2017-11-15T20:03:13-06:00 2016-12-31 GRANT THORNTON LLP 757 THIRD AVENUE 3RD FLOOR NEW YORK NY 100172013 990 2016-01-01 131828429 Health Insurance Plan of Greater New York % MICHAEL PALMATEER HEAL 6464475000 55 WATER STREET NEW YORK NY 10041 MICHAEL PALMATEER CFO 6464475000 2017-11-15 true SCOTT THOMPSETT P00741490 2125990100 2017-11-15 38.84.128.189 26377520173195000019 2017-11-15 P 0AE51D185F2B8DBE64241C7507ECC047D5915589 BB689B47C4810116FFAF734305B3B6F212C66569 2016 2017-02-10 21:41:12Z Karen Ignagni President CEO 55 WATER STREET NEW YORK NY 10041 4951232533 false X WWW.EMBLEMHEALTH.COM X 1944 NY HIPgny is committed to providing AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS AT PRICES THEY CAN AFFORD. 7 5 3833 0 9063691 0 0 5065680992 4862308355 41506659 31672787 54460525 37421432 5161648176 4931402574 1450564 857613 0 0 224734703 222394513 0 0 0 5017957126 4957217619 5244142393 5180469745 -82494217 -249067171 2019662603 1786175144 960170653 978532248 1059491950 807642896 X HEALTH INSURANCE PLAN OF GREATER NEW YORK ("HIPGNY") IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS. HIPgny PURSUES ITS MISSION BY PROVIDING A CHOICE OF PRODUCTS AND NETWORKS SO MEMBERS HAVE ACCESS TO THE MEDICAL CARE THEY NEED AT PRICES THEY CAN AFFORD. false false 1563409488 0 1594267961 MEDICARE - HIPGNY SERVED APPROXIMATELY 112,000 MEDICARE MEMBERS THROUGH its MEDICARE RISK AND COST CONTRACT PROGRAMS. 1135491884 0 1158758381 MEDICAID - HIPGNY SERVED APPROXIMATELY 206,000 MEDICAID MEMBERS. HIP HAS BEEN SERVICING THE MEDICAID POPULATION SINCE 1967 (WITH THE PASSAGE OF FEDERAL LEGISLATION AUTHORIZING THIS PROGRAM) AND HAS AN EXTENSIVE PROGRAM IN PLACE TO ENCOURAGE PREVENTIVE MEDICAL CARE. 1995602267 603112 2110945400 SUBSCRIBER BENEFITS - HIPgny IS A NOT-FOR-PROFIT CORPORATION THAT ARRANGES FOR THE PROVISION OF COMPREHENSIVE MEDICAL AND HEALTH CARE SERVICES FOR ITS SUBSCRIBERS/MEMBERS (INCLUDING HEALTH CARE SERVICES TO MEDICARE AND MEDICAID MEMBERS) WHICH IS AN EXEMPT FUNCTION. In 2016, HIPgny provided services (across all services lines) to a total of 350,000 members. Form 990, Part III - Revenue & Expense Allocations The organization notes that the allocation of program service expenditures reported on Part III of the Form 990 is derived from HIPgNY's Statutory Financial Statements (STAT) - Analysis of Operations by Lines of Business. The Form 990 is prepared in accordance with Generally Accepted Accounting Principles (GAAP); accordingly, there may be additional allocations of expenditures to achieve conformity between the GAAP and STAT reports. 4694503639 false false false false false false false false false true true false true true true false true false false false false false false false false false true false true false false false false false false true true false false false false true true true true false true X 946 0 true 3833 true true true false false false false false X 7 5 true false false false true false false true true false false true true true true true true true true false NY X MICHAEL PALMATEER 6464475000 55 WATER STREET NEW YORK NY 10041 X Karen Ignagni President & CEO 2.0 35.0 X X 2418037 0 22521 John D Feerick Chairman of the Board 2.0 3.0 X X 0 147125 0 Bernard Schayes MD Director 2.0 0.0 X 0 19693 0 Robert W Brokaw Director (thru 06/2016) 2.0 0.0 X 7005 0 0 Gregory E Floyd Director 2.0 0.0 X 0 0 0 Paul E Gibson Director 2.0 0.0 X 500 127625 0 Margaret T Pan-Loo Director (thru 06/2016) 2.0 0.0 X 1250 0 0 Arthur Pepper Director (As of 6/2016) 2.0 0.0 X 0 0 0 Charles Wang Director (As of 6/2016) 2.0 0.0 X 0 115572 0 William C Lamoreaux President MSO New Ventures 35.0 0.0 X 553786 0 188497 Edward Mailander thru 12016 SVP, Chief Actuary 35.0 0.0 X 1072312 0 16650 Shawn M Fitzgibbon Chief Product Officer 35.0 0.0 X 424736 0 25520 Michael Palmateer Chief Financial Officer 35.0 0.0 X 522771 0 134548 Jeffrey D Chansler Chief Legal Officer 35.0 0.0 X 456665 0 72624 Valerie Reardon thru 62016 Chief Risk & Compliance 35.0 0.0 X 2485417 0 20260 George Babitsch SVP, Underwriting & Acct Mgmt 35.0 0.0 X 330469 0 24018 Robert Branchini thru 22016 VP, Information Technology 35.0 0.0 X 632957 0 60633 Mariann E Drohan Chief Human Resources Officer 35.0 0.0 X 401451 0 37357 John D Mahder VP, Marketing (thru 4/2016) 35.0 0.0 X 320999 0 12795 William Yurkowski VP, Operations (thru 1/2016) 35.0 0.0 X 352068 0 4640 Carl A Lund VP, Facility Contracting 35.0 0.0 X 265026 0 18240 Jennifer L Truscott VP, Medical Mgmt Operations 35.0 0.0 X 284399 0 28283 Philip Gillich thru 72016 VP, Network Management 35.0 0.0 X 645249 0 22494 Daniel Byrne VP, Labor Relations 35.0 0.0 X 206384 0 24619 Ernesto Marrero Jr VP, Med Comp (thru 9/2016) 35.0 0.0 X 332442 0 17087 Vincent Hartmann thru 72016 VP, Underwriting 35.0 0.0 X 429972 0 13155 Peter S Moore VP, Government Programs 