2015-11-13T18:02:21-06:00 2014-12-31 GRANT THORNTON LLP 757 THIRD AVE 4TH FLOOR NEW YORK NY 100172013 990 2014-01-01 131828429 Health Insurance Plan of Greater New York % MICHAEL PALMATEER HEAL 55 WATER STREET NEW YORK NY 10041 Michael Palmateer CFO 2125990100 2015-11-13 true Scott Thompsett P00741490 2125990100 2014 2016-03-07 17:11:31Z Karen Ignagni President CEO 55 WATER STREET NEW YORK NY 10041 5187437630 false X WWW.EMBLEMHEALTH.COM X 1944 NY HIP-NY is committed to providing AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS AT PRICES THEY CAN AFFORD. 7 6 5003 0 14119839 0 0 0 4964254970 5068169667 46266085 65088868 25799405 54179095 5036320460 5187437630 0 0 0 0 275668967 251466209 0 0 0 4608889100 5279614715 4884558067 5531080924 151762393 -343643294 2219457420 2262326560 697030180 1041879788 1522427240 1220446772 HEALTH INSURANCE PLAN OF GREATER NEW YORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTH COVERAGE IN WAYS THAT RESPECT AND RESPOND TO PEOPLE'S FUNDAMENTAL NEEDS. HIP PURSUES ITS MISSION BY PROVIDING A CHOICE OF PRODUCTS AND NETWORKS SO MEMBERS HAVE ACCESS TO THE MEDICAL CARE THEY NEED AT PRICES THEY CAN AFFORD. THE ORGANIZATION DOES THIS BY IMPROVING THE HEALTH OF MEMBERS THROUGH WELLNESS PROGRAMS THAT FOSTER PREVENTION AND HEALTHIER LIVING AND BY USING TECHNOLOGY TO EASE ACCESS TO INFORMATION AND SERVICES. false false 1519896287 1582681112 MEDICARE - HIP SERVED APPROXIMATELY 112,000 MEDICARE MEMBERS THROUGH its MEDICARE RISK AND COST CONTRACT PROGRAMS. 1108617953 1203108339 MEDICAID - HIP SERVED APPROXIMATELY 240,000 MEDICAID MEMBERS. HIP HAS BEEN SERVICING THE MEDICAID POPULATION SINCE 1967 (WITH THE PASSAGE OF FEDERAL LEGISLATION AUTHORIZING THIS PROGRAM) AND HAS AN EXTENSIVE PROGRAM IN PLACE TO ENCOURAGE PREVENTIVE MEDICAL CARE. 2195779310 1425168 2292443502 SUBSCRIBER BENEFITS - HIP OF GREATER NEW YORK IS A NOT-FOR-PROFIT CORPORATION THAT ARRANGES FOR THE PROVISION OF COMPREHENSIVE MEDICAL AND HEALTH CARE SERVICES FOR ITS SUBSCRIBERS/MEMBERS (INCLUDING HEALTH CARE SERVICES TO MEDICARE AND MEDICAID MEMBERS) WHICH IS AN EXEMPT FUNCTION. In 2014, HIP-NY provided services (across all services lines) to a total of 730,000 members. Included within these subscriber benefits are various state and local benefit programs, including the following: 1. CHIPS (Children's Health Insurance Program) - HIP SERVED APPROXIMATELY 12,500 MEMBERS. HIP HAS BEEN SERVING THE CHIPS POPULATION SINCE THE INCEPTION OF THE STATE DEMONSTRATION PROGRAM FOR UNISURED CHILDREN UNDER 19, IN 1991 AND CONTINUED WITH THE PASSAGE OF The Childrens Health Insurance Program (CHIP) in 1997. CHIPS is a partnership between the federal government and the states to extend health coverage to uninsured children and pregnant women in families who cannot afford to purchase private health insurance but have incomes too high to qualify for Medicaid. 2. Family Health Plus Program - HIP SERVED APPROXIMATELY 2,800 MEMBERS. HIP BEGAN TO SERVE FHPLUS MEMBERS AT THE START OF THE PROGRAM IN THE NY DOWNSTATE AREA IN OCTOBER 2001. THE BENEFIT PACKAGE FOR THE PROGAM PROVIDES a comprehensive set of medically needed health care benefits and services to the ADULT UNINSURED and low-income wage earners. The organization notes that the allocation of program service expenditures reported on Part III of the Form 990 is derived from HIP-NY's Statutory Financial Statements (STAT) The Form 990 is prepared in accordance with Generally Accepted Accounting Principles (GAAP); accordingly, there may be additional allocations of expenditures to achieve conformity between the GAAP and STAT reports. 4824293550 false false false false false false false false false true true false true true true false true false false true false false false false false false false false true false false false false false false true true false false false false true true true true false true 636 0 true 5003 true true true false false false false false X 7 6 true false false false true false false true true false false true true true true true true true true false NY X MICHAEL PALMATEER 6464475000 55 WATER STREET NEW YORK NY 10041 X Frank J Branchini Chairman and CEO 2.0 35.0 X X 4859450 0 3015144 Robert W Brokaw Director 2.0 0.0 X 7313 0 0 Elaine Friedman Director 2.0 0.0 X 1576 0 0 David J Cooper Director (through 10/2014) 2.0 0.0 X 0 0 0 Gregory E Floyd Director 2.0 0.0 X 0 0 0 Paul E Gibson Director 2.0 0.0 X 0 131530 0 Margaret T Pan-Loo Director 2.0 0.0 X 0 0 0 Oliver Gray Director 2.0 0.0 X 0 0 0 Daniel P Finke President and COO 35.0 0.0 X 1558961 0 1275546 William C Lamoreaux EVP & Chief Operating Officer 35.0 0.0 X 987752 0 717461 William A Gillespie Chief Medical Officer 35.0 0.0 X 894886 0 453349 Edward Mailander SVP, Chief Actuary 35.0 0.0 X 801849 0 428715 Charlene A Maher SVP, Chief Marketing Officer 35.0 0.0 X 773209 0 399941 Shawn M Fitzgibbon SVP, Government Programs 35.0 0.0 X 703004 0 362568 Michael Palmateer SVP, Finance 35.0 0.0 X 694434 0 503448 Jeffrey D Chansler General Counsel 35.0 0.0 