2018-01-30T10:07:11-06:00 2016-12-31 TEXAS HURRICANE HARVEY BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2016-01-01 742838488 Driscoll Children's Health Plan % RICK VILLARREAL DRIS 3616946432 615 N Upper Broadway St Suite 1621 Corpus Christi TX 784010764 MARY D PETERSON CEO 7134994600 2017-12-15 true Jana Kirksey P01261744 7134994600 167.68.126.162 76915820180305000008 2018-01-30 P 3C05F97901279AF0647DFC7D8771036E0E35E774 FA092DA6EEDA918C82E14F1EE035B098C54497F0 2016 2021-01-29 14:40:06Z DR MARY DAHLEN PETERSON 615 N UPPER BROADWAY ST 1621 CORPUS CHRISTI TX 784010764 525681202 false X WWW.DCHPKIDS.COM X 1997 TX DCHP IS COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED AND COMPASSIONATE HEALTH CARE TEAM & RESPECTFUL COLLABORATION WITH ITS PROVIDER NETWORK. 7 4 374 4 0 0 0 436170194 523498054 330102 629976 0 0 436500296 524128030 0 0 0 0 11152285 21000933 0 0 0 440966539 496717074 452118824 517718007 -15618528 6410023 83473281 119306399 51040769 65402166 32432512 53904233 X DRISCOLL CHILDREN'S HEALTH PLAN IS COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED AND COMPASSIONATE HEALTHCARE TEAM AND RESPECTFUL COLLABORATION WITH ITS PROVIDER NETWORK. false false 470036812 523498054 DRISCOLL CHILDREN'S HEALTH PLAN IS THE CONTRACTOR FOR THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). THIS SERVICE AREA INCLUDES 14 COUNTIES COMPRISED OF ARANSAS, BEE, BROOKS, CALHOUN, GOLIAD, JIM WELLS, KARNES, KENEDY, KLEBERG, LIVE OAK, NUECES, REFUGIO, SAN PATRICIO, AND VICTORIA. THE PLAN ALSO PROVIDES HEALTH BENEFITS FOR CHILDREN ENROLLED IN THE STATE OF TEXAS ACCESS REFORM (STAR) PROGRAM FOR 24 COUNTIES. THE PLAN IS A HEALTH MAINTENANCE ORGANIZATION (HMO) COMMITTED TO PROVIDING ITS MEMBERS A NETWORK OF HEALTH SERVICE PROVIDERS. ITS AFFILIATION WITH DRISCOLL CHILDREN'S HOSPITAL (DCH), THE SOLE CORPORATE MEMBER, LENDS TO THE PLAN'S SUCCESS BY OFFERING ITS MEMBERS DCH'S EXTENSIVE NETWORK INCLUDING PHYSICIANS, HOSPITAL, AND SERVICES IN ITS TOTAL EXPANDED SERVICE AREA, THUS OFFERING CHIP AND STAR MEMBERS WHO LIVE IN THE ADJACENT COUNTIES A FULL CONTINUUM OF QUALITY SERVICES TAILORED TO MEET THE NEEDS OF THE CHIP AND STAR POPULATION. IN ADDITION TO STAR AND CHIP LINES OF BUSINESS, DRISCOLL HEALTH PLAN ENTERED INTO STAR KIDS ON NOVEMBER 1, 2016. STAR KIDS IS A NEW LINE OF BUSINESS PRIMARILY RELATED TO CHILDREN WITH DISABILITIES AND IT RESIDES WITHIN THE SAME COUNTIES AND SERVICE AREAS AS DESCRIBED ABOVE WITH STAR AND CHIP. THE PLAN'S ENROLLMENT WAS 169,262 AND 148,473 AT DECEMBER 31, 2016 AND 2015, RESPECTIVELY. 470036812 true false false true false false false false false false true true false false true false true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 374 true false false false false false false false false false false X 7 4 false false false false true true true true true false false true true true true true true true true false X RICK VILLARREAL 3616946781 615 N UPPER BROADWAY ST STE 1621 CORPUS CHRISTI TX 784010764 X D ERIC HAMON SECRETARY/TREASURER 1.0 44.0 X X 0 445237 287435 MARY DAHLEN PETERSON PRESIDENT 40.0 0.0 X X 453993 0 83038 STEVE WOERNER DIRECTOR 1.0 40.0 X 0 628110 528722 C IVAN WILSON DIRECTOR 1.0 1.0 X 0 10000 0 WILLIAM JAMES STERETT CHAIRMAN 1.0 1.0 X X 0 0 0 SAM L SUSSER DIRECTOR 1.0 2.0 X 0 0 0 S LOYD NEAL JR DIRECTOR 1.0 2.0 X 0 10000 0 ERNEST DALE BUCK CHIEF MEDICAL DIRECTOR 40.0 0.0 X 341780 0 37024 MICHAEL PIERCE LANCE VICE PRESIDENT 40.0 0.0 X 265932 0 38019 RICARDO JAVIER VILLARREAL DCHP VICE