TUFTS HEALTH PUBLIC PLANS INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
TUFTS HEALTH PUBLIC PLANS INC (EIN 80-0721489)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201913189349309176
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-14T13:55:56-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12100 ONE PPG PLACEAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15222ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN800721489EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TUFTS HEALTH PUBLIC PLANS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% UMESH KURPADInCareOfNm
Business Name ControlTUFTBusinessNameControlTxt
Phone6179729400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 MOUNT AUBURN STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02472ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROLAND PRICEPersonNm
Person TitleVPPersonTitleTxt
Phone6179729400PhoneNum
Signature2019-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEILEEN WEBBPreparerPersonNm
PTINP01641852PTIN
Phone4126447800PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address164.57.159.254IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id04750420193185000021FederalOriginalSubmissionId
Federal Original Submission Id2019-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4D246B334FDE1475AEF91B82CBC01055CBF82DD5AtSubmissionCreationDeviceId
At Submission Filing Device IdA5F2FECDAE8DB169B1E75CE6C5EFBEE0D18B6ED7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS CROSWELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 MOUNT AUBURN STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP024721508ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,302,584,058GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.TUFTSHEALTHPLAN.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2014FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES SERVED BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee621TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$97,214NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$1,792,531,048PYProgramServiceRevenueAmt
CY Program Service Revenue$2,151,844,335CYProgramServiceRevenueAmt
PY Investment Income$15,317,372PYInvestmentIncomeAmt
CY Investment Income$28,690,511CYInvestmentIncomeAmt
PY Other Revenue$10,438PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,807,858,858PYTotalRevenueAmt
CY Total Revenue$2,180,534,846CYTotalRevenueAmt
PY Grants And Similar Paid$112,478PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$167,696CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$1,655,188,239PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$1,927,352,166CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$41,253,909PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,609,296CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$117,439,642PYOtherExpensesAmt
CY Other Expenses$155,441,999CYOtherExpensesAmt
PY Total Expenses$1,813,994,268PYTotalExpensesAmt
CY Total Expenses$2,126,571,157CYTotalExpensesAmt
PY Revenues Less Expenses-$6,135,410PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$53,963,689CYRevenuesLessExpensesAmt
Total Assets BOY$588,373,246TotalAssetsBOYAmt
Total Assets EOY$653,961,790TotalAssetsEOYAmt
Total Liabilities BOY$341,043,016TotalLiabilitiesBOYAmt
Total Liabilities EOY$375,232,331TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$247,330,230NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$278,729,459NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,459,373,067ExpenseAmt
Grant$118,383GrantAmt
Revenue$1,519,067,522RevenueAmt
DescTUFTS HEALTH TOGETHER IS THE NAME OF THPP'S MASSACHUSETTS MEDICAID MCO AND ACO PLANS THAT PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. MASSHEALTH IS THE NAME OF THE MASSACHUSETTS MEDICAID PROGRAM FUNDED BY THE FEDERAL GOVERNMENT AND THE STATE. MASSHEALTH HELPS PEOPLE WITH LIMITED INCOMES AND RESOURCES PAY FOR MEDICAL AND SUPPORT SERVICES. IT ALSO COVERS EXTRA SERVICES AND DRUGS NOT COVERED BY MEDICARE. TO BE ELIGIBLE FOR MASSHEALTH, YOU MUST BE A MASSACHUSETTS RESIDENT WITH LOW TO MODERATE INCOME. (See Schedule O)Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$507,387,019ExpenseAmt
Grant$41,159GrantAmt
Revenue$528,141,267RevenueAmt
DescTUFTS HEALTH DIRECT IS AN INDIVIDUAL AND SMALL GROUP QUALIFIED HEALTH PLAN (QHP) ESTABLISHED BY THE ORGANIZATION AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT TO PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES WHO ARE NOT ELIGIBLE FOR AFFORDABLE EMPLOYER-SPONSORED INSURANCE, AND SMALL EMPLOYER GROUPS WITH 1-50 EMPLOYEES. (See Schedule O)Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$62,857,135ExpenseAmt
Grant$5,098GrantAmt
Revenue$65,428,254RevenueAmt
DescTUFTS HEALTH UNIFY IS A MEDICARE-MEDICAID PLAN FOR INDIVIDUALS AGE 21-64 WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. TUFTS HEALTH UNIFY IS ONE OF TWO MASSACHUSETTS ONECARE PLANS PARTICIPATING IN THE FINANCIAL ALIGNMENT INITIATIVE ('DUALS DEMONSTRATION') TO INTEGRATE BENEFITS AND CARE FOR MEDICARE-MEDICAID ENROLLEES. THE PLAN CONTRACTS WITH THE CENTER FOR MEDICARE AND MEDICAID SERVICES AND MASSHEALTH TO PROVIDE THE BENEFITS OF BOTH PROGRAMS TO LOW AND MODERATE INCOME INDIVIDUALS WITH DISABILITIES. (See Schedule O)Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$37,666,571TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$3,056TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$39,207,292TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$2,067,283,792TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document7035IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee621EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonUMESH KURPADPersonNm
Phone6179729400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 MOUNT AUBURN STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02472ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Thomas Croswell
DIRECTOR & CEO15.035.0Yes (X)Yes (X)$0$2,040,778$181,001
Umesh Kurpad
DIRECTOR & CFO15.035.0Yes (X)Yes (X)$0$1,049,619$118,128
Mary Mahoney
DIR/CLERK/SVP/CLO15.035.0Yes (X)Yes (X)$0$686,137$77,195
MARC SPOONER
EXECUTIVE VP15.035.0Yes (X)$0$874,432$310,065
ROLAND PRICE
TREASURER10.040.0Yes (X)$0$450,360$69,217
TRACEY B CARTER
SVP/Chief Actuary15.035.0Yes (X)$0$678,692$182,852
MAURICE HEBERT
SVP, Finance & CAO (THRU 9/18)15.035.0Yes (X)$0$595,210$43,242
JEAN YANG
PRES OF PUB PLANS50.00.0Yes (X)$0$327,958$51,383
BARRIE BAKER
VP, CMO PUB PLANS50.00.0$0$447,646$32,552Yes (X)
DAVID WEBSTER
VP, FIN&NTWK CNTRCTG Pub Plans45.05.0$0$410,016$19,100Yes (X)
Helene Forte
VP, RI Market Public Plans50.00.0$0$323,620$56,218Yes (X)
Duke Dufresne
Medical Director50.00.0$0$357,419$33,377Yes (X)
SUSAN ALBERT
VP, POPULATION HEALTH15.035.0$0$275,302$115,981Yes (X)
James Roosevelt Jr
FORMER OFFICER (THRU 1/16)15.035.0$0$185,748$7,430Yes (X)
Christopher Gorton
FORMER DIR/PRES (THRU 12/17)0.00.0$0$650,968$13,706Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$9,353,905TotReportableCompRltdOrgAmt
Total Other Compensation$1,311,447TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Insight Global LLC
4170 Ashford Dunwoody Rd NEAtlantaGA30319Outside labor$5,859,274
CDR Associates LLC
307 International CircleHunt ValleyMD21030Outsourcing$5,818,784
Healthcare Financial Inc
2 Hertiage Drive 7th FlQuincyMA02171Consulting$3,603,868
Interglobal Communication
67 Millbrook St Ste 423WorcesterMA01606Outsourcing$1,689,323
Beacon Hill Staffing Group LLC
152 Bowdoin StBostonMA02108Outside labor$1,404,917
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Together (Medicaid)524114$1,519,067,522$1,519,067,522
MA ACA Exchange524114$528,141,267$528,141,267
Care One (Medicare/Medica524114$65,428,254$65,428,254
RI Together (Medicaid)524114$39,207,292$39,207,292
FieldValueIRS element (for citing)
Total Program Service Revenue$2,151,844,335TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,008,580TotalRevenueColumnAmt
Exclusion$17,008,580ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$133,731,143SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$122,049,212SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$11,681,931SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,681,931TotalRevenueColumnAmt
Exclusion$11,681,931ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,180,534,846TotalRevenueColumnAmt
