2017-11-15T15:03:03-05:00 2016-12-31 383133790 ANDREWS HOOPER PAVLIK PLC 4295 OKEMOS RD STE 200 OKEMOS MI 488646201 990 2016-01-01 364497604 SPARROW PHP SPAR 5173648400 PO BOX 30377 LANSING MI 48909 DENNIS REESE PRESIDENT/CEO - PHP 5173648400 2017-11-07 true MARK E HOOPER P00039887 5177060800 2017-11-07 53D458C82320E5CA4BCA37F288A6CEEB15A0A3C7 CCD344DB358877955BD6CDA542A4954E7FA27565 2016 2017-02-10 21:41:12Z DENNIS SWAN 1215 E MICHIGAN AVENUE LANSING MI 48912 1818744 false X WWW.PHPMICHIGAN.COM X 2002 MI SPARROW PHP'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, AND COST EFFECTIVE HEALTHCARE. 2 1 0 0 0 92432304 847726 470088 284896 2024919 413552 94927311 1546174 0 60119785 130178 2666712 23197 0 0 29246794 878821 92033291 1032196 2894020 513978 24790567 12577811 13728566 891816 11062001 11685995 X SPARROW PHP'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, AND COST EFFECTIVE HEALTHCARE. false true 974688 847726 SPARROW PHP (SPHP)IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO). SPHP USES A PRIMARY CARE CONCEPT FOR DELIVERING HEALTH CARE IN A HEALTH DELIVERY NETWORK (HDN) STRUCTURE. IT ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS AND THEIR QUALIFIED DEPENDENTS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER OR QUALIFIED DEPENDENT. SPHP CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. SPHP'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. SPHP'S SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW SPHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. SPHP MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY A HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY THE HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. SPHP OFFERS A VARIETY OF HEALTH CARE PROGRAMS. SPHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE SPHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO- PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO PAYOR NEEDS. SPHP IS OWNED BY PHYSICIAN HEALTH PLAN (PHP). PHYSICIANS HEALTH PLAN (PHP) IS OWNED BY SPARROW HEALTH SYSTEM (SPARROW) AND HOLDS A CERTIFICATE OF AUTHORITY AS AN HMO IN THE STATE OF MICHIGAN. PHP IS PRIMARILY A COMMERCIAL HMO AND ALSO OPERATES THREE SUBSIDIARIES, PHP INSURANCE COMPANY (PHPIC), A COMMERCIAL INSURANCE COMPANY, SPHP, AND PHP SERVICE COMPANY (TPA) A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHP. EFFECTIVE DECEMBER 31, 2015 SPARROW PHP SOLD 100 PERCENT OF ITS MEMBERSHIP TO AN UNAFFILIATED HEALTH PLAN. PHP GAINED APPROVAL FORM THE BOARD OF DIRECTORS AND COMMISSIONER OF THE DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES TO MERGE SPARROW PHP INTO PHP EFFECTIVE APRIL 2017. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHP APPLY TO PHP, PHPIC, SPHP, AND TPA. PHP'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE, PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. PHPIC OFFERS PRODUCTS ACROSS MICHIGAN. FOR THE YEARS ENDED DECEMBER 31, 2015 AND PRIOR THE SPHP PRODUCT WAS AVAILABLE TO MEDICAID ENROLLEES IN EATON, CLINTON, INGHAM, IONIA, MONTCALM, ISABELLA, AND SHIAWASSEE COUNTIES. AS OF DECEMBER 31, 2016, THERE WERE APPROXIMATELY 36,000 ENROLLEES IN PHP'S COMMERCIAL HMO, 15,700 IN TPA, 5,500 IN PHPIC, AND 0 ENROLLEES IN SPHP. ONE HUNDRED PERCENT OF SPHP'S MEMBERSHIP WAS SOLD TO AN UNRELATED HEALTH PLAN EFFECTIVE DECEMBER 30, 2015. PHP AND SPHP CONTRACT DIRECTLY WITH PHYSICIANS HEALTH NETWORK (PHN), A WHOLLY OWNED SUBSIDIARY OF SPARROW. THE PHP NETWORK IS