2019-11-14T16:14:23-06:00 2018-12-31 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2018-01-01 113153422 NEW YORK STATE CATHOLIC HEALTH PLANINC C/O WILLIAM WHISTON NEWY 2123711011 1011 FIRST AVENUE NEW YORK NY 10022 WILLIAM WHISTON CEO 2123711011 2019-11-14 1 CHRISTINE KAWECKI P00743140 5169187000 167.219.172.209 2019-11-14 16:05:26 ES P E9C924457B5D275461852EC86B70A375E5271692 934115C41A372782CAA2C37E99928821B09BF6A8 2018 2020-03-31 21:24:44Z FIDELIS LEGACY PLAN WILLIAM WHISTON 1011 FIRST AVENUE NEW YORK NY 10022 9999680489 0 X X 1993 NY SEE SCHEDULE O. X 7 7 4773 0 0 548910 415749 28798 9692298442 6106592962 55522502 2531156365 25519534 40199332 9773756227 8677977457 5184210 550843 8893847473 5492652894 342970670 192500524 0 0 0 219978558 1715788696 9461980911 7401492957 311775316 1276484500 4275726392 659716609 2154215164 502548349 2121511228 157168260 X SEE SCHEDULE O 0 1 2723402778 377857 3116488480 MEDICAID MANAGED CARE PROGRAM ("MEDICAID") IS A NEW YORK STATE PROGRAM ADMINISTERED BY NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("NYSCHP") THROUGH JUNE 30, 2018 THAT PROVIDED FREE COMPREHENSIVE HEALTH COVERAGE FOR ELIGIBLE INDIVIDUALS AND FAMILIES WHO ARE RESIDENTS OF NEW YORK STATE AND HAVE LOW INCOME AND LIMITED RESOURCES. THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHED ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE. AS OF JUNE 30, 2018, NYSCHP SERVED APPROXIMATELY 1,230,400 MEDICAID BENEFICIARIES. 963819670 25535 1027201548 MEDICARE ADVANTAGE PROGRAM IS A PROGRAM AVAILABLE TO ADULTS AGED 65 AND OVER WHO ARE ELIGIBLE UNDER MEDICARE. BENEFICIARIES MAY CHOOSE TO USE PRIVATE PAY OPTIONS, ESTABLISH MEDICAL SAVINGS ACCOUNT, USE MANAGED CARE PLANS SUCH AS NYSCHP, OR JOIN PROVIDER-SPONSORED PLAN. AS OF DECEMBER 31, 2018, NYSCHP SERVED APPROXIMATELY 72,000 MEDICARE ADVANTAGE PROGRAM BENEFICIARIES UNDER REINSURANCE ARRANGEMENTS WITH HALLMARK LIFE INSURANCE COMPANY.SEE SCHEDULE O, PART III, LINE 3 NARRATIVE FOR MORE DETAILS. 563081563 5421 632971312 FIDELIS CARE AT HOME IS A MEDICAID LONG-TERM CARE CAPITATED PROGRAM WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ADMINISTERED BY NYSCHP THROUGH JUNE 30, 2018, WHICH PROVIDED AN ARRAY OF HOME, COMMUNITY, AND INSTITUTIONALLY BASED, LONG-TERM CARE SERVICES TO PERSONS WHO ARE ELIGIBLE FOR MEDICAID AND WHO HAVE BEEN CERTIFIED AS APPROPRIATE CANDIDATES FOR NURSING HOME PLACEMENT. AS OF JUNE 30, 2018, NYSCHP SERVED APPROXIMATELY 21,100 FIDELIS CARE AT HOME PROGRAM BENEFICIARIES. 1242899726 142030 1368219202 OTHER PROGRAMS ADMINISTERED BY NYSCHP THROUGH JUNE 30, 2018, INCLUDED THE CHILD HEALTH PLUS PROGRAM, HEALTH AND RECOVERY PLAN ("HARP") PROGRAM, AND THE ESSENTIAL PLAN PROGRAM. OTHER PROGRAMS WHICH CONTINUED THROUGH DECEMBER 31, 2018, UNDER REINSURANCE ARRANGEMENTS WITH HALLMARK LIFE INSURANCE COMPANY INCLUDED THE MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM, MEDICAID ADVANTAGE PLUS PROGRAM AND THE INDIVIDUAL COMMERCIAL MARKET PRODUCTS.CHILD HEALTH PLUS PROGRAM IS A PROGRAM THAT COVERED UNINSURED CHILDREN UNDER THE AGE OF 19, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID. AS JUNE 30, 2018, NYSCHP SERVED APPROXIMATELY 119,600 CHILD HEALTH PLUS PROGRAM BENEFICIARIES. HARP PROGRAM IS A MEDICAID PROGRAM THAT PROVIDED CARE MANAGEMENT SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICAID REQUIRING BEHAVIORAL HEALTH SERVICES. AS OF JUNE 30, 2018, NYSCHP SERVED APPROXIMATELY 29,300 HARP BENEFICIARIES. ESSENTIAL PLAN IS A PROGRAM THAT PROVIDED MINIMUM ESSENTIAL COVERAGE TO QUALIFIED INDIVIDUALS WHO ARE NOT ELIGIBLE FOR MEDICAID OR THE CHILD HEALTH PLUS PROGRAMS. AS OF JUNE 30, 2018, NYSCHP SERVED APPROXIMATELY 164,800 ESSENTIAL PLAN BENEFICIARIES.MEDICARE/MEDICAID DUAL ADVANTAGE IS A PROGRAM FOR THOSE WHO MEET ELIGIBILITY REQUIREMENTS FOR BOTH MEDICARE AND MEDICAID AND ARE ENROLLED IN BOTH PROGRAMS. AS OF DECEMBER 31, 2018, NYSCHP SERVED APPROXIMATELY 1,300 MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM BENEFICIARIES. MEDICAID ADVANTAGE PLUS IS A FULL-RISK MANAGED LONG-TERM CARE PROGRAM FOR INDIVIDUALS 18 YEARS OF AGE AND OLDER WITH MEDICARE AND MEDICAID COVERAGE WHO HAVE A CHRONIC ILLNESS OR DISABILITY. MEMBERS MUST BE IN NEED OF LONG-TERM CARE SERVICES AND MAY NEED CARE TYPICALLY GIVEN IN A NURSING HOME. AS OF DECEMBER 31, 2018, NYSCHP SERVED APPROXIMATELY 90 MEDICAID ADVANTAGE PLUS PROGRAM BENEFICIARIES. HEALTH BENEFIT EXCHANGE IS A PROGRAM PROVIDING HEALTH COVERAGE TO INDIVIDUALS UNDER THE HEALTH CARE REFORM ACT. AS OF DECEMBER 31, 2018, NYSCHP SERVED APPROXIMATELY 98,200 HEALTH BENEFIT EXCHANGE BENEFICIARIES. 