2016-11-14T18:58:44-06:00 2015-12-31 PricewaterhouseCoopers LLP 101 SEAPORT BOULEVARD BOSTON MA 02210 990 2015-01-01 042708004 HARVARD PILGRIM HEALTH CARE FOUNDATION INC % BETH CREAVIN HARV 7812636000 93 WORCESTER STREET WELLESLEY MA 024819181 ELIZABETH CREAVIN TREASURER 7812636000 2016-11-14 true GWEN SPENCER P00641463 6175305000 2015 2017-02-10 21:41:12Z ERIC H SCHULTZ 93 WORCESTER STREET WELLESLEY MA 024819181 6292151 false X WWW.HARVARDPILGRIM.ORG/FOUNDATION X 1980 MA SEE SCHEDULE O 12 11 0 11 0 4244378 6223744 0 0 142382 68407 0 0 4386760 6292151 3688046 3807583 0 0 1270904 1178221 0 0 0 1453183 1109673 6412133 6095477 -2025373 196674 3895385 2874723 1669268 502767 2226117 2371956 X SEE SCHEDULE O false false 5809736 3807583 0 HARVARD PILGRIM HEALTH CARE FOUNDATION, INC., (THE FOUNDATION), OPERATES EXCLUSIVELY IN CONNECTION WITH HARVARD PILGRIM HEALTH CARE, INC. IN 2015, THE FOUNDATION SUPPORTED HEALTH AND WELLNESS INITIATIVES IN CONNECTION WITH A NUMBER OF COMMUNITY ORGANIZATIONS THROUGH ITS EMPLOYEE MINI-GRANT AND COMMUNITY SERVICE PROGRAMS. 5809736 true true false false false false false false false false false false false false true true false true false false false false false false false false false true false true false false false false false false false false false false false false false true true false false false true 0 0 0 false false false false false false false false false false X 12 11 true false true false true true true true true false false true true true true true true false false false MA X BETH CREAVIN 6175095692 93 WORCESTER STREET WELLESLEY MA 024819181 X ERIC H SCHULTZ PRESIDENT (UNTIL 5/15)/CHAIR 5.0 45.0 X X 0 1366581 306781 RUTH ELLEN FITCH DIRECTOR 2.0 0.0 X 0 0 0 ELINOR GOLDBERG LSW DIRECTOR 2.0 0.0 X 0 0 0 JOSHUA KRAFT DIRECTOR 2.0 0.0 X 0 0 0 JOSEPH F O'DONNELL md DIRECTOR 2.0 3.0 X 0 16450 0 PATRICIA A WALRATH DIRECTOR 2.0 0.0 X 0 0 0 MARTIN COHEN DIRECTOR 2.0 0.0 X 0 0 0 MARIANNE E FELICE MD DIRECTOR 2.0 0.0 X 0 0 0 HEIDI BROOKS DIRECTOR 2.0 0.0 X 0 0 0 CHARLES DEUTSCHE SCD DIRECTOR 2.0 0.0 X 0 0 0 THOMAS BOUCHER DIRECTOR 2.0 0.0 X 0 0 0 LISA DESISTO DIRECTOR 2.0 0.0 X 0 0 0 MICHELLE J CLAYMAN TREASURER (UNTIL 6/15) 5.0 45.0 X 0 313557 48129 SUZANNE M FINN CLERK 5.0 45.0 X 0 136659 33994 KAREN VOCI EXEC DIR/PRESIDENT(AS OF 5/15) 40.0 0.0 X 0 210901 36642 ELIZABETH CREAVIN TREASURER (AS OF 6/15) 5.0 45.0 X 0 196438 48888 THOMAS F MALONEY FORMER CLERK 0.0 50.0 X 0 263418 49240 0 2504004 523674 0 true true false SEE SCHEDULE O 0 6220994 2750 6223744 0 68407 68407 0 0 0 0 0 0 0 0 0 0 6292151 68407 3807583 3807583 0 0 0 247543 198034 49509 0 673053 614608 58445 0 257625 227415 30210 0 0 0 0 0 0 0 138363 138363 0 74506 74127 379 0 0 44088 40987 3101 40464 40464 0 25524 25524 0 0 0 0 MANAGEMENT SERVICE EXPENSE 681244 544995 136249 VOLUNTEER EVENT EXPENSE 66249 66249 BUSINESS EXPENSE 32154 25723 6431 MEMBERSHIPS AND DUES 5750 4600 1150 1331 1064 267 6095477 5809736 285741 0 0 0 497927 155335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3377845 2700907 0 0 0 0 0 0 19613 18481 3895385 2874723 24196 