Related Or Exempt Func Income$2,151,844,335RelatedOrExemptFuncIncomeAmt
Exclusion$28,690,511ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$167,696TotalAmt
Program Services$167,696ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$1,927,352,166TotalAmt
Program Services$1,927,352,166ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,984,415TotalAmt
Program Services$33,984,415ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$9,624,881TotalAmt
Program Services$9,624,881ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$91,414,431TotalAmt
Program Services$73,131,545ProgramServicesAmt
Management And General$18,282,886ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$159,729TotalAmt
Management And General$159,729ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$480,952TotalAmt
Program Services$0ProgramServicesAmt
Management And General$480,952ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$98,068TotalAmt
Program Services$0ProgramServicesAmt
Management And General$98,068ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$35,054,343TotalAmt
Program Services$0ProgramServicesAmt
Management And General$35,054,343ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,656,036TotalAmt
Program Services$2,924,829ProgramServicesAmt
Management And General$731,207ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,621,448TotalAmt
Program Services$0ProgramServicesAmt
Management And General$1,621,448ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,223,064TotalAmt
Program Services$4,178,451ProgramServicesAmt
Management And General$1,044,613ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$488,130TotalAmt
Program Services$0ProgramServicesAmt
Management And General$488,130ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$174,085TotalAmt
Program Services$139,268ProgramServicesAmt
Management And General$34,817ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$110,844TotalAmt
Program Services$110,844ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$186,168TotalAmt
Program Services$148,935ProgramServicesAmt
Management And General$37,233ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,822,961TotalAmt
Program Services$3,858,369ProgramServicesAmt
Management And General$964,592ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$454,291TotalAmt
Program Services$0ProgramServicesAmt
Management And General$454,291ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
HIF Fee$17,711,748$17,711,748$0$0
COB Fees$921,708$0$921,708$0
Claims Interest$619,528$619,528$0$0
Licensing Fees$580,568$0$580,568$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total-$8,336,103TotalAmt
Program Services-$6,668,883ProgramServicesAmt
Management And General-$1,667,220ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,126,571,157TotalAmt
Program Services$2,067,283,792ProgramServicesAmt
Management And General$59,287,365ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$59,570,722BOYAmt
EOY$76,437,962EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,070,551BOYAmt
EOY$53,523,974EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,798,035LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,197,433LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,183,223BOYAmt
EOY$3,600,602EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$454,682,451BOYAmt
EOY$462,569,535EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,000,000BOYAmt
EOY$2,000,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,866,299BOYAmt
EOY$55,829,717EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$588,373,246BOYAmt
EOY$653,961,790EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$326,031,462BOYAmt
EOY$362,815,910EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,011,554BOYAmt
EOY$12,416,421EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$341,043,016BOYAmt
EOY$375,232,331EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$247,330,230BOYAmt
EOY$278,729,459EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$247,330,230BOYAmt
EOY$278,729,459EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$588,373,246BOYAmt
EOY$653,961,790EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$53,963,689ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$39,375,410NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$16,810,950OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,798,035OtherCostOrOtherBasisAmt
Depreciation$6,197,433DepreciationAmt
Book Value$3,600,602BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$3,600,602TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
Rx Rebates$42,659,390
HIF Fee Receivable$13,170,327
FieldValueIRS element (for citing)
Total Book Value Other Assets$55,829,717TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Payable to Affiliates$8,673,414
Premiums received in advance$3,743,007
FieldValueIRS element (for citing)
Total Liability$12,416,421TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$2,180,436,778TotalRevEtcAuditedFinclStmtAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$2,180,436,778RevenueSubtotalAmt
Investment Expenses Not Incld$98,068InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$98,068RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,180,534,846TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,126,473,089TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$2,126,473,089ExpensesSubtotalAmt
Investment Expenses Not Incld2$98,068InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$98,068ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,126,571,157TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationASC 740 (FKA FIN 48) FOOTNOTE IN 2018, THE AUDITED FINANCIAL STATEMENTS FOR TUFTS HEALTH PUBLIC PLANS, INC. DID NOT DISCLOSE AN ASC 740 FOOTNOTE.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
Friendly House Inc
36 Wall StWorcesterMA01604042104239501(c)(3)$6,000$0Sponsorship
Community Rowing Inc
20 Nonantum RdBrightonMA02135042863756501(c)(3)$10,000$0Inclusive rowing
The Latino Health Insurnace Program Inc
88 Waverly St 1st FlFraminghamMA01702300614874501(c)(3)$10,000$0Take care of yourself
Boys & Girls Club of Providence
550 Wickenden StProvidenceRI02903050258929501(c)(3)$10,000$0150th Anniversary Celebration
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE I, Part I, LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION ONLY CONTRIBUTES TO TAX-EXEMPT ORGANIZATIONS UNDER 501(C)(3) AND CERTAIN GOVERNMENTAL UNITS AS WELL AS SPONSORS EVENTS THAT BENEFIT THESE TYPES OF ORGANIZATIONS. THE ORGANIZATION CONTRIBUTES TO WELL ESTABLISHED, NON-PROFIT ORGANIZATIONS THAT HAVE ESTABLISHED POLICIES AND PROCEDURES FOR MONITORING THE USE OF FUNDS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (true)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BARRIE BAKER
VP, CMO PUB PLANS$127,985$111,153$208,508$19,093$13,459$480,198
DAVID WEBSTER
VP, FIN&NTWK CNTRCTG Pub Plans$258,371$98,105$53,540$19,100$429,116
James Roosevelt Jr
FORMER OFFICER (THRU 1/16)$185,748$7,430$193,178
Thomas Croswell
DIRECTOR & CEO$943,991$952,297$144,490$174,223$6,778$2,221,779$142,339
Umesh Kurpad
DIRECTOR & CFO$534,228$443,480$71,911$105,831$12,297$1,167,747$74,519
Christopher Gorton
FORMER DIR/PRES (THRU 12/17)$267,707$383,261$8,100$5,606$664,674
Mary Mahoney
DIR/CLERK/SVP/CLO$387,923$252,607$45,607$75,811$1,384$763,332$43,568
Helene Forte
VP, RI Market Public Plans$236,502$85,894$1,224$55,358$860$379,838
MARC SPOONER
EXECUTIVE VP$471,215$355,091$48,126$292,181$17,884$1,184,497$56,473
ROLAND PRICE
TREASURER$264,050$150,698$35,612$57,556$11,661$519,577$29,423
TRACEY B CARTER
SVP/Chief Actuary$372,005$267,065$39,622$165,101$17,751$861,544$46,680
MAURICE HEBERT
SVP, Finance & CAO (THRU 9/18)$277,413$269,259$48,538$30,600$12,642$638,452
Duke Dufresne
Medical Director$287,964$72,643-$3,188$17,178$16,199$390,796
JEAN YANG
PRES OF PUB PLANS$329,808-$1,850$43,981$7,402$379,341
SUSAN ALBERT
VP, POPULATION HEALTH$208,765$73,368-$6,831$98,649$17,332$391,283

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 3SUPPLEMENTAL COMPENSATION INFORMATION TUFTS HEALTH PUBLIC PLANS, INC. USES THE COMPENSATION POLICIES OF ITS SOLE MEMBER, TUFTS HEALTH PLAN, INC. SCHEDULE J, PART I, LINE 4A CHRISTOPHER GORTON RECEIVED $367,729 IN SEVERANCE. BARRIE BAKER RECEIVED $176,866 IN SEVERANCE.
