AFFINITY HEALTH PLAN INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- AFFINITY HEALTH PLAN INC (EIN 13-3330672)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202233189349303643
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T09:34:02-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 345 PARK AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 101540102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133330672 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AFFINITY LEGACY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AFFI | BusinessNameControlTxt |
| Phone | 7187947700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 922 E TREMONT AVE 2105 | AddressLine1Txt |
| City | BRONX | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10460 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RACHEL AMALFITANO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5169821146 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RACHEL | PersonFirstNm |
| Person Last | AMALFITANO | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | OMO-OSE JOSEPH-ERAMEH | PreparerPersonNm |
| PTIN | P02534927 | PTIN |
| Phone | 2127589700 | PhoneNum |
| Preparation | 2022-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Change | Yes (X) | NameChangeInd |
| Principal Officer | CLARA HANSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 922 E TREMONT AVE 2105 | AddressLine1Txt |
| City | BRONX | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10460 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,720,685,032 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | AFFINITYLEGACY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE HEALTH AND WELL-BEING OF MEMBERS, THEIR FAMILIES, AND THEIR COMMUNITIES. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 722 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,354,034,147 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,311,867,660 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,797,341 | PYInvestmentIncomeAmt |
| CY Investment Income | $812,922 | CYInvestmentIncomeAmt |
| PY Other Revenue | $22,667,749 | PYOtherRevenueAmt |
| CY Other Revenue | $626,941 | CYOtherRevenueAmt |
| PY Total Revenue | $1,379,499,237 | PYTotalRevenueAmt |
| CY Total Revenue | $1,313,307,523 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $60,100,558 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $66,398,515 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,242,590,137 | PYOtherExpensesAmt |
| CY Other Expenses | $1,221,886,550 | CYOtherExpensesAmt |
| PY Total Expenses | $1,302,690,695 | PYTotalExpensesAmt |
| CY Total Expenses | $1,288,285,065 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $76,808,542 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $25,022,458 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $556,524,045 | TotalAssetsBOYAmt |
| Total Assets EOY | $103,380,908 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $518,534,257 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,377,925 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $37,989,788 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $102,002,983 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF AFFINITY LEGACY, INC., F/K/A AFFINITY HEALTH PLAN (AFFINITY), IS TO IMPROVE THE HEALTH AND WELL-BEING OF ITS MEMBERS, THEIR FAMILIES, AND THEIR COMMUNITIES IN COLLABORATION WITH PRIMARY CARE PROVIDERS. FOR MORE INFORMATION, SEE SCHEDULE O. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $852,633,074 | ExpenseAmt |
| Revenue | $969,470,201 | RevenueAmt |
| Desc | MEDICAID PROGRAM - AFFINITY HEALTH PLAN'S MEDICAID PROGRAM WAS FUNDED BY THE STATE OF NEW YORK TO MANAGE THE HEALTHCARE AND RELATED COSTS OF MEDICAID PATIENTS IN NEW YORK CITY AND THE SURROUNDING COUNTIES OF NASSAU, SUFFOLK, WESTCHESTER, ROCKLAND AND ORANGE. AFFINITY SOLD THIS BUSINESS/CONTRACT TO MOLINA HEALTHCARE EFFECTIVE 11/1/2021. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $167,296,070 | ExpenseAmt |
| Revenue | $190,220,811 | RevenueAmt |
| Desc | ESSENTIAL PLAN - THE ESSENTIAL PLAN COVERED ESSENTIAL HEALTH BENEFITS, INCLUDING INPATIENT AND OUTPATIENT CARE, PHYSICIAN SERVICES, DIAGNOSTIC SERVICES AND PRESCRIPTION DRUGS AMONG OTHERS, WITH NO ANNUAL DEDUCTIBLE AND LOW OUT-OF-POCKET COSTS. PREVENTIVE CARE, SUCH AS ROUTINE OFFICE VISITS AND RECOMMENDED SCREENINGS ARE FREE. AFFINITY SOLD THIS BUSINESS/CONTRACT TO MOLINA HEALTHCARE EFFECTIVE 11/1/2021. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $109,607,770 | ExpenseAmt |