X 666322 0 479745 Arthur Byrd Chief Financial Officer 35.0 0.0 X 638782 0 297078 Valerie A Reardon SVP, Compliance&Internal Audit 35.0 0.0 X 609645 0 441643 William Mastrogiacomo SVP, Dep Gen Counsel, Corp Sec 35.0 0.0 X 600242 0 427678 George Babitsch SVP, Underwriting & Acct Mgmt 35.0 0.0 X 582601 0 410244 Nicholas P Kambolis SVP, Legal 35.0 0.0 X 577415 0 294010 Michele A Powers VP, Operations 35.0 0.0 X 507651 0 229604 Robert Branchini VP, Information Technology 35.0 0.0 X 482611 0 265993 Mariann E Drohan VP, Human Resources 35.0 0.0 X 472546 0 201566 David J Morin VP, Customer Service 35.0 0.0 X 460294 0 166687 John D Mahder VP, Marketing 35.0 0.0 X 438113 0 184542 Williams Lewis VP, Fac,RE,Crp Svc/Ass Gen Csl 35.0 0.0 X 404501 0 218994 John A Kennedy VP, Gov't Prog & Direct to Con 35.0 0.0 X 387332 0 131875 William Yurkowski VP, Operations 35.0 0.0 X 385740 0 186577 Karen Smith-Hagman VP, Medical Management 35.0 0.0 X 385474 0 179075 Mohamed Diab VP, Medical Mgmt Operations 35.0 0.0 X 384125 0 183805 Carl A Lund VP, Facility Contracting 35.0 0.0 X 380230 0 169114 Richard R Gross VP, Account Management 35.0 0.0 X 366313 0 133300 Jennifer L Truscott VP, Claims Operations 35.0 0.0 X 362462 0 148958 Mary E Soul VP, Actuarial Valuation 35.0 0.0 X 358466 0 147201 Brendan R Shanahan VP, Budget & Analysis 35.0 0.0 X 352539 0 110985 Wanda Wareham VP, Gov't Assisted Programs 35.0 0.0 X 351335 0 147794 Stuart Lefkowich VP, Medicare Advantage 35.0 0.0 X 350564 0 146976 Philip J Gillich VP, Network Management 35.0 0.0 X 348845 0 154900 Jose R Diaz VP, Membership 35.0 0.0 X 348410 0 210878 Eliza Ng VP, Clinical Affairs 35.0 0.0 X 347106 0 106555 Daniel Byrne VP, Labor Relations 35.0 0.0 X 342498 0 159832 Ernesto Marrero Jr VP, Medicare Compliance 35.0 0.0 X 333244 0 138723 Vincent A Hartmann VP, Underwriting 35.0 0.0 X 316034 0 171425 Erhard V Krause VP, Business Development 35.0 0.0 X 309140 0 154965 Peter S Moore VP, Government Programs 35.0 0.0 X 307760 0 185459 Christopher W Chappelear VP, Actuarial & Underwriting 35.0 0.0 X 301816 0 109417 Douglas Cowieson SVP, Administrative Transform 35.0 0.0 X 301393 0 12443 Jerry A Gallo VP, Commercial Sales 35.0 0.0 X 289385 0 96044 Suzanne G Ronner VP, Service Administration 35.0 0.0 X 258844 0 42310 Michele H Podolak VP, Customer Service 35.0 0.0 X 258454 0 130352 Stephen A Zeng VP, Enterprise PMO 35.0 0.0 X 231190 0 167700 Richard M Densing VP, Gov't Prog & Direct to Con 35.0 0.0 X 152846 0 55823 Munish Khaneja VP, Medical Mgmt Operations 35.0 0.0 X 105131 0 51910 Wei Jia Shen Sr. Director -Applications Dev 40.0 X 335527 9348 Terrylynn Smith Director, Labor Relations 40.0 0.0 X 320501 0 5223 Thomas MAcMillan Sr. Director, EPMO 40.0 0.0 X 309522 0 10388 Eleanor Sorrentino Sr. Director, Quality Mgmt 40.0 0.0 X 314046 0 6869 Bruce Sosler Senior Medical Director 40.0 0.0 X 315080 0 3816 27934509 131530 14443996 1138 false true false Price Waterhouse Coopers LLP PO Box 905615 CHARLOTTE NC 28290 Accounting/Consult 8351517 The Sourcing Group LLC 938 Lincoln Avenue SPRINGFIELD PA 19064 Business Solutions 9149620 Sharp Decisions 1040 Avenue of the Americas NEW YORK NY 10018 IT Solutions 8299188 Merkle Inc 7001 Columbia Gateway Drive COLUMBIA MD 21046 Marketing Solutions 8041274 Gannon Vitolo Contracting LLC 49 West 38th Street NEW YORK NY 10018 Construction 8029293 186 X 0 PREMIUM REVENUE 900099 5063581662 5061553159 2028503 THIRD PARTY ADMINISTRATIVE FEES 900099 4588005 4534525 53480 5068169667 43041672 4636525 38405147 0 0 32109942 2160594 32109942 2160594 34270536 2160594 32109942 22047196 22047196 22047196 22047196 0 0 0 PHARMACY REVENUE 900099 17386006 12145269 5240737 HURRICANE SANDY RECOVERY 900099 6676632 6676632 LOSS ON IMPAIRMENT OF GOODWILL 900099 -4154079 -4154079 19908559 5187437630 5078232953 14119839 95084838 X 0 0 0 0 26604689 26604689 130759136 130759136 41290474 41290474 38721381 38721381 14090529 14090529 0 3499137 3499137 2076362 2076362 536680 536680 0 2595920 2595920 88775491 88775491 16133003 16133003 25992266 25992266 0 0 24916220 24916220 3806288 3806288 0 0 60839 60839 0 47466844 47466844 5313142 5313142 SUBSCRIBER BENEFITS 4616131685 4616131685 OUTSOURCED SERVICES 56233394 56233394 QUALITY OF CARE EXPENSES 28112223 28112223 ACA HEALTHCARE FEES 57909249 57909249 300055972 122140393 177915579 5531080924 4824293550 706787374 0 0 0 109716962 236125131 0 0 233840612 225165499 0 0 0 0 165000000 240987161 0 0 4805929 5721692 498022581 332946942 183227126 165075639 1132648702 740299393 107132267 394687007 0 0 4154079 0 278931743 254265038 2219457420 2262326560 495532973 846665282 0 0 6037473 10631753 0 0 0 0 0 0 0 0 0 0 195459734 184582753 697030180 1041879788 X 1522427240 1220446772 0 0 0 0 1522427240 1220446772 2219457420 2262326560 X -343643294 41662826 X false true X true false 6963425 6963425 149223556 83228257 66003300 192025930 109353667 82672263 74954699 70171412 4783287 74846971 70193607 4653364 165075639 INVESTMENT IN ADVANTAGECARE 185046456 C INVESTMENT IN HIP HOLDINGS INC 209640551 