NEW YORK STATE CATHOLIC HEALTH PLAN INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
NEW YORK STATE CATHOLIC HEALTH PLAN INC (EIN 11-3153422)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-13
IRS object ID
201723179349300302
Schema version
2016v3.0
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)
Return2017-11-13T00:54:37-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1Txt
CityJERICHOCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11753ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN113153422EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLAN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNEWYBusinessNameControlTxt
Phone7183936403PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICK J FRAWLEYPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone7183936403PhoneNum
Signature2017-10-27SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTINE KAWECKIPreparerPersonNm
PTINP00743140PTIN
Phone5169187000PhoneNum
Preparation2017-10-23PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.219.88.223IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-10IPDt
IP Tm08:14:30IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE926D9D9CBB0DE0FF1DFC229F1F4D615F8091EDCAtSubmissionCreationDeviceId
At Submission Filing Device IdE926D9D9CBB0DE0FF1DFC229F1F4D615F8091EDCAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1FIDELIS CARE NEW YORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerPATRICK J FRAWLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,519,484,909GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FIDELISCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE O.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee4319TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$470,690PYContributionsGrantsAmt
CY Contributions Grants$896,865CYContributionsGrantsAmt
PY Program Service Revenue$6,463,087,126PYProgramServiceRevenueAmt
CY Program Service Revenue$8,407,238,664CYProgramServiceRevenueAmt
PY Investment Income$23,275,108PYInvestmentIncomeAmt
CY Investment Income$15,301,767CYInvestmentIncomeAmt
PY Other Revenue$6,741,364PYOtherRevenueAmt
CY Other Revenue$14,901,768CYOtherRevenueAmt
PY Total Revenue$6,493,574,288PYTotalRevenueAmt
CY Total Revenue$8,438,339,064CYTotalRevenueAmt
PY Grants And Similar Paid$4,967,568PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,937,087CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$5,881,025,777PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$7,694,782,844CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$217,170,211PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$263,733,378CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$138,632,362PYOtherExpensesAmt
CY Other Expenses$163,804,432CYOtherExpensesAmt
PY Total Expenses$6,241,795,918PYTotalExpensesAmt
CY Total Expenses$8,127,257,741CYTotalExpensesAmt
PY Revenues Less Expenses$251,778,370PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$311,081,323CYRevenuesLessExpensesAmt
Total Assets BOY$2,655,764,792TotalAssetsBOYAmt
Total Assets EOY$3,370,300,258TotalAssetsEOYAmt
Total Liabilities BOY$1,220,675,396TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,600,301,484TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,435,089,396NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,769,998,774NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE O.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,126,793,241ExpenseAmt
Grant$3,575,470GrantAmt
Revenue$5,466,966,283RevenueAmt
DescMEDICAID MANAGED CARE PROGRAM IS A NEW YORK STATE PROGRAM ADMINISTERED BY FIDELIS THAT PROVIDES FREE COMPREHENSIVE HEALTH COVERAGE FOR ELIGIBLE INDIVIDUALS AND FAMILIES WHO ARE RESIDENTS OF NEW YORK STATE AND HAVE LOW INCOME AND LIMITED RESOURCES.THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE.CONT. IN SCHEDULE OAS OF DECEMBER 31, 2016, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF BENEFICIARIES OF THE MEDICAL ASSISTANCE PROGRAM ("MEDICAID"), APPROXIMATELY 1,156,000.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$788,046,237ExpenseAmt
Grant$177,409GrantAmt
Revenue$774,937,792RevenueAmt
DescMEDICARE ADVANTAGE PROGRAM IS A PROGRAM AVAILABLE TO ADULTS AGED 65 AND OVER WHO ARE ELIGIBLE UNDER MEDICARE. BENEFICIARIES MAY CHOOSE TO USE PRIVATE PAY OPTIONS, ESTABLISH MEDICAL SAVINGS ACCOUNT, USE MANAGED CARE PLANS SUCH AS FIDELIS, OR JOIN PROVIDER-SPONSORED PLAN.AS OF DECEMBER 31, 2016, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF BENEFICIARIES OF THE MEDICARE ADVANTAGE PROGRAM BENEFICIARIES, A PROGRAM FOR THE ELDERLY, APPROXIMATELY 62,400.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$685,744,918ExpenseAmt
Grant$44,464GrantAmt
Revenue$756,587,030RevenueAmt
DescFIDELIS CARE AT HOME IS A MEDICAID LONG-TERM CARE CAPITATED PROGRAM WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES AN ARRAY OF HOME, COMMUNITY, AND INSTITUTIONALLY BASED, LONG-TERM CARE SERVICES TO PERSONS WHO ARE ELIGIBLE FOR MEDICAID AND WHO HAVE BEEN CERTIFIED AS APPROPRIATE CANDIDATES FOR NURSING HOME PLACEMENT.AS OF DECEMBER 31, 2016, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF BENEFICIARIES OF THE FIDELIS CARE AT HOME MANAGED LONG-TERM CARE PROGRAM BENEFICIARIES, A PROGRAM FOR RESIDENTS WHO NEED LONG-TERM CARE SERVICES AND ARE ELIGIBLE FOR MEDICAID, APPROXIMATELY 17,000.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$1,099,135,535ExpenseAmt
Grant$1,139,745GrantAmt
Revenue$1,423,649,327RevenueAmt
