2017-11-13T16:01:18-06:00 2016-12-31 350921680 CROWE HORWATH LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2016-01-01 760486264 Texas Children's Health Plan TEXA 8009908247 6330 WEST LOOP SOUTH 8TH FLOOR 800 Houston TX 77041 Weldon Gage EXECUTIVE VICE PRESIDENT & CFO 2017-11-13 true RACHEL SPURLOCK P00520729 2147775200 2016 2017-02-10 21:41:12Z X Weldon Gage 6330 WEST LOOP S 8TH FL STE 800 Houston TX 77041 1175390775 false X WWW.TEXASCHILDRENSHEALTHPLAN.ORG X 1995 TX To create a healthier future for children and women throughout our global community by leading in patient care, education, and research. 9 0 895 0 0 0 889946 718445 957559900 1066927841 537272 1876083 0 958987118 1069522369 0 841081447 1001631524 32277186 18946525 0 0 69771295 66681435 943129928 1087259484 15857190 -17737115 213076143 226281681 88205884 121350580 124870259 104931101 To create a healthier future for children and women throughout our global community by leading in patient care, education, and research. false false 1068996278 1066927841 TEXAS CHILDREN'S HEALTH PLAN'S (TCHP) PROGRAM SERVICE OBJECTIVE IS TO PROVIDE HEALTH CARE COVERAGE TO UNDERSERVED CHILDREN AND WOMEN WHO, WITHOUT MEDICAID, STAR, STAR KIDS, OR CHIP, WOULD NOT HAVE ACCESS TO AFFORDABLE HEALTH INSURANCE. TCHP PARTICIPATES IN MEDICAID, WHICH TARGETS CHILDREN UNDER 185-100% OF THE FEDERAL POVERTY LEVEL AND THE CHILDREN'S HEALTH INSURANCE PROGRAM, WHICH TARGETS CHILDREN BETWEEN 200-100% OF THE POVERTY LEVEL. Health Plan: TCHP was founded in 1996 by Texas Children's Hospital. TCHP is the nation's first health maintenance organization created just for children. TCHP has a network of more than 6,250 doctors, 7,811 specialists, and 221 hospitals to cover kids, teens, pregnant women and adults. As of December 31, 2016, TCHP had 437,712 members. Star: The State of Texas Access Reform (STAR) is a Medicaid program offered at no cost for children up to age 21, some adults and pregnant women who cannot afford health insurance. As of December 31, 2016, TCHP had 351,218 Star members. Star Kids: Effective November 1, 2016, TCHP began offering Star Kids, a new Texas Medicaid managed care program that provides Medicaid benefits to children and adults 20 and younger who have disabilities. Star kids offers regular Medicaid services along with long-term services and supports (LTSS) which include things like help in a home with basic daily activities and help making changes to a home so that members can move around safely. As of December 31, 2016, TCHP had 24,384 Star Kids members. CHIP: The Children's Health Insurance Program (CHIP) offers low-cost health coverage for children from birth through age 18. CHIP is designed for families who earn too much money to qualify for Medicaid but cannot afford to buy private health coverage. As of December 31, 2016, TCHP had 62,110 CHIP members. 1068996278 true true false true false false false false false false true false true false true true true false false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 2510 0 true 895 true false false false false false false false false false false X 9 0 false false false false true true true true false false false true true true true true true false false false X Jennifer Wilson 8328242972 1919 S Braeswood Blvd Houston TX 77030 Christopher Born SCHEDULE O 39.0 1.0 X X 1585608 0 120925 Benjamin Melson Schedule O 1.0 39.0 X X 0 1615019 197627 Michelle Riley-Brown Schedule O 1.0 39.0 X X 0 585141 199637 Mark A Wallace BOARD MEMBER / Chairman 1.0 39.0 X X 0 