2019-11-12T11:55:37-06:00 2018-12-31 GRANT THORNTON LLP 757 THIRD AVENUE 3RD FLOOR NEW YORK NY 100172013 990 2018-01-01 131828429 Health Insurance Plan of Greater New York % MICHAEL PALMATEER HEAL 6464475000 55 WATER STREET Tax Dept Suite 13th NEW YORK NY 10041 MICHAEL PALMATEER CAO 6464475000 2019-11-12 true Scott Thompsett P00741490 2125990100 2019-11-12 65.229.27.130 26377520193165000011 2019-11-12 P 979609585EDF7A80B261DC170E7F22891F321D40 979609585EDF7A80B261DC170E7F22891F321D40 2018 2020-04-17 16:48:07Z X Karen Ignagni President CEO 55 WATER STREET Tax Dept13th Fl NEW YORK NY 10041 5072413651 false X WWW.EMBLEMHEALTH.COM X 1944 NY HIPgny's mission is to create healthier futures for its customers and communities by offering access to high-quality, affordable health care. 7 3 2320 0 9903599 0 0 4762633716 5014390464 13992167 6517301 34140893 31474207 4810766776 5052381972 504612 441864 0 0 177169945 182210706 0 0 0 4805220007 4936729308 4982894564 5119381878 -172127788 -66999906 1530485251 1646076948 882375465 1042902564 648109786 603174384 X HIPGNY'S MISSION IS TO CREATE HEALTHIER FUTURES FOR ITS CUSTOMERS AND COMMUNITIES. HIPGNY WORKS ALONGSIDE ITS CUSTOMERS TO OFFER ACCESS TO HIGH-QUALITY, AFFORDABLE CARE, HELP NAVIGATE THE HEALTH CARE EXPERIENCE, AND MAKE GOOD HEALTH ACHIEVABLE. false false 1527920116 0 1591134668 MEDICARE - HIPGNY SERVED APPROXIMATELY 120,000 MEDICARE MEMBERS THROUGH its MEDICARE RISK AND COST CONTRACT PROGRAMS. 983114936 0 1056375365 MEDICAID - HIPGNY SERVED APPROXIMATELY 165,000 MEDICAID MEMBERS. HIP HAS BEEN SERVICING THE MEDICAID POPULATION SINCE 1967 (WITH THE PASSAGE OF FEDERAL LEGISLATION AUTHORIZING THIS PROGRAM) AND HAS AN EXTENSIVE PROGRAM IN PLACE TO ENCOURAGE PREVENTIVE MEDICAL CARE. 2034080183 441864 2377484590 SUBSCRIBER BENEFITS - HIPgny IS A NOT-FOR-PROFIT CORPORATION THAT ARRANGES FOR THE PROVISION OF COMPREHENSIVE MEDICAL AND HEALTH CARE SERVICES FOR ITS SUBSCRIBERS/MEMBERS (INCLUDING HEALTH CARE SERVICES TO MEDICARE AND MEDICAID MEMBERS) WHICH IS AN EXEMPT FUNCTION. In 2018, HIPgny provided services (across all service lines) to approximately 615,000 members. Form 990, Part III - Revenue & Expense Allocations The organization notes that the allocation of program service expenditures reported on Part III of the Form 990 is derived from HIPgNY's Statutory Financial Statements (STAT) - Analysis of Operations by Lines of Business. The Form 990 is prepared in accordance with Generally Accepted Accounting Principles (GAAP); accordingly, there may be additional allocations of expenditures to achieve conformity between the GAAP and STAT reports. 4545115235 false false false false false false false false false true true false true true true false true false false false false false false false false false true false true false false false false false false true false false false false false true true true true false true X 1791 0 true 2320 true true true false false false false false true false X 7 3 true false false false true false false true true false false true true true true true true true true false NY X MICHAEL PALMATEER 6464475000 55 WATER STREET NEW YORK NY 10041 X Karen Ignagni President & CEO 35.0 2.0 X X 3095534 0 28586 John Feerick Chairman 2.0 3.0 X X 0 157625 0 Bernard Schayes MD Director 2.0 0.0 X 38143 0 0 Arthur Pepper Director 2.0 0.0 X 0 0 0 Charles Wang Thru 102018 Director 2.0 1.0 X 0 123654 0 Dr Stuart Altman Director 2.0 1.0 X 0 124250 0 John H Banks III Director 2.0 1.0 X 0 102466 0 Richard Berman Director 2.0 1.0 X 0 138647 0 George Babitsch SVP, Account Mgmt. 35.0 0.0 X 420182 0 28240 David Baum VP, Operations 35.0 0.0 X 285911 0 28194 Cara Berkowitz VP, Gov't Affairs & Policy 35.0 0.0 X 198189 0 19898 Daniel Byrne VP, Labor Relations 35.0 0.0 X 277002 0 22205 Antoinette Cassetta SVP, Gov't Programs 