TUFTS HEALTH PUBLIC PLANS INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
TUFTS HEALTH PUBLIC PLANS INC (EIN 80-0721489)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201833179349308088
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-13T19:11:43-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12100 ONE PPG PLACEAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15222ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN800721489EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TUFTS HEALTH PUBLIC PLANS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% UMESH KURPADInCareOfNm
Business Name ControlTUFTBusinessNameControlTxt
Phone6179729400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 MOUNT AUBURN STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02472ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEDWARD TEXERIAPersonNm
Person TitleVP, CONTROLLERPersonTitleTxt
Phone6179729400PhoneNum
Signature2018-11-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEILEEN WEBBPreparerPersonNm
PTINP01641852PTIN
Phone4126447800PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address98.217.127.68IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id04750420183175000013FederalOriginalSubmissionId
Federal Original Submission Id2018-11-13FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7E659306EFE8AB3B64B9EC1E9A33CFA3490291F4AtSubmissionCreationDeviceId
At Submission Filing Device Id36455B2BDA99E2162F05488401542DAAB5EDB38CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS CROSWELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 MOUNT AUBURN STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP024721508ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,905,540,097GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.TUFTSHEALTHPLAN.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2014FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES SERVED BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee570TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$1,528,284,931PYProgramServiceRevenueAmt
CY Program Service Revenue$1,792,531,048CYProgramServiceRevenueAmt
PY Investment Income$11,903,043PYInvestmentIncomeAmt
CY Investment Income$15,317,372CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$10,438CYOtherRevenueAmt
PY Total Revenue$1,540,187,974PYTotalRevenueAmt
CY Total Revenue$1,807,858,858CYTotalRevenueAmt
PY Grants And Similar Paid$174,610PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$112,478CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$1,391,820,623PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$1,655,188,239CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$38,003,192PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,253,909CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$119,771,839PYOtherExpensesAmt
CY Other Expenses$117,439,642CYOtherExpensesAmt
PY Total Expenses$1,549,770,264PYTotalExpensesAmt
CY Total Expenses$1,813,994,268CYTotalExpensesAmt
PY Revenues Less Expenses-$9,582,290PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$6,135,410CYRevenuesLessExpensesAmt
Total Assets BOY$529,677,780TotalAssetsBOYAmt
Total Assets EOY$588,373,246TotalAssetsEOYAmt
Total Liabilities BOY$336,157,728TotalLiabilitiesBOYAmt
Total Liabilities EOY$341,043,016TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$193,520,052NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$247,330,230NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,320,000,824ExpenseAmt
Grant$84,177GrantAmt
Revenue$1,341,499,727RevenueAmt
DescTHE ORGANIZATION PROVIDES ACCESS TO AFFORDABLE HEALTH CARE THROUGH A MEDICAID MANAGED CARE ORGANIZATION CONTRACT WITH THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. SEE SCHEDULE ODesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$366,086,931ExpenseAmt
Grant$23,345GrantAmt
Revenue$372,049,402RevenueAmt
DescTUFTS HEALTH DIRECT IS AN INDIVIDUAL AND SMALL GROUP QUALIFIED HEALTH PLAN (QHP) ESTABLISHED BY THE ORGANIZATION AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT TO PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES WHO ARE NOT ELIGIBLE FOR AFFORDABLE EMPLOYER-SPONSORED INSURANCE, AND SMALL EMPLOYER GROUPS WITH 1-50 EMPLOYEES. SEE SCHEDULE ODesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$72,936,922ExpenseAmt
Grant$4,651GrantAmt
Revenue$74,124,848RevenueAmt
DescTUFTS HEALTH UNIFY IS A MEDICARE-MEDICAID PLAN FOR INDIVIDUALS AGE 21-64 WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. SEE SCHEDULE ODesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$4,779,231TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$305TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$4,857,071TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$1,763,803,908TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document6247IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee570EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonUMESH KURPADPersonNm
Phone6179729400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1705 MOUNT AUBURN STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP024721508ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Thomas Croswell
DIRECTOR & CEO15.035.0Yes (X)Yes (X)$0$1,730,340$170,133
Umesh Kurpad
DIRECTOR & CFO15.035.0Yes (X)Yes (X)$0$905,836$109,883
Christopher Gorton
DIR/PRESIDENT (UNTIL 10/17)50.00.0Yes (X)Yes (X)$0$679,750$82,933
Mary Mahoney
DIR/CLERK/SVP/CLO15.035.0Yes (X)Yes (X)$0$555,713$65,760
ROLAND PRICE
TREASURER10.040.0Yes (X)$0$399,457$97,361
MARC SPOONER
EXECUTIVE VICE PRESIDENT15.035.0Yes (X)$0$677,514$222,081
BARRIE BAKER
VP, CMO PUBLIC PLANS50.00.0$0$366,702$37,512Yes (X)
DAVID WEBSTER
VP, FIN&NTWK CNTRCTG Pub Plans50.00.0$0$355,411$45,041Yes (X)
James Roosevelt Jr
CONSULTANT15.035.0$0$780,968$93,949Yes (X)
Helene Forte
VP, RI Market Public Plans50.00.0$0$279,764$78,803Yes (X)
HYUNSOOK SONG
VP, COMMUNITY PLC PLNS50.00.0$0$335,810$39,372Yes (X)
LOIS CORNELL
CLERK (UNTIL 12/15)0.00.0$0$424,230$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,491,495TotReportableCompRltdOrgAmt
Total Other Compensation$1,042,828TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HEALTHCARE FINANCIAL INC
220 HIGH ST 6TH FLBOSTONMA02110CONSULTING$3,624,000
MASSACHUSETTS BUSINESS ASSOCIATION
135 WOOD ROADBRAINTREEMA02184OUTSOURCING$230,909
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
TOGETHER (MEDICAID)524114$1,341,499,727$1,341,499,727
MA ACA EXCHANGE524114$372,049,402$372,049,402
CARE ONE (MEDICARE/MEDICAID)524114$74,124,848$74,124,848
RI TOGETHER (MEDICAID)524114$4,857,071$4,857,071
FieldValueIRS element (for citing)
Total Program Service Revenue$1,792,531,048TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,159,045TotalRevenueColumnAmt
Exclusion$13,159,045ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$99,839,566SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$97,681,239SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,158,327SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,158,327TotalRevenueColumnAmt
Exclusion$2,158,327ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business900099BusinessCd
Total Revenue Column$10,438TotalRevenueColumnAmt
Exclusion$10,438ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$10,438OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,807,858,858TotalRevenueColumnAmt
Related Or Exempt Func Income$1,792,531,048RelatedOrExemptFuncIncomeAmt
Exclusion$15,327,810ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$112,478TotalAmt
