2016-11-14T17:17:41-06:00 2015-12-31 840795096 DALBY WENDLAND & CO PC P O BOX 430 GRAND JUNCTION CO 81502 990 2015-01-01 840614905 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED ROCK 9702447760 2775 CROSSROADS BOULEVARD GRAND JUNCTION CO 81506 PATRICK J DUNCAN CHIEF FINANCIAL OFFICER 9702447760 2016-11-14 1 SABRINA J HOYT CPA P00855363 9702431921 2015 2017-02-10 21:41:12Z ROCKY MOUNTAIN HEALTH PLANS STEPHEN ERKENBRACK 2775 CROSSROADS BOULEVARD GRAND JUNCTION CO 81506 685592678 0 X WWW.RMHP.ORG X 1971 CO COORDINATE THE FINANCE AND DELIVERY OF HIGH QUALITY HEALTH CARE AND RELATED SERVICES THROUGH COMMUNITY BASED ORGANIZATIONAL STRUCTURE TO A BROAD CROSS-SECTION OF COLORADANS, FOCUSING ON PREVENTATIVE CARE, ACCESS AND QUALITY IMPROVEMENT FOR THE BENEFIT OF MEMBERS AND THE GREATER COMMUNITY. 14 11 0 0 10411 0 836601 288178 578135503 652200772 3083341 4111080 402574 424382 582458019 657024412 862780 612355 538482566 607858114 2217970 4629754 0 0 0 54759984 65465226 596323300 678565449 -13865281 -21541037 203148763 222417395 109463852 152743924 93684911 69673471 X MISSIONCOORDINATE THE FINANCE AND DELIVERY OF HIGH QUALITY HEALTH CARE AND RELATED SERVICES THROUGH COMMUNITY BASED ORGANIZATIONAL STRUCTURE TO A BROAD CROSS-SECTION OF COLORADANS, FOCUSING ON PREVENTATIVE CARE, ACCESS AND QUALITY IMPROVEMENT FOR THE BENEFIT OF MEMBERS AND THE GREATER COMMUNITY. 0 0 298361775 300219276 EMPLOYER GROUP AND INDIVIDUAL PLANS:PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 44,000 PEOPLE ENROLLED THROUGH EMPLOYER GROUP AND INDIVIDUAL PLANS. OVER 90% OF EMPLOYER GROUPS WERE SMALL BUSINESSES. 140959866 156636533 MEDICARE PLANS:PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 24,000 MEDICARE BENEFICIARIES, OVER HALF OF WHOM RESIDE IN RURAL AREAS NOT SERVED BY ANY OTHER MANAGED CARE PLAN. MEMBERS RECEIVED BROAD ACCESS TO MEDICAL CARE AND WELLNESS PROGRAMS. 168536473 195344963 MEDICAID PLANS:UNDER THE MEDICAID ASO AGREEMENT, RMHMO PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO MEDICAID RECIPIENTS IN 7 RURAL COUNTIES, ENSURING ACCESS TO QUALITY MEDICAL CARE NOT OTHERWISE AVAILABLE. SAVED TAXPAYER DOLLARS WHILE EXCEEDING NATIONAL BENCHMARKS FOR QUALITY. THIS PROGRAM CONTRACTUALLY ENDED IN 2014 BUT THE ORGANIZATION HAD RUN-OUT IN 2015.EXPENSES $ 973,318. INCLUDING GRANTS OF $ 0. REVENUE $ 7,253,345.EFFECTIVE ON SEPTEMBER 1, 2014, RMHP LAUNCHED A NEW MEDICAID PAYMENT REFORM PILOT KNOWN AS MEDICAID PRIME, WHICH IS AUTHORIZED STATUTORILY BY THE COLORADO GENERAL ASSEMBLY. NEW PAYMENT METHODS AND QUALITY METRICS ARE BEING TESTED TO IMPROVE ACCESS AND VALUE FOR COLORADO MEDICAID RECIPIENTS IN A RIGOROUS, EXTERNALLY EVALUATED DEMONSTRATION. AN AVERAGE OF 36,000 ENROLLEES WERE SERVED BY RMHP IN MEDICAID PRIME DURING 2015.EXPENSES $143,715,599. INCLUDING GRANTS OF $0. REVENUE $160,328,344. CHILDREN'S HEALTH PLAN PLUS:THROUGH THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, RMHMO PROVIDED MEDICAL BENEFIT SERVICES AND PROGRAMS TO OVER 7,000 CHILDREN IN LOW-INCOME HOUSEHOLDS IN 22 RURAL COUNTIES IN WESTERN COLORADO THROUGH PARTICIPATION IN CHILDREN'S HEALTH PLAN PLUS PROGRAM. THESE CHILDREN GAINED ACCESS TO HIGH QUALITY MEDICAL CARE THROUGH A MANAGED CARE PROGRAM THAT PROVIDES