2016-11-14T11:10:49-06:00 2015-12-31 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2015-01-01 042864973 Health New England Inc HEAL 4137874000 One Monarch Place No 1500 Springfield MA 011441500 Michael Marrone VP of Finance & CFO 4132333301 2016-11-14 1 Christine Kawecki P00743140 5169187000 2015 2017-02-10 21:41:12Z Maura C McCaffrey One Monarch Place No 1500 Springfield MA 011441500 931823392 0 X www.HealthNewEngland.Org X 2013 MA Health New England is a part of the Baystate Health System formed by its parent and sole member, Baystate Health, Inc., whose mission is "To improve the health of the people in our communities every day with quality and compassion." The mission of Health New England, based on the mission of our parent, is as follows: "To improve the health and life of our communities by: providing outstanding service; delivering superior value; and acting as a leading corporate citizen." 10 6 416 0 0 0 0 0 590207500 898478501 3868760 2477833 0 0 594076260 900956334 0 0 537349846 848220788 28860703 32034357 0 0 0 34543699 42294376 600754248 922549521 -6677988 -21593187 151023845 165499490 103041378 125390619 47982467 40108871 X See Schedule OThe mission of HNE, as part of Baystate Health (an integrated health care system), is to improve the overall quality of life and health status of the communities we serve and to contribute to the economic success of our region. HNE is committed to meeting the identified health and wellness needs of our communities served through the combined efforts of Baystate Health, community organizations, affiliated providers, and community partners. 0 0 848220788 898478501 Health New England makes high quality, low cost health care services available through HMO plans within a service area that comprises more poor, medically underserved and rural communities than any other part of Massachusetts. In a federal Health Resources & Services Administration (HRSA) report stated that of the 102 Massachusetts towns designated as medically underserved, 78 are in the four counties that Health New England serves. Based on that statistic, in all, over 45% of HNE's enrollees live in medically underserved areas.See Schedule O for further information HNE's service area includes four of the five counties with the highest percentage of poverty and the lowest per capita income in Massachusetts, based on US Census Bureau data. More than half of HNE's enrollees live in Hampden County, the poorest county in Massachusetts measured by per capita income and the second poorest measured by people living in poverty. In 2011, the four Western Massachusetts counties comprised 12.5% of the state's population but accounted for 20.9% of its Medicaid enrollees. HNE makes care available by offering health plans which serve the following: Individuals and Small Groups: Enrollees at 12/31/2015: 25,569 Revenue: $132,919,921Program Expenses: $111,211,214 HNE offers health plans to individuals and families (both directly and through the Commonwealth Health Connector) and small employer groups (employers with 50 or fewer employees). In Massachusetts, tax exempt health plans, including Health New England, serve 94% of the small employer groups. HNE is one of the leading sources of HMO coverage for individuals and small groups in Western Massachusetts, and provides coverage to nearly 4,000 groups with five or fewer employees.MedicareEnrollees at 12/31/2015: 8,601Revenue: $85,785,336Program Expense: $79,941,854 HNE serves Medicare enrollees through the HNE Medicare Advantage plan, which CMS has evaluated as one of the highest rated Medicare Advantage plan in Massachusetts. MedicaidEnrollees at 12/31/2015: 81,894Revenue: $385,395,942 Program Expense: $382,186,943 HNE participates in MassHealth, the Massachusetts Medicaid program, through a rapidly growing Medicaid plan. The number of HNE's Medicaid plan enrollees has generally increased since 2010 when HNE began offering such plans, more than tripled in 2014 to over 58,000 enrollees, and increased to over 82,000 enrollees in 2015.State and MunicipalEnrollees at 12/31/2015: 22,534Revenue: $107,539,792Program Expense: $99,402,629 HNE offers health plans through the Massachusetts Group Insurance Commission (GIC), which provides coverage for Massachusetts state and municipal employees (Health New England has one of the largest enrollments of GIC covered employees in Western Massachusetts). HNE also covers many municipal employees who do not obtain coverage through the GIC. Other Individuals and FamiliesEnrollees at 12/31/2015: 40,177 Revenue: $186,837,510Program Expense: $175,478,151 HNE also provides coverage to individuals and families through plans offered by employers