UNIVERSITY OF MICHIGAN HEALTH PLAN: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY OF MICHIGAN HEALTH PLAN (EIN 38-2356288)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-14
- IRS object ID
- 201103189349305875
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-14T14:51:57-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREWS HOOPER PAVLIK PLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4295 OKEMOS RD STE 200 | AddressLine1 |
| City | OKEMOS | City |
| State | MI | State |
| ZIP Code | 488646201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382356288 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHYSICIANS HEALTH PLAN OF | BusinessNameLine1 |
| Business Name Line2 | MID-MICHIGAN | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PHYS | NameControl |
| Phone | 5173648400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 30377 | AddressLine1 |
| City | LANSING | City |
| State | MI | State |
| ZIP Code | 48909 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID VIS | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 5173648400 | Phone |
| Date Signed | 2011-11-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARK E HOOPER | Name |
| Phone | 5177060800 | Phone |
| Date Prepared | 2011-11-08 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DENNIS SWAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 E MICHIGAN AVE | AddressLine1 |
| City | LANSING | City |
| State | MI | State |
| ZIP Code | 48912 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 166680683 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.PHPMM.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1980 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | PHYSICIANS HEALTH PLAN OF MID-MICHIGAN'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, COST EFFECTIVE HEALTHCARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 123 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 180341884 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 167450023 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1471494 | InvestmentIncomePriorYear |
| Investment Income Current Year | -1696665 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -397831 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 178472559 | TotalRevenuePriorYear |
| Total Revenue Current Year | 165753358 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 158700858 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 152160107 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5548193 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6894150 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9948342 | OtherExpensePriorYear |
| Other Expenses Current Year | 7400411 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 174197393 | TotalExpensesPriorYear |
| Total Expenses Current Year | 166454668 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4275166 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -701310 | RevenuesLessExpensesCY |
| Total Assets BOY | 83514302 | TotalAssetsBOY |
| Total Assets EOY | 83088295 | TotalAssetsEOY |
| Total Liabilities BOY | 24512555 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22176834 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 59001747 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 60911461 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PHYSICIANS HEALTH PLAN OF MID-MICHIGAN'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, COST EFFECTIVE HEALTHCARE. | MissionDescription |
| Significant New Program Services | true | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 159794198 | Expense |
| Revenue | 166302865 | Revenue |
| Description | PHYSICIANS HEALTH PLAN OF MID-MICHIGAN (PHPMM) IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO). PHPMM USES A PRIMARY CARE CONCEPT FOR DELIVERING HEALTHCARE IN A HEALTH DELIVERY NETWORK (HDN) STRUCTURE. IT ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS AND THEIR QUALIFIED DEPENDENTS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER OR QUALIFIED DEPENDENT. PHYSICIANS HEALTH PLAN OF MID-MICHIGAN (PHPMM) IS OWNED BY SPARROW HEALTH SYSTEM AND HOLDS A CERTIFICATE OF AUTHORITY AS AN HMO IN THE STATE OF MICHIGAN. PHPMM CONSISTS OF A COMMERCIAL HMO CALLED PHYSICIANS HEALTH PLAN OF MID-MICHIGAN (PHPMM), A COMMERCIAL INSURANCE COMPANY (PHPMM-IC), AND A MEDICAID HEALTH PLAN THAT OPERATES THROUGH A SEPARATE CORPORATION. PHYSICIANS HEALTH PLAN OF MID-MICHIGAN FAMILYCARE (PHPMM-FC) IS ALSO A LICENSED HMO AND A WHOLLY OWNED SUBSIDIARY OF PHPMM. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHPMM. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHPMM APPLY TO PHPMM-IC, AND PHPMM-FC. PHPMM CONTRACTS WITH TRIZETTO TO PROVIDE ADMINISTRATIVE SERVICES NECESSARY FOR MEMBER PLANS' DAY-TO-DAY OPERATIONS THROUGH AN ADMINISTRATIVE SERVICES AGREEMENT. PHPMM'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, GRATIOT, IONIA, MONTCALM AND ISABELLA. PHPMM-IC OFFERS PRODUCTS ACROSS MICHIGAN. THE FAMILYCARE PRODUCT IS AVAILABLE TO MEDICAID ENROLLEES IN EATON, CLINTON, INGHAM, IONIA, MONTCALM AND SHIAWASSEE COUNTIES. AS OF DECEMBER 31, 2010, THERE WERE 35,129 ENROLLEES IN PHPMM'S COMMERCIAL HMO, 12,208 IN TPA, 2,993 IN PHP-IC, AND 18,789 ENROLLEES IN FAMILYCARE. PHPMM CONTRACTS DIRECTLY WITH 719 PRIMARY CARE PHYSICIANS, 1,269 SPECIALTY CARE PHYSICIANS, 365 ALLIED HEALTH PROFESSIONALS, AND 308 ORGANIZATIONAL PROVIDERS THAT INCLUDE 29 HOSPITALS. PHPMM CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. PHPMM'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. PHPMM'S