2015-11-10T09:20:44-06:00 2014-12-31 383133790 ANDREWS HOOPER PAVLIK PLC 4295 OKEMOS RD STE 200 OKEMOS MI 488646201 990 2014-01-01 382356288 PHYSICIANS HEALTH PLAN PHYS 5173648400 PO BOX 30377 LANSING MI 48909 DENNIS REESE PRESIDENT AND CEO 5173648400 2015-11-03 true MARK E HOOPER P00039887 5177060800 2015-11-03 2014 2016-03-07 17:11:31Z DENNIS SWAN 1215 E MICHIGAN AVENUE LANSING MI 48912 162449737 false X WWW.PHPMICHIGAN.COM X 1980 MI PHYSICIANS HEALTH PLAN'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, COST EFFECTIVE HEALTHCARE. 13 6 116 0 0 195352910 158456463 2346464 3361517 0 197699374 161817980 0 180398538 141494444 5869700 5456099 0 0 8428154 11309827 194696392 158260370 3002982 3557610 89679813 94236687 25054855 26625539 64624958 67611148 X PHYSICIANS HEALTH PLAN'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, COST EFFECTIVE HEALTHCARE. false false 152399681 158456463 PHYSICIANS HEALTH PLAN (PHP) IS OWNED BY SPARROW HEALTH SYSTEM (SPARROW) 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, SPARROW PHP (SPHP) A MICHIGAN MEDICAID MANAGED CARE PLAN, 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, TPA, AND SPHP. PHPS SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, AND ISABELLA. 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, 2014, THERE WERE APPROXIMATELY 30,100 ENROLLEES IN PHPS COMMERCIAL HMO, 14,600 IN TPA, 10,600 IN PHPIC, AND 19,700 ENROLLEES IN SPHP. PHP ALSO OPERATES THE STATE OF MICHIGANS PRE-EXISTING CONDITION INSURANCE PLAN CALLED HIP MICHIGAN. THE HIP PROGRAM WAS TERMINATED EFFECTIVE JUNE 30, 2013. PHP AND SPHP CONTRACT DIRECTLY WITH PHYSICIANS HEALTH NETWORK (PHN), A WHOLLY OWNED SUBSIDIARY OF SPARROW. THE PHP NETWORK IS APPROXIMATELY 1,047 PRIMARY CARE PHYSICIANS, 1,976 SPECIALTY CARE PHYSICIANS, 837 ALLIED HEALTH PROFESSIONALS, AND 974 ORGANIZATIONAL PROVIDERS THAT INCLUDE 45 HOSPITALS. PHP CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. PHPS COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. PHPS 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 PHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGANS 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. PHP 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 HDN, IS NOT AVAILABLE WITHIN THE HDNS NETWORK. PHP OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS, TO GROUPS AND INDIVIDUALS. PHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE PHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. 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. PHP RECEIVED THE HIGHEST RATING OF EXCELLENT FROM THE UTILIZATION REVIEW ACCREDITATION COMMITTEE (URAC). THIS STATUS IS GRANTED TO HEALTHCARE PLANS THAT HAVE DEMONSTRATED CONTINUOUS QUALITY IMPROVEMENT IN THEIR PROGRAMS WHILE MEETING OR EXCEEDING URAC'S RIGOROUS ACCREDITATION STANDARDS. SPARROW PHP RECEIVED AN "EXCELLENT" RATING. PHP AND SPARROW PHP WERE REVIEWED BY URAC IN 2012. 174861 PHYSICIANS HEALTH PLAN ESTABLISHED AND OPERATES A TEMPORARY HIGH RISK HEALTH INSURANCE POOL PROGRAM (PHP-HRPP) IN MICHIGAN TO PROVIDE AFFORDABLE HEALTH INSURANCE COVERAGE TO CURRENTLY UNINSURED INDIVIDUALS WITH PRE- EXISTING CONDITIONS. IT IS PART OF A FEDERAL PROGRAM ESTABLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) IN RESPONSE TO THE AFFORDABLE CARE ACT. THE PROGRAM PROVIDES COVERAGE FOR ELIGIBLE INDIVIDUALS BEGINNING OCTOBER 1, 2010, THROUGH AND ENDING JUNE 30, 2013. AS OF DECEMBER 31, 2014, THERE WERE NO MEMBERS ENROLLED IN THE PROGRAM. 