2015-11-13T12:29:30-06:00 2014-12-31 PricewaterhouseCoopers LLP 101 SEAPORT BOULEVARD Boston MA 02210 990 2014-01-01 042708004 HARVARD PILGRIM HEALTH CARE FOUNDATION INC % ELIZABETH CREAVIN HARV 7812636000 93 WORCESTER STREET WELLESLEY MA 024819181 ELIZABETH CREAVIN TREASURER 7812636000 2015-11-13 true GWEN SPENCER P00641463 6175305000 2014 2016-03-07 17:11:31Z ERIC H SCHULTZ 93 WORCESTER STREET WELLESLEY MA 024819181 7166196 false X WWW.HARVARDPILGRIM.ORG/FOUNDATION X 1980 MA SEE SCHEDULE O 12 11 0 11 0 1788491 4244378 0 0 202760 142382 0 0 1991251 4386760 3794826 3688046 0 0 1265587 1270904 0 0 0 1001425 1453183 6061838 6412133 -4070587 -2025373 7010537 3895385 2883979 1669268 4126558 2226117 X SEE SCHEDULE O false false 6163985 3688046 0 HARVARD PILGRIM HEALTH CARE FOUNDATION, INC., (THE FOUNDATION), OPERATES EXCLUSIVELY IN CONNECTION WITH HARVARD PILGRIM HEALTH CARE, INC. IN 2014, THE FOUNDATION SUPPORTED HEALTH AND WELLNESS INITIATIVES IN CONNECTION WITH A NUMBER OF COMMUNITY ORGANIZATIONS THROUGH ITS EMPLOYEE MINI-GRANT AND COMMUNITY SERVICE PROGRAMS AND PROVIDED HEALTH CARE PROVIDERS WITH CULTURAL COMPETENCY TRAINING. 6163985 true true false false false false false false false false false false false false true true false true false false false false false false false false false true false true false false false false false false false false false false false false false true true false false false true 0 0 0 false false false false false false false false false false X 12 11 true false false false true true true true true false false true true true true true true false false false MA X ELIZABETH CREAVIN 6175095692 93 WORCESTER STREET WELLESLEY MA 024819181 X ERIC H SCHULTZ PRESIDENT/CHAIRMAN 5.0 45.0 X X 0 1413401 310805 RUTH ELLEN FITCH DIRECTOR 2.0 0.0 X 0 0 0 ELINOR GOLDBERG LSW DIRECTOR 2.0 0.0 X 0 0 0 JOSHUA KRAFT DIRECTOR 2.0 0.0 X 0 0 0 JOSEPH F O'DONNELL md DIRECTOR 2.0 3.0 X 0 25500 0 PATRICIA A WALRATH DIRECTOR 2.0 0.0 X 0 0 0 MARTIN COHEN DIRECTOR 2.0 0.0 X 0 0 0 MARIANNE E FELICE MD DIRECTOR 2.0 0.0 X 0 0 0 CARTER FRIEND DIRECTOR (UNTIL 9/14) 2.0 0.0 X 0 0 0 HEIDI BROOKS DIRECTOR 2.0 0.0 X 0 0 0 CHARLES DEUTSCHE DIRECTOR 2.0 0.0 X 0 0 0 THOMAS BOUCHER DIRECTOR (as of 3/14) 2.0 0.0 X 0 0 0 LISA DESISTO DIRECTOR (as of 3/14) 2.0 0.0 X 0 0 0 MICHELLE J CLAYMAN TREASURER 5.0 45.0 X 0 299878 48477 SUZANNE M FINN CLERK 5.0 45.0 X 0 133969 34937 KAREN VOCI EXECUTIVE DIRECTOR 40.0 0.0 X 0 209064 35810 THOMAS F MALONEY FORMER CLERK 0.0 50.0 X 0 275740 48177 0 2357552 478206 0 true true false SEE SCHEDULE O 0 4242389 1989 4244378 0 135303 135303 0 0 0 0 0 2786515 2779436 7079 7079 7079 0 0 0 0 4386760 142382 3688046 3688046 0 0 0 244874 195899 48975 0 748738 733726 15012 0 277292 271732 5560 0 0 0 0 0 0 0 346775 346775 0 29041 28618 423 0 0 86302 81420 4882 31930 31930 0 4520 4520 0 0 0 0 MANAGEMENT SERVICE EXPENSE 837294 669835 167459 VOLUNTEER EVENT EXPENSE 88140 88140 BUSINESS EXPENSE 12756 10205 2551 MEMBERSHIPS AND DUES 10125 8100 