2017-11-06T10:00:19-06:00 2016-12-31 BKD LLP 200 E Main St Suite 700 Fort Wayne IN 46802 990 2016-01-01 311069321 PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA INC % STACEY OTTENWELLER PHYS 2604326690 8101 WEST JEFFERSON BLVD FORT WAYNE IN 46804 DUSTIN W CRIDER CFO 2604326690 2017-11-15 true Joyce A Dulworth P00151125 2604604000 167.68.126.162 35027420173105000002 2017-11-06 P 6D61E2A24AA052E41AF4DA6A29299CDAFD2BBB3C 1466242D98572CF50F8DAFF8C03C944EFBA58CF0 2016 2021-01-29 14:40:06Z MICHAEL D CAHILL 8101 W JEFFERSON BLVD FORT WAYNE IN 46804 191419237 false X WWW.PHPNI.COM X 1983 IN THE ORGANIZATION PROVIDES INSURANCE COVERAGE AND EDUCATIONAL MATERIALS PROMOTING A HEALTHY LIFESTYLE TO THOUSANDS OF INDIVIDUALS THROUGHOUT NORTHERN INDIANA. 16 14 142 788290 0 0 192390280 179922300 1417282 1477501 690917 668011 194498479 182067812 817904 91791 164706379 157303654 9806780 10189712 0 0 0 16460103 14714639 191791166 182299796 2707313 -231984 84627937 82349132 40738485 33256011 43889452 49093121 X PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA, INC. IS SPONSORED BY INDEPENDENT PHYSICIANS AS A NOT-FOR-PROFIT, INDIANA CERTIFIED AND FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION. PHYSICIANS HEALTH PLAN WILL EXCEED OUR CUSTOMERS' HEALTHCARE EXPERIENCE EXPECTATIONS BY DELIVERING OUR SERVICES WITH A PERSONAL TOUCH, DEVELOPING LONG-TERM RELATIONSHIPS, AND PROVIDING RESOURCES TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES. false false 170393056 91791 179802021 PHP HAS DEVELOPED A VOLUNTARY DIABETES MANAGEMENT INCENTIVE PROGRAM DESIGNED TO PROVIDE ENCOURAGEMENT FOR COMPLYING WITH TREATMENT GUIDELINES FOR THE MANAGEMENT OF DIABETES AS WELL AS TO OFFER DIABETIC EDUCATION. MEMBERS CAN JOIN THE PROGRAM BY CALLING PHP AND REQUESTING ENROLLMENT, HAVING THEIR PHYSICIAN CALL AND REQUEST ENROLLMENT, A REFERRAL FROM A HOSPITAL CASE MANAGER DURING AN INPATIENT STAY, A REFERRAL AS A RESULT OF A CUSTOMER SERVICE CALL, A REFERRAL AS A RESULT OF A PHARMACY CALL OR BY INVITATION FROM PHP FOLLOWING THE RECEIPT OF A MEDICAL CLAIM WHERE A DIABETIC DIAGNOSIS, DIABETIC SUPPLY, OR DIABETIC MEDICATION IS IDENTIFIED. THE MEMBER MUST FIRST COMPLETE A HEALTH RISK ASSESSMENT AND DIABETES PROGRAM ENROLLMENT FORM WHICH BOTH CAN BE FOUND ON OUR WEBSITE. ONCE A CLAIM OR CLAIMS HAVE BEEN RECEIVED FOR THE HBA1C TEST AND/OR A DIABETIC EYE EXAM HAS BEEN PROCESSED/PAID, THE MEMBER RECEIVES A $50 VISA GIFT CARD FOR A SINGLE TEST/EXAM FOR A TOTAL REWARD OF $100 PER CALENDAR YEAR. OUR HEALTH RISK ASSESSMENT IS INTENDED TO INCREASE MEMBER AWARENESS OF HEALTH BEHAVIORS, ENCOURAGE SCREENING OF TESTS FOR EARLY IDENTIFICATION OF ISSUES, AND SUPPORT MEMBERS IN ADOPTING A HEALTHIER LIFESTYLE. IN ADDITION, THE INFORMATION GATHERED BY PHP, ENABLES A BETTER UNDERSTANDING OF THE HEALTH AND HABITS OF OUR MEMBER POPULATION. THIS IN TURN ALLOWS PHP TO DEVELOP PROGRAMS AND OUTREACH TO