2021-05-14T08:55:21-05:00 2020-06-30 346565596 ERNST & YOUNG US LLP 1101 NEW YORK AVE NW WASHINGTON DC 20005 990 2019-07-01 541760974 VIRGINIA PREMIER HEALTH PLAN VIRG 8048195151 6015 POPLAR HALL DRIVE NORFOLK VA 23502 JEFF SNYDER TREASURER 8048195164 2021-05-14 1 JUSTIN LOWE P01866796 2023276000 2019 2022-09-23 18:48:47Z X DENNIS MATHEIS 6015 POPLAR HALL DRIVE RICHMOND VA 23502 2185804321 0 X WWW.VAPREMIER.COM X 2010 VA SEE SCHEDULE O 10 3 2000 0 144531 0 0 108692904 1730318354 2066017019 4889628 10941781 557362 152617 1735765344 2185804321 40488 12800 0 0 155390813 102952931 0 0 0 1636712347 1849293054 1792143648 1952258785 -56378304 233545536 440107533 597588792 347870041 274863444 92237492 322725348 X SEE SCHEDULE O 0 0 1906307476 12800 2066017019 VIRGINIA PREMIER MAINTAINED CONTRACTS WITH AREA PROVIDERS TO SUPPLY HEALTH CARE, DISEASE PREVENTION, AND HEALTH PROMOTION FOR INDIVIDUALS AND FAMILIES IN THE COMMUNITY IN AN EFFECTIVE, ACCESSIBLE AND AFFORDABLE MANNER. 1906307476 1 1 0 1 0 0 0 0 0 0 1 0 0 0 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 0 1 1 1 0 0 1 5584 0 1 2000 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 3 1 0 1 0 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 0 VA X LINDA HINES 8048195164 600 EAST BROAD STREET RICHMOND VA 23219 X DOMINIC PULEO FORMER VCUHS CFO 0.00 0.00 X 0 1326845 65069 MARSHA RAPPLEY MD PRESIDENT(JULY-APRIL) 1.00 40.00 X X 0 1204398 130572 CARL GATTUSO FORMER VICE CHAIR 0.00 0.00 X 0 1108720 41279 MELINDA HANCOCK DIRECTOR 1.00 40.00 X 0 737241 38940 LINDA HINES CEO 40.00 0.00 X 560504 0 71216 PAUL NEIMEYER SECRETARY (JULY-APRIL) 1.00 40.00 X 0 553864 31181 JOHN JOHNSON MD CMO & FORMER KE 40.00 0.00 X 436484 0 60016 TIM CARPENTER CFO, TREAS(TREAS-MAY) 40.00 0.00 X 394727 0 70076 ALICIA TURNER COO & FORMER KE 40.00 0.00 X 376017 0 72433 DAVID SUMMERS VP-ISOM & FORMER KE 40.00 0.00 X 318082 0 78287 SUSAN ROSEFF MD DIRECTOR(JULY-APRIL) 1.00 40.00 X 0 317718 55522 MARK MATTINGKY MD MEDICAL DIRECTOR 40.00 0.00 X 289573 0 72290 PATRICK MCMAHON VP - CONTRACTING 40.00 0.00 X 272610 0 76792 JAVIER MENENEDEZ VP - PHARMACY 40.00 0.00 X 261395 0 75110 JAMIE MCPHERSON VP - QUALITY 40.00 0.00 X 265594 0 66434 ANDREA COBB MD MEDICAL DIRECTOR 40.00 0.00 X 286044 0 38462 RYAN MCCARTHY VP - NEW BUSINESS 40.00 0.00 X 257834 0 61272 PETER PAVELL VP -STRATEGIC ALLIANCES 40.00 0.00 X 261632 0 57400 ERIC WILSON VP - HEALTH SERVICES 40.00 0.00 X 245034 0 67157 ARLINE BOHANNON DIRECTOR 1.00 40.00 X 0 260095 48466 DENAIRE JOHNSON VP - MEDICAID 40.00 0.00 X 247972 0 52023 RICHARD ROSENDAHL VP - ANALYTICS 40.00 0.00 X 208333 0 59490 DANA DREHER-RODWELL VP - COMPLIANCE 40.00 0.00 X 215615 0 49581 ELIZABETH VELIZ VP - HUMAN RESOURCES 40.00 0.00 X 207114 0 46648 RANDY DOVEL VP - ENROLLMENT 40.00 0.00 X 198114 0 43352 GORDON RICHARD VP - MEDICARE 40.00 0.00 X 207292 