2016-11-14T13:32:00-06:00 2015-12-31 PricewaterhouseCoopers LLP 101 SEAPORT BOULEVARD BOSTON MA 02210 990 2015-01-01 455591420 FALLON TOTAL CARE INC % R SCOTT WALKER FALL 5087992100 C/O FCHP 10 CHESTNUT STREET WORCESTER MA 01608 R SCOTT WALKER DIRECTOR/TREASURER 5087992100 2016-11-14 true ERIN COUTURE P01390592 6175305000 2015 2017-02-10 21:41:12Z RICHARD P BURKE 10 Chestnut Street Worcester MA 01608 86641385 false X www.fchp.org X 2013 MA SEE SCHEDULE O 3 0 110 0 0 0 0 0 94515910 86376610 10596 0 0 0 94526506 86376610 0 0 90110341 79859382 9379113 5415896 0 0 0 4439677 3958395 103929131 89233673 -9402625 -2857063 11272176 20671949 20486128 12092964 -9213952 8578985 X MAKE A POSITIVE DIFFERENCE BY IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES THROUGH THE DELIVERY OF HIGH QUALITY, ECONOMICAL HEALTHCARE SERVICES TO BOTH MEDICARE AND MEDICAID ELIGIBLE POPULATION FROM 21 TO 64 YEARS OF AGE. false true 79859382 86376610 SEE SCHEDULE O 79859382 true false false false false false false false false false false false false false false false true true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 1083 0 true 110 true false false false false false false false false false false X 3 0 true false false false true true true true true false false true true true true true true false true false MA X X R SCOTT WALKER 5087992100 10 CHESTNUT STREET WORCESTER MA 01608 Richard P Burke Chairman 2.0 55.0 X X 0 448049 64782 CHRISTINE CASSIDY Director/Clerk 1.0 50.0 X X 0 252703 39241 R Scott Walker Director/Treasurer 1.0 47.0 X X 0 458106 59331 SARIKA AGGARWAL DIRECTOR, ENDED 9/15 5.0 50.0 X 0 320111 36904 SONJA BREHM VP, Health Care Services 50.0 0.0 X 46394 157598 17729 Dan Rome Medical Director UNTIL 9/15 20.0 0.0 X 222297 0 23267 Lisa Price-Stevens Medical Director, UNTIL 7/15 30.0 10.25 X 210978 132459 29230 MICHAEL NICKEY EXECUTIVE DIRECTOR FTC & MH 10.0 40.0 X 0 228022 26093 Jo Ann Savage Director, Clinical Operations 42.0 8.0 X 104714 20911 3802 JILL BENOIT CLINICAL PHARMACIST UNTIL 9/15 50.0 0.0 X 104417 0 24521 MATTHEW COLLINS DIRECTOR/CLERK UNTIL 11/14 0.0 50.0 X 0 173350 10658 MARY RITTER PRESIDENT & CEO, UNTIL 12/13 0.0 50.0 X 0 185030 4326 Judith Roark-Mackey Dir. MKTG&outreach until 12/13 0.0 50.0 X 0 114181 18538 688800 2490520 358422 4 true true false UMASS MEMORIAL MEDICAL CENTER PO BOX 415353 BOSTON MA 02241 MEDICAL SERVICES 9575353 BAYSTATE MEDICAL CENTER 759 CHESTNUT ST SPRINGFIELD MA 01199 MEDICAL SERVICES 5430609 STAVROS CENTER FOR INDEPENDENT LIVI PO BOX 2130 AMHERST MA 01004 COUNSELING SERVICES 3691131 FALLON COMMUNITY HEALTH PLAN INC 10 CHESTNUT ST WORCESTER MA 01608 MANAGEMENT FEES 3022601 CEREBRAL PALSY OF MASSACHUSETTS INC 600 TECHNOLOGY CENTER DR STOUGHTON MA 02072 MEDICAL SERVICES 2849678 102 0 PREMIUM REVENUE 524114 86366610 86366610 FTC ONE CARE PROGRAM STUDY REVENUE 524114 10000 10000 86376610 0 0 0 264775 264775 0 0 0 0 0 0 0 0 86376610 86376610 0 0 0 79859382 79859382 524415 524415 0 3786418 3786418 152970 152970 565931 565931 386162 386162 3022601 3022601 0 128500 128500 0 0 1525 1525 160562 160562 11790 11790 57875 57875 10389 10389 0 478045 478045 0 0 0 6004 6004 0 33478 33478 46521 46521 DUES & SUBSCRIPTIONS 1105 1105 89233673 79859382 9374291 0 0 0 1973640 400328 0 0 9165975 20269121 0 0 0 0 0 0 0 0 38729 2500 93832 0 0 0 0 0 0 0 0 0 0 11272176 