2011-11-15T14:56:21-06:00 2010-12-31 DALBY WENDLAND & CO PC P O BOX 430 GRAND JUNCTION CO 81502 990 2010-01-01 840614905 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED ROCK 9702447760 2775 CROSSROADS BOULEVARD GRAND JUNCTION CO 81506 PATRICK J DUNCAN 9702447760 2011-11-07 1 DANIEL S VOGEL 9702431921 2010 2016-03-07 17:11:31Z ROCKY MOUNTAIN HEALTH PLANS STEPHEN ERKENBRACK 2775 CROSSROADS BOULEVARD GRAND JUNCTION CO 81506 369700761 0 X WWW.RMHP.ORG X 1974 CO DELIVERY OF HIGH QUALITY HEALTH CARE AND RELATED SERVICES THROUGH COMMUNITY BASED ORGANIZATIONAL STRUCTURE TO A BROAD CROSS-SECTION OF COLORADANS, FOCUSING ON PREVENTATIVE CARE, ACCESS AND QUALITY IMPROVEMENT FOR THE BENEFIT OF MEMBERS AND THE GREATER COMMUNITY. 14 9 0 0 66905 0 0 4270229 363563558 332518109 3741138 5178610 -1633336 -1176644 365671360 340790304 775100 943819 312624864 285599537 1845200 2070700 0 0 0 34268606 36200323 349513770 324814379 16157590 15975925 147036775 155776296 39720681 39978085 107316094 115798211 X DELIVERY OF HIGH QUALITY HEALTH CARE AND RELATED SERVICES THROUGH COMMUNITY BASED ORGANIZATIONAL STRUCTURE TO A BROAD CROSS-SECTION OF COLORADANS, FOCUSING ON PREVENTATIVE CARE, ACCESS AND QUALITY IMPROVEMENT FOR THE BENEFIT OF MEMBERS AND THE GREATER COMMUNITY. 0 0 103858412 0 127765827 PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 25,000 PEOPLE ENROLLED THROUGH EMPLOYER GROUP AND INDIVIDUAL PLANS. OVER 90% OF EMPLOYER GROUPS WERE SMALL BUSINESSES. 118331088 0 138776159 PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 23,000 MEDICARE BENEFICIARIES, OVER HALF OF WHOM RESIDE IN RURAL AREAS NOT SERVED BY ANY OTHER MANAGED CARE PLAN. MEMBERS RECEIVED BROAD ACCESS TO MEDICAL CARE AND WELLNESS PROGRAMS. 59292044 0 65976061 PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 19,000 MEDICAID RECIPIENTS IN 7 RURAL COUNTIES, ENSURING ACCESS TO QUALITY MEDICAL CARE NOT OTHERWISE AVAILABLE. SAVED TAXPAYER DOLLARS WHILE EXCEEDING NATIONAL BENCHMARKS FOR QUALITY.CHILDREN'S HEALTH PLAN PLUSTHROUGH THE MEDICAID PROGRAM, PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 9,000 NEEDY CHILDREN IN 22 RURAL COUNTIES IN WESTERN COLORADO THROUGH PARTICIPATION IN CHILDREN'S HEALTH PLAN PLUS PROGRAM. THESE CHILDREN GAINED ACCESS TO HIGH QUALITY MEDICAL CARE. 3576262 0 3576262 GETTINGUSCOVEREDPEOPLE WITH SERIOUS HEALTH CONDITIONS WHO HAVE STRUGGLED TO FIND HEALTH INSURANCE HAVE A NEW OPTION, THANKS TO GETTINGUSCOVERED, A HEALTH PLAN THAT OPENED FOR ENROLLMENT IN COLORADO JULY 6, 2010 GETTINGUSCOVERED IS A STATEWIDE, COMPREHENSIVE HEALTH PLAN FOR PEOPLE WITH PRE-EXISTING MEDICAL CONDITIONS WHO HAVE BEEN UNINSURED FOR AT LEAST SIX MONTHS. AS COLORADO'S FEDERAL HIGH-RISK POOL, THE HEALTH PLAN WAS DEVELOPED THROUGH A PARTNERSHIP BETWEEN ROCKY MOUNTAIN HEALTH PLANS, COVERCOLORADO, THE STATE OF COLORADO AND THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. IT IS FUNDED THOUGH INDIVIDUAL PREMIUMS AND A FEDERAL FINANCIAL SUBSIDY. GETTINGUSCOVERED MEMBERS HAVE ACCESS TO A COMPREHENSIVE BENEFITS PACKAGE AND STRONG STATEWIDE NETWORK. MEMBERS