2024-11-15T08:18:24-06:00 2023-12-31 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2023-01-01 042452600 HARVARD PILGRIM HEALTH CARE INC % SCOTT WALKER CFO HARV 7812636000 1 WELLNESS WAY CANTON MA 020211166 MARK PORTER TREASURER 7812636000 2024-11-13 true true ANTONIO C RUSSO P00858539 2673303000 2024-11-13 2023 2024-10-15 13:58:12Z MARK PORTER 1 WELLNESS WAY CANTON MA 020211166 2334371080 false X www.harvardpilgrim.org X 1969 MA SEE SCHEDULE O 13 12 8 0 305647519 0 62940443 108861517 1762272007 2094574737 22358243 26146615 3521121 5091855 1851091814 2234674724 6000000 6000000 1517656041 1763798074 100023347 147609145 0 0 0 256835572 356840899 1880514960 2274248118 -29423146 -39573394 1102710194 1111423122 466733432 497415505 635976762 614007617 X SEE SCHEDULE O false false 2096743867 6000000 2099516981 TO IMPROVE THE QUALITY AND VALUE OF HEALTH CARE FOR THE PEOPLE AND COMMUNITIES WE SERVE. 108861517 0 0 HARVARD PILGRIM HEALTH CARE INSTITUTE, LLC PERFORMS RESEARCH AND RESEARCH ADMINISTRATION FOR GRANTS AND CONTRACTS AWARDED TO HPHC, INC. THE INSTITUTE IS A COLLABORATION BETWEEN HPHC, INC. AND HARVARD MEDICAL SCHOOL. ITS MISSION IS TO IMPROVE HEALTH CARE DELIVERY AND POPULATION HEALTH THROUGH RESEARCH AND EDUCATION, IN PARTNERSHIP WITH HEALTH PLANS, DELIVERY SYSTEMS, AND PUBLIC HEALTH AGENCIES. 2205605384 true true false true false false false false false false true true false true true true true true false false false false false false false false false true false true false false false false false false false false false false false false true true true true true false true 16431 0 true 8 true true true false false false false false false false false false false false X 13 12 true true false false true true true true true false false true true true true true true true true false MA X SCOTT WALKER CFO 6179729400 1 WELLNESS WAY CANTON MA 020211166 X CAIN HAYES PRESIDENT & CEO 10.0 40.0 X X 0 3859017 387442 PHILIP BARR EVP, PRESIDENT, MARKETS 10.0 40.0 X 0 1750853 201705 PATRICIA HOWARD COO (END 5/3) 10.0 40.0 X 0 1613105 59229 UMESH KURPAD CFO (END 7/4) 10.0 40.0 X 0 1454835 166409 PETE CHURCH CHIEF PEOPLE OFFICER 10.0 40.0 X 0 1348346 199722 R SCOTT WALKER CFO (START 7/5) 10.0 40.0 X 0 1454449 15325 TISA HUGHES CLERK/SECRETARY 10.0 40.0 X 0 1330477 135726 TRACEY CARTER SVP, CHIEF ACTUARY 10.0 40.0 X 0 1175535 167611 SELMA FERHATBEGOVIC SVP, CHIEF INFORMATION OFFICER 10.0 40.0 X 0 1107453 152803 MARK PORTER TREASURER (START 10/12) 10.0 40.0 X 0 1055628 166825 PATRICIA BLAKE SVP, PRESIDENT MEDICARE 10.0 40.0 X 0 1051263 160733 KRISTIN LEWIS CHIEF PUB & COMM AFF OFFICER 10.0 40.0 X 0 1034645 152533 MICHAEL CARSON FORMER PRESIDENT (END 10/1/21) 0.0 0.0 X 0 866154 0 SUSAN KEE CLERK/SECRETARY (START 12/11) 10.0 40.0 X 0 645368 72203 ROLAND PRICE TREASURER (END 10/11) 10.0 40.0 X 0 596123 79256 THOMAS CROSWELL FORMER CEO 0.0 0.0 X 0 612500 9150 DEBORAH NORTON FORMER SVP, CIO 0.0 0.0 X 170069 0 8843 EILEEN AUEN DIRECTOR, CHAIR 2.0 6.0 X X 161250 0 0 MICHAEL J MCCOLGAN DIRECTOR 1.0 3.0 X 131750 0 0 GREGORY D TRANTER DIRECTOR 1.0 3.0 X 129375 0 0 MICHAEL SHEA DIRECTOR 1.0 3.0 X 123375 0 0 BERTRAM L SCOTT DIRECTOR 1.0 3.0 X 