2011-11-15T15:15:55-05:00 2010-12-31 GRANT THORNTON LLP 666 THIRD AVENUE NEW YORK NY 100174011 990 2010-01-01 131828429 Health Insurance Plan of Greater New York HEAL 6464475000 55 WATER STREET NEW YORK NY 10041 CRAIG WILLEY 6464475000 2011-11-15 true 2125990100 2010 2016-03-07 17:11:31Z ANTHONY L WATSON 55 WATER STREET NEW YORK NY 10041 4958207854 false X WWW.EMBLEMHEALTH.COM X 1944 NY HEALTH INSURANCE PLAN OF GREATER NEW YORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS AT PRICES THEY CAN AFFORD. 15 14 1120 0 5811633 -9122069 0 0 4766282090 4903335816 48745293 43200127 57772670 8814884 4872800053 4955350827 0 0 0 0 243431084 248850948 0 0 0 4561577950 4467262403 4805009034 4716113351 67791019 239237476 1855781274 1807356420 822038082 711491170 1033743192 1095865250 X HEALTH INSURANCE PLAN OF GREATER NEW YORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS. HIP PURSUES ITS MISSION BY PROVIDING A CHOICE OF PRODUCTS AND NETWORKS SO MEMBERS HAVE ACCESS TO THE MEDICAL CARE THEY NEED AT PRICES THEY CAN AFFORD. THE ORGANIZATION DOES THIS BY IMPROVING THE HEALTH OF MEMBERS THROUGH WELLNESS PROGRAMS THAT FOSTER PREVENTION AND HEALTHIER LIVING AND BY USING TECHNOLOGY TO EASE ACCESS TO INFORMATION AND SERVICES. false false 1688966334 0 1972759381 MEDICARE - HIP SERVED APPROXIMATELY 133,000 MEDICARE MEMBERS THROUGH its MEDICARE RISK AND COST CONTRACT PROGRAMS. 620964390 0 730932731 MEDICAID - HIP SERVED APPROXIMATELY 225,000 MEDICAID MEMBERS. HIP HAS BEEN SERVICING THE MEDICAID POPULATION SINCE 1967 (WITH THE PASSAGE OF FEDERAL LEGISLATION AUTHORIZING THIS PROGRAM) AND HAS AN EXTENSIVE PROGRAM IN PLACE TO ENCOURAGE PREVENTIVE MEDICAL CARE. 1739633257 0 2050407675 SUBSCRIBER BENEFITS - HIP OF GREATER NEW YORK IS A NOT-FOR-PROFIT CORPORATION THAT ARRANGES FOR THE PROVISION OF COMPREHENSIVE MEDICAL AND HEALTH CARE SERVICES FOR ITS SUBSCRIBERS/MEMBERS (INCLUDING HEALTH CARE SERVICES TO MEDICARE AND MEDICAID MEMBERS) WHICH IS AN EXEMPT FUNCTION. 28076799 0 34105791 CHIPS (See Schedule O) 79100329 0 99091921 FAMILY HEALTH PLUS (See Schedule O) 14188121 0 14721365 HEALTHY NEW YORK (See Schedule O) 15147770 0 4869115 Laboratory Services 3892936 0 -3552163 Other Program Service Activities 140405955 0 149236029 4189969936 false false true false false false false false false true false false true true true false true false false true false false false false false false false false true false false false false false false false false false false false false false true true true false true X 53452 0 true 1120 true true true false false false false false X 15 14 true false false false true false false true true false false true true true true true true true true true true NY X MICHAEL FULLWOOD 6464475000 55 WATER STREET NEW YORK NY 10041 Robert W Brokaw 2.0 X 16599 0 0 David J Cooper 2.0 X 0 0 0 Karen J Davis 2.0 X 10544 0 0 Gregory E Floyd 2.0 X 0 0 0 Elaine Friedman 2.0 X 5421 0 0 Paul E Gibson 2.0 X 25389 54000 0 Oliver J Gray 2.0 X 0 0 0 Ronald C Jones 2.0 X 5123 0 0 Yungman F Lee 2.0 X 26499 0 0 Carmelo Mallia 2.0 X 0 0 0 John J O'Connor 2.0 X 16599 0 0 Margaret T Pan-Loo 2.0 X 0 0 0 Charles P Wang 2.0 X 14018 88500 0 Anthony Watson 35.0 X X 0 4335361 4211375 David M Weiss 2.0 X 0 0 0 David Abernethy 35.0 X 0 678206 782513 Robert Allen 35.0 X 0 154077 21144 Rachel Amalfitano 35.0 X 0 308962 202947 George Babitsch 35.0 X 0 499507 533046 Lynn Balducci 35.0 X 0 240009 172865 Fred Blickman 35.0 X 0 2298924 279294 Frank Branchini 35.0 X 0 3095544 2673705 Robert Branchini 35.0 X 0 329442 245808 Arthur Byrd 35.0 X 0 408011 219763 Jeffrey Chansler 35.0 X 0 602064 595422 Sunny Chiu 35.0 X 0 354369 215321 Michael Della Iacono 35.0 X 0 293727 161030 Marilyn DeQuatro 35.0 X 0 517417 469492 Kerry DeWitt 35.0 X 0 301656 203924 Mohamed Diab 35.0 X 0 272970 117653 Jose Diaz 35.0 X 0 234922 199609 Mariann Drohan 35.0 X 0 309229 186672 William Dunne 35.0 X 0 344182 13096 Thomas Dwyer 35.0 X 0 635992 713212 Daniel Finke 35.0 X 0 692111 1649849 Shawn Fitzgibbon 35.0 X 0 364564 188411 Michael Fullwood 35.0 X 0 1721903 1975848 Philip Gandolfo 35.0 X 0 2826290 190303 Raymond Gannon 35.0 X 0 245343 169419 William Gillespie 35.0 X 0 509542 225104 Philip Gillich 35.0 X 0 254660 147578 Jefferson Grahling 35.0 X 0 173321 64984 James Greenidge 35.0 X 0 386502 433362 Richard Gross 35.0 X 0 239849 142161 Vincent Hartmann 35.0 X 0 215897 168959 Nicholas Kambolis 35.0 X 0 389148 230375 John Kennedy 35.0 X 0 500863 101200 Steven Kessler 35.0 X 0 3108880 295718 Erhard Krause 35.0 X 0 225382 359564 William Lamoreaux 35.0 X 0 534733 253958 Stuart Lefkowich 35.0 X 0 255502 158735 Williams Lewis 35.0 X 0 377779 221228 Dennis Liotta 35.0 X 0 322233 179336 Carl Lund 35.0 X 0 271478 103497 Katherine Magill 35.0 X 0 256842 116750 Charlene Maher 35.0 X 0 262299 114737 Ilene Margolin 35.0 X 0 1164141 447035 David Mascia 35.0 X 0 515266 71585 William Mastrogiacomo 35.0 X 0 545208 523006 Roslyn Meren 35.0 X 0 1922161 3675 Peter Moore 35.0 X 0 215194 187732 David Morin 35.0 X 0 218597 197679 