2019-11-14T14:23:13-06:00 2018-12-31 ERNST & YOUNG US LLP 221 E 4TH STREET SUITE 2900 CINCINNATI OH 45202 990 2018-01-01 050477052 Neighborhood Health Plan of Rhode Island % Peter M Marino CEO NEIG 4014596000 910 Douglas Pike Smithfield RI 02917 Frank Meaney CFO 4014596000 2018-11-14 true JULIE L SPARKS P01268401 5136121400 164.57.159.253 26308520193185000148 2019-11-14 P 1DE38BAEECF40ACD47782A8DE1D45BDD0E0DA758 B97875EEF6FBD007A090F94F770A4AFFCC21AB16 2018 2020-03-31 21:24:44Z Peter M Marino CEO 910 Douglas Pike Smithfield RI 02917 1413416266 false X www.nhpri.org X 1993 RI NEIGHBORHOOD HEALth plan of rhode island SECURES ACCESS TO HIGH QUALITY, COST-EFFECTIVE HEALTH CARE FOR RHODE ISLAND'S AT-RISK POPULATIONS. 17 16 605 15 2251345 0 2500 0 1365884063 1377747020 2051872 3220104 0 0 1367938435 1380967124 381 1270 1262175749 1270918000 33334974 33724743 0 0 0 74091182 70251987 1369602286 1374896000 -1663851 6071124 382573256 333881489 282295188 232315200 100278068 101566289 X NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND, AN INNOVATIVE HEALTH PLAN, IN PARTNERSHIP WITH THE COMMUNITY HEALTH CENTERS, SECURES ACCESS TO, HIGH QUALITY, COST-EFFECTIVE HEALTH CARE FOR RHODE ISLAND'S AT-RISK, POPULATIONS. false true 1308194491 1270 1377747020 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO) THAT PROVIDES HIGH-QUALITY, LOW-COST HEALTH CARE SERVICES ON A PREPAID BASIS PRINCIPALLY TO MEDICAID RECIPIENTS AND CERTAIN OTHER ELIGIBLE PERSONS UNDER STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS MANAGED CARE PROGRAM, RITECARE. THE ORGANIZATION ALSO EXTENDS ITS SERVICE, BENEFITS AND VALUE TO INDIVIDUALS AND BUSINESSES THROUGH HEALTH SOURCE RI, THE STATE'S HEALTH INSURANCE EXCHANGE. AS OF DECEMBER 31, 2018, THE ORGANIZATION IS RESPONSIBLE FOR PROVIDING HEALTH CARE SERVICES TO OVER 192,000 MEMBERS. 1308194491 true false false true false false false false false false true false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 2992 0 true 605 true true true false false false false false false false false false false false X 17 16 true false false false true true false true true false false true true true true false false true true false RI X Peter M Marino CEO 4014596000 910 Douglas Pike Smithfield RI 02917 X X JEANNE LACHANCE TRUSTEE 1.0 0.0 X 0 0 0 DENNIS ROY TRUSTEE 1.0 0.0 X 0 0 0 PATRICIA MARTINEZ TRUSTEE 1.0 0.0 X 0 0 0 PETER MARINO PRESIDENT & CEO 38.0 0.0 X X 489385 0 32428 CHRISTOPHER LITTLE ESQ TRUSTEE 1.0 0.0 X 0 0 0 DORIS DE LOS SANTOS TRUSTEE 1.0 0.0 X 0 0 0 WILLIAM HOCHSTRASSER-WALSH TRUSTEE 1.0 0.0 X 0 0 0 RICHARD BESDINE MD TRUSTEE 1.0 0.0 X 0 0 0 BRENDA DOWLATSHAHI SECRETARY 1.0 0.0 X 0 0 0 MERRILL THOMAS TREASURER 1.0 0.0 X 0 0 0 PETER BANCROFT CPA TRUSTEE 1.0 0.0 X 0 0 0 GARY FURTADO TRUSTEE 1.0 0.0 X 0 0 0 KEITH OLIVEIRA TRUSTEE 1.0 0.0 X 0 0 0 ALLISON CROKE TRUSTEE (AS OF 11/18) 1.0 0.0 X 0 0 0 JANE HAYWARD VICE CHAIRMAN 1.0 0.0 X 0 0 0 RAYMOND JOSEPH LAVOIE JR TRUSTEE 1.0 0.0 X 0 0 0 PABLO RODRIGUEZ MD TRUSTEE 1.0 0.0 X 0 0 0 MICHEAL LICHETENSTEIN TRUSTEE (THROUGH 10/18) 1.0 0.0 X 0 0 0 FRANK MEANEY CFO 38.0 0.0 X 324597 0 7622 DOUGLAS BYRD GENERAL COUNSEL 38.0 0.0 X 312301 0 31602 NANCY HERMIZ VP MEDICAID 38.0 0.0 X 225218 0 16178 MARYLOU BUYSE CHIEF MEDICAL OFFICER 38.0 0.0 X 70101 0 0 PETER LYMM CHIEF OPERATING OFFICER 38.0 0.0 X 202285 0 21646 DAVID BURNETT CHIEF GROWTH OFFICER 38.0 0.0 X 263565 0 35998 BRENDA SEAGRAVE-WHITTLE CHIEF MARKETING OFFICER-VP EXC 38.0 0.0 X 224124 0 23986 JEFFREY MEYER CHIEF INFORMATION OFFICER 38.0 0.0 X 221075 0 9794 2332651 0 179254 77 false true false Argus Health Systems Inc 1300 Washington KANSAS CITY MO 64105 Healthcare Services 236056718 Beacon Health Strategies LLC 500 Unicorn Park WOBURN MA 01801 Healthcare Services 188922471 Integra Dimension LLC 100 Wall Street Suite 2502 NEW YORK NY 10005 Healthcare Services 16953061 THE FOGARTY CENTER 220 WOONSASQUATUCKET AVE NORTH PROVIDENCE RI 02911 Healthcare Services 6517608 DST Healthcare Holdings Inc 333 WEST 11TH STREET KANSAS CITY MO 64105 HEALTHCARE SERVICES 5613027 99 0 Premiums Earned 524114 1353634710 1353634710 0 0 Reinsurance Recoveries 524114 4569785 4569785 0 0 PPC Admin Services 524114 2251345 0 2251345 0 Pharmacy Dividends 524114 13232693 13232693 0 0 All other program service 524114 4058487 4058487 0 0 1377747020 3765561 3765561 0 0 0 0 0 31903685 32449142 -545457 -545457 -545457 0 0 0 0 0 0 0 0 0 0 1380967124 1375495675 2251345 3220104 0 0 0 0 1270 1270 1270918000 1270918000 1783774 1783774 0 0 0 0 0 27082297 14927964 12154333 0 1298577 715786 582791 0 1304590 708957 595633 0 2255505 1243251 1012254 0 0 0 0 0 163661 0 163661 0 825814 0 825814 0 86400 0 86400 0 0 0 75000 75000 0 22020797 18219956 3800841 0 1805999 11141 1794858 0 2206680 308661 1898019 0 8002329 95795 7906534 0 0 0 0 0 3017813 1663418 1354395 0 199955 112974 86981 0 0 0 0 0 0 0 0 0 -37 0 -37 0 0 0 0 0 1184000 414829 769171 0 779622 0 779622 0 State Premium Tax 23630195 0 23630195 0 Temporary Help 2005257 1082306 922951 0 Other Expenses - Training 199147 116910 82237 0 State & Local Taxes Paid 4212186 0 4212186 0 -162831 -2346727 2183896 1374896000 1308194491 66701509 0 0 96160025 43818989 0 0 0 0 11466657 44718208 0 0 0 0 0 0 0 0 0 0 4410230 3507676 1361628 902554 250657744 204640711 0 0 0 0 0 0 22927202 39801027 382573256 333881489 15821628 12967731 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266473560 219347469 282295188 232315200 X 100278068 101566289 0 0 0 0 100278068 101566289 382573256 333881489 X 6071124 480882 0 0 0 -5263785 X X false true X true false X 35400 0 11987 2500 0 49887 848055027 980546905 1165729604 1365884063 1377747020 5737962619 0 0 0 848090427 980546905 