2025 6300 5039 1261 6412133 6163985 248148 0 0 0 666861 497927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6292234 3377845 0 0 0 0 0 0 51442 19613 7010537 3895385 43255 24196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2840724 1645072 2883979 1669268 X 4126558 2226117 0 0 0 0 4126558 2226117 7010537 3895385 -2025373 124932 X false true X true X X 1 HARVARD PILGRIM HEALTH CARE INC(HPHC) 042452600 0 true 3688046 0 1 3688046 0.00000 true false false false false true false false false false false false false false false true false SCHEDULE A, PART IV, LINE 6 THE FOUNDATION CARRIES OUT THE CHARITABLE PURPOSE OF HPHC, ITS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO HPHC, INC. 1645072 1645072 X SCHEDULE D, PART X, LINE 2: THE CONSOLIDATED FINANCIAL STATEMENTS OF HARVARD PILGRIM HEALTH CARE, INC. AND AFFILIATES INCLUDE THE FOLLOWING ENTITIES: HARVARD PILGRIM HEALTH CARE, INC. ("HPHC, INC."), HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. ("NEW ENGLAND"), HARVARD PILGRIM HEALTH CARE OF CONNECTICUT, INC. ("HPHC OF CT"), HARVARD PILGRIM HEALTH CARE FOUNDATION, INC. (THE "FOUNDATION"), HARVARD PILGRIM HEALTH CARE INSTITUTE, LLC (THE "INSTITUTE"), HPHC INSURANCE AGENCY (THE "AGENCY"), HPHC INSURANCE COMPANY, INC. (THE "INSURANCE COMPANY"), HPHC HOLDING CORPORATION ("HOLDINGS") AND HEALTH PLANS, INC. ("HPI"). FOLLOWING IS THE RELEVANT PORTION OF THE FIN 48 FOOTNOTE FROM HARVARD PILGRIM HEALTH CARE, INC. AND AFFILIATES CONSOLIDATED FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES THAT APPLIES TO THE FILING ORGANIZATION. HPHC, INC., NEW ENGLAND, HPHC OF CT AND THE FOUNDATION ARE TAX-EXEMPT ORGANIZATIONS UNDER INTERNAL REVENUE SERVICE REGULATIONS. THE INSTITUTE HAS NO TAX STATUS AND THEREFORE FOLLOWS THE TAX-EXEMPT STATUS OF HPHC, INC. AS ITS SOLE MEMBER. HARVARD PILGRIM DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2014 AND 2013. true ALAN DAY COMMUNITY GARDEN 26 WHITMAN STREET NORWAY ME 04268 272720573 501(C)(3) 8500 N/A N/A FOOD FOREST AMERICAN HEART ASSOCIATION - EASTERN MA 1 UNION STREET ROBBINSVILLE NJ 08691 135613797 501(C)(3) 172000 N/A N/A SUPPORT HEART HEALTH AND AWARENESS AMERICAN RED CROSS OF MA 139 MAIN STREET CAMBRIDGE MA 02142 530196605 501(C)(3) 11000 N/A N/A LEADERSHIP BREAKFAST ARC OF MASSACHUSETTS 217 SOUTH STREET WALTHAM MA 02453 042223502 501(C)(3) 6000 N/A N/A FUNDRAISING BREAKFAST BAKER-POLITO INAUGURAL 1505 COMMONWEALTH AVE BRIGHTON MA 02135 472283861 501(C)(4) 25000 N/A N/A EVENT SPONSORSHIP BIG SISTER ASSOC OF GREATER BOSTON 161 MASSACHUSTTS AVE BOSTON MA 02115 042150651 501(C)(3) 10300 N/A N/A MENTORSHIP FOR GIRLS BILLINGS FORGE COMMUNITY 140 RUSS STREET N100 HARTFORD CT 06106 261412551 501(c)(3) 5540 N/A N/A AFTERSCHOOL COOKING CLASSES BOSTON CLUB PO BOX 1126 MARBLEHEAD MA 01945 042605110 501(c)(7) 6000 N/A N/A PROMOTE WOMEN BOSTON FIREFIGHTERS 60 HALLET STREET DORCHESTER MA 02124 042077206 501(c)(4) 7500 N/A N/A SUPPORT FOR FAMILIES OF DECEASED BOSTON FIREFIGHTERS BOSTON HEALTH CARE FOR THE