2013-08-13T14:00:48-05:00 2012-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD SUITE 1000 ATLANTA GA 30308 990 2012-01-01 050477052 Neighborhood Health Plan of Rhode Island % T CLARK PHILLIP CFO NEIG 4014596000 299 Promenade Street Suite Providence RI 02908 Thomas Clark Phillip 2013-08-13 4048748300 2012 2016-02-24 21:20:13Z T Clark Phillip CFO 299 Promenade Street Providence RI 02908 481295039 false X www.nhpri.org X 2000 RI Neighborhood Health Plan of Rhode Island, an innovative health plan in partnership with community health centers, is a catalyst for improved access and better health in Rhode Island. 15 5 265 15 0 0 0 415423037 423568151 1342194 2773938 4860 2545 416770091 426344634 2002694 902017 362327339 381293213 18803589 21366809 0 0 0 22482813 23458869 405616435 427020908 11153656 -676274 155028299 149497178 112661009 108424860 42367290 41072318 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND, AN INNOVATIVE HEALTH PLAN IN IN PARTNERSHIP WITH COMMUNITY HEALTH CENTERS, IS A CATALYST FOR IMPROVED ACCESS AND BETTER HEALTH IN RHODE ISLAND, ESPECIALLY FOR VULNERABLE POPULATIONS. false false 395301326 902017 423568151 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, 2012 the organization is responsible for providing health care services to over 91,200 members. 395301326 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 true false true false false false false false false false true false false false false false false false false false true X 1419 0 true 265 true false false false false false false false false false false X 15 5 true false true false true false false true true false false true false false false true true false X T CLARK PHILLIP CFO 4014596000 299 Promenade Street Providence RI 02908 Merrill Thomas 1.0 0.0 X Jane Hayward 1.0 0.0 X Peter Walsh 1.0 0.0 X Brenda Dowlatshahi 1.0 0.0 X Darrell Lee 1.0 0.0 X Pablo Rodriguez MD 1.0 0.0 X Patricia Martinez 1.0 0.0 X Peter Bancroft 1.0 0.0 X Doris DeLos Santos 1.0 0.0 X Raymond Lavoie 1.0 0.0 X William Hochstrasser-Walsh 1.0 0.0 X Chuck Jones 1.0 0.0 X Christopher Little 1.0 0.0 X Dennis Roy 1.0 0.0 X Michael Lichtenstein 1.0 0.0 X James Hooley 40.0 0.0 X X 46915 Jerald Fingerut MD 1.0 0.0 X 0 0 0 Mark Reynolds 40.0 0.0 X 396394 39435 Thomas Clark Phillip 40.0 0.0 X 216784 31039 Leon McTyeire Johnston 40.0 0.0 X 235000 32477 Shantha Diaz 40.0 0.0 X 191356 18665 Brenda Seagrave-Whittle 40.0 0.0 X 141397 37960 Nancy Hermiz 40.0 0.0 X 146117 20697 Michelle Lupoli 40.0 0.0 X 146001 36707 Jeffrey Meyer 40.0 0.0 X 153049 10935 Tracy Cohen 40.0 0.0 X 141144 36011 1814157 0 263926 32 false true false Rhode Island Hospital PO Box 373 PROVIDENCE RI 029010373 Healthcare Services 64596108 Argus Health Systems Inc 1300 Washington KANSAS CITY MO 64105 Healthcare Services 58570320 Beacon Health Strategies LLC 500 Unicorn Park WOBURN MA 01801 Healthcare Services 51830824 Women Infants Hospital of Rhode I 101 Dudley St PROVIDENCE RI 029052401 Healthcare Services 32906020 The Miriam Hospital PO Box 1202 PROVIDENCE RI 029011202 Healthcare Services 11461482 243 0 PREMIUMS EARNED 524114 420574069 420574069 MISCELLANEOUS REVENUE 524114 1535395 1535395 REINSURANCE RECOVERIES 524114 320836 320836 PHARMACY DIVIDENDS 524114 1137851 1137851 423568151 756428 756428 0 0 0 0 0 56967915 54950405 2017510 2017510 2017510 0 0 0 Miscellaneous Revenue 900099 2545 2545 2545 426344634 423568151 2776483 900000 900000 2017 2017 0 381293213 381293213 1417763 433262 984501 0 15564586 7982035 7582551 505472 245932 259540 2526435 884678 1641757 1352553 662679 689874 0 148135 148135 306115 306115 94750 94750 0 308410 308410 5581656 1245556 4336100 776394 20190 756204 836187 75816 760371 2489170 2489170 0 1525455 771785 753670 13890 3897 9993 0 0 81459 81459 0 267407 61305 206102 203661 203661 STATE PREMIUM TAX 8583210 8583210 TEMPORARY HELP 1288153 666719 621434 TRAINING 328206 328206 ALL OTHER EXPENSES 626611 52242 574369 427020908 395301326 31719582 0 0 0 16430375 16423246 0 0 7608304 5815086 0 0 0 0 0 0 0 0 0 0 1421122 1120579 269746 300543 130566622 125350627 0 0 0 0 0 0 153252 1607676 155028299 149497178 16599615 15154280 2000000 1066146 0 0 0 0 0 0 0 0 1000000 1000000 0 0 93061394 91204434 112661009 108424860 X 42367290 41072318 0 0 0 0 42367290 41072318 155028299 149497178 X -676274 97646 -716344 X X false true X true false X 430425 24087 51662 0 0 506174 290088053 351528454 388620353 415427897 423570696 1869235453 0 0 0 290518478 351552541 388672015 415427897 423570696 1869741627 0 0 0 1869741627 2858373 1394666 984765 1160371 756428 7154603 0 2858373 1394666 984765 1160371 756428 7154603 0 0 0 14988 14988 293376851 352947207 389671768 416588268 424327124 1876911218 0.99618 0.99426 0.00381 0.00569 X For the year ended December 31, 2010, miscellaneous income of $14,988 resulted from the receipt of legal claim settlements, unclaimed property from the state of rhode island, and a small amount of close out prescription claims. false false false false false false true 94750 false false 94750 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 two lobbying companies, Capitol City Group and Advocacy Solutions, to conduct federal and state lobbying activities to ensure that Medicaid funding is not decreased. For the year ended 12/31/12, the organization paid Capitol City Group $76,000 and Advocacy Solutions $18,750. 