2013-11-15T15:45:32-06:00 2012-12-31 840795096 DALBY WENDLAND & CO PC P O BOX 430 GRAND JUNCTION CO 81502 990 2012-01-01 840614905 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED ROCK 9702447760 2775 CROSSROADS BOULEVARD GRAND JUNCTION CO 81506 PATRICK J DUNCAN 9702447760 2013-11-15 1 JESSICA M MIRACLE P01665682 9702431921 2012 2016-02-25 16:41:14Z ROCKY MOUNTAIN HEALTH PLANS STEPHEN ERKENBRACK 2775 CROSSROADS BOULEVARD GRAND JUNCTION CO 81506 452915662 0 X WWW.RMHP.ORG X 1971 CO DELIVERY OF HIGH QUALITY HEALTH CARE AND RELATED SERVICES THROUGH COMMUNITY BASED ORGANIZATIONAL STRUCTURE TO A BROAD CROSS-SECTION OF COLORADANS, FOCUSING ON PREVENTATIVE CARE, ACCESS AND QUALITY IMPROVEMENT FOR THE BENEFIT OF MEMBERS AND THE GREATER COMMUNITY. 14 10 0 0 12865 0 37327105 48673175 350144989 351745885 4752181 6443827 363464 439719 392587739 407302606 1653560 4577510 339034050 344784109 1996720 1872300 0 0 0 41876282 41831919 384560612 393065838 8027127 14236768 155063587 181909093 46148702 61313305 108914885 120595788 X DELIVERY OF HIGH QUALITY HEALTH CARE AND RELATED SERVICES THROUGH COMMUNITY BASED ORGANIZATIONAL STRUCTURE TO A BROAD CROSS-SECTION OF COLORADANS, FOCUSING ON PREVENTATIVE CARE, ACCESS AND QUALITY IMPROVEMENT FOR THE BENEFIT OF MEMBERS AND THE GREATER COMMUNITY. 0 0 91605192 114359611 EMPLOYER GROUP AND INDIVIDUAL PLANS:PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 21,000 PEOPLE ENROLLED THROUGH EMPLOYER GROUP AND INDIVIDUAL PLANS. OVER 90% OF EMPLOYER GROUPS WERE SMALL BUSINESSES. 127866622 149123066 MEDICARE PLANS:PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 24,000 MEDICARE BENEFICIARIES, OVER HALF OF WHOM RESIDE IN RURAL AREAS NOT SERVED BY ANY OTHER MANAGED CARE PLAN. MEMBERS RECEIVED BROAD ACCESS TO MEDICAL CARE AND WELLNESS PROGRAMS. 84200757 88263208 MEDICAID PLANS:PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 23,000 MEDICAID RECIPIENTS IN 7 RURAL COUNTIES, ENSURING ACCESS TO QUALITY MEDICAL CARE NOT OTHERWISE AVAILABLE. SAVED TAXPAYER DOLLARS WHILE EXCEEDING NATIONAL BENCHMARKS FOR QUALITY.EXPENSES $ 67,504,523. INCLUDING GRANTS OF $ 0. REVENUE $ 67,556,160.CHILDREN'S HEALTH PLAN PLUS:THROUGH THE MEDICAID PROGRAM, PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 12,000 NEEDY CHILDREN IN 22 RURAL COUNTIES IN WESTERN COLORADO THROUGH PARTICIPATION IN CHILDREN'S HEALTH PLAN PLUS PROGRAM. THESE CHILDREN GAINED ACCESS TO HIGH QUALITY MEDICAL CARE.EXPENSES $ 15,668,782. INCLUDING GRANTS OF $ 0. REVENUE $ 18,510,681.REGIONAL CARE COLLABORATIVE:AS PART OF AN AWARD RECEIVED FROM STATE MEDICAID PROGRAM, CREATING A REGIONAL CARE COLLABORATIVE ORGANIZATION, WHOSE GOALS ARE TO IMPROVE HEALTH OUTCOMES OF MEDICAID CLIENTS BY ADDRESSING HEALTH NEEDS AND TO CONTROL COSTS BY REDUCING INAPPROPRIATE USE OF HEALTH CARE RESOURCES, EFFORTS WILL FOCUS ON PROVIDING CARE COORDINATION AND CARE MANAGEMENT SERVICES TO MEMBERS; PROVIDING A FOCAL POINT OF CARE; ENSURING POSITIVE MEMBER AND PROVIDER EXPERIENCES; AND APPLYING STATEWIDE DATA TO SUPPORT DATA-DRIVEN QUALITY IMPROVEMENT INTERVENTIONS. THE ADMINISTRATIVE SERVICES CONTRACT COVERS 22 COUNTIES IN COLORADO AND SERVIES OVER 17,000 MEDICAID CLIENTS. EXPENSES $ 1,027,452. INCLUDING GRANTS OF $ 0. REVENUE $ 2,196,367. 