119375 0 0 HEDWIG VEITH WHITNEY DIRECTOR 0.0 1.0 X 117375 0 0 MYECHIA MINTER-JORDAN MD DIRECTOR (END 12/8) 1.0 3.0 X 116375 0 0 TODD WHITBECK DIRECTOR 1.0 3.0 X 113000 0 0 PETER SLAVIN MD DIRECTOR 1.0 3.0 X 112000 0 0 RAYMOND PAWLICKI DIRECTOR 1.0 3.0 X 111000 0 0 IRINA SIMMONS DIRECTOR 1.0 3.0 X 109000 0 0 JOYCE MURPHY DIRECTOR 1.0 3.0 X 107000 0 0 GREG SHELL DIRECTOR, VICE CHAIR 1.0 5.0 X X 13000 0 0 1181944 20955751 2135515 13 true true false DELOITTE TOUCHE LLP PO BOX 844717 DALLAS TX 752844717 CONSULTING SERVICES 6358440 SEI-BOSTON LLC 11500 NORTHLAKE DRIVE STE 450 CINCINNATI OH 45249 CONSULTING SERVICES 2543175 MERKLE INC 29432 NETWORK PLACE CHICAGO IL 606731294 DIGITAL MARKETING 1804369 LOEB LOEB LLP 10100 SANTA MONICA BLVD STE 2200 LOS ANGELES CA 90067 LEGAL SERVICES 1061656 ROPES GRAY LLP PO BOX 11839 NEWARK NJ 071018138 LEGAL SERVICES 615335 156 82623113 26238404 108861517 MEMBER PREMIUMS & FEES 524114 1789102974 1789102974 PPO PREMIUMS (FULLY INSURED) 524298 305471763 305471763 2094574737 21225831 -13980 21239811 0 0 1751733 1602122 149611 0 149611 189736 -40125 100085830 2929188 95198379 2895855 4887451 33333 4920784 4920784 0 0 0 0 0 0 0 0 0 PROVIDER SETTLEMENT & OTHER 900099 4942244 4942244 4942244 2234674724 1794045218 305647519 26120470 X 6000000 6000000 0 0 1763798074 1763798074 96604 77283 19321 0 0 110331353 88265081 22066272 0 8276204 6620963 1655241 0 20697193 16557754 4139439 0 8207791 6566233 1641558 0 0 1105104 0 1105104 0 8021679 0 8021679 0 0 0 0 33851128 33851128 0 0 7771770 7771770 0 0 69393447 55514758 13878689 0 85437619 68350095 17087524 0 0 2944593 2355674 588919 0 270949 270949 0 0 0 121036 121036 0 0 2102109 1681687 420422 0 0 0 1170042 936034 234008 0 0 GRANT EXPENDITURES 105513348 108861517 -3348169 0 BROKER FEES 33474440 33474440 0 0 OTHER EXPENSES 5663635 4530908 1132727 0 2274248118 2205605384 68642734 0 X -8300632 -25276 23908386 32938519 0 0 188017109 236398202 0 0 0 0 0 0 0 0 6279504 7034710 606388754 585271733 23966992 21117021 163684453 147012737 261167327 246683008 0 0 0 0 443987055 420264201 1102710194 1111423122 254356046 312252682 0 0 0 0 0 0 0 0 0 0 0 6806620 0 0 212377386 178356203 466733432 497415505 X 0 0 0 0 635976762 614007617 635976762 614007617 1102710194 1111423122 X -39573394 14519069 3085180 X X false true X true true true X 57613894 65457721 79331804 62940443 108861517 374205379 1519972733 1571425742 1632644608 1501890865 1789102974 8015036922 0 0 0 1577586627 1636883463 1711976412 1564831308 1897964491 8389242301 0 56053752 51449790 54943955 53364320 43526106 259337923 56053752 51449790 54943955 53364320 43526106 259337923 8129904378 19605318 18634286 23511750 24008498 22801808 108561660 0 19605318 18634286 23511750 24008498 22801808 108561660 0 0 0 0 0 0 2695104 4743055 3156296 2583622 4942244 18120321 1599887049 1660260804 1738644458 1591423428 1925708543 8515924282 0.95467 0.95280 0.01275 0.01246 X FORM 990, SCHEDULE A, PART III, LINE 12 DETAIL OF OTHER INCOME OTHER INCOME IS COMPOSED OF PROVIDER SETTLEMENT/OTHER MISC. REVENUES FOR THE TAX YEARS REPORTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 0 false true 0 0 false FORM 990, SCHEDULE C, PART II-B, LINE 