| Revenue | $124,627,428 | RevenueAmt |
| Desc | HARP PROGRAM - HARP WAS AN ADDENDUM TO THE MEDICAID CONTRACT STATED ABOVE AND IS SUBJECT TO THE SAME CONTRACT TERMS. HARP PLANS PROVIDE ENHANCED CARE MANAGEMENT FOR MEMBERS TO HELP THEM COORDINATE ALL THEIR PHYSICAL HEALTH, BEHAVIORAL HEALTH, SUBSTANCE USE DISORDER, AND NONMEDICAL SUPPORT NEEDS. HARP PARTICIPANTS MUST BE 21 OR OLDER, INSURED ONLY BY MEDICAID, AND BE ELIGIBLE FOR MEDICAID MANAGED CARE. AFFINITY SOLD THIS BUSINESS/CONTRACT TO MOLINA HEALTHCARE EFFECTIVE 11/1/2021. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $24,229,086 | ExpenseAmt |
| Revenue | $27,549,220 | RevenueAmt |
| Desc | CHILD HEALTH PLUS PROGRAM - CHP WAS AVAILABLE TO CHILDREN UNDER THE AGEOF 19 WHO ARE NOT ELIGIBLE FOR MEDICAID AND WHO DO NOT ALREADY HAVECOMPREHENSIVE HEALTH COVERAGE. THE PREMIUM RECEIVED BY THE PLAN DEPENDSUPON INCOME (SOME PARTICIPANTS ARE FULLY SUBSIDIZED). AFFINITY SOLD THIS BUSINESS/CONTRACT TO MOLINA HEALTHCARE EFFECTIVE 11/1/2021. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $24,229,086 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $27,549,220 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $1,153,766,000 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4922 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 722 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (1) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RACHEL AMALFITANO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5169821146 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 922 E TREMONT AVE 2105 | AddressLine1Txt |
| City | BRONX | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10460 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| AMY KNAPP | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $83,000 | $0 | $0 | ||
| CALEB DESROSIERS | ||||||||
| TRUSTEE & VICE CHAIR (THRU JAN 2021) | 1.00 | 2.00 | Yes (X) | $50,000 | $0 | $0 | Yes (X) | |
| JOHN SARDELIS | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $99,500 | $0 | $0 | ||
| YVETTE WALKER MD | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $100,000 | $0 | $0 | ||
| NANETTE FALKENBERG | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $92,000 | $0 | $0 | ||
| ROBERT SCHILLER MD | ||||||||
| TRUSTEE (THRU DEC 2021) | 1.00 | 2.00 | Yes (X) | $65,000 | $0 | $0 | ||
| VERONA GREENLAND | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $100,000 | $0 | $0 | ||
| PALOMA IZQUIERDO-HERNANDEZ | ||||||||
| TRUSTEE & CHAIR | 1.00 | 2.00 | Yes (X) | $100,000 | $0 | $0 | Yes (X) | |
| LYNN SHERMAN | ||||||||
| TRUSTEE & TREASURER | 1.00 | 2.00 | Yes (X) | $100,000 | $0 | $0 | Yes (X) | |
| BRIAN MCINDOE | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $81,500 | $0 | $0 | ||
| LINDA MULLER | ||||||||
| TRUSTEE & SECRETARY | 1.00 | 2.00 | Yes (X) | $78,500 | $0 | $0 | Yes (X) | |
| JUDITH FAIRWEATHER | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $86,000 | $0 | $0 | ||
| MICHAEL MURPHY | ||||||||
| PRESIDENT & CEO | 35.00 | 0.00 | $4,388,277 | $0 | $45,932 | Yes (X) | ||
| SCOTT BREIDBART | ||||||||
| CHIEF MEDICAL OFFICER | 35.00 | 0.00 | $1,321,853 | $0 | $49,715 | Yes (X) | ||
| LISA MINGIONE | ||||||||
| VP/CHIEF COMPLIANCE OFFICE | 35.00 | 0.00 | $635,414 | $0 | $20,057 | Yes (X) | ||
| RACHEL AMALFITANO | ||||||||
| CONSULTANT/CFO | 35.00 | 0.00 | $1,067,700 | $0 | $0 | Yes (X) | ||
| MARK SCLAFANI | ||||||||
| VP SALES & RETENTION | 35.00 | 0.00 | $577,477 | $0 | $45,708 | Yes (X) | ||
| CRAIG BELLISE | ||||||||
| VP/CONTROLLER | 35.00 | 0.00 | $547,236 | $0 | $38,244 | Yes (X) | ||
| CLARA MERCEDES HANSEN | ||||||||
| VP; EXEC DIR AFFINITY LEGACY | 35.00 | 0.00 | $593,988 | $0 | $42,006 | Yes (X) | ||
| DENISE J PESICH | ||||||||
| VP/CHIEF MARKETING OFFICER | 35.00 | 0.00 | $542,751 | $0 | $19,510 | Yes (X) | ||
| JOANNE SCILIA | ||||||||
| VICE PRESIDENT, MEDICAL MGMT | 35.00 | 0.00 | $591,643 | $0 | $25,019 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,301,839 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $286,191 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHANGE HEALTHCARE SOLUTIONS LLC | |||||