20671949 20181460 11958433 0 0 304668 134531 0 0 0 0 0 0 0 0 0 0 0 0 20486128 12092964 X -9213952 8578985 0 0 0 0 -9213952 8578985 11272176 20671949 X -2857063 20650000 X false true X true false X 0 0 0 0 0 0 1551981 94515910 86376610 182444501 0 0 0 0 0 1551981 94515910 86376610 182444501 0 0 0 182444501 184145 264775 448920 0 184145 264775 448920 0 0 0 0 1551981 94700055 86641385 182893421 X 0.00000 86375000 86375000 1610 1610 86376610 89232000 89232000 1673 1673 89233673 SCHEDULE D, PART XI, LINE 4b INVESTMENT FEE RECLASS TO EXPENSE 1,525 FINANCIAL STATEMENT ROUNDING 85 ------------------ TOTAL ON FORM 990, NOT ON FINANCIALS 1,610 SCHEDULE D, PART XII, LINE 4B INVESTMENT FEE RECLASS TO EXPENSE 1,525 FINANCIAL STATEMENT ROUNDING 148 ------------ TOTAL ON FORM 990, NOT ON FINANCIALS 1,673 X X X X true true false false false false false true false Richard P Burke Chairman 0 357164 0 81678 0 9207 0 38005 0 26777 0 512831 0 31678 CHRISTINE CASSIDY Director/Clerk 0 224697 0 15625 0 12381 0 18330 0 20911 0 291944 0 15625 R Scott Walker Director/Treasurer 0 370963 0 80634 0 6509 0 34098 0 25233 0 517437 0 30634 SONJA BREHM VP, Health Care Services 28775 124732 0 32673 17619 193 2125 4808 2105 8691 50624 171097 0 26171 Dan Rome Medical Director UNTIL 9/15 142304 0 39383 0 40610 0 8669 0 14598 0 245564 0 39383 0 Lisa Price-Stevens Medical Director, UNTIL 7/15 163389 132071 37141 0 10448 388 6375 4007 10874 7974 228227 144440 37141 0 Judith Roark-Mackey Dir. MKTG&outreach until 12/13 0 101765 0 8497 0 3919 0 4224 0 14314 0 132719 0 8497 MARY RITTER PRESIDENT & CEO, UNTIL 12/13 0 39065 0 0 0 145965 0 1532 0 2794 0 189356 0 0 SARIKA AGGARWAL DIRECTOR, ENDED 9/15 0 208951 0 26950 0 84210 0 11441 0 25463 0 357015 0 26950 MICHAEL NICKEY EXECUTIVE DIRECTOR FTC & MH 0 197879 0 29606 0 537 0 8176 17917 0 254115 0 25806 MATTHEW COLLINS DIRECTOR/CLERK UNTIL 11/14 129441 37863 6046 7918 2740 184008 37863 FORM 990 SCHEDULE J: PART I, LINE 4A SEVERANCE PAYMENT FALLON TOTAL CARE, INC. (FTC), PAID SEVERANCE PAYMENTS TO THE FOLLOWING INDIVIDUALS: DAN ROME, MEDICAL DIRECTOR, WAS PAID $31,508 FOR 10 WEEKS OF SEVERANCE PAY. JILL BENOIT, CLINICAL PHARMACIST, WAS PAID $23,981 FOR 12 WEEKS OF SEVERANCE PAY. FALLON COMMUNITY HEALTH PLAN, INC. (FCHP), THE PARENT ORGANIZATION, PAID SEVERANCE PAYMENTS TO MARY RITTER, FORMER FTC PRESIDENT & CEO, A LUMP SUM PAYMENT OF $136,154 FOR 24 WEEKS OF SEVERANCE PAY. PART I, LINE 4B SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN OF FCHP FCHP, THE PARENT ORGANIZATION OF FTC, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT 457(F) PLAN THAT COVERS CERTAIN EXECUTIVES OF FCHP, WHO ARE ALSO DIRECTORS OF FTC. UNDER THE TERMS OF THE PLAN, INDIVIDUALS VEST AS PROVIDED, DEPENDING ON THE DATE OF ELIGIBILITY TO PARTICIPATE IN THE PLAN. FOR INDIVIDUALS LISTED WHO WERE ELIGIBLE ON OR BEFORE MARCH 1, 2007, 50% OF THE YEARLY CONTRIBUTION VESTS IMMEDIATELY WITH THE REMAINING CONTRIBUTION SUBJECT TO VESTING UPON NORMAL RETIREMENT AGE, OR IF EARLIER, UPON DEATH, DISABILITY, OR INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN CAUSE, INCLUDING INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN CAUSE FOLLOWING A CHANGE IN CONTROL. FOR INDIVIDUALS LISTED WHO WERE ELIGIBLE ON OR BEFORE DECEMBER 31, 2012, 50% OF THE YEARLY CONTRIBUTION VESTS IMMEDIATELY IF THE PARTICIPANT