2019-11-04T08:11:51-06:00 2018-12-31 161131146 BONADIO & CO LLP 6 WEMBLEY CT ALBANY NY 12205 990 2018-01-01 141641028 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN INC CAPI 5186414085 500 PATROON CREEK BLVD ALBANY NY 122061057 BETHANY SMITH SVP FINANCE, CFO 5186414085 2019-10-21 1 GLORIA M NOSTRAMO P01385068 5184644080 2019-10-21 24.103.149.254 2019-10-21 16:00:18 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0E5F91F65C498096414EBC24C61E85079E3E5A5A 2018 2020-04-17 16:48:07Z BETHANY SMITH 500 PATROON CREEK BLVD ALBANY NY 122061057 1546286766 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 1251 0 0 199084 0 0 1442558514 1513648272 5497236 5924732 -72224 389937 1447983526 1519962941 89995 830044 1278983822 1299303932 84802028 92919738 0 0 0 64670568 83954114 1428546413 1477007828 19437113 42955113 564420374 623455338 204919672 219337641 359500702 404117697 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 463677863 830044 497525326 CDPHP PROVIDES HEALTH CARE BENEFITS TO EMPLOYER GROUP MEMBERS AND INDIVIDUALS IN OUR COMMUNITY. AS OF DECEMBER 31, 2018, 71,525 MEMBERS WERE ENROLLED IN COMMERCIAL PRODUCTS. 482487064 503851430 CDPHP'S MEDICAID AND HARP PROGRAMS PROVIDE HEALTH CARE BENEFITS TO 83,842 MEMBERS IN NEW YORK STATE. 447033838 468325240 CDPHP'S MEDICARE PROGRAM PROVIDES HEALTH CARE BENEFITS TO 39,113 MEMBERS IN NEW YORK STATE. -1485 FAMILY HEALTH PLUS - 0 MEMBERS 6617250 6858368 HEALTHY NEW YORK - 1,872 MEMBERS 31972821 37087908 CHILD HEALTH PLUS - 13,172 MEMBERS 38588586 43946276 1431787351 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 1 1 0 0 0 0 0 1 1 1 0 1 4214 0 1 1251 1 0 1 BD 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 6.20 X X 68548 0 0 THOMAS J MARUSAK DIRECTOR 7.80 X 68350 0 0 SUSAN CROSBY SCRIMSHAW DIRECTOR 5.10 X 45950 0 0 JOSEPH POLITO II MD DIRECTOR 5.70 X 23050 0 0 JOSEPH J DUDEK MD DIRECTOR 1.90 X 25550 0 0 HOLLY K CLENEY MD DIRECTOR 1.90 X 27250 0 0 HENRY M NEILLEY MD DIRECTOR 3.50 X 35450 0 0 GERALD JENNINGS DIRECTOR 3.80 X 43450 0 0 AMY JOHNSON DIRECTOR 6.50 X 57250 0 0 CATHERINE BARTHOLOMEW MD DIRECTOR 3.80 X 35650 0 0 ANTHONY J MARINELLO MD DIRECTOR/SVP PRIMARY CARE MED SERVICES 40.00 X 259869 0 7605 MICHAEL DEVITO DIRECTOR 5.25 X 13300 0 0 CARMEN MAZZOTTA DIRECTOR 8.10 X 61150 0 0 WILLIAM P PHELAN SECRETARY 7.50 X X 73150 0 0 RICHARD E GRANT TREASURER OF THE BOARD 8.90 X X 82350 0 0 BRUCE E COPLIN MD VICE CHAIRMAN OF THE BOARD 7.00 X X 53950 0 0 JOHN D BENNETT MD CEO/PRESIDENT 40.00 X 1286004 0 27536 BRIAN O'GRADY EVP COMMERCIAL BUSINESS/CMO 40.00 X 484350 0 30953 BARBARA DOWNS EVP CORP ADMIN/COO 40.00 X 763487 0 18519 BETHANY SMITH EVP FINANCE AND CFO 40.00 X 608391 