FORM 990, SCHEDULE J, PART I, LINE 4BTHE RELATED ORGANIZATION MAINTAINS AN EXECUTIVE SAVINGS PLAN (ESP) FOR ITS SENIOR MANAGERS WITH THE TITLE DIRECTOR AND ABOVE. THE NUMBERS LISTED ON SCHEDULE J PART II COLUMN C REFLECT BOTH THE EMPLOYEE DEFERRALS AS WELL AS THE EMPLOYER CONTRIBUTIONS TO THE ESP.
FORM 990, SCHEDULE J, PART I, LINE 6THE OFFICERS AND KEY EMPLOYEES OF TUFTS HEALTH PUBLIC PLANS PARTICIPATE IN AN EXECUTIVE INCENTIVE PLAN THAT IS BASED ON THE OVERALL ANNUAL SUCCESS OF THE ORGANIZATION. THE ORGANIZATION'S GOALS ARE ESTABLISHED EARLY IN THE YEAR AND APPROVED BY ITS INDEPENDENT BOARD OF DIRECTORS. ONE OF THE COMPONENTS OF THE PLAN IS BASED ON MEETING TARGETED OPERATING EARNINGS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1THE PURPOSE OF TUFTS HEALTH PUBLIC PLANS, INC. ("THPP", OR THE "ORGANIZATION") IS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES IT SERVES BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING PROVIDING COMMUNITY OUTREACH AND EDUCATION TO THE COMMUNITY IT SERVES. THE ORGANIZATION AIMS TO IMPROVE THE LIVES OF MASSACHUSETTS RESIDENTS AND RHODE ISLAND RESIDENTS BY PROVIDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH CARE, PRIMARILY THROUGH MANAGED CARE PROGRAMS DIRECTED AT LOW TO MODERATE INCOME RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS AND STATE OF RHODE ISLAND. ACCESS IS PROVIDED THROUGH PROGRAMS SUCH AS, BUT NOT LIMITED TO, MASSHEALTH AND THE COMMONWEALTH OF MASSACHUSETTS MEDICAID MANAGED CARE ORGANIZATION (MCO) AND ACCOUNTABLE CARE ORGANIZATION (ACO) PLANS AND PROVIDING COVERAGE TO MASSACHUSETTS RESIDENTS ELIGIBLE FOR MEDICAID OR THE CHILDREN'S HEALTH INSURANCE PROGRAM. THE ORGANIZATION ALSO OFFERS COVERAGE TO RHODE ISLAND rESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THE ORGANIZATION ALSO OFFERS SUBSIDIZED HEALTH PLANS TO LOW AND MIDDLE INCOME INDIVIDUALS THROUGH THE COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY (THE MASSACHUSETTS STATE RUN EXCHANGE), AS WELL AS THE ONECARE PROGRAM FOR MASSACHUSETTS RESIDENTS WHO ARE UNDER 65 YEARS OLD AND ELIGIBLE FOR BOTH MEDICARE AND MEDICAID WITH INTEGRATED, COORDINATED MEDICAL AND BEHAVIORAL HEALTHCARE.
FORM 990, PART III, LINE 1ORGANIZATION'S MISSION STATEMENT THE PURPOSE OF TUFTS HEALTH PUBLIC PLANS, INC. ("THPP", OR THE "ORGANIZATION") IS TO IMPROVE THE HEALTH AND WELLESS OF THE DIVERSE COMMUNITIES IT SERVES BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING PROVIDING COMMUNITY OUTREACH AND EDUCATION TO THE COMMUNITY IT SERVES. THE ORGANIZATION AIMS TO IMPROVE THE LIVES OF MASSACHUSETTS AND RHODE ISLAND RESIDENTS BY PROVIDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH CARE, PRIMARILY THROUGH MANAGED CARE PROGRAMS DIRECTED AT LOW TO MODERATE INCOME RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS AND STATE OF RHODE ISLAND. ACCESS IS PROVIDED THROUGH PROGRAMS SUCH AS, BUT NOT LIMITED TO, MASSHEALTH AND THE COMMONWEALTH OF MASSACHUSETTS MEDICAID MANAGED CARE ORGANIZATION (MCO), PROVIDING COVERAGE TO MASSACHUSETTS RESIDENTS ELIGIBLE FOR MEDICAID OR THE CHILDREN'S HEALTH INSURANCE PROGRAM. THE ORGANIZATION ALSO OFFERS SUBSIDIZED HEALTH PLANS TO LOW AND MIDDLE INCOME INDIVIDUALS THROUGH THE COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY THE MASSACHUSETTS STATE RUN EXCHANGE), AS WELL AS THE ONECARE PROGRAM FOR MEMBERS WHO ARE UNDER 65 YEARS OLD AND ELIGIBLE FOR BOTH MEDICARE AND MEDICAID WITH INTEGRATED, COORDINATED MEDICAL AND BEHAVIORAL HEALTH CARE. THE ORGANIZATION ALSO OFFERS COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THPP'S PRIMARY ACTIVITY IS TO PROVIDE HEALTH COVERAGE AND EDUCATION ABOUT BENEFITS TO LOW AND