which have more than 50 employees. As noted earlier, this category includes many municipal employees, and also includes many employees of health care and nonprofit organizations. HNE also conducts community benefit activities outside of the programs described above. HNE has used its agreements with health care providers to promote quality improvement activities and to finance improved coordination of health care for individuals with severe or chronic diseases. HNE has worked with a number of local medical practices to assist them in developing the capability of becoming patient centered medical homes (PCMHs). Specifically, HNE has worked with 25 medical practices to assist them in becoming PCMHs and attaining certification as such by the National Committee for Quality Assurance. In addition to its own direct service programs, HNE has aided or worked with a wide variety of community organizations to support programs for health improvement and community benefit, such as: - MOCHA and Project Coach providing education to empower youth and reduce severe health disparities in the city. - The Open Gym Program and Neutral Corner, Anti-Bullying Educational Program (provide a safe environment for youth in dangerous neighborhoods, mentoring, tutoring, exercise and organized physical activity, anti-bullying) -Partners for a Healthier Community/Live Well Springfield (promotes access to healthy foods, physical activity, and improved access to care for all members of the greater Springfield Community) - Square One Preschool (LAUNCH Health Curriculum that focuses on nutrition and physical activity)- Link-to-Libraries (provision of backpacks and books for children entering kindergarten in Holyoke and Springfield. HNE Be Healthy (Medicaid) Members are included in this outreach) - Springfield YMCA Y-Aim Program (Increase graduation rate for at-risk high school students) - Pioneer Valley Girl Scouts (Supports all girls involved in scouting, including HNE Be Healthy (Medicaid) Members.) - American Heart Association Go Red for Women, Heart Walk, and Get to Goal Campaign (Heart disease prevention and health screenings and health education for the community at large and focused on achieving optimal Blood Pressure in minority populations throughout the Pioneer Valley)- Diabetes Education at Brightwood Health Center (Culturally appropriate, Spanish language diabetes education available to all patients at the Brightwood community health center.) - La Esperanza Latina Health Fair (Free, public annual event providing over 800 Latina women with health information, education and screening.- Safe Passage Hot Chocolate Run (fund raiser hosted by Safe Passage which provides a variety of support and advocacy services for women and children who have experienced domestic violence)- Mason Square Task Force (A coalition working to eliminate racial health disparities in Mason Square through information sharing, policy change, and promoting healthy eating and nutrition by providing health care providers with vouchers for Mason Square Farmers Market.) - Friends of the Homeless (Collaboration with Friends of the homeless to provide funding, health education and health and wellness programs for the homeless.)- AIDS Foundation of W. Mass (focused on community education on the prevention and management of AIDS)- Mother Woman (provides training to diverse community leaders and professionals that teaches about the complex mental health and socio-political factors involved in the crisis of postpartum emotional complications)- Treehouse Foundation (aims to restore and strengthen the well-being of children and youth placed in foster care with the aim of moving them out of foster care and into permanent, loving families)- Top Floor Learning (providing adult literacy services and lifelong learning opportunities)- Mass In Motion Springfield (promotes opportunities for healthy eating and active living in the places people live, learn, work, and play)The programs above are among the dozens of community partnerships listed by HNE in its annual Community Benefits Report filed with the Massachusetts Attorney General. In addition, HNE's own community health education programs, such as our annual Life Enrichment Program, reach approximately 7,500 individuals throughout the community. HNE also supports numerous programs sponsored by the Baystate Health Foundation, and has been instrumental in raising hundreds of thousands of dollars for Foundation programs. 