152574542 false false false false false false false false true true false true false 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 12 0 true 116 true false false false false false false X 13 6 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 853448 33430 MARK BRETT DIRECTOR 1.00 40.00 X 0 437616 39529 PETER GRAHAM MD MEDICAL DIRE 40.00 5.00 X X 0 293996 36042 TIMOTHY HODGE DO DIRECTOR 1.00 1.00 X 0 1500 0 MARYLEE DAVIS PHD CHAIR/DIRECT 2.00 2.00 X X 0 1350 0 DAVID KAUFMAN DO DIRECTOR 1.00 40.00 X 0 1350 0 JAMES BUTLER III BOARD CHAIR 1.00 1.00 X X 0 1350 0 JUDITH CARDENAS PHD DIRECTOR 1.00 1.00 X 0 0 0 DIANA RODRIGUEZ ALGRA SECRETARY/DI 1.00 1.00 X X 0 0 0 PATRICK MCPHARLIN DIRECTOR 1.00 1.00 X 0 0 0 KENNETH RUDMAN MD DIRECTOR 1.00 1.00 X X 0 0 0 KATHLEEN CONKLIN DIRECTOR 1.00 1.00 X X 0 0 0 THOMAS HOFMAN PHD DIRECTOR 1.00 1.00 X X 0 0 0 DEBORAH MUCHMORE DIRECTOR 1.00 1.00 X 0 0 0 DENNIS REESE PRESIDENT & 40.00 5.00 X 0 289302 36562 KEVIN KAPLAN VP SALES 40.00 5.00 X 0 169955 26827 ANN HUNT-FUGATE RPH MGR CLINICAL 40.00 5.00 X 138667 0 28287 KEVIN ESSENMACHER CONTROLLER 40.00 5.00 X 0 134470 28048 PAULA HOWARD SENIOR SALES 40.00 5.00 X 133174 0 24513 LINDA DICKINSON DIR OF MED R 40.00 5.00 X 0 130643 25502 SCOTT WILKERSON FORMER PRES/ 0.00 0.00 X 0 364095 19240 THOMAS OSTRANDER FORMER DIREC 0.00 40.00 X 0 335657 39540 LARRY RAWSTHORNE MD FORMER DIREC 0.00 40.00 X 0 268065 34628 DAWN SPRINGER MD FORMER DIREC 0.00 40.00 X 0 202106 15681 271841 3484903 387829 2 true true false TRIZETTO 1085 MORRIS AVENUE UNION NJ 07083 HEALTHCARE IT 6468647 HIGHPOINT SOLUTIONS 301 E GERMANTOWN PIKE EAST NORRITON PA 19401 CONSULTING 1188268 TC3 HEALTH INC 1901 E ALTON AVE SUITE 100 SANTA ANA CA 92705 COST MGTMT. 1026405 GLOBALCARE INC 6875 SHILOH RD E ALPHARETTA GA 300058403 HEALTH 949422 MILLIMAN 15800 BLUEMOUND RD SUITE 100 BROOKFIELD WI 53005 CONSULTING 898735 12 PREPAID HEALTHCARE 621990 158456463 158456463 158456463 1355811 611306 744505 2637463 631757 2005706 2005706 2005706 161817980 159067769 2750211 141494444 141494444 655903 655903 3646961 3257267 389694 179243 135687 43556 703597 532623 170974 270395 204689 65706 2708833 2708833 118580 89765 28815 264649 264649 104895 104895 1198872 1198872 390489 295600 94889 339294 256846 82448 490259 371126 119133 88689 88689 46038 46038 1904 1904 994705 994705 48734 48734 MISCELLANEOUS 3023417 2288725 734692 BROKER COMMISSONS 965949 965949 ADMINISTRATIVE EXPENSES 349659 349659 HHS HRPP REIMBURSEMENT 174861 174861 158260370 152574542 5685828 0 36960522 40868943 5991862 2794193 1482488 808083 27240112 20714223 5093805 6525889 22003000 23629017 16885749 17997054 1262387 1613508 89679813 94236687 23605184 23279491 410050 1421575 1039621 1924473 25054855 26625539 X 64624958 67611148 64624958 67611148 89679813 94236687 3557610 -571420 X false true X true false 3184706 200567 40893 15000 3411165 2926676 82387 187643 12000 3184706 2641860 147795 149021 12000 2926676 1779759 796243 97691 30000 1833 2641860 1550687 163793 65279 1779759 1.00000 false true true 455895 455895 4387041 3164602 1222439 22397176 17549621 4847555 6525889 INVESTMENT IN PHP INSURANCE COMPANY 9056769 C INVESTMENT IN SPARROW PHP 8664448 C INVESTMENT IN PHP SERVICE COMPANY 275837 C 17997054 RELATED PARTY PAYABLE 1924473 1924473 160740123 -571420 -571420 161311543 506437 506437 161817980 157753933 157753933 506437 506437 158260370 SCHEDULE D, PAGE 2, PART V, LINE 4 PHP DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHP, SPARROW CLINTON HOSPITAL, AND SPARROW FOUNDATION. 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 4B RECLASS BETWEEN REVENUE & EXPENSE 506,437 SCHEDULE D, PAGE 4, PART XII, LINE 4B RECLASS BETWEEN REVENUE AND EXPENSE 506,437 SCHEDULE D, PAGE 4, PART XIII SEPARATE AUDITED FINANCIAL STATEMENTS WERE PREPARED FOR PHYSICIANS HEALTH PLAN UNDER STATUTORY ACCOUNTING PRINCIPLES AS PERMITTED BY THE MICHIGAN DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS). THE DIFS REQUIRES THAT INSURANCE COMPANIES DOMICILED IN THE STATE OF MICHIGAN PREPARE THEIR STATUTORY-BASIS FINANCIAL STATEMENTS IN ACCORDANCE WITH PRACTICES ESTABLISHED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS. THESE PRACTICES DIFFER IN SOME RESPECTS FROM U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. PHYSICIANS HEALTH PLAN WAS INCLUDED AS PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF SPARROW HEALTH SYSTEM. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHYSICIANS HEALTH PLAN. THE SPARROW HEALTH SYSTEM FINANCIAL STATEMENTS WERE PREPARED USING THE U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE FORM 990 FOR PHYSICIANS HEALTH PLAN HAS BEEN PREPARED USING U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. X X X X X X true false false true true true true true false DENNIS SWAN PRES/CEO - SHS 818019 35429 19240 14190 886878 MARK BRETT DIRECTOR 416594 21022 23250 16279 477145 PETER GRAHAM MD MEDICAL DIRECTOR 286648 5311 2037 19240 16802 330038 DENNIS REESE PRESIDENT & CEO 232958 55000 1344 22349 14213 325864 KEVIN KAPLAN VP SALES 154852 14986 117 10285 16542 196782 ANN HUNT-FUGATE RPH MGR CLINICAL PHARM 138278 389 10261 18026 166954 KEVIN ESSENMACHER CONTROLLER 134392 78 11610 16438 162518 PAULA HOWARD SENIOR SALES REP 130083 3000 91 12191 12322 157687 LINDA DICKINSON DIR OF MED RES MGMT 130249 394 11533 13969 156145 SCOTT WILKERSON FORMER PRES/CEO/SEC 363982 113 19240 383335 THOMAS OSTRANDER FORMER DIRECTOR 315259 20398 23250 16290 375197 LARRY RAWSTHORNE MD FORMER DIRECTOR 255348 12717 19240 15388 302693 DAWN SPRINGER MD FORMER DIRECTOR 160553 38308 3245 14956 725 217787 SCHEDULE J, PAGE 1, PART I, LINE 3 SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHYSICIANS HEALTH PLAN. 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 364,095 0 0 SCHEDULE J, PAGE 1, PART I, LINE 5A THE 2014 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2014 AND WILL BE PAID IN 2015. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP, AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 5B THE 2014 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2014 AND WILL BE PAID IN 2015. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP, AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 6A THE 2014 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2014 AND WILL BE PAID IN 2015. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP, AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 6B THE 2014 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2014 AND WILL BE PAID IN 2015. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP, AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 7 COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NON-FIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET. SCHEDULE J, PART III THOMAS OSTRANDER, LARRY RAWSTHORNE, AND DAWN SPRINGER ARE FORMER BOARD MEMBERS OF PHYSICIANS HEALTH PLAN. THE BOARD MEMBERS ARE BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES IN POSITIONS OTHER THAN AS BOARD MEMBERS OF PHYSICIANS HEALTH PLAN. THE BOARD MEMBERS ARE NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO PHYSICIANS HEALTH PLAN. FORM 990 ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. FORM 990, PAGE 2, PART III, LINE 4A 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, 2014, THERE WERE APPROXIMATELY 30,100 ENROLLEES IN PHPS COMMERCIAL HMO, 14,600 IN TPA, 10,600 IN PHPIC, AND 19,700 ENROLLEES IN SPHP. PHP ALSO OPERATES THE STATE OF MICHIGANS PRE-EXISTING CONDITION INSURANCE PLAN CALLED HIP MICHIGAN. THE HIP PROGRAM WAS TERMINATED EFFECTIVE JUNE 30, 2013. PHP AND SPHP CONTRACT DIRECTLY WITH PHYSICIANS HEALTH NETWORK (PHN), A WHOLLY OWNED SUBSIDIARY OF SPARROW. THE PHP NETWORK IS APPROXIMATELY 1,047 PRIMARY CARE PHYSICIANS, 1,976 SPECIALTY CARE PHYSICIANS, 837 ALLIED HEALTH PROFESSIONALS, AND 974 ORGANIZATIONAL PROVIDERS THAT INCLUDE 45 HOSPITALS. PHP CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. PHPS COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. PHPS 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 PHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGANS 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. PHP 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 HDN, IS NOT AVAILABLE WITHIN THE HDNS NETWORK. PHP OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS, TO GROUPS AND INDIVIDUALS. PHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE PHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. 