| 3055 LEBANON PIKE | NASHVILLE | TN | 37214 | CLAIM PROCESSING | $5,668,608 |
| COGNIZANT TECHNOLOGY SOLUTIONS | |||||
| 500 GLENPOINTE CTRE WEST | TEANECK NJ | NJ | 07666 | IT STAFF AUGMENTATION | $1,570,255 |
| SUPPORT SERVICE GROUP | |||||
| 300 S 13TH STREET | WACO | TX | 76701 | CUSTOMER SERVICE CONSULTANTS | $1,202,387 |
| AMERIDIAL INC | |||||
| 4535 STRAUSSER ST NW | NORTH CANTON | OH | 44720 | CUSTOMER SERVICE | $1,084,729 |
| DC SOLUTIONS LLC | |||||
| 41 MEADOW DRIVE | SHREWSBURY | NJ | 07702 | FACETS SOFTWARE SUPPORT | $814,642 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 900099 | $969,470,201 | $969,470,201 |
| ESSENTIAL PLAN | 900099 | $190,220,811 | $190,220,811 |
| HARP | 900099 | $124,627,428 | $124,627,428 |
| CHILD HEALTH PLUS | 900099 | $27,549,220 | $27,549,220 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,311,867,660 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,957,343 | TotalRevenueColumnAmt |
| Exclusion | $1,957,343 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $406,233,088 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $407,377,509 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,144,421 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,144,421 | TotalRevenueColumnAmt |
| Exclusion | -$1,144,421 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | VIRTUAL CARD INTERCHAN | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $626,941 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $626,941 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $626,941 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,313,307,523 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,312,494,601 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $812,922 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,564,448 | TotalAmt |
| Management And General | $8,564,448 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,762,772 | TotalAmt |
| Management And General | $47,762,772 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,489,907 | TotalAmt |
| Management And General | $1,489,907 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,037,333 | TotalAmt |
| Management And General | $6,037,333 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,544,055 | TotalAmt |
| Management And General | $2,544,055 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,211 | TotalAmt |
| Management And General | $396,211 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,277 | TotalAmt |
| Management And General | $431,277 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,608 | TotalAmt |
| Management And General | $320,608 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,152,531 | TotalAmt |
| Management And General | $14,152,531 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,335,140 | TotalAmt |
| Management And General | $1,335,140 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,316,174 | TotalAmt |
| Management And General | $24,316,174 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,775,022 | TotalAmt |
| Management And General | $14,775,022 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,595,212 | TotalAmt |
| Management And General | $6,595,212 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,540 | TotalAmt |
| Management And General | $58,540 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,746 | TotalAmt |
| Management And General | $636,746 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,528,398 | TotalAmt |
| Management And General | $1,528,398 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,042,596 | TotalAmt |
| Management And General | $3,042,596 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,095 | TotalAmt |
| Management And General | $532,095 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| INPATIENT CLAIMS | $297,050,399 | $297,050,399 |
| PHARMACY | $237,836,357 | $237,836,357 |
| PRIMARY CARE | $133,838,946 | $133,838,946 |
| OTHER PROFESSIONAL SERV | $124,803,073 | $124,803,073 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,237,225 | TotalAmt |
| Program Services | $360,237,225 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,288,285,065 | TotalAmt |
| Program Services | $1,153,766,000 | ProgramServicesAmt |
