2018-11-14T13:49:37-06:00 2017-12-31 ERNST & YOUNG US LLP 312 WALNUT ST SUITE 1900 CINCINNATI OH 45202 990 2017-01-01 050477052 Neighborhood Health Plan of Rhode Island % PETER M MARINO CEO NEIG 4014596000 910 Douglas Pike Smithfield RI 02917 Frank Meaney CFO 4014596000 2018-11-14 true JULIE L SPARKS P01268401 5136121400 104.183.205.7 26308520183185000065 2018-11-14 P 2BAE214FEF11F2FC1D4688B70D6C316E0922AE3D F213E6B48CE9C544D9E09D7DB47DBE98D420130F 2017 2019-02-21 02:37:17Z Peter M Marino CEO 910 Douglas Pike Smithfield RI 02917 1403180178 false X www.nhpri.org X 1993 RI NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND SECURES ACCESS TO HIGH QUALITY, COST-EFFECTIVE HEALTH CARE FOR RHODE ISLAND'S AT-RISK POPULATIONS. 15 14 579 1 2038709 0 11987 2500 1165729604 1365884063 2037430 2051872 0 0 1167779021 1367938435 2682 381 1023914429 1262175749 44448745 33334974 0 0 0 79681885 74091182 1148047741 1369602286 19731280 -1663851 348826156 382573256 246123485 282295188 102702671 100278068 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND, AN INNOVATIVE HEALTH PLAN IN PARTNERSHIP WITH THE COMMUNITY HEALTH CENTERS, SECURES ACCESS TO HIGH QUALITY, COST-EFFECTIVE HEALTH CARE FOR RHODE ISLAND'S AT-RISK POPULATIONS. false false 1291970863 381 1363845354 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO) THAT PROVIDES COMPREHENSIVE HEALTH CARE SERVICES ON A PREPAID BASIS PRINCIPALLY TO MEDICAID RECIPIENTS AND CERTAIN OTHER ELIGIBLE PERSONS UNDER THE STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS MANAGED CARE PROGRAM, RITECARE. AS OF DECEMBER 31, 2017, THE ORGANIZATION IS RESPONSIBLE FOR PROVIDING HEALTH CARE SERVICES TO OVER 199,000 MEMBERS. 1291970863 true false false true false false false false false false true false false true true false 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 false false false false true 2704 0 true 579 true true true false false false false false false false false false X 15 14 true false false false true true false true true true false true true true true false false true true false X PETER M MARINO CEO 4014596000 910 DOUGLAS PIKE SMITHFIELD RI 02917 X JANE HAYWARD VICE CHAIRMAN 1.0 0.0 X 0 0 0 RAYMOND JOSEPH LAVOIE JR TRUSTEE 1.0 0.0 X 0 0 0 PABLO RODRIGUEZ MD TRUSTEE 1.0 0.0 X 0 0 0 PETER BANCROFT CPA TRUSTEE 1.0 0.0 X 0 0 0 JEANNE LACHANCE TRUSTEE 1.0 0.0 X 0 0 0 DENNIS ROY TRUSTEE 1.0 0.0 X 0 0 0 PATRICIA MARTINEZ TRUSTEE 1.0 0.0 X 0 0 0 PETER MARINO PRESIDENT & CEO 38.0 0.0 X X 523277 0 31218 PETER WALSH TRUSTEE (through 10/31/17) 1.0 0.0 X 0 0 0 CHRISTOPHER LITTLE ESQ TRUSTEE 1.0 0.0 X 0 0 0 DORIS DE LOS SANTOS TRUSTEE 1.0 0.0 X 0 0 0 WILLIAM HOCHSTRASSER-WALSH TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL LICHTENSTEIN TRUSTEE 1.0 0.0 X 0 0 0 RICHARD BESDINE MD TRUSTEE 1.0 0.0 X 0 0 0 BRENDA DOWLATSHAHI SECRETARY 1.0 0.0 X 0 0 0 MERRILL THOMAS TREASURER 1.0 0.0 X 0 0 0 CHARLES JONES Trustee (through 2/6/17) 1.0 0.0 X 0 0 0 FRANK MEANEY CFO 38.0 0.0 X 294040 0 9030 FRANCISCO TRILLA MD CHIEF MEDICAL OFFICER 38.0 0.0 X 384417 0 10686 SHANTHA DIAZ COO (ended 6/2/2017) 38.0 0.0 X 112172 0 11256 DOUGLAS BYRD GENERAL COUNSEL 38.0 0.0 X 285202 0 32821 JEFFREY MEYER VP/CHIEF INFORMATION OFFICER 38.0 0.0 X 219039 0 9756 NANCY HERMIZ VP MEDICAID 38.0 0.0 X 212346 0 15425 TRACEY COHEN MEDICAL DIRECTOR 38.0 0.0 X 205077 0 28958 ALISON CROKE VP MEDICARE/MEDICAID INTEGRATI 38.0 0.0 X 201902 0 31923 2437472 0 181073 90 false true false Argus Health Systems Inc 1300 Washington KANSAS CITY MO 64105 Healthcare Services 