848220788 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 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 1 1 0 1 8204 0 1 416 1 0 0 0 0 0 0 X 10 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Health New England Inc 4137874000 One Monarch Place Suite 1500 Springfield MA 011441500 Dennis Chalke Treasurer/Director 1.00 40.00 X X 0 1085400 89529 Mark R Tolosky Director 1.00 40.00 X X 0 745183 80519 Joel Feinman PhD Director 1.00 0.00 X 0 0 0 Eric Fuller III Director 1.00 0.00 X 0 0 0 Benjamin Liptzin MD Director 1.00 0.00 X 0 355358 54503 Richard Segool MD Vice Chair/Director 1.00 0.00 X X 0 0 0 Robert Lounsbury Thru 63015 Director 1.00 0.00 X 0 0 0 Steven Mitus Thru 73015 Director 1.00 0.00 X 0 0 0 Anne Paradis Director 1.00 0.00 X 0 0 0 Howard Trietsch As of 1115 Director 1.00 0.00 X 0 0 0 Carol Campbell As of 1115 Director 1.00 0.00 X 0 0 0 Mark A Keroack MD Chair/Director 1.00 40.00 X X 0 1258998 213008 Maura C McCaffrey President & CEO 40.00 0.00 X 776384 0 289281 Judith M Danek Clerk Of Corporation 40.00 0.00 X 103597 0 37405 Thomas J Brown III Interim VP of Finance 1.00 40.00 X 0 189196 34710 Thomas H Ebert end 712015 VP & Chief Medical Officer 40.00 0.00 X 455273 0 104914 Robert A Kosior end 121115 VP of Finance & CFO 40.00 0.00 X 456070 0 534185 Amy Trombley VP & Chief Talent Officer 40.00 0.00 X 383939 0 107557 Jim Kessler VP General Counsel 40.00 0.00 X 238389 0 89430 Jody Gross VP of Sales 40.00 0.00 X 269321 0 110248 Kenneth Bernard VP of Information Technology 40.00 0.00 X 222367 0 91706 Frank Meaney end 9112015 VP of Operations 40.00 0.00 X 185633 0 10169 David Methe Security Officer 40.00 0.00 X 139616 0 46946 Jason Rio Compliance Officer 40.00 0.00 X 121697 0 44112 Laurie Gianturco Beg 93015 VP & Senior Medical Director 40.00 0.00 X 319199 0 141246 Jeffrey Krawczyk Director of Sales 40.00 0.00 X 178842 0 52273 Jacqueline Spain Medical Director 32.00 0.00 X 194040 0 52337 Gary J Tereso Pharmacist 40.00 0.00 X 159049 0 43017 Julie Bodde Director of Healthcare Informatics 40.00 0.00 X 147350 0 31269 Susan Silver O'Connor Director of Government Programs 40.00 0.00 X 153381 0 53393 4504147 3634135 2311757 75 0 1 0 CATAMARAN INC 2441 Warrenvile Rd Suite 610 Lisle IL IL 60532 Pharmacy Benefits Manager 171477308 MASSACHUSETTS BEHAVIORAL HEALTH PARTNERS 1000 Washington Street Suite 310 Boston MA 02118 Medical Services Mental Health 51969889 BERKSHIRE MEDICAL CENTER PO 4999 Pittsfield MA 012024999 Medical Services 31794819 MERCY MEDICAL CENTER PO Box 414432 Boston MA 02241 Medical Services 29322473 COOLEY DICKENSON HOSPITAL PO Box 5001 Northampton MA 01061 Medical Services 19895837 416 Medicaid Premium 524114 385395942 385395942 Premium - Commercial Large Group 524114 187522522 187522522 Premium - Commercial Small Group 524114 132551934 132551934 Massachusetts Group Insurance Com 524114 107222767 107222767 Medicare Advantage Premium 524114 85785336 85785336 898478501 2423458 2423458 30921433 30867058 54375 54375 54375 900956334 898478501 0 2477833 848220788 848220788 3671218 3671218 20291804 20291804 1335027 1335027 4875634 4875634 1860674 1860674 491023 491023 1232426 1232426 71790 71790 426121 426121 18771592 18771592 2042111 2042111 1772960 1772960 5167216 5167216 858610 858610 265672 265672 8256 8256 1447345 1447345 129567 129567 ACA and Other Taxes 9272256 9272256 Recruiting Fees 243008 243008 Bad Debt Expense 87401 87401 Charitable Fees 7022 7022 922549521 848220788 74328733 0 8198548 29472726 537180 548851 14001955 4428372 22866118 22261666 1193646 604452 108519133 109806019 10156863 9603669 8416520 11035401 151023845 165499490 84285526 108608982 18755852 16781637 103041378 125390619 X 47982467 40108871 47982467 40108871 151023845 165499490 X -21593187 -1068780 14788371 X X 0 1 X 1 0 1006730 1006730 0 7868535 7264083 604452 13990853 13990853 0 604452 9603669 C 9603669 Health Care Receivables 6835166 Receivables from Subsidiaries 1916711 Accrued Investment Receivable 929234 Reinsurance Receivable 1225018 Other Receivables 129272 11035401 Premiums Received in advance 7889183 Reimbursements from Providers to be applied 559689 Amounts due to Subsidiaries 555404 ACA Risk Adjustment Payable 3500000 Rebates Payable 1000000 Medical Subsidy Payable 2843241 Valuation Account 434120 16781637 900530213 0 900530213 426121 426121 900956334 922123400 0 922123400 426121 426121 922549521 X X X X 0 1 0 0 0 0 0 0 0 Dennis Chalke Treasurer/Director 0 466083 0 357889 0 261428 0 64000 0 25529 0 1174929 0 0 Mark R Tolosky Director 0 263593 0 150000 0 331590 0 66319 0 14200 0 825702 0 0 Benjamin Liptzin MD Director 0 301378 0 38716 0 15264 0 43200 0 11303 0 409861 0 0 Mark A Keroack MD Chair/Director 0 760075 0 310077 0 188846 0 192620 0 20388 0 1472006 0 90766 Maura C McCaffrey President & CEO 488287 0 183144 0 104953 0 249249 0 40032 0 1065665 0 0 0 Thomas J Brown III Interim VP of Finance 0 171964 0 16399 0 833 0 24396 0 10314 0 223906 0 