SUCCESS IN MANAGING HEALTHCARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW PHPMM TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY PHPMM'S BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. PHPMM MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH A REFERRAL IS RECOMMENDED BY AN HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY THE HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. PHPMM OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS, TO GROUPS AND INDIVIDUALS. PHPMM OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN'S PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE PHPMM NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. PHPMM WAS ALSO RANKED AMONG THE TOP 50 OF AMERICA'S BEST HEALTH PLANS BY U.S. NEWS AND WORLD REPORT/CONSUMER REPORTS FOR THE 5TH CONSECUTIVE YEAR. NCQA USES AN ALGORITHM COMPOSED OF HEDIS, CAHPS AND ACCREDITATION SCORING TO CREATE THESE NATIONAL RANKINGS. THE GOAL OF THE QUALITY IMPROVEMENT PROGRAM IS TO CONTINUOUSLY IMPROVE HEALTH OUTCOMES AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. PHPMM PURSUES ITS GOALS THROUGH IMPLEMENTATION OF THE QUALITY IMPROVEMENT MODEL: -MEASUREMENT OF THE OUTCOMES OF CARE AND SERVICE, INCLUDING BEHAVIORAL HEALTH SERVICES. -ANALYSIS OF BARRIERS TO CARE AND SERVICE. -DEVELOPMENT AND IMPLEMENTATION OF INTERVENTIONS. -FORMAL EVALUATION OF THE EFFECTIVENESS OF THE INTERVENTIONS. PHPMM MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: -DISEASE MANAGEMENT PROGRAM PARTICIPATION. -QUALITY OF CARE CONCERNS. -HEDIS MEASURES - THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHPMM USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: -DIABETES. -ASTHMA. -DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS. -BREAST AND CERVICAL CANCER SCREENING. -USE OF BETA-BLOCKERS AFTER HEART ATTACKS. -CHILD AND ADOLESCENT IMMUNIZATIONS. -CHOLESTEROL MANAGEMENT. -CONTROLLING HIGH BLOOD PRESSURE. -SMOKING CESSATION. -PRENATAL AND POSTPARTUM CARE. -TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHPMM MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: -ACCESS AND AVAILABILITY. -ENROLLEE COMPLAINTS AND APPEALS. -CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE. -MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS' EXPECTATIONS. PHYSICIANS HEALTH PLAN OF MID-MICHIGAN RECEIVED THE HIGHEST RATING OF "EXCELLENT" FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). THIS STATUS IS GRANTED TO HEALTH CARE PLANS THAT HAVE DEMONSTRATED CONTINUOUS QUALITY IMPROVEMENT IN THEIR PROGRAMS WHILE MEETING OR EXCEEDING NCQA'S RIGOROUS ACCREDITATION STANDARDS. PHP FAMILY CARE RECEIVED A COMMENDABLE RATING. PHPMM AND PHPMM-FC WERE REVIEWED BY NCQA IN 2009. THE SERVICE EXCELLENCE PROGRAM HAS A MISSION OF: PROVIDING FOCUSED LEADERSHIP TO CREATE AND MAINTAIN A CULTURE OF WORLD CLASS CUSTOMER SATISFACTION. IN 2010 PHPMM WAS RANKED ABOVE THE 90TH PERCENTILE IN SATISFACTION WITH CUSTOMER SERVICE AND WAS THE HIGHEST RANKED HEALTH PLAN IN MICHIGAN. THIS WAS YEAR FOUR OF A HIGHLY STRUCTURED AND GOAL ORIENTED APPROACH TO MEMBER SATISFACTION AND EMPLOYEE ENGAGEMENT. THE PROGRAM IS A "TOP DOWN BOTTOM UP" APPROACH TO CHANGING THE CULTURE OF SERVICE. SERVICE EXCELLENCE ADVISORS ARE FRONT LINE STAFF TRAINED TO PRESENT A TWO HOUR CLASS TO ALL ASSOCIATES IN THE HEALTH PLAN. THE BOOK A COMPLAINT IS A GIFT BY JANELLE BARLOW WAS THE BASIS FOR THE 2010 TRAINING. -CAPITALIZING ON COMPLAINTS -HOW TO SAY NO AND REMAIN FRIENDS -BUILDING A CUSTOMER TOLERANCE ZONE -THE GIFT FORMULA OUR 2010 CAHPS SCORES FOR THE COMMERCIAL PRODUCT RESULTED IN A RANKING OF 1 IN MICHIGAN FOR CUSTOMER SERVICE AND 4 FOR THE OVERALL HEALTH PLAN RANKING. NATIONALLY, PHPMM'S COMMERCIAL PRODUCT WAS RANKED 40TH FOR OVERALL HEALTH PLAN RANKING. CUSTOMER SATISFACTION AND ASSOCIATE ENGAGEMENT ARE CLOSELY RELATED. WEBSTER DEFINES ENGAGEMENT AS "EMOTIONAL INVOLVEMENT OR COMMITMENT." EVERY CUSTOMER WANTS SOMEONE TO PARTNER WITH THEM, TO SHOW CONCERN AND BE COMMITTED TO THEIR ISSUE AT HAND. MAINTAINING AN ENGAGED WORKFORCE IS THE FOUNDATION FOR DELIVERING COMPASSIONATE AND EXCEPTIONAL SERVICE. PHPMM PARTICIPATES IN A HEALTH SYSTEM WIDE ANNUAL ASSOCIATE ENGAGEMENT SURVEY CONDUCTED BY KENEXA. THE NATIONALLY RECOGNIZED SURVEY MEASURES ELEVEN DIMENSIONS OF THE WORKFORCE AND PROVIDES REPORTS TO DEPARTMENT TEAMS. THE 2010 SURVEY REPORTED PHPMM ASSOCIATE ENGAGEMENT LEVEL IN THE 93RD PERCENTILE. FOLLOWING THE ANNUAL SURVEY, PHPMM INVITES ALL ASSOCIATES TO PARTICIPATE IN GROUP DISCUSSIONS LED BY FRONT LINE STAFF WHERE RESULTS ARE REVIEWED AND IDEAS FOR IMPROVEMENT ARE WELCOMED. TEAMS MAKE RECOMMENDATIONS, THE BEST OF WHICH ARE IMPLEMENTED. OVER THE YEARS, CHANGES HAVE OCCURRED THAT HAVE BECOME PART OF THE PHPMM WAY OF DOING BUSINESS. SOME OF THOSE INCLUDE: CROSS FUNCTIONAL COMMUNICATION TEAMS, MONTHLY ALL STAFF MEETING UPDATES, ENHANCED ON-LINE ACCESS TO INFORMATION, NEW APPROACHES TO TRAINING, IMPROVED REFERENCE RESOURCES AND MANY MORE. COMMITMENT AND INVOLVEMENT DESCRIBE OUR EXPECTATION FOR STAFF. MAINTAINING A HIGH LEVEL OF ASSOCIATE ENGAGEMENT IS A VERY IMPORTANT PART OF PHPMM'S DEDICATED EFFORT TO PROVIDE OUTSTANDING SERVICE AND TO ACHIEVE NATIONAL RANKINGS IN OVERALL CUSTOMER SATISFACTION. PROCESS IMPROVEMENTS DESIGNED TO ENSURE THAT PHPMM MAXIMIZED THE AUTOMATED CAPABILITIES OF ITS CLAIMS PAYMENT SYSTEM WERE THE FOCUS FOR THE INFORMATION TECHNOLOGY DEPARTMENT. AS A RESULT OF THESE EFFORTS, PHPMM EXPERIENCED EXCELLENT ELECTRONIC DATA INTERCHANGE (EDI) AND AUTO-ADJUDICATION RATES AS WELL AS A REDUCTION IN CLAIM TURNAROUND TIME. PHPMM ENDED 2010 WITH AN AUTO ADJUDICATION RATE OF 76%, AND AN EDI RATE OF 92%. DAYS RECEIPT ON HAND OF CLAIMS WAS REDUCED FROM 2.4 TO 1.96. MAJOR INITIATIVES: -COMPLETED IMPLEMENTATION OF MENTAL HEALTH PARITY LEGISLATION. -DETERMINED PRODUCT DIRECTION NECESSARY TO SUPPORT HEALTH CARE REFORM LEGISLATION. -IN-SOURCED OUR ID CARD GENERATION PROCESS, RESULTING IN FEWER ERRORS AND MORE FLEXIBILITY IN CARD DESIGN. -BEGAN UPGRADE OF CORE SYSTEM AND WEB PRESENCE TO INCREASE INFORMATION SHARING AND IMPROVE CONSTITUENT EXPERIENCES. -IMPLEMENTED WRAP PRODUCTS TO SUP | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1147158 | Expense |