35.0 0.0 X 186142 0 17748 Christopher W Chappelear Chief Actuary 35.0 0.0 X 264204 0 73221 Douglas Cowieson SVP, MSO New Ventures 35.0 0.0 X 394368 0 27587 Suzanne G Ronner VP, Customer Service 35.0 0.0 X 236839 0 14153 Michele H Podolak VP, Customer Service 35.0 0.0 X 178260 0 13865 Richard M Densing VP, Gov't Prog & Direct to Con 35.0 0.0 X 219650 0 22849 Munish Khaneja thru 92016 VP, Medical Mgmt Operations 35.0 0.0 X 384545 0 22629 Wei Jia Shen VP, Multicultural Marketing 35.0 0.0 X 293704 0 23910 Thomas MAcMillan VP, Transform, IT & Analytics 35.0 0.0 X 277192 0 18103 James Albano SVP,Provider Ntwk & Pop Health 35.0 0.0 X 362176 0 22568 Scott Breidbart thru 92016 Chief Clinical Officer 35.0 0.0 X 1418823 0 21386 Robin C Golston VP, Community & Gov't Affairs 35.0 0.0 X 220620 0 20081 Thomas Conway VP, Controller 35.0 0.0 X 261998 0 18962 Lorraine Cortes-Vazquez SVP, Corp Rel & Gov't Affairs 35.0 0.0 X 351982 0 21452 Edmond Cunningham VP, Procurement 35.0 0.0 X 255186 0 15669 Scott Dickler SVP, Gov't & Indiv. Programs 35.0 0.0 X 332742 0 21915 Craig Effrain thru 72016 VP, Corporate Secretary 35.0 0.0 X 366428 0 13520 Thomas Mafale VP, Commercial Sales 35.0 0.0 X 260487 0 16284 Douglas Parks VP, HR Transformation & Strat 35.0 0.0 X 307118 0 21332 Russell Petrella EVP 35.0 0.0 X 681061 0 23130 Andrew Rein thru 72016 SVP, Strategy & Business Dev 35.0 0.0 X 1022944 0 12159 John Sheehy SVP, Product Innovation 35.0 0.0 X 400899 0 17293 William Voigt VP, HR Business Operations 35.0 0.0 X 230416 0 25653 Joseph Zeitlin thru 92016 SVP, President/CMO ACPNY 35.0 0.0 X 298762 0 29072 Paul Zurlo thru 22016 VP, Small Group & Indiv. Bus 35.0 0.0 X 220224 0 6599 Beth Fabbri Chief Marketing & Comm Officer 35.0 0.0 X 602132 0 7198 Robert Fox EmblemHealth General Counsel 35.0 0.0 X 379471 0 12250 Cynthia Goff VP, Policy 35.0 0.0 X 339685 0 6550 Jim Karagiorgis VP, Customer Service 35.0 0.0 X 242627 0 22800 Hemant Lanjewar VP, Medicare Stars & Qual Mgmt 35.0 0.0 X 246533 0 18666 Debra Lightner Chief Compliance Officer 35.0 0.0 X 151802 0 2498 Michelle Lyddon VP, Products & ACPNY Comm. 35.0 0.0 X 20062 0 0 Andrew McBrien VP, Medicare 35.0 0.0 X 103184 0 2580 Lorraine McDonald VP, Clinical Strategy & Ops 35.0 0.0 X 185947 0 13623 Pansy McRae VP, Claims 35.0 0.0 X 232273 0 22855 Frank Melaccio VP, Treasurer 35.0 0.0 X 267192 0 27078 Karen Moran VP, Ancillary Products 35.0 0.0 X 145000 0 1950 Carolyn Oser VP, Bus & Tech Transformation 35.0 0.0 X 269214 0 23178 Navarra Rodriguez SVP, President/CMO ACPNY 35.0 0.0 X 137419 0 7882 Jill Stein VP, Assistant General Counsel 35.0 0.0 X 274995 0 21954 Paula Tavsanli VP, Client Relations Mgmt 35.0 0.0 X 366878 0 20868 Kevin F Tighe thru 122016 VP, Internal Audit 35.0 0.0 X 288533 0 17855 Roberto Hormazabal Sr. Dir. Account Management 40.0 0.0 X 277556 0 14702 Bruce Sosler Senior Medical Director 40.0 0.0 X 302362 0 5580 Robin James Labor/Large Group Rep. 40.0 0.0 X 482807 0 3864 Robert W Stallings Senior Director, IT Govern. 40.0 0.0 X 287318 0 7320 John R English Senior Dir, Network Services 40.0 0.0 X 279533 0 8526 Jose R Diaz VP, Membership 35.0 0.0 X 515088 0 0 Karen Smith-Hagman VP, Medical Management 35.0 0.0 X 233930 0 0 William Mastrogiacomo SVP, Dep Gen Counsel, Corp Sec 35.0 0.0 X 559859 0 0 Richard Gross VP, Account Management 35.0 0.0 X 216432 0 0 28978497 410015 1554858 741 true true false COGNIZANT HEALTHCARE SERVICES LLC 500 Frank W Burr Suite 3F TEANECK NJ 07666 Consulting 66711244 INOVALON INC 4321 Collington Road BOWIE MD 20716 Data Analytics 12003975 TRIZETTO CORPORATION 9655 Maroon Cir ENGLEWOOD CO 80112 IT solutions 4212349 MERKLE INC 1745 Broadway NEW YORK NY 10019 Marketing 3649829 THE SOURCING GROUP LLC 77 Water Street NEW YORK NY 10005 Business Solutions 3394113 145 0 PREMIUM REVENUE 900099 4848751793 4848751793 THIRD PARTY ADMINISTRATIVE FEES 900099 13556562 13556562 4862308355 18479906 3764115 14715791 0 0 31796718 19829959 11966759 0 11966759 11966759 13192881 13192881 13192881 13192881 0 0 0 0 0 0 0 0 0 PHARMACY REVENUE 900099 20519525 15219949 5299576 CASH PROCEEDS FROM LEGAL SETTLEMENT 900099 4912553 4912553 MISCELLANEOUS REVENUE 900099 22595 22595 25454673 4931402574 4877528304 9063691 44810579 X 857613 857613 0 0 0 39623127 39623127 1265180 1265180 121914676 121914676 20394528 20394528 26307210 26307210 12889792 12889792 0 2312687 2312687 3085798 3085798 576735 576735 0 1966408 1966408 131023720 0 131023720 0 9371164 9371164 22685326 22685326 0 0 23792543 23792543 2056374 2056374 0 146970 146970 16460 16460 0 49665915 49665915 5471075 5471075 SUBSCRIBER BENEFITS 4543988652 4543988652 0 0 CAPITATION PAYMENTS 50536012 50536012 0 0 QUALITY OF CARE EXPENSES 40258214 40258214 0 0 ACA HEALTHCARE FEES 53199158 53199158 0 0 17064408 5663990 11400418 5180469745 4694503639 485966106 0 0 0 146331938 110869498 0 0 