CAN CHOOSE THEIR OWN DOCTOR AND GET ACCESS TO THE ROCKY MOUNTAIN HEALTH PLANS PROVIDER NETWORK, WHICH INCLUDES MORE THAN 2,500 PRIMARY CARE PHYSICIANS, 9,000 SPECIALISTS AND SPECIALTY PROVIDERS AND 99 HOSPITALS STATEWIDE. BENEFITS INCLUDE A PRESCRIPTION DRUG PLAN, COVERAGE FOR PREVENTIVE CARE, MENTAL HEALTH, MATERNITY CARE, AND MORE. CARE MANAGEMENT PROGRAMS WILL ALSO BE OFFERED.WHILE FEDERAL FUNDS WILL SUBSIDIZE THE COST OF GETTINGUSCOVERED, IT WILL ALSO BE FUNDED BY INDIVIDUAL PREMIUMS. PREMIUMS WILL BE BASED ON AN APPLICANT'S AGE, COUNTY OF RESIDENCE AND SMOKING STATUS AND WILL COST NO MORE THAN WHAT A HEALTHY INDIVIDUAL OF THE SAME AGE WOULD PAY. 721896 328838 693967 COLORADO BEACON CONSORTIUMIN MAY 2010, THE COLORADO BEACON CONSORTIUM WAS AWARDED $11,878,279 TO IMPLEMENT A HEALTH INFORMATION TECHNOLOGY PILOT PROJECT IN WESTERN COLORADO. THE COLORADO BEACON CONSORTIUM IS MADE UP OF EXECUTIVE-LEVEL REPRESENTATION FROM FOUR MISSION-DRIVEN, NOT-FOR-PROFIT, WESTERN COLORADO-BASED ORGANIZATIONS, ALL OF WHICH HAVE A NATIONALLY-ACKNOWLEDGED TRACK RECORD OF COORDINATION TO ACHIEVE SUPERIOR OUTCOMES. THEY INCLUDE MESA COUNTY PHYSICIANS INDEPENDENT PRACTICE ASSOCIATION, QUALITY HEALTH NETWORK, ROCKY MOUNTAIN HEALTH PLANS AND ST. MARY'S REGIONAL MEDICAL CENTER. A REPRESENTATIVE FROM EACH ORGANIZATION SITS ON THE COLORADO BEACON CONSORTIUM'S EXECUTIVE COMMITTEE, ALONG WITH A CONSUMER REPRESENTATIVE-AT-LARGE.THE FUNDS FROM THE GRANT WILL BE USED TO ENABLE ROBUST COLLECTION OF CLINICAL DATA FROM HEALTH SYSTEMS, PROVIDERS, AND HOSPITALS IN ORDER TO IMPROVE THE QUALITY OF HEALTH CARE AND PATIENT EXPERIENCES WITH THE SYSTEM, WHILE REDUCING COSTS. THE COLORADO BEACON CONSORTIUM'S MISSION IS TO OPTIMIZE THE EFFICIENCY, QUALITY, AND PERFORMANCE OF OUR HEALTH CARE SYSTEM, AND INTEGRATE THE DELIVERY OF CARE AND USE OF CLINICAL INFORMATION TO IMPROVE COMMUNITY HEALTH. THE GEOGRAPHIC FOCUS OF THE CONSORTIUM'S ACTIVITIES INCLUDES THE COLORADO COUNTIES OF MESA, DELTA, MONTROSE, GARFIELD, GUNNISON, PITKIN, AND RIO BLANCO. 2227381 614981 0 REGIONAL CARE COLLABORATIVEIN DECEMBER, RMHP WAS AWARDED ONE OF ONLY SEVEN CONTRACTS IN THE STATE BY THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING TO CREATE A REGIONAL CARE COLLABORATIVE ORGANIZATION. OUR CONTRACT WILL TOUCH THE LIVES OF COLORADANS WHO LIVE IN 24 OF COLORADO'S 64 COUNTIES.THE TWO CENTRAL GOALS OF THE PROGRAM ARE TO IMPROVE HEALTH OUTCOMES OF MEDICAID CLIENTS TO ADDRESS HEALTH NEEDS, AND TO CONTROL COSTS BY REDUCING INAPPROPRIATE USE OF HEALTH CARE RESOURCES.OUR EFFORTS WILL FOCUS ON EXPANDING ACCESS TO COMPREHENSIVE PRIMARY CARE; PROVIDING A FOCAL POINT OF CARE (MEDICAL HOME); ENSURING POSITIVE MEMBER AND PROVIDER EXPERIENCES; AND APPLYING STATEWIDE DATA TO SUPPORT SECURE DATA-SHARING. ONE IMPORTANT COMPONENT OF THIS PROJECT IS TO SUPPORT A PARADIGM SHIFT FROM A VOLUME-DRIVEN, FEE-FOR-SERVICE (FFS) MODEL TO A COORDINATED, OUTCOMES-BASED SYSTEM WHICH CONTROLS COSTS WHILE MAINTAINING OBJECTIVES AND GOALS CONSISTENT WITH OUR APPROACH TO MEDICAID FOR 35 YEARS.WE ARE PROUD TO BE A