42411678 42411678 GETTINGUSCOVEREDPEOPLE WITH SERIOUS HEALTH CONDITIONS WHO HAVE STRUGGLED TO FIND HEALTH INSURANCE HAVE A NEW OPTION, THANKS TO GETTINGUSCOVERED, A HEALTH PLAN THAT OPENED FOR ENROLLMENT IN COLORADO JULY 6, 2010 GETTINGUSCOVERED IS A STATEWIDE, COMPREHENSIVE HEALTH PLAN FOR PEOPLE WITH PRE-EXISTING MEDICAL CONDITIONS WHO HAVE BEEN UNINSURED FOR AT LEAST SIX MONTHS. AS COLORADO'S FEDERAL HIGH-RISK POOL, THE HEALTH PLAN WAS DEVELOPED THROUGH A PARTNERSHIP BETWEEN ROCKY MOUNTAIN HEALTH PLANS, COVERCOLORADO, THE STATE OF COLORADO AND THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. IT IS FUNDED THOUGH INDIVIDUAL PREMIUMS AND A FEDERAL FINANCIAL SUBSIDY. GETTINGUSCOVERED MEMBERS HAVE ACCESS TO A COMPREHENSIVE BENEFITS PACKAGE AND STRONG STATEWIDE NETWORK. MEMBERS CAN CHOOSE THEIR OWN DOCTOR AND GET ACCESS TO THE ROCKY MOUNTAIN HEALTH PLANS PROVIDER NETWORK, WHICH INCLUDES MORE THAN 2,500 PRIMARY CARE PHYSICIANS, 9,000 SPECIALISTS AND SPECIALTY PROVIDERS AND 99 HOSPITALS STATEWIDE. BENEFITS INCLUDE A PRESCRIPTION DRUG PLAN, COVERAGE FOR PREVENTIVE CARE, MENTAL HEALTH, MATERNITY CARE, AND MORE. CARE MANAGEMENT PROGRAMS WILL ALSO BE OFFERED.WHILE FEDERAL FUNDS WILL SUBSIDIZE THE COST OF GETTINGUSCOVERED, IT WILL ALSO BE FUNDED BY INDIVIDUAL PREMIUMS. PREMIUMS WILL BE BASED ON AN APPLICANT'S AGE, COUNTY OF RESIDENCE AND SMOKING STATUS AND WILL COST NO MORE THAN WHAT A HEALTHY INDIVIDUAL OF THE SAME AGE WOULD PAY. 6682734 4219148 6256730 COLORADO BEACON CONSORTIUMIN MAY 2010, THE COLORADO BEACON CONSORTIUM WAS AWARDED $11,878,279 TO IMPLEMENT A HEALTH INFORMATION TECHNOLOGY PILOT PROJECT IN WESTERN COLORADO. THE COLORADO BEACON CONSORTIUM IS MADE UP OF EXECUTIVE-LEVEL REPRESENTATION FROM FOUR MISSION-DRIVEN, NOT-FOR-PROFIT, WESTERN COLORADO-BASED ORGANIZATIONS, ALL OF WHICH HAVE A NATIONALLY-ACKNOWLEDGED TRACK RECORD OF COORDINATION TO ACHIEVE SUPERIOR OUTCOMES. THEY INCLUDE MESA COUNTY PHYSICIANS INDEPENDENT PRACTICE ASSOCIATION, QUALITY HEALTH NETWORK, ROCKY MOUNTAIN HEALTH PLANS AND ST. MARY'S REGIONAL MEDICAL CENTER. A REPRESENTATIVE FROM EACH ORGANIZATION SITS ON THE COLORADO BEACON CONSORTIUM'S EXECUTIVE COMMITTEE, ALONG WITH A CONSUMER REPRESENTATIVE-AT-LARGE.THE FUNDS FROM THE GRANT WILL BE USED TO ENABLE ROBUST COLLECTION OF CLINICAL DATA FROM HEALTH SYSTEMS, PROVIDERS, AND HOSPITALS IN ORDER TO IMPROVE THE QUALITY OF HEALTH CARE AND PATIENT EXPERIENCES WITH THE SYSTEM, WHILE REDUCING COSTS. THE COLORADO BEACON CONSORTIUM'S MISSION IS TO OPTIMIZE THE EFFICIENCY, QUALITY, AND PERFORMANCE OF OUR HEALTH CARE SYSTEM, AND INTEGRATE THE DELIVERY OF CARE AND USE OF CLINICAL INFORMATION TO IMPROVE COMMUNITY HEALTH. THE GEOGRAPHIC FOCUS OF THE CONSORTIUM'S ACTIVITIES INCLUDES THE COLORADO COUNTIES OF MESA, DELTA, MONTROSE, GARFIELD, GUNNISON, PITKIN, AND RIO BLANCO. 817988 358362 4766 MISCELLANEOUS PROGRAMSCOLLABORATED WITH HEALTH CARE PROVIDERS AND COMMUNITY ORGANIZATIONS TO ADDRESS IDENTIFIED NEEDS, TO SUPPORT IMPROVEMENTS IN MEDICAL MANAGEMENT AND QUALITY OF CARE, TO FUND RESEARCH, HEALTH AND ASSIST THOSE AT-RISK AND VULNERABLE IN OUR COMMUNITIES. THE VALUE OF RMHP WELLNESS EDUCATION, AND LEADERSHIP, VOLUNTEER TIME AND IN-KIND SUPPORT HAS NOT BEEN QUANTIFIED. TOTAL OTHER PROGRAM SERVICES:EXPENSES $ 49,912,400. INCLUDING GRANTS OF $ 4,577,510. REVENUE $ 48,673,174. 