| Management And General | $134,519,065 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,198,081 | BOYAmt |
| EOY | $14,680,357 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,654,216 | BOYAmt |
| EOY | $8,677,052 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,831,301 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,102,945 | BOYAmt |
| EOY | $2,089,930 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,036,970 | BOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $215,483,594 | BOYAmt |
| EOY | $29,481,213 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,216,938 | BOYAmt |
| EOY | $48,452,356 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $556,524,045 | BOYAmt |
| EOY | $103,380,908 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $499,366,039 | BOYAmt |
| EOY | $1,377,925 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,904 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,084,314 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $518,534,257 | BOYAmt |
| EOY | $1,377,925 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$62,886,862 | BOYAmt |
| EOY | $102,002,983 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,876,650 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,989,788 | BOYAmt |
| EOY | $102,002,983 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $556,524,045 | BOYAmt |
| EOY | $103,380,908 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $25,022,458 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$525,609 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $39,516,346 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,556,450,091 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,534,514,333 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,304,530,050 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,354,403,147 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,311,867,660 | CurrentTaxYearAmt |
| Total | $7,061,765,281 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,556,450,091 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,534,514,333 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,304,530,050 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,354,403,147 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,311,867,660 | CurrentTaxYearAmt |
| Total | $7,061,765,281 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $7,061,765,281 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,723,908 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,276,181 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,647,573 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,372,084 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,957,343 | CurrentTaxYearAmt |
| Total | $11,977,089 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,723,908 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,276,181 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,647,573 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,372,084 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,957,343 | CurrentTaxYearAmt |
| Total | $11,977,089 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,937,798 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,183,743 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,221,197 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,667,749 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $626,941 | CurrentTaxYearAmt |
| Total | $46,637,428 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,563,111,797 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,543,974,257 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,319,398,820 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,379,442,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,314,451,944 | CurrentTaxYearAmt |
| Total | $7,120,379,798 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99180 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99140 | PublicSupportPY509Pct |
| Investment Income CY | 0.00170 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00190 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $17,488 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $17,488 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | LOBBYING ACTIVITIES | FormAndLineReferenceDesc |