DescOTHER PROGRAMS ADMINISTERED BY THE PLAN INCLUDE THE CHILD HEALTH PLUS PROGRAM, MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM, MEDICAID ADVANTAGE PLUS PROGRAM, THE NEW YORK HEALTH BENEFIT EXCHANGE PROGRAM ("HEALTH BENEFIT EXCHANGE"), THE FULLY INTEGRATED DUALS ADVANTAGE PROGRAM ("FIDA"), HEALTH AND RECOVERY PLAN PROGRAM ("HARP"), AND THE ESSENTIAL PLAN PROGRAM.CHILD HEALTH PLUS PROGRAM IS A PROGRAM THAT COVERS UNINSURED CHILDREN UNDER THE AGE OF 19, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID.MEDICARE/MEDICAID DUAL ADVANTAGE IS A PROGRAM FOR THOSE WHO MEETELIGIBILITY REQUIREMENTS FOR BOTH MEDICARE AND MEDICAID AND AREENROLLED IN BOTH PROGRAMS.MEDICAID ADVANTAGE PLUS IS A FULL-RISK MANAGED LONG-TERM CARE PROGRAMFOR INDIVIDUALS 18 YEARS OF AGE AND OLDER WITH MEDICARE AND MEDICAIDCOVERAGE WHO HAVE A CHRONIC ILLNESS OR DISABILITY. MEMBERS MUST BE INNEED OF LONG-TERM CARE SERVICES AND MAY NEED CARE TYPICALLY GIVEN IN ANURSING HOME.HEALTH BENEFIT EXCHANGE IS A PROGRAM PROVIDING HEALTHCOVERAGE TO INDIVIDUALS UNDER THE HEALTH CARE REFORM ACT.FIDA PROGRAM IS A PLAN DESIGNED TO PROVIDE MANAGED CARE TO INDIVIDUALS WHO HAVE BOTH MEDICARE AND MEDICAID. THE FIDA PLAN ALLOWS THE INDIVIDUAL'S MEDICARE AND MEDICAID BENEFITS TO BE COVERED AND MANAGED UNDER ONE PLAN, INCLUDING LONG-TERM CARE NEEDS, SUPPORTS AND PRESCRIPTION DRUGS.HARP PROGRAM IS A MEDICAID PROGRAM THAT PROVIDES CARE MANAGEMENT SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICAID REQUIRING BEHAVIORAL HEALTH SERVICES.ESSENTIAL PLAN IS A PROGRAM THAT PROVIDES MINIMUM ESSENTIAL COVERAGE TO QUALIFIED INDIVIDUALS WHO ARE NOT ELIGIBLE FOR MEDICAID OR THE CHILD HEALTH PLUS PROGRAMS. FIDELIS IMPLEMENTED THE ESSENTIAL PLAN PROGRAM EFFECTIVE JANUARY 1, 2016.AS OF DECEMBER 31, 2016, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF THE CHILD HEALTH PLUS PROGRAM BENEFICIARIES, A PROGRAM FOR LOW INCOME UNINSURED CHILDREN, APPROXIMATELY 99,000; MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM BENEFICIARIES, A PROGRAM FOR THE ELDERLY, APPROXIMATELY 1,600; MEDICAID ADVANTAGE PLUS, APPROXIMATELY 125; HEALTH BENEFIT EXCHANGE PROGRAM BENEFICIARIES, A PROGRAM WHICH PROVIDES HEALTH COVERAGE TO INDIVIDUAL MEMBERS UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010 ("HEALTH CARE REFORM ACT"), APPROXIMATELY 55,000; THE FIDA PROGRAM BENEFICIARIES, A PROGRAM WHICH PROVIDES MANAGED CARE TO INDIVIDUALS WHO HAVE BOTH MEDICARE AND MEDICAID, APPROXIMATELY 300; HARP PROGRAM BENEFICIARIES, A PROGRAM WHICH PROVIDES CARE MANAGEMENT SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICAID REQUIRING BEHAVIORAL HEALTH SERVICES, APPROXIMATELY 19,000; AND THE ESSENTIAL PLAN, A PROGRAM THAT BEGAN IN JANUARY 2016, WHICH PROVIDES MINIMUM ESSENTIAL COVERAGE TO QUALIFIED INDIVIDUALS WHO ARE NOT ELIGIBLE FOR MEDICAID OR THE CHILD HEALTH PLUS PROGRAMS, APPROXIMATELY 146,000.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$1,099,135,535TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$1,139,745TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$1,423,649,327TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$7,699,719,931TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document16923IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee4319EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANNE C KONTOPOULOSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7183936403PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BLVDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
KARL P ADLER MD
DIRECTOR1.000.00Yes (X)$0$0$0
JACK BALINSKY
DIRECTOR1.000.00Yes (X)$0$0$0
M WILLIAM BENEDETTO
DIRECTOR1.000.00Yes (X)$0$0$0
SR PATRICIA BURKARD
DIRECTOR/SECRETARY1.000.00Yes (X)$0$0$0Yes (X)
JAMES M CORRIGAN
DIRECTOR1.000.00Yes (X)$0$0$0
REV JOHN COUGHLIN
DIRECTOR1.000.00Yes (X)$0$0$0
THOMAS F DOODIAN
DIRECTOR1.000.00Yes (X)$0$0$0
REVEREND DONALD J HARRINGTON
CHAIRMAN OF THE BOARD1.000.00Yes (X)$0$0$0Yes (X)
JOHN J HURLEY
DIRECTOR1.000.00Yes (X)$0$0$0
THOMAS L KELLY
DIRECTOR1.000.00Yes (X)$0$0$0
DONNA O' BRIEN
DIRECTOR1.000.00Yes (X)$0$0$0
REVEREND LEO J O'DONOVAN
DIRECTOR1.000.00Yes (X)$0$0$0
GINO J PAZZAGLINI
DIRECTOR/VICE-CHAIRMAN1.000.00Yes (X)$0$0$0Yes (X)
REV MONSIGNOR ALAN J PLACA
DIRECTOR (THRU FEB 2016)1.000.00Yes (X)$0$0$0
JOHN RYDZEWSKI
DIRECTOR1.000.00Yes (X)$0$0$0
JOSEPH SLAVIK
DIRECTOR1.000.00Yes (X)$0$0$0
DEACON FRANK J THOMAS MD
DIRECTOR1.000.00Yes (X)$0$0$0
MARY THOMPSON
DIRECTOR1.000.00Yes (X)$0$0$0
MICHAEL J TOOLEY
DIRECTOR1.000.00Yes (X)$0$0$0
JOHN A WERWAISS
DIRECTOR/TREASURER1.000.00Yes (X)$0$0$0Yes (X)
PATRICK J FRAWLEY
PRESIDENT & CEO37.500.00$4,918,335$0$133,440Yes (X)
THOMAS HALLORAN
CHIEF FINANCIAL OFFICER33.753.75$634,622$71,653$330,721Yes (X)
DAVID THOMAS
EVP & COO34.702.80$1,346,589$63,155$76,105Yes (X)
SANJIV SHAH MD
CHIEF MEDICAL OFFICER32.804.70$527,770$75,823$49,717Yes (X)
PAMELA HASSEN
CHIEF MARKETING OFFICER37.500.00$462,236$0$281,847Yes (X)
MARTIN KREBS
CHIEF INFORMATION OFFICER37.500.00$502,240$0$204,932Yes (X)
SANTO RUSSO
CHIEF LEGAL OFFICER33.753.75$455,404$51,767$212,884Yes (X)
THOMAS BROWN
CHIEF ADMINISTRATIVE OFFICER37.500.00$505,977$0$158,444Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,353,173TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$262,398TotReportableCompRltdOrgAmt
Total Other Compensation$1,448,090TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K392IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COTIVI DOMESTIC HOLDINGS INC
50 DANBURY ROADWILTONCT06897MEDICAL CLAIMS REVIEW$10,681,099
AARETE LLC
8574 SOLUTION CENTERCHICAGOIL606778005CONSULTING SERVICES/COST SAVINGS$6,968,276
TEKSYSTEMS INC
7437 RACE ROADHANOVERMD21076TEMPORARY SUPPORT/PLACEMENT FEES$4,525,732
HEALTH MANAGEMENT SYSTEMS INC
PO BOX 27151NEW YORKNY10087COORDINATION OF BENEFITS REVIEW$3,956,871
PERSONAL COMPUTERS INC
703 WASHINGTON STREETBUFFALONY14203IT SERVICES$1,663,808
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K52CntrctRcvdGreaterThan100KCnt
Related Organizations$10,000RelatedOrganizationsAmt
Government Grants$592,165GovernmentGrantsAmt
All Other Contributions$294,700AllOtherContributionsAmt
Total Contributions$896,865TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID524114$5,466,966,283$5,466,966,283
MEDICARE ADVANTAGE524114$774,937,792$774,937,792
