2018-11-09T15:03:24-06:00 2017-12-31 990 2017-01-01 462737696 Children's Medical Center Health Plan CHIL 2144567000 1935 Medical District Drive Dallas TX 75235 Tammie Sibley CHST SVP, Finance 2018-11-09 2017 2019-02-21 02:37:17Z Peter Perialas 1935 Medical District Drive Dallas TX 75235 245101344 false X N/A X 2013 TX TO INSURE HEALTH COVERAGE FOR POOR, DISTRESSED, OR UNDERPRIVILEGED CHILDREN & ADULTS. 6 0 177 0 0 38616489 245065321 2643 36023 0 38619132 245101344 0 0 8840428 18431810 0 0 43132948 302712062 51973376 321143872 -13354244 -76042528 31785913 42916565 21442181 53515363 10343732 -10598798 TO INSURE HEALTH COVERAGE FOR POOR, DISTRESSED, OR UNDERPRIVILEGED CHILDREN & ADULTS IN THE STATE OF TEXAS. false false 304584541 245065321 To insure poor, distressed, or underprivileged children or adults enrolled in Texas Medicaid (STAR), Children's Health Insurance Program (CHIP), Medicaid recipients on Social Security Administration's Supplemental Security Income (STAR Kids and STAR+PLUS), Medicaid for foster children (STAR health), and Medicare Advantage (covering only those patients that have dual eligibility for Medicaid and Medicare benefits) in the State of Texas. 304584541 true false false false false false false false false false true false false false true false false true 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 50 0 true 177 true false false false false false false true false false false X 6 0 false false false false true true true true true false false false true true true true true false false false X STEPHANIE K SMITH 2144597000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Peter Perialas Dir. and Pres., CMCHP & SVP Strategy and Innovation, CHST 1.0 54.0 X X 0 621380 21713 Doris Hunt Dir. and VP/Executive Director, CMCHP & SVP CHST Insurance Services, CHST 51.0 4.0 X X 0 609822 20694 Christopher J Durovich Chairman, CMCHP & President and CEO, CHST 1.0 59.0 X 0 3886127 34737 Ray Tsai MD Director, CMCHP & SVP System Ambulatory Services, CHST 1.0 54.0 X 0 628244 31511 Lawrence Foust Director, CMCHP & EVP CLO and General Counsel, CHST 1.0 54.0 X 0 805476 25812 Richard Goode Director, CMCHP & EVP CHST Finance CFO and Treas, CHST 1.0 54.0 X 0 786266 21340 Mark Chulick Secretary, CMCHP & Assistant General Counsel, CHST 1.0 49.0 X 0 219717 21359 Michele Chulick (term 1617) Former Director and Officer, CMCHP & President CHST Ventures, CHST 0.0 55.0 X 0 1485371 10800 Stephanie Smith Former Officer, CMCHP & Sr Legal Counsel, CHST 0.0 50.0 X 0 140567 11005 Peter Roberts (term 33117) Former Director and Officer, CMCHP & Pres Pop Hlth Insurance Svcs, CHST 0.0 55.0 X 0 1325750 19580 Mary Goessler MD (term 100117) Former Medical Director, CMCHP & VP Medical Dir ACO and HMO, CHST 0.0 50.0 X 0 892243 25733 0 11400961 244286 0 true true false MEDIWARE INFORMATION SYSTEMS PO BOX 204176 Dallas TX 75230 Professional Services 626903 HMS Inc 5615 High Point Drive Ste 100 Irving TX 75038 Professional Services 564553 HALLE HEALTHCARE INFORMATICS 241 S BEVERLY STREET Chandler AZ 85225 Professional Services 482390 ENVOLVE PEOPLECARE INC 1366 Paysphere Circle Chicago IL 60674 Professional Services 402424 Invidasys Inc 2500 S Power Road Suite 215 Mesa AZ 85209 Professional Services 303430 8 0 Premium Revenue 900099 245065321 245065321 0 0 0 0 245065321 36023 36023 0 0 0 0 0 0 0 0 0 245101344 245065321 0 36023 14811713 9876421 4935292 739026 492781 246245 1887760 1258755 629005 993311 662338 330973 125601 125601 5107726 68678 5039048 0 517864 382507 135357 770842 1235 769607 3722978 3722978 207802 123263 84539 131119 14058 117061 117646 117646 106155 106155 Medical Claims Expense 287227224 287227224 Premium Taxes 4273834 4273834 Shared Services 277403 277403 Transltn & Interprtn Srvc 93600 93600 32268 3692 28576 0 321143872 304584541 16559331 0 21924294 38644595 17 251362 0 0 0 40973 935454 2783999 198845 0 2585154 0 0 9820629 500000 31785913 42916565 892135 26272842 0 20550046 27242521 21442181 53515363 X 10343732 -10598798 10343732 -10598798 31785913 42916565 X -76042528 55099998 X false true X true false X 0 0 0 0 0 0 0 0 38616489 245065321 283681810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38616489 245065321 283681810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283681810 0 1784 1595 2643 36023 42045 0 0 0 0 0 0 0 1784 1595 2643 36023 42045 0 0 0 0 0 0 0 0 0 0 0 1784 1595 38619132 245101344 283723855 X 2463291 108277 2355014 187382 90568 96814 133326 133326 2585154 LT Advances - Affiliates 