0 33139 ARAVIND GOPALKRISHNAN VP - ANALYTICS 40.00 0.00 X 161403 0 15399 MEGAN PERRY SECRETARY (APRIL-MAY) 2.00 45.00 X X 0 0 0 DENNIS MATHEIS PRESIDENT (APRIL-JUNE) 0.20 41.00 X X 0 0 0 ROBERT FORT DIRECTOR(APRIL-JUNE) 0.20 1.00 X 0 0 0 CATHIE VICK DIRECTOR(APRIL-JUNE) 0.20 1.00 X 0 0 0 LES HALL DIRECTOR(APRIL-JUNE) 0.20 3.00 X 0 0 0 JAMES HILBERT DIRECTOR(APRIL-MAY) 0.20 40.00 X 0 0 0 PATRICIA DARNLEY DIRECTOR(APRIL-JUNE) 0.20 40.00 X 0 0 0 COLIN DROZDOWSKI DIRECTOR(APRIL-JUNE) 0.20 40.00 X 0 0 0 ROBERT BROERMANN DIRECTOR(MAY-JUNE) 0.20 51.00 X 0 0 0 JORDAN ASHER MD DIRECTOR(APRIL-JUNE) 0.20 41.00 X 0 0 0 MAY FOX DIRECTOR(JULY-APRIL) 1.00 1.00 X 0 0 0 5671373 5508881 1577606 113 1 1 0 KAISER FOUNDATION HEALTH PLAN 2101 E JEFFERSON ST STE 100 ROCKVILLE MD 208524912 MEDICAL CLAIMS 81844467 CARILION MEDICAL CENTER 213 S JEFFERSON ST ROANOKE VA 24011 MEDICAL CLAIMS 74652940 VCU HEALTH SYSTEM PO BOX 758997 BALTIMORE MD 212750001 MEDICAL CLAIMS 62996393 THE UNIVERSITY OF VIRGINIA 2205 FONTAINE AVE CHARLOTTESVILLE VA 22903 MEDICAL CLAIMS 52825518 CENTRA HEALTH INC VIRGINIA BAPTIST HOSP DIV LYNCHBURG VA 245010496 MEDICAL CLAIMS 35483603 1389 108692904 108692904 MEDICAL PREMIUMS 900099 2066017019 2066017019 2066017019 3839077 -8086 3847163 6425944 676760 0 0 6425944 676760 7102704 7102704 TPA SERVICES 524292 152617 152617 152617 2185804321 2066017019 144531 10949867 12800 12800 1096523 767566 328957 78208729 54746110 23462619 5005318 3503723 1501595 13271102 9289771 3981331 5371259 3759881 1611378 11216606 7851624 3364982 362293 257203 105090 3927798 2749459 1178339 105376 73763 31613 107227 75059 32168 17719115 12403381 5315734 5038441 3526909 1511532 746486 522540 223946 3140009 2198006 942003 5266697 3686688 1580009 580092 406064 174028 MEDICAL CLAIM DISBURSEM 1799074956 1799074956 CORPORATE ALLOCATION 933142 653199 279943 REGULATORY FEES 426669 298668 128001 DUES & SUBSCRIPTIONS 340629 238440 102189 307518 211666 95852 1952258785 1906307476 45951309 0 150 0 44951794 234327788 0 223023285 229246129 5218767 7508655 40875534 23930946 19034488 16944588 91309921 93892170 36491312 11611267 20077816 4058195 440107533 597588792 229735436 272903230 0 368582 165097 98750000 0 19016023 1795117 347870041 274863444 X 83965515 314453371 8271977 8271977 92237492 322725348 440107533 597588792 233545536 -3057680 0 X X 0 1 X 1 0 X 108692904 108692904 1052657487 1093283222 1371673587 1730318354 2066017019 7313949669 1052657487 1093283222 1371673587 1730318354 2174709923 7422642573 0 0 0 7422642573 2542409 2713787 3766937 4653908 3839077 17516118 580193 580193 3122602 2713787 3766937 4653908 3839077 18096311 1055780089 1095997009 1375440524 1734972262 2178549000 7440738884 0.99760 0.99700 0.00240 0.00260 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11993 11993 0 PART II-B, LINE 1: DUES 303075 303075 5200927 