| Revenue | 1147158 | Revenue |
| Description | PHP OF MID-MICHIGAN ESTABLISHED AND OPERATES A TEMPORARY HIGH RISK HEALTH INSURANCE POOL PROGRAM (PHPMM-HRPP) IN MICHIGAN TO PROVIDE AFFORDABLE HEALTH INSURANCE COVERAGE TO CURRENTLY UNINSURED INDIVIDUALS WITH PRE-EXISTING CONDITIONS. IT IS PART OF A FEDERAL PROGRAM ESTABLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) IN RESPONSE TO THE AFFORDABLE CARE ACT. THE PROGRAM PROVIDES COVERAGE FOR ELIGIBLE INDIVIDUALS BEGINNING OCTOBER 1, 2010, THROUGH AND ENDING DECEMBER 31, 2013. AS OF DECEMBER 31, 2010, THERE WERE 92 MEMBERS ENROLLED IN THE PROGRAM. PHP OF MID-MICHIGAN HAS MANY INITIATIVES IN PLACE TO GROW MEMBERSHIP AND HAS SEEN SIGNIFICANT INCREASES SUBSEQUENT TO YEAR END. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 160941356 | TotalProgramServiceExpense |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | true | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 151 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 123 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID VIS | NamePerson |
| Telephone Number | 5173648400 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 E MICHIGAN AVE | AddressLine1 |
| City | LANSING | City |
| State | MI | State |
| ZIP Code | 48909 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| DENNIS SWAN | |||||||||
| PRES/CEO - S | 1.00 | X | X | 0 | 1063298 | 30471 | |||
| SCOTT WILKERSON | |||||||||
| PRESIDENT/CE | 25.00 | X | X | 0 | 438165 | 32408 | |||
| LARRY RAWSTHORNE MD | |||||||||
| DIRECTOR | 1.00 | X | 0 | 411455 | 31251 | ||||
| MARYLEE DAVIS PHD | |||||||||
| CHAIR/DIRECT | 1.00 | X | 0 | 0 | 0 | ||||
| RANDOLPH RIFKIN | |||||||||
| SECRETARY/DI | 1.00 | X | 0 | 0 | 0 | ||||
| PATRICK GRIBBEN JR | |||||||||
| TREASURER/DI | 1.00 | X | 0 | 0 | 0 | ||||
| WENDELL BARRON | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MARTHA BIBBS | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD BRUNER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| DIANA RODRIGUEZ ALGRA | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| DAWN SPRINGER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| PAULA REICHLE | |||||||||
| VP/CFO - SHS | 1.00 | X | 0 | 415453 | 23739 | ||||
| DAVID VIS | |||||||||
| VP FINANCE/A | 30.00 | X | 0 | 220692 | 16020 | ||||
| HOWARD BURGESS | |||||||||
| EXECUTIVE ME | 30.00 | 0 | 299358 | 30912 | X | ||||
| CRAIG LESLIE | |||||||||
| VP SALES & M | 30.00 | 0 | 209246 | 0 | X | ||||
| JULIA GRIFFITH | |||||||||
| DIR MED RESO | 30.00 | 0 | 146652 | 18497 | X | ||||
| SANDRA WINCHELL | |||||||||
| VP NEW PROGR | 30.00 | 0 | 137450 | 22722 | X | ||||
| MARY ANNE SESTI | |||||||||
| DIR GOVT PRO | 5.00 | 0 | 129549 | 22114 | X | ||||
| ANN HUNT-FUGATE RPH | |||||||||
| MGR CLINICAL | 30.00 | 124778 | 0 | 23152 | X | ||||
| KEVIN ESSENMACHER | |||||||||
| CONTROLLER | 30.00 | 0 | 121826 | 15569 | X | ||||
| PETER GRAHAM MD | |||||||||
| FORMER DIREC | 0.00 | 0 | 313894 | 32401 | X | ||||
| THOMAS OSTRANDER | |||||||||
| FORMER DIREC | 0.00 | 0 | 289344 | 34745 | X | ||||
| GARY REETZ | |||||||||
| FORMER DIREC | 0.00 | 0 | 212575 | 20009 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 124778 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4408957 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 354010 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MILLIMAN INC | |||||
| 15800 BLUEMOUND DR STE 400 | BROOKFIELD | WI | 53005 | ACTUARIAL/CONS | 809050 |
| DNH MEDICAL MANAGEMENT INC | |||||
| 100 N SEPULVEDA BLVD STE 600 | EL SEGUNDO | CA | 90245 | PROFESSIONAL | 249962 |
| LESLEY CONSULTING SVC LLC | |||||
| PO BOX 2301 | BRIGHTON | MI | 48116 | SALES/MARKETING | 209246 |
| ERNST & YOUNG LLP | |||||
| PO BOX 96550 | CHICAGO | IL | 60693 | AUDITING/TAX | 194133 |
| INGENIX INC | |||||
| 2771 MOMENTUM PL | CHICAGO | IL | 60689 | PROFESSIONAL | 157017 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PREPAID HEALTHCARE | 621990 | 166364681 | 166364681 |
| HHS HRPP REIMBURSEMENT | 621990 | 1085342 | 1085342 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 167450023 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1790941 | TotalRevenueColumn |
| Related Or Exempt Function Income | -2092773 | RelatedOrExemptFunctionIncome |
| Exclusion | $301,832 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1021601 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 927325 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 94276 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 94276 | TotalRevenueColumn |
| Exclusion | $94,276 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 165753358 | TotalRevenueColumn |
| Related Or Exempt Function Income | 165357250 | RelatedOrExemptFunctionIncome |
| Exclusion | $396,108 | ExclusionAmount |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152160107 | Total |
| Program Services | 152160107 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1139148 | Total |