49912400 4577510 48673174 353584971 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1 3171 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 X 14 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICK J DUNCAN CFO 9702447760 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 EUGENE CHRISTIAN LAUNER 5.00 X X 9100 0 0 MICHAEL WAYNE BLACKBURN 5.00 X X 13500 0 0 CORINNE MARIE JOHNSON 5.00 X X 400 0 0 DENNIS LEE STAHL 5.00 X 3500 0 0 PAMELA PATRICIA HANES 5.00 X 3800 0 0 DAVID WARREN TERRY DO 5.00 X 400 0 0 WILLIAM JAMES KIRVEN III 5.00 X 300 0 0 GARY DALLAS KNAUS MD 5.00 X 400 0 0 WILLIAM ALFORD KELLEY MD 5.00 X 200 0 0 ARTHUR CURTIS ROBINSON 5.00 X 3300 0 0 DIANE MARIE SCHWENKE 5.00 X 7100 0 0 JAY YOUNG WANT MD 5.00 X 5700 0 0 ROBERT GLEN WILSON 5.00 X 3300 0 0 ANNE WARHOVER 5.00 X 300 0 0 STEPHEN K ERKENBRACK 40.00 X 381000 0 210000 LAUREL D WALTERS 40.00 X 273300 0 107100 PATRICK J DUNCAN 40.00 X 296300 0 124400 JANICE L ROHR 40.00 X 171700 0 17400 MICHAEL E HUOTARI 40.00 X 231300 0 61100 NEIL J WALDRON 40.00 X 291100 0 73700 KEVIN R FITZGERALD 40.00 X 265200 0 97600 JOHN HOPKINS 20.00 X 104200 0 1100 JAMES SWAYZE 40.00 X 0 336800 95800 2065400 336800 788200 8 1 1 1 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 606731216 RX PAYMENTS 78773559 ST MARY'S HOSPITAL & MEDICAL CENTER IN PO BOX 62 GRAND JUNCTION CO 81502 MEDICAL PAYMENTS 40000079 ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORA 2775 CROSSROADS BLVD GRAND JUNCTION CO 81502 MANAGEMENT SERVICES 27546700 COLORADO WEST HEALTHCARE SYSTEM 2021 N 12TH ST GRAND JUNCTION CO 815012980 MEDICAL PAYMENTS 9379408 PRIMARY CARE PARTNERS PC PO BOX 10700 GRAND JUNCTION CO 815025517 MEDICAL PAYMENTS 7626413 250 48673175 48673175 MEDICARE/MEDICAID PMTS 524114 218776040 218776040 PREMIUMS AND CO-PAYS 524114 114169215 114169215 CHILD HEALTH PLAN 524114 18510669 18510669 OTHER PROGRAMS 524114 289961 289961 351745885 3138388 9359 3129029 302405 65511 302405 65511 0 0 0 48550579 45245140 3305439 3305439 3305439 MISCELLANEOUS INCOME 524114 439719 3506 436213 439719 407302606 351745885 12865 6870681 4577510 4577510 344784109 344784109 1872300 1872300 20848719 20848719 389172 389172 179879 179879 85817 85817 259668 259668 1049183 1049183 1098534 1098534 2050015 2050015 367904 367904 64808 64808 1975027 1975027 235382 120052 115330 OTHER BEACON PROGRAM EX 2463586 2463586 BROKER COMMISSIONS 2417819 2417819 OTHER GUSC PROGRAM EXPE 1300138 1300138 REPAIRS AND MAINTENANCE 317324 317324 6728944 339576 6389368 393065838 353584971 39480867 0 8340362 24469647 6546578 15242674 8023371 7699758 28903052 27254533 1029642 795840 32830392 18906836 13760231 13923556 87530459 84946532 370208 695360 559684 6881193 155063587 181909093 40433462 48403388 4854111 11743473 861129 1166444 46148702 61313305 X 108914885 120595788 108914885 120595788 155063587 181909093 X 14236768 444135 -3000000 X X 0 1 X 1 1 1 3105818 3105818 5436052 1625877 3810175 255397 157157 98240 24033125 17123802 6909323 13923556 CONTINGENCY RESERVE 1166444 1166444 1 ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841424932 501(C)(3) 113209 CONTRIBUTIONS SUPPORT VARIOUS INITIATIVES INCLUDING, BUT NOT LIMITED TO, FUNDS TO SUPPORT INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE, AN INNOVATIVE MEDICAL RESEARCH PROGRAM TO STUDY CONCUSSION TREATMENT AND THE "BABY AND ME - TOBACCO FREE" PROGRAM RUN BY THE FOUNDATION THAT HELPS KEEP WOMEN FROM SMOKING DURING AND AFTER PREGNANCY. MARILLAC CLINIC 2333 N 6TH STREET GRAND JUNCTION CO 81501 841085822 