HAS BEEN COVERED FOR AT LEAST 36 MONTHS, WITH THE REMAINING CONTRIBUTION SUBJECT TO VESTING UPON NORMAL RETIREMENT AGE, OR IF EARLIER, UPON DEATH, DISABILITY, OR INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN CAUSE, INCLUDING INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN CAUSE FOLLOWING A CHANGE IN CONTROL. FOR INDIVIDUALS WHO FIRST BECOME ELIGIBLE FOR A PLAN YEAR THAT BEGINS IN 2013 OR 2014, 50% OF THE YEARLY CONTRIBUTIONS VEST IMMEDIATELY IF THE PARTICIPANT HAS BEEN COVERED FOR AT LEAST 60 MONTHS, WITH THE REMAINING CONTRIBUTIONS SUBJECT TO VESTING UPON THE EARLIEST OF NORMAL RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN CAUSE, INCLUDING INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN CAUSE FOLLOWING A CHANGE IN CONTROL. Effective January 1, 2015, SERP contributions may be made on behalf of an employee who is the President and Chief Executive Officer, the Division President, Senior Care Services, an Executive Vice President or a Senior Vice President. In addition, contributions may be made on behalf of an employee who is designated as eligible for a plan year by the Board at its discretion. The SERP contribution made for an employee for the 2015 plan year or a later plan year will vest 20% EACH YEAR BEGINNING IN THE YEAR OF THE CONTRIBUTION AND ENDING ON THE LAST DAY OF THE FIFTH PLAN YEAR. If a participant separates from service for any reason, prior to the last day of the fifth year for which the contribution is credited, he or she will forfeit the non-vested portion of the contribution that has been credited, except that a participant automatically becomes vested upon death, disability or attainment of normal retirement age. IN 2015, THE FOLLOWING INDIVIDUALS LISTED IN SCHEDULE J, PART II PARTICIPATED IN THE PLAN. AMOUNTS VESTED AND PAID UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B) (III). AMOUNTS DEFERRED ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). CONTRIBUTIONS THAT WERE PREVIOUSLY REPORTED ON A PRIOR FORM 990, AND ARE PAID OUT IN THE CURRENT YEAR ARE REPORTED IN SCHEDULE J, PART II, COLUMN (F). OFFICER AMOUNT PAID AMOUNT DEFERRED RICHARD P. BURKE $6,520 $26,080 R. SCOTT WALKER $5,543 $22,173 CHRISTINE CASSIDY $2,220 $8,880 PART I, LINE 7 THE FCHP BOARD HAS THE AUTHORITY AND DISCRETION TO DETERMINE COMPENSATION OF THE SENIOR EXECUTIVES AND EXECUTIVE INCENTIVES. THE DISCRETION IS TYPICALLY EXERCISED THROUGH THE BOARD'S EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE, WHICH HAS THE AUTHORITY TO DISCHARGE THE BOARD'S RESPONSIBILITIES FOR COMPENSATION AND EXECUTIVE INCENTIVES. HOWEVER, THE DISCRETIONARY COMPENSATION/INCENTIVES RECOMMENDED MUST BE WITHIN THE PARAMETERS OF THE STANDARDS THAT THE COMMITTEE HAS ESTABLISHED AND NEEDS TO BE CONSISTENT WITH THE IRS STANDARDS OF REASONABLENESS FOR SUCH INCENTIVES PROVIDED TO NONPROFIT EXECUTIVES. FORM 990, PART I, LINE 1 FTC'S MISSION Fallon Total Care, Inc. ("FTC") was formed as a Massachusetts nonprofit corporation on September 20, 2013 for charitable, educational, and scientific purposes, for relief of the poor and distressed and to lessen the burdens of government within the meaning of Sections 170(c)(2)(B) and 501(c)(3) of the Internal Revenue Code of 1986. Specifically, FTC was formed to promote, facilitate, and enhance the delivery of quality, efficient, effective