2014-08-14T11:57:28-05:00 2013-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2012-10-01 043373331 BOSTON MEDICAL CENTER HEALTH PLAN INC % LAURIE DORAN BOST 6177486000 2 COPLEY PLACE SUITE 600 Suite BOSTON MA 02116 LAURIE DORAN 6175304000 2014-08-12 true 6175305000 2012 2015-11-30 17:44:51Z SUSAN COAKLEY 2 COPLEY PLACE SUITE 600 BOSTON MA 02116 1372748755 false X WWW.BMCHP.ORG X 1997 MA SEE SCHEDULE O 7 3 539 0 0 0 0 1191612568 1362040133 8573388 10708622 0 0 1200185956 1372748755 0 0 1127099864 1265046201 42137436 47397310 0 0 0 45207680 44136479 1214444980 1356579990 -14259024 16168765 382093088 356082737 152370360 133685408 229722728 222397329 X SEE SCHEDULE O false false 1333820154 1362040133 THE CORPORATION IS ORGANIZED AND OPERATES AS A NONPROFIT CORPORATION EXCLUSIVELY FOR THE BENEFIT OF AND TO SUPPORT BOSTON MEDICAL CENTER CORPORATION AND TO PROVIDE ACCESS TO EFFECTIVE, EFFICIENT MEDICAL CARE AMONG LOW INCOME, UNDERSERVED, DISABLED, ELDERLY AND OTHER VULNERABLE RESIDENTS OF THE COMMUNITY. 1333820154 true false false true false false false false false false true false false false true false true true false false false false false false false false false false false true false false false false false false false true false false false false false true true false false false true 4481 0 true 539 true false false false false false false false false false false X 7 3 true false true false true true true true true false false true true true true true true true true false MA NH X LAURIE DORAN 6177486000 2 COPLEY PLACE BOSTON MA 02116 X EDMOND J ENGLISH 1.0 2.0 X DAVID A PASSAFARO 1.0 2.0 X LISA GUSCOTT 1.0 1.0 X THOMAS ALPERIN 1.0 2.0 X RICHARD SLIFKA 1.0 2.0 X AZZIE YOUNG MPA PHD 1.0 1.0 X DAVID COLEMAN MD 1.0 1.0 X SUSAN DONAHUE 1.0 1.0 X RANDI CUTLER 1.0 1.0 X BARBARA FERRER PHD 1.0 1.0 X STEVEN D LEVY 1.0 1.0 X SCOTT O'GORMAN 50.0 X X 628145 54581 WILLIAM J HALPIN JR 1.0 1.0 X MARTHA S SAMUELSON 1.0 2.0 X CHRISTINE M DUNN 1.0 1.0 X KATHLEEN E WALSH 5.0 55.5 X X 0 1151272 110583 JOHN T HAILER 1.0 1.0 X PAUL EGERMAN 1.0 1.0 X PEGGY KOENIG 1.0 2.0 X JAMES S PHALEN 1.0 2.0 X RONALD L WALKER II 1.0 1.0 X MARK NUNNELLY 1.0 2.0 X DAVID AMENT 1.0 2.0 X CLAIRE PERLMAN 1.0 1.0 X SANDRA COTTERELL 1.0 1.0 X ANAND DEVAIAH 1.0 1.0 X JAMES BLUE 1.0 1.0 X JACK CRADOCK 1.0 2.0 X GERARD DOHERTY MD 1.0 1.0 X FAY DONOHUE 1.0 0.0 X 0 0 0 KEITH P LEWIS MD 1.0 0.0 X 0 0 0 SUSAN COAKLEY 50.0 X 395162 56645 THOMAS TRAYLOR 5.0 45.0 X 0 762814 63830 LAURIE DORAN 50.0 X 349057 50745 JUDITH LEVY INT COO 1112-413 50.0 X 307838 48713 MICHAEL SCHRADER 50.0 X 392958 47098 KIMBERLY SINCLAIR 50.0 X 236014 43172 SCOTT POLANSKY 50.0 X 272526 47296 Karen Boudreau MD 50.0 X 211743 34056 KATHLEEN BRODIE 50.0 X 230628 39348 DEBORAH BENJAMIN 50.0 X 247885 56654 DUANE DOWNEY 50.0 X 242701 48594 Matthew Herndon 50.0 X 232542 48862 Harry Castleman Jr 50.0 X 213266 46753 RICHARD KALISH MD 50.0 X 195443 0 4155908 1914086 796930 89 true true false BOSTON MEDICAL CENTER ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 MEDICAL SERVICES 99137624 BEACON HEALTH STRATEGIES LLC 200 STATE STREET SUITE 302 BOSTON MA 02110 BEHAVIORAL HLTH SVCS 101632611 BAYSTATE MEDICAL CENTER 759 CHESTNUT STREET SPRINGFIELD MA 01199 MEDICAL SERVICES 93694780 SOUTHCOAST HOSPITAL GROUP 101 PAGE STREET NEW BEDFORD MA 02740 MEDICAL SERVICES 46694196 BERKSHIRE MEDICAL CENTER 725 NORTH STREET PITTSFIELD MA 01201 MEDICAL SERVICES 28950012 693 0 0 CAPITATION REVENUE 524114 1362040133 1362040133 1362040133 10708622 10708622 0 0 0 0 0 0 0 0 0 0 1372748755 1362040133 10708622 0 0 0 1265046201 1265046201 2877428 2877428 0 33835981 26957488 6878493 1364092 1003720 360372 5374976 4357924 1017052 3944833 2902670 1042163 155070 155070 550083 550083 632104 632104 84100 72326 11774 0 0 19515034 15496506 4018528 3687889 3687889 1411667 668648 743019 7654149 4979483 2674666 0 4374342 3318342 1056000 258384 207981 50403 0 150174 150174 0 0 2858541 2858541 178978 178978 PRINTING AND FORMS 1879458 1879458 MISC EXPENSES 540506 77733 462773 ADMINISTRATIVE FEES 206000 206000 1356579990 1333820154 22759836 0 0 0 36354781 35032226 0 0 33884366 49577664 0 0 0 0 0 0 0 0 150000 278197 41051408 33877885 7732554 7173523 286198854 246228313 0 0 0 0 0 0 17772533 17792814 382093088 356082737 127626005 101351438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24744355 32333970 152370360 133685408 X 229722728 222397329 0 0 0 0 229722728 222397329 382093088 356082737 X 16168765 -494164 -23000000 X false true X true X X X false false false BOSTON MEDICAL CENTER (THROUGH 06302013) 043314093 03 true 0 BMC HEALTH SYSTEM INC (EFFECTIVE 07012013) 463556853 07 true 0 2 false false false false false false true 84100 false true 189502 273602 false SCHEDULE C, PART II-B, LINE 1 FOR THE YEAR ENDED SEPTEMBER 30, 2013, THE ORGANIZATION PAID $189,502 IN MEMBERSHIP DUES TO MEMBER ORGANIZATIONS WHICH MAY ENGAGE IN LOBBYING ACTIVITIES ON BEHALF OF ITS MEMBERS. THEREFORE, A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING ACTIVITIES. BMCHP ALSO PAID MCLANE GOVERNMENT & PUBLIC STRATEGIES, LLC $84,100 FOR LOBBYING SERVICES. 0 11648353 7557910 4090443 0 15678339 14706009 972330 0 13724716 11613966 2110750 7173523 0 DUE TO AFFILIATE 23042820 DEFERRED RENT 1011150 PREMIUM DEFICIENCY RESERVE 8280000 32333970 1378492000 -494164 6237409 5743245 1372748755 1372748755 1362818000 1362818000 -6238010 -6238010 1356579990 SCHEDULE D, PART X, LINE 2 THE ORGANIZATION'S FINANCIAL STATEMENTS DID NOT REPORT A LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. SCHEDULE D, PART XI, LINE 2D RECLASS OF PHARMACY REBATES $6,237,209 ROUNDING $200 ------------- TOTAL $6,237,409 SCHEDULE D, PART XII, LINE 4B RECLASS OF PHARMACY REBATES ($6,237,209) ROUNDING ($801) ------------- TOTAL ($6,238,010) X X X X X true true false false false true false false false SCOTT O'GORMAN 430705 196750 690 32843 21738 682726 0 SUSAN COAKLEY 278267 116205 690 33404 23241 451807 0 THOMAS TRAYLOR 0 443205 0 101185 0 218424 0 42403 0 21427 0 826644 