PART OF THE COLORADO'S EFFORT TO IMPROVE HEALTH OUTCOMES FOR MEDICAID CLIENTS AND SAVE ON HEALTH CARE COSTS. MISCELLANEOUS PROGRAMSCOLLABORATED WITH HEALTH CARE PROVIDERS AND COMMUNITY ORGANIZATIONS TO ADDRESS IDENTIFIED NEEDS, TO SUPPORT IMPROVEMENTS IN MEDICAL MANAGEMENT AND QUALITY OF CARE, TO FUND RESEARCH, HEALTH AND ASSIST THOSE AT-RISK AND VULNERABLE IN OUR COMMUNITIES. THE VALUE OF RMHP WELLNESS EDUCATION, AND LEADERSHIP, VOLUNTEER TIME AND IN-KIND SUPPORT HAS NOT BEEN QUANTIFIED. TOTAL OTHER PROGRAM SERVICES:EXPENSES $ 6,525,538. INCLUDING GRANTS OF $ 943,819. REVENUE $ 4,270,229. 6525539 943819 4270229 288007083 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1 3210 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 X 14 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICK J DUNCAN CFO 9702447760 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 X DENNIS LEE STAHL 5.00 X X 3400 0 0 EUGENE CHRISTIAN LAUNER 5.00 X 400 0 0 DAVID WARREN TERRY DO 5.00 X X 1300 0 0 MICHEAL WAYNE BLACKBURN 5.00 X 300 0 0 PAMELA PATRICIA HANES 5.00 X 400 0 0 CORINNE MARIE JOHNSON 5.00 X 400 0 0 WILLIAM JAMES KIRVEN III 5.00 X 200 0 0 GARY DALLAS KNAUS MD 5.00 X 400 0 0 WILLIAM ALFORD KELLEY MD 5.00 X 200 0 0 ARTHUR CURTIS ROBINSON 5.00 X 600 0 0 DIANE MARIE SCHWENKE 5.00 X 100 0 0 ROBERT GLEN WILSON 16.00 X 5300 0 0 JAY YOUNG WANT MD 5.00 X 100 0 0 ANNE WARHOVER 5.00 X 100 0 0 STEPHEN K ERKENBRACK 40.00 X 386200 0 99000 LAUREL D WALTERS 40.00 X 236900 0 54600 PATRICK J DUNCAN 40.00 X 234400 0 55700 JAMES J SWAYZE 40.00 X 298800 0 60200 JANICE L ROHR 40.00 X 189600 0 78200 MICHAEL E HUOTARI 40.00 X 222900 0 93300 NEIL J WALDRON 40.00 X 268800 0 96300 KEVIN R FITZGERALD 40.00 X 283000 0 118500 MARK J CARLEY 40.00 X 122600 0 8200 VICKI SUE ESPINOZA 40.00 X 176100 0 6100 ANGELA SIMMONS MOORE 40.00 X 158700 0 7600 JOHN HOPKINS 40.00 X 118700 0 0 2709900 0 677700 12 1 1 1 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 606731216 RX PAYMENTS 66530620 ST MARY'S HOSPITAL & MEDICAL CENTER IN PO BOX 62 GRAND JUNCTION CO 81502 MEDICAL PAYMENTS 36094783 ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORA 2775 CROSSROADS BLVD GRAND JUNCTION CO 81502 MANAGEMENT SERVICES 27645546 COLORADO WEST HEALTHCARE SYSTEM 2021 N 12TH ST GRAND JUNCTION CO 815012980 MEDICAL PAYMENTS 8682499 PRIMARY CARE PARTNERS PC PO BOX 10700 GRAND JUNCTION CO 815025517 MEDICAL PAYMENTS 7246309 251 4270229 4270229 MEDICARE/MEDICAID PMTS 524114 191925838 191925838 PREMIUMS AND CO-PAYS 524114 127687097 127687097 CHILD HEALTH PLAN 524114 12873848 12873848 OTHER PROGRAMS 524114 31326 31326 332518109 4295134 4295134 306290 75041 306290 75041 0 0 0 29412602 28524791 4335 887811 -4335 883476 883476 MISCELLANEOUS INCOME 524114 323356 66905 256451 GOODWILL IMPAIRMENT WR 524114 -1500000 -1500000 -1176644 340790304 332518109 66905 3935061 943819 943819 285599537 285599537 2070700 2070700 23240618 23240618 659286 659286 81650 81650 43826 43826 198511 198511 586176 586176 1128884 1128884 1901030 1901030 411705 411705 33939 33939 1022407 1022407 237291 115898 121393 