MODERATE INCOME RESIDENTS OF MASSACHUSETTS AND RHODE ISLAND THROUGH CONTRACTS WITH THE MASSACHUSETTS' COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY AND THE MASSACHUSETTS AND RHODE ISLAND EXECUTIVE OFFICES OF HEALTH AND HUMAN SERVICES. THE ORGANIZATION OFFERS FULLY INTEGRATED, IN-HOUSE CARE MANAGEMENT, PROVIDING A TEAM OF MEDICAL,BEHAVIORAL HEALTH, SOCIAL CARE AND PHARMACY PROFESSIONALS WHO COORDINATE MEMBER CARE. THE ORGANIZATION CONTRACTS WITH THOUSANDS OF PRIMARY CARE PHYSICIANS, SPECIALISTS, HOSPITALS AND COMMUNITY ORGANIZATIONS IN MASSACHUSETTS AND RHODE ISLAND. THE ORGANIZATION ENROLLS A SUBSTANTIAL NUMBER OF PERSONS WHO MAY OTHERWISE BE UNABLE TO OBTAIN AFFORDABLE HEALTH CARE SERVICES AS WELL AS THOSE POPULATIONS WHO HAVE SPECIAL HEALTH CARE NEEDS, SUCH AS DISABLED INDIVIDUALS BETWEEN 21-64 YEARS OLD ELIGIBLE FOR THE ORGANIZATION'S ONECARE DEMONSTRATION PROGRAM IN MASSACHUSETTS, AND THOSE INDIVIDUALS ELIGIBLE FOR THE ORGANIZATION'S MEDICAID PROGRAMS. THE ORGANIZATION PROVIDES ACCESS TO HEALTH CARE STATEWIDE, IN OVER 400 CITIES AND TOWNS IN MASSACHUSETTS AND OVER 50 CITIES AND TOWNS IN RHODE ISLAND THROUGH ITS EXTENSIVE PROVIDER NETWORK. THE ORGANIZATION'S ACTIVITIES FURTHER ITS EXEMPT PURPOSE OF PROVIDING COMPREHENSIVE HEALTH CARE SERVICES, OUTREACH, AND EDUCATION TO RESIDENTS OF MASSACHUSETTS AND RHODE ISLAND, MOST OF WHOM ARE LOW AND MODERATE INCOME. THE ORGANIZATION PROVIDES COMMUNITY AND PUBLIC BENEFITS BY ENSURING ACCESS TO NEEDED HEALTH CARE SERVICES BY LOW TO MODERATE INCOME, HIGH-RISK, AND MEDICALLY UNDERSERVED POPULATIONS THROUGH ITS PARTICIPATION IN MEDICARE-MEDICAID (DUAL ELIGIBLES) AND OTHER STATE PROGRAMS WHOSE PURPOSE IS TO SERVE SUCH POPULATIONS. THE ORGANIZATION OPERATES EXCLUSIVELY FOR THE PROMOTION OF SOCIAL WELFARE BY PRIMARILY ENGAGING IN ACTIVITIES THAT PROMOTE THE COMMON GOOD, GENERAL WELFARE, AND EDUCATION OF THE MASSACHUSETTS AND RHODE ISLAND COMMUNITIES. THE ORGANIZATION DOES THIS BY PROVIDING AND ENCOURAGING PREVENTIVE CARE TO THOSE WHO MIGHT OTHERWISE NOT RECEIVE SUCH CARE AND THE ABILITY TO SEEK HEALTH CARE SERVICES WHEN NEEDED TO THOSE WHO MIGHT NOT OTHERWISE BE ABLE TO AFFORD IT. AS PART OF THE ORGANIZATION'S EFFORTS TO EDUCATE AND ASSIST THE MULTICULTURAL POPULATION IT SERVES, THE ORGANIZATION ALSO MAINTAINS ONGOING EDUCATIONAL OUTREACH EFFORTS. THESE EFFORTS INCLUDE: 1) COMMUNITY OUTREACH REPRESENTATIVES WORKING WITH MEMBERS TO ENSURE ENGAGEMENT AND EDUCATION ON HEALTH CARE ACCESS AS WELL AS POTENTIAL ACCESS TO OTHER SOCIAL SERVICE PROGRAMS. 2) BUILDING RELATIONSHIPS WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THPP'S AUDIENCES, INCLUDING SMALL BUSINESSES THAT OFFER A WIDE RANGE OF SERVICES TO IMMIGRANT POPULATIONS. 3) PARTNERING WITH FINANCIAL COUNSELORS AT LOCAL HEALTH CENTERS TO OFFER ASSISTANCE WITH MEDICAID. 4) PARTNERING WITH LOCAL SOCIAL SERVICE, ADVOCACY ORGANIZATIONS TO GIVE PRESENTATIONS REGARDING HEALTH CARE ACCESS, AVAILABLE BENEFITS, AND PLAN OFFERINGS. 5) PARTNERING WITH LOCAL RELIGIOUS ORGANIZATIONS TO COORDINATE HEALTH AND WELLNESS EVENTS FOR THEIR DIVERSE CONGREGATIONS. 6) COMMUNITY OUTREACH REPRESENTATIVES SERVING AS CULTURAL EXPERTS FOR MEMBER OUTREACH EFFORTS, LOCAL MEDIA PRESENTATIONS, AND SPEAKING ENGAGEMENTS TO PROVIDE UP TO DATE INFORMATION ON HEALTH ACCESS AND THPP OFFERINGS IN A CULTURALLY COMPETENT MANNER. 7) PROVIDING IN-KIND, MONETARY, AND VOLUNTEER SUPPORT TO LOCAL COMMUNITY BASED ORGANIZATIONS, INCLUDING PRESENTING ON AND LEADING ACTIVITIES RELATED TO HEALTH AND WELLNESS. 8) PROVIDING IN-KIND AND VOLUNTEER SUPPORT TO OTHER LOCAL COMMUNITY INSTITUTIONS, SUCH AS FOOD PANTRIES AND HOMELESS SHELTERS.
