2016-11-15T08:59:13-06:00 2015-12-31 GRANT THORNTON LLP 757 THIRD AVE 3RD FLOOR NEW YORK NY 100172013 990 2015-01-01 131828429 Health Insurance Plan of Greater New York % MICHAEL PALMATEER HEAL 6464475000 55 WATER STREET NEW YORK NY 10041 MICHAEL PALMATEER CFO 6464475000 2016-11-14 true Scott Thompsett P00741490 2125990100 2015 2017-02-10 21:41:12Z Karen Ignagni President CEO 55 WATER STREET NEW YORK NY 10041 5161648176 false X WWW.EMBLEMHEALTH.COM X 1944 NY HIP-NY 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 6 4452 0 11819060 0 0 5068169667 5065680992 65088868 41506659 54179095 54460525 5187437630 5161648176 0 1450564 0 0 251466209 224734703 0 0 0 5279614715 5017957126 5531080924 5244142393 -343643294 -82494217 2262326560 2019662603 1041879788 960170653 1220446772 1059491950 X HEALTH INSURANCE PLAN OF GREATER NEW YORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS. HIP 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. THE ORGANIZATION DOES THIS BY IMPROVING THE HEALTH OF MEMBERS THROUGH WELLNESS PROGRAMS THAT FOSTER PREVENTION AND HEALTHIER LIVING AND BY USING TECHNOLOGY TO EASE ACCESS TO INFORMATION AND SERVICES. false false 1613830388 1675158309 MEDICARE - HIP SERVED APPROXIMATELY 115,000 MEDICARE MEMBERS THROUGH its MEDICARE RISK AND COST CONTRACT PROGRAMS. 1206506322 1265562574 MEDICAID - HIP SERVED APPROXIMATELY 233,000 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. 1891106218 1450564 2116863061 SUBSCRIBER BENEFITS - HIP OF GREATER NEW YORK 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 2015, HIP-NY provided services (across all services lines) to a total of 712,000 members. Included within these subscriber benefits are various state and local benefit programs, including the following: 1. CHIPS (Children's Health Insurance Program) - HIP HAS BEEN SERVING THE CHIPS POPULATION SINCE THE INCEPTION OF THE STATE DEMONSTRATION PROGRAM FOR UNISURED CHILDREN UNDER 19 IN 1991 AND CONTINUED WITH THE PASSAGE OF The Childrens Health Insurance Program (CHIP) in 1997. CHIPS is a partnership between the federal government and the states to extend health coverage to uninsured children and pregnant women in families who cannot afford to purchase private health insurance but have incomes too high to qualify for Medicaid. 2. Family Health Plus Program - HIP BEGAN TO SERVE FHPLUS MEMBERS AT THE START OF THE PROGRAM IN THE NY DOWNSTATE AREA IN OCTOBER 2001. THE BENEFIT PACKAGE FOR THE PROGAM PROVIDES a comprehensive set of medically needed health care benefits and services to the ADULT UNINSURED and low-income wage earners. 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 HIP-NY'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. 4711442928 false false false false false false false false false true true false true true true false true false false true 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 1117 0 true 4452 true true true false false false false false X 7 6 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 Frank J Branchini Chairman & CEO (thru 10/2015) 2.0 35.0 X X 6536690 0 9070 Karen Ignagni President & CEO (as of 9/2015) 2.0 35.0 X X 1294088 0 431037 John D Feerick As of 92015 Chairman of the Board 2.0 3.0 X X 0 115750 0 Elaine Friedman Director (Thru 9/2015) 2.0 0.0 X 4517 0 0 Bernard Schayes MD Director (as of 5/2015) 2.0 0.0 X 0 24476 0 Robert W Brokaw Director 2.0 0.0 X 12186 0 0 Gregory E Floyd Director 2.0 0.0 X 0 0 0 Paul E Gibson Director 2.0 0.0 X 0 121500 0 Margaret T Pan-Loo Director 2.0 0.0 X 4500 0 0 William C Lamoreaux EVP & Chief Operating Officer 35.0 0.0 X 674824 0 134378 Edward Mailander SVP, Chief Actuary 35.0 0.0 X 510018 0 233840 Charlene Maher thru 62015 SVP, Chief Marketing Officer 35.0 0.0 X 838632 0 7373 Shawn M Fitzgibbon Chief Product Officer 35.0 0.0 X 464456 0 20264 Michael Palmateer Chief Financial Officer 35.0 0.0 X 477745 0 148229 Jeffrey D Chansler Chief Legal Officer 35.0 0.0 X 458569 0 177091 Arthur Byrd thru 112015 Chief Financial Officer 35.0 0.0 X 452399 0 11358 Valerie A Reardon Chief Risk & Compliance 35.0 0.0 X 396738 0 18158 William Mastrogiacomo SVP, Dep Gen Cl (thru 10/2015) 35.0 0.0 X 1440503 0 8441 George Babitsch SVP, Underwriting & Acct Mgmt 35.0 0.0 X 369342 0 16955 Nicholas P Kambolis SVP, Legal (thru 4/2015) 35.0 0.0 X 1161079 0 6845 Michele A Powers VP, Operations (thru 5/2015) 35.0 0.0 X 188555 0 3848 Robert Branchini VP, Information Technology 35.0 0.0 X 357337 0 112215 Mariann E Drohan Chief Human Resources Officer 