Program Services$112,478ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$1,655,188,239TotalAmt
Program Services$1,655,188,239ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$32,720,466TotalAmt
Program Services$32,720,466ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,533,443TotalAmt
Program Services$8,533,443ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$70,744,654TotalAmt
Program Services$56,595,723ProgramServicesAmt
Management And General$14,148,931ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$136,910TotalAmt
Management And General$136,910ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$434,332TotalAmt
Management And General$434,332ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$115,318TotalAmt
Management And General$115,318ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$30,006,238TotalAmt
Management And General$30,006,238ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,906,743TotalAmt
Program Services$2,325,394ProgramServicesAmt
Management And General$581,349ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,181,301TotalAmt
Management And General$1,181,301ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,605,075TotalAmt
Program Services$4,484,060ProgramServicesAmt
Management And General$1,121,015ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$204,801TotalAmt
Program Services$163,841ProgramServicesAmt
Management And General$40,960ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$155,812TotalAmt
Program Services$155,812ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$184,277TotalAmt
Program Services$147,421ProgramServicesAmt
Management And General$36,856ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,846,152TotalAmt
Program Services$3,876,922ProgramServicesAmt
Management And General$969,230ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$469,688TotalAmt
Management And General$469,688ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CLAIMS INTEREST$7,144,732$7,144,732
CAE ADJUSTMENT$1,035,772$1,035,772
COB FEES$1,009,284$1,009,284
LICENSING FEES$929,649$929,649

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total-$9,671,096TotalAmt
Program Services-$7,644,623ProgramServicesAmt
Management And General-$2,026,473ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,813,994,268TotalAmt
Program Services$1,763,803,908ProgramServicesAmt
Management And General$50,190,360ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$100,600,260BOYAmt
EOY$59,570,722EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,698,017BOYAmt
EOY$58,070,551EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,759,848LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,576,625LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,171,248BOYAmt
EOY$3,183,223EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$407,273,915BOYAmt
EOY$454,682,451EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,000,000BOYAmt
EOY$2,000,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,934,340BOYAmt
EOY$10,866,299EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$529,677,780BOYAmt
EOY$588,373,246EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$317,074,150BOYAmt
EOY$326,031,462EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,083,578BOYAmt
EOY$15,011,554EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$336,157,728BOYAmt
EOY$341,043,016EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$193,520,052BOYAmt
EOY$247,330,230EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$193,520,052BOYAmt
EOY$247,330,230EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$529,677,780BOYAmt
EOY$588,373,246EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$6,135,410ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$21,767,834NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$38,177,754OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,759,848OtherCostOrOtherBasisAmt
Depreciation$4,579,625DepreciationAmt
Book Value$3,183,223BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$3,183,223TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
PAYABLE TO AFFILIATES$6,217,587
PREMIUMS RECEIVED IN ADVANCE$8,793,967
FieldValueIRS element (for citing)
Total Liability$15,011,554TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,807,743,540TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$1,807,743,540RevenueSubtotalAmt
Investment Expenses Not Incld$115,318InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$115,318RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,807,858,858TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,813,878,950TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$1,813,878,950ExpensesSubtotalAmt
Investment Expenses Not Incld2$115,318InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$115,318ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,813,994,268TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationASC 740 (FKA FIN 48) FOOTNOTE IN 2017, THE AUDITED FINANCIAL STATEMENTS FOR TUFTS HEALTH PUBLIC PLANS, INC. DID NOT DISCLOSE AN ASC 740 FOOTNOTE.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
HEAD OF THE CHARLES REGATTA INC
PO Box 380052CambridgeMA02238043317489501(C)(3)$12,200Patron Display Sponsorship
South Shore YMCA Inc
91 LONGWATER CIRCLENorwellMA02061042105881501(C)(3)$10,000Germantown Teaching Kitchen Programs
COMMUNITY ROWING INC
HP BOATHOUSE 20 NONANTM RDBRIGHTONMA02135042863756501(C)(3)$40,000INCLUSION ROWING
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE I, Part I, LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION ONLY CONTRIBUTES TO TAX-EXEMPT ORGANIZATIONS UNDER 501(C)(3) AND CERTAIN GOVERNMENTAL UNITS AS WELL AS SPONSORS EVENTS THAT BENEFIT THESE TYPES OF ORGANIZATIONS. THE ORGANIZATION CONTRIBUTES TO WELL ESTABLISHED, NON-PROFIT ORGANIZATIONS THAT HAVE ESTABLISHED POLICIES AND PROCEDURES FOR MONITORING THE USE OF FUNDS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (true)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROLAND PRICE
TREASURER$0$256,503$0$107,092$0$35,862$0$86,798$0$10,563$0$496,818$0$30,199
BARRIE BAKER
VP, CMO PUBLIC PLANS$0$297,284$0$78,837$0-$9,419$0$18,900$0$18,612$0$404,214$0$0
DAVID WEBSTER
VP, FIN&NTWK CNTRCTG Pub Plans$0$248,941$0$85,528$0$20,942$0$43,065$0$1,976$0$400,452$0$23,972
James Roosevelt Jr
CONSULTANT$0$348,614$0$332,594$0$99,760$0$93,949$0$0$0$874,917$0$99,760
Thomas Croswell
DIRECTOR & CEO$0$890,865$0$706,350$0$133,125$0$163,839$0$6,294$0$1,900,473$0$130,657
Umesh Kurpad
DIRECTOR & CFO$0$518,959$0$315,155$0$71,722$0$98,619$0$11,264$0$1,015,719$0$73,546
Christopher Gorton
DIR/PRESIDENT (UNTIL 10/17)$0$396,719$0$202,989$0$80,042$0$76,643$0$6,290$0$762,683$0$21,523
LOIS CORNELL
CLERK (UNTIL 12/15)$0$0$0$0$0$424,230$0$0$0$0$0$424,230$0$0
Mary Mahoney
DIR/CLERK/SVP/CLO$0$337,588$0$176,093$0$42,032$0$64,496$0$1,264$0$621,473$0$40,288
Helene Forte
VP, RI Market Public Plans$0$225,701$0$54,016$0$47$0$77,933$0$870$0$358,567$0$1,062
MARC SPOONER
EXECUTIVE VICE PRESIDENT$0$420,383$0$210,480$0$46,651$0$205,836$0$16,245$0$899,595$0$54,120
HYUNSOOK SONG
VP, COMMUNITY PLC PLNS$0$230,000$0$80,250$0$25,560$0$38,502$0$870$0$375,182$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 3SUPPLEMENTAL COMPENSATION INFORMATION TUFTS HEALTH PUBLIC PLANS,INC. USES THE COMPENSATION POLICIES OF ITS SOLE MEMBER, TUFTS HEALTH PLAN, INC. UNTIL OCTOBER 2017, IT USED THE POLICIES OF ITS SOLE MEMBER, TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO). FORM 990, SCHEDULE J, PART I, LINE 4A LOIS CORNELL RECEIVED A Severance PAYMENT OF $424,230.
