2011-08-12T15:15:16-05:00 2010-12-31 ERNST & YOUNG US LLP 200 CLARENDON STREET BOSTON MA 021165076 990 2010-01-01 050477052 Neighborhood Health Plan of Rhode Island NEIG 4014596000 299 Promenade Street Providence RI 02908 T Clark Phillip 2011-08-12 6172662000 2010 2016-02-24 21:20:13Z T Clark Phillip CFO 299 Promenade Street Providence RI 02908 521444821 false X www.nhpri.org X 2000 RI Neighborhood Health Plan of Rhode Island, an innovative health plan in partnership with community health centers, is a catalyst for improved access and better health in Rhode Island. 14 4 236 13 0 0 24087 51662 350428606 388620353 1510846 1085822 1099848 14988 353063387 389772825 1350 1501978 336657211 335433395 18179747 18296334 0 0 0 18499350 21165215 373337658 376396922 -20274271 13375903 110011506 114622138 90120963 82249490 19890543 32372648 Neighborhood Health Plan of Rhode Island, an innovative health plan IN PARTNERSHIP WITH COMMUNITY HEALTH CENTERS, IS A CATALYST FOR IMPROVED ACCESS AND BETTER HEALTH IN RHODE ISLAND, ESPECIALLY FOR VULNERABLE POPULATIONS. false false 347952188 1500000 388620353 Neighborhood Health Plan of Rhode Island is a Health Maintenance Organization (HMO) that provides comprehensive health care services on a prepaid basis principally to Medicaid recipients and certain other eligible persons under the State of Rhode Island and Providence Plantations managed care program, RIteCare. As of December 31, 2010 the organization is responsible for providing health care services to over 90,372 members. 347952188 true true false true false false false false false true false false false true false true false false false false false false false false false false true false true false false false true false false false true false false false false false false false false false false true 1443 0 true 236 true false false false false false false false false false false X 14 4 true false false false true true true true true false false true false false false true true false X T CLARK PHILLIP CFO 4014596000 299 Promenade Street Providence RI 02908 Maria Montanaro 1.0 X 0 0 0 Jane Hayward 1.0 X 0 0 0 Merrill Thomas 1.0 X 0 0 0 Brenda Dowlatshahi 1.0 X 0 0 0 James Hooley 1.0 X 0 0 0 Darrell Lee 1.0 X 0 0 0 Stephanie McCaffrey 1.0 X 0 0 0 Pablo Rodrigues MD 1.0 X 0 0 0 Peter Bancroft 1.0 X 0 0 0 Doris DeLos Santos 1.0 X 0 0 0 Raymond Lavoie 1.0 X 0 0 0 Peter Walsh 1.0 X 0 0 0 Jerald Fingerut MD 1.0 X 0 0 0 Mark Reynolds 40.0 X X 288568 0 39749 Nancy Coburn 40.0 X 186529 0 23205 Leon McTyeire Johnson 40.0 X 199391 0 34181 T Clark Phillip 40.0 X 185759 0 25709 Michelle Lupoli 40.0 X 128514 0 30020 Brenda Seagrave-Whittle 40.0 X 121983 0 32029 Nancy Hermiz 40.0 X 125233 0 21441 Beth Ann Marootian 40.0 X 120839 0 30510 Peter Vargas 40.0 X 118167 0 28484 1474983 0 265328 23 false true false Rhode Island Hospital 593 Eddy Street PROVIDENCE RI 02903 Healthcare Services 59836249 Argus Health Systems Inc 1300 Washington Street KANSAS CITY MO 64105 Healthcare Services 54671972 Beacon Health Strategies LLC 200 State Street BOSTON MA 02109 Healthcare Services 53220454 Women Infants Hospital of Rhode I 101 Dudley Street PROVIDENCE RI 02905 Healthcare Services 33555968 Memorial Hospital of Rhode Island P O Box 1908 PAWTUCKET RI 02860 Healthcare Services 10889757 214 50000 1662 51662 Premiums Earned 524114 384148522 384148522 Administrative Fees 524114 14741 14741 REINSURANCE RECOVERIES 524114 2422696 2422696 PHARMACY DIVIDENDS 524114 893849 893849 DHS SITE VISIT PROGRAM 524114 1140545 1140545 388620353 984765 984765 0 0 131773053 131671996 101057 101057 101057 0 0 0 MISELLANEOUS REVENUE 900099 14988 14988 14988 389772825 388620353 0 1100810 1500000 1500000 1978 1978 0 335433395 335433395 2741944 2741944 0 11898893 6748604 5150289 469957 194345 275612 2010502 952935 1057567 1175038 479468 695570 0 193614 193614 492820 492820 0 0 247995 247995 5561868 1164700 4397168 430742 15122 415620 685783 5762 680021 1309541 16515 1293026 0 1511597 770914 740683 11980 2228 9752 0 0 144310 144310 0 540408 92564 447844 173620 173620 State Premium Tax 7741735 7741735 Temporary Help 1262893 520071 742822 Training 278399 