2139262 LT DEFERRED RENT Accrued Premium Tax Payable HM 3617259 HMO IBNR 21486000 Premium Deficiency Reserve 27242521 Schedule D, Part X, Line 2 The organization's consolidated financial statements for the year ending December 31, 2017 did not require a FIN 48 (ASC 740) footnote. true true false false false false false true false Peter Roberts (term 33117) Former Director and Officer, CMCHP & Pres Pop Hlth Insurance Svcs, CHST 0 152837 0 605165 0 567748 0 16200 0 3380 0 1345330 0 0 Mary Goessler MD (term 100117) Former Medical Director, CMCHP & VP Medical Dir ACO and HMO, CHST 0 243263 0 150411 0 498569 0 10800 0 14933 0 917976 0 0 Peter Perialas Dir. and Pres., CMCHP & SVP Strategy and Innovation, CHST 0 409183 0 208812 0 3385 0 10800 0 10913 0 643093 0 0 Doris Hunt Dir. and VP/Executive Director, CMCHP & SVP CHST Insurance Services, CHST 0 363743 0 223715 0 22363 0 10800 0 9894 0 630516 0 0 Christopher J Durovich Chairman, CMCHP & President and CEO, CHST 0 1087098 0 2641501 0 157528 0 12946 0 21791 0 3920864 0 0 Ray Tsai MD Director, CMCHP & SVP System Ambulatory Services, CHST 0 375621 0 207525 0 45098 0 14901 0 16610 0 659754 0 0 Lawrence Foust Director, CMCHP & EVP CLO and General Counsel, CHST 0 511526 0 270308 0 23642 0 10800 0 15012 0 831288 0 0 Richard Goode Director, CMCHP & EVP CHST Finance CFO and Treas, CHST 0 638971 0 144875 0 2420 0 10696 0 10644 0 807606 0 0 Michele Chulick (term 1617) Former Director and Officer, CMCHP & President CHST Ventures, CHST 0 20596 0 311646 0 1153129 0 10800 0 0 0 1496171 0 0 Stephanie Smith Former Officer, CMCHP & Sr Legal Counsel, CHST 0 124399 0 12883 0 3285 0 6793 0 4213 0 151572 0 0 Mark Chulick Secretary, CMCHP & Assistant General Counsel, CHST 0 186652 0 29248 0 3816 0 9130 0 12230 0 241076 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER HEALTH PLAN (CMCHP). THEREFORE, CMCHP'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used. Schedule J, Part I, Line 4a Severance or change-of-control payment Severance Payment: *Severance - Mary Goessler - $337,600 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Non-Qualified Retirement Plan: *Retirement Income Restoration Plan - No employees received taxable income from the Retirement Income Restoration Plan. Employees who participated in the Retirement Income Restoration Plan include Christopher J Durovich. *Savings Restoration Plan - Peter Roberts received $60,740 as taxable income from the Savings Restoration Plan. Additional employees who participated in the Savings Restoration Plan include Christopher J Durovich and Ray Tsai. Schedule J, Part I, Line 7 Non-fixed payments Non-Fixed Payments - The Human Resources Committee of the Board of Directors of Children's Health System of Texas retains the authority to adjust annual payout percentages solely at their discretion. There were no non-fixed payments in 2017. Form 990, Part V, Line 2a CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST) EIN 75-2062019 IS THE COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER HEALTH PLAN (CMCHP) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY CHST ON BEHALF OF CMCHP. CMCHP HAS APPROXIMATELY 177 EMPLOYEES. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER HEALTH PLAN (CMCHP). THEREFORE, CMCHP'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used. Form 990, Part VI, Line 6 Classes of members or stockholders Children's Health System of Texas (CHST) is the sole member. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHST elects all members of the organization's Board of Directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Member reserve powers are specified in the organization's Bylaws and represent those actions by the organization which require member approval. These powers generally encompass changes in the mission of the organization, addition of new members, specified financial matters, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors. Form 990, Part VI, Line 11b Review of form 990 by governing body Children's Medical Center Health Plan has delegated its oversight and review of the Form 990 to the Board of Directors of Children's Health System of Texas (CHST), its Sole Member. A draft of the Form 990 is presented to the CHST Audit Committee for review prior to filing. A copy of the Final Form 990 is made available to the CHST directors through our Board portal before it is filed. Form 990, Part VI, Line 12c Conflict of interest policy Officers, directors, and key employees received a copy of the Statement of Interest form to execute. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer and discussed as necessary at the appropriate Committee and Board meetings to determine if further action is needed. Form 990, Part VI, Line 19 Required documents available to the public Certificate of Formation, Consolidated Financial Statements , and the conflict of interest policy is made available upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHST Paid-in Capital - 55100000; Rounding - -2; Children's Medical Center of Dallas 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 750800628 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Children's Medical Center Foundation 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062015 Foundation TX 501(c)(3) 7 CHILDREN'S HEALTH SYSTEM OF TEXAS false Anesthesiologists for Children 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752917570 PHYSICIANS TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false Dallas Physician Medical Services for Childrens 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 810584868 PHYSICIANS TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Physicians for Children 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752854505 PHYSICIANS TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false COMPLEX CARE MED SVC CORP 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461893597 MEDICAL SERVICES TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MED CTR RESEARCH INST AT UTSWMC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 433462044 RESEARCH INSTITUTE TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false PEDIATRIC PARTNERS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461917702 CLINICALLY INTEGRATED NETWORK TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S POPULATION HEALTH 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463104601 POPULATION HEALTH TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S HEALTH SYSTEM OF TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062019 MANAGEMENT COMPANY TX 501(c)(3) Type II N/A false OCH Holdings 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 474837308 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 464049491 PHYSICIANS TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false SOUTHWESTERN MEDICAL DISTRICT 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 204101612 MEDICAL DISTRICT TX 501(c)(3) Type I N/A false WOMEN'S AUXILIARY OF CMCD 12720 HILLCREST RD DALLAS TX 75230 752485538 WOMEN'S AUXILIARY TX 501(c)(3) 10 N/A false THE HEALTH AND WELLNESS ALLIANCE FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463080586 PHYSICIANS TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 1 1935 Medical District Drive Dallas TX 75235 813582843 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 2 1935 Medical District Drive Dallas TX 75235 813679995 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 3 1935 Medical District Drive Dallas TX 75235 813691209 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 4 1935 Medical District Drive Dallas TX 75235 814577909 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 5 1935 Medical District Drive Dallas TX 75235 814848085 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 6 1935 Medical District Drive Dallas TX 75235 814865847 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false Wellness Innovations LLC 1935 Medical District Drive Dallas TX 75235 475246461 Physicians TX CHST Investment Holdings LLC Unrelated false false 0 ALTERNATIVE CARE SYSTEMS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752244475 OTHER MEDICAL SERVICES TX CHST C Corporation 0 false NTPSS INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 471036641 PHYSICIAN SOLUTIONS TX Pediatric Partners C Corporation 0 false Texas Bluebonnet Insurance Company 1935 Medical District Drive Dallas TX 75235 475032893 Insurance Company TX CHST C Corporation 0 false TEXAS TRINITY RIVER ASSURANCE COMPANY LTD 878 West Bay Road PO Box 1159 Grand Cayman Grand Cayman CJ KY11202 981318151 Self-insurance CJ CHST C Corporation 0 false Wellness Innovations Physician Partners 1935 Medical District Drive Dallas TX 75235 811734937 Physicians TX CHST C Corporation 0 0 0 false Children's BMG 1935 Medical District Drive Dallas TX 75235 475057374 Physicians TX CHST C Corporation 0 0 0 false false false true false true false false false false false false true false false true false false false false