35.0 0.0 X 384710 0 24370 Jeffrey Chansler Chief Legal Officer 35.0 0.0 X 662270 0 46523 Christopher Chappelear Chief Actuary 35.0 0.0 X 427291 0 29942 Thomas Conway VP, Controller 35.0 0.0 X 361620 0 21293 Edmond Cunningham VP, Procurement 35.0 0.0 X 327749 0 32282 Jeff Danilo SVP,Prov. Ntwk & Pop Health 35.0 0.0 X 583385 0 27402 Mariann Drohan Chief HR Officer (Thru 11/2018 35.0 0.0 X 493059 0 21753 Beth Amber Fabbri Chief Mkting & Comm Officer 35.0 0.0 X 599987 0 24280 Jerry Frank SVP, Medical Delivery 35.0 0.0 X 497106 0 25305 Vitaliy Fuzaylov VP, Medical Economics 35.0 0.0 X 328852 0 23222 Cynthia Goff Thru 22018 VP, Gov't Affairs & Policy 35.0 0.0 X 128589 0 2691 Andrew Harrell VP, Enterprise Underwriting 35.0 0.0 X 270164 0 19863 Linda Henderson VP, Regulatory Compliance 35.0 0.0 X 263517 0 12798 DeWayne Hiebert VP, Provider Netwk Mgmt 35.0 0.0 X 165071 0 7114 Carol Huffman VP, ACPNY Relationship 35.0 0.0 X 262522 0 12072 Beatriz Jaramillo Thru 92018 VP, Med. Stars&Qual Mgmt 35.0 0.0 X 559945 0 17062 Bruce Jarvie Chief Financial Officer 35.0 0.0 X 494831 0 30650 Jim Karagiorgis VP, Vendor Oversight 35.0 0.0 X 318974 0 26734 Kimberly Lauersdorf VP, Marketing 35.0 0.0 X 261668 0 19696 Debra Lightner Chief Compliance Officer 35.0 0.0 X 475305 0 18103 Carl Lund VP, Facility Contracting 35.0 0.0 X 342608 0 25004 Michelle Lyddon VP, Communications 35.0 0.0 X 270356 0 23938 Thomas MacMillan Chief Info. Officer 35.0 0.0 X 494436 0 26497 Carlos Manalansan VP, Deputy General Counsel 35.0 0.0 X 339540 0 31621 Jennifer Martino VP, G&A and Ops Comp. 35.0 0.0 X 259478 0 19405 Julie Mascari VP, Medicare 35.0 0.0 X 235388 0 16600 Lorraine McDonald Thru 92018 VP, Clinical Strat. & Ops 35.0 0.0 X 207434 0 21562 Peter Moore Thru 52018 VP, Gov't Programs 35.0 0.0 X 146745 0 13576 Karen Moran VP, Ancillary Products 35.0 0.0 X 334791 0 16118 Timothy Nolan EVP,Chief Rev & HC Del Officer 35.0 0.0 X 1639888 0 25572 David Notari SVP, Sales 35.0 0.0 X 385356 0 22358 Carolyn Oser VP, Bus & Tech Transformation 35.0 0.0 X 332339 0 32371 Michael Palmateer Chief Financial Officer 35.0 0.0 X 1390680 0 39780 Priyank Pandey VP, Ops. Strategy 35.0 0.0 X 122917 0 7828 Michele Podolak VP, Customer Service 35.0 0.0 X 231881 0 22331 Jameson Reuter VP, Ent. Pharm Solutions 35.0 0.0 X 283308 0 22999 Navarra Rodriguez SVP, Pres./CMO ACPNY 35.0 0.0 X 842983 0 26550 Angel Rosario VP, Marketpl. Sales 35.0 0.0 X 22255 0 130 John J Sheehy III SVP, Product Innovation 35.0 0.0 X 445465 0 32145 Wei-Jia Shen VP, Multicultural Mkting. 35.0 0.0 X 342189 0 22521 Jill Stein VP, Deputy General Counsel 35.0 0.0 X 360256 0 23808 Paula Tavsanli VP, Client Relations Mgmt. 35.0 0.0 X 313194 0 24100 Jennifer Truscott SVP, Operations 35.0 0.0 X 490184 0 19296 William Voigt VP, HR Bus. Operations 35.0 0.0 X 390820 0 22910 Rodger Wenzel SVP, Med. Economics 35.0 0.0 X 403386 0 11029 Michael Worthington VP, Facilities 35.0 0.0 X 322552 0 21733 Andrew JD Mcbrien VP, Medicare (Thru 5/2018) 35.0 0.0 X 127404 0 2025 Robin James Labor/Large Grp Rep 40.0 0.0 X 468777 0 7074 Scott Ushkowitz AVP, Medicare Ind. Sales 40.0 0.0 X 354462 0 5451 Thomas M McDermott AVP, IT Governance 40.0 0.0 X 339843 0 14863 Cecilia C Fingal Small Group Rep 40.0 0.0 X 346691 0 7333 Roberto Hormazabal Sr. Dir. Account Mgmt 40.0 0.0 X 338688 0 9881 Paul E Gibson Former Director 2.0 1.0 X 0 156625 0 25107870 803267 1188687 719 true true false COGNIZANT HEALTHCARE SERVICES LLC 500 Frank W Burr Suite 3F TEANECK NJ 07666 Consulting 179997697 THE SOURCING GROUP LLC 77 Water Street NEW YORK NY 10005 business solutions 6747393 INOVALON INC 4321 collington road BOWIE MD 20716 data analytics 5363643 MERKLE INC 32 6th avenue NEW YORK NY 10013 Business Solutions 5287797 GYRO LLC 115 Broadway 14th floor NEW YORK NY 10006 Business Solutions 5005663 109 0 PREMIUM