1421122 1120579 300543 300543 0 IBNR Liabilities 31705364 Unearned Premiums 30956452 Risk Share Gain/Liability 24242618 Premium Deficiency Reserve 4300000 91204434 430041661 -3545896 -3545896 433587557 -7242923 -7242923 426344634 430717935 7242923 7242923 423475012 3545896 3545896 427020908 Reconciliation of Revenue on AFS to Tax Return Schedule D Part XII Line 2D and Line 4B Line 2D Reclass of Reinsurance Premiums ($3,179,828) Reclass of Investment fees & Interest ($366,068) ---------- Total ($3,545,896) Line 4B Reclass of Pharmacy Dividends $1,137,851 Reclass of Reinsurance Recoveries 320,836 Relass of Risk Share Settlements ($8,701,610) ---------- Total ($7,242,923) Reconciliation of Expenses on AFS to Tax Return Schedule D Part XIII Line 2D and Line 4B Line 2D Reclass of Pharmacy Dividends ($1,137,851) Reclass of Reinsurance Recoveries (320,836) Reclass of Risk Share Settlements $8,701,610 ---------- Total $7,242,923 Line 4B Reclass of Reinsurance Premiums $3,179,828 Reclass of Investment fees & Interest $366,068 ---------- Total $3,545,896 Schedule D Part XIV There was no Fin 48 / ASC 740 foonote in the audited financial statements. true State of RI Exec Ofc of Hlth & Human Svcs 57 Howard Avenue Cranston RI 02920 056018801 HLTH & HUM SERV 900000 SUPPORT THE STATE'S ADULT DENTAL BENEFITS. 1 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants Grant recipients submit applications/proposals for capacity development or expansion of medical services based upon their internal statistics and external reviews and surveys. The applications/proposals include bench mark deliverables and payments based upon the satisfactory attainment of the goals/benchmarks. Neighborhood monitors the progress of the recipients and offers information and recomendations when required. X true true X X X X false false false false false false false true false Mark Reynolds 335158 54187 7049 9800 29635 435829 9800 Thomas Clark Phillip 195583 19241 1960 8771 22268 247823 8244 Brenda Seagrave-Whittle 130618 9978 801 5921 32039 179357 5636 Nancy Hermiz 135439 9874 804 5930 14767 166814 5678 Michelle Lupoli 135444 10267 290 6089 30618 182708 5800 Jeffrey Meyer 136846 15751 452 6217 4718 163984 0 Tracy Cohen 132143 8719 282 5166 30845 177155 0 Leon McTyeire Johnston 213140 19682 2178 9522 22955 267477 9089 Shantha Diaz 166729 6808 17819 1985 16680 210021 0 Supplemental Compensation Information Schedule J, Part I, line 1 The organization paid for temporary housing on behalf of the Chief Operating Officer while she was relocating from her previous permanent residence to Rhode Island. The amount paid on her behalf was included in her W-2 for 2012. NON-FIXED PAYMENTS SCHEDULE J, PART I, QUESTION 7 Purpose: The 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 2012 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 0 Blackstone Valley Community Health See Part V 4263245 Cap & Fee for Svce Med Paymt false Thundermist Health Center See Part V 4772778 Cap & Fee for Svce Med Paymt false Providence Community Health Center See Part V 11063332 Cap & Fee for Svce Med Paymt false Tri-Town Community Action Agency See Part V 797515 Cap & Fee for Svce Med Paymt false Rhode Island Health Center Associat See Part V 205000 Consulting Fees false East Bay Community Action Program See Part V 717749 Cap & Fee for Svce Med Paymt false WellOne Primary Medical Dental Ca See Part V 653440 Cap & Fee for Svce Med Paymt false Comprehensive Community Action See Part V 1204711 Cap & Fee for Svce Med Paymt false Wood River Health Systems See Part V 557465 Cap & Fee for Svce Med Paymt false Transactions with Interested Parties Schedule L, Part IV All of the interested parties listed in Part IV are 501(c)(3) exempt organizations and are therefore not considered interested parties by the Form 990 Schedule L instructions. However, the organization has voluntarily chosen to disclose these transactions. (1)Raymond Lavoie - Member of the Organization's Board of Directors and is Executive Director Of a CHC, Blackstone Valley Community Health Care, Inc. The Organization makes capitation and fee for service medical payments to Blackstone