NEW YORK STATE CATHOLIC HEALTH PLAN INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
NEW YORK STATE CATHOLIC HEALTH PLAN INC (EIN 11-3153422)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-08-10
IRS object ID
201622239349302037
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-08-10T16:19:48-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1Txt
CityJERICHOCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11753ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN113153422EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NEW YORK STATE CATHOLIC HEALTH PLANINCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNEWYBusinessNameControlTxt
Phone7183936403PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICK J FRAWLEYPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone7183936403PhoneNum
Signature2016-08-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTINE KAWECKIPreparerPersonNm
PTINP00743140PTIN
Phone5169187000PhoneNum
Preparation2016-08-10PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1FIDELIS CARE NEW YORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerPATRICK J FRAWLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,206,499,264GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FIDELISCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE O.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee3380TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$196,215PYContributionsGrantsAmt
CY Contributions Grants$470,690CYContributionsGrantsAmt
PY Program Service Revenue$5,282,714,979PYProgramServiceRevenueAmt
CY Program Service Revenue$6,463,087,126CYProgramServiceRevenueAmt
PY Investment Income$21,647,808PYInvestmentIncomeAmt
CY Investment Income$23,275,108CYInvestmentIncomeAmt
PY Other Revenue$201,752PYOtherRevenueAmt
CY Other Revenue$6,741,364CYOtherRevenueAmt
PY Total Revenue$5,304,760,754PYTotalRevenueAmt
CY Total Revenue$6,493,574,288CYTotalRevenueAmt
PY Grants And Similar Paid$3,565,309PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,967,568CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$4,758,014,894PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$5,881,025,777CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$169,288,472PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$217,170,211CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$102,149,659PYOtherExpensesAmt
CY Other Expenses$138,632,362CYOtherExpensesAmt
PY Total Expenses$5,033,018,334PYTotalExpensesAmt
CY Total Expenses$6,241,795,918CYTotalExpensesAmt
PY Revenues Less Expenses$271,742,420PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$251,778,370CYRevenuesLessExpensesAmt
Total Assets BOY$2,199,606,728TotalAssetsBOYAmt
Total Assets EOY$2,655,764,792TotalAssetsEOYAmt
Total Liabilities BOY$979,578,494TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,220,675,396TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,220,028,234NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,435,089,396NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$4,556,232,690ExpenseAmt
Grant$3,907,883GrantAmt
Revenue$5,065,450,680RevenueAmt
DescMEDICAID MANAGED CARE PROGRAM IS A NEW YORK STATE PROGRAM ADMINISTEREDBY FIDELIS THAT PROVIDES FREE COMPREHENSIVE HEALTH COVERAGE FORELIGIBLE INDIVIDUALS AND FAMILIES WHO ARE RESIDENTS OF NEW YORK STATEAND HAVE LOW INCOME AND LIMITED RESOURCES.THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITYCRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THEFEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATIONSTATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM ISDETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$524,390,028ExpenseAmt
Grant$139,198GrantAmt
Revenue$495,363,073RevenueAmt
DescMEDICARE ADVANTAGE PROGRAM IS A PROGRAM AVAILABLE TO ADULTS AGED 65 ANDOVER WHO ARE ELIGIBLE UNDER MEDICARE. BENEFICIARIES MAY CHOOSE TO USEPRIVATE PAY OPTIONS, ESTABLISH MEDICAL SAVINGS ACCOUNTS, USE MANAGEDCARE PLANS SUCH AS FIDELIS, OR JOIN PROVIDER-SPONSORED PLAN.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$410,404,829ExpenseAmt
Grant$36,471GrantAmt
Revenue$462,374,750RevenueAmt
DescFIDELIS CARE AT HOME IS A MEDICAID LONG-TERM CARE CAPITATED PROGRAMWITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES AN ARRAY OFHOME, COMMUNITY, AND INSTITUTIONALLY BASED, LONG-TERM CARE SERVICES TOPERSONS WHO ARE ELIGIBLE FOR MEDICAID AND WHO HAVE BEEN CERTIFIED ASAPPROPRIATE CANDIDATES FOR NURSING HOME PLACEMENT.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$394,965,798ExpenseAmt
Grant$884,016GrantAmt
Revenue$446,639,987RevenueAmt
DescOTHER PROGRAMS ADMINISTERED BY THE PLAN INCLUDE THE CHILD HEALTH PLUSPROGRAM, MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM, MEDICAID ADVANTAGE PLUS PROGRAM, HEALTH BENEFIT EXCHANGE PROGRAM, FIDA PROGRAM AND HARP PROGRAM. CHILD HEALTH PLUS PROGRAM IS A PROGRAM THAT COVERS UNINSURED CHILDREN UNDER THE AGE OF 19, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID.MEDICARE/MEDICAID DUAL ADVANTAGE IS A PROGRAM FOR THOSE WHO MEETELIGIBILITY REQUIREMENTS FOR BOTH MEDICARE AND MEDICAID AND AREENROLLED IN BOTH PROGRAMS.MEDICAID ADVANTAGE PLUS IS A FULL-RISK MANAGED LONG-TERM CARE PROGRAMFOR INDIVIDUALS 18 YEARS OF AGE AND OLDER WITH MEDICARE AND MEDICAIDCOVERAGE WHO HAVE A CHRONIC ILLNESS OR DISABILITY. MEMBERS MUST BE INNEED OF LONG-TERM CARE SERVICES AND MAY NEED CARE TYPICALLY GIVEN IN ANURSING HOME. HEALTH BENEFIT EXCHANGE IS A PROGRAM PROVIDING HEALTHCOVERAGE TO INDIVIDUALS UNDER THE HEALTH CARE REFORM ACT.FIDA PROGRAM IS A PLAN DESIGNED TO PROVIDE MANAGED CARE TO INDIVIDUALS WHO HAVE BOTH MEDICARE AND MEDICAID. THE FIDA PLAN ALLOWS THE INDIVIDUAL'S MEDICARE AND MEDICAID BENEFITS TO BE COVERED AND MANAGED UNDER ONE PLAN, INCLUDING LONG-TERM CARE NEEDS, SUPPORTS AND PRESCRIPTION DRUGS. FIDELIS IMPLEMENTED THE FIDA PROGRAM EFFECTIVE JANUARY 1, 2015.HARP PROGRAM IS A MEDICAID PROGRAM THAT PROVIDES CARE MANAGEMENT SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICAID REQUIRING BEHAVIORAL HEALTH SERVICES. FIDELIS IMPLEMENTED THE HARP PROGRAM EFFECTIVE OCTOBER 1, 2015.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$394,965,798TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$884,016TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$446,639,987TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$5,885,993,345TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document15917IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3380EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANNE C KONTOPOULOSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7183936403PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BLVDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP113744510ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