200659523 271216803 0 0 0 0 362591477 171822631 0 0 5368856 6412223 404870938 243908236 163043124 160962702 490985282 253709443 394687007 582800087 0 0 0 0 255995396 228381757 2019662603 1786175144 753220405 757010376 0 0 14994437 31060934 0 0 0 0 0 0 0 0 0 0 191955811 190460938 960170653 978532248 X 1059491950 807642896 0 0 0 0 1059491950 807642896 2019662603 1786175144 X -249067171 -2781883 X false true X true false 6963425 6963425 159697571 91398961 68298610 195273402 117457735 77815667 36706538 34042604 2663934 6230003 1008937 5221066 160962702 INVESTMENT IN ADVANTAGECARE 373159536 C INVESTMENT IN HIP HOLDINGS INC 209640551 C 582800087 ACCRUED INTEREST RECEIVABLE 19237903 DEFERRED RENT 515801 INTEREST/DIVIDENDS RECEIVABLE 1799718 OTHER CURRENT ASSETS 3574773 HEALTHCARE RECEIVABLES 150608273 INTERCOMPANY RECEIVABLES 52645289 228381757 0 PENSION LIABILITY 122544079 DEFERRED RENT 61176517 OTHER LONG TERM LIABILITIES 6740342 190460938 X FIN 48 DISCLOSURE The Company has not taken any unsubstantiated tax position that would require provisions of a liability under ASC 740, Accounting for Uncertainty in Income Taxes. The Company does not believe there are any material uncertain tax positions and, accordingly, did not recognize any liability for unrecognized tax positions. For the year ended December 31, 2016, there were no interest or penalties recorded or included in the consolidated statements of operations and changes in net assets. true 1199 SEIU HOME CARE INDUSTRY PO BOX 842 NEW YORK NY 10108 711028611 501(c)(3) 14400 General Support AGING IN NEW YORK FUND 2 Lafayette Street NEW YORK NY 10007 133153550 501(c)(3) 10000 General Support AHRC NYC FOUNDATION 83 Maiden Lane NEW YORK NY 10038 133779611 501(c)(3) 12500 General Support ALZHEIMERS DISEASE & RELATED 225 N MICHIGAN AVE CHICAGO IL 60601 363463656 501(c)(3) 25000 General Support BEDFORD STUYVESANT RESTORATION 1368 Fulton Street Brooklyn NY 11216 116083182 501(c)(3) 54000 General Support CALVARY FUND INC 1740 EASTCHESTER RD BRONX NY 10461 133259649 501(c)(3) 6300 General Support COMUNILIFE INC 214 W 29 Street NEW YORK NY 10001 133530299 501(c)(3) 9400 General Support DDI FOUNDATION 99 HOLLYWOOD DR SMITHTOWN NY 11787 112911733 501(c)(3) 6720 General Support STRIVE International Inc 240 E 123rd St NEW YORK NY 10035 133255679 501(c)(3) 9050 General Support FRIENDS IN DEED INC 594 Broadway NEW YORK NY 10012 133628657 501(c)(3) 10000 General Support GRACIE MANSION CONSERVANCY 88 St AT EAST END AVE NEW YORK NY 10128 521241502 501(c)(3) 8750 General Support HABNET Services Corp 1401 Flatbush Avenue Brooklyn NY 11210 300516278 501(c)(3) 7700 General Support HAITIAN CENTERS COUNCIL INC 123 Linden Blvd 3 Brooklyn NY 11226 112648501 501(c)(3) 72000 General Support HARVEST HOME FARMER'S MARKET 104-106 E 126th St Ste NEW YORK NY 10035 061800512 501(c)(3) 25000 General Support HISPANIC DENTAL ASSOCIATION 4030 JUSTIN RD FLOWER MOUND TX 75077 363719494 501(c)(3) 10000 General Support HISPANIC FEDERATION INC 55 Exchange Pl NEW YORK NY 10005 133573852 501(c)(3) 20000 General Support Intersections International Initiative 145 West 28th St NEW YORK NY 10001 900458939 501(c)(3) 10000 General Support LITTLE FLOWER CHILDREN & FAM SERVICES N Wading River Rd Wading River NY 11792 111633572 501(c)(3) 7220 General Support LIVEON NY 460 West 34th St NEW YORK NY 10001 132945229 501(c)(3) 6000 General Support MAYOR'S FUND TO ADVANCE NYC 253 Broadway NEW YORK NY 10007 133783906 501(c)(3) 30000 General Support MEDICARE RIGHTS CENTER 266 West 37th Street NEW YORK NY 10018 133505372 501(c)(3) 7710 General Support NATIONAL CR FOR CIVIC INNOVATION 21 SIXTH AVENUE NEW YORK NY 10013 020590588 501(c)(3) 10000 General Support NATIONAL FOUNDATION FOR HUMAN POTENTIAL 191 Sweet Hollow Rd Old Bethpage NY 11804 113544632 501(c)(3) 30200 General Support NATIONAL HISPANIC HEALTH Fdn 1920 L Street NW Washington DC 20036 260051902 501(c)(3) 10000 General Support NEW YORK CENTER FOR INTERPERSONAL 130 Stuyvesant Pl Staten Island NY 10301 237085239 501(c)(3) 13500 General Support NORTHERN MANAHATTAN IMPROVEMENT 76 Wadsworth Avenue NEW YORK NY 10033 132972415 501(c)(3) 45000 General Support QUEENS COMMUNITY HOUSE INC 108-25 62nd Dr Queens NY 11375 112375583 501(c)(3) 54000 General Support SERVICES & ADVOCACY FOR GLBT ELDERS 305 Seventh Ave NEW YORK NY 10001 132947657 501(c)(3) 10000 General Support Somos Inc 90 S SWAN ST ALBANY NY 12210 223128393 501(c)(3) 15000 General Support THE CATHOLIC HEALTHCARE Fdn 155 East 56th Street NEW YORK NY 10022 134054158 501(c)(3) 22700 General Support THE NY WOMEN'S Fdn 39 Broadway NEW YORK NY 10006 133457287 501(c)(3) 9205 General Support THE WORKING THEATRE 730 KIRKWOOD AVE IOWA CITY IA 52240 272997323 501(c)(3) 10000 General Support UNIFORMED FIREFIGHTERS ASSOC PO Box 2085 Mount Vernon NY 10551 133907650 501(c)(5) 