1 DETAIL OF LOBBYING ACTIVITIES POINT32HEALTH, INC., A RELATED IRC SECTION 501(C)(4) ORGANIZATION AND SOLE CORPORATE MEMBER OF HARVARD PILGRIM HEALTH CARE, INC. (HPHC), ENGAGES IN LOBBYING ACTIVITIES ON BEHALF OF ITSELF AND RELATED ORGANIZATIONS. POINT32HEALTH SERVICES, INC., A RELATED FOR-PROFIT ORGANIZATION, PAYS FOR ALL LOBBYING EXPENSES INCURRED, INCLUDING THE SALARIES ASSOCIATED WITH ANY DIRECT LOBBYING ACTIVITIES. EXAMPLES OF LOBBYING ACTIVITIES INCLUDE STRATEGIES FOR ADDRESSING PENDING LEGISLATION AND PROVIDING LEGISLATORS WITH INFORMATION REGARDING THE IMPACT OF ANY PENDING LEGISLATION ON THE ORGANIZATION'S ACTIVITIES. TOTAL LOBBYING EXPENSES INCURRED BY POINT32HEALTH SERVICES, INC. FOR THE YEAR ENDED DECEMBER 31, 2023 WERE APPROX. $1,374,000. HPHC IS ALSO A MEMBER OF VARIOUS TRADE ASSOCIATIONS, INCLUDING THE MASSACHUSETTS ASSOCIATION OF HEALTH PLANS. A PORTION OF THE MEMBERSHIP DUES PAID MAY BE USED BY THESE TRADE ASSOCIATIONS FOR LOBBYING PURPOSES. 4000000 4000000 42321552 27438639 14882913 560067202 557833094 2234108 21117021 DEBT & OTHER INVESTMENTS 246683008 C 246683008 INVESTMENTS IN AFFILIATES 275120249 SPECIAL DEPOSITS 402847 DUE FROM AFFILIATES 10365541 OTHER INVESTED ASSETS 134375564 420264201 0 UNEARNED GROUP PREMIUM 49129898 LIAB FOR AMTS UNDER UNINSURED 94114433 BORROWED MONEY & INTEREST THER 20000000 DUE TO AFFILIATES 15111872 178356203 X 2067853219 14519069 14519069 2053334150 181340574 181340574 2234674724 2094154129 -9897838 -9897838 2104051967 170196151 170196151 2274248118 FORM 990, SCHEDULE D, PART X, LINE 2 ASC 740 (FKA FIN 48) FOOTNOTE THIS ORGANIZATION IS AN AFFILIATE OF POINT32HEALTH, INC. (P32H). THE BELOW FOOTNOTE DERIVES FROM THE CONSOLIDATED AUDITED FINCIAL STATEMENTS OF POINT32HEALTH, INC. AND AFFILIATES. THE COMPANY BELIEVES THAT THE POSITIONS TAKEN ON ITS INCOME TAX RETURNS FOR OPEN TAX YEARS WILL BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS"). THEREFORE, P32H HAS NOT RECORDED ANY LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740, INCOME TAXES. AS OF DECEMBER 31, 2023, THERE ARE NO UNRECOGNIZED TAX BENEFITS, AND THE COMPANY DOES NOT ANTICIPATE ANY SIGNIFICANT CHANGES IN THE AMOUNT OF UNRECOGNIZED TAX BENEFITS DURING THE NEXT TWELVE MONTHS. ---------- FORM 990, SCHEDULE D, PART XI, LINE 4B DETAIL OF OTHER AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12 ASO FEES 63,886,438 GRANT EXPENSES 108,861,517 RENTAL & OTHER INCOME 4,601,816 INSTITUTE INVESTMENT INCOME 3,990,803 ------------ TOTAL $181,340,574 ---------- FORM 990, SCHEDULE D, PART XII, LINE 4B DETAIL OF OTHER AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25 ASO FEES 64,376,477 GRANT REVENUE 108,861,517 RENTAL & OTHER EXPENSES (3,041,843) ------------ TOTAL 170,196,151 ---------- true POINT32HEALTH FOUNDATION INC 1 WELLNESS WAY CANTON MA 02021 261374263 501(C)(3) 6000000 FUND OPERATIONS 1 0 FORM 990, SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS HARVARD PILGRIM HEALTH CARE INC. MAKES GRANTS TO ITS SUPPORTED ORGANIZATION, POINT32HEALTH FOUNDATION, INC. ("P32H FND"). P32H FND MAKES COMMUNITY GRANTS AND MONITORS THEM IN ACCORDANCE WITH HPHC'S TAX EXEMPT MISSION. P32H FND INVESTS IN