2013-01-30T16:06:34-06:00 2011-12-31 SANDY STORM ERNST & YOUNG LLP 111 MONUMENT CIRCLE STE 2600 INDIANAPOLIS IN 462045120 990 2011-01-01 133783732 Healthfirst PHSP Inc % MARYBETH TITA HEAL 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 MARYBETH TITA 2013-01-24 Christopher Boggs 3176817000 2011 2016-02-25 16:41:14Z PATRICIA J WANG 100 CHURCH ST FL 18 NEW YORK NY 100072601 1711477346 false X WWW.HEALTHFIRSTNY.ORG X 1994 NY TO IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS BY PROVIDING COMPREHENSIVE PREPAID HEALTHCARE COVERAGE TO MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS RECIPIENTS. 5 3 0 0 0 0 0 1373305871 1709235704 3115511 2239456 0 2186 1376421382 1711477346 0 0 0 0 0 0 0 0 0 1375258305 1728069509 1375258305 1728069509 1163077 -16592163 406633994 495534814 241537934 327250004 165096060 168284810 TO IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS BY PROVIDING COMPREHENSIVE PREPAID HEALTHCARE COVERAGE TO MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS RECIPIENTS. false false 1494315662 1514017408 MEDICAID MANAGED CARE HEALTHFIRST PHSP, INC. (PHSP) IS A LICENSED PREPAID HEALTH SERVICES PLAN THAT PROVIDES COMPREHENSIVE PREPAID HEALTH CARE COVERAGE TO MEDICAID RECIPIENTS PURSUANT TO ARTICLE 44 OF THE NEW YORK STATE PUBLIC HEALTH LAW. PHSP HAS PARTICIPATED IN NEW YORK'S MEDICAID PROGRAM SINCE OCTOBER 1994. FOR 2011 THERE WERE 424,058 MEMBERS ENROLLED IN PHSP'S MEDICAID PLAN. PHSP'S NETWORK INCLUDES 65 REGIONAL HOSPITALS THAT PROVIDE SERVICES TO MEMBERS. 139126049 140960351 FAMILY HEALTH PLUS (FHP) HEALTHFIRST PHSP, INC. (PHSP) IS A LICENSED PREPAID HEALTH SERVICES PLAN THAT PROVIDES COMPREHENSIVE PREPAID HEALTH CARE COVERAGE TO FHP RECIPIENTS PURSUANT TO ARTICLE 44 OF THE NEW YORK STATE PUBLIC HEALTH LAW. PHSP HAS PARTICIPATED IN NEW YORK'S FHP PROGRAM SINCE 1997. FOR 2011 THERE WERE 47,818 MEMBERS ENROLLED IN PHSP'S FHP PLAN. PHSP'S NETWORK INCLUDES 65 REGIONAL HOSPITALS THAT PROVIDE SERVICES TO MEMBERS. 53551892 54257945 CHILD HEALTH PLUS (CHP) HEALTHFIRST PHSP, INC. (PHSP) IS A LICENSED PREPAID HEALTH SERVICES PLAN THAT PROVIDES COMPREHENSIVE PREPAID HEALTH CARE COVERAGE TO CHP RECIPIENTS PURSUANT TO ARTICLE 44 OF THE NEW YORK STATE PUBLIC HEALTH LAW. PHSP HAS PARTICIPATED IN NEW YORK'S CHP PROGRAM SINCE 1997. FOR 2011 THERE WERE 43,539 MEMBERS ENROLLED IN PHSP'S CHP PLAN. PHSP'S NETWORK INCLUDES 65 REGIONAL HOSPITALS THAT PROVIDE SERVICES TO MEMBERS. 1686993603 true false false false false false false false false false false false false false 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 false true 9092 0 true 0 false false false false 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 MARYBETH TITA 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 JAY A SCHECHTMAN 1.0 X X 0 506932 85509 ELIZABETH R ST CLAIR 1.0 X X 484057 63664 EVELYN DEL ORBE 1.0 X STEPHEN ROSENTHAL 1.0 X DON SCANLON 1.0 X JENNIFER CADET 1.0 X MARYBETH A TITA 1.0 X 465214 64541 PATRICIA J WANG 1.0 X 1108563 219531 DANIEL P MCCARTHY 1.0 X 673189 93316 KEITH GORDON 1.0 X 387353 63166 SEAN NATARO 1.0 X 330389 14700 ANDREA C FORINO 1.0 X 312563 56873 REBECCA SCHWIETZ 1.0 X 323369 14700 JOHN CHENG 1.0 X 324973 14700 MICHAEL HONIG 1.0 X 485996 114385 STEVEN SAKOVITS 1.0 X 424227 0 0 5826825 805085 0 true true false EXPRESS SCRIPTS 21653 Network Place CHICAGO IL 606731216 PHARMACY 109865742 MONTEFIORE MEDICAL CENTER PO BOX 4296 CHURCH STREET STATION NEW YORK NY 10261 MEDICAL/HOSPITAL 71625857 BETH ISRAEL MEDICAL CENTER 207 EAST 94TH STREET NEW YORK NY 10128 MEDICAL/HOSPITAL 23673776 BRONX LEBANON HOSPITAL 1276 FULTON AVENUE BRONX NY 10456 MEDICAL/HOSPITAL 25067044 MAIMONIDES MEDICAL CENTER 948 48TH STREET BROOKLYN NY 11219 MEDICAL/HOSPITAL 33361685 587 0 MEDICAID MANAGED CARE 524114 1514017408 1514017408 FAMILY HEALTH PLUS 524114 140960351 140960351 CHILD HEALTH PLUS 524114 54257945 54257945 1709235704 2239456 2239456 0 0 0 0 0 0 OTHER 900099 2186 2186 2186 1711477346 1709235704 2241642 0 0 0 0 0 0 0 0 0 0 145528064 104466319 41061745 0 0 0 0 0 97015 82854 14161 1804551 1804551 476530 476530 9113474 9113474 0 0 0 