1242899726 142030 1368219202 5493203737 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 1 0 0 4773 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 7 7 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X WILLIAM WHISTON 6467942939 1011 FIRST AVENUE NEW YORK NY 10022 X DEACON FRANK J THOMAS MD CHAIRMAN OF THE BOARD (AS OF 7/1/18) 1.00 0.00 X X 0 0 0 DONNA O'BRIEN DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 GINO J PAZZAGLINI DIRECTOR/VICE CHAIR (THRU 7/1/2018) 1.00 0.00 X X 0 0 0 JACK BALINSKY DIRECTOR 1.00 0.00 X 0 0 0 JAMES M CORRIGAN DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 JOHN A WERWAISS DIRECTOR/TREASURER (THRU 7/1/2018) 1.00 0.00 X X 0 0 0 JOHN J HURLEY DIRECTOR 1.00 0.00 X 0 0 0 JOHN RYDZEWSKI DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 KARL P ADLER MD DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 M WILLIAM BENEDETTO DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 MARY THOMPSON DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL J TOOLEY DIRECTOR 1.00 0.00 X 0 0 0 PATRICK J FRAWLEY PLAN PRES (AS OF 7/1/2018); CEO (THRU 7/1/18) 37.50 0.00 X X 5367708 0 93163 REV DONALD J HARRINGTON CHAIR OF THE BOARD (THRU 7/1/2018) 1.00 0.00 X X 0 0 0 REV JOHN COUGHLIN DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 REV LEO J O'DONOVAN DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 SR PATRICIA BURKARD DIRECTOR/SECRETARY (THRU 7/1/2018) 1.00 0.00 X X 0 0 0 THOMAS DOODIAN DIRECTOR 1.00 0.00 X 0 0 0 THOMAS L KELLY DIRECTOR (THRU 7/1/2018) 1.00 0.00 X 0 0 0 WILLIAM WHISTON CEO (AS OF 7/1/2018) 1.00 0.00 X 0 0 0 DAVID THOMAS PRESIDENT (THRU 6/30/18) 34.70 2.80 X 1650028 45356 53930 THOMAS HALLORAN EVP & CFO (THRU 6/30/2018) 33.75 3.75 X 463489 52127 45983 ALICIA L DELMONT-VORBURGER CPOO (THRU 6/30/2018) 37.50 0.00 X 420725 0 17213 PAMELA HASSEN CHIP ENROLL. OFF (THRU 6/30/2018) 37.50 0.00 X 1435400 0 40996 ROBERT FAZZOLARI COMPLIANCE OFFICER (THRU 6/30/2018) 37.50 0.00 X 543206 0 23865 SANTO F RUSSO CHIEF LEGAL OFFICER (THRU 6/30/2018) 33.75 3.75 X 355098 40088 46214 VINCENT MARCHELLO MD CMO (THRU 6/30/2018) 32.80 4.70 X 349357 50622 28610 10585011 188193 349974 123 0 1 0 EVICORE HEALTHCARE 400 BUCKWALTER PLACE BLVD BLUFTON SC 29910 UTILIZATION MANAGEMENT REVIEW 7020312 COTIVITI DOMESTIC HOLDINGS INC 50 DANBURY ROAD WILTON CT 06897 MEDICAL CLAIM REVIEW 6396623 OPTUMINSIGHT INC 2771MOMENTUM PLACE CHICAGO IL 60689 CONSULTING/COST SAVINGS 5565266 HEALTH MANAGEMENT SYSTEMS INC PO BOX 27151 NEW YORK NY 10087 COORDINATION OF BENEFITS REVIEW 3486069 AARETE LLC 8574 SOLUTION CENTER CHICAGO IL 60677 CONSULTING/COST SAVINGS 1991082 43 28798 28798 MEDICAID 524114 3116488480 3116488480 MEDICARE ADVANTAGE 524114 1027201548 1027201548 FEDELIS CARE AT HOME 524114 632971312 632971312 ESSENTIAL PLAN 524114 368352271 368352271 HARP 524114 344832500 344832500 616746851 616746851 6106592962 24677665 24677665 6781027 4869275 1911752 1911752 1911752 423696614 3399615843 420780032 896053725 2916582 2503562118 2506478700 2506478700 REINSURANCE 524298 18563384 18563384 STATE SUPPL INCTV PROG 524298 18076980 18076980 TAX RECOVERY 900099 295638 295638 1351578 1351578 38287580 8677977457 6144880542 0 2533068117 335000 335000 215843 215843 5492652894 5492652894 7666707 7666707 150928745 150928745 4622976 4622976 17862791 17862791 11419305 11419305 1903271 1903271 884881 884881 47488 47488 2641105 2641105 88260670 88260670 11114284 11114284 7001415 7001415 22245751 22245751 4845313 4845313 2559732 2559732 768539 768539 2573221 2573221 19853733 19853733 3256938 