35.0 0.0 X 358848 0 23025 John D Mahder VP, Marketing 35.0 0.0 X 314652 0 71453 Williams Lewis thru 62015 VP, Facilities, RE, Corp Svc. 35.0 0.0 X 555226 0 13087 William Yurkowski VP, Operations 35.0 0.0 X 266234 0 76761 Karen Smith-Hagman VP, Med. Mgmt. (thru 9/2015) 35.0 0.0 X 278198 0 17527 Carl A Lund VP, Facility Contracting 35.0 0.0 X 266995 0 19691 Richard Gross thru 112015 VP, Account Management 35.0 0.0 X 283835 0 102004 Jennifer L Truscott VP, Medical Mgmt Operations 35.0 0.0 X 259703 0 12082 Mary E Soul thru 102015 VP, Actuarial Valuation 35.0 0.0 X 417575 0 15172 Brendan Shanahan thru 72015 VP, Budget & Analysis 35.0 0.0 X 366061 0 8817 Philip J Gillich VP, Network Management 35.0 0.0 X 239947 0 12970 Jose R Diaz VP, Membership (thru 11/2015) 35.0 0.0 X 236123 0 134882 Eliza Ng thru 12015 VP, Clinical Affairs 35.0 0.0 X 18077 0 477 Daniel Byrne VP, Labor Relations 35.0 0.0 X 234202 0 19785 Ernesto Marrero Jr VP, Medicare Compliance 35.0 0.0 X 248519 0 15288 Vincent A Hartmann VP, Underwriting 35.0 0.0 X 216850 0 21987 Erhard V Krause thru 42015 VP, Business Development 35.0 0.0 X 426266 0 3189 Peter S Moore VP, Government Programs 35.0 0.0 X 212019 0 39738 Christopher W Chappelear VP, Actuarial & Underwriting 35.0 0.0 X 244562 0 13762 Douglas Cowieson SVP, Operations 35.0 0.0 X 375502 0 24193 Jerry A Gallo thru 92015 VP, Commercial Sales 35.0 0.0 X 182394 0 12317 Suzanne G Ronner VP, Customer Service 35.0 0.0 X 230227 0 17235 Michele H Podolak VP, Customer Service 35.0 0.0 X 182503 0 11624 Richard M Densing VP, Gov't Prog & Direct to Con 35.0 0.0 X 219962 0 19538 Munish Khaneja VP, Medical Mgmt Operations 35.0 0.0 X 293065 0 20032 Thomas MAcMillan Sr. Director, EPMO 35.0 0.0 X 253371 0 15050 James Albano as of 102015 SVP,Provider Ntwk & Pop Health 35.0 0.0 X 71083 0 3051 Scott Breidbart as of 102015 Chief Clinical Officer 35.0 0.0 X 251580 0 3947 Robin C Golston As of 92015 VP, Community & Gov't Affairs 35.0 0.0 X 57801 0 3453 Thomas Conway as of 122015 VP, Controller 35.0 0.0 X 21824 0 789 Lorraine Cortes-Vazquez SVP, Gov't Aff. (as of 9/2015) 35.0 0.0 X 100827 0 4981 Edmond Cunningham VP, Procurement (as of 7/2015) 35.0 0.0 X 119482 0 7697 Scott Dickler as of 82015 SVP, Gov't & Indiv. Programs 35.0 0.0 X 186678 0 8971 Craig Effrain VP, Corporate Secretary 35.0 0.0 X 209639 0 11659 Thomas Mafale as of 92015 VP, Commercial Sales 35.0 0.0 X 135697 0 4927 Douglas Parks as of 62015 VP, HR Transformation & Strat 35.0 0.0 X 195712 0 57769 Russell Petrella EVP (as of 2/2015) 35.0 0.0 X 496387 0 139475 Andrew Rein as of 112015 SVP, Strategy & Business Dev 35.0 0.0 X 30513 0 1066 John Sheehy as of 122015 SVP, Product Innovation 35.0 0.0 X 67276 0 0 William Voigt VP, HR Business Operations 35.0 0.0 X 186845 0 15134 Joseph Zeitlin as of 22015 VP, ACP Relations 35.0 0.0 X 402305 0 21251 Paul Zurlo VP, Small Group & Indiv. Bus 35.0 0.0 X 230019 0 19088 Wei Jia Shen Sr. Director -Applications Dev 40.0 0.0 X 251894 0 39180 Roberto Hormazabal Sr. Dir. Account Management 40.0 0.0 X 267137 0 10997 James P Meidlinger Sr. Actuary 40.0 0.0 X 242642 0 16868 Bruce Sosler Senior Medical Director 40.0 0.0 X 295569 0 28219 Dr Donald Wernsing Medical Director 40.0 0.0 X 256779 0 39106 William A Gillespie CMO 35.0 0.0 X 2329325 0 0 Wanda Wareham VP, Gov't Assisted Programs 35.0 0.0 X 220649 0 0 Stuart Lefkowich VP, Medicare Advantage 35.0 0.0 X 149815 0 0 29600572 261726 2518416 812 true true false INOVALON INC 4321 Collington Road BOWIE MD 20716 Data Analytics 14943921 MCKINSEY COMPANY INC 300 E Randolph St 3100 CHICAGO IL 60601 Consulting 5715787 PA CONSULTING GROUP INC 123 BUCKINGHAM PALACE ROAD UK SW1W 9SR tech consulting 4732702 THE SOURCING GROUP LLC 77 Water Street NEW YORK NY 10005 business solutions 3868965 SHARP DECISIONS 1040 Avenue of the Americas NEW YORK NY 10018 IT Solutions 3810272 154 X 0 PREMIUM REVENUE 900099 5057583944 5057583944 0 0 THIRD PARTY ADMINISTRATIVE FEES 900099 8097048 7777342 319706 0 5065680992 27332519 4218555 23113964 0 0 32669260 870300 32669260 870300 33539560 870300 32669260 14174140 14174140 14174140 14174140 0 0 0 PHARMACY REVENUE 900099 20918641 14508142 6410499 MISCELLANEOUS REVENUE 900099 2324 2324 20920965 5161648176 5079869428 11819060 69959688 X 1450564 1450564 0 0 0 41739323 41739323 2699789 2699789 129038129 129038129 3261317 3261317 34022978 34022978 13973167 13973167 0 2194301 2194301 2865014 2865014 513254 513254 0 1583510 1583510 85080976 0 85080976 0 12218878 12218878 25460704 