2022-11-15T15:31:11-06:00 2021-12-31 420714325 RSM US LLP 80 CITY SQUARE BOSTON MA 021293742 990 2021-01-01 043756900 COMMONWEALTH CARE ALLIANCE INC COMM 6174260600 30 WINTER STREET BOSTON MA 02108 MARY HAMILTON INTERIM CFO 6174260600 2022-11-15 1 MARY HAMILTON 999009999 LYNNE JOHNSON P00757336 6179129000 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CHRISTOPHER D PALMIERI 30 WINTER STREET BOSTON MA 02108 2262410276 0 X WWW.COMMONWEALTHCARE.ORG X 2003 MA COMMONWEALTH CARE ALLIANCE, INC.'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF PEOPLE WITH SIGNIFICANT NEEDS BY INNOVATING, COORDINATING AND PROVIDING THE HIGHEST QUALITY, INDIVIDUALIZED CARE. 14 13 1889 13 0 0 0 0 1797212518 2032668552 3016076 3923850 1164828 7578115 1801393422 2044170517 296451 200209 0 0 138956384 145230133 0 0 0 1595246344 1847636890 1734499179 1993067232 66894243 51103285 585038382 813491332 386729111 575877978 198309271 237613354 X COMMONWEALTH CARE ALLIANCE, INC.'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF PEOPLE WITH SIGNIFICANT NEEDS BY INNOVATING, COORDINATING AND PROVIDING THE HIGHEST QUALITY, INDIVIDUALIZED CARE. 0 0 1754011895 200209 2040246667 COMMONWEALTH CARE ALLIANCE (CCA) HAS CONTRACTED WITH COMMUNITY BASED PRIMARY CARE PRACTICES THAT HAVE DEMONSTRATED EXPERIENCE SERVING ADULTS IN A MANAGED CARE NETWORK. EXAMPLES OF THESE PRIMARY CARE SITES INCLUDE AFFILIATED PHYSICIANS GROUP OF JAMAICA PLAIN, BOSTON UNIVERSITY GERIATRICS, BRIGHTWOOD HEALTH SERVICES, CAMBRIDGE HEALTH ALLIANCE, EAST BOSTON HEALTH CENTER, ELDER SERVICE PLAN OF THE NORTH SHORE, HARBOR HEALTH SERVICE, UPHAM'S CORNER HEALTH CENTER. CCA IS ONE OF THE SIX SENIOR CARE OPTION OR "SCO ORGANIZATIONS IN THE COMMONWEALTH: THE SCO PROGRAM IS A COMPREHENSIVE HEALTH PLAN THAT COVERS ALL SERVICES REIMBURSABLE UNDER A DELIVERY SYSTEM AND ITS PREFERRED NETWORK OF PROVIDERS. CCA IS ALSO ONE OF TWO ORGANIZATIONS THAT OFFERS ONE CARE TO INDIVIDUALS AGED 18 TO 64 RESIDENT IN THE COMMONWEALTH OF MASSACHUSETTS. 1754011895 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 4180 0 1 1889 1 0 0 0 0 0 0 0 0 0 0 1 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X ELIZABETH CAHN GOODMAN SECRETARY & CLERK CHIEF LEGAL OFFICER 6174260600 30 WINTER STREET BOSTON MA 02108 CHRISTOPHER D PALMIERI PRESIDENT & CEO, DIRECTOR 15.00 25.00 X X 1536295 0 151990 ROBERT GITTENS CHAIR OF THE BOARD 3.00 2.00 X 0 0 0 CAROL RAPHAEL VICE CHAIR OF THE BOARD 3.00 2.00 X 0 0 0 CHARLES CARR DIRECTOR 3.00 2.00 X 0 0 0 ALEXANDRA DACOSTA DIRECTOR 3.00 2.00 X 0 0 0 STEPHANIE DYSON DIRECTOR 3.00 2.00 X 0 0 0 LEN FISHMAN DIRECTOR 3.00 2.00 X 0 0 0 TEJAL GANDHI MD DIRECTOR 3.00 2.00 X 0 0 0 IRA GOTTLIEB DIRECTOR 3.00 2.00 X 0 0 0 SYATRIZAL HAMDALLAH DIRECTOR 3.00 2.00 X 0 0 0 LESLIE KIRWAN DIRECTOR 