HOMELESS 780 ALBANY STREET BOSTON MA 02118 043160480 501(c)(3) 14908 N/A N/A FUNDRAISING CHALLENGE BOSTON INAUGURAL 2014 202 BONHAM RD DEDHAM MA 020265404 464081503 501(C)(4) 10000 N/A N/A EVENT SPONSORHIP BOSTON MEDICAL CENTER 801 MASSACHUSETTS AVE BOSTON MA 02118 043314093 501(c)(3) 25000 N/A N/A GOLF TOURNAMENT AND GALA BOSTON PRIVATE INDUSTRY COUNCIL 2 OLIVER STREET BOSTON MA 02109 042676661 501(c)(3) 17559 N/A N/A SUMMER JOBS PROGRAM BOSTON SYMPHONY ORCHESTRA 301 MASSACHUSETTS AVE BOSTON MA 021154511 042103550 501(c)(3) 6500 N/A N/A CHRISTMAS PROGRAM BOYS AND GIRLS CLUB OF BOSTON 50 CONGRESS STREET BOSTON MA 02109 042103922 501(c)(3) 118903 N/A N/A HEALTHY LIFESTYLE CAMPAIGN BULGARIAN SUNDAY SCHOOL SV SV KICILI METODI INC 60 ELLIOT STREET BRAINTREE MA 02184 043553442 501(c)(3) 5500 N/A N/A MINI GRANTS CAMP SUNSHINE 35 ACADIA RD CASCO ME 04015 222582877 501(c)(3) 14658 N/A N/A FUNDRAISING CHALLENGE CENTER FOR GRIEVING CHILDREN PO BOX 1438 PORTLAND ME 04104 010431501 501(c)(3) 27750 N/A N/A MULTICULTURAL PEER SUPPORT PROGRAM CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 010211494 501(c)(3) 11700 N/A N/A ANNUAL GALA SPONSORSHIP CHOP CHOP MAGAZINE 32B CALVIN STREET WATERTOWN MA 02472 043505334 501(c)(3) 100000 N/A N/A COOKING CLASSES AT BOYS AND GIRLS CLUBS CITY OF BOSTON 287 COLUMBUS AVE BOSTON MA 02116 043290071 115 33500 N/A N/A SPONSORSHIP TO SUPPORT DIVERSE COMMUNITY CITY YEAR 287 COLUMBUS AVE BOSTON MA 02116 222882549 501(C)(3) 35000 N/A N/A TEAM SPONSORSHIP AT A BOSTON ELEMENTARY SCHOOL CITY YEAR NEW HAMPSHIRE 848 ELM STREET MANCHESTER NH 03101 222882549 501(C)(3) 70000 N/A N/A TEAM SPONSORSHIP AT A NH ELEMENTARY SCHOOL COURAGEOUS SAILING ONE FIRST STREET BOSTON MA 02129 042987534 501(C)(3) 10000 N/A N/A FUNDRAISER TO REMOVE BARRIERS TO SAILING CRADLES TO CRAYONS 155 NORTH BEACON STREET BRIGHTON MA 01239 043584367 501(C)(3) 11750 N/A N/A SPONSORSHIP AND SLEEP KITS CULTIVATING COMMUNITY 52 MAYO STREET PORTLAND ME 041013116 043607322 501(C)(3) 15000 N/A N/A CONSTRUCT COMMUNITY GARDEN DIMOCK CENTER 55 DIMOCK STREET ROXBURY MA 02119 043487835 501(C)(3) 15000 N/A N/A FUNDRAISING GALA EMARC 26 PRINCESS STREET WAKEFIELD MA 01880 042239964 501(C)(3) 6000 N/A N/A SUPPORT PEOPLE WITH DEVELOPMENTAL DISABILITIES FOCUS ON AGRICULTURE IN RURAL MAINE SCHOOLS PO BOX 421 DAMARISCOTTA ME 04543 272291336 501(C)(3) 10600 N/A N/A SUPPORT COOKING CLASSES FOR K-8 FOOD AND MEDICINE 20 IVERS STREET BREWER ME 04412 501(c)(4) 14600 N/A N/A SUPPORT EXPANSION OF COMMUNITY FARMERS MARKET FUND FOR BOSTON NEIGHBORHOODS PO BOX 961555 BOSTON MA 021961555 046185609 501(C)(3) 10000 N/A N/A "FIRST NIGHT" CELEBRATION SPONSORSHIP GATE CITY STRIDERS PO BOX 3692 NASHUA NH 03061 020427575 501(C)(3) 6000 N/A N/A 5K ROAD RACE GREAT NH RESTAURANTS CHARITABLE TRUST 124 BEDFORD CENTER RD BEDFORD NH 03110 467194327 501(C)(3) 75500 N/A N/A COOKING CLASSES AT NH BOYS & GIRLS CLUBS GREATER BOSTON CHAMBER OF COMMERCE 265 FRANKLIN STREET BOSTON MA 021103113 041103090 501(C)(6) 14000 