3300873 298334 Randy Wright Schedule O 1.0 39.0 X X 0 674125 6160 Dan DiPrisco SCHEDULE O 1.0 39.0 X 0 334599 87278 Lucio Fragoso SCHEDULE O 1.0 39.0 X 0 349680 93540 Weldon Gage SCHEDULE O 1.0 39.0 X 0 394875 118719 Angelo P Giardino MD PHD BOARD MEMBER 1.0 39.0 X 0 572059 158428 Alec King Schedule O 1.0 39.0 X 0 271380 79076 Mark Mullarkey Board Member 1.0 39.0 X 0 585408 206373 John R Nickens IV BOARD MEMBER 1.0 39.0 X 0 559980 198478 Lisa Hollier Chief Medical Officer of Obstetrics 1.0 1.0 X 0 0 0 Anna Mateja SCHEDULE O 39.0 1.0 X 412525 0 120131 Dace Reinholds Assistant Secretary 1.0 39.0 X 0 222476 30533 Heidi Schwarzwald Chief Medical Officer of Pediatrics 1.0 1.0 X 0 0 0 Justin Loudon DIRECTOR OF FINANCE 40.0 0 X 168088 0 31581 Laurie Levermann CIO 40.0 0 X 207394 0 34782 LIA RODRIGUEZ MEDICAL DIRECTOR 40.0 0 X 271521 0 16579 Jan Scott SENIOR PROJECT ANALYST 40.0 0 X 278260 0 12327 Janet Treadwell Provider & Care Coordinator 40.0 0 X 204772 0 36388 Sherry L Vetter DIRECTOR OF ADMINISTRATION 40.0 0 X 240115 0 35106 Linda Aldred Former BOARD MEMBER 0.0 40.0 X 0 579291 168115 Susan MacDonald FORMER BOARD MEMBER 0.0 0.0 X 0 205526 522 Tabitha Rice Former BOARD MEMBER 0.0 40.0 X 0 419145 123993 Tangula Taylor SCHEDULE O 0.0 40.0 X 0 223853 37984 3368283 10893430 2412616 63 true true false SHERRY MATTHEWS ADVOCACY MARKETING 200 SOUTH CONGRESS AVENUE AUSTIN TX 78704 MARKETING SERVICES 3314443 PRESIDIO NETWORKED SOLUTIONS GROUP LLC PO BOX 677638 DALLAS TX 752677638 IT SOLUTIONS 2949611 TRIZETTO CORPORATION DEPT 2140 PO BOX 122140 DALLAS TX 753122140 HEALTHCARE IT CONSULTING SERVICE 1952197 COMFORCE TECHNICAL SERVICES INC PO BOX 9695 UNIONDALE NY 115559695 STAFFING SERVICES 1633663 MCKESSON TECHNOLOGIES INC 21987 NETWORK PLACE CHICAGO IL 606731219 HEALTHCARE IT SERVICES 1330531 32 718445 718445 PREMIUM REVENUE 524114 1065428629 1065428629 VENDED SERVICE REVENUE 541600 1394481 1394481 ACA SUPPLEMENTAL PASS-THROUGH REVENUE 524298 104731 104731 0 0 0 0 1066927841 1793527 1793527 0 0 105950962 105868406 82556 0 82556 82556 0 0 0 0 0 1069522369 1066927841 0 1876083 1001631524 1001631524 2438858 2438858 7195518 6272934 922584 1282363 1214270 68093 5005766 4748027 257739 3024020 2798883 225137 86350 86350 42900 42900 230010 230010 20083235 17209630 2873605 0 5505066 287551 5217515 1881834 1119624 762210 2949577 2796758 152819 3837824 3357353 480471 625131 590121 35010 209440 185314 24126 6059145 5280454 778691 151691 132700 18991 PREMIUM TAXES 18969777 18969777 VENDED SERVICES FROM TCH 3605901 3605901 ACA SUPPLEMENTAL PAYMENT TO PROVIDERS 997172 997172 MEMBERSHIP INCENTIVES 895243 895243 551139 466043 85096 0 1087259484 1068996278 18263206 0 78075964 75010502 17736909 4006934 8733380 7301000 0 0 0 15538968 1417905 11913272 14121063 69840708 98818193 0 26440855 26488292 335055 535697 213076143 226281681 81203823 119537106 15061 15061 6987000 1798413 88205884 121350580 X 41056000 50056000 83814259 54875101 124870259 104931101 213076143 226281681 X -17737115 21050 -2223093 X false true X true true true X 657621 715669 936312 889946 718445 3917993 734552547 792787575 918430037 957559900 1066927841 4470257900 0 0 0 735210168 793503244 919366349 958449846 1067646286 4474175893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4474175893 1515365 917569 395261 752860 1793527 5374582 0 1515365 917569 395261 752860 1793527 5374582 0 0 0 0 0 0 0 736725533 794420813 919761610 959202706 1069439813 4479550475 0.9988 0.9988 0.0012 0.0012 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 42900 42900 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY TCHP PAYS FOR LOBBYING EXPENSES TO THE TEXAS ASSOCIATION OF HEALTH PLANS (TAHP), Association for Community Affiliated Plans (ACAP), and the Texas Association of Community-Based Health Plans (TACHP) TO HELP SUPPORT ADVOCACY EFFORTS IN THE TEXAS LEGISLATURE RELATED TO ISSUES THAT IMPACT HEALTH PLANS IN TEXAS. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY TCHP PAYS FOR LOBBYING EXPENSES TO THE TEXAS ASSOCIATION OF HEALTH PLANS (TAHP), Association for Community Affiliated Plans (ACAP), and the Texas Association of Community-Based Health Plans (TACHP) TO HELP SUPPORT ADVOCACY EFFORTS IN THE TEXAS LEGISLATURE RELATED TO ISSUES THAT IMPACT HEALTH PLANS IN TEXAS. 5591951 685288 4906663 7599879 732617 6867262 2347138 2347138 14121063 INVESTMENT IN TEXAS CHILDREN'S HEALTH PLAN - THE CENTER FOR CHILDREN AND WOMEN 26488292 C 26488292 DUE TO AFFILIATES 1798413 1798413 X 1069288117 0 0 1069288117 234252 0 234252 1069522369 1087025232 0 0 1087025232 234252 0 234252 1087259484 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AS OF SEPTEMBER 30, 2016 OR 2015. true true false false false false false false false Christopher Born SCHEDULE O 545110 0 416689 0 623809 0 101420 0 19505 0 1706533 0 160922 0 Benjamin Melson Schedule O 0 775998 0 699811 0 139210 0 170502 0 27125 0 1812646 0 115702 Michelle Riley-Brown Schedule O 0 465919 0 85800 0 33422 0 170524 0 29113 0 784778 0 31130 Mark A Wallace BOARD MEMBER / Chairman 0 1288208 0 1311535 0 701130 0 274609 0 23725 0 3599207 0 412641 Randy Wright Schedule O 0 133117 0 39975 0 501033 0 2302 0 3858 0 680285 0 312024 Linda Aldred Former BOARD MEMBER 0 425331 0 67725 0 86235 0 133512 0 34603 0 747406 0 45736 Susan MacDonald FORMER BOARD MEMBER 0 2753 0 0 0 202773 0 0 0 522 0 206048 0 12935 Tabitha Rice Former BOARD MEMBER 0 323863 0 49950 0 45332 0 97067 0 26926 0 543138 0 43356 Dan DiPrisco SCHEDULE O 0 283755 0 45150 0 5694 0 78786 0 8492 0 421877 0 0 Lucio Fragoso SCHEDULE O 0 280172 0 49650 0 19858 0 81314 0 12226 0 443220 0 0 Weldon Gage SCHEDULE O 0 342246 0 45000 0 7629 0 108466 0 10253 0 513594 0 0 Angelo P Giardino MD PHD BOARD MEMBER 0 476426 0 73725 0 21908 0 145783 0 12645 0 730487 0 0 Alec King Schedule O 0 151263 0 0 0 120117 0 65526 0 13550 0 350456 0 67115 Mark Mullarkey Board Member 0 460540 0 85800 0 39068 0 170524 0 35849 0 791781 0 36972 John R Nickens IV BOARD MEMBER 0 467804 0 85800 0 6376 0 170524 0 27954 0 758458 0 3973 Anna Mateja SCHEDULE O 301400 0 53925 0 57200 0 94785 0 25346 0 532656 0 35923 0 Dace Reinholds Assistant Secretary 0 205336 0 15300 0 1840 0 18973 0 11560 0 253009 0 0 Justin Loudon DIRECTOR OF FINANCE 153614 0 13800 0 674 0 4826 0 26755 0 199669 0 0 0 Tangula Taylor SCHEDULE O 0 204440 0 18300 0 1113 0 15997 0 21987 0 261837 0 0 Laurie Levermann CIO 155856 0 0 0 51538 0 9183 0 25599 0 242176 0 0 0 LIA RODRIGUEZ MEDICAL DIRECTOR 230874 0 21600 0 19047 0 6830 0 9749 0 288100 0 0 0 Jan Scott SENIOR PROJECT ANALYST 243144 0 3497 0 31619 0 10589 0 1738 0 290587 0 31065 0 Janet Treadwell Provider & Care Coordinator 186590 0 16576 0 1606 0 15383 0 21005 0 241160 0 0 0 Sherry L Vetter DIRECTOR OF ADMINISTRATION 186043 0 34800 0 19272 0 12615 0 22491 0 275221 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED BY TEXAS CHILDREN'S AND TEXAS CHILDREN'S HOSPITAL, USING THE FOLLOWING METHODS: *COMPENSATION COMMITTEE *INDEPENDENT COMPENSATION CONSULTANT *COMPENSATION SURVEY OR STUDY *APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4a