REVENUE 900099 5008236815 5008236815 THIRD PARTY ADMINISTRATIVE FEES 541990 6153649 5783739 369910 5014390464 5444654 1650000 3794654 0 0 31144456 18528007 12616449 0 12616449 12616449 44399 2531920 1503672 44399 1028248 1072647 1072647 0 0 0 0 0 0 0 0 0 PHARMACY REVENUE 446110 18857758 10974069 7883689 18857758 5052381972 5024994623 9903599 17483750 X 441864 441864 0 0 0 25050139 25050139 156625 156625 110423120 110423120 14639740 14639740 22037808 22037808 9903274 9903274 0 4437311 4437311 3346455 3346455 473630 473630 0 780913 780913 228255942 228255942 13976756 13976756 13146566 13146566 0 0 21674281 21674281 2566077 2566077 0 139298 139298 479561 479561 0 20570466 20570466 5213537 5213537 SUBSCRIBER BENEFITS 4420572381 4420572381 0 0 ACA HEALTHCARE FEES 48188956 48188956 0 0 CAPITATION PAYMENTS 43290246 43290246 0 0 QUALITY OF CARE EXPENSES 21904262 21904262 0 0 87712670 10717526 76995144 5119381878 4545115235 574266643 0 0 0 212990991 221853486 0 0 183694652 175268089 0 0 0 0 171330349 185695527 0 0 4915871 15516418 486827208 292407238 164335174 194419970 10229777 22540088 603848197 619366027 0 0 0 0 179140240 211417343 1530485251 1646076948 689955232 808104167 0 0 20712790 19004221 0 0 0 0 0 0 0 0 0 0 171707443 215794176 882375465 1042902564 X 648109786 603174384 0 0 0 0 648109786 603174384 1530485251 1646076948 X -66999906 22064504 X false true X true false 6963425 6963425 163179931 99155178 64024753 275779327 156309517 119469810 38349574 35884830 2464744 2554951 1057713 1497238 194419970 INVESTMENT IN ADVANTAGECARE 409725476 C INVESTMENT IN HIP HOLDINGS INC 209640551 C 619366027 ACCRUED INTEREST RECEIVABLE 1650000 DEFERRED RENT 798181 INTEREST/DIVIDENDS RECEIVABLE 48154 OTHER CURRENT ASSETS 9664133 FEDERAL TAX RECEIVABLE 794730 HEALTHCARE RECEIVABLES 130210536 INTERCOMPANY RECEIVABLES 68251609 211417343 0 PENSION LIABILITY 147802345 DEFERRED RENT 55205860 OTHER LONG TERM LIABILITIES 12785971 215794176 X FIN 48 DISCLOSURE The Company has not taken any unsubstantiated tax position that would require provisions of a liability under ASC 740, Accounting for Uncertainty in Income Taxes. The Company does not believe there are any material uncertain tax positions and, accordingly, did not recognize any liability for unrecognized tax positions. For the year ended December 31, 2018, there were no interest or penalties recorded or included in the consolidated statements of operations and changes in net assets. true 1199 SEIU EMPLOYER CHILD CARE FUND 330 West 42nd Street New York NY 10036 753086330 501(c)(9) 7500 General Support ACLD FOUNDATION 807 S Oyster Bay Rd Bethpage NY 11714 812018946 501(c)(3) 6600 General Support AHRC NYC FOUNDATION 83 Maiden Lane New York NY 10038 133779611 501(c)(3) 15000 General Support AHRC SUFFOLK FOUNDATION 2900 Veterans Memorial HW Bohemia NY 11716 263876547 501(c)(3) 8000 General Support ARCHCARE 205 Lexington Avenue New York NY 10016 133896624 501(c)(3) 47600 General Support CAMBA INC 1720 Church Avenue Brooklyn NY 11226 112480339 501(c)(3) 6000 General Support CHILDREN'S AID SOCIETY 711 Third Avenue New York NY 10017 135562191 501(c)(3) 6000 General Support CHINA AIDS FUND INC 4260 Main Street Suite E Flushing NY 11355 460502387 501(c)(3) 6000 General Support CHINESE AMERICAN MEDICAL SOCIETY 11 East Broadway New York NY 10038 133418133 501(c)(3) 7000 General Support COMUNILIFE INC 214 West 29th Street New York NY 10001 133530299 501(c)(3) 10000 General Support HARVEST HOME FARMER'S MARKET 104-106 126th Street New York NY 10035 061800512 501(c)(3) 12000 General Support HISPANIC FEDERATION INC 55 Exchange Pl 5th Fl New York NY 10005 133573852 501(c)(3) 20000 General Support MAYOR'S FUND TO ADVANCE NEW YORK CITY 253 Broadway New York NY 10007 133783906 501(c)(3) 25000 General Support MEDICARE RIGHTS CENTER 266 West 37th Street New