3.00 2.00 X 0 0 0 DAVID KLEIN DIRECTOR 3.00 2.00 X 0 0 0 CHRISTOPHER KOLLER DIRECTOR 3.00 2.00 X 0 0 0 JOSEPH PADUDA DIRECTOR 3.00 2.00 X 0 0 0 MIHIR SHAH TREASURER & CFO 20.00 20.00 X 817643 0 18730 LISA FLEMING SEC. & CLERK, CHIEF LEGAL OFFICER 15.00 25.00 X 553260 0 97654 COURTNEY MURPHY COO PRESIDENT OF MARKETS (AS OF 12/13/21) 40.00 0.00 X 817180 0 119105 ROBERT MACARTHUR CHIEF MEDICAL OFFICER 35.00 5.00 X 622504 0 117471 SARAH GARRITY CHIEF MARKETING OFFICER 40.00 0.00 X 519467 0 35139 ALFRED ENAGBARE CHIEF PEOPLE OFFICER 40.00 0.00 X 514082 0 104501 DONALD STIFFLER CHIEF DEVELOPMENT OFFICER (FROM 5/3/21) 40.00 0.00 X 241164 0 39127 LAWRENCE GOTTLIEB CHIEF QUALITY OFFICER 30.00 10.00 X 489872 0 47633 JONATHAN GORDON SVP & MANAGING DIRECTOR WSV 40.00 0.00 X 459847 0 54978 KALYAN NARAYANAN CHIEF INFORMATION OFFICER 40.00 0.00 X 410292 0 32887 SEBASTIAAN FOPPEMA GENERAL MANAGER INSTED 40.00 0.00 X 410146 0 15729 DIDZIS VOLDINS SVP GENERAL COUNSEL 40.00 0.00 X 390883 0 42660 7782635 0 877604 523 0 1 0 STAVROS CENTER FOR INDEPENDENT LIVING PO BOX 2130 210 OLD FARM ROAD AMHERST MA 01004 HEALTHCARE & TECHNOLOGY 66538956 TEMPUS UNLIMITED INC 600 TECHNOLOGY CENTER DRIVE STOUGHTON MA 02072 HEALTHCARE & TECHNOLOGY 62752726 NORTHEAST ARC INC 64 HOLTON ST DANVERS MA 01923 HEALTHCARE & TECHNOLOGY 42970675 PUBLIC CONSULTING GROUP INC 148 STATE STREET BOSTON MA 02109 CONSULTING 7361963 GREATER SPRINGFIELD SENIOR SERVICES INC 66 INDUSTRY AVENUE SUITE 9 SPRINGFIELD MA 01104 HEALTHCARE & TECHNOLOGY 2918180 997 ENROLLEE FEES 621300 2032200977 2032200977 GRANT REVENUE 900099 467575 467575 2032668552 3859544 3859544 218304065 218237081 2678 66984 -2678 64306 64306 COVID CENTER 900099 6993000 6993000 MISCELLANEOUS INCOME 900099 585115 585115 7578115 2044170517 2040246667 0 3923850 200209 200209 7057389 7057389 107548241 107548241 5983645 5983645 11182472 11182472 13458386 13458386 2780081 2780081 937480 937480 1709887 1709887 483541 483541 28724263 28724263 3524397 3524397 3376977 3376977 11464472 11464472 8500503 8500503 2647378 2647378 431583 431583 52279 52279 7097235 7097235 1431541 1431541 MEDICAL EXPENSES 1503727739 1503727739 CAPITATION EXPENSES 250083947 250083947 CLAIMS ADJUDICATION 19550665 19550665 MEDICAL SUPPLIES 448082 448082 664840 664840 1993067232 1754011895 239055337 0 5063156 34733995 165162 154013 137652320 200437446 6636522 6374485 41942077 17522154 24103813 24419923 277946226 289394939 565000 11519280 132906183 246457251 585038382 813491332 38679832 72081887 348049279 503796091 386729111 575877978 X 198309271 237613354 198309271 237613354 585038382 813491332 51103285 -11799202 0 X 0 1 X 1 1 1 X 1029992170 1257805887 1541164995 1798377346 2040246667 7667587065 1029992170 1257805887 1541164995 1798377346 2040246667 7667587065 