KARL P ADLER MD
DIRECTOR1.00Yes (X)$0$0$0
JACK BALINSKY
DIRECTOR1.00Yes (X)$0$0$0
M WILLIAM BENEDETTO
DIRECTOR1.00Yes (X)$0$0$0
SR PATRICIA BURKARD
DIRECTOR/SECRETARY1.00Yes (X)$0$0$0Yes (X)
JAMES M CORRIGAN
DIRECTOR1.00Yes (X)$0$0$0
REV JOHN COUGHLIN
DIRECTOR1.00Yes (X)$0$0$0
THOMAS F DOODIAN
DIRECTOR1.00Yes (X)$0$0$0
REV DONALD J HARRINGTON CM
CHAIRMAN OF THE BOARD1.00Yes (X)$0$0$0Yes (X)
JOHN J HURLEY
DIRECTOR1.00Yes (X)$0$0$0
THOMAS L KELLY
DIRECTOR1.00Yes (X)$0$0$0
REV LEO J O'DONOVAN
DIRECTOR1.00Yes (X)$0$0$0
GINO J PAZZAGLINI
DIRECTOR/VICE CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
REV MONSIGNOR ALAN J PLACA
DIRECTOR1.00Yes (X)$0$0$0
JOHN RYDZEWSKI
DIRECTOR1.00Yes (X)$0$0$0
JOSEPH SLAVIK
DIRECTOR1.00Yes (X)$0$0$0
MARY THOMPSON
DIRECTOR1.00Yes (X)$0$0$0
MICHAEL J TOOLEY
DIRECTOR1.00Yes (X)$0$0$0
FRANK J THOMAS MD
DIRECTOR1.00Yes (X)$0$0$0
JOHN A WERWAISS
DIRECTOR/TREASURER1.00Yes (X)$0$0$0Yes (X)
PATRICK J FRAWLEY
PRESIDENT & CEO37.50$3,648,607$0$133,441Yes (X)
THOMAS HALLORAN
CHIEF FINANCIAL OFFICER33.75$589,405$66,623$285,250Yes (X)3.75
DAVID THOMAS
EVP & COO34.70$1,374,654$59,468$76,1052.80Yes (X)
SANJIV SHAH MD
CHIEF MEDICAL OFFICER32.80$486,473$69,923$214,5694.70Yes (X)
PAMELA HASSEN
CHIEF MARKETING OFFICER37.50$436,018$0$236,830Yes (X)
MARTIN KREBS
CHIEF INFORMATION OFFICER37.50$472,546$0$191,275Yes (X)
SANTO RUSSO
CHIEF LEGAL OFFICER33.75$408,313$46,474$192,7813.75Yes (X)
THOMAS BROWN
CHIEF ADMINISTRATIVE OFFICER37.50$490,005$0$148,497Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,906,021TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$242,488TotReportableCompRltdOrgAmt
Total Other Compensation$1,478,748TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K311IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
IHT SERVICES LLCCOTIVITI DOMESTIC HOLD
50 DANBURY ROADWILTONCT06897MEDICAL CLAIMS REVIEW$7,987,747
TEKSYSTEMS INC
7437 RACE ROADHANOVERMD21076TEMPORARY SUPPORT/PLACEMENT FEES$4,095,189
HEALTH MANAGEMENT SYSTEMS INC
PO BOX 27151NEW YORKNY10087COORDINATION OF BENEFITS REVIEW$3,890,100
AARETE LLC
8574 SOLUTION CENTERCHICAGOIL606778005CONSULTING SERVICES/COST SAVINGS$3,632,918
PERSONAL COMPUTERS INC
703 WASHINGTON STREETBUFFALONY14203IT SERVICES$2,467,463
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K44CntrctRcvdGreaterThan100KCnt
Related Organizations$10,000RelatedOrganizationsAmt
Government Grants$294,709GovernmentGrantsAmt
All Other Contributions$165,981AllOtherContributionsAmt
Total Contributions$470,690TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID524114$5,065,450,680$5,065,450,680
MEDICARE ADVANTAGE524114$495,363,073$495,363,073
FIDELIS CARE AT HOME524114$462,374,750$462,374,750
HEALTH BEN. EXCHANGE524114$205,105,424$205,105,424
CHILD HEALTH PLUS524114$151,312,324$151,312,324

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,480,875TotalRevenueColumnAmt
Related Or Exempt Func Income$83,480,875RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$6,463,087,126TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,525,457TotalRevenueColumnAmt
Exclusion$16,525,457ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$719,674,627SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$712,924,976SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$6,749,651SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,749,651TotalRevenueColumnAmt
Exclusion$6,749,651ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
VBP QIP ADMIN FEES524298$6,752,347$6,752,347
PURCHASE REBATES524298$77,380$77,380
EQUITY IN SALUS ADMINI900099-$133,632-$133,632

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$45,269TotalRevenueColumnAmt
Related Or Exempt Func Income$45,269RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$6,741,364OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,493,574,288TotalRevenueColumnAmt
Related Or Exempt Func Income$6,469,828,490RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$23,275,108ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,768,322TotalAmt
Program Services$4,768,322ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$199,246TotalAmt
Program Services$199,246ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$5,881,025,777TotalAmt
Program Services$5,881,025,777ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,306,131TotalAmt
Management And General$6,306,131ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$166,786,097TotalAmt
Management And General$166,786,097ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,298,152TotalAmt
Management And General$5,298,152ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$26,537,899TotalAmt
Management And General$26,537,899ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$12,241,932TotalAmt
Management And General$12,241,932ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$612,984TotalAmt
Management And General$612,984ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$775,700TotalAmt
Management And General$775,700ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$75,233TotalAmt
Management And General$75,233ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$885,403TotalAmt
Management And General$885,403ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$15,396,936TotalAmt
Management And General$15,396,936ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$15,252,641TotalAmt
Management And General$15,252,641ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,753,508TotalAmt
Management And General$2,753,508ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$13,678,297TotalAmt
Management And General$13,678,297ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,873,443TotalAmt
Management And General$9,873,443ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,685,540TotalAmt
Management And General$3,685,540ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$544,785TotalAmt
Management And General$544,785ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$897,726TotalAmt
Management And General$897,726ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$21,166,208TotalAmt
Management And General$21,166,208ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$868,851TotalAmt
Management And General$868,851ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
