2021-11-10T12:53:26-06:00 2020-12-31 161131146 BONADIO & CO LLP 6 WEMBLEY CT ALBANY NY 12205 990 2020-01-01 141641028 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN INC CAPI 5186414085 500 PATROON CREEK BLVD ALBANY NY 122061057 FRANK ULIBARRI INTERIM CFO 5186414085 2021-09-21 1 FRANK ULIBARRI XXX-XX-XXXX GLORIA M NOSTRAMO P01385068 5184644080 2021-09-21 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z FRANK ULIBARRI 500 PATROON CREEK BLVD ALBANY NY 122061057 1808645108 0 X WWW.CDPHP.COM X 1984 NY CDPHP PROVIDES QUALITY HEALTH CARE AT A REASONABLE COST FOR CDPHP MEMBERS AND OPERATES AS A MODEL FOR THE DELIVERY, FINANCING, AND ADMINISTRATION OF HEALTH CARE SERVICES. 15 7 1328 0 0 0 0 0 1601339563 1742108726 8293946 6806780 500525 357794 1610134034 1749273300 262128 12338894 1419156296 1551964047 99276122 113862366 0 0 0 73635894 99687536 1592330440 1777852843 17803594 -28579543 671719138 778008144 236548634 301294044 435170504 476714100 X CDPHP PROVIDES QUALITY HEALTH CARE AT A REASONABLE COST FOR CDPHP MEMBERS AND OPERATES AS A MODEL FOR THE DELIVERY, FINANCING, AND ADMINISTRATION OF HEALTH CARE SERVICES. 0 0 540077064 4679803 575897349 CDPHP PROVIDES HEALTH CARE BENEFITS TO EMPLOYER GROUP MEMBERS AND INDIVIDUALS IN OUR COMMUNITY. AS OF DECEMBER 31, 2020, 77,595 MEMBERS WERE ENROLLED IN COMMERCIAL PRODUCTS. 615091497 664542 553275771 CDPHP'S MEDICAID, HARP, AND ESSENTIAL PLANS PROVIDE HEALTH CARE BENEFITS TO 106,616 MEMBERS IN NEW YORK STATE. 513063399 6052932 567079413 CDPHP'S MEDICARE PROGRAM PROVIDES HEALTH CARE BENEFITS TO 42,173 MEMBERS IN NEW YORK STATE. 0 0 -1800 FAMILY HEALTH PLUS - 0 MEMBERS 7939274 7690 4616674 HEALTHY NEW YORK - 1,942 MEMBERS 36227299 933927 41241319 CHILD HEALTH PLUS - 14,491 MEMBERS 44166573 941617 45856193 1712398533 0 0 1 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1 4428 0 1 1328 1 0 1 BD 0 0 0 0 0 0 1 0 X 15 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X ELLEN PIERCE FINANCE DIRECTOR 5186413000 500 PATROON CREEK BLVD ALBANY NY 122061057 GENNARO A DANIELS MD CHAIRMAN OF THE BOARD 4.10 X X 87600 0 0 SUSAN SCRIMSHAW PHD DIRECTOR 5.20 X 48250 0 0 JOSEPH POLITO II MD VICE CHAIRMAN OF THE BOARD 4.90 X X 29650 0 0 JOSEPH J DUDEK MD DIRECTOR 3.30 X 19050 0 0 HOLLY K CLENEY MD DIRECTOR 4.10 X 44250 0 0 HENRY M NEILLEY MD DIRECTOR 7.30 X 30550 0 0 GERALD JENNINGS DIRECTOR 4.90 X 56450 0 0 AMY JOHNSON DIRECTOR 6.20 X 61450 0 0 MICHAEL DEVITO MD DIRECTOR 4.60 X 50450 0 0 CARMEN MAZZOTTA SECRETARY 8.10 X X 72650 0 0 RICHARD E GRANT TREASURER OF THE BOARD 9.00 X X 85850 0 0 MICHAEL CASTELLANA DIRECTOR 5.20 X 49300 0 0 REBECCA KEIM MD DIRECTOR 2.20 X 31600 0 0 GREGORY SERIO DIRECTOR 3.80 X 43250 0 0 BRIAN SHERIDAN MD DIRECTOR 1.80 X 18890 0 0 ADETUTU ADETONA MD DIRECTOR 1.80 X 16850 0 0 TODD DOYLE MD DIRECTOR 1.40 X 15850 0 0 JOHN D BENNETT MD CEO/PRESIDENT 40.00 X 1396948 0 38968 ANTHONY MARINELLO EVP CHIEF MEDICAL OFFICER 40.00 X 565234 0 32877 BRIAN O'GRADY PRESIDENT - HEALTH PLANS MARKETS 40.00 X 605582 0 38861 BARBARA DOWNS EVP CORP ADMIN/COO 40.00 X 818804 0 23719 BETHANY SMITH EVP FINANCE AND CFO 40.00 X 695057 0 37887 FREDERICK GALT ESQ EVP GENERAL COUNSEL 40.00 X 572811 0 35599 ROBERT HINCKLEY EVP STRATEGY COMM AND CSO 40.00 X 579896 0 38766 BRIAN MORRISSEY EVP MARKETING/CMO 40.00 X 668260 0 38648 MICHAEL RENZI PRESIDENT - HEALTHCARE DELIVERY 40.00 X 538303 0 30968 EILEEN WOOD EVP PHARMACY SERVICES/CPO 40.00 X 525067 0 33046 BRUCE E COPLIN MD VP SPECIALTY TRANSFORMATION 40.00 X 430156 0 32319 UMESH REGE SVP INFORMATION TECHNOLOGY CIO 40.00 X 503602 0 30470 ELIZABETH WARNER SVP MEMBER HEALTH 40.00 X 458296 0 37825 ANNE FERNANDEZ VP BEHAVIORAL HEALTH AND M 40.00 X 465169 0 6413 PATRICIA LUSHKEVICH SVP INTERNAL OPERATIONS 40.00 X 458024 0 36534 RICHARD DAL COL FORMER EVP CHIEF MEDICAL OFFICER 40.00 X 249940 0 480 10293089 0 493380 394 1 1 0 LANDMARK HEALTH LLC 7755 CENTER AVE STE 630 HUNTINGTON CA 92647 HEALTHCARE SERVICES 28625640 ATOS SYNTEL INC 525 E BIG BEAVER RD SUITE 300 TROY MI 48083 IT PROCESSING AND CONSULTING 10795462 WELLTOK INC 6061 SOUTH WILLOW DRIVE GREENWOOD VILLAGE CO 80111 WELLNESS PROMOTIONS 5229001 EPAM SYSTEMS INC 41 UNIVERSITY DR 202 NEWTOWN PA 18940 IT PROCESSING AND CONSULTING 4769729 HURON CONSULTING GROUP INC PO BOX 71223 CHICAGO IL 60694 IT PROCESSING AND CONSULTING 3665783 115 COMMERCIAL PREMIUMS 524114 575897349 575897349 MEDICARE PREMIUMS 524114 