BROKER COMMISSIONS 2655745 2655745 OTHER GUSC PROGRAM EXPE 736423 736423 OTHER BEACON PROGRAM EX 393058 393058 IPA COSTS 385137 385137 REPAIRS AND MAINTENANCE 324563 324563 2160074 218348 1941726 324814379 288007083 36807296 0 29135801 18604488 9516190 13241219 1645820 19435726 19054242 4000000 647777 686470 25584374 13675362 8316719 11909012 75360640 89921819 623922 713226 147036775 155776296 33751943 34010496 5101233 5183345 867505 784244 39720681 39978085 X 107316094 115798211 107316094 115798211 147036775 155776296 X 15975925 -7493808 X X 0 1 1 X 1 1 3098963 3098963 4949468 1083036 3866432 249936 66286 183650 17286007 12526040 4759967 11909012 163270 C U.S. TREASURY SECURITIES 25973022 F U.S. AGENCY SECURITIES 7816529 F CORPORATE BONDS 25455776 F MORTGAGE BACKED SECURITIES 30196646 F CERTIFICATES OF DEPOSIT 316576 F 89921819 CONTINGENCY RESERVE 784244 784244 1 ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841424932 501(C)(3) 189248 TO SUPPORT INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE AND TO SUPPORT THE "BABY AND ME TOBACCO FREE" PROGRAM RUN BY THE ROCKY MOUNTAIN HEALTH PLANS FOUNDATION MARILLAC CLINIC 2333 N 6TH STREET GRAND JUNCTION CO 81501 841085822 501(C)(3) 36000 TO ENSURE DENTAL CARE IS AVAILABLE TO HELP PREVENT PREMATURE BIRTHS AND LOW BIRTH RATES FOR UNINSURED AND MEDICAID RECIPIENT PREGNANT WOMEN MESA DEVELOPMENTAL SERVICES 950 GRAND AVE GRAND JUNCTION CO 81501 846044855 501(C)(3) 9962 TO PROVIDE ACCESS AND SUPPORT TO COMMUNITY DEVELOPMENTAL SERVICES QUALITY HEALTH NETWORK 2764 COMPASS DR GRAND JUNCTION CO 81506 201632384 501(C)(3) 603839 TO SUPPORT THE ON-GOING MISSION OF QUALITY HEALTH NETWORK, NAMELY TO IMPROVE THE HEALTH OF AREA RESIDENTS THROUGH BETTER ACCESS TO INFORMATION, IMPROVE EFFICIENCIES AND ELIMINATE REDUNDANCIES, AND IMPROVE THE SATISFACTION OF PATIENTS AND PROVIDERS WITH THE HEALTHCARE DELIVERY SYSTEM. OF THE TOTAL FUNDS DISBURSED, $275,000 PERTAINS TO CONTRIBUTIONS IN SUPPORTING THE GENERAL OPERATIONS OF THE ORGANIZATION'S MISSION AND $328,839 PERTAINS TO FUNDS GIVEN TO QHN AS THE SUB-RECEIPIENT OF THE COLORADO BEACON CONSORTIUM GRANT. HILLTOP COMMUNITY RESOURCES 1331 HERMOSA AVE GRAND JUNCTION CO 81506 742321009 501(C)(3) 75000 TO SUPPORT WESTERN SLOPE OUTREACH AND ENROLLMENT IN THE "B4 BABIES AND BEYOND" PROGRAM WHICH PROMOTES HEALTHY WOMEN AND CHILDREN BY PROVIDING EARLY ACCESS TO PARENTAL HEALTH CARE HOSPICE & PALLIATIVE CARE OF WESTERN COLORADO PO BOX 60307 GRAND JUNCTION CO 81506 841207388 501(C)(3) 26000 TO SUPPORT THE ON-GOING MISSION OF HOSPICE AND PALLIATIVE CARE OF WESTERN COLORADO'S MANY PROGRAMS AND SERVICES TO HELP PATIENTS, FAMILIES, AND THE COMMUNITIES THEY SERVE UNDERSTAND AND COPE WITH THE MULTIPLE ISSUES THAT ARISE WHEN FACING ILLNESS, GRIEF, AND THE END OF LIFE. 6 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE REVIEWS IN DETAIL THE UNDERLYING MERIT OF AN ORGANIZATION'S REQUEST PRIOR TO GRANTING FUNDS. THE BOARD, ITS COMMITTEES AND/OR MANAGEMENT ALSO MONITOR AND INQUIRE ON THE UNDERLYING PROGRAM AS A WHOLE. X X X 0 0 0 0 0 0 0 0 0 STEPHEN K