CASE MANAGEMENT AND CARE COORDINATION.EXPENSES $ 13,296,213. INCLUDING GRANTS OF $ 0. REVENUE $ 13,814,447. REGIONAL CARE COLLABORATIVE:AS PART OF A CONTRACT AWARD RECEIVED FROM THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, RMHMO PROVIDES SERVICES AS PART OF A REGIONAL CARE COLLABORATIVE ORGANIZATION FOR THE MEDICAID PROGRAM, WHOSE GOALS ARE TO IMPROVE HEALTH OUTCOMES OF MEDICAID RECIPIENTS BY ADDRESSING HEALTH NEEDS AND TO CONTROL COSTS BY REDUCING INAPPROPRIATE USE OF HEALTH CARE RESOURCES, EFFORTS FOCUS ON PROVIDING CARE COORDINATION AND CARE MANAGEMENT SERVICES TO MEDICAID RECIPIENTS; PROVIDING A FOCAL POINT OF CARE; ENSURING POSITIVE PATIENT AND PROVIDER EXPERIENCES; AND APPLYING STATEWIDE DATA TO SUPPORT DATA-DRIVEN QUALITY IMPROVEMENT INTERVENTIONS. THE CONTRACT COVERS 22 COUNTIES IN COLORADO AND SERVES OVER 119,000 MEDICAID CLIENTS.EXPENSES $ 10,551,343. INCLUDING GRANTS OF $ 0. REVENUE $ 13,948,827. 1002148 612355 MISCELLANEOUS PROGRAMSCOLLABORATED WITH HEALTH CARE PROVIDERS AND COMMUNITY ORGANIZATIONS TO ADDRESS IDENTIFIED NEEDS, TO SUPPORT IMPROVEMENTS IN MEDICAL MANAGEMENT AND QUALITY OF CARE, TO FUND RESEARCH, HEALTH AND ASSIST THOSE AT-RISK AND VULNERABLE IN OUR COMMUNITIES. THE VALUE OF RMHP WELLNESS EDUCATION, AND LEADERSHIP, VOLUNTEER TIME AND IN-KIND SUPPORT HAS NOT BEEN QUANTIFIED.EXPENSES $ 1,002,148. INCLUDING GRANTS OF $ 612,355. REVENUE $ 0. TOTAL OTHER PROGRAM SERVICES:CONTRIBUTION & GRANT REVENUE OF $288,178 WAS USED TO SUPPORT THESE OTHER PROGRAM SERVICE COSTS. 1002148 612355 608860262 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1 4900 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 14 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICK J DUNCAN CFO 9702447760 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 JOHN DAVID SEATON CHAIR OF THE BOARD 5.00 X X 5075 0 0 DIANE MARIE SCHWENKE VICE CHAIR OF THE BOARD 5.00 X X 9545 0 0 CORINNE MARIE JOHNSON SECRETARY 5.00 X X 600 0 0 MICHAEL WAYNE BLACKBURN BOARD MEMBER 5.00 X 6910 0 0 PAMELA PATRICIA HANES BOARD MEMBER 5.00 X 5583 0 0 DAVID WARREN TERRY DO BOARD MEMBER 5.00 X 525 0 0 WILLIAM JAMES KIRVEN III BOARD MEMBER 5.00 X 525 0 0 GARY DALLAS KNAUS MD BOARD MEMBER 5.00 X 525 0 0 WILLIAM ALFORD KELLEY MD BOARD MEMBER 5.00 X 300 0 0 ARTHUR CURTIS ROBINSON BOARD MEMBER 5.00 X 3835 0 0 EUGENE CHRISTIAN LAUNER BOARD MEMBER 5.00 X 3665 0 0 JAY YOUNG WANT MD BOARD MEMBER 5.00 X 10012 0 0 ROBERT GLEN WILSON BOARD MEMBER 5.00 X 4299 0 0 EDWARD LEROY FORSMAN BOARD MEMBER 5.00 X 150 0 0 STEPHEN K ERKENBRACK PRESIDENT AND CEO 40.00 X 0 1834287 189469 LAUREL D WALTERS CHIEF OPERATING OFFICER 40.00 X 0 796500 148714 PATRICK J DUNCAN CHIEF FINANCIAL OFFICER 40.00 X 0 938549 153954 MICHAEL E HUOTARI VICE PRESIDENT 40.00 X 0 247068 69419 NEIL J WALDRON VICE PRESIDENT 40.00 X 0 304872 74099 KEVIN R FITZGERALD CHIEF MEDICAL OFFICER 40.00 X 0 280700 106419 JANICE L ROHR FORMER VICE PRESIDENT 5.00 X 0 109120 0 JAMES SWAYZE FORMER VICE PRESIDENT 40.00 X 0 372251 171132 51549 4883347 913206 0 1 1 0 MEDIMPACT HEALTHCARE SYSTEMS INC 450 B STREET SAN DIEGO CA 92101 RX PAYMENTS 143190477 ST MARY'S HOSPITAL & MEDICAL CENTER IN PO BOX 62 GRAND JUNCTION CO 81502 MEDICAL PAYMENTS 60837373 ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORA 2775 CROSSROADS BLVD GRAND JUNCTION CO 81502 MANAGEMENT SERVICES 44751387 COLORADO WEST HEALTHCARE SYSTEM DBA CO 2021 N 12TH ST GRAND JUNCTION CO 81501 MEDICAL PAYMENTS 18991404 CATHOLIC HEALTH INITIATIVES COLORADO PO BOX 911057 DENVER CO 80291 MEDICAL PAYMENTS 18512470 425 15834 272344 288178 MEDICARE/MEDICAID PMTS 524114 338085426 338085426 PREMIUMS AND CO-PAYS 524114 299937106 299937106 CHILD HEALTH PLAN 524114 13814447 13814447 OTHER PROGRAMS 524114 363793 363793 652200772 871117 871117 151178 151178 0 0 31656831 220 28413042 4046 3243789 -3826 3239963 3239963 MISCELLANEOUS INCOME 524114 424382 10411 413971 424382 657024412 652200772 10411 4525051 612355 612355 607858114 607858114 4629754 4629754 30361677 163506 30198171 1068191 1068191 223897 223897 66450 66450 40223 40223 1474312 1474312 1811107 1811107 3854373 3854373 1051317 1051317 98734 98734 3434885 3434885 408297 139563 268734 BROKER COMMISSIONS 6168684 6168684 ACA REGULATORY FEE EXPE 5561964 5561964 VARIOUS IPA EXPENSES 463584 463584 REPAIRS AND MAINTENANCE 388849 388849 8988682 86724 8901958 678565449 608860262 69705187 0 28573363 86306428 1887844 563874 106527327 66022523 1087923 1287424 48216228 29874776 16684555 18341452 27480622 25443275 6315303 8028633 14591826 16423786 203148763 222417395 104512222 143995681 4852450 6420009 99180 2328234 109463852 152743924 X 93684911 69673471 93684911 69673471 203148763 222417395 -21541037 -2470403 0 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2671913 2671913 8320956 2591975 5728981 37223359 27282801 9940558 18341452 ACCRUED INTEREST RECEIVABLE 75348 SURPLUS NOTE TO ROCKY MOUNTAIN HEALTHCARE OPTIONS, INC 16348438 16423786 CONTINGENCY RESERVE 2328234 2328234 1 ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841424932 501(C)(3) 138224 CONTRIBUTIONS SUPPORT VARIOUS INITIATIVES INCLUDING, BUT NOT LIMITED TO, FUNDS TO SUPPORT INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE, AN INNOVATIVE MEDICAL RESEARCH PROGRAM TO STUDY CONCUSSION TREATMENT AND THE "BABY AND ME -- TOBACCO FREE" PROGRAM RUN BY THE FOUNDATION THAT HELPS KEEP WOMEN FROM SMOKING DURING AND AFTER PREGNANCY. THE CONTRIBUTIONS ALSO FUND A BEHAVIORAL HEALTH CLINIC THAT RESIDES WITH THE LARGEST PRIMARY CARE PRACTICE IN MESA COUNTY, COLORADO, WHICH AMONG OTHER THINGS, COORDINATED MENTAL HEALTH AND MEDICAL CARE FOR PATIENTS FROM SEVEN COUNTIES ON THE WESTERN SLOPE OF COLORADO. MARILLAC CLINIC 2333 N 6TH STREET GRAND JUNCTION CO 81501 841085822 501(C)(3) 75000 CONTRIBUTIONS SUPPORT VARIOUS INITIATIVES INCLUDING, BUT NOT LIMITED TO, ACCESS FOR PROPER DENTAL CARE FOR PREGNANT WOMEN WHO ARE EITHER UNDERINSURED OR UNINSURED WHICH HELPS TO PREVENT PREMATURE BIRTHS AND LOW BIRTH RATES. HILLTOP COMMUNITY RESOURCES 1331 HERMOSA AVE GRAND JUNCTION CO 81506 742321009 501(C)(3) 98000 CONTRIBUTION HELPS SUPPORT THE WESTERN SLOPE OUTREACH AND ENROLLMENT PROGRAM (B4 BABIES AND BEYOND) THAT PROMOTES HEALTHY WOMEN AND CHILDREN BY PROVIDING EARLY ACCESS TO PRENATAL HEALTH CARE. COLORADO MESA UNIVERSITY FOUNDATION 1450 NORTH 12TH STREET GRAND JUNCTION CO 81501 846037667 501(C)(3) 50000 PROVIDED GRANT FUNDING TO EXPAND THE COLLEGE'S NURSING PROGRAM IN AN EFFORT TO INCREASE