2016-05-02T19:46:51-05:00 2015-06-30 KPMG LLP 1676 International Drive McLean VA 22102 990 2014-07-01 541760974 VIRGINIA PREMIER HEALTH PLAN INC % TIMOTHY CARPENTER VIRG 8048195151 600 East Broad Street Richmond VA 23298 TIMOTHY E CARPENTER CHIEF FINANCIAL OFFICER 8048195164 2016-05-02 true WHITNEY E BLAIR P01226647 7032868000 2016-04-27 2014 2016-08-17 19:52:53Z JAMES PARROTT CEO 600 EAST BROAD STREET RICHMOND VA 23219 969940578 false X WWW.VAPREMIER.COM X 2010 VA TO ENSURE OUR MEMBERS RECEIVE THE HIGHEST QUALITY MEDICAL SERVICES. OUR GOAL IS TO IMPROVE THE HEALTH STATUS OF OUR MEMBERSHIP. 9 8 937 0 9176107 1857325 0 0 739261937 957916323 2159437 2848148 8313995 9176107 749735369 969940578 45350 33750 0 0 38806682 52024924 0 0 0 696621009 918133725 735473041 970192399 14262328 -251821 196604737 319536618 85510165 207297284 111094572 112239334 X VIRGINIA PREMIER HEALTH PLAN IS COMMITTED TO ENSURING OUR MEMBERS RECEIVE THE HIGHEST QUALITY MEDICAL SERVICES FROM OUR PHYSICIANS, HOSPITALS, AND OTHER HEALTH CARE PROVIDERS. THROUGH OPERATIONAL EXCELLENCE, OUR DEDICATED TEAM WILL PROMOTE MEMBER-FOCUSED SERVICES, CONTINUALLY FOSTER STRONG PROVIDER RELATIONSHIPS AND SHIFT MORE OF OUR FINANCIAL RESOURCES TO HEALTH CARE SERVICES. OUR GOAL IS TO IMPROVE THE HEALTH STATUS OF OUR MEMBERSHIP. GUIDING VALUES AND PRINCIPLES - SERVE AND SUPPORT THE VIRGINIA MEDICAID ELIGIBLE POPULATION - MEET THE HEALTH CARE NEEDS OF OUR MEMBERS - EMPOWER OUR MEMBERS THROUGH EDUCATION AND MEMBER-FOCUSED SERVICES - SUPPORT DOCTOR/PATIENT RELATIONSHIPS BY FOSTERING STRONG PROVIDER RELATIONSHIPS - EFFECTIVELY INTEGRATE MANAGED CARE ADMINISTRATION AND HEALTH CARE SERVICES - ABIDE BY ALL ETHICAL STANDARDS AND DEMONSTRATE INTEGRITY AND QUALITY IN ALL BUSINESS PRACTICES false false 947198811 33750 967092430 VIRGINIA PREMIER MAINTAINED CONTRACTS WITH AREA PROVIDERS TO SUPPLY HEALTH CARE, DISEASE PREVENTION, AND HEALTH PROMOTION FOR INDIVIDUALS AND FAMILIES IN THE COMMUNITY IN AN EFFECTIVE, ACCESSIBLE, AND AFFORDABLE MANNER. 947198811 true false false false false false false false false false true false false true true true false true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false true X 3529 0 true 937 true true true false false false false false false false false false false X 9 8 false false false false true false false true true false false false true true true true true true true false X TIMOTHY CARPENTER 8048195164 600 EAST BROAD STREET RICHMOND RICHMOND VA 23219 X Sheldon Retchin MD President 1.0 40.0 X X 0 1012278 68298 Donald Stern Director 1.0 0.0 X 0 0 0 Jennifer McClellan Director 1.0 0.0 X 0 0 0 Leonard Edloe Director 1.0 0.0 X 0 0 0 Jane Kusiak Director 1.0 0.0 X 0 0 0 Joe Teefey Director 1.0 0.0 X 0 0 0 Nadine Marsh-Carter Director 1.0 0.0 X 0 0 0 Steve Worley Director 1.0 0.0 X 0 0 0 