COMMUNITIES THROUGH GRANTMAKING TO NONPROFIT ORGANIZATIONS TO SUPPORT, ADVOCATE AND ADVANCE HEALTHIER LIVES FOR EVERYONE. P32H FND'S PROCESS IS COMPREHENSIVE AND THOROUGH. AFTER A PROPOSAL IS SUBMITTED AND APPROVED, PARAMETERS OF THE GRANT SERVE AS THE BASIS OF A MUTUAL PERFORMANCE AGREEMENT AND FOR MONITORING GRANT ACTIVITY AND HOW FUNDS ARE USED. AN INDEPENDENT THIRD PARTY VERIFIES 501(C)(3) STATUS. P32H FND STAFF ASSESS EACH ORGANIZATION'S ABILITY TO EXECUTE ON A GRANT AWARDED BY P32H FND. GRANTS LESS THAN $100,000 ARE APPROVED BY STAFF BUT THE TOTAL OF THESE GRANTS CANNOT EXCEED 25% OF THE TOTAL GRANTS BUDGET. GRANTS MORE THAN $100,000 ARE VOTED ON BY THE BOARD OF DIRECTORS. ONCE AWARDED, GRANTEES ARE REQUIRED TO SHARE PERIODIC UPDATES OR REPORTS. true true false false false false false false false CAIN HAYES PRESIDENT & CEO 0 1219827 0 2572806 0 66384 0 359082 0 28360 0 4246459 0 61865 PHILIP BARR EVP, PRESIDENT, MARKETS 0 689979 0 1038329 0 22545 0 191017 0 10688 0 1952558 0 17965 PATRICIA HOWARD COO (END 5/3) 0 221778 0 976250 0 415077 0 51154 0 8075 0 1672334 0 0 UMESH KURPAD CFO (END 7/4) 0 421895 0 889814 0 143126 0 151586 0 14823 0 1621244 0 134450 PETE CHURCH CHIEF PEOPLE OFFICER 0 599057 0 729488 0 19801 0 171542 0 28180 0 1548068 0 16798 TISA HUGHES CLERK/SECRETARY 0 555477 0 721793 0 53207 0 109372 0 26354 0 1466203 0 47454 TRACEY CARTER SVP, CHIEF ACTUARY 0 485791 0 593808 0 95936 0 145413 0 22198 0 1343146 0 92765 SELMA FERHATBEGOVIC SVP, CHIEF INFORMATION OFFICER 0 413120 0 610978 0 83355 0 124712 0 28091 0 1260256 0 0 MARK PORTER TREASURER (START 10/12) 0 421133 0 589288 0 45207 0 139911 0 26914 0 1222453 0 44111 PATRICIA BLAKE SVP, PRESIDENT MEDICARE 0 432426 0 523929 0 94908 0 132631 0 28102 0 1211996 0 86066 KRISTIN LEWIS CHIEF PUB & COMM AFF OFFICER 0 423813 0 535467 0 75365 0 130361 0 22172 0 1187178 0 72661 MICHAEL CARSON FORMER PRESIDENT (END 10/1/21) 0 0 0 0 0 866154 0 0 0 0 0 866154 0 0 R SCOTT WALKER CFO (START 7/5) 0 326498 0 400000 0 727951 0 1453 0 13872 0 1469774 0 0 SUSAN KEE CLERK/SECRETARY (START 12/11) 0 342136 0 287804 0 15428 0 71137 0 1066 0 717571 0 12642 ROLAND PRICE TREASURER (END 10/11) 0 275979 0 287902 0 32242 0 64858 0 14398 0 675379 0 12850 THOMAS CROSWELL FORMER CEO 0 0 0 612500 0 0 0 9150 0 0 0 621650 0 0 DEBORAH NORTON FORMER SVP, CIO 0 0 0 0 170069 0 8843 0 0 0 178912 0 0 0 EILEEN AUEN DIRECTOR, CHAIR 161250 0 0 0 0 0 0 0 0 0 161250 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 METHOD USED TO ESTABLISH CEO COMPENSATION HARVARD PILGRIM HEALTH CARE, INC. RELIED ON ITS PARENT AND SOLE CORPORATE MEMBER, POINT32HEALTH, INC., TO ESTABLISH COMPENSATION FOR ITS CEO. THE METHODS USED BY POINT32HEALTH, INC. ARE AS FOLLOWS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE -WRITTEN EMPLOYMENT AGREEMENT ---------- FORM 990, SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE FOLLOWING SENIOR LEADERS, WHO DEPARTED THE COMPANY FOLLOWING THE CLOSE OF THE TRANSACTION, RECEIVED SEVERANCE OR CHANGE IN CONTROL PAYMENTS RELATING TO THE COMBINATION OF HARVARD PILGRIM HEALTH CARE AND TUFTS HEALTH PLAN. THESE PAYMENTS WERE DESIGNED TO RETAIN LEADERS WITH SIGNIFICANT EXPERTISE IN KEY