| Management And General | 1139148 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3559419 | Total |
| Program Services | 2602567 | ProgramServices |
| Management And General | 956852 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 586898 | Total |
| Program Services | 528208 | ProgramServices |
| Management And General | 58690 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1160311 | Total |
| Program Services | 1044280 | ProgramServices |
| Management And General | 116031 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 448374 | Total |
| Program Services | 403537 | ProgramServices |
| Management And General | 44837 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1579480 | Total |
| Management And General | 1579480 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135144 | Total |
| Program Services | 128387 | ProgramServices |
| Management And General | 6757 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110079 | Total |
| Program Services | 110079 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5321 | Total |
| Management And General | 5321 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 287689 | Total |
| Program Services | 163922 | ProgramServices |
| Management And General | 123767 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 807278 | Total |
| Program Services | 250754 | ProgramServices |
| Management And General | 556524 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 225048 | Total |
| Program Services | 24755 | ProgramServices |
| Management And General | 200293 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 361987 | Total |
| Program Services | 307689 | ProgramServices |
| Management And General | 54298 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 197360 | Total |
| Management And General | 197360 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77827 | Total |
| Management And General | 77827 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24773 | Total |
| Management And General | 24773 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11775 | Total |
| Management And General | 11775 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1197623 | Total |
| Program Services | 1197623 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86898 | Total |
| Program Services | 86898 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BROKER COMMISSONS | 1712164 | 1712164 | |
| MISCELLANEOUS | 579965 | 220386 | 359579 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166454668 | Total |
| Program Services | 160941356 | ProgramServices |
| Management And General | 5513312 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33479503 | BOY |
| EOY | 31220009 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3567613 | BOY |
| EOY | 4668159 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 388656 | BOY |
| EOY | 634726 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 20703444 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12815235 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10016881 | BOY |
| EOY | 7888209 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19600575 | BOY |
| EOY | 22607161 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15099787 | BOY |
| EOY | 13007014 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1361287 | BOY |
| EOY | 3063017 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83514302 | BOY |
| EOY | 83088295 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21810947 | BOY |
| EOY | 17605093 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1638645 | BOY |
| EOY | 1687923 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1062963 | BOY |
| EOY | 2883818 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24512555 | BOY |
| EOY | 22176834 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59001747 | BOY |
| EOY | 60911461 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59001747 | BOY |
| EOY | 60911461 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83514302 | BOY |
| EOY | 83088295 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -701310 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2611024 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1550687 | BeginningOfYearBalance |
| Contributions | 163793 | Contributions |
| Investment Earnings Or Losses | 65279 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1779759 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1307182 | BeginningOfYearBalance |
| Contributions | 134195 | Contributions |
| Investment Earnings Or Losses | 109310 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1550687 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 455895 | OtherCostOrOtherBasis |
| Book Value | 455895 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4347272 | OtherCostOrOtherBasis |
| Depreciation | 2746681 | Depreciation |
| Book Value | 1600591 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15885277 | OtherCostOrOtherBasis |
| Depreciation | 10064983 | Depreciation |
| Book Value | 5820294 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15000 | OtherCostOrOtherBasis |
| Depreciation | 3571 | Depreciation |
| Book Value | 11429 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7888209 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT IN PHPMM INS CO | 8909143 | C |
| INVESTMENT IN PHPMM FAMILY CARE | 6641020 | C |
| INVESTMENT IN PHP SHARED SVCS | -58497 | C |
| INVESTMENT IN PHPMM TPA | -2484652 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 13007014 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RELATED PARTY PAYABLE | Description |