ENROLLMENT RESULTING IN A HIGHER AVAILABILITY OF LICENSED NURSES. HOPEWEST PO BOX 60307 GRAND JUNCTION CO 81506 841207388 501(C)(3) 240000 HOSPICE IS BASED UPON A PHILOSOPHY OF COMPASSION, COMFORT, PERSONAL CHOICE, AND MOST IMPORTANTLY, HOPE. HOSPICE & PALLIATIVE CARE OF WESTERN COLORADO OFFERS MANY PROGRAMS AND SERVICES TO HELP PATIENTS, FAMILIES, AND THE COMMUNITIES THEY SERVE UNDERSTAND AND COPE WITH THE MULTIPLE ISSUES THAT ARISE WHEN FACING ILLNESS, GRIEF, AND THE END OF LIFE. THE PURPOSE OF THE CONTRIBUTION WAS TO ASSIST WITH OPERATIONAL EXPENSES FOR THE MISSION OF THE HOSPICE AND TO PROVIDE A CAPITAL CONTRIBUTION FOR A NEW HOSPICE FACILITY IN MONTROSE, COLORADO. STRIVE 950 GRAND AVE GRAND JUNCTION CO 81501 846044855 501(C)(3) 11131 CONTRIBUTIONS SUPPORT VARIOUS ACTIVITIES INCLUDING ASSISTING INDIVIDUALS, YOUNG AND OLD, WHO LIVE WITH DEVELOPMENTAL DISABILITIES TO HAVE ACCESS AND SUPPORT TO COMMUNITY SERVICES AND OTHER GENERAL PROGRAM SERVICES THAT PROMOTE THE NON-PROFIT MISSION. 6 0 PART I, LINE 2: THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE REVIEWS THE UNDERLYING MERIT OF AN ORGANIZATION'S REQUEST PRIOR TO GRANTING FUNDS. THE BOARD, ITS COMMITTEES AND/OR MANAGEMENT ALSO MONITOR AND INQUIRE ON THE UNDERLYING PROGRAM AS A WHOLE. X X X 0 1 0 0 0 0 0 0 0 STEPHEN K ERKENBRACK PRESIDENT AND CEO 0 377787 0 77750 0 1378750 0 170250 0 19219 0 2023756 0 1378750 LAUREL D WALTERS CHIEF OPERATING OFFICER 0 239083 0 54750 0 502667 0 138200 0 10514 0 945214 0 502667 PATRICK J DUNCAN CHIEF FINANCIAL OFFICER 0 257466 0 65750 0 615333 0 139000 0 14954 0 1092503 0 615333 MICHAEL E HUOTARI VICE PRESIDENT 0 199963 0 47105 0 0 0 50200 0 19219 0 316487 0 0 NEIL J WALDRON VICE PRESIDENT 0 247647 0 57225 0 0 0 59200 0 14899 0 378971 0 0 KEVIN R FITZGERALD CHIEF MEDICAL OFFICER 0 226170 0 54530 0 0 0 80700 0 25719 0 387119 0 0 JANICE L ROHR FORMER VICE PRESIDENT 0 0 0 0 0 109120 0 0 0 0 0 109120 0 102678 JAMES SWAYZE FORMER VICE PRESIDENT 0 297416 0 74835 0 0 0 158821 0 12311 0 543383 0 0 SCHEDULE J, PART I, LINE 4B JAMES SWAYZE PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN WITH CNIC, A RELATED ORGANIZATION. NO AMOUNTS HAVE BEEN PAID TO OR RECEIVED BY JAMES SWAYZE FROM THIS PLAN. STEPHEN K ERKENBRACK, LAUREL D WALTERS, PATRICK J DUNCAN, MICHAEL E. HUOTARI, NEIL J WALDRON, AND KEVIN R. FITZGERALD PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN WITH ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC), A RELATED ORGANIZATION. THE AMOUNTS REFLECTED IN PART II, COLUMN C, REPRESENT THE AMOUNTS ACCRUED BUT UNVESTED BY THOSE INDIVIDUALS DURING THE YEAR. THE AMOUNTS REFLECTED IN PART II, COLUMNS B(III) AND F FOR STEPHEN K ERKENBRACK, LAUREL D WALTERS, AND PATRICK J DUNCAN REPRESENT AMOUNTS VESTED BY THOSE INDIVIDUALS DURING THE YEAR UNDER THE NONQUALIFIED DEFERRED COMPENSATION PLAN. NO AMOUNTS HAVE BEEN PAID TO OR RECEIVED BY THOSE LISTED FROM THIS PLAN. JANICE L. ROHR PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN WITH ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC), A RELATED ORGANIZATION. JANICE ROHR RECEIVED $102,678 FROM THIS PLAN. SCHEDULE J, PART II EXCEPT FOR JAMES SWAYZE, ALL THE COMPENSATION INCLUDED ON SCHEDULE J IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC). HMC IS A RELATED ORGANIZATION WITH WHOM ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO) HAS A CONTRACT FOR MANAGEMENT SERVICES. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ORGANIZATION TO RMHMO AND IS LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J (EXCEPT JAMES SWAYZE) IS 100% OF THE COMPENSATION PAID BY HMC TO THESE INDIVIDUALS. HOWEVER, APPROXIMATELY 89% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 11% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. JAMES SWAYZE'S COMPENSATION (INCLUDING AMOUNTS REPORTED UNDER DEFERRED COMPENSATION) IS INCURRED BY CNIC HEALTH SOLUTIONS, INC. (CNIC). CNIC IS A WHOLLY-OWNED SUBSIDIARY OF ROCKY MOUNTAIN HEALTHCARE OPTIONS, INC. (RMHCO) AND THEREFORE A RELATED ORGANIZATION. MR. SWAYZE IS THE CEO AND PRESIDENT OF CNIC AND DEDICATES SUBSTANTIALLY ALL HIS EFFORTS TO THE DAY-TO-DAY OPERATIONS OF CNIC. MESA COUNTY PHYSICIANS IPA INC BOARD MEMBER, DAVID TERRY, IS A DIRECTOR OF MESA COUNTY PHYSICIANS IPA, INC 2419436 CONTRACTUAL MEDICAL PAYMENTS 0 DAVID WARREN TERRY DO BOARD MEMBER 108140 MEDICAL PROVIDER PAYMENTS 0 HOSKINFARINA & KAMPF PC B.O.D ASS'T SEC., DAVID SCANGA, IS A HOSKIN, FARINA & KAMPF SHAREHOLDER 668259 GENERAL LEGAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTS WITH A RELATED ENTITY, ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC), TO PERFORM MANAGEMENT SERVICES FOR THE ORGANIZATION. HMC HAS A SEPARATE GOVERNING BOARD. THE COMPENSATION REPORTED ON PART VII AND SCHEDULE J FOR THOSE INDIVIDUALS WHO ARE NOT DIRECTORS OF THE ORGANIZATION BUT WHO ARE LISTED AS OFFICERS OR OTHER EMPLOYEES OF THE ORGANIZATION WAS PAID BY HMC. FORM 990, PART VI, SECTION B, LINE 11 THE ENTIRE 990 IS DISTRIBUTED TO EACH DIRECTOR. EACH DIRECTOR IS GIVEN THE OPPORTUNITY TO ASK QUESTIONS AND/OR PROVIDE COMMENTS PRIOR TO FILING. THE FORM 990 AND TAX RETURN IS APPROVED BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE COMPREHENSIVE CONFLICT OF INTEREST DISCLOSURE STATEMENTS. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE MAINTAINED BY THE ORGANIZATION AND ARE REVIEWED ANNUALLY BY THE ORGANIZATION'S LEGAL COUNSEL. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE COVERED UNDER THE POLICY. BEFORE EACH BOARD MEETING, LEGAL COUNSEL, THE CHAIR OF THE BOARD, AND THE CEO REVIEW THE AGENDA AND DETERMINE IF THERE IS A CONFLICT OF INTEREST POTENTIAL FOR EACH BOARD ACTION ITEM, AND DURING EACH BOARD MEETING LEGAL COUNSEL, THE CHAIR OF THE BOARD AND THE CEO ARE PRESENT AND DO THE SAME. IF THERE IS A POTENTIAL FOR A CONFLICT, THE BOARD IS ADVISED AND THE BOARD ACTS IN ACCORDANCE WITH ITS CONFLICT OF INTEREST POLICY. IF SOMEONE HAS A CONFLICT, THAT PERSON CANNOT PARTICIPATE IN THE DELIBERATIONS OR DECISION ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS INCLUDED ARE CEO, CFO, COO, MEDICAL DIRECTOR AND VICE PRESIDENTS. COMPARABILITY DATA IS USED TO DETERMINE COMPENSATION. A THIRD PARTY COMPENSATION EXPERT REPORT CERTIFIES THE REASONABLENESS OF THE COMPENSATION AMOUNTS. THIS PROCESS WAS USED IN 2015. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST TO THE EXTENT REQUIRED BY APPLICABLE LAW. FORM 990 PART XII LINE 2C THE BOARD ASSUMES RESPONSIBILITY FOR THE AUDIT, WHICH IS DONE ON THE STATUTORY BASIS OF ACCOUNTING, AND SELECTION OF AN INDEPENDENT AUDITOR. FORM 990, PART VII, SECTION A, LINE 1A, COMPENSATION INFORMATION: EXCEPT FOR JAMES SWAYZE, ALL THE COMPENSATION INCLUDED ON SCHEDULE J IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC) A RELATED ORGANIZATION. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ORGANIZATION TO RMHMO AND IS LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J (EXCEPT JAMES SWAYZE) IS 100% OF THE COMPENSATION PAID BY HMC TO THESE INDIVIDUALS. HOWEVER, APPROXIMATELY 89% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 11% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. FORM 990, NARRATIVE STATEMENT: ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO)D/B/A ROCKY MOUNTAIN HEALTH PLANS IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTH BENEFITS PROVIDER THAT HAS SERVED THE HEALTH CARE NEEDS OF COLORADANS FOR OVER 40 YEARS. RMHMO UNIQUELY UNDERSTANDS COLORADO'S HEALTH CARE CONSUMERS. WE PROVIDE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE ENABLING OUR MORE THAN 230,000 MEMBERS TO LIVE LONGER, HEALTHIER LIVES. RMHMO IS KNOWN AS A STRONG AND TRUSTED LEADER IN HEALTH CARE AND IS EVER COMMITTED TO ITS COMMUNITY BENEFIT GOALS. THE ORGANIZATION IS DILIGENT AND DEVOTED TO PROVIDING INNOVATIVE, QUALITY HEALTH PLANS, IMPROVING ACCESS TO HEALTH CARE COVERAGE, AND IMPROVING THE WELL BEING OF INDIVIDUALS, FAMILIES, AND THE COMMUNITIES WE SERVE. VISION WE ARE A COST EFFECTIVE, EFFICIENTLY RUN ORGANIZATION IN THE HEALTH CARE INDUSTRY. WE ADD VALUE TO EVERYONE WE TOUCH. MISSION WE TAKE THE INITIATIVE TO IMPROVE THE LIVES OF OUR MEMBERS AND THE HEALTH OF OUR COMMUNITIES BY OFFERING INNOVATIVE HEALTH PLANS, PROVIDING EXCELLENCE IN SERVICE AND CARE OF OUR MEMBERS, AND STAYING TRUE TO OUR TRADITION OF PUTTING PEOPLE BEFORE PROFITS. VALUES WE MAKE DECISIONS BASED ON THE WELL BEING OF OUR MEMBERS. WE ARE RESPECTFUL, COMPASSIONATE, AND FAIR. WE ARE INNOVATIVE AND ACTION-ORIENTED. WE HONOR THE RIGHTS OF PHYSICIANS AND PATIENTS IN MEDICAL DECISION-MAKING. WE ARE CATALYSTS FOR CONTINUOUS QUALITY IMPROVEMENT. WE BELIEVE THAT THE QUALITY OF OUR RELATIONSHIPS SHAPES OUR FUTURE. SERVING THE UNDERSERVED CHILDREN'S HEALTH PLANS PLUS (CHP+) & CHILDREN'S HEALTH PLAN PRENATAL SERVICES RMHMO OFFERS CHP+ COVERAGE TO INDIGENT CHILDREN AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES TO PREGNANT WOMEN. IN 2015, RMHMO SERVED OVER 7,000 INDIGENT CHILDREN AND PREGNANT WOMEN UNDER THE CHP+ AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES PROGRAM THROUGHOUT 22 COLORADO COUNTIES. THE RMHMO MEDICAID AND CHP+ PROGRAMS CONTINUALLY RECEIVE THE HIGHEST APPROVAL RATING IN ALL PROGRAM CATEGORIES, INCLUDING OVERALL RATING OF HEALTH PLAN. THIS ACHIEVEMENT EXEMPLIFIES A 40-PLUS YEAR COMMITMENT THAT ROCKY MOUNTAIN HEALTH PLANS HAS MADE TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE UNDERSERVED IN COLORADO. MEDICAID PRIME: EFFECTIVE SEPTEMBER 1, 2014, RMHMO AND THE DEPARTMENT OF HEALTH CARE POLICY & FINANCING ("HCPF") ENTERED INTO A NEW PROGRAM REFERRED TO AS "MEDICAID PRIME" TO REPLACE RMMHO'S THEN EXISTING MEDICAID PROGRAM. THE MEDICAID PRIME PROGRAM WAS THE RESULT OF A COLLABORATIVE EFFORT BETWEEN RMHMO AND HCPF. MEDICAID