25460704 0 0 24473347 24473347 2663821 2663821 0 0 31095 31095 0 56237221 56237221 5248780 5248780 SUBSCRIBER BENEFITS 4604717248 4604717248 0 0 OUTSOURCED SERVICES 23256810 0 23256810 0 QUALITY OF CARE EXPENSES 36459626 36459626 0 0 ACA HEALTHCARE FEES 62269237 62269237 0 0 72683304 6546253 66137051 5244142393 4711442928 532699465 0 0 0 236125131 146331938 0 0 225165499 200659523 0 0 0 0 240987161 362591477 0 0 5721692 5368856 511792871 348749747 165075639 163043124 740299393 490985282 394687007 394687007 0 0 0 0 254265038 255995396 2262326560 2019662603 846665282 753220405 0 0 10631753 14994437 0 0 0 0 0 0 0 0 0 0 184582753 191955811 1041879788 960170653 X 1220446772 1059491950 0 0 0 0 1220446772 1059491950 2262326560 2019662603 X -82494217 -78460605 X false true X true false 6963425 6963425 152106143 87189413 64916730 199601851 118141587 81460264 71300790 68650685 2650105 81820662 74768062 7052600 163043124 INVESTMENT IN ADVANTAGECARE 185046456 C INVESTMENT IN HIP HOLDINGS INC 209640551 C 394687007 ACCRUED INTEREST RECEIVABLE 15937903 DEFERRED RENT 866884 INTEREST/DIVIDENDS RECEIVABLE 2870334 OTHER CURRENT ASSETS 3733751 HEALTHCARE RECEIVABLES 137432704 INTERCOMPANY RECEIVABLES 75281206 OTHER RECEIVABLES 19872614 255995396 0 PENSION LIABILITY 120162595 DEFERRED RENT 64238246 OTHER LONG TERM LIABILITIES 7554970 191955811 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, 2015, there were no interest or penalties recorded or included in the consolidated statements of comprehensive loss. East Asia and the Pacific Investments 2472867 Europe (Including Iceland and Greenland) Investments 11378029 Central America and the Caribbean Investments 683675 North America Investments 6000397 20534968 20534968 false false false false false false Schedule F, Part 1 HIP-NY does not conduct any activities outside the United States. In accordance with the instructions to the Form 990, the organization is reporting the market value of non-U.S. investments. true 1199 SEIU EMPLOYER CHILD CARE CORP PO BOX 842 NEW YORK NY 10108 134063281 501(c)(3) 14687 General Support 1199 SEIU BILL MICHELSON HOME CARE 330 WEST 42ND ST NEW YORK NY 10036 711028611 501(c)(3) 9077 General Support AHRC NYC FOUNDATION 83 Maiden Lane NEW YORK NY 10038 133779611 501(c)(3) 7879 General Support ALZHEIMERS DISEASE AND RELATED 225 N MICHIGAN AVE CHICAGO IL 60601 363463656 501(c)(3) 9455 General Support AMERICAN CANCER SOCIETY 250 WILLIAM ST NW ATLANTA GA 30303 465439010 501(c)(3) 32147 General Support BEDFORD STUYVESANT RESTORATION 1368 Fulton Street Brooklyn NY 11216 116083182 501(c)(3) 47275 General Support BROOKLYN CHAMBER OF COMMERCE 335 ADAMS ST Brooklyn NY 11201 110577070 501(c)(3) 6303 General Support CHINESE AMERICAN PLANNING COUNCIL INC 150 ELIZABETH ST NEW YORK NY 10012 136202692 501(c)(3) 28535 General Support CITY MEALS ON WHEELS 355 Lexington Ave NEW YORK NY 10017 133634381 501(c)(3) 29941 General Support CITY PARKS FOUNDATION 830 Fifth Ave NEW YORK NY 10065 133561657 501(c)(3) 31516 General Support COMUNILIFE INC 214 W 29 Street NEW YORK NY 10001 133530299 501(c)(3) 5950 General Support CONGRESSIONAL HISPANIC CAUCUS INSTITUTE 1128 16th Street NW Washington DC 20036 521114225 501(c)(3) 5421 General Support COUNCIL OF SENIOR CTRS & SVCS NYC INC 49 WEST 45 STREET NEW YORK NY 10036 132967277 501(c)(3) 22061 General Support COUNCIL ON THE ENVIRONMENT INC 100 Gold Street NEW YORK NY 10038 132765465 501(c)(3) 32147 General Support FAMILY COOK PRODUCTIONS 330 East 43rd Street NEW YORK NY 10017 273710500 501(c)(3) 16704 General Support FORDHAM UNIVERSITY 45 Columbus Ave Fl 8 Bronx NY 10458 131740451 501(c)(3) 5988 General Support HABNET-HAITIAN AMERICAN BUSINESS NETWORK 1452 Flatbush Avenue Brooklyn NY 11210 480939800 501(c)(3) 5043 General Support HAITIAN CENTERS COUNCIL INC 123 Linden Blvd 3 Brooklyn NY 11226 112648501 501(c)(3) 56729 General Support HARLEM WEEK INC 200A W 136TH ST NEW YORK NY 10030 133058019 501(c)(3) 15758 General Support HARVEST HOME FARMER'S MARKET 104-106 East 126th St NEW YORK NY 10035 061800512 501(c)(3) 15758 General Support HEALTHCARE CHAPLAINCY NETWORK 315 E 62nd St 4th Fl NEW YORK NY 10021 132634080 501(c)(3) 5017 General Support HEALTHCORPS INC 75 Broad Street NEW YORK NY 10004 261269358 501(c)(3) 17649 General Support HISPANIC FEDERATION INC 55 Exchange Place NEW YORK NY 10005 133573852 501(c)(3) 18989 General Support HONG KONG DRAGON BOAT FESTIVAL IN NEW 14107 20TH AVE Whitestone NY 11357 133716785 501(c)(3) 10716 General