0 31453 FREDERICK GALT ESQ EVP GENERAL COUNSEL 40.00 X 522270 0 27553 ROBERT HINCKLEY EVP STRATEGY COMM AND CSO 40.00 X 510306 0 31721 BRIAN MORRISSEY EVP MARKETING/CMO 40.00 X 621933 0 30953 RICHARD DAL COL EVP CHIEF MEDICAL OFFICER 40.00 X 523425 0 8550 NEIL BRANDMAIER SVP CHIEF INFORMATION OFFI 40.00 X 460446 0 29488 SCOTT KLENK SVP HUMAN CAPITAL MANAGEME 40.00 X 447616 0 15069 PATRICIA LUSHKEVICH SVP INTERNAL OPERATIONS 40.00 X 382071 0 28960 UMESH REGE SVP INFORMATION TECHNOLOGY CIO 40.00 X 437350 0 29378 ROBERT LITTLE VP UNDERWRITING 40.00 X 402285 0 16759 8424201 0 334497 314 0 1 0 LANDMARK HEALTH LLC 7755 CENTER AVE STE 630 HUNTINGTON CA 92647 HEALTHCARE SERVICES 17583056 SYNTEL INC 525 E BIG BEAVER RD SUITE 300 TROY MI 48083 IT PROCESSING AND CONSULTING 11414479 WELLTOK INC 6061 SOUTH WILLOW DRIVE GREENWOOD VILLAGE CO 80111 WELLNESS PROMOTIONS 5010927 SALESFORCECOM INC PO BOX 203141 DALLAS TX 75320 IT PROCESSING AND CONSULTING 2579516 CHANGE HEALTHCARE LLC 3055 LEBANON PIKE NASHVILLE TN 37214 PRINT AND MAIL SERVICES 2499786 95 MEDICAID PREMIUMS 524114 503851430 503851430 COMMERCIAL PREMIUMS 524114 497525326 497525326 MEDICARE PREMIUMS 524114 468325240 468325240 CHILD HEALTH PLUS PREMIUMS 524114 37087908 37087908 HEALTHY NEW YORK PREMIUMS 524114 6858368 6858368 1513648272 5927460 5927460 26321097 26323825 -2728 -2728 -2728 AGGREGATE WRITE-INS FOR OTHER INC 524114 389937 389937 389937 1519962941 1513648272 0 6314669 830044 830044 1299303932 1299303932 4157794 1797217 2360577 67187466 44228100 22959366 6211159 4067999 2143160 10466745 6021570 4445175 4896574 3223312 1673262 214999 171999 43000 344345 275476 68869 196269 196269 336740 336740 6513044 6513044 5199126 2732663 2466463 15442864 14979578 463286 2963074 1481537 1481537 961636 673145 288491 75585 75585 222769 178215 44554 3313021 2319115 993906 652436 652436 CONSULTING AND OUTSOURC 19627926 15599008 4028918 FEDERAL AND STATE ASSES 17662958 17662958 BROKER COMMISSIONS 8169939 8169939 MISCELLANEOUS 2057383 1558500 498883 1477007828 1431787351 45220477 0 60522418 80590956 98645174 104334789 7894110 10116213 97760081 74887850 17677286 22872231 216403722 231896972 162393623 170288195 884041 3355982 564420374 623455338 195721345 209498850 4078254 5783872 5120073 4054919 204919672 219337641 X 359500702 404117697 359500702 404117697 564420374 623455338 X 42955113 -6225090 7886972 X 0 1 X 1 1 1 2000 2000 1 CDPHP PAC 121 STATE STREET ALBANY NY 12207 800957344 2000 0 0 0 0 196269 196269 196269 0 196269 9518042 3223912 6294130 82584513 71663938 10920575 5657526 5657526 22872231 INVESTMENT IN CDPHN 28945635 F INVESTMENT IN CDPHP UBI 134481201 F INVESTMENT IN CARTER, LTD. 6610391 F