2020-10-28T08:11:18-05:00 2019-12-31 BKD LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2019-01-01 814077507 Community Health Choice Texas Inc % MARK VAN ELDEN - CONTROLLER COMM 7132952222 2636 South Loop West Suite 125 Houston TX 77054 LISA WRIGHT CEO 7132952222 2020-05-15 true Amanda Maya P01067777 7134994600 167.68.126.162 76915820203025000002 2020-10-28 P 9AEC08D74923599287911B210CAE7E2D802AD5A0 0BC942DC6D92374EAB539E8634E50C7C7D90570C 2019 2021-04-22 16:20:28Z LISA WRIGHT 2636 South Loop West Suite 125 Houston TX 77054 991009820 false X N/A X 2017 TX THE OPERATION OF A MEDICAID/CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) HEALTH MAINTENANCE ORGANIZATION PROVIDING PRE-PAID MEDICAL & DENTAL CARE TO SOUTHEAST TX RESIDENTS. 9 9 0 9 0 0 0 0 959876043 976421468 1801368 3133352 0 0 961677411 979554820 465562 296028 0 0 35186665 27830749 0 0 0 924209630 969085258 959861857 997212035 1815554 -17657215 186214854 204475292 98000492 116578627 88214362 87896665 X COMMUNITY HEALTH CHOICE TEXAS'S MISSION IS TO IMPROVE THE HEALTH OF THE UNDERSERVED RESIDENTS OF SOUTHEAST TEXAS BY PROVIDING ACCESS TO COORDINATED, HIGH QUALITY, AFFORDABLE, HEALTHCARE SERVICES. OUR MISSION IS ACHIEVED THROUGH: 1) COMMUNITY: COLLABORATING WITH COMMUNITY-BASED PROVIDERS & ORGANIZATIONS TO IMPROVE ACCESS, QUALITY, COORDINATION AND COST-EFFECTIVENESS OF SERVICES. 2) HEALTH: DEVELOPING PROGRAMS TO ESTABLISH MEDICAL HOMES, MANAGE HEALTH CONDITIONS, AND PROMOTE WELLNESS AND PREVENTIVE CARE. 3) CHOICE: ENCOURAGING PERSONAL ACCOUNTABILITY AND EDUCATED CHOICES FOR INDIVIDUAL AND FAMILY HEALTH. false false 974760613 296028 976421468 THE OPERATION OF A HEALTH MAINTENANCE ORGANIZATION PROVIDING PRE-PAID MEDICAL & DENTAL CARE TO ITS APPROXIMATELY 241,887 MEDICAID, 26,317 CHIP AND 3,381 CHIP PERINATAL MEMBERS WITHIN A PRIMARY SERVICE AREA OF HARRIS AND CONTIGUOUS COUNTIES IN THE STATE OF TEXAS. PART OF CHCT'S MISSION IS TO SERVE THE UNINSURED POPULATION IN SOUTHEAST TEXAS. TEXAS HAS THE LARGEST NUMBER OF RESIDENTS WITHOUT MEDICAL COVERAGE IN THE ENTIRE COUNTRY. 974760613 false false false false false false false false false false false false false true false true false false false false false false false false false false true false true false false false false false false false false false false false false false true true true false true X 1755 0 true 0 false false false false false false false false X 9 9 false false false false false true true true false false false true true true true true true true true false X MARK VAN ELDEN - CONTROLLER 7132952238 2636 SOUTH LOOP W STE 125 houston TX 77054 X CATHERINE MITCHELL INTERIM PRESIDENT/CEO 20.0 20.0 X 203227 203227 32758 KAREN HILL CMO/SENIOR VP-MEDICAL AFFAIRS 20.0 20.0 X 186599 186599 37462 BRIAN MAUDE CHIEF FINANCIAL OFFICER 20.0 20.0 X 184345 184345 36006 KENNETH JANDA PRESIDENT/CEO (THRU 4/11/19) 20.0 20.0 X 182742 182742 29398 ALFONSO RUBIO CHIEF INFORMATION OFFICER 20.0 20.0 X 159945 159945 35420 ANGELA WALTMAN VP - SALES & MEMBER OPERATIONS 20.0 20.0 X 146923 146923 20794 LISA FULLER VP-ASSOCIATE MEDICAL DIRECTOR 20.0 20.0 X 148064 148064 15376 PAMELA HELLSTROM CHIEF COMPLIANCE OFFICER 20.0 20.0 X 144030 144030 19534 VALERIE BAHAR ASSOCIATE MEDICAL DIRECTOR 20.0 20.0 X 137564 137564 20308 LAURIE LEVERMANN VP - INFORMATION SYSTEMS 20.0 20.0 X 128453 128453 32358 KAREN GRAY ASSOCIATE MEDICAL DIRECTOR 20.0 20.0 X 123322 123322 20622 THOMAS NGUYEN DIRECTOR-MANAGED CARE SYSTEMS 20.0 20.0 X 113101 113101 27058 NANCY EDGAR CHIEF HR/ADMIN OFFICER 20.0 20.0 X 115092 115092 19548 DAISY MORALES VP - COMMUNITY AFFAIRS 20.0 20.0 X 108945 108945 28470 TAYLOR COOPER VP 20.0 20.0 X 95178 95178 15904 HEMINA PATEL VP 20.0 20.0 X 91878 91878 17194 Jose Garcia Jr SECRETARY OF THE BOARD 2.0 2.0 X X 0 0 0 Vivian Ho PhD director 1.0 1.0 X 0 0 0 Vicki Keiser CHAIRMAN OF THE BOARD 4.0 4.0 X X 0 0 0 Raymond Khoury VICE CHAIRMAN OF THE BOARD 4.0 4.0 X X 0 0 0 Elena Marks director 2.0 2.0 X 0 0 0 Anne Clutterback director 1.0 1.0 X 0 0 0 Stephen McKernan director 1.0 1.0 X 0 0 0 DR ARTHUR BRACEY BOARD MEMBER 1.0 1.0 X 0 0 0 LINDSEY M COOKSEN BOARD MEMBER 1.0 1.0 X 0 0 0 2269408 2269408 408210 113 false true false LEGACY COMMUNITY HEALTH SERVICES 1415 California Street HOUSTON TX 77006 HEALTHCARE PROVIDER 27179380 TEXAS CHILDREN'S HOSPITAL 6621 FANNIN ST HOUSTON TX 77030 HOSPITAL SERVICES 126823859 MEMORIAL HERMANN HEALTH SYSTEM 929 Gessner Rd 2700 HOUSTON TX 77024 HOSPITAL SERVICES 119995487 UTMB GALVESTON HOSPITAL 301 UNIVERSITY BLVD HOUSTON TX 77555 HOSPITAL SERVICES 36940874 WOMEN'S HOSPITAL OF TEXAS 7600 FANNIN ST HOUSTON TX 77054 HOSPITAL SERVICES 27152807 438 0 Net Premium Revenue 524114 976421468 976421468 976421468 3133352 3133352 0 0 0 0 0 11455000 11455000 0 0 0 0 0 0 0 0 0 0 0 979554820 976421468 3133352 296028 296028 0 0 0 1763581 1410865 352716 0 19979236 15983389 3995847 1142998 914399 228599 3482387 2785909 696478 1462547 1170038 292509 0 107396 107396 201811 201811 0 0 0 15097478 8010569 7086909 570775 570775 1998080 1998080 4916563 4916563 0 1068550 1068550 118332 118332 0 108910 108910 0 0 0 161496 161496 Medical Claims Expense 914788925 914788925 Premium & Maintenance Taxes 17694799 17694799 Reinsurance expense 2935147 2935147 Provider Incentive 8182351 8182351 1134645 588194 546451 997212035 974760613 22451422 0 0 0 131242022 138988871 0 0 22615298 29884141 0 0 0 0 0 0 0 0 448267 0 0 0 30442611 35317278 0 0 0 0 0 0 1466656 285002 186214854 204475292 2900850 14957902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95099642 101620725 98000492 116578627 X 0 0 49500000 67500000 38714362 20396665 88214362 87896665 186214854 204475292 X -17657215 17339518 X false true X true false 0 Medical Claims Payable 94107765 Provider Incentive Payable 1628673 Due to Affiliate 5884287 101620725 977769040 -3251477 -3251477 981020517 -1465697 -1465697 979554820 995426255 1465697 1465697 993960558 3251477 3251477 997212035 SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: REINSURANCE