Support HOSTOS COMMUNITY COLLEGE 120 E 149th St Bronx NY 10451 133138072 501(c)(3) 6555 General Support LIVEON NY 460 West 34th St NEW YORK NY 10001 132945229 501(c)(3) 5169 General Support MONTEFIORE MEDICAL CENTER 111 East 210th Street Bronx NY 10467 131740114 501(c)(3) 7249 General Support NATIONAL Fdn FOR HUMAN POTENTIAL 191 Sweet Hollow Rd Old Bethpage NY 11804 113544632 501(c)(3) 15632 General Support NEW HOPE CHRISTIAN FELLOWSHIP PO Box 2958 Silverdale WA 98383 911262549 501(c)(3) 9455 General Support NEW YORK CENt FOR INTERPERSONAL 130 Stuyvesant Pl Staten Island NY 10301 237085239 501(c)(3) 18910 General Support NEW YORK JUNIOR TENNIS & LEARNING 58-12 Queens Boulevard Woodside NY 11377 237442256 501(c)(3) 24463 General Support NORTHEAST BUSINESS GROUP ON HEALTH 61 BROADWAY RM 2705 NEW YORK NY 10006 133156952 501(c)(3) 8667 General Support NORTHERN MANAHATTAN IMPROVEMENT 76 Wadsworth Avenue NEW YORK NY 10033 132972415 501(c)(3) 63033 General Support QUEENS COMMUNITY HOUSE INC 108-25 62nd Dr Queens NY 11375 112375583 501(c)(3) 63033 General Support SDTC - THE CENTER FOR DISCOVERY INC PO Box 840 Harris NY 12742 141782615 501(c)(3) 5496 General Support STARLIGHT CHILDREN'S Fdn Gl Off 2049 Ct Pk Los Angeles CA 90067 953802159 501(c)(3) 7516 General Support THE APOLLO THEATER FOUNDATION 253 W 125th St NEW YORK NY 10027 133630066 501(c)(3) 18910 General Support THE ARMORY FOUNDATION 216 Fort Washington Ave NEW YORK NY 10032 133680286 501(c)(3) 22061 General Support THE CATHOLIC HEALTHCARE FOUNDATION 155 East 56th St NEW YORK NY 10022 134054158 501(c)(3) 14340 General Support THE METROPOLITAN GOLF ASSOCiation 49 Knollwood Rd Elmsford NY 10523 133637689 501(c)(3) 6303 General Support UNIFORMED FIREFIGHTERS ASSOC PO Box 2085 Mount Vernon NY 10551 133907650 501(c)(3) 5043 General Support UNITED CEREBRAL PALSY OF NYC 80 MAIDEN LN NEW YORK NY 10038 135654532 501(c)(3) 5169 General Support UNITED HOSPITAL FUND 1411 Broadway NEW YORK NY 10018 131562656 501(c)(3) 187838 General Support UNITED NEIGHBORHOOD HOUSES 70 West 36th St NEW YORK NY 10018 135563409 501(c)(3) 33670 General Support UNIVERSITY SETTLEMENT SOCIETY OF NY 184 Eldridge Street NEW YORK NY 10002 135562374 501(c)(3) 42862 General Support WEST INDIANAMERICAN DAY CARNIVAL ASSOC 325 Rogers Ave Brooklyn NY 11225 237176396 501(c)(3) 25591 General Support YMCA OF GREATER NEW YORK 5 West 63rd St New York NY 10023 131624228 501(c)(3) 50535 General Support 47 Schedule I, Part I, Line 2 Health Insurance Plan of Greater New York has an internal committee called the Contributions Review Committee that supervises and recommends all charitable grants paid out by the organization. Every request for a grant must be submitted in writing to the Committee with a detailed description of the intended use of the proposed funds. Each submission is reviewed during scheduled meetings and either approved or rejected. Grant applications will only be accepted from 501(c)(3) tax exempt organizations. Once grant monies have been sent to a grant recipient, HIP requests either quarterly or biannual reports on how the grantee expended the money. If the grant funds are not used for the purposes originally intended, HIP will cease funding that project. X true true X X X X X true true false false false true false false false Frank J Branchini Chairman & CEO (thru 10/2015) 690713 0 3177750 0 2668227 0 3975 0 5095 0 6545760 0 2529457 0 Karen Ignagni President & CEO (as of 9/2015) 412620 0 875000 0 6468 0 426990 0 4047 0 1725125 0 0 0 William C Lamoreaux EVP & Chief Operating Officer 518908 0 127500 0 28416 0 127286 0 7092 0 809202 0 0 0 William A Gillespie CMO 0 0 2088325 0 241000 0 0 0 0 0 2329325 0 0 0 Edward Mailander SVP, Chief Actuary 361560 0 115500 0 32958 0 225940 0 7900 0 743858 0 0 0 Charlene Maher thru 62015 SVP, Chief Marketing Officer 146302 0 269000 0 423330 0 3975 0 3398 0 846005 0 0 0 Shawn M Fitzgibbon Chief Product Officer 341973 0 93000 0 29483 0 15404 0 4860 0 484720 0 0 0 Michael Palmateer Chief Financial Officer 350627 0 97500 0 29618 0 143369 0 4860 0 625974 0 0 0 Jeffrey D Chansler Chief Legal Officer 333323 0 93000 0 32246 0 170761 0 6330 0 635660 0 0 0 Arthur Byrd thru 112015 Chief Financial Officer 302950 0 105000 0 44449 0 3975 0 7383 0 463757 0 0 0 Valerie A Reardon Chief Risk & Compliance 280277 0 90000 0 26461 0 8718 0 9440 0 414896 0 0 0 William Mastrogiacomo SVP, Dep Gen Cl (thru 10/2015) 190100 0 1191607 0 58796 0 3975 0 4466 0 1448944 0 0 0 George Babitsch