FIDELIS CARE AT HOME524114$756,587,030$756,587,030
ESSENTIAL PLAN524114$660,916,923$660,916,923
HARP524114$289,124,095$289,124,095

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$458,706,541TotalRevenueColumnAmt
Related Or Exempt Func Income$458,706,541RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$8,407,238,664TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,015,784TotalRevenueColumnAmt
Exclusion$21,015,784ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,075,431,828SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,081,145,845SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$5,714,017SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$5,714,017TotalRevenueColumnAmt
Exclusion-$5,714,017ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
VBP QIP & OTHER ADMIN524298$14,851,626$14,851,626
PURCHASE REBATES524298$35,785$35,785
EQUITY FROM SUBSIDIARI900099-$5,992-$5,992

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,349TotalRevenueColumnAmt
Related Or Exempt Func Income$20,349RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$14,901,768OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,438,339,064TotalRevenueColumnAmt
Related Or Exempt Func Income$8,422,140,432RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$15,301,767ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,705,553TotalAmt
Program Services$4,705,553ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$231,534TotalAmt
Program Services$231,534ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$7,694,782,844TotalAmt
Program Services$7,694,782,844ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$7,446,507TotalAmt
Management And General$7,446,507ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$201,560,025TotalAmt
Management And General$201,560,025ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,975,272TotalAmt
Management And General$6,975,272ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$32,959,759TotalAmt
Management And General$32,959,759ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,791,815TotalAmt
Management And General$14,791,815ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,124,428TotalAmt
Management And General$1,124,428ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$893,150TotalAmt
Management And General$893,150ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$76,653TotalAmt
Management And General$76,653ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$988,504TotalAmt
Management And General$988,504ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$15,178,483TotalAmt
Management And General$15,178,483ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$18,118,346TotalAmt
Management And General$18,118,346ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,140,588TotalAmt
Management And General$3,140,588ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,367,691TotalAmt
Management And General$17,367,691ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$11,201,746TotalAmt
Management And General$11,201,746ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,512,488TotalAmt
Management And General$4,512,488ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$900,859TotalAmt
Management And General$900,859ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$682,418TotalAmt
Management And General$682,418ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$26,907,492TotalAmt
Management And General$26,907,492ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,207,554TotalAmt
Management And General$1,207,554ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
CLAIMS PROCESSING$18,535,746$18,535,746
POSTAGE & SHIPPING$7,916,532$7,916,532
TELEPHONE EXPENSE$4,914,078$4,914,078
PRINTING & PUBLICATIONS$4,301,425$4,301,425

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$25,836,251TotalAmt
Management And General$25,836,251ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,127,257,741TotalAmt
Program Services$7,699,719,931ProgramServicesAmt
Management And General$427,537,810ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,694,651BOYAmt
EOY$69,579,692EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,123,306,889BOYAmt
EOY$1,720,092,292EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$241,180,947BOYAmt
EOY$203,708,261EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$78,315,016BOYAmt
EOY$124,910,660EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$176,184,128LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$118,697,177LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$51,968,669BOYAmt
EOY$57,486,951EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$584,254,162BOYAmt
EOY$650,604,208EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$204,833,154BOYAmt
EOY$46,486,899EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$281,421BOYAmt
EOY$269,092EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$15,849,777BOYAmt
EOY$15,849,778EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$348,080,106BOYAmt
EOY$481,312,425EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,655,764,792BOYAmt
EOY$3,370,300,258EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$141,935,224BOYAmt
EOY$187,631,041EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$15,177,996BOYAmt
EOY$14,245,393EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$100,000,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,063,562,176BOYAmt
EOY$1,298,425,050EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,220,675,396BOYAmt
EOY$1,600,301,484EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,434,465,387BOYAmt
EOY$1,769,344,153EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$624,009BOYAmt
EOY$654,621EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,435,089,396BOYAmt
EOY$1,769,998,774EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,655,764,792BOYAmt
