2014-10-24T16:36:09-05:00 2013-12-31 ERNST & YOUNG LLP 5 TIMES SQUARE NEW YORK NY 100366530 990 2013-01-01 113029569 Managed Health Inc % MARYBETH TITA MANA 2128016000 100 CHURCH ST FL 18 Suite New York NY 100072601 MARYBETH TITA SVP/TREASURER 2014-10-24 CHRISTOPHER BOGGS P00032493 2013 2015-11-30 17:44:51Z PATRICIA J WANG 100 CHURCH ST FL 18 NEW YORK NY 100072601 1618599531 false X www.healthfirstny.org X 1990 NY IMPROVE THE HEALTH AND WELL-BEING OF UN- DERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE AND COMMERCIAL RECIPIENTS. 5 3 0 0 0 0 0 1474760609 1615459009 4098415 3140522 0 0 1478859024 1618599531 0 0 0 0 0 0 0 0 0 1462192719 1628776902 1462192719 1628776902 16666305 -10177371 515271133 494542039 298927072 282584866 216344061 211957173 IMPROVE THE HEALTH AND WELL-BEING OF UN- DERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE AND COMMERCIAL RECIPIENTS. false false 1575252355 1615459009 MANAGED HEALTH, INC. IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. MANAGED HEALTH INC. PROVIDES HEALTH CARE SERVICES TO MEDICARE AND COMMERCIAL SUBSCRIBERS/BENEFICIARIES, WHO ARE INDIGENT, AGED, DISABLED AND/OR MEDICALLY UNDERSERVED. IN 2013, THERE ARE about 62 PARTICIPATING HOSPITALS WITH MANAGED HEALTH, INC. THAT SERVED 115,638 MEDICARE MEMBERS AND THERE ARE ABOUT 35 PARTICIPATING HOSPITALS WITH MANAGED HEALTH, INC. THAT SERVED 719 COMMERCIAL RECIPIENTS. 1575252355 false false false false false false false false false false false false true 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 true false true 8552 0 true 0 false false false false false false X 5 3 false true false false true true true true true false false true true true true true true false false false NY X MARYBETH TITA 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 X RICHARD MURCOTT COMMUNITY REPRESENTATIVE 1.0 0.0 X 0 JAY A SCHECHTMAN SVP/CHIEF MEDICAL OFFICER 1.0 40.0 X 0 589373 90479 ELIZABETH R ST CLAIR SVP/GENERAL COUNSEL 1.0 40.0 X 649837 121101 STEVE ROSENTHAL DIRECTOR 1.0 0.0 X ERIC SCALETTAR DIRECTOR 1.0 0.0 X PATRICIA J WANG PRESIDENT/CEO 1.0 40.0 X 1286944 307077 MARYBETH A TITA CFO/TREASURER 1.0 40.0 X 610978 111385 NAHUM KIANOVSKY VP/ASSOC GEN COUNSEL II 1.0 40.0 X 275812 15300 DANIEL P MCCARTHY EVP/COO 1.0 40.0 X 833034 150193 ARUN K BHATIA SVP CIO 1.0 40.0 X 450195 86195 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 1.0 40.0 X 367802 15300 ANDREA C FORINO SVP, HUMAN RESOURCES-TERM 9/13 1.0 40.0 X 574273 60634 YI QI WU VP, FACILITATED ENROLLMENT 1.0 40.0 X 388488 15300 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUI 1.0 40.0 X 368107 15300 0 6394843 988264 0 false true false CAREMARK LLC ONE CVS DRIVE WOONSOCKET RI 02895 PHARMACY 438817269 BRONX LEBANON HOSPITAL CENTER PO BOX 27853 NEW YORK NY 100877853 MEDICAL/HOSPITAL 39618715 NEW YORK CITY HEALTH AND HOSPITAL C 125 WORTH STREET ROOM 514 NEW YORK NY 10013 MEDICAL/HOSPITAL 214114533 MONTEFIORE MEDICAL CENTER PO BOX 4296 CHURCH STREET STATION NEW YORK NY 10261 MEDICAL/HOSPITAL 122035639 ST LUKE'S-ROOSEVELT HOPITAL PO BOX 95000-2468 PHILADELPHIA PA 191952468 MEDICAL/HOSPITAL 37934386 889 0 MEDICARE ADVANTAGE (PART C) 524114 1467426982 1467426982 MEDICARE PRESCRIPTION DRUG COVERAGE (PART D) 524114 145544736 145544736 COMMERCIAL (INCLUDING HEALTHY NY) 524114 2487291 2487291 1615459009 3140522 3140522 0 0 0 0 0 0 0 0 0 0 1618599531 1615459009 3140522 0 0 0 0 0 0 0 0 0 0 190165407 136919093 53246314 0 0 0 0 0 457410 179177 278233 3853119 3853119 43011 43011 0 0 0 0 0 0 576166 576166 0 0 0 HEALTHCARE SERVICE COSTS 1410977835 1410977835 MEDICAL ADMINISTRATIVE 22655228 22655228 CLAIMS ADJUSTMENT EXPENSE 48726 48726 1628776902 1575252355 53524547 0 0 0 87767449 70756057 0 0 46415767 58490863 0 0 0 0 0 0 0 0 0 0 0 358060122 310661938 0 0 0 0 0 0 23027795 54633181 515271133 494542039 246765683 247862475 0 0 10354 0 0 0 0 0 0 0 0 0 0 0 52151035 