7500 General Support UNITED HOSPITAL FUND 1411 Broadway NEW YORK NY 10018 131562656 501(c)(3) 13000 General Support UNITED NEIGHBORHOOD HOUSES 70 West 36th St NEW YORK NY 10018 135563409 501(c)(3) 55000 General Support UNIVERSITY SETTLEMENT SOCIETY OF NY 184 Eldridge Street NEW YORK NY 10002 135562374 501(c)(3) 40000 General Support 35 1 Schedule I, Part I, Line 2 Health Insurance Plan of Greater New York ("hipGNY") has an internal REVIEW PROCESS FOR all charitable grants paid out by the organization. Every request for a grant must be submitted in writing TO THE ceo AND CHIEF ADMINISTRATIVE OFFICER FOR REVIEW AND APPROVAL. Grant applications will only be accepted from 501(c)(3) tax exempt organizations. X X X X X true true false false false true false false false Karen Ignagni President & CEO 969846 0 1416667 0 31524 0 16367 0 6154 0 2440558 0 416667 0 William C Lamoreaux President MSO New Ventures 528377 0 0 0 25409 0 180457 0 8040 0 742283 0 0 0 Edward Mailander thru 12016 SVP, Chief Actuary 0 0 209833 0 862479 0 16413 0 237 0 1088962 0 0 0 Shawn M Fitzgibbon Chief Product Officer 398782 0 0 0 25954 0 19760 0 5760 0 450256 0 0 0 Michael Palmateer Chief Financial Officer 496320 0 0 0 26451 0 129868 0 4680 0 657319 0 0 0 Jeffrey D Chansler Chief Legal Officer 429440 0 0 0 27225 0 67189 0 5435 0 529289 0 0 0 Valerie Reardon thru 62016 Chief Risk & Compliance 129846 0 1325024 0 1030547 0 15900 0 4360 0 2505677 0 1200807 0 George Babitsch SVP, Underwriting & Acct Mgmt 305674 0 0 0 24795 0 15900 0 8118 0 354487 0 0 0 Robert Branchini thru 22016 VP, Information Technology 16830 0 105750 0 510377 0 59705 0 928 0 693590 0 0 0 Mariann E Drohan Chief Human Resources Officer 374653 0 0 0 26798 0 32677 0 4680 0 438808 0 0 0 John D Mahder VP, Marketing (thru 4/2016) 56026 0 51356 0 213617 0 10800 0 1995 0 333794 0 0 0 William Yurkowski VP, Operations (thru 1/2016) 0 0 50700 0 301368 0 4437 0 203 0 356708 0 0 0 Carl A Lund VP, Facility Contracting 239910 0 0 0 25116 0 15900 0 2340 0 283266 0 0 0 Jennifer L Truscott VP, Medical Mgmt Operations 259753 0 0 0 24646 0 26411 0 1872 0 312682 0 0 0 Philip Gillich thru 72016 VP, Network Management 89193 0 84958 0 471098 0 20723 0 1771 0 667743 0 0 0 Daniel Byrne VP, Labor Relations 201803 0 0 0 4581 0 14889 0 9730 0 231003 0 0 0 Ernesto Marrero Jr VP, Med Comp (thru 9/2016) 137532 0 47566 0 147344 0 13088 0 3999 0 349529 0 0 0 Vincent Hartmann thru 72016 VP, Underwriting 68426 0 40083 0 321463 0 8726 0 4429 0 443127 0 0 0 Peter S Moore VP, Government Programs 161021 0 0 0 25121 0 11477 0 6271 0 203890 0 0 0 Christopher W Chappelear Chief Actuary 245795 0 0 0 18409 0 58038 0 15183 0 337425 0 0 0 Douglas Cowieson SVP, MSO New Ventures 368545 0 0 0 25823 0 16799 0 10788 0 421955 0 0 0 Suzanne G Ronner VP, Customer Service 212681 0 0 0 24158 0 14153 0 0 0 250992 0 0 0 Michele H Podolak VP, Customer Service 153377 0 0 0 24883 0 10825 0 3040 0 192125 0 0 0 Richard M Densing VP, Gov't Prog & Direct to Con 202366 0 0 0 17284 0 14221 0 8628 0 242499 0 0 0 Munish Khaneja thru 92016 VP, Medical Mgmt Operations 179610 0 33122 0 171813 0 15568 0 7061 0 407174 0 0 0 Wei Jia Shen VP, Multicultural Marketing 236707 0 23550 0 33447 0 15900 0 8010 0 317614 0 0 0 Roberto Hormazabal Sr. Dir. Account Management 277419 0 0 0 137 0 6629 0 8073 0 292258 0 0 0 Thomas MAcMillan VP, Transform, IT & Analytics 259172 0 0 0 18020 0 15900 0 2203 0 295295 0 0 0 Bruce Sosler Senior Medical Director 261843 0 36671 0 3848 0 0 0 5580 0 307942 0 0 0 James Albano SVP,Provider Ntwk & Pop Health 338515 0 0 0 23661 0 16025 0 6543 0 384744 0 0 0 Scott Breidbart thru 92016 Chief Clinical Officer 273169 0 0 0 1145654 0 16039 0 5347 0 1440209 0 0 0 Robin C Golston VP, Community & Gov't Affairs 202407 0 0 0 18213 0 13613 0 6468 0 240701 0 0 0 Thomas Conway VP, Controller 236895 0 0 0 25103 0 15841 0 3121 0 280960 0 0 0 Lorraine Cortes-Vazquez SVP, Corp Rel & Gov't Affairs 323365 0 0 0 28617 0 15900 0 5552 0 373434 0 0 0 Edmond Cunningham VP, Procurement 246734 0 0 0 8452 0 8101 0 7568 0 270855 0 0 0 Scott Dickler SVP, Gov't & Indiv. Programs 314224 0 0 0 18518 0 16347 0 5568 0 354657 0 0 0 Craig Effrain thru 72016 VP, Corporate Secretary 104009 0 0 0 262419 0 8189 0 5331 0 379948 0 0 0 Thomas Mafale VP, Commercial Sales 251841 0 0 0 8646 0 8044 0 8240 0 276771 0 0 0 Douglas Parks VP, HR Transformation & Strat 238735 0 50000 0 18383 0 15900 0 5432 0 328450 0 0 0 Russell Petrella EVP 529478 0 119831 0 31752 0 15900 0 7230 0 704191 0 0 0 Andrew Rein thru 72016 SVP, Strategy & Business Dev 151205 0 0 0 871739 0 11018 0 1141 0 1035103 0 0 0 John Sheehy SVP, Product Innovation 339791 0 50000 0 11108 0 9588 0 7705 0 418192 0 0 0 William Voigt VP, HR Business Operations 212351 0 0 0 18065 0 14475 0 11178 0 256069 0 0 0 Joseph Zeitlin thru 92016 SVP, President/CMO ACPNY 242340 