N/A N/A SPEAKER FORUMS GREATER PORTLAND REGIONAL CHAMBER OF COMMERCE 443 CONGRESS STREET PORTLAND ME 04101 010043280 501(C)(6) 10024 N/A N/A EGGS & ISSUES BREAKFAST PROGRAM GROUND CONTROL EVENT LLC PO BOX 1940 EAST GREENWICH RI 02818 061490587 15000 N/A N/A ROAD RACES TO SUPPORT GOOD HEALTH HANOVER THEATRE 2 SOUTHBRIDGE STREET WORCESTER MA 01608 050521735 501(C)(3) 25000 N/A N/A SPONSORSHIP HARTFORD FOOD SYSTEM ONE CONGRESS STREET HARTFORD CT 06114 060991880 501(C)(3) 40000 N/A N/A MOBILE FARMERS MARKET HARTFORD MARATHON FOUNDATION INC 41 SEQUIN DR GLASTONBURY CT 06033 061415320 501(C)(3) 20000 N/A N/A EVENT SPONSORHIP HORACE MANN EDUCATIONAL ASSOCIATES INC 8 FORGE PARK EAST FRANKLIN MA 02038 042300014 501(C)(3) 5500 N/A N/A MINI GRANTS INSTITUTE OF CONTEMPORARY ART 100 NORTHERN AVE BOSTON MA 02210 042104327 501(C)(3) 15000 N/A N/A EDUCATION PROGRAMS AND FALL EXHIBITION KENNEBEC COUNTY- GARDEN PROGRAM 115 STATE STREET AUGUSTA ME 04430 016000007 5650 Other SUPPLIES INMATE GARDEN PROGRAM MAINE HEALTH 110 FREE STREET PORTLAND ME 04101 010431680 501(C)(3) 500000 N/A N/A OBESITY PREVENTION MAINE QUALITY COUNTS PO BOX 16 MANCHESTER ME 043510016 204935972 501(C)(3) 21000 N/A N/A ANNUAL CONFERENCE MAINE STATE CHAMBER OF COMMERCE 125 COMMUNITY DRIVE AUGUSTA ME 043308010 010021545 501(C)(6) 8150 N/A N/A SPONSORSHIP OF LEADERSHIP SUMMIT AND HEALTH CARE FORUM MANCHESTER MONARCHS HOCKEY LLC 66 HANOVER STREET MANCHESTER NH 03101 841546915 12000 N/A N/A WINNING WITH WELLNESS PROGRAM MASS INSIGHT CORPORATION 18 TREMONT STREET BOSTON MA 02108 043369687 501(C)(3) 15000 N/A N/A SURVEY RESEARCH GROUP MASSACHUSETTS ASSOCIATION FOR MENTAL HEALTH 130 BOWDOIN STREET BOSTON MA 02108 042104711 501(C)(3) 15000 N/A N/A ASSIST THOSE WITH MENTAL ILLNESS MASSACHUSETTS GENERAL HOSPITAL 100 CAMBRIDGE STREET BOSTON MA 02114 042697983 501(C)(3) 7500 N/A N/A TO HELP ELIMINATE RACIAL AND ETHNIC DISPARITIES IN HEALTH CARE MASSACHUSETTS HEALTH COUNCIL INC 200 RESERVIOR STREET NEEDHAM MA 02494 042296739 501(C)(3) 12500 N/A N/A WORK ON PRESSING HEALTH CARE ISSUES MASSACHUSETTS WOMENS POLITICAL CAUCUS 98 HAMILTON PLACE BOSTON MA 021084715 042738443 501(C)(3) 10000 N/A N/A SUPPORTS WOMEN IN POLITICS AND PUBLIC POLICY MOHEGAN COUNCIL INC 19 HARVARD STREET WORCESTER MA 01609 042105867 501(C)(3) 7000 N/A N/A BOY SCOUTS PROGRAMS MUSEUM OF SCIENCE CORP RELATIONS OFF BOSTON MA 021141099 042103916 501(C)(3) 140000 N/A N/A CORPORATE PARTNERSHIP MY PLACE TEEN CENTER 755 MAIN STREET WESTBROOK ME 04092 010509578 501(C)(3) 11083 N/A N/A GRANT TO PURCHASE RANGE AND FREEZER NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON MA 02120 042103612 501(C)(3) 15000 N/A N/A FUNDRAISER FOR WELLNESS PROGRAMS NEW ENGLAND COUNCIL 96 NORTH WASHINGTON ST BOSTON MA 02114 041661090 501(C)(6) 37000 N/A N/A PROMOTE ECONOMIC GROWTH & QUAL OF LIFE NEW HAMPSHIRE CITIZENS HEALTH INITIATIVES TWO WHITE STREET CONCORD NH 03301 026000937 115 25000 N/A N/A ANNUAL CONFERENCE NEW HAVEN FARMS PO BOX 8953 NEW HAVEN CT 06532 451794893 