158508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1645072 344259 1669268 502767 X 2226117 2371956 0 0 0 0 2226117 2371956 3895385 2874723 196674 -50835 X false true X true X X 1 HARVARD PILGRIM HEALTH CARE INC (HPHC) 042452600 9 true 3807583 0 1 3807583 0 true false false false false true false false false false false false false false false true false SCHEDULE A, PART IV, LINE 6 THE FOUNDATION CARRIES OUT THE CHARITABLE PURPOSE OF HPHC, INC., ITS CONTROLLING SUPPORTED ORGANIZATION, BY MAKING GRANTS TO ORGANIZATIONS. (PLEASE SEE SCHEDULE I). THESE GRANTS PROVIDE FINANCIAL ASSISTANCE TO SUPPORT SOCIALLY BENEFICIAL COMMUNITY ACTIVITIES FOR PREVENTION ORIENTED PROGRAMS THAT PROMOTE HEALTH AND WELLNESS. THE MISSION OF HPHC, INC., THE FOUNDATION'S SUPPORTED ORGANIZATION, IS TO IMPROVE THE QUALITY AND VALUE OF HEALTH CARE FOR THE COMMUNITIES IT SERVES. THE FOUNDATION'S GRANT PROGRAM HELPS TO ACCOMPLISH THIS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO HPHC, INC. 344259 344259 X SCHEDULE D, PART X, LINE 2: THE CONSOLIDATED FINANCIAL STATEMENTS OF HARVARD PILGRIM HEALTH CARE, INC. AND AFFILIATES INCLUDE THE FOLLOWING ENTITIES: HARVARD PILGRIM HEALTH CARE, INC. ("HPHC, INC."), HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. ("NEW ENGLAND"), HARVARD PILGRIM HEALTH CARE OF CONNECTICUT, INC. ("HPHC OF CT"), HARVARD PILGRIM HEALTH CARE FOUNDATION, INC. (THE "FOUNDATION"), HARVARD PILGRIM HEALTH CARE INSTITUTE, LLC (THE "INSTITUTE"), HPHC INSURANCE AGENCY (THE "AGENCY"), HPHC INSURANCE COMPANY, INC. (THE "INSURANCE COMPANY"), HPHC HOLDING CORPORATION AND SUBSIDIARY ("HOLDINGS") AND HEALTH PLANS, INC. AND SUBSIDIARIES ("HPI"). FOLLOWING IS THE RELEVANT PORTION OF THE FIN 48 FOOTNOTE FROM HARVARD PILGRIM HEALTH CARE, INC. AND AFFILIATES CONSOLIDATED FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES THAT APPLIES TO THE FILING ORGANIZATION. HPHC, INC., NEW ENGLAND, HPHC OF CT, AND THE FOUNDATION ARE TAX-EXEMPT ORGANIZATIONS UNDER INTERNAL REVENUE SERVICE REGULATIONS. THE INSTITUTE HAS NO TAX STATUS AND THEREFORE FOLLOWS THE TAX-EXEMPT STATUS OF HPHC, INC. AS ITS SOLE MEMBER. HARVARD PILGRIM DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2015 AND 2014. true AIDS ACTION COMMITTEE OF MASSACHUSETTS 75 ARMORY ST BOSTON MA 02119 222707246 501(C)(3) 10000 N/A N/A TASTE OF SOUTH END SPONSORSHIP AMERICAN HEART ASSOCIATION 51 US ROUTE 1 SCARBOROUGH ME 02119 135613797 501(C)(3) 70000 N/A N/A GO RED FOR WOMEN SPONSORSHIP ARC OF MASSACHUSETTS 217 SOUTH STREET WALTHAM MA 02453 042223502 501(C)(3) 10000 N/A N/A ANNUAL DINNER SPONSORSHIP ASSOCIATED INDUSTRIES OF MASS INC ONE BEACON ST 16 FL BOSTON MA 02108 041045830 501(C)(6) 25000 N/A N/A 100TH ANNIV. CELEBRATION BIG SISTER ASSOC OF GREATER BOSTON 20 PARK PLAZA SUITE 1420 BOSTON MA 02116 042150651 501(C)(3) 16000 N/A N/A HEALTHY EATING GRANT & GALA BOSTON AREA GLEANERS 240 BEAVER STREET WALTHAM MA 02452 300434755 501(C)(3) 25000 N/A N/A FOOD RECOVERY GRANT BOSTON CHINATOWN NEIGHBORHOOD CENTER INC 885 WASHINGTON STREET BOSTON MA 02111 237209691 501(C)(3) 30000 N/A N/A COUNT US IN PROG SPONSORSHIP BOSTON HEALTH CARE FOR THE