ADDRESS AREAS OF CONCERN. MEMBER EDUCATION AND ENCOURAGING SELF-ADVOCACY ARE THE PRIMARY GOALS OF THE HRA. IN COLLABORATION WITH AGING AND IN-HOME SERVICES, PHP HAS CREATED THE CARE TRANSITIONS PROGRAM BECAUSE AT THE TIME OF DISCHARGE, IT IS EASY FOR A MEMBER TO BECOME OVERWHELMED WITH POTENTIAL CHANGES IN MEDICATION, FOLLOW-UP APPOINTMENTS, AND GENERAL CARE NEEDS. THE TEAM AT CARE TRANSITIONS IS AVAILABLE TO ASSIST THE MEMBER WITH ANY ISSUES THEY MAY EXPERIENCE IN TRANSITION FROM A FACILITY SETTING TO HOME FOCUSING ON EDUCATIONAL NEEDS, TREATMENT PLAN COMPLIANCE, AND REMOVAL OF BARRIERS TO CARE. PENDING VERIFICATION OF ELIGIBILITY/NECESSITY, MEMBERS JOIN THE CARE TRANSITIONS PROGRAM THROUGH A REFERRAL FROM A PHP CASE MANAGER, PHYSICIANS RECOMMENDATION, OR A REFERRAL FROM A HOSPITAL CASE MANAGER. THIS IS PROVIDED AT NO COST TO THE MEMBER. 170393056 false false false false false false false false false true false false false true false true false false false true false false false false false false true false true false false false false false false true true false false false false false true true true false true 1848 0 true 142 true true true false false false false false X 16 14 false false false false true true true true true false false true true true true true true true false true false IN X STACEY OTTENWELLER 2604326690 8101 W JEFFERSON BLVD FORT WAYNE IN 46804 JAMES C WEHRENBERG CHAIRMAN THRU 6/16, EX-OFFICIO 1.0 1.0 X X 10250 0 0 JAMES C STEVENS VICE-CHAIR THRU 6/16, CHAIRMAN 1.0 1.0 X X 8500 0 0 THERESA A GUTIERREZ VICE CHAIR STARTING 6/16 1.0 1.0 X X 3900 0 0 MICHAEL R DEWALD TREASURER 1.0 1.0 X X 10100 0 0 KARL R LAPAN SECRETARY 1.0 1.0 X X 9750 0 0 TIMOTHY R DIRIG DIRECTOR 1.0 1.0 X 5125 0 0 PETER P FETTIG DIRECTOR 1.0 1.0 X 4750 0 0 JUDITH KENNEDY DIRECTOR 1.0 1.0 X 3625 0 0 MICHAEL LARKIN DIRECTOR 1.0 1.0 X 4125 0 0 DAVID E LENTZ DIRECTOR 1.0 1.0 X 2000 0 0 ANDREW O'SHAUGHNESSY DIRECTOR 1.0 1.0 X 2000 0 0 RHYS RUDOLPH DIRECTOR 1.0 1.0 X 1250 0 0 JOHN SAMPSON DIRECTOR 1.0 1.0 X 2750 0 0 DON SCHENKEL DIRECTOR 1.0 1.0 X 9525 0 0 JOEL VALCARCEL DIRECTOR 1.0 1.0 X 2000 0 0 JOSEPH P YURKANIN DIRECTOR 1.0 1.0 X 2000 0 0 MICHAEL D CAHILL PRESIDENT & CEO 40.0 10.0 X 331619 0 38698 JAMES A BRUNNEMER CHIEF FINANCIAL OFFICER 44.8 5.2 X 270160 0 30482 GAIL M DORAN CHIEF OPERATING OFFICER 40.0 3.0 X 261997 0 36477 FRED L RASP LEAD MEDICAL ADVISOR 12.0 8.0 X 161338 0 0 SUZANNE S FISK AVP OF IT & BUSINESS SERVICES 48.0 2.0 X 152807 0 20461 DALE A BULTEMEIER AVP OF ANCILLARY SERVICES 42.0 3.0 X 147032 0 23215 KEVEN LINKER CHIEF ACTUARY/DIR. OF ANALYT. 