FORM 990, PART III, LINE 4AMASSACHUSETTS MEDICAID COVERAGE THE ORGANIZATION PROVIDES ACCESS TO AFFORDABLE HEALTH CARE THROUGH A MEDICAID MANAGED CARE ORGANIZATION CONTRACT WITH THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. IN MARCH 2018, THPP WAS ALSO AWARDED FOUR (4) MEDICAID ACCOUNTABLE CARE ORGANIZATION CONTRACTS BY EOHHS IN ADDITION TO THE MANAGED CARE ORGANIZATION CONTRACT. THROUGH CONTRACTS WITH FOUR MASSACHUSETTS-BASED PROVIDER SYSTEMS, THPP PROVIDES MEDICAID MANAGED CARE CLOSELY ALIGNED WITH PRIMARY CARE PHYSICIANS AND COMMUNITY PARTNERS. TUFTS HEALTH TOGETHER IS THE NAME OF THPP'S MASSACHUSETTS MEDICAID MCO AND ACO PLANS THAT PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. MASSHEALTH IS THE NAME OF THE MASSACHUSETTS MEDICAID PROGRAM FUNDED BY THE FEDERAL GOVERNMENT AND THE STATE. MASSHEALTH HELPS PEOPLE WITH LIMITED INCOMES AND RESOURCES PAY FOR MEDICAL AND SUPPORT SERVICES. IT ALSO COVERS EXTRA SERVICES AND DRUGS NOT COVERED BY MEDICARE. TO BE ELIGIBLE FOR MASSHEALTH, YOU MUST BE A MASSACHUSETTS RESIDENT WITH LOW TO MODERATE INCOME. THE INCOME LIMITS DEPEND ON FAMILY SIZE, CATEGORY OF ELIGIBILITY, AND THE TYPE OF MASSHEALTH COVERAGE FOR WHICH AN INDIVIDUAL IS ELIGIBLE. FINANCIAL ELIGIBILITY IS BASED ON THE MODIFIED ADJUSTED GROSS INCOME ("MAGI"), WHICH IS COMPARED TO THE FPL. DIFFERENT MASSHEALTH CATEGORIES USE DIFFERENT PERCENTAGES OF THE FEDERAL POVERTY LEVEL ("FPL") AS THE THRESHOLD FOR FINANCIAL ELIGIBILITY. A FAMILY'S MAGI MUST BE NO GREATER THAN THE AMOUNT SHOWN IN THE FPL TABLES FOR THE INDIVIDUAL OR FAMILY'S CATEGORY AND FAMILY SIZE. TUFTS HEALTH TOGETHER PROVIDES LOW TO MODERATE INCOME INDIVIDUALS WITH ACCESS TO THOUSANDS OF HIGH QUALITY DOCTORS AND SPECIALISTS ACROSS THE STATE, SUPPORTIVE SERVICE REPRESENTATIVES, INFORMATION IN A NUMBER OF LANGUAGES, AS WELL AS PREVENTIVE MEASURES SUCH AS BIKE HELMETS AND HOME SAFETY KITS AT NO COST, INCENTIVES FOR HEALTHY BEHAVIORS, FITNESS REIMBURSEMENTS, AND OTHER IMPORTANT TOOLS TO PROMOTE HEALTH AND WELLNESS. TUFTS HEALTH TOGETHER HAS EARNED "EXCELLENT" HEALTH PLAN ACCREDITATION STATUS BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE, WHICH IS THE COMMITTEE'S HIGHEST ACCREDITATION RATING. IN 2014-2015, TUFTS HEALTH TOGETHER RECEIVED A RANKING OF NO. 1 IN THE COUNTRY BY NCQA'S HEALTH INSURANCE PLAN RANKINGS BASED ON THE ORGANIZATION'S EXCEPTIONAL CLINICAL PERFORMANCE, MEMBER SATISFACTION, AND QUALITY PROCESSES. IN 2015, NCQA INTRODUCED A NEW SCORING METHODOLOGY FOR ITS HEALTH INSURANCE PLAN RATINGS, ASSIGNING AN OVERALL RATING TO EACH HEALTH PLAN BASED ON A SCALE OF 1 TO 5, WHERE FIVE IS THE HIGHEST SCORE. IN OCTOBER 2018, THPP RECEIVED A RATING OF 4.5 OUT OF 5 BASED ON THIS SCORING METHODOLOGY FOR THE FOURTH YEAR IN A ROW. THE ORGANIZATION IN ITS PREDECESSOR FORMS (NETWORK HEALTH,LLC. AND NETWORK HEALTH,INC.) ALSO WON THE DORLAND HEALTH CASE IN POINT PLATINUM AWARD FOR "BEST SOCIAL CARE MANAGEMENT PROGRAM" IN 2013, "BEST INTEGRATED CASE MANAGEMENT PROGRAM" IN 2012, AND "BEST OVERALL CASE/CARE MANAGEMENT PROGRAM" IN 2010. IN 2012, THE ORGANIZATION WAS AMONG TEN NATIONALLY AND THE FIRST IN NEW ENGLAND TO EARN THE NCQA MULTICULTURAL HEALTH CARE DISTINCTION. AS OF THE END OF 2018, THE ORGANIZATION HAD OVER 272,428 ENROLLEES IN TUFTS HEALTH TOGETHER.
FORM 990, PART III, LINE 4BMASSACHUSETTS QUALIFIED HEALTH PLAN COVERAGE TUFTS HEALTH DIRECT IS AN INDIVIDUAL AND SMALL GROUP QUALIFIED HEALTH PLAN (QHP) ESTABLISHED BY THE ORGANIZATION AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT TO PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES WHO ARE NOT ELIGIBLE FOR AFFORDABLE EMPLOYER-SPONSORED INSURANCE, AND SMALL EMPLOYER GROUPS WITH 1-50 EMPLOYEES. THESE PLANS ARE SOLD PRIMARILY THROUGH THE MASSACHUSETTS HEALTH CONNECTOR, THE MASSACHUSETTS STATE MARKETPLACE. TUFTS HEALTH DIRECT IS ACCREDITED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. AS OF DECEMBER 31, 2018, THE ORGANIZATION SERVED CLOSE TO 94,470 CONNECTORCARE MEMBERS (A SUBSET OF TUFTS HEALTH DIRECT MEMBERS WHO RECEIVE BOTH STATE AND FEDERAL SUBSIDIES), WHICH ACCOUNTED FOR ROUGHLY 49% OF THE TOTAL MARKET SHARE. ALSO AS OF DECEMBER 31, 2018, THPP SERVED AN ADDITIONAL 58,273 TUFTS HEALTH DIRECT MEMBERS, 14% OF WHOM RECEIVED FEDERAL SUBSIDIES ONLY IN THE FORM OF ADVANCED PREMIUM TAX CREDITS TO PURCHASE INSURANCE.
FORM 990, PART III, LINE 4CTUFTS HEALTH UNIFY IS A MEDICARE-MEDICAID PLAN FOR INDIVIDUALS AGE 21-64 WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. TUFTS HEALTH UNIFY IS ONE OF TWO MASSACHUSETTS ONECARE PLANS PARTICIPATING IN THE FINANCIAL ALIGNMENT INITIATIVE ("DUALS DEMONSTRATION") TO INTEGRATE BENEFITS AND CARE FOR MEDICARE-MEDICAID ENROLLEES. THE PLAN CONTRACTS WITH THE CENTER FOR MEDICARE AND MEDICAID SERVICES AND MASSHEALTH TO PROVIDE THE BENEFITS OF BOTH PROGRAMS TO LOW AND MODERATE INCOME INDIVIDUALS WITH DISABILITIES. THE PLAN INCLUDES AN EXPANDED BENEFITS PACKAGE AND COMMUNITY-BASED, LONG-TERM SERVICES AND SUPPORT, SUCH AS HOME CARE SERVICES, HOMEMAKER SERVICES, RESPITE CARE, ADULT FOSTER CARE, DAY HABILITATION AND OTHER TYPES OF SUPPORT, COUNSELING AND NAVIGATION. EACH TUFTS HEALTH UNIFY ENROLLEE IS ASSIGNED A CARE MANAGER, WHO DEVELOPS A PERSONALIZED CARE PLAN TO MEET ALL OF THE ENROLLEE'S PHYSICAL, MENTAL, AND SOCIAL CARE NEEDS. THE GOAL OF THIS INNOVATIVE MODEL IS TO IMPROVE THE QUALITY OF CARE, WHILE IMPROVING HEALTH AND PROVIDING MORE COST EFFECTIVE CARE. AS OF THE END OF 2018, THE ORGANIZATION HAD OVER 2,977 ENROLLEES IN TUFTS HEALTH UNIFY.