HOMELESS 780 ALBANY STREET BOSTON MA 02118 043160480 501(C)(3) 10000 N/A N/A ANNUAL DINNER SPONSORSHIP BOSTON MEDICAL CENTER 801 MASS AVE1ST FL BOSTON MA 02118 043314093 501(C)(3) 10000 N/A N/A ANNUAL DINNER SPONSORSHIP BOSTON PRIVATE INDUSTRY COUNCIL 2 OLIVER STREET BOSTON MA 02109 042676661 501(C)(3) 13865 N/A N/A INTERN SPONSORSHIP BOYS AND GIRLS CLUB OF BOSTON 50 CONGRESS STREET BOSTON MA 02109 042103922 501(C)(3) 75000 N/A N/A FARM TO FAMILIES GRANT BRASS CITY HARVEST 86 BANK STREET WATERBURY CT 06703 753263005 501(C)(3) 22349 N/A N/A FOOD DISTRIB. PROG. GRANT CENTER FOR GRIEVING CHILDREN PO BOX 1438 PORTLAND ME 04104 010431501 501(C)(3) 32500 N/A N/A MULTICULTURAL PEER SUPPORT PROGRAM CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 010211494 501(C)(3) 12500 N/A N/A ANNUAL GALA SPONSORSHIP CITY OF NEW BEDFORD 133 WILLIAM STREET NEW BEDFORD MA 02740 046001402 115 14548 N/A N/A FOOD DISTR. PROG. GRANT CITY YEAR 287 COLUMBUS AVE BOSTON MA 02116 222882549 501(C)(3) 85000 N/A N/A TEAM SPONSORSHIP & GALA SPONSORSHIP CITY YEAR NEW HAMPSHIRE 848 ELM STSUITE 201 MANCHESTER NH 03101 222882549 501(C)(3) 25000 N/A N/A TEAM SPONSORSHIP COMMUNITY HARVEST PROJECT INC 37 WHEELER ROAD GRAFTON MA 01536 043424018 501(C)(3) 21000 N/A N/A FOOD DISTR. PROG. GRANT CONNECTICUT FOOD BANK INC PO BOX 8686 NEW HAVEN CT 06531 061063025 501(C)(3) 20000 N/A N/A FOOD DISTR. PROG. GRANT COURAGEOUS SAILING ONE FIRST AVE BOSTON MA 02129 042987534 501(C)(3) 7500 N/A N/A GALA SPONSORSHIP CRADLES TO CRAYONS 155 NORTH BEACON STREET BRIGHTON MA 02135 043584367 501(C)(3) 10000 N/A N/A BACKPACK PROGRAM CULTIVATING COMMUNITY PO BOX 3792 PORTLAND ME 041013116 043607322 501(C)(3) 24918 N/A N/A CSA PROGRAM GRANT DCU CENTER DONALD LYNCH BLVD MIDDLEBOROUGH MA 01752 022184636 501(C)(3) 10000 N/A N/A HPHC PAVILLION SPONSORSHIP DIMOCK CENTER 55 DIMOCK STREET ROXBURY MA 02119 043487835 501(C)(3) 65000 N/A N/A CAPITAL CAMPAIGN & STEPPIN' OUT GALA DIOCESE OF WORCESTER 49 ELM STREET WORCESTER MA 01609 042106686 501(C)(3) 10000 N/A N/A GALA SPONSORSHIP ELDER SERMERRIMACK VALL 280 MERRIMACK STREET LAWRENCE MA 01843 452545136 501(C)(3) 49187 N/A N/A HEALTH EATING FOR SUCCESSFUL LIVING GRANT FENWAY HEALTH 1340 BOYLSTON ST BOSTON MA 02215 042510564 501(C)(3) 10000 N/A N/A MEN'S DINNER SPONSORSHIP FOUNDATION FOR HEALTHY COMMUNITIES 125 AIRPORT ROAD CONCORD NH 03301 020275078 501(C)(3) 20000 N/A N/A HEALTHY EATING ACTIVE LIVING PROGRAM GATE CITY STRIDERS PO BOX 3692 NASHUA NH 03061 020427575 501(C)(3) 8000 N/A N/A HPHC 5K ROAD RACE GREATER BOSTON CHAMBER OF COMMERCE 265 FRANKLIN STREET BOSTON MA 021103113 041103090 501(C)(6) 10000 N/A N/A ANNUAL DINNER SPONSORSHIP GREATER PORTLAND REGIONAL CHAMBER OF COMMERCE 443 CONGRESS STREET PORTLAND ME 04101 010043280 501(C)(6) 10000 N/A N/A ANNUAL DINNER SPONSORSHIP GREEN VILLAGE INITIATIVE INC 325 LAFAYETTE STREET BRIDGEPORT CT 06606 271439954 501(C)(3) 25000 N/A N/A GARDEN EXPANSION PROGRAM GRANT GROUNDWORK LAWRENCE INC 60 ISLAND STREET LAWRENCE MA 01841 043546770 501(C)(3) 25000 N/A N/A FARMERS MARKET EXPANSION PROGRAM GRANT GROW FOOD NORTHAMPTON INC 245 MAIN STREET