AREAS AND TO ENSURE CONTINUITY OF OPERATIONS FOR BOTH ORGANIZATIONS THROUGH A LENGTHY AND UNCERTAIN REGULATORY REVIEW PROCESS THAT SPANNED OVER A FIFTEEN MONTH PERIOD, AS WELL AS A GLOBAL PANDEMIC: MICHAEL CARSON = $866,154 DEBORAH NORTON = $170,069 THE FOLLOWING SENIOR LEADER ALSO RECEIVED SEVERANCE PAYMENTS IN 2023: PATRICIA HOWARD = $413,486 ---------- FORM 990, SCHEDULE J, PART I, LINE 4B DISCRETIONARY RETIREMENT PLAN THE ORGANIZATION'S LEADERS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN SPONSORED BY THEIR EMPLOYER, POINT32HEALTH SERVICES, INC., A RELATED PARTY. THE EMPLOYEES AND AMOUNTS LISTED ON SCHEDULE J, PART II, COLUMN C REFLECT EMPLOYER CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. ---------- FORM 990, PART I, LINE 1 & PART III, LINE 1 DETAIL REGARDING THE ORGANIZATION MISSION HARVARD PILGRIM HEALTH CARE INC.'S ("HARVARD PILGRIM"HPHC") PURPOSE IS TO GUIDE AND EMPOWER HEALTHIER LIVES FOR EVERYONE. FOR MORE THAN 50 YEARS, HARVARD PILGRIM HAS BUILT A REPUTATION FOR EXCEPTIONAL CLINICAL QUALITY, PREVENTIVE CARE, DISEASE MANAGEMENT AND MEMBER SATISFACTION AND HAS CONSISTENTLY RATED AMONG THE TOP PLANS IN THE COUNTRY. HPHC OPERATES AS A NOT-FOR-PROFIT HEALTH PLAN PROVIDING COMPREHENSIVE HEALTH BENEFIT PLANS, ACCESS TO HEALTH CARE AND OTHER RELATED SERVICES IN MASSACHUSETTS, MAINE AND CONNECTICUT TO GROUP, INDIVIDUAL AND MEDICARE MEMBERS THROUGH CONTRACTS WITH PHYSICIANS, ESTABLISHED PRIMARY CARE AND MULTISPECIALTY PHYSICIAN GROUPS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS. HPHC IS PART OF THE POINT32HEALTH ("P32H") FAMILY OF COMPANIES. ---------- FORM 990, PART VI, LINE 2 DETAIL OF FAMILY OR BUSINESS RELATIONSHIPS BUSINESS RELATIONSHIP - THE FOLLOWING INDIVIDUALS SERVED ON THE BOARDS OR WERE AN OFFICER OR KEY EMPLOYEE OF ONE OR MORE FOR-PROFIT ORGANIZATIONS AFFILIATED WITH THE FILING ORGANIZATION FROM 1/1/2023 TO 12/31/2023: CAIN HAYES, PRESIDENT & CEO TISA HUGHES, CLERK/SECRETARY SUSAN KEE, CLERK/SECRETARY EILEEN AUEN, DIRECTOR, CHAIR UMESH KURPAD, CFO (END 7/4) R. SCOTT WALKER, CFO (START 7/5) ---------- FORM 990, PART VI, LINE 3 DELEGATION OF CONTROL OF MANAGEMENT DUTIES THE FILING ORGANIZATION'S SOLE MEMBER IS P32H. ITS AFFILIATE, POINT32HEALTH SERVICES, INC., PERFORMS CERTAIN MANAGEMENT, ADMINISTRATIVE, AND MARKETING SERVICES FOR THE FILING ORGANIZATION AND OTHER AFFILIATES. THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A ARE EMPLOYEES OF POINT32HEALTH SERVICES, INC. THEIR COMPENSATION IS LISTED IN PART VII, SECTION A AND SCHEDULE J. -------------- FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS P32H IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. --------------- FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT MEMBERS P32H, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. -------------- FORM 990, PART VI, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS P32H, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE RIGHT TO MAKE CERTAIN DECISIONS REGARDING THE ORGANIZATION, AND IS REQUIRED TO APPROVE ANY CHANGES TO THE ORGANIZATION'S BYLAWS. ---------- FORM 990, PART VI, LINE 8B CONTEMPORANEOUS BOARD MEETING DOCUMENTATION FOR A MAJORITY OF