3256938 AGREEMENT WITH NYS 1500000000 1500000000 BAD DEBT PROVISION 14285531 14285531 CLAIMS PROCESSING 11933037 11933037 HBX ASSESSMENT 4448127 4448127 17165660 17165660 7401492957 5493203737 1908289220 0 87994994 19132619 2309422521 1206291 209850337 101271384 641516 143170337 5197845 210105617 137972492 748498315 31615519 420366 15849778 560697561 500763691 4275726392 659716609 246349322 2548349 30784525 85714286 1791367031 500000000 2154215164 502548349 X 2119731353 157168260 1779875 0 2121511228 157168260 4275726392 659716609 X 1276484500 -12264615 -3228562853 X 0 1 X 1 1 1 X 196215 470690 896865 415749 28798 2008317 5282714979 6469839473 8422090289 9717643812 6144880542 36037169095 5282911194 6470310163 8422987154 9718059561 6144909340 36039177412 0 0 0 36039177412 18001330 16525457 21015784 34066417 31458692 121067680 18001330 16525457 21015784 34066417 31458692 121067680 209418 -10983 50142 174164 581642421 582065162 5301121942 6486824637 8444053080 9752300142 6758010453 36742310254 0.98090 0.99700 0.00330 0.00300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 47488 47488 0 PART II-B, LINE 1: NYSCHP WAS A MEMBER OF CERTAIN ASSOCIATIONS THROUGH JUNE 30, 2018, TO WHICH IT PAID ANNUAL DUES. A PORTION OF THOSE DUES ARE DETERMINED TO BE EXPENDITURES FOR LOBBYING PURPOSES. IN 2018, THAT PORTION WAS $47,488 REPRESENTING AN INSIGNIFICANT AMOUNT OF OVERALL EXPENDITURES. 26562244 26562244 113312656 5084542 108228114 3295437 113303 3182134 137972492 OTHER RECEIVABLES 500763691 500763691 DUE TO THIRD PARTIES 500000000 500000000 6167034107 -12264618 14111 -12250507 6179284614 2498692843 2498692843 8677977457 7406376340 9226283 9226283 7397150057 4342900 4342900 7401492957 PART XI, LINE 2D - OTHER ADJUSTMENTS: SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 14,111. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF FIDELIS 2,503,562,118. RENT EXPENSE -4,869,275. PART XII, LINE 2D - OTHER ADJUSTMENTS: SALUS EXPENSES ELIMINATED IN CONSOLIDATION 9,226,283. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES FROM SUBSIDIARY 8,050,314. LOSS FROM SUBSIDIARY 1,161,861. RENT EXPENSE OFFSET -4,869,275. 1 1199SEIU HOME CARE INDUSTRY EDUCATION 330 WEST 42ND STREET NEW YORK NY 10036 711028611 501(C)(3) 5000 CASH PART IV, SUPPLEMENTAL INFORMATION ANTHONY L JORDAN HEALTH CORPORATION 214 C LAKE AVENUE ROCHESTER NY 14608 160977295 501(C)(3) 7500 CASH PART IV, SUPPLEMENTAL INFORMATION CATHOLIC CHARITIES OF BROOME COUNTY 232 MAIN STREET BINGHAMTON NY 13905 161170407 501(C)(3) 100000 CASH PART IV, SUPPLEMENTAL INFORMATION CATHOLIC CHARITIES OF FULTON & MONTGOMERY COUNTIES 55 EAST MAIN STREET STE 100 JOHNSTOWN NY 12095 141340033 501(C)(3) 6000 CASH PART IV, SUPPLEMENTAL INFORMATION CATHOLIC MEDICAL MISSION BOARD INC 100 WALL STREET FLOOR 9 NEW YORK NY 10005 135602319 501(C)(3) 60000 CASH PART IV, SUPPLEMENTAL INFORMATION CHARLES B WANG COMMUNITY HEALTH CENTER 268 CANAL STREET NEW YORK NY 10013 132739694 501(C)(3) 7000 CASH PART IV, SUPPLEMENTAL INFORMATION COMMUNITY HEALTH CENTER OF BUFFALO INC 34 BENWOOD AVENUE BUFFALO NY 14214 161566929 501(C)(3) 10000 CASH PART IV, SUPPLEMENTAL INFORMATION EZRAS CHOILIM HEALTH CENTER INC 49 FOREST AVENUE MONROE NY 10950 133595755 501(C)(3) 5000 CASH PART IV, SUPPLEMENTAL INFORMATION FOODLINK INC 1999 MT READ BLVD ROCHESTER NY 14615 222428304 501(C)(3) 5500 CASH PART IV, SUPPLEMENTAL INFORMATION HEALTH ALLIANCE FOUNDATION 396 BROADWAY KINGSTON NY 12401 222511450 501(C)(3) 7500 CASH PART IV, SUPPLEMENTAL INFORMATION HEALTH PLAN ALLIANCE LLC 290 E JOHN CARPENTER FWY IRVING TX 750622710 752674044 501(C)(3) 5000 CASH PART IV, SUPPLEMENTAL INFORMATION IBERO-AMERICAN ACTION LEAGUE INC 817 EAST MAIN STREET ROCHESTER NY 14605 160954745 501(C)(3) 5000 CASH PART IV, SUPPLEMENTAL INFORMATION MATERNITY & EARLY CHILDHOOD FOUNDATION INC 40 NORTH MAIN AVENUE ALBANY NY 12203 141650131 501(C)(3) 50000 CASH PART IV, SUPPLEMENTAL INFORMATION MERCY HOSPITAL FOUNDATION INC 565 ABBOTT ROAD BUFFALO NY 14220 222209721 501(C)(3) 7500 CASH PART IV, SUPPLEMENTAL INFORMATION MORRIS HEIGHTS HEALTH CENTER 85 