PRESIDENT 40.0 0.0 X 249942 0 42159 WILLIAM BRIAN BRENDEL MEDICAL DIRECTOR 40.0 0.0 X 298696 0 42083 TAMARA MERSHON DIRECTOR OF QUALITY 40.0 0.0 X 155710 0 18863 HEATHER PIGOTT SENIOR DIRECTOR OF HEALTH SVCS 40.0 0.0 X 166214 0 23579 DONALD WELL DIR PROV REL CONTCTG & CLAIMS 40.0 0.0 X 148557 0 12917 JUDITH KRAFT DIRECTOR OF REGULATORY AFFAIRS 40.0 0.0 X 144004 0 21553 2224828 1093347 1135392 22 false true false VALENCE HEALTH 540 W MADISON 1500 CHICAGO IL 60661 THIRD PARTY ADMIN 14569596 NAVITUS HEALTH SYSTEMS 2601 W BELTLINE HWY 600 MADISON WI 53713 PRESCRIPTION BENEFIT 2917437 HEALTH MANAGEMENT SYSTEMS 5615 HIGH POINT DRIVE 900 NEW YORK NY 100877151 BENEFIT SERVICES 625408 CORPORATE PRINTING INC 3509 OAK FOREST DRIVE HOUSTON TX 77018 PRINTING 1118914 MIS 2019 CUTTER DRIVE LEAGUE CITY TX 77573 PRINTING 710082 15 0 Preimum Revenue 524292 523209207 523209207 Net Reinsurance 524292 3212 3212 Other Income 900099 285635 285635 523498054 562737 562737 0 0 0 0 0 1620411 1553172 67239 67239 67239 0 0 0 0 0 0 0 0 0 0 524128030 523498054 629976 0 0 0 0 1511887 1511887 0 15507345 5752329 9755016 470950 130524 340426 2380165 950805 1429360 1130586 474846 655740 17253705 1948026 15305679 0 0 0 0 8500 8500 5222111 5222111 419249 419249 2450465 2450465 579198 579198 0 978535 978535 419111 419111 0 0 0 0 37007 37007 138030 138030 Medical Expenses 450982680 450982680 Premium Taxes 9006212 8285715 720497 Member Value Add Expense 3956886 3956886 ALLOCATED COSTS 2734921 2734921 2530464 2530464 517718007 470036812 47681195 0 48833921 70704942 11589600 15609860 0 0 5729476 6934657 0 0 0 0 0 0 0 0 52062 88846 974927 709737 59759 265190 0 0 14298191 24437904 0 0 0 0 2910272 1265000 83473281 119306399 43392125 60401877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7648644 5000289 51040769 65402166 X 0 0 0 0 32432512 53904233 32432512 53904233 83473281 119306399 X 6410023 61698 15000000 X false true X false true true X 162643 35154 0 0 0 197797 290937187 317186494 385360095 436170194 523498054 1953152024 0 0 0 291099830 317221648 385360095 436170194 523498054 1953349821 0 0 0 1953349821 441183 387321 343424 327076 562737 2061741 0 441183 387321 343424 327076 562737 2061741 0 0 291541013 317608969 385703519 436497270 524060791 1955411562 0.99895 0.99872 0.00105 0.00128 X false false false false false true 111301 false false false 111301 false SCHEDULE C, PART II-B, LINE 1F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES TOTALED $ 111,301. 974927 709737 265190 265190 Vanguard 24437904 F 24437904 0 A/P-DVPG 63037 Unearned Premiums 4937252 5000289 523224078 523224078 903952 903952 524128030 516814055 516814055 903952 903952 517718007 SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 AUDIT EXPENSES NETTED WITH INCOME ON FORM 990 $ 903,952 SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 AUDIT EXPENSES NETTED WITH INCOME ON FORM 990 $ 903,952 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X X X X X false true false false false false false false false D ERIC HAMON SECRETARY/TREASURER 0 284104 0 129180 0 31953 0 255529 0 31906 0 732672 0 0 MARY DAHLEN PETERSON PRESIDENT 347093 0 88900 0 18000 0 59665 0 23373 0 537031 0 0 0 STEVE WOERNER DIRECTOR 0 343547 0 236705 0 47858 0 502690 0 26032 0 1156832 0 0 ERNEST DALE BUCK CHIEF MEDICAL DIRECTOR 273793 0 44133 0 23854 0 18144 0 18880 0 378804 0 0 0 MICHAEL PIERCE LANCE VICE PRESIDENT 210922 0 53602 0 1408 0 18103 0 19916 0 303951 0 0 0 RICARDO JAVIER VILLARREAL DCHP VICE PRESIDENT 196443 0 50393 