0 0 0 7667587065 103606 1254268 3608988 3254094 3859544 12080500 103606 1254268 3608988 3254094 3859544 12080500 1030095776 1259060155 1544773983 1801631440 2044106211 7679667565 0.99840 0.99870 0.00160 0.00130 X 0 1 0 0 0 0 1 3798225 0 1 412207 4210432 0 PART II-B, LINE 1: CCA PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, A PIECE OF WHICH MAY BE USED BY SUCH ORGANIZATIONS FOR FEDERAL LOBBYING ACTIVITIES ON BEHALF OF CCA AND OTHER SIMILARLY SITUATED ORGANIZATIONS. $1,164,600 WAS PAID TO OUTSIDE CONSULTANT FOR LOBBYING ACTIVITIES. 119298 119298 2498744 454098 2044646 13094838 5681854 7412984 7430882 3746635 3684247 18798315 7639567 11158748 24419923 ASSETS LIMITED AS TO USE 532554 DUE FROM COMMONWEALTH COMMUNITY CARE, INC. 46511779 DEPOSITS 89690 DUE FROM COMMONWEALTH CLINICAL ALLIANCE, INC. 139163591 DUE FROM INSTITUTE FOR ADVANCING CONSUMER CENTERED QUALITY, INC. 2841648 DUE FROM COMMONWEALTH CARE ALLIANCE MASSACHUSETTS, INC. 4906610 DUE FROM COMMONWEALTH CARE ALLIANCE RHODE ISLAND, INC. 7367563 DUE FROM COMMONWEALTH CARE ALLIANCE INDIANA, LLC 1505000 DUE FROM COMMONWEALTH CARE ALLIANCE CALIFORNIA, LLC 6768617 DUE FROM COMMONWEALTH CARE ALLIANCE MICHIGAN, LLC 36770199 246457251 MEDICAL EXPENSE OBLIGATIONS 218465416 REFUNDABLE ADVANCES 94821331 DEFERRED RENT 5011641 DEFERRED FUNDRAISING 819807 OTHER LIABILITIES 278279 DUE TO COMMONWEALTH COMMUNITY CARE, INC. 39364619 DUE TO COMMONWEALTH CLINICAL ALLIANCE, INC. 143979352 DUE TO INSTITUTE FOR ADVANCING CONSUMER CENTERED QUALITY, INC. 1052945 DUE TO COMMONWEALTH CARE ALLIANCE MASSACHUSETTS, INC. 2290 DUE TO COMMONWEALTH CARE ALLIANCE RHODE ISLAND, INC. 411 503796091 X PART X, LINE 2: CCA IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS GENERALLY EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. 1 ADVOCATES INC 290 ELWOOD DAVIS ROAD SUITE 101 LIVERPOOL NY 13088 161453716 501(C)(3) 7500 0 HOST SPONSORSHIP BOSTON CENTER FOR INDEPENDENT LIVING 60 TEMPLE PLACE BOSTON MA 02111 042546595 501(C)(3) 20000 0 HOST SPONSORSHIP HEALTH CARE FOR ALL ONE FEDERAL STREET BOSTON MA 02110 043071598 501(C)(3) 30000 0 HOST SPONSORSHIP MASSACHUSETTS HEALTH COUNCIL INC 200 RESERVOIR STREET SUITE 101 NEEDHAM MA 02494 042296739 501(C)(3) 10000 0 HOST SPONSORSHIP THE PROVIDENCE COMMUNITY HEALTH CENTERS INC 375 ALLENS AVENUE PROVIDENCE RI 02905 050368134 501(C)(3) 27000 0 HOST SPONSORSHIP DUFFY & SHANLEY 10 CHARLES STREET PROVIDENCE RI 02904 24500 0 GRANTS TO OTHER NONPROFITS: ALZHEIMER'S ASSOCIATION PROVIDENCE WALK CORPORATE SPONSOR $1,500; ELISHA PROJECT DONATION $15,000; RI ELDER INFO PRESENTING SPONSOR $1,000; PROVIDENCE BUSINESS NEWS FALL HEALTH CARE SUMMIT SPONSORSHIP $7,000. 