WEST BURNSIDE AVENUE BRONX NY 10453 061081232 501(C)(3) 5000 CASH PART IV, SUPPLEMENTAL INFORMATION PS 130 M PARENTS ASSOCIATION 143 BAXTER STREET NEW YORK NY 10013 200766928 501(C)(3) 6000 CASH PART IV, SUPPLEMENTAL INFORMATION THE FOUNDATION FOR ELLIS MEDICINE 1101 NOTT STREET SCHENECTADY NY 12308 141638957 501(C)(3) 10000 CASH PART IV, SUPPLEMENTAL INFORMATION THE MARY IMOGENE BASSETT HOSPITAL 1 ATWELL ROAD COOPERSTOWN NY 13326 135596796 501(C)(3) 10000 CASH PART IV, SUPPLEMENTAL INFORMATION UB FOUNDATION INC PO BOX 900 BUFFALO NY 142260900 160865182 501(C)(3) 20000 CASH PART IV, SUPPLEMENTAL INFORMATION MISCELLANEOUS CONTRIBUTIONS 5000 95-25 QUEENS BLVD REGO PARK NY 11374 113153422 501(C)(3) 3000 CASH PART IV, SUPPLEMENTAL INFORMATION 20 0 HEALTHY KIDS FUND 23962 215843 CASH PAID N/A PART I, LINE 2: RECIPIENTS OF GRANT AWARDS UNDER THE COMMUNITY GRANT FUND ARE REQUIRED TO PROVIDE PERIODIC UPDATES ON THE ACCOMPLISHMENTS OF THE GRANT AND DISBURSEMENTS. IT IS THE RESPONSIBILITY OF THE GRANT RECIPIENT TO ENSURE THAT THE GRANT IS USED FOR THE PURPOSE(S) STATED IN THE ORIGINAL APPLICATION. NYSCHP HAS MONITORED GRANT USAGE BY CORRESPONDENCE, TELEPHONE OR SITE VISITS. AN EVALUATION OF THE PROJECT IS REQUIRED UPON THE GRANTEE'S COMPLETION. NON-COMPLIANCE WITH THESE GUIDELINES MAY RESULT IN A REQUEST FOR RETURN OF THE FUNDS IN QUESTION OR INELLIGIBILITY OF THE ORGANIZATION FOR FUTURE GRANTS FROM NYSCHP. PART II, COLUMN H: SINCE 2004, THE PURPOSE OF NYSCHP COMMUNITY GRANT FUND HAS BEEN TO OFFER SUPPORT ANNUALLY THROUGH CHARITABLE CONTRIBUTIONS TO SELECTED TAX-EXEMPT NONPROFIT ORGANIZATIONS THAT SHARE SIMILAR MISSIONS AND VALUES OF SERVICE TO LOW-INCOME VULNERABLE INDIVIDUALS. PROPOSALS ARE EVALUATED ON THEIR RELEVANCE TO NYSCHP'S MISSION OF CARING FOR THE NEEDS AND CONCERNS OF THE POOR AND MEDICALLY UNDERSERVED IN CONSULTATION WITH NYSCHP'S MEMBERS. THE TOTAL AMOUNT DISTRIBUTED EACH YEAR HAS BEEN APPROVED BY THE BOARD OF DIRECTORS AND DISTRIBUTED IN ACCORDANCE WITH THE APPROVED BOARD POLICY. IN ADDITION TO THE GRANTS MADE THROUGH ITS COMMUNITY GRANT FUND, NYSCHP HAS PROVIDED SUPPORT THROUGH CHARITABLE CONTRIBUTIONS THROUGH ITS CATHOLIC SCHOOLS GRANT INITIATIVE TO SELECTED CATHOLIC SCHOOLS OR DIOCESAN SCHOOL SYSTEMS IN THEIR EFFORT TO IMPROVE THE HEALTH STATUS OF CHILDREN AND THEIR FAMILIES. LASTLY, NYSCHP HAS MADE CHARITABLE DONATIONS TO ORGANIZATIONS CLASSIFIED AS TAX-EXEMPT NONPROFIT ORGANIZATIONS UNDER STATE AND FEDERAL LAW THAT WORK WITH NYSCHP TO SUPPORT ITS MISSION. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 PATRICK J FRAWLEY PLAN PRES (AS OF 7/1/2018); CEO (THRU 7/1/18) 690025 0 0 0 4677683 0 18972 0 74191 0 5460871 0 0 0 DAVID THOMAS PRESIDENT (THRU 6/30/18) 300849 25853 188700 15300 1160479 4203 17549 1423 32786 2172 1700363 48951 0 0 THOMAS HALLORAN EVP & CFO (THRU 6/30/2018) 245859 29402 156600 17400 61030 5325 17075 1897 24909 2102 505473 56126 0 0 ALICIA L DELMONT-VORBURGER CPOO (THRU 6/30/2018) 152985 0 258360 0 9380 0 16511 0 702 0 437938 0 0 0 PAMELA HASSEN CHIP ENROLL. OFF (THRU 6/30/2018) 237947 0 150000 0 1047453 0 18972 0 22024 0 1476396 0 0 0 ROBERT FAZZOLARI COMPLIANCE OFFICER (THRU 6/30/2018) 140245 0 264090 0 138871 0 17208 0 6657 0 567071 0 0 0 SANTO F RUSSO CHIEF LEGAL OFFICER (THRU 6/30/2018) 192328 22812 121500 13500 41270 3776 17075 1897 25110 2132 397283 44117 0 0 VINCENT MARCHELLO MD CMO (THRU 6/30/2018) 150478 23445 185509 26501 13370 676 16601 2372 8432 1205 374390 54199 0 0 PART I, LINE 4B SERP COMPENSATION OF OFFICERS AND HIGHEST COMPENSATED EMPLOYEES INCLUDED IN COLUMN: PATRICK J. FRAWLEY - $3,897,162*; DAVID THOMAS - $1,096,284*; PAMELA HASSEN - $1,001,470*; * THESE PAYMENTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II) AND INCLUDE GROSS-UP TAXES PAID ON BEHALF OF THE PARTICIPANTS (LINE 1A). PART I, LINE 7 PERFORMANCE-BASED INCENTIVES ARE PAID AS PART OF NYSCHP'S ANNUAL INCENTIVE PROGRAM. THE CHIEF EXECUTIVE OFFICER DOES NOT PARTICIPATE IN ANY INCENTIVE PROGRAM. PART II, COLUMN (B)(III): IN 2018, NYSCHP'S PAID GRANDFATHERED PAID TIME OFF BALANCES TO ELIGIBLE