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AFFINITY HEALTH PLAN INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
AFFINITY HEALTH PLAN INC (EIN 13-3330672)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-03
IRS object ID
201103079349301240
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-03T16:08:55-04:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN133330672EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AFFINITY HEALTH PLAN INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlAFFINameControl
Phone7187947700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12500 Halsey StreetAddressLine1
CityBronxCity
StateNYState
ZIP Code10461ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMaura BluestoneName
TitlePresidentTitle
Date Signed2011-11-03DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts877630798GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.affinityplan.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1981YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission Descriptionimprove the health of underserved populations.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees941TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year695017527ProgramServiceRevenuePriorYear
Program Service Revenue CY810725771ProgramServiceRevenueCY
Investment Income Prior Year-35713InvestmentIncomePriorYear
Investment Income Current Year2765674InvestmentIncomeCurrentYear
Other Revenue Prior Year56986OtherRevenuePriorYear
Other Revenue Current Year25091OtherRevenueCurrentYear
Total Revenue Prior Year695038800TotalRevenuePriorYear
Total Revenue Current Year813516536TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year6000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year57276378SalariesEtcPriorYear
Salaries Etc Current Year55173044SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year644031550OtherExpensePriorYear
Other Expenses Current Year754685191OtherExpensesCurrentYear
Total Expenses Prior Year701313928TotalExpensesPriorYear
Total Expenses Current Year809858235TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-6275128RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3658301RevenuesLessExpensesCY
Total Assets BOY259282550TotalAssetsBOY
Total Assets EOY256800675TotalAssetsEOY
Total Liabilities BOY123342197TotalLiabilitiesBOY
Total Liabilities EOY116555725TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY135940353NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY140244950NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMISSION OF AFFINITY HEALTH PLANS IS TO IMPROVE THE HEALTH OF UNDERSERVED POPULATIONS BY PROVIDING COMPREHENSIVE, AFFORDABLE, HIGH QUALITY HEALTH CARE COVERAGE, AND BY STRIVING, IN COLLABORATION WITH ITS PRIMARY CARE PROVIDERS, TO IMPROVE CARE SEEKING AND CARE GIVING.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense579240193Expense
Grants0Grants
Revenue644802193Revenue
DescriptionAFFINITY HEALTH PLAN'S MEDICAID PROGRAM IS FUNDED BY THE STATE OF NY TO MANAGE THE HEALTHCARE AND RELATED COSTS OF MEDICAID PATIENTS IN NEW YORK CITY AND THE SURROUNDING COUNTIES OF NASSAU, SUFFOLK, WESTCHESTER, ROCKLAND AND ORANGE COUNTY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense74589649Expense
Grants0Grants
Revenue80580928Revenue
DescriptionTHE FAMILY HEALTH PLUS (FHP) PROGRAM PROVIDES HEALTH INSURANCE COVERAGE FOR LOW INCOME SINGLE ADULTS AND ADULTS WITH CHILDREN. THE FHP PROGRAM IS ADMINISTERED UNDER AGREEMENTS WITH THE NYS DEPARTMENT OF HEALTH.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense33607883Expense
Grants0Grants
Revenue46433609Revenue
DescriptionTHE CHILD HEALTH PLUS (CHP) PROGRAM IS FUNDED BY THE STATE OF NEW YORK TO PROVIDE HEALTH INSURANCE COVERAGE FOR CHILDREN THAT ARE UNDER THE AGE OF 19.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp30527584TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev38909040TotalOfOtherProgramServiceRev
Total Program Service Expense717965309TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965766NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees941NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARK CORCORANNamePerson
Telephone Number7187947700TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12500 HALSEY STREETAddressLine1
CityBRONXCity
StateNYState
ZIP Code10461ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
James Hooley
Trustee1.0X000
Yvette Walker
Trustee1.0X000
Nanette Falkenberg
Trustee1.0X000
Katherine Golar
Trustee1.0X000
Verona Greenland
Trustee1.0X000
Paloma Hernandez
Trustee1.0X000
Amy Knapp
Trustee1.0X000
Lynn Sherman
Trustee1.0X000
John Sardelis
Trustee1.0X000
Maura Bluestone
President & CEO37.5383356050074X
Mark Corcoran
EVP & Chief Financial Officer37.5277138031059X