INVESTMENT IN CDPHP FOUNDATION, INC. 250968 F 170288195 CLAIM ADJUSTMENT EXPENSE LIABILITY 4054919 4054919 X 1527127864 9227571 9227571 1517900293 336740 1725909 2062649 1519962942 1476285778 1340599 1340599 1474945179 336740 1725909 2062649 1477007828 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 1,340,599. CURRENT YEAR EQUITY METHOD LOSS ON INVESTMENT IN SUBSIDIARIES 7,894,571. STATUTORY DIFFERENCE IN BOND AMORTIZATION -7,599. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER REINSURANCE EXPENSE NETTED IN AUDITED PREMIUMS 1,725,909. PART XII, LINE 2D - OTHER ADJUSTMENTS: GROSS EXPENSES ON SUPPORT SERVICES 1,340,599. PART XII, LINE 4B - OTHER ADJUSTMENTS: REINSURANCE EXPENSE 1,725,909. 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 0 0 INVESTMENT 6610391 0 0 0 0 0 0 6610391 0 6610391 0 0 1 0 0 0 1 CDPHP FOUNDATION INC 500 PATROON CREEK BLVD ALBANY NY 12206 471619130 501(C)(3) 247708 65671 FMV DONATED GOODS/SERVICES OPERATING GRANT RENSSELAER POLYTECHNIC INSTITUTE 110 8TH ST TROY NY 12180 141340095 501(C)(3) 516665 0 FMV VALUE BASED ANALYTICS 2 0 PART 1, LINE 2 EXPLANATION: GRANTS ARE PROVIDED TO THE FOUNDATION FOR USE TO OTHER CHARITABLE ORGANIZATIONS AND ADMINISTRATION OF THE FOUNDATION. THE ALLOCATED PORTION OF THE GRANT TO RENSSELAER POLYTECHNIC INSTITUTE PROVIDES FUNDING UNDER THE TERMS OF A WRITTEN CONTRACT. 1 X X X X X 1 1 0 0 0 0 0 1 0 ANTHONY J MARINELLO MD DIRECTOR/SVP PRIMARY CARE MED SERVIC 238824 0 325 0 20720 0 7530 0 75 0 267474 0 0 0 JOHN D BENNETT MD CEO/PRESIDENT 781777 0 469467 0 34760 0 8550 0 18986 0 1313540 0 0 0 BRIAN O'GRADY EVP COMMERCIAL BUSINESS/CMO 336027 0 104436 0 43887 0 8550 0 22403 0 515303 0 0 0 BARBARA DOWNS EVP CORP ADMIN/COO 543364 0 191253 0 28870 0 8550 0 9969 0 782006 0 0 0 BETHANY SMITH EVP FINANCE AND CFO 434139 0 153697 0 20555 0 8550 0 22903 0 639844 0 0 0 FREDERICK GALT ESQ EVP GENERAL COUNSEL 356755 0 119773 0 45742 0 8550 0 19003 0 549823 0 0 0 ROBERT HINCKLEY EVP STRATEGY COMM AND CSO 346932 0 117676 0 45698 0 8550 0 23171 0 542027 0 0 0 BRIAN MORRISSEY EVP MARKETING/CMO 389029 0 192917 0 39987 0 8550 0 22403 0 652886 0 0 0 RICHARD DAL COL EVP CHIEF MEDICAL OFFICER 362690 0 113901 0 46834 0 8550 0 0 0 531975 0 0 0 NEIL BRANDMAIER SVP CHIEF INFORMATION OFFI 162223 0 110316 0 187907 0 8550 0 20938 0 489934 0 0 0 SCOTT KLENK SVP HUMAN CAPITAL MANAGEME 307384 0 111123 0 29109 0 8550 0 6519 0 462685 0 0 0 PATRICIA LUSHKEVICH SVP INTERNAL OPERATIONS 259298 0 95786 0 26987 0 7397 0 21563 0 411031 0 0 0 UMESH REGE SVP INFORMATION TECHNOLOGY CIO 288730 0 103228 0 45392 0 8550 0 20828 0 466728 0 0 0 ROBERT LITTLE VP UNDERWRITING 259584 0 100192 0 42509 0 8550 0 8209 0 419044 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 2018. NEIL BRANDMAIER RECEIVED $157,707 AS PART OF A SEVERENCE AGREEMENT DURING 2018. 