York NY 10018 133505372 501(c)(3) 6000 General Support ONE BROOKLYN FUND INC 209 Joralemon Street Brooklyn NY 11201 465189061 501(c)(3) 6100 General Support ONE HUNDRED BLACK MEN INC 2601 F Douglasss Blvd New York NY 10030 237379940 501(c)(3) 21250 General Support PATROLMEN'S BENEVOLENT ASSOCIATION 125 Board St 11th Fl New York NY 10004 135308915 501(c)(5) 7600 General Support PRIMARY CARE DEVELOPMENT CORPORATION 45 Broadway Suite 530 New York NY 10006 133711803 501(c)(3) 5800 General Support SDTC - THE CENTER FOR DISCOVERY INC PO Box 840 Benmosche Road Harris NY 12742 141395426 501(c)(3) 20000 General Support SOMOS INC 90 South Swan St Ste 300 Albany NY 12210 223128393 501(c)(3) 20000 General Support THE WORKMEN'S CIRCLE ARBETER RING INC 247 W 37th St Front 5 New York NY 10018 136178558 501(c)(3) 25000 General Support UNITED HOSPITAL FUND 1411 Broadway 12th Floor New York NY 10018 131562656 501(c)(3) 13000 General Support 20 2 Schedule I, Part I, Line 2 Health Insurance Plan of Greater New York ("hipGNY") has an internal REVIEW PROCESS FOR all charitable grants paid out by the organization. Every request for a grant must be submitted in writing TO THE ceo AND CHIEF ADMINISTRATIVE OFFICER FOR REVIEW AND APPROVAL. Grant applications are primarily accepted from 501(c)(3) tax-exempt organizations; to the extent any of the grantees are non 501(c)(3) organization, those grantees are either volunteer fire departments or benevolent funds that support charitable endeavors. X true X X X X true true false false false true false true false Karen Ignagni President & CEO 1049701 0 2000000 0 45833 0 16500 0 12086 0 3124120 0 0 0 John Feerick Chairman 0 157625 0 0 0 0 0 0 0 0 0 157625 0 0 Paul E Gibson Former Director 0 156625 0 0 0 0 0 0 0 0 0 156625 0 0 George Babitsch SVP, Account Mgmt. 331340 0 88842 0 0 0 16500 0 11740 0 448422 0 0 0 David Baum VP, Operations 269159 0 16500 0 252 0 16500 0 11694 0 314105 0 0 0 Cara Berkowitz VP, Gov't Affairs & Policy 198189 0 0 0 0 0 12325 0 7573 0 218087 0 0 0 Daniel Byrne VP, Labor Relations 224607 0 52395 0 0 0 13933 0 8272 0 299207 0 0 0 Antoinette Cassetta SVP, Gov't Programs 384710 0 0 0 0 0 16500 0 7870 0 409080 0 0 0 Jeffrey Chansler Chief Legal Officer 482270 0 180000 0 0 0 16500 0 30023 0 708793 0 0 0 Christopher Chappelear Chief Actuary 343291 0 84000 0 0 0 16500 0 13442 0 457233 0 0 0 Thomas Conway VP, Controller 294420 0 67200 0 0 0 16500 0 4793 0 382913 0 0 0 Edmond Cunningham VP, Procurement 264101 0 63648 0 0 0 16500 0 15782 0 360031 0 0 0 Jeff Danilo SVP,Prov. Ntwk & Pop Health 403385 0 180000 0 0 0 16500 0 10902 0 610787 0 0 0 Mariann Drohan Chief HR Officer (Thru 11/2018 360993 0 97920 0 34146 0 16500 0 5253 0 514812 0 0 0 Beth Amber Fabbri Chief Mkting & Comm Officer 446987 0 153000 0 0 0 16500 0 7780 0 624267 0 0 0 Jerry Frank SVP, Medical Delivery 436206 0 60900 0 0 0 15301 0 10004 0 522411 0 0 0 Vitaliy Fuzaylov VP, Medical Economics 278452 0 50400 0 0 0 16500 0 6722 0 352074 0 0 0 Andrew Harrell VP, Enterprise Underwriting 251414 0 18750 0 0 0 16375 0 3488 0 290027 0 0 0 Linda Henderson VP, Regulatory Compliance 223017 0 40500 0 0 0 5216 0 7582 0 276315 0 0 0 DeWayne Hiebert VP, Provider Netwk Mgmt 165071 0 0 0 0 0 2625 0 4489 0 172185 0 0 0 Carol Huffman VP, ACPNY Relationship 247930 0 0 0 14592 0 7938 0 4134 0 274594 0 0 0 Beatriz Jaramillo Thru 92018 VP, Med. Stars&Qual Mgmt 197524 0 55245 0 307176 0 15771 0 1291 0 577007 0 0 0 Bruce Jarvie Chief Financial Officer 325081 0 0 0 169750 0 16500 0 14150 0 525481 0 0 0 Jim Karagiorgis VP, Vendor Oversight 256318 0 62400 0 256 0 16500 0 10234 0 345708 0 0 0 Kimberly Lauersdorf VP, Marketing 261668 0 0 0 0 0 15900 0 3796 0 281364 0 0 0 Debra Lightner Chief Compliance Officer 349305 0 126000 0 0 0 10675 0 7428 0 493408 0 0 0 Carl Lund VP, Facility Contracting 275983 0 