FORM 990, SCHEDULE J, PART I, LINE 4BTHE RELATED ORGANIZATION MAINTAINS AN EXECUTIVE SAVINGS PLAN (ESP) FOR ITS SENIOR MANAGERS WITH THE TITLE DIRECTOR AND ABOVE. THE NUMBERS LISTED ON SCHEDULE J PART II COLUMN C REFLECT BOTH THE EMPLOYEE DEFERRALS AS WELL AS THE EMPLOYER CONTRIBUTIONS TO THE ESP.
FORM 990, SCHEDULE J, PART I, LINE 6THE OFFICERS AND KEY EMPLOYEES LISTED ON PART VII OF TUFTS HEALTH PUBLIC PLANS PARTICIPATE IN AN EXECUTIVE INCENTIVE PLAN THAT IS BASED ON THE OVERALL ANNUAL SUCCESS OF THE ORGANIZATION. THE ORGANIZATION'S GOALS ARE ESTABLISHED EARLY IN THE YEAR AND APPROVED BY ITS INDEPENDENT BOARD OF DIRECTORS. ONE OF THE COMPONENTS OF THE PLAN IS BASED ON MEETING TARGETED NET EARNINGS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1THE PURPOSE OF TUFTS HEALTH PUBLIC PLANS, INC. ("THPP", OR THE "ORGANIZATION") IS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES IT SERVES BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING PROVIDING COMMUNITY OUTREACH AND EDUCATION TO THE COMMUNITY IT SERVES. THE ORGANIZATION AIMS TO IMPROVE THE LIVES OF MASSACHUSETTS RESIDENTS AND RHODE ISLAND RESIDENTS BY PROVIDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH CARE, PRIMARILY THROUGH MANAGED CARE PROGRAMS DIRECTED AT LOW TO MODERATE INCOME RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS AND STATE OF RHODE ISLAND. ACCESS IS PROVIDED THROUGH PROGRAMS SUCH AS, BUT NOT LIMITED TO, MASSHEALTH AND THE COMMONWEALTH OF MASSACHUSETTS MEDICAID MANAGED CARE ORGANIZATION (MCO) AND PROVIDING COVERAGE TO MASSACHUSETTS RESIDENTS ELIGIBLE FOR MEDICAID OR THE CHILDREN'S HEALTH INSURANCE PROGRAM. IN MARCH 2017, THE ORGANIZATION ALSO BEGAN OFFERING COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THE ORGANIZATION ALSO OFFERS SUBSIDIZED HEALTH PLANS TO LOW AND MIDDLE INCOME INDIVIDUALS THROUGH THE COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY (THE MASSACHUSETTS STATE RUN EXCHANGE), AS WELL AS THE ONECARE PROGRAM FOR MASSACHUSETTS RESIDENTS WHO ARE UNDER 65 YEARS OLD AND ELIGIBLE FOR BOTH MEDICARE AND MEDICAID WITH INTEGRATED, COORDINATED MEDICAL AND BEHAVIORAL HEALTHCARE. ORGANIZATION'S MISSION STATEMENT FORM 990, PART III, LINE 1 THE PURPOSE OF TUFTS HEALTH PUBLIC PLANS, INC. ("THPP", OR THE "ORGANIZATION") IS TO IMPROVE THE HEALTH AND WELLESS OF THE DIVERSE COMMUNITIES IT SERVES BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING PROVIDING COMMUNITY OUTREACH AND EDUCATION TO THE COMMUNITY IT SERVES. THE ORGANIZATION AIMS TO IMPROVE THE LIVES OF MASSACHUSETTS RESIDENTS AND RHODE ISLAND RESIDENTS BY PROVIDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH CARE, PRIMARILY THROUGH MANAGED CARE PROGRAMS DIRECTED AT LOW TO MODERATE INCOME RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS AND STATE OF RHODE ISLAND. ACCESS IS PROVIDED THROUGH PROGRAMS SUCH AS, BUT NOT LIMITED TO, MASSHEALTH AND THE COMMONWEALTH OF MASSACHUSETTS MEDICAID MANAGED CARE ORGANIZATION (MCO), PROVIDING COVERAGE TO MASSACHUSETTS RESIDENTS ELIGIBLE FOR MEDICAID OR THE CHILDREN'S HEALTH INSURANCE PROGRAM. THE ORGANIZATION ALSO OFFERS SUBSIDIZED HEALTH PLANS TO LOW AND MIDDLE INCOME INDIVIDUALS THROUGH THE COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY (THE MASSACHUSETTS STATE RUN EXCHANGE), AS WELL AS THE ONECARE PROGRAM FOR MEMBERS WHO ARE UNDER 65 YEARS OLD AND ELIGIBLE FOR BOTH MEDICARE AND MEDICAID WITH INTEGRATED, COORDINATED MEDICAL AND BEHAVIORAL HEALTH CARE. IN MARCH 2017, THE ORGANIZATION ALSO BEGAN OFFERING COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THPP'S PRIMARY ACTIVITY IS TO PROVIDE HEALTH COVERAGE AND EDUCATION ABOUT BENEFITS TO LOW AND MODERATE INCOME RESIDENTS OF MASSACHUSETTS AND RHODE ISLAND THROUGH CONTRACTS WITH THE MASSACHUSETTS' COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY AND THE MASSACHUSETTS AND RHODE ISLAND EXECUTIVE OFFICES OF HEALTH AND HUMAN SERVICES. THE ORGANIZATION OFFERS FULLY INTEGRATED, IN-HOUSE CARE MANAGEMENT, PROVIDING A TEAM OF MEDICAL, BEHAVIORAL HEALTH, SOCIAL CARE AND PHARMACY PROFESSIONALS WHO COORDINATE MEMBER CARE. THE ORGANIZATION CONTRACTS WITH THOUSANDS OF PRIMARY CARE PHYSICIANS, SPECIALISTS, HOSPITALS AND COMMUNITY ORGANIZATIONS IN MASSACHUSETTS AND RHODE ISLAND. THE ORGANIZATION ENROLLS A SUBSTANTIAL NUMBER OF PERSONS WHO MAY OTHERWISE BE UNABLE TO OBTAIN AFFORDABLE HEALTH CARE SERVICES AS WELL AS THOSE POPULATIONS WHO HAVE SPECIAL HEALTH CARE NEEDS, SUCH AS DISABLED INDIVIDUALS BETWEEN 21-64 YEARS OLD ELIGIBLE FOR THE ORGANIZATION'S ONECARE DEMONSTRATION PROGRAM IN MASSACHUSETTS, AND THOSE INDIVIDUALS ELIGIBLE FOR THE ORGANIZATION'S