Severance or change-of-control payment SEVERANCE PAY: CHRISTOPHER BORN 77,535 LAURIE LEVERMANN 25,870 SUSAN MACDONALD 189,838 SEVERANCE IS DETERMINED ON A CASE-BY-CASE BASIS, WITH LEGAL COUNSEL INVOLVED IN THE DECISION. CONSIDERATION IS GIVEN TO FACTORS SUCH AS LENGTH OF SERVICE AND LEVEL OF POSITION WITH THE ORGANIZATION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 457 (F) PLAN: PAID/DEFERRED CHRISTOPHER BORN 505,086 / 80,220 BENJAMIN MELSON 259,927 / 149,302 MICHELLE RILEY-BROWN 116,930 / 149,324 MARK A. WALLACE 982,368 / 250,759 RANDY WRIGHT 482,802 / 0 DAN DIPRISCO 45,150 / 60,040 LUCIO FRAGOSO 49,650 / 65,414 WELDON GAGE 0 / 100,458 ANGELO P. GIARDINO MD, PHD 73,725 / 124,583 ALEC KING 67,115 / 52,640 MARK MULLARKEY 122,772 / 149,324 JOHN R. NICKENS, IV 89,773 / 149,324 ANNA MATEJA 89,848 / 73,585 JAN SCOTT 31,065 / 0 LINDA ALDRED 113,461 / 112,312 SUSAN MACDONALD 12,935 / 0 TABITHA RICE 93,306 / 75,867 SHERRY L. VETTER 34,800 / 0 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED DACE REINHOLDS 15,300 / 0 JUSTIN LOUDON 13,800 / 0 LIA RODRIGUEZ 21,600 / 0 JANET TREADWELL 16,576 / 0 TANGULA TAYLOR 18,300 / 0 457(F): THE 457(F) PLAN IS A DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO CONTRIBUTE MONEY ON A PRE-TAX BASIS. FUNDS MAY BE DEFERRED INTO THIS ACCOUNT FROM ANY OF FOUR SOURCES: BASE SALARY, ANNUAL INCENTIVE PLAN, LONG-TERM INCENTIVE PLAN, AND CAPITAL ACCUMULATION ACCOUNT FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THESE VEST AFTER THREE YEARS IN THE 457(F) WITH THE EXCEPTION OF THE CAPITAL ACCUMULATION ACCOUNT WHICH VESTS AFTER FIVE YEARS IN THE 457(F) PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND/OR YEAR. Form 990, Part VI, Line 6 Classes of members or stockholders TEXAS CHILDREN'S IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S HEALTH PLAN. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body TEXAS CHILDREN'S, AS THE SOLE MEMBER CORPORATION, HAS THE AUTHORITY TO ELECT THE BOARD OF DIRECTORS OF THE ORGANIZATION. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PER THE ORGANIZATION'S BYLAWS THE MEMBER HAS CERTAIN RESERVED POWERS: - APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. - FIX THE NUMBER, APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. - APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. - APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER, OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIC FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. - APPROVE CAPITAL AND OPERATING BUDGET OF THE CORPORATION. - ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION (INCLUDING THE AWARDING OF ANY INCENTIVE COMPENSATION) OF THE OFFICERS OF THE CORPORATION, PHYSICIAN EMPLOYEES OF THE CORPORATION, IF ANY, AND PHYSICIANS WHO ARE INDEPENDENT CONTRACTORS OF THE CORPORATION, IF ANY. - APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. - APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. - APPROVE ANY LONG-RANGE FINANCIAL OR STRATEGIC PLANS FOR THE CORPORATION. - SELECTION OF THE CORPORATION'S AUDITORS. - DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBER(S). - TAKE ANY ACTION WHICH WOULD BE CONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body NO SUCH COMMITTEES EXIST. Form 990, Part VI, Line 11b Review of form 990 by governing body PER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF TRUSTEES, THE MEMBER BOARD'S AUDIT & COMPLIANCE COMMITTEE HAS THE DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REVIEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS - PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS/KEY EMPLOYEES - PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS. Form 990, Part VI, Line 19 Required documents available to the public ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VII, Section A, Line 1a, Column (A) TITLES CHRISTOPHER BORN: BOARD MEMBER THROUGH 11/3/16 AND PRESIDENT THROUGH 10/26/16 BENJAMIN MELSON: BOARD MEMBER, VICE CHAIRMAN AND TREASURER THROUGH 11/3/16 MICHELLE RILEY-BROWN: BOARD MEMBER, VICE CHAIRMAN AND TREASURER AS OF 11/3/16 RANDY WRIGHT: BOARD MEMBER AS OF 11/3/16 AND PRESIDENT AS OF 10/26/16 DAN DIPRISCO: BOARD MEMBER AS OF 1/1/16 LUCIO FRAGOSO: BOARD MEMBER AS OF 1/1/16 WELDON GAGE: BOARD MEMBER AS OF 6/6/16 ALEC KING: BOARD MEMBER THROUGH 5/19/16 ANNA MATEJA: CFO FOR THE ENTIRE YEAR AND SECRETARY AS OF 7/21/16 TANGULA TAYLOR: Former Director of Business Development and Community Initiatives Form 990, Part XI, Line 9 Other changes in net assets or fund balances CAPITAL TRANSFER FROM TEXAS CHILDREN'S HOSPITAL - 9000000; CHANGE IN NON-ADMITTED ASSETS - -11223093; SCHEDULE O Note Regarding Foreign Insurance TEXAS CHILDREN'S HEALTH PLAN DOES BENEFIT FROM EXCESS LIABILITY AND PROPERTY INSURANCE POLICIES ISSUED BY FOREIGN INSURERS. THE PREMIUMS FOR THESE POLICIES ARE PAID BY TEXAS CHILDREN'S HOSPITAL WITH AN EXPENSE ALLOCATION TO TEXAS CHILDREN'S HEALTH PLAN. SCHEDULE O FORM 5471 DISCLOSURE STATEMENT UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: -TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN:20-2380599 6621 FANNIN ST. HOUSTON, TX 77030 -TEXAS CHILDREN'S EIN:76-0461578 6621 FANNIN ST. HOUSTON, TX 77030 TEXAS CHILDREN'S 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 760461578 PARENT TX 501(c)(3) Type II NA false TEXAS CHILDREN'S PHYSICIAN GROUP 6621 FANNIN STREET HOUSTON TX 77030 260834681 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S true TEXAS CHILDREN'S WOMEN'S SPECIALISTS PO BOX 300630 HOUSTON TX 77230 261482195 HEALTH CARE TX 501(c)(3) Type II TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON TX 77030 741100555 HOSPITAL TX 501(c)(3) 3 TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON TX 77030 202380599 SUPPORTING ORG TX 501(c)(3) Type II TEXAS CHILDREN'S true TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON TX 77230 760460242 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S true TEXAS CHILDREN'S HEALTH PLAN - THE CENTER 6621 FANNIN STREET HOUSTON TX 77030 461392824 HEALTH CARE TX 501(c)(3) Type II TEXAS CHILDREN'S HEALTH PLAN true TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 472029489 HEALTH CARE TX 501(c)(3) 10 TCH PEDIATRIC ASSOCIATES true THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON TX 77046 760246858 SUPPORTING ORG TX 501(c)(3) Type II TEXAS CHILDREN'S HOSPITAL true TCH INSURANCE COMPANY LTD 23 LIME BAY AVE GRAND CAYMAN CJ KY11102 980176652 INSURANCE CJ NA C Corporation true CVI GVF HOLDINGS 3 LTD UGLAND HOUSE SOUTH CHURCH ST GEORGE TOWN CJ KY11104 981078282 INVESTMENT CJ NA C Corporation true false false false false false false false false false false true true true false false true false true true TCH PEDIATRIC ASSOCIATES INC M 17635923 COST TEXAS CHILDREN'S PHYSICIAN GROUP M 41182038 COST TEXAS CHILDREN'S HOSPITAL M 234766105 COST TEXAS CHILDREN'S HOSPITAL K 581858 COST TEXAS CHILDREN'S HOSPITAL S 9000000 COST TEXAS CHILDREN'S HEALTH PLAN - THE CENTER L 1394481 COST TEXAS CHILDREN'S HEALTH PLAN - THE CENTER R 10424393 COST