2018-11-13T13:21:31-06:00 2017-12-31 GRANT THORNTON LLP 757 THIRD AVENUE 3RD FLOOR NEW YORK NY 100172013 990 2017-01-01 131828429 Health Insurance Plan of Greater New York % MICHAEL PALMATEER HEAL 6464475000 55 WATER STREET NEW YORK NY 10041 MICHAEL PALMATEER CAO 6464475000 2018-11-12 true Scott Thompsett P00741490 2125990100 2018-11-13 209.220.136.124 26377520183175000010 2018-11-13 P 25D858DE85B81CAA8DEDDE0B47ADD735021FFE67 BB689B47C4810116FFAF734305B3B6F212C66569 2017 2019-02-21 02:37:17Z Karen Ignagni President CEO 55 WATER STREET NEW YORK NY 10041 4867977478 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. 8 5 2826 0 12791732 0 0 0 4862308355 4762633716 31672787 13992167 37421432 34140893 4931402574 4810766776 857613 504612 0 0 222394513 177169945 0 0 0 4957217619 4805220007 5180469745 4982894564 -249067171 -172127788 1786175144 1530485251 978532248 882375465 807642896 648109786 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 1485338880 0 1443703316 MEDICARE - HIPGNY SERVED APPROXIMATELY 112,000 MEDICARE MEMBERS THROUGH its MEDICARE RISK AND COST CONTRACT PROGRAMS. 1085887218 0 1128145689 MEDICAID - HIPGNY SERVED APPROXIMATELY 185,000 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. 1880276515 504612 2202155884 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 2017, HIPgny provided services (across all services lines) to approximately 603,000 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. 4451502613 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 796 0 true 2826 true true true false false false false false X 8 5 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 2993718 0 24463 John D Feerick Chairman 2.0 3.0 X X 0 155000 0 Gregory Eric Floyd Director (Thru 06/2017) 2.0 0.0 X 0 0 0 Paul E Gibson Director (Thru 06/2017) 2.0 0.0 X 0 147000 0 Bernard Schayes MD Director 2.0 0.0 X 0 38769 0 Arthur Pepper Director 2.0 0.0 X 0 0 0 Charles P Wang Director 2.0 0.0 X 0 121194 0 Dr Stuart Altman Director (As of 01/2017) 2.0 0.0 X 0 152875 0 JOHN H BANKS III Director (As of 12/2017) 2.0 0.0 X 0 56375 0 Richard Berman Director (As of 01/2017) 2.0 0.0 X 0 161805 0 James Albano Thru 82017 SVP,Prov. Ntwk & Pop Health 35.0 0.0 X 1618874 0 19831 George Babitsch SVP, Account Mgmt. 35.0 0.0 X 419969 0 27200 David Baum VP, Operations 35.0 0.0 X 241241 0 1957 Daniel Byrne VP, Labor Relations 35.0 0.0 X 293369 0 13843 Antoinette Cassetta SVP, Gov't Programs 35.0 0.0 X 36780 0 328 Jeffrey D Chansler Chief Legal Officer 35.0 0.0 X 669369 0 38426 Christopher W Chappelear Chief Actuary 35.0 0.0 X 428189 0 29192 Robin Golston Thru 22017 VP, Community & Gov't Affairs 35.0 0.0 X 334403 0 7309 Thomas A Conway VP, Controller 35.0 0.0 X 344927 0 19660 Lorraine A Cortes-Vazquez SVP, Corp Rel (Thru 2/2017) 35.0 0.0 X 1100841 0 16693 Douglas Cowieson Thru 72017 SVP, MSO New Ventures 35.0 0.0 X 1524725 0 21112 Edmond A Cunningham VP, Procurement 35.0 0.0 X 313391 0 26492 Jeff Danilo SVP,Prov. Ntwk & Pop Health 35.0 0.0 X 181105 0 1673 Richard Densing Thru 122017 VP, Marketplace Sales 35.0 0.0 X 265304 0 22133 Scott Dickler Thru 102017 SVP, Gov't Programs 35.0 0.0 X 1213064 0 30121 Mariann E Drohan Chief HR Officer 35.0 0.0 X 560482 0 20424 