2016-11-11T08:29:53-06:00 2015-12-31 221478099 COHNREZNICK LLP 7501 WISCONSIN AVE SUITE 400E BETHESDA MD 20814 990 2015-01-01 201581237 INTOTAL HEALTH LLC INTO 7032892433 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 richard magenheimer CFO 7032892433 2016-11-09 1 FRED HUTCHISON P00640420 7037446700 2015 2017-02-10 21:41:12Z MARK STAUDER 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 189821778 0 X INOVA.ORG X 2012 VA INTotal Health's mission is to improve the health of its members, the quality of their health care, and the accessibility of health care services for Medicaid consumers. 4 0 91 0 0 0 0 0 177779265 189717143 -953 88812 0 0 177778312 189805955 0 0 0 0 7112027 7783284 0 0 0 176272607 181622925 183384634 189406209 -5606322 399746 118163938 118197154 25215855 24918797 92948083 93278357 X INTotal Health's charitable mission is to improve the health of its members, the quality of their health care, and the accessibility of health care services for Medicaid consumers through its broad state-wide network, including primary care and specialist physicians, hospitals, nursing facilities, home health care agencies, and other medical providers who provide medical care as well as assist in the coordination of member care. 0 0 186183977 189701320 INTotal Health, LLC is a Medicaid managed care health insurance plan that is licensed by the Commonwealth of Virginia. The Plan serves approximately 58,000 Temporary Assistance for Needy Families, Children's Health Insurance Program recipients, and Supplemental Security Income/Aged, Blind and Disabled members through the Medallion 3.0 and Family Access to Medical Insurance Security programs. The Plan's network includes primary care and specialist physicians, hospitals, nursing facilities, home health care agencies, and other medical providers who provide medical care as well as assist in the coordination of member care. The Plan provides case management and outreach services to its members in order to assess their needs and to help coordinate their care with the healthcare system and community.The Plan operates as a network-model health plan and contracts directly with physicians, hospitals, and other health care providers for the provision of services to its members. The Plan also contracts with several third party benefit administrators for the provision of certain ancillary services, including pharmacy, vision, lab, and transportation services. 186183977 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 1674 0 1 91 1 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X INTOTAL HEALTH LLC 7032892433 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 RUSSELL MOHAWK PRESIDENT/CEO 10.00 30.00 X X 0 591560 137239 JAMES SANTRY SECRETARY/COO 5.00 45.00 X X 0 643227 84294 RICHARD MAGENHEIMER TREASURER/CFO 1.00 49.00 X X 0 1886593 495017 MARK STAUDER PRESIDENT/COO 0.50 49.50 X 0 2723958 821565 JOHN MURACA ITH VP CEO HEALTHPLAN 40.00 X 371964 0 94910 FARZANA RAHMAN ITH PHARMACY DIRECTOR 40.00 X 154174 0 40920 JANINE WOLDT ITH AVP CAO HEALTHPLAN 40.00 X 211726 0 52197 CHERYL RICCARDI ITH AVP CLINICAL SVCS 40.00 X 213864 0 43051 JULIE GARCIA DIR CASE MGMT AND DISEASE MGMT 40.00 X 127704 0 8152 MOHAMED ALLY ITH AVP CMO HEALTHPLAN 40.00 X 305424 0 51528 1384856 5845338 1828873 10 0 1 0 CRP-3 FAIRVIEW PARTK LLC TWO INTERNATIONAL PLACE SUITE 2500 BOSTON MA 02110 CONFERENCE SERVICES 411269 MILLIMAN CARE GUIDELINES LLC 901 FIFTH AVE SUITE 2000 SEATTLE WA 98164 CONSULTING 407745 MICHAEL K GRADY MD 8 KNOLL LANE ROSLYN HEIGHTS NY 11577 MEDICAL 151800 LOCKTON COMPANIES 7401 METRO BLVE SUITE 210 EDINA MD 55439 INSURANCE 130000 JONES DAY REAVIS & POGUE PO BOX 165017 COLUMBUS OH 43216 LEGAL 108233 6 INSURANCE PREMIUMS 524298 189717143 189717143 189717143 104635 104635 15823 -15823 -15823 -15823 189805955 189701320 0 104635 371964 371964 6046206 5224038 822168 322920 281554 41366 613401 534824 78577 428793 373865 54928 10355322 9028805 1326517 58857 51317 7540 42282 36866 5416 3331945 2905123 426822 8629 7524 1105 8845 7712 1133 449198 391656 57542 131329 114506 16823 35936 31333 4603 10493 9149 1344 1707413 1488693 218720 14216 12395 1821 MEDICAL CLAIMS 164252174 164252174 TAXES AND LICENSES 1040161 906916 133245 PRINTING 64444 56189 8255 OTHER PURCHASED SERVICE 43917 38291 5626 67764 59083 8681 189406209 186183977 3222232 0 21767700 22083984 15864392 16115816 1528393 2670360 883284 578773 496924 304511 12070822 12101776 66435707 64920707 118163938 118197154 2669604 2656070 22546251 22262727 25215855 24918797 X 92948083 93278357 92948083 93278357 118163938 118197154 399746 -69472 0 X X 0 1 X 1 0 X 13991799 178353226 177779265 189717143 559841433 13991799 178353226 177779265 189717143 559841433 0 0 0 559841433 5501 280512 -953 88812 373872 5501 280512 -953 88812 373872 13997300 178633738 177778312 189805955 560215305 0.99930 0.00070 X 0 0 0 0 0 0 0 0 1 13217 13217 0 Part II-B, Line 1: There were no significant lobbying activities during 2015. Amounts under Other activities per Part II-B represent a portion of membership dues related to lobbying. 