567079413 567079413 MEDICAID PREMIUMS 524114 553275771 553275771 CHILD HEALTH PLUS PREMIUMS 524114 41241319 41241319 HEALTHY NEW YORK PREMIUMS 524114 4616674 4616674 -1800 -1800 1742108726 6596560 6596560 59582028 59371808 210220 210220 210220 AGGREGATE WRITE-INS FOR OTHER INC 524114 357794 357794 357794 1749273300 1742108726 0 7164574 12338894 12338894 1551964047 1551964047 5956446 2647183 3309263 80547584 46302661 34244923 7365643 4205255 3160388 14008433 7312164 6696269 5984260 3440043 2544217 531430 425144 106286 510024 408019 102005 250260 250260 383208 383208 6246001 6246001 5319298 2809572 2509726 18149894 17605397 544497 3368146 1684073 1684073 537490 376243 161247 64175 64175 208581 166865 41716 6425094 4497566 1927528 744023 744023 CONSULTING AND OUTSOURC 30547077 24437662 6109415 FEDERAL AND STATE ASSES 13178521 13178521 0 BROKER COMMISSIONS 11070713 11070713 MISCELLANEOUS 2153601 1282510 871091 1777852843 1712398533 65454310 0 57420524 21540152 115817676 144976160 18345306 13389914 118110866 91327747 26203333 26783119 261495307 329944233 189478010 238568085 2958982 2806481 671719138 778008144 229181626 294663826 3528831 2282823 3838177 4347395 236548634 301294044 X 435170504 476714100 435170504 476714100 671719138 778008144 X -28579543 7534061 62589078 X 0 1 X 1 1 1 0 1 0 0 0 250260 250260 250260 250260 10805988 5087586 5718402 98522070 86240161 12281909 8782808 8782808 26783119 INVESTMENT IN CDPHP UBI 237907352 F INVESTMENT IN CDPHP FOUNDATION, INC. 598269 F INVESTMENT IN HEALTH PLAN ALLIANCE 62464 F 238568085 CLAIM ADJUSTMENT EXPENSE LIABILITY 4347395 4347395 X 1811943003 63290572 63290572 1748652431 383208 237661 620869 1749273300 1777933467 763994 763994 1777169473 445708 237661 683369 1777852842 PART X, LINE 2: EXPLANATION: UNDER ASC 740, CDPHP IS REQUIRED TO DETERMINE WHETHER A TAX POSITION OF THE PLAN IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OF THE LITIGATION PROCESS, BASED ON THE TECHNICAL MERITS OF THE POSITIONS. FOR TAX POSITIONS MEETING THE MORE LIKELY THAN NOT THRESHOLD, THE TAX AMOUNT RECOGNIZED IN THE FINANCIAL STATEMENT IS REDUCED BY THE LARGEST BENEFIT THAT HAS A GREATER THAN FIFTY PERCENT LIKELIHOOD OF BEING REALIZED UPON THE ULTIMATE SETTLEMENT WITH THE RELEVANT TAXING AUTHORITY. PART XI, LINE 2D - OTHER ADJUSTMENTS: GROSS REVENUE ON SUPPORT SERVICES 763,994. RECOGNIZED GAINS ON EQUITIES 5,703,689. STATUTORY AMORTIZATION ADJUSTMENT -5,932. GAIN ON EQUITY OF CONSOLIDATED SUBSIDIARY 56,828,821. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER REINSURANCE EXPENSE NETTED IN AUDITED PREMIUMS 237,661. PART XII, LINE 2D - OTHER ADJUSTMENTS: GROSS EXPENSES ON SUPPORT SERVICES 763,994. PART XII, LINE 4B - OTHER ADJUSTMENTS: REINSURANCE EXPENSE 237,661. FORM 990, SCHEDULE D, PART VII, LINES 3A-3D: EXPLANATION: THE METHOD OF VALUATION IN COLUMN C IS THE EQUITY METHOD OF ACCOUNTING. CENTRAL AMERICA, CARIBBEAN INVESTMENT 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 PART III ACCOUNTING METHOD: PART 1, LINE 6 CARTER INSURANCE COMPANY, LTD WAS DISSOLVED DURING 2020 AND HAD NO ASSETS OR LIABILITIES AT DECEMBER 31, 2020. 1 CDPHP FOUNDATION INC 500 PATROON CREEK BLVD ALBANY NY 12206 471619130 501(C)(3) 163168 68128 FMV DONATED GOODS/SERVICES OPERATING GRANT HILLTOWN HEALTHCARE NP FAMILY PLLC 1772 HELDEBERG TRAIL BERNE NY 12023 842538889 501(C)(3) 30000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE VISITING NURSE SERVICES ASSOCIATION 108 ERIE BLVD SCHENECTADY NY 12305 222218991 501(C)(3) 864053 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE ADDICTIONS CARE CENTER OF ALBANY INC 1044 BROADWAY MENANDS NY 12204 141501404 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE ADIRONDACK COMMUNITY ACTION PROGRAM 7572 COURT ST 2 ELIZABETHTOWN NY 12932 146037204 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86 PO BOX 471 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BRDWAY RENSSELAER NY 12144 141471475 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE BOYS & GIRLS CLUBS OF SCHENECTADY EXECUTIVE DIRECTOR SHANE BARGY 37 YATES STREET SCHENECTADY NY 12301 141364595 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE BRIGHTSIDE UP 91 BOARDWAY MENANDS NY 12204 141648493 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CANTONPOTSDAM HOSPITAL 50 LEROY ST POTSDAM NY 13676 161012691 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CAPE VINCENT COMMUNITY FOOD PANTRY PO