2020-11-13T08:43:00-06:00 2019-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2019-01-01 451294709 NEW MEXICO HEALTH CONNECTIONS NEWM 5055926100 6001 INDIAN SCHOOL RD NE NO 150 ALBUQUERQUE NM 87110 MARILYN RIPPIE CFO 5055926100 2020-11-11 1 DAVID LOWENTHAL P00378651 3122071040 2020-11-11 68.34.66.206 2020-11-11 12:44:25 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3BA07AC1E7B37A4123F7B0FAF00AF3DF039E44A3 2019 2021-04-22 16:20:28Z X MARILYN RIPPIE 6001 INDIAN SCHOOL RD NE NO 150 ALBUQUERQUE NM 87110 27502046 0 X WWW.MYNMHC.ORG X 2011 NM TO ESTABLISH A CONSUMER OPERATED AND ORIENTED PLAN (COOP) CONSISTENT WITH THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. NMHC WILL GENERATE FUNDING, ANALYSIS, AND SUSTAINABILITY CRITERIA FOR A COOP HEALTH PLAN, INCLUDING AN ORGANIZATIONAL MODEL THAT ACCOMMODATES REGIONAL AND POPULATION-SPECIFIC PLANS FOR DELIVERING AFFORDABLE, COMMUNITY-SPECIFIC HEALTH CARE ACROSS THE STATE. 5 5 8 0 0 0 0 0 47171417 21099175 500955 174797 0 0 47672372 21273972 0 0 0 0 595923 869963 0 0 0 40946043 17176863 41541966 18046826 6130406 3227146 45026020 20889430 45022309 17746531 3711 3142899 X TO ESTABLISH A CONSUMER OPERATED AND ORIENTED PLAN (COOP) CONSISTENT WITH THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. NMHC WILL GENERATE FUNDING, ANALYSIS, AND SUSTAINABILITY CRITERIA FOR A COOP HEALTH PLAN, INCLUDING AN ORGANIZATIONAL MODEL THAT ACCOMMODATES REGIONAL AND POPULATION-SPECIFIC PLANS FOR DELIVERING AFFORDABLE, COMMUNITY-SPECIFIC HEALTH CARE ACROSS THE STATE. 0 0 NEW MEXICO HEALTH CONNECTIONS (THE "COMPANY") IS A PRIVATE, NONPROFIT COMPANY ESTABLISHED UNDER INTERNAL REVENUE CODE 501(C)(29) THAT WAS INCORPORATED IN THE STATE OF NEW MEXICO IN FEBRUARY 2011. ON FEBRUARY 17, 2012, THE COMPANY BECAME A QUALIFIED NONPROFIT HEALTH INSURANCE ISSUER UNDER THE CONSUMER-OPERATED AND ORIENTED PLAN (CO-OP) PROGRAM ESTABLISHED BY SECTION 1322 OF THE AFFORDABLE CARE ACT AND APPLICABLE REGULATIONS. UNDER THIS PROGRAM, THE COMPANY RECEIVES STARTUP AND SOLVENCY LOANS FROM THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THE COMPANY IS GOVERNED BY ITS BOARD OF DIRECTORS, WHICH HAVE THE AUTHORITY AND RESPONSIBILITY FOR MANAGEMENT, CONTROL, AND ADMINISTRATION OF THE COMPANY. THE COMPANY RECEIVED ITS CERTIFICATE OF AUTHORITY FROM THE STATE OF NEW MEXICO PUBLIC REGULATION COMMISSION, INSURANCE DIVISION IN FEBRUARY 2013. THE PRIMARY MISSION OF THE COMPANY IS TO PROVIDE AFFORDABLE COMMUNITY HEALTH CARE INSURANCE ACROSS THE STATE OF NEW MEXICO TO THE INDIVIDUAL AND SMALL GROUP MARKETS. THE COMPANY BEGAN OPEN ENROLLMENT IN OCTOBER 2013, FOR AN EFFECTIVE INSURANCE COVERAGE DATE OF JANUARY 1, 2014. THE COMPANY IS FOCUSED ON THE WELL-BEING OF PARTIES BY MAKING SURE THEIR HEALTH CARE IS COORDINATED AT EVERY LEVEL AND THAT A STRONG NETWORK OF PRIMARY-CARE PROVIDERS IS AVAILABLE TO ENSURE GOOD HEALTH OF OUR MEMBERS. THE COMPANY'S PRIORITY IS TO KEEP MEMBERS HEALTHY, LOWERING PREMIUM COSTS AND DELIVERING APPROPRIATE LEVELS OF CARE AT THE RIGHT TIME TO KEEP MEMBERS HOME AND OUT OF UNNECESSARY HOSPITAL STAYS. THIS WILL BE ACCOMPLISHED BY PROVIDING COMMUNITY-BASED CASE MANAGEMENT TO ENSURE THE MEMBERS ARE WELL CARED FOR. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 41 0 8 1 0 0 0 0 0 0 0 0 412671 412671 0 0 0 X 5 5 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MARILYN RIPPIE 5055966103 6001 INDIAN SCHOOL ROAD NE ALBUQUERQUE NM 87110 MARLENE BACA CEO 40.00 0.00 X 308897 0 12980 MARILYN RIPPIE CFO 40.00 0.00 X 163600 0 6658 DENNIS MICHAEL LITOS CHAIRMAN BOARD OF DIRECTOR 1.00 0.00 X 4500 0 0 MARGARET J GUNTER BOARD OF DIRECTORS 1.00 0.00 X 3500 0 0 MARIA ELENA ALVAREZ BOARD OF DIRECTORS 1.00 0.00 X 2500 0 0 JAMES TRYON MD BOARD OF DIRECTORS 1.00 0.00 X 2500 0 0 MARK EDWARD UNVERZAGT