EXPENSE INCLUDED IN AUDIT REVENUE ($ 3,251,477) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: OPERATING REVENUE INCLUDED IN AUDIT EXPENSE ($ 1,465,697) SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: OPERATING REVENUE INCLUDED IN AUDIT EXPENSE $ 1,465,697 SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS TO FORM 990 OTHER CHANGES: REINSURANCE EXPENSE INCLUDED IN AUDIT REVENUE $ 3,251,477 true Harris County Hospital District PO Box 301168 Houston TX 77054 741536936 GOV 10000 Texas Med Run Hispanic Health Coalition 2626 South Loop West suite 650R Houston TX 77054 760609180 501(c)(3) 7000 Scholarship Luncheon/Vive Tu Vida! Get Up Get Moving! MARCH OF DIMES 5420 Dashwood Dr 302 HOUSTON TX 77081 131846366 501(C)(3) 35000 March for Babies 2019-Houston/Fort Bend EASTER SEALS OF GREATER HOUSTON 4888 LOOP CENTRAL DR STE 200 HOUSTON TX 77081 741238418 501(C)(3) 20500 BridgingApps Training/Teens w/Disabilities, Walk w/Me(Sharing Food Sponsorship w/HEB), & Hats Off to Mothers Luncheon GREATER HOUSTON COMMUNITY FOUNDATION 515 POST OAK BLVD SUITE 1000 HOUSTON TX 77027 237160400 501(C)(3) 20000 Healthy Women Houston Fund HCHD FOUNDATION 2525 HOLLY HALL ST STE 292 HOUSTON TX 77054 760408224 501(C)(3) 20000 Purchase Mobile Health Clinic for Dialysis Patients FIRST3YEARS 15851 DALLAS PKWY STE 106 ADDISON TX 75001 752067421 501(C)(3) 10000 Assist with Program Expansion DOGAN ELEMENTARY SCHOOL 4202 LIBERTY RD HOUSTON TX 77026 746001255 GOV 6000 Dogan Elementary School Holiday Event GENESYS WORKS 601 JEFFERSON ST STE 3950 HOUSTON TX 77002 271628570 501(C)(3) 5250 40 Days/40 Ways & Ambassadors Luncheon 9 SCHEDULE I, PART I, LINE 2 THE ORGANIZATION EVALUATES DONEES BASED ON PUBLIC AND PRIVATE DATA. X X false false false false false false false false false KENNETH JANDA PRESIDENT/CEO (THRU 4/11/19) 130954 130954 51788 51788 0 0 6875 6875 7824 7824 197441 197441 0 0 ALFONSO RUBIO CHIEF INFORMATION OFFICER 132945 132945 27000 27000 0 0 6647 6647 11063 11063 177655 177655 0 0 DAISY MORALES VP - COMMUNITY AFFAIRS 92078 92078 16867 16867 0 0 4604 4604 9631 9631 123180 123180 0 0 PAMELA HELLSTROM CHIEF COMPLIANCE OFFICER 122215 122215 21815 21815 0 0 3969 3969 5798 5798 153797 153797 0 0 LISA FULLER VP-ASSOCIATE MEDICAL DIRECTOR 134863 134863 13201 13201 0 0 6743 6743 945 945 155752 155752 0 0 VALERIE BAHAR ASSOCIATE MEDICAL DIRECTOR 125429 125429 12135 12135 0 0 4797 4797 5357 5357 147718 147718 0 0 THOMAS NGUYEN DIRECTOR-MANAGED CARE SYSTEMS 98682 98682 14419 14419 0 0 4662 4662 8867 8867 126630 126630 0 0 ANGELA WALTMAN VP - SALES & MEMBER OPERATIONS 123926 123926 22997 22997 0 0 6196 6196 4201 4201 157320 157320 0 0 KAREN HILL CMO/SENIOR VP-MEDICAL AFFAIRS 157880 157880 28719 28719 0 0 7000 7000 11731 11731 205330 205330 0 0 CATHERINE MITCHELL INTERIM PRESIDENT/CEO 176615 176615 26612 26612 0 0 6817 6817 9562 9562 219606 219606 0 0 BRIAN MAUDE CHIEF FINANCIAL OFFICER 154776 154776 29569 29569 0 0 7000 7000 11003 11003 202348 202348 0 0 NANCY EDGAR CHIEF