CLAIMS PROCESSING$16,571,514$16,571,514
POSTAGE & SHIPPING$7,070,370$7,070,370
PRINTING & PUBLICATIONS$5,071,761$5,071,761
TELEPHONE EXPENSE$4,328,745$4,328,745

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$19,122,717TotalAmt
Management And General$19,122,717ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,241,795,918TotalAmt
Program Services$5,885,993,345ProgramServicesAmt
Management And General$355,802,573ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$41,167,982BOYAmt
EOY$7,694,651EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$907,141,291BOYAmt
EOY$1,123,306,889EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$243,776,681BOYAmt
EOY$241,180,947EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$74,508,175BOYAmt
EOY$78,315,016EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$144,453,892LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$92,485,223LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$34,333,181BOYAmt
EOY$51,968,669EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$527,869,989BOYAmt
EOY$584,254,162EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$131,276,298BOYAmt
EOY$204,833,154EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$412,046BOYAmt
EOY$281,421EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$16,022,278BOYAmt
EOY$15,849,777EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$223,098,807BOYAmt
EOY$348,080,106EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,199,606,728BOYAmt
EOY$2,655,764,792EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$131,979,295BOYAmt
EOY$141,935,224EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,693,172BOYAmt
EOY$15,177,996EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$840,906,027BOYAmt
EOY$1,063,562,176EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$979,578,494BOYAmt
EOY$1,220,675,396EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,219,380,960BOYAmt
EOY$1,434,465,387EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$647,274BOYAmt
EOY$624,009EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,220,028,234BOYAmt
EOY$1,435,089,396EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,199,606,728BOYAmt
EOY$2,655,764,792EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$251,778,370ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$36,717,208NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$537,543CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$270,351CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$353,245CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$196,215CurrentTaxYearMinus1YearAmt
Current Tax Year$470,690CurrentTaxYearAmt
Total$1,828,044TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,401,477,190CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,273,848,371CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,086,015,198CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,282,714,979CurrentTaxYearMinus1YearAmt
Current Tax Year$6,463,087,126CurrentTaxYearAmt
Total$21,507,142,864TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,402,014,733CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,274,118,722CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,086,368,443CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,282,911,194CurrentTaxYearMinus1YearAmt
Current Tax Year$6,463,557,816CurrentTaxYearAmt
Total$21,508,970,908TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$21,508,970,908PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,022,612CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,356,791CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,866,741CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,001,330CurrentTaxYearMinus1YearAmt
Current Tax Year$16,525,457CurrentTaxYearAmt
Total$62,772,931TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,022,612CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,356,791CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,866,741CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,001,330CurrentTaxYearMinus1YearAmt
Current Tax Year$16,525,457CurrentTaxYearAmt
Total$62,772,931TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$296,626CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$239,217CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$153,519CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$209,418CurrentTaxYearMinus1YearAmt
Current Tax Year$6,741,364CurrentTaxYearAmt
Total$7,640,144TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,409,333,971CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,283,714,730CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,098,388,703CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,301,121,942CurrentTaxYearMinus1YearAmt
Current Tax Year$6,486,824,637CurrentTaxYearAmt
Total$21,579,383,983TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99670PublicSupportCY509Pct
Public Support PY5090.99690PublicSupportPY509Pct
Investment Income CY0.00290InvestmentIncomeCYPct
Investment Income PY0.00310InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$75,233OtherActivitiesAmt
Total Lobbying Expenditures$75,233TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationFIDELIS IS A MEMBER OF CERTAIN ASSOCIATIONS, TO WHICH IT PAYS ANNUAL DUES. A PORTION OF THOSE DUES ARE DETERMINED TO BE EXPENDITURES FOR LOBBYING PURPOSES. IN 2015, THAT PORTION WAS $75,233.ExplanationTxt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,942,533OtherCostOrOtherBasisAmt
Depreciation$7,050,933DepreciationAmt
Book Value$9,891,600BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,558,714OtherCostOrOtherBasisAmt
Depreciation$11,866,516DepreciationAmt
Book Value$692,198BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$114,952,645OtherCostOrOtherBasisAmt
Depreciation$73,567,774DepreciationAmt
Book Value$41,384,871BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$51,968,669TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
FIXED INCOME FUNDS$39,576,949F
LONG TERM CERTIFICATES OF DEPOSIT$165,256,205F
FieldValueIRS element (for citing)
Total Book Value Securities$204,833,154TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS)$275,081,560
OTHER RECEIVABLES$7,707,045
PHARMACY RECEIVABLES$65,258,623
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS)-CURRENT$32,878
FieldValueIRS element (for citing)
Total Book Value Other Assets$348,080,106TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
CLAIMS PAYABLE$936,074,856
DUE TO THIRD PARTIES$127,035,529
CAPITAL LEASE PAYABLE$451,791