MEDICAID PROGRAMS. THE ORGANIZATION PROVIDES ACCESS TO HEALTH CARE STATEWIDE, IN OVER 400 CITIES AND TOWNS IN MASSACHUSETTS AND over 50 CITIES AND TOWNS IN RHODE ISLAND THROUGH ITS EXTENSIVE PROVIDER NETWORK. THE ORGANIZATION'S ACTIVITIES FURTHER ITS EXEMPT PURPOSE OF PROVIDING COMPREHENSIVE HEALTH CARE SERVICES, OUTREACH, AND EDUCATION TO RESIDENTS OF MASSACHUSETTS AND RHODE ISLAND, MOST OF WHOM ARE LOW AND MODERATE INCOME. THE ORGANIZATION PROVIDES COMMUNITY AND PUBLIC BENEFITS BY ENSURING ACCESS TO NEEDED HEALTH CARE SERVICES BY LOW TO MODERATE INCOME, HIGH-RISK, AND MEDICALLY UNDERSERVED POPULATIONS THROUGH ITS PARTICIPATION IN MEDICARE-MEDICAID (DUAL ELIGIBLES) AND OTHER STATE PROGRAMS WHOSE PURPOSE IS TO SERVE SUCH POPULATIONS. THE ORGANIZATION OPERATES EXCLUSIVELY FOR THE PROMOTION OF SOCIAL WELFARE BY PRIMARILY ENGAGING IN ACTIVITIES THAT PROMOTE THE COMMON GOOD, GENERAL WELFARE, AND EDUCATION OF THE MASSACHUSETTS AND RHODE ISLAND COMMUNITIES. THE ORGANIZATION DOES THIS BY PROVIDING AND ENCOURAGING PREVENTIVE CARE TO THOSE WHO MIGHT OTHERWISE NOT RECEIVE SUCH CARE AND THE ABILITY TO SEEK HEALTH CARE SERVICES WHEN NEEDED TO THOSE WHO MIGHT NOT OTHERWISE BE ABLE TO AFFORD IT. AS PART OF THE ORGANIZATION'S EFFORTS TO EDUCATE AND ASSIST THE MULTICULTURAL POPULATION IT SERVES, THE ORGANIZATION ALSO MAINTAINS ONGOING EDUCATIONAL OUTREACH EFFORTS. THESE EFFORTS INCLUDE: 1) COMMUNITY OUTREACH REPRESENTATIVES WORKING WITH MEMBERS TO ENSURE ENGAGEMENT AND EDUCATION ON HEALTH CARE ACCESS AS WELL AS POTENTIAL ACCESS TO OTHER SOCIAL SERVICE PROGRAMS. 2) BUILDING RELATIONSHIPS WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THPP'S AUDIENCES, INCLUDING SMALL BUSINESSES THAT OFFER A WIDE RANGE OF SERVICES TO IMMIGRANT POPULATIONS. 3) PARTNERING WITH FINANCIAL COUNSELORS AT LOCAL HEALTH CENTERS TO OFFER ASSISTANCE WITH MEDICAID. 4) PARTNERING WITH LOCAL SOCIAL SERVICE, ADVOCACY ORGANIZATIONS TO GIVE PRESENTATIONS REGARDING HEALTH CARE ACCESS, AVAILABLE BENEFITS, AND PLAN OFFERINGS. 5) PARTNERING WITH LOCAL RELIGIOUS ORGANIZATIONS TO COORDINATE HEALTH AND WELLNESS EVENTS FOR THEIR DIVERSE CONGREGATIONS. 6) COMMUNITY OUTREACH REPRESENTATIVES SERVING AS CULTURAL EXPERTS FOR MEMBER OUTREACH EFFORTS, LOCAL MEDIA PRESENTATIONS, AND SPEAKING ENGAGEMENTS TO PROVIDE UP TO DATE INFORMATION ON HEALTH ACCESS AND THPP OFFERINGS IN A CULTURALLY COMPETENT MANNER. 7) PROVIDING IN-KIND, MONETARY, AND VOLUNTEER SUPPORT TO LOCAL COMMUNITY BASED ORGANIZATIONS, INCLUDING PRESENTING ON AND LEADING ACTIVITIES RELATED TO HEALTH AND WELLNESS. 8) PROVIDING IN-KIND AND VOLUNTEER SUPPORT TO OTHER LOCAL COMMUNITY INSTITUTIONS, SUCH AS FOOD PANTRIES AND HOMELESS SHELTERS. FORM 990, PART III, LINE 2 IN MARCH 2017, THE ORGANIZATION ALSO BEGAN OFFERING MEDICAID COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN, DESCRIBED FURTHER IN RESPONSE TO PART III, LINE 4D. FORM 990, PART III, LINE 4A MASSACHUSETTS MEDICAID COVERAGE THE ORGANIZATION PROVIDES ACCESS TO AFFORDABLE HEALTH CARE THROUGH A MEDICAID MANAGED CARE ORGANIZATION CONTRACT WITH THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. TUFTS HEALTH TOGETHER IS THE NAME OF THPP'S MASSACHUSETTS MEDICAID PLAN THAT PROVIDES ACCESS TO AFFORDABLE HEALTH CARE FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. MASSHEALTH IS THE NAME OF THE MASSACHUSETTS MEDICAID PROGRAM FUNDED BY THE FEDERAL GOVERNMENT AND THE STATE. MASSHEALTH HELPS PEOPLE WITH LIMITED INCOMES AND RESOURCES PAY FOR MEDICAL AND SUPPORT SERVICES. IT ALSO COVERS EXTRA SERVICES AND DRUGS NOT COVERED BY MEDICARE. TO BE ELIGIBLE FOR MASSHEALTH, YOU MUST BE A MASSACHUSETTS RESIDENT WITH LOW TO MODERATE INCOME. THE INCOME LIMITS DEPEND ON FAMILY SIZE, CATEGORY OF ELIGIBILITY, AND THE TYPE OF MASSHEALTH COVERAGE FOR WHICH AN INDIVIDUAL IS ELIGIBLE. FINANCIAL ELIGIBILITY IS BASED ON THE MODIFIED ADJUSTED GROSS INCOME ("MAGI"), WHICH IS COMPARED TO THE FPL. DIFFERENT MASSHEALTH CATEGORIES USE DIFFERENT PERCENTAGES OF THE FEDERAL POVERTY LEVEL ("FPL") AS THE THRESHOLD FOR FINANCIAL ELIGIBILITY. A FAMILY'S MAGI MUST BE NO GREATER THAN THE AMOUNT SHOWN IN THE FPL TABLES FOR THE INDIVIDUAL OR FAMILY'S CATEGORY AND FAMILY SIZE. TUFTS HEALTH TOGETHER PROVIDES LOW TO MODERATE INCOME INDIVIDUALS WITH ACCESS TO THOUSANDS OF HIGH QUALITY DOCTORS AND SPECIALISTS ACROSS THE STATE, SUPPORTIVE SERVICE REPRESENTATIVES, INFORMATION IN A NUMBER OF LANGUAGES, AS WELL AS PREVENTIVE MEASURES SUCH AS BIKE HELMETS AND HOME SAFETY KITS AT NO COST, INCENTIVES FOR HEALTHY BEHAVIORS, FITNESS REIMBURSEMENTS, AND OTHER IMPORTANT TOOLS TO PROMOTE HEALTH AND WELLNESS.