3092300 2108627 34495105 20838646 13656459 876427 876427 16944588 DUE TO AFFILIATES 340174 OTHER LIABILITES 1454943 1795117 X PART X, LINE 2: VIRGINIA PREMIER IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. VIRGINIA PREMIER PROVIDES VARIOUS ADMINISTRATIVE SERVICES FOR OTHER HEALTH CARE PROVIDERS. NET INCOME RELATED TO THESE SERVICES IS CONSIDERED UNRELATED BUSINESS TAXABLE INCOME (UBTI) AND INCOME TAXES ARE PAID ACCORDINGLY. VIRGINIA PREMIER RECORDED IMMATERIAL INCOME TAX EXPENSE FOR THE YEARS ENDED JUNE 30, 2020 (PRIOR TO THE SALE TRANSACTION) AND 2019, IN UBTI FOR SERVICES PROVIDED. 1 VA ASSOC OF HEALTH PLANS 1111 E MAIN STREET RICHMOND VA 232843075 541335178 501(C)(6) 10000 GENERAL SUPPORT SUPPORT 1 SCHEDULE I, PART I, LINE 2 VIRGINIA PREMIER HEALTH PLAN MAKES DONATIONS FROM TIME TO TIME TO EXTERNAL ORGANIZATIONS AS WELL AS TO ORGANIZATIONS RELATED TO VIRGINIA COMMONWEALTH UNIVERSITY OR VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY. ALL GRANT FUNDS ARE DETAILED IN GENERAL LEDGER ACCOUNTING RECORDS. ALL GRANT REQUESTS ARE REVIEWED AND APPROVED ON A MONTHLY BASIS BY SENIOR MANAGEMENT. 1 0 0 0 0 0 0 0 0 DOMINIC PULEO FORMER VCUHS CFO 0 574772 0 102377 0 649696 0 43160 0 21909 0 1391914 0 0 MARSHA RAPPLEY MD PRESIDENT(JULY-APRIL) 0 919330 0 275675 0 9393 0 110229 0 20343 0 1334970 0 0 CARL GATTUSO FORMER VICE CHAIR 0 372306 0 0 0 736414 0 28000 0 13279 0 1149999 0 0 MELINDA HANCOCK DIRECTOR 0 634209 0 99716 0 3316 0 16800 0 22140 0 776181 0 0 LINDA HINES CEO 552980 0 0 0 7524 0 52600 0 18616 0 631720 0 0 0 PAUL NEIMEYER SECRETARY (JULY-APRIL) 0 469497 0 76713 0 7654 0 21200 0 9981 0 585045 0 0 JOHN JOHNSON MD CMO & FORMER KE 433963 0 0 0 2521 0 41400 0 18616 0 496500 0 0 0 TIM CARPENTER CFO, TREAS(TREAS-MAY) 387203 0 0 0 7524 0 51460 0 18616 0 464803 0 0 0 ALICIA TURNER COO & FORMER KE 374872 0 0 0 1145 0 45797 0 26636 0 448450 0 0 0 DAVID SUMMERS VP-ISOM & FORMER KE 315460 0 0 0 2622 0 51651 0 26636 0 396369 0 0 0 SUSAN ROSEFF MD DIRECTOR(JULY-APRIL) 0 297000 0 14918 0 5800 0 32185 0 23337 0 373240 0 0 MARK MATTINGKY MD MEDICAL DIRECTOR 282049 0 0 0 7524 0 46949 0 25341 0 361863 0 0 0 PATRICK MCMAHON VP - CONTRACTING 270089 0 0 0 2521 0 50156 0 26636 0 349402 0 0 0 JAVIER MENENEDEZ VP - PHARMACY 254160 0 0 0 7235 0 49769 0 25341 0 336505 0 0 0 JAMIE MCPHERSON VP - QUALITY 263884 0 0 0 1710 0 42616 0 23818 0 332028 0 0 0 ANDREA COBB MD MEDICAL DIRECTOR 285126 0 0 0 918 0 38462 0 0 0 324506 0 0 0 RYAN MCCARTHY VP - NEW BUSINESS 256808 0 0 0 1026 0 35931 0 25341 0 319106 0 0 0 PETER PAVELL VP -STRATEGIC ALLIANCES 260606 0 0 0 1026 0 32059 0 25341 0 319032 0 0 0 ERIC WILSON VP - HEALTH SERVICES 243320 0 0 0 1714 0 40521 0 26636 0 312191 0 0 0 ARLINE BOHANNON DIRECTOR 0 241558 0 14963 0 3574 0 10134 0 38332 0 308561 0 0 DENAIRE JOHNSON VP - MEDICAID 245346 0 0 0 2626 0 38861 0 13162 