0 KATHLEEN E WALSH 0 895640 0 225000 0 30632 0 75375 0 35208 0 1261855 0 0 LAURIE DORAN 247361 101396 300 28774 21971 399802 0 JUDITH LEVY INT COO 1112-413 194152 111630 2056 28888 19825 356551 0 MICHAEL SCHRADER 277371 115154 433 26261 20837 440056 0 KIMBERLY SINCLAIR 183462 52252 300 26812 16360 279186 0 KATHLEEN BRODIE 177121 51527 1980 29427 9921 269976 0 SCOTT POLANSKY 151060 0 121466 33321 13975 319822 0 DEBORAH BENJAMIN 171881 74714 1290 32777 23877 304539 0 DUANE DOWNEY 179205 62206 1290 26008 22586 291295 0 RICHARD KALISH MD 195443 0 0 0 0 195443 0 Karen Boudreau MD 186518 24800 425 21886 12170 245799 0 Matthew Herndon 172592 59500 450 27282 21580 281404 0 Harry Castleman Jr 158755 52531 1980 32693 14060 260019 0 SCHEDULE J, PART I, LINE 1 IN CONNECTION WITH HIS TERMINATION OF EMPLOYMENT WITH BOSTON MEDICAL CENTER HEALTH PLAN, INC. EFFECTIVE JULY 27,2012, SCOTT POLANSKY RECEIVED 1 YEAR OF PLACEMENT COUNSELING SERVICES. THE VALUE OF SUCH SERVICE IN 2012 WAS $15,000. SCHEDULE J, PART I, LINE 3 BOSTON MEDICAL CENTER HEALTH PLAN (BMCHP) RELIED ON BOSTON MEDICAL CENTER (BMC), A RELATED ORGANIZATION OF BMCHP, TO ESTABLISH ITS PRESIDENT/CEO'S COMPENSATION. THE PRESIDENT/CEO'S COMPENSATION WAS DETERMINED BY BMC USING ALL METHODS INCLUDED ON LINE 3. SCHEDULE J, PART I, LINE 4A IN CONNECTION WITH HIS TERMINATION OF EMPLOYMENT WITH BOSTON MEDICAL CENTER HEALTH PLAN, INC. EFFECTIVE JULY 27,2012, SCOTT POLANSKY IS ENTITLED TO 52 WEEKS OF SEVERANCE, 1 YEAR OF PLACEMENT COUNSELING, AND A LUMP SUM PAYMENT OF $25,000. INCLUDED IN COLUMN (B)(III) IS $120,672 PAID UNDER THIS AGREEMENT. SCHEDULE J, PART I, LINE 4B CERTAIN EXECUTIVES DISCLOSED ON THE BMCHP FORM 990, PART VII AND SCHEDULE J, PART II ARE COMPENSATED BY BMC, A RELATED ORGANIZATION, FOR SERVICES TO BMC. BOSTON MEDICAL CENTER PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO CERTAIN EXECUTIVES. IN ADDITION, AN EXECUTIVE OF BMCHP PARTICIPATES IN THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE CREDITED TO PARTICIPANTS' ACCOUNTS EACH YEAR. PLAN AMOUNTS ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET, AS OUTLINED IN THE PLAN AGREEMENT. BOSTON MEDICAL CENTER MAINTAINS AN EXECUTIVE BENEFIT PLAN WHICH OFFERS PARTICIPATING EXECUTIVES THE OPTION OF ANNUALLY ALLOCATING BENEFIT DOLLARS TO A SUPPLEMENTAL RETIREMENT/PRE-TAX SAVINGS ACCOUNT. AMOUNTS VEST ON SPECIFIED DATES BASED ON CONTINUED EMPLOYMENT BUT NO LATER THAN THE EXECUTIVE'S 68TH BIRTHDAY. THE AMOUNT THAT BECAME VESTED AND WAS PAID TO THOMAS TRAYLOR IN CALENDAR YEAR 2012 WAS $46,704. BMC PROVIDED A SEPARATE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO KATHLEEN E. WALSH, PRESIDENT AND CEO AS OF MARCH 1, 2010. PURSUANT TO THE TERMS OF THE AGREEMENT, certain amounts were credited to the President and CEO's account in prior years. THESE AMOUNTS ARE SUBJECT TO FORFEITURE AND PAYMENT WILL BE MADE ONLY IF CERTAIN CONDITIONS ARE MET, AS OUTLINED IN THE AGREEMENT. No amounts were accrued or vested under the plan in 2012. BMC PROVIDED