TUFTS HEALTH TOGETHER HAS EARNED "EXCELLENT" HEALTH PLANACCREDITATION STATUS BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE, WHICH IS THE COMMITTEE'S HIGHEST ACCREDITATION RATING. IN 2014-2015, TUFTS HEALTH TOGETHER RECEIVED A RANKING OF NO. 1 IN THE COUNTRY BY NCQA'S HEALTH INSURANCE PLAN RANKINGS BASED ON THE ORGANIZATION'S EXCEPTIONAL CLINICAL PERFORMANCE, MEMBER SATISFACTION, AND QUALITY PROCESSES. IN 2015, NCQA INTRODUCED A NEW SCORING METHODOLOGY FOR ITS HEALTH INSURANCE PLAN RATINGS, ASSIGNING AN OVERALL RATING TO EACH HEALTH PLAN BASED ON A SCALE OF 1 TO 5, WHERE FIVE IS THE HIGHEST SCORE. IN OCTOBER 2017, THPP RECEIVED A RATING OF 4.5 OUT OF 5 BASED ON THIS SCORING METHODOLOGY FOR THE THIRD YEAR IN A ROW. THE ORGANIZATION IN ITS PREDECESSOR FORMS (NETWORK HEALTH,LLC. AND NETWORK HEALTH,INC.) ALSO WON THE DORLAND HEALTH CASE IN POINT PLATINUM AWARD FOR "BEST SOCIAL CARE MANAGEMENT PROGRAM" IN 2013, "BEST INTEGRATED CASE MANAGEMENT PROGRAM" IN 2012, AND "BEST OVERALL CASE/CARE MANAGEMENT PROGRAM" IN 2010. IN 2012, THE ORGANIZATION WAS AMONG TEN NATIONALLY AND THE FIRST IN NEW ENGLAND TO EARN THE NCQA MULTICULTURAL HEALTH CARE DISTINCTION. AS OF THE END OF 2017, THE ORGANIZATION HAD OVER 220,324 ENROLLEES IN TUFTS HEALTH TOGETHER. FORM 990, PART III, LINE 4B MASSACHUSETTS QUALIFIED HEALTH PLAN COVERAGE TUFTS HEALTH DIRECT IS AN INDIVIDUAL AND SMALL GROUP QUALIFIED HEALTH PLAN (QHP) ESTABLISHED BY THE ORGANIZATION AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT TO PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES WHO ARE NOT ELIGIBLE FOR AFFORDABLE EMPLOYER-SPONSORED INSURANCE, AND SMALL EMPLOYER GROUPS WITH 1-50 EMPLOYEES. THESE PLANS ARE SOLD PRIMARILY THROUGH THE MASSACHUSETTS HEALTH CONNECTOR, THE MASSACHUSETTS STATE MARKETPLACE. TUFTS HEALTH DIRECT IS ACCREDITED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. AS OF DECEMBER 31, 2017, THE ORGANIZATION SERVED CLOSE TO 91,336 CONNECTORCARE MEMBERS (A SUBSET OF TUFTS HEALTH DIRECT MEMBERS WHO RECEIVE BOTH STATE AND FEDERAL SUBSIDIES), WHICH ACCOUNTED FOR ROUGHLY 49% OF THE TOTAL MARKET SHARE. ALSO AS OF DECEMBER 31, 2017, THPP SERVED AN ADDITIONAL 36,886 TUFTS HEALTH DIRECT MEMBERS, 11.5% OF WHOM RECEIVED FEDERAL SUBSIDIES IN THE FORM OF ADVANCED PREMIUM TAX CREDITS TO PURCHASE INSURANCE. FORM 990, PART III, LINE 4C TUFTS HEALTH UNIFY IS A MEDICARE-MEDICAID PLAN FOR INDIVIDUALS AGE 21-64 WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. TUFTS HEALTH UNIFY IS ONE OF TWO MASSACHUSETTS ONECARE PLANS PARTICIPATING IN THE FINANCIAL ALIGNMENT INITIATIVE ("DUALS DEMONSTRATION") TO INTEGRATE BENEFITS AND CARE FOR MEDICARE-MEDICAID ENROLLEES. THE PLAN CONTRACTS WITH THE CENTER FOR MEDICARE AND MEDICAID SERVICES AND MASSHEALTH TO PROVIDE THE BENEFITS OF BOTH PROGRAMS TO LOW AND MODERATE INCOME INDIVIDUALS WITH DISABILITIES. THE PLAN INCLUDES AN EXPANDED BENEFITS PACKAGE AND COMMUNITY-BASED, LONG-TERM SERVICES AND SUPPORT, SUCH AS HOME CARE SERVICES, HOMEMAKER SERVICES, RESPITE CARE, ADULT FOSTER CARE, DAY HABILITATION AND OTHER TYPES OF SUPPORT, COUNSELING AND NAVIGATION. EACH TUFTS HEALTH UNIFY ENROLLEE IS ASSIGNED A CARE MANAGER, WHO DEVELOPS A PERSONALIZED CARE PLAN TO MEET ALL OF THE ENROLLEE'S PHYSICAL, MENTAL, AND SOCIAL CARE NEEDS. THE GOAL OF THIS INNOVATIVE MODEL IS TO IMPROVE THE QUALITY OF CARE, WHILE IMPROVING HEALTH AND PROVIDING MORE COST EFFECTIVE CARE. AS OF THE END OF 2017, THE ORGANIZATION HAD OVER 2,993 ENROLLEES IN TUFTS HEALTH UNIFY. FORM 990, PART III, LINE 4D RHODE ISLAND MEDICAID COVERAGE IN MARCH 2017, THE ORGANIZATION ALSO BEGAN OFFERING MEDICAID COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THE ORGANIZATIONS COVERAGE IS CALLED TUFTS HEALTH RI TOGETHER, AND IS SIMILAR TO THE MEDICAID COVERAGE OFFERED IN MASSACHUSETTS. AS OF THE END OF 2017, THE ORGANIZATION HAD APPROXIMATELY 3,756 ENROLLEES IN TUFTS HEALTH RI TOGETHER. FORM 990, PART VI, LINE 1 THE INDEPENDENCE AND COMMUNITY RESPONSIVENESS OF THE ORGANIZATION'S BOARD IS ENSURED BY THE ULTIMATE CONTROL AND OVERSIGHT OF THE MAJORITY COMMUNITY BOARD OF THE ORGANIZATION'S SOLE MEMBER, TUFTS HEALTH PLAN, INC. ("THPI"). THPI APPOINTS AND HAS THE AUTHORITY TO REMOVE AND REPLACE THE ORGANIZATION'S BOARD OF DIRECTORS AND TO APPROVE THE CREATION OF ANY COMMITTEE OF THE ORGANIZATION'S BOARD. IN ADDITION, CERTAIN SIGNIFICANT ACTIONS CANNOT BE TAKEN BY THE ORGANIZATION'S BOARD WITHOUT THPI'S APPROVAL, INCLUDING (1) EXECUTION OF ANY CONTRACT OR ENGAGEMENT IN ANY TRANSACTION PROVIDING FOR THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S PROPERTY; (2) FILING OR ACQUIESCENCE IN THE FILING OF ANY VOLUNTARY OR INVOLUNTARY BANKRUPTCY OR INSOLVENCY PROCEEDINGS UNDER ANY FEDERAL OR STATE INSOLVENCY OR BANKRUPTCY LAWS OR THE MAKING OF AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS; (3) ADOPTION OF A PLAN