SVP, Underwriting & Acct Mgmt 260560 0 82500 0 26282 0 9465 0 7490 0 386297 0 0 0 Nicholas P Kambolis SVP, Legal (thru 4/2015) 78205 0 292500 0 790374 0 3975 0 2870 0 1167924 0 0 0 Michele A Powers VP, Operations (thru 5/2015) 88272 0 75000 0 25283 0 2831 0 1017 0 192403 0 0 0 Robert Branchini VP, Information Technology 270720 0 78000 0 8617 0 107355 0 4860 0 469552 0 0 0 Mariann E Drohan Chief Human Resources Officer 291700 0 36000 0 31148 0 21225 0 1800 0 381873 0 0 0 John D Mahder VP, Marketing 244038 0 40500 0 30114 0 65561 0 5892 0 386105 0 0 0 Williams Lewis thru 62015 VP, Facilities, RE, Corp Svc. 81397 0 113139 0 360690 0 10642 0 2445 0 568313 0 0 0 William Yurkowski VP, Operations 207780 0 34500 0 23954 0 69401 0 7360 0 342995 0 0 0 Karen Smith-Hagman VP, Med. Mgmt. (thru 9/2015) 130015 0 118111 0 30072 0 11664 0 5863 0 295725 0 0 0 Carl A Lund VP, Facility Contracting 205740 0 33780 0 27475 0 15323 0 4368 0 286686 0 0 0 Richard Gross thru 112015 VP, Account Management 213525 0 27480 0 42830 0 94695 0 7309 0 385839 0 0 0 Jennifer L Truscott VP, Medical Mgmt Operations 213533 0 27000 0 19170 0 10282 0 1800 0 271785 0 0 0 Mary E Soul thru 102015 VP, Actuarial Valuation 174000 0 116084 0 127491 0 11894 0 3278 0 432747 0 0 0 Brendan Shanahan thru 72015 VP, Budget & Analysis 108701 0 90500 0 166860 0 3499 0 5318 0 374878 0 0 0 Wanda Wareham VP, Gov't Assisted Programs 0 0 81261 0 139388 0 0 0 0 0 220649 0 0 0 Stuart Lefkowich VP, Medicare Advantage 0 0 78390 0 71425 0 0 0 0 0 149815 0 0 0 Philip J Gillich VP, Network Management 193924 0 30000 0 16023 0 10169 0 2801 0 252917 0 0 0 Jose R Diaz VP, Membership (thru 11/2015) 151475 0 28980 0 55668 0 131259 0 3623 0 371005 0 0 0 Daniel Byrne VP, Labor Relations 189465 0 28980 0 15757 0 9801 0 9984 0 253987 0 0 0 Ernesto Marrero Jr VP, Medicare Compliance 210542 0 31500 0 6477 0 10123 0 5165 0 263807 0 0 0 Vincent A Hartmann VP, Underwriting 161871 0 28260 0 26719 0 15627 0 6360 0 238837 0 0 0 Erhard V Krause thru 42015 VP, Business Development 52084 0 82911 0 291271 0 1809 0 1380 0 429455 0 0 0 Peter S Moore VP, Government Programs 159371 0 25980 0 26668 0 34180 0 5558 0 251757 0 0 0 Christopher W Chappelear VP, Actuarial & Underwriting 225557 0 0 0 19005 0 3799 0 9963 0 258324 0 0 0 Douglas Cowieson SVP, Operations 345890 0 0 0 29612 0 14916 0 9277 0 399695 0 0 0 Jerry A Gallo thru 92015 VP, Commercial Sales 126183 0 32280 0 23931 0 5458 0 6859 0 194711 0 0 0 Suzanne G Ronner VP, Customer Service 209605 0 0 0 20622 0 11625 0 5610 0 247462 0 0 0 Michele H Podolak VP, Customer Service 135515 0 21780 0 25208 0 8639 0 2985 0 194127 0 0 0 Richard M Densing VP, Gov't Prog & Direct to Con 204390 0 0 0 15572 0 11678 0 7860 0 239500 0 0 0 Munish Khaneja VP, Medical Mgmt Operations 276297 0 0 0 16768 0 12204 0 7828 0 313097 0 0 0 Wei Jia Shen Sr. Director -Applications Dev 233276 0 0 0 18618 0 33360 0 5820 0 291074 0 0 0 Roberto Hormazabal Sr. Dir. Account Management 266810 0 0 0 327 0 4717 0 6280 0 278134 0 0 0 Thomas MAcMillan Sr. Director, EPMO 234865 0 0 0 18506 0 8990 0 6060 0 268421 0 0 0 James P Meidlinger Sr. Actuary 226338 0 0 0 16304 0 7352 0 9516 0 259510 0 0 0 Bruce Sosler Senior Medical Director 287435 0 0 0 8134 0 24079 0 4140 0 323788 0 0 0 Scott Breidbart as of 102015 Chief Clinical Officer 98176 0 150000 0 3404 0 3137 0 810 0 255527 0 0 0 Scott Dickler as of 82015 SVP, Gov't & Indiv. Programs 97470 0 75000 0 14208 0 7351 0 1620 0 195649 0 0 0 Craig Effrain VP, Corporate Secretary 196815 0 0 0 12824 0 2959 0 8700 0 221298 0 0 0 Douglas Parks as of 62015 VP, HR Transformation & Strat 134222 0 50000 0 11490 0 55991 0 1778 0 253481 0 0 0 Russell Petrella EVP (as of 2/2015) 461827 0 0 0 34560 0 133475 0 6000 0 635862 0 0 0 William Voigt VP, HR Business Operations 177529 0 0 0 9316 0 4724 0 10410 0 201979 0 0 0 Joseph Zeitlin as of 22015 VP, ACP Relations 344976 0 41280 0 16049 0 17014 0 4237 0 423556 0 0 0 Paul Zurlo VP, Small Group & Indiv. Bus 214326 0 0 0 15693 0 8930 0 10158 0 249107 0 0 0 Dr Donald Wernsing Medical Director 234154 0 0 0 22625 0 32416 0 6690 0 295885 0 0 0 Form 990, Schedule J, Part I - Tax Gross Up Payments Mr. Branchini receives a tax gross up for amounts paid into the secular Trust. Form 990, Schedule J, Part I, Line 4a - Severance The following officers received severance in 2015: Nicholas Kambolis - $737,100 Erhard Krause - $278,975 Williams Lewis - $321,852 Charlene Maher - $395,000 Brendan Shanahan - $136,965 Mary Soul - $111,965 William