Beth Amber L Fabbri Chief Mkting & Comm Officer 35.0 0.0 X 489462 0 31613 Shawn Fitzgibbon Thru 22017 Chief Product Officer 35.0 0.0 X 1352149 0 17009 Robert Fox Thru 92017 EmblemHealth General Counsel 35.0 1.0 X 1030871 0 17972 Jerry Frank SVP, Medical Delivery 35.0 0.0 X 353987 0 9702 Vitaliy Fuzaylov VP, Medical Economics 35.0 0.0 X 274673 0 22368 Cynthia L Goff VP, Gov't Affairs & Policy 35.0 0.0 X 339029 0 14020 Andrew Harrell VP, Enterprise Underwriting 35.0 0.0 X 121278 0 3336 Linda M Henderson VP, Regulatory Compliance 35.0 0.0 X 246264 0 10146 Carol Huffman VP, ACPNY Relationship 35.0 0.0 X 74167 0 1510 Beatriz M Jaramillo MD VP, Medicare Stars & Qual Mgmt 35.0 0.0 X 147582 0 2538 Jim Karagiorgis VP, Vendor Oversight 35.0 0.0 X 317177 0 27051 William Lamoreaux Thru 72017 Pres. MSO New Ventures 35.0 0.0 X 6067557 0 20354 Hemant Lanjewar Thru 92017 VP, Med. Stars & Qual Mgmt 35.0 0.0 X 516081 0 18125 Kimberly Lauersdorf VP, Marketing 35.0 0.0 X 45736 0 496 Debra M Lightner Chief Compliance Officer 35.0 0.0 X 354406 0 17673 Carl A Lund VP, Facility Contracting 35.0 0.0 X 369278 0 22704 Michelle Lyddon VP, Communications 35.0 0.0 X 244328 0 17474 Thomas A MacMillan VP,Transform,IT&Analytics 35.0 0.0 X 415515 0 22285 Thomas Mafale Thru 52017 VP, Commercial Sales 35.0 0.0 X 168685 0 13164 Carlos Manalansan VP, Deputy General Counsel 35.0 0.0 X 268776 0 28692 Andrew JD McBrien VP, Medicare 35.0 0.0 X 302992 0 20990 Lorraine McDonald VP, Clinical Services 35.0 0.0 X 256317 0 22024 Pansy McRae VP, Claims (Thru 7/2017) 35.0 0.0 X 454815 0 17792 Frank Melaccio VP, Treasurer (Thru 7/2017) 35.0 0.0 X 250395 0 27205 Peter S Moore VP, Gov't Programs 35.0 0.0 X 259886 0 22103 Karen Moran VP, Ancillary Products 35.0 0.0 X 260252 0 14950 Timothy Nolan EVP,Chief Rev & HC Del Officer 35.0 0.0 X 765454 0 21519 Carolyn A Oser VP, Bus & Tech Transform 35.0 0.0 X 319884 0 31350 Michael Palmateer Chief Financial Officer 35.0 0.0 X 849246 0 37500 Douglas Parks Thru 32017 VP, HR Transform & Strat 35.0 0.0 X 427775 0 1292 Russell Petrella EVP (Thru 10/2017) 35.0 0.0 X 640272 0 11416 Michele H Podolak VP, Customer Service 35.0 0.0 X 232345 0 16486 Jameson Reuter VP, Ent. Pharm Solutions 35.0 0.0 X 178268 0 12084 Navarra Rodriguez SVP, Pres./CMO ACPNY 35.0 0.0 X 487650 0 25800 Suzanne G Ronner Thru 72017 VP, Vend. Oversight 35.0 0.0 X 462853 0 13423 John J Sheehy III SVP, Product Innovation 35.0 0.0 X 481878 0 33738 Wei-Jia Shen VP, Multicultural Mkting. 35.0 0.0 X 329143 0 22092 Jill Stein VP, Deputy General Counsel 35.0 0.0 X 346538 0 23063 Paula Tavsanli VP, Client Relations Mgmt. 35.0 0.0 X 315238 0 28737 Jennifer L Truscott VP, G&A & Ops Compl. 35.0 0.0 X 451709 0 18306 William Voigt VP, HR Bus. Operations 35.0 0.0 X 382886 0 21860 Roberto Hormazabal Sr. Dir. Account Management 40.0 0.0 X 485589 0 23525 Bonnie Deger Dir., Account Management 40.0 0.0 X 393624 0 20247 Jayne Sullivan-Savage Sr. Account Exec 40.0 0.0 X 324894 0 5822 Bruce Sosler Thru 052017 Senior Medical Director 40.0 0.0 X 317651 0 4883 Michael Worthington AVP, Facilities 40.0 0.0 X 291715 0 22341 Joseph Zeitlin Former President/CMO ACPNY 35.0 0.0 X 554667 0 0 Kevin Tighe Former VP, Internal Audit 35.0 