Bob Brown
EVP & Chief Operating Officer37.51385840554X
Robert Allen
SVP - Chief Information Office37.513013107167X
Abenna Abboa-Offei
SVP - Customer & Comm. Connect37.5226911034748X
Ann Van Etten
VP - Corp. & Human Resources37.5188406030502X
Caron Cullen
VP - Compliance & Reg. Affairs37.5182862035330X
Kelbourne Ritter
VP - Marketing Sales37.5220066044986X
Dr Munish Khaneja
VP - Senior Medical Director37.5237487016629X
Joseph Karp
MD37.521012506746X
Charlie Krajacic
Controller37.5184849020707X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2379915TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation278502TotalOtherCompensation
Number Individuals GT100 K60NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Emdeon
12016 Collection Center DriveCHICAGOIL60693RETRO BILLING1356520
HERNANDO MAINTENANCE
1780 EASTBURN AVE 3CBRONXNY10457BUILDING MAINTENANCE601565
ERNST YOUNG
Bank of America - PO Box 96550CHICAGOIL60693AUDIT AND CONSULTING539488
EXPRESS SCRIPT
ONE EXPRESS WAY HQ3W01ST LOUISMO63121ADMINISTRATIVE SVCS516197
RDT
40 WEST FIRST STREETMT VERNONNY10552SECURITY217325
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionTotal Program Service RevenuesDescription
Business Code524114BusinessCode
Total Revenue Column810725771TotalRevenueColumn
Related Or Exempt Function Income810725771RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue810725771TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1567033TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,567,033ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real96294Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real80071Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real16223Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column16223TotalRevenueColumn
Exclusion$16,223ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities65232832Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities64034191Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1198641Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1198641TotalRevenueColumn
Exclusion$1,198,641ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Business Code900099BusinessCode
Total Revenue Column8868TotalRevenueColumn
Exclusion$8,868ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue8868TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column813516536TotalRevenueColumn
Related Or Exempt Function Income810725771RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,790,765ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2283438Total
Management And General2283438ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40843338Total
Management And General40843338ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1639456Total
Management And General1639456ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6531747Total
Management And General6531747ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3875065Total
Management And General3875065ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2330446Total
Management And General2330446ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total328173Total
Management And General328173ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total390756Total
Management And General390756ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total236747Total
Management And General236747ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total1118947Total
Management And General1118947ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1581850Total
Management And General1581850ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total83055Total
Management And General83055ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6073801Total
Management And General6073801ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total221424Total
Management And General221424ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total125126Total
Management And General125126ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2166153Total
Management And General2166153ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6273639Total
Management And General6273639ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total639007Total
Management And General639007ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
INPATIENT236945273236945273
OUTPATIENT137836475137836475
PHARMACY1459856514598565
PHYSICIAN PATIENT CARE224547374224547374
Other Medical104037622104037622

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total15150758Total
Management And General15150758ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total809858235Total
Program Services717965309ProgramServices
Management And General91892926ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY59186128BOY