NORTHAMPTON MA 01060 010959428 501(C)(3) 25000 N/A N/A GARDEN EXPANSION PROGRAM GRANT GROWING PLACES GARDEN PROJECT INC 325 LINDELL AVE LEOMINSTER MA 01453 100004885 501(C)(3) 35000 N/A N/A GARDEN EXPANSION PROGRAM GRANT HANDS ON HARTFORD 55 BARTHOLOMEW AVE HARTFORD CT 06106 060861268 501(C)(3) 10000 N/A N/A EMPLOYEE SERVICE DAY SPONSORSHIP HANOVER THEATRE 2 SOUTHBRIDGE STREET WORCESTER MA 01608 050521735 501(C)(3) 20000 N/A N/A SEASON SPONSORSHIP HARTFORD FOOD SYSTEM ONE CONGRESS STREET HARTFORD CT 06114 060991880 501(C)(3) 40000 N/A N/A MOBILE MARKET GRANT HARTFORD MARATHON FOUNDATION INC 41 SEQUIN DR GLASTONBURY CT 06033 061415320 501(C)(3) 17500 N/A N/A HALF MARATHON SPONSORHIP HEALTHY COMMUNITIES OF THE CAPITAL AREA 36 BRUNSWICK AVENUE GARDINER ME 04345 412097383 501(C)(3) 25000 N/A N/A FOOD RECOVERY GRANT INE MULTIMEDIA 1344 MAIN STREET WALTHAM MA 02493 471159801 501(C)(3) 30000 N/A N/A COUNT US IN PROGRAM SPONSORSHIP INSTITUTE FOR FAMILY-OWNED BUSINESS PO BOX 3364 PORTLAND ME 04104 262428220 501(C)(3) 7500 N/A N/A ANNUAL NEXT GENERATION PROG SPONSORSHIP LAKES REGION PARTNERSHIP FOR PUBLIC HEALTH INC 65 WATER STREET LACONIA NH 03246 202713484 501(C)(3) 25000 N/A N/A FARMERS MARKET EXPANSION PROGRAM GRANT MAINE FARMLAND TRUST INC 97 MAIN STREET BELFAST ME 04915 010528014 501(C)(3) 25000 N/A N/A SNAP EXPANSION GRANT SUPPORT MAINE HEALTH 110 FREE STREET PORTLAND ME 04101 010431680 501(C)(3) 108626 N/A N/A LET'S GO HEALTHCARE PROGRAM FINAL GRANT MAINE HEALTH MANAGEMENT COALITION 11 BOWDOIN MILL ISLAND TOPSHAM ME 04086 043845053 501(C)(3) 10000 N/A N/A HEALTH SYMPOSIUM SPONSORSHIP MAINE MEDICAL CENTER 22 BRAMHALL STREET PORTLAND ME 04101 010238552 501(C)(3) 25000 N/A N/A LET'S GO HEALTHCARE CONFERENCE SPONSORSHIP MAINE QUALITY COUNTS PO BOX 16 MANCHESTER ME 04351 024935972 501(C)(3) 25000 N/A N/A HEALTH PROVIDER CONFERENCE SPONSORSHIP MASSACHUSETTS HEALTH POLICY FORUM 415 SOUTH STREET WALTHAM MA 02454 042103552 501(C)(3) 25000 N/A N/A MA HEALTH POLICY FORMUM SPONSORSHIP MASSACHUSETTS WOMENS POLITICAL CAUSUS 9B HAMILTON PLACE 1ST FL BOSTON MA 02108 042738443 501(C)(3) 20000 N/A N/A ANNUAL WOMENS AND MENS LEADERSHIP EVENT SPONSORSHIP MILL CITY GROWS PO BOX 7133 LOWELL MA 01852 472096070 501(C)(3) 40000 N/A N/A MOBILE MARKET GRANT MUSEUM OF SCIENCE SCIENCE PARK BOSTON MA 021141099 042103916 501(C)(3) 100000 N/A N/A SPONSORSHIP NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON MA 02120 042103612 501(C)(3) 10000 N/A N/A DINNER SPONSORSHIP NEW ENGLAND COUNCIL 98 NORTH WASHINGTON ST BOSTON MA 02114 041661090 501(C)(6) 30019 N/A N/A ANNUAL DINNER SPONSORSHIP NEW HAMPSHIRE CATHOLIC CHARITIES 700 EAST INDUSTRIAL DR MANCHESTER NH 03109 020222163 501(C)(3) 30000 N/A N/A NH FOOD BANK PRODUCTION GARDEN GRANT NEW HAVEN FARMS PO BOX 8953 NEW HAVEN CT 06532 451794893 501(C)(3) 38000 N/A N/A COOKING & GARDEN CLASS GRANT PERKINS SCHOOL FOR THE BLIND 175 NORTH BEACON ST WATERTOWN MA 02472 042103616 501(C)(3) 10000 N/A N/A DINNER SPONSORSHIP REGIONAL ENVIRONMENTAL COUNCIL INC PO BOX 255 WORCESTER MA 01613 046364350 501(C)(3) 40000 N/A N/A MOBILE MARKET GRANT REGIS COLLEGE 