0.0 X 281314 0 0 36842002 833018 1159637 649 true true false COGNIZANT HEALTHCARE SERVICES LLC 500 Frank W Burr Suite 3F TEANECK NJ 07666 Consulting 19334276 INOVALON INC 4321 Collington Road BOWIE MD 20716 Data Analytics 15783179 THE SOURCING GROUP LLC 77 Water Street NEW YORK NY 10005 business solutions 4296907 CHANGE HEALTHCARE OPERATIONS LLC 3055 Lebanon Pike NASHVILLE TN 37214 Technology Solutions 4038004 MCKESSON TECHNOLOGIES INC 1145 Sanctuary Parkway ALPHARETTA GA 30004 Business Solutions 3897346 115 0 PREMIUM REVENUE 900099 4753321367 4753321367 THIRD PARTY ADMINISTRATIVE FEES 900099 9312349 7671432 1640917 4762633716 8079133 3376888 4702245 0 0 31622163 18267287 13354876 0 13354876 13354876 44856449 38943415 5913034 5913034 5913034 0 0 0 0 0 0 0 0 0 PHARMACY REVENUE 900099 20786017 13012090 7773927 20786017 4810766776 4774004889 12791732 23970155 X 504612 504612 0 0 0 36107986 36107986 835981 835981 98948321 98948321 10961028 10961028 20273324 20273324 10043305 10043305 0 4420838 4420838 3305246 3305246 733433 733433 0 924985 924985 181727473 181727473 11218737 11218737 16032037 16032037 0 0 21189494 21189494 2275340 2275340 0 128338 128338 68057 68057 0 41818559 41818559 5226478 5226478 SUBSCRIBER BENEFITS 4373233347 4373233347 0 0 CAPITATION PAYMENTS 49117564 49117564 0 0 QUALITY OF CARE EXPENSES 19492424 19492424 0 0 CLAIMS ADJUSTMENT EXPENSE 8385789 8385789 0 0 65921868 768877 65152991 4982894564 4451502613 531391951 0 0 0 110869498 212990991 0 0 271216803 183694652 0 0 0 0 171822631 171330349 0 0 6412223 4915871 424565786 260230612 160962702 164335174 253709443 10229777 582800087 603848197 0 0 0 0 228381757 179140240 1786175144 1530485251 757010376 689955232 0 0 31060934 20712790 0 0 0 0 0 0 0 0 0 0 190460938 171707443 978532248 882375465 X 807642896 648109786 0 0 0 0 807642896 648109786 1786175144 1530485251 X -172127788 12594678 X false true X true false 6963425 6963425 163017451 94979158 68038293 214129790 129286348 84843442 37388701 34907393 2481308 3066419 1057713 2008706 164335174 INVESTMENT IN ADVANTAGECARE 394207646 C INVESTMENT IN HIP HOLDINGS INC 209640551 C 603848197 ACCRUED INTEREST RECEIVABLE 22537903 DEFERRED RENT 778725 INTEREST/DIVIDENDS RECEIVABLE 144519 OTHER CURRENT ASSETS 4709654 HEALTHCARE RECEIVABLES 133457482 INTERCOMPANY RECEIVABLES 17511957 179140240 0 PENSION LIABILITY 110257575 DEFERRED RENT 58940288 OTHER LONG TERM LIABILITIES 2509580 171707443 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, 2017, 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) 5800 0 General Support 1199 SEIU HOME CARE INDUSTRY EDUCATION PO BOX 842 NEW YORK NY 10108 711028611 501(c)(3) 14600 0 General Support AHRC NYC FOUNDATION 83 Maiden Lane NEW YORK NY 10038 133779611 501(c)(3) 12500 0 General Support AHRC SUFFOLK FOUNDATION 2900 VETERANS MEM HWY BOHEMIA NY 11716 263876547 501(c)(3) 6776 0 General Support ARCHCARE 205 LEXINGTON AVE NEW YORK NY 10016 133896624 501(c)(3) 22650 0 General Support BRONXWORKS INC 60 E Tremont Ave Bronx NY 10453 133254484 501(c)(3) 6000 0 General Support CHINESE-AMERICAN PLANNING COUNCIL INC 150 ELIZABETH ST NEW YORK NY 10012 136202692 501(c)(3) 9000 0 General Support COMUNILIFE INC 214 W 29 Street