Chester Moskal 35.0 X 0 220674 193286 Thomas Nemeth 35.0 X 0 482767 520065 Michael Palmateer 35.0 X 0 633289 365566 Michele Podolak 35.0 X 0 180055 119262 Michele Powers 35.0 X 0 313044 103309 Valerie Reardon 35.0 X 0 515113 453852 David Reimer 35.0 X 0 240111 170494 Robert Ronda 35.0 X 0 267201 302078 Joan Ruby 35.0 X 0 295433 223392 Araksi Sarafian 35.0 X 0 677003 174881 Sharon Schmerzler 35.0 X 0 231471 173152 DeWitt Smith 35.0 X 0 1838068 680593 Karen Smith-Hagman 35.0 X 0 284518 157365 John Steber 35.0 X 0 1318170 1444043 Leslie Strassberg 35.0 X 0 2920898 302281 Pedro Villalba 35.0 X 0 649975 654071 Wanda Wareham 35.0 X 0 311029 245507 John White 35.0 X 0 221283 154798 Craig Willey 35.0 X 0 378714 195997 William Yurkowski 35.0 X 0 283994 184080 Joseph Zeitlin 35.0 X 0 312984 135481 Glenn Sansone 35.0 X 162390 0 482 Keith Fischer 35.0 X 177771 0 6158 June Giuffo 35.0 X 160818 0 1072 Ruben Oritz 35.0 X 166012 0 1758 Len Proctor 35.0 X 159814 0 853 Cynthia Aureli 35.0 X 0 140248 0 946997 47788801 28103555 43 true true false Cauldwell Wingate Company LLC 380 Lexington Avenue NEW YORK NY 10168 Construction Sharp Decisions 55 West 39th Street NEW YORK NY 10018 Consulting BR Fries Associates LP 34 west 32nd street NEW YORK NY 10001 construction Stroock Stroock Lavan LLP 180 Maiden Lane NEW YORK NY 10038 Legal Deloitte Touche LLP NW8781 PO Box 1450 MINNEAPOLIS MN 46704 Audit 0 0 PREMIUM REVENUE 900099 4902018864 4902018864 GROUP SERVICES & ADMIN FEE INCOME 900099 1316952 1316952 4903335816 23990897 533602 23457295 0 0 3264984 2857027 407957 407957 407957 19917855 -708625 19917855 -708625 19209230 19209230 0 0 0 LABORATORY REVENUE 900002 4869115 4869115 PHARMACY BENEFIT MANAGER INCOME 900099 1304294 1304294 MISCELLANEOUS REVENUE 900099 1916846 959 1915887 316672 316672 8406927 4955350827 4904640110 5811633 44899084 0 0 0 0 47788801 47788801 0 137821823 137821823 22590757 22590757 26115988 26115988 14533579 14533579 0 5644253 5644253 4393524 4393524 0 0 3415739 3415739 69998061 69998061 11681323 11681323 10114866 10114866 0 0 23523057 23523057 4315778 4315778 0 0 3127947 3127947 0 18932312 18932312 3147065 3147065 SUBSCRIBER BENEFITS 4189969936 4189969936 CLAIMS ADJUSTMENT EXPENSE 40424822 40424822 BROKERS COMMISSIONS 23134323 23134323 POSTAGE/TELEPHONE/ETC 18471246 18471246 EQUIPMENT EXPENSE 28786327 28786327 8181824 8181824 0 4716113351 4189969936 526143415 0 5138310 1476588 213890150 163425394 156648122 221006321 2545933 115000000 1680481 1193082 9385464 3304228 607206312 368443042 244575920 238763270 867957669 891228122 34975898 39950636 318983327 132008779 1855781274 1807356420 569273329 516296880 18272749 13450801 234492004 181743489 822038082 711491170 X 1033743192 1095865250 1033743192 1095865250 1855781274 1807356420 X 239237476 -177115418 X false true true X false 0 0 0 0 false EmblemHealth New York PAC 55 Water Street New York NY 10041 320150872 8125 7095354 7095354 138344941 66147163 72197778 216936277 106920400 114580049 101375736 73807004 27568732 143454003 121568475 27009451 238763270 OTHER RECEIVABLES 2455952 DEFERRED RENT 2973513 INTEREST/DIVIDENDS RECEIVABLE 5674565 OTHER CURRENT ASSETS 1518346 HEALTHCARE RECEIVABLES 82976609 INTERCOMPANY RECEIVABLES 36409794 132008779 0 SUBLEASE LOSS (34TH STREET) 976686 PENSION LIABILITY 104350706 WORLD TRADE CENTER DISASTER RE 1714773 INTERCOMPANY PAYABLE 0 DEFERRED RENT 74044418 OTHER LONG TERM LIABILITIES 656906 181743489 FIN 48 DISCLOSURE SCHEDULE D, PART X In July 2006, the Financial Accounting Standards Board (FASB) issued Interpretation No. 48, Accounting for Uncertainty in Income Taxes, an Interpretation of SFAS Statement No. 109 (FIN No. 48). Among other things, FIN No. 48 creates a model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing minimum recognition thresholds which all income tax positions must achieve before being recognized in the financial statements. In addition, FIN No. 48 requires expanded annual disclosures, including a reconciliation of the beginning and ending aggregate unrecognized tax benefits as well as specific detail related to tax uncertainties for which it is reasonably possible the amount of unrecognized tax benefit will significantly increase or decrease within 12 months. Any tax differences between the amounts recognized in the statements of financial position prior to the adoption of FIN No. 48 and the amounts reported after adoption are generally accounted for as a cumulative-effect adjustment recorded to the beginning balance of retained earnings. Effective January 1, 2007, the Company adopted FIN No. 48, which did not have any impact on the Company's consolidated financial statements. The Company does not have any unrecognized tax benefits as of or for the year ended December 31, 2010. Middle East and North Africa Investments 493515 North America Investments 6422444 Europe (Including Iceland and Greenland) Investments 8416912 Central America and the Caribbean Investments 2296909 17629780 17629780 false false false false false false Schedule F, Part 