C 394687007 OTHER RECEIVABLES 12637903 DEFERRED RENT 1198500 INTEREST/DIVIDENDS RECEIVABLE 4142070 OTHER CURRENT ASSETS 3443908 HEALTHCARE RECEIVABLES 126726671 INTERCOMPANY RECEIVABLES 105960747 DEFERRED TAX ASSET 155239 254265038 0 PENSION LIABILITY 110127402 DEFERRED RENT 67552225 OTHER LONG TERM LIABILITIES 6853289 ACCRUED INCOME TAXES 49837 184582753 FIN 48 DISCLOSURE The organization's consolidated audited financial statements contain a modified version of the original Fin-48 footnote included when it initially adopted FIN-48: In July 2006, the Financial Accounting Standards Board (FASB) issued Interpretation No. 48, Accounting for Uncertainty in Income Taxes, an Interpretation of SFAS Statement No. 109 (FIN No. 48). Among other things, FIN No. 48 creates a model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing minimum recognition thresholds which all income tax positions must achieve before being recognized in the financial statements. In addition, FIN No. 48 requires expanded annual disclosures, including a reconciliation of the beginning and ending aggregate unrecognized tax benefits as well as specific detail related to tax uncertainties for which it is reasonably possible the amount of unrecognized tax benefit will significantly increase or decrease within 12 months. Any tax differences between the amounts recognized in the statements of financial position prior to the adoption of FIN No. 48 and the amounts reported after adoption are generally accounted for as a cumulative-effect adjustment recorded to the beginning balance of retained earnings. Effective January 1, 2007, the Company adopted FIN No. 48, which did not have any impact on the Company's consolidated financial statements. The Company does not have any unrecognized tax benefits as of or for the year ended December 31, 2014. East Asia and the Pacific Investments 3799342 North America Investments 13929435 Europe (Including Iceland and Greenland) Investments 11381162 Central America and the Caribbean Investments 722104 29832043 29832043 false false false false false false Schedule F, Part 1 HIP-NY does not conduct any activities outside the United States. In accordance with the instructions to the Form 990, the organization is reporting the market value of non-U.S. investments. X true true X X X X X true true false false false true false false false Frank J Branchini Chairman and CEO 919404 0 2981100 0 958946 0 3007548 0 7596 0 7874594 0 0 0 Daniel P Finke President and COO 250526 0 1268838 0 39597 0 1272738 0 2808 0 2834507 0 0 0 William C Lamoreaux EVP & Chief Operating Officer 484491 0 471495 0 31766 0 710369 0 7092 0 1705213 0 0 0 William A Gillespie Chief Medical Officer 415415 0 445792 0 33679 0 449692 0 3657 0 1348235 0 0 0 Edward Mailander SVP, Chief Actuary 362772 0 407119 0 31958 0 421027 0 7688 0 1230564 0 0 0 Charlene A Maher SVP, Chief Marketing Officer 361799 0 382353 0 29057 0 393875 0 6066 0 1173150 0 0 0 Shawn M Fitzgibbon SVP, Government Programs 330512 0 343914 0 28578 0 356080 0 6488 0 1065572 0 0 0 Michael Palmateer SVP, Finance 305972 0 360555 0 27907 0 498960 0 4488 0 1197882 0 0 0 Jeffrey D Chansler General Counsel 291969 0 343914 0 30439 0 476253 0 3492 0 1146067 0 0 0 Arthur Byrd Chief Financial Officer 362119 0 260165 0 16498 0 288590 0 8488 0 935860 0 0 0 Valerie A Reardon SVP, Compliance&Internal Audit 276144 0 307820 0 25681 0 432327 0 9316 0 1051288 0 0 0 William Mastrogiacomo SVP, Dep Gen Counsel, Corp Sec 260146 0 310633 0 29463 0 422362 0 5316 0 1027920 0 0 0 George Babitsch SVP, Underwriting & Acct Mgmt 252042 0 305085 0 25474 0 401826 0 8418 0 992845 0 0 0 Nicholas P Kambolis SVP, Legal 316127 0 235555 0 25733 0 286522 0 7488 0 871425 0 0 0 Michele A Powers VP, Operations 268394 0 213961 0 25296 0 227068 0 2536 0 737255 0 0 0 Robert Branchini VP, Information Technology 249994 0 207194 0 25423 0 261505 0 4488 0 748604 0 0 0 Mariann E Drohan VP, Human Resources 269577 0 173091 0 29878 0 199910 0 1656 0 674112 0 0 0 David J Morin VP, Customer Service 17234 0 162039 0 281021 0 165939 0 748 0 626981 0 0 0 John D Mahder VP, Marketing 245038 0 166091 0 26984 0 178650 0 5892 0 622655 0 0 0 Williams Lewis VP, Fac,RE,Crp Svc/Ass Gen Csl 215790 0 162192 0 26519 0 213854 0 5140 0 623495 0 0 0 John A Kennedy VP, Gov't Prog & Direct to Con 223712 0 125170 0 38450 0 129070 0 2805 0 519207 0 0 0 William Yurkowski VP, Operations 203942 0 155434 0 26364 0 179589 0 6988 0 572317 0 0 0 Karen Smith-Hagman VP, Medical Management 202864 0 155434 0 27176 0 171009 0 8066 0 564549 0 0 0 Mohamed Diab VP, Medical Mgmt Operations 185508 0 172392 0 26225 0 176292 0 7513 0 567930 0 0 0 Carl A Lund VP, Facility Contracting 201562 0 152118 0 26550 0 164746 0 4368 0 549344 0 0 0 Richard R Gross VP, Account Management 281675 0 57250 0 27388 0 124694 0 8606 0 499613 0 0 0 Jennifer L Truscott VP, Claims Operations 205844 0 137993 0 18625 0 147302 0 1656 0 511420 0 0 0 Mary E Soul VP, Actuarial Valuation 220114 0 133426 0 4926 0 143385 0 3816 0 505667 0 0 0 