1165741591 1365886563 1377747020 5738012506 0 0 0 0 0 5738012506 1005897 1477997 1721501 2138981 3765561 10109937 0 1005897 1477997 1721501 2138981 3765561 10109937 0 0 849096324 982024902 1167463092 1368025544 1381512581 5748122443 0.99824 0.99857 0.00176 0.00143 X false false false 0 false 0 false 0 false 0 true 86400 false 0 false 0 86400 false Schedule C, Part II-B Line 1G NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND DOES NOT DIRECTLY ENGAGE IN ANY LOBBYING ACTIVITIES BUT RETAINS A GOVERNMENT RELATIONS COMPANY, CAPITOL CITY GROUP, TO ADVOCATE THAT FUNDING FOR THE MEDICAID PROGRAM NOT BE REDUCED. FOR THE YEAR ENDED DECEMBER 31, 2018, THE ORGANIZATION PAID CAPITOL CITY GROUP $86,400. 0 4410230 3507676 902554 902554 Risk Share 14557001 Part D Subsidies 9130503 Acc Income 10623677 MCA 3982236 MEDICAL COST ACTION 1507610 39801027 0 IBNR LIABILITIES 109529770 UNEARNED PREMIUMS 72909685 RISK ADJUSTMENT 7500000 CLAIMS PAYABLE 9402132 OTHER ACCRUED LIABILITIES 13814995 ACCRUED PAYROLL 6112404 SECURITY DEPOSITS 78483 219347469 1377747020 0 0 1377747020 3220104 3220104 1380967124 1374896000 0 0 1374896000 0 0 1374896000 Other amounts included on line 1 but not on Form 990 Part VIII Line 12 SCHEDULE D, PART X, LINE 2 THERE WAS NO FIN 48 (ASC 740) FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS. Schedule D, Part XI, Line 4b Reconciliation of Revenue Investment Income - $3,220,104 X X X X false false false false false false false true false PETER MARINO PRESIDENT & CEO 442691 0 44100 0 2594 0 8537 0 23891 0 521813 0 0 0 FRANK MEANEY CFO 281029 0 41500 0 2068 0 7622 0 0 0 332219 0 0 0 DOUGLAS BYRD GENERAL COUNSEL 269509 0 39560 0 3232 0 9611 0 21991 0 343903 0 0 0 NANCY HERMIZ VP MEDICAID 196527 0 25335 0 3356 0 8927 0 7251 0 241396 0 0 0 PETER LYMM CHIEF OPERATING OFFICER 176073 0 25000 0 1212 0 2192 0 19454 0 223931 0 0 0 DAVID BURNETT CHIEF GROWTH OFFICER 226212 0 36220 0 1133 0 9757 0 26241 0 299563 0 0 0 BRENDA SEAGRAVE-WHITTLE CHIEF MARKETING OFFICER-VP EXC 189173 0 31400 0 3551 0 8261 0 15725 0 248110 0 0 0 JEFFREY MEYER CHIEF INFORMATION OFFICER 207439 0 11115 0 2521 0 8794 0 1000 0 230869 0 0 0 NON-FIXED PAYMENTS PURPOSE: NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND'S (NHPRI) PERFORMANCE INCENTIVE PLAN (THE PLAN) HAS BEEN IMPLEMENTED TO OFFER A PERFORMANCE-BASED INCENTIVE AWARD OPPORTUNITY TO ELIGIBLE NHPRI EMPLOYEES BASED ON ACHIEVEMENT OF THE ORGANIZATION'S ANNUAL BUSINESS OBJECTIVES AS WELL AS THEIR OWN JOB PERFORMANCE. THE PLAN ALLOWS A PORTION OF NHPRI'S ANNUAL COMPENSATION COSTS TO BE VARIABLE IN RELATION TO THE ORGANIZATION'S PERFORMANCE. AMOUNTS PAID IN 2018 UNDER THE PLAN ARE INCLUDED IN PART II COLUMN (B)(II). OTHER OBJECTIVES: THE PLAN IS EXPECTED TO INCLUDE THE FOLLOWING: A) FOCUS THE ATTENTION, EFFORT AND TEAMWORK OF PLAN PARTICIPANTS ON THE ACCOMPLISHMENT