0 0 0 56422 0 26411 0 2661 0 327834 0 0 0 Paul Zurlo thru 22016 VP, Small Group & Indiv. Bus 17073 0 0 0 203151 0 5241 0 1358 0 226823 0 0 0 Jose R Diaz VP, Membership 0 0 87228 0 427860 0 0 0 0 0 515088 0 0 0 Beth Fabbri Chief Marketing & Comm Officer 249059 0 250000 0 103073 0 2850 0 4348 0 609330 0 0 0 Robert Fox EmblemHealth General Counsel 216917 0 75000 0 87554 0 12250 0 0 0 391721 0 0 0 Karen Smith-Hagman VP, Medical Management 0 0 0 0 233930 0 0 0 0 0 233930 0 0 0 William Mastrogiacomo SVP, Dep Gen Counsel, Corp Sec 260129 0 0 0 299730 0 0 0 0 0 559859 0 0 0 Richard Gross VP, Account Management 9333 0 42344 0 164755 0 0 0 0 0 216432 0 0 0 Cynthia Goff VP, Policy 233867 0 50000 0 55818 0 4850 0 1700 0 346235 0 0 0 Jim Karagiorgis VP, Customer Service 217598 0 0 0 25029 0 14973 0 7827 0 265427 0 0 0 Hemant Lanjewar VP, Medicare Stars & Qual Mgmt 228293 0 0 0 18240 0 14998 0 3668 0 265199 0 0 0 Debra Lightner Chief Compliance Officer 100964 0 50000 0 838 0 750 0 1748 0 154300 0 0 0 Lorraine McDonald VP, Clinical Strategy & Ops 136029 0 30000 0 19918 0 11263 0 2360 0 199570 0 0 0 Pansy McRae VP, Claims 206821 0 0 0 25452 0 14363 0 8492 0 255128 0 0 0 Frank Melaccio VP, Treasurer 248947 0 0 0 18245 0 15900 0 11178 0 294270 0 0 0 Carolyn Oser VP, Bus & Tech Transformation 220862 0 15000 0 33352 0 15840 0 7338 0 292392 0 0 0 Jill Stein VP, Assistant General Counsel 229279 0 17350 0 28366 0 15900 0 6054 0 296949 0 0 0 Paula Tavsanli VP, Client Relations Mgmt 320553 0 25000 0 21325 0 15900 0 4968 0 387746 0 0 0 Kevin F Tighe thru 122016 VP, Internal Audit 202938 0 25000 0 60595 0 15900 0 1955 0 306388 0 0 0 Robin James Labor/Large Group Rep. 482531 0 0 0 276 0 0 0 3864 0 486671 0 0 0 Robert W Stallings Senior Director, IT Govern. 252379 0 31758 0 3181 0 7320 0 0 0 294638 0 0 0 John R English Senior Dir, Network Services 168537 0 0 0 110996 0 3800 0 4726 0 288059 0 0 0 Form 990, Schedule J, Part I, Line 1a - Housing Payments Chief Risk and Compliance Officer, Valerie Reardon, received a housing subsidy in calendar year 2016; this amount was treated as taxable wages and is included in Schedule J, Part II, Column (b)(iii). Form 990, Schedule J, Part I, Line 4a - Severance The following individuals reported on Form 990, Part VII and Schedule J received severance payments in 2016: John R. English - $110,097 Robert Branchini - $463,492 Scott Breidbart - $1,101,600 Jose R. Diaz - $427,860 Craig Effrain - $235,000 Philip Gillich - $450,350 Richard Gross - $164,755 Vincent Hartmann - $288,347 Munish Khaneja - $150,000 John D. Mahder - $182,620 Edward Mailander - $826,266 Ernesto Marrero Jr. - $117,300 William Mastrogiacomo - $299,730 Valerie Reardon - $960,000 Andrew Rein - $840,000 Karen Smith-Hagman - $233,930 William Yurkowski - $274,533 Paul Zurlo - $180,000 All of the severance payments documented above are reported in the Form 990, Schedule J, part II, Column (b)(iii). Form 990, Schedule J, Part I, Line 4(b) Supplemental Non-Qualified Retirement Plan EmblemHealth Services company, LLC ("Emblemhealth Services") sponsors A nonqualified retirement plan that officers of HIPgny with the titles of senior vice president and above hired before June 1, 2009, participate in. The supplemental executive retirement plan for emblemhealth services provides a retirement benefit calculated on the basis of 50% of final average pay, offset by benefits under any qualified benefit plan, such as The emblemhealth services company, LLC employees' retirement plan. Participants who retire prior to age 65 have their benefits reduced by early retirement factors. Bonus Payments HIPGNY (via EmblemHealth Services, the payroll payor) provide annual incentive awards based upon the achievement of performance metrics and percentage target awards. The compensation committees approve the performance metrics and targets and the ultimate payout to participants based upon the performance achieved under the Annual Incentive Plan (AIP). All management, non-union employees may be eligible to participate in the AIP. HIPGNY (Via EmblemHealth Services, The Payroll Payor) also has a long term incentive plan based upon longer term performance over three year performance cycles. The compensation committees approve the performance metrics, targets and payouts based upon achievement of performance under these plans. Officers and key employees are generally eligible to participate in the long term incentive plan. Bonus Compensation for President & CEO, Karen Ignagni The bonus reported in Schedule J, Part II, Column (b)(ii) for President & CEO, Karen Igagni, includes a retention bonus of $416,667 that was accrued for in a prior tax year and reported as deferred compensation in Schedule J, part II, Column (c) on the 2015 Form 990. This compensation was actually paid in calendar year 2016 and thus it is reported