0 299995 0 0 0 RICHARD ROSENDAHL VP - ANALYTICS 207308 0 0 0 1025 0 32854 0 26636 0 267823 0 0 0 DANA DREHER-RODWELL VP - COMPLIANCE 214475 0 0 0 1140 0 23401 0 26180 0 265196 0 0 0 ELIZABETH VELIZ VP - HUMAN RESOURCES 205404 0 0 0 1710 0 30809 0 15839 0 253762 0 0 0 RANDY DOVEL VP - ENROLLMENT 196974 0 0 0 1140 0 34872 0 8480 0 241466 0 0 0 GORDON RICHARD VP - MEDICARE 206269 0 0 0 1023 0 33139 0 0 0 240431 0 0 0 ARAVIND GOPALKRISHNAN VP - ANALYTICS 161074 0 0 0 329 0 11388 0 4011 0 176802 0 0 0 LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: CARL GATTUSO, $653,432; DOMINIC PULEO, $563,475. PART I, LINE 1 TO ENSURE OUR MEMBERS RECEIVE THE HIGHEST QUALITY MEDICAL SERVICES. OUR GOAL IS TO IMPROVE THE HEALTH STATUS OF OUR MEMBERSHIP. PART III, LINE 1 VIRGINIA PREMIER HEALTH PLAN IS COMMITTED TO ENSURING OUR MEMBERS RECEIVE THE HIGHEST QUALITY MEDICAL SERVICES FROM OUR PHYSICIANS, HOSPITALS, AND OTHER HEALTH CARE PROVIDERS. THROUGH OPERATIONAL EXCELLENCE, OUR DEDICATED TEAM WILL PROMOTE MEMBER-FOCUSED SERVICES, CONTINUALLY FOSTER STRONG PROVIDER RELATIONSHIPS AND SHIFT MORE OF OUR FINANCIAL RESOURCES TO HEALTH CARE SERVICES. OUR GOAL IS TO IMPROVE THE HEALTH STATUS OF OUR MEMBERSHIP. GUIDING VALUES AND PRINCIPLES - SERVE AND SUPPORT THE VIRGINIA MEDICAID AND MEDICARE ELIGIBLE POPULATION - MEET THE HEALTH CARE NEEDS OF OUR MEMBERS - EMPOWER OUR MEMBERS THROUGH EDUCATION AND MEMBER-FOCUSED SERVICES - SUPPORT DOCTOR/PATIENT RELATIONSHIPS BY FOSTERING STRONG PROVIDER RELATIONSHIPS - EFFECTIVELY INTEGRATE MANAGED CARE ADMINISTRATION AND HEALTH CARE SERVICES - ABIDE BY ALL ETHICAL STANDARDS AND DEMONSTRATE INTEGRITY AND QUALITY IN ALL BUSINESS PRACTICES FORM 990, PART VI, SECTION A, LINE 2 THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM") AND VCU HEALTH SYSTEM, AS WELL AS JOINT VENTURES IN WHICH THESE SYSTEMS HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES. FORM 990, PART VI, SECTION A, LINE 4 VA PREMIER HEALTH PLAN, INC. AMENDED ITS ARTICLES OF INCORPORATION AND BYLAWS TO REFLECT GOVERNANCE CHANGES RESULTING FROM SENTARA HEALTHCARE'S ACQUISITION OF 80% OF THE ISSUED AND OUTSTANDING SHARES OF VA PREMIER HEALTH PLAN, INC. FORM 990, PART VI, SECTION A, LINE 6 VA PREMIER HEALTH PLAN, INC. HAS TWO SHAREHOLDERS WITH THE RIGHT TO DESIGNATE THE DIRECTORS OF THE BOARD OF VA PREMIER HEALTH PLAN, INC. VCU HEALTH SYSTEM AUTHORITY HAS THE RIGHT TO DESIGNATE TWO DIRECTORS AND SENTARA HEALTHCARE HAS THE RIGHT TO DESIGNATE EIGHT DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A VCU HEALTH SYSTEM AUTHORITY AND SENTARA HEALTHCARE HAVE THE RIGHT TO DESIGNATE DIRECTORS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 AND ALL SCHEDULE ATTACHMENTS ARE PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY THE FINANCE DEPARTMENT AND IS SUBSEQUENTLY REVIEWED BY THE CFO. THE COMPLETE FORM 