NEW YORK NY 10001 133530299 501(c)(3) 9400 0 General Support Flushing Chinese Business Association 40-48 MAIN STREET FLUSHING NY 11354 112958388 501(c)(3) 6300 0 General Support FOUNDATION FOR A BETTER PUERTO RICO INC PO BOX 938 CULEBRA PR 009368362 660817772 501(c)(3) 15000 0 General Support HARLEM WEEK INC 200A W 136TH ST NEW YORK NY 10030 133058019 501(c)(3) 12500 0 General Support HISPANIC FEDERATION INC 55 Exchange Pl 5th Fl NEW YORK NY 10005 133573852 501(c)(3) 20000 0 General Support MAYOR'S FUND TO ADVANCE NEW YORK CITY 253 Broadway NEW YORK NY 10007 133783906 501(c)(3) 60000 0 General Support MEDICARE RIGHTS CENTER 266 West 37th Street NEW YORK NY 10018 133505372 501(c)(3) 6000 0 General Support NORTHEAST BUSINESS GROUP ON HEALTH 80 PINE ST 29TH FLR NEW YORK NY 10005 133156952 501(c)(3) 6250 0 General Support PATROLMEN'S BENEVOLENT ASSOCIATION 125 BROAD ST 11TH FL NEW YORK NY 10004 135308915 501(c)(5) 7600 0 General Support THE METROPOLITAN GOLF ASSOCATION 49 KNOLLWOOD RD ELMSFORD NY 10523 911814922 501(c)(3) 20000 0 General Support THE NEW YORK ACADEMY OF MEDICINE 1216 Fifth Ave NEW YORK NY 10029 131656674 501(c)(3) 6436 0 General Support THE WORKMEN'S CIRCLE ARBETER RING INC 247 W 37th St Frnt 5 NEW YORK NY 10018 136178558 501(c)(3) 23000 0 General Support UNIFORMED FIRE OFFICERS ASSOCIATION 573 Warburton Ave Yonkers NY 10701 133081498 501(c)(5) 5500 0 General Support UNIFORMED FIREFIGHTERS ASSOC PO Box 2085 Mount Vernon NY 10551 133907650 501(c)(5) 24000 0 General Support UNITED CEREBRAL PALSY OF NYC INC 80 MAIDEN LANE 8TH FLOOR NEW YORK NY 10038 135654532 501(c)(3) 6950 0 General Support UNITED HOSPITAL FUND 1411 Broadway 12th Fl NEW YORK NY 10018 131562656 501(c)(3) 13000 General Support 19 4 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 967738 0 2000000 0 25980 0 16200 0 8263 0 3018181 0 0 0 John D Feerick Chairman 0 155000 0 0 0 0 0 0 0 0 0 155000 0 0 Dr Stuart Altman Director (As of 01/2017) 0 152875 0 0 0 0 0 0 0 0 0 152875 0 0 Richard Berman Director (As of 01/2017) 0 161805 0 0 0 0 0 0 0 0 0 161805 0 0 James Albano Thru 82017 SVP,Prov. Ntwk & Pop Health 193736 0 487920 0 937218 0 16200 0 3631 0 1638705 0 0 0 George Babitsch SVP, Account Mgmt. 306700 0 82008 0 31261 0 16200 0 11000 0 447169 0 0 0 David Baum VP, Operations 89023 0 75000 0 77218 0 1375 0 582 0 243198 0 0 0 Daniel Byrne VP, Labor Relations 203922 0 78592 0 10855 0 5807 0 8036 0 307212 0 0 0 Jeffrey D Chansler Chief Legal Officer 453774 0 180000 0 35595 0 16200 0 22226 0 707795 0 0 0 Christopher W Chappelear Chief Actuary 319008 0 84000 0 25181 0 16200 0 12992 0 457381 0 0 0 Robin Golston Thru 22017 VP, Community & Gov't Affairs 14047 0 70013 0 250343 0 6350 0 959 0 341712 0 0 0 Thomas A Conway VP, Controller 252540 0 67200 0 25187 0 16200 0 3460 0 364587 0 0 0 Lorraine A Cortes-Vazquez SVP, Corp Rel (Thru 2/2017) 21401 0 179013 0 900427 0 14723 0 1970 0 1117534 0 0 0 Douglas Cowieson Thru 72017 SVP, MSO New Ventures 176657 0 334380 0 1013688 0 16200 0 4912 0 1545837 0 0 0 Edmond A Cunningham VP, Procurement 238763 0 63648 0 10980 0 9921 0 16571 0 339883 0 0 0 Jeff Danilo SVP,Prov. Ntwk & Pop Health 164994 0 15000 0 1111 0 0 0 1673 0 182778 0 0 0 Richard