1 HIP-NY does not conduct any activities outside the United States. In accordance with the instructions to the Form 990, the organization is reporting the market value of non-U.S. investments. X X X X true true X X X X X true true false false false true false false false Anthony Watson 0 995774 0 3216007 0 123580 0 4204149 0 7226 0 8546736 0 3216007 David Abernethy 0 317024 0 331500 0 29682 0 781537 0 976 0 1460719 0 331500 Robert Allen 0 88009 0 49171 0 16897 0 20066 0 1078 0 175221 0 49171 Rachel Amalfitano 0 228740 0 63240 0 16982 0 200187 0 2760 0 511909 0 63240 Cynthia Aureli 0 0 0 42748 0 97500 0 0 0 0 0 140248 0 42748 George Babitsch 0 253742 0 223200 0 22565 0 528288 0 4758 0 1032553 0 223200 Lynn Balducci 0 188379 0 36288 0 15342 0 165246 0 7619 0 412874 0 36288 Fred Blickman 0 231822 0 543500 0 1523602 0 277346 0 1948 0 2578218 0 543500 Frank Branchini 0 997099 0 1684520 0 413925 0 2672769 0 936 0 5769249 0 1684520 Robert Branchini 0 239342 0 66300 0 23800 0 241650 0 4158 0 575250 0 66300 Arthur Byrd 0 247881 0 146603 0 13527 0 212777 0 6986 0 627774 0 146603 Jeffrey Chansler 0 283925 0 286923 0 31216 0 591346 0 4076 0 1197486 0 286923 Sunny Chiu 0 200080 0 125853 0 28436 0 207401 0 7920 0 569690 0 125853 Michael Della Iacono 0 230000 0 58650 0 5077 0 161030 0 0 0 454757 0 58650 Marilyn DeQuatro 0 237064 0 251666 0 28687 0 468556 0 936 0 986909 0 251666 Kerry DeWitt 0 166298 0 110675 0 24683 0 202222 0 1702 0 505580 0 110675 Mohamed Diab 0 215364 0 40223 0 17383 0 111392 0 6261 0 390623 0 40223 Jose Diaz 0 158331 0 46474 0 30117 0 197257 0 2352 0 434531 0 46474 Mariann Drohan 0 217902 0 61200 0 30127 0 186574 0 98 0 495901 0 61200 William Dunne 0 210442 0 128000 0 5740 0 8538 0 4558 0 357278 0 0 Thomas Dwyer 0 310888 0 288925 0 36179 0 706100 0 7112 0 1349204 0 288925 Daniel Finke 0 455542 0 213750 0 22819 0 1646891 0 2958 0 2341960 0 213750 Shawn Fitzgibbon 0 289174 0 49702 0 25688 0 186185 0 2226 0 552975 0 49702 Michael Fullwood 0 534338 0 1145854 0 41711 0 1974546 0 1302 0 3697751 0 1145854 Philip Gandolfo 0 52260 0 467188 0 2306842 0 189613 0 690 0 3016593 0 467188 Raymond Gannon 0 172847 0 48535 0 23961 0 166166 0 3253 0 414762 0 48535 William Gillespie 0 377648 0 121600 0 10294 0 222752 0 2352 0 734646 0 121600 Philip Gillich 0 193498 0 51001 0 10161 0 145574 0 2004 0 402238 0 51001 Jefferson Grahling 0 170213 0 0 0 3108 0 59658 0 5326 0 238305 0 0 James Greenidge 0 215950 0 138610 0 31942 0 432823 0 539 0 819864 0 138610 Richard Gross 0 155320 0 53900 0 30629 0 136286 0 5875 0 382010 0 0 Vincent Hartmann 0 162385 0 25421 0 28091 0 165043 0 3916 0 384856 0 25421 Nicholas Kambolis 0 228514 0 142874 0 17760 0 225389 0 4986 0 619523 0 142874 John Kennedy 0 150774 0 326778 0 23311 0 98974 0 2226 0 602063 0 57378 Steven Kessler 0 189904 0 550865 0 2368111 0 293623 0 2095 0 3404598 0 550865 Erhard Krause 0 162135 0 38060 0 25187 0 357212 0 2352 0 584946 0 0 William Lamoreaux 0 367574 0 135000 0 32159 0 250532 0 3426 0 788691 0 135000 Stuart Lefkowich 0 180807 0 48212 0 26483 0 156383 0 2352 0 414237 0 48212 Williams Lewis 0 214130 0 139800 0 23849 0 217358 0 3870 0 599007 0 139800 Dennis Liotta 0 239923 0 57465 0 24845 0 175874 0 3462 0 501569 0 57465 Carl Lund 0 200042 0 43041 0 28395 0 100539 0 2958 0 374975 0 43041 Katherine Magill 0 241332 0 0 0 15510 0 103267 0 13483 0 373592 0 0 Charlene Maher 0 175491 0 0 0 86808 0 113561 0 1176 0 377036 0 0 Ilene Margolin 0 251148 0 273625 0 639368 0 439683 0 7352 0 1611176 0 273625 David Mascia 0 152782 0 340800 0 21684 0 65867 0 5718 0 586851 0 0 William Mastrogiacomo 0 254378 0 264748 0 26082 0 519382 0 3624 0 1068214 0 264748 Roslyn Meren 0 0 0 308000 0 1614161 0 3675 0 0 0 1925836 0 308000 Peter Moore 0 147718 0 44179 0 23297 0 184200 0 3532 0 402926 0 44179 David Morin 0 153042 0 43988 0 21567 0 194721 0 2958 0 416276 0 43988 Chester Moskal 0 151140 0 44345 0 25189 0 192350 0 936 0 413960 0 44345 Thomas Nemeth 0 219304 0 230803 0 32660 0 511369 0 8696 0 1002832 0 230803 Michael Palmateer 0 322189 0 303875 0 7225 0 362755 0 2811 0 998855 0 303875 Michele Podolak 0 126148 0 36975 0 16932 0 116910 0 2352 0 299317 0 36975 Michele Powers 0 232651 0 63750 0 16643 0 101793 0 1516 0 416353 0 63750 Valerie Reardon 0 238730 0 253500 0 22883 0 449082 0 4770 0 968965 0 253500 David Reimer 0 184309 0 29074 0 26728 0 161438 0 9056 0 410605 0 29074 Robert Ronda 0 211330 0 30524 0 25347 0 298008 0 4070 0 569279 0 30524 Joan Ruby 0 210014 0 61200 0 24219 0 215406 0 7986 0 518825 0 61200 Araksi Sarafian 0 126583 0 210833 0 339587 0 173131 0 1750 0 851884 0 210833 Sharon Schmerzler 0 170316 0 48068 0 13087 0 165392 0 7760 0 404623 0 48068 DeWitt Smith 0 154045 0 462477 0 1221546 0 678305 0 2288 0 2518661 0 462477 Karen Smith-Hagman 0 202102 0 58650 0 23766 0 151467 0 5898 0 441883 0 58650 John Steber 0 451230 0 829371 0 37569 0 1442273 0 1770 0 2762213 0 829371 Leslie Strassberg 0 192650 0 561708 0 2166540 0 300265 0 2016 0 3223179 0 561708 Pedro Villalba 0 295774 0 316875 0 37326 0 646845 0 7226 