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. CAPITAL REGION OTOLARYNGOLOGY HEAD & NECK GROUP LLP MICHAEL A. DEVITO MD 661128 SEE EXPLANATION BELOW 0 ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATION BRUCE E. COPLIN MD 17985494 SEE EXPLANATION BELOW 0 ALBANY MEDICAL COLLEGE CATHERINE R. BARTHOLOMEW MD 31973873 SEE EXPLANATION BELOW 0 COMMUNITY CARE PHYSICIANS PC ANTHONY J. MARINELLO MD 48039802 SEE EXPLANATION BELOW 0 CAP DISTRICT COLONRECTAL SURG ASSOC GENNARO A. DANIELS MD 396889 SEE EXPLANATION BELOW 0 ALBANY GASTROENTEROLOGY CONSULTANTS PLLC JOSEPH M. POLITO II MD 5373960 SEE EXPLANATION BELOW 0 NEW YORK ONCOLOGY HEMATOLOGY PC JOSEPH JAMES DUDEK MD 23364766 SEE EXPLANATION BELOW 0 SHAKER PEDIATRICS PC HENRY M. NEILLEY MD 901835 SEE EXPLANATION BELOW 0 COMMUNITY CARE PHYSICIANS PC HOLLY KRICK CLENEY 48039802 SEE EXPLANATION BELOW 0 FORM 990, SCHEDULE L, PART IV, LINES 2-9, COLUMN D: PURSUANT TO ITS CERTIFICATE OF INCORPORATION AND BY-LAWS, EIGHT OF THE MEMBERS OF THE CDPHP BOARD OF DIRECTORS MUST BE PRACTICING PHYSICIANS. 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 589 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 BY THE DIRECTOR OF ACCOUNTING AND REGULATORY REPORTING AND THE CFO. IT IS THEN PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. FINALLY, IT IS PRESENTED TO THE BOARD FOR REVIEW AND APPROVAL. 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 7,894,571. STATUTORY DIFFERENCE IN BOND AMORTIZATION -7,599. 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 N/A C 27252553 32195961 1.00000 0 CARTER INSURANCE COMPANY LTD 40 CHURCH ST PO BOX HM2062 HAMILTON BD 141641028 CAPTIVE REINSURANCE BD N/A C 2558792 8200856 1.00000 0 CDPHP UNIVERSAL BENEFITS INC 500 PATROON CRK BLVD ALBANY NY 12206 161520935 ARTICLE 43 INSURANCE NY N/A C 567187454 211196337 1.00000 0 PRACTICE SUPPORT SERVICES LLC 500 PATROON CRK BLVD ALBANY NY 12206 611803877 CONSULTING NY N/A C 1.00000 0 ACUITAS HEALTH LLC 500 PATROON CRK BLVD ALBANY NY 12206 821422585 CONSULTING NY N/A C 0.65000 0 STRATEGIC SOLUTIONS MANAGEMENT 429 CLIFTON CORP PKWY CLIFTON PARK NY 12065 141814293 BILLING AND CONSULTING NY N/A C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC N 2327176 ALLOCATION CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC O 7554004 ALLOCATION CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC Q 5357103 ALLOCATION CDPHP UNIVERSAL BENEFITS INC N 7910615 ALLOCATION CDPHP UNIVERSAL BENEFITS INC O 25668449 ALLOCATION CDPHP UNIVERSAL BENEFITS INC Q 18294582 ALLOCATION