48.0 4.0 X 152329 0 29803 DUSTIN CRIDER CORPORATE CONTROLLER 50.0 5.0 X 129545 0 28488 JON ALBRIGHT GEN. COUNSEL/DIR. OF EMP. REL. 47.5 1.0 X 117390 0 27206 1805867 0 234830 11 false true false OPTUM 11000 OPTUM CIRCLE EDEN PRAIRIE MN 55344 TRANSPLANT COVERAGE 1525991 MUNICH REINSURANCE 10900 WAYZATA BLVD MINNETONKA MN 55305 REINSURANCE SOLUTION 1152933 THE TRIZETTO GROUP DEPT 2140 PO BOX 122140 DALLAS TX 75312 SOFTWARE VENDOR 833141 KEYSTONE INSURANCE 1995 POINT TOWNSHIP DR NORTHUMBERLAND PA 17857 BROKER 587258 MULTIPLAN INC PO BOX 29380 NEW YORK NY 10087 NETWORK DISCOUNT 545895 31 0 PREMIUM REVENUE 524114 179922300 179783425 138875 179922300 1397533 1397533 0 0 0 0 0 9431393 9351425 79968 79968 79968 0 0 0 0 0 0 0 0 0 ALLOCATED ADMIN 524298 649415 649415 MISCELLANEOUS 524298 18596 18596 668011 182067812 179802021 788290 1477501 91791 91791 0 0 157303654 157303654 1212421 430773 781648 0 81441 37875 43566 0 6248436 2905914 3342522 0 323838 150605 173233 0 1970164 916250 1053914 0 353412 164359 189053 0 0 207939 207939 0 212107 212107 0 18725 18725 0 0 92732 92732 0 159822 159822 618111 618111 0 806307 806307 0 542556 542556 0 0 431955 431955 0 114974 114974 0 0 0 15827 15827 0 0 975780 975780 0 181469 181469 0 COMMISSIONS 5356805 5356805 ACA ASSESSMENTS 2903570 2903570 HEALTH RELATED ACTIVITY 66102 66102 ACCREDITATION FEES 58504 58504 1951354 6854 1944500 182299796 170393056 11906740 0 5293085 4849101 12422094 10798481 0 0 9957785 4499584 0 0 0 0 0 0 0 0 0 0 6211771 3417689 2854128 2794082 50900204 56215051 2393934 2560936 0 0 0 0 806707 631897 84627937 82349132 11224792 6844074 0 0 5172049 3609852 0 0 0 0 0 0 0 0 0 0 24341644 22802085 40738485 33256011 X 0 0 2759600 2890600 41129852 46202521 43889452 49093121 84627937 82349132 X -231984 1766935 3668718 X false true X true false 661698 661698 3035177 1731170 1304007 2300823 1566346 734477 214073 120173 93900 2794082 0 IBNR CLAIMS AND CLAIMS PAYABLE 22802085 22802085 186748905 1766935 3668718 5435653 181313252 92732 661828 754560 182067812 181545236 181545236 92732 661828 754560 182299796 ASC 740 FOOTNOTE MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D CHANGE IN NONADMITTED ASSETS 3,537,718 INCREASE IN CONTRIBUTED CAPITAL 131,000 TOTAL 3,668,718 PART XI, LINE 4B ADMINISTRATIVE FEES 646,001 INTEREST EXPENSE 15,827 TOTAL 661,828 PART XII, LINE 4B ADMINISTRATIVE FEES 646,001 INTEREST EXPENSE 15,827 OTHER 661,828 North America PASSIVE INVESTMENTS 682091 Europe PASSIVE INVESTMENTS 2696358 Middle East and North Africa PASSIVE INVESTMENTS 45485 Russia PASSIVE INVESTMENTS 18839 SUB-SAHARAN AFRICA PASSIVE INVESTMENTS 36228 East Asia and the Pacific PASSIVE INVESTMENTS 1180461 South Asia PASSIVE INVESTMENTS 56130 South America PASSIVE INVESTMENTS 225917 4941509 4941509 false false false false false false true COMMUNITY TRANS NETWORK 5601 INDUSTRIAL RD FORT WAYNE IN 46825 352109955 501(C) 3 5800 MEDICAL ASSISTANCE THE ALLIANCE 200 E MAIN ST STE 800 FORT WAYNE IN 46802 351787258 501(C) 3 10750 ECONOMIC DEVELOPMENT UNITED WAY OF ALLEN COUNTY 334 E BERRY ST FORT WAYNE IN 46802 350867932 501(C) 3 6200 MEDICAL ASSISTANCE 3 SCHEDULE I, PART I, LINE 2 CHARITABLE CONTRIBUTION EXPENDITURES ARE SUBJECT TO THE ORGANIZATION'S