501(C)(3) 30000 CONTRIBUTIONS SUPPORT VARIOUS INTITIATIVES INCLUDING, BUT NOT LIMITED TO, ACCESS FOR PROPER DENTAL CARE FOR PREGNANT WOMEN WHO ARE EITHER UNDERINSURED OR UNINSURED WHICH HELPS TO PREVENT PREMATURE BIRTHS AND LOW BIRTH RATES. QUALITY HEALTH NETWORK 2764 COMPASS DR GRAND JUNCTION CO 81506 201632384 501(C)(3) 4279148 QHN HAS DEVELOPED AN ELECTRONIC HEALTH INFORMATION EXCHANGE THAT PROVIDES A SECURE INFRASTRUCTURE AND ELECTRONIC TOOLS TO AREA PROVIDERS WHICH PROMOTE AND ENABLE SHARING OF CLINICAL INFORMATION AT THE POINT OF CARE. PARTICIPANTS INCLUDE HEALTHCARE ORGANIZATIONS, WITH A FOCUS ON NON-PROFIT HOSPITALS, PUBLIC HEALTH, SAFETY NET CLINICS, HOME HEALTH AGENCIES, EXTENDED CARE FACILITIES, URGENT CARE CENTERS, SURGICAL CENTERS, BEHAVIOR HEALTH PROVIDERS, PHARMACIES, AMBULATORY PHYSICIAN PRACTICES, AND OTHER AGENCIES. QHN'S MISSION IS TO IMPROVE THE HEALTH OF AREA RESIDENTS BY IMPROVING TREATING CLINICIANS' ACCESS TO INFORMATION, IMPROVE EFFICIENCES AND ELIMINATE REDUNDANCIES, AND IMPROVE THE SATISFACTION OF PATIENTS AND PROVIDERS WITH THE HEALTHCARE DELIVERY SYSTEM. QHN WAS FORMED THROUGH THE COLLABORATION AND CONTRIBUTIONS BY AND BETWEEN RMHMO AND LOCAL AREA PHYSICIANS AND HOSPITALS. THE CONTRIBUTION PROVIDES FOR THE ON-GOING FINANCIAL SUPPORT OF THE ORGANIZATION AND ITS MISSION. HILLTOP COMMUNITY RESOURCES 1331 HERMOSA AVE GRAND JUNCTION CO 81506 742321009 501(C)(3) 86000 CONTRIBUTION HELPS SUPPORT THE WESTERN SLOPE OUTREACH AND ENROLLMENT PROGRAM (B4 BABIES AND BEYOND) THAT PROMOTES HEALTHY WOMEN AND CHILDREN BY PROVIDING EARLY ACCESS TO PRENATAL HEALTH CARE. COLORADO MESA UNIVERSITY FOUNDATION 1450 NORTH 12TH STREET GRAND JUNCTION CO 81501 846037667 501(C)(3) 40000 PROVIDED GRANT FUNDING TO EXPAND THE COLLEGE'S NURSING PROGRAM IN AN EFFORT TO INCREASE ENROLLMENT RESULTING IN A HIGHER AVAILABILITY OF LICENSED NURSES. HOSPICE & PALLIATIVE CARE OF WESTERN COLORADO PO BOX 60307 GRAND JUNCTION CO 81506 841207388 501(C)(3) 25000 HOSPICE IS BASED UPON A PHILOSOPHY OF COMPASSION, COMFORT, PERSONAL CHOICE, AND MOST IMPORTANTLY, HOPE. HOSPICE & PALLIATIVE CARE OF WESTERN COLORADO OFFERS MANY PROGRAMS AND SERVICES TO HELP PATIENTS, FAMILIES, AND THE COMMUNITIES THEY SERVE UNDERSTAND AND COPE WITH THE MULTIPLE ISSUES THAT ARISE WHEN FACING ILLNESS, GRIEF, AND THE END OF LIFE. 6 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE REVIEWS IN DETAIL THE UNDERLYING MERIT OF AN ORGANIZATION'S REQUEST PRIOR TO GRANTING FUNDS. THE BOARD, ITS COMMITTEES AND/OR MANAGEMENT ALSO MONITOR AND INQUIRE ON THE UNDERLYING PROGRAM AS A WHOLE. X X X 0 1 0 0 0 0 0 0 0 STEPHEN K ERKENBRACK 381000 0 0 0 0 0 194500 0 15500 0 591000 0 0 0 LAUREL D WALTERS 227800 0 45500 0 0 0 89700 0 17400 0 380400 0 0 0 PATRICK J DUNCAN 250700 0 45600 0 0 0 112700 0 11700 0 420700 0 0 0 JANICE L ROHR 144900 0 26800 0 0 0 4300 0 13100 0 189100 0 0 0 MICHAEL E HUOTARI 199900 0 31400 0 0 0 45600 0 15500 0 292400 0 0 0 NEIL J WALDRON 245400 0 45700 0 0 0 54600 0 19100 0 364800 0 0 0 KEVIN R FITZGERALD 228800 0 36400 0 0 0 76100 0 21500 0 362800 0 0 0 JOHN HOPKINS 0 0 0 0 104200 0 0 0 1100 0 105300 0 103000 0 JAMES SWAYZE 0 266900 0 69900 0 0 0 88100 0 7700 0 432600 0 0 SUPPLEMENTAL INFORMATION PART III PART I, 4B. JAMES SWAYZE PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN WITH CNIC, A RELATED ORGANIZATION. NO AMOUNTS HAVE BEEN PAID TO OR RECEIVED BY JAMES SWAYZE FROM THIS PLAN. PART II. EXCEPT FOR JAMES SWAYZE, ALL THE COMPENSATION INCLUDED ON SCHEDULE J IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC). HMC IS AN UNRELATED ORGANIZATION WITH WHOM ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) HAS A CONTRACT FOR MANAGEMENT SERVICES. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ORGANIZATION TO RMHMO AND IS LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J (EXCEPT JAMES SWAYZE) IS 100% OF THE COMPENSATION PAID BY HMC TO THESE INDIVIDUALS. HOWEVER, APPROXIMATELY 70% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 30% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. JAMES SWAYZE'S COMPENSATION (INCLUDING AMOUNTS REPORTED UNDER DEFERRED COMPENSATION) IS INCURRED BY CNIC HEALTH SOLUTIONS, INC. (CNIC). CNIC IS A WHOLLY-OWNED SUBSIDIARY OF RMHMO AND THEREFORE A RELATED ORGANIZATION. MR. SWAYZE IS THE CEO AND PRESIDENT OF CNIC AND DEDICATES SUBSTANTIALLY ALL HIS EFFORTS TO THE DAY-TO-DAY OPERATIONS OF CNIC. DAVID WARREN TERRY DO BOARD SECRETARY 99709 MEDICAL PROVIDER PAYMENTS 0 WILLIAM A KELLEY MD BOARD MEMBER 74993 MEDICAL PROVIDER PAYMENTS 0 GARY KNAUS MD BOARD MEMBER 11185 MEDICAL PROVIDER PAYMENTS 0 ROCKY MOUNTAIN HEALTH MANAGEMENT CO ENTITY OWNED >35% BUT NOT >50% BY CURRENT OR FORMER OFFICERS AND DIRECTORS 27546700 MANAGEMENT FEES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTS WITH ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC) TO PERFORM MANAGEMENT SERVICES OF THE ORGANIZATION. HMC IS NOT A RELATED ORGANIZATION AND HAS A SEPARATE GOVERNING BOARD. THE COMPENSATION REPORTED ON PART VII AND SCHEDULE J FOR THOSE INDIVIDUALS WHO ARE NOT DIRECTORS OF THE ORGANIZATION BUT ARE LISTED AS OFFICERS OF THE ORGANIZATION WAS PAID BY HMC. FORM 990, PART VI, SECTION B, LINE 11 THE ENTIRE 990 IS DISTRIBUTED TO EACH DIRECTOR. EACH DIRECTOR IS GIVEN THE OPPORTUNITY TO ASK QUESTIONS AND/OR PROVIDE COMMENTS PRIOR TO FILING. THE TAX RETURN IS APPROVED BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD AS PREPARED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE COMPREHENSIVE CONFLICT OF INTEREST DISCLOSURE STATEMENTS. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE MAINTAINED BY THE ORGANIZATION AND ARE REVIEWED ANNUALLY BY THE ORGANIZATION'S LEGAL COUNSEL. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE COVERED UNDER THE POLICY. BEFORE EACH BOARD MEETING, LEGAL COUNSEL, THE CHAIR OF THE BOARD, AND THE CEO REVIEW THE AGENDA AND DETERMINE IF THERE IS A CONFLICT OF INTEREST POTENTIAL FOR EACH BOARD ACTION ITEM, AND DURING EACH BOARD MEETING LEGAL COUNSEL, THE CHAIR OF THE BOARD AND THE CEO ARE PRESENT AND DO THE SAME. IF THERE IS A POTENTIAL FOR A CONFLICT, THE BOARD IS ADVISED AND THE BOARD ACTS IN ACCORDANCE WITH ITS CONFLICT OF INTEREST POLICY. IF SOMEONE HAS A CONFLICT, THAT PERSON CANNOT PARTICIPATE IN THE DELIBERATIONS OR DECISION ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS INCLUDED ARE CEO, CFO, COO, MEDICAL DIRECTOR AND VICE PRESIDENTS. COMPARABILITY DATA IS USED TO DETERMINE COMPENSATION. A THIRD PARTY COMPENSATION EXPERT REPORT CERTIFIES THE REASONABLENESS OF THE COMPENSATION AMOUNTS. THIS PROCESS WAS USED IN 2012. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST TO THE EXTENT REQUIRED BY APPLICABLE LAW. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CONTRIBUTED CAPITAL TO ROCKY MOUNTAIN HEALTHCARE OPTIONS, INC. -3,000,000. FORM 990 PART XII LINE 2C THE BOARD ASSUMES RESPONSIBILITY FOR THE AUDIT, WHICH IS DONE ON THE STATUTORY BASIS OF ACCOUNTING, AND SELECTION OF AN INDEPENDENT AUDITOR. FORM 990, PART VII, SECTION A, LINE 1A, COMPENSATION INFORMATION: EXCEPT FOR JAMES SWAYZE, ALL THE COMPENSATION INCLUDED ON SCHEDULE J IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC). HMC IS AN UNRELATED ORGANIZATION WITH WHOM ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) HAS A CONTRACT FOR MANAGEMENT SERVICES. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ORGANIZATION TO RMHMO AND IS LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J (EXCEPT JAMES SWAYZE) IS 100% OF THE COMPENSATION PAID BY HMC TO THESE INDIVIDUALS. HOWEVER, APPROXIMATELY 70% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 30% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. FORM 990, NARRATIVE STATEMENT: ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) D/B/A ROCKY MOUNTAIN HEALTH PLANS IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTH BENEFITS PROVIDER THAT HAS SERVED THE HEALTH CARE NEEDS OF COLORADANS FOR ALMOST 40 YEARS. RMHMO UNIQUELY UNDERSTANDS COLORADO'S HEALTH CARE CONSUMERS. WE PROVIDE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE ENABLING OUR MORE THAN 97,000 MEMBERS TO LIVE LONGER, HEALTHIER LIVES. RMHMO BELIEVES RECEIVING PREVENTIVE CARE IS KEY TO MAINTAINING GOOD HEALTH, WHICH IS WHY IT IS INCLUDED AS A STANDARD COMPONENT IN OUR BENEFIT PLANS. RMHMO IS KNOWN AS A STRONG AND TRUSTED LEADER IN HEALTH CARE AND IS EVER COMMITTED TO ITS COMMUNITY BENEFIT GOALS. THE ORGANIZATION IS DILIGENT AND DEVOTED TO PROVIDING INNOVATIVE, QUALITY HEALTH PLANS, IMPROVING ACCESS TO HEALTH CARE COVERAGE, AND IMPROVING THE WELL BEING OF INDIVIDUALS, FAMILIES, AND THE COMMUNITIES WE SERVE. VISION WE ARE A COST EFFECTIVE, EFFICIENTLY RUN ORGANIZATION IN THE HEALTH CARE INDUSTRY. WE ADD VALUE TO EVERYONE WE TOUCH. MISSION WE TAKE THE INITIATIVE TO IMPROVE THE LIVES OF OUR MEMBERS AND THE HEALTH OF OUR COMMUNITIES BY OFFERING INNOVATIVE HEALTH PLANS, PROVIDING EXCELLENCE IN SERVICE AND CARE OF OUR MEMBERS, AND STAYING TRUE TO OUR TRADITION OF PUTTING PEOPLE BEFORE PROFITS. VALUES WE MAKE DECISIONS BASED ON THE WELL BEING OF OUR MEMBERS. WE ARE RESPECTFUL, COMPASSIONATE, AND FAIR. WE ARE INNOVATIVE AND ACTION-ORIENTED. WE HONOR THE RIGHTS OF PHYSICIANS AND PATIENTS IN MEDICAL DECISION-MAKING. WE ARE CATALYSTS FOR CONTINUOUS QUALITY IMPROVEMENT. WE BELIEVE THAT THE QUALITY OF OUR RELATIONSHIPS SHAPES OUR FUTURE. SERVING THE UNDERSERVED CHILDREN'S HEALTH PLANS PLUS (CHP+) & CHILDREN'S HEALTH PLAN PRENATAL SERVICES RMHMO OFFERS CHP+ COVERAGE TO INDIGENT CHILDREN AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES TO PREGNANT WOMEN. IN 2012, RMHMO SERVED OVER 12,000 INDIGENT CHILDREN AND PREGNANT WOMEN UNDER THE CHP+ AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES PROGRAM THROUGHOUT 22 COLORADO COUNTIES. THE RMHMO MEDICAID AND CHP+ PROGRAMS CONTINUALLY RECEIVE THE HIGHEST APPROVAL RATING IN ALL PROGRAM CATEGORIES, INCLUDING OVERALL RATING OF HEALTH PLAN. THIS ACHIEVEMENT SIGNIFIES THE ALMOST 40 YEAR COMMITMENT ROCKY MOUNTAIN HEALTH PLANS HAS TAKEN TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE UNDERSERVED IN COLORADO. MEDICAID UNDER A MEDICAID AGREEMENT BETWEEN