Gillespie - $241,000 Wanda Wareham - $139,388 Stuart Lefkowich - $71,425 All of the severance payments documented above are reported in the Form 990, Schedule J, part II, Column (b)(iii). Non-Qualified Retirement Plan Emblem Health Services, LLC sponsors nonqualified retirement plans that the officers of HIPNY participate in, Officers with the titles of senior vice president and above hired before June 1, 2009, with the exception of Frank Branchini, participate in the supplemental executive retirement plan for emblemhealth services company, llc ("SERP"). The SERP 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 require the approval of the board of directors to retire under the serp between the ages of 55 and 60. Participants who retire prior to age 65 have their serp benefits reduced by early retirement factors. Mr. branchini participates in the GHI supplemental retirement plan ("Secular trust") which provides a retirement benefit calculated to provide the retirement benefits that would otherwise be payable under the local 153-ghi pension plan and the ghi cash balance plan (qualified plans), but for funding and contributions limits imposed by the IRS regulations. Senior vice presidents and above, hired before june 1, 2009, participate in the supplemental retirement plan ii for emblemhealth services company, llc (SERP II"). The SERP II provides a retirement beneft calculated on the basis of 30% of final average pay after 5 years of service, and increasing to 50% of final average pay after 15 years of service, offset by benefits under any qualified benefit plan, such as the emblemhealth services company, llc employees' retirement plan. Participants require the approval of the board of directors to retire under the SERP II between the ages of 55 and 60. Participants who retire prior to age 65 have their SERP II benefits reduced by early retirement factors. Bonus Payments HIP (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. In the 2015 AIP, two equally weighted performance metrics were Operating Income and Administrative Per Member Per Month (PMPM) savings. Operating Income was defined as premiums earned and administrative service fee revenue, less subscriber benefits, depreciation and amortization, interest and general administrative expenses, as reported in the annual financial statements, and exluding certain specified and extraordinary items. Administrative PMPM was defined as the depreciation and amortization, interest and general administrative expenses as reported in the annual audited financials associated with the administration of the company's insured commercial managed care, Medicare and State sponsored programs expressed on a per member per month basis, and excluding certain specified and extraordinary items. HIP also has a long term incentive plan based upon longer term performance over three year performance cycles and a limited supplemental incentive plan with payment triggered by threshold performance under the AIP. The compensation committees approve the performance metrics, targets and payouts based upon achievement of performance under these plans as well. Officers and key employees are generally eligible to participate in the long term incentive plan. Schedule J, Part II, Column C Health Insurance Plan of Greater New York, 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 Director/HR Department 151125 See Schedule L Narrative false Christine O'Connor Burns Kin of Board Member 202213 See Schedule L Narrative false Diane Pirone Kin of President & COO 2015751 See Schedule L Narrative false Keith Dahl Kin of President 285156 See Schedule L Narrative false Form 990, Schedule L Former Chairman and Chief Executive Officer (As of 10/2015), 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 HIP/EMBLEM ACCOUNT. IN CALENDAR YEAR 2015, HIP-NY PAID THE CONTRACTED ENTITY, RCG, $2,015,751. Former Chairman and Chief Executive Officer, Frank Branchini, has a family member, Keith Dahl, son-in-law, who is a physician employed by AdvantageCare Physician, P.C.