66000 0 625 0 16500 0 8504 0 367612 0 0 0 Michelle Lyddon VP, Communications 247856 0 22500 0 0 0 16500 0 7438 0 294294 0 0 0 Thomas MacMillan Chief Info. Officer 382836 0 111600 0 0 0 16500 0 9997 0 520933 0 0 0 Carlos Manalansan VP, Deputy General Counsel 265290 0 74250 0 0 0 16500 0 15121 0 371161 0 0 0 Jennifer Martino VP, G&A and Ops Comp. 213326 0 45900 0 252 0 16500 0 2905 0 278883 0 0 0 Julie Mascari VP, Medicare 135388 0 100000 0 0 0 16500 0 100 0 251988 0 0 0 Lorraine McDonald Thru 92018 VP, Clinical Strat. & Ops 151457 0 52800 0 3177 0 12852 0 8710 0 228996 0 0 0 Peter Moore Thru 52018 VP, Gov't Programs 84308 0 52800 0 9637 0 9010 0 4566 0 160321 0 0 0 Karen Moran VP, Ancillary Products 264591 0 70200 0 0 0 15860 0 258 0 350909 0 0 0 Timothy Nolan EVP,Chief Rev & HC Del Officer 744888 0 895000 0 0 0 16500 0 9072 0 1665460 0 0 0 David Notari SVP, Sales 234429 0 0 0 150927 0 14483 0 7875 0 407714 0 0 0 Carolyn Oser VP, Bus & Tech Transformation 259439 0 72900 0 0 0 16500 0 15871 0 364710 0 0 0 Michael Palmateer Chief Financial Officer 730680 0 660000 0 0 0 16500 0 23280 0 1430460 0 0 0 Michele Podolak VP, Customer Service 186761 0 45120 0 0 0 16500 0 5831 0 254212 0 0 0 Jameson Reuter VP, Ent. Pharm Solutions 250908 0 32400 0 0 0 16500 0 6499 0 306307 0 0 0 Navarra Rodriguez SVP, Pres./CMO ACPNY 484183 0 358800 0 0 0 16500 0 10050 0 869533 0 0 0 John J Sheehy III SVP, Product Innovation 350045 0 95420 0 0 0 11230 0 20915 0 477610 0 0 0 Wei-Jia Shen VP, Multicultural Mkting. 269289 0 72900 0 0 0 16500 0 6021 0 364710 0 0 0 Jill Stein VP, Deputy General Counsel 283306 0 76950 0 0 0 16500 0 7308 0 384064 0 0 0 Paula Tavsanli VP, Client Relations Mgmt. 265494 0 47700 0 0 0 13471 0 10629 0 337294 0 0 0 Jennifer Truscott SVP, Operations 408584 0 81600 0 0 0 16500 0 2796 0 509480 0 0 0 William Voigt VP, HR Bus. Operations 315220 0 75600 0 0 0 16500 0 6410 0 413730 0 0 0 Rodger Wenzel SVP, Med. Economics 207966 0 0 0 195420 0 7969 0 3060 0 414415 0 0 0 Michael Worthington VP, Facilities 277129 0 45423 0 0 0 16500 0 5233 0 344285 0 0 0 Robin James Labor/Large Grp Rep 133262 0 318525 0 16990 0 0 0 7074 0 475851 0 0 0 Scott Ushkowitz AVP, Medicare Ind. Sales 176837 0 177625 0 0 0 0 0 5451 0 359913 0 0 0 Thomas M McDermott AVP, IT Governance 247443 0 92400 0 0 0 0 0 14863 0 354706 0 0 0 Cecilia C Fingal Small Group Rep 91257 0 247261 0 8173 0 0 0 7333 0 354024 0 0 0 Roberto Hormazabal Sr. Dir. Account Mgmt 168948 0 169740 0 0 0 0 0 9881 0 348569 0 0 0 Form 990, Schedule J, Part I, Line 1b The following individuals reported on Schedule J, received a gross-up payment in 2018; the tax gross-up is reported in Schedule J, Part II, Column (b)(iii): David Baum Bruce Jarvie Jim Karagiorgis Jennifer Martino David Notari Rodger Wenzel Form 990, Schedule J, Part I, Line 4a - Severance Vice President of Medicare Stars and Quality Management, Beatriz Jaramillo, received a severance payment of $295,800 in calendar year 2018. The severance payment documented above is reported in the Form 990, Schedule J, part II, Column (b)(iii). Form 990, Schedule J, Part I, Line 4(b) Supplemental Non-Qualified Retirement Plan EmblemHealth Services company, LLC ("Emblemhealth Services") sponsors A nonqualified retirement plan that officers of HIPgny with the titles of senior vice president and above hired before June 1, 2009, participate in. The supplemental executive retirement plan for emblemhealth services provides a retirement benefit calculated on the basis of 50% of final average pay, offset by benefits under any qualified benefit plan, such as The emblemhealth services company, LLC employees' retirement plan. Participants who retire prior to age 65 have their benefits reduced by early retirement factors. Bonus Payments HIPGNY (via EmblemHealth Services, the payroll payor) provides annual