| Amount | $2,883,818 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2883818 | TotalOfAmounts |
| Total Revenue | 165753358 | TotalRevenue |
| Total Expenses | 166454668 | TotalExpenses |
| Excess Or Deficit For Year | -701310 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2611024 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 2611024 | TotalAdjustments |
| Excess Or Deficit Per FS | 1909714 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 168364382 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2611024 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 2611024 | RevenueNotRptdF990 |
| Revenue Subtotal | 165753358 | RevenueSubtotal |
| Total Revenue Per Form990 | 165753358 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 166454668 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 166454668 | ExpensesSubtotal |
| Total Expenses Per Form990 | 166454668 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| INTENDED USES FOR ENDOWMENT FUNDS | SCHEDULE D, PAGE 2, PART V, LINE 4 | PHP OF MID-MICHIGAN DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW FOUNDATION. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF BOTH PHP OF MID-MICHIGAN AND SPARROW FOUNDATION. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME, WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE OF ESTABLISHMENT BY THE ENDOWMENT. |
| SUPPLEMENTAL FINANCIAL INFORMATION | SCHEDULE D, PAGE 4, PART XIV | SCH D - PART XI SEPARATE AUDITED FINANCIAL STATEMENTS WERE PREPARED FOR PHP OF MID-MICHIGAN UNDER STATUTORY ACCOUNTING PRINCIPLES AS PERMITTED BY THE MICHIGAN OFFICE OF FINANCIAL AND INSURANCE REGULATION (OFIR). THE OFIR REQUIRES THAT INSURANCE COMPANIES DOMICILED IN THE STATE OF MICHIGAN PREPARE THEIR STATUTORY-BASIS FINANCIAL STATEMENTS IN ACCORDANCE WITH THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS. THESE PRACTICES DIFFER IN SOME RESPECTS FROM U.S. GENERALLY ACCEPTED ACCOUNTING PRACTICES. CERTAIN ADJUSTMENTS ARE REQUIRED TO COMPLY WITH STATUTORY ACCOUNTING PRINCIPLES. PHP OF MID-MICHIGAN WAS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SPARROW HEALTH SYSTEM, THE SOLE MEMBER OF PHP OF MID-MICHIGAN. THE SPARROW HEALTH SYSTEM FINANCIAL STATEMENTS WERE PREPARED USING THE U.S. GENERALLY ACCEPTED ACCOUNTING PRACTICES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | true | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|
| DENNIS SWAN | |||||
| 726090 | 307354 | 29854 | 18130 | 12341 | 1093769 |
| SCOTT WILKERSON | |||||
| 329439 | 106745 | 1981 | 18130 | 14278 | 470573 |
| LARRY RAWSTHORNE MD | |||||
| 349730 | 58218 | 3507 | 18130 | 13121 | 442706 |
| PAULA REICHLE | |||||
| 389545 | 25300 | 608 | 13573 | 10166 | 439192 |
| DAVID VIS | |||||
| 173566 | 46184 | 942 | 15424 | 596 | 236712 |
| HOWARD BURGESS | |||||
| 299358 | 18130 | 12782 | 330270 | ||
| CRAIG LESLIE | |||||
| 171246 | 38000 | 209246 | |||
| JULIA GRIFFITH | |||||
| 127563 | 19089 | 4377 | 14120 | 165149 | |
| SANDRA WINCHELL | |||||
| 119436 | 18014 | 22722 | 160172 | ||
| MARY ANNE SESTI | |||||
| 112631 | 16918 | 22114 | 151663 | ||
| PETER GRAHAM MD | |||||
| 268513 | 45096 | 285 | 18130 | 14271 | 346295 |
| THOMAS OSTRANDER | |||||
| 246947 | 40513 | 1884 | 20499 | 14246 | 324089 |
| GARY REETZ | |||||
| 187769 | 23086 | 1720 | 15731 | 4278 | 232584 |
Form990 Schedule J Part III Form990ScheduleJPartIII (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FRINGE OR EXPENSE EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 1A | PHP OF MID-MICHIGAN PAYS SOCIAL DUES ON BEHALF OF SCOTT WILKERSON, CEO; THESE AMOUNTS ARE INCLUDED IN MR. WILKERSON'S COMPENSATION. |
| COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION | SCHEDULE J, PAGE 1, PART I, LINE 5A | THE 2010 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2010 AND WILL BE PAID IN 2011. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP OF MID-MICHIGAN AS WELL AS ITS AFFILIATED COMPANIES. |
| COMPENSATION CONTINGENT UPON REVENUES OF RELATED ORG | SCHEDULE J, PAGE 1, PART I, LINE 5B | THE 2010 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2010 AND WILL BE PAID IN 2011. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP OF MID-MICHIGAN AS WELL AS ITS AFFILIATED COMPANIES. |
| COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION | SCHEDULE J, PAGE 1, PART I, LINE 6A | THE 2010 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2010 AND WILL BE PAID IN 2011. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP OF MID-MICHIGAN AS WELL AS ITS AFFILIATED COMPANIES. |
| COMPENSATION CONTINGENT UPON NET EARNINGS OF RELATED ORG | SCHEDULE J, PAGE 1, PART I, LINE 6B | THE 2010 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2010 AND WILL BE PAID IN 2011. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM, WHICH INCLUDES PHP OF MID-MICHIGAN AS WELL AS ITS AFFILIATED COMPANIES. |
| NON-FIXED PAYMENTS PROVIDED | SCHEDULE J, PAGE 1, PART I, LINE 7 | COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NON-FIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET. |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | SCHEDULE J, PART I, LINE 3: SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHP OF MID-MICHIGAN. SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGANIZATION THAT INCLUDES A NUMBER OF NON-PROFIT ENTITIES. THE METHODS SELECTED FOR DETERMINING THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR ARE METHODS WHICH ARE BEING USED BY ALL SPARROW HEALTH SYSTEM RELATED ENTITIES. PETER GRAHAM, THOMAS OSTRANDER, AND GARY REETZ ARE FORMER KEY EMPLOYEES AND BOARD MEMBERS OF PHP OF MID-MICHIGAN. THE FORMER KEY EMPLOYEES AND BOARD MEMBERS ARE BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES. THE FORMER KEY EMPLOYEES AND BOARD MEMBERS ARE NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO PHP OF MID-MICHIGAN. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ADDITIONAL INFORMATION | FORM 990 | ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. |