ERKENBRACK 346100 0 0 0 40100 0 77600 0 21400 0 485200 0 317700 0 LAUREL D WALTERS 204800 0 32100 0 0 0 30600 0 24000 0 291500 0 259200 0 PATRICK J DUNCAN 203300 0 31100 0 0 0 32700 0 23000 0 290100 0 244000 0 JAMES J SWAYZE 252800 0 46000 0 0 0 35900 0 24300 0 359000 0 321300 0 JANICE L ROHR 164100 0 25500 0 0 0 56400 0 21800 0 267800 0 196100 0 MICHAEL E HUOTARI 192900 0 30000 0 0 0 71900 0 21400 0 316200 0 214700 0 NEIL J WALDRON 232800 0 36000 0 0 0 72000 0 24300 0 365100 0 229000 0 KEVIN R FITZGERALD 227700 0 55300 0 0 0 97200 0 21300 0 401500 0 206400 0 VICKI SUE ESPINOZA 152200 0 23900 0 0 0 0 0 6100 0 182200 0 173800 0 ANGELA SIMMONS MOORE 136600 0 22100 0 0 0 0 0 7600 0 166300 0 154400 0 JOHN HOPKINS 0 0 0 0 118700 0 0 0 0 0 118700 0 264600 0 SUPPLEMENTAL INFORMATION PART III COMPENSATION INCLUDED ON SCHEDULE J IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC). HMC IS AN UNRELATED ENTITY MANAGEMENT COMPANY WITH WHOM ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) HAS A CONTRACT FOR MANAGEMENT SERVICES. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ENTITY LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J IS 100% OF THE COMPENSATION PAID BY HMC. HOWEVER, APPROXIMATELY 68% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 32% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. DAVID WARREN TERRY MD BOARD SECRETARY 121638 MEDICAL PROVIDER PAYMENTS 0 WILLIAM A KELLEY MD BOARD MEMBER 120776 MEDICAL PROVIDER PAYMENTS 0 EUGENE CHRISTIAN LAUNER BOARD MEMBER 975293 PURCHASE OF BUILDING OWNED BY THE ENTITY WHERE BOARD MEMBER IS AN OFFICER 0 ROCKY MOUNTAIN HEALTH MANAGEMENT CO ENTITY OWNED > 35% BUT <50% BY CURRENT OR FORMER OFFICERS AND DIRECTORS 27645546 MANAGEMENT FEES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTS WITH ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC) TO PERFORM MANAGEMENT SERVICES OF THE ORGANIZATION. HMC IS NOT A RELATED ORGANIZATION AND HAS A SEPARATE GOVERNING BOARD. THE COMPENSATION REPORTED ON PART VII AND SCHEDULE J FOR THOSE INDIVIDUALS WHO ARE NOT DIRECTORS OF THE ORGANIZATION BUT ARE LISTED AS OFFICERS OF THE ORGANIZATION WAS PAID BY HMC. FORM 990, PART VI, SECTION B, LINE 11 THE ENTIRE 990 IS DISTRIBUTED TO EACH DIRECTOR. EACH DIRECTOR IS GIVEN THE OPPORTUNITY TO ASK QUESTIONS AND/OR PROVIDE COMMENTS PRIOR TO FILING. THE TAX RETURN IS APPROVED BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD AS PREPARED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE COMPREHENSIVE CONFLICT OF INTEREST DISCLOSURE STATEMENTS. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE MAINTAINED BY THE ORGANIZATION AND ARE REVIEWED ANNUALLY BY THE ORGANIZATION'S LEGAL COUNSEL. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE COVERED UNDER THE POLICY. BEFORE EACH BOARD MEETING, LEGAL COUNSEL, THE CHAIR OF THE BOARD, AND THE CEO REVIEW THE AGENDA AND DETERMINE IF THERE IS A CONFLICT OF INTEREST POTENTIAL FOR EACH BOARD ACTION ITEM, AND DURING EACH BOARD MEETING LEGAL COUNSEL, THE CHAIR OF THE BOARD AND THE CEO ARE PRESENT AND DO THE SAME. IF THERE IS A POTENTIAL FOR A CONFLICT, THE BOARD IS ADVISED AND THE BOARD ACTS IN ACCORDANCE WITH ITS CONFLICT OF INTEREST POLICY. IF SOMEONE HAS A CONFLICT, THAT PERSON CANNOT PARTICIPATE IN THE DELIBERATIONS OR DECISION ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS INCLUDED ARE CEO, CFO, COO, MEDICAL DIRECTOR AND VICE PRESIDENTS. COMPARABILITY DATA IS USED TO DETERMINE COMPENSATION. A THIRD PARTY COMPENSATION EXPERT REPORT CERTIFIES THE REASONABLENESS OF THE COMPENSATION AMOUNTS. THIS PROCESS WAS USED IN 2010. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST TO THE EXTENT REQUIRED BY APPLICABLE LAW. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 506,192. CONTRIBUTED CAPITAL TO ROCKY MOUNTAIN HEALTHCARE OPTIONS, INC. -8,000,000. TOTAL TO FORM 990, PART XI, LINE 5: -7,493,808. FORM 990 PART XII LINE 2C THE BOARD ASSUMES RESPONSIBILITY FOR THE AUDIT, WHICH IS DONE ON THE STATUTORY BASIS OF ACCOUNTING, AND SELECTION OF AN INDEPENDENT AUDITOR. FORM 990 PART XII LINE 3B THE BOARD ASSUMES RESPONSIBILITY FOR AUDIT AND SELECTION OF THE INDEPENDENT AUDITOR IN ACCORDANCE WITH A-133 OR OTHER GRANT AGREEMENTS. FORM 990, PART VII, SECTION A, LINE 1A, COMPENSATION INFORMATION: COMPENSATION INCLUDED ON FORM 990, PART VII IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC). HMC IS AN UNRELATED ENTITY MANAGEMENT COMPANY WITH WHOM ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) HAS A CONTRACT FOR MANAGEMENT SERVICES. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ENTITY LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J IS 100% OF THE COMPENSATION PAID BY HMC. HOWEVER, APPROXIMATELY 68% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 32% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. FORM 990, NARRATIVE STATEMENT: ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) D/B/A ROCKY MOUNTAIN HEALTH PLANS IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTH BENEFITS PROVIDER THAT HAS SERVED THE HEALTH CARE NEEDS OF COLORADANS FOR MORE THAN 35 YEARS. RMHMO UNIQUELY UNDERSTANDS COLORADO'S HEALTH CARE CONSUMERS. WE PROVIDE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE ENABLING OUR MORE THAN 76,000 MEMBERS TO LIVE LONGER, HEALTHIER LIVES. RMHMO BELIEVES RECEIVING PREVENTIVE CARE IS KEY TO MAINTAINING GOOD HEALTH, WHICH IS WHY IT IS INCLUDED AS A STANDARD COMPONENT IN OUR BENEFIT PLANS. RMHMO IS KNOWN AS A STRONG AND TRUSTED LEADER IN HEALTH CARE AND IS EVER COMMITTED TO ITS COMMUNITY BENEFIT GOALS. THE ORGANIZATION IS DILIGENT AND DEVOTED TO PROVIDING INNOVATIVE, QUALITY HEALTH PLANS, IMPROVING ACCESS TO HEALTH CARE COVERAGE, AND IMPROVING THE WELL BEING OF INDIVIDUALS, FAMILIES, AND THE COMMUNITIES WE SERVE. VISION WE ARE A COST EFFECTIVE, EFFICIENTLY RUN ORGANIZATION IN THE HEALTH CARE INDUSTRY. WE ADD VALUE TO EVERYONE WE TOUCH. MISSION WE TAKE THE INITIATIVE TO IMPROVE THE LIVES OF OUR MEMBERS AND THE HEALTH OF OUR COMMUNITIES BY OFFERING INNOVATIVE HEALTH PLANS, PROVIDING EXCELLENCE IN SERVICE AND CARE OF OUR MEMBERS, AND STAYING TRUE TO OUR TRADITION OF PUTTING PEOPLE BEFORE PROFITS. VALUES WE