HR/ADMIN OFFICER 99197 99197 15895 15895 0 0 4232 4232 5542 5542 124866 124866 0 0 LAURIE LEVERMANN VP - INFORMATION SYSTEMS 106979 106979 21474 21474 0 0 5349 5349 10830 10830 144632 144632 0 0 KAREN GRAY ASSOCIATE MEDICAL DIRECTOR 112514 112514 10808 10808 0 0 0 0 10311 10311 133633 133633 0 0 TAYLOR COOPER VP 85343 85343 9835 9835 0 0 4267 4267 3685 3685 103130 103130 0 0 HEMINA PATEL VP 83095 83095 8783 8783 0 0 0 0 8597 8597 100475 100475 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION FOR THE CEO/PRESIDENT IS DETERMINED THROUGH NEGOTIATIONS WITH THE HARRIS COUNTY HOSPITAL DISTRICT (HCHD), A RELATED ORGANIZATION, AND IS THEN SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF HCHD FOR ALL OTHER EXECUTIVES. COMPENSATION IS DETERMINED BY THE BOARD OF HCHD UTILIZING MARKET SURVEYS FOR EXECUTIVES IN SIMILAR ORGANIZATIONS AND IN SIMILAR POSITIONS. MARKET ADJUSTMENTS ARE MADE ANNUALLY TO ACCOUNT FOR ANY CHANGES IN COMPENSATION. FORM 990, PART VI, SECTION A, LINES 7A & 7B HARRIS COUNTY HOSPITAL DISTRICT (HCHD) HAS CERTAIN ENUMERATED RESERVED POWERS OVER THE GOVERNING BOARD OF COMMUNITY HEALTH CHOICE TEXAS, INC. (CHCT). THE GOVERNING BODY IS PROHIBITED FROM TAKING FINAL ACTION ON THE FOLLOWING WITHOUT THE APPROVAL BY RESOLUTION OF THE HCHD BOARD OF MANAGERS: 1. ADOPTION, AMENDMENT, OR REVOCATION OF THE BYLAWS OF CHCT; 2. ADOPTION, AMENDMENT, OR REVOCATION OF THE ARTICLES OF INCORPORATION OF CHCT; 3. APPOINTMENT OR REMOVAL OF DIRECTORS OR PRESIDENT AND CEO OF CHCT; 4. ADOPTION, AMENDMENT, OR REVOCATION OF CHCT'S PURCHASING MANUAL; 5. ADOPTION, AMENDMENT, OR REVOCATION OF CHCT'S PERSONNEL POLICIES; 6. ADOPTION, AMENDMENT, OR REVOCATION OF CHCT'S FINANCIAL POLICIES; 7. ADOPTION OF CHCT'S ANNUAL OPERATING AND CAPITAL BUDGETS; 8. ANY DEVIATION OF 10% OR MORE FROM CHCT'S ANNUAL OPERATING BUDGET OR $100,000 FROM CHCT'S ANNUAL CAPITAL BUDGET; 9. ANY TRANSACTION INVOLVING REAL PROPERTY; 10. ANY MORTGAGE, ENCUMBRANCES, OR DEBT OF CHCT IN EXCESS OF $200,000; 11. THE SALE OR OTHER DISPOSITION OF PROPERTY OF ANY KIND EXCEEDING $200,000; 12. THE PURCHASE OR ACQUISITION OF PROPERTY OF ANY KIND BY CHCT EXCEEDING $200,000 AND NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHCT'S ANNUAL OPERATING AND CAPITAL BUDGET; 13. ALL PAYMENTS OTHER THAN PURCHASES, INCLUDING GUARANTEES AND GRANTS THAT ARE NOT INCLUDED IN AND APPROVED BY HCHD'S BOARD OF MANAGERS AS PART OF CHCT'S ANNUAL OPERATING AND CAPITAL BUDGETS; 14. ANY ACTION TO AMEND, REDUCE, OR ENLARGE THE SERVICE AREA OF CHCT'S CERTIFICATE OF AUTHORITY TO DO BUSINESS AS A HEALTH MAINTENANCE ORGANIZATION IN THE STATE OF TEXAS; 15. ANY REORGANIZATION, CONSOLIDATION, OR THE CREATION OF ANY SUBSIDIARY OR ANY OTHER AFFILIATED ENTITY; 16. ANY CHANGE IN ANY OF THE CONTRACTUAL RELATIONSHIPS BETWEEN CHCT AND CHCI (COMMUNITY HEALTH CHOICE, INC.) AND/OR THE HCHD; 17. ANY CHANGE IN THE MISSION, PURPOSES, OR BUSINESS LINES; 18. ANY CHANGE IN THE PRINCIPAL OFFICE; 19. PURCHASE, ADOPTION, AMENDMENT, CANCELLATION OR REPLACEMENT