and economical health care and related services to individuals who are dually eligible for both Medicare and Medicaid, and to improve and enhance the health and well-being of those individuals, by providing integrated behavioral and physical health management services on a risk basis. The enrollees are generally underprivileged, underserved, low-income population with major health care needs, including many individuals who suffer from chronic physical and/or mental health conditions. Serving this population is challenging and costly for federal and state governments. Established as a Demonstration Program by the Commonwealth of Massachusetts Executive Office of Health and Human Services' Office of Medicaid and the Center for Medicare Services, participating health plans coordinate and manage integrated behavioral and physical health management services to enrollees ages 21-64 who are eligible for both Medicare and Medicaid. By combining Medicare and Medicaid funding, the Demonstration Program enables a broader menu of services to better meet the needs of Dual Eligibles in the most cost effective way and enables an unprecedented level of integration to achieve better health outcomes for this population and to provide higher quality, more cost effective, person-centered care. FTC was formed by Fallon Community Health Plan, Inc. ("FCHP"), a Section 501(c)(3) tax-exempt Massachusetts nonprofit corporation and licensed Massachusetts health maintenance organization (HMO). FCHP is dedicated to improving the health and welfare of the populations it serves through the delivery of high quality, affordable health care. FCHP formed FTC to further FCHP's charitable health care mission, and FTC's purposes explicitly include supporting, benefiting, performing certain functions of, and carrying out the charitable, educational, or scientific purposes of FCHP. FORM 990, PART III, LINE 3 After careful consideration, FCHP, THE PARENT COMPANY, decided to reluctantly end its participation in the Commonwealth of Massachusetts One Care demonstration program effective September 30, 2015. This decision was reached after exploring alternatives with Medicare and Medicaid but ultimately we determined that our continued participation was not economically sustainable. FCHP worked with Medicare and Medicaid officials throughout the wind down process. We notified each member by mail in advance of the effective date that their coverage would end. This letter also explained the member's options for coverage after September 30 and included telephone numbers to call with any questions. FCHP held informational meetings in two Massachusetts locations to answer questions and help members' understand their choices. FCHP also notified all providers in its network prior to the effective date. FORM 990, PART III, LINE 4 FTC's Program activities consist of prepaid healthcare in the Commonwealth of Massachusetts. The covered population as of September 30, 2015, was 4,684 members. Members pay no premiums, co-payments, or co-insurance while participating in the Plan. All premiums are paid by state and federal agencies to cover traditional Medicaid and Medicare services. In addition to these services, FTC provides comprehensive care management, dedicated Navigators, expanded dental and Long Term Service and Support