A NON-QUALIFIED DEFINED BENEFIT PLAN TO CERTAIN EXECUTIVES. IN 2012, THIS PLAN WAS TERMINATED BY THE ORGANIZATION AND AMOUNTS DUE UNDER THE PLAN WERE FULLY PAID TO PARTICIPANTS. THE AMOUNTS PAID TO THE FOLLOWING EXECUTIVES ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(III). Traylor - $169,860 SCHEDULE J, PART I, LINE 6A BOSTON MEDICAL CENTER HEALTH PLAN PAID COMPENSATION CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION BASED ON THE ACHIEVEMENT OF VARIOUS GOALS. THESE COMPENSATION AMOUNTS ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(II). MARSH MCLENNAN AGENCY NEW ENGLAND SEE PART V 147141 CONSULTING SERVICES false SCHEDULE L, PART IV, LINE 1 NAME OF INTERESTED PERSON: MARSH & MCLENNAN AGENCY NEW ENGLAND RELATIONSHIP: TRUSTEE BLUE IS CEO OF Marsh & McLennan Agency New England Description of Transaction: Marsh & McLennan Agency New England provides employee and retiree benefits consulting services to Boston Medical Center Health Plan, inc (BMCHP). As an interested person, Trustee Blues participation in any matters regarding Marsh & McLennan Agency New England is governed by BMCHPs conflict of interest policy and subject to disclosure and review by disinterested trustees. FORM 990, PART I, LINE 1 & PART III, LINE 1 THE CORPORATION IS ORGANIZED AND SHALL OPERATE AS A NONPROFIT CORPORATION EXCLUSIVELY FOR THE BENEFIT OF AND TO SUPPORT BOSTON MEDICAL CENTER CORPORATION AND TO PROVIDE ACCESS TO EFFECTIVE, EFFICIENT MEDICAL CARE AMONG LOW INCOME, UNDERSERVED, DISABLED, ELDERLY AND OTHER VULNERABLE RESIDENTS OF THE COMMUNITY. FORM 990, PART VI, LINE 2 DAVID COLEMAN, M.D. SUSAN DONAHUE DAVID PASSAFARO KATHLEEN E. WALSH BUSINESS RELATIONSHIP EACH SERVES AS A DIRECTOR OF BOSTON MEDICAL CENTER INSURANCE COMPANY, LTD. KATHLEEN E. WALSH IS THE PRESIDENT/CEO OF BOSTON MEDICAL CENTER (BMC). CERTAIN INDIVIDUALS LISTED IN PART VII, SECTION A ARE EMPLOYEES OF BMC, A RELATED ORGANIZATION OF BOSTON MEDICAL CENTER HEALTH PLAN, INC. (BMCHP). FORM 990, PART VI, LINE 4 EFFECTIVE JULY 1, 2013 THE ORGANIZATION'S BYLAWS WERE AMENDED TO CHANGE THE SOLE MEMBER FROM BOSTON MEDICAL CENTER (BMC) TO BMC HEALTH SYSTEM, INC. (BMCHS). EFFECTIVE JULY 1, 2013 THE ORGANIZATION'S BYLAWS WERE AMENDED TO CHANGE THE SOLE MEMBER FROM BOSTON MEDICAL CENTER (BMC) TO BMC HEALTH SYSTEM, INC. (BMCHS). FORM 990, PART VI, LINE 6 PRIOR TO JULY 1, 2013 BMC WAS THE SOLE MEMBER OF BMCHP. AS OF JULY 1, 2013 BMCHS IS THE SOLE MEMBER OF BMCHP. FORM 990, PART VI, LINE 7A PRIOR TO JULY 1, 2013 BMC trustees also served as members of the board of trustees of BMCHP. FORM 990, PART VI, LINE 7B Certain actions including, but not limited to, the approval of budgets, mergers, acquisitions, and indebtedness are subject to the approval of the sole member. FORM 990, PART VI, LINE 11B BOSTON MEDICAL CENTER HEALTH PLAN'S (BMCHP) TAX RETURN IS PREPARED BY PRICEWATERHOUSECOOPERS LLP (PWC) AND REVIEWED BY BMCHP'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, BMCHP'S INTERNAL MANAGEMENT AND PWC