FieldValueIRS element (for citing)
Total Liability$1,063,562,176TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$6,456,990,987TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$36,717,208NetUnrealizedGainsInvstAmt
Other Revenue$133,907OtherRevenueAmt
Revenue Not Reported-$36,583,301RevenueNotReportedAmt
Revenue Subtotal$6,493,574,288RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$6,493,574,288TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,241,929,825TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$133,907OtherExpensesIncludedAmt
Expenses Not Reported$133,907ExpensesNotReportedAmt
Expenses Subtotal$6,241,795,918ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,241,795,918TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC ("SALUS") 133,632. SALUS CONTRIBUTIONS ELIMINATED IN CONSOLIDATION -10,000. SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 10,275.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC ("SALUS") 133,632. SALUS CONTRIBUTIONS ELIMINATED IN CONSOLIDATION -10,000. SALUS INTEREST INCOME ELIMINATED IN CONSOLIDATION 10,275.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (37 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
AMAUS HEALTH SERVICES AT THE CATHEDRAL
259 E ONONDAGA STREETSYRACUSENY13202611548780501(C)(3)$28,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
ARCHCARE
205 LEXINGTON AVENUE 3RD FLOORNEW YORKNY10016133896624501(C)(3)$471,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES COMMUNITY SERVICES ARCHDIOCESE OF NEW YORK
1011 FIRST AVENUE 6TH FLOORNEW YORKNY10022135562185501(C)(3)$471,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES DIOCESE OF OGDENSBURG
6866 STATE HIGHWAY 37OGDENSBURGNY13669150614025501(C)(3)$200,500CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES FULTON & MONTGOMERY
55 EAST MAIN STREET SUITE 100JOHNSTOWNNY12095141340033501(C)(3)$6,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF BROOKLYN & QUEENS
191 JORALEMON STREET 7TH FLOORBROOKLYNNY11201112047151501(C)(3)$491,460CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF FINGER LAKES
94 EXCHANGE STREETGENEVANY14456142005241501(C)(3)$15,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF LIVINGSTON COUNTY
34 EAST STATE STREETMT MORRISNY14510205493091501(C)(3)$15,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF STEUBEN COUNTY
23 LIBERTY STREETBATHNY14810300553416501(C)(3)$15,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF THE DIOCESE OF ALBANY
40 NORTH MAIN AVENUEALBANYNY12203141340033501(C)(3)$382,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
1150 BUFFALO ROADROCHESTERNY14624160743944501(C)(3)$51,595CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
90 CHERRY LANEHICKSVILLENY11801111843801501(C)(3)$381,500CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF TOMPKINSTIOGA
324 W BUFFALO STREETITHACANY14850510621633501(C)(3)$15,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES OF WAYNE COUNTY
1141 EAST UNION STREETNEWARKNY14513204649120501(C)(3)$15,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC CHARITIES RC DIOCESE OF SYRACUSE
240 EAST ONONDAGA STREET/PO BOX511SYRACUSENY13202150532085501(C)(3)$321,700CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC MEDICAL MISSION BOARD
10 WEST 17TH STREETNEW YORKNY10011135602319501(C)(3)$10,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CATHOLIC MIGRATION SERVICES
191 JORALEMON STREET 4TH FLOORBROOKLYNNY11201112634818501(C)(3)$368,290CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CHARLES B WANG COMMUNITY HEALTH CENTER
268 CANAL STREETNEW YORKNY10013132739694501(C)(3)$10,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
CORTLAND-CHENANGO RURAL SERVICES
2704 LOWER CINCINNATUS RD PO 57CINCINNATUSNY13040455599324501(C)(3)$15,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
DIOCESE OF OGDENSBURG DEPARTMENT OF EDUCATION CATHOLIC SCHOOLS
100 ELIZABETH STREETOGDENSBURGNY13669150532120501(C)(3)$60,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
DIOCESE OF ROCHESTER DEPARTMENT OF CATHOLIC SCHOOLS
1150 BUFFALO ROADROCHESTERNY14624160755765501(C)(3)$60,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
DIOCESE OF ROCKVILLE CENTRE
50 NORTH PARK AVENUEROCKVILLE CENTRENY115719023111837437501(C)(3)$53,460CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
FRANCISCAN NORTHSIDE MINISTRIES
812 NORTH SALINA STREETSYRACUSENY13208150532104501(C)(3)$35,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
FRIENDS OF BASSETT INC
ONE ATWELL ROADCOOPERSTOWNNY13326237041610501(C)(3)$10,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
OFFICE OF THE SUPERINTENDENT OF SCHOOLS
1011 FIRST AVENUENEW YORKNY10022510453629501(C)(3)$90,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
PARISH AND CLERGY SERVICES DIOCESE OF ROCHESTER
1150 BUFFALO ROADROCHESTERNY14624530196617501(C)(3)$235,105CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
ROMAN CATHOLIC DIOCESE OF BROOKLYN NY
310 PROSPECT PARK WESTBROOKLYNNY11215111631807501(C)(3)$90,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
REFUAH HEALTH CENTER INC
728 MAIN STREETSPRING VALLEYNY10977133652555501(C)(3)$50,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
ROMAN CATHOLIC DIOCESE OF SYRACUSE - CATHOLIC SCHOOL OFFICE
240 EAST ONONDAGA STREETSYRACUSENY13202150625353501(C)(3)$60,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
SCHOOLS OF THE ROMAN CATHOLIC DIOCESE OF ALBANY
40 NORTH MAIN AVENUEALBANYNY12203141605502501(C)(3)$38,900CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
SAINT ELIZABETH MEDICAL CENTER
2209 GENESEE STREETUTICANY13501150532245501(C)(3)$7,500CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
SAINT JOSEPH'S HOME
950 LINDEN STREETOGDENSBURGNY13669150532217501(C)(3)$69,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
THE ALFRED ESMITH MEMORIAL FOUNDATION
1011 FIRST AVENUE SUITE 1400NEW YORKNY10022131553263501(C)(3)$127,500CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
THE DIOCESE OF BUFFALO
795 MAIN STREETBUFFALONY14203160743984501(C)(3)$60,000CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
THE FOUNDATION FOR ELLIS MEDICINE
1101 NOTT STREETSCHENECTADYNY12308141638957501(C)(3)$7,500CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
THE FOUNDATION OF THE ROMAN CATHOLIC DIOCESE OF BUFFALO
795 MAIN STREET 3RD FLBUFFALONY14203161517131501(C)(3)$403,850CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
GRANTS 5000
95-25 QUEENS BOULEVARDREGO PARKNY113744570501(C)(3)$27,462CASHSEE PURPOSE OF GRANTS IN SCHEDULE O.