THE TIME, THE ORGANIZATION CONTEMPORANEOUSLY DOCUMENTS MEETINGS HELD AND WRITTEN ACTIONS UNDERTAKEN BY ITS GOVERNING BODY AND COMMITTEES. HOWEVER, ON LIMITED OCCASIONS, THE GOVERNING BODY OR A COMMITTEE MAY HAVE A SERIES OF CONFERENCE CALLS AND MINUTES FOR THOSE CALLS ARE NOT APPROVED UNTIL THE NEXT MEETING. ---------- FORM 990, PART VI, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THIS FORM 990 WAS PREPARED BY THE ORGANIZATION'S EXTERNAL ACCOUNTANT, REVIEWED BY P32H'S FINANCE DEPARTMENT AND CERTAIN SECTIONS ARE REVIEWED FOR INPUT BY SUBJECT MATTER PERSONNEL IN OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. ---------- FORM 990, PART VI, LINE 12C MONITORING & ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE P32H'S CONFLICT OF INTEREST ("COI") POLICY AND PROCEDURES ("P&P") APPLIES TO THE FILING COMPANY AS A SUBSIDIARY ORGANIZATION. P32H'S COI P&P IS REVIEWED ANNUALLY, REVISED AS NEEDED AND APPROVED UPON MATERIAL REVISIONS. THE POLICY REQUIRES ALL EMPLOYEES, INCLUDING THE PRESIDENT AND CEO AND GOVERNING BODY MEMBERS TO COMPLY WITH THE COI POLICY AND PROCESSES. ALL EMPLOYEES RECEIVE ANNUAL COMPLIANCE TRAINING WHICH INCLUDE EXPECTATIONS RELATED TO FOLLOWING THE COI P&P. THE COI P&P REQUIRES THE OFFICERS, KEY EMPLOYEES AND BOARD OF DIRECTORS OF THE TAX-EXEMPT ENTITIES TO COMPLETE AND SUBMIT AN ANNUAL DISCLOSURE SURVEY AND STATEMENT TO THE CHIEF LEGAL OFFICER ("CLO") OR DESIGNEE IN THE LEGAL DEPARTMENT, LISTING ANY OUTSIDE RELATIONSHIPS, INCLUDING FINANCIAL AND/OR BOARD RELATIONSHIPS THAT THEY OR A FAMILY MEMBER HAVE WITH P32H'S (OR ITS SUBSIDIARIES) SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. ADDITIONALLY, P32H. REQUIRES EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT (AS DEFINED IN THE COI POLICY) TO COMPLETE AND SUBMIT AN ANNUAL DISCLOSURE SURVEY AND STATEMENT TO THE CHIEF COMPLIANCE OFFICER OR DIRECTOR, CORPORATE COMPLIANCE. BY COMPLETING THE ANNUAL DISCLOSURE STATEMENT, THESE INDIVIDUALS ACKNOWLEDGE THE POINT32HEALTH COI P&P. ALL EMPLOYEES ARE REQUIRED TO REPORT THE OFFER BY AN OUTSIDE ENTITY OF GIFTS OVER $250, HONORARIA OR COVERAGE OF BUSINESS EXPENSES, OR OTHER EVENTS OR RELATIONSHIPS THAT MAY BE PERCEIVED AS CONFLICTS TO THE CHIEF COMPLIANCE OFFICER, DIRECTOR, CORPORATE COMPLIANCE OR DESIGNEE AND THE EMPLOYEE'S MANAGEMENT. BOTH MUST APPROVE BEFORE ACCEPTANCE IS ALLOWED. THERE ARE PROTOCOLS AND PROCESSES TO REVIEW ANY DISCLOSURE THAT MIGHT BE A POTENTIAL CONFLICT OF INTEREST. BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES' RESPONSES TO THE DISCLOSURE SURVEY AND STATEMENT ARE REVIEWED BY THE CLO, WHO WILL REVIEW THE SELF-DISCLOSURE WITH THE CHAIR OF THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS Of P32H AND DETERMINE EXPECTATIONS AND RECOMMENDED ACTIONS IF NEEDED. A SUMMARY REPORT OF ALL DISCLOSED ACTUAL OR POTENTIAL CONFLICTS ALONG WITH ANY RECOMMENDED ACTIONS TO ADDRESS A DISCLOSED ACTUAL OR POTENTIAL CONFLICT IS REVIEWED AND APPROVED BY THE GOVERNANCE COMMITTEE AND THE COMMITTEE'S REVIEW/FINDINGS ARE REPORTED TO THE FULL BOARD. THE CLO COMMUNICATES THE RECOMMENDED ACTIONS TO INDIVIDUAL SURVEY RECIPIENTS. THE CHIEF COMPLIANCE OFFICER IS CONSULTED AND INFORMED