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. PHP RECEIVED THE HIGHEST RATING OF EXCELLENT FROM THE UTILIZATION REVIEW ACCREDITATION COMMITTEE (URAC). THIS STATUS IS GRANTED TO HEALTHCARE PLANS THAT HAVE DEMONSTRATED CONTINUOUS QUALITY IMPROVEMENT IN THEIR PROGRAMS WHILE MEETING OR EXCEEDING URAC'S RIGOROUS ACCREDITATION STANDARDS. SPARROW PHP RECEIVED AN "EXCELLENT" RATING. PHP AND SPARROW PHP WERE REVIEWED BY URAC IN 2012. FORM 990, PAGE 6, PART VI, LINE 6 SPARROW HEALTH SYSTEM (SHS) IS THE PARENT AND SOLE MEMBER OF PHYSICIANS HEALTH PLAN AND HAS 100% OWNERSHIP. FORM 990, PAGE 6, PART VI, LINE 7A THE NON-ENROLLEE MEMBERS OF THE BOARD OF DIRECTORS OF PHYSICIANS HEALTH PLAN ARE RATIFIED BY THE BOARD OF DIRECTORS OF SPARROW HEALTH SYSTEM. FORM 990, PAGE 6, PART VI, LINE 7B THE NON-ENROLLEE MEMBERS OF THE BOARD OF DIRECTORS OF PHYSICIANS HEALTH PLAN ARE RATIFIED BY THE BOARD OF DIRECTORS OF SPARROW HEALTH SYSTEM. THE DECISIONS OF THE PHYSICIANS HEALTH PLAN BOARD OF DIRECTORS MAY BE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS OF SPARROW HEALTH SYSTEM. FORM 990, PAGE 6, PART VI, LINE 11B COPIES OF THE 2014 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT COMPLETED ITS REVIEW OF THE FORM 990 COPIES WERE PROVIDED AT THE SEPTEMBER 2015 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, 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 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 PHP ARE SUBMITTED TO THE 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 REQUESTING THE POLICY FROM THE SPARROW COMPLIANCE OFFICER. FORM 990, PART XI, LINE 9 RECLASS BETWEEN REVENUE & EXPENSE -506,437 RECLASS BETWEEN REVENUE AND EXPENSE 506,437 SPARROW HEALTH SYSTEM 1215 E MICHIGAN AVENUE LANSING MI 48912 382542859 PARENT MI 501C3 11A N/A false SPARROW PHP 1400 E MICHIGAN AVENUE LANSING MI 48912 364497604 HMO MI 501C4 PHP true PHYSICIANS HEALTH NETWORK 1400 E MICHIGAN AVENUE LANSING MI 48912 382594856 HMO MI 501C4 SHS true SPARROW FOUNDATION 1110 E MICHIGAN AVENUE LANSING MI 48912 386100687 FUNDRAISE MI 501C3 11B SHS true SPARROW COMMUNITY CARE 2909 E GRAND RIVER LANSING MI 48912 382543305 HOME HLTH MI 501C3 9 SHS true SPARROW CLINTON HOSPITAL 805 S OAKLAND STREET ST JOHNS MI 48879 381358172 HLTH CARE MI 501C3 3 SHS true EDWARD W SPARROW HOSPITAL 1215 E MICHIGAN AVENUE LANSING MI 48912 381360584 HLTH CARE MI 501C3 3 SHS true SPARROW IONIA HOSPITAL 3565 S STATE RD IONIA MI 48846 383218134 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 CLINICAL RESEARCH INSTITUTE 1200 E MICHIGAN AVENUE LANSING MI 48912 383075242 RESEARCH MI 501C3 4 SHS true PHP INSURANCE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 205565219 INSURANCE MI PHP C CORP -235862 16275527 1.00000 true PHP SERVICE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 383344741 MED SVS MI PHP C CORP -75782 3317170 1.00000 true SPARROW DEVELOPMENT INC 1215 E MICHIGAN AVENUE LANSING MI 48912 382595963 RENTAL PRO 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 1100 W SAGINAW ST LANSING MI 48915 382635630 CONDO 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 true true false true true true false false PHYSICIANS HEALTH NETWORK M 138142561 COST EDWARD W SPARROW HOSPITAL L 1974086 COST EDWARD W SPARROW HOSPITAL Q 2565385 COST SPARROW PHP Q 5555727 COST PHP INSURANCE COMPANY Q 5650227 COST PHP SERVICE CO (TPA) Q 3787425 COST