0 0 0 0 0 0 HEALTHCARE SERVICE COSTS 1570965897 1570965897 CLAIMS PROCESSING 83978 83978 1728069509 1686993603 41075906 0 0 0 31217620 63227977 0 0 93801211 104279299 0 0 0 0 0 0 0 0 0 0 0 261437799 310759896 0 0 0 0 0 0 20177364 17267642 406633994 495534814 234250769 311144949 0 0 67174 430897 0 0 0 0 0 0 0 0 0 0 7219991 15674158 241537934 327250004 X 165096060 168284810 0 0 0 0 165096060 168284810 406633994 495534814 X -16592163 19780913 X X false true true X true true X 1038582860 1021061311 1176018993 1373305871 1709235704 6318204739 1038582860 1021061311 1176018993 1373305871 1709235704 6318204739 6318204739 8238553 4685766 4314310 3115511 2239456 22593596 8238553 4685766 4314310 3115511 2239456 22593596 1046821413 1025747077 1180333303 1376421382 1711475160 6340798335 0.99644 0.99508 0.00356 0.00492 X 0 DUE TO STATE OF NEW YORK 15674158 15674158 1711477346 1728069509 -16592163 -397084 20177997 19780913 3188750 1731258259 -397084 20177997 19780913 1711477346 1711477346 1728069509 1728069509 1728069509 1 PART XI, LINE 8 - OTHER ADJUSTMENTS RETAINED HOSPITAL PAYMENTS: 20,177,997. The health care services agreements with the Members provide that payments due to each Member, as a health care provider to PHSP Members, attributable to a specified initial period of enrollment of each enrollee, are retained by PHSP as additional capital contributions. Members may be entitled to have their retained payments repaid in the future, without interest, upon the dissolution of PHSP or similar circumstances, or with the approval of PHSP's Board of Directors, subject to any restrictions by the State of New York, as detailed in such agreement. Retained payments required to be withheld by PHSP totaled $20,177,997 2 PART XII, LINE 2D - OTHER ADJUSTMENTS RETAINED HOSPITAL PAYMENTS: 20,177,997. The health care services agreements with the Members provide that payments due to each Member, as a health care provider to PHSP Members, attributable to a specified initial period of enrollment of each enrollee, are retained by PHSP as additional capital contributions. Members may be entitled to have their retained payments repaid in the future, without interest, upon the dissolution of PHSP or similar circumstances, or with the approval of PHSP's Board of Directors, subject to any restrictions by the State of New York, as detailed in such agreement. Retained payments required to be withheld by PHSP totaled $20,177,997 true true false false false false false false false JAY A SCHECHTMAN 0 383174 0 122421 0 1337 0 85509 0 9168 0 601609 0 ELIZABETH R ST CLAIR 353522 115258 15277 63664 9058 556779 12455 MARYBETH A TITA 340269 112244 12701 64541 13358 543113 11716 PATRICIA J WANG 717447 326138 64978 219531 7998 1336092 62140 DANIEL P MCCARTHY 465257 186854 21078 93316 13962 780467 18324 KEITH GORDON 292301 80256 14796 63166 9460 459979 9030 SEAN NATARO 260032 69425 932 14700 13962 359051 ANDREA C FORINO 242648 69082 833 56873 7998 377434 REBECCA SCHWIETZ 257883 65276 210 14700 13358 351427 JOHN CHENG 248913 75000 1060 14700 13648 353321 STEVEN SAKOVITS 8080 96887 319260 0 8266 432493 MICHAEL HONIG 280254 101709 104033 114385 8982 609363 1 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUALS ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION: STEVEN SAKOVITS TOTAL OF SEVERANCE AGREEMENT IN 2010: 488,265 SEVERANCE PAID IN 2011: 319,250 SEVERANCE DEFERRED TO 2012: 169,015 2 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 2011. Patrica J. Wang 204,831. [Col. C] Daniel P. McCarthy 78,616. [Col. C] Jay A. Schechtman 70,809. [Col. C] Elizabeth R. St Clair 48,964. [Col. C] Marybeth A. Tita 49,841. [Col. C] Keith Y. Gordon 48,466. [Col. C] Andrea Forino 42,173 [Col. C] 3 SCHEDULE J, PART 1, LINE 6B A PORTION OF THE BONUS COMPENSATION RECEIVED BY OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS CONTINGENT UPON THE NET EARNINGS OF HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 145528064 MANAGEMENT AND ADMIN SERVICES false 1 FORM 990, PART VI, SECTION A, LINE 3 HEALTHFIRST PHSP, INC. (PHSP) CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS) TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. PHSP DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE; THESE ARE PROVIDED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUM ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY RESOLUTION OF THE BOARD OF DIRECTORS AND THE NY STATE DEPARTMENT OF HEALTH. 