278399 All other expenses 577910 53587 524323 376396922 347952188 28444734 0 38564509 17128604 50000 10537817 5195613 21600 6160 3960925 3111968 1320263 848957 59452411 91266119 114906 126685 110011506 114622138 18330463 13939341 1500000 1500000 1500000 70290500 65310149 90120963 82249490 X 19890543 32372648 19890543 32372648 110011506 114622138 X 13375903 -893798 X false true true X false X 124651 0 430425 24087 51662 630825 245593457 250384451 290088053 351528454 388620353 1526214768 245718108 250384451 290518478 351552541 388672015 1526845593 1526845593 2297844 3309728 2858373 1394666 984765 10845376 2297844 3309728 2858373 1394666 984765 10845376 1645 67322 0 0 14988 83955 248017597 253761501 293376851 352947207 389671768 1537774924 0.99289 0.99003 0.00705 0.00827 X Miscellaneous Income of $14,988 results from the receipt of legal claim settlements, unclaimed property from the State of Rhode Island, and a small of amount of close out prescription claims. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 112592 false false 112592 false Schedule C Part II-B Line g Neighborhood Health Plan of Rhode Island does not directly engage in any lobbying activities but does engage two lobbying companies, one for Federal lobbying activities and one for State lobbying activities. 662600 353389 309211 2668506 2371252 297254 629820 387328 242492 848957 0 IBNR LIABILITIES 24745572 UNEARNED PREMIUMS 32285054 RISK SHARE GAIN/LIABILITY 8279523 65310149 389772825 376396922 13375903 -893798 -893798 12482105 386927837 -2782128 -2782128 389709965 62860 62860 389772825 373809931 257997 -62860 195137 373614794 335454 2446674 2782128 376396922 Reconciliation of Change in Net Assets from Form 990 to Audited Fin Stmts Schedule D Part XI Claim Adjustment Expense change thru 12/31/10 - $906,649 and Unrealized (Gain)/Loss on Investments ($12,851.) Reconciliation of Revenue per Audited Financial Statements to Tax Return Schedule D Part XII - 2d - Other Reclass of Reinsurance Premiums - $2,446,674. Reclass of Investment fees & Interest - $335,454. Reconciliation of Expenses per Audited Financial Statement to Tax Return Schedule D Part XII - 4b - Other Reclass of Pharmacy Dividends - $893,846. Reclass of Reinsurance Recoveries - $2,422,696. Reclass of Risk Share Settlements - ($3,268,670.) Reclass of Miscellaneous Income - $14,988. Reconciliation of Expenses per Audited Financial Statements to Tax Return Schedule D Part XIII 2d-Other Reclass of Pharmacy Dividends - $893,846.; Reclass of Reinsurance Recoveries - $2,422,696.; Reclass of Risk Share Settlements - $3,268,670.; Reclass of Miscellaneous Income - $14,988 Reconciliation of Expenses per Audited Financial Statements to Tax Return Schedule D Part XIII 4B Other Reclass of Reinsurance Premiums - $2,446,674. Schedule D Part XIV There was no FIN 48 footnote in the audited financial statements. true Blackstone Valley Community Health Center 428 Park Place Pawtucket RI 02860 510183476 501(c)(3) 217483 Reduce Medical Expenses, expand services, upgrade EMR system Chad Brown Health Center 285A Chad Brown Street Providence RI 02908 050391357 501(c)(3) 33947 Reduce Medical Expenses, expand services, upgrade EMR system East Bay Community Action Program 19 Broadway Newport RI 02840 050310024 501(c)(3) 69244 Reduce Medical Expenses, expand services, upgrade EMR system WellOne Pascog 36 Bridge Way Pascoag RI 02859 050258811 501(c)(3) 41496 Reduce Medical Expenses, expand services, upgrade EMR system Providence Community Health Center 375 Aliens Avenue Providence RI 02905 050368134 501(c)(3) 643894 Reduce Medical Expenses, expand services, upgrade EMR system Thundermist Health Center of Woonsocket 191 Social Street Woonsocket RI 02895 050355097 501(c)(3) 292173 Reduce Medical Expenses, expand services, upgrade EMR system Tri Town Economic Opportunity Committee 1126 Hartford Avenue Johnston RI 02919 050309695 501(c)(3) 39345 Reduce Medical Expenses, expand services, upgrade EMR system Wood River Health Services Inc 823 Main Street Hope Valley RI 02832 050378071 501(c)(3) 47596 Reduce Medical Expenses, expand services, upgrade EMR system Comprehensive Community Action 311 Doric