incentive awards based upon the achievement of performance metrics. The compensation committees approve the performance metrics and targets and the ultimate payout to participants based upon the performance achieved under the Annual Incentive Plan (AIP). Schedule J, Part II, Column C The management pension plan was frozen effective January 1, 2016 and replaced with a matching 401(k) program. The amounts in column c represent the company match. To the extent any individual reported on Schedule J has compensation reported in column (f), those amounts reflect payouts from the Supplemental Executive Retirement Plan. William White family of former officer 225713 Employee Wages false christine o'connor burns family of former officer 294022 Employee Wages false Keith Dahl family of former officer 355425 Employee Wages false Alyssa Pepper family of board member 151613 Employee Wages false Dr Lester LeBlanc family of board member 103985 Dental Wages false Form 990, Schedule L HIPGNY does not believe it has any other business transactions or relationships between itself and an officer, director, or key employee of the organization that rise to the monetary threshold required for disclosure on Schedule L of the Form 990. The organization takes its responsibilities of monitoring potential conflicts of interest very seriously (please see disclosure on Part VI, Line 12). HIPGNY compiles a lengthy Summary report of all potential business transactions between the individuals reported on Part VII of the Form 990 and HIPGNY or one of its affiliated organizations. This report discloses all potential business transactions regardless of monetary value. Amounts reported on Schedule L represent the W-2, Box 5 wages paid to each of these individuals. Additional taxable and non-taxable fringe benefits may have been provided (but are not included above). Additional information is available upon request. Part V, Line 1a and Part VII, Independent Contractors. The total number of independent contractors reported on Part V, Line 1a represents those vendors that received a 1099 directly from HIPgny'S EIN#. HIPGNY, as a part of its business, undertakes a significant amount of claims processing; in 2018, HIPGNY issued 34,063 1099s AS A RESULT OF ITS CLAIMS PROCESSING ACTIVITIES. The 1099s for the claims processing are not reported on Line 1(a) but are disclosed here in the interests of full disclosure. In total, HIPgny and Emblemhealth Services paid compensation exceeding $100,000 to 109 vendors in 2018. Form 990, Part V, Line 2(a) HIPGNY does not file a Form W-3 as all employee payroll is paid out of EmblemHealth Services. In the interests of clarity, HIPGNY is disclosing that 2,320 employees received W-2s from EmblemHealth Services (ostensibly for services rendered to HIPGNY and to other affiliated entities). Form 990, Part VI, Line 2 In the interests of full disclosure, the organization notes that various Officers and/or directors, may serve on the Board of Directors of related for-profit organizations (e.g. - those disclosed in Schedule R of the Form 990). No individual is compensated for board services rendered to the related for-profit organization. Form 990, Part VI, Line 6 EmblemHealth, Inc., a New York not-for-profit corporation, is the sole member of Hipgny. EmblemHealth, Inc. (EIN 13-3941542) is exempt from federal taxation pursuant to IRC 501(c)(3). Form 990, Part VI, Line 11 The taxpayer's Form 990 for the year ending December 31, 2018 was provided to each member of the organization's governing body before it was filed. A detailed review of the Form 990 was undertaken by the Organization's Tax Director, Chief ADMINISTRATIVE Officer and VP, Deputy General Counsel. Form 990, Part VI, Line 12 To determine if an employee's personal interests, activities or relationships constitute a