0 3106 0 20079 0 22080 0 292101 0 0 0 WILLIAM BRIAN BRENDEL MEDICAL DIRECTOR 259306 0 39390 0 0 0 19875 0 22208 0 340779 0 0 0 TAMARA MERSHON DIRECTOR OF QUALITY 128563 0 24793 0 2354 0 407 0 18456 0 174573 0 0 0 HEATHER PIGOTT SENIOR DIRECTOR OF HEALTH SVCS 144975 0 21189 0 50 0 12499 0 11080 0 189793 0 0 0 DONALD WELL DIR PROV REL CONTCTG & CLAIMS 123780 0 19032 0 5745 0 11027 0 1890 0 161474 0 0 0 JUDITH KRAFT DIRECTOR OF REGULATORY AFFAIRS 117066 0 18182 0 8756 0 10045 0 11508 0 165557 0 0 0 SCHEDULE J, PART I, LINE 4B PARTICIPANTS IN/PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN: NAME AMOUNT PAID BY D. ERIC HAMON $ 182,009 DRISCOLL CHILDREN'S HOSPITAL STEVE WOERNER $ 380,579 DRISCOLL CHILDREN'S HOSPITAL NO PAYMENTS WERE RECEIVED. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS DRISCOLL CHILDREN'S HOSPITAL IS THE SOLE MEMBER OF DRISCOLL CHILDREN'S HEALTH PLAN. FORM 990, PART VI, SECTION A, LINE 7A CLASS OF PERSONS AND NATURE AND THEIR RIGHTS ANY VACANCY OCCURRING IN THE BOARD OF DIRECTORS SHALL BE FILLED IN ACCORDANCE WITH THE FOLLOWING PROCEDURE: THE MEMBER SHALL ELECT AND APPOINT A CANDIDATE TO FILL THE VACANCY. FORM 990, PART VI, SECTION A, LINE 7B CLASS OF THE PERSON, DECISIONS THAT REQUIRE APPROVAL, AND VOTING RIGHTS THE FOLLOWING MATTERS ARE RESERVED TO THE MEMBER AND SHALL REQUIRE THE AFFIRMATIVE ACTION OF THE MEMBER TO BE EFFECTIVE: A. ANNUAL OPERATING & CAPITAL BUDGETS OF THE CORPORATION; B. MERGER, ACQUISITION OR CONSOLIDATION OF THE CORPORATION; C. BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTEE OF ANOTHER DEBT OR SIMILAR ACTION; AND D. APPOINTMENT & REMOVAL OF DIRECTORS IN ACCORDANCE WITH THE BY-LAWS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 PROVIDED TO GOVERNING BODY THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE WITH POLICY ANNUALLY, ALL DIRECTORS, OFFICERS, AND KEY PERSONNEL FILL OUT A CONFLICT OF INTEREST FORM. THE COMPLIANCE OFFICER MAKES SURE ALL CONFLICT OF INTEREST FORMS ARE TURNED IN AND REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINES 15A &15B COMPENSATION REVIEW OF OFFICERS OR KEY EMPLOYEES THE BOARD OF DIRECTORS REVIEW THE APPLICABLE MARKETING DATA PROVIDED BY A THIRD PARTY COMPENSATION FIRM AND MATCHES THE PRESIDENT/CEO SALARY TO THE APPROPRIATE MARKET RATE FOR THE DUTIES. SULLIVAN COTTER REVIEWED 2015. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATIONAL DOCUMENTS MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CAPITAL CONTRIBUTION $ 15,000,000 DRISCOLL CHILDREN'S HOSPITAL 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742577746 HOSPITAL TX 501(C)(3) 3 NA false DRISCOLL PHYSICIAN'S GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742988134 HOSPITAL TX 501(C)(3) 3 DCH true DRISCOLL VALLEY PHYSICIANS GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 201234322 HOSPITAL TX 501(C)(3) 3 DCH true DRISCOLL MATERNAL AND FETAL PHYSICIAN'S 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 201234461 HEALTH CARE TX 501(C)(3) 7 DCH true CHILDRENS PHYSICIAN SERVICES OF SOUTH TX 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78401 742620408 HOSPITAL TX 501(C)(3) 3 DCH true DRISCOLL FOUNDATION 615 NORTH UPPER BROADWAY 1635 CORPUS CHRISTI TX 78401 741170270 CHAR. TRUST TX 501(C)(3) 11A NA false DRISCOLL HEALTHCARE SERVICES 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 010962276 HEALTH CARE TX 501(C)(3) 11A DCH true false false true false false false false false false false true false false true true true false false false