APPROXIMATELY 684 PRIMARY CARE PHYSICIANS, 1,085 SPECIALTY CARE PHYSICIANS, 532 ALLIED HEALTH PROFESSIONALS, AND 572 ORGANIZATIONAL PROVIDERS THAT INCLUDE 31 HOSPITALS. PHP MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: - DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES, - QUALITY OF CARE CONCERNS, AND - HEDIS MEASURES: THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLAN PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHP USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: DIABETES, ASTHMA, DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, BREAST AND CERVICAL CANCER SCREENINGS, USE OF BETA- BLOCKERS AFTER HEART ATTACKS, CHILD AND ADOLESCENT IMMUNIZATIONS, CHOLESTEROL MANAGEMENT, CONTROLLING HIGH BLOOD PRESSURE, SMOKING CESSATION, PRENATAL AND POSTPARTUM CARE, AND TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHP MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS EXPECTATIONS. THE PHP QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2015 PHP RECEIVED "FULL ACCREDITATION" STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. PHP HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. THE NEXT ACCREDITATION WILL OCCUR FOR THE YEAR ENDED DECEMBER 31, 2018. 974688 false false false false false false false false true false false false false false false true true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false true 0 0 0 false false false false false false X 2 1 false false false false true true true true true false false true true true true true true true true false MI X DENNIS REESE 5173648400 1400 E MICHIGAN AVENUE LANSING MI 48909 DENNIS REESE PRESIDENT/CE 5.00 40.00 X X 0 388425 57659 JAMES BUTLER III DIRECTOR 1.00 1.00 X 0 1350 0 GEORGE SCHNEIDER CFO/COO - PH 5.00 40.00 X 0 301746 51553 KEVIN KAPLAN VP SALES 5.00 40.00 X 0 187926 48227 ANN HUNT-FUGATE RPH MGR CLINICAL 5.00 40.00 X 0 152445 26914 LINDA DICKINSON DIR OF MED R 5.00 40.00 X 0 147179 38533 PAULA HOWARD SENIOR SALES 5.00 40.00 X 0 130185 34337 JOY WAHAWISAN CLINICAL PHA 5.00 40.00 X 0 124108 30651 DENNIS SWAN PRES/CEO - S 1.00 40.00 X 0 1327029 217230 2760393 505104 true true false MEDICAID PAYMENTS 621990 847726 847726 847726 140711 140711 416755 272570 144185 144185 144185 OTHER REVENUE 900099 413552 413552 413552 1546174 1261278 284896 130178 130178 23061 17457 5604 136 103 33 22312 22312 925 700 225 GME EXPENSE 805358 805358 OTHER 27598 20892 6706 BANKING FEES 22628 22628 1032196 974688 57508 0 15296673 7647189 937750 141164 4638209 4752115 3917935 37343 24790567 12577811 12612193 891816 1116373 13728566 891816 X 11062001 11685995 11062001 11685995 24790567 12577811 513978 110016 X false true X true false 3707924 191313 102555 15000 3986792 3411165 361583 -49824 15000 3707924 3184706 200567 40893 15000 3411165 2926676 82387 187643 12000 3184706 2641860 147795 149021 12000 2926676 1.00000 false true true 1563034 110016 110016 1453018 93156 93156 1546174 939040 939040 93156 93156 1032196 SCHEDULE D, PAGE 2, PART V, LINE 4 SPARROW PHP DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHYSICIANS HEALTH PLAN, SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. PHYSICIANS HEALTH PLAN IS THE SOLE MEMBER OF SPARROW PHP. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE ESTABLISHED BY THE ENDOWMENT. SCHEDULE D, PAGE 4, PART XI, LINE 4B STATUTORY RECLASS FROM REVENUE TO EXPENSE 70,844 INVESTMENT EXPENSES 22,312 SCHEDULE D, PAGE 4, PART XII, LINE 4B STATUTORY RECLASS FROM REVENUE TO EXPENSE 70,844 INVESTMENT EXPENSES 22,312 X X X X X X false false false true true true true false false DENNIS REESE PRESIDENT/CEO - PHP 317940 68301 2184 23850 33809 446084 GEORGE SCHNEIDER CFO/COO - PHP 278411 21509 1826 15900 35653 353299 KEVIN KAPLAN VP SALES 153414 34384 128 17964 30263 236153 ANN HUNT-FUGATE RPH MGR CLINICAL PHARM 123358 10094 18993 11875 15039 179359 LINDA DICKINSON DIR OF MED RES MGMT 132636 14108 435 13602 24931 185712 PAULA HOWARD SENIOR SALES REP 83978 46018 189 12252 22085 164522 JOY WAHAWISAN CLINICAL PHARMACIST 124020 15 73 7534 23117 154759 DENNIS SWAN PRES/CEO - SHS 909306 376849 40874 164658 52572 1544259 SCHEDULE J, PAGE 1, PART I, LINE 3 SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF PHYSICIAN HEALTH PLAN, AND PHP IS THE SOLE MEMBER OF SPARROW PHP. SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGRANIZATION THAT INCLUDES A NUMBER OF NON-PROFIT ENTITIES. THE METHODS SELECTED FOR DETERMINING THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR ARE METHODS WHICH ARE BEING USED BY ALL SPARROW HEALTH SYSTEM RELATED ENTITIES. SCHEDULE J, PAGE 1, PART I, LINE 5A THE 2016 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2016 AND WILL BE PAID IN 2017. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES. SCHEDULE J, PAGE 1, PART I, LINE 5B THE 2016 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2016 AND WILL BE PAID IN 2017. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES SCHEDULE J, PAGE 1, PART I, LINE 6A THE 2016 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2016 AND WILL BE PAID IN 2017. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES SCHEDULE J, PAGE 1, PART I, LINE 6B THE 2016 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2016 AND WILL BE PAID IN 2017. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES SCHEDULE J, PART III DENNIS SWAN IS A FORMER BOARD MEMBER OF SPARROW PHP. MR. SWAN IS BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES IN A POSITION OTHER THAN AS A BOARD MEMBER OF SPARROW PHP. THE BOARD MEMBER IS NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO SPARROW PHP. FORM 990 ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. FORM 990, PAGE 2, PART III, LINE 3 DURING THE YEAR ENDED DECEMBER 31, 2015 SPARROW PHP WAS NOT RECOMMENDED BY THE STATE OF MICHIGAN AS AN APPROVED CARRIER OF MICHIGAN MEDICAID INSURANCE FOR THE PROSPERITY REGION IN WHICH THE COMPANY OPERATES. AS A RESULT EFFECTIVE DECEMBER 31, 2015, SPARROW PHP SOLD 100 PERCENT OF THE MEMBERSHIP TO AN UNAFFILIATED HEALTH PLAN. THE MEMBERSHIP WAS SOLD FOR AN AGREED UPON SUM THAT WAS COLLECTED SUBSEQUENT TO YEAR END. EFFECTIVE APRIL 30, 2017 SPARROW PHP WAS MERGED INTO PHYSICIANS HEALTH PLAN AFTER APPROVAL BY THE BOARD OF DIRECTORS AND THE COMMISSIONER OF THE DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS). THE ACTIVITY REPORTED ON THE 2016 FORM 990 IS WINDING DOWN OF OPERATIONS FOR SPARROW PHP. FORM 990, PAGE 2, PART III, LINE 4A SPHP'S SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW SPHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. SPHP MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY A HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY THE HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. SPHP OFFERS A VARIETY OF HEALTH CARE PROGRAMS. SPHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE SPHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO- PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO PAYOR NEEDS. SPHP IS OWNED BY PHYSICIAN HEALTH PLAN (PHP). PHYSICIANS HEALTH PLAN (PHP) IS OWNED BY SPARROW HEALTH SYSTEM (SPARROW) AND HOLDS A CERTIFICATE OF AUTHORITY AS AN HMO IN THE STATE OF MICHIGAN. PHP IS PRIMARILY A COMMERCIAL HMO AND ALSO OPERATES THREE SUBSIDIARIES, PHP INSURANCE COMPANY (PHPIC), A COMMERCIAL INSURANCE COMPANY, SPHP, AND PHP SERVICE COMPANY (TPA) A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHP. EFFECTIVE DECEMBER 31, 2015 SPARROW PHP SOLD 100 PERCENT OF ITS MEMBERSHIP TO AN UNAFFILIATED HEALTH PLAN. PHP GAINED APPROVAL FORM THE BOARD OF DIRECTORS AND COMMISSIONER OF THE DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES TO MERGE SPARROW PHP INTO PHP EFFECTIVE APRIL 2017. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHP APPLY TO PHP, PHPIC, SPHP, AND TPA. PHP'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE, PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. PHPIC OFFERS PRODUCTS ACROSS MICHIGAN. FOR THE YEARS ENDED DECEMBER 31, 2015 AND PRIOR THE SPHP PRODUCT WAS AVAILABLE TO MEDICAID ENROLLEES IN EATON, CLINTON, INGHAM, IONIA, MONTCALM, ISABELLA, AND SHIAWASSEE COUNTIES. AS OF DECEMBER 31, 2016, THERE WERE APPROXIMATELY 36,000 ENROLLEES IN PHP'S COMMERCIAL HMO, 15,700 IN TPA, 5,500 IN PHPIC, AND 0 ENROLLEES IN SPHP. ONE HUNDRED PERCENT OF SPHP'S MEMBERSHIP WAS SOLD TO AN UNRELATED HEALTH PLAN EFFECTIVE DECEMBER 30, 2015. PHP AND SPHP CONTRACT DIRECTLY WITH PHYSICIANS HEALTH NETWORK (PHN), A WHOLLY OWNED SUBSIDIARY OF SPARROW. THE PHP NETWORK IS APPROXIMATELY 684 PRIMARY CARE PHYSICIANS, 1,085 SPECIALTY CARE PHYSICIANS, 532 ALLIED HEALTH PROFESSIONALS, AND 572 ORGANIZATIONAL PROVIDERS THAT INCLUDE 31 HOSPITALS. PHP MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: - DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES, - QUALITY OF CARE CONCERNS, AND - HEDIS MEASURES: THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLAN PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHP USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: DIABETES, ASTHMA, DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, BREAST AND CERVICAL CANCER SCREENINGS, USE OF BETA- BLOCKERS AFTER HEART ATTACKS, CHILD AND ADOLESCENT IMMUNIZATIONS, CHOLESTEROL MANAGEMENT, CONTROLLING HIGH BLOOD PRESSURE, SMOKING CESSATION, PRENATAL AND POSTPARTUM CARE, AND TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHP MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS EXPECTATIONS. THE PHP QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2015 PHP RECEIVED "FULL ACCREDITATION" STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. PHP HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. THE NEXT ACCREDITATION WILL OCCUR FOR THE YEAR ENDED DECEMBER 31, 2018. FORM 990, PAGE 6, PART VI, LINE 6 PHP IS THE SOLE MEMBER OF SPHP AND SPARROW IS THE PARENT AND SOLE MEMBER OF PHP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE SPARROW BOARD OF DIRECTORS. DECISIONS OF THE SPHP BOARD OF DIRECTORS MAY BE SUBJECT TO APPROVAL BY THE SPARROW BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7A PHP IS THE SOLE MEMBER OF SPHP AND SPARROW IS THE PARENT AND SOLE MEMBER OF PHP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE SPARROW BOARD OF DIRECTORS. DECISIONS OF THE SPHP BOARD OF DIRECTORS MAY BE SUBJECT TO APPROVAL BY THE SPARROW BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7B PHP IS THE SOLE MEMBER OF SPHP AND SPARROW IS THE