conflict of interest or the appearance of a conflict of interest, certain employees, based upon functionality, as determined by the chief compliance officer and BY the VP, Deputy General Counsel, on an annual basis, any reportable situations on the company's conflict of interest disclosure. All employees, at the time of employment, are required to fully disclose any personal interest, activities or relationships that constitute a conflict of interest or the appearance of a conflict of interest. Disclosures are reviewed by the chief compliance officer and THE VP, Deputy General Counsel. Any Employee, who violates the conflict of interest policy, fails to make a required report or fails to comply with any remedial action required by the company, is subject to disciplinary action, up to and including termination of employment. Form 990, Part VI, Line 15 To determine the compensation of the CEO and all other officers of the company, HIPgny and EmblemHealth Services engage an outside compensation consultant to provide guidance and the comparable market data on the compensation of similarly situated executive positions in the organizations' competitive peer group comprised of profit and not for profit entities. The compensation consultant presents the comparable market data to the compensation committee of the board of directors of HIPGNY and EmblemHealth Services. The compensation committees are composed entirely of outside, independent, disinterested directors. The compensation committees review and approve the proposed compensation arrangements and the deliberations and actions of the compensation committees are documented in the minutes of each meeting. Thereafter, the actions of the compensation committees are reported to the full boards in a timely manner. The CEO, or any other officer, is excused from the compensation committee meeting while the committee deliberates and approves any action related to the compensation arrangement of the CEO or other officer. Form 990, Part VI, Line 19 The taxpayer makes its Form 990 and Form 1023 available to the public by retaining a copy of each at its hOME office at 55 Water Street, New York, New York. The organization's Form 990 is also available for public inspection on www.guidestar.com. The taxpayer's financial statements are available upon request. The organization's governing documents and conflict of interest policy are not available to the public. Form 990, Part VII - Hours Served for Related Party The compensated individuals reported in Part VII of the Form 990 may provide services to a variety of entities within the Hipgny network. Allocating those hours between the many entities presents a challenge; accordingly, the hours represented on Part VII represent the hours worked by the individual in their capacity as an employee for the entire HIPGNY network. Form 990, Part IX Amounts reported on Part IX, Line 5, as compensation paid to officers, directors and key-employees of HIPGNY represent those salary costs reported on Form 990, Part VII, Line 1(d) that are allocated from the related party, EmblemHealth Services, LLC. HIPGNY has adopted a simplified approach of allocating its expenditures between programmatic and management and general. The organization does not categorize its expenses internally or in its audited financial statements by these means. For purposes of its 990 reporting, HIPGNY is treating all subscriber benefits as programmatic expenses and all other expenses as management and general even though a large percentage of those expenses are likely related to HIPGNY's day-to-day mission activities. Nevertheless, even taking this conservative approach, HIPGNY's program service expenses constitute 90% of total expenditures. Form 990, Part XI, Line 9 A difference of $22,064,504 is reported on part XI of the