OF THE DECISIONS MADE BY THE CLO OR LEGAL DESIGNEE. EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT'S RESPONSES TO THE DISCLOSURE SURVEY AND STATEMENT ARE REVIEWED BY THE DIRECTOR, CORPORATE COMPLIANCE, LEGAL, AND CHIEF COMPLIANCE OFFICER, WHO WILL REPORT TO THE CLO ANY POTENTIAL CONFLICTS ALONG WITH ANY RECOMMENDED ACTIONS TO ADDRESS THE POTENTIAL CONFLICT, IF NECESSARY. RECOMMENDED ACTIONS/EXPECTATIONS ARE COMMUNICATED BY THE DIRECTOR, CORPORATE COMPLIANCE, LEGAL, AND CHIEF COMPLIANCE OFFICER TO IMPACTED INDIVIDUALS. FOR CONFLICT DISCLOSURES INVOLVING THE CHIEF COMPLIANCE OFFICER, THE CLO WILL MAKE THE FINAL DETERMINATION. ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST THAT ARISES AFTER COMPLETION OF THE DISCLOSURE SURVEY WILL FOLLOW THE SAME REVIEW PROCESS. ---------- FORM 990, PART VI, LINE 13 WRITTEN WHISTLEBLOWER/NON-RETALIATION POLICY THE FILING ORGANIZAION IS SUBJECT TO THE WRITTEN WHISTLEBLOWER/NON-RETALIATION POLICY WITHIN THE CODE OF CONDUCT THAT WAS APPROVED BY THE BOARD OF DIRECTORS OF P32H. ---------- FORM 990, PART VI, LINES 14 WRITTEN DOCUMENT RETENTION POLICY THE FILING ORGANIZATION IS SUBJECT TO THE WRITTEN DOCUMENT RETENTION POLICY AND RECORD RETENTION SCHEDULE OF P32H. ---------- FORM 990, PART VI, LINE 15A & 15B COMPENSATION REVIEW AND APPROVAL THE FILING ORGANIZATION'S PARENT COMPANY, P32H, HAS AN INDEPENDENT HUMAN RESOURCES COMMITTEE (THE "COMMITTEE") THAT ANNUALLY REVIEWS THE TOTAL REMUNERATION OPPORTUNITIES, POLICIES AND PROGRAMS OF THE CEO AND CERTAIN EXECUTIVES, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES AS WELL AS INDIVIDUALS THE COMMITTEE DEEMS APPROPRIATE TO REVIEW. THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS OF THE COMPANY. THE COMMITTEE CONSIDERS MARKET DATA AND ANALYSES ASSEMBLED BY INDEPENDENT AND INTERNAL COMPENSATION CONSULTANTS WITH THE GOAL TO DETERMINE EXECUTIVE TOTAL REMUNERATION THAT IS REASONABLE AND COMPETITIVE WITHIN THE INDUSTRY AND GEOGRAPHY IN WHICH P32H OPERATES. ---------- FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND ANNUAL FINANCIAL REPORT AND QUARTERLY FINANCIAL UPDATES ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ---------- FORM 990, PART IX, COLUMN D DETAIL OF FUNDRAISING EXPENSES THERE ARE NO EXPENSES FOR FUNDRAISING INCLUDED IN THE INCOME STATEMENT FOR HPHC. ANY COSTS INCURRED WITH THE ADMINISTRATION OF FEDERAL OR PRIVATE GRANTS ARE INCURRED BY THE PARENT ENTITY. ---------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CHANGE IN NON ADMITTED ASSETS 3,269,826 CHANGE IN PRIOR SERVICE COSTS AND RECOGNIZED LOSS FOR POSTRETIREMENT MEDICAL PLAN (184,646) OTHER CHANGES IN NET ASSETS (32,555) ----------- TOTAL $ 3,052,625 ---------- FORM 990, PART XII, LINE 1 ACCOUNTING METHOD USED TO PREPARE FORM 990 HPHC FOLLOWS THE STATUTORY ACCOUNTING METHOD PRESCRIBED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' ACCOUNTING PRACTICES AND PROCEDURES MANUAL FOR STATUTORY ACCOUNTING PRINCIPLES. ---------- HARVARD PILGRIM HEALTH CARE INST LLC 133 BROOKLINE AVE BOSTON MA 02215 943477531 RESEARCH MA 36516918 72446377 HPHCINC HPHC OF NEW ENGLAND INC 1 WELLNESS WAY CANTON MA 02021 042663394 HEALTH INSURA MA 501(C)(4) N/A