235 WELLESLEY ST WESTON MA 024931571 042104451 501(C)(3) 15000 N/A N/A SPEAKER SERIES SPONSORSHIP RELIANT MEDICAL GROUP FOUNDATION 100 FRONT STREET WORCESTER MA 01608 222912515 501(C)(3) 10000 N/A N/A GOLF SPONSORSHIP RIVERSIDE COMMUNITY CARE 450 WASHINGTON ST DEDHAM MA 02026 043097170 501(C)(3) 10000 N/A N/A GALA SPONSORSHIP ROSIES PLACE 889 HARRISON AVENUE BOSTON MA 02118 042582187 501(C)(3) 10000 N/A N/A LUNCHEON SPONSORSHIP SCHWARTZ CTR FOR COMPASSIONATE CARE PO BOX 417597 BOSTON MA 02241 041564655 501(C)(3) 50000 N/A N/A BREAKFAST & DINNER SPONSORSHIPS SOUTH END COMMUNITY HEALTH CENTER 1601 WASHINGTON STREET BOSTON MA 02118 042456134 501(C)(3) 35000 N/A N/A ANNUAL DINNER SPONSORSHIP ST MARY'S REGIONAL MEDICAL CTR PO BOX 7291 LEWISTON ME 04243 010211551 501(C)(3) 40000 N/A N/A MOBILE MARKET GRANT TAMWORTH COMMUNITY NURSE ASSOCIATION INC 84 MAIN STREET TAMWORTH NH 03886 020235235 501(C)(3) 14088 N/A N/A FARMERS MARKET EXPANSION PROGRAM GRANT THIRD SECTOR NEW ENGLAND INC 89 SOUTH STREET SUITE 700 BOSTON MA 02111 042261109 501(C)(3) 24892 N/A N/A GARDENING THE COMMUNITY GRANT TRUSTEES OF TUFTS COLLEGE 150 HARRISON AVE BOSTON MA 02111 042103634 501(C)(3) 168266 N/A N/A HEALTH KIDS OUT OF SCHOOL FINAL GRANT UMASS MEDICAL SCHOOL 333 SOUTH STREET SHREWSBURY MA 01545 043108190 501(C)(3) 8750 N/A N/A WINTER BALL SPONSORSHIP UNIVERSITY OF MASSACHUSETTS BOSTON 100 MORRISSEY BLVD BOSTON MA 02125 043167352 115 115000 N/A N/A SET SAIL FOR SPONSORSHIP & SAFE DRIVING CONF UNIVERSITY OF NEW HAMPSHIRE HEWITT HALL SUITE 202 DURHAM NH 03824 026000937 501(C)(3) 25000 N/A N/A ANNUAL CONTRIBUTION SPONSORSHIP VOLUNTEER NEW HAMPSHIRE 117 PLEASANT ST CONCORD NH 03301 912069574 501(C)(3) 10000 N/A N/A NH COMMUNITY SPIRIT AWARDS SPONSORSHIP WOLFES NECK FARM FOUNDATION 184 BURNETT ROAD FREEPORT ME 04032 222586116 501(C)(3) 25000 N/A N/A TEEN AGRICULTURE PROGRAM GRANT WOMENS RURAL ENTREPRENURIAL NETWORK PO BOX 331 BETHLEHEM NH 03574 020492339 501(C)(3) 19665 N/A N/A FARMERS MARKET EXPANSION PROG GRANT WORCESTER FIREFIGHTERS 6K 87 MARK BRADFORD DR HOLDEN MA 01520 200329974 501(C)(3) 6000 N/A N/A 5K RACE SPONSORSHIP WORKSITE WELLNESS COUNCIL OF MA 170 MAPLEWOOD ST WATERTOWN MA 02472 452697521 501(C)(3) 20000 N/A N/A CONFERENCE SPONSORSHIP YMCA OF CENTRAL MASSACHUSETTS 766 MAIN STREET WORCESTER MA 01610 042105885 501(C)(3) 10000 N/A N/A 150TH ANNIVERSARY GALA SPONSORSHIP YOU AND MAINE 14 BANCROFT STREET PORTLAND ME 04102 128601350 6000 N/A N/A PAL 5K RACE SPONSORSHIP YWCA GREATER NEWBURYPORT 13 MARKET STREET NEWBURYPORT MA 01950 042123678 501(C)(3) 25000 N/A N/A FOOD PRODUCTION EXPANSION GRANT 74 5 MONITORING PROCEDURES - FORM 990, SCHEDULE I, PART I, LINE 2 MINI GRANTS OF $500 EACH ARE APPROVED BY AN APPOINTED COMMITTEE BEFORE THEY ARE ISSUED. MINI GRANTS OF $500 EACH ARE RECOMMENDED BY EMPLOYEES WHO FILL OUT A DETAILED APPLICATION REGARDING THE PURPOSE OF FUNDS, AND MUST PROVE THAT FUNDS WILL GO TO A LEGAL, NOT-FOR-PROFIT ORGANIZATION, WHERE THE EMPLOYEE LIVES OR WHERE HPHC DOES BUSINESS. FOUNDATION STAFF REVIEWS THESE APPLICATIONS FOR ACCURACY OF PURPOSE AND LEGITIMACY OF THE