Valley Community Health Care, Inc. (2)Chuck Jones - Member of the Organization's Board of Directors and is CEO of a CHC, Thundermist Health Center. The Organization makes capitation and fee for service medical payments to Thundermist Health Center. (3)Merrill Thomas - Chair of the Organization's Board of Directors and is CEO of a CHC, Providence Community Health Center. The Organization makes capitation and fee for service medical payments to Providence Community Health Center. (4)Brenda Dowlatshahi - Secretary of the Organization's Board of Directors and is Associate Executive Director of a CHC, Tri-Town Economic Opportunity Committee. The Organization makes capitation and fee for service medical payments to Tri-Town Economic Opportunity Committee. (5)Jane Hayward - Vice Chair of the Organization's Board of Directors and is Executive Director of the Rhode Island Health Center Association. The Organization makes contributions toward the Association's various health center professional development programs and public awareness functions. (6)Dennis Roy - Member of the Organization's Board of Directors and CEO of a CHC, East Bay Community Action Program. The Organization makes capitation and fee for service medical payments to East Bay Community Action Program. (7)Peter Bancroft - Member of the Organization's Board of Directors and Director of a CHC, WellOne Primary Medical & Dental Care. The Organization makes capitation and fee for service medical payments to WellOne Primary Medical & Dental Care. (8)William Hochstrasser-Walsh - Member of the Organization's Board of Directors and CEO of a CHC, Comprehensive Community Action Program. The Organization makes capitation and fee for service medical payments to Comprehensive Community Action Program. (9)Michael Lichtenstein - Member of the Organization's Board of Directors and CEO of a CHC, Wood River Health Services. The Organization makes capitation and fee for service medical payments to Wood River Health Services. Description of Relationships Form 990, Part VI, Question 2 A member of the Organization's Board of Directors is an Executive Director of a Community Health Center (CHC), Blackstone Valley Community Health Care, Inc. Blackstone Valley Community Health Care, Inc., through a grant, invested in equipment and software for an Electronic Medical Record (EMR) system. Three other CHC's, East Bay, Tri-Town and Comprehensive Community Action Program, have use of the EMR and billing ssystem and WellOne uses the EMR portion of the system. The CHCs share the cost of running the system. Change in Governing Documents Form 990, Part VI, Question 4 The organization amended its bylaws in 2012 to accurately reflect the number of health centers in the state and to give each health center representation on the Board of Directors. The amended bylaws also added an additional community seat to the Board of Directors. Description of Classes of Members or Stockholders Form 990, Part VI, Question 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. Describe the Process used by Management and/or Governing Body to Review 990 Form 990, Part VI, Question 11b The Organization's Fiscal Operations department accumulates the information and data necesssary 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 Board is also provided an electronic copy of the return prior to filing with the IRS. Policies Part VI, Lines 12A, 13 & 14 Pursuant to the instructions for Form 990, the Organization must answer no the these 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 Policy Part VI Line 12C A promulgated by the Organization's compliance plan, the Organization's Director of Human Resources and Organizational Development is also the Organization's Chief Privacy Officer. 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 Chief Privacy Officer meets with the employee or member to discuss the issue in order to determine if a posssible conflict exists. IF it is determined that a conflict exists, the Chief Privacy Officer 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 conflict. Executive Compensation Form 990, Part VI, Question 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. Availability of Governing Documents, Conflict of Interest Policy, and Financial Statements to General Public Form 990, Part VI, Question 19 The governing documents, conflict of interest policy and financial statements are available to the public upon request at the Organization's location at 299 Promenade Street, Providence, RI 02908. Other Changes in Net Assets Form 990, Part XI, Question 9 Year end changes in ending balances of nonadmitted assets - ($716,344) Accounting Method Form 990, Part XII, Question 1 The organization uses the Statutory method of accounting.