("ACP"), a related entity to HIP-NY. HIP-NY engages in various transactions with ACP to provide medical services to its members. Dr. Dahl received $285,156 in compensation from ACP. Former Officer, John White, has a family member who is, likewise, employed by EmblemHealth Services Company, LLC. William White is employed by EmblemHealth Services Company, LLC. as a Director in the Human Resources Department; his W-2 wages for the year ending 12/31/2015 are $151,125. William receives fringe benefits from EmblemHealth Services Company, LLC as well. Former Board of Directors Member John O'Connor has a family member who is, likewise, employed by EmblemHealth Services Company, LLC. Christine O'Connor Burns' W-2 compensation in the calendar year ending 12/31/2015 from EmblemHealth Services Company, LLC was $202,213. Christine receives fringe benefits from EmblemHealth Services Company, LLC as well. HIP-NY 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). HIP-NY compiles a lengthy Summary report of all potential business transactions between the individuals reported on Part VII of the Form 990 and HIP-NY 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 HIP-NY's EIN#. In addition, HIP-NY's 100% owned disregarded entity, EmblemHealth Services, LLC, (EHS) also issued 1099s in calendar year 2015. In the interests of full disclosure, HIP-NY is disclosing that EmblemHealth Services, LLC issued 1,216 1099s in calendar year 2015. In total, HIP-NY and EHS paid compensation exceeding $100,000 to 154 vendors. HIP-NY, as a part of its business, undertakes a significant amount of claims processing; in 2015, HIP-NY issued 22,460 1099s through its claims processing department. 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) HIP-NY does not file a Form W-3 as all employee payroll is paid out of EmblemHealth Services, LLC. In the interests of clarity, HIP-NY is disclosing that 4,452 employees received W-2s from EmblemHealth Services (ostensibly for services rendered to HIP-NY and to other affiliated entities). Form 990, Part VI, Line 2 Frank Branchini, Former Chairman and Chief Executive Officer, has a family relationship with Robert Branchini, VP Information Technology. 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 Health Insurance Plan of Greater New York. 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, 2015 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 Financial 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 by VP, The 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, HIP 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 HIP 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 head offices at 55 Water Street, New York, New York. Any individual requesting a copy of these documents is provided that copy on the same business day. 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 website, 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 Health Insurance Plan of Greater New York 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 HIP network. Form 990, Part VIII Health Insurance Plan of Greater New York generates rental revenue from medical groups who lease a combination of personal and real property. HIP does not book this revenue in its general ledger as rental income, but rather offsets payments due to the health provider/facilities as monthly settlements are made. These transactions result in a net out-flow of cash as HIP finalizes its monthly settlements. For the most part, the rental income generated by HIP is for space rental and incidental personal property rental (i.e. 10% or less of the total rents received under the lease are from personal property). To the extent that the rental income is attributable to a mixed lease (i.e. where personal property is 11% to 50% of the total rents), HIP reports this revenue as unrelated business income and specifically reports this revenue on Part VIII, Lines 6a and 6b and on its Form 990-T. Quantifying total rental income received across all medical groups is difficult, but the organization has approximated the revenue and disclosed it in Part VIII, Line 6. Form 990, Part IX Amounts reported on Part IX, Line 5, as compensation paid to officers, directors and key-employees of HIP-NY represent those salary costs reported on Form 990, Part VII, Line 1(d) that are allocated from the related party, EmblemHealth Services, LLC. Health Insurance Plan of Greater New York 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, HIP-NY 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 HIP's day-to-day mission activities. Nevertheless, even taking this conservative approach, HIP's program service expenses constitute 90% of total expenditures. Form 990, Part XI, Line 9 A difference of ($78,460,605) 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 0 91544679 HIP-NY EMBLEMHEALTH INC 55 WATER STREET NEW YORK NY 10041 133941542 support svcs NY 501(c)(3) 11(C) HIP-NY true Group Health