| Explanation | SCHEDULE C, PART II-B, LINE 1I AFFINITY HEALTH PLAN PAYS ANNUAL DUES TO THE COALITION OF NEW YORK STATE PUBLIC HEALTH PLANS, A PORTION OF WHICH ARE ALLOCABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST RECEIVABLE | $165,800 |
| PHARMACY REBATE RECEIVABLE | $10,784,501 |
| MOLINA ESCROW AGREEMENT | $37,502,055 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $48,452,356 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,657,298,260 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$525,609 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $344,516,346 | OtherRevenueAmt |
| Revenue Not Reported | $343,990,737 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,313,307,523 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,313,307,523 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,593,285,065 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $305,000,000 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $305,000,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,288,285,065 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,288,285,065 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | ASC 740 FOOTNOTE AFFINITY IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ITS INCOME IS NOT SUBJECT TO FEDERAL, NEW YORK STATE, OR LOCAL INCOME TAXES. THE PLAN RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2021 AND 2020. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | GAIN ON SALE OF HEALTH PLAN, NET 344,516,346. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | DISTRIBUTION TO STATE OF NEW YORK 110,000,000. ORGANIZATIONAL MEMBER DISTRIBUTIONS 195,000,000. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL MURPHY | ||||||||||||||
| PRESIDENT & CEO | $750,156 | $0 | $3,450,000 | $0 | $188,121 | $0 | $16,507 | $0 | $29,425 | $0 | $4,434,209 | $0 | $0 | $0 |
| SCOTT BREIDBART | ||||||||||||||
| CHIEF MEDICAL OFFICER | $291,339 | $0 | $569,837 | $0 | $460,677 | $0 | $17,400 | $0 | $32,315 | $0 | $1,371,568 | $0 | $0 | $0 |
| RACHEL AMALFITANO | ||||||||||||||
| CONSULTANT/CFO | $1,067,700 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,067,700 | $0 | $0 | $0 |
| LISA MINGIONE | ||||||||||||||
| VP/CHIEF COMPLIANCE OFFICE | $229,786 | $0 | $384,200 | $0 | $21,428 | $0 | $13,471 | $0 | $6,586 | $0 | $655,471 | $0 | $0 | $0 |
| CLARA MERCEDES HANSEN | ||||||||||||||
| VP; EXEC DIR AFFINITY LEGACY | $191,100 | $0 | $344,265 | $0 | $58,623 | $0 | $11,861 | $0 | $30,145 | $0 | $635,994 | $0 | $0 | $0 |
| MARK SCLAFANI | ||||||||||||||
| VP SALES & RETENTION | $189,319 | $0 | $346,371 | $0 | $41,787 | $0 | $12,860 | $0 | $32,848 | $0 | $623,185 | $0 | $0 | $0 |
| JOANNE SCILIA | ||||||||||||||
| VICE PRESIDENT, MEDICAL MGMT | $207,283 | $0 | $348,045 | $0 | $36,315 | $0 | $12,615 | $0 | $12,404 | $0 | $616,662 | $0 | $0 | $0 |
| CRAIG BELLISE | ||||||||||||||
| VP/CONTROLLER | $181,166 | $0 | $322,416 | $0 | $43,654 | $0 | $11,951 | $0 | $26,293 | $0 | $585,480 | $0 | $0 | $0 |
| DENISE J PESICH | ||||||||||||||
| VP/CHIEF MARKETING OFFICER | $178,977 | $0 | $313,308 | $0 | $50,466 | $0 | $5,815 | $0 | $13,695 | $0 | $562,261 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4A | SEVERANCE COMPENSATION SCOTT BREIDBART RECEIVED SEVERANCE COMPENSATION OF $397,727 IN CALENDAR YEAR 2021. |
| PART I, LINE 7: | NON-FIXED PAYMENTS INDIVIDUALS LISTED ON SCHEDULE J, PART II RECEIVED DISCRETIONARY BONUS COMPENSATION, INCLUDING ANNUAL BONUSES AND INCENTIVE RETENTION BONUSES IN CALENDAR YEAR 2021. A PORTION OF THE PRESIDENT'S BONUS PAYMENT WAS CONTRACTUAL AND BASED ON THE ACHIEVEMENT OF FINANCIAL AND OPERATIONAL METRICS WHICH WERE ESTABLISHED BY THE BOARD OF DIRECTORS. |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail (24 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| NYS HEALTH CARE TRANSFORMATION FUND | |||||||||
| CASH | 2021-12-22 | $110,000,000 | ACTUAL COST | 146013200 | 1805 CORNING TOWER | ALBANY | NY | 12237 | GOVERNMENT |
| MHHC FOUNDATION | |||||||||
| CASH | 2021-12-02 | $68,850,000 | ACTUAL COST | 133276364 | 85 W BURNSIDE AVE | BRONX | NY | 10453 | 501(C)(3) |
| CHARLES B WANG COMMUNITY HEALTH CENTER | |||||||||
| CASH | 2021-12-02 | $40,120,000 | ACTUAL COST | 132739694 | 268 CANAL STREET | NEW YORK | NY | 10013 | 501(C)(3) |
| THE FOUNDATION FOR URBAN HEALTH AND WELL BEING INC | |||||||||