EOY$3,370,300,258EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$311,081,323ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$23,828,055NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$270,351CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$353,245CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$196,215CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$470,690CurrentTaxYearMinus1YearAmt
Current Tax Year$896,865CurrentTaxYearAmt
Total$2,187,366TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,273,848,371CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,086,015,198CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,282,714,979CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,469,839,473CurrentTaxYearMinus1YearAmt
Current Tax Year$8,422,090,289CurrentTaxYearAmt
Total$27,534,508,310TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,274,118,722CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,086,368,443CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,282,911,194CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,470,310,163CurrentTaxYearMinus1YearAmt
Current Tax Year$8,422,987,154CurrentTaxYearAmt
Total$27,536,695,676TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$27,536,695,676PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,356,791CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,866,741CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,001,330CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,525,457CurrentTaxYearMinus1YearAmt
Current Tax Year$21,015,784CurrentTaxYearAmt
Total$76,766,103TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,356,791CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,866,741CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,001,330CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,525,457CurrentTaxYearMinus1YearAmt
Current Tax Year$21,015,784CurrentTaxYearAmt
Total$76,766,103TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$239,217CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$153,519CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$209,418CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year-$10,983CurrentTaxYearMinus1YearAmt
Current Tax Year$50,142CurrentTaxYearAmt
Total$641,313TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,283,714,730CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,098,388,703CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,301,121,942CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,486,824,637CurrentTaxYearMinus1YearAmt
Current Tax Year$8,444,053,080CurrentTaxYearAmt
Total$27,614,103,092TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99720PublicSupportCY509Pct
Public Support PY5090.99670PublicSupportPY509Pct
Investment Income CY0.00280InvestmentIncomeCYPct
Investment Income PY0.00290InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$76,653OtherActivitiesAmt
Total Lobbying Expenditures$76,653TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationFIDELIS IS A MEMBER OF CERTAIN ASSOCIATIONS, TO WHICH IT PAYS ANNUAL DUES. A PORTION OF THOSE DUES ARE DETERMINED TO BE EXPENDITURES FOR LOBBYING PURPOSES. IN 2016, THAT PORTION WAS $76,653.ExplanationTxt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,236,665OtherCostOrOtherBasisAmt
Depreciation$9,348,790DepreciationAmt
Book Value$11,887,875BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,923,445OtherCostOrOtherBasisAmt
Depreciation$12,507,662DepreciationAmt
Book Value$1,415,783BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$141,024,018OtherCostOrOtherBasisAmt
Depreciation$96,840,725DepreciationAmt
Book Value$44,183,293BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$57,486,951TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$10,958,666
PHARMACY RECEIVABLES$103,959,250
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS) - CURRENT$32,990
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS)$366,361,519
FieldValueIRS element (for citing)
Total Book Value Other Assets$481,312,425TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
CAPITAL LEASE PAYABLE$40,556
CLAIMS PAYABLE$1,079,491,173
DUE TO THIRD PARTIES$218,893,321
FieldValueIRS element (for citing)
Total Liability$1,298,425,050TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$8,462,184,220TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$23,828,055NetUnrealizedGainsInvstAmt
Other Revenue$17,101OtherRevenueAmt
Revenue Not Reported$23,845,156RevenueNotReportedAmt
Revenue Subtotal$8,438,339,064RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$8,438,339,064TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,127,274,842TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$17,101OtherExpensesIncludedAmt
Expenses Not Reported$17,101ExpensesNotReportedAmt
Expenses Subtotal$8,127,257,741ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,127,257,741TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS") 5,992. SALUS CONTRIBUTION ELIMINATED IN CONSOLIDATION -10,000. SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 21,109.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EQUITY INVESTMENT IN SALUS 5,992. SALUS CONTRIBUTION ELIMINATED IN CONSOLIDATION -10,000. SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 21,109.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (41 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
1199SEIU HOME CARE INDUSTRY EDUCATION
330 WEST 42ND STREETNEW YORKNY10036711028611501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
AMAUS HEALTH SERVICES AT THE CATHEDRAL
259 EAST ONONDAGA STREETSYRACUSENY13202611548780501(C)(3)$30,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
ARCHCARE
205 LEXINGTON AVE 3RD FLNEW YORKNY10016133896624501(C)(3)$471,500$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES COMMUNITY SERVICES ARCHDIOCESE OF NEW YORK