RMHMO AND THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, RMHMO PROVIDED COST-SAVING MEDICAL SERVICES TO NEARLY 23,000 MEDICAID RECIPIENTS IN 2012. THE COUNTIES SERVED BY RMHMO UNDER THE MEDICAID AGREEMENT ARE DELTA, MESA, MOFFAT, MONTROSE, OURAY, RIO BLANCO, AND SAN MIGUEL. UNDER THIS PROGRAM RMHMO PROVIDED ACCESS FOR MEDICAID RECIPIENTS TO NEARLY ALL PHYSICIANS (PRIMARY CARE AND SPECIALISTS) WHO PRACTICE IN THESE COUNTIES. RMHMO IS THE ONLY MANAGED CARE ORGANIZATION IN WESTERN COLORADO PROVIDING SERVICES FOR PEOPLE COVERED BY MEDICAID. AS PART OF AN AWARD RECEIVED FROM THE STATE MEDICAID PROGRAM, RMHMO HAS CREATED A REGIONAL CARE COLLABORATIVE ORGANIZATION, WHOSE GOALS ARE TO IMPROVE HEALTH OUTCOMES OF MEDICAID CLIENTS BY ADDRESSING HEALTH NEEDS AND TO CONTROL COSTS BY REDUCING INAPPROPRIATE USE OF HEALTH CARE RESOURCES. EFFORTS WILL FOCUS ON PROVIDING CARE COORDINATION AND CARE MANAGEMENT SERVICES TO MEMBERS; PROVIDING A FOCAL POINT OF CARE; ENSURING POSITIVE MEMBER AND PROVIDER EXPERIENCES; AND APPLYING STATEWIDE DATA TO SUPPORT DATA-DRIVEN QUALITY IMPROVEMENT INTERVENTIONS. THE ADMINISTRATIVE SERVICES CONTRACT COVERS 22 COUNTIES IN COLORADO AND SERVICES OVER 17,000 MEDICAID CLIENTS. ADDITIONAL COMMUNITY BENEFITS AND CHARITABLE CONTRIBUTIONS: COPAYMENT COLLECTIONS RMHMO IS THE ONLY HEALTH PLAN IN COLORADO THAT BILLS AND COLLECTS COPAYMENTS ON BEHALF OF ITS MEMBERS. THIS SERVICE ELIMINATES THE BARRIER FOR PEOPLE SEEKING AND NEEDING CARE THAT DO NOT HAVE THE MONEY TO PAY THEIR COPAYMENT AT THE TIME OF THEIR VISIT. MEMBERS AND FAMILIES ARE RELIEVED OF THIS BURDEN AS ARE PHYSICIANS WHO STRUGGLE TO COLLECT FROM PATIENTS WHO NEED CARE, BUT CAN NOT PAY AT THE TIME OF THE SERVICE. COVERCOLORADO COVERCOLORADO IS THE COLORADO INSURANCE PROGRAM THAT PROVIDES COVERAGE TO INDIVIDUALS WHO CANNOT OBTAIN INSURANCE DUE TO THEIR HEALTH CONDITION. RMHMO PROVIDES CONCURRENT HOSPITAL NURSING REVIEWS FREE OF CHARGE IN MESA COUNTY FOR INDIVIDUALS COVERED BY COVERCOLORADO. GRAND VALLEY HEALTH FAIR CONTRIBUTION AS A MAJOR SPONSOR WITH MORE THAN 100 HOURS OF LABOR CONTRIBUTED TO THE PROGRAM THAT HELPS TO PROVIDE MESA COUNTY WITH COMMUNITY HEALTH AND AWARENESS SCREENINGS. STRIVE (F/K/A MESA DEVELOPMENTAL SERVICES) CONTRIBUTION ASSISTS INDIVIDUALS, YOUNG AND OLD, WHO LIVE WITH DEVELOPMENTAL DISABILITIES TO HAVE ACCESS AND SUPPORT TO COMMUNITY SERVICES. COLORADO MESA UNIVERSITY (F/K/A MESA STATE COLLEGE) NURSING PROGRAM PROVIDE GRANT FUNDING TO EXPAND THE COLLEGE'S NURSING PROGRAM IN AN EFFORT TO INCREASE ENROLLMENT RESULTING IN A HIGHER AVAILABILITY OF LICENSED NURSES. QUALITY HEALTH NETWORK CONTRIBUTION HELPS IN THE DEVELOPMENT, IMPLEMENTATION, AND SUPPORT OF ELECTRONIC MEDICAL SERVICE DATA AND NATIONALLY RECOGNIZED FOR HELPING COORDINATE AND SUPPORT CARE FOR OVER 300,000 PATIENTS. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION, INC. CONTRIBUTION OFFERS SUPPORT TO NUMEROUS COMMUNITY PROJECTS AROUND THE STATE, SUCH AS: - HELPING INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE, - CREATING INCENTIVES FOR PREGNANT WOMEN TO STOP SMOKING, - HELPING SCHOOLS OFFER MORE PHYSICAL ACTIVITY FOR STUDENTS TO DECREASE OBESITY AND INCREASE TEST SCORES. WORKSITE WELLNESS PROGRAMS PROVIDE TOOLS, RESOURCES, AND TRAINING TO ASSIST EMPLOYERS IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THIS COMPREHENSIVE PROGRAM FOCUSES