501(C)(3) 12814 N/A N/A DIABETES PREVENTION PERKINS SCHOOL FOR THE BLIND 175 NORTH BEACON ST WATERTOWN MA 02472 042103616 501(C)(3) 10500 N/A N/A SUPPORT THOSE WITH BLINDNESS AND DEAFNESS REGIS COLLEGE 235 WELLESLEY ST WESTON MA 024931571 042104451 501(C)(3) 15000 N/A N/A LECTURE SERIES RELIANT MEDICAL GROUP 100 FRONT STREET WORCESTER MA 01608 222912515 501(C)(3) 10000 N/A N/A EVENT SPONSORSHIP RIVERSIDE COMMUNITY CARE 450 WASHINGTON ST DEDHAM MA 02026 043097170 501(C)(3) 15500 N/A N/A SUPPORT BEHAVIORAL HEALTH CARE AND HUMAN SERVICES ROSIES PLACE 889 HARRISON AVENUE BOSTON MA 02118 042582187 501(C)(3) 10250 N/A N/A LUNCHEON TO SUPPORT HOMELESS WOMEN SAINT ANSELM COLLEGE 100 ST ANSELM DRIVE MANCHESTER NH 03101 020222182 501(C)(3) 15000 N/A N/A PRIMARY SOCIETY AND NURSING SCHOLARSHIPS SCHWARTZ CTR FOR COMPASSIONATE CARE 205 PORTLAND STREET BOSTON MA 02114 041564655 501(C)(3) 60050 N/A N/A NURTURING PATIENT-CAREGIVER RELATIONSHIPS TRUSTEES OF SAINT JOSEPH'S COLLEGE 278 WHITES BRIDGE RD STANDISH ME 04084 010212542 501(C)(3) 8420 N/A N/A EXPANSION OF GARDEN FOR COLLEGE FOOD SERVICE TUFTS UNIVERSITY 150 HARRISON AVE BOSTON MA 02111 042103634 501(C)(3) 472586 N/A N/A HEALTHY KIDS OUT OF SCHOOL PROG UNITED WAY OF CENTRAL MASSACHUSETTS 484 MAIN STREET WORCESTER MA 01608 042104017 501(C)(3) 10750 N/A N/A SPONSORSHIP UNITED WAY OF MASS BAY AND MERRIMACK VALLEY PO BOX 51381 BOSTON MA 022051381 042382233 501(C)(3) 10000 N/A N/A PREVENTATIVE CARE EVENT UNITED WAY OF NEW ENGLAND 51 SLEEPER STREET BOSTON MA 02210 042382233 501(C)(3) 10075 N/A N/A FUNDRAISING CHALLENGE UNIVERSITY OF MAINE SYSTEM 9 OLSON ROAD SOUTH PARIS ME 04381 016000769 501(C)(3) 8345 N/A N/A TEACHING GARDEN UNIVERSITY OF MASSACHUSETTS BOSTON 100 MORRISSEY BLVD BOSTON MA 02125 043167352 115 105500 N/A N/A SET SAIL FOR SUCCESS PROGRAM VOLUNTEER NEW HAMPSHIRE 117 PLEASANT ST CONCORD NH 03301 912069574 501(C)(3) 10000 N/A N/A SPIRIT OF NH AWARDS WASHINGTON COUNTY FOOD AND FUEL ALLIANCE 85 COURT STREET MACHIAS ME 04654 272966830 501(C)(3) 10000 N/A N/A EQUIPMENT & EDUCATION FOR NETWORK OF PANTRIES WORKSITE WELLNESS COUNCIL OF MA 170 MAPLEWOOD ST WATERTOWN MA 02472 452697521 501(C)(3) 20000 N/A N/A WELLNESS PROGRAM YOU AND MAINE 14 BANCROFT STREET PORTLAND ME 04102 128601350 6000 N/A N/A ROAD RACE YOUTH OPPORTUNITIES UPHELD INC 81 PLANTATION STREET WORCESTER MA 01604 237112665 501(C)(3) 10000 N/A N/A GALA FOR KIDS ADVOCATES INC 1 CLARKS HILL FRAMINGHAM MA 01702 237451423 501(C)(3) 7500 N/A N/A FUNDRAISING BREAKFAST 65 13 MONITORING PROCEDURES - FORM 990, SCHEDULE I, PART I, LINE 2 MINI GRANTS OF $500 EACH ARE APPROVED BY AN APPOINTED COMMITTEE BEFORE THEY ARE ISSUED. MINI GRANTS OF $500 EACH ARE RECOMMENDED BY EMPLOYEES WHO FILL OUT A DETAILED APPLICATION REGARDING THE PURPOSE OF FUNDS, AND MUST PROVE THAT FUNDS WILL GO TO A LEGAL, NOT-FOR-PROFIT ORGANIZATION, WHERE THE EMPLOYEE LIVES OR WHERE HPHC DOES BUSINESS. FOUNDATION STAFF REVIEWS THESE APPLICATIONS FOR ACCURACY OF PURPOSE AND LEGITIMACY OF