OF OR AUTHORIZATION OF A PETITION FOR LIQUIDATION AND/OR DISSOLUTION OF THE ORGANIZATION; (4) ADOPTION OR AUTHORIZATION OF A PLAN AND/OR AGREEMENT OF MERGER OR SHARE EXCHANGE WITH ANY OTHER FOREIGN OR DOMESTIC CORPORATION; (5)AMENDMENT, ALTERATION OR REPEAL OF THE ORGANIZATION'S ARTICLES OF ORGANIZATION; AND (6) AMENDMENT, ALTERATION OR REPEAL OF THE ORGANIZATION'S BYLAWS, EXCEPT FOR ALTERATION, AMENDMENT OR REPEAL BY A VOTE OF A MAJORITY OF DIRECTORS PENDING NOTIFICATION OF THE MEMBER. PRIOR TO OCTOBER 1, 2017, TUFTS ASSOCIATED HEALTH MAINTAINENCE ORGANIZATION, INC. WAS THE SOLE MEMBER OF THE ORGANIZATION AND PERFORMED THESE SAME FUNCTIONS. FAMILY OR BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 DESCRIPTION OF RELATIONSHIPS The following people served as a board member and/or officer of Tufts Health Plan Inc.: Tom Croswell CHRISTOPHER GORTON - THROUGH OCTOBER 17, 2017 MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING INDIVIDUALS SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE CHRISTOPHER GORTON - through October 17, 2017 MARC SPOONER - As of December 11, 2017 THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS HEALTH PLAN FOUNDATION, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS ASSOCIATED HEALTH PLANS, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE MARC SPOONER THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TOTAL HEALTH PLAN, INC: THOMAS CROSWELL UMESH KURPAD MARY MAHONEY ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS INSURANCE COMPANY: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TUFTS BENEFIT ADMINISTRATORS, INC: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER AND/OR OFFICER FOR TAHP BROKERAGE CORPORATION: THOMAS CROSWELL MARY MAHONEY UMESH KURPAD ROLAND PRICE THE FOLLOWING PEOPLE SERVED AS A BOARD MEMBER FOR INTEGRA PARTNERS HOLDINGS, INC.: THOMAS CROSWELL UMESH KURPAD CHRISTOPHER GORTON - THROUGH OCTOBER 17, 2017 DELEGATION OF CONTROL OF MANAGEMENT DUTIES FORM 990, PART VI, LINE 3 THE ORGANIZATION'S SOLE MEMBER IS TUFTS HEALTH PLAN, INC. ("THPI"). TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO), PREVIOUSLY THPPS SOLE CORPORATE MEMBER, IS ALSO A SUBSIDIARY OF THPI. TAHMO'S WHOLLY-OWNED SUBSIDIARY, TUFTS ASSOCIATED HEALTH PLANS, INC., PERFORMS CERTAIN MANAGEMENT, ADMINISTRATIVE, AND MARKETING SERVICES FOR THPP, INCLUDING EMPLOYEE DECISIONS AND SUPERVISING AND PLANNING AND EXECUTING BUDGETS AND FINANCIAL OPERATIONS. MANY OF THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A ARE EMPLOYEES OF TAHP. THEIR COMPENSATION IS LISTED IN PART VII, SECTION A AND SCHEDULE J. CHANGES TO GOVERNING DOCUMENTS FORM 990, PART VI, LINE 4 On October 1, 2017, the Tufts Health Plan corporate family went through a restructuring whereby Tufts Health Plan, Inc. (THPI), a newly created entity, became the sole corporate member of the Organization and Tufts Associated Health Maintenance Organization, Inc. Previously, the Organizations sole corporate member had been TAHMO. The Organizations bylaws were amended, effective October 1, 2017, to reflect this change.
Members or stockholdersFORM 990, PART VI, LINE 6 THROUGH SEPTEMBER 30, 2017, TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO) WAS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. EFFECTIVE OCTOBER 1, 2017, TUFTS HEALTH PLAN, INC.(THPI) IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION.
Power to elect or appoint membersFORM 990, PART VI, LINE 7A THROUGH SEPTEMBER 30, 2017, TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO) AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION ELECTED THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. EFFECTIVE OCTOBER 1, 2017, TUFTS HEALTH PLAN, INC.(THPI) AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
Decisions reserved to members or stockholdersFORM 990, PART VI, LINE 7B THROUGH SEPTEMBER 30, 2017, TAHMO, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAD THE RIGHT TO MAKE CERTAIN DECISIONS REGARDING THE ORGANIZATION, AND IS REQUIRED TO APPROVE ANY CHANGES TO THE ORGANIZATION'S BYLAWS. EFFECTIVE OCTOBER 1, 2017, THPI AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAD THE RIGHT TO MAKE CERTAIN DECISIONS REGARDING THE ORGANIZATION, AND IS REQUIRED TO APPROVE ANY CHANGES TO THE ORGANIZATION'S BYLAWS.
Process used to review the Form 990FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED IN OUR FINANCE DEPARTMENT, WITH ASSISTANCE FROM OUR EXTERNAL ACCOUNTANTS, ERNST & YOUNG. INFORMATION IS PROVIDED BY OUR FINANCE DEPARTMENT, GOVERNANCE MANAGER, COMPLIANCE & PRIVACY OFFICER, AND INTERNAL LEGAL COUNSEL. CERTAIN SECTIONS OF THE FORM ARE REVIEWED BY A NUMBER OF SENIOR MANAGERS; OUR CHIEF FINANCIAL OFFICER REVIEWS THE FORM IN ITS ENTIRETY. ONCE THE FORM IS COMPLETE, IN NOVEMBER 2018, IT IS FORWARDED ON TO OUR BOARD OF DIRECTORS AND IT IS THEN SUBMITTED FOR FILING.
MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OFINTEREST POLICY FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST THE TUFTS HEALTH PLAN (THP) CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND REVISED AS NEEDED. THE POLICY REQUIRES MANAGERS WHO OVERSEE OUTSIDE RELATIONSHIPS, AS WELL AS ALL DIRECTORS, AVPS, VPS, SVPS, EVPS, THE PRESIDENT AND CEO, AND THE BOARD TO ATTEST ANNUALLY THAT THEY WILL ABIDE BY THE POLICY. IT ALSO REQUIRES THEM TO SUBMIT AN ANNUAL DISCLOSURE STATEMENT TO THE SENIOR MANAGER, CORPORATE COMPLIANCE, LISTING ANY OUTSIDE RELATIONSHIPS, INCLUDING FINANCIAL AND/OR BOARD RELATIONSHIPS, THAT THEY OR A FAMILY MEMBER HAVE WITH THP'S SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. THERE IS A PROTOCOL TO REVIEW ANY DISCLOSURE THAT MIGHT BE A POTENTIAL CONFLICT OF INTEREST. ALSO, ALL EMPLOYEES ARE REQUIRED TO REPORT THE OFFER BY AN OUTSIDE ENTITY OF GIFTS OVER $100, HONORARIA OR COVERAGE OF BUSINESS EXPENSES TO THE SENIOR MANAGER, CORPORATE COMPLIANCE AND A SENIOR LEADER. BOTH MUST APPROVE BEFORE ACCEPTANCE IS ALLOWED. ONCE DISCLOSURES ARE REVIEWED AND APPROVED, THEY ARE COMMUNICATED TO THE GOVERNANCE MANAGER AND TO THE SENIOR MANAGER, CORPORATE COMPLIANCE. FOR TUFTS HEALTH PLAN MANAGEMENT, THE CONFLICT OF INTEREST DISCLOSURES THAT NEED FURTHER REVIEW ARE BROUGHT TO THE BOARD AUDIT & COMPLIANCE COMMITTEE CHAIR. IF A CONFLICT OF INTEREST DOES EXIST, A TRANSACTION WITH THE ENTITY WITH WHICH THERE IS A CONFLICT MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST IS FULLY DISCLOSED; 2. THE PERSON WITH THE CONFLICT OF INTEREST MAY PRESENT INFORMATION, BUT THEN SHALL BE EXCUSED FROM FURTHER DISCUSSION AND FROM THE DECISION REGARDING APPROVING SUCH TRANSACTION; 3. IF PRACTICAL, A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND 4. THE BOARD (OR A DULY CONSTITUTED COMMITTEE THEREOF OR BOARD APPOINTEE) OR THE CHIEF COMPLIANCE & ETHICS OFFICER HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. ALL NEW HIRES, AND ALL EMPLOYEES ON AN ANNUAL BASIS, COMPLETE COMPLIANCE TRAINING THAT ADDRESSES CONFLICT OF INTEREST AND REQUIRES THE EMPLOYEE TO ATTEST THAT THEY DO NOT HAVE ANY POTENTIAL CONFLICTING RELATIONSHIPS THAT THEY HAVE NOT DISCLOSED TO THE PROPER LEVEL OF MANAGEMENT AND TO THE SENIOR MANAGER, CORPORATE COMPLIANCE.
Process for determining compensationFORM 990, PART VI, LINE 15 THE COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS (THE "BOARD") OF TUFTS HEALTH PLAN, INC. (TUFTS HP OR THE "COMPANY") REVIEWS AND ADMINISTERS TOTAL REMUNERATION OPPORTUNITIES, POLICIES, PROGRAMS, AND MAJOR CHANGES IN TUFTS HP'S BENEFIT PLANS THAT ARE APPLICABLE TO THE OFFICERS AND EXECUTIVES OF THE COMPANY (THE "EXECUTIVES" - THESE INCLUDE THE CEO AND ALL SENIOR VICE PRESIDENTS), AS WELL AS TO THE GENERAL AUDITOR, CHIEF COMPLIANCE & ETHICS OFFICER, AND ANY OTHER INDIVIDUAL OR GROUPS THE COMMITTEE DEEMS APPROPRIATE BASED ON ITS INTERPRETATION OF THE DEFINITION OF "DISQUALIFIED PERSONS" IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986. THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS OF THE COMPANY. PRIOR TO THE RESTRUCTURING DESCRIBED IN RESPONSE TO PART VI, LINE 4, THIS COMMITTEE RESIDED AT THE TAHMO LEVEL. THE COMMITTEE REPORTS TO THE FULL BOARD OF DIRECTORS. FOR CEO COMPENSATION, THE COMMITTEE REVIEWS THE INFORMATION DESCRIBED BELOW AND RECOMMENDS THE CEO'S COMPENSATION TO THE FULL BOARD FOR ITS APPROVAL. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION RECOMMENDATIONS FROM THE CEO FOR OTHER EXECUTIVES, AND PROVIDES A REPORT TO THE FULL BOARD ON THIS INFORMATION. IT IS THE BOARD'S INTENTION THAT THE COMMITTEE WILL PERFORM ITS DUTIES IN A MANNER THAT WILL ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OFFERED TO EXECUTIVES AND OTHER "DISQUALIFIED PERSONS" ARE REASONABLE. COMPARABILITY DATA AND REASONABLENESS THE TOTAL COMPENSATION OPPORTUNITIES PROVIDED TO EXECUTIVES OF THE COMPANY ARE INTENDED TO BE COMPETITIVE WITH, AND IN REASONABLE COMPARISON TO, THOSE OPPORTUNITIES PROVIDED BY ORGANIZATIONS IN THOSE BUSINESS SECTORS WITH WHICH THE COMPANY COMPETES FOR EXECUTIVE TALENT. THE BOARD BELIEVES THAT SUCH COMPETITORS ARE NOT LIMITED TO OTHER HEALTHCARE INSTITUTIONS AND THAT COMPARISONS SHOULD BE MADE TO THE COMPENSATION PRACTICES OF A CROSS-SECTION OF BUSINESS SECTORS IN BOTH FOR-PROFIT AND NOT-FOR-PROFIT ORGANIZATIONS, WHEN APPROPRIATE. THE COMMITTEE RETAINS INDEPENDENT COMPENSATION CONSULTANTS TO PROVIDE DATA AS NECESSARY, AND ALSO USES AVAILABLE SOURCES OF INDEPENDENT DATA ON COMPENSATION. PEER ORGANIZATIONS AND PUBLISHED SURVEY SOURCES WILL BE APPROVED BY THE COMMITTEE BASED ON ITS REASONABLE DETERMINATION. THE COMMITTEE MAY ALSO RELY ON MEMBERS OF MANAGEMENT AND OUTSIDE ADVISORS, CONSULTANTS, AND COUNSEL TO PROVIDE MARKET DATA REPORTS, ANALYSIS, AND OPINIONS WITH RESPECT TO COMPENSATION-RELATED MATTERS. THE DATA REVIEWED