OF ANY INSURANCE AND/OR SELF-INSURANCE COVERAGES REQUIRED PER THE BYLAWS; 20. COMMENCEMENT OF ANY LITIGATION IN EXCESS OF $200,000; 21. ANY MERGER, AFFILIATION, DISSOLUTION, OR OTHER DISPOSITION OF CHCT FORM 990, PART VI, SECTION A, LINE 8B COMMUNITY HEALTH CHOICE TEXAS, INC. DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THEREFORE, NO DOCUMENTATION OF COMMITTEE MEETINGS WAS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGES A PAID PREPARER, EXPERIENCED IN THE PREPARATION OF THE FORM 990, TO PREPARE THE FORM. MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO HELP COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. ONCE PREPARED, IT IS REVIEWED BY THE ORGANIZATION'S CONTROLLER AND THEN AGAIN BY THE CHIEF FINANCIAL OFFICER. A COPY OF THE RETURN IS THEN MAILED OR EMAILED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS IN ANNUAL STATEMENTS. THE CHIEF COMPLIANCE OFFICER OF THE ORGANIZATION THEN REVIEWS THE ANNUAL STATEMENTS BEFORE SENDING TO THE HARRIS COUNTY HOSPITAL DISTRICT CORPORATE COMPLIANCE DEPARTMENT FOR FURTHER REVIEW OF THE ANNUAL CONFLICT OF INTEREST STATEMENTS. FORM 990, PART VI, SECTION B, LINES 15A & 15B THE COMPENSATION OF THE PRESIDENT/CEO OF THE ORGANIZATION IS REVIEWED BY THE BOARD OF DIRECTORS OF HCHD. THE COMPENSATION OF ALL OTHER EMPLOYEES IS SUBJECT TO THE GUIDELINES AND MERIT RAISE PROCESSING OF THE HARRIS COUNTY HOSPITAL DISTRICT. FORM 990, PART VI, SECTION C, LINE 19 AS A SUBSIDIARY OF THE HARRIS COUNTY HOSPITAL DISTRICT (A SUBSIDIARY OF HARRIS COUNTY, TEXAS), ALL DOCUMENTS AND POLICIES ARE PART OF THE PUBLIC RECORD AND ARE THEREFORE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 RECONCILIATION OF NET ASSETS OTHER CHANGES IN NET ASSETS: CAPITAL CONTRIBUTION FROM HCHD $ 18,000,000 CHANGE IN NONADMITTED ASSETS (660,482) ------------ $ 17,339,518 FORM 990, PART V, LINES 1A & 2A THE NUMBER OF FORMS W-2 FILED FOR THE YEAR IS REPORTED AS ZERO. RELATED ORGANIZATION, HCHD, FILES THE PAYROLL FORMS FOR AND ALLOCATES RELATED EXPENSES TO CHCT AND CHCI. CHCI REPORTS THE TOTAL NUMBER OF FORMS W-2 FOR BOTH CHCI AND CHCT. FORM 990, PART VII, SECTION A The organization's payroll is processed by and reported on Forms W-2 & W-3 of related organization Harris County Hospital District (HCHD). Related organization CHCI reimburses HCHD for salaries and expenses incurred on behalf of CHCI and CHCT and then allocates the related portion of payroll expenses to CHCT. Part VII compensation is therefore reported 50% paid by CHCI and 50% paid by CHCT in an effort to report according to the related salary expense. HARRIS COUNTY HOSPITAL DISTRICT 2525 HOLLY HALL HOUSTON TX 77054 741536936 HEALTH CARE TX NA false COMMUNITY HEALTH CHOICE INC 2636 S LOOP WEST SUITE 700 HOUSTON TX 77054 760495152 INSURANCE TX 501(c)(4) HCHD true false false true false false false false false false false false false true true true false true false true COMMUNITY HEALTH CHOICE INC P 2040708 BOOK VALUE COMMUNITY HEALTH CHOICE INC C 18000000 BOOK VALUE