5 1 PART I, LINE 2: IN 2021, THE ORGANIZATION SPONSORED OTHER HUMAN SERVICES ORGANIZATIONS AND ORGANIZATIONS WITH SIMILAR MISSIONS. MEMBERS OF THE ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM SELECT THE THIRD PARTIES THAT IT WILL SPONSOR, DETERMINE THE AMOUNT OF SPONSORSHIP AND MAINTAIN RECORDS TO SUBSTANTIATE THE CONTRIBUTIONS MADE. 1 X X X X 0 1 0 0 0 0 0 1 0 CHRISTOPHER D PALMIERI PRESIDENT & CEO, DIRECTOR 986455 0 401350 0 148490 0 125550 0 26440 0 1688285 0 112500 0 COURTNEY MURPHY COO PRESIDENT OF MARKETS (AS OF 12/13/21) 530050 0 236202 0 50928 0 78662 0 40443 0 936285 0 0 0 MIHIR SHAH TREASURER & CFO 544616 0 223767 0 49260 0 13050 0 5680 0 836373 0 0 0 ROBERT MACARTHUR CHIEF MEDICAL OFFICER 432478 0 166139 0 23887 0 72575 0 44896 0 739975 0 0 0 LISA FLEMING SEC. & CLERK, CHIEF LEGAL OFFICER 382838 0 147391 0 23031 0 65863 0 31791 0 650914 0 0 0 ALFRED ENAGBARE CHIEF PEOPLE OFFICER 348119 0 161606 0 4357 0 61300 0 43201 0 618583 0 0 0 SARAH GARRITY CHIEF MARKETING OFFICER 364142 0 133992 0 21333 0 13050 0 22089 0 554606 0 0 0 LAWRENCE GOTTLIEB CHIEF QUALITY OFFICER 365015 0 116475 0 8382 0 13050 0 34583 0 537505 0 0 0 JONATHAN GORDON SVP & MANAGING DIRECTOR WSV 354196 0 105016 0 635 0 13050 0 41928 0 514825 0 0 0 KALYAN NARAYANAN CHIEF INFORMATION OFFICER 340592 0 64182 0 5518 0 13050 0 19837 0 443179 0 0 0 DIDZIS VOLDINS SVP GENERAL COUNSEL 328024 0 61869 0 990 0 6679 0 35981 0 433543 0 0 0 SEBASTIAAN FOPPEMA GENERAL MANAGER INSTED 354786 0 54370 0 990 0 10661 0 5068 0 425875 0 0 0 DONALD STIFFLER CHIEF DEVELOPMENT OFFICER (FROM 5/3/21) 240172 0 0 0 992 0 11144 0 27983 0 280291 0 0 0 PART I, LINE 4B CCA PROVIDES MR. PALMIERI WITH A LONG-TERM BENEFIT, WHICH IF EARNED IN FULL HAS A TARGET VALUE OF $450,000. MR. PALMIERI IS ENTITLED TO PAYMENTS UNDER THIS AWARD PURSUANT TO A VESTING SCHEDULE WHICH COMBINES BOTH TIME AND PERFORMANCE BASED TARGET. UNDER THIS AWARD, MR. PALMIERI WILL RECEIVE $112,500 ON EACH OF NOVEMBER 2022 AND NOVEMBER 2, 2023, PROVIDED HE IS EMPLOYED AS CCA'S CEO AT THE TIME OF PAYOUT. THE REMAINING AMOUNT OF THE AWARD IS TO BE PAID ON NOVEMBER 2, 2023 SUBJECT TO ACHIEVEMENT OF LONG-TERM PERFORMANCE GOALS WHICH WERE SET BASED ON THRESHOLD, TARGET AND MAXIMUM CRITERIA BY THE BOARD IN ADVANCE. THE FINAL TRANCHE WILL VEST ON NOVEMBER 3, 2023 AND MR. PALMIERI WILL BE PAID AN AMOUNT BASED ON ACHIEVEMENT OF THE PERFORMANCE GOALS. IF MR. PALMIERI ACHIEVES TARGET PERFORMANCE, HE MAY EARN $225,000, HOWEVER UP TO A MAXIMUM OF $303,750 CAN BE EARNED SUBJECT TO PERFORMANCE AT THE MAXIMUM LEVEL UNDER THESE GOALS. ON NOVEMBER 2, 2021, MR. PALMIERI WAS PAID $112,500 (LESS APPLICABLE TAX WITHHOLDING) UPON VESTING OF THE FIRST TRANCHE UNDER THE 2020 LONG TERM INCENTIVE. CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATE IN THE COMMONWEALTH CARE ALLIANCE EXECUTIVE RETENTION PLAN, A NONQUALIFIED