FieldValueIRS element (for citing)
Total501c3 Org38Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeHEALTHY KIDS FUNDGrantTypeTxt
Recipient22116RecipientCnt
Cash Grant$199,246CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedCASH PAIDValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationRECIPIENTS OF GRANT AWARDS UNDER THE COMMUNITY GRANT FUND ARE REQUIRED TO PROVIDE PERIODIC UPDATES ON THE ACCOMPLISHMENTS OF THE GRANT AND DISBURSEMENTS. IT IS THE RESPONSIBILITY OF THE GRANT RECIPIENT TO ENSURE THAT THE GRANT IS USED FOR THE PURPOSE(S) STATED IN THE ORIGINAL APPLICATION. FIDELIS MONITORS GRANT USAGE BY CORRESPONDENCE, TELEPHONE OR SITE VISITS. AN EVALUATION OF THE PROJECT IS REQUIRED UPON THE GRANTEE'S COMPLETION. NON-COMPLIANCE WITH THESE GUIDELINES MAY RESULT IN A REQUEST FOR RETURN OF THE FUNDS IN QUESTION OR INELIGIBILITY OF THE ORGANIZATION FOR FUTURE GRANTS FROM FIDELIS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PATRICK J FRAWLEY
PRESIDENT & CEO$1,195,899$0$0$0$2,452,708$0$18,518$0$114,923$0$3,782,048$0$0$0
THOMAS HALLORAN
CHIEF FINANCIAL OFFICER$432,415$51,923$132,300$14,700$24,690$0$240,298$1,852$39,931$3,169$869,634$71,644$0$0
DAVID THOMAS
EVP & COO$537,547$46,418$160,950$13,050$676,157$0$17,129$1,389$54,285$3,302$1,446,068$64,159$0$0
SANJIV SHAH MD
CHIEF MEDICAL OFFICER$355,471$54,735$106,312$15,188$24,690$0$181,055$2,315$27,759$3,440$695,287$75,678$0$0
PAMELA HASSEN
CHIEF MARKETING OFFICER$313,729$0$97,500$0$24,789$0$212,134$0$24,696$0$672,848$0$0$0
MARTIN KREBS
CHIEF INFORMATION OFFICER$347,656$0$106,500$0$18,390$0$153,799$0$37,476$0$663,821$0$0$0
SANTO RUSSO
CHIEF LEGAL OFFICER$313,771$36,424$90,450$10,050$4,092$0$147,393$1,852$40,330$3,206$596,036$51,532$0$0
THOMAS BROWN
CHIEF ADMINISTRATIVE OFFICER$345,695$0$116,500$0$27,810$0$147,129$0$1,368$0$638,502$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BSERP COMPENSATION OF OFFICERS, KEY EMPLOYEES, OR HIGHEST COMPENSATED EMPLOYEES: PATRICK J. FRAWLEY - $2,426,728*; DAVID THOMAS - $651,414* THOMAS HALLORAN - $223,632**; PAMELA HASSEN - $193,616**; SANJIV SHAH - $164,852**; MARTIN KREBS - $135,282**; SANTO RUSSO - $130,727**; THOMAS BROWN - $128,612** *THE ABOVE AMOUNTS INCLUDE GROSS-UP TAXES PAID ON BEHALF OF THE PARTICIPANTS. (LINE 1A) **THESE REPRESENT NON-VESTED SERP BENEFITS
PART I, LINE 7PERFORMANCE-BASED INCENTIVES ARE PAID AS PART OF THE PLAN'S ANNUAL INCENTIVE PROGRAM. THE PRESIDENT & CHIEF EXECUTIVE OFFICER DOES NOT PARTICIPATE IN ANY INCENTIVE PROGRAM.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
DONOR #1
SUBSTANTIAL CONTRIBUTOR$13,658,743BUSINESS TRANSACTION0
DONOR #3
SUBSTANTIAL CONTRIBUTOR$2,467,463BUSINESS TRANSACTION0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1DESCRIPTION OF ORGANIZATION MISSION: TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES TO THE COMMUNITY, ESPECIALLY TO THE POOR AND UNDERSERVED; TO PROMOTE HEALTH EDUCATION AND PREVENTATIVE MEDICINE.