ORGANIZATION. FOUNDATION STAFF RECOMMENDATIONS ARE REVIEWED BY A NON-STAFF APPOINTED COMMITTEE. REPORTS ON THESE GRANTS ARE COLLECTED FROM A SAMPLE OF THESE ORGANIZATIONS. FOUNDATION'S INTERNAL MANAGEMENT REPORTS A SUMMARY OF THIS INFORMATION TO THE FOUNDATION'S BOARD. OTHER MORE SIGNIFICANT COMMUNITY GRANTS REQUIRE A CONCEPT PROPOSAL TO BE SUBMITTED AND APPROVED BY AN APPOINTED COMMITTEE. ONCE THE GRANTS ARE APPROVED, THE FOUNDATION EMPLOYEES PERFORM SITE VISITS AND REGULAR EVALUATIONS OF THE GRANTS. IN ADDITION, THE FOUNDATION HIRES AN INDEPENDENT EVALUATION GROUP TO REVIEW GRANT RESULTS. ADDITIONALLY, FORMAL FISCAL REPORTING OF ALL GRANTS IS PERFORMED AND REVIEWED BY EMPLOYEES OF THE FOUNDATION. false true false false false false false false false ERIC H SCHULTZ PRESIDENT (UNTIL 5/15)/CHAIR 0 870489 0 473190 0 22902 0 283700 0 23081 0 1673362 0 0 MICHELLE J CLAYMAN TREASURER (UNTIL 6/15) 0 260960 0 47662 0 4935 0 17945 0 30184 0 361686 0 0 SUZANNE M FINN CLERK 0 135502 0 750 0 407 0 9272 0 24722 0 170653 0 0 KAREN VOCI EXEC DIR/PRESIDENT(AS OF 5/15) 0 181210 0 19980 0 9711 0 15284 0 21358 0 247543 0 0 THOMAS F MALONEY FORMER CLERK 0 227767 0 33840 0 1811 0 20945 0 28295 0 312658 0 0 ELIZABETH CREAVIN TREASURER (AS OF 6/15) 0 169304 0 26250 0 884 0 16028 0 32860 0 245326 0 0 SCHEDULE J, PART I, LINE 3 THE FOUNDATION RELIED ON HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.), A RELATED ORGANIZATION OF THE FOUNDATION, TO ESTABLISH ITS PRESIDENT AND EXECUTIVE DIRECTOR'S COMPENSATION. THE METHODS USED BY HPHC, INC. ARE AS FOLLOWS: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B LONG TERM INCENTIVE PLAN HPHC, A RELATED ORGANIZATION TO HARVARD PILGRIM HEALTH CARE FOUNDATION, INC., ADOPTED A LONG-TERM INCENTIVE PLAN FOR ITS CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF LEGAL OFFICER, CHIEF INFORMATION OFFICER, CHIEF OF INNOVATION AND STRATEGY, AND CHIEF HUMAN RESOURCES OFFICER FOR 2013-2015. THE PLAN IS BASED ON A VARIETY OF PERFORMANCE MEASURES AND AMOUNTS ARE EARNED OVER A THREE YEAR PERIOD. SOME OR ALL OF THE DEFERRED COMPENSATION AMOUNTS REPORTED HEREIN FOR THE POTENTIAL EARNINGS UNDER THE PLAN MAY OR MAY NOT BE PAID TO THE EXECUTIVES BASED ON THE ACTUAL RESULTS OF THE PERFORMANCE MEASURES AS DETERMINED AT THE END OF THE APPLICABLE THREE YEAR PERIOD. ANNUAL ACCRUALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). NO PAYMENTS WERE MADE FROM THE PLAN DURING 2015. PART I, LINE 1 AND PART III, LINE 1: ORGANIZATION'S MISSION The Harvard Pilgrim Health Care Foundation ("The Foundation")supports Harvard Pilgrim Health Care, Inc.'s ("HPHC, Inc.")mission to improve the quality and value of health care for the people and communities we serve. The Foundation provides the tools, training and leadership to help build healthy communities throughout Connecticut, Maine, Massachusetts, and New Hampshire. In 2015, the Foundation awarded approximately $3.8 million in grants to APPROXIMATELY 700 not-for-profit organizations in the region. Since its inception, the Foundation has granted approximately $136 million in funds and resources throughout the four