DEFERRED COMPENSATION PLAN WHICH IN 2020 WAS OFFERED TO CERTAIN MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM. PAYMENTS WILL BE MADE TO THE EXECUTIVE ONLY IF THE EXECUTIVE STAYS WITH THE ORGANIZATION THROUGH 2024 AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION OF THE PARTICIPANTS. THE MARKET FOR EXECUTIVE TALENT IN THIS COUNTRY IS FIERCELY COMPETITIVE AND WE RECRUIT INDIVIDUALS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE SUCCESSFULLY. PAYMENTS WILL BE MADE AT THE END OF A FIVE-YEAR PERIOD BASED ON AN EFFECTIVE DATE OF JANUARY 1, 2020 THROUGH DECEMBER 31, 2021 IN AN AMOUNT EQUAL TO 90% OF THE EXECUTIVE'S BASE SALARY ON DECEMBER 31, 2024. IN 2021, 12.5% OF BASE SALARY FOR MR. SHAH, MS. FLEMING, MS. MURPHY, DR. MACARTHUR AND DR. ENAGBARE WAS ACCRUED AND HAS BEEN INCLUDED AS DEFERRED COMPENSATION IN (SCHEDULE J, PART II, COLUMN C). AMOUNTS WILL BE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). PART I, LINE 7 BONUSES REPORTED IN PART II, COLUMN (B)(II) WERE DETERMINED BY A FIXED FORMULA BASED ON ATTAINING BOTH COMPANY AND INDIVIDUAL PERFORMANCE GOALS. THE CEO'S SHORT-TERM BONUS WAS DETERMINED BY A FIXED FORMULA BASED ON ACHIEVING PRE-ESTABLISHED COMPANY GOALS WHICH WERE APPROVED BY THE BOARD OF DIRECTORS. PART II, COLUMN (B)(III): CHRISTOPHER PALMIERI RECEIVES AN ANNUAL STIPEND OF $35,000 TO PURCHASE ADDITIONAL BENEFITS OF HIS CHOOSING. MIHIR SHAH AND COURTNEY MURPHY RECEIVED $25,000 EACH IN 2021 FOR THE PURCHASE OF ADDITIONAL BENEFITS. THERE ARE BONUSES REPORTED ON PART II, COLUMN (B)(III) THAT ARE NOT PERFORMANCE BASED OR RELATED TO SHORT-TERM INCENTIVE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS THE FORM 990 BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. THE BOARD ALSO REVIEWS THE ORGANIZATION'S FINANCIAL STATEMENTS ON A QUARTERLY BASIS. FORM 990, PART VI, SECTION B, LINE 12C THE ANNUAL COMPLIANCE POLICY AND CONFLICT OF INTEREST DISCLOSURE FORMS ARE DISTRIBUTED TO CCA'S WORKFORCE WHICH INCLUDES THE BOARD, OFFICERS, AND KEY EMPLOYEES. THIS PROCESS IS OVERSEEN BY THE COMPLIANCE DEPARTMENT WHICH ALSO MONITORS THE PROCESS TO ENSURE DISCLOSURES ARE OBTAINED AND ANALYZED APPROPRIATELY. THE BOARD, OFFICERS, AND KEY EMPLOYEES ALSO RECEIVE ANNUAL TRAINING ON CONFLICTS OF INTEREST AND COMPLIANCE. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS CCA EMPLOYEES, OFFICERS AND DIRECTORS. THE POLICY CALLS FOR CONFLICT OF INTEREST ANALYSIS AND ACTUAL CONFLICTS ARE REVIEWED AND CONFLICTS DETERMINATIONS ARE MADE BY THE CHIEF COMPLIANCE OFFICER AND CHIEF LEGAL OFFICER. WHERE AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST INVOLVING A TRANSACTION IS DETERMINED, THE INDIVIDUAL WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN EITHER MANAGEMENT'S OR THE