2015-11-10T14:33:26-06:00 2014-12-31 ERNST & YOUNG LLP 5 TIMES SQUARE NEW YORK NY 100366530 990 2014-01-01 113029569 Managed Health Inc % CRAIG BARATTIN-VP CONTROLLER MANA 100 CHURCH ST FL 18 New York NY 100072601 ELIZABETH ST CLAIR CHIEF LEGAL OFFICER 2015-08-07 CHRISTOPHER B BOGGS P00032493 2127733000 2014 2016-03-07 17:11:31Z PATRICIA J WANG 100 CHURCH ST FL 18 NEW YORK NY 100072601 1780755230 false X www.healthfirstny.org X 1990 NY IMPROVE THE HEALTH AND WELL-BEING OF UN- DERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE AND COMMERCIAL RECIPIENTS. 5 3 0 0 0 0 0 1615459009 1777556176 3140522 3199054 0 0 1618599531 1780755230 0 0 0 0 0 0 0 0 0 1628776902 1813071250 1628776902 1813071250 -10177371 -32316020 494542039 564772819 282584866 349305203 211957173 215467616 IMPROVE THE HEALTH AND WELL-BEING OF UN- DERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE AND COMMERCIAL RECIPIENTS. false false 1753229817 1777556176 MANAGED HEALTH, INC. IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. MANAGED HEALTH INC. PROVIDES HEALTH CARE SERVICES TO MEDICARE AND COMMERCIAL SUBSCRIBERS/BENEFICIARIES, WHO ARE INDIGENT, AGED, DISABLED AND/OR MEDICALLY UNDERSERVED. IN 2014, THERE ARE about 69 PARTICIPATING HOSPITALS WITH MANAGED HEALTH, INC. THAT SERVED 124,165 MEDICARE MEMBERS AND THERE ARE ABOUT 42 PARTICIPATING HOSPITALS WITH MANAGED HEALTH, INC. THAT SERVED 17 COMMERCIAL RECIPIENTS. 1753229817 false false false false false false false false false 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 true false false false false false true true true false true 8866 0 true 0 false false false false false false X 5 3 false true false false true true true true true false false true true true true true true false false false NY X CRAIG BARATTIN-VP CONTROLLER 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 RICHARD MURCOTT BOARD DIRECOR-COMMUNITY REP. 1.0 0.0 X 0 0 0 JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 1.0 40.0 X 0 695229 0 ELIZABETH RST CLAIR Beg21814 CHIEF LEGAL OFFICER 1.0 40.0 X X 0 1006265 0 STEVE ROSENTHAL BOARD DIRECTOR 1.0 0.0 X 0 0 0 ERIC SCALETTAR BOARD DIRECTOR 1.0 0.0 X 0 0 0 PATRICIA J WANG CHIEF EXECUTIVE OFFICER 1.0 40.0 X 0 1597100 0 MARYBETH A TITA SVP-CORP. FINANCE 1.0 40.0 X 0 669733 0 DANIEL P MCCARTHY PRESIDENT&COO 1.0 40.0 X 0 984361 0 MICHAEL FEDYNA CFO 1.0 40.0 X 0 218056 0 NAHUM KIANOVSKY End 21814 VP/ASSOC GEN COUNSEL II 1.0 40.0 X 0 302110 0 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUI 1.0 40.0 X 0 470563 0 IAN SHAFFER EXEC MED DIR BEHAV HEALTH 1.0 40.0 X 0 392065 0 SEAN M NATARO DEPUTY GENERAL COUNSEL 1.0 40.0 X 0 382462 0 REBECCA SCHWIETZ SVP CLINICAL SERVICES 1.0 40.0 X 0 376809 0 THOMAS E MEIXNER VP FINANCIAL ANALYSIS 1.0 40.0 X 0 373553 0 ANDREA C FORINO SVP HUMAN RESOURCES TERM-9/13 1.0 0.0 X 0 346954 0 0 7815260 0 0 true true false CAREMARK LLC ONE CVS DRIVE WOONSOCKET RI 02895 PHARMACY 599274356 NEW YORK CITY HEALTH AND HOSPITAL C 125 WORTH STREET ROOM 514 NEW YORK NY 10013 MEDICAL/HOSPITAL 230480866 MONTEFIORE MEDICAL CENTER PO BOX 4296 CHURCH STREET STATION NEW YORK NY 10261 MEDICAL/HOSPITAL 116077959 NY PRESBYTERIAN HOSP-COLUMBIA PO BOX 6154 NEW YORK NY 10249 MEDICAL/HOSPITAL 55197638 MOUNT SINAI HOSPITAL PO BOX 27759 NEW YORK NY 10007 MEDICAL/HOSPITAL 41244730 1013 0 MEDICARE ADVANTAGE (PART C) 524114 1626768140 1626768140 MEDICARE PRESCRIPTION DRUG COVERAGE (PART D) 524114 150807277 