Arline Bohannon MD Director 1.0 0.0 X 0 0 0 James Parrott CEO 40.0 0.0 X 361397 0 38423 Tim Carpenter CFO 40.0 0.0 X 289500 0 33726 Carl Gattuso CHIEF CORPORATE OFFICER, VCUHS 1.0 40.0 X 0 527855 54591 Dominic Puleo Chief Financial Officer, VCUHS 1.0 40.0 X 0 673836 43609 Renee Miskimmin MD CHIEF MEDICAL OFFICER 40.0 0.0 X 333976 0 25552 Linda Hines Chief Operating Officer 40.0 0.0 X 319978 0 36910 Patrick McMahon VP - CONTRACTING 40.0 0.0 X 265056 0 40283 Melvin Pinn MD MEDICAL DIRECTOR 40.0 0.0 X 261378 0 31142 Darrin Mangiacarne MD MEDICAL DIRECTOR 40.0 0.0 X 260893 0 32974 Mark Mattingly MD MEDICAL DIRECTOR 40.0 0.0 X 255034 0 29034 David Summers VP - INFORMATION SYSTEMS 40.0 0.0 X 251208 0 36842 Wallisa Vaughn MD MEDICAL DIRECTOR 40.0 0.0 X 231040 0 9025 Javier Menendez VP - Pharmacy 40.0 0.0 X 214543 0 43999 Harold Brooks VP - Member Services 40.0 0.0 X 214008 0 32101 Derrick Lee VP - Claims 40.0 0.0 X 210760 0 16230 Terry Granderson AVP - Information Systems 40.0 0.0 X 200102 0 29723 Alicia Turner VP - Human Resources 40.0 0.0 X 199252 0 24706 Mike Parker AVP - Information Systems 40.0 0.0 X 194920 0 33412 Gloria Reynolds VP - Compliance 40.0 0.0 X 179864 0 20698 Ryan McCarthy VP - External Services 40.0 0.0 X 165745 0 37134 Peter Pavell AVP - Contracting 40.0 0.0 X 159405 0 28131 Angela Moyer Controller 40.0 0.0 X 153634 0 31028 Shawn Fisher AVP - Medical Economics 40.0 0.0 X 150426 0 34323 Gene Pawlowski Director - Contracting 40.0 0.0 X 145940 0 39050 Dana Dreher-Rodwell VP - Compliance 40.0 0.0 X 136013 0 25974 5154072 2213969 876918 31 false true false CARILION MEDICAL CENTER INC P O Box 75311 BALTIMORE MD 212755311 Medical Claims 32354657 UVA Health Services P O Box 403059 ATLANTA GA 303843059 Medical Claims 31933429 VCU HEALTH SYSTEM P O BOX 758997 BALTIMORE MD 21275 Medical Claims 22202604 CENTRA HEALTH INC 1920 Atherholt Road LYNCHBURG VA 245010496 Medical Claims 11864314 Carilion Medical Center P O Box 826755 Philadelphia PA 191826755 Medical Claims 11444968 569 0 PREMIUMS EARNED 900099 957916323 957916323 957916323 2334649 2334649 0 0 0 0 0 513499 513499 513499 513499 0 0 0 TPA SERVICES 524292 9176107 9176107 9176107 969940578 957916323 9176107 2848148 33750 33750 0 0 0 8244959 5970175 2274784 0 42671834 30894347 11777487 0 1108131 802303 305828 0 0 0 0 0 0 455253 329610 125643 3709652 2685844 1023808 0 6073710 4397457 1676253 0 0 5964655 4318500 1646155 811366 587441 223925 0 0 3181438 2303409 878029 5299505 3836921 1462584 2747567 1989280 758287 0 Covered Medical Expenses 819393857 819393857 Uncovered Medical Expenses 67484898 67484898 OTHER ADMINISTRATIVE EXPENSES 2199671 1583008 616663 Postage and Delivery 812153 588011 224142 970192399 947198811 22993588 0 150 150 116784831 194502579 0 0 67032389 83351997 0 0 0 0 0 0 0 0 1894728 4343995 24456961 