1011 FIRST AVENUE 6TH FLOORNEW YORKNY10022135562185501(C)(3)$471,500$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES FULTON & MONTGOMERY
55 EAST MAIN STREETJOHNSTOWNNY12095141340033501(C)(3)$6,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF BUFFALO
741 DELAWARE AVEBUFFALONY14209160743251501(C)(3)$411,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF FINGER LAKES
94 EXCHANGE STREETGENEVANY14456142005241501(C)(3)$15,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF LIVINGSTON COUNTY
34 EAST STATE STREETMT MORRISNY14510205493091501(C)(3)$15,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF STEUBEN
23 LIBERTY STREETBATHNY14810300553416501(C)(3)$15,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF ALBANY
40 NORTH MAIN AVENUEALBANYNY12203141340033501(C)(3)$447,250$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
90 CHERRY LANEHICKSVILLENY11801111843801501(C)(3)$383,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES OF TOMPKINSTIOGA
324 W BUFFALO STREETITHACANY14850510621633501(C)(3)$15,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES RC DIOCESE OF SYRACUSE
240 EAST ONONDAGA STREETSYRACUSENY13202150532085501(C)(3)$313,800$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES DIOCESE OF BROOKLYN & QUEENS
191 JORALEMON STREETBROOKLYNNY11201112047151501(C)(3)$467,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC CHARITIES DIOCESE OF OGDENSBURG
6866 STATE HIGHWAY 37OGDENSBURGNY13669150614025501(C)(3)$200,500$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC MEDICAL MISSION BOARD
100 WALL STREET FLOOR 9NEW YORKNY10005135602319501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC MIGRATION SERVICES INC
191 JORALEMON STREETBROOKLYNNY11201112634818501(C)(3)$400,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CATHOLIC SCHOOLS IN THE ARCHDIOCESE OF NEW YORK
1101 FIRST AVENUE 18TH FLOORNEW YORKNY10022530196617501(C)(3)$90,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
CHARLES B WANG COMMUNITY HEALTH CENTER
268 CANAL STREETNEW YORKNY10013132739694501(C)(3)$10,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
COLUMBIA MEMORIAL HOSPITAL
71 PROSPECT AVENUEHUDSONNY12534141338373501(C)(3)$5,053$0CASHPART IV, SUPPLEMENTAL INFORMATION
COMMUNITY HEALTH CENTER OF BUFFALO INC
34 BENWOOD AVEBUFFALONY14214161566929501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF OGDENSBURG
100 ELIZABETH STREETOGDENSBURGNY13669150532120501(C)(3)$60,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF ROCHESTER DEPARTMENT OF CATHOLIC SCHOOLS
1150 BUFFALO ROADROCHESTERNY14624160755765501(C)(3)$290,750$0CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF ROCKVILLE CENTRE
128 CHERRY LANEHICKSVILLENY11801111837437501(C)(3)$55,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESE OF SYRACUSE CATHOLIC SCHOOLS
240 E ONONDAGA STREETSYRACUSENY13207150532137501(C)(3)$60,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
DIOCESES OF BUFFALO
795 MAIN STREETBUFFALONY14203160743984501(C)(3)$60,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
FRANCISCAN NORTHSIDE MINISTRIES
812 NORTH SALINA STSYRACUSENY13208150532104501(C)(3)$30,400$0CASHPART IV, SUPPLEMENTAL INFORMATION
FRIENDS OF BASSETT INC
1 ATWELL ROADCOOPERSTOWNNY13326237041610501(C)(3)$10,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
MATERNITY AND EARLY CHILDHOOD FOUNDATION INC
40 NORTH MAIN AVENUEALBANYNY12203141650131501(C)(3)$50,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
MERCY HOSPITAL FOUNDATION
565 ABBOTT ROADBUFFALONY14220222209721501(C)(3)$7,500$0CASHPART IV, SUPPLEMENTAL INFORMATION
MORRIS HEIGHTS HEALTH CENTER
85 WEST BURNSIDE AVEBRONXNY10453061081232501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
PS130-M PARENTS ASSOCIATION
143 BAXTER STREETNEW YORKNY10013200766928501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
ROMAN CATHOLIC DIOCESE OF BROOKLYN NY
310 PROSPECT PARK WESTBROOKLYNNY11215111631807501(C)(3)$90,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
SAINT JOSEPH'S HOME
950 LINDEN STREETOGDENSBURGNY13669150532217501(C)(3)$69,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
SCHOOLS OF THE ROMAN CATHOLIC DIOCESE OF ALBANY
40 NORTH MAIN AVENUEALBANYNY12203141605502501(C)(3)$38,900$0CASHPART IV, SUPPLEMENTAL INFORMATION
THE ALFRED E SMITH MEMORIAL FOUNDATION
1011 FIRST AVENUE SUITE 1400NEW YORKNY10022131553263501(C)(3)$50,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
THE FOUNDATION FOR ELLIS MEDICINE
1101 NOTT STSCHENECTADYNY12308141638957501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
THE UNITY HOSPITAL OF ROCHESTER
1555 LONG POND ROADROCHESTERNY14626237221763501(C)(3)$5,500$0CASHPART IV, SUPPLEMENTAL INFORMATION
URBAN HEALTH PLAN INC
1065 SOUTHERN BOULEVARDBRONXNY10459237360305501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
WILLIAM F RYAN COMMUNITY HEALTH CENTER INC
110 W 97TH STREETNEW YORKNY10025132884976501(C)(3)$5,000$0CASHPART IV, SUPPLEMENTAL INFORMATION
GRANTS 5000
95-92 QUEENS BOULEVARDREGO PARKNY113744570501(C)(3)$21,900$0CASHPART IV, SUPPLEMENTAL INFORMATION
FieldValueIRS element (for citing)
Total501c3 Org41Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeHEALTHY KIDS FUNDGrantTypeTxt
Recipient25249RecipientCnt
Cash Grant$231,534CashGrantAmt
Valuation Method UsedCASH PAIDValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2:RECIPIENTS OF GRANT AWARDS UNDER THE COMMUNITY GRANT FUND ARE REQUIRED TO PROVIDE PERIODIC UPDATES ON THE ACCOMPLISHMENTS OF THE GRANT AND DISBURSEMENTS. IT IS THE RESPONSIBILITY OF THE GRANT RECIPIENT TO ENSURE THAT THE GRANT IS USED FOR THE PURPOSE(S) STATED IN THE ORIGINAL APPLICATION. FIDELIS MONITORS GRANT USAGE BY CORRESPONDENCE, TELEPHONE OR SITE VISITS. AN EVALUATION OF THE PROJECT IS REQUIRED UPON THE GRANTEE'S COMPLETION. NON-COMPLIANCE WITH THESE GUIDELINES MAY RESULT IN A REQUEST FOR RETURN OF THE FUNDS IN QUESTION OR INTELLIGIBILITY OF THE ORGANIZATION FOR FUTURE GRANTS FROM FIDELIS.