FORM 990, PART III, LINE 1DESCRIPTION OF ORGANIZATION MISSION: THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("FIDELIS OR THE "PLAN") STRIVES TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES FOR ALL; TO JOIN IN PARTNERSHIP WITH HEALTH PROFESSIONALS TO ASSIST THEM IN THEIR HEALING WORK; TO ACT AS A FACILITATOR TO BUILD LINKAGES AND SYSTEMS FOR THE COORDINATION OF CARE AND SERVICES AMONG HEALTHCARE, BEHAVIORAL AND SOCIAL SERVICES, AS WELL AS EDUCATORS AND RELIGIOUS LEADERS, TO ADDRESS THE SPIRITUAL, EMOTIONAL AND PHYSICAL NEEDS OF THOSE WE SERVE; TO ADVOCATE FOR A HEALTH POLICY THAT ACCORDS TRUE DIGNITY AND RESPECT FOR ALL HUMAN PERSONS, ESPECIALLY THE POOR AND UNDERSERVED. AS OF DECEMBER 31, 2015, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF BENEFICIARIES OF THE MEDICAL ASSISTANCE PROGRAM ("MEDICAID"), APPROXIMATELY 1,137,000, THE CHILD HEALTH PLUS BENEFICIARIES, APPROXIMATELY 80,400, A PROGRAM FOR LOW INCOME UNINSURED CHILDREN, MEDICARE/DUAL ADVANTAGE PROGRAM BENEFICIARIES, APPROXIMATELY 46,700, A PROGRAM FOR THE ELDERLY, FIDELIS CARE AT HOME MANAGED LONG-TERM CARE PROGRAM BENEFICIARIES, APPROXIMATELY 11,200, A PROGRAM FOR RESIDENTS WHO NEED LONG-TERM CARE SERVICES AND ARE ELIGIBLE FOR MEDICAID, THE NEW YORK HEALTH BENEFIT EXCHANGE PROGRAM ("HEALTH BENEFIT EXCHANGE") BENEFICIARIES, APPROXIMATELY 84,700, A PROGRAM WHICH PROVIDES HEALTH COVERAGE TO INDIVIDUAL MEMBERS UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010 ("HEALTH CARE REFORM ACT"), THE FULLY INTEGRATED DUALS ADVANTAGE PROGRAM ("FIDA") BENEFICIARIES, APPROXIMATELY 300, A PROGRAM THAT BEGAN ON JANUARY 1, 2015 WHICH PROVIDES MANAGED CARE TO INDIVIDUALS WHO HAVE BOTH MEDICARE AND MEDICAID AND HEALTH AND RECOVERY PLAN PROGRAM ("HARP") BENEFICIARIES, APPROXIMATELY 6,000, A PROGRAM THAT BEGAN ON OCTOBER 1, 2015 WHICH PROVIDES CARE MANAGEMENT SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICAID REQUIRING BEHAVIORAL HEALTH SERVICES.
FORM 990, PART III, LINE 2EFFECTIVE JANUARY 1, 2015, FIDELIS IMPLEMENTED THE FIDA PROGRAM. EFFECTIVE OCTOBER 1, 2015, FIDELIS IMPLEMENTED THE HARP PROGRAM. SEE PART III LINE 4D FOR DETAILS.
FORM 990, PART III, LINE 3THE NEW YORK STATE DEPARTMENT OF HEALTH ENDED THE FAMILY HEALTH PLUS PROGRAM EFFECTIVE DECEMBER 31, 2014.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ORGANIZATION SHALL BE LIMITED TO THE DIOCESAN BISHOPS OF THE STATE AND THE ECCLESIASTICAL PROVINCE OF NEW YORK.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION IS A MEMBERSHIP CORPORATION UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW (THE "N-PCL") THE ORGANIZATION'S MEMBERS ELECT ITS BOARD OF DIRECTORS AND, AS MEMBERS OF A NEW YORK NOT-FOR-PROFIT CORPORATION, POSSESS CERTAIN OTHER POWERS UNDER THE N-PCL. FURTHERMORE, THE ORGANIZATION'S BY-LAWS, WHICH ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYSDOH"), DEFINE THE FOLLOWING RESERVED POWERS OF THE MEMBERS: (I) THE INTERPRETATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES TO WHICH THE ORGANIZATION, AS A FAITH-BASED ORGANIZATION, IS SUBJECT; (II) APPROVAL OF THE MISSION STATEMENT; (III) STANDING TO ENSURE THE ORGANIZATION'S COMPLIANCE WITH ITS PHILOSOPHY AND MISSION STATEMENT; (IV) APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S CERTIFICATE OF INCORPORATION AND BY-LAWS; (V) APPROVAL OF CERTAIN TRANSACTIONS INVOLVING REAL PROPERTY; (VI) APPROVAL OF CERTAIN ACTIONS BY THE ORGANIZATION WHEN ACTING AS A SHAREHOLDER OR MEMBER OF ANOTHER ENTITY; (VII) APPROVAL OF THE ACCEPTANCE AND ISSUANCE OF SUBVENTIONS; (VIII) APPROVAL OF ANY MERGER, DISSOLUTION OR CONSOLIDATION, (IX) REMOVAL OF DIRECTORS AND CERTAIN OFFICERS OF THE CORPORATION; (X) APPROVAL OF THE ELECTION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, AND (XI) REVIEW OF THE AUDITED FINANCIAL STATEMENTS. CERTAIN OF THESE POWERS ALREADY EXIST BY VIRTUE OF THE N-PCL (E.G., THE POWER TO APPROVE ANY MERGER, DISSOLUTION OR CONSOLIDATION UNDER N-PCL 903(A)(2) & 1002(A)).
FORM 990, PART VI, SECTION A, LINE 7BPLEASE SEE LINE 11 NARRATIVE.