CONTRIBUTION POLICY WHICH CALLS FOR THE FIRST $500,000 OF NET INCOME AND 15% OF OPERATING INCOME TO BE ALLOCATED TO CHARITABLE CONTRIBUTIONS. INDIVIDUAL CHARITABLE CONTRIBUTION EXPENDITURES ARE APPROVED BY SENIOR MANAGEMENT AND REVIEWED TO ENSURE THE GRANTEE'S ELIGIBILITY AND ABILITY TO PROVIDE AN APPROPRIATE LEVEL OF MEDICAL ASSISTANCE TO THE UNDERSERVED BASED ON THE AMOUNT OF THE GRANT. X true true X X X X X X false false false false false false false false false MICHAEL D CAHILL PRESIDENT & CEO 289643 0 37019 0 4957 0 13250 0 25448 0 370317 0 JAMES A BRUNNEMER CHIEF FINANCIAL OFFICER 231145 0 39015 0 0 0 13250 0 17232 0 300642 0 GAIL M DORAN CHIEF OPERATING OFFICER 207583 0 54414 0 0 0 13045 0 23432 0 298474 0 FRED L RASP LEAD MEDICAL ADVISOR 161338 0 0 0 0 0 0 0 0 0 161338 0 SUZANNE S FISK AVP OF IT & BUSINESS SERVICES 137424 0 15383 0 0 0 4551 0 15910 0 173268 0 DALE A BULTEMEIER AVP OF ANCILLARY SERVICES 131205 0 15827 0 0 0 7296 0 15919 0 170247 0 KEVEN LINKER CHIEF ACTUARY/DIR. OF ANALYT. 136363 0 15966 0 0 0 7561 0 22242 0 182132 0 DUSTIN CRIDER CORPORATE CONTROLLER 115958 0 13587 0 0 0 6422 0 22066 0 158033 0 SCHEDULE J, PART I, LINE 1B MICHAEL CAHILL WAS PROVIDED SOCIAL CLUB DUES TO PROVIDE A VENUE FOR CONDUCTING COMPANY BUSINESS. ALL TIME ACCESSING THE BENEFIT WAS RELATED TO COMPANY BUSINESS. AS A RESULT, IT WAS NOT TREATED AS TAXABLE INCOME TO THE INDIVIDUAL. SEAN CAHILL SON OF CEO/PRESIDENT 81441 EMPLOYEE OF PHP false FORM 990, PART IV, LINE 12 PHYSICIAN HEALTH PLAN'S AUDITED FINANCIAL STATEMENTS ARE PREPARED USING ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE INDIANA DEPARTMENT OF INSURANCE, WHICH PRACTICES DIFFER FROM ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. FORM 990, PART VI, SECTION A, LINE 1B JAMES WEHRENBERG and MICHAEL DEWALD ARE NON-INDEPENDENT VOTING MEMBERS OF THE BOARD BECAUSE THEY ARE COMPENSATED GREATER THAN $10,000 BY THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 ONLY ONE MEMBER CLASS EXISTS. MEMBERS WITHIN ALLEN COUNTY, INDIANA PAY A $2,000 MEMBERSHIP FEE. MEMBERS IN THE INDIANA COUNTIES SURROUNDING ALLEN (DEKALB, NOBLE, WHITLEY, HUNTINGTON, WELLS, AND ADAMS) PAY A $500 MEMBERSHIP FEE. MEMBERS, NO MATTER THEIR LOCATION, HAVE THE SAME VOTING RIGHTS AND ARE ASSOCIATED WITH THE SAME FEE TABLE. THERE ARE NO MEMBERS OUTSIDE OF THE COUNTIES LISTED ABOVE IN PHP'S 40 COUNTY SERVICE AREA. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS CONSISTS OF NO LESS THAN THIRTEEN TO NO MORE THAN SEVENTEEN MEMBERS. THE DIRECTORS MUST BE CLASSIFIED AS PHYSICIAN DIRECTORS OR CONSUMER DIRECTORS. PHYSICIAN DIRECTORS MUST REPRESENT AT LEAST ONE-HALF BUT NO MORE THAN TWO-THIRDS OF THE TOTAL DIRECTORS OF THE BOARD AND CONSUMER DIRECTORS MUST CONSIST OF AT LEAST ONE THIRD OF THE TOTAL DIRECTORS OF THE BOARD. THE PHYSICIAN DIRECTORS ARE ELECTED BY THE MEMBER DOCTORS AND THEN THE ELECTED PHYSICIAN DIRECTORS APPOINT