THE ORGANIZATION. FOUNDATION STAFF RECOMMENDATIONS ARE REVIEWED BY A NON-STAFF APPOINTED COMMITTEE. REPORTS ON THESE GRANTS ARE COLLECTED FROM A SAMPLE OF THESE ORGANIZATIONS. FOUNDATION'S INTERNAL MANAGEMENT REPORTS A SUMMARY OF THIS INFORMATION TO THE FOUNDATION'S BOARD. OTHER MORE SIGNIFICANT COMMUNITY GRANTS REQUIRE A CONCEPT PROPOSAL TO BE SUBMITTED AND APPROVED BY AN APPOINTED COMMITTEE. ONCE THE GRANTS ARE APPROVED, THE FOUNDATION EMPLOYEES PERFORM SITE VISITS AND REGULAR EVALUATIONS OF THE GRANTS. IN ADDITION, THE FOUNDATION HIRES AN INDEPENDENT EVALUATION GROUP TO REVIEW GRANT RESULTS. ADDITIONALLY, FORMAL FISCAL REPORTING OF ALL GRANTS IS PERFORMED AND REVIEWED BY EMPLOYEES OF THE FOUNDATION. false true false false false false false false false ERIC H SCHULTZ PRESIDENT/CHAIRMAN 0 869299 0 521700 0 22402 0 283300 0 27505 0 1724206 0 0 MICHELLE J CLAYMAN TREASURER 0 231332 55469 13077 0 17619 0 30858 0 348355 0 0 SUZANNE M FINN CLERK 0 132707 1000 262 0 10785 0 24152 0 168906 0 0 KAREN VOCI EXECUTIVE DIRECTOR 0 178513 23297 7254 0 14935 0 20875 0 244874 0 0 THOMAS F MALONEY FORMER CLERK 0 214683 59456 1601 0 20385 0 27792 0 323917 0 0 SCHEDULE J, PART I, LINE 3 THE FOUNDATION RELIED ON HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.), A RELATED ORGANIZATION OF THE FOUNDATION, TO ESTABLISH ITS PRESIDENT AND EXECUTIVE DIRECTOR'S COMPENSATION. THE METHODS USED BY HPHC, INC. ARE AS FOLLOWS: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B LONG TERM INCENTIVE PLAN HPHC, A RELATED ORGANIZATION TO HARVARD PILGRIM HEALTH CARE FOUNDATION, INC., ADOPTED A LONG-TERM INCENTIVE PLAN FOR ITS CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, CHIEF LEGAL OFFICER, CHIEF INFORMATION OFFICER, AND CHIEF HUMAN RESOURCES OFFICER FOR 2013 - 2015. THE PLAN IS BASED ON A VARIETY OF PERFORMANCE MEASURES AND AMOUNTS ARE EARNED OVER A THREE YEAR PERIOD. SOME OR ALL OF THE DEFERRED COMPENSATION AMOUNTS REPORTED HEREIN FOR THE POTENTIAL EARNINGS UNDER THE PLAN MAY OR MAY NOT BE PAID TO THE EXECUTIVES BASED ON THE ACTUAL RESULTS OF THE PERFORMANCE MEASURES AS DETERMINED AT THE END OF THE APPLICABLE THREE YEAR PERIOD. ANNUAL ACCRUALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). NO PAYMENTS WERE MADE FROM THE PLAN DURING 2014. PART I, LINE 1 AND PART III, LINE 1 ORGANIZATION'S MISSION The Harvard Pilgrim Health Care Foundation supports Harvard Pilgrim's mission to improve the quality and value of health care for the people and communities we serve. The Foundation provides the tools, training and leadership to help build healthy communities throughout Connecticut, Maine, Massachusetts, and New Hampshire.In 2014, the Harvard Pilgrim Foundation awarded nearly $2.9 million in grants to 710 not-for-profit organizations in the region. Since its inception, the Foundation has granted nearly $133 million in funds and resources throughout the four states. PART I, LINE 6: THE FOUNDATION'S VOLUNTEERS INCLUDE UNCOMPENSATED DIRECTORS WHO SERVE ON A VOLUNTARY