ON PROMOTING WELLNESS AND PREVENTING ILLNESS. RMHMO IS NAMED A GOLD WELL WORKPLACE BY THE WELLNESS COUNCIL OF AMERICA. RECOGNITION IS EARNED BY SUCCESSFULLY MEETING RIGOROUS HEALTH PROMOTION STANDARDS. BY EARNING THIS PRESTIGIOUS DESIGNATION, WE ARE RECOGNIZED AS ONE OF THE AMERICA'S HEALTHIEST COMPANIES. PHYSICIAN RECRUITMENT EFFORT IN 2009, RMHMO COMMITTED SIGNIFICANT FUNDING TO COORDINATE, RECRUIT, ATTRACT AND MAINTAIN ADDITIONAL PRIMARY CARE PHYSICIANS IN CERTAIN COMMUNITIES. THIS EFFORT WAS INITIATED TO ADDRESS THE PRIMARY CARE PHYSICIAN SHORTAGE AND WILL STRIVE TO ACQUIRE AND MAINTAIN A SUFFICIENT NUMBER OF QUALIFIED PHYSICIANS TO ADEQUATELY SERVE THE HEALTH CARE NEEDS OF OUR MEMBERS IN KEY AREAS. THE COMMITMENT WILL BE FUNDED THROUGH 2013. GETTINGUSCOVERED (GUSC) AS DESCRIBED IN MORE DETAIL IN SCHEDULE O, RMHMO WAS AWARDED THE COLORADO HIGH RISK POOL IN 2010. GUSC IS A STATEWIDE, COMPREHENSIVE HEALTH PLAN FOR PEOPLE WITH PRE-EXISTING MEDICAL CONDITIONS WHO HAVE BEEN UNINSURED FOR AT LEAST SIX MONTHS. AS COLORADO'S FEDERAL HIGH RISK POOL, THE HEALTH PLAN WAS DEVELOPED THROUGH A PARTNERSHIP BETWEEN RMHMO, COVERCOLORADO, THE STATE OF COLORADO AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES. IT IS FUNDED THROUGH INDIVIDUAL PREMIUMS AND A FEDERAL FINANCIAL SUBSIDY. COLORADO BEACON CONSORTIUM AS DESCRIBED IN MORE DETAIL IN SCHEDULE O, THE COLORADO BEACON CONSORTIUM WAS FORMED WITH SEVERAL ORGANIZATION IN MESA COUNTY INCLUDING RMHMO AS LEAD AND WAS AWARDED A BEACON COMMUNITY COOPERATIVE AGREEMENT THROUGH FUNDING PROVIDED BY THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009. THE PROGRAM WILL SEEK TO ADVANCE A HEALTH IT INFRASTRUCTURE THAT WILL SUPPORT EH NATIONWIDE ELECTRONIC EXCHANGE AND USE OF HEALTH INFORMATION IN A SECURE, PRIVATE AND ACCURATE MANNER. THE PROGRAM PERIOD IS APRIL 1, 2010 THROUGH MAY 31, 2013. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841424932 TO FACILITATE PHILANTHROPIC SUPPORT FOR INNOVATIVE HEALTHCARE APPROACHES. CO 501(C)(3) 7 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED 0 QUALITY HEALTH NETWORK 2764 COMPASS DRIVE GRAND JUNCTION CO 81506 201632384 DEVELOPMENT, IMPLEMENT, & SUPPORT OF THE HEALTH INFORMATION EXCHANGE. CO 501(C)(3) 11, TYPE 1 N/A 0 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841224718 OFFERS ALTERNATIVE HEALTH CARE PRODUCTS IN THE AREA SERVICED BY RMHMO. CO ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED C 205638865 53441605 1.00000 1 CNIC HEALTH SOLUTIONS INC 6251 GREENWOOD PLAZA BLVD STE 300 GREENWOOD VILLAGE CO 80111 710873411 PROVIDES ADMIN SVCS FOR MEDICAL, DENTAL, AND CONSUMER DRIVEN HEALTH PLANS. CO ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED C 16234709 3011757 1.00000 1 LEIF ASSOCIATES INC 1515 ARAPAHOE ST STE 530 TOWER 1 DENVER CO 80202 841324324 PROVIDES ACTUARIAL AND DATA CONSULTING. CO ROCKY MOUNTAIN HEALTHCARE OPTIONS INCORPORATED C 1280978 1194668 1 0 1 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC B 3000000 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC N 302405 CNIC HEALTH SOLUTIONS INC J 74870 CNIC HEALTH SOLUTIONS INC Q 683000 QUALITY HEALTH NETWORK B 4279148 ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC B 113209 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC Q 4630000 LEIF ASSOCIATES INC M 268000 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC D 6384000