states. PART I, LINE 6: THE FOUNDATION'S VOLUNTEERS INCLUDE UNCOMPENSATED DIRECTORS WHO SERVE ON A VOLUNTARY BASIS. PART VI, LINE 2: BUSINESS RELATIONSHIP - THE FOLLOWING INDIVIDUALS SERVE ON THE BOARDS OF ONE OR MORE FOR PROFIT ORGANIZATIONS RELATED TO THE FOUNDATION, AND/OR ARE EMPLOYED BY AN ORGANIZATION (OTHER THAN THE FILING ORGANIZATION), FOR WHICH ANOTHER PERSON LISTED SERVES AS AN OFFICER OR DIRECTOR. ERIC H. SCHULTZ - PRESIDENT (UNTIL 5/15)/CHAIR ELIZABETH CREAVIN - TREASURER (AS OF 6/15) MICHELLE J. CLAYMAN - TREASURER (UNTIL 6/15) SUZANNE M. FINN - CLERK KAREN VOCI - EXECUTIVE DIRECTOR/PRESIDENT (AS OF 5/15) PART VI, LINE 4: THE FOUNDATION BYLAWS WERE AMENDED ON 5/13/15 TO ADD THE POSITION OF CHAIR, ADD THE RESPONSIBILITIES OF CHAIR, AND TO AMEND THE RESPONSIBILITIES OF PRESIDENT. PART VI, LINE 6: HARVARD PILGRIM HEALTH CARE, INC. IS THE PARENT AND SOLE MEMBER OF THE FOUNDATION. PART VI, LINE 7A: HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.) IS THE SOLE MEMBER OF THE FOUNDATION. THE HPHC, INC. BOARD OF DIRECTORS AT ITS ANNUAL MEETING RATIFIES THE SLATE OF ELECTED FOUNDATION DIRECTORS WHEN IT ELECTS THE DIRECTORS OF ITS SUBSIDIARIES. ANY VACANCY IN THE FOUNDATION'S BOARD OF DIRECTORS MAY BE FILLED BY THE HPHC, INC. BOARD OF DIRECTORS OR BY THE MAJORITY OF THE FOUNDATION DIRECTORS THEN IN OFFICE. PART VI, LINE 7B: THE FOUNDATION'S BYLAWS SET FORTH RESERVED POWERS OF THE SOLE MEMBER, HPHC, INC., WHICH INCLUDE THE POWER TO APPROVE CERTAIN ACTIONS, SUCH AS ANY AMENDMENT TO THE FOUNDATION'S ARTICLES OF ORGANIZATION OR BYLAWS; THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE FOUNDATION; AND THE SALE, LEASE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE FOUNDATION'S ASSETS. PART VI, LINE 11B: ONCE THE FOUNDATION'S FORM 990 IS COMPLETED WITH THE ASSISTANCE OF ITS OUTSIDE TAX ADVISORS, IT IS FIRST REVIEWED BY HPHC, INC.'S INTERNAL MANAGEMENT AND THEN BY HPHC, INC.'S AUDIT COMMITTEE CHAIRPERSON (AN INDEPENDENT MEMBER OF THE BOARD OF DIRECTORS OF HPHC, INC.). THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE HPHC, INC. BOARD OF DIRECTORS AS WELL AS THE FOUNDATION BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. PART VI, LINE 12C: THE FOUNDATION'S DIRECTORS AND OFFICERS ARE SUBJECT TO HARVARD PILGRIM HEALTH CARE'S CODE OF CONDUCT WHICH INCLUDES A CONFLICTS OF INTEREST POLICY. THE CONFLICTS OF INTEREST POLICY REQUIRES DIRECTORS AND OFFICERS TO DISCLOSE ON AN ONGOING BASIS THE OCCURRENCE OF ANY SITUATION WHEN THEIR OUTSIDE ACTIVITIES, PERSONAL INTERESTS OR RELATIONSHIPS MIGHT INFLUENCE, OR APPEAR TO INFLUENCE, THEIR ABILITY TO MAKE OBJECTIVE DECISIONS IN THE COURSE OF PERFORMING THEIR JOB RESPONSIBILITIES, ARE PREJUDICIAL TO THE LEGITIMATE INTERESTS OF THE FOUNDATION, OR CAUSE THE USE OF THE FOUNDATION RESOURCES FOR OTHER THAN FOUNDATION PURPOSES. IN ADDITION TO BEING SUBJECT TO THE FOUNDATION'S CONFLICTS OF INTEREST POLICY, THE FOUNDATION'S BOARD OF DIRECTORS ARE ANNUALLY REQUIRED TO COMPLETE AND SIGN A CONFLICTS OF INTEREST FORM, WHICH IS REPORTED TO THE BOARD OF DIRECTORS, IN ACCORDANCE WITH THE DISCLOSURE AND REVIEW PROCESS