209526844 Beacon Health Strategies LLC 500 Unicorn Park WOBURN MA 01801 Healthcare Services 182401640 Integra Dimension LLC 100 Wall Street Suite 2502 NEW YORK NY 10005 Healthcare Services 15128185 DST Healthcare Holdings Inc 333 West 11th Street KANSAS CITY MO 64105 Healthcare Services 4214624 HealthEdge Software Inc 30 Corporate Drive BURLINGTON MA 01803 healthcare services 2965204 50 0 2500 0 2500 PREMIUMS EARNED 524114 1346299427 1346299427 0 0 REINSURANCE RECOVERIES 524114 2269561 2269561 0 0 PPC ADMIN SERVICES 524114 2038709 0 2038709 PHARMACY DIVIDENDS 524114 13061568 13061568 0 0 ALL OTHER PROGRAM SERVICE REVENUE 524114 2214798 2214798 0 0 1365884063 2138981 2138981 0 0 0 0 0 35154634 35241743 -87109 -87109 -87109 0 0 0 0 0 0 0 0 0 0 1367938435 1363845354 2038709 2051872 0 0 381 381 0 0 1262175749 1262175749 1533168 0 1533168 0 0 0 0 0 26868464 10933827 15934637 0 1153118 643465 509653 0 1355129 745433 609696 0 2425095 1094619 1330476 0 0 0 0 0 254936 0 254936 0 854189 0 854189 0 57600 0 57600 0 0 0 538243 0 538243 0 18076082 12036911 6039171 0 2187522 23589 2163933 0 2245166 17121 2228045 0 11648824 0 11648824 0 0 0 0 0 3363715 1876953 1486762 0 188235 128037 60198 0 0 0 0 0 0 0 0 0 20544 0 20544 0 0 0 0 0 1248289 493279 755010 0 752546 0 752546 0 State Premium Tax 23675701 0 23675701 0 Temporary Help 2034738 1441544 593194 0 Other Expense - Training 445137 90077 355060 0 STATE AND LOCAL TAXES PAID 2864834 0 2864834 0 3634881 269878 3365003 1369602286 1291970863 77631423 0 0 64473862 96160025 0 0 0 0 15705700 11466657 0 0 0 0 0 0 0 0 0 0 6515742 5154114 1517701 1361628 243230402 250657744 0 0 0 0 0 0 23898491 22927202 348826156 382573256 30756197 15821628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215367288 266473560 246123485 282295188 X 102702671 100278068 0 0 0 0 102702671 100278068 348826156 382573256 X -1663851 343000 0 0 0 -1103752 X X false true X true false X 0 35400 0 11987 2500 49887 430147979 848055027 980546905 1165729604 1365884063 4790363578 0 0 0 430147979 848090427 980546905 1165741591 1365886563 4790413465 0 0 0 4790413465 518891 1005897 1477997 1721501 2138981 6863267 0 518891 1005897 1477997 1721501 2138981 6863267 0 0 430666870 849096324 982024902 1167463092 1368025544 4797276732 0.99857 0.99858 0.00143 0.00142 X false false false 0 false 0 false 0 false 0 true 57600 false 0 false 0 57600 false Schedule C, Part II-B Line 1G NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND DOES NOT DIRECTLY ENGAGE IN ANY LOBBYING ACTIVITIES BUT RETAINS A GOVERNMENT RELATIONS COMPANY, CAPITOL CITY GROUP, TO ADVOCATE THAT FUNDING FOR THE MEDICAID PROGRAM NOT BE REDUCED. FOR THE YEAR ENDED DECEMBER 31,2017 THE ORGANIZATION PAID CAPITOL CITY GROUP $57,600. 0 6515742 5154114 1361628 1361628 RISK SHARE 12905497 RECOV. - REINS/RX/STOP-LOSS 9746955 OTHER ADMITTED ASSETS 274750 22927202 0 IBNR Liabilities 161727397 Unearned Premiums 91787572 RISK ADJUSTMENT 10413159 Medicare Subsidy 2446518 Security Deposits 98914 266473560 1365886563 1365886563 2051872 2051872 1367938435 1369603000 714 714 1369602286 1369602286 FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART X, LINE 2 THERE WAS NO FIN 48 (ASC 740) FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS. Schedule D, Part XI, Line 4b Reconciliation of Revenue Investment Income - $2,051,872 Schedule D, Part XII, Line 2d Reconciliation of Expense Rounding - $714 X X X X false false false false false false false true false PETER MARINO PRESIDENT & CEO 427435 0 94250 0 1592 0 7597 0 23621 0 554495 