Brendan R Shanahan VP, Budget & Analysis 237491 0 89917 0 25131 0 99653 0 11332 0 463524 0 0 0 Wanda Wareham VP, Gov't Assisted Programs 179181 0 139520 0 32634 0 143420 0 4374 0 499129 0 0 0 Stuart Lefkowich VP, Medicare Advantage 172352 0 138660 0 39552 0 142560 0 4416 0 497540 0 0 0 Philip J Gillich VP, Network Management 188851 0 135161 0 24833 0 151900 0 3000 0 503745 0 0 0 Jose R Diaz VP, Membership 187114 0 133293 0 28003 0 207062 0 3816 0 559288 0 0 0 Eliza Ng VP, Clinical Affairs 243337 0 85750 0 18019 0 95817 0 10738 0 453661 0 0 0 Daniel Byrne VP, Labor Relations 187226 0 136704 0 18568 0 150528 0 9304 0 502330 0 0 0 Ernesto Marrero Jr VP, Medicare Compliance 187166 0 121918 0 24160 0 133887 0 4836 0 471967 0 0 0 Vincent A Hartmann VP, Underwriting 163030 0 127285 0 25719 0 165224 0 6201 0 487459 0 0 0 Erhard V Krause VP, Business Development 155284 0 123032 0 30824 0 151149 0 3816 0 464105 0 0 0 Peter S Moore VP, Government Programs 160756 0 121336 0 25668 0 180285 0 5174 0 493219 0 0 0 Christopher W Chappelear VP, Actuarial & Underwriting 226263 0 57573 0 17980 0 99933 0 9484 0 411233 0 0 0 Douglas Cowieson SVP, Administrative Transform 186119 0 0 0 115274 0 7937 0 4506 0 313836 0 0 0 Jerry A Gallo VP, Commercial Sales 192682 0 78110 0 18593 0 87296 0 8748 0 385429 0 0 0 Suzanne G Ronner VP, Service Administration 208249 0 27853 0 22742 0 37572 0 4738 0 301154 0 0 0 Michele H Podolak VP, Customer Service 132684 0 101583 0 24187 0 126036 0 4316 0 388806 0 0 0 Stephen A Zeng VP, Enterprise PMO 35996 0 162192 0 33002 0 165686 0 2014 0 398890 0 0 0 Richard M Densing VP, Gov't Prog & Direct to Con 100861 0 50000 0 1985 0 52953 0 2870 0 208669 0 0 0 Munish Khaneja VP, Medical Mgmt Operations 55021 0 50000 0 110 0 51162 0 748 0 157041 0 0 0 Wei Jia Shen Sr. Director -Applications Dev 242887 0 92640 0 0 0 3900 0 5448 0 344875 0 0 0 Terrylynn Smith Director, Labor Relations 151540 0 21597 0 147364 0 2365 0 2858 0 325724 0 0 0 Thomas MAcMillan Sr. Director, EPMO 230218 0 79304 0 0 0 3900 0 6488 0 319910 0 0 0 Eleanor Sorrentino Sr. Director, Quality Mgmt 226690 0 86950 0 406 0 3457 0 3412 0 320915 0 0 0 Bruce Sosler Senior Medical Director 252114 0 62966 0 0 0 0 0 3816 0 318896 0 0 0 Schedule J, Line 1A Per EmblemHealth's Travel and Business expense Policy, the Chairman and Chief Executive officer, the President and Chief Operating Officer, the President of EmbleHealth Services, the Executive Vice Presidents, and, in the discretion of the Chairman and Chief Executive Officer, members of the Board of Directors of EmblemHealth may travel first class and can request staff traveling on business with them to travel first class on accompanied segments of the trip. Any such expenses are reimbursed upon presentation of accurate receipts. Per EmblemHealth's Travel and Business Expense Policy, approved Spousal or Guest travel and related lodging, meal expenditures and other appropriate related cost will be reimbursed when the travel is required by EmblemHealth for a legitimate business purpose. Spousal and Guest travel that is not approved in advance is referred to the Senior Vice President for compliance for review. It should be noted that the above policy applies to all entities within the Emblemhealth universe. In 2014, Health Insurance Plan of Greater New York did not provide any spousal travel or first class travel to any of the individuals reported in the Form 990. Mr. Branchini receives a tax gross up for amounts paid into the secular Trust. Severance Payment The following officers received severance in 2014: David Morin - $264,645 John White - $163,611 All of the severance payments documented above are reported in the Form 990, Schedule J, part II, Column (b)(iii). Non-Qualified Retirement Plan Emblem Health Services, LLC sponsors nonqualified retirement plans that the officers of HIPNY participate in, Officers with the titles of senior vice president and above hired before June 1, 2009, with the exception of Frank Branchini, participate in the supplemental executive retirement plan for emblemhealth services company, llc ("SERP"). The SERP provides a retirement benefit calculated on the basis of 50% of final average pay, offset by benefits under any qualified benefit plan, such as The emblemhealth services company, llc employees' retirement plan. Participants require the approval of the board of directors to retire under the serp between the ages of 55 and 60. Participants who retire prior to age 65 have their serp benefits reduced by early retirement factors. Mr. branchini participates in the GHI supplemental retirement plan ("Secular trust") which provides a retirement benefit calculated to provide the retirement benefits that would otherwise be payable under the local 153-ghi pension plan and the ghi cash balance plan (qualified plans), but for funding and contributions limits imposed by the IRS regulations. Senior vice presidents and above, hired before june 1, 2009, participate in the supplemental retirement plan ii for emblemhealth