SET FORTH IN THE FOUNDATION'S BYLAWS. IN ADDITION, THE FOUNDATION'S OFFICERS MAKE DECISIONS ON BEHALF OF THE ORGANIZATION AND ARE IN A POSITION TO INFLUENCE DECISIONS MADE ON BEHALF OF THE FOUNDATION. THE OFFICERS ARE SURVEYED ON AN ANNUAL BASIS. THE EMPLOYEES MUST COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE FORM AND SUBMIT IT TO THE VICE PRESIDENT OF CORPORATE COMPLIANCE PROGRAMS (COMPLIANCE OFFICER). THESE FORMS ARE THEN REVIEWED BY THE COMPLIANCE OFFICER AND THE ASSISTANT GENERAL COUNSEL RESPONSIBLE FOR CORPORATE GOVERNANCE/COMPLIANCE. IF A DISCLOSURE OF A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST IS MADE, THE COMPLIANCE OFFICER AND COUNSEL MAKE A DETERMINATION IF SUCH DISCLOSURE IS MATERIAL AND NEEDS TO BE MANAGED, MITIGATED, OR ELIMINATED. AS A GENERAL RULE, CONFLICTS OF INTEREST ARE NOT PERMITTED. HOWEVER, IN CERTAIN AREAS, IF THE CONFLICT IS NOT MATERIAL AND IS PROPERLY AND FULLY DISCLOSED AND IS APPROVED BY THE COMPLIANCE OFFICER, A WAIVER OF THE CONFLICT MAY BE GRANTED, AND APPROPRIATE STEPS WILL BE TAKEN TO MITIGATE THE CONFLICT. PART VI, LINE 15: THE FOUNDATION DOES NOT COMPENSATE ITS PRESIDENT OR OFFICERS. THE COMPENSATION REPORTED FOR THESE INDIVIDUALS IS PAID BY HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.), A RELATED ORGANIZATION OF THE FOUNDATION. THEREFORE, THEIR COMPENSATION AND BENEFITS ARE DETERMINED BY HPHC, INC. PART VI, LINE 19: THE FOUNDATION FURNISHES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY TO THE PUBLIC UPON REQUEST. PART VI, SECTION B, LINE 1: ANY INDEPENDENT CONTRACTORS ARE RETAINED BY THE PARENT COMPANY, HARVARD PILGRIM HEALTH CARE, INC. HPHC INC 93 WORCESTER STREET WELLESLEY MA 20481 042452600 HEALTH INSURA MA 501(C)(3) 9 NA false HPHC OF NEW ENGLAND INC 93 WORCESTER STREET WELLESLEY MA 02481 042663394 HEALTH INSURA MA 501(C)(4) HPHC INC true HPHC OF CONNECTICUT INC 185 ASYLUM ST 2ND FLOOR HARTFORD CT 06103 461681667 HEALTH INSURA CT 501(C)(4) HPHC INC true NA HARVARD PILGRIM PHYSICIANS ASSOC INC 93 WORCESTER STREET WELLESLEY MA 024819181 PHYSICIAN ORG MA NA SEE PART VII true HPHC INSURANCE COMPANY INC 93 WORCESTER STREET WELLESLEY MA 024819181 043149694 HEALTH INSURANCE MA NA C CORP true HPHC HOLDING CORPORATION 93 WORCESTER STREET WELLESLEY MA 024819181 043306439 HOLDING COMPANY MA NA C CORP true PLAN MARKETING INSURANCE AGENCY INC 1500 WEST PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 042734281 BROKERAGE MA NA C CORP true HPHC INSURANCE AGENCY INC 93 WORCESTER STREET WELLESLEY MA 024819181 043016201 BROKERAGE MA NA C CORP true HEALTH PLANS INC 1500 WEST PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 042734278 TPA MA NA C CORP true CARE MANAGEMENT SERVICES INC 1500 WEST PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 043438779 ASO SERVICES MA NA C CORP true false false true false true false false false false false true false true true true true false false false SCHEDULE R, PART IV, LINE 1 HARVARD PILGRIM PHYSICIANS ASSOCIATION, INC. IS A NON-PROFIT ORGANIZED UNDER THE LAWS OF MASSACHUSETTS. THIS IS AN INACTIVE ORGANIZATION WHICH WAS DISSOLVED IN 2015.