| ANY SIGNIFICANT NEW PROGRAM SERVICES NOT LISTED ON A PRIOR RETURN | FORM 990, PAGE 2, PART III, LINE 2 | THE OFFICE OF CONSUMER INFORMATION & INSURANCE OVERSIGHT IN THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES (HHS) IN COORDINATION WITH THE OFIR AWARDED A CONTRACT TO PHP OF MID-MICHIGAN TO ESTABLISH AND OPERATE A TEMPORARY HIGH RISK HEALTH INSURANCE POOL PROGRAM (PHPMM-HRPP) IN MICHIGAN TO PROVIDE HEALTH INSURANCE COVERAGE TO CURRENTLY UNINSURED INDIVIDUALS WITH PRE-EXISTING CONDITIONS. THE PROGRAM PROVIDES COVERAGE FOR ELIGIBLE INDIVIDUALS BEGINNING OCTOBER 1, 2010, THROUGH AND ENDING DECEMBER 31, 2013. |
| FIRST ACHIEVEMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | OF MID-MICHIGAN (PHPMM), A COMMERCIAL INSURANCE COMPANY (PHPMM-IC), AND A MEDICAID HEALTH PLAN THAT OPERATES THROUGH A SEPARATE CORPORATION. PHYSICIANS HEALTH PLAN OF MID-MICHIGAN FAMILYCARE (PHPMM-FC) IS ALSO A LICENSED HMO AND A WHOLLY OWNED SUBSIDIARY OF PHPMM. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHPMM. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHPMM APPLY TO PHPMM-IC, AND PHPMM-FC. PHPMM CONTRACTS WITH TRIZETTO TO PROVIDE ADMINISTRATIVE SERVICES NECESSARY FOR MEMBER PLANS' DAY-TO-DAY OPERATIONS THROUGH AN ADMINISTRATIVE SERVICES AGREEMENT. PHPMM'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, GRATIOT, IONIA, MONTCALM AND ISABELLA. PHPMM-IC OFFERS PRODUCTS ACROSS MICHIGAN. THE FAMILYCARE PRODUCT IS AVAILABLE TO MEDICAID ENROLLEES IN EATON, CLINTON, INGHAM, IONIA, MONTCALM AND SHIAWASSEE COUNTIES. AS OF DECEMBER 31, 2010, THERE WERE 35,129 ENROLLEES IN PHPMM'S COMMERCIAL HMO, 12,208 IN TPA, 2,993 IN PHP-IC, AND 18,789 ENROLLEES IN FAMILYCARE. PHPMM CONTRACTS DIRECTLY WITH 719 PRIMARY CARE PHYSICIANS, 1,269 SPECIALTY CARE PHYSICIANS, 365 ALLIED HEALTH PROFESSIONALS, AND 308 ORGANIZATIONAL PROVIDERS THAT INCLUDE 29 HOSPITALS. PHPMM CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. PHPMM'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. PHPMM'S SUCCESS IN MANAGING HEALTHCARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW PHPMM TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY PHPMM'S BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. PHPMM MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH A REFERRAL IS RECOMMENDED BY AN HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY THE HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. PHPMM OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS, TO GROUPS AND INDIVIDUALS. PHPMM OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN'S PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE PHPMM NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. PHPMM WAS ALSO RANKED AMONG THE TOP 50 OF AMERICA'S BEST HEALTH PLANS BY U.S. NEWS AND WORLD REPORT/CONSUMER REPORTS FOR THE 5TH CONSECUTIVE YEAR. NCQA USES AN ALGORITHM COMPOSED OF HEDIS, CAHPS AND ACCREDITATION SCORING TO CREATE THESE NATIONAL RANKINGS. THE GOAL OF THE QUALITY IMPROVEMENT PROGRAM IS TO CONTINUOUSLY IMPROVE HEALTH OUTCOMES AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. PHPMM PURSUES ITS GOALS THROUGH IMPLEMENTATION OF THE QUALITY IMPROVEMENT MODEL: -MEASUREMENT OF THE OUTCOMES OF CARE AND SERVICE, INCLUDING BEHAVIORAL HEALTH SERVICES. -ANALYSIS OF BARRIERS TO CARE AND SERVICE. -DEVELOPMENT AND IMPLEMENTATION OF INTERVENTIONS. -FORMAL EVALUATION OF THE EFFECTIVENESS OF THE INTERVENTIONS. PHPMM MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: -DISEASE MANAGEMENT PROGRAM PARTICIPATION. -QUALITY OF CARE CONCERNS. -HEDIS MEASURES - THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHPMM USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: -DIABETES. -ASTHMA. -DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS. -BREAST AND CERVICAL CANCER SCREENING. -USE OF BETA-BLOCKERS AFTER HEART ATTACKS. -CHILD AND ADOLESCENT IMMUNIZATIONS. -CHOLESTEROL MANAGEMENT. -CONTROLLING HIGH BLOOD PRESSURE. -SMOKING CESSATION. -PRENATAL AND POSTPARTUM CARE. -TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHPMM MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: -ACCESS AND AVAILABILITY. -ENROLLEE COMPLAINTS AND APPEALS. -CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE. -MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS' EXPECTATIONS. PHYSICIANS HEALTH PLAN OF MID-MICHIGAN RECEIVED THE HIGHEST RATING OF "EXCELLENT" FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). THIS STATUS IS GRANTED TO HEALTH CARE PLANS THAT HAVE DEMONSTRATED CONTINUOUS QUALITY IMPROVEMENT IN THEIR PROGRAMS WHILE MEETING OR EXCEEDING NCQA'S RIGOROUS ACCREDITATION STANDARDS. PHP FAMILY CARE RECEIVED A COMMENDABLE RATING. PHPMM AND PHPMM-FC WERE REVIEWED BY NCQA IN 2009. THE SERVICE EXCELLENCE PROGRAM HAS A MISSION OF: PROVIDING FOCUSED LEADERSHIP TO CREATE AND MAINTAIN A CULTURE OF WORLD CLASS CUSTOMER SATISFACTION. IN 2010 PHPMM WAS RANKED ABOVE THE 90TH PERCENTILE IN SATISFACTION WITH CUSTOMER SERVICE AND WAS THE HIGHEST RANKED HEALTH PLAN IN MICHIGAN. THIS WAS YEAR FOUR OF A HIGHLY STRUCTURED AND GOAL ORIENTED APPROACH TO MEMBER SATISFACTION