10291904 10229899 14165057 0 0 0 0 0 0 0 0 662740 23172840 196604737 319536618 80590253 112247852 0 0 0 623381 0 0 0 0 0 0 0 75000000 0 0 4919912 19426051 85510165 207297284 X 102822595 103967357 8271977 8271977 0 0 111094572 112239334 196604737 319536618 -251821 1396583 X false true X true false X 560052529 512248225 665811720 739261936 957916323 3435290733 0 0 0 0 560052529 512248225 665811720 739261936 957916323 3435290733 0 0 0 3435290733 265146 397937 1992869 1774019 2334649 6764620 0 265146 397937 1992869 1774019 2334649 6764620 0 0 560317675 512646162 667804589 741035955 960250972 3442055353 X 0.00000 303074 303074 5298642 1689037 3609605 18855245 8602867 10252378 14165057 DUE FROM AFFILIATES 22500000 DEPOSITS 71788 OTHER ASSETS 601052 23172840 0 DUE TO AFFILIATES 15739904 OTHER LIABILITIES 3686147 19426051 X FIN 48 FOOTNOTE PER AUDIT REPORT EFFECTIVE AUGUST 7, 2013, VIRGINIA PREMIER HEALTH PLAN, INC. (VAPHP) RECEIVED APPROVAL FROM THE IRS FOR TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE EFFECTIVE DATE OF EXEMPTION IS JULY 1, 2010. VAPHP WAS DETERMINED TO BE A PUBLIC CHARITY. VAPHP RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEIND SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. AT JUNE 30, 2015 AND 2014, VAPHP HAS NO INCOME TAX POSITIONS THAT ARE NOT CONSIDERED GREATER THAN 50% LIKELY OF BEING REALIZED. true VIRGINIA ASSOCIATION OF HEALTH PLANS 1111 E MAIN ST SUITE 910 RICHMOND VA 23219 541335178 501(C)(6) 16000 1 SCHEDULE I, PART I, LINE 2 VIRGINIA PREMIER HEALTH PLAN MAKES DONATIONS FROM TIME TO TIME TO ORGANIZATIONS RELATED TO VIRGINIA COMMONWEALTH UNIVERSITY OR VCU HEALTH SYSTEM AUTHORITY. X false false false false false false false false false Sheldon Retchin MD President 0 1012278 0 0 0 0 0 0 0 68298 0 1080576 0 0 Carl Gattuso CHIEF CORPORATE OFFICER, VCUHS 0 527855 0 0 0 0 0 0 0 54591 0 582446 0 0 Dominic Puleo Chief Financial Officer, VCUHS 0 673836 0 0 0 0 0 0 0 43609 0 717445 0 0 James Parrott CEO 361397 0 0 0 0 0 0 0 38423 0 399820 0 0 0 Tim Carpenter CFO 289500 0 0 0 0 0 0 0 33726 0 323226 0 0 0 Renee Miskimmin MD CHIEF MEDICAL OFFICER 333976 0 0 0 0 0 0 0 25552 0 359528 0 0 0 Linda Hines Chief Operating Officer 319978 0 0 0 0 0 0 0 36910 0 356888 0 0 0 Patrick McMahon VP - CONTRACTING 265056 0 0 0 0 0 0 0 40283 0 305339 0 0 0 Melvin Pinn MD MEDICAL DIRECTOR 261378 0 0 0 0 0 0 0 31142 0 292520 0 0 0 Darrin Mangiacarne MD MEDICAL DIRECTOR 260893 0 0 0 0 0 0 0 32974 0 293867 0 0 0 Mark Mattingly MD MEDICAL DIRECTOR 255034 0 0 0 0 0 0 0 29034 0 284068 0 0 0 David Summers VP - INFORMATION SYSTEMS 251208 0 0 0 0 0 0 0 36842 0 288050 0 0 0 Wallisa Vaughn MD MEDICAL DIRECTOR 231040 0 0 0 0 0 0 0 9025 0 240065 0 0 0 Javier Menendez VP - Pharmacy 214543 0 0 0 0 0 0 0 43999 0 258542 0 0 0 Harold Brooks VP - Member Services 214008 0 0 0 