PRIME IS A PROGRAM DESIGNED WITH THE OBJECTIVE TO REFORM HOW THE MEDICAID POPULATION IS SERVED AND ENCOMPASSES AND ATTEMPTS TO INTEGRATE PHYSICAL HEALTH, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES. THE EFFORT TARGETS THE ENTIRE POPULATION BELOW 250 PERCENT OF THE FEDERAL POVERTY LEVEL. MAJOR PROGRAM THEMES UNDER THE PRIME PILOT PROGRAM INCLUDE: -PAYING FOR VALUE, NOT VOLUME -HEALTH EQUITY FOR VULNERABLE POPULATIONS -BEHAVIORAL HEALTH INTEGRATION AND "WHOLE PERSON CARE" -MORE FLEXIBILITY IN PROGRAM RULES, NOT MORE MONEY IN HEALTH CARE -PRIORITIZING RESOURCES WHILE ACCOUNTING FOR EVERYONE -ACCOUNTABLE COMMUNITIES, NOT ISOLATED PROVIDER SYSTEMS -SHARING DATA TO IMPROVE POPULATION HEALTH -SHARING BURDENS AND BENEFITS WITH PARTNERS -IMPROVING HEALTH CARE EFFICIENCY AS HEALTH INSURANCE COVERAGE EXPANDS THE GEOGRAPHIC AREA INCLUDED WITHIN RMHMO'S PLAN INCLUDES MESA, GARFIELD, PITKIN, GUNNISON, RIO BLANCO, AND MONTROSE COUNTIES. THE PROJECT IS THE OUTCOME OF NEARLY THREE YEARS OF DISCUSSION AMONG RMHMO, PHYSICIAN, HOSPITAL AND COMMUNITY MENTAL HEALTH CENTER LEADERS. ADDITIONAL PARTNERS INCLUDE THE MESA COUNTY DEPARTMENT OF PUBLIC HEALTH, FQHCS, INDEPENDENT PRIMARY CARE PRACTICES, AN ASPEN VALLEY EMPLOYER INITIATIVE, AND THE UNIVERSITY OF COLORADO DEPT. OF FAMILY MEDICINE. RMHMO AND HCPF WILL COLLABORATE TO STREAMLINE PROGRAM ADMINISTRATION, REFORM PAYMENT AT ALL LEVELS AND CREATE A MORE SUSTAINABLE, VALUE-ORIENTED MEDICAID DELIVERY MODEL IN WESTERN COLORADO. THE PURPOSE OF THIS REFORM IS TO ALIGN THE PAYMENT MODEL AT THE POINT OF CARE WITH QUALITY IMPROVEMENT AND COST CONTAINMENT OBJECTIVES FOR THE MEDICAID PROGRAM AS A WHOLE. AS PART OF A CONTRACT AWARD RECEIVED FROM THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, RMHMO PROVIDES SERVICES AS PART OF A REGIONAL CARE COLLABORATIVE ORGANIZATION FOR THE MEDICAID PROGRAM, WHOSE GOALS ARE TO IMPROVE HEALTH OUTCOMES OF MEDICAID RECIPIENTS BY ADDRESSING HEALTH NEEDS AND TO CONTROL COSTS BY REDUCING INAPPROPRIATE USE OF HEALTH CARE RESOURCES, EFFORTS FOCUS ON PROVIDING CARE COORDINATION AND CARE MANAGEMENT SERVICES TO MEDICAID RECIPIENTS; PROVIDING A FOCAL POINT OF CARE; ENSURING POSITIVE PATIENT AND PROVIDER EXPERIENCES; AND APPLYING STATEWIDE DATA TO SUPPORT DATA-DRIVEN QUALITY IMPROVEMENT INTERVENTIONS. THE CONTRACT COVERS 22 COUNTIES IN COLORADO AND IN 2015 SERVED OVER 119,000 MEDICAID CLIENTS. COMPREHENSIVE PRIMARY CARE INITIATIVE (CPC) DURING 2015, RMHP MADE $1,600,000 IN PAYMENTS TO PRIMARY CARE PRACTICES OPERATING UNDER A SPECIAL AGREEMENT WITH CMS TO UNDERTAKE SUBSTANTIAL "PRACTICE TRANSFORMATION" EFFORTS TO IMPROVE HEALTH CARE QUALITY AND REDUCE TOTAL COSTS. UNDER CPC, MEDICARE, MEDICAID AND SEVERAL PRIVATE HEALTH INSURANCE PLANS ALL CONTRIBUTE ALIGNED, NON-VOLUME PAYMENTS, ALIGN THEIR MEASURMENT PROGRAMS AND SHARE DATA TO ACCELERATE THE PACE OF IMPROVEMENT. GRAND VALLEY HEALTH FAIR CONTRIBUTION AS A MAJOR SPONSOR WITH MORE THAN 100 HOURS OF LABOR CONTRIBUTED TO THE PROGRAM THAT HELPS TO PROVIDE MESA COUNTY WITH COMMUNITY HEALTH AND AWARENESS SCREENINGS. STRIVE (F/K/A MESA DEVELOPMENTAL SERVICES) IS A TAX EXEMPT ENTITY THAT PROVIDES SERVICES FOR DEVELOPMENTALLY DISABLED INDIVIDUALS. THE RMHMO CONTRIBUTION ASSISTS INDIVIDUALS, YOUNG AND OLD, WHO LIVE WITH DEVELOPMENTAL DISABILITIES TO HAVE ACCESS AND SUPPORT TO COMMUNITY SERVICES. COLORADO MESA UNIVERSITY (F/K/A MESA STATE COLLEGE) NURSING PROGRAM PROVIDE GRANT FUNDING TO EXPAND THE COLLEGE'S NURSING PROGRAM IN AN EFFORT TO INCREASE ENROLLMENT RESULTING IN A HIGHER AVAILABILITY OF LICENSED NURSES. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION IS A TAX EXEMPT PUBLIC CHARITY. RMHMO'S CONTRIBUTION OFFERS SUPPORT TO NUMEROUS COMMUNITY PROJECTS AROUND THE STATE, SUCH AS: -HELPING INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE, -CREATING INCENTIVES FOR PREGNANT WOMEN TO STOP SMOKING, -HELPING SCHOOLS OFFER MORE PHYSICAL ACTIVITY FOR STUDENTS TO DECREASE OBESITY AND INCREASE TEST SCORES. -SPEARHEAD, WITH GRANT FUNDS, A BEHAVIORAL HEALTH CLINIC THAT RESIDES WITH THE LARGEST PRIMARY CARE PRACTICE IN MESA COUNTY, COLORADO, WHICH AMONG OTHER THINGS, COORDINATED MENTAL HEALTH AND MEDICAL CARE FOR PATIENTS FROM SEVEN COUNTIES ON THE WESTERN SLOPE OF COLORADO. WORKSITE WELLNESS PROGRAMS PROVIDE TOOLS, RESOURCES, AND TRAINING TO ASSIST EMPLOYERS IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THIS COMPREHENSIVE PROGRAM FOCUSES ON PROMOTING WELLNESS AND PREVENTING ILLNESS. RMHMO IS NAMED A GOLD WELL WORKPLACE BY THE WELLNESS COUNCIL OF AMERICA. RECOGNITION IS EARNED BY SUCCESSFULLY MEETING RIGOROUS HEALTH PROMOTION STANDARDS. BY EARNING THIS PRESTIGIOUS DESIGNATION, WE ARE RECOGNIZED AS ONE OF THE AMERICA'S HEALTHIEST COMPANIES. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841424932 TO FACILITATE PHILANTHROPIC SUPPORT FOR INNOVATIVE HEALTHCARE APPROACHES. CO 501(C)(3) 7 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED 0 QUALITY HEALTH NETWORK 2764 COMPASS DRIVE GRAND JUNCTION CO 81506 201632384 DEVELOPMENT, IMPLEMENT, & SUPPORT OF THE HEALTH INFORMATION EXCHANGE. CO 501(C)(3) 11, TYPE 1 N/A 0 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841224718 OFFERS ALTERNATIVE HEALTH CARE PRODUCTS IN THE AREA SERVICED BY RMHMO. CO ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED C 98860655 41299495 1.00000 1 CNIC HEALTH SOLUTIONS INC 6251 GREENWOOD PLAZA BLVD STE 300 GREENWOOD VILLAGE CO 80111 710873411 PROVIDES ADMIN SVCS FOR MEDICAL, DENTAL, AND CONSUMER DRIVEN HEALTH PLANS. CO ROCKY MOUNTAIN HEALTHCARE OPTIONS INC C 12561945 5039688 1.00000 1 LEIF ASSOCIATES INC 1515 ARAPAHOE ST STE 530 TOWER 1 DENVER CO 80202 841324324 PROVIDES ACTUARIAL AND DATA CONSULTING. CO ROCKY MOUNTAIN HEALTHCARE OPTIONS INC C 665051 1 ROCKY MOUNTAIN HEALTH MANAGEMENT CORP 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 841009248 PROVIDES MANAGEMENT SERVICES. CO ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INCORPORATED C 50966256 1133567 1.00000 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC N 82641 ROCKY MOUNTAIN HEALTH PLANS FOUNDATION INC B 138224 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC Q 2300153 LEIF ASSOCIATES INC M 972896 ROCKY MOUNTAIN HEALTHCARE OPTIONS INC D 2200000 ROCKY MOUNTAIN HEALTH MANAGEMENT CORP M 44751388 PART IV, IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS CORP OR TRUST: ALL OF THE STOCK IN LEIF ASSOCIATES, INC. WAS SOLD TO AN UNRELATED ENTITY AS OF 3/31/2015.