| CASH | 2021-12-02 | $40,120,000 | ACTUAL COST | 200565715 | 1065 SOUTHERN BLVD | BRONX | NY | 10459 | 501(C)(3) |
| INSTITUTE FOR FAMILY HEALTH | |||||||||
| CASH | 2021-12-02 | $25,000,000 | ACTUAL COST | 133273402 | 2006 MADISON AVENUE 2ND FL | NEW YORK | NY | 10035 | 501(C)(3) |
| CORNERSTONE FAMILY HEALTHCARE | |||||||||
| CASH | 2021-12-02 | $11,390,000 | ACTUAL COST | 061036715 | 2570 ROUTE 9W SUITE 10 | CORNWALL | NY | 12518 | 501(C)(3) |
| WILLIAN F RYAN COMMUNITY HEALTH CTR | |||||||||
| CASH | 2021-12-02 | $9,520,000 | ACTUAL COST | 132884976 | 110 WEST 97TH STREET | NEW YORK | NY | 10025 | 501(C)(3) |
| MOLINA HEALTHCARE INC | |||||||||
| CASH | 2021-10-25 | $85,455,129 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| PREMIUM RECEIVABLE | 2021-10-25 | $70,007,840 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| DUE FROM MEDICAID | 2021-10-25 | $3,986,399 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| KICK RECEIVABLE | 2021-10-25 | $15,956,450 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| STOP-LOSS RECEIVABLE | 2021-10-25 | $28,824,646 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| OTHER CURRENT ASSETS | 2021-10-25 | $26,383,778 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| FIXED ASSETS, NET | 2021-10-25 | $8,362,404 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| NYSDOH-DSRIP FUND | 2021-10-25 | $12,472,967 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| ACCOUNTS PAYABLE AND ACCRUED EXPENSES | 2021-10-25 | -$20,593,550 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| CLAIMS PAYABLE | 2021-10-25 | -$231,320,032 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| DUE TO NY STATE & CMS | 2021-10-25 | -$153,169,580 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| DEFERRED RENT | 2021-10-25 | -$8,255,181 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| NYSDOH-DSRIP FUND | 2021-10-25 | -$12,472,968 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| MOLINA HEALTHCARE INC | |||||||||
| NON ADMITTED ASSETS TRANFERRING TO MOLINA | 2021-10-25 | $11,623,478 | NET ASSET VALUE | 134204626 | 200 OCEANGATE SUITE 100 | LONG BEACH | CA | 90802 | CORPORATION |
| AFFINITY EMPLOYEES | |||||||||
| EMPLOYEE COMPENSATION | 2021-10-25 | $18,343,000 | ACTUAL COST | 922 E TREMONT AVE 2105 | BRONX | NY | 10460 | INDIVIDUALS | |
| GREENBERG TRAURIG LLP | |||||||||
| LEGAL EXPENSES | 2021-10-25 | $1,078,777 | ACTUAL COST | 133613083 | 2101 L ST NW STE 1000 | WASHINGTON | DC | 20037 | LLP |
| CAIN BROTHERS | |||||||||
| PROFESSIONAL FEES | 2021-10-25 | $5,407,765 | ACTUAL COST | 341391952 | 1301 6TH AVE | NEW YORK | NY | 10019 | CORPORATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | Yes (1) | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, LINE 2A | THE FOLLOWING TRUSTEES OF AFFINITY HEALTH PLAN, INC. BECAME DIRECTORS OF A TRANSFEREE ORGANIZATION: VERONA GREENLAND |
| PART II, LINE 2B | THE FOLLOWING TRUSTEES OF AFFINITY HEALTH PLAN, INC. WERE EMPLOYEES OR INDEPENDENT CONTRACTORS OF A TRANSFEREE ORGANIZATION BOTH PRIOR TO AND AFTER THE TRANSFER OF ASSETS. EACH TRANSFEREE ORGANIZATION IS A TAX-EXEMPT ENTITY RECOGNIZED UNDER IRC SECTION 501(C)(3) AND TRANSFERS WERE MADE IN LINE WITH NYS OFFICE OF ATTORNEY GENERAL APPROVAL OF THE MOLINA HEALTHCARE ASSET PURCHASE AGREEMENT.*LYNN SHERMAN, CHARLES B WANG COMMUNITY HEALTH CENTER (A 501(C)(3) ORGANIZATION)*PALOMA IZQUIERDO-HERNANDEZ, THE FOUNDATION FOR URBAN HEALTH AND WELL BEING (A 501(C)(3) ORGANIZATION)*ROBERT SCHILLER, THE INSTITUTE FOR FAMILY HEALTH (A 501(C)(3) ORGANIZATION)*LINDA MULLER, CORNERSTONE FAMILY HEALTHCARE (A 501(C)(3) ORGANIZATION)*BRIAN MCINDOE, WILLIAM F. RYAN COMMUNITY HEALTH CENTER (A 501(C)(3) ORGANIZATION)THE FOLLOWING OFFICERS AND KEY EMPLOYEES OF AFFINITY HEALTH PLAN, INC. BECAME EMPLOYEES OR INDEPENDENT CONTRACTORS OF A TRANSFEREE ORGANIZATION: MICHAEL MURPHY AND LISA MINGIONE BECAME EMPLOYEES OF MOLINA HEALTHCARE |
| PART II, LINE 2D | THE FOLLOWING OFFICERS AND KEY EMPLOYEES OF AFFINITY HEALTH PLAN, INC. RECEIVED COMPENSATION AS A RESULT OF THE TRANSACTION WITH MOLINA HEALTHCARE: MICHAEL MURPHY, SCOTT BREIDBART AND LISA MINGIONE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 AND PART III, LINE 1 THE MISSION OF AFFINITY HEALTH PLAN IS TO IMPROVE THE HEALTH AND WELL-BEING OF ITS MEMBERS, THEIR FAMILIES, AND THEIR COMMUNITIES IN COLLABORATION WITH PRIMARY CARE PROVIDERS. AFFINITY STRIVES TO BE THE HEALTH PLAN OF CHOICE FOR ITS MEMBERS AND ITS PROVIDERS -- KNOWN FOR ASSURING ACCESS TO HIGH QUALITY, COST-EFFECTIVE CARE; DELIVERING THE BEST CUSTOMER EXPERIENCE; AND CONTRIBUTING SIGNIFICANTLY TO ACHIEVING A PATIENT-CENTERED HEALTH CARE SYSTEM. |