0 0 0 0 32101 0 246109 0 0 0 Derrick Lee VP - Claims 210760 0 0 0 0 0 0 0 16230 0 226990 0 0 0 Terry Granderson AVP - Information Systems 200102 0 0 0 0 0 0 0 29723 0 229825 0 0 0 Alicia Turner VP - Human Resources 199252 0 0 0 0 0 0 0 24706 0 223958 0 0 0 Mike Parker AVP - Information Systems 194920 0 0 0 0 0 0 0 33412 0 228332 0 0 0 Gloria Reynolds VP - Compliance 179864 0 0 0 0 0 0 0 20698 0 200562 0 0 0 Ryan McCarthy VP - External Services 165745 0 0 0 0 0 0 0 37134 0 202879 0 0 0 Peter Pavell AVP - Contracting 159405 0 0 0 0 0 0 0 28131 0 187536 0 0 0 Angela Moyer Controller 153634 0 0 0 0 0 0 0 31028 0 184662 0 0 0 Shawn Fisher AVP - Medical Economics 150426 0 0 0 0 0 0 0 34323 0 184749 0 0 0 Gene Pawlowski Director - Contracting 145940 0 0 0 0 0 0 0 39050 0 184990 0 0 0 Dana Dreher-Rodwell VP - Compliance 136013 0 0 0 0 0 0 0 25974 0 161987 0 0 0 Form 990, Part VI, Section A, Line 6 VCU HEALTH SYSTEM AUTHORITY IS THE SOLE SHAREHOLDER OF VIRGINIA PREMIER HEALTH PLAN, INC. Form 990, Part VI, Section A, line 11a THE PLAN PREPARES FORM 990 WITH THE ASSISTANCE OF ITS INDEPENDENT ACCOUNTING FIRM, KPMG, WHO SIGNS THE RETURN AS PAID PREPARER. THE RETURN IS THEN REVIEWED BY THE FINANCE DIRECTOR. THE COMPLETE FORM 990 IS PROVIDED TO THE BOARD. Form 990, Part VI, Section B, lines 12a, 12b and 12c BOARD MEMBERS AND OFFICERS ARE REQUIRED ANNUALLY TO DISCLOSE CONFLICT OF INTEREST IN A FORM PRESCRIBED BY THE BOARD. THE CONFLICT STATEMENTS ARE REVIEWED BY THE BOARD. IN THE EVENT OF ANY CONFLICT, THE BOARD MEMBER WILL RECUES HIM OR HERSELF FROM ANY DELIBERATIONS REGARDING THE TRANSACTION. Form 990, Part VI, Section B, lines 15a and 15b SALARY WAS DETERMINED FROM COMPARABLE DATA WITH SIMILAR COMPANIES IN OUR HEALTHCARE FIELD, AND A COMPLETE ANALYSIS OF JOB DUTIES AND JOB DESCRIPTION. VIRGINIA PREMIER DOES NOT COMPENSATE ITS OFFICERS OR DIRECTORS OTHER THAN THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. Form 990, Part VI, Section C, line 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. VCU HEALTH SYSTEM AUTHORITY PO BOX 980510 RICHMOND VA 23298 541848065 HEALTHCARE VA 170(C )(1) NA false CAROLINA CRESECENT HEALTH PLAN INC 600 EAST BROAD STREET STE 400 RICHMOND VA 23219 205547869 HEALTH PLAN SC 501(C )(3) 9 NA false CRIPPLED CHILDREN'S HOSPITAL 2924 BROOK ROAD RICHMOND VA 23220 540506309 HOSPITAL VA 501(C )(3) 3 VCUHSA false UNIVERSITY HEALTH SERVICES INC PO BOX 980512 RICHMOND VA 23298 541790550 EDUCATION VA 501(C )(3) 11-1 VCUHSA false MCV ASSOCIATED PHYSICANS PO BOX 980620 RICHMOND VA 23298 541581185 HEALTHCARE VA 501(C )(3) 11-1 NA false COMMUNITY MEMORIAL HOSPITAL 125 BUENA VISTA CIRCLE SOUTH HILL VA 23970 540551711 HOSPITAL VA 501(C )(3) 3 VCUHSA false false false false false true false false false false false false false false true true false false false false