OF NHPRI'S KEY BUSINESS OBJECTIVES; B)ENABLE NHPRI TO OFFER A COMPENSATION PROGRAM WITH METHODS AND LEVELS OF PAY THAT ARE COMPETITIVE WITH OTHER ORGANIZATIONS SEEKING COMPARABLE EMPLOYEE RESOURCES; C)REINFORCE NHPRI'S COMMITMENT TO A PERFORMANCE-BASED CULTURE FOR ITS EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION; D) ASSIST NHPRI'S EFFORTS TO RETAIN ITS VALUED EMPLOYEES. AMOUNTS PAID IN 2018 UNDER THE PLAN ARE INCLUDED IN PART II COLUMN(B)(II) Cessation of Services 990, PART III, LINE 3 Neighborhood Health Plan ceased services to the Rhody Health Options - Unity line of business. DESCRIPTION OF RELATIONSHIPS 990, PART VI, LINE 2 A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS IS AN EXECUTIVE DIRECTOR OF A COMMUNITY HEALTH CENTER (CHC), BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC. BLACKSTONE VALLEY HEALTH CARE, THROUGH A GRANT,INVESTED IN EQUIPMENT AND SOFTWARE FOR AN ELECTRONIC MEDICAL RECORD(EMR)SYSTEM. ONE OTHER CHC, TRI-TOWN, HAS USE OF THE EMR AND BILLING SYSTEM. THE CHCS SHARE THE COST OF RUNNING the system. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE ORGANIZATION IS A 501(C)(3) CORPORATION AND HAS MEMBERS, BUT DOES NOT HAVE ANY STOCKHOLDERS. THE ORGANIZATION HAS A BOARD OF DIRECTORS WHO ARE MEMBERS OF THE ORGANIZATION THAT MEET ON A REGULAR BASIS AND FUNCTION AS THE GOVERNING BODY OF THE ORGANIZATION. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A THE MEMBERS OF THE ORGANIZATION ARE RHODE ISLAND COMMUNITY HEALTH CENTERS WHO HAVE THE AUTHORITY TO APPOINT A PORTION OF THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ALSO APPROVES THE HIRING OF THE CHIEF EXECUTIVE OFFICER WHO IS A VOTING MEMBER OF THE BOARD. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE ORGANIZATION'S FISCAL OPERATIONS DEPARTMENT ACCUMULATES THE INFORMATION AND DATA NECESSARY TO COMPLETE THE FEDERAL FORM 990. AUDITED FINANCIAL STATEMENTS AND APPROVED POLICIES AND PROCEDURES ARE USED AS INPUT TO COMPLETE THE 990. A DRAFT RETURN IS PREPARED AND REVIEWED BY THE ORGANIZATION'S INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS. AFTER THE REVIEW PROCESS IS COMPLETED BY THE INDEPENDENT ACCOUNTANTS, THE FINANCE STAFF REVIEW THE RETURN PRIOR TO FILING WITH THE IRS. THE FINANCE AND AUDIT COMMITTEE AND BOARD OF DIRECTORS ARE PROVIDED A DRAFT COPY OF THE RETURN FOR APPROVAL PRIOR TO FILING WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO, AND SERVES TO DESCRIBE EXPECTED BEHAVIORS AND ACTIONS OF, ITS OFFICERS AND MEMBERS OF ITS BOARD OF DIRECTORS (DIRECTORS). THE BOARD OF DIRECTORS (BOARD) IS RESPONSIBLE FOR ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY. AN OFFICER OR DIRECTOR OF THE ORGANIZATION HAS AN "INTEREST" IN A GIVEN MATTER IF HE OR SHE HAS, DIRECTLY OR INDIRECTLY, THROUGH AN IMMEDIATE FAMILY MEMBER, A BUSINESS, FINANCIAL, FIDUCIARY OR