THE CONSUMER DIRECTORS. ALL DIRECTORS, PHYSICIAN OR CONSUMER, HAVE THE SAME VOTING RIGHTS. FORM 990,PART VI, SECTION A, LINE 7B MEMBER DOCTORS HAVE THE ABILITY TO ELECT AND REMOVE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND RELATED SCHEDULES UNDERGO A THOROUGH REVIEW BY THE CONTROLLER, CHIEF FINANCIAL OFFICER, AND AN INDEPENDENT CPA FIRM. IN ADDITION, A COPY OF THE 990 IS EMAILED TO THE GOVERNING BODY. THE GOVERNING BODY REVIEWS THE 990 AND SUBMITS ANY QUESTIONS, COMMENTS, OR CORRECTIONS PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE IS SENT OUT ANNUALLY TO ALL OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE PERSONAL AND BUSINESS RELATIONSHIPS. THE QUESTIONNAIRES ARE REVIEWED ANNUALLY. IF A CONFLICT EXISTS, RESTRICTIONS WILL BE IMPOSED ON PERSONS WITH A CONFLICT SUCH AS PROHIBITING THEM FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSCATIONS. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S PAY (INCLUDING BASE PAY AND BONUS) IS REVIEWED AND DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE INCLUDES THE BOARD CHAIR AND VICE-CHAIR (BOTH OF WHICH ARE MEMBER DOCTORS) AND FOUR OF THE CONSUMER DIRECTORS. BONUS PAY IS DETERMINED ANNUALLY. BASE PAY IS REVIEWED PERIODICALLY BASED ON THE PROVISIONS SET FORTH IN THE CEO'S EMPLOYMENT AGREEMENT. A REVIEW INVOLVING AN INDEPENDENT THIRD-PARTY CONSULTANT WAS CONDUCTED DURING 2016 TO DETERMINE 2016 BASE PAY. THESE REVIEWS INCLUDE A REVIEW OF COMPARABILITY DATA FROM SOURCES SUCH AS WARREN SALARY SURVEY. CONTEMPORANEOUS SUBSTANTIATION OF THE RESULTING DECISIONS IS RETAINED. FORM 990, PART VI, SECTION B, LINE 16B THE ORGANIZATION HAS AN INFORMAL NON-WRITTEN POLICY REQUIRING THE ORGANIZATION TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE AGREEMENTS UNDER APPLICABLE FEDERAL TAX LAW, AND TAKES STEPS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS WITH RESPECT TO SUCH ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 PHYSICIANS HEALTH PLAN'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. PHYSICIANS HEALTH PLAN'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC) WEBSITE. FORM 990, PART XI, LINE 9 INCREASES IN CONTRIBUTED CAPITAL $131,000 CHANGES IN NONADMITTED ASSETS $3,537,718 TOTAL $3,668,718 PHP FOUNDATION INC 8101 W JEFFERSON BLVD FORT WAYNE IN 46804 204615314 PRIVATE FDN IN 501(C)(3) PF PHPNI false PHP HOLDING CO 8101 W JEFFERSON BLVD FORT WAYNE IN 46804 208074365 HOLDING CO IN PHPNI C CORP 628405 2948643 1.00000 true PHP MANAGEMENT SYSTEMS 8101 W JEFFERSON BLVD FORT WAYNE IN 46804 351826719 LICENSED TPA IN PHP HOLDING CO C CORP true PHP INSURANCE COMPANY OF INDIANA INC 8101 W JEFFERSON BLVD FORT WAYNE IN 46804 203064284 STOP-LOSS REINSUR IN PHP HOLDING CO C CORP true false true false false false false false false false false false true false true true false true false false PHP HOLDING COMPANY B 300000 CASH PAYMENT PHP MANAGEMENT SYSTEMS L 609597 COST