SCHEDULE I, PART II, COLUMN HSINCE 2004, THE PURPOSE OF THE FIDELIS CARE COMMUNITY GRANT FUND IS TO OFFER SUPPORT ANNUALLY THROUGH CHARITABLE CONTRIBUTIONS TO SELECTED TAX-EXEMPT NONPROFIT ORGANIZATIONS THAT SHARE SIMILAR MISSIONS AND VALUES OF SERVICE TO LOW-INCOME VULNERABLE INDIVIDUALS. PROPOSALS ARE EVALUATED ON THEIR RELEVANCE TO FIDELIS' MISSION OF CARING FOR THE NEEDS AND CONCERNS OF THE POOR AND MEDICALLY UNDERSERVED IN CONSULTATION WITH FIDELIS' MEMBERS. THE TOTAL AMOUNT TO BE DISTRIBUTED EACH YEAR IS APPROVED BY THE BOARD OF DIRECTORS AND DISTRIBUTED IN ACCORDANCE WITH THE APPROVED BOARD POLICY. IN ADDITION TO THE GRANTS MADE THROUGH ITS COMMUNITY GRANT FUND, FIDELIS PROVIDES SUPPORT THROUGH CHARITABLE CONTRIBUTIONS THROUGH ITS CATHOLIC SCHOOLS GRANT INITIATIVE TO SELECTED CATHOLIC SCHOOLS OR DIOCESAN SCHOOL SYSTEMS IN THEIR EFFORT TO IMPROVE THE HEALTH STATUS OF CHILDREN AND THEIR FAMILIES. LASTLY, FIDELIS MAKES CHARITABLE DONATIONS TO ORGANIZATIONS CLASSIFIED AS TAX-EXEMPT NONPROFIT ORGANIZATIONS UNDER STATE AND FEDERAL LAW THAT WORK WITH FIDELIS TO SUPPORT THE PLAN'S MISSION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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
PATRICK J FRAWLEY
PRESIDENT & CEO$1,290,399$0$0$0$3,627,936$0$18,517$0$114,923$0$5,051,775$0$0$0
THOMAS HALLORAN
CHIEF FINANCIAL OFFICER$474,941$56,654$134,991$14,999$24,690$0$285,719$1,852$39,617$3,533$959,958$77,038$0$0
DAVID THOMAS
EVP & COO$580,360$49,889$163,609$13,266$602,620$0$17,129$1,389$53,710$3,877$1,417,428$68,421$0$0
SANJIV SHAH MD
CHIEF MEDICAL OFFICER$391,649$59,904$111,431$15,919$24,690$0$16,203$2,315$27,358$3,841$571,331$81,979$0$0
PAMELA HASSEN
CHIEF MARKETING OFFICER$339,911$0$97,635$0$24,690$0$257,151$0$24,696$0$744,083$0$0$0
MARTIN KREBS
CHIEF INFORMATION OFFICER$376,250$0$107,540$0$18,450$0$167,456$0$37,476$0$707,172$0$0$0
SANTO RUSSO
CHIEF LEGAL OFFICER$355,326$41,154$95,513$10,613$4,565$0$166,946$1,852$40,559$3,527$662,909$57,146$0$0
THOMAS BROWN
CHIEF ADMINISTRATIVE OFFICER$372,042$0$106,125$0$27,810$0$157,076$0$1,368$0$664,421$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BSERP COMPENSATION OF OFFICERS, KEY EMPLOYEES, OR HIGHEST COMPENSATED EMPLOYEES: PATRICK J. FRAWLEY - $3,601,956*; DAVID THOMAS - $577,930*; THOMAS HALLORAN - $269,053**; PAMELA HASSEN - $238,633**; MARTIN KREBS - $148,939**; SANTO RUSSO - $150,280**; THOMAS BROWN - $138,558** *THE ABOVE AMOUNTS INCLUDE GROSS-UP TAXES PAID ON BEHALF OF THE PARTICIPANTS (LINE 1A). **THESE REPRESENT NON-VESTED SERP BENEFITS.
PART I, LINE 7PERFORMANCE-BASED INCENTIVES ARE PAID AS PART OF THE PLAN'S ANNUAL INCENTIVE PROGRAM. THE PRESIDENT & CHIEF EXECUTIVE OFFICER DOES NOT PARTICIPATE IN ANY INCENTIVE PROGRAM.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SUBSTANTIAL CONTRIBUTORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionSUBSTANTIAL CONTRIBUTORRelationshipDescriptionTxt
Transaction$20,355,980TransactionAmt
TransactionBUSINESS TRANSACTIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1DESCRIPTION OF ORGANIZATION MISSION: TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES TO THE COMMUNITY, ESPECIALLY TO THE POOR AND UNDERSERVED; TO PROMOTE HEALTH EDUCATION AND PREVENTATIVE MEDICINE.
FORM 990, PART III, LINE 1DESCRIPTION OF ORGANIZATION MISSION: THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("FIDELIS OR THE "PLAN") STRIVES TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES FOR ALL; TO JOIN IN PARTNERSHIP WITH HEALTH PROFESSIONALS TO ASSIST THEM IN THEIR HEALING WORK; TO ACT AS A FACILITATOR TO BUILD LINKAGES AND SYSTEMS FOR THE COORDINATION OF CARE AND SERVICES AMONG HEALTHCARE, BEHAVIORAL AND SOCIAL SERVICES, AS WELL AS EDUCATORS AND RELIGIOUS LEADERS, TO ADDRESS THE SPIRITUAL, EMOTIONAL AND PHYSICAL NEEDS OF THOSE WE SERVE; TO ADVOCATE FOR A HEALTH POLICY THAT ACCORDS TRUE DIGNITY AND RESPECT FOR ALL HUMAN PERSONS, ESPECIALLY THE POOR AND UNDERSERVED.
FORM 990, PART III, LINE 2EFFECTIVE JANUARY 1, 2016, FIDELIS IMPLEMENTED THE ESSENTIAL PLAN PROGRAM. SEE PART III LINE 4D FOR DETAILS.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ORGANIZATION SHALL BE LIMITED TO THE DIOCESAN BISHOPS OF THE STATE AND THE ECCLESIASTICAL PROVINCE OF NEW YORK.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION IS A MEMBERSHIP CORPORATION UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW (THE "N-PCL") THE ORGANIZATION'S MEMBERS ELECT ITS BOARD OF DIRECTORS AND, AS MEMBERS OF A NEW YORK NOT-FOR-PROFIT CORPORATION, POSSESS CERTAIN OTHER POWERS UNDER THE N-PCL. FURTHERMORE, THE ORGANIZATION'S BY-LAWS, WHICH ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYSDOH"), DEFINE THE FOLLOWING RESERVED POWERS OF THE MEMBERS: (I) THE INTERPRETATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES TO WHICH THE ORGANIZATION, AS A FAITH-BASED ORGANIZATION, IS SUBJECT; (II) APPROVAL OF THE MISSION STATEMENT; (III) STANDING TO ENSURE THE ORGANIZATION'S COMPLIANCE WITH ITS PHILOSOPHY AND MISSION STATEMENT; (IV) APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S CERTIFICATE OF INCORPORATION AND BY-LAWS; (V) APPROVAL OF CERTAIN TRANSACTIONS INVOLVING REAL PROPERTY; (VI) APPROVAL OF CERTAIN ACTIONS BY THE ORGANIZATION WHEN ACTING AS A SHAREHOLDER OR MEMBER OF ANOTHER ENTITY; (VII) APPROVAL OF THE ACCEPTANCE AND ISSUANCE OF SUBVENTIONS; (VIII) APPROVAL OF ANY MERGER, DISSOLUTION OR CONSOLIDATION, (IX) REMOVAL OF DIRECTORS AND CERTAIN OFFICERS OF THE CORPORATION; (X) APPROVAL OF THE ELECTION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, AND (XI) REVIEW OF THE AUDITED FINANCIAL STATEMENTS. CERTAIN OF THESE POWERS ALREADY EXIST BY VIRTUE OF THE N-PCL (E.G., THE POWER TO APPROVE ANY MERGER, DISSOLUTION OR CONSOLIDATION UNDER N-PCL 903(A)(2) & 1002(A)).