EMPLOYEES INCLUDING EXECUTIVES. CASH AND CASH EQUIVALENTS 2018-07-02 2004589962 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 PREMIUM RECEIVABLES-NET 2018-07-02 345391031 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 REINSURANCE RECEIVABLES 2018-07-02 98734374 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 PHARMACY REBATES RECEIVABLE 2018-07-02 90175946 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 OTHER RECEIVABLES 2018-07-02 14065362 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 PREPAID EXPENSES AND OTHER CURRENT ASSETS 2018-07-02 21620977 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 ASSETS WHOSE USE IS LIMITED 2018-07-02 492347130 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 PROPERTY AND EQUIPMENT 2018-07-02 79831816 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 GOODWILL AND INTANGIBLES 2018-07-02 15849778 BOOK VALUE 421406317 CENTENE CORPORATION 7700 FORSYTH BOULEVARD ST LOUIS MO 63105 CASH AND CASH EQUIVALENTS 2018-07-02 3551129964 BOOK VALUE 830590263 MOTHER CABRINI HEALTH FOUNDATION 777 THIRD AVENUE NEW YORK NY 10017 501(C)(3) OTHER RECEIVABLES 2018-07-02 9322 BOOK VALUE 830590263 MOTHER CABRINI HEALTH FOUNDATION 777 THIRD AVENUE NEW YORK NY 10017 501(C)(3) INVESTMENTS 2018-07-02 766924262 BOOK VALUE 830590263 MOTHER CABRINI HEALTH FOUNDATION 777 THIRD AVENUE NEW YORK NY 10017 501(C)(3) 0 1 0 0 PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: PATRICK J. FRAWLEY, DAVID THOMAS AND THOMAS HALLORAN BECAME EMPLOYEES OF CENTENE EFFECTIVE JULY 2, 2018. THESE INDIVIDUALS RECEIVE COMPENSATION FOR THEIR SERVICES TO CENTENE, BUT THEY DID NOT RECEIVE ANY COMPENSATION FROM NYSCHP RELATED TO THE DISPOSITION OF ITS ASSETS TO CENTENE. FORM 990, PART I, LINE 1: TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES TO THE COMMUNITY, ESPECIALLY TO THE POOR AND UNDERSERVED; TO PROMOTE HEALTH EDUCATION AND PREVENTATIVE MEDICINE. FORM 990, PART I, LINE 1: FROM 1/1/18 TO 6/30/18, NYSCHP WAS KNOWN AS "FIDELIS CARE". FROM 7/1/18 TO 12/31/18, NYSCHP WAS KNOWN AS "FIDELIS LEGACY." FOR EASE OF REFERENCE, NYSCHP WILL BE USED TO REFER TO THE FILING ORGANIZATION. FORM 990, PART III, LINE 1: NEW YORK STATE CATHOLIC HEALTH PLAN, INC. STRIVES TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES FOR ALL; TO JOIN IN PARTNERSHIP WITH HEALTH PROFESSIONALS TO ASSIST THEM IN THEIR HEALING WORK; TO ACT AS A FACILITATOR TO BUILD LINKAGES AND SYSTEMS FOR THE COORDINATION OF CARE AND SERVICES AMONG HEALTHCARE, BEHAVIORAL AND SOCIAL SERVICES, AS WELL AS EDUCATORS AND RELIGIOUS LEADERS, TO ADDRESS THE SPIRITUAL, EMOTIONAL AND PHYSICAL NEEDS OF THOSE IT SERVES; TO ADVOCATE FOR A HEALTH POLICY THAT ACCORDS TRUE DIGNITY AND RESPECT FOR ALL HUMAN PERSONS, ESPECIALLY THE POOR AND UNDERSERVED. FORM 990, PART III, LINE 3 ON JULY 2, 2018, UPON REGULATORY APPROVAL, NYSCHP SOLD SUBSTANTIALLY ALL OF ITS OPERATIONS, ASSETS AND LIABILITIES RELATING TO ITS INSURANCE BUSINESS, INCLUDING ITS SUBSIDIARY SALUS ADMINISTRATIVE SERVICES, INC. (SALUS), TO CENTENE CORPORATION (CENTENE) IN ACCORDANCE WITH THE TERMS OF THE ASSET PURCHASE AGREEMENT ("APA") ENTERED INTO IN SEPTEMBER 2017 BY BOTH PARTIES. AS A RESULT OF THE SALE, NYSCHP CEASED CONDUCTING THE FOLLOWING PROGRAMS: THE MEDICAID MANAGED CARE PROGRAM (MEDICAID), CHILD HEALTH PLUS, FIDELIS CARE AT HOME, HEALTH AND RECOVERY PLAN ("HARP") AND THE ESSENTIAL PLAN PROGRAM. NYSCHP'S INDIVIDUAL COMMERCIAL MARKET PRODUCTS (INCLUDING QUALIFIED HEALTH PLANS) AND MEDICARE PRODUCTS (MEDICARE ADVANTAGE, MEDICARE ADVANTAGE D-SNP, MEDICARE ADVANTAGE PLUS, AND MEDICAID ADVANTAGE PLUS) WERE NOT IMMEDIATELY TRANSFERRED TO CENTENE. THE INDIVIDUAL COMMERCIAL MARKET PRODUCTS (INCLUDING QUALIFIED HEALTH PLANS) WERE TRANSFERRED TO CENTENE EFFECTIVE JANUARY 1, 2019 TO ACCOMMODATE THE ANNUAL OPEN ENROLLMENT PERIOD CYCLE FOR ENROLLEES. WITH REGARD TO THE MEDICARE AND MEDICARE-RELATED PRODUCTS, THE NOVATION OR ASSIGNMENT OF THE CONTRACTS RELATED TO THESE PRODUCTS IS SUBJECT TO APPROVAL BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES, WHICH IS EXPECTED TO OCCUR