EOY80109251EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY92670521BOY
EOY92418530EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis58742821LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec33565253LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY27810995BOY
EOY25177568EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY70025447BOY
EOY39496269EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2141721BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7447738BOY
EOY19599057EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY259282550BOY
EOY256800675EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY120571148BOY
EOY113883866EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2771049BOY
EOY2671859EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY123342197BOY
EOY116555725EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY49324096BOY
EOY34487364EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY86616257BOY
EOY105757586EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY135940353BOY
EOY140244950EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY259282550BOY
EOY256800675EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3658301ReconcilationRevenueExpenses
Reconcilation Other Changes646296ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance85672701BeginningOfYearBalance
Contributions19141329Contributions
End Of Year Balance104814030EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance71789689BeginningOfYearBalance
Contributions14354790Contributions
Other Expenditures471778OtherExpenditures
End Of Year Balance85672701EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance79076598BeginningOfYearBalance
Contributions11787917Contributions
Other Expenditures19074826OtherExpenditures
End Of Year Balance71789689EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.31500BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.68500PermanentEndowmentEOYBalance
LandLand
BuildingsBuildings

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis7962612OtherCostOrOtherBasis
Depreciation715930Depreciation
Book Value7246682BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3084426OtherCostOrOtherBasis
Depreciation887625Depreciation
Book Value2196801BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20353076OtherCostOrOtherBasis
Depreciation4618991Depreciation
Book Value15734085BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings25177568TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
ADVANCES TO PROVIDERS18445204
OTHER1153853
FieldValueIRS element (for citing)
Total Book Value Other Assets19599057TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOther LiabilitiesDescription
Amount$2,671,859Amount
FieldValueIRS element (for citing)
Total Of Amounts2671859TotalOfAmounts
Total Revenue813516536TotalRevenue
Total Expenses809858235TotalExpenses
Excess Or Deficit For Year3658301ExcessOrDeficitForYear
Net Unrealized GL On Investments646296NetUnrealizedGLOnInvestments
Total Adjustments646296TotalAdjustments
Excess Or Deficit Per FS4304597ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt814162832TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments646296NetUnrealizedGainsInvestments
Revenue Not Rptd F990646296RevenueNotRptdF990
Revenue Subtotal813516536RevenueSubtotal
Total Revenue Per Form990813516536TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt807716514TotExpensesEtcAuditedFinclStmt
Other Expenses Included-2141721OtherExpensesIncluded
Expenses Not Rptd F990-2141721ExpensesNotRptdF990
Expenses Subtotal809858235ExpensesSubtotal
Total Expenses Per Form990809858235TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PART V, LINE 4ReturnReference
ExplanationSTATUTORILY RESTRICTED NET ASSETS: NYSDOH REGULATIONS REQUIRE THE PLAN TO MAINTAIN AN ESCROW DEPOSIT OF THE GREATER OF 5% OF PROJECTED MEDICAL EXPENSES FOR THE CALENDAR YEAR OR $100,000 - $40,176,762. BOARD DESIGNATED NET ASSETS: BOARD DESIGNATED NET ASSETS CONSIST PRIMARILY OF AMOUNTS SET ASIDE BY THE BOARD OF DIRECTORS TO FUND STRATEGIC INITIATIVES - $20,762,333. SCHEDULE D, PART XIII, LINE 2D LOSS OF $2,141,721 WAS DUE TO A CHANGE IN ACCOUNTING PRINCIPLES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Maura Bluestone
37482200085340294000206740433430000
Mark Corcoran
27610600010320129850180740308197000
Abenna Abboa-Offei
22345600034550218500128980261659000
Ann Van Etten
1868220001584022604078980218908000
Caron Cullen
170630000122320224400128900218192000
Kelbourne Ritter
20814506600053210219260230600265052000
Dr Munish Khaneja
237271000216000166290254116000
Joseph Karp
21012500000630404420216871000
Charlie Krajacic
16298900021860027090179980205556000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE J, PART IIIdentifier