Densing Thru 122017 VP, Marketplace Sales 204336 0 27540 0 33428 0 14849 0 7284 0 287437 0 0 0 Scott Dickler Thru 102017 SVP, Gov't Programs 249678 0 113258 0 850128 0 16200 0 13921 0 1243185 0 0 0 Mariann E Drohan Chief HR Officer 379776 0 146880 0 33826 0 16200 0 4224 0 580906 0 0 0 Beth Amber L Fabbri Chief Mkting & Comm Officer 379962 0 91200 0 18300 0 16200 0 15413 0 521075 0 0 0 Shawn Fitzgibbon Thru 22017 Chief Product Officer 12984 0 254040 0 1085125 0 16200 0 809 0 1369158 0 0 0 Robert Fox Thru 92017 EmblemHealth General Counsel 265196 0 68000 0 697675 0 16200 0 1772 0 1048843 0 0 0 Jerry Frank SVP, Medical Delivery 246851 0 100000 0 7136 0 5438 0 4264 0 363689 0 0 0 Vitaliy Fuzaylov VP, Medical Economics 217837 0 37403 0 19433 0 15900 0 6468 0 297041 0 0 0 Cynthia L Goff VP, Gov't Affairs & Policy 271553 0 56000 0 11476 0 9898 0 4122 0 353049 0 0 0 Linda M Henderson VP, Regulatory Compliance 210767 0 34615 0 882 0 0 0 10146 0 256410 0 0 0 Beatriz M Jaramillo MD VP, Medicare Stars & Qual Mgmt 111919 0 25000 0 10663 0 2538 0 0 0 150120 0 0 0 Jim Karagiorgis VP, Vendor Oversight 224693 0 62400 0 30084 0 15744 0 11307 0 344228 0 0 0 William Lamoreaux Thru 72017 Pres. MSO New Ventures 261558 0 3102023 0 2703976 0 16200 0 4154 0 6087911 0 2022356 0 Hemant Lanjewar Thru 92017 VP, Med. Stars & Qual Mgmt 169515 0 60710 0 285856 0 15920 0 2205 0 534206 0 0 0 Debra M Lightner Chief Compliance Officer 319273 0 24000 0 11133 0 10695 0 6978 0 372079 0 0 0 Carl A Lund VP, Facility Contracting 244496 0 99000 0 25782 0 16200 0 6504 0 391982 0 0 0 Michelle Lyddon VP, Communications 219776 0 0 0 24552 0 11250 0 6224 0 261802 0 0 0 Thomas A MacMillan VP,Transform,IT&Analytics 285915 0 111600 0 18000 0 16200 0 6085 0 437800 0 0 0 Thomas Mafale Thru 52017 VP, Commercial Sales 83791 0 66000 0 18894 0 5291 0 7873 0 181849 0 0 0 Carlos Manalansan VP, Deputy General Counsel 221687 0 28724 0 18365 0 15900 0 12792 0 297468 0 0 0 Andrew JD McBrien VP, Medicare 261910 0 22800 0 18282 0 15900 0 5090 0 323982 0 0 0 Lorraine McDonald VP, Clinical Services 187534 0 35200 0 33583 0 13558 0 8466 0 278341 0 0 0 Pansy McRae VP, Claims (Thru 7/2017) 103659 0 58752 0 292404 0 12851 0 4941 0 472607 0 0 0 Frank Melaccio VP, Treasurer (Thru 7/2017) 134250 0 78000 0 38145 0 15705 0 11500 0 277600 0 0 0 Peter S Moore VP, Gov't Programs 183630 0 46704 0 29552 0 12908 0 9195 0 281989 0 0 0 Karen Moran VP, Ancillary Products 242000 0 0 0 18252 0 14950 0 0 0 275202 0 0 0 Timothy Nolan EVP,Chief Rev & HC Del Officer 587507 0 0 0 177947 0 16200 0 5319 0 786973 0 0 0 Carolyn A Oser VP, Bus & Tech Transform 236688 0 64800 0 18396 0 16038 0 15312 0 351234 0 0 0 Michael Palmateer Chief Financial Officer 688866 0 134400 0 25980 0 16200 0 21300 0 886746 0 0 0 Douglas Parks Thru 32017 VP, HR Transform & Strat 47904 0 85315 0 294556 0 0 0 1292 0 429067 0 0 0 Russell Petrella EVP (Thru 10/2017) 447501 0 146400 0 46371 0 0 0 11416 0 651688 0 0 0 Michele H Podolak VP, Customer Service 158898 0 45120 0 28327 0 11384 0 5102 0 248831 0 0 0 Jameson Reuter VP, Ent. Pharm Solutions 164516 0 0 0 13752 0 10200 0 1884 0 190352 0 0 0 Navarra Rodriguez SVP, Pres./CMO ACPNY 432400 0 36800 0 18450 0 16200 0 9600 0 513450 0 0 0 Suzanne G Ronner Thru 72017 VP, Vend. Oversight 98996 0 86516 0 277341 0 13423 0 0 0 476276 0 0 0 John J Sheehy III SVP, Product Innovation 332804 0 132120 0 16954 0 14515 0 19223 0 515616 0 0 0 Wei-Jia Shen VP, Multicultural Mkting. 