150807277 COMMERCIAL (INCLUDING HEALTHY NY) 524114 -19241 -19241 1777556176 3199054 3199054 0 0 0 0 0 0 0 0 0 0 1780755230 1777556176 3199054 0 0 0 0 0 0 0 0 0 0 204058697 144881675 59177022 0 0 0 0 0 425197 197671 227526 5303052 5209072 93980 285572 191112 94460 0 0 0 0 0 0 601136 601136 0 0 0 HEALTHCARE SERVICE COSTS 1577936385 1577936385 MEDICAL ADMINISTRATIVE 24378006 24130103 247903 CLAIMS ADJUSTMENT EXPENSE 30808 30808 UNPAID CLAIMS PROCESSING EXP 51855 51855 542 542 1813071250 1753229817 59841433 0 0 0 70756057 94251449 0 0 58490863 65333197 0 0 0 0 0 0 0 0 0 0 0 310661938 274576548 0 0 0 0 0 0 54633181 130611625 494542039 564772819 247862475 320939632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34722391 28365571 282584866 349305203 X 211957173 215467616 0 0 0 0 211957173 215467616 494542039 564772819 X -32316020 1288228 34538235 X X false true X true false INTEREST RECEIVABLE 1099241 PHARMACY REBATE RECEIVABLE 67182306 COVERAGE GAP DISCOUNT PROGRAM 4116965 MEDICARE NEGATIVE VENDOR BAL 2328850 MEDICARE D PLAN-TO-PLAN RECV 27041 OTHER CURRENT ASSETS/PREPAID 7507300 OTHER MEDICAL RECEIVABLE 2520153 SECURITY DEPOSIT - OTHER 147200 PART D DEPOSIT - LOW INCOME 17205396 PART D DEPOSIT - REINSURANCE 28477173 130611625 0 DUE TO CMS 5418584 MEDICARE PART D DEPOSIT LIABIL 3303954 DUE TO 501(C)(3) AFFILIATE 325829 NOTE PAYABLE TO RELATED PARTY 14472116 OTHER CURRENT LIABILITIES 4845088 28365571 1816581693 1288228 34538235 35826463 1780755230 1780755230 1813071250 1813071250 1813071250 PART XI, LINE 2D - OTHER ADJUSTMENTS RELEASES FROM FINANCIAL SECURITY DEPOSITS FOR MEMBER HOSPITALS: $(120,057). RETAINED HOSPITAL PAYMENTS: $19,658,292. The health care services agreements with certain hospitals provide that payments due to these hospitals, as health care providers to MHI Members, attributable to a % of premium are retained by MHI. EQUITY TRANSFER FROM AFFILIATE: $15,000,000. During 2014, Healthfirst requested and received approval from the DOH to transfer $15.0 million of capital reserves from Neighborhood Health Providers, Inc. ("NHP") to MHI. NHP is a managed care plan under Article 44 of the New York Public Health Law and was acquired by Healthfirst in January 2013. Effective June 1, 2013, NHP members were transferred to PHSP which managed all member activities subsequent to the effective date of the transfer as per the agreed-upon requirements of the DOH. The capital reserve transfer from NHP to MHI is in conjunction with the ongoing wind-down of the NHP operations. true true false false false false false false false JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 0 426680 0 163435 0 105114 0 0 0 0 0 695229 0 104035 ELIZABETH RST CLAIR Beg21814 CHIEF LEGAL OFFICER 0 462832 0 172943 0 370490 0 0 0 0 0 1006265 0 366148 PATRICIA J WANG CHIEF EXECUTIVE OFFICER 0 892547 0 440090 0 264463 0 0 0 0 0 1597100 0 260107 MARYBETH A TITA SVP-CORP. FINANCE 0 437159 0 165923 0 66651 0 0 0 0 0 669733 0 65350 DANIEL P MCCARTHY PRESIDENT&COO 0 624390 0 267278 0 92693 0 0 0 0 0 984361 0 88889 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUI 0 346704 0 121999 0 1860 0 0 0 0 0 470563 0 0 IAN SHAFFER EXEC MED DIR BEHAV HEALTH 0 337137 0 48401 0 6527 0 0 0 0 0 392065 0 0 SEAN M NATARO DEPUTY GENERAL COUNSEL 0 283041 0 98207 0 1214 0 0 0 0 0 382462 0 0 REBECCA SCHWIETZ SVP CLINICAL SERVICES 0 303974 0 72413 0 422 0 0 0 0 0 376809 0 0 THOMAS E MEIXNER VP FINANCIAL