ExplanationKEL RITTER REACHED HIS MEMBERSHIP GROWTH GOAL FOR 2009. THE INCENTIVE WAS PAID TO HIM IN 2010. THE INCENTIVE BONUS REPRESENTED 3% OF KEL RITTER'S 2009 BASE SALARY OF $220,000. THIS WAS BASED ON THE OVERALL INCENTIVE PERFORMANCE SCORE ACHIEVED AS DEFINED IN THE INCENTIVE PROGRAM PERFORMANCE FACTORS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF OTHER PROGRAM SERVICESFORM 990, PART III, LINE 4DEFFECTIVE JANUARY 1, 2007, AFFINITY HEALTH PLAN BEGAN OFFERING THE MEDICARE ADVANTAGE COVERAGE TO ELIGIBLE INDIVIDUALS. THE MEDICARE ADVANTAGE PLAN IS ADMINISTERED UNDER AN AGREEMENT WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND INCLUDES A PRESCRIPTION DRUG BENEFIT COMPONENT UNDER PART D OF TITLE XVIII OF THE SOCIAL SECURITY ACT. THE MEDICARE ADVANTAGE PROGRAM INCLUDES AFFINITY MEDICARE ULTIMATE AND AFFINITY MEDICARE SOLUTIONS.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990FORM 990, PART VI, QUESTION 11THE FINANCIAL STAFF COMPILES THE FINANCIAL AND OTHER INFORMATION REQUIRED IN THE 990 RETURN. ERNST & YOUNG, LLP, PREPARES THE RETURN AND THE INFORMATION IS REVIEWED BY THE COMPANY'S CFO AND CONTROLLER. A FINAL COPY OF THE FORM 990 IS NOT MADE AVAILABLE TO THE ENTIRE GOVERNING BODY BEFORE FILING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, QUESTION 12C1. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO APPROPRIATE MANAGEMENT PERSONNEL, HUMAN RESOURCES OR THE CORPORATE COMPLIANCE OFFICER. 2. EMPLOYEES MUST SEEK GUIDANCE AND APPROVAL FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MAY CONSTITUTE A CONFLICT OF INTEREST. 3. MANAGEMENT, WITH PURCHASING AUTHORITY, WILL COMPLETE A RELATED PARTY QUESTIONNAIRE ANNUALLY TO IDENTIFY ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST. 4. ALL EMPLOYEES WILL COMPLETE THE COMPLIANCE CODE OF ETHICS ATTESTATION DURING INITIAL TRAINING AND AN INDEPENDENT ACKNOWLEDGMENT REGARDING THE CODE OF ETHICS THEREAFTER DURING ANNUAL TRAINING.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUNFORM 990, PART VI, QUESTION 15A AND 15BTHE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES INCLUDED REVIEW AND APPROVAL BY A COMPENSATION COMMITTEE (THE "COMMITTEE") COMPRISED OF INDEPENDENT DIRECTORS CHARGED WITH THIS RESPONSIBILITY, CONSIDERATION OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION AND DOCUMENTATION OF THE DELIBERATION AND DECISION. AFFINITY HEALTH PLAN'S COMPENSATION PROGRAM INCLUDES ESTABLISHED POLICIES FOR JOB EVALUATION USING A POINT FACTOR SYSTEM; MERIT INCREASES; AND SALARY ACTIONS ASSOCIATED WITH NEW HIRES, PROMOTIONS, TRANSFERS AND DEMOTIONS. SPECIFICALLY, FOR: A) THE CEO - COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER IS ESTABLISHED IN AN EMPLOYMENT CONTRACT WITH THE BOARD OF DIRECTORS OF AFFINITY HEALTH PLAN. THE BOARD AND THE COMMITTEE HAS ESTABLISHED COMPENSATION TERMS FOR THE CEO THAT ARE CONTAINED IN THE EMPLOYMENT CONTRACT, CONSIDERING COMPARABILITY DATA FOR CEO POSITIONS IN SIMILAR ORGANIZATIONS IN THEIR DELIBERATIONS AND DECISION MAKING. THESE DECISIONS ARE DOCUMENTED. THE COMPENSATION TERMS INCLUDE PROVISIONS FOR ANNUAL SALARY ADJUSTMENTS AND DISCRETIONARY BONUS COMPENSATION, BOTH WITH SPECIFIC CAPS DEFINED IN THE CONTRACT. B) OTHER OFFICERS AND KEY EMPLOYEES - JOBS HELD BY OTHER OFFICERS AND JOBS HELD BY KEY EMPLOYEES ARE EVALUATED USING THE POINT FACTOR JOB EVALUATION PROCESS APPLICABLE TO ALL JOBS AT AFFINITY HEALTH PLAN. BASED ON THE POINT FACTOR EVALUATION, JOBS ARE PLACED IN A SALARY GRADE. MERIT INCREASES ARE CALCULATED THROUGH A FORMULAIC APPROACH BASED DIRECTLY ON THE RESULTS OF A FORMAL YEAR END PERFORMANCE EVALUATION. THIS PROGRAM APPLIES TO ALL EMPLOYEES INCLUDING OTHER OFFICERS AND KEY EMPLOYEES. DISCRETIONARY COMPENSATION DECISIONS APPLICABLE FOR OTHER OFFICERS AND KEY EMPLOYEES, INCLUDING PROMOTIONAL SALARY ADJUSTMENTS, MARKET/EQUITY SALARY ADJUSTMENTS AND STARTING SALARIES FOR NEWLY HIRED OFFICERS AND KEY EMPLOYEES ARE MADE AFTER REVIEW OF COMPARABILITY DATA FROM PUBLISHED SOURCES FOR SIMILAR POSITIONS IN THE RELEVANT LABOR MARKET. PUBLISHED COMPARABILITY DATA UTILIZED INCLUDES INDUSTRY SPECIFIC DATA. INTERNAL DATA IS REVIEWED AS WELL WITH THE OBJECTIVE OF ENSURING INTERNAL EQUITY WITH SIMILARLY SITUATED STAFF. DISCRETIONARY COMPENSATION DECISIONS IMPACTING OTHER POSITIONS THAT ARE DEEMED TO BE "DISQUALIFIED PERSONS" UNDER THE INTERNAL REVENUE CODE (E.G., CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER) ARE MADE BY THE COMMITTEE IN ACCORDANCE WITH "INTERMEDIATE SANCTIONS SAFE HARBOR" STANDARDS.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICFORM 990, PART VI, QUESTION 19UPON REQUEST. RECONCILIATION OF NET ASSETS PART XI, LINE 5 $646,296 OF OTHER CHANGES IN NET ASSETS IS A RESULT OF NET UNREALIZED GAINS.