in Schedule J, Part II, column (f). Schedule J, Part II, Column C HIPGNY reports the change in the actuarial value of the pension plan as deferred compensation (as required by the expanded disclosures in the form 990). Present values are calculated based on the SEC Proxy Summary Compensation Table methodology and assumptions, as the discounted present value of normal retirement benefits earned to the measurement date payable at the later of current age or age 65, without regard to projected service, projected salary increases, pre-retirement mortality or other decrements. To the extent any individual reported on Schedule J has compensation reported in column (f), those amounts reflect payouts from the Supplemental Executive Retirement Plan. William White family of former officer 197591 see sch L narrative false christine o'connor burns family of former officer 267460 see sch L narrative false Diane Pirone family of former officer 481997 see sch L narrative false Keith Dahl family of former officer 85083 see sch L narrative false Alyssa Pepper family of board member 117383 see sch L narrative false Form 990, Schedule L Former Chairman and Chief Executive Officer, FRANK BRANCHINI, HAS A FAMILY MEMBER, DIANE PIRONE (SISTER), WHO IS A MANAGER AT RCG, A CONSULTING FIRM WHICH HAS BEEN UTILIZED BY HIP SINCE 2004. MS. PIRONE DOES NOT DO BUSINESS ON THE HIPgny/eMBLEMHEALTH SERVICES ACCOUNT. IN CALENDAR YEAR 2016, RCG WAS PAID $481,997. Former Chairman and Chief Executive Officer, Frank Branchini, has a family member, Keith Dahl, son-in-law, WHO wAS a physician employed by AdvantageCare Physicians, P.C.("ACP"), a related entity to HIPGNY. HIPGNY engages in various transactions with ACP to provide medical services to its members. Dr. Dahl received $85,083 in compensation from ACP. Former Officer, John White, has a family member who is employed by EmblemHealth Services Company, LLC. William White is employed as a Director in the Human Resources Department; his W-2 wages for the year ending 12/31/2016 are $197,591. Former Board of Directors Member John O'Connor has a family member who is employed by EmblemHealth Services Company, LLC. Christine O'Connor Burns' W-2 compensation in the calendar year ending 12/31/2016 from EmblemHealth Services Company, LLC was $267,460. Board of Directors Member, Arthur Pepper's daughter, Alyssa Pepper, is an employee of Emblemhealth Services Company, LLC. For the year ending 12/31/2016, her wages are $117,383. HIPGNY does not believe it has any other business transactions or relationships between itself and an officer, director, or key employee of the organization that rise to the monetary threshold required for disclosure on Schedule L of the Form 990. The organization takes its responsibilities of monitoring potential conflicts of interest very seriously (please see disclosure on Part VI, Line 12). HIPGNY compiles a lengthy Summary report of all potential business transactions between the individuals reported on Part VII of the Form 990 and HIPGNY or one of its affiliated organizations. This report discloses all potential business transactions regardless of monetary value. Amounts reported on Schedule L represent the W-2, Box 5 wages paid to each of these individuals. Additional taxable and non-taxable fringe benefits may have been provided (but are not included above). Additional information is available upon request. Part V, Line 1a and Part VII, Independent Contractors. The total number of independent contractors reported on Part V, Line 1a represents those vendors that received a 1099 directly from HIPgny'S EIN#. In addition, HIPGNY's 100% owned disregarded entity, EmblemHealth Services, also issued 1099s in calendar year 2016. In the interests of full disclosure, HIPGNY is disclosing that EmblemHealth Services issued 1,009 1099s in calendar year 2016. In total, HIPgny and EHS paid compensation exceeding $100,000 to 145 vendors. HIPGNY, as a part of its business, undertakes a significant amount of claims processing; in 2016, HIPGNY issued 22,031 1099s AS A RESULT OF ITS CLAIMS PROCESSING ACTIVITIES. The 1099s for the claims processing are not reported on Line 1(a) but are disclosed here in the interests of full disclosure. Form 990, Part V, Line 2(a) HIPGNY does not file a Form W-3 as all employee payroll is paid out of EmblemHealth Services, LLC. In the interests of clarity, HIPGNY is disclosing that 3,833 employees received W-2s from EmblemHealth Services (ostensibly for services rendered to HIPGNY and to other affiliated entities). Form 990, Part VI, Line 2 In the interests of full disclosure, the organization notes that various Officers and/or directors, may serve on the Board of Directors of related for-profit organizations (e.g. - those disclosed in Schedule R of the Form 990). No individual is compensated for board