245947 0 64800 0 18396 0 16038 0 6054 0 351235 0 0 0 Jill Stein VP, Deputy General Counsel 260138 0 68400 0 18000 0 16200 0 6863 0 369601 0 0 0 Paula Tavsanli VP, Client Relations Mgmt. 235711 0 60000 0 19527 0 15698 0 13039 0 343975 0 0 0 Jennifer L Truscott VP, G&A & Ops Compl. 310019 0 117000 0 24690 0 16200 0 2106 0 470015 0 0 0 William Voigt VP, HR Bus. Operations 274548 0 90000 0 18338 0 16200 0 5660 0 404746 0 0 0 Roberto Hormazabal Sr. Dir. Account Management 464141 0 0 0 21448 0 14190 0 9335 0 509114 0 0 0 Bonnie Deger Dir., Account Management 372829 0 0 0 20795 0 12279 0 7968 0 413871 0 0 0 Jayne Sullivan-Savage Sr. Account Exec 314836 0 0 0 10058 0 2745 0 3077 0 330716 0 0 0 Bruce Sosler Thru 052017 Senior Medical Director 98157 0 36671 0 182823 0 0 0 4883 0 322534 0 0 0 Michael Worthington AVP, Facilities 218651 0 44100 0 28964 0 14479 0 7862 0 314056 0 0 0 Joseph Zeitlin Former President/CMO ACPNY 0 0 164667 0 390000 0 0 0 0 0 554667 0 0 0 Kevin Tighe Former VP, Internal Audit 0 0 0 0 281314 0 0 0 0 0 281314 0 0 0 Form 990, Schedule J, Part I, Line 1b Two individuals reported on Schedule J, Robert Fox and Timothy Nolan, received a gross-up payment in 2017; the tax gross-up is reported in Schedule J, Part II, Column (b)(iii). Form 990, Schedule J, Part I, Line 4a - Severance The following individuals reported on Form 990, Part VII and Schedule J received severance payments in 2017: James Albano - $904,800 Robin Golston - $229,500 Lorraine A. Cortes-Vazquez - $856,800 Douglas Cowieson - $979,200 Scott Dickler - $820,080 Shawn Fitzgibbon - $1,040,400 Robert Fox - $637,500 William Lamoreaux - $2,070,000 Hemant Lanjewar - $252,960 Pansy McRae - $244,800 Douglas Parks - $265,200 Suzanne G. Ronner - $238,609 Joseph Zeitlin - $390,000 Kevin Tighe - $281,314 Bruce Sosler - $152,796 All of the severance payments documented above are 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) provide 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). HIPGNY (Via EmblemHealth Services, The Payroll Payor) also has a long term incentive plan based upon longer term performance over three year performance cycles. The compensation committees approve the performance metrics, targets and payouts based upon achievement of performance under these plans. Officers and key employees are generally eligible to participate in the long term incentive plan. 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 191196 Employee Wages false christine o'connor burns family of former officer 237949 Employee Wages false Keith Dahl family of former officer 302774 Employee Wages false Alyssa Pepper family of board member 121834 Employee Wages false Dr Lester LeBlanc family of board member 71540 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#. In addition, HIPGNY's 100% owned disregarded entity, EmblemHealth Services, also issued 1099s in calendar year 2017. In the interests of full disclosure, HIPGNY is disclosing that EmblemHealth Services issued 1,138 1099s in calendar year 2017. In total, HIPgny and Emblemhealth Services paid compensation exceeding $100,000 to 115 vendors. HIPGNY, as a part of its business, undertakes a significant amount of claims processing; in 2017, HIPGNY issued 22,203 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. 