services company, llc (SERP II"). The SERP II provides a retirement beneft calculated on the basis of 30% of final average pay after 5 years of service, and increasing to 50% of final average pay after 15 years of service, offset by benefits under any qualified benefit plan, such as the emblemhealth services company, llc employees' retirement plan. Participants require the approval of the board of directors to retire under the SERP II between the ages of 55 and 60. Participants who retire prior to age 65 have their SERP II benefits reduced by early retirement factors. Bonus Payments HIP and EmblemHealth Services provide annual incentive awards based upon the achievement of performance metrics and percentage target awards. The compensation committees approve the performance metrics and targets and the ultimate payout to participants based upon the performance achieved under the Annual Incentive Plan (AIP). All management, non-union employees may be eligible to participate in the AIP. In the 2014 AIP, two equally weighted performance metrics were Operating Income and Administrative Per Member Per Month (PMPM) savings. Operating Income was defined as premiums earned and administrative service fee revenue, less subscriber benefits, depreciation and amortization, interest and general administrative expenses, as reported in the annual financial statements, and exluding certain specified and extraordinary items. Administrative PMPM was defined as the depreciation and amortization, interest and general administrative expenses as reported in the annual audited financials associated with the administration of the company's insured commercial managed care, Medicare and State sponsored programs expressed on a per member per month basis, and excluding certain specified and extraordinary items. HIP and EmblemHealth Services also have a long term incentive plan based upon longer term performance over three year performance cycles and a limited supplemental incentive plan with payment triggered by threshold performance under the AIP. The compensation committees approve the performance metrics, targets and payouts based upon achievement of performance under these plans as well. Officers and key employees are generally eligible to participate in the long term incentive plan. Schedule J, Part II, Column C Related party, Health Insurance Plan of Greater New York, reports the change in the actuarial value of the pension plan as deferred compensation (as required by the expanded disclosures in the form 990). Present values are calculated based on the SEC Proxy Summary Compensation Table methodology and assumptions, as the discounted present value of normal retirement benefits earned to the measurement date payable at the later of current age or age 65, without regard to projected service, projected salary increases, pre-retirement mortality or other decrements. To the extent any individual reported on Schedule J has compensation reported in column (f), those amounts reflect payouts from the Supplemental Executive Retirement Plan. William White Director/HR Department 175332 See Schedule L Narrative false Christine O'Connor Burns Kin of Board Member 233033 See Schedule L Narrative false William O'Connor Kin of Board Member 232827 See Schedule L Narrative false Diane Pirone Kin of President & COO 3130362 See Schedule L Narrative false Keith Dahl Kin of President 275157 See Schedule L Narrative false David Cooper Board Member 42100000 See Schedule L Narrative false Form 990, Schedule L Chairman and Chief Executive Officer, FRANK BRANCHINI, HAS A FAMILY MEMBER, DIANE PIRONE (SISTER), WHO IS A MANAGER AT RCG, A CONSULTING FIRM WHICH HAS BEEN UTILIZED BY HIP SINCE 2004. MS. PIRONE DOES NOT DO BUSINESS ON THE HIP/EMBLEM ACCOUNT. IN CALENDAR YEAR 2014, HIP-NY PAID THE CONTRACTED ENTITY, RCG, $3,130,362. Chairman and Chief Executive Officer, Frank Branchini, has a family member, Keith Dahl, son-in-law, who is a physician employed by AdvantageCare Physician, P.C.("ACP"), a related entity to HIP-NY. HIP-NY engages in various transactions with ACP to provide medical services to its members. Dr. Dahl received $275,157 in compensation from ACP. Former Vice President of Integrative Wellness, John White, has a family member who is, likewise, employed by EmblemHealth Services Company, LLC. William White is employed by EmblemHealth Services Company, LLC. as a Director in the Human Resources Department; his W-2 wages for the year ending 12/31/2014 are $175,332. John receives fringe benefits from EmblemHealth Services Company, LLC as well. Board of Directors Member John O'Connor has two family members that are employees of EmblemHealth Services Company, LLC. Christine O'Connor Burns and William O'Connor received W-2 compensation of $233,033 and $232,827 respectively from EmblemHealth Services Company, LLC. Both individuals, likewise, receive fringe benefits from EmblemHealth Services Company, LLC as well. Board of Directors Member, David Cooper, is the chief executive officer of ProHealth