FORM 990, PART VI, SECTION A, LINE 7BPLEASE SEE LINE 11 NARRATIVE.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE FORM 990 PREPARED BY THE ORGANIZATION'S FINANCE DEPARTMENT IS REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER, IN COLLABORATION WITH THE ORGANIZATION'S OUTSIDE INDEPENDENT TAX ADVISORS. THEREAFTER, THE ORGANIZATION'S PRESIDENT & CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER REVIEW THE DRAFT FORM 990 WITH CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AUTHORIZED THE EXECUTIVE COMMITTEE OF THE BOARD TO REVIEW AND ACCEPT THE DRAFT FORM 990 BEFORE ITS FILING WITH THE IRS. ACCORDINGLY, AFTER THE ORGANIZATION'S MANAGEMENT HAS COMPLETED ITS REVIEW OF THE DRAFT FORM 990, IT IS CIRCULATED IN DRAFT FOR REVIEW, COMMENT AND APPROVAL TO THE MEMBERS OF THE EXECUTIVE COMMITTEE. ONCE ANY COMMENTS HAVE BEEN INCORPORATED AND THE FORM 990 HAS BEEN ACCEPTED BY THE EXECUTIVE COMMITTEE, A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE ORGANIZATION'S OFFICERS, DIRECTORS AND SENIOR EXECUTIVES ARE PROVIDED WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND AN ACKNOWLEDGEMENT FORM. THESE INDIVIDUALS ARE INSTRUCTED TO SIGN AND RETURN THE FORM, (A) TO ACKNOWLEDGE THAT THEY HAVE REVIEWED THE POLICY AND (B) TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS. THE CONFLICTS OF INTEREST POLICY DEFINES "DISCLOSABLE INTERESTS", I.E., THOSE INTERESTS THAT AN INDIVIDUAL COVERED BY THE POLICY MUST HAVE IN ANOTHER ENTITY IN ORDER FOR A TRANSACTION BETWEEN THE ORGANIZATION AND THAT ENTITY TO BE COVERED BY THE POLICY. THE POLICY ALSO DEFINES THE TYPES OF TRANSACTIONS BETWEEN THE ORGANIZATION AND ANOTHER ENTITY INVOLVING AN INDIVIDUAL COVERED BY THE POLICY THAT IS SUBJECT TO BY THE POLICY. THE POLICY REQUIRES DISCLOSURE TO THE BOARD OF DIRECTORS AND/OR THE EXECUTIVE COMMITTEE BY ANY PERSON WITH A DISCLOSABLE INTEREST IN A TRANSACTION AS DEFINED IN THE POLICY OF ALL CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. INITIALLY, AFTER THE INTERESTED INDIVIDUAL HAS RECUSED HIMSELF, THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE DETERMINES WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE DECIDES WHETHER TO ENTER INTO THE TRANSACTION BASED ON ITS DETERMINATION OF WHETHER (A) A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, (B) THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND (C) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15OUTSIDE COUNSEL FOR THE ORGANIZATION, A NATIONAL LAW FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, HAS ADVISED FIDELIS AS TO WHICH EMPLOYEES ARE DISQUALIFIED PERSONS WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EMPLOYS A COMPENSATION CONSULTANT FIRM, A NATIONAL HUMAN RESOURCES CONSULTING FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, TO PREPARE ANNUALLY A DETAILED REPORT ON THE PROPOSED COMPENSATION FOR THE ORGANIZATION'S DISQUALIFIED PERSONS THAT INCLUDES DATA AS TO COMPARABLE COMPENSATION FOR SIMILAR QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY-SITUATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH HAS BEEN AUTHORIZED BY THE BOARD TO REVIEW AND APPROVE ALL MATTERS CONCERNING EXECUTIVE COMPENSATION, IS PROVIDED WITH THE COMPENSATION CONSULTANT'S DETAILED EXECUTIVE COMPENSATION REPORT. THE REVIEW AND APPROVAL OF THE COMPENSATION OF THE ORGANIZATION'S DISQUALIFIED PERSONS IS ACCOMPLISHED IN TWO PHASES: FIRST WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER AND THEN WITH RESPECT TO ALL OTHER DISQUALIFIED PERSONS, NAMELY, (I) THE EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER, (II) THE CHIEF FINANCIAL OFFICER, (III) THE CHIEF LEGAL OFFICER, (IV) THE CHIEF MEDICAL OFFICER, (V) CHIEF MARKETING OFFICER, (VI) CHIEF INFORMATION OFFICER AND (VII) CHIEF ADMINISTRATIVE OFFICER. FIRST, THE AFOREMENTIONED OUTSIDE COUNSEL AND HUMAN RESOURCES CONSULTING FIRM, AT THE INVITATION OF THE EXECUTIVE COMMITTEE, REVIEW WITH THE COMMITTEE THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO RETAINS THE SERVICES OF A SECOND HUMAN RESOURCES CONSULTING FIRM TO ASSIST IN ITS EVALUATION OF THE PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE FULL REVIEW OF THE COMPENSATION AND PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER IS PERFORMED BY THE EXECUTIVE COMMITTEE AT LEAST BI-ANNUALLY. AFTER ESTABLISHING THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, THE EXECUTIVE COMMITTEE REPORTS ON ITS DELIBERATIONS AND DETERMINATIONS TO THE ORGANIZATION'S BOARD OF DIRECTORS. SECOND, THE EXECUTIVE COMMITTEE REVIEWS THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS WITH THE ASSISTANCE OF THE SAME OUTSIDE COUNSEL AND COMPENSATION CONSULTANTS PARTICIPATING IN THE REVIEW OF THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE DETERMINES WHETHER TO APPROVE THE COMPENSATION ANALYSIS AND CONCLUSIONS CONTAINED IN THE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS. AFTER CONSULTING WITH OUTSIDE COUNSEL, THE EXECUTIVE COMMITTEE HAS DESIGNATED THE PRESIDENT & CHIEF EXECUTIVE OFFICER TO SERVE AS AN "AUTHORIZED BODY" AS CONTEMPLATED BY THE EXCESS BENEFIT TRANSACTION REGULATIONS FOR THE PURPOSE OF SETTING THE COMPENSATION OF THOSE DISQUALIFIED PERSONS WITHIN AN APPROVED RANGE. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS FOR ALL DISQUALIFIED PERSONS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION IS A NEW YORK NOT-FOR-PROFIT CORPORATION. ITS CERTIFICATE OF INCORPORATION IS READILY AVAILABLE TO THE GENERAL PUBLIC FROM THE NEW YORK STATE DEPARTMENT OF STATE UNDER THE NEW YORK FREEDOM OF INFORMATION LAW ("FOIL"). ITS CERTIFICATE OF INCORPORATION AND BY-LAWS ARE ALSO ON FILE WITH THE NYSDOH AND LIKEWISE AVAILABLE TO THE GENERAL PUBLIC UNDER FOIL. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO ENROLLEES IN ITS MEDICAID PROGRAM AND TO INDIVIDUALS CONSIDERING BECOMING ENROLLEES BY INCLUDING IN THE MEMBER HANDBOOKS, WHICH ARE PROVIDED TO ENROLLEES AND ARE ACCESSIBLE ON THE ORGANIZATION'S WEB SITE, A STATEMENT THAT THE FINANCIAL STATEMENTS (AS WELL AS OTHER INFORMATION DESCRIBED IN THE HANDBOOKS) ARE AVAILABLE UPON REQUEST BY CALLING A TOLL-FREE NUMBER PROVIDED IN THE HANDBOOKS.
FORM 990, PART VII:AVG. HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: THE FOLLOWING INDIVIDUALS DEVOTE A PERCENTAGE OF THEIR TIME TO SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED ORGANIZATION, AS DETAILED BELOW: DAVID THOMAS, EVP & COO - 7.5% THOMAS HALLORAN, CHIEF FINANCIAL OFFICER - 10% SANJIV SHAH, MD, CHIEF MEDICAL OFFICER - 12.5% SANTO RUSSO, CHIEF LEGAL OFFICER - 10% THIS ARRANGEMENT IS COVERED BY AN EMPLOYEE SERVICE AGREEMENT BETWEEN FIDELIS AND SALUS.
FORM 990, PART IX, LINE 12THE ORGANIZATION'S LINE 12, ADVERTISING AND PROMOTION EXPENSES INCLUDE PAYMENTS TO OTHER EXEMPT ORGANIZATIONS IN SUPPORT OF THEIR CHARITABLE PURPOSES, TO BENEFIT THE COMMUNITY, OR IN SPONSORSHIP OF THEIR FUNDRAISING EVENTS. THE EXPENDITURES INCLUDE THE AMOUNTS PAID TO THE FOLLOWING: THANKSGIVING CONTRIBUTION TO NEEDY: $166,291
NOT APPLICABLE QUESTIONS:TO THE EXTENT THAT A QUESTION ON THE FORM 990 HAS BEEN LEFT BLANK, THE RESPONSE TO THIS QUESTION SHOULD BE NOT APPLICABLE. DUE TO SOFTWARE LIMITATIONS, FIDELIS COULD NOT PROPERLY RESPOND TO THE RESPECTIVE QUESTION AS N/A.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1REGO PARK OFFICE TOWER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BLVD 8TH FLOORAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11374ZIPCd
FieldValueIRS element (for citing)
EIN815473320EIN
Primary ActivitiesREAL PROPERTY OWNERPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLAN INCBusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SALUS ADMINISTRATIVE SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11374ZIPCd
FieldValueIRS element (for citing)
EIN550878053EIN
Primary ActivitiesTHIRD PARTY ADMINISTRATORPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLAN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$10,231,048ShareOfTotalIncomeAmt
Share Of EOY Assets$31,533,178ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
SALUS ADMINISTRATIVE SERVICES INC
M$10,209,939
SALUS ADMINISTRATIVE SERVICES INC
N$704,922
SALUS ADMINISTRATIVE SERVICES INC
O$9,441,119

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART VFormAndLineReferenceDesc
ExplanationSCHEDULE R, PART V RELATED PARTY TRANSACTIONS: FIDELIS REPORTS CERTAIN RELATED PARTY TRANSACTIONS BETWEEN ITSELF AND SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED PARTY, ON SCHEDULE R, PART V. THE METHODS USED FOR DETERMINING THE AMOUNTS REPORTED DIFFER BASED ON THE TYPE OF TRANSACTION BUT ARE ALL CONTAINED IN WRITTEN CONTRACTS BETWEEN THE TWO PARTIES. SALUS REPORTS A PERFORMANCE OF SERVICES TO FIDELIS. THE WRITTEN AGREEMENT SPECIFIES A FIXED DISPENSING FEE PER PHARMACY CLAIM PROCESSED. THE FEE IS AN ESTIMATE DESIGNED TO COVER DIRECT AND INDIRECT COSTS AS WELL AS A MODEST AMOUNT OF PROFIT. THE AMOUNT IS DEEMED CONSISTENT WITH AN INDEPENDENT THIRD PARTY TRANSACTION. FIDELIS REPORTS A SHARING OF FACILITIES, EQUIPMENT, AND OTHER ASSETS. THE OVERHEAD AND ADMINISTRATIVE COSTS ARE ALLOCATED BASED ON THE SHARE OF FACILITIES AND ASSETS SALUS IS DEEMED TO USE. FIDELIS SHARES PAID EMPLOYEES WITH SALUS. FIDELIS ALLOCATES SALARIES FOR EACH EMPLOYEE BASED ON THE PERCENTAGE OF TOTAL HOURS SPENT PROVIDING SERVICES TO SALUS.ExplanationTxt

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