2 FORM 990, PART VI, SECTION A, LINE 6 HEALTHFIRST PHSP, INC. IS A NEW YORK STATE NOT-FOR-PROFIT MEMBERSHIP CORPORATION. HEALTHFIRST PHSP'S SOLE CORPORATE MEMBER IS HEALTHFIRST, INC. 3 FORM 990, PART VI, SECTION A, LINE 7A HEALTHFIRST PHSP, INC. (PHSP) IS A NEW YORK STATE NOT-FOR-PROFIT MEMBERSHIP CORPORATION. HEALTHFIRST PHSP'S SOLE CORPORATE MEMBER IS HEALTHFIRST, INC. HEALTHFIRST, INC. HAS THE RIGHT TO APPOINT MEMBERS TO THE BOARD OF DIRECTORS OF PHSP. 4 FORM 990, PART VI, SECTION A, LINE 7B THE AMENDMENT OF THE ORGANIZATION'S GOVERNING DOCUMENTS IS SUBJECT TO THE APPROVAL OF HEALTHFIRST, INC. SOME OF THE DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY STATE REGULATORS: * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS * CERTAIN CHANGES TO PREMIUM RATES * EXPANSION TO OTHER MANAGED CARE BUSINESSES * SPECIFIC TYPES OF CHANGES TO THE ORGANIZATION'S BENEFIT PLANS * MANAGEMENT FEE RATE CHANGES [APPROVAL IS ALSO REQUIRED FROM THE MANAGEMENT COMPANY] 5 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 DIRECTOR OF TREASURY. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS ASSISTANT VICE PRESIDENT OF FINANCE, GENERAL COUNSEL AND CHIEF FINANCIAL 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 AND THE DIRECTORS ARE GIVEN AN OPPORTUNITY TO DISCUSS THE 990 AT A MEETING. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. 6 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 HEALTHFIRST PHSP, 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. 7 FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICER OR EMPLOYEE, THE REPORTING 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 (A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY 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. 8 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. 9 FORM 990, PART VII, SECTION A ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED 40 HOURS A WEEK FOR HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION) WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NO ALLOCATION OF TIME SPENT ON INDIVIDUAL NOT FOR PROFIT ENTITIES EXISTED FOR THE PERIOD COVERED BY THIS RETURN. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM THE NOT-FOR-PROFIT ENTITY. 10 FORM 990, PART XI, LINE 5 RETAINED HOSPITAL PAYMENTS: 20,177,997. CHANGE IN UNREALIZED GAINS AND LOSSES ON INVESTMENTS: (397,084) 11 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). MANAGED HEALTH INC 100 CHURCH ST FL 18 NEW YORK NY 10007 113029569 MANAGED CARE NY 501(c)(4) HEALTHFIRST true HEALTHFIRST INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501(c)(3) 11 Type I NA 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 HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA RELATED false 0 false HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY HF MGMT SVCS C CORP HF PURCHASING SERVICES INC 100 CHURCH STREET 18FL NEW YORK NY 10007 020537865 EQUIP. LEASING N/A C CORP false false false false true false false false false false false true false false false false false true HEALTHFIRST INC E 40000000 AMT AVAILABLE HF MANAGEMENT SERVICES LLC L 145528064 CONTRACTED RATE MANAGED HEALTH INC R 5900000 CONTRACT 1 FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (1): THE AMOUNT REPRESENTS THE AVAILABLE BALANCE OF THE LINE OF CREDIT. ANY AMOUNTS DRAWN ARE GUARANTEED BY HEALTHFIRST, INC. THERE WERE NO AMOUNTS OUTSTANDING AT DECEMBER 31, 2011. ITEM (2): 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 BY STATE REGULATORS. ITEMS (3) AND (4): IN ACCORDANCE WITH THE ORGANIZATION'S CONTRACTUAL ARRANGEMENTS WITH HOSPITALS , RISK-SHARING POOL BALANCES IN PHSP MAY BE OFFSET BY OR MAY BE USED TO OFFSET A PERCENTAGE OF THE SAME HOSPITAL(S)RISK-SHARING POOL BALANCE IN MHI 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.