0 1304046 0 316875 Wanda Wareham 0 169691 0 116500 0 24838 0 238737 0 6770 0 556536 0 116500 John White 0 146538 0 72603 0 2142 0 146336 0 8462 0 376081 0 72603 Craig Willey 0 229241 0 139800 0 9673 0 189036 0 6961 0 574711 0 139800 William Yurkowski 0 201836 0 58650 0 23508 0 176122 0 7958 0 468074 0 58650 Joseph Zeitlin 0 255394 0 54833 0 2757 0 133255 0 2226 0 448465 0 54833 Stephen Zeng 0 216653 0 133250 0 17304 0 205799 0 6847 0 579853 0 133250 Glenn Sansone 162082 0 0 0 308 0 0 0 482 0 162872 0 0 0 Keith Fischer 157264 0 526 0 19981 0 893 0 5265 0 183929 0 526 0 June Giuffo 138595 0 0 0 22223 0 0 0 1072 0 161890 0 0 0 Ruben Oritz 145125 0 525 0 20362 0 860 0 898 0 167770 0 525 0 Len Proctor 142549 0 509 0 16756 0 838 0 15 0 160667 0 509 0 Schedule J, Line 1A Per the company's Travel and Business Expense Policy, the Chairman and Chief Executive Officer, the President and Chief Operating Officer, the President of EmblemHealth Services, and the Executive Vice Presidents may travel first class and can request staff traveling on business with them to travel first class on accompanied segments of the trip. Any such expenses are reimbursed upon presentation of comprehensive and accurate receipts. Per the company's Travel and Business Expense Policy, approved Spousal/Guest travel and related lodging, meal expenditures and other appropriate related costs will be reimbursed when the travel is required by EmblemHealth for a legitimate business purpose. Spousal/Guest travel that is not approved in advance is referred to the Senior Vice President for Compliance for review. Mr. Branchini receives a tax gross up for amounts paid into the secular Trust. Officer parking allowances are paid on a grossed-up basis. Severance Payment Schedule J, Line 4a The following officers received severance in 2010: Cynthia Aureli, Vice President of Claims (terminated employment November 11, 2009) received $97,500. Fred Blickman, Senior Vice President of Human Resources (terminated employment November 5, 2010) received $656,250. Philip Gandolfo, Senior Vice President of Melville Operations (terminated employment on March 31, 2010) received $629,580. Steven Kessler, Senior Vice President, Sales & Marketing (terminated employment on August 31, 2010) received $674,100. Roslyn Meren, Senior Vice President of Products and Customer Management (terminated employment on January 1, 2010) received $562,500. Araksi Sarafian, Vice President of Pharmacy Services (terminated employment on July 30, 2010) received $330,000. DeWitt Smith, Senior Vice President of Marketing (terminated employment on August 31, 2010) received $561,750. Leslie Strassberg, Chief Actuary (terminated employment on August 31, 2010) received $682,500. Non-Qualified Retirement Plan Schedule J, Line 4b Emblem Health Services, LLC sponsors nonqualified retirement plans that the officers of HIPNY participate in, Officers with the titles of executive vice president and above, with the exception of Frank Branchini, participate in the supplemental executive retirement plan for emblemhealth services company, llc ("SERP"). The SERP provides a retirement benefit calculated on the basis of 50% of final average pay, offset by benefits under any qualified benefit plan, such as The emblemhealth services company, llc employees' retirement plan. Participants require the approval of the board of directors to retire under the serp between the ages of 55 and 60. Participants who retire prior to age 65 have their serp benefits reduced by early retirement factors. Mr. branchini participates in the GHI supplemental retirement plan ("Secular trust") which provides a retirement benefit calculated to provide the retirement benefits that would otherwise be payable under the local 153-ghi pension plan and the ghi cash balance plan (qualified plans), but for funding and contributions limits imposed by the IRS regulations. Senior vice presidents and above, hired before june 1, 2009, participate in the supplemental retirement plan ii for emblemhealth services company, llc (SERP II"). The SERP II provides a retirement beneft calculated on the basis of 30% of final average pay after 5 years of service, and increasing to 50% of final average pay after 15 years of service, offset by benefits under any qualified benefit plan, such as the emblemhealth services company, llc employees' retirement plan. Participants require the approval of the board of directors to retire under the SERP II between the ages of 55 and 60. Participants who retire prior to age 65 have their SERP II benefits reduced by early retirement factors. Bonus Payments Schedule J, Line 6a HIP and EmblemHealth Services provide annual incentive awards based upon the achievement of performance metrics and percentage target awards. The compensation committees approve the performance metrics and targets and the ultimate payout to participants based upon the performance achieved under the Annual Incentive Plan (AIP). All management, non-union employees may be eligible to participate