2018-11-14T09:01:58-06:00 2017-12-31 350921680 CROWE LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2017-01-01 461392824 Texas Children's Health Plan The Center TEXA 8328242982 6621 FANNIN STREET HOUSTON TX 77030 Weldon Gage EXECUTIVE VICE PRESIDENT & CFO 2018-11-14 true RACHEL SPURLOCK P00520729 2147775200 2017 2019-02-21 02:37:17Z Texas Children's Health Plan-The Center for Children and Women Weldon Gage 6621 FANNIN STREET Houston TX 77030 121679237 false X WWW.JOINTHECENTER.ORG X 2008 TX TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION, AND RESEARCH. 5 2 198 0 0 0 621374 96188779 120983120 0 3039 74743 96191818 121679237 0 0 11978130 12336874 0 0 84213688 109342363 96191818 121679237 0 0 35419475 36180944 8931183 9692652 26488292 26488292 TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION, AND RESEARCH. false false 118328017 120983120 TEXAS CHILDREN'S HEALTH PLAN - THE CENTER FOR CHILDREN AND WOMEN (CCW), IN FULFILLING ITS PURPOSE OF SUPPORTING TEXAS CHILDREN'S HEALTH PLAN, ESTABLISHES PATIENT AND FAMILY-CENTERED MEDICAL HOMES PROVIDING CARE TO PRIMARILY MEDICAID AND CHIP PATIENTS THAT ARE MEMBERS OF TEXAS CHILDREN'S HEALTH PLAN. THE MEDICAL HOMES ARE SPECIFICALLY IN SUPPORT OF TEXAS CHILDREN'S HEALTH PLAN'S MISSION TO PROVIDE CARE THAT IS ACCESSIBLE, COORDINATED, COMPREHENSIVE, CONTINUOUS, CULTURALLY SENSITIVE, COMMUNITY-BASED AND FAMILY-CENTERED. 118328017 true true false false false false false false false false true false false true true true true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 28 0 true 198 true false false false false false false true false false false X 5 2 false false false false true true true true false false false true true true true true true false false false X Anna Mateja 8328281020 1919 S Braeswood Blvd Houston TX 77030 Michael A Belfort MD PhD Board Member / Secretary 1.0 3.0 X X 0 37790 0 Angelo P Giardino MD PHD Board Member / Chairman / Chief Medical Officer 1.0 39.0 X X 0 593925 105249 Lisa Hollier Board Member / Medical Director for Obstetrics and Gynecology 1.0 1.0 X X 0 0 0 Mark W Kline MD Board Member / Vice Chairman 1.0 4.0 X X 0 40122 0 Heidi Schwarzwald Board Member / Pediatric Medical Director 1.0 1.0 X X 0 0 0 Lucio Fragoso Schedule O 1.0 39.0 X 0 371184 79394 Aisha Jamal Schedule O 1.0 39.0 X 0 150982 23582 Anna Mateja Chief Financial Officer 1.0 39.0 X 0 381856 121273 Dace Reinholds Schedule O 1.0 39.0 X 0 124894 15111 Tangula Taylor Director of Business Development and Community Initiatives 40.0 0.0 X 218973 0 39600 Randy Wright Schedule O 1.0 39.0 X 0 203983 3576 Toronda Baker Education Coordinator - TCHP/TCHPC 40.0 0 X 109483 0 19536 Kristine Barton Director of Business development / strategic planning 40.0 0 X 133845 0 24486 Sydnee Lucas NURSE PRACTITIONER 40.0 0 X 103885 0 14891 Ijeoma Opara Nurse Practitioner 40.0 0 X 106545 0 12978 Victoria Taiwo Nurse Practitioner 40.0 0 X 102449 0 14139 775180 1904736 473815 6 false true false THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON PO BOX 301365 DALLAS TX 753031365 STAFFING SERVICES 470871 PHYSICIAN RESOURCES INC 1818 MEMORIAL DRIVE 200 HOUSTON TX 77007 PHYSICIAN STAFFING 152031 STRATUS VIDEO LLC PO BOX 674954 DETROIT MI 482674954 INTERPRETING SERVICES 118760 OMNINET SWCC LP 9420 Wilshire Boulevard 4th Floor BEVERLY HILLS CA 90212 PROPERTY MANAGEMENT 110586 LANGUAGE LINE SERVICES INC 1 LOWER RAGSDALE DRIVE BUILDING 2 MONTEREY CA 93940 INTERPRETING SERVICES 108262 5 609923 11451 621374 PREMIUM REVENUE 900099 120218471 120218471 NET PATIENT SERVICE REVENUE 622310 529904 529904 PROGRAM SERVICE RENTAL 900099 185019 185019 CMS Incentives 900099 49726 49726 0 0 0 0 120983120 0 0 0 0 Non-patient revenue 900099 74743 74743 0 0 0 0 74743 121679237 120983120 0 74743 258573 258573 9362090 8779549 582541 495426 187751 307675 1464210 1391954 72256 756575 691806 64769 10522513 10488360 34153 0 276 269 7 129931 125244 4687 1767529 1629313 138216 6586 4199 2387 15949 15275 674 2198889 1838081 360808 324717 320638 4079 MEDICAL EXPENSE PER PROVIDER AGREEMENT 87160775 87160775 VENDED SERVICES FROM TCH 3551973 3312365 239608 MEDICAL SUPPLIES 2318977 