BOX 474 CAPE VINCENT NY 13618 833408634 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CAPITAL CITY RESCUE MISSION PO BOX 1999 ALBANY NY 12201 562663290 175000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CAPITAL COUNSELING INC 650 WARREN STREET ALBANY NY 12208 141338477 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CAPITAL REGION CHAMBER OF COMMERCE 5 COMPUTER DRIVE SOUTH ALBANY NY 12205 140461460 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CAPITAL ROOTS 594 RIVER STREET TROY NY 12180 141596291 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CARES CAPITAL REGION 200 HENRY JOHNSON BLVD 4 ALBANY NY 12210 141731746 501(C)(3) 500000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CARTHAGE AREA HOSPITAL 40 FRANKLIN STREET SUITE 4 CARTHAGE NY 13619 161012691 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CATHOLIC CHARITIES DIOCESE OF OGDENSBURG 716 CAROLINE ST OGDENSBURG NY 13669 150614025 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CATHOLIC CHARITIES OF THE ALBANY DIOCESE 40 NORTH MAIN ALBANY NY 12203 141340033 501(C)(3) 500000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CENTER FOR DISABILITY SERVICES 314 S MANNING BLVD ALBANY NY 12208 141425851 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CENTRAL AVENUE BUSINESS IMPROVEMENT DIST 279 CENTRAL AVE ALBANY NY 12206 141803886 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CENTRO CIVICO 143-145 EAST MAIN STREET AMSTERDAM NY 12010 222877236 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CHAMPLAIN VALLEY PHYSICIANS HOSPITAL 75 BEEKMAN STREET PLATTSBURGH NY 12901 141338471 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MED 75 BEEKMAN STREET PLATTSBURGH NY 12901 141338471 501(C)(3) 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CHILDCARE COORD COUNCIL OF THE N CNTRY PO BOX 2640 PLATTSBURGH NY 12901 141731550 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CITY MISSION OF SCHENECTADY 425 HAMILTON STREET SCHENECTADY NY 12305 141403652 501(C)(3) 175000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CLAYTON COUNCIL OF CHURCHES 521 JAMES STREET CLAYTON NY 13624 150543525 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COLONIE SENIOR SERVICES CENTER 6 WINNERS CIRCLE 1 ALBANY NY 12205 222366576 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COLUMBIA MEMORIAL HOSPITAL 71 PROSPECT AVE HUDSON NY 12534 161012691 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COLUMBIA OPPORTUNITIES 540 COLUMBIA STREET HUDSON NY 12534 141627038 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMFORT FOOD COMMUNITY PO BOX 86 GREENWICH NY 12834 411858498 133545 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMISSION ON ECONOMIC OPPORTUNITY 2331 FIFTH AVENUE TROY NY 12180 141490509 501(C)(3) 150000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMUNITY ACTION OF GREENE COUNTY INC 7856 ROUTE 9W CATSKILL NY 12414 141498767 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMUNITY ACTION PLANNING COUNCIL OF JEF 518 DAVIDSON ST WATERTOWN NY 13601 160912787 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMUNITY BUILDERS 90 STATE STREET ALBANY NY 12207 222663779 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMUNITY CONNECTIONS OF FRANKLIN COUNTY 7 PEARL STREET MALONE NY 12953 141779296 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMUNITY HOSPICE 295 VALLEY VIEW BLVD RENSSELAER NY 12144 141608921 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE COMMUNITY WORK AND INDEPENDENCE PO BOX 303 GLENS FALLS NY 12801 141470091 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CONIFER PARK 79 GLENRIDGE RD GLENVILLE NY 12302 141539594 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE CROSSROADS CENTER FOR CHILDREN 1136 N WESTCOTT RD ROTTERDAM NY 12306 141809027 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE DAUGHTERS OF SARAH NURSING CENTER 180 WASHINGTON AVE EXT ALBANY NY 12203 237120570 501(C)(3) 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE DELMAR FARMERS MARKET 332 KENWOOD AVE DELMAR NY 12054 943473799 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE DOWNTOWN ALBANY BUSINESS IMPROVEMENT DIS 21 LODGE ST FLOOR 1 ALBANY NY 12207 141790346 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE DOWNTOWN SCHENECTADY IMPROVEMENT CORPORATION 143 STATE STREET SCHENECTADY NY 12305 364465022 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE DOWNTOWN TROY BUSINESS