in the AIP. For the most senior executives of the company, the annual incentive awards are entirely based upon the successful achievement of objective performance goals. In the 2010 AIP, the two equally weighted performance metrics were Operating Income and Administrative Per Member Per Month (PM PM) savings. Operating Income was defined as premiums earned and administrative service fee revenue, less subscriber benefits, depreciation and amortization, interest and general administrative expenses, as reported in the annual financial statements, and exluding certain specified and extraordinary items. Administrative PM PM was defined as the depreciation and amortization, interest and general administrative expenses as reported in the annual audited financials associated with the administration of the company's insured commercial managed care, Medicare and State sponsored programs expressed on a per member per month basis, and excluding certain specified and extraodinary items. HIP and EmblemHealth Services also have a long term incentive plan based upon longer term performance over three year performance cycles and a limited supplemental incentive plan with payment triggered by threshold performance under the AIP. The compensation committees approve the performance metrics, targets and payouts based upon achievement of performance under these plans as well. Officers and key employees are generally eligible to participate in the long term incentive plan. A very limited number of senior officers are eligible to participate in the supplemental incentive plan, which will expire in 2011. Schedule J, Part III, Column C Deferred Compensation Health Insurance Plan of Greater New York reports the change in the actuarial value of the pension plan as deferred compensation (as required by the expanded disclosures in the form 990). A large percentage of the compensation reported in Schedule J, Part III, Column C represents this change in value. Present values are calculated based on the SEC Proxy Summary Compensation Table methodology and assumptions, as the discounted present value of normal retirement benefits earned to the measurement date payable at the later of current age or age 65, without regard to projected service, projected salary increases, pre-retirement mortality or other decrements. Displayed change in total pension value during 2010 above reflects all defined benefit plans the participants are entitled to. Form 990, Part I, Line 5 & Part V, Line 2a On March 6, 2007, Emblemhealth Services Company, LLC was formed as a joint venture by Health Insurance Plan of Greater New York (HIP) and Group Health Incorporated (GHI). On January 1, 2008, HIP and GHI transferred vendor agreements and management employees to EmblemHealth Service Company, LLC. To that end, all officers and directors (and most employees) of HIP receive their Forms W-2 from Emblemhealth Services Company, LLC. The number of employees (1,120) reported on Part 1, Line and Part V, Line 2a represents only those unionized employees who still receive their Forms W-2 from HIP. Part V, Line 1a and Part VII, Independent Contractors. HIP-NY transferred all vendor agreements to Emblemhealth Services Company, LLC; accordingly, most independent contractors are paid by a related party rather than HIP-NY itself. To the extent HIP-NY is still under contract with certain vendors (e.g. rent etc), those 1099s are still issued by HIP-NY. As noted in Part V, Line 1a of the Form 990, Health Insurance Plan of Greater New York issued over 50,000 Forms 1099. 98% of these 1099s are issued to physicians that provide medical services to members of HIP-NY and do not provide services directly to HIP-NY. These physicians are not reportable in Part VII as independent contractors that provide services to HIP-NY. Accordingly, even though HIP-NY issued over 50,000 1099s, the organization did not pay any independent contractors for services over $100,000. Form 990, Part III, Line 4d - Other Program Service Accomplishments 1. CHIPS (Children's Health Insurance Program) - HIP SERVED APPROXIMATELY 13,000 MEMBERS. HIP HAS BEEN SERVING THE CHIPS POPULATION SINCE THE INCEPTION OF THE STATE DEMONSTRATION PROGRAM FOR UNISURED CHILDREN UNDER 19, IN 1991 AND CONTINUED WITH THE PASSAGE OF The Childrens Health Insurance Program (CHIP) in 1997. CHIPS is a partnership between the federal government and the states to extend health coverage to uninsured children and pregnant women in families who cannot afford to purchase private health insurance but have incomes too high to qualify for Medicaid. 2. Family Health Plus Program - HIP SERVED APPROXIMATELY 33,000 MEMBERS. HIP BEGAN TO SERVE FHPLUS MEMBERS AT THE START OF THE PROGRM IN THE NY DOWNSTATE AREA IN OCTOBER OF 2001. THE BENEFIT PACKAGE FOR THE PROGAM PROVIDES a comprehensive set of medically needed health care benefits and services to the ADULT UNINSURED and low-income wage earners. 