PERSONAL RELATIONSHIP WITH A PARTY OR PARTIES AS DESCRIBED WITHIN THE ORGANIZATION'S BYLAWS. THE ORGANIZATION REQUIRES CURRENT AND PROSPECTIVE OFFICERS AND DIRECTORS TO DISCLOSE IN WRITING, AND UPDATE ANNUALLY, ALL INTERESTS WHICH MAY CREATE A CONFLICT OF INTEREST AND, WHERE APPLICABLE, PROVIDE A STATEMENT SUGGESTING HOW SUCH CONFLICT COULD BE AVOIDED OR MITIGATED. OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE IN WRITING ANY INTERESTS THAT ARISE AFTER FILING THE ANNUAL DISCLOSURE. THE BOARD, OR A DULY DESIGNATED COMMITTEE, REVIEWS INSTANCES WHERE A DISCLOSURE INDICATES A POTENTIAL CONFLICT OF INTEREST. THE INDIVIDUAL WITH THE POTENTIAL CONFLICT IS REQUIRED TO PROVIDE INFORMATION REQUESTED BY, AND RESPOND TO QUESTIONS FROM, THE BOARD OR ITS DESIGNATED COMMITTEE. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL FAILED TO DISCLOSE AN INTEREST, THE INDIVIDUAL MUST BE INFORMED OF THIS AND GIVEN THE OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE INDIVIDUAL'S RESPONSE, AND CONDUCTING FURTHER INVESTIGATION AS NEEDED, IF THE BOARD DETERMINES THE INDIVIDUAL HAS FAILED TO DISCLOSE AN INTEREST AS DEFINED IN ACCORDANCE WITH THE ORGANIZATION'S BYLAWS, THE BOARD WILL TAKE APPROPRIATE CORRECTIVE AND/OR DISCIPLINARY ACTION. POLICIES FORM 990, PART VI, LINES 13 & 14 PURSUANT TO THE INSTRUCTIONS FOR FORM 990, THE ORGANIZATION MUST ANSWER NO TO QUESTIONS 13 & 14 BECAUSE THE BOARD OF DIRECTORS HAS NOT YET FORMALLY ADOPTED THESE POLICIES. HOWEVER, THE ORGANIZATION HAS ISSUED THESE POLICIES AT THE DIRECTION OF MANAGEMENT AND THESE POLICIES AND PROCEDURES ARE STRICTLY ENFORCED BY THE ORGANIZATION'S MANAGEMENT TEAM. THE ORGANIZATION HAS WRITTEN WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES. OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A & 15B THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CONTRACT OF THE CEO AND ANY CHANGES TO THE CONTRACT. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER BASED ON COMPENSATION SURVEYS. THE EXECUTIVE COMMITTEE SUBSCRIBES TO THREE OR FOUR SALARY SURVEYS THAT LIST SALARY AND SALARY INCREASES BY POSITION, GEOGRAPHY, PLAN SIZE AND PROFIT VS. NON-PROFIT ORGANIZATIONS. THESE SURVEYS ARE USED TO SET COMPENSATION ANNUALLY. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S LOCATION AT 910 DOUGLAS PIKE, SMITHFIELD, RI 02917. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN NON-ADMITTED ASSETS ($5,262,829) ROUNDING ($956) ------------ TOTAL ($5,263,785) ACCOUNTING METHOD USED TO PREPARE THE FORM 990 FORM 990, PART XII, LINE 1a THE ORGANIZATION'S STATUTORY FINANCIAL STATEMENTS ARE PRESENTED ON THE BASIS OF ACCOUNTING PRATICES PRESCRIBED OR PERMITTED BY THE DBR. THE DBR HAS ADPOTED THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' STATUTORY ACCOUNTING PRATICES (NAIC SAP) AS THE BASIS OF ITS STATUTORY ACCOUNTING PRATICES (SAP)