MAKE DECISIONS BASED ON THE WELL BEING OF OUR MEMBERS. WE ARE RESPECTFUL, COMPASSIONATE, AND FAIR. WE ARE INNOVATIVE AND ACTION-ORIENTED. WE HONOR THE RIGHTS OF PHYSICIANS AND PATIENTS IN MEDICAL DECISION-MAKING. WE ARE CATALYSTS FOR CONTINUOUS QUALITY IMPROVEMENT. WE BELIEVE THAT THE QUALITY OF OUR RELATIONSHIPS SHAPES OUR FUTURE. SERVING THE UNDERSERVED CHILDREN'S HEALTH PLANS PLUS (CHP+) & CHILDREN'S HEALTH PLAN PRENATAL SERVICES RMHMO OFFERS CHP+ COVERAGE TO INDIGENT CHILDREN AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES PREGNANT WOMEN. IN 2010, RMHMO SERVED OVER 9,000 INDIGENT CHILDREN AND PREGNANT WOMEN UNDER THE CHP+ AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES PROGRAM THROUGHOUT 22 COLORADO COUNTIES. THE RMHMO MEDICAID AND CHP+ PROGRAMS CONTINUALLY RECEIVE THE HIGHEST APPROVAL RATING IN ALL PROGRAM CATEGORIES, INCLUDING OVERALL RATING OF HEALTH PLAN. THIS ACHIEVEMENT SIGNIFIES THE 35 YEAR COMMITMENT ROCKY MOUNTAIN HEALTH PLANS HAS TAKEN TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE UNDERSERVED IN COLORADO. MEDICAID UNDER A MEDICAID AGREEMENT BETWEEN RMHMO AND THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, RMHMO PROVIDED COST-SAVING MEDICAL SERVICES TO NEARLY 19,000 MEDICAID RECIPIENTS IN 2010. THE COUNTIES SERVED BY RMHMO UNDER THE MEDICAID AGREEMENT ARE DELTA, MESA, MOFFAT, MONTROSE, OURAY, RIO BLANCO, AND SAN MIGUEL. UNDER THIS PROGRAM RMHMO PROVIDED ACCESS FOR MEDICAID RECIPIENTS TO NEARLY ALL PHYSICIANS (PRIMARY CARE AND SPECIALISTS) WHO PRACTICE IN THESE COUNTIES. RMHMO IS THE ONLY MANAGED CARE ORGANIZATION IN WESTERN COLORADO PROVIDING SERVICES FOR PEOPLE COVERED BY MEDICAID. ADDITIONAL COMMUNITY BENEFITS AND CHARITABLE CONTRIBUTIONS: AMERICAN DIABETES ASSOCIATION MAJOR SPONSOR OF STEP OUT TO FIGHT DIABETES WALK WHICH FUNDS RESEARCH TO PREVENT, CURE, AND MANAGE DIABETES. BABY & ME, TOBACCO FREE A TOBACCO CESSATION PROGRAM TO HELP WOMEN STOP SMOKING BOTH DURING AND AFTER THEIR PREGNANCY. THIS STATEWIDE PROGRAM OFFERS COACHING, CARBON MONOXIDE TESTING, AND MONITORING. MOTHERS WHO STAY SMOKE-FREE RECEIVE FREE DIAPERS FOR UP TO ONE YEAR AFTER THE BABY IS BORN. COPAYMENT COLLECTIONS RMHMO IS THE ONLY HEALTH PLAN IN COLORADO THAT BILLS AND COLLECTS COPAYMENTS ON BEHALF OF ITS MEMBERS. THIS SERVICE ELIMINATES THE BARRIER FOR PEOPLE SEEKING AND NEEDING CARE THAT DO NOT HAVE THE MONEY TO PAY THEIR COPAYMENT AT THE TIME OF THEIR VISIT. MEMBERS AND FAMILIES ARE RELIEVED OF THIS BURDEN AS ARE PHYSICIANS WHO STRUGGLE TO COLLECT FROM PATIENTS WHO NEED CARE, BUT CAN NOT PAY AT THE TIME OF THE SERVICE. COVERCOLORADO COVERCOLORADO IS THE COLORADO INSURANCE PROGRAM THAT PROVIDES COVERAGE TO INDIVIDUALS WHO CANNOT OBTAIN INSURANCE DUE TO THEIR HEALTH CONDITION. RMHMO PROVIDES CONCURRENT HOSPITAL NURSING REVIEWS FREE OF CHARGE IN MESA COUNTY FOR INDIVIDUALS COVERED BY COVERCOLORADO. GIRLS ON THE RUN RMHMO IS THE TITLE SPONSOR OF THIS NOT-FOR-PROFIT PROGRAM THAT HELPS PREPARE GIRLS AGES EIGHT THROUGH 14 FOR A LIFETIME OF HEALTHY LIVING. GRAND VALLEY HEALTH FAIR CONTRIBUTION AS A MAJOR