392433 263954 128479 490851 314819 176032 304511 DUE TO SUBSIDIARIES AND AFFILIATES 1538692 MEDICAL CLAIMS LIABILITY 20724035 22262727 X Part X, Line 2: From Inova Health System consolidated financial statements that include the organization: The Foundation, IHCS, LHC, and INTotal Health are not-for-profit corporations and have been determined to be exempt from Federal income tax under the provisions of section 501(c)(3) of the Internal Revenue Code. IHI and its subsidiaries are taxable organizations. Deferred income taxes are provided for all significant timing differences between revenues and expenses reported for financial statement and for tax purposes. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements X X X X X X 0 1 0 0 0 0 0 0 0 RUSSELL MOHAWK PRESIDENT/CEO 0 425840 0 140818 0 24902 0 118991 0 18248 0 728799 0 0 JAMES SANTRY SECRETARY/COO 0 412241 0 145248 0 85738 0 60259 0 24035 0 727521 0 29205 RICHARD MAGENHEIMER TREASURER/CFO 0 686647 0 455969 0 743977 0 478579 0 16438 0 2381610 0 603000 MARK STAUDER PRESIDENT/COO 0 991051 0 588826 0 1144081 0 801492 0 20073 0 3545523 0 778291 JOHN MURACA ITH VP CEO HEALTHPLAN 278490 0 71252 0 22222 0 71398 0 23512 0 466874 0 0 0 FARZANA RAHMAN ITH PHARMACY DIRECTOR 153967 0 0 0 207 0 24983 0 15937 0 195094 0 0 0 JANINE WOLDT ITH AVP CAO HEALTHPLAN 176311 0 25059 0 10356 0 38835 0 13362 0 263923 0 0 0 CHERYL RICCARDI ITH AVP CLINICAL SVCS 169018 0 23484 0 21362 0 30406 0 12645 0 256915 0 10732 0 MOHAMED ALLY ITH AVP CMO HEALTHPLAN 272922 0 21315 0 11187 0 29879 0 21649 0 356952 0 0 0 Part I, Line 4b SERP Plan Payments Richard Magenheimer $101,665 James Santry $51,990 Mark Stauder $246,020 Cheryl Ricciardi $10,732 The Supplemental Executive Retirement Plan (SERP Plan) is a nonqualified retirement plan. Employees eligible to participate are Executive Directors, Assistant Vice Presidents, Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, CFO, COO, and CEO. Each year, a certain percentage of each participant's base salary is contributed to the SERP Plan. This amount ranges from 5% to 20%, depending on position. After three years of continuous participation, participants vest in 50% of their balance at that time and are paid out the vested balance as a taxable event. After a total of six years participation and after attaining age 50, participants are 100% vested and are paid out their remaining balance as a taxable event. Vesting then reverts to a three-year rolling schedule until year 12. Thereafter, the annual contribution is paid out to the participant each year as a taxable event. PART V, LINE 1A AND 2A - NUMBER OF 1099S AND EMPLOYEES The organization falls under a master pay agent and does not file any payroll returns under its own EIN. Form 990, Part VI, Section A, line 6 The organization has a single member. The sole member is Inova Health Care Services, a charitable 501(c)(3) tax-exempt organization which is part of the integrated health care delivery system. The sole member elects the trustees of the organization and has certain other reserved powers. Form 990, Part VI, Section A, line 7a The sole member of the organization, Inova Health Care Services, is a charitable 501(c)(3) tax-exempt organization. The sole member elects the members of the governing body of the organization periodically as terms expire. The sole member has the right to remove trustees and fill any vacancies on the board. Form 990, Part VI, Section A, line 7b The sole member of the organization, Inova Health Care Services, is a charitable 501(c)(3) tax-exempt organization. The sole member holds reserved powers with respect to certain actions, including approval of borrowings, amendments of Articles of Incorporation and Bylaws. Approval by the Board of Trustees is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. Form 990, Part VI, Section B, line 11 The Form 990 is prepared and provided to the Chief Accounting Officer and external tax consultants for initial review. After the review it is given to the CFO of Inova Health System for his review and comment. The Form 990 is presented to the Executive Committee of the Board of Trustees for their review. Upon completion of the Executive Committee review, it is provided to the full Board of Trustees. In this process, the Form 990 has been provided to the Governing Board approximately two weeks prior to the filing of the return. Form 990, Part VI, Section B, line 12c Yes, annually the organization distributes the conflict of interest policy to all directors, officers, trustees, and key employees. The organization requires that each director, officer, trustee, and key employee acknowledge that they have read, understood, and will abide by the policy. Each director, officer, trustee, and key employee is required to complete and submit an annual conflict of interest disclosure. These disclosures are broad and require that the individual list any business relationships or personal relationships with other directors, officers, trustees, and key employees, as well as any relationships with competitors, or current or potential vendors or contractors. Disclosure statements are reviewed by senior management and any potential conflicts are discussed with governing body chairman to ensure that any member who may have a conflict discloses their potential conflict, and is dismissed from related discussions and recused from participation in applicable decisions. Form 990, Part VI, Section B, line 15 The compensation of all senior management positions is evaluated annually in light of each manager's job content, scope