3. Healthy New York Program - HIP SERVED APPROXIMATELY 4500 MEMBERS. HIP HAS BEEN SERVING HEALTHY NY MEMBERS SINCE THE PROGRAM'S INCEPTION JANUARY 2001. THE NYS HEALTH CARE REFORM ACT OF 2000 CREATED THIS PROGRAM OF COMPREHENSIVE HEALTH INSURANCE COVERAGE FOR NY's UNINSURED WORKERS AND THEIR FAMILIES. Healthy NY is a program designed to help promote comprehensive and quality health care for small business owners and their employee's. The Healthy NY program also helps sole proprietors and those whose employers do not provide health insurance for them. Healthy NY includes benefits that cover essential health needs including inpatient and outpatient hospital services, physician services, maternity care, preventative health services, diagnostic and x-ray services, and emergency services. 4. Laboratory Services - HIP operated Centralized Laboratory Services which provided laboratory research for services such as celiac disease, antinuclear antibodies and allergies. The laboratory ceased providing services in May of 2010. 5. Other Program Service Activities - the allocation of program service expenditures reported on Part III of the Form 990 is derived from HIP-NY's Statutory Financial Statements (STAT) The Form 990 is prepared in accordance with Generally Accepted Accounting Principles (GAAP). The $19,040,706 in expenditures and $1,316,952 in revenues represent a STAT to GAAP difference. Form 990, Part VI, Line 1 The organization has 15 board members, 14 of which are independent for purposes of the Form 990. Chairman and CEO, Anthony Watson, is the lone Board member that is not independent by virtue of his having received compensation from a related party, EmblemHealth, Services, LLC for services rendered to HIP-NY. Several of HIP-NY's Board Members do receive payment for services rendered in their capacity as Board Members. Such amounts represent reasonable compensation for services rendered (as a Board Member) and do not impair their independence. Form 990, Part VI, Line 2 Frank Branchini, President and Chief Operating Officer, is the father of Robert Branchini, VP Information Technology. Form 990, Part VI, Line 6 EmblemHealth, Inc., a New York not-for-profit corporation, is the sole member of Health Insurance Plan of Greater New York. EmblemHealth (EIN 13-3941542) is exempt from federal taxation pursuant to IRC 501(c)(3). Form 990, Part VI, Line 11 The taxpayer's Form 990 for the year ending December 31, 2010 was provided to each member of the organization's governing body before it was filed. A detailed review of the Form 990 was undertaken by the organization's Vice President/Tax Director and by the Executive Vice President, Chief Financial Officer and General Counsel. Form 990, Part VI, Line 12 To determine if an employee's personal interests, activities or relationships constitute a conflict of interest or the appearance of a conflict of interest, certain employees, based upon functionality, as determined by the Senior Vice President for Compliance, Internal Audit and Internal controls are required to fully disclose, on an annual basis, any reportable situations on the company's conflict of interest disclosure. All employees, at the time of employment, are required to fully disclose any personal interest, activities or relationships that constitute a conflict of interest or the appearance of a conflict of interest. Disclosures are reviewed by the Senior Vice President for Compliance, Internal Audit and Internal Controls and by the Executive Vice President, Chief Financial Officer and General Counsel. Any Employee, who violates the conflict of interest policy, fails to make a required report or fails to comply with any remedial action required by the company, is subject to disciplinary action, up to and including termination of employment. Form 990, Part VI, Line 15 To determine the compensation of the CEO and all other officers of the company, HIP and EmblemHealth Services engage an outside compensation consultant to provide guidance and the comparable market data on the compensation of similarly situated executive positions in the organizations' competitive peer group comprised of profit and not for profit entities. The compensation consultant presents the comparable market data to the compensation committee of the board of directors of each of HIP and EmblemHealth Services. The compensation committees are composed entirely of outside, independent, disinterested directors. The compensation committees review and approve the proposed compensation arrangements and the deliberations and actions of the compensation committees are documented in the minutes of each meeting. Thereafter, the actions of the compensation committees are reported to the full boards in a timely manner. The CEO, or any other officer, is excused from the compensation committee meeting while the committee deliberates and approves any action related to the compensation arrangement of the CEO or other officer. Form 990, Part VI, Line 16 On March 6, 2007, EmblemHealth Services Company, LLC ("EHS") was formed as a joint venture between Health Insurance Plan of Greater