AND EMPLOYEE ENGAGEMENT. THE PROGRAM IS A "TOP DOWN BOTTOM UP" APPROACH TO CHANGING THE CULTURE OF SERVICE. SERVICE EXCELLENCE ADVISORS ARE FRONT LINE STAFF TRAINED TO PRESENT A TWO HOUR CLASS TO ALL ASSOCIATES IN THE HEALTH PLAN. THE BOOK A COMPLAINT IS A GIFT BY JANELLE BARLOW WAS THE BASIS FOR THE 2010 TRAINING. -CAPITALIZING ON COMPLAINTS -HOW TO SAY NO AND REMAIN FRIENDS -BUILDING A CUSTOMER TOLERANCE ZONE -THE GIFT FORMULA OUR 2010 CAHPS SCORES FOR THE COMMERCIAL PRODUCT RESULTED IN A RANKING OF 1 IN MICHIGAN FOR CUSTOMER SERVICE AND 4 FOR THE OVERALL HEALTH PLAN RANKING. NATIONALLY, PHPMM'S COMMERCIAL PRODUCT WAS RANKED 40TH FOR OVERALL HEALTH PLAN RANKING. CUSTOMER SATISFACTION AND ASSOCIATE ENGAGEMENT ARE CLOSELY RELATED. WEBSTER DEFINES ENGAGEMENT AS "EMOTIONAL INVOLVEMENT OR COMMITMENT." EVERY CUSTOMER WANTS SOMEONE TO PARTNER WITH THEM, TO SHOW CONCERN AND BE COMMITTED TO THEIR ISSUE AT HAND. MAINTAINING AN ENGAGED WORKFORCE IS THE FOUNDATION FOR DELIVERING COMPASSIONATE AND EXCEPTIONAL SERVICE. PHPMM PARTICIPATES IN A HEALTH SYSTEM WIDE ANNUAL ASSOCIATE ENGAGEMENT SURVEY CONDUCTED BY KENEXA. THE NATIONALLY RECOGNIZED SURVEY MEASURES ELEVEN DIMENSIONS OF THE WORKFORCE AND PROVIDES REPORTS TO DEPARTMENT TEAMS. THE 2010 SURVEY REPORTED PHPMM ASSOCIATE ENGAGEMENT LEVEL IN THE 93RD PERCENTILE. FOLLOWING THE ANNUAL SURVEY, PHPMM INVITES ALL ASSOCIATES TO PARTICIPATE IN GROUP DISCUSSIONS LED BY FRONT LINE STAFF WHERE RESULTS ARE REVIEWED AND IDEAS FOR IMPROVEMENT ARE WELCOMED. TEAMS MAKE RECOMMENDATIONS, THE BEST OF WHICH ARE IMPLEMENTED. OVER THE YEARS, CHANGES HAVE OCCURRED THAT HAVE BECOME PART OF THE PHPMM WAY OF DOING BUSINESS. SOME OF THOSE INCLUDE: CROSS FUNCTIONAL COMMUNICATION TEAMS, MONTHLY ALL STAFF MEETING UPDATES, ENHANCED ON-LINE ACCESS TO INFORMATION, NEW APPROACHES TO TRAINING, IMPROVED REFERENCE RESOURCES AND MANY MORE. COMMITMENT AND INVOLVEMENT DESCRIBE OUR EXPECTATION FOR STAFF. MAINTAINING A HIGH LEVEL OF ASSOCIATE ENGAGEMENT IS A VERY IMPORTANT PART OF PHPMM'S DEDICATED EFFORT TO PROVIDE OUTSTANDING SERVICE AND TO ACHIEVE NATIONAL RANKINGS IN OVERALL CUSTOMER SATISFACTION. PROCESS IMPROVEMENTS DESIGNED TO ENSURE THAT PHPMM MAXIMIZED THE AUTOMATED CAPABILITIES OF ITS CLAIMS PAYMENT SYSTEM WERE THE FOCUS FOR THE INFORMATION TECHNOLOGY DEPARTMENT. AS A RESULT OF THESE EFFORTS, PHPMM EXPERIENCED EXCELLENT ELECTRONIC DATA INTERCHANGE (EDI) AND AUTO-ADJUDICATION RATES AS WELL AS A REDUCTION IN CLAIM TURNAROUND TIME. PHPMM ENDED 2010 WITH AN AUTO ADJUDICATION RATE OF 76%, AND AN EDI RATE OF 92%. DAYS RECEIPT ON HAND OF CLAIMS WAS REDUCED FROM 2.4 TO 1.96. MAJOR INITIATIVES: -COMPLETED IMPLEMENTATION OF MENTAL HEALTH PARITY LEGISLATION. -DETERMINED PRODUCT DIRECTION NECESSARY TO SUPPORT HEALTH CARE REFORM LEGISLATION. -IN-SOURCED OUR ID CARD GENERATION PROCESS, RESULTING IN FEWER ERRORS AND MORE FLEXIBILITY IN CARD DESIGN. -BEGAN UPGRADE OF CORE SYSTEM AND WEB PRESENCE TO INCREASE INFORMATION SHARING AND IMPROVE CONSTITUENT EXPERIENCES. -IMPLEMENTED WRAP PRODUCTS TO SUPPORT SALES OF HIGH DEDUCTIBLE HEALTH PLANS. -IMPLEMENTED THE HIP MICHIGAN PRODUCT, A FEDERAL PROGRAM TO PROVIDE COVERAGE TO PEOPLE WHO OTHERWISE WOULD NOT QUALIFY FOR INSURANCE. PHPMM'S QUALITY IMPROVEMENT PROGRAM CONTINUES TO BE HIGHLY EFFECTIVE AND HAS DEMONSTRATED SIGNIFICANT RESULTS YEAR AFTER YEAR. QI STRUCTURE AND SUPPORT THE QUALITY IMPROVEMENT STRUCTURE REMAINS STRONG. ADEQUATE RESOURCES HAVE BEEN ALLOCATED TO SUPPORT THE INITIATIVES FOR THE CURRENT AND UPCOMING YEAR. THE QUALITY AND MEDICAL RESOURCE MANAGEMENT COMMITTEE RECEIVES SUPPORT FROM PHPMM LEADERSHIP AND FROM PHPMM PRACTITIONERS. OTHER PHPMM DEPARTMENTS AND STAFF, INCLUDING NETWORK SERVICES, CUSTOMER SERVICE, COMPLIANCE AND GOVERNMENT PROGRAMS |
| MATERIAL DIFFERENCES IN VOTING RIGHTS EXPLANATION | FORM 990, PAGE 6, PART VI | THE COMPOSITION OF THE BOARD OF DIRECTORS MEETS THE REQUIREMENTS OF THE OFFICE OF FINANCIAL AND INSURANCE REGULATIONS, WHICH WE ARE REQUIRED TO ADHERE TO. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHP OF MID-MICHIGAN AND HAS 100% OWNERSHIP. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE NON-ENROLLEE MEMBERS OF THE BOARD OF DIRECTORS OF PHP OF MID-MICHIGAN ARE RATIFIED BY THE BOARD OF DIRECTORS OF SPARROW HEALTH SYSTEM. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | THE NON-ENROLLEE MEMBERS OF THE BOARD OF DIRECTORS OF PHP OF MID-MICHIGAN ARE RATIFIED BY THE BOARD OF DIRECTORS OF SPARROW HEALTH SYSTEM. THE DECISIONS OF THE PHP OF MID-MICHIGAN BOARD OF DIRECTORS MAY BE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS OF SPARROW HEALTH SYSTEM. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 WAS PROVIDED TO THE FINANCE COMMITTEE FOR REVIEW AND COMMENTS. UPON COMPLETION OF THIS REVIEW, THE FINANCE COMMITTEE RECOMMENDED RATIFICATION OF THE FORM 990 AND COPIES OF THE COMPLETED FORM WERE PROVIDED TO THE BOARD OF DIRECTORS OF PHP OF MID-MICHIGAN. BASED UPON THIS RECOMMENDATION, THE BOARD APPROVED THE FILING OF THE FORM 990. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | 1) CORPORATE COMPLIANCE SENDS OUT CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON). |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS FOLLOWS: THE GOVERNING DOCUMENTS OF PHP OF MID-MICHIGAN ARE SUBMITTED TO THE OFFICE OF FINANCIAL AND INSURANCE REGULATIONS (OFIR). THOSE ARE PUBLICLY AVAILABLE TO INTERESTED PARTIES. THE CONFLICT OF INTEREST IS AVAILABLE THROUGH SPARROW HEALTH SYSTEM BY REQUEST TO THE SPARROW COMPLIANCE OFFICER. |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGANIZATION AND IS THE PARENT CORPORATION FOR PHP OF MID-MICHIGAN AND OTHER RELATED ENTITIES - SEE SCHEDULE R. DENNIS SWAN IS THE PRESIDENT & CHIEF OPERATING EXECUTIVE OF SPARROW HEALTH SYSTEM AND THEREBY SERVES AS THE PRINCIPAL OFFICER WITH ULTIMATE RESPONSIBILITY FOR IMPLEMENTING THE DECISIONS OF THE GOVERNING BODY OR SUPERVISING THE MANAGEMENT, ADMINISTRATION, OR OPERATION OF ENTITIES WITHIN THE SYSTEM. THE FOLLOWING OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES PROVIDE SERVICES TO BOTH PHP OF MID-MICHIGAN AND OTHER RELATED ORGANIZATIONS. BELOW IS THE AVERAGE NUMBER OF HOURS DEVOTED TO THE RELATED ORGANIZATIONS: SCOTT WILKERSON 15 HOURS LARRY RAWSTHORNE 39 HOURS DENNIS SWAN 39 HOURS PAULA REICHLE - 39 HOURS DAVID VIS 10 HOURS HOWARD BURGESS - 10 HOURS CRAIG LESLIE - 10 HOURS JULIA GRIFFITH 10 HOURS SANDRA WINCHELL 10 HOURS MARY ANN SESTI 35 HOURS KEVIN ESSENMACHER 10 HOURS ANN HUNT-FUGATE 10 HOURS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHP SHARED SERVICES LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 30377 | AddressLine1 |
| City | LANSING | City |
| State | MI | State |
| ZIP Code | 48909 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383361367 | EIN |
| Primary Activities | CONTRACTS | PrimaryActivities |
| Legal Domicile State | MI | LegalDomicileState |
| EOY Assets | 25510 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHPMM | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SPARROW HEALTH SYSTEM | |||||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 382542859 | PARENT | MI | 501C3 | 11A | N/A | false | |
| PHYS HLTH PLAN MID MI FAMILY CARE | |||||||||||
| PO BOX 30377 | LANSING | MI | 48909 | 364497604 | HMO | MI | 501C4 | true | PHPMM | ||
| PHYSICIANS HEALTH NETWORK | |||||||||||
| PO BOX 30377 | LANSING | MI | 48909 | 382594856 | HMO | MI | 501C4 | false | SHS | ||
| SPARROW FOUNDATION | |||||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 386100687 | FUNDRAISE | MI | 501C3 | 11B | false | SHS | |
| HOME HEALTH CARE OF SPARROW INC | |||||||||||
| 2909 E GRAND RIVER | LANSING | MI | 48912 | 382543305 | HOME HLTH | MI | 501C3 | 9 | false | SHS | |
| CLINTON MEMORIAL HOSPITAL | |||||||||||
| 805 S OAKLAND STREET | ST JOHNS | MI | 48879 | 381358172 | HLTH CARE | MI | 501C3 | 3 | false | SHS | |
| EDWARD W SPARROW HOSPITAL | |||||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 381360584 | HLTH CARE | MI | 501C3 | 3 | false | SHS | |
| IONIA COUNTY MEMORIAL HOSPITAL CORP | |||||||||||
| 479 LAFAYETTE STREET | IONIA | MI | 48846 | 383218134 | HLTH CARE | MI | 501C3 | 3 | false | SHS | |
| SPARROW SPECIALTY HOSPITAL | |||||||||||
| 1210 W SAGINAW | LANSING | MI | 48915 | 141885340 | LT ACUTE | MI | 501C3 | 3 | false | SHS | |
Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| LANSING MEDICAL DENTAL BUILDING | |||||||||
| 2909 EAST GRAND RIVER | LANSING | MI | 48909 | 382566150 | RENTAL PRO | MI | N/A | false | false |
| SPARROW REGIONAL MEDICAL SUPPLY | |||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 383243561 | SALES/RENT | MI | N/A | false | false |
| LANSING MEDICAL DENTAL BUILDING | |||||||||
| 2909 EAST GRAND RIVER | LANSING | MI | 48909 | 382566150 | RENTAL PRO | MI | N/A | false | false |
| SPARROW REGIONAL MEDICAL SUPPLY | |||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 383243561 | SALES/RENT | MI | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PHPMM INSURANCE COMPANY | ||||||||||||
| PO BOX 30377 | LANSING | MI | 48909 | 205565219 | INSURANCE | MI | PHPMM | C CORP | -198857 | 10790387 | 1.00000 | |
| PHP OF MID-MICHIGAN TPA INC | ||||||||||||
| 1400 E MICHIGAN AVE | LANSING | MI | 48912 | 383344741 | MED SVS | MI | PHPMM | C CORP | -1622719 | 552048 | 1.00000 | |
| SPARROW DEVELOPMENT INC | ||||||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 382595963 | HEALTH SVS | MI | N/A | |||||
| EAST LANSING ATHLETIC CLUB | ||||||||||||
| 2900 HANNAH BLVD | EAST LANSING | MI | 48823 | 382886420 | HLTH CLUB | MI | N/A | |||||
| MAC RESTAURANT LLC | ||||||||||||
| 2900 HANNAH BLVD | EAST LANSING | MI | 48823 | 205120690 | RESTAURANT | MI | N/A | |||||
| MEDICAL CENTER WEST CONDO ASSOC | ||||||||||||
| 1100 W SAGINAW ST | LANSING | MI | 48915 | 382635630 | CONDO ASSO | MI | N/A | |||||
| CLINTON SERVICES CORPORATION | ||||||||||||
| 805 SOUTH OAKLAND | ST JOHNS | MI | 48879 | 382494110 | SERVICES | MI | N/A | |||||
| PHPMM INSURANCE COMPANY | ||||||||||||
| PO BOX 30377 | LANSING | MI | 48909 | 205565219 | INSURANCE | MI | PHPMM | C CORP | -198857 | 10790387 | 1.00000 | |
| PHP OF MID-MICHIGAN TPA INC | ||||||||||||
| 1400 E MICHIGAN AVE | LANSING | MI | 48912 | 383344741 | MED SVS | MI | PHPMM | C CORP | -1622719 | 552048 | 1.00000 | |
| SPARROW DEVELOPMENT INC | ||||||||||||
| 1215 E MICHIGAN AVE | LANSING | MI | 48912 | 382595963 | HEALTH SVS | MI | N/A | |||||
| EAST LANSING ATHLETIC CLUB | ||||||||||||
| 2900 HANNAH BLVD | EAST LANSING | MI | 48823 | 382886420 | HLTH CLUB | MI | N/A | |||||
| MAC RESTAURANT LLC | ||||||||||||
| 2900 HANNAH BLVD | EAST LANSING | MI | 48823 | 205120690 | RESTAURANT | MI | N/A | |||||
| MEDICAL CENTER WEST CONDO ASSOC | ||||||||||||
| 1100 W SAGINAW ST | LANSING | MI | 48915 | 382635630 | CONDO ASSO | MI | N/A | |||||
| CLINTON SERVICES CORPORATION | ||||||||||||
| 805 SOUTH OAKLAND | ST JOHNS | MI | 48879 | 382494110 | SERVICES | MI | N/A | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PHP OF MID-MICHIGAN FAMILY CARE | ||
| P | 4624556 | COST |
| PHPMM INSURANCE COMPANY | ||
| P | 869475 | COST |
| PHP OF MID-MICHIGAN TPA INC | ||
| P | 3332947 | COST |