IMPROVEMENT DISTR 251 RIVER ST TROY NY 12180 273638583 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE EDDY HERITAGE HOUSE NURSING AND REHABILITATION 2920 UPPER TIBBITS AVENUE TROY NY 12180 141725101 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE EDDY MEMORIAL GERIATRIC CENTER 310 S MANNING BLVD ALBANY NY 12208 222570478 501(C)(3) 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE EDDY VILLAGE GREEN AT BEVERWYCK 31 BEVERWYCK LN SLINGERLANDS NY 12159 141717028 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE EDDY VILLAGE GREEN AT COHOES 421 COLUMBIA ST COHOES NY 12047 141701597 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE ELLIS RESIDENTIAL & REHABILITATION CENTER 600 MCCLELLAN STREET SCHENECTADY NY 12304 141338428 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE ELLIS HOSPITAL 1101 NOTT ST SCHENECTADY NY 12308 141338428 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE EQUINOX 95 CENTRAL AVE ALBANY NY 12206 141554346 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FAMILIES FIRST IN ESSEX COUNTY 196 WATER ST PO BOX 565 ELIZABETHTOWN NY 12933 141763863 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FAMILY PROMISE OF THE CAPITAL REGION 738 NEW SCOTLAND AVE ALBANY NY 12208 462683239 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FAMILY SERVICES ASSOC OF GLENS FALLS 150 WARREN ST GLENS FALLS NY 12801 141338395 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FOCUS CHURCHES 275 STATE ST ALBANY NY 12210 300257933 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FOOD PANTRIES OF THE CAPITAL REGION 32 ESSEX ST ALBANY NY 12206 222546680 200000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FORT HUDSON NURSING CENTER INC 319 BROADWAY FORT EDWARD NY 12828 200481583 501(C)(3) 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE FULTON FRIENDSHIP HOUSE INC 18-20 CAYADUTTA ST GLOVERSVILLE NY 12078 222327741 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE GLENDALE HOME SCHDY CNTY DEPT SOCIAL SER 59 HETCHELTOWN RD SCHENECTADY NY 12302 141338428 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE GLENS FALLS FARMERS MARKET ASSOCIATION 1 CIVIC PLAZA GLENS FALLS NY 12801 824732017 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE GLENS FALLS HOSPITAL 100 PARK ST GLENS FALLS NY 12801 141338413 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE GLENS FALLS SENIOR CENTER 380 GLEN ST GLENS FALLS NY 12801 141454572 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE GOUVERNEUR HOSPITAL 77 WEST BARNEY ST GOUVERNEUR NY 13642 464249555 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE GRASSROOTS GIVERS PO BOX 84 DELMAR NY 12054 800267317 501(C)(3) 25000 PPE, FOOD, HOUSING 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50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE HUNGER SOLUTIONS NEW YORK INC 14 COMPUTER DR EAST ALBANY NY 12205 222954760 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE IN OUR OWN VOICES INC 245 LARK ST ALBANY NY 12210 141804364 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE IPH 176 SHERIDAN AVE ALBANY NY 12210 141666321 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE JEWISH FAMILY SERVICES OF NORTHEASTER NY 184 WASHINGTON AVE EX ALBANY NY 12203 141338308 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE JOINT COUNCIL OF ECONOMIC OPPORTUNITY 54 MARGARET ST PLATTSBURGH NY 12901 141494810 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE JOSEPH'S HOUSE & SHELTER 74 FERY STREET TROY NY 12180 462485173 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE LEAP 383 BROADWAY FORT EDWARD NY 12828 822456538 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE LAKESIDE HOUSE INC 33 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156001040 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MECHANICVILLE AREA COMMUNITY SVS CENTER PO BOX 30 MECHANICVILLE NY 12118 141536118 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MENTAL HEALTH ASSOCIATION OF COLUMBIA 713 UNION ST HUDSON NY 12534 146030796 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MENTAL HEALTH ASSOCIATION OF FULTON 307 MEADOW ST 1 JOHNSTOWN NY 12095 141680341 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MENTAL HEALTH ASSOCIATION OF WARREN WASHINGTON 3043 US-4 HUDSON FALLS NY 12839 141495169 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MERCY LIVING CENTER 114 WAWBEEK AVE TUPPER LAKE NY 12986 141731786 