BASIS. PART VI, LINE 2: BUSINESS RELATIONSHIP - THE FOLLOWING INDIVIDUALS SERVE ON THE BOARDS OF ONE OR MORE FOR PROFIT ORGANIZATIONS RELATED TO THE FOUNDATION, AND/OR ARE EMPLOYED BY AN ORGANIZATION, (OTHER THAN THE FILING ORGANIZATION), FOR WHICH ANOTHER PERSON LISTED SERVES AS AN OFFICER OR DIRECTOR. ERIC H. SCHULTZ - PRESIDENT/BOARD CHAIR MICHELLE J. CLAYMAN - TREASURER SUZANNE M. FINN - CLERK KAREN VOCI - EXECUTIVE DIRECTOR PART VI, LINE 6: HARVARD PILGRIM HEALTH CARE, INC. IS THE PARENT AND SOLE MEMBER OF THE FOUNDATION. PART VI, LINE 7A: HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.) IS THE SOLE MEMBER OF THE FOUNDATION. THE HPHC, INC. BOARD OF DIRECTORS AT ITS ANNUAL MEETING RATIFIES THE SLATE OF ELECTED FOUNDATION DIRECTORS WHEN IT ELECTS THE DIRECTORS OF ITS SUBSIDIARIES. ANY VACANCY IN THE FOUNDATION'S BOARD OF DIRECTORS MAY BE FILLED BY THE HPHC, INC. BOARD OF DIRECTORS OR BY THE MAJORITY OF THE FOUNDATION DIRECTORS THEN IN OFFICE. PART VI, LINE 7B: THE FOUNDATION'S BYLAWS SET FORTH RESERVED POWERS OF THE SOLE MEMBER, HPHC, INC., WHICH INCLUDE THE POWER TO APPROVE CERTAIN ACTIONS, SUCH AS ANY AMENDMENT TO THE FOUNDATION'S ARTICLES OF ORGANIZATION OR BYLAWS; THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE FOUNDATION; AND THE SALE, LEASE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE FOUNDATION'S ASSETS. PART VI, LINE 11B: ONCE THE FOUNDATION'S FORM 990 IS COMPLETED WITH THE ASSISTANCE OF ITS OUTSIDE TAX ADVISORS, IT IS FIRST REVIEWED BY HARVARD PILGRIM'S INTERNAL MANAGEMENT AND THEN BY HARVARD PILGRIM'S AUDIT COMMITTEE CHAIRPERSON (AN INDEPENDENT MEMBER OF THE BOARD OF DIRECTORS OF HARVARD PILGRIM HEALTH CARE, INC.). THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE HPHC, INC. BOARD OF DIRECTORS AS WELL AS THE FOUNDATION BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. PART VI, LINE 12C: THE FOUNDATION'S DIRECTORS, OFFICERS, AND KEY EMPLOYEE ARE SUBJECT TO HARVARD PILGRIM HEALTH CARE'S CODE OF CONDUCT WHICH INCLUDES A CONFLICTS OF INTEREST POLICY. THE CONFLICTS OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS AND THE KEY EMPLOYEE TO DISCLOSE ON AN ONGOING BASIS THE OCCURRENCE OF ANY SITUATION WHEN THEIR OUTSIDE ACTIVITIES, PERSONAL INTERESTS OR RELATIONSHIPS MIGHT INFLUENCE, OR APPEAR TO INFLUENCE, THEIR ABILITY TO MAKE OBJECTIVE DECISIONS IN THE COURSE OF PERFORMING THEIR JOB RESPONSIBILITIES, ARE PREJUDICIAL TO THE LEGITIMATE INTERESTS OF THE FOUNDATION, OR CAUSE THE USE OF THE FOUNDATION RESOURCES FOR OTHER THAN FOUNDATION PURPOSES. IN ADDITION TO BEING SUBJECT TO THE FOUNDATION'S CONFLICTS OF INTEREST POLICY, THE FOUNDATION'S BOARD OF DIRECTORS ARE ANNUALLY REQUIRED TO COMPLETE AND SIGN A CONFLICTS OF INTEREST FORM, WHICH IS REPORTED TO THE BOARD OF DIRECTORS IN ACCORDANCE WITH THE DISCLOSURE AND REVIEW PROCESS SET FORTH IN THE FOUNDATION'S BYLAWS. IN ADDITION, THE FOUNDATION'S KEY EMPLOYEE MAKES DECISIONS ON BEHALF OF THE ORGANIZATION AND IS IN A POSITION TO INFLUENCE DECISIONS MADE ON