CONSISTS OF COMPARABLE, RELEVANT MARKET DATA FOR THE COMPANY'S POSITIONS FROM PUBLISHED SURVEYS, AND OTHER AVAILABLE SOURCES, OF HEALTH AND MANAGED CARE INSTITUTIONS AND THE GENERAL INDUSTRY. OTHER SURVEYS OF SPECIALIZED SKILL SETS OR EMPLOYEE ATTRIBUTES CRITICAL TO THE SUCCESS OF THE COMPANY, E.G., ACTUARIAL, LEGAL, ETC., ARE ALSO INCORPORATED AS NEEDED, ALONG WITH GEOGRAPHIC REFERENCES TO THE BOSTON AND NEW ENGLAND LABOR MARKETS. THE COMMITTEE WILL RELY ON THIS MARKET DATA TO ASSESS, DETERMINE, AND VALIDATE COMPENSATION LEVELS FOR THE COMPANY'S EXECUTIVES. THE COMMITTEE USES THIS DATA IN ITS REVIEW OF: - SETTING BASE SALARIES - IN LIGHT OF MARKET DATA AND THE INDIVIDUAL'S PERFORMANCE, BACKGROUND, EXPERIENCES, AND PERSONAL SKILLS. BASE SALARY WILL BE SET SO THAT THE TARGETED POSITIONING OF AN EXECUTIVE IS AT THE 50TH PERCENTILE FOR EACH POSITION. ACTUAL BASE SALARY MAY VARY BASED ON SKILLS, BACKGROUND, AND EXPERIENCE. - ANNUAL INCENTIVE COMPENSATION - THE COMPANY'S GOAL IS TO PROVIDE COMPETITIVE AND REASONABLE OPPORTUNITIES UNDER THE TERMS OF AN EXECUTIVE ANNUAL INCENTIVE PLAN FOR THE SELECTED POSITIONS WHICH ARE RESPONSIBLE FOR ACHIEVING PERFORMANCE GOALS THAT REFLECT THE OVERALL MISSION OF THE COMPANY, AND THE STRATEGIC DIRECTION OF THE COMPANY FOR THE PERFORMANCE YEAR. THE COMMITTEE MAKES EVERY EFFORT TO ESTABLISH A PRESUMPTION THAT THE TOTAL REMUNERATION OPPORTUNITIES PROVIDED TO EXECUTIVES ARE REASONABLE; AS SUCH PRESUMPTION IS CONTEMPLATED IN SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED FROM TIME TO TIME. IN ESTABLISHING THE PRESUMPTION OF REASONABLENESS, THE COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. TIMING EXECUTIVE BENCHMARKING IS COMPLETED EVERY TWO YEARS FOR THOSE INDIVIDUALS UNDER THE COMPENSATION COMMITTEE'S PURVIEW BY THE EXTERNAL CONSULTANT ENGAGED BY THE COMPENSATION COMMITTEE. TO COMPLETE THE ANALYSIS, THE CONSULTANT: - COLLECTED RELEVANT INFORMATION REGARDING THE COMPANY'S OPERATIONS, COMPLEXITY, STRUCTURE, SIZE, AND SCOPE, AS WELL AS RELEVANT BACKGROUND ON THE EXECUTIVES' DUTIES AND SCOPE OF RESPONSIBILITIES; - DETERMINED THE SURVEY SOURCES TO USE IN THE ANALYSIS, BASED ON THE COMPANY'S COMPETITIVE MARKET FOR EXECUTIVE POSITIONS (AS DESCRIBED ABOVE); - MATCHED THE COMPANY'S EXECUTIVE POSITIONS IN THE SURVEYS BASED ON THE COMPANY'S SIZE COMPLEXITY, AND SCOPE, AS WELL AS ACCORDING TO SPECIFIC POSITION RESPONSIBILITIES AND REPORTING RELATIONSHIPS; - VALIDATED THE SURVEY SOURCES AND MARKET MATCHES WITH THE INTERNAL COMPENSATION TEAM TO ENSURE CONSISTENCY; - REVIEWED, COMPILED, AND SUMMARIZED THE DATA IN REPORT FORM. THE REPORT SUMMARIZING THE RESULTS OF THE ANALYSIS WAS PRESENTED TO THE COMPENSATION COMMITTEE FOR DISCUSSION AND DELIBERATION. DOCUMENTATION A SUMMARY OF THE DISCUSSIONS AND DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN THE MEETING MINUTES, WHICH ARE REVIEWED AND APPROVED BY THE COMMITTEE. COPIES OF ALL MEETING MATERIALS DISTRIBUTED PRIOR TO AND DURING THE MEETING ARE MAINTAINED IN THE CORPORATE RECORDS ALONG WITH MEETING MINUTES.
Process for making documents available to the publicFORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS OF THE ORGANIZATION ARE AVAILABLE AT ITS HEADQUARTERS IN WATERTOWN, MA. ALL REQUESTS CAN BE MADE TO THE CORPORATE COMMUNICATIONS OR FINANCE DEPARTMENTS.
Other Change in Net AssetsFORM 990, PART XI, LINE 9 CAPITAL CONTRIBUTIONS FROM PARENT $50,000,000 CHANGE IN Non-admitted Assets ($11,822,246) ------------- Total ($38,177,754)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

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Tufts Health Plan Foundation Inc
705 Mount Auburn StWatertownMA02472261374263Grant MakingMA501(c)(3)12ATAMHOfalse
Tufts Assoc Hlth Maintenance Org Inc
705 Mount Auburn StWatertownMA02472042674079HMOMA501(c)(4)N/ATHPIfalse
Tufts Health Plan Inc
705 MOUNT AUBURN STREETWATERTOWNMA02472814089215HEALTHCAREMA501(C)(4)N/ANAfalse
CAREPARTNERS OF CONNECTICUT INC
705 MOUNT AUBURN STWATERTOWNMA02472822604728HMOCT501(C)(4)N/ATAHMOfalse

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US Address USAddress

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Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

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TUFTS ASSOCIATED HEALTH PLANS INC
705 MOUNT AUBURN STREETWATERTOWNMA02472042985923MANAGEMENT SVDETAHMOC CORPYes (true)
INTEGRA PARTNERS HOLDINGS INC
705 MOUNT AUBURN STWATERTOWNMA02472453032233MED EQPMT & SPPLSMATAHMOC CORPYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Tufts Associated Health Plans Inc
p$67,270,050accrual
Tufts Assoc Health Maint Organization Inc
R$3,249,000accrual
Tufts Assoc Health Maint Organization Inc
S$580,000accrual
TUFTS HEALTH PLAN INC
C$25,000,000ACCRUAL
TUFTS ASSOC HEALTH MAINT ORGANIZATION INC
C$25,000,000ACCRUAL

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