PARENT AND SOLE MEMBER OF PHP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE SPARROW BOARD OF DIRECTORS. DECISIONS OF THE SPHP BOARD OF DIRECTORS MAY BE SUBJECT TO APPROVAL BY THE SPARROW BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 11B COPIES OF THE 2016 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT COMPLETED ITS REVIEW OF THE FORM 990 COPIES WERE PROVIDED AT THE OCTOBER 2017 BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON. FORM 990, PAGE 6, PART VI, LINE 12C 1) CORPORATE COMPLIANCE SENDS OUT THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON). FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SPARROW BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PAGE 6, PART VI, LINE 15B THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SPARROW BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS FOLLOWS: THE GOVERNING DOCUMENTS OF SPHP ARE SUBMITTED TO DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS). THOSE ARE PUBLICLY AVAILABLE TO INTERESTED PARTIES. THE CONFLICT OF INTEREST IS AVAILABLE THROUGH SPARROW BY REQUEST TO THE SPARROW COMPLIANCE OFFICER. FORM 990, PART XI, LINE 9 STATUTORY RECLASS FROM REVENUE TO EXPENSE -70,844 INVESTMENT EXPENSES -22,312 STATUTORY RECLASS FROM REVENUE TO EXPENSE 70,844 INVESTMENT EXPENSES 22,312 EDWARD W SPARROW HOSPITAL 1215 E MICHIGAN AVENUE LANSING MI 48912 381360584 HLTH CARE MI 501C3 3 SHS true SPARROW COMMUNITY CARE 3315 E MICHIGAN AVENUE STE 4 LANSING MI 48912 382543305 HOME HLTH MI 501C3 10 SHS true SPARROW HEALTH SYSTEM 1215 E MICHIGAN AVENUE LANSING MI 48912 382542859 PARENT MI 501C3 12A NA false PHYSICIANS HEALTH PLAN 1400 E MICHIGAN AVENUE LANSING MI 48912 382356288 INSURANCE MI 501C4 SHS false PHYSICIANS HEALTH NETWORK 1400 E MICHIGAN AVENUE LANSING MI 48912 382594856 HMO MI 501C4 SHS true SPARROW FOUNDATION 1215 E MICHIGAN AVENUE LANSING MI 48912 386100687 FUNDRAISE MI 501C3 12B SHS true SPARROW CLINTON HOSPITAL 805 S OAKLAND STREET ST JOHNS MI 48879 381358172 HLTH CARE MI 501C3 3 SHS true SPARROW SPECIALTY HOSPITAL 1215 E MICH AVE 8W SPARROW TOWER LANSING MI 48912 141885340 LT ACUTE MI 501C3 3 SHS true SPARROW IONIA HOSPITAL 3565 S STATE RD IONIA MI 48846 383218134 HLTH CARE MI 501C3 3 SHS true SPARROW CLINICAL RESEARCH INSTITUTE 1200 E MICHIGAN AVENUE LANSING MI 48912 383075242 RESEARCH MI 501C3 4 SHS true SPARROW CARSON HOSPITAL 406 E ELM ST PO BOX 879 CARSON CITY MI 48811 381490180 HLTH CARE MI 501C3 3 SHS true CARSON CITY FOUNDATION 406 E ELM ST PO BOX 879 CARSON CITY MI 48811 460877509 FUNDRAISE MI 501C3 12A CCH true SPARROW DEVELOPMENT INC 1215 E MICHIGAN AVENUE LANSING MI 48912 382595963 RENTAL PRO MI N/A true PHP INSURANCE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 205565219 INSURANCE MI N/A true PHP SERVICE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 383344741 MED SVS MI N/A true EAST LANSING ATHLETIC CLUB 2900 HANNAH BLVD EAST LANSING MI 48823 382886420 HLTH CLUB MI N/A true MAC RESTAURANT LLC 2900 HANNAH BLVD EAST LANSING MI 48823 205120690 RESTAURANT MI N/A true MEDICAL CENTER WEST CONDO ASSOC 1322 E MICHIGAN AVENUE LANSING MI 48912 382635630 CONOD ASSO MI N/A true CLINTON SERVICES CORPORATION 805 S OAKLAND ST JOHNS MI 48879 382494110 SERVICES MI N/A true EAST LANSING ATHLETIC CLUB & HSP 1200 E MICHIGAN AVENUE STE 600 LANSING MI 48912 813131851 CONDO ASSO MI N/A true false false false false false false false false false false false false true true true true false false false