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE METROPOLITAN BAPTIST CHURCH OF ALBANY 105 2ND ST ALBANY NY 12210 222514547 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MOHAWK OPPORTUNITIES INC CO JOE GALLAGHER 201 NOTT TERRACE SCHENECTADY NY 12307 141672130 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MOM STARTS HERE 154 N LAKE AVE TROY NY 12180 811682516 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MOUNTAINSIDE RESIDENTIAL CARE CENTER 42158 STATE HWY 28 MARGARETVILLE NY 12455 223143565 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE MT CALVARY BAPTIST CHURCH ATTN REVEREND DALE 58 ALEXANDER ST ALBANY NY 12206 141596389 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NAMI OF CHAMPLAIN VALLEY 304 NEW YORK ROAD PLATTSBURGH NY 12903 760710744 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NATHAN LITTAUER 99 EAST STATE ST GLOVERSVILLE NY 12078 141338465 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NATHAN LITTAUER HOSPITAL NURSING HOME PO BOX 1250 99 E STATE ST GLOVERSVILLE NY 12078 141660137 501(C)(3) 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NEW CHOICES RECOVERY CENTER 728 STATE ST SCHENECTADY NY 12307 141505720 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NEW JERUSALEM HOME OF THE SAVED CHURCH PO BOX 6307 ALBANY NY 12206 141823138 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NEW YORK STATE COALITION AGAINST SEXUAL 28 ESSEX ST ALBANY NY 12206 222337608 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NORTH COUNTRY CHAMBER OF COMMERCE PO BOX 310 PLATTSBURGH NY 12901 141258003 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NORTH COUNTRY MINISTRY 3933 MAIN ST WARRENSBURG NY 12885 223787718 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NORTHERN RIVERS 19 JEFFERSON AVE RENSSELAER NY 12144 460759782 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE NYS COALITION AGAINST DOMESTIC VIOLENCE 119 WASHINGTON AVENUE ALBANY NY 12210 222337608 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE OAKWOOD COMMUNITY CENTER 313 TENTH ST TROY NY 12180 453980699 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE OPEN DOOR MISSION (GLENS FALLS) ATTN KIM COOK 226 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12206 133411787 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE REFUGEE AND IMMIGRANT SUPPORT SERVICES E 715 MORRIS ST ALBANY NY 12208 274809744 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE REGIONAL FOOD BANK 965 ALBANY SHAKER RD LATHAM NY 12110 222470885 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE REIGNING LIFE CHURCH 33 RENSSELAER ST ALBANY NY 12202 222408524 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE RENSSELAER ARC 79 102ND ST TROY NY 12180 141485873 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE RENSSELAER COUNTY CHAMBER OF COMMERCE 90 4TH ST 200 TROY NY 12180 141127090 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE RENSSELAER POLYTECHNIC INSTITUTE 110 EIGHTH ST TROY NY 12180 141340095 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE ROBERT AND DOROTHY LUDWIG JEWISH COMMUNITY 2565 BALLTOWN RD SCHENECTADY NY 12309 141343041 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE RONALD MCDONALD HOUSE OF THE CAPITAL REGION INC 139 S LAKE AVE ALBANY NY 12208 222356004 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE RUSSELL SAGE COLLEGE 65 1ST ST TROY NY 12180 141338488 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SAFE INC OF SCHENECTADY 1344 ALBANY ST SCHENECTADY NY 12304 141794075 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SAMARITAN HEALTH WATERTOWN 830 WASHINGTON ST WATERTOWN NY 13601 141338544 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SAMARITAN HOSPITAL 2215 BURDETT AVE TROY NY 12180 141338544 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SARATOGA COUNTY CHAMBER OF COMMERCE 28 CLINTON ST SARATOGA SPRINGS NY 12866 140558213 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SARATOGA COUNTY ECONOMIC OPPORTUNITY COU 39 BATH ST PO BOX 169 BALLSTON SPA NY 12020 237438457 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID 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ENTERPRISE AND TRAINING 131 STATE ST PLATTSBURGH NY 12305 473946521 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SEAT SOCIAL ENTERPRISE AND TRAINING 131 STATE ST SCHENECTADY NY 12305 473946521 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SENIOR CITIZEN'S