ANALYSIS 0 301313 0 70583 0 1657 0 0 0 0 0 373553 0 0 MICHAEL FEDYNA CFO 0 216185 0 0 0 1871 0 0 0 0 0 218056 0 0 NAHUM KIANOVSKY End 21814 VP/ASSOC GEN COUNSEL II 0 219283 0 82497 0 330 0 0 0 0 0 302110 0 0 ANDREA C FORINO SVP HUMAN RESOURCES TERM-9/13 0 0 0 31401 0 315553 0 0 0 0 0 346954 0 0 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUAL ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. ANDREA FORINO TOTAL OF SEVERANCE AGREEMENT IN 2013: $442,771 SEVERANCE PAID IN 2013: $85,148 SEVERANCE PAID IN 2014: $295,181 SEVERANCE DEFERRED: $62,442 SCHEDULE J, PART 1, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS FROM THE PLAN SPONSOR FOR 2014: PATRICIA J. WANG $314,732. [Col. C] DANIEL P. McCARTHY $153,004. [Col. C] ELIZABETH R. ST CLAIR $108,327. [Col. C] JAY A. SCHECHTMAN $77,409 [Col. C] MARYBETH A. TITA $98,433. [Col. C] PAUL PORTSMORE $53,398. [Col. C] REBECCA SCHWIETZ $15,036 [Col. C]. HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 204058697 MANAGEMENT AND ADMIN SERVICES false HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 14472116 NOTES PAYABLE OUTSTANDING false HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 46000000 PHARMACY RECEIVABLE ASSIGNMENT false FORM 990, PART VI, SECTION A, LINE 3 MANAGED HEALTH INC. CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS)-A RELATED ORGANIZATION-TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE; THESE ARE PROVIDED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUMS ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY STATE REGULATORS. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR HFMS, A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM MANAGED HEALTH INC. FORM 990, PART VI, SECTION A, LINE 6 MANAGED HEALTH, INC. HAS A SOLE CORPORATE MEMBER, WHICH IS HEALTHFIRST, INC. FORM 990, PART VI, SECTION A, LINE 7A HEALTHFIRST, INC., A RELATED NOT-FOR-PROFIT ORGANIZATION, HAS THE RIGHT TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS OF MANAGED HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY OTHER ENTITIES: * REPAYMENT OF THE ORGANIZATION'S DEBT OBLIGATIONS REQUIRES STATE REGULATORY APPROVAL * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS REQUIRES STATE REGULATORY APPROVAL * CERTAIN CHANGES TO PREMIUM RATES ARE SUBJECT TO FEDERAL OR STATE REGULATORY APPROVAL * EXPANSION TO OTHER MANAGED CARE BUSINESSES REQUIRES STATE LICENSURE * MANAGEMENT FEE RATE CHANGES REQUIRE APPROVAL FROM THE MANAGEMENT COMPANY AND STATE REGULATORS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS TREASURER AND VICE PRESIDENT CONTROLLER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS CHIEF LEGAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS GIVEN A COPY OF THE DISCLOSURE STATEMENT TO COMPLETE ON AN ANNUAL BASIS. A MEMBER WHO DOES NOT COMPLETE THE STATEMENT IS NOT ALLOWED TO ATTEND BOARD MEETINGS AND MAY BE REMOVED FROM THE BOARD. AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE STATEMENT WILL BE DISCIPLINED, UP TO TERMINATION FROM THE POSITION. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. A REPORT OF ANY CONFLICTS IS PREPARED FOR DISCUSSION WITH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC., THE NOT FOR PROFIT CORPORATE PARENT, AS WELL AS THE FULL BOARD OF DIRECTORS OF MANAGED HEALTH, INC. AS APPROPRIATE, ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION MAKING, MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICERS OR EMPLOYEES, THE ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO MHI.