Incorporated 55 Water Street New York NY 10041 135511997 Insurance NY NA C Corp 932581257 602425621 1.00000 true HIP Holdings Inc & Subsidiaries 55 Water Street New York NY 10041 133819759 Insurance NY NA C Corp. 1842167755 1202584838 1.00000 true Central Brooklyn Medical Group PC 440 9th Avenue New York NY 10001 112937992 Healthcare NY HIP-NY C Corp 123621211 9405734 1.00000 true Queens Long Island Medical Group PC 440 9th Avenue New York NY 10001 113039101 Healthcare NY HIP-NY C Corp 342830180 107907774 1.00000 true Staten Island Physician Practice PC 440 9th avenue new york NY 10001 204659577 healthcare NY HIP-NY C corp 40584272 3155207 1.00000 true AdvantageCare Physicians PC 440 9th Avenue New York NY 10001 460790995 healthcare NY HIP-NY C Corp 298387631 155519033 1.00000 true LHHN Medical PC 440 9th Avenue New York NY 10001 134121055 healthcare NY HIP-NY C Corp 51904562 4754671 1.00000 true true false false true false false false false false false true true true true true true true true EmblemHealth Inc M,P 1283292 Cost Group Health Incorporated A 3300000 Market Rate Group Health Incorporated D 165000000 Market Rate Hip Holdings Inc & Subsidiaries (EHA) M 17700000 COST Hip Holdings Inc & Subsidiaries (HIPIC) L,Q 5600000 COST Hip Holdings Inc & Subsidiaries (HIPIC) M 33300000 COST Hip Holdings Inc & Subsidiaries (HIP-IPA) l 600000 cost Hip Holdings Inc & Subsidiaries (HIP-IPA) M 12700000 cost central brooklyn medical group pc a 146783 cost Queens Long Island Medical Group PC a 516313 cost LHHN Medical PC a 207000 cost central brooklyn medical group pc d 1419118 cost Queens Long Island Medical Group PC d 6579885 cost LHHN Medical PC d 1786593 cost Staten Island Physician Practice PC d 2142437 cost Schedule R, Part V, Line 2 TRANSACTIONS with Emblem Health, Inc. EmblemHealth, Inc. is the parent organization of Health Insurance Plan of Greater New York (HIP-NY), a 501(c)(4) tax-exempt organization that delivers quality, affordable health insurance to members and provides employers and individuals with a range of plan choices and attractive benefit options designed to meet the individual needs of today's healthcare consumers. EmblemHealth, Inc., in conjunction with its subsidiaries, fosters and facilitates HIP-NY's efforts to give back to the community. Costs associated with running EmblemHealth Inc. are reimbursed by HIP-NY (at cost); these transactions are memorialized with Transaction Code M & P. Transactions with Group health Incorporated To date, HIP-NY 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 2015. 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. As of December 31, 2015, no payments were made to HIP. Nevertheless, HIP 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 HIP and HIP administers the collection of premiums and pays claims on behalf of HIPIC. Premiums collected on behalf of HIPIC were approximately $19,400,000 for the year ended December 31, 2015. HIP paid out-of-network claims on behalf of HIPIC of $13,900,000 in 2015. Under the terms of a service agreement, HIP allocated costs associated with administering the premiums and claims of approximately $5,600,000 to HIPIC for the year ended December 31, 2015. 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, 2015, HIP incurred approximately $12,700,000 for capitation and $400,000 for data collection services. In addition, HIP provides certain administrative and support services to HIP IPA, which are reimbursed by HIP IPA. For the year ended December 31, 2015, amounts charged by HIP 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, 2015, EHA charged HIP approximately $17,700,000 for these services. Transactions with Physician Medical Groups As of January 1, 2013 Emblem completed a series of transactions that resulted in a nominee shareholder arrangement with four independent medical groups that provide health care services to certain subscribers of Emblems health benefit plans and which operate out of facilities owned or leased by Emblem. Pursuant to the transactions, the Chief Medical Officer of Emblem became the sole shareholder of each of the Medical Groups and the physicians employed by and/or contracted with the Medical Groups became employees of, or contracted with, AdvantageCare Physician, P.C. During 2015, HIP invested $0 in ACP. In addition, HIP-NY has loan agreements with various medical groups. These loans are memorialized with transaction (d) and any interest paid on the loan is memorialized with transaction (a).