PRESENT THE FORM 990 TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. FORM 990, PART VI, LINE 12 CONFLICT OF INTEREST QUESTIONNAIRES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2013 WERE DISTRIBUTED BY THE ORGANIZATION'S LEGAL DEPARTMENT. THE CHIEF COMPLIANCE OFFICER QUERIES TRUSTEES AND OFFICERS ON AT LEAST AN ANNUAL BASIS REGARDING RELATIONSHIPS THAT MAY CREATE POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER REVIEWS ALL DISCLOSURES AND DETERMINES WHETHER THERE ARE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER INFORMS THE GENERAL COUNSEL OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL ADVISES THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION ACCORDINGLY. FORM 990, PART VI, LINE 15A & B BOSTON MEDICAL CENTER HEALTH PLAN (BMCHP) RELIED ON BOSTON MEDICAL CENTER (BMC), A RELATED ORGANIZATION OF BMCHP, TO ESTABLISH ITS PRESIDENT/CEO'S COMPENSATION. BMC'S PROCESS FOR DETERMINING COMPENSATION OF ITS TOP MANAGEMENT AND KEY EMPLOYEES INCLUDES PERFORMING STANDARD BENCHMARKING, USING PUBLIC DATA AND SALARY SURVEYS FROM SOURCES INCLUDING MERCER AND THE HAY GROUP, BOTH AT THE TIME OF HIRE AND AGAIN WHEN OTHER THAN STANDARD INCREASES ARE CONSIDERED. DATA COLLECTED ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE CONSISTING OF INDEPENDENT PERSONS AND DELIBERATIONS AND DECISIONS ARE CONTEMPORANEOUSLY SUBSTANTIATED. FORM 990, PART VI, LINE 19 OTHER THAN AS REQUIRED BY LAW, BOSTON MEDICAL CENTER HEALTH PLAN DOES NOT MAKE DOCUMENTS PUBLICLY AVAILABLE. HOWEVER, THE RESTATED ARTICLES OF THE ORGANIZATION ARE POSTED ON THE SECRETARY OF THE COMMONWEALTH'S WEBSITE. FORM 990, PART XI, LINE 9 TRANSFER TO AFFILIATE ($23,000,000) BOSTON MEDICAL CENTER 88 EAST NEWTON STREET BOSTON MA 02118 043314093 HEALTHCARE MA 501(C)(3) 3 BMCHS true UNIVER DEVELOPMENT FOUNDATION INC 88 EAST NEWTON STREET BOSTON MA 02118 043101957 REAL ESTATE MA 501(C)(3) 11 TYPE 1 BMC true BMC INSURANCE CO LTD OF VERMONT PO BOX 530 100 BANK STREET BURLINGTON VT 05401 201810549 INSURANCE VT 501(C)(3) 11 TYPE 1 BMC true BOSTON UNIVERSITY AFFILIATED PHYSICIANS 660 HARRISON AVENUE BOSTON MA 02118 043218267 HEALTHCARE MA 501(C)(3) 3 BMC true BMC HEALTH SYSTEM INC ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 463556853 SUPPORT SVCS. MA 501(C)(3) 11 B-II NA false BMC NAB BUS TR 85 CONCORD ST BOSTON MA 02118 266368869 PROPERTY MGMT MA NA BCD BUILDING LLC 33 UNION ST BOSTON MA 02108 201855864 REAL ESTATE MA NA BMC INSURANCE COMPANY LTD 10 MAIN STREET GRAND CAYMAN, CAYMAN ISLANDS CJ 980375219 INSURANCE CJ NA C-CORP true GRYANT INC ONE BOSTON MEDICAL CENTER BOSTON MA 02118 202047166 REAL ESTATE MA NA C-CORP true CHARITABLE REMAINDER TRUST (3) SUPPORT MA NA TRUST true false false false false false false false false false false false false false false false true false true false SCHEDULE R, PART II BMC Health System, Inc. is a non-profit organization seeking exemption under IRC 501(c)(3). Currently, BMC Health System, Inc.'s application for tax exemption is pending.