Care Associates, LLP, a physician group practice that provided services to HIP-NY and was paid $42.1 million dollars. HIP-NY does not believe it has any other business transactions or relationships between itself and an officer, director, or key employee of the organization that rise to the monetary threshold required for disclosure on Schedule L of the Form 990. The organization takes its responsibilities of monitoring potential conflicts of interest very seriously (please see disclosure on Part VI, Line 12). HIP-NY compiles a lengthy Summary report of all potential business transactions between the individuals reported on Part VII of the Form 990 and HIP-NY or one of its affiliated organizations. This report discloses all potential business transactions regardless of monetary value. Amounts reported on Schedule L represent the W-2, Box 5 wages paid to each of these individuals. Additional taxable and non-taxable fringe benefits may have been provided (but are not included above). Additional information is available upon request. Form 990, Principal Officer Effective September 1, 2015, the EmblemHealth Board of Directors selected Karen Ignani to be the next President & Ceo of Emblemhealth. Ms. Ignani is not reported on Part VII of the Form 990 as she was not employed by the organization in 2014. Part V, Line 1a and Part VII, Independent Contractors. The total number of independent contractors reported on Part V, Line 1a represents those vendors that received a 1099 directly from HIP-NY's EIN#. In addition, HIP-NY's 100% owned disregarded entity, EmblemHealth Services, LLC, (EHS) also issued 1099s in calendar year 2014. In the interests of full disclosure, HIP-NY is disclosing that EmblemHealth Services, LLC issued 2,392 1099s in calendar year 2014. In total, HIP-NY and EHS paid compensation exceeding $100,000 to 186 vendors (18 paid by HIP-NY and 168 by EHS) HIP-NY, as a part of its business, undertakes a significant amount of claims processing; in 2014, HIP-NY issued 22,903 1099s through its claims processing department. The 1099s for the claims processing are not reported on Line 1(a) but are disclosed here in the interests of full disclosure. Form 990, Part V, Line 2(a) HIP-NY does not file a Form W-3 as all employee payroll is paid out of EmblemHealth Services, LLC. In the interests of clarity, HIP-NY is disclosing that 5,003 employees received W-2s from EmblemHealth Services (ostensibly for services rendered to HIP-NY and to other affiliated entities). Form 990, Part VI, Line 2 Frank Branchini, President and Chief Operating Officer, has a family relationship with Robert Branchini, VP Information Technology. In the interests of full disclosure, the organization notes that various Officers and/or directors, may serve on the Board of Directors of related for-profit organizations (e.g. - those disclosed in Schedule R of the Form 990). No individual is compensated for board services rendered to the related for-profit organization. Form 990, Part VI, Line 6 EmblemHealth, Inc., a New York not-for-profit corporation, is the sole member of Health Insurance Plan of Greater New York. EmblemHealth (EIN 13-3941542) is exempt from federal taxation pursuant to IRC 501(c)(3). Form 990, Part VI, Line 11 The taxpayer's Form 990 for the year ending December 31, 2014 was provided to each member of the organization's governing body before it was filed. A detailed review of the Form 990 was undertaken by the Organization's Tax Director, Chief Financial Officer and VP, Corporate Secretary. Form 990, Part VI, Line 12 To determine if an employee's personal interests, activities or relationships constitute a conflict of interest or the appearance of a conflict of interest, certain employees, based upon functionality, as determined by the Senior Vice President for Compliance, Internal Audit and Internal controls are required to fully disclose, on an annual basis, any reportable situations on the company's conflict of interest disclosure. All employees, at the time of employment, are required to fully disclose any personal interest, activities or relationships that constitute a conflict of interest or the appearance of a conflict of interest. Disclosures are reviewed by the Senior Vice President for Compliance, Internal Audit and Internal Controls and by the Executive Vice President, Chief Financial Officer and General Counsel. Any Employee, who violates the conflict of interest policy, fails to make a required report or fails to comply with any remedial action required by the company, is subject to disciplinary action, up to and including termination of employment. Form 990, Part VI, Line 15 To determine the compensation of the CEO and all other officers of the company, HIP and EmblemHealth Services engage an outside compensation consultant to provide guidance and the comparable market data on the compensation of similarly situated executive positions in the organizations' competitive peer group comprised of profit and not for profit entities. The compensation