Avenue Cranston RI 02910 056018801 501(c)(3) 95840 Reduce Medical Expenses, expand services, upgrade EMR system WellOne North Kingstown 308 Callahan Road North Kingstown RI 02852 050258811 501(c)(3) 18500 Reduce Medical Expenses, expand services, upgrade EMR system 10 0 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants The recipients submitted paid invoices in their requests with respect to the EMR and system capacity portion of the grants. As per the organizations by-laws, all Community Health Centers must be 501(c)(3) entities and members of the Rhode Island Health Center Association, which also is a 501(c)(3) entity. Neighborhood monitors and works with the CHC's on a monthly basis providing them with statistical information and recommendations regarding controlling costs and member satisfaction. X X X false false false false false false false false false Mark Reynolds 281926 0 0 6642 9800 29949 328317 0 0 Nancy Coburn 185418 0 0 1111 7589 15616 209734 0 0 Leon McTyeire Johnson 198124 0 0 1267 8130 26051 233572 0 0 T Clark Phillip 184075 0 0 1684 7489 18220 211468 0 0 Michelle Lupoli 128346 0 0 168 5314 24706 158534 0 0 Brenda Seagrave-Whittle 121617 0 0 366 5125 26904 154012 0 0 Beth Ann Marootian 120607 0 0 232 5030 25480 151349 0 0 RI Community Fndn Surplus Note Payable X 2000000 1500000 false true true 1500000 Blackstone Valley Community Health See Part V 2843677 Cap & Fee for Svce Med Paymt Thundermist Health Center See Part V 3668519 Cap & Fee for Svce Med Paymt Providence Community Health Center See Part V 7549728 Cap & Fee for Svce Med Paymt Tri-Town Community Action Agency See Part V 353384 Cap & Fee for Svce Med Paymt Rhode Island Health Center Associat See Part V 150000 Cap & Fee for Svce Med Paymt East Bay Community Action Program See Part V 522675 Cap & Fee for Svce Med Paymt WellOne Primary Medical Dental Ca See Part V 519992 Cap & Fee for Svce Med Paymt Transactions with Interested Parties Schedule L, Part IV Raymond Lavoie - Member of the Organization's Board of Directors and is Ex. Dir of a CHC, Blackstone Valley Community Health Center, Inc. The Organization makes capitation and fee for service medical payments to Blackstone Valley Community Health Care, Inc. Maria Montanaro - Officer of the Organization's Board of Directors and is Pres. of a CHC, Thundermist Health Center. The Organization makes capitation and fee for service medical payments to Thundermist Health Center. Merrill Thomas - Officer of the Organization's Board of Directors and is CEO of a CHC, Providence Community Health Center. The Organization makes capitation and fee for service medical payments to Providence Community Health Center. Brenda Dowlatshahi - Officer of the Organization's Board of Directors and is Assoc. Ex. Dir. of a CHC, Tri-Town Community Action Agency. The Organization makes capitation and fee for service medical payments to Tri-Town Community Action Agency. Jane Hayward - Officer of the Organization's Board of Directors and is Ex. Dir. of the RI Health Center Association. The Organization makes contributions towards the Association's various health center professional development programs and public awareness functions. Stephanie McCaffrey - Member of the Organization's Board of Directors and is the Administrator of a CHC, East Bay Community Action Program. The Organization makes capitation and fee for service medical payments to East Bay Community Action Program. Peter Bancroft - Member of the Organization's Board of Directors and is Pres. of a CHC, WellOne Primary Medical & Dental Care. The Organization makes capitation and fee for service medical payments to WellOne Primary Medical & Dental Care. Jerald Fingerut - Member of the Organization's Board of Directors and Medical Director of Blackstone Valley Community Health Care, Inc. The Organization makes capitation and fee for service medical payments to Blackstone Valley Community Health Care, Inc. Pablo Rodrigues, MD - Member of the Organization's Board of Directors and CEO of Women's Care, Inc. The Organizaton makes fee for service medical payments to Women's Care, Inc. Form 990 VI, Question 2 A member of the