CENTER OF SARATOGA 5 WILLIAMS ST SARATOGA NY 12866 141458762 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SENIOR HOPE COUNSELING INC 650 WARREN STREET ALBANY NY 12208 020570419 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SETON HEALTH AT SCHUYLER RIDGE RESIDENTI 1 ABELE DRIVE CLIFTON PARK NY 12065 141756230 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SHAKER PLACE REHABILITATION & NURSING 100 HERITAGE LANE ALBANY NY 12211 146002563 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SIDNEY ALBERT JEWISH COMMUNITY CENTER 340 WHITEHALL ROAD ALBANY NY 12208 141364462 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE SIENA COLLEGE 515 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501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE THE VOLUNTEER TRANSPORTATION CENTER PO BOX 515 4 COMMERCE LANE CANTON NY 13617 161469952 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE THINGS OF MY VERY OWN INC 249 GREEN STREET SCHENECTADY NY 12305 900370316 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE TRANSITIONAL LIVING SERVICES OF NORTHERN 482 BLACK RIVER PARKWAY WATERTOWN NY 13601 161104065 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE TRINITY ALLIANCE 15 TRINITY PLACE ALBANY NY 12202 141340122 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE TROY REHABILITATION IMPROVEMENT PROJEC 415 RIVER STREET TROY NY 12180 141503655 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE TROY SCHOOL 14 PTA ATTN EMILY HODGES 475 1ST ST TROY NY 12180 141762917 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE TROY SCHOOL 2 PTA ATTN LAKIME MEADOWS 475 1ST ST TROY NY 12180 146002473 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE TROY WATERFRONT FARMERS MARKET PO BOX 1534 TROY NY 12181 510611280 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE UNION COLLEGE 807 UNION STREET SCHENECTADY NY 12308 200258004 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE UNITED WAY OF NORTHERN NY 200 WASHINGTON ST SUITE 402A WATERTOWN NY 13601 141364505 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE UNITED WAY OF THE GREATER CAPITAL REGION PO BOX 13865 ALBANY NY 12202 141364505 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE UNITY HOUSE 2431 6TH AVE TROY NY 12180 232378930 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE UNIVERSITY AT ALBANY FOUNDATION PO BOX 761 ALBANY NY 12201 141503972 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE UPPER UNION STREET BUSINESS IMPROVEMENT 1598 UNION ST SCHENECTADY NY 12309 010676579 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE URBAN GRIEF 350 NORTHERN BLVD STE 324 41 ALBANY NY 12204 831265614 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE VAN RENSSELAER MANOR 85 BLOOMINGGROVE DR TROY NY 12180 146002569 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE VANDERHEYDEN HALL 614 COOPER HILL RD WYANTSKILL NY 12198 141338575 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WASHINGTON IRVING ADULT AND CONTINUING E 422 MUMFORD ST SCHENECTADY NY 12307 146004188 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WATERTOWN URBAN MISSION 247 FACTORY ST WATERTOWN NY 13601 160957201 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WATERVLIET CIVIC CHEST INC 14TH ST AND 1ST AVENUE WATERVLIET NY 12189 141387856 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WATERVLIET ELEMENTARY SCHOOL PTA ATTN ROSIE SHARPE 2557 10TH AVE 1 WATERVLIET NY 12189 146009353 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WELLSPRING 480 BRDWAY LL20 SARATOGA SPRINGS NY 12866 141644567 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WESLEY HEALTH CENTER 131 LAWRENCE ST SARATOGA SPRINGS NY 12866 223642737 501(C)(3) 35000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WHITNEY YOUNG HEALTH 920 LARK DRIVE ALBANY NY 12207 141539594 501(C)(3) 100000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WILDWOOD PROGRAMS INC 2995 B CURRY RD EXT SCHENECTADY NY 12303 141808612 501(C)(3) 50000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE WILLING HELPERS HOME FOR WOMEN INC 226 W MADISON AVENUE JOHNSTOWN NY 12095 141340001 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE YMCA CAPITAL REGION 465 NEW KARNER RD 2 ALBANY NY 12205 141726531 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE YMCA OF FULTON COUNTY 213 HARRISON STREET JOHNSTOWN NY 12095 141374493 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE YWCA OF SCHENECTADY 44 WASHINGTON AVE SCHENECTADY NY 12305 141340139 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE YWCA OF THE GREATER CAPITAL REGION 21 FIRST STREET TROY NY 12180 141338577 501(C)(3) 25000 PPE, FOOD, HOUSING AND EMERGENCY AID ASSISTANCE 174 60 PART 1, LINE 2 EXPLANATION: GRANTS ARE PROVIDED TO THE FOUNDATION FOR USE TO OTHER CHARITABLE ORGANIZATIONS AND ADMINISTRATION OF THE FOUNDATION. 