BOARD'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS COMPRISED ENTIRELY OF INDEPENDENT DIRECTORS. THIS COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, EXECUTIVE COMPENSATION POLICIES AS WELL AS THE COMPENSATION STRUCTURE OF ITS PRESIDENT AND CHIEF EXECUTIVE OFFICER. AMONG OTHER THINGS, THIS COMMITTEE IS RESPONSIBLE FOR ENSURING THAT THE TOTAL COMPENSATION PROVIDED TO EXECUTIVE OFFICERS IS DETERMINED BY A FAIR AND EQUITABLE PROCESS, INFORMED BY CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION, AND IS COMPLIANT WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE ORGANIZATION ENGAGED COMPENSATION CONSULTANTS TO PROVIDE A COMPREHENSIVE COMPENSATION ASSESSMENT AND RECOMMENDATIONS TO CREATE A REASONABLE COMPENSATION PACKAGE FOR ITS PRESIDENT AND CEO UNDER AN EMPLOYMENT AGREEMENT WITH THE CEO DATED NOVEMBER 2, 2018. THE COMMITTEE MET ON SEVERAL OCCASIONS TO REVIEW THE EXECUTIVE COMPENSATION STRUCTURE AND THE CURRENT AND PROPOSED COMPENSATION LEVELS, ALL IN THE CONTEXT OF COMPARABLE MARKET DATA. WITH REGARD TO THE CEO'S COMPENSATION, THE COMMITTEE MET WITHOUT THE CEO PRESENT TO REVIEW INDIVIDUAL ELEMENTS AND HIS TOTAL COMPENSATION AS WELL AS THE CEO'S PERFORMANCE AGAINST PRE-ESTABLISHED GOALS. IN 2021, THE COMMITTEE AND THE BOARD APPROVED THE PAYMENT OF A SHORT TERM INCENTIVE TO THE CEO BASED UPON ACHIEVEMENT OF 2020 PERFORMANCE GOALS WHICH HAD BEEN APPROVED BY THE BOARD IN 2020. IN ADDITION, IN ESTABLISHING THE CEO'S BASE SALARY AND OTHER COMPENSATION ELEMENTS UNDER THE CEO'S 2018 EMPLOYMENT CONTRACT, THE COMMITTEE RECEIVED A MARKET SURVEY PREPARED BY ITS INDEPENDENT COMPENSATION CONSULTANT. THE BOARD OF DIRECTORS VOTED TO APPROVE THE COMMITTEE'S RECOMMENDATION AND RECOMMENDED THAT THE BOARD INCREASE THE PRESIDENT AND CEO'S BASE SALARY TO BRING IT INTO ALIGNMENT WITH CURRENT MARKET DATA AND THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY. ALL OF THE DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES OF THE COMMITTEE AND BOARD. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY AND ARE ADJUSTED BASED UPON PERFORMANCE AND IN RELATION TO MARKET VALUE OF SURVEY OF POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IN ADDITION, THE FORM 990 WITHOUT SCHEDULE B IS AVAILABLE VIA GUIDESTAR AND THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. WINTER STREET VENTURES LLC 30 WINTER STREET BOSTON MA 02108 812358124 INVEST IN COMPANIES RELATED TO HEALTH CARE DELIVERY AND PAYMENT DE 0 63967 COMMONWEALTH CARE ALLIANCE INC 747 CAMBRIDGE STREET LLC 30 WINTER STREET BOSTON MA 02108 464325429 REAL ESTATE HOLDING MA 0 0 COMMONWEALTH CARE ALLIANCE INC INSTED LLC 30 WINTER STREET BOSTON MA 02108 831983756 BROKERING AND DISPATCHING MOBILE INTEGRATED HEALTH SERVICES MA 3529383 5792629 COMMONWEALTH CARE ALLIANCE INC