PRIOR TO JANUARY 1, 2021. ACCORDINGLY, CONCURRENTLY WITH THE SALE TO CENTENE, NYSCHP ENTERED INTO REINSURANCE AGREEMENTS WITH HALLMARK LIFE INSURANCE COMPANY, AN AFFILIATE OF CENTENE, TO PROVIDE FOR 100% REINSURANCE OF THE LIABILITIES UNDER THESE PROGRAMS. THE REINSURANCE AGREEMENTS PROVIDE THAT DURING THE TIME BETWEEN CLOSING OF THE SALE AND THE DATE OF TRANSFER OF THE REMAINING BUSINESS, AN EXISTING CENTENE SUBSIDIARY COMPANY, HALLMARK LIFE INSURANCE COMPANY, WILL REINSURE 100% OF THE FINANCIAL LIABILITIES RELATING TO NYSCHP'S MEDICARE BUSINESS (INCLUDING CERTAIN MEDICARE-RELATED PRODUCTS) AND NYSCHP'S INDIVIDUAL PRODUCTS (INCLUDING QUALIFIED HEALTH PLANS) PRODUCTS IN ACCORDANCE WITH THE REINSURANCE AGREEMENTS. IN CONNECTION WITH THE REINSURANCE AGREEMENTS AND IN LIGHT OF THE ASSUMPTION BY CENTENE OF ALL ECONOMIC RISK RELATING TO THE MEDICARE, MEDICARE-RELATED AND INDIVIDUAL COMMERCIAL PRODUCTS, NYSCHP ALSO ENTERED INTO A MANAGEMENT AGREEMENT WITH THE CENTENE AFFILIATES SALUS ADMINISTRATIVE SERVICES, INC., CENTENE MANAGEMENT COMPANY, LLC, AND CENTENE COMPANY OF NEW YORK WHEREBY THE CENTENE AFFILIATES WOULD ASSUME ALL ADMINISTRATIVE AND OPERATIONAL RESPONSIBILITY FOR THESE PRODUCTS UNTIL THEY ARE FINALLY TRANSITIONED TO CENTENE. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A TRANSITION SERVICES AGREEMENT ("TSA") EXECUTED BETWEEN CENTENE MANAGEMENT COMPANY, LLC ("CMC") AND NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("NYSCHP"), DATED JULY 2, 2018, CMC AGREED TO PROVIDE CERTAIN SERVICES TO NYSCHP THAT ARE SPECIFICALLY SET FORTH IN SCHEDULE A OF THE TSA. THE SERVICES INCLUDED INFORMATION TECHNOLOGY, HUMAN RESOURCES, ACCOUNTING / FINANCE / TREASURY / AUDITS, LEGAL / COMPLIANCE, TAX / IRS FILINGS AND LOGISTICS / OPERATIONS / SOURCING. UNDER THE TERMS OF THE TSA, CMC ALONE WAS REIMBURSED FOR ANY SERVICES THAT CMC PERSONNEL PROVIDED TO NYSCHP PURSUANT TO THE COST SCHEDULE SET FORTH IN SCHEDULE A OF THE TSA. THUS, NO CURRENT OR FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES (HEREINAFTER, COLLECTIVELY, THE "EMPLOYEES") LISTED IN PART VII, SECTION A OF FORM 990 RECEIVED ANY COMPENSATION FROM NYSCHP FOR THE SERVICES ANY OF THE EMPLOYEES PROVIDED TO NYSCHP. MOREOVER, NONE OF THE EMPLOYEES LISTED IN PART VII, SECTION A OF FORM 990 RECEIVED COMPENSATION FROM CMC FOR THE SERVICES PROVIDED TO NYSCHP. FORM 990, PART VI, SECTION A, LINE 4 CERTIFICATE OF INCORPORATION: IN ACCORDANCE WITH CHANGES IN NEW YORK LAW, THE CERTIFICATE OF INCORPORATION NOW PROVIDES THAT UPON DISSOLUTION, THE DISTRIBUTION OF ASSETS ARE SUBJECT TO EITHER COURT APPROVAL OR THE APPROVAL OF THE NEW YORK STATE ATTORNEY GENERAL. BYLAWS: CHANGES INCLUDE A REDUCTION IN THE NUMBER OF BOARD MEMBERS FROM 20 TO 8, THE REMOVAL OF THE POSITION OF VICE-CHAIRPERSON AND THE CREATION OF A NEW OFFICER POSITION, PLAN PRESIDENT. IN ADDITION, THE OFFICERS ARE NOW ELECTED BY THE MEMBERS, CLASSES OF DIRECTORS HAVE BEEN REMOVED AND THE QUORUM REQUIRED TO CONDUCT BUSINESS AT BOARD MEETINGS IS NOW A MAJORITY OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ORGANIZATION SHALL BE LIMITED TO THE DIOCESAN BISHOPS OF THE STATE AND THE ECCLESIASTICAL PROVINCE OF NEW YORK. FORM 990, PART VI, SECTION A, LINE 7A 1.THE ORGANIZATION IS A MEMBERSHIP CORPORATION UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW (THE "N-PCL"). THE ORGANIZATION'S MEMBERS ELECT ITS BOARD OF DIRECTORS AND, AS MEMBERS OF A NEW YORK NOT-FOR-PROFIT CORPORATION, POSSESS CERTAIN OTHER POWERS UNDER THE N-PCL. FURTHERMORE, THE ORGANIZATION'S BY-LAWS, WHICH ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYSDOH"), DEFINE THE FOLLOWING RESERVED POWERS OF THE MEMBERS: (I) THE INTERPRETATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES TO WHICH THE ORGANIZATION, AS A FAITH-BASED ORGANIZATION, IS SUBJECT; (II) APPROVAL OF THE MISSION STATEMENT; (III) STANDING TO ENSURE THE ORGANIZATION'S COMPLIANCE WITH ITS PHILOSOPHY AND MISSION STATEMENT; (IV) APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S CERTIFICATE OF INCORPORATION AND BY-LAWS; (V) APPROVAL OF CERTAIN TRANSACTIONS