0 Thomas H Ebert end 712015 VP & Chief Medical Officer 331537 0 115592 0 8144 0 74254 0 30660 0 560187 0 0 0 Robert A Kosior end 121115 VP of Finance & CFO 345343 0 75492 0 35235 0 491126 0 43059 0 990255 0 0 0 Amy Trombley VP & Chief Talent Officer 290186 0 60480 0 33273 0 78246 0 29311 0 491496 0 0 0 Jim Kessler VP General Counsel 182012 0 51840 0 4537 0 66096 0 23334 0 327819 0 0 0 Jody Gross VP of Sales 210073 0 48708 0 10540 0 68328 0 41920 0 379569 0 0 0 Kenneth Bernard VP of Information Technology 172586 0 30529 0 19252 0 53534 0 38172 0 314073 0 0 7685 Frank Meaney end 9112015 VP of Operations 152754 0 32566 0 313 0 0 0 10169 0 195802 0 0 0 David Methe Security Officer 127598 0 10524 0 1494 0 14723 0 32223 0 186562 0 0 0 Jason Rio Compliance Officer 116260 0 5313 0 124 0 12513 0 31599 0 165809 0 0 0 Laurie Gianturco Beg 93015 VP & Senior Medical Director 268694 0 35655 0 14850 0 99273 0 41973 0 460445 0 0 0 Jeffrey Krawczyk Director of Sales 168655 0 9826 0 361 0 13746 0 38527 0 231115 0 0 0 Jacqueline Spain Medical Director 191639 0 0 0 2401 0 28151 0 24186 0 246377 0 0 0 Gary J Tereso Pharmacist 144499 0 14354 0 196 0 10816 0 32201 0 202066 0 0 0 Julie Bodde Director of Healthcare Informatics 135861 0 10403 0 1086 0 0 0 31269 0 178619 0 0 0 Susan Silver O'Connor Director of Government Programs 139358 0 13168 0 855 0 19683 0 33710 0 206774 0 0 0 Part I, Line 4b Maura McCaffrey - Supplemental Retirement of $102,343 is included in column B. This amount was earned and paid in 2015. Dennis Chalke - Deferred non-qualified compensation of $64,000 is included in column B. This amount was earned and paid in 2015. Mark Tolosky - Deferred non-qualified compensation of $66,319 is included in column B. This amount was earned and paid in 2015. Benjamin Liptzin, MD - Deferred non-qualified compensation of $43,200 is included in column B. This amount was earned and paid in 2015. Mark Keroack, MD - Deferred non-qualified compensation of $192,620 is included in column C. This amount was earned in 2015. Thomas Ebert, MD - Supplemental Retirement of $3,946 is included in column B. This amount was earned and paid in 2015. Robert Kosior - Supplemental Retirement of $32,931 is included in column C. This amount was earned and paid in 2015. Amy Trombley - Supplemental Retirement of $30,561 is included in column B. This amount was earned and paid in 2015. Jody Gross - Supplemental Retirement of $9,255 is included in column B. This amount was earned and paid in 2015. Laurie Gianturco - Supplemental Retirement of $12,978 is included in column B. This amount was earned and paid in 2015. Kenneth Bernard - Supplemental Retirement of $15,704 is included in column B. This amount includes $7,685 earned in 2014 paid in 2015 and $8,019 earned in 2015 and paid in 2015. Form 990, Part VI, Section A, line 2 Two or more of the persons listed in this Form 990, Part VII have a business relationship with each other by virtue of sitting on one or boards of directors/trustees or by serving in employment relationship one or more entities within the network of affiliated organizations. Form 990, Part VI, Section A, line 6 As a Massachusettts nonprofit organization, Health New England has no stockholders and one legal Member - Baystate Health, Inc. HNE refers to its enrollees as "members," but HNE's organizational documents and Bylaws give enrollees no organizational membership status from a legal perspective. Form 990, Part VI, Section A, line 7a Baystate Health, Inc. is the sole member of Health New England, Consequently, Baystate Health has final authority on all appointments and elections to the Health New England, Inc. Board. Form 990, Part VI, Section A, line 7b The functions of a nominating committee are carried out by the Governance Committee of Baystate Health and the Baystate Health Audit and Compliance committee has full audit oversight duties and responsibilities for Health New England. Form 990, Part VI, Section B, line 11 Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Finance and Legal Departments of Health New England, Inc., some of whom are officers of the filing organization. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was sent out to the Board of Directors and Officers of Health New England, Inc. for comment and review. Form 990, Part VI, Section B, line 12c Health New England, Inc. has a comprehensive conflict of interest policy. All directors, officers, key employees, and highest compensated employees of HNE and its affiliates are asked to complete an annual "conflict of interest" form. We use an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the Director of Compliance and the Health New England Legal Department. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. HNE employees also sign an annual statement which affirms that such person: (a) has received a copy of the Conflict of Interest Policy; (b) has read and understands the Conflict of Interest Policy; and (c) has agreed to comply with the Conflict of Interest Policy. Form 990, Part VI, Section B, line 15 The compensation of the President and CEO and of other key officers and key employees is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the independent compensation committee of Health New England, Inc. and all such deliberations and decisions are documented contemporaneously. Form 990, Part VI, Section C, line 19 Available on request and at management's discretion Form 990, Part XI, line 9: Decrease in non-admitted assets -6,336,629. Capital Contribution from Baystate Health 1,125,000. Surplus Note from Baystate Health 20,000,000. Form 990, Part XII, Line 1: The audited financial statements are based on Insurance Statutory Accounting Principles (AAP) promulgated by the Accounting Practices and Procedures Task Force under the auspices of the National Association of Insurance Commissioners (NAIC). This form of accounting is typically looked upon as more conservative than accrual accounting without quite being cash basis. The accompanying statutory financial statements of the Company have been prepared in accordance with the National Association of Insurance Commissioners (NAIC) Accounting Practices and Procedures Manual for Statutory Accounting Principles (NAIC SAP), which do not differ from the accounting practices prescribed by the Division of Insurance of the Commonwealth of Massachusetts. NAIC SAP does differ from the accounting principles generally accepted in the United States of America (GAAP). The significant variances from GAAP are as follows: Investments-Investments in bonds are reported at amortized cost or fair value based on their NAIC rating; for GAAP, such fixed maturity investments would be designated at purchase as held-to-maturity, trading, or available-for-sale. Held-to-maturity fixed investments would be reported at amortized cost, and the remaining fixed maturity investments would be reported at fair value. For statutory purposes, unrealized gains and losses on investments are excluded from net income, and reported as an increase or decrease in surplus, except that declines in fair value that are determined by management to be other than temporary are reported as realized losses. HNE has elected the fair value option for certain of its investments. HNE made this election to reflect changes in fair value of its investments, including both increases and decreases and whether realized or unrealized, in its excess of revenue over expenses for GAAP purposes. All single-class and multiclass mortgage-backed/asset-backed securities (e.g., CMOs) are adjusted for the effects of changes in prepayment assumptions on the related accretion of discount or amortization of premium of such securities using the prospective method. If it is determined that a decline in fair value is other than temporary, the cost basis of the security is written down to the present value of estimated future cash flows using the original effective interest rate inherent in the security. Investments in Affiliates-The results of HNE's investments in unconsolidated affiliates are accounted for on the equity method under GAAP, whereas under NAIC SAP the investment is valued at book value with unrealized gains or losses recorded directly to net worth. GAAP also requires the consolidation of all wholly owned subsidiaries. As HAS, HIS and HHE are not audited, the investments in these subsidiaries are not admitted in accordance with SSAP No. 97. Nonadmitted Assets-Certain assets designated as "nonadmitted," principally certain deferred taxes, electronic data processing equipment, prepaid items, certain health care receivables, receivables over 90 days' past due, and the equity value of subsidiaries, are excluded from the accompanying statutory-basis statements of admitted assets, liabilities, and capital and surplus and are charged directly to unassigned surplus. Under GAAP, such assets are included in the balance sheets, to the extent they are not impaired. Deferred Income Taxes-Due to the Company's conversion to a tax-exempt entity and the IRS determination letter, deferred tax balances will no longer be recognized. Surplus Notes - GAAP classifies surplus notes in liabilities, whereas NAIC SAP classifies them in statutory net worth. Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Improve the health of people in our communities every day. 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