New York and its sister company, Group Health Incorporated, a New York not-for-profit corporation, in order to integrate certain common administrative operations of these two entities, among other purposes. EmblemHealth, Inc., a New York not-for-profit corporation, is the sole member of both Health Insurance Plan of Greater New York and Group Health Incorporated. EmblemHealth, Inc. (EIN 13-3941542) is exempt from federal taxation pursuant to IRC 501(c)(3). In January 2008, EHS began performing those administrative operations for the organizations. The Limited Liability Agreement requires that EHS be managed at all times in a manner that furthers the tax-exempt purposes of Health Insurance Plan of Greater New York. Form 990, Part VI, Line 19 The taxpayer makes its Form 990 and Form 1023 available to the public by retaining a copy of each at its head offices at 55 Water Street, New York, New York. Any individual requesting a copy of these documents is provided that copy on the same business day. The organization's Form 990 is also available for public inspection on www.guidestar.com. The taxpayer's financial statements are available for public inspection on the organization's website, www.emblemhealth.com. The organization's governing documents and conflict of interest policy are not available to the public. Form 990, Part VIII, Rental Income Health Insurance Plan of Greater New York generates rental revenue from medical groups who lease a combination of personal and real property. HIP does not book this revenue in its general ledger as rental income, but rather offsets payments due to the health provider/facilities as monthly settlements are made. These transactions result in a net out-flow of cash as HIP finalizes its monthly settlements. For the most part, the rental income generated by HIP is for space rental and incidental personal property rental (i.e. 10% or less of the total rents received under the lease are from personal property). To the extent that the rental income is attributable to a mixed lease (i.e. where personal property is 11% to 50% of the total rents), HIP reports this revenue as unrelated business income and specifically reports this revenue on Part VIII, Lines 6a and 6b and on its Form 990-T. Quantifying total rental income received across all medical groups would be labor intensive and since this revenue is passive revenue that does not implicate unrelated business income, HIP has opted to continue reporting this revenue as an offset to its facilities expenditures (which are quantified on Part IX, Schedule of Functional Expenses). Form 990, Part IX, Functional Expenses Amounts reported on Part IX, Line 5, as compensation paid to officers, directors and key-employees of HIP-NY represent those salary costs reported on Form 990, Part VII, Line 1(d) that are allocated from the related party, EmblemHealth Services, LLC. Part IV, Line 28 HIP-NY does not believe it has any business transactions or relationships between itself and an officer, director, or key employee of the organization that rise to the monetary threshold required for disclosure on Schedule L of the Form 990. The organization takes its responsibilities of monitoring potential conflicts of interest very seriously (please see disclosure on Part VI, Line 12). HIP-NY compiles a lengthy Summary report of all potential business transactions between the individuals reported on Part VII of the Form 990 and HIP-NY or one of its affiliated organizations. This report discloses all potential business transactions regardless of monetary value. The organization's due diligence efforts reported no transactions that meet the 990's threshold for dislcosure. Additional information is available upon request. Form 990, Part IX, Line 5 A difference of -177,115,418 is reported on part XI of the Reconciliation of Net Assets. This difference is attributable to changes in unrealized gains and losses on investments as well as Statutory-to-GAAP financial statement adjustments. EmblemHealth Services Company 55 Water Street New York NY 10041 261330097 Support Servi NY na -7511934 152219300 false 0 false 0.50000 Group Health Incorporated 55 Water Street New York NY 10041 135511997 Insurance NY NA C Corp -18791496 1073261580 1.00000 HIP Holdings Inc & Subsidiaries 55 Water Street New York NY 10041 133819759 Insurance NY NA C Corp. 27568496 1053416198 1.00000 true true false true false true false false false false true true true true true true true true EmblemHealth Inc C, L, 2450199 EmblemHealth Inc M 51799 EmblemHealth Inc N 2053798 Group Health Incorporated A 533602 Group Health Incorporated D 115000000 Hip Holdings Inc & Subsidiaries (HIPA) L 30400000 Hip Holdings Inc & Subsidiaries (HIPA) K 2100000 Hip Holdings Inc & Subsidiaries (HIPIC) L 148700000 Hip Holdings Inc & Subsidiaries (HIPIC) K 144500000 Hip Holdings Inc & Subsidiaries (HIPIC) K, P 20600000 Hip Holdings Inc & Subsidiaries (HIP-IPA) l 28600000 Hip Holdings Inc & Subsidiaries (HIP-IPA) k 200000 Schedule R, Part V, Line 2 