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF THE FORM 990 PREPARED BY THE ORGANIZATION'S FINANCE DEPARTMENT IS REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER, IN COLLABORATION WITH THE ORGANIZATION'S OUTSIDE INDEPENDENT TAX ADVISORS. THEREAFTER, THE ORGANIZATION'S PRESIDENT & CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER REVIEW THE DRAFT FORM 990 WITH CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AUTHORIZED THE EXECUTIVE COMMITTEE OF THE BOARD TO REVIEW AND ACCEPT THE DRAFT FORM 990 BEFORE ITS FILING WITH THE IRS. ACCORDINGLY, AFTER THE ORGANIZATION'S MANAGEMENT HAS COMPLETED ITS REVIEW OF THE DRAFT FORM 990, IT IS CIRCULATED IN DRAFT FOR REVIEW, COMMENT AND APPROVAL TO THE MEMBERS OF THE EXECUTIVE COMMITTEE. ONCE ANY COMMENTS HAVE BEEN INCORPORATED AND THE FORM 990 HAS BEEN ACCEPTED BY THE EXECUTIVE COMMITTEE, A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE ORGANIZATION'S OFFICERS, DIRECTORS AND SENIOR EXECUTIVES ARE PROVIDED WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND AN ACKNOWLEDGEMENT FORM. THESE INDIVIDUALS ARE INSTRUCTED TO SIGN AND RETURN THE FORM, (A) TO ACKNOWLEDGE THAT THEY HAVE REVIEWED THE POLICY AND (B) TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS. THE CONFLICTS OF INTEREST POLICY DEFINES "DISCLOSABLE INTERESTS", I.E., THOSE INTERESTS THAT AN INDIVIDUAL COVERED BY THE POLICY MUST HAVE IN ANOTHER ENTITY IN ORDER FOR A TRANSACTION BETWEEN THE ORGANIZATION AND THAT ENTITY TO BE COVERED BY THE POLICY. THE POLICY ALSO DEFINES THE TYPES OF TRANSACTIONS BETWEEN THE ORGANIZATION AND ANOTHER ENTITY INVOLVING AN INDIVIDUAL COVERED BY THE POLICY THAT IS SUBJECT TO BY THE POLICY. THE POLICY REQUIRES DISCLOSURE TO THE BOARD OF DIRECTORS AND/OR THE EXECUTIVE COMMITTEE BY ANY PERSON WITH A DISCLOSABLE INTEREST IN A TRANSACTION AS DEFINED IN THE POLICY OF ALL CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. INITIALLY, AFTER THE INTERESTED INDIVIDUAL HAS RECUSED HIMSELF, THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE DETERMINES WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE DECIDES WHETHER TO ENTER INTO THE TRANSACTION BASED ON ITS DETERMINATION OF WHETHER (A) A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, (B) THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND (C) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15OUTSIDE COUNSEL FOR THE ORGANIZATION, A NATIONAL LAW FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, HAS ADVISED FIDELIS AS TO WHICH EMPLOYEES ARE DISQUALIFIED PERSONS WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EMPLOYS A COMPENSATION CONSULTANT FIRM, A NATIONAL HUMAN RESOURCES CONSULTING FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, TO PREPARE ANNUALLY A DETAILED REPORT ON THE PROPOSED COMPENSATION FOR THE ORGANIZATION'S DISQUALIFIED PERSONS THAT INCLUDES DATA AS TO COMPARABLE COMPENSATION FOR SIMILAR QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY-SITUATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH HAS BEEN AUTHORIZED BY THE BOARD TO REVIEW AND APPROVE ALL MATTERS CONCERNING EXECUTIVE COMPENSATION, IS PROVIDED WITH THE COMPENSATION CONSULTANT'S DETAILED EXECUTIVE COMPENSATION REPORT. THE REVIEW AND APPROVAL OF THE COMPENSATION OF THE ORGANIZATION'S DISQUALIFIED PERSONS IS ACCOMPLISHED IN TWO PHASES: FIRST WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER AND THEN WITH RESPECT TO ALL OTHER DISQUALIFIED PERSONS, NAMELY, (I) THE EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER, (II) THE CHIEF FINANCIAL OFFICER, (III) THE CHIEF LEGAL OFFICER, (IV) THE CHIEF MEDICAL OFFICER, (V) CHIEF MARKETING OFFICER, (VI) CHIEF INFORMATION OFFICER AND (VII) CHIEF ADMINISTRATIVE OFFICER. FIRST, THE AFOREMENTIONED OUTSIDE COUNSEL AND HUMAN RESOURCES CONSULTING FIRM, AT THE INVITATION OF THE EXECUTIVE COMMITTEE, REVIEW WITH THE COMMITTEE THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO RETAINS THE SERVICES OF A SECOND HUMAN RESOURCES CONSULTING FIRM TO ASSIST IN ITS EVALUATION OF THE PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE FULL REVIEW OF THE COMPENSATION AND PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER IS PERFORMED BY THE EXECUTIVE COMMITTEE AT LEAST BI-ANNUALLY. AFTER ESTABLISHING THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, THE EXECUTIVE COMMITTEE REPORTS ON ITS DELIBERATIONS AND DETERMINATIONS TO THE ORGANIZATION'S BOARD OF DIRECTORS. SECOND, THE EXECUTIVE COMMITTEE REVIEWS THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS WITH THE ASSISTANCE OF THE SAME OUTSIDE COUNSEL AND COMPENSATION CONSULTANTS PARTICIPATING IN THE REVIEW OF THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE DETERMINES WHETHER TO APPROVE THE COMPENSATION ANALYSIS AND CONCLUSIONS CONTAINED IN THE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS. AFTER CONSULTING WITH OUTSIDE COUNSEL, THE EXECUTIVE COMMITTEE HAS DESIGNATED THE PRESIDENT & CHIEF EXECUTIVE OFFICER TO SERVE AS AN "AUTHORIZED BODY" AS CONTEMPLATED BY THE EXCESS BENEFIT TRANSACTION REGULATIONS FOR THE PURPOSE OF SETTING THE COMPENSATION OF THOSE DISQUALIFIED PERSONS WITHIN AN APPROVED RANGE. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS FOR ALL DISQUALIFIED PERSONS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION IS A NEW YORK NOT-FOR-PROFIT CORPORATION. ITS CERTIFICATE OF INCORPORATION IS READILY AVAILABLE TO THE GENERAL PUBLIC FROM THE NEW YORK STATE DEPARTMENT OF STATE UNDER THE NEW YORK FREEDOM OF INFORMATION LAW ("FOIL"). ITS CERTIFICATE OF INCORPORATION AND BY-LAWS ARE ALSO ON FILE WITH THE NYSDOH AND LIKEWISE AVAILABLE TO THE GENERAL PUBLIC UNDER FOIL. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO ENROLLEES IN ITS MEDICAID PROGRAM AND TO INDIVIDUALS CONSIDERING BECOMING ENROLLEES BY INCLUDING IN THE MEMBER HANDBOOKS, WHICH ARE PROVIDED TO ENROLLEES AND ARE ACCESSIBLE ON THE ORGANIZATION'S WEB SITE, A STATEMENT THAT THE FINANCIAL STATEMENTS (AS WELL AS OTHER INFORMATION DESCRIBED IN THE HANDBOOKS) ARE AVAILABLE UPON REQUEST BY CALLING A TOLL-FREE NUMBER PROVIDED IN THE HANDBOOKS.