FORM 990, PART III, LINE 4DRHODE ISLAND MEDICAID COVERAGE THE ORGANIZATION ALSO OFFERS MEDICAID COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THE ORGANIZATION'S COVERAGE IS CALLED TUFTS HEALTH RI TOGETHER, AND IS SIMILAR TO THE MEDICAID COVERAGE OFFERED IN MASSACHUSETTS. AS OF THE END OF 2018, THE ORGANIZATION HAD APPROXIMATELY 9,351 ENROLLEES IN TUFTS HEALTH RI TOGETHER.
FORM 990, PART VI, LINE 1THE INDEPENDENCE AND COMMUNITY RESPONSIVENESS OF THE ORGANIZATION'S BOARD IS ENSURED BY THE ULTIMATE CONTROL AND OVERSIGHT OF THE MAJORITY COMMUNITY BOARD OF THE ORGANIZATION'S SOLE MEMBER, TUFTS HEALTH PLAN, INC. ("THPI"). THPI APPOINTS AND HAS THE AUTHORITY TO REMOVE AND REPLACE THE ORGANIZATION'S BOARD OF DIRECTORS AND TO APPROVE THE CREATION OF ANY COMMITTEE OF THE ORGANIZATION'S BOARD. IN ADDITION, CERTAIN SIGNIFICANT ACTIONS CANNOT BE TAKEN BY THE ORGANIZATION'S BOARD WITHOUT THPI'S APPROVAL, INCLUDING (1) EXECUTION OF ANY CONTRACT OR ENGAGEMENT IN ANY TRANSACTION PROVIDING FOR THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S PROPERTY; (2) FILING OR ACQUIESCENCE IN THE FILING OF ANY VOLUNTARY OR INVOLUNTARY BANKRUPTCY OR INSOLVENCY PROCEEDINGS UNDER ANY FEDERAL OR STATE INSOLVENCY OR BANKRUPTCY LAWS OR THE MAKING OF AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS; (3) ADOPTION OF A PLAN OF OR AUTHORIZATION OF A PETITION FOR LIQUIDATION AND/OR DISSOLUTION OF THE ORGANIZATION; (4) ADOPTION OR AUTHORIZATION OF A PLAN AND/OR AGREEMENT OF MERGER OR SHARE EXCHANGE WITH ANY OTHER FOREIGN OR DOMESTIC CORPORATION; (5) AMENDMENT, ALTERATION OR REPEAL OF THE ORGANIZATION'S ARTICLES OF ORGANIZATION; AND (6)AMENDMENT, ALTERATION OR REPEAL OF THE ORGANIZATION'S BYLAWS, EXCEPT FOR ALTERATION, AMENDMENT OR REPEAL BY A VOTE OF A MAJORITY OF DIRECTORS PENDING NOTIFICATION OF THE MEMBER.
FORM 990, PART VI, LINE 2THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS HEALTH PLAN, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE Jean Yang January 8, 2018 through June 5, 2018 Tracey Carter As of June 6, 2018 Maurice Hebert As of June 6, 2018 THE FOLLOWING INDIVIDUALS SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE MARC SPOONER - Through June 5, 2018 Tracey Carter As of June 6, 2018 Maurice Hebert June 6, 2018 through September 14, 2018 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS HEALTH PLAN FOUNDATION, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS ASSOCIATED HEALTH PLANS, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE MARC SPOONER Through June 5, 2018 Jean Yang January 8, 2018 through June 5, 2018 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TOTAL HEALTH PLAN, INC: THOMAS CROSWELL UMESH KURPAD MARY MAHONEY ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS INSURANCE COMPANY: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE Tracey Carter As of June 5, 2018 Maurice Hebert June 5, 2018 through September 14, 2018 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS BENEFIT ADMINISTRATORS, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER OR OFFICER FOR TAHP BROKERAGE CORPORATION THOMAS CROSWELL UMESH KURPAD MARY MAHONEY ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER FOR INTEGRA PARTNERS HOLDINGS, INC.: THOMAS CROSWELL UMESH KURPAD
FORM 990, PART VI, LINE 3DELEGATION OF CONTROL OF MANAGEMENT DUTIES THE ORGANIZATION'S SOLE MEMBER IS TUFTS HEALTH PLAN, INC. ("THPI"). TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO),PREVIOUSLY THPP'S SOLE CORPORATE MEMBER, IS ALSO A SUBSIDIARY OF THPI. TAHMO'S WHOLLY-OWNED SUBSIDIARY, TUFTS ASSOCIATED HEALTH PLANS, INC.,PERFORMS CERTAIN MANAGEMENT, ADMINISTRATIVE, AND MARKETING SERVICES FOR THPP,INCLUDING EMPLOYEE DECISIONS AND SUPERVISING AND PLANNING AND EXECUTING BUDGETS AND FINANCIAL OPERATIONS. MANY OF THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A ARE EMPLOYEES OF TAHP. THEIR COMPENSATION IS LISTED IN PART VII,SECTION A AND SCHEDULE J.
MEMBERS OR STOCKHOLDERSFORM 990, PART VI, LINE 6 TUFTS HEALTH PLAN, INC.(THPI) IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. POWER TO ELECT OR APPOINT MEMBERS FORM 990, PART VI, LINE 7A TUFTS HEALTH PLAN, INC.(THPI), AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 7B THPI, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAD THE RIGHT TO MAKE CERTAIN DECISIONS REGARDING THE ORGANIZATION, AND IS REQUIRED TO APPROVE ANY CHANGES TO THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, LINE 8B FOR MAJORITY OF THE TIME, THE ORGANIZATION CONTEMPORANEOUSLY DOCUMENTS MEETINGS HELD AND WRITTEN ACTIONS UNDERTAKEN BY ITS COMMITTEES. HOWEVER,ON LIMITED OCCASIONS, A COMMITTEE MAY HAVE A SERIES OF CONFERENCE CALLS AND MINUTES FOR THOSE CALLS ARE NOT APPROVED UNTIL THE NEXT IN-PERSON MEETING, WHICH MAY BE MORE THAN SIXTY DAYS LATER.