BOSTON'S COMMUNITY MEDICAL GROUP INC 30 NORTHAMPTON STREET BOSTON MA 02118 260100022 MEDICAL SERVICE MA 501(C)(3) LINE 3 COMMONWEALTH CARE ALLIANCE INC 1 COMMONWEALTH CLINICAL ALLIANCEINC 30 WINTER STREET BOSTON MA 02108 562382058 MEDICAL SERVICE MA 501(C)(3) LINE 10 COMMONWEALTH CARE ALLIANCE INC 1 THE CENTER TO ADVANCE CONSUMER PARTNERSHIP INC 30 WINTER STREET BOSTON MA 02108 822810261 INNOVATION HUB FOR DEVELOPMENT IN THE QUALITY OF CARE AND HEALTH SERVICES MA 501(C)(3) LINE 12A, I COMMONWEALTH CARE ALLIANCE INC 1 LIFEPOD SOLUTIONS INC 759 CHIEF JUSTICE CUSHING HWY 255 COHASSET MA 02025 815421292 2 WAY VOICE INTERFACES TO HELP PROFESSIONAL & FAMILY CAREGIVERS MA COMMONWEALTH CARE ALLIANCE INC C 340614 82114 0.51000 1 COMMONWEALTH CARE ALLIANCE MASSACHUSETTS INC 30 WINTER STREET BOSTON MA 02108 854228186 MEDICARE ADVANTAGE PRODUCTS MA COMMONWEALTH CARE ALLIANCE INC C 11532 4165807 1.00000 1 COMMONWEALTH CARE ALLIANCE RHODE ISLAND INC 30 WINTER STREET BOSTON MA 02108 854310885 MEDICARE ADVANTAGE PRODUCTS MA COMMONWEALTH CARE ALLIANCE INC C 7434975 1.00000 1 COMMONWEALTH CARE ALLIANCE INDIANA LLC 30 WINTER STREET BOSTON MA 02108 873317576 MEDICARE ADVANTAGE PRODUCTS IN COMMONWEALTH CARE ALLIANCE INC C 3010000 1.00000 1 COMMONWEALTH CARE ALLIANCE MICHIGAN LLC 30 WINTER STREET BOSTON MA 02108 872560730 HOLDING COMPANY MI COMMONWEALTH CARE ALLIANCE INC C 36770199 1.00000 1 RELIANCE HMO INC (ACQUIRED DEC10 2021) 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 814977640 MEDICAL SERVICES TO PERSONS IN MICHIGAN MI COMMONWEALTH CARE ALLIANCE MICHIGAN LLC C -78791 19624871 0.70000 1 RELIANCE ACO LLC (ACQUIRED DEC10 2021) 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 461262045 MEDICARE ADVANTAGE PRODUCTS MI COMMONWEALTH CARE ALLIANCE MICHIGAN LLC C 11683878 0.60000 1 RELIANCE PO OF MICHIGAN INC (ACQUIRED DEC10 2021) 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 813685900 MEDICARE ADVANTAGE PRODUCTS MI COMMONWEALTH CARE ALLIANCE MICHIGAN LLC C 23912 4890196 0.60000 1 RELIANCE NEXT GEN ACO LLC (ACQUIRED DEC10 2021) 23900 ORCHARD LAKE RD SUITE 210 FARMINGTON MI 48336 812185714 MEDICARE ADVANTAGE PRODUCTS MI COMMONWEALTH CARE ALLIANCE MICHIGAN LLC C 6701 0.60000 1 COMMONWEALTH CARE ALLIANCE CALIFORNIA LLC 30 WINTER STREET BOSTON MA 02108 873361607 HOLDING COMPANY CA COMMONWEALTH CARE ALLIANCE INC C 6768617 1.00000 1 VITALITY HEALTH PLAN OF CALIFORNIA INC (ACQUIRED DEC 2021) 18000 STUDEBAKER RD STE 150 CERRITOS CA 90703 814822508 ARRANGES FOR HEALTHCARE SERVICES TO MEDICARE BENEFICIARIES CA COMMONWEALTH CARE ALLIANCE CALIFORNIA LLC C 12747294 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 COMMONWEALTH CLINICAL ALLIANCE M 101479734 FAIR MARKET VALUE BOSTON'S COMMUNITY MEDICAL GROUP INC M 26867347 FAIR MARKET VALUE