benefits. FORM 990, PART VI, SECTION A, LINE 1B NONE OF THE VOTING MEMBERS ARE INDEPENDENT BECAUSE THE MEMBERS ARE EMPLOYEES OF THE PARENT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS - THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY AN ORGANIZATION, (OTHER THAN THE FILING ORGANIZATION), FOR WHICH ANOTHER PERSON LISTED SERVES AS AN OFFICER - RICHARD P. BURKE, CHRISTINE CASSIDY, R. SCOTT WALKER, AND SARIKA AGGARWAL. FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION'S MEMBERS OR STOCKHOLDERS THE ORGANIZATION'S MEMBER IS FALLON COMMUNITY HEALTH PLAN, INC. (FCHP), THE PARENT COMPANY. FORM 990, PART VI, SECTION A, LINE 7A MEMBER'S POWER TO ELECT THE GOVERNING BODY THE PARENT COMPANY CAN ELECT THE MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS OF THE ORGANIZATION RESERVED TO MEMBERS OTHER THAN THE GOVERNING BODY FCHP MAY APPROVE THE DECISIONS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED BY MANAGEMENT AND GOVERNING BODY TO REVIEW 990 A DRAFT OF THE FORM 990 IS PREPARED BY FCHP AND REVIEWED BY ITS TAX CONSULTING FIRM. THE FINAL VERSION OF THE FORM 990 IS PROVIDED TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DESCRIBE THE PROCESS TO MONITOR CONFLICTS OF INTEREST FTC'S PROCESS OF MONITORING CONFLICTS OF INTEREST IS SAME AS ITS PARENT ORGANIZATION, FCHP. FTC'S BYLAWS REQUIRE ALL DIRECTORS AND OFFICERS TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AS DEFINED IN THE ORGANIZATION'S CONFLICT OF INTEREST POLICY RELATING TO DIRECTORS, OFFICERS AND MEMBERS OF A COMMITTEE WITH BOARD-DELEGATED POWERS. THIS IS ENFORCED BY THE REQUIREMENT THAT SUCH INDIVIDUALS ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. EACH YEAR THE COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF THE PARENT ORGANIZATION, FALLON COMMUNITY HEALTH PLAN, WHICH REPORTS ANY ACTUAL OR POTENTIAL CONFLICTS TO THE FULL BOARD OF THE PARENT. ANY BOARD MEMBER OR OFFICER WITH A CONFLICT OF INTEREST IS PROHIBITED FROM PARTICIPATING IN ANY DISCUSSION OF, OR VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. TWO INDEPENDENT BOARD MEMBERS OF THE PARENT ALSO CONDUCT AN ANNUAL REVIEW OF ANY BUSINESS TRANSACTIONS INVOLVING THE ORGANIZATION THAT COULD POTENTIALLY BENEFIT A BOARD MEMBER OR OFFICER, TO ENSURE THAT THE TRANSACTIONS DO NOT INVOLVE ANY UNDUE INFLUENCE, ARE AT FAIR MARKET VALUE, AND ARE IN THE ORGANIZATION'S BEST INTEREST. THE REVIEWING BOARD MEMBERS REPORT THEIR FINDINGS TO THE FULL BOARD. FURTHERMORE, AT BOARD MEETINGS, INDIVIDUAL BOARD MEMBERS ARE ASKED TO IDENTIFY, AND RECUSE THEMSELVES FROM ANY DISCUSSION AND VOTE ON ANY MATTER BEFORE THE BOARD IN WHICH THEY MAY HAVE A CONFLICT. FTC ALSO REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A WRITTEN DISCLOSURE STATEMENT DESIGNED TO IDENTIFY POTENTIAL CONFLICTS. FTC ALSO HAS GENERAL CORPORATE-WIDE CONFLICT OF INTEREST POLICIES THAT REQUIRE REPORTING OF POTENTIAL CONFLICTS AND MANAGEMENT APPROVAL OF CERTAIN TRANSACTIONS, AND PROHIBITS CERTAIN SPECIFIC TRANSACTIONS. THESE POLICIES ARE ENFORCED BY SENIOR MANAGEMENT, INCLUDING THE CHIEF COMPLIANCE OFFICER OF THE PARENT. FORM 990, PART VI, SECTION B, LINE 15A AND 15B THE PROCESS FOR DETERMINING CEO AND OTHER OFFICERS' COMPENSATION THE CEO POSITION WAS NOT FILLED IN 2015. THE COMPENSATION FOR THE CEO AND OTHER OFFICERS OF FTC WERE DETERMINED BY THE PARENT