consultant presents the comparable market data to the compensation committee of the board of directors of HIP and EmblemHealth Services. The compensation committees are composed entirely of outside, independent, disinterested directors. The compensation committees review and approve the proposed compensation arrangements and the deliberations and actions of the compensation committees are documented in the minutes of each meeting. Thereafter, the actions of the compensation committees are reported to the full boards in a timely manner. The CEO, or any other officer, is excused from the compensation committee meeting while the committee deliberates and approves any action related to the compensation arrangement of the CEO or other officer. Form 990, Part VI, Line 19 The taxpayer makes its Form 990 and Form 1023 available to the public by retaining a copy of each at its head offices at 55 Water Street, New York, New York. Any individual requesting a copy of these documents is provided that copy on the same business day. The organization's Form 990 is also available for public inspection on www.guidestar.com. The taxpayer's financial statements are available for public inspection on the organization's website, www.emblemhealth.com. The organization's governing documents and conflict of interest policy are not available to the public. Form 990, Part VII - Hours Served for Related Party The compensated individuals reported in Part VII of the Form 990 may provide services to a variety of entities within the Health Insurance Plan of Greater New York network. Allocating those hours between the many entities presents a challenge; accordingly, the hours represented on Part VII represent the hours worked by the individual in their capacity as an employee for the entire HIP network. Form 990, Part VIII Health Insurance Plan of Greater New York generates rental revenue from medical groups who lease a combination of personal and real property. HIP does not book this revenue in its general ledger as rental income, but rather offsets payments due to the health provider/facilities as monthly settlements are made. These transactions result in a net out-flow of cash as HIP finalizes its monthly settlements. For the most part, the rental income generated by HIP is for space rental and incidental personal property rental (i.e. 10% or less of the total rents received under the lease are from personal property). To the extent that the rental income is attributable to a mixed lease (i.e. where personal property is 11% to 50% of the total rents), HIP reports this revenue as unrelated business income and specifically reports this revenue on Part VIII, Lines 6a and 6b and on its Form 990-T. Quantifying total rental income received across all medical groups is difficult, but the organization has approximated the revenue and disclosed it in Part VIII, Line 6. Form 990, Part IX Amounts reported on Part IX, Line 5, as compensation paid to officers, directors and key-employees of HIP-NY represent those salary costs reported on Form 990, Part VII, Line 1(d) that are allocated from the related party, EmblemHealth Services, LLC. Health Insurance Plan of Greater New York has adopted a simplified approach of allocating its expenditures between programmatic and management and general. The organization does not categorize its expenses internally or in its audited financial statements by these means. For purposes of its 990 reporting, HIP-NY is treating all subscriber benefits as programmatic expenses and all other expenses as management and general even though a large percentage of those expenses are likely related to HIP's day-to-day mission activities. Nevertheless, even taking this conservative approach, HIP's program service expenses constitute 87% of total expenditures. Form 990, Part XI, Line 9 A difference of $41,662,826 is reported on part XI of the Reconciliation of Net Assets. This difference is attributable to changes in unrealized gains and losses on investments, book to tax adjustments on investments as well as Statutory-to-GAAP financial statement adjustments. EmblemHealth Services Company LLC 55 Water Street New York NY 10041 Support Svcs NY 0 408172000 HIP-NY EMBLEMHEALTH INC 55 WATER STREET NEW YORK NY 10041 133941542 support svcs NY 501(c)(3) 11e HIP-NY true Group Health Incorporated 55 Water Street New York NY 10041 135511997 Insurance NY NA C Corp 1918896814 722764243 1.00000 true HIP Holdings Inc & Subsidiaries 55 Water Street New York NY 10041 133819759 Insurance NY NA C Corp. 1630545162 1140998500 1.00000 true Central Brooklyn Medical Group PC 440 9th Avenue New York NY 10001 112937992 Healthcare NY HIP-NY C Corp 80334785 7908310 1.00000 true Queens Long Island Medical Group PC 440 9th Avenue New York NY 10001 113039101 Healthcare NY HIP-NY C Corp 69434592 106990415 1.00000 true Staten Island Physician Practice PC 440 9th avenue new york NY 10001 204659577 healthcare NY HIP-NY C corp 10470073 3340886 1.00000 true AdvantageCare Physicians PC 440 9th