and complexity. Compensation levels for Vice Presidents and above are reviewed by an independent external consultant to ensure that remuneration is consistent with the organization's compensation philosophy and objectives and competitive with other large complex health systems. The independent compensation consultant maintains national benchmark compensation databases and surveys and also reviews Forms 990 of comparable healthcare systems to determine market levels of compensation. In addition, the Inova Health System's CEO's compensation is reviewed and approved annually by an independent governing Board. The job requirements and complexity of all other management positions are evaluated annually using nationally recognized third party salary surveys to assure that the compensation for such positions is consistent with external market compensation comparisons. Salary ranges are developed for each management position classification to ensure that the compensation levels for these positions are consistent with the organization's compensation philosophy and objectives and with competitive market comparisons. Form 990, Part VI, Section C, line 18 The Form 1023 and Form 990 are available at the address listed on page 1 of the Form 990 upon request during regular business hours. Form 990, Part VI, Section C, line 19 Inova Health System makes certain information publicly available. Inova's consolidated financial statements are posted on the Electronic Municipal Market Access's (EMMA) website on a quarterly basis. Inova's Form 990s are disclosed on the Guidestar website. Inova's governing documents are not currently publicly available. While the conflict of interest policy is not specifically publicly disclosed, Inova's Code of Conduct is on the public website. Section III of the Code of Conduct describes what can constitute a conflict and requires that potential conflicts be reported to management or the Chief Compliance Officer. The Code also refers to the conflict of interest policy which is available to staff and physicians on Inova's intranet website. PART XII, LINE 2A AND 2B - AUDITED FINANCIAL STATEMENTS The company is part of the Inova Health System, a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. The company's financial statements are consolidated in the Inova Health System consolidated financial statements. Inova Health System is audited on an annual basis by a large "Big Four" independent public accounting firm. In addition, they are responsible for the issuance of a management letter encompassing each member of the consolidated group. The Finance and Audit Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the audit, including the hiring of the audit firm, review and approval of audited financial statements and communication with the external auditors at least twice a year without the presence of internal management. PART XII, LINE 3A - A-133 AUDIT The company is a subsidiary of the Inova Health System (IHS), a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. IHS receives various federal grants. These grants and awards are audited as part of the consolidated Inova Health System A-133 compliance audit. The Inova Health System's federal grants are audited on an annual basis by a large "Big Four" independent public accounting firm and a "Report on Compliance with Requirements Applicable to Each Major Program and on Internal Controls over Compliance in Accordance with OMB Circular A-133" is issued on a consolidated basis. The Finance and Audit Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the A-133 audit, including the hiring of the audit firm, review and approval of audited financial statements and communications with the external auditors at least twice a year without the presence of internal management. INOVA HEALTH SYSTEM FOUNDATION 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 541071867 FUNDRAISING VA 501(C)(3) 11,III N/A 0 INOVA HEALTH CARE SERVICES 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 540620889 HOSPITAL SYSTEM VA 501(C)(3) 3 N/A 0 PEDIATRIC SPECIALISTS OF VIRGINIA LLC 3023 HAMAKER COURT FAIRFAX VA 22031 461851763 MEDICAL SERVICES FOR CHILDREN VA 501(C)(3) 9 N/A 0 IMANCOINC 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 541340725 PAYROLL CORPORATION VA 501(C)(3) 11, I N/A 0 INOVA VNA HOME CARE 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 541277164 HOME HEALTH VA 501(C)(3) 9 N/A 0 LOUDOUN HEALTHCARE FOUNDATION 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 542011240 FUNDRAISING VA 501(C)(3) 11, I N/A 0 ALEXANDRIA HOSPITAL FOUNDATION 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 510241913 FUNDRAISING VA 501(C)(3) 11, I N/A 0 LOUDOUN HOSPITAL CENTER 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 540525802 HOSPITAL VA 501(C)(3) 3 N/A 0 LOUDOUN NURSING AND REHABILITATION CENTER 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 541361310 NURSING HOME VA 501(C)(3) 9 N/A 0 LOUDOUN HEALTH SERVICES 8110 GATEHOUSE ROAD SUITE 400W FALL CHURCH VA 22042 541555489 SURGERY CENTER VA 501(C)(3) 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 INOVA HEALTH SYSTEM FOUNDATION S 720296 INTERCOMPANY BALANCE INOVA HEALTH CARE SERVICES R 19880663 FAIR MARKET VALUE INOVA VNA HOME CARE R 70249 FAIR MARKET VALUE LOUDOUN HOSPITAL CENTER R 1880879 FAIR MARKET VALUE