ORGANIZATION, FCHP, PURSUANT TO FCHP'S PROCESS FOR DETERMINING COMPENSATION FOR SUCH INDIVIDUALS AS FOLLOWS: FCHP HAS ESTABLISHED AN EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS THAT ESTABLISHES POLICIES AND THE COMPENSATION STRUCTURE OF CERTAIN FTC AND FCHP EXECUTIVE OFFICERS. THIS COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE EXECUTIVE OFFICERS IS DETERMINED BY A FAIR AND EQUITABLE PROCESS, INFORMED BY CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION, AND COMPLIANT WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN 2015, THE COMMITTEE CONSISTED OF FOUR MEMBERS OF FCHP'S BOARD OF DIRECTORS WHO ARE NOT EMPLOYED BY THE ORGANIZATION. FCHP'S CEO SERVED AS AN EX OFFICIO MEMBER OF THE COMMITTEE WITHOUT A VOTING RIGHT. THE EXECUTIVE OFFICERS OVER WHOSE COMPENSATION THE COMMITTEE IS RESPONSIBLE ARE COMPRISED OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER ("CEO"), AND THE PRESIDENT, EXECUTIVE VICE PRESIDENT, AND SENIOR VICE PRESIDENT POSITIONS THAT REPORT DIRECTLY TO THE CEO ("EXECUTIVE GROUP"). IN 2015, TO DETERMINE THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP, THE COMMITTEE RELIED ON A WRITTEN COMPENSATION SURVEY PRODUCED IN 2014 BY AN INDEPENDENT CONSULTING FIRM THAT ASSESSES EXECUTIVE COMPENSATION AND BENEFITS AND REFRESHED IN 2015 BY FALLON HEALTHs COMPENSATION DEPARTMENT. THE COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP AND REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT CONSULTING FIRM and updated by Fallon Health. THE COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION OF THE EXECUTIVE GROUP (OTHER THAN THE CEO). FOR THE CEO'S COMPENSATION THE COMMITTEE (MEETING WITHOUT THE CEO) RECOMMENDED A COMPENSATION STRUCTURE THAT WAS PRESENTED TO THE FCHP'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS (WITHOUT THE CEO PRESENT), VOTED TO APPROVE THE COMMITTEE'S RECOMMENDATION. ALL THESE DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES OF THE COMMITTEE AND BOARD OF DIRECTORS. THE PROCESS WAS USED TO ESTABLISH THE COMPENSATION FOR THE EXECUTIVE GROUP IN 2015. THIS PROCESS WAS NOT USED TO ESTABLISH COMPENSATION FOR THE "KEY EMPLOYEES" LISTED IN SCHEDULE J. FORM 990, PART VI, LINES 18 AND 19 FTC'S FORM 990 AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FTC'S FORM 990, FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY, ARE ALSO PROVIDED UPON REQUEST. FORM 990, PART XI, LINE 9 CAPITAL CONTRIBUTION FROM PARENT: $20,650,000 FALLON COMMUNITY HEALTH PLAN INC 10 CHESTNUT STREET WORCESTER MA 01608 237442369 HEALTH CARE MA 501(C)(3) 9 N/A false SUMMIT LIVING INC 10 CHESTNUT STREET WORCESTER MA 01608 261836279 ASST LIVING MA 501(C)(3) 11A FCHP true FALLON HEALTH WEINBERG INC 2700 NORTH FOREST RD GETZVILLE NY 14068 161580245 HEALTH CARE NY 501(C)(3) 9 FCHP true FALLON HEALTH & LIFE ASSURANCE COMPANY 10 CHESTNUT STREET WORCESTER MA 01608 043169246 HEALTH & LIFE MA NA C CORP true ULTRABENEFITS INC 29 EAST MOUNTAIN STREET WORCESTER MA 01608 043525752 3RD PARTY ADM MA N/A C CORP true GROUP INSURANCE SERVICE CENTER INC 20 WINTER STREET 1 PEMBROKE MA 02359 043271304 3RD PARTY ADM MA NA C CORP true GISC INSURANCE AGENCY INC 20 WINTER STREET 1 PEMBROKE MA 02359 043273688 INSURANCE AGENCY MA NA C CORP true false false true false true false false true false true false false true false false false false true false