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 2,826 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, 2017 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 $12,594,678 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 126006000 HIPGNY EMBLEMHEALTH INC 55 WATER STREET NEW YORK NY 10041 133941542 support svcs NY 501(c)(3) 12(c) HIPGNY true Group Health Incorporated 55 Water Street New York NY 10041 135511997 Insurance NY NA C Corp 780971656 723141193 1.00000 true HIP Holdings Inc & Subsidiaries 55 Water Street New York NY 10041 133819759 Insurance NY NA C Corp. 1828660944 1062158081 1.00000 true AdvantageCare Physicians PC 55 water street New York NY 10041 460970995 healthcare NY HIPGNY C Corp 475844407 91375154 1.00000 true S I Urgent Care 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 true true EmblemHealth Inc M,P 1453569 Cost EmblemHealth Inc S 600000 Cost Group Health Incorporated A 3300000 Market Rate Group Health Incorporated D 165000000 Market Rate Hip Holdings Inc & Subsidiaries (EHA) M 3500000 COST Hip Holdings Inc & Subsidiaries (EHA) L 600000 COST Hip Holdings Inc & Subsidiaries (HIPIC) L,Q 3300000 COST Hip Holdings Inc & Subsidiaries (HIPIC) M 16200000 COST Hip Holdings Inc & Subsidiaries (HIP-IPA) l 400000 cost Hip Holdings Inc & Subsidiaries (HIP-IPA) M 2500000 cost AdvantageCare Physicians PC a 76888 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 2017. 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. As of December 31, 2017, no payments were made to HIPgny. Nevertheless, HIPgny is disclosing the amount of accrued interest with Transaction Code A. 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 $9,200,000 for the year ended December 31, 2017. HIPgny paid out-of-network claims on behalf of HIPIC of $7,000,000 in 2017. Under the terms of a service agreement, HIPgny allocated costs associated with administering the premiums and claims of approximately $3,300,000 to HIPIC for the year ended December 31, 2017. 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, 2017, HIPGNY incurred approximately $2,500,000 for capitation and $200,000 for data collection services. In addition, HIPgny provides certain administrative and support services to HIP-IPA, which are reimbursed by HIP-IPA. For the year ended December 31, 2017, amounts charged by HIPgny to HIP-IPA for these services was approximately $200,000. Transactions with HIP HOldings, Inc. & Subsidiaries - Emblemhealth Administrators, Inc. ("EHA") EHA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) provides claims processing and certain member services for HIPGNYs members. For the year ended December 31, 2017, EHA charged HIPgny approximately $3,500,000 for these services. HIPGNY provides administrative and management services to EHA; amounts paid in 2017 were approximately $600,000. EHA ceased doing business in 2017.