services rendered to the related for-profit organization. Form 990, Part VI, Line 6 EmblemHealth, Inc., a New York not-for-profit corporation, is the sole member of Hipgny. EmblemHealth (EIN 13-3941542) is exempt from federal taxation pursuant to IRC 501(c)(3). Form 990, Part VI, Line 11 The taxpayer's Form 990 for the year ending December 31, 2016 was provided to each member of the organization's governing body before it was filed. A detailed review of the Form 990 was undertaken by the Organization's Tax Director, Chief ADMINISTRATIVE Officer and VP, Deputy General Counsel. Form 990, Part VI, Line 12 To determine if an employee's personal interests, activities or relationships constitute a conflict of interest or the appearance of a conflict of interest, certain employees, based upon functionality, as determined by the chief compliance officer and BY the VP, Deputy General Counsel, on an annual basis, any reportable situations on the company's conflict of interest disclosure. All employees, at the time of employment, are required to fully disclose any personal interest, activities or relationships that constitute a conflict of interest or the appearance of a conflict of interest. Disclosures are reviewed by the chief compliance officer and THE VP, Deputy General Counsel. Any Employee, who violates the conflict of interest policy, fails to make a required report or fails to comply with any remedial action required by the company, is subject to disciplinary action, up to and including termination of employment. Form 990, Part VI, Line 15 To determine the compensation of the CEO and all other officers of the company, HIPgny and EmblemHealth Services engage an outside compensation consultant to provide guidance and the comparable market data on the compensation of similarly situated executive positions in the organizations' competitive peer group comprised of profit and not for profit entities. The compensation consultant presents the comparable market data to the compensation committee of the board of directors of HIPGNY and EmblemHealth Services. The compensation committees are composed entirely of outside, independent, disinterested directors. The compensation committees review and approve the proposed compensation arrangements and the deliberations and actions of the compensation committees are documented in the minutes of each meeting. Thereafter, the actions of the compensation committees are reported to the full boards in a timely manner. The CEO, or any other officer, is excused from the compensation committee meeting while the committee deliberates and approves any action related to the compensation arrangement of the CEO or other officer. Form 990, Part VI, Line 19 The taxpayer makes its Form 990 and Form 1023 available to the public by retaining a copy of each at its hOME office at 55 Water Street, New York, New York. The organization's Form 990 is also available for public inspection on www.guidestar.com. The taxpayer's financial statements are available for public inspection on the organization's webiste, www.emblemhealth.com. The organization's governing documents and conflict of interest policy are not available to the public. Form 990, Part VII - Hours Served for Related Party The compensated individuals reported in Part VII of the Form 990 may provide services to a variety of entities within the Hipgny network. Allocating those hours between the many entities presents a challenge; accordingly, the hours represented on Part VII represent the hours worked by the individual in their capacity as an employee for the entire HIPGNY network. Form 990, Part IX Amounts reported on Part IX, Line 5, as compensation paid to officers, directors and key-employees of HIPGNY represent those salary costs reported on Form 990, Part VII, Line 1(d) that are allocated from the related party, EmblemHealth Services, LLC. HIPGNY has adopted a simplified approach of allocating its expenditures between programmatic and management and general. The organization does not categorize its expenses internally or in its audited financial statements by these means. For purposes of its 990 reporting, HIPGNY is treating all subscriber benefits as programmatic expenses and all other expenses as management and general even though a large percentage of those expenses are likely related to HIPGNY's day-to-day mission activities. Nevertheless, even taking this conservative approach, HIPGNY's program service expenses constitute 90% of total expenditures. Form 990, Part XI, Line 9 A difference of ($2,781,883) is reported on part XI of the Reconciliation of Net Assets. This difference is attributable to changes in unrealized gains and losses on investments, book to tax adjustments on investments as well as Statutory-to-GAAP financial statement adjustments. EmblemHealth Services Company