| FORM 990, PART III, LINE 3 | IN OCTOBER 2020, AFFINITY ENTERED INTO AN ASSET PURCHASE AGREEMENT ("APA") TO SELL ITS HEALTH PLAN OPERATIONS TO MOLINA. THE PARTIES SUBSEQUENTLY RECEIVED ALL REQUIRED REGULATORY APPROVALS FROM THE NEW YORK STATE DEPARTMENT OF HEALTH AND THE NEW YORK STATE ATTORNEY GENERAL AND CLOSED ON THE TRANSACTION ON OCTOBER 25, 2021. THE PURCHASE PRICE FOR THE TRANSACTION WAS $500,000,000, LESS THE AMOUNT BY WHICH THE TARGET NET ASSET VALUE ("NAV") IS GREATER THAN THE ESTIMATED NAV OF THE ASSETS AND LIABILITIES ASSUMED BY MOLINA AS OF OCTOBER 25, 2021. THEREFORE, AFFINITY RECORDED A GAIN ON THE SALE OF $349,925,000 LESS TRANSACTION COSTS OF $5,409,000 OR $344,516,000. FOR PURPOSES OF THE AUDITED FINANCIAL STATEMENTS, THIS GAIN IS RECORDED IN OTHER NON-OPERATING REVENUE (EXPENSES) IN THE STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS AS OF DECEMBER 31, 2021. FOR PURPOSES OF FORM 990, THE GAIN IS REPORTED AS AN OTHER CHANGE IN NET ASSETS OR FUND BALANCES ON PART XI, LINE 9. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW THE FINANCIAL STAFF COMPILES THE FINANCIAL AND OTHER INFORMATION REQUIRED IN THE 990 RETURN. KPMG LLP PREPARES THE RETURN AND THE INFORMATION IS REVIEWED BY THE COMPANY'S CFO. A FINAL COPY OF THE FORM 990 IS MADE AVAILABLE TO THE ENTIRE GOVERNING BODY BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 1. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO APPROPRIATE MANAGEMENT PERSONNEL, HUMAN RESOURCES OR THE CORPORATE COMPLIANCE OFFICER. 2. EMPLOYEES MUST SEEK GUIDANCE AND APPROVAL FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MAY CONSTITUTE A CONFLICT OF INTEREST. 3. MANAGEMENT, WITH PURCHASING AUTHORITY, WILL COMPLETE A RELATED PARTY QUESTIONNAIRE ANNUALLY TO IDENTIFY ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST. 4. EMPLOYEES, UPON HIRE AND ANNUALLY THEREAFTER, REVIEW THE CODE OF ETHICS WHICH INCLUDES INFORMATION ON CONFLICTS OF INTEREST. IN ADDITION, EMPLOYEES ARE REQUIRED TO SIGN AN ATTESTATION, UPON HIRE AND ANNUALLY THEREAFTER, THAT THEY ACKNOWLEDGE AND UNDERSTOOD THE CODE OF ETHICS. IF A CONFLICT OF INTEREST IS FOUND, PERSONS WITH A CONFLICT RECUSE THEMSELVES FROM DECISIONS RELATED TO THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION REVIEW THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO AND CFO INCLUDED REVIEW AND APPROVAL BY A COMPENSATION COMMITTEE (THE "COMMITTEE") COMPRISED OF INDEPENDENT DIRECTORS CHARGED WITH THIS RESPONSIBILITY, CONSIDERATION OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION AND DOCUMENTATION OF THE DELIBERATION AND DECISION. AFFINITY HEALTH PLAN'S ANNUAL COMPENSATION PROGRAM FOR THESE POSITIONS AND OTHER OFFICERS AND KEY EMPLOYEES INCLUDES: A) COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER IS ESTABLISHED BY THE COMPENSATION COMMITTEE AND RATIFIED BY THE BOARD OF DIRECTORS OF AFFINITY HEALTH PLAN. THE BOARD AND THE COMMITTEE HAVE ESTABLISHED COMPENSATION TERMS FOR THE CEO CONSIDERING COMPARABILITY DATA FOR CEO POSITIONS IN SIMILAR ORGANIZATIONS IN THEIR DELIBERATIONS AND DECISION MAKING. THESE DECISIONS ARE DOCUMENTED IN ACCORDANCE WITH LEGAL REQUIREMENTS AND BEST PRACTICES. B) COMPENSATION DECISIONS APPLICABLE FOR OTHER OFFICERS AND KEY EMPLOYEES, INCLUDING INCENTIVE BONUSES, MERIT INCREASES, PROMOTIONAL SALARY ADJUSTMENTS, AND STARTING SALARIES FOR NEWLY HIRED OFFICERS AND KEY EMPLOYEES ARE MADE AFTER REVIEW OF COMPARABILITY DATA FROM PUBLISHED SOURCES FOR SIMILAR POSITIONS IN THE RELEVANT LABOR MARKET. PUBLISHED COMPARABILITY DATA UTILIZED INCLUDES INDUSTRY SPECIFIC DATA. INTERNAL DATA IS REVIEWED AS WELL WITH THE OBJECTIVE OF ENSURING INTERNAL EQUITY WITH SIMILARLY SITUATED STAFF. COMPENSATION DECISIONS IMPACTING THOSE OF THE FOREGOING POSITIONS THAT ARE ALSO DEEMED TO BE "DISQUALIFIED PERSONS" UNDER THE INTERNAL REVENUE CODE (E.G., CHIEF FINANCIAL OFFICER) ARE MADE BY THE COMMITTEE (AND RATIFIED BY THE BOARD) IN ACCORDANCE WITH "INTERMEDIATE SANCTIONS SAFE HARBOR" STANDARDS UTILIZING THE SAME PROCESSES AS ARE APPLIED TO THE CEO (DISCUSSED ABOVE). |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 24E | EMERGENCY ROOM CLAIMS : PROGRAM SERVICE EXPENSES 105,203,356. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,203,356. PRIMARY CARE: PROGRAM SERVICE EXPENSES 70,286,233. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 70,286,233. BEACON-OUTPATIENT SUBSTANCE AB: PROGRAM SERVICE EXPENSES 56,291,482. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 56,291,482. BEACON IBNR EXPENSE : PROGRAM SERVICE EXPENSES 31,650,278. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,650,278. DIAGNOSTIC TESTS LAB & X-RAY C: PROGRAM SERVICE EXPENSES 28,407,731. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,407,731. MEDICAID STOP LOSS INSURANCE : PROGRAM SERVICE EXPENSES 19,667,461. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,667,461. OUTPATIENT FACILITIES COSTS: PROGRAM SERVICE EXPENSES 17,471,746. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,471,746. DENTAL CAPITATION : PROGRAM SERVICE EXPENSES 15,335,732. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,335,732. HEALTH HOME CLAIMS : PROGRAM SERVICE EXPENSES 10,862,368. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,862,368. CAPITATION EXPENSES: PROGRAM SERVICE EXPENSES 6,119,699. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,119,699. COVERED LIVES : PROGRAM SERVICE EXPENSES 5,209,909. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,209,909. OTHER PROFESSIONAL SVC-HCRA : PROGRAM SERVICE EXPENSES 3,262,249. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,262,249. VISION CAPITATION : PROGRAM SERVICE EXPENSES 2,920,369. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,920,369. SHARE SAVINGS EXPENSE : PROGRAM SERVICE EXPENSES 2,628,929. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,628,929. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 2,586,489. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,586,489. LAB HCRA : PROGRAM SERVICE EXPENSES 2,361,553. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,361,553. EMERGENCY ROOM HCRA : PROGRAM SERVICE EXPENSES 2,035,476. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,035,476. NURSING FACILITY : PROGRAM SERVICE EXPENSES 1,882,521. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,882,521. BEACON HCRA : PROGRAM SERVICE EXPENSES 1,870,250. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,870,250. OUTPATIENT CLAIMS-IBNR : PROGRAM SERVICE EXPENSES 1,254,625. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,254,625. OUTPATIENT NON VALUATED EXPENS: PROGRAM SERVICE EXPENSES 219,635. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219,635. CHIROPRACTIC : PROGRAM SERVICE EXPENSES 159,553. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 159,553. DENTAL HCRA : PROGRAM SERVICE EXPENSES 108,837. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 108,837. NURSING FACILITY HCRA : PROGRAM SERVICE EXPENSES 253. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 253. PROFESSION SERVICE-IBNR : PROGRAM SERVICE EXPENSES -480,314. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -480,314. BEACON OUTPATIENT DRUG&ALCOHOL: PROGRAM SERVICE EXPENSES -1,208,240. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -1,208,240. THIRD PARTY RECOVERIES - REINS: PROGRAM SERVICE EXPENSES -25,870,955. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -25,870,955. |
| FORM 990, PART XI, LINE 9: | ORGANIZATIONAL MEMBER DISTRIBUTIONS -195,000,000. DISTRIBUTION TO STATE OF NEW YORK -110,000,000. GAIN ON SALE OF HEALTH PLAN, NET 344,516,346. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|
| AHP ENTERPRISES INC | ||||||||||
| 922 E TREMONT AVE 2105 | BRONX | NY | 10460 | 473885217 | MGMT SVCS | DE | AHSH | C | 0 | |
| AFFINITY HEALTH SERVICES HOLDINGS INC | ||||||||||
| 922 E TREMONT AVE 2105 | BRONX | NY | 10460 | 473909849 | HOLDING CO | DE | C | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R PART IV | FormAndLineReferenceDesc |
| Explanation | AFFINITY INCORPORATED AHP ENTERPRISES, INC. ON DECEMBER 12, 2013 AS A DELAWARE CORPORATION FOR THE PURPOSE OF PROVIDING MANAGEMENT SERVICES. AFFINITY HEALTH SERVICES HOLDINGS, INC. IS THE SOLE CORPORATE MEMBER OF AFFINITY. | ExplanationTxt |
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