2318977 VENDED SERVICES FROM TCHP 1271499 1271499 72749 63461 9288 0 121679237 118328017 3351220 0 12588445 13881329 0 0 0 129833 143296 26519132 13561743 15164321 12957389 0 0 7536876 9198930 35419475 36180944 3157468 4583653 44378 49613 0 5729337 5059386 8931183 9692652 X 26488292 26488292 26488292 26488292 35419475 36180944 0 0 X false true X true false X X X 1 TEXAS CHILDREN'S HEALTH PLAN 760486264 9 true 118328017 0 1 118328017 0 true false false false false false false false false false false false false false false true false 18508910 6568428 11940482 8010222 6993315 1016907 12957389 MISCELLANEOUS RECEIVABLE 9198930 DUE FROM AFFILIATES 9198930 DEFERRED RENT 4300176 DUE TO AFFILIATES 759210 5059386 X 121679237 0 0 121679237 0 0 121679237 121679237 0 0 121679237 0 0 121679237 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION ON THE ACCOMPANYING BALANCE SHEETS AS OF DECEMBER 31, 2017 OR 2016. false true false false false false false false false Angelo P Giardino MD PHD Board Member / Chairman / Chief Medical Officer 0 481709 0 33075 0 79141 0 92350 0 12899 0 699174 0 57233 Lucio Fragoso Schedule O 0 331547 0 19600 0 20037 0 66900 0 12494 0 450578 0 0 Aisha Jamal Schedule O 0 147677 0 2225 0 1080 0 11140 0 12442 0 174564 0 0 Anna Mateja Chief Financial Officer 0 306573 0 14225 0 61058 0 105255 0 16018 0 503129 0 41562 Tangula Taylor Director of Business Development and Community Initiatives 208698 0 9275 0 1000 0 16009 0 23591 0 258573 0 0 0 Randy Wright Schedule O 0 116001 0 0 0 87982 0 2596 0 980 0 207559 0 0 Kristine Barton Director of Business development / strategic planning 132272 0 1416 0 157 0 5330 0 19156 0 158331 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED BY TEXAS CHILDREN'S AND TEXAS CHILDREN'S HOSPITAL, USING THE FOLLOWING METHODS: *COMPENSATION COMMITTEE *INDEPENDENT COMPENSATION CONSULTANT *COMPENSATION SURVEY OR STUDY *APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 457 (F) PLAN: PAID/DEFERRED LUCIO FRAGOSO 19,600 / 51,000 ANGELO P. GIARDINO, MD, PHD 90,308 / 71,000 ANNA MATEJA 55,787 / 83,905 RANDY WRIGHT 77,544 / 0 TANGULA TAYLOR 9,275 / 0 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED AISHA JAMAL 2,225 / 0 457(F): THE 457(F) PLAN IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO RECEIVE SUPPLEMENT EXECUTIVE RETIREMENT INCOME. FUNDS MAY BE CREDITED INTO THIS ACCOUNT FROM AN EMPLOYER CONTRIBUTION, CALCULATED BASED ON AN INDIVIDUAL'S TITLE AND BASE SALARY AS OF JANUARY 1. THESE EMPLOYER FUNDED CONTRIBUTIONS VEST THE EARLIER OF FIVE YEARS, OR THE ATTAINMENT OF AGE 60 AND 75-POINTS DETERMINED AS OF THEIR AGE AND YEARS OF SERVICE. THE 457(F) PLAN ALSO CONTAINS RESIDUAL LONG-TERM INCENTIVE PLAN CONTRIBUTIONS AND CAPITAL ACUMULATION CONTRIBUTIONS FROM A FLEXILBE BENEFIT ACCOUNT SURPLUS. THE LONG-TERM INCENTIVE CONTRIBUTIONS VEST AFTER THREE YEARS AND THE CAPITAL ACCUMULATION CONRIBUTIONS VEST AFTER 5 YEARS IN THE PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND/OR YEAR. Form 990, Part VI, Line 6 Classes of members or stockholders TEXAS CHILDREN'S HEALTH PLAN IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S HEALTH PLAN - THE CENTER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body TEXAS CHILDREN'S HEALTH PLAN, AS THE SOLE MEMBER CORPORATION, HAS THE AUTHORITY TO ELECT THE BOARD OF DIRECTORS OF THE ORGANIZATION. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PER THE ORGANIZATION'S BYLAWS THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER OF DIRECTORS AND APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION, OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIED FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION (INCLUDING THE AWARDING OF ANY INCENTIVE COMPENSATION) OF THE OFFICERS OF THE CORPORATION, PHYSICIAN EMPLOYEES OF THE CORPORATION, IF ANY, AND PHYSICIANS WHO ARE INDEPENDENT CONTRACTORS TO THE CORPORATION, IF ANY. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS AND LEGAL COUNSEL. -CREATION OR SALE OF ANY SUBSIDIARIES OF THE CORPORATION. -ANY AFFILIATION, JOINT VENTURE, CONTRACT, EMPLOYMENT, RETENTION, INDEMNIFICATION, OR OTHER ARRANGEMENTS BETWEEN THE CORPORATION AND ANY INSURER, HEALTH MAINTENANCE ORGANIZATION, PREFERRED PROVIDER ORGANIZATION, MEDICAL SCHOOL, HOSPITAL, CLINIC, PHARMACY, PHYSICIAN, TEXAS CHILDREN'S HEALTH PLAN AFFILIATE, OR OTHER PROVIDER OF HEALTH OR RELATED SERVICES, INCLUDING, WITHOUT LIMITATION, ALL SERVICE TERMS AND COMPENSATION ARRANGEMENTS. -ESTABLISHMENT BY THE CORPORATION OF ANY TRAINING OR RESIDENCY PROGRAM. -THE GIVING, SEEKING, OR RECEIVING OF GRANTS. -ADOPTION OR AMENDMENT OF ANY INDEMNIFICATION RIGHTS, OBLIGATIONS, OR AGREEMENTS AFFECTING THE CORPORATION. -PURCHASE, ADOPTION, AMENDMENT, CANCELLATION, OR REPLACEMENT OF ANY INSURANCE COVERAGE FOR THE CORPORATION OR ITS DIRECTORS, OFFICERS AND AGENTS, AS WELL AS COPIES OF ANY NOTICES OF CANCELLATION RECEIVED BY THE CORPORATION. -THE COMMENCEMENT OF LITIGATION OR THE SETTLEMENT OF LITIGATION OR OTHER CLAIMS. -APPROVAL OF THE ADOPTION OR AMENDMENT OF FEE SCHEDULES RELATING TO PATIENT SERVICES. -DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBER(S). -TAKE ANY ACTION WHICH WOULD BE CONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body NO SUCH COMMITTEES EXIST. Form 990, Part VI, Line 11b Review of form 990 by governing body PER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF TRUSTEES, THE MEMBER BOARD'S AUDIT & COMPLIANCE COMMITTEE HAS DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REVEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS / KEY EMPLOYEES: PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS. Form 990, Part VI, Line 19 Required documents available to the public THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VII, Section A INCENTIVE COMPENSATION DRS. BELFORT AND KLINE, WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVE AS IN-CHIEFS DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO THEIR SENIOR LEADERSHIP ROLES, THEY ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THEIR CONTRIBUTIONS TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN THEIR CAPACITY AS PHYSICIAN LEADERS. Form 990, Part VII, Section A TITLES LUCIO FRAGOSO: PRESIDENT STARTING 3/1/17 AISHA JAMAL: ASSISTANT SECRETARY STARTING 6/1/17 DACE REINHOLDS: ASSISTANT SECRETARY THROUGH 6/1/17 RANDY WRIGHT: PRESIDENT THROUGH 3/1/17 SCHEDULE O FORM 5471 DISCLOSURE STATEMENT UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: -TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN:20-2380599 6621 FANNIN ST HOUSTON, TX 77030 -TEXAS CHILDREN'S EIN: 76-0461578 1919 S. BRAESWOOD BLVD, 4TH FL HOUSTON, TX 77030 TEXAS CHILDREN'S 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 760461578 PARENT TX 501(c)(3) Type II NA false TEXAS CHILDREN'S PHYSICIAN GROUP 6621 FANNIN STREET HOUSTON TX 77030 260834681 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S false TEXAS CHILDREN'S WOMEN'S SPECIALISTS PO BOX 300630 HOUSTON TX 77230 261482195 HEALTH CARE TX 501(c)(3) Type II TEXAS CHILDREN'S false TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON TX 77030 741100555 HOSPITAL TX 501(c)(3) 3 TEXAS CHILDREN'S false TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON TX 77030 202380599 SUPPORTING ORG TX 501(c)(3) Type II TEXAS CHILDREN'S false TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON TX 77230 760460242 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S false TEXAS CHILDREN'S HEALTH PLAN 6330 WEST LOOP SOUTH SUITE 800 8TH FLOOR HOUSTON TX 77401 760486264 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S false TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 472029489 HEALTH CARE TX 501(c)(3) 10 TCH PEDIATRIC ASSOCIATES INC false THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON TX 77046 760246858 SUPPORTING ORG TX 501(c)(3) Type I TEXAS CHILDREN'S HOSPITAL false CORDILLERA PRIMARY WAVE CO-INVESTMENT FUND LP 3000 SAND HILL RD BLDG 3 STE 100 MENLO PARK CA 94025 821568240 INVESTMENT CA NA N/A TCH INSURANCE COMPANY LTD 23 LIME BAY AVENUE GRAND CAYMAN CJ KY11102 980176652 INSURANCE CJ NA C Corporation false CVI GVF HOLDINGS 3 LTD 981078282 INVESTMENT CJ NA C Corporation false false false false false false false false false false false false false true false false false false true false