(A RELATED ORGANIZATION). THE COMMITTEE CONSISTS SOLELY OF INDEPENDENT DIRECTORS. THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEES CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XI, LINE 9 CHANGE IN NET ASSETS - RELEASES FROM FINANCIAL SECURITY DEPOSITS FOR MEMBER HOSPITALS: $(120,057) RETAINED HOSPITAL PAYMENTS: $19,658,292 EQUITY TRANSFER FROM AFFILIATE (NHP): $15,000,000 TOTALING $34,538,235. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC. (A RELATED ORGANIZATION). HEALTHFIRST PHSP INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133783732 MANAGED CARE NY 501 (C)3 9 HEALTHFIRST true HEALTHFIRST INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501 (C)3 11 Type I N/A false HEALTHFIRST HEALTH PLAN OF NJ INC 1 WASHINGTON ST STE 1405 NEWARK NJ 07102 510609967 MANAGED CARE NJ 501 (C)4 HF MGMT SVCS true SENIOR HEALTH PARTNERS INC 100 CHURCH STREET 18FL NEW YORK NY 10007 134103882 MGD LT CARE NY 501 (C)3 9 HF MGMT SVCS true NEIGHBORHOOD HEALTH PROVIDERS INC 100 CHURCH ST FL 18 NEW YORK NY 10007 943474115 MANAGED CARE NY 501 (C) 3 9 HEALTHFIRST true HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA false 0 HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY HF MGMT SVCS C CORP true HEALTHFIRST INSURANCE COMPANY INC 100 CHURCH STREET FL 18 New York NY 100072601 464545744 Insur. Provider NY NA C corp false false false false false true false true false false false false false true false false false false true true HF MANAGEMENT SERVICES LLC E 14472116 NOTES PAYABLE HF MANAGEMENT SERVICES LLC G 46000000 AGREEMENT HF MANAGEMENT SERVICES LLC M 204058697 CONTRACTED RATE HEALTHFIRST PHSP INC R 1800000 CONTRACT NEIGHBORHOOD HEALTH PROVIDERS INC (NHP) S 15000000 CONTRACT FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (1): THE AMOUNT REPRESENTS THE BALANCE OUTSTANDING, INCLUDING INTEREST ACCRUED AND UNPAID, AT DECEMBER 31, 2014. ITEM (2): MHI ENTERED INTO AN ASSIGNMENT OF PROCEEDS AGREEMENT WITH HFMS. UNDER THE TERMS OF THIS AGREEMENT, MHI CAN ASSIGN, FROM TIME TO TIME, ALL OR PARTS OF ITS RIGHTS, TITLE AND INTEREST IN THE PROCEEDS OF CERTAIN PHARMACY REBATES RECEIVABLE TO HFMS IN EXCHANGES FOR CASH OR OTHER CONSIDERATION. IN DOING SO, MHI RETAINS 95% OF THE VALUE OF THE ASSIGNED RECEIVABLE, WITH HFMS RECEIVING A 5% FEE FOR THE ASSIGNMENT. ITEM (3): THE AMOUNT REPRESENTS THE EXPENSES INCURRED AND PAID OR DUE TO THE RELATED ORGANIZATION FOR SERVICES RENDERED BASED ON CONTRACTED RATES APPROVED BY RESOLUTION OF THE BOARD OF DIRECTORS AND STATE REGULATORS. ITEM (4) : In accordance with the organization's contractual arrangements with hospitals and upon approval by the Boards of Directors of MHI, Healthfirst PHSP, Inc. (PHSP), a related organization, and Healthfirst, Inc., risk-sharing pool balances in MHI may be offset by or may be used to offset a percentage of the same hospital(s)risk-sharing pool balance in PHSP through an intercompany transfer. The current policies permit the offsetting of any deficits that may accrue for a hospital, or its affiliate institutions, with up to 100% of surpluses that may accrue. ITEM (5): During 2014, Healthfirst requested and received approval from the DOH to transfer capital reserves from NHP to MHI. The capital reserve transfer from NHP to MHI is in conjunction with the ongoing wind-down of the NHP operations.