PARTICIPANTS, I.E. UTILITY SUPPLIER, LANDLORD, FOOD VOUCHER, GIFT CARD OR BILL PAYMENT. THROUGH THIS DIRECT DISBURSEMENT, THE FUND IS ABLE TO ENSURE THAT PROCEEDS AND GRANTS ARE GOING TO ASSIST IN A MANNER CONSISTENT WITH NHPRIS EXEMPT PURPOSE. THE FUND BALANCE IS REVIEWED AND RECONCILED BY NHPRI FINANCE DEPARTMENT ON A REGULAR BASIS. X X X X true false false false false false false true false PETER MARINO CEO (HIRED 9/1/14) 303489 0 18367 0 753 0 3752 0 7550 0 333911 0 748 0 SHANTA DIAZ CHIEF OPERATING OFFICER 234809 0 19497 0 860 0 8270 0 21465 0 284901 0 855 0 FRANCISCO TRILLA MD CHIEF MEDICAL OFFICER 281301 0 24221 0 2892 0 10600 0 0 0 319014 0 2892 0 LISA WHITING CHR - VP HUMAN RESOURCES 152802 0 15150 0 923 0 6025 0 26877 0 201777 0 918 0 CRAIG MCANAUGH - INTERIM CFO (EFF 5/8/15-9/21/15) 150723 0 29932 0 211 0 7293 0 8895 0 197054 0 206 0 NANCY HERMIZ VICE PRESIDENT MEDICAID 180988 0 15278 0 1121 0 7935 0 9847 0 215169 0 1121 0 JEFFREY MEYER VP/CHIEF INFORMATION OFFICER 180505 0 14307 0 612 0 7841 0 1000 0 204265 0 607 0 BRENDA SEAGRAVE-WHITTLE CHIEF MARKETING OFF/VP EXCH 165033 0 14408 0 1031 0 6264 0 20764 0 207500 0 1026 0 LOUISE POVALL VICE PRESIDENT MEDICARE 133886 0 15180 0 30576 0 0 0 0 0 179642 0 6110 0 MICHELLE LUPOLI VP MEDICAL MANAGEMENT 159188 0 14393 0 359 0 7207 0 29848 0 210995 0 354 0 NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 PURPOSE: NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND (NHPRI) PERFORMANCE INCENTIVE PLAN (THE PLAN) HAS BEEN IMPLEMENTED TO OFFER A PERFORMANCE-BASED INCENTIVE AWARD OPPORTUNITY TO ELIGIBLE NHPRI EMPLOYEES BASED ON ACHIEVEMENT OF THE ORGANIZATION'S ANNUAL BUSINESS OBJECTIVES AS WELL AS THEIR OWN JOB PERFORMANCE. THE PLAN ALLOWS A PORTION OF NHPRI'S ANNUAL COMPENSATION COSTS TO BE VARIABLE IN RELATION TO THE ORGANIZATION'S PERFORMANCE. AMOUNTS PAID IN 2015 UNDER THE PLAN ARE INCLUDED IN PART II COLUMN (B)(II). OTHER OBJECTIVES THE PLAN IS EXPECTED TO PROVIDE INCLUDE THE FOLLOWING: A) FOCUS THE ATTENTION, EFFORT AND TEAMWORK OF PLAN PARTICIPANTS ON ACCOMPLISHMENT OF NHPRI'S KEY BUSINESS OBJECTIVES; B) ENABLE NHPRI TO OFFER A COMPENSATION PROGRAM WITH METHODS AND LEVELS OF PAY THAT ARE COMPETITIVE WITH OTHER ORGANIZATIONS SEEKING COMPARABLE EMPLOYEE RESOURCES; C) REINFORCE NHPRI'S COMMITMENT TO A PERFORMANCE-BASED CULTURE FOR ITS EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION; D) ASSIST NHPRI'S EFFORTS TO RETAIN ITS VALUED EMPLOYEES. DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, LINE 2 A MEMBER OF THE ORGANIZATIONS BOARD OF DIRECTORS IS AN EXECUTIVE DIRECTOR OF A COMMUNITY HEALTH CENTER (CHC) BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC. BLACKSTONE VALLEY HEALTH CARE, THROUGH A GRANT, INVESTED IN EQUIPMENT AND SOFTWARE FOR AN ELECTRONIC MEDICAL RECORD (EMR) SYSTEM. ONE OTHER CHC, TRI-TOWN, HAS USE OF THE EMR AND BILLING SYSTEM. THE CHCS SHARE THE COST OF RUNNING THE SYSTEM. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE ORGANIZATION IS A 501(C)(3) CORPORATION AND HAS MEMBERS BUT DOES NOT HAVE ANY STOCKHOLDERS. THE ORGANIZATION HAS A BOARD OF DIRECTORS WHO ARE MEMBERS OF THE ORGANIZATION THAT MEET ON A REGULAR BASIS AND FUNCTION AS THE GOVERNING BODY OF THE ORGANIZATION. FORM 990, PART VI, LINE 7A THE MEMBERS OF THE ORGANIZATION ARE RHODE ISLAND COMMUNITY HEALTH CENTERS WHO HAVE THE AUTHORITY TO APPOINT A PORTION OF THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ALSO APPROVES THE HIRING OF THE CHIEF EXECUTIVE OFFICER WHO IS A VOTING MEMBER OF THE BOARD. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE ORGANIZATION'S FISCAL OPERATIONS DEPARTMENT ACCUMULATES THE INFORMATION AND DATA NECESSARY TO COMPLETE THE FEDERAL FORM 990. AUDITED FINANCIAL STATEMENTS AND APPROVED POLICIES AND PROCEDURES ARE USED AS INPUT TO COMPLETE THE 990. A DRAFT RETURN IS PREPARED AND REVIEWED BY THE ORGANIZATION'S INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS. AFTER THE REVIEW PROCESS IS COMPLETED BY THE INDEPENDENT ACCOUNTANTS, THE FINANCE STAFF REVIEWS THE RETURN PRIOR TO FILING WITH THE IRS. THE FINANCE AND AUDIT COMMITTEE IS PROVIDED A DRAFT COPY OF THE RETURN FOR APPROVAL PRIOR TO FILING WITH THE IRS. POLICIES FORM 990, PART VI, LINES 12A, 12B, 13 & 14 PURSUANT TO THE INSTRUCTIONS FOR FORM 990, THE ORGANIZATION MUST ANSWER NO TO THE QUESTIONS BECAUSE THE BOARD OF DIRECTORS DOES NOT APPROVE OR ADOPT THESE POLICIES ON AN ANNUAL BASIS. HOWEVER, THE ORGANIZATION HAS ISSUED THESE POLICIES AT THE DIRECTION OF MANAGEMENT AND THESE POLICIES AND PROCEDURES ARE STRICTLY ENFORCED BY THE ORGANIZATION'S MANAGEMENT TEAM. CONFLICT OF INTEREST FORM 990, PART VI, LINE 12C AS PROMULGATED BY THE ORGANIZATION'S COMPLIANCE PLAN, THE ORGANIZATION'S DIRECTOR OF COMPLIANCE IS ALSO THE ORGANIZATION'S CHIEF PRIVACY OFFICIAL. ALL BOARD MEMBERS, COMMITTEE MEMBERS AND EMPLOYEES MUST DISCLOSE ALL CONFLICTS ON A SIGNED DISCLOSURE FORM ON A YEARLY BASIS. IF A POTENTIAL CONFLICT OF INTEREST IS REPORTED, THE PRIVACY OFFICIAL REVIEWS THE CIRCUMSTANCES TO DETERMINE IF A POSSIBLE CONFLICT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE PRIVACY OFFICIAL WILL MONITOR THE CONFLICT OF INTEREST AS NECESSARY AND/OR REFERS THE APPROPRIATE ITEMS THROUGH THE CHIEF FINANCIAL OFFICER TO THE CHIEF EXECUTIVE OFFICER FOR A RESOLUTION/DECISION. BOARD AND COMMITTEE MEMBERS REFRAIN FROM VOTING ON ISSUES WHERE THERE IS AN APPEARANCE OF A CONFLICT. OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A & 15B THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CONTRACT OF THE CEO AND ANY CHANGES TO THE CONTRACT. THE ORGANIZATIONAL DEVELOPMENT AND HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER BASED ON COMPENSATION SURVEYS. THE COMMITTEE SUBSCRIBES TO THREE OR FOUR SALARY SURVEYS THAT LIST SALARY AND SALARY INCREASES BY POSITION, GEOGRAPHY, PLAN SIZE AND PROFIT VS NON-PROFIT ORGANIZATIONS. THESE SURVEYS ARE USED TO SET COMPENSATION ANNUALLY. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S LOCATION AT 910 DOUGLAS PIKE, SMITHFIELD, RI 02917. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN NON-ADMITTED ASSETS: $(68,154) ACCOUNTING METHOD FORM 990, PART XII, LINE 1 THE ORGANIZATION USES THE STATUTORY METHOD OF ACCOUNTING.