Avenue New York NY 10001 460790995 healthcare NY HIP-NY C Corp 248368754 110583514 1.00000 true LHHN Medical PC 440 9th Avenue New York NY 10001 134121055 healthcare NY HIP-NY C Corp 22499400 3617840 1.00000 true true true false true false true false false false false true true true true true true true true EmblemHealth Inc M,P 1916171 Cost Group Health Incorporated A 3300000 Market Rate Group Health Incorporated D 165000000 Market Rate Hip Holdings Inc & Subsidiaries (EHA) M 19400000 COST Hip Holdings Inc & Subsidiaries (EHA) L 2200000 COST Hip Holdings Inc & Subsidiaries (HIPIC) L,Q 11600000 COST Hip Holdings Inc & Subsidiaries (HIPIC) M 110200000 COST Hip Holdings Inc & Subsidiaries (HIP-IPA) l 800000 cost Hip Holdings Inc & Subsidiaries (HIP-IPA) M 15400000 cost Advantage Care Physician PC B 77900000 cost Central Brooklyn Medical Group PC a 236835 cost Staten Island Physician Practice PC a 59261 cost Queens Long Island Medical Group PC a 762911 cost LHHN Medical PC a 277518 cost Central Brooklyn Medical Group PC d 2630160 cost Staten Island Physician Practice PC d 2932066 cost Queens Long Island Medical Group PC d 10903184 cost LHHN Medical PC d 2559593 cost Schedule R, Part V, Line 2 TRANSACTIONS with Emblem Health, Inc. EmblemHealth, Inc. is the parent organization of Health Insurance Plan of Greater New York (HIP-NY), a 501(c)(4) tax-exempt organization that delivers quality, affordable health insurance to members and provides employers and individuals with a range of plan choices and attractive benefit options designed to meet the individual needs of today's healthcare consumers. EmblemHealth, Inc., through its subsidiaries helps facilitate HIP-NY's community programs. Costs associated with running EmblemHealth Inc. are reimbursed by HIP-Ny and are memorialized with Transaction Code M & P. Transactions with Group health Incorporated To date, HIP-NY has advanced $165 million to GHI in accordance with Section 1307 of the Insurance Law of the State of New York with interest accruing at 2% per annum. No new loans were issued in 2014. As provided in Section 1307, the payment of principal and interest thereon shall only be made out of free and disposable surplus, subject to prior approval of the Superintendent. As of December 31, 2014, no payments were made to HIP. Nevertheless, HIP is disclosing the amount of accrued interest with Transaction Code A. Transactions with HIP Holdings, Inc. & Subs (HIPIC) HIPIC (a member of HIP Holdings, Inc. & Subs) provides the indemnity health insurance portion of dual option products offered by HIP and HIP administers the collection of premiums and pays claims on behalf of HIPIC. Premiums collected on behalf of HIPIC were approximately $60,200,000 million for the year ended December 31, 2014. HIP paid out-of-network claims on behalf of HIPIC of $50,000,000 in 2014. Under the terms of a service agreement, HIP allocated costs associated with administering the premiums and claims of approximately $11,600,000 million to HIPIC for the year ended December 31, 2014. Transactions with HIP Holdings, Inc. (HIP-IPA) HIP pays HIP IPA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) a monthly per-member-per-month capitation rate for members enrolled in HIP IPA as well as a monthly fee for data collection services. For the year ended December 31, 2014, HIP incurred approximately $15,400,000 million for capitation and $600,000 for data collection services. In addition, HIP provides certain administrative and support services to HIP IPA, which are reimbursed by HIP IPA. For the year ended December 31, 2014, amounts charged by HIP to HIP IPA for these services was approximately $200,000. Transactions with HIP HOldings, Inc. & Subsidiaries (EHA) EHA (another subsidiary in the HIP Holdings, Inc. & Subsidiaries consolidated group) provides claims processing and certain member services for HIPs members. For the year ended December 31, 2014, EHA charged HIP approximately $19,400,000 million for these services. HIP -NY provides administrative and management services to EHA; amounts paid in 2014 were approximately $2,200,000 Transactions with Physician Medical Groups As of January 1, 2013 Emblem completed a series of transactions that resulted in a nominee shareholder arrangement with four independent medical groups that provide health care services to certain subscribers of Emblems health benefit plans and which operate out of facilities owned or leased by Emblem. Pursuant to the transactions, the Chief Medical Officer of Emblem became the sole shareholder of each of the Medical Groups and the physicians employed by and/or contracted with the Medical Groups became employees of, or contracted with, AdvantageCare Physician, P.C., During 2014, HIP invested $77,900,000 in ACP; this has been reflected in Schedule R with Transaction Code (b). In addition, HIP-NY has loan agreements with various medical groups. These loans are memorialized with transaction (d) and any interest paid on the loan is memorailized with transaction (a).