LLC 55 Water Street New York NY 10041 Support Svcs NY -95693687 170890000 HIPGNY EMBLEMHEALTH INC 55 WATER STREET NEW YORK NY 10041 133941542 support svcs NY 501(c)(3) 12(c) HIPGNY true Group Health Incorporated 55 Water Street New York NY 10041 135511997 Insurance NY NA C Corp 1188318556 672150738 1.00000 true HIP Holdings Inc & Subsidiaries 55 Water Street New York NY 10041 133819759 Insurance NY NA C Corp. 1914301404 1067957194 1.00000 true Central Brooklyn Medical Group PC 440 9th Avenue New York NY 10001 112937992 Healthcare NY HIPGNY C Corp 140715787 6949550 1.00000 true Queens Long Island Medical Group PC 440 9th Avenue New York NY 10001 113039101 Healthcare NY HIPGNY C Corp 353782332 101232361 1.00000 true Staten Island Physician Practice PC 440 9th avenue new york NY 10001 204659577 healthcare NY HIPGNY C corp 47431549 5900973 1.00000 true AdvantageCare Physicians PC 440 9th Avenue New York NY 10001 460790995 healthcare NY HIPGNY C Corp 409627448 213335285 1.00000 true LHHN Medical PC 440 9th Avenue New York NY 10001 134121055 healthcare NY HIPGNY C Corp 69524337 3791873 1.00000 true true true false true false false false false false false false true true true true true true true true EmblemHealth Inc M,P 1206003 Cost Group Health Incorporated A 3300000 Market Rate Group Health Incorporated D 165000000 Market Rate Hip Holdings Inc & Subsidiaries (EHA) M 15400000 COST Hip Holdings Inc & Subsidiaries (EHA) L 2200000 COST Hip Holdings Inc & Subsidiaries (HIPIC) L,Q 3500000 COST Hip Holdings Inc & Subsidiaries (HIPIC) M 14700000 COST Hip Holdings Inc & Subsidiaries (HIP-IPA) l 500000 cost Hip Holdings Inc & Subsidiaries (HIP-IPA) M 10300000 cost central brooklyn medical group pc a 54204 cost Queens Long Island Medical Group PC a 250625 cost LHHN Medical PC a 129393 cost Staten Island Physician Practice PC a 29890 cost central brooklyn medical group pc d 113323 cost Queens Long Island Medical Group PC d 1992850 cost LHHN Medical PC d 935987 cost Staten Island Physician Practice PC d 1081153 cost AdvantageCare Physicians PC b 188200000 cost Schedule R, Part V, Line 2 TRANSACTIONS with EmblemHealth, Inc. EmblemHealth, Inc. is the parent organization of HIPGNY, a 501(c)(4) tax-exempt organization that delivers quality, affordable health insurance to members. EmblemHealth, Inc., in conjunction with its subsidiaries, fosters and facilitates HIPGNY's efforts to give back to the community. Costs associated with running EmblemHealth, Inc. are reimbursed by HIPgNY (at cost); these transactions are memorialized with Transaction Code M & P. Transactions with Group health Incorporated To date, HIPGNY has advanced $165 million to GHI in accordance with Section 1307 of the Insurance Law of the State of New York with interest accruing at 2% per annum. No new loans were issued in 2016. As provided in Section 1307, the payment of principal and interest thereon shall only be made out of free and disposable surplus, subject to prior approval of the Superintendent of insurance. As of December 31, 2016, no payments were made to HIPgny. Nevertheless, HIPgny is disclosing the amount of accrued interest with Transaction Code A. Transactions with HIP Holdings, Inc. & Subs (HIPIC) HIPIC (a member of HIP Holdings, Inc. & Subs) provides the indemnity health insurance portion of dual option products offered by HIPgny, WHICH administers the collection of premiums and pays claims on behalf of HIPIC. Premiums collected on behalf of HIPIC were approximately $8,300,000 for the year ended December 31, 2016. HIPgny paid out-of-network claims on behalf of HIPIC of $6,400,000 in 2016. Under the terms of a service agreement, HIPgny allocated costs associated with administering the premiums and claims of approximately $3,500,000 to HIPIC for the year ended December 31, 2016. Transactions with HIP Holdings, Inc. (HIP-IPA) HIP pays HIP IPA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) a monthly per-member-per-month capitation rate for members enrolled in HIP IPA as well as a monthly fee for data collection services. For the year ended December 31, 2016, HIP incurred approximately $10,300,000 for capitation and $300,000 for data collection services. In addition, HIPgny provides certain administrative and support services to HIP IPA, which are reimbursed by HIP IPA. For the year ended December 31, 2016, amounts charged by HIPgny to HIP IPA for these services was approximately $200,000. Transactions with HIP HOldings, Inc. & Subsidiaries (EHA) EHA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) provides claims processing and certain member services for HIPs members. For the year ended December 31, 2016, EHA charged HIPgny approximately $15,400,000 for these services. HIPGNY provides administrative and management services to EHA; amounts paid in 2016 were approximately $2,200,000.