TRANSACTIONS with Emblem Health, Inc. EMBLEMHEALTH, INC. IS THE PARENT ORGANIZATION OF HEALTH INSURANCE PLAN OF NEW YORK (HIPNY), A 501(C)(4) TAXEXEMPT ORGANIZATION THAT DELIVERSQUALITY, AFFORDABLE HEALTH INSURANCE TO MILLIONS OF MEMBERS AND PROVIDES EMPLOYERS AND INDIVIDUALS WITH A RANGE OF PLAN CHOICES AND ATTRACTIVE BENEFIT OPTIONS DESIGNED TO MEET THE INDIVIDUAL NEED OF TODAY'S HEALTHCARE CONSUMERS. AS THE PARENT ORGANIZATION, EMBLEMHEALTH, INC. RUNS HIP-NY'S INTEGRATIVE WELLNESS PROGRAM, AN INNOVATIVE EVIDENCEBASED PROGRAM THAT PROMOTES HEALTHY LIVING AND ENHANCES INDIVIDUALS' QUALITY OF LIFE. EMBLEMHEALTH,INC. DOES NOT GENERATE ANY REVENUE. THE EXPENSES IT INCURS IN RUNNING THE INTEGRATIVE WELLNESS PROGRAM FOR HIP-NY ARE PAID ATCOST BY HIP-NY VIA A MANAGEMENT FEE. THESE AMOUNTS ARE REPRESENTED IN SCHEDULE R, PART V, TRANSACTION TYPE K. SINCE HIPNY'S PAYMENT REPRESENTS A REIMBURSEMENT OF ALL EXPENSES INCURRED, THIS TRANSACTION IS ALSO REPRESENTED IN SCHEDULE R, PART V, TRANSACTION TYPE P. EMBLEMHEALTH, INC. SHARES AN OFFICE SPACE WITH HIP-NY AT 55 WATER STREET. TO THAT END, ITS ALLOCATION OF RENTAL EXPENSE IS REPORTED IN SCHEDULE R, PART V, TRANSACTION TYPE M. Transactions with Group health Incorporated, HIP-NY advanced $115 million to GHI in accordance with Section 1307 of the Insurance Law of the State of New York with interest accruing at 2% per annum. As provided in Section 1307, the payment of principal and interest thereon amounting to approximately $500,000, shall only be made out of free and disposable surplus, subject to prior approval of the Superintendent. As of December 31, 2010, no payments were made to HIP. Transactions with HIP Holdings, Inc. & Subs (HIPIC) HIPIC (a member of HIP Holdings, Inc. & Subs) provides the indemnity health insurance portion of dual option products offered by HIP and HIP administers the collection of premiums and pays claims on behalf of HIPIC. Premiums collected on behalf of HIPIC were approximately $148.7 million for the year ended December 31, 2010. HIP paid out-of-network claims on behalf of HIPIC of $144.5 million in 2009. Under the terms of a service agreement, HIP allocated costs associated with administering the premiums and claims of approximately $20.6 million to HIPIC for the year ended December 31, 2010. Transactions with HIP Holdings, Inc. (HIP-IPA) HIP pays HIP IPA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) a monthly per-member-per-month capitation rate for members enrolled in HIP IPA as well as a monthly fee for data collection services. For the year ended December 31, 2010, HIP incurred approximately $28.6 million for capitation and $.2 million for data collection services. In addition, HIP provides certain administrative and support services to HIP IPA, which are reimbursed by HIP IPA. For the year ended December 31, 2010, amounts charged by HIP to HIP IPA for these services was approximately $200,000. Transactions with HIP HOldings, Inc. & Subsidiaries (HIPA) HIPA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) provides claims processing and certain member services for HIPs members. For the year ended December 31, 2010, HIPA charged HIP approximately $30.4 million for these services. HIP-NY provides administrative and management services to HIPA; amounts paid in 2010 were approximately 2.1 million. Transactions with EmblemHealth Services, LLC. EmblemHealth Services, LLC (EHS) was formed as a limited liability company under the laws of the state of Delaware as a joint venture of HIP and GHI, in which both HIP and GHI each contributed $100 for equal ownership rights and are the sole corporate partners of EHS. Effective January 1, 2008, HIP and GHI entered into a management services agreement with EHS, for the purpose of providing administrative services to the companies. HIP and GHI entered into a guaranty agreement as of January 1, 2008 with EHS. In conjunction with this guaranty agreement, HIP and GHI transferred all of their respective non-union employees to EHS. EHS assumed all of the associated benefit and compensation related liabilities of the transferred employees. EHS became the plan sponsor of the related pension and postretirement plans it assumed. The transfer was accounted for as a non-economic transaction between related parties, and as such, no consideration was exchanged and no gains or losses were recorded. Under this guaranty arrangement HIP and GHI are jointly and severally liable for: (i) guaranteed obligations earned by transferred employees who were employed by HIP and GHI prior to the effective date of the agreement; and (ii) a pro rata share of guaranteed obligations earned by transferred employees after the effective date of this agreement, based on the allocation of costs under the services agreement. For the year ending December 31, 2010, amounts of transactions between HIP-NY and EmblemHealth Services, LLC were not quantified. Further information is contained in the organization's audiited financial statements and annual statutory filing.