BEHALF OF THE FOUNDATION. THE KEY EMPLOYEE IS SURVEYED ON AN ANNUAL BASIS. THE EMPLOYEE MUST COMPLETE AND SIGN A CONFLICTS OF INTEREST DISCLOSURE FORM AND SUBMIT IT TO THE VICE PRESIDENT OF CORPORATE COMPLIANCE PROGRAMS (COMPLIANCE OFFICER). THESE FORMS ARE THEN REVIEWED BY THE COMPLIANCE OFFICER AND THE ASSISTANT GENERAL COUNSEL RESPONSIBLE FOR CORPORATE GOVERNANCE/COMPLIANCE. IF A DISCLOSURE OF A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST IS MADE, THE COMPLIANCE OFFICER AND COUNSEL MAKE A DETERMINATION IF SUCH DISCLOSURE IS MATERIAL AND NEEDS TO BE MANAGED, MITIGATED OR ELIMINATED. AS A GENERAL RULE, CONFLICTS OF INTEREST ARE NOT PERMITTED. HOWEVER, IN CERTAIN AREAS, IF THE CONFLICT IS NOT MATERIAL AND IS PROPERLY AND FULLY DISCLOSED AND IS APPROVED BY THE COMPLIANCE OFFICER, A WAIVER OF THE CONFLICT MAY BE GRANTED AND APPROPRIATE STEPS WILL BE TAKEN TO MITIGATE THE CONFLICT. PART VI, LINE 15: THE FOUNDATION DOES NOT COMPENSATE ITS PRESIDENT, OFFICERS, AND KEY EMPLOYEE. THE COMPENSATION REPORTED FOR THESE INDIVIDUALS IS PAID BY HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.), A RELATED ORGANIZATION OF THE FOUNDATION. THEREFORE, THEIR COMPENSATION AND BENEFITS ARE DETERMINED BY HPHC, INC. PART VI, LINE 19: THE FOUNDATION FURNISHES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY TO THE PUBLIC UPON REQUEST. PART VII, SECTION B, LINE 1: ANY INDEPENDENT CONTRACTORS ARE RETAINED BY THE PARENT COMPANY, HARVARD PILGRIM HEALTH CARE, INC. HPHC INC 93 WORCESTER STREET WELLESLEY MA 204819181 042452600 HEALTH INSURA MA 501(C)(3) 9 NA false HPHC OF NEW ENGLAND INC 93 WORCESTER STREET WELLESLEY MA 024819181 042663394 HEALTH INSURA MA 501(C)(4) HPHC INC true HPHC OF CONNECTICUT INC 185 ASYLUM ST 2ND FLOOR HARTFORD CT 06103 461681667 HEALTH INSURA CT 501(C)(4) HPHC INC true NA HARVARD PILGRIM PHYSICIANS ASSOC INC 93 WORCESTER STREET WELLESLEY MA 024819181 PHYSICIAN ORG MA HPHC INC SEE PART VII true HPHC INSURANCE COMPANY INC 93 WORCESTER STREET WELLESLEY MA 024819181 043149694 HEALTH INSURANCE MA HPHC INC C CORP true HPHC HOLDING CORPORATION 93 WORCESTER STREET WELLESLEY MA 024819181 043306439 HOLDING CO MA HPHC INC C CORP true PLAN MARKETING INSURANCE AGENCY INC 1500 WEST PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 042734281 BROKERAGE MA HEALTH PLANS C CORP true HPHC INSURANCE AGENCY INC 93 WORCESTER STREET WELLESLEY MA 024819181 043016201 BROKERAGE MA HPHC INC C CORP true HEALTH PLANS INC 1500 WEST PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 042734278 TPA MA HPHC INC C CORP true CARE MANAGEMENT SERVICES INC 1500 WEST PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 043438779 ASO SERVICES MA HEALTH PLANS C CORP true false false true false true false false false false false true false true true true true false false false SCHEDULE R, PART IV, LINE 1 HARVARD PILGRIM PHYSICIANS ASSOCIATION, INC. IS A NON-PROFIT ORGANIZED UNDER THE LAWS OF MASSACHUSETTS. THIS IS AN INACTIVE ORGANIZATION WHICH WAS DISSOLVED IN 2015.