990 IS PROVIDED TO THE BOARD BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ARE REQUIRED ANNUALLY TO DISCLOSE CONFLICTS OF INTEREST IN A FORM PRESCRIBED BY THE BOARD. THE CONFLICT STATEMENTS ARE REVIEWED BY MANAGEMENT. IN THE EVENT OF ANY CONFLICT, THE BOARD MEMBER WILL RECUSE HIM OR HERSELF FROM ANY DELIBERATIONS REGARDING THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 AS A GENERAL PHILOSOPHY, VA PREMIER COMPENSATES THE CEO, TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES BASED ON NOT-FOR-PROFIT MARKET COMPARABLES ADJUSTED FOR EACH EMPLOYEE TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EMPLOYEE. THESE COMPARABLES ARE PERFORMED ON AN ANNUAL BASIS. ANYONE DEEMED TO HAVE A CONFLICT OF INTEREST IS EXCLUDED FROM THIS PROCESS. THIS PROCESS IS MAINTAINED ON AN INTERNAL BASIS. A MOST RECENT COMPARISON TARGETED OTHER HEALTH SYSTEMS BASED ON NET REVENUE, OPERATING MARGIN, VARIOUS CLINICAL QUALITY METRICS AND PATIENT SATISFACTION. OVERALL SALARY INCREASES ARE REVIEWED AND APPROVED BY THE VA PREMIER BOARD AS WELL AS THE VCU HEALTH SYSTEM BOARD. VIRGINIA PREMIER DOES NOT COMPENSATE ITS OFFICERS OR DIRECTORS OTHER THAN THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 VPHP MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 9: BOARD MEMBER: MELINDA HANCOCK CAN BE REACHED AT: 1010 E. MARSHALL STREET RICHMOND, VA 23298 BOARD MEMBER: ARLINE BOHANNON, MD CAN BE REACHED AT: BOX 980102 RICHMOND, VA 23298 THE REMAINING INDIVIDUALS LISTED ON PART VII, SECTION A CAN BE REACHED AT THE ORGANIZATION'S MAILING ADDRESS. PART VII THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM") AND THE VCU HEALTH SYSTEM, AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM THESE SYSTEMS HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM LAST YEAR. VCU HEALTH SYSTEM AUTHORITY PO BOX 980510 RICHMOND VA 23298 541848065 ACA MEDICAL C VA 170(C)(1) N/A 0 CRIPPLED CHILDREN'S HOSPITAL 2924 BROOK ROAD RICHMOND VA 23220 540506309 HOSPITAL VA 501(C)(3) LINE 3 VCU HEALTH 0 UNIVERSITY HEALTH SERVICES INC 1010 E MARSHALL STREET RICHMOND VA 23298 541790550 EDUCATION VA 501(C)(3) LINE 12A, I VCU HEALTH 0 MCV ASSOCIATED PHYSICIANS PO BOX 980620 RICHMOND VA 23298 541581185 HEALTHCARE VA 501(C)(3) LINE 12A, I VCU HEALTH 0 COMMUNITY MEMORIAL HOPSITAL 1755 N MECKLENBERG AVE RICHMOND VA 23970 540551711 HOSPITAL VA 501(C)(3) LINE 3 VCU HEALTH 0 COMMUNITY MEMORIAL HOSPITAL FOUNDATION 1755 N MECKLENBERG AVE RICHMOND VA 23970 541831331 ADMIN FOR CMH VA 501(C)(3) LINE 12A, I CMH 0 UHS PROFESSIONAL EDUCATION PROGRAM P O BOX 980048 RICHMOND VA 23298 541790553 EDUCATION VA 501(C)(3) LINE 12A, I VCU HEALTH 0 VIRGINIA COMMONWEALTH UNIVERSITY PO BOX 842512 RICHMOND VA 23284 546001758 EDU INSTITUTE VA N/A 0 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 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