Organization's Board of Directors is an Executive Director of a Community Health Center (CHC), Blackstone Valley Community Health Center, Inc. Blackstone Valley Community Health Center, through a grant, invested in equipment and software for an Electronic Medical Records (EMR) system. Three other CHC's, East Bay, Tri-Town and Comprehensive Community Action Plan, have use of the EMR and billing systems and WellOne uses the EMR portion of the system. The CHC's share the cost of the system. FORM 990, PART VI, LINE 6 The organization is a 501 C (3) corporation and has members but does not have any stockholders. The Organization has a Board of Directors who are members of the organization that meet on a regular basis and function as the governing body for the organization. FORM 990, PART VI, LINE 7A, 7B The Board of Directors has a number of committees, one of which is a nominating committee. When a seat on the Board becomes open, the nominating committee is charged with filling the vacancy. The Board invites people to submit resumes and letters of interest and then develops a list of candidates to interview. After the interview process, the nominating committee submits its recommendation to the full Board for consideration. The Board can either vote to approve the candidate or request other candidates for consideration. The organization's Board of Directors elects other members of the governing body and provides overall direction for the organization. The Board approves budgets, financial statements and major projects. Form 990, Part VI, Question 11b The organization's Fiscal Operations department accumulates the information and data necessary to complete the Federal Form 990. Audited Financial Statements and approved policies and procedures are used as input to complete the 990. A draft return is prepared and reviewed by the organization's independent Certified Public Accountants. After the review process is completed by the independent accountants, the Finance staff reviews the form 990 prior to filing with the IRS. The Board is also provided an electronic copy of the return prior to filing with the IRS. Part VI Governance, Questions 12a, 13 and 14 Pursuant to the instructions for Form 990, the Organization must answer no to these questions because neither the Board of Directors nor a Board delegated committee approved or adopted these policies during 2010 by the end of the tax year. However, the Organization has issued these policies at the direction of management and these policies and procedures are strictly enforced by the Organization's management team. Form 990, Part VI, Question 12c As promulgated by the organization's compliance plan, the organization's Director of Human Resources and Organizational Development is also the organization's Chief Privacy Officer. If a potential conflict of interest is reported, the Chief Privacy Officer meets with the employee to discuss the issue in order to determine if a possible conflict exists. If it is determined that a conflict exists, the Chief Privacy Officer refers the appropriate items through the CFO to the CEO for a resolution/decision. FORM 990, PART VI, LINE 15A & 15B The Planning Committee of the Board of Directors reviews and approves the contract of the CEO and any changes to the contract. The Organizational Development and Human Resources Committee of the Board of Directors reviews the compensation of the Chief Financial Officer, Chief Medical Officer and Chief Operating Officer based on a compensation survey. The Committee subscribes to three or four salary surveys that list salary and salary increases by position, geography, plan size, and profit vs. non-profit. These surveys are used to set compensation annually with the last one being completed in 2010. Form 990, Part VI, Question 19 The governing documents, conflict of interest policy and financial statements are available to the public upon request at the organization's location at 299 Promenade Street, Providence, RI 02908. Part XI - Reconciliation of Net Assets - Line 5 Claim Adjustment Expense change thru 12/31/10 - $906,649 and Unrealized (Gain)/Loss on Investments ($12,851.)