BOARD OF DIRECTORS 1.00 0.00 X 2500 0 0 487997 0 19638 2 0 1 0 DAVITA MEDICAL NEW MEXICO LLC PO BOX 26028 ALBUQUERQUE NM 87125 SETTLEMENT OF MEDICAL 710955 PEPPER HAMILTON LLP 3000 TWO LOGAN SQUARE EIGHTEENTH AN PHILADELPHIA PA 19103 LEGAL 345869 MILLIMAN 1400 WESATTA STREET SUITE 300 DENVER CO 80202 ACTUARIAL 317459 LAURUS LAW GROUP 141 E PALACE AVENUE 2ND FLOOR SANTA FE NM 87501 LEGAL 212260 KAREN FURBUSH 10253 N 42ND ST PHOENIX AZ 85028 CONSULTING 111446 6 NET PREMIUM INCOME 524114 21099175 21099175 21099175 154074 154074 6248797 6228074 20723 20723 20723 21273972 21119898 0 154074 507635 247197 6316 86316 22499 695416 254468 240095 840432 21570 14522 13338 1995 3047 143582 HOSPITAL/MEDICAL BENEFI 93201928 CLAIMS ADJUSTMENT EXPEN 5897197 PREMIUM ASSESSMENTS 2620063 PREMIUM TAXES 2504078 -89274868 18046826 3780819 4183539 802507 616435 2252042 3391142 33602 2317 1003 31285 8932485 3190232 29257164 9476797 45026020 20889430 29616754 10973582 2110042 2770211 13295513 4002738 45022309 17746531 X 0 0 77318782 78018267 -77315071 -74875368 3711 3142899 45026020 20889430 X 3227146 -87958 X 0 1 X 1 1 1 3452 115 3337 30150 2202 27948 31285 AMOUNTS RECOVERABLE FROM REINSURERS 1729933 UNCOLLECTED PREMIUMS 296899 ACCRUED RETROSPECTIVE PREMIUMS 7437209 INVESTMENT INCOME DUE AND ACCRUED 12756 9476797 CLAIMS UNPAID 3250682 AGGREGATE HEALTH POLICY RESERVES 343349 UNPAID CLAIMS ADJUSTMENT EXPENSES 408707 4002738 X 21273972 0 21273972 0 21273972 18046826 0 18046826 0 18046826 PART X, LINE 2: THE COMPANY RECEIVED A DETERMINATION LETTER FROM THE IRS GRANTING IT 501(C)(29) TAX-EXEMPT STATUS. THE EFFECTS OF TAX POSITIONS ARE GENERALLY RECOGNIZED IN THE STATUTORY FINANCIAL STATEMENTS CONSISTENT WITH AMOUNTS REFLECTED IN RETURNS FILED, OR EXPECTED TO BE FILED, WITH TAXING AUTHORITIES. AS OF DECEMBER 31, 2019 AND 2018, THE COMPANY IS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS. X 0 0 0 MARLENE BACA CEO 308897 0 0 0 0 0 12400 0 580 0 321877 0 0 0 MARILYN RIPPIE CFO 163600 0 0 0 0 0 6600 0 58 0 170258 0 0 0 FORM 990, PART V, LINE 13A NM FORM 990, PART VI, SECTION A, LINE 6 ALL INDIVIDUALS, INCLUDING DEPENDENTS, COVERED UNDER A HEALTH INSURANCE POLICY ISSUED BY THE CORPORATION ARE MEMBERS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ALL MEMBERS WHO ARE AT LEAST 18 YEARS OF AGE ARE QUALIFIED AND HAVE THE RIGHT TO ONE (1) VOTE ON THE ELECTION OF DIRECTORS AND ON ALL MATTERS COMING BEFORE THE MEMBERS FOR CONSIDERATION. VOTING MAY OCCUR BY MAIL OR ELECTRONIC FORMAT. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND CEO REVIEW THE FORM 990 UPON COMPLETION. AFTER APPLICABLE CHANGES ARE MADE, IF ANY, THE UPDATED FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY UPON EMPLOYMENT OR POSITION ON THE BOARD. ON AN ANNUAL BASIS, ALL KEY EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO CERTIFY THAT NO CONFLICT OF INTEREST HAS ARISEN. IF A CONFLICT ARISES, THE PERSON WITH SUCH CONFLICT IS NOT ALLOWED TO VOTE ON THE TRANSACTION. THERE HAVE BEEN NO INCIDENCES OF CONFLICT DURING THE REPORTING YEAR. FORM 990, PART VI, SECTION B, LINE 15 IN 2018 WITH THE CHANGE IN THE STRUCTURE OF THE NMHC BOARD OF DIRECTORS THE COMPENSATION COMMITTEE WAS DISBANDED AND THE ENTIRE BOARD OF DIRECTORS REVIEWED AND APPROVED THE REASONABLENESS AND COMPENSATION FOR BOTH THE CHIEF EXECUTIVE OFFICE AND CHIEF FINANCIAL OFFICER. AFTER THE BOARD OF DIRECTORS REVIEWED AND APPROVED THE COMPENSATION FOR THESE TWO EXECUTIVE POSITIONS THEIR RECOMMENDATIONS WERE SENT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR APPROVAL. THE EXECUTIVE BEING EVALUATED IS NOT PRESENT DURING THE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS ARE ALSO FILED WITH THE OFFICE OF THE SECRETARY OF STATE AND ARE AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS -87,958.