1 X X X X X 1 1 0 0 0 0 0 1 0 JOHN D BENNETT MD CEO/PRESIDENT 830790 0 531273 0 34885 0 16001 0 22967 0 1435916 0 0 0 BARBARA DOWNS EVP CORP ADMIN/COO 576186 0 210021 0 32597 0 11766 0 11953 0 842523 0 0 0 BETHANY SMITH EVP FINANCE AND CFO 493188 0 180189 0 21680 0 9189 0 28698 0 732944 0 0 0 BRIAN MORRISSEY EVP MARKETING/CMO 402722 0 218526 0 47012 0 10158 0 28490 0 706908 0 0 0 BRIAN O'GRADY PRESIDENT - HEALTH PLANS MARKETS 408597 0 148893 0 48092 0 10203 0 28658 0 644443 0 0 0 ROBERT HINCKLEY EVP STRATEGY COMM AND CSO 382576 0 147732 0 49588 0 10108 0 28658 0 618662 0 0 0 FREDERICK GALT ESQ EVP GENERAL COUNSEL 377074 0 147508 0 48229 0 10041 0 25558 0 608410 0 0 0 ANTHONY MARINELLO EVP CHIEF MEDICAL OFFICER 393156 0 137850 0 34228 0 9910 0 22967 0 598111 0 0 0 MICHAEL RENZI PRESIDENT - HEALTHCARE DELIVERY 475725 0 28660 0 33918 0 12410 0 18558 0 569271 0 0 0 EILEEN WOOD EVP PHARMACY SERVICES/CPO 280253 0 213880 0 30934 0 8779 0 24267 0 558113 0 0 0 UMESH REGE SVP INFORMATION TECHNOLOGY CIO 326721 0 128789 0 48092 0 9589 0 20881 0 534072 0 0 0 ELIZABETH WARNER SVP MEMBER HEALTH 298636 0 119580 0 40080 0 10167 0 27658 0 496121 0 0 0 PATRICIA LUSHKEVICH SVP INTERNAL OPERATIONS 308607 0 119725 0 29692 0 7876 0 28658 0 494558 0 0 0 ANNE FERNANDEZ VP BEHAVIORAL HEALTH AND M 295095 0 120740 0 49334 0 1832 0 4581 0 471582 0 0 0 BRUCE E COPLIN MD VP SPECIALTY TRANSFORMATION 323018 0 74010 0 33128 0 9352 0 22967 0 462475 0 0 0 RICHARD DAL COL FORMER EVP CHIEF MEDICAL OFFICER 115923 0 125853 0 8164 0 480 0 0 0 250420 0 0 0 PART 1 LINES 4A-B: THE EXECUTIVE VICE PRESIDENTS ARE ELIGIBLE FOR A NON-QUALIFIED DEFERRED COMPENSATION PLAN CONTRIBUTION. NO PAYMENT WAS MADE TO THIS PLAN IN 2020. PART 1 LINE 7: EXPLANATION: CDPHP HAS A MANAGEMENT INCENTIVE PROGRAM THAT IS BASED UPON THREE CRITERIA: ATTAINMENT OF PERSONAL AND COMPANY GOALS, ACHIEVEMENT OF QUALITY AND SERVICE TARGETS, AND ACHIEVEMENT OF ENROLLMENT TARGETS. THE BOARD ANNUALLY APPROVES THE METRICS TO BE USED TO ASSESS EACH CRITERION. THE MANAGEMENT INCENTIVE IS PAYABLE ONLY IF DETERMINED TO BE AFFORDABLE BY THE BOARD. IN ADDITION, THE BOARD HAS FINAL DISCRETION AT THE CLOSE OF THE YEAR TO MAKE THE INCENTIVE PAYMENT. LANSINGBURGH FAMILY PRACTICE ADETUTU ADETONA MD 359415 SEE EXPLANATION BELOW 0 COMMUNITY CARE PHYSICIANS PC HOLLY K CLENEY MD 54462840 SEE EXPLANATION BELOW 0 ST PETER'S HOSPITAL GENNARO A DANIELS MD 108768435 SEE EXPLANATION BELOW 0 ALBANY MEDICAL CENTER HOSPITAL MICHAEL DEVITO MD 141948218 SEE EXPLANATION BELOW 0 NY ONCOLOGY HEMATOLOGY TODD DOYLE MD 29035520 SEE EXPLANATION BELOW 0 ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATION REBECCA KEIM MD 22885251 SEE EXPLANATION BELOW 0 ALBANY CAPITAL REGION GASTROENTEROLOGY JOSEPH POLITO MD 5537046 SEE EXPLANATION BELOW 0 SCHOOLHOUSE PEDIATRICS BRIAN SHERIDAN MD 2055383 SEE EXPLANATION BELOW 0 NEW YORK ONCOLOGY HEMATOLOGY PC JOSEPH JAMES DUDEK MD 29035520 SEE EXPLANATION BELOW 0 SHAKER PEDIATRICS PC HENRY M. NEILLEY, MD 1176970 SEE EXPLANATION BELOW 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS PURSUANT TO ITS CERTIFICATE OF INCORPORATION AND BY-LAWS, EIGHT OF THE MEMBERS OF THE CDPHP BOARD OF DIRECTORS MUST BE PRACTICING PHYSICIANS. THERE WAS A VACANCY IN THE BOARD AT YEAR END 2019 WHICH WAS FILLED IN 2020 BY A PRACTICING PHYSICIAN. AS PRACTICING PHYSICIANS, EACH OF THESE PHYSICIAN DIRECTORS HAS A STANDARD PARTICIPATING PROVIDER AGREEMENT WITH CDPHP PURSUANT TO WHICH THEY ARE PAID FEES FOR SERVICES RENDERED TO CDPHP MEMBERS. PURSUANT TO THE PARTICIPATING PROVIDER AGREEMENT, THE PHYSICIAN DIRECTORS ARE PAID IN ACCORDANCE WITH THE STANDARD FEE SCHEDULE APPLICABLE TO ALL PHYSICIANS GENERALLY.HOWEVER, ALTHOUGH EACH PHYSICIAN HAS AN INDIVIDUAL CONTRACT WITH CDPHP, PAYMENT FOR SERVICES RENDERED BY INDIVIDUAL PHYSICIANS ARE PAYABLE TO THAT PHYSICIAN'S PRACTICE, NOT TO THE PROVIDER INDIVIDUALLY. PAYMENTS MADE BY CDPHP TO THE PROVIDER PRACTICE ARE NOT ALLOCATED OR REPORTED BY CDPHP BY INDIVIDUAL