PROCESS USED TO REVIEW THE FORM 990FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED IN OUR FINANCE DEPARTMENT, WITH ASSISTANCE FROM OUR EXTERNAL ACCOUNTANTS, ERNST & YOUNG. INFORMATION IS PROVIDED BY OUR FINANCE DEPARTMENT, HUMAN RESOURCES DEPARTMENT, GOVERNANCE MANAGER, COMPLIANCE & PRIVACY OFFICER, AND INTERNAL LEGAL COUNSEL. CERTAIN SECTIONS OF THE FORM ARE REVIEWED BY A NUMBER OF SENIOR MANAGERS; OUR CHIEF FINANCIAL OFFICER REVIEWS THE FORM IN ITS ENTIRETY. ONCE THE FORM IS COMPLETE, IN NOVEMBER 2019, IT IS FORWARDED ON TO OUR BOARD OF DIRECTORS AND IT IS THEN SUBMITTED FOR FILING. MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C THE TUFTS HEALTH PLAN (THP) CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND REVISED AS NEEDED. THE POLICY REQUIRES MANAGERS, ALL DIRECTORS, AVPS, VPS, SVPS, EVPS, THE PRESIDENT AND CEO, AND THE BOARD OF DIRECTORS TO ATTEST ANNUALLY THAT THEY WILL ABIDE BY THE POLICY. IT ALSO REQUIRES THEM TO SUBMIT AN ANNUAL DISCLOSURE STATEMENT TO THE CORPORATE COMPLIANCE OFFICER, LISTING ANY OUTSIDE RELATIONSHIPS, INCLUDING FINANCIAL AND/OR BOARD RELATIONSHIPS, THAT THEY OR A FAMILY MEMBER HAVE WITH THP'S SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. THERE IS A PROTOCOL TO REVIEW ANY DISCLOSURE THAT MIGHT BE A POTENTIAL CONFLICT OF INTEREST. ALSO, ALL EMPLOYEES ARE REQUIRED TO REPORT THE OFFER BY AN OUTSIDE ENTITY OF GIFTS OVER $100, HONORARIA OR COVERAGE OF BUSINESS EXPENSES TO THE CORPORATE COMPLIANCE OFFICER AND A SENIOR LEADER. BOTH MUST APPROVE BEFORE ACCEPTANCE IS ALLOWED. THE LEVELS OF REVIEW ARE: - FOR BOARD MEMBERS, THE BOARD CHAIR, CEO, AND BOARD AUDIT & COMPLIANCE COMMITTEE CHAIR - ONCE DISCLOSURES ARE REVIEWED AND APPROVED, THEY ARE COMMUNICATED TO THE GOVERNANCE MANAGER AND TO THE CORPORATE COMPLIANCE OFFICER. - FOR TUFTS HEALTH PLAN MANAGEMENT, THE SENIOR MANAGER, CORPORATE COMPLIANCE OFFICER,CHIEF COMPLIANCE & ETHICS OFFICER, AND CHIEF LEGAL OFFICER. DISCLOSURES THAT NEED FURTHER REVIEW ARE BROUGHT TO THE BOARD AUDIT & COMPLIANCE COMMITTEE CHAIR. IF A CONFLICT OF INTEREST DOES EXIST, A TRANSACTION WITH THE ENTITY WITH WHICH THERE IS A CONFLICT MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST IS FULLY DISCLOSED; 2. THE PERSON WITH THE CONFLICT OF INTEREST MAY PRESENT INFORMATION, BUT THEN SHALL BE EXCUSED FROM FURTHER DISCUSSION AND FROM THE DECISION REGARDING APPROVING SUCH TRANSACTION; 3. IF PRACTICAL, A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND 4. THE BOARD (OR A DULY CONSTITUTED COMMITTEE THEREOF OR BOARD APPOINTEE) OR THE CHIEF COMPLIANCE & ETHICS OFFICER HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. ALL NEW HIRES, AND ALL EMPLOYEES ON AN ANNUAL BASIS, COMPLETE COMPLIANCE TRAINING THAT ADDRESSES CONFLICT OF INTEREST AND REQUIRES THE EMPLOYEE TO ATTEST THAT THEY DO NOT HAVE ANY POTENTIAL CONFLICTING RELATIONSHIPS THAT THEY HAVE NOT DISCLOSED TO THE PROPER LEVEL OF MANAGEMENT AND TO THE CORPORATE COMPLIANCE OFFICER.
PROCESS FOR DETERMINING COMPENSATIONFORM 990, PART VI, LINE 15 THE COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS (THE "BOARD") OF TUFTS HEALTH PLAN, INC. (TUFTS HP OR THE "COMPANY") REVIEWS AND ADMINISTERS TOTAL REMUNERATION OPPORTUNITIES, POLICIES, PROGRAMS, AND MAJOR CHANGES IN TUFTS HP'S BENEFIT PLANS THAT ARE APPLICABLE TO THE OFFICERS AND EXECUTIVES OF THE COMPANY (THE "EXECUTIVES" - THESE INCLUDE THE CEO AND ALL SENIOR VICE PRESIDENTS), AS WELL AS TO THE GENERAL AUDITOR, CHIEF COMPLIANCE & ETHICS OFFICER, AND ANY OTHER INDIVIDUAL OR GROUPS THE COMMITTEE DEEMS APPROPRIATE BASED ON ITS INTERPRETATION OF THE DEFINITION OF "DISQUALIFIED PERSONS" IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986. THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS OF THE COMPANY. THE COMMITTEE REPORTS TO THE FULL BOARD OF DIRECTORS. FOR CEO COMPENSATION, THE COMMITTEE REVIEWS THE INFORMATION DESCRIBED BELOW AND RECOMMENDS THE CEO'S COMPENSATION TO THE FULL BOARD FOR ITS APPROVAL. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION RECOMMENDATIONS FROM THE CEO FOR OTHER EXECUTIVES, AND PROVIDES A REPORT TO THE FULL BOARD ON THIS INFORMATION. IT IS THE BOARD'S INTENTION THAT THE COMMITTEE WILL PERFORM ITS DUTIES IN A MANNER THAT WILL ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OFFERED TO EXECUTIVES AND OTHER "DISQUALIFIED PERSONS" ARE REASONABLE. COMPARABILITY DATA AND REASONABLENESS THE TOTAL REMUNERATION OPPORTUNITIES PROVIDED TO EXECUTIVES OF THE COMPANY ARE INTENDED TO BE COMPETITIVE WITH, AND IN REASONABLE COMPARISON TO, THOSE OPPORTUNITIES PROVIDED BY ORGANIZATIONS IN THOSE BUSINESS SECTORS WITH WHICH THE COMPANY COMPETES FOR EXECUTIVE TALENT. THE BOARD BELIEVES THAT SUCH COMPETITORS ARE NOT LIMITED TO OTHER HEALTHCARE INSTITUTIONS AND THAT COMPARISONS SHOULD BE MADE TO THE COMPENSATION PRACTICES OF A CROSS-SECTION OF BUSINESS SECTORS IN BOTH FOR-PROFIT AND NOT-FOR-PROFIT ORGANIZATIONS, WHEN APPROPRIATE. THE COMMITTEE RETAINS INDEPENDENT COMPENSATION CONSULTANTS TO PROVIDE DATA AS NECESSARY, AND ALSO USES AVAILABLE SOURCES OF INDEPENDENT DATA ON COMPENSATION. PEER ORGANIZATIONS AND PUBLISHED SURVEY SOURCES WILL BE APPROVED BY THE