0 0 0 FRANK MEANEY CFO 268400 0 23952 0 1688 0 9030 0 0 0 303070 0 0 0 FRANCISCO TRILLA MD CHIEF MEDICAL OFFICER 346231 0 32550 0 5636 0 10686 0 0 0 395103 0 0 0 DOUGLAS BYRD GENERAL COUNSEL 258742 0 23657 0 2803 0 10800 0 22021 0 318023 0 0 0 JEFFREY MEYER VP/CHIEF INFORMATION OFFICER 194505 0 22455 0 2079 0 8756 0 1000 0 228795 0 0 0 NANCY HERMIZ VP MEDICAID 186682 0 22789 0 2875 0 8432 0 6993 0 227771 0 0 0 TRACEY COHEN MEDICAL DIRECTOR 191802 0 12098 0 1177 0 6937 0 22021 0 234035 0 0 0 ALISON CROKE VP MEDICARE/MEDICAID INTEGRATI 169046 0 32031 0 825 0 8302 0 23621 0 233825 0 0 0 NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 The Neighborhood Health Plan of Rhode Island (Neighborhood) Performance Incentive Plan (the Plan) has been implemented to offer a performance based incentive award opportunity to eligible Neighborhood employees based on achievement of the organizations annual business objectives as well as their job performance. The Plan allows a portion of Neighborhoods annual compensation costs to be variable in relation to the organizations performance. Other objectives the Plan is expected to provide include the following: . Focus the attention, effort and teamwork of plan participants on accomplishment of Neighborhoods key business objectives . Enable Neighborhood to offer a compensation program with methods and levels of pay that are competitive with other organizations . Reinforce Neighborhoods commitment to a performance-based culture for its employees at all levels of the organization . Assist Neighborhoods efforts to retain its valued employees Amounts paid in 2017 under the Plan are included in Part II Column (B)(II). DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, LINE 2 A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS IS AN EXECUTIVE DIRECTOR OF A COMMUNITY HEALTH CENTER (CHC) BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC. BLACKSTONE VALLEY HEALTH CARE, THROUGH A GRANT, INVESTED IN EQUIPMENT AND SOFTWARE FOR AN ELECTRONIC MEDICAL RECORD (EMR) SYSTEM. ONE OTHER CHC, TRI-TOWN, HAS USE OF THE EMR AND BILLING SYSTEM. THE CHCS SHARE THE COST OF RUNNING THE SYSTEM. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE ORGANIZATION IS A 501(C)(3) CORPORATION AND HAS MEMBERS, BUT DOES NOT HAVE ANY STOCKHOLDERS. THE ORGANIZATION HAS A BOARD OF DIRECTORS WHO ARE MEMBERS OF THE ORGANIZATION THAT MEET ON A REGULAR BASIS AND FUNCTION AS THE GOVERNING BODY OF THE ORGANIZATION. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A THE MEMBERS OF THE ORGANIZATION ARE RHODE ISLAND COMMUNITY HEALTH CENTERS WHO HAVE THE AUTHORITY TO APPOINT A PORTION OF THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ALSO APPROVES THE HIRING OF THE CHIEF EXECUTIVE OFFICER WHO IS A VOTING MEMBER OF THE BOARD. OTHER MAILING ADDRESSES FOR OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES FORM 990, PART VI, LINE 9 SHANTHA DIAZ, FORMER CHIEF OPERATING OFFICER, RESIGNED FROM HER POSITION AT NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND ON 06/02/17. SHE CAN BE REACHED AT 8738 TERRACINA LAKE DRIVE, TAMPA FL 33625. DR. FRANCISCO TRILLA, CHIEF MEDICAL OFFICER, RESIGNED FROM HIS POSITION AT NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND ON 03/09/2018. HE CAN BE REACHED AT 200 EXCHANGE STREET, APT 1413, PROVIDENCE, RI 02903. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE ORGANIZATION'S FISCAL OPERATIONS DEPARTMENT ACCUMULATES THE INFORMATION AND DATA NECESSARY TO COMPLETE THE FEDERAL FORM 990. AUDITED FINANCIAL STATEMENTS AND APPROVED POLICIES AND PROCEDURES ARE USED AS INPUT TO COMPLETE THE 990. A DRAFT RETURN IS PREPARED AND REVIEWED BY THE ORGANIZATION'S INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS. AFTER THE REVIEW PROCESS IS COMPLETED BY THE INDEPENDENT ACCOUNTANTS, THE FINANCE STAFF REVIEWS THE RETURN PRIOR TO FILING WITH THE IRS. THE FINANCE AND AUDIT COMMITTEE IS PROVIDED A DRAFT COPY OF THE RETURN FOR APPROVAL PRIOR TO FILING WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C The organizations Conflict of Interest policy applies to, and serves to describe expected behaviors and actions of, its officers and members of its Board of Directors (directors). The Board of Directors (Board) is responsible for enforcement of the Conflict of Interest policy. An officer or director of the organization has an "Interest" in a given matter if he or she has, directly or indirectly, through an immediate family member, a business, financial, fiduciary or personal relationship with a party or parties as described within the organizations bylaws. The organization requires current and prospective officers and directors to disclose in writing, and update annually, all Interests which may create a conflict of interest and, where applicable, provide a statement suggesting how such conflict could be avoided or mitigated. Officers and directors are required to disclose in writing any Interests that arise after filing the annual disclosure. The Board, or a duly designated committee, reviews instances where a disclosure indicates a potential conflict of interest. The individual with the potential conflict is required to provide information requested by, and respond to questions from, the Board or its designated committee. If the Board has reasonable cause to believe that an individual failed to disclose an Interest, the individual must be informed of this and given the opportunity to explain the alleged failure to disclose. After hearing the individuals response, and conducting further investigation as needed, if the Board determines the individual has failed to disclose an Interest as defined in accordance with the organizations bylaws, the Board will take appropriate corrective and/or disciplinary action. POLICIES FORM 990, PART VI, LINES 13 & 14 PURSUANT TO THE INSTRUCTIONS FOR FORM 990, THE ORGANIZATION MUST ANSWER NO TO QUESTIONS 13 & 14 BECAUSE THE BOARD OF DIRECTORS DOES NOT APPROVE OR ADOPT THESE POLICIES. HOWEVER, THE ORGANIZATION HAS ISSUED THESE POLICIES AT THE DIRECTION OF MANAGEMENT AND THESE POLICIES AND PROCEDURES ARE STRICTLY ENFORCED BY THE ORGANIZATION'S MANAGEMENT TEAM. THE ORGANIZATION HAS WRITTEN WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES. OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A & 15B THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CONTRACT OF THE CEO AND ANY CHANGES TO THE CONTRACT. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER BASED ON COMPENSATION SURVEYS. THE EXECUTIVE COMMITTEE SUBSCRIBES TO THREE OR FOUR SALARY SURVEYS THAT LIST SALARY AND SALARY INCREASES BY POSITION, GEOGRAPHY, PLAN SIZE AND PROFIT VS. NON-PROFIT ORGANIZATIONS. THESE SURVEYS ARE USED TO SET COMPENSATION ANNUALLY. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S LOCATION AT 910 DOUGLAS PIKE, SMITHFIELD, RI 02917. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 Change in Non Admitted Assets (1,104,000) Rounding 248 Total (1,103,752) ACCOUNTING METHOD FORM 990, PART XII, LINE 1 THE ORGANIZATION USES THE STATUTORY METHOD OF ACCOUNTING.