HPHCINC true POINT32HEALTH FOUNDATION INC 1 WELLNESS WAY CANTON MA 02021 261374263 GRANT MAKING MA 501 (C)(3) 12A TAHMO true TUFTS HEALTH PUBLIC PLANS INC 1 WELLNESS WAY CANTON MA 02021 800721489 HMO MA 501(C)(4) N/A P32H true POINT32HEALTH INC 1 WELLNESS WAY CANTON MA 02021 814089215 HEALTHCARE MA 501(C)(4) N/A NA false TUFTS ASSOC HEALTH MAINTEN ORG INC 1 WELLNESS WAY CANTON MA 02021 042674079 HMO MA 501(C)(4) N/A P32H true CARE PARTNERS OF CONNECTICUT INC 1 WELLNESS WAY CANTON MA 02021 822604728 HMO CT 501(C)(4) N/A TAHMO true CAREPARTNERS OF CT HOLDINGS LLC 1 WELLNESS WAY CANTON MA 02021 823129930 HOLDING COMPA CT TAHMO N/A CLARION MANAGEMENT SOLUTIONS LLC 1212 CORPORATE DRIVE SUITE 225 IRVING TX 75038 822713764 CLINICAL CONS DE EH NEXUS N/A EMPLOYERS HEALTH NEXUS LLC 1500 W PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 882938454 HOLDING COMPA MA HEALTH PLANS N/A EMPLOYERS HEALTH NETWORK LLC 1212 CORPORATE DRIVE SUITE 225 IRVING TX 75038 471678150 SELF INSURANC DE EH NEXUS N/A KP VENTURES LLC SERIES B 1 KAISER PLAZA OAKLAND CA 94612 273339892 HEALTHCARE CA TAHMO N/A KP VENTURES LLC SERIES D 1 KAISER PLAZA OAKLAND CA 94612 471874366 HEALTHCARE CA TAHMO N/A HPHC INSURANCE COMPANY INC 1 WELLNESS WAY CANTON MA 02021 043149694 HEALTH INSURANCE MA NEW HPHC HOLDCO C CORP true PLAN MARKETING INSURANCE AGENCY INC 1500 W PARK DRIVE STE 330 WESTBOROUGH MA 01581 042734281 BROKERAGE MA HEALTH PLANS C CORP true HPHC INSURANCE AGENCY INC 1 WELLNESS WAY CANTON MA 02021 043016201 BROKERAGE MA NEW HPHC HOLDCO C CORP true HEALTH PLANS INC 1500 W PARK DRIVE STE 330 WESTBOROUGH MA 01581 042734278 TPA MA NEW HPHC HOLDCO C CORP true CARE MANAGEMENT SERVICES INC 1500 W PARK DRIVE STE 330 WESTBOROUGH MA 01581 043438779 CARE MANAGEMENT MA HEALTH PLANS C CORP true NEW HPHC HOLDING CORPORATION 1 WELLNESS WAY CANTON MA 02021 815340662 HOLDING COMPANY DE HPHC INC C CORP true POINT32HEALTH SERVICES INC 1 WELLNESS WAY CANTON MA 02021 042985923 MANAGEMENT SVCS DE TAHMO C CORP true TUFTS INSURANCE COMPANY 1 WELLNESS WAY CANTON MA 02021 043319729 INSURANCE MA P32H SRVCS INC C CORP true TUFTS BENEFIT ADMINISTRATORS INC 1 WELLNESS WAY CANTON MA 02021 043270923 TPA MA P32H SRVCS INC C CORP true TOTAL HEALTH PLAN INC 1 WELLNESS WAY CANTON MA 02021 042918943 TPA MA P32H SRVCS INC C CORP true TAHP BROKERAGE CORPORATION 1 WELLNESS WAY CANTON MA 02021 043072692 BROKERAGE MA P32H SRVCS INC C CORP true INTEGRA PARTNERS HOLDINGS INC 100 WALL ST STE 2502 NEW YORK NY 10005 453032233 MED EQUIPT & SVCS NY TAHMO C CORP true true true true true true false false false false true false true false true false true true true true CARE PARTNERS OF CONNECTICUT INC L, N, 90196 FMV HPHC INSTITUTE LLC L, N, 2603679 FMV HPHC INSURANCE COMPANY INC L, N, -24226048 FMV HPHC OF NEW ENGLAND INC L, N, -3705155 FMV TUFTS ASSOC HEALTH MAINTEN ORG INC L, N, 6353668 FMV TUFTS BENEFIT ADMINISTRATORS INC L, N, 586761 FMV TUFTS HEALTH PUBLIC PLANS INC LNPQR -4638467 FMV TUFTS INSURANCE COMPANY L, N, 175742 FMV TUFTS TOTAL HEALTH PLAN L, N, -11130 FMV POINT32HEALTH FOUNDATION INC B -6000000 CASH POINT32HEALTH FOUNDATION INC L, N, -699661 FMV POINT32HEALTH SERVICES INC L, N, 53562249 FMV