Reconciliation of Net Assets. This difference is attributable to changes in unrealized gains and losses on investments, book to tax adjustments on investments as well as Statutory-to-GAAP financial statement adjustments. EmblemHealth Services Company LLC 55 Water Street New York NY 10041 Support Svcs NY 0 112986000 HIPGNY EMBLEMHEALTH INC 55 WATER STREET NEW YORK NY 10041 133941542 support svcs NY 501(c)(3) 12(c) HIPGNY true EmblemHealth Cityblock LLC C/O EmblemHealth 55 Water Street TA New York NY 10041 831246245 Healthcare NY EmblemHealth None 0 0 false 0 false 0.00000 Group Health Incorporated 55 Water Street New York NY 10041 135511997 Insurance NY NA C Corp 817868374 706538671 1.00000 true HIP Holdings Inc & Subsidiaries 55 Water Street New York NY 10041 133819759 Insurance NY NA C Corp. 1871451752 1228951508 1.00000 true AdvantageCare Physicians PC 55 water street New York NY 10041 460970995 healthcare NY HIPGNY C Corp 476769752 185932617 1.00000 true SIUC Medical PC 55 water street New York NY 10041 810689784 healthcare NY HIPGNY C Corp 0 0 1.00000 true true false false true false false false false false false false true true true true true true false false EmblemHealth Inc M,P 1560801 Cost Group Health Incorporated A 24200000 Market Rate Group Health Incorporated D 165000000 Market Rate Hip Holdings Inc & Subsidiaries (HIPIC) L,Q 900000 COST Hip Holdings Inc & Subsidiaries (HIPIC) M 16100000 COST Hip Holdings Inc & Subsidiaries (HIP-IPA) L,Q 800000 cost Hip Holdings Inc & Subsidiaries (HIP-IPA) M 1100000 cost Schedule R, Part V, Line 2 EmblemHealth, Inc. is the parent organization of HIPGNY, a 501(c)(4) tax-exempt organization that delivers quality, affordable health insurance to members. EmblemHealth, Inc., in conjunction with its subsidiaries, fosters and facilitates HIPGNY's efforts to give back to the community. Costs associated with running EmblemHealth, Inc. are reimbursed by HIPgNY (at cost); these transactions are memorialized with Transaction Code M & P. Transactions with Group health Incorporated To date, HIPGNY has advanced $165 million to GHI in accordance with Section 1307 of the Insurance Law of the State of New York with interest accruing at 2% per annum. No new loans were issued in 2018. As provided in Section 1307, the payment of principal and interest thereon shall only be made out of free and disposable surplus, subject to prior approval of the Superintendent of insurance. HIPgny is disclosing the amount of accrued interest during 2018 with Transaction Code A. As of December 31, 2018, GHI paid HIPGNY $24.2 million of accrued interest on its Surplus Notes. Transactions with HIP Holdings, Inc. & Subs - HIP Insurance Company of New York ("HIPIC") HIPIC (a member of HIP Holdings, Inc. & Subs) provides the indemnity health insurance products, including the portion of dual option products offered by HIPgny, WHICH administers the collection of premiums and pays claims on behalf of HIPIC. Premiums collected on behalf of HIPIC were approximately $8,400,000 for the year ended December 31, 2018. HIPgny paid out-of-network claims on behalf of HIPIC of $7,700,000 in 2018. Under the terms of a service agreement, HIPgny allocated costs associated with administering the premiums and claims of approximately $900,000 to HIPIC for the year ended December 31, 2018. Transactions with HIP Holdings, Inc. - HIP Network Services IPA, Inc. ("HIP-IPA") HIPGNY pays HIP-IPA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) a monthly per-member-per-month capitation rate for members enrolled in HIP-IPA as well as a monthly fee for data collection services. For the year ended December 31, 2018, HIPGNY incurred approximately $1,100,000 for capitation and $100,000 for data collection services. HIPGNY paid providers $700,000 on behalf of HIP-IPA for claims incurred.