FORM 990, PART VII:AVG. HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: THE FOLLOWING INDIVIDUALS DEVOTE A PERCENTAGE OF THEIR TIME TO SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED ORGANIZATION, AS DETAILED BELOW: DAVID THOMAS, EVP & COO - 7.5% THOMAS HALLORAN, CHIEF FINANCIAL OFFICER - 10% SANJIV SHAH, MD, CHIEF MEDICAL OFFICER - 12.5% SANTO RUSSO, CHIEF LEGAL OFFICER - 10% THIS ARRANGEMENT IS COVERED BY AN EMPLOYEE SERVICE AGREEMENT BETWEEN FIDELIS AND SALUS.
FORM 990, PART IX, LINE 12THE ORGANIZATION'S LINE 12, ADVERTISING AND PROMOTION EXPENSES INCLUDE PAYMENTS TO OTHER EXEMPT ORGANIZATIONS IN SUPPORT OF THEIR CHARITABLE PURPOSES, TO BENEFIT THE COMMUNITY, OR IN SPONSORSHIP OF THEIR FUNDRAISING EVENTS. THE EXPENDITURES INCLUDE THE AMOUNTS PAID TO THE FOLLOWING: THANKSGIVING CONTRIBUTION TO NEEDY: $153,933 OTHER CHARITABLE CONTRIBUTION LESS THAN $5,000: $450
FORM 990 SCHEDULE I, PART II COL H:SINCE 2004, THE PURPOSE OF THE FIDELIS CARE COMMUNITY GRANT FUND IS TO OFFER SUPPORT ANNUALLY THROUGH CHARITABLE CONTRIBUTIONS TO SELECTED TAX-EXEMPT NONPROFIT ORGANIZATIONS THAT SHARE SIMILAR MISSIONS AND VALUES OF SERVICE TO LOW-INCOME VULNERABLE INDIVIDUALS. PROPOSALS ARE EVALUATED ON THEIR RELEVANCE TO FIDELIS' MISSION OF CARING FOR THE NEEDS AND CONCERNS OF THE POOR AND MEDICALLY UNDERSERVED IN CONSULTATION WITH FIDELIS' MEMBERS. THE TOTAL AMOUNT TO BE DISTRIBUTED EACH YEAR IS APPROVED BY THE BOARD OF DIRECTORS AND DISTRIBUTED IN ACCORDANCE WITH THE APPROVED BOARD POLICY. IN ADDITION TO THE GRANTS MADE THROUGH ITS COMMUNITY GRANT FUND, FIDELIS PROVIDES SUPPORT THROUGH CHARITABLE CONTRIBUTIONS THROUGH ITS CATHOLIC SCHOOLS GRANT INITIATIVE TO SELECTED CATHOLIC SCHOOLS OR DIOCESAN SCHOOL SYSTEMS IN THEIR EFFORT TO IMPROVE THE HEALTH STATUS OF CHILDREN AND THEIR FAMILIES. LASTLY, FIDELIS MAKES CHARITABLE DONATIONS TO ORGANIZATIONS CLASSIFIED AS TAX-EXEMPT NONPROFIT ORGANIZATIONS UNDER STATE AND FEDERAL LAW THAT WORK WITH FIDELIS TO SUPPORT THE PLAN'S MISSION.
NOT APPLICABLE QUESTIONS:TO THE EXTENT THAT A QUESTION ON THE FORM 990 HAS BEEN LEFT BLANK, THE RESPONSE TO THIS QUESTION SHOULD BE NOT APPLICABLE. DUE TO SOFTWARE LIMITATIONS, FIDELIS COULD NOT PROPERLY RESPOND TO THE RESPECTIVE QUESTION AS N/A.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SALUS ADMINISTRATIVE SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line195-25 QUEENS BOULEVARDAddressLine1Txt
CityREGO PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11374ZIPCd
FieldValueIRS element (for citing)
EIN550878053EIN
Primary ActivitiesTHIRD PARTY ADMINISTRATORPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1FIDELIS CARE NEW YORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$6,812,443ShareOfTotalIncomeAmt
Share Of EOY Assets$63,953,764ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SALUS ADMINISTRATIVE SERVICES INC
L$6,802,168CASH
SALUS ADMINISTRATIVE SERVICES INC
N$457,750CASH
SALUS ADMINISTRATIVE SERVICES INC
O$6,398,825CASH

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART VFormAndLineReferenceDesc
ExplanationSCHEDULE R, PART V RELATED PARTY TRANSACTIONS: FIDELIS REPORTS CERTAIN RELATED PARTY TRANSACTIONS BETWEEN ITSELF AND SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED PARTY, ON SCHEDULE R, PART V. THE METHODS USED FOR DETERMINING THE AMOUNTS REPORTED DIFFER BASED ON THE TYPE OF TRANSACTION BUT ARE ALL CONTAINED IN WRITTEN CONTRACTS BETWEEN THE TWO PARTIES. SALUS REPORTS A PERFORMANCE OF SERVICES TO FIDELIS. THE WRITTEN AGREEMENT SPECIFIES A FIXED DISPENSING FEE PER PHARMACY CLAIM PROCESSED. THE FEE IS AN ESTIMATE DESIGNED TO COVER DIRECT AND INDIRECT COSTS AS WELL AS A MODEST AMOUNT OF PROFIT. THE AMOUNT IS DEEMED CONSISTENT WITH AN INDEPENDENT THIRD PARTY TRANSACTION. FIDELIS REPORTS A SHARING OF FACILITIES, EQUIPMENT, AND OTHER ASSETS. THE OVERHEAD AND ADMINISTRATIVE COSTS ARE ALLOCATED BASED ON THE SHARE OF FACILITIES AND ASSETS SALUS IS DEEMED TO USE. FIDELIS SHARES PAID EMPLOYEES WITH SALUS. FIDELIS ALLOCATES SALARIES FOR EACH EMPLOYEE BASED ON THE PERCENTAGE OF TOTAL HOURS SPENT PROVIDING SERVICES TO SALUS.ExplanationTxt

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