INVOLVING REAL PROPERTY; (VI) APPROVAL OF CERTAIN ACTIONS BY THE ORGANIZATION WHEN ACTING AS A SHAREHOLDER OR MEMBER OF ANOTHER ENTITY; (VII) APPROVAL OF THE ACCEPTANCE AND ISSUANCE OF SUBVENTIONS; (VIII) APPROVAL OF ANY MERGER, DISSOLUTION OR CONSOLIDATION; (IX) REMOVAL OF DIRECTORS AND CERTAIN OFFICERS OF THE CORPORATION; (X) APPROVAL OF THE ELECTION OF THE CHIEF EXECUTIVE OFFICER; AND (XI) REVIEW OF THE AUDITED FINANCIAL STATEMENTS. CERTAIN OF THESE POWERS ALREADY EXIST BY VIRTUE OF THE N-PCL (I.E., THE POWER TO APPROVE ANY MERGER, DISSOLUTION OR CONSOLIDATION UNDER N-PCL 903(A)(2) & 1002(A)). FORM 990, PART VI, SECTION A, LINE 7B PLEASE SEE LINE 11 NARRATIVE. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 IS PREPARED BY THE ORGANIZATION'S OUTSIDE INDEPENDENT TAX ADVISORS IN COLLABORATION WITH THE ORGANIZATION'S FORMER EXECUTIVE AND FINANCE PERSONNEL. THE 990 WILL BE REVIEWED BY ITS CEO AND OUTSIDE COUNSEL. THE ORGANIZATION'S BOARD OF DIRECTORS HAS REVIEWED AND ACCEPTED THE DRAFT FORM 990 BEFORE ITS FILING WITH THE IRS. ACCORDINGLY, AFTER THE ORGANIZATION'S MANAGEMENT HAS COMPLETED ITS REVIEW OF THE DRAFT FORM 990, IT IS CIRCULATED IN DRAFT FOR REVIEW, COMMENT AND APPROVAL TO THE MEMBERS OF THE BOARD OF DIRECTORS. ONCE ANY COMMENTS HAVE BEEN INCORPORATED AND THE FORM 990 HAS BEEN ACCEPTED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C 1. ANNUALLY, THE ORGANIZATION'S OFFICERS, DIRECTORS AND SENIOR EXECUTIVES ARE PROVIDED WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND AN ACKNOWLEDGEMENT FORM. THESE INDIVIDUALS ARE INSTRUCTED TO SIGN AND RETURN THE FORM, (A) TO ACKNOWLEDGE THAT THEY HAVE REVIEWED THE POLICY AND (B) TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS. THE CONFLICTS OF INTEREST POLICY DEFINES "DISCLOSABLE INTERESTS", I.E., THOSE INTERESTS THAT AN INDIVIDUAL COVERED BY THE POLICY MUST HAVE IN ANOTHER ENTITY IN ORDER FOR A TRANSACTION BETWEEN THE ORGANIZATION AND THAT ENTITY TO BE COVERED BY THE POLICY. THE POLICY ALSO DEFINES THE TYPES OF TRANSACTIONS BETWEEN THE ORGANIZATION AND ANOTHER ENTITY INVOLVING AN INDIVIDUAL COVERED BY THE POLICY THAT IS SUBJECT TO BY THE POLICY. THE POLICY REQUIRES DISCLOSURE TO THE BOARD OF DIRECTORS AND/OR THE EXECUTIVE COMMITTEE BY ANY PERSON WITH A DISCLOSABLE INTEREST IN A TRANSACTION AS DEFINED IN THE POLICY OF ALL CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. INITIALLY, AFTER THE INTERESTED INDIVIDUAL HAS RECUSED HIMSELF, THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE DETERMINES WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE DECIDES WHETHER TO ENTER INTO THE TRANSACTION BASED ON ITS DETERMINATION OF WHETHER (A) A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, (B) THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND (C) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 OUTSIDE COUNSEL FOR THE ORGANIZATION, A NATIONAL LAW FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, HAS ADVISED NYSCHP AS TO WHICH EMPLOYEES ARE DISQUALIFIED PERSONS WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EMPLOYS A COMPENSATION CONSULTANT FIRM, A NATIONAL HUMAN RESOURCES CONSULTING FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, TO PREPARE ANNUALLY A DETAILED REPORT ON THE PROPOSED COMPENSATION FOR THE ORGANIZATION'S DISQUALIFIED PERSONS THAT INCLUDES DATA AS TO COMPARABLE COMPENSATION FOR SIMILAR QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY-SITUATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH HAS BEEN AUTHORIZED BY THE BOARD TO REVIEW AND APPROVE ALL MATTERS CONCERNING EXECUTIVE COMPENSATION, IS PROVIDED WITH THE COMPENSATION CONSULTANT'S DETAILED EXECUTIVE COMPENSATION REPORT. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS FOR ALL DISQUALIFIED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION IS A NEW YORK NOT-FOR-PROFIT CORPORATION. ITS CERTIFICATE OF INCORPORATION IS READILY AVAILABLE TO THE GENERAL PUBLIC FROM THE NEW YORK STATE DEPARTMENT OF STATE UNDER THE NEW YORK FREEDOM OF INFORMATION LAW ("FOIL"). ITS CERTIFICATE OF INCORPORATION AND BY-LAWS ARE ALSO ON FILE WITH THE NYSDOH AND LIKEWISE AVAILABLE TO THE GENERAL PUBLIC UNDER FOIL. FORM 990, PART VII, SECTION A, COLUMN B: AVG. HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: THE FOLLOWING INDIVIDUALS DEVOTED A PERCENTAGE OF THEIR TIME TO SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED ORGANIZATION THROUGH JUNE 30, 2018, AS DETAILED BELOW: DAVID THOMAS, PRESIDENT (THRU 06/30/18) - 7.5% THOMAS HALLORAN, EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER (THRU JUNE 30, 2018) - 10% VINCENT MARCHELLO, MD, CHIEF MEDICAL OFFICER (THRU JUNE 30, 2018) - 12.5% SANTO RUSSO, CHIEF LEGAL OFFICER (THRU JUNE 30, 2018) - 10% THIS ARRANGEMENT IS COVERED BY AN EMPLOYEE SERVICE AGREEMENT BETWEEN NYSCHP AND SALUS THRU JUNE 30, 2018. PART VII, SECTION B: IN CONNECTION WITH THE REINSURANCE AGREEMENTS ENTERED INTO WITH HALLMARK LIFE INSURANCE COMPANY, NYSCHP ALSO ENTERED INTO A MANAGEMENT AGREEMENT WITH THE CENTENE AFFILIATES SALUS ADMINISTRATIVE SERVICES, INC., CENTENE MANAGEMENT COMPANY, LLC, AND CENTENE COMPANY OF NEW YORK WHEREBY THE CENTENE AFFILIATES AGREED TO ASSUME ALL ADMINISTRATIVE AND OPERATIONAL RESPONSIBILITY FOR THE MEDICARE, MEDICARE-RELATED AND INDIVIDUAL COMMERCIAL PRODUCTS CENTENE ACQUIRED UNDER THE ASSET PURCHASE AGREEMENT UNTIL THEY ARE FINALLY TRANSITIONED TO CENTENE. UNDER THIS ARRANGEMENT, CENTENE MANAGEMENT COMPANY RECEIVES A FEE, ON A CAPITATION BASIS, IN ACCORDANCE WITH THE TERMS OF THE AGREEMENT, WHICH AMOUNTED TO APPROXIMATELY $65.7 MILLION BETWEEN THE CLOSING AND DECEMBER 31, 2018. GIVEN THAT CENTENE MANAGEMENT COMPANY, LLC IS PROVIDING THESE SERVICES ON A TRANSITIONAL BASIS TO ACCOMMODATE THE STAGGERED GOVERNMENTAL APPROVAL PROCESS WITH RESPECT TO ASSETS CENTENE ACQUIRED AND HAS ASSUMED ALL ECONOMIC RISK, AND GIVEN THAT THE COST OF SERVICES PROVIDED BY CENTENE MANAGEMENT COMPANY, LLC ARE FULLY ASSUMED BY CENTENE UNDER THE REINSURANCE AGREEMENTS WITH HALLMARK LIFE INSURANCE COMPANY, CENTENE MANAGEMENT COMPANY, LLC IS NOT CONSIDERED TO BE AN INDEPENDENT CONTRACTOR OF NYSCHP AND IS THEREFORE NOT LISTED IN PART VII, SECTION B. FORM 990, PART XI, LINE 9: SALE AND DISTRIBUTION OF ASSETS -3,228,562,853. SCHEDULE O, NOT APPLICABLE QUESTIONS: TO THE EXTENT THAT A QUESTION ON THE FORM 990 HAS BEEN LEFT BLANK, THE RESPONSE TO THIS QUESTION SHOULD BE NOT APPLICABLE. DUE TO SOFTWARE LIMITATIONS, NYSCHP COULD NOT PROPERLY RESPOND TO THE RESPECTIVE QUESTION AS N/A. REGO PARK OFFICE TOWER LLC 95-25 QUEENS BLVD 8TH FLOOR REGO PARK NY 11374 815473320 REAL PROPERTY OWNER NY 12198604 148700930 NEW YORK STATE CATHOLIC HEALTH PLAN INC SALUS ADMINISTRATIVE SERVICES INC 95-25 QUEENS BOULEVARD REGO PARK NY 11374 550878053 THIRD PARTY ADMINISTRATOR NY NEW YORK STATE CATHOLIC HEALTH PLAN INC C 8064422 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 SALUS ADMINISTRATIVE SERVICES INC M 8050311 SALUS ADMINISTRATIVE SERVICES INC N 642918 SALUS ADMINISTRATIVE SERVICES INC O 8502301 SCHEDULE R, PART V: SCHEDULE R, PART V RELATED PARTY TRANSACTIONS: THROUGH JUNE 30, 2018, NYSCHP REPORTS CERTAIN RELATED PARTY TRANSACTIONS BETWEEN ITSELF AND SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED PARTY, ON SCHEDULE R, PART V. THE METHODS USED FOR DETERMINING THE AMOUNTS REPORTED DIFFER BASED ON THE TYPE OF TRANSACTION BUT ARE ALL CONTAINED IN WRITTEN CONTRACTS BETWEEN THE TWO PARTIES. THROUGH JUNE 30, 2018, SALUS REPORTS A PERFORMANCE OF SERVICES TO NYSCHP. THE WRITTEN AGREEMENT SPECIFIES A FIXED DISPENSING FEE PER PHARMACY CLAIM PROCESSED. THE FEE IS AN ESTIMATE DESIGNED TO COVER DIRECT AND INDIRECT COSTS AS WELL AS A MODEST AMOUNT OF PROFIT. THE AMOUNT IS DEEMED CONSISTENT WITH AN INDEPENDENT THIRD PARTY TRANSACTION. THROUGH JUNE 30, 2018, NYSCHP REPORTS A SHARING OF FACILITIES, EQUIPMENT, AND OTHER ASSETS. THE OVERHEAD AND ADMINISTRATIVE COSTS ARE ALLOCATED BASED ON THE SHARE OF FACILITIES AND ASSETS SALUS IS DEEMED TO USE. THROUGH JUNE 30, 2018, NYSCHP SHARED PAID EMPLOYEES WITH SALUS. NYSCHP ALLOCATED SALARIES FOR EACH EMPLOYEE BASED ON THE PERCENTAGE OF TOTAL HOURS SPENT PROVIDING SERVICES TO SALUS.