SPONSOR WITH MORE THAN 100 HOURS OF LABOR CONTRIBUTED TO THE PROGRAM THAT HELPS TO PROVIDE MESA COUNTY WITH COMMUNITY HEALTH AND AWARENESS SCREENINGS. MESA DEVELOPMENTAL SERVICES CONTRIBUTION ASSISTS INDIVIDUALS, YOUNG AND OLD, WHO LIVE WITH DEVELOPMENTAL DISABILITIES TO HAVE ACCESS AND SUPPORT TO COMMUNITY SERVICES. QUALITY HEALTH NETWORK CONTRIBUTION HELPS IN THE DEVELOPMENT, IMPLEMENTATION, AND SUPPORT OF THE HEALTH INFORMATION EXCHANGE. THE ORGANIZATION IS NATIONALLY RECOGNIZED FOR HELPING COORDINATE AND SUPPORT CARE FOR OVER 300,000 PATIENTS. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION, INC. CONTRIBUTION OFFERS SUPPORT TO NUMEROUS COMMUNITY PROJECTS AROUND THE STATE, SUCH AS: - HELPING INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE, - CREATING INCENTIVES FOR PREGNANT WOMEN TO STOP SMOKING, - HELPING SCHOOLS IN ALLOWING MORE PHYSICAL ACTIVITY FOR STUDENTS TO DECREASE OBESITY AND INCREASE TEST SCORES. WORKSITE WELLNESS PROGRAMS PROVIDE TOOLS, RESOURCES, AND TRAINING TO ASSIST EMPLOYERS IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THIS COMPREHENSIVE PROGRAM FOCUSES ON PROMOTING WELLNESS AND PREVENTING ILLNESS. RMHMO WAS NAMED A GOLD WELL WORKPLACE BY THE WELLNESS COUNCIL OF AMERICA. RECOGNITION GAINED BY SUCCESSFULLY MEETING RIGOROUS HEALTH PROMOTION STANDARDS. BY EARNING THIS PRESTIGIOUS DESIGNATION, WE ARE RECOGNIZED AS ONE OF THE AMERICA'S HEALTHIEST COMPANIES. PHYSICIAN RECRUITMENT EFFORT IN 2009 RMHMO COMMITTED SIGNIFICANT FUNDING TO MUTI-YEAR EFFORT TO COORDINATE, RECRUIT, ATTRACT AND MAINTAIN ADDITIONAL PRIMARY CARE PHYSICIANS IN CERTAIN COMMUNITIES. THIS EFFORT WAS INITIATED TO ADDRESS THE PRIMARY PHYSICIAN SHORTAGE AND WILL STRIVE TO ACQUIRE AND MAINTAIN A SUFFICIENT NUMBER OF QUALIFIED PHYSICIANS TO ADEQUATELY SERVE THE HEALTH CARE NEEDS OF OUR MEMBERS IN KEY AREAS. THE COMMITTMENT WILL BE FUNDED THROUGH 2013. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841424932 TO FACILITATE PHILANTHROPIC SUPPORT FOR INNOVATIVE HEALTHCARE APPROACHES. CO 501(C)(3) 7 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED 0 QUALITY HEALTH NETWORK 2764 COMPASS DRIVE GRAND JUNCTION CO 81506 201632384 DEVELOPMENT, IMPLEMENT, & SUPPORT OF THE HEALTH INFORMATION EXCHANGE. CO 501(C)(3) 11, TYPE 1 N/A 0 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841224718 OFFERS ALTERNATIVE HEALTH CARE PRODUCTS IN THE AREA SERVICED BY RMHMO. CO ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED C 156110648 29365051 1.00000 CNIC HEALTH SOLUTIONS INC 6251 GREENWOOD PLAZA BLVD STE 300 GREENWOOD VILLAGE CO 80111 710873411 PROVIDES ADMIN SVCS FOR MEDICAL, DENTAL, AND CONSUMER DRIVEN HEALTH PLANS. CO ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED C 16781371 2414336 1.00000 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC B 8000000 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC P 306290 CNIC HEALTH SOLUTIONS INC I 75041 CNIC HEALTH SOLUTIONS INC P 607000 QUALITY HEALTH NETWORK B 275000 QUALITY HEALTH NETWORK B 328839 ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC B 189248