COMMITTEE BASED ON ITS REASONABLE DETERMINATION. THE COMMITTEE MAY ALSO RELY ON MEMBERS OF MANAGEMENT AND OUTSIDE ADVISORS, CONSULTANTS, AND COUNSEL TO PROVIDE MARKET DATA REPORTS, ANALYSIS, AND OPINIONS WITH RESPECT TO COMPENSATION-RELATED MATTERS. THE DATA REVIEWED CONSISTS OF COMPARABLE, RELEVANT MARKET DATA FOR THE COMPANY'S POSITIONS FROM PUBLISHED SURVEYS, AND OTHER AVAILABLE SOURCES, OF HEALTH AND MANAGED CARE INSTITUTIONS AND THE GENERAL INDUSTRY. OTHER SURVEYS OF SPECIALIZED SKILL SETS OR EMPLOYEE ATTRIBUTES CRITICAL TO THE SUCCESS OF THE COMPANY, E.G., ACTUARIAL, LEGAL, ETC., ARE ALSO INCORPORATED AS NEEDED, ALONG WITH GEOGRAPHIC REFERENCES TO THE BOSTON AND NEW ENGLAND LABOR MARKETS. THE COMMITTEE WILL RELY ON THIS MARKET DATA TO ASSESS, DETERMINE, AND VALIDATE COMPENSATION LEVELS FOR THE COMPANY'S EXECUTIVES. THE COMMITTEE USES THIS DATA IN ITS REVIEW OF: - SETTING BASE SALARIES - IN LIGHT OF MARKET DATA AND THE INDIVIDUAL'S PERFORMANCE, BACKGROUND, EXPERIENCES, AND PERSONAL SKILLS. BASE SALARY WILL BE SET SO THAT THE TARGETED POSITIONING OF AN EXECUTIVE IS AT THE 50TH PERCENTILE FOR EACH POSITION. ACTUAL BASE SALARY MAY VARY BASED ON SKILLS, BACKGROUND, AND EXPERIENCE. - ANNUAL INCENTIVE COMPENSATION - THE COMPANY'S GOAL IS TO PROVIDE COMPETITIVE AND REASONABLE OPPORTUNITIES UNDER THE TERMS OF AN EXECUTIVE ANNUAL INCENTIVE PLAN FOR THE SELECTED POSITIONS WHICH ARE RESPONSIBLE FOR ACHIEVING PERFORMANCE GOALS THAT REFLECT THE OVERALL MISSION OF THE COMPANY, AND THE STRATEGIC DIRECTION OF THE COMPANY FOR THE PERFORMANCE YEAR. THE COMMITTEE MAKES EVERY EFFORT TO ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OPPORTUNITIES PROVIDED TO EXECUTIVES ARE REASONABLE; AS SUCH PRESUMPTION IS CONTEMPLATED IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED FROM TIME TO TIME. IN ESTABLISHING THE PRESUMPTION OF REASONABLENESS, THE COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS,AND OTHER EXPERTS AND ADVISORS. TIMING EXECUTIVE BENCHMARKING IS COMPLETED EVERY TWO YEARS FOR THOSE INDIVIDUALS UNDER THE COMPENSATION COMMITTEE'S PURVIEW BY THE EXTERNAL CONSULTANT ENGAGED BY THE COMPENSATION COMMITTEE. TO COMPLETE THE ANALYSIS, THE CONSULTANT: - COLLECTED RELEVANT INFORMATION REGARDING THE COMPANY'S OPERATIONS, COMPLEXITY, STRUCTURE, SIZE, AND SCOPE, AS WELL AS RELEVANT BACKGROUND ON THE EXECUTIVES' DUTIES AND SCOPE OF RESPONSIBILITIES; - DETERMINED THE SURVEY SOURCES TO USE IN THE ANALYSIS, BASED ON THE COMPANY'S COMPETITIVE MARKET FOR EXECUTIVE POSITIONS (AS DESCRIBED ABOVE); - MATCHED THE COMPANY'S EXECUTIVE POSITIONS IN THE SURVEYS BASED ON THE COMPANY'S SIZE COMPLEXITY, AND SCOPE, AS WELL AS ACCORDING TO SPECIFIC POSITION RESPONSIBILITIES AND REPORTING RELATIONSHIPS; - VALIDATED THE SURVEY SOURCES AND MARKET MATCHES WITH THE INTERNAL COMPENSATION TEAM TO ENSURE CONSISTENCY; - REVIEWED, COMPILED, AND SUMMARIZED THE DATA IN REPORT FORM. THE REPORT SUMMARIZING THE RESULTS OF THE ANALYSIS WAS PRESENTED TO THE COMPENSATION COMMITTEE FOR DISCUSSION AND DELIBERATION. DOCUMENTATION A SUMMARY OF THE DISCUSSIONS AND DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN THE MEETING MINUTES, WHICH ARE REVIEWED AND APPROVED BY THE COMMITTEE. COPIES OF ALL MEETING MATERIALS DISTRIBUTED PRIOR TO AND DURING THE MEETING ARE MAINTAINED IN THE CORPORATE RECORDS ALONG WITH MEETING MINUTES.
PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS OF THE ORGANIZATION ARE AVAILABLE AT ITS HEADQUARTERS IN WATERTOWN, MA. ALL REQUESTS CAN BE MADE TO THE CORPORATE COMMUNICATIONS OR FINANCE DEPARTMENTS.
OTHER CHANGE IN NET ASSETSFORM 990, PART XI, LINE 9 Non-Admitted Assets (8,189,050) Capital Contributions 25,000,000 TOTAL 16,810,950

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Tufts Health Plan Foundation Inc
705 Mount Auburn StWatertownMA02472261374263Grant MakingMA501(c)(3)12ATAMHOfalse
Tufts Assoc Hlth Maintenance Org Inc
705 Mount Auburn StWatertowmMA02472042674079HMOMA501(c)(4)N/ATHPIfalse
Tufts Health Plan Inc
705 Mount Auburn StWatertownMA02472814089215HealthcareMA501(c)(4)N/ANAfalse
CarePartners of Connecticut Inc
705 Mount Auburn StWatertownMA02472822604728HMOCT501(c)(4)N/ATAHMOfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CarePartners of CT Holdings LLBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 Mount Auburn StAddressLine1Txt
CityWatertownCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02472ZIPCd
FieldValueIRS element (for citing)
EIN823129930EIN
Primary ActivitiesHolding CompanyPrimaryActivitiesTxt
Legal Domicile StateCTLegalDomicileStateCd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Tufts Associated Health Plans Inc
705 Mount Auburn StWatertownMA02472042985923Management SvcDETAHMOC CorpYes (true)
Intergra Partners Holdings Inc
705 Mount Auburn StWatertownMA02472453032233Med Equip & SpplsMATAHMOC CorpYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Tufts Associated Health Plans Inc
p$82,130,000Accrual
Tufts Assoc Health Maint Organization Inc
r$19,265,000Accrual
Tufts Assoc Health Maint Organization Inc
s$2,432,000Accrual
Tufts Health Plan Inc
c$25,000,000Accrual

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.