PROVIDER. ACCORDINGLY, PAYMENTS REPORTED HEREIN REFLECT THE AMOUNTS PAID IN FULL TO THE PRACTICE. AS NOTED ABOVE AND AS SHOWN IN SCHEDULE L, THESE AMOUNTS WERE PAID TO THE ORGANIZATIONS WHERE THE PHYSICIAN DIRECTOR IS AN EMPLOYEE, PARTNER, SHAREHOLDER, OR BOARD MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION: THE CORPORATION CURRENTLY HAS 553 CORPORATE MEMBERS ALL OF WHOM ARE OR WERE PARTICIPATING PHYSICIANS WITH CDPHP. FORM 990, PART VI, SECTION A, LINE 7A EXPLANATION: CDPHP'S CORPORATE MEMBERS ELECT THE BOARD OF DIRECTORS OF CDPHP. FORM 990, PART VI, SECTION A, LINE 7B EXPLANATION: CORPORATE MEMBERS MUST APPROVE ANY CHANGES IN THE CORPORATION'S MISSION STATEMENT, BY-LAWS, CLASSES OF CORPORATE MEMBERSHIP, OR CHANGES TO THE BOARD OF DIRECTORS. IN ADDITION, THE CLASS "A" MEMBERS MUST APPROVE ANY CHANGES TO THE BY-LAWS AND CERTIFICATE OF INCORPORATION THAT ALTER THE RIGHTS OF CLASS "A" MEMBERS, MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION, OR ANY CONVERSION FROM NOT-FOR-PROFIT STATUS. FORM 990, PART VI, SECTION B, LINE 11B EXPLANATION: THE FORM 990 IS REVIEWED AND APPROVED BY THE DIRECTOR OF ACCOUNTING AND FINANCIAL REPORTING AND THE CFO. IT IS THEN PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD FOR REVIEW. FINALLY, IT IS PRESENTED TO THE BOARD FOR REVIEW PRIOR TO THE IRS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION: CDPHP HAS A CONFLICT OF INTEREST POLICY. CDPHP REGULARLY POLLS EMPLOYEES AND BOARD MEMBERS REGARDING POTENTIAL CONFLICT OF INTEREST SITUATIONS. ANY ACTUAL OR POTENTIAL CONFLICTS DISCLOSED ARE PRESENTED TO THE BOARD, AT LEAST ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 EXPLANATION: CDPHP USES OUTSIDE COMPENSATION CONSULTING FIRMS. THESE FIRMS UTILIZE CUSTOM AND PUBLISHED SURVEYS. INFORMATION IS PROVIDED TO CDPHP'S BOARD COMPENSATION COMMITTEE FOR ANNUAL APPROVAL OF EXECUTIVE POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 EXPLANATION: FINANCIAL DOCUMENTS ARE FILED QUARTERLY WITH THE DEPARTMENT OF FINANCIAL SERVICES AND ARE AVAILABLE THROUGH THE FREEDOM OF INFORMATION ACT (FOIA). GOVERNING DOCUMENTS ARE ALSO AVAILABLE THROUGH THE DEPARTMENT OF FINANCIAL SERVICES, ALSO THROUGH FOIA. THE CONFLICT OF INTEREST POLICY IS NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CURRENT YEAR EQUITY METHOD LOSS ON INVESTMENT IN SUBSIDIARIES 56,828,820. STATUTORY DIFFERENCE IN BOND AMORTIZATION -5,932. RECOGNIZED LOSS ON VANGUARD INVESTMENT 5,703,690. STATUTORY ADJUSTMENT FOR HEALTH PLAN ALLIANCE CONSULTING EXPENSE 62,500. CDPHP FOUNDATION INC 500 PATROON CREEK BLVD ALBANY NY 12206 471619130 FOUNDATION NY 501(C)(3) LINE 10 N/A 0 CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK INC 500 PATROON CRK BLVD ALBANY NY 12206 141745298 ADMIN SERVICES NY CDPHP UNIVERSAL BENEFITS INC C 28873586 45082698 1.00000 0 CDPHP UNIVERSAL BENEFITS INC 500 PATROON CRK BLVD ALBANY NY 12206 161520935 ARTICLE 43 INSURANCE NY CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN INC C 654433868 319169478 1.00000 0 STRATEGIC SOLUTIONS MANAGEMENT 429 CLIFTON CORP PKWY CLIFTON PARK NY 12065 141814293 BILLING AND CONSULTING NY CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK INC C 0 CARTER INSURANCE COMPANY LTD 40 CHURCH ST PO BOX HM2062 HAMILTON BD 141641028 CAPTIVE REINSURANCE BD CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN INC 36068 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC Q 4810351 ALLOCATION CDPHP UNIVERSAL BENEFITS INC N 9266121 ALLOCATION CDPHP UNIVERSAL BENEFITS INC O 31261626 ALLOCATION CDPHP UNIVERSAL BENEFITS INC Q 17882741 ALLOCATION CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC N 2529215 ALLOCATION CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC O 8515756 ALLOCATION CDPHP UNIVERSAL BENEFITS INC B 46533897 FMV FORM 990, SCHEDULE R, RELATED ORGANIZATIONS ON JANUARY 1, 2020, CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. TRANSFERRED ITS OWNERSHIP OF CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK, INC. (EIN: 14-1745298) TO CDPHP UNIVERSAL BENEFITS, INC. (EIN: 16-1520935). CDPHP UNIVERSAL BENEFITS, INC. IS 100% OWNED BY CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK, INC. IS STILL CONSIDERED A RELATED ORGANIZATION TO THE FILING ENTITY THROUGH A BROTHER-SISTER RELATIONSHIP AND IS THEREFORE BEING REPORTED ON SCHEDULE R. FORM 990, SCHEDULE R, RELATED ORGANIZATIONS ON DECEMBER 31, 2020, CARTER INSURANCE COMPANY LTD WAS DISSOLVED.