34722391 298927072 282584866 X 216344061 211957173 0 0 0 0 216344061 211957173 515271133 494542039 X -10177371 -1772636 7563119 X X false true X true false INTEREST RECEIVABLE 1418573 PHARMACY REBATE RECEIVABLE 38969171 COVERAGE GAP DISCOUNT PROGRAM 179393 MEDICARE NEGATIVE VENDOR BAL 1522821 MEDICARE D PLAN-TO-PLAN RECV 37277 OTHER CURRENT ASSETS/PREPAID 6557350 OTHER MEDICAL RECEIVABLE 1803537 DUE FROM HF MGMT SVCS, LLC 667306 SECURITY DEPOSIT - OTHER 147200 PART D DEPOSIT - LOW INCOME 707529 PART D DEPOSIT - REISURANCE 2623024 54633181 0 DUE TO CMS 14420330 MEDICARE PART D DEPOSIT LIABIL 1154121 DUE TO 501(C)(3) AFFILIATE 2587917 NOTE PAYABLE TO RELATED PARTY 13870981 OTHER CURRENT LIABILITIES 2689042 34722391 1624390014 -1772636 7563119 5790483 1618599531 1618599531 1628776902 1628776902 1628776902 PART XI, LINE 2D - OTHER ADJUSTMENTS FINANCIAL SECURITY DEPOSITS FOR MEMBER HOSPITALS: $148,203. RETAINED HOSPITAL PAYMENTS: $7,414,916 The health care services agreements with certain hospitals provide that payments due to these hospitals, as a health care providers to MHI Members, attributable to a % of premium are retained by MHI. These hospitals may be entitled to have their retained payments refunded in the future, without interest, upon the dissolution of MHI or similar circumstances, subject to any restrictions by the State of New York, as detailed in such agreement. Retained payments required to be withheld by MHI totaled $7,414,916 for 2013. true true false false false false false false false JAY A SCHECHTMAN SVP/CHIEF MEDICAL OFFICER 0 414432 173865 1076 90479 17272 0 697124 ELIZABETH R ST CLAIR SVP/GENERAL COUNSEL 453483 182487 13867 121101 11195 782133 9535 PATRICIA J WANG PRESIDENT/CEO 826007 402833 58104 307077 10699 1604720 55266 MARYBETH A TITA CFO/TREASURER 426559 172135 12284 111385 17328 739691 10988 NAHUM KIANOVSKY VP/ASSOC GEN COUNSEL II 213388 62105 319 15300 17328 308440 DANIEL P MCCARTHY EVP/COO 548258 267631 17145 150193 17328 1000555 13703 ARUN K BHATIA SVP CIO 341008 108202 985 86195 15595 551985 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 285779 80142 1881 15300 11519 394621 ANDREA C FORINO SVP, HUMAN RESOURCES-TERM 9/13 211848 112826 249599 60634 7552 642459 YI QI WU VP, FACILITATED ENROLLMENT 275301 106245 6942 15300 17272 421060 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUI 330625 35625 1857 15300 383407 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUAL ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION: ANDREA FORINO TOTAL OF SEVERANCE AGREEMENT IN 2013: $442,771 SEVERANCE PAID IN 2013: $85,148. SEVERANCE DEFERRED: $357,623. SCHEDULE J, PART 1, LINE 4B THE FOLLOWING INDIVIDUAL PARTICIPATED IN THE NON-QUALIFIED REQUIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS FROM THE PLAN SPONSOR FOR 2013: PATRICIA J. WANG $81,900. [Col. C] DANIEL P. McCARTHY $36,604. [Col. C] ELIZABETH R. ST CLAIR $28,539. [Col. C] JAY A. SCHECHTMAN $20,401 [Col. C] MARYBETH A. TITA $25,943. [Col. C] ARUN K.BHATIA $19,238. [Col. C]. SEAN KANE $9,188 [Col. C] HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 190165407 MANAGEMENT AND ADMIN SERVICES false HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 13870981 NOTES PAYABLE OUTSTANDING false FORM 990, PART VI, SECTION A, LINE 3 MANAGED HEALTH INC. CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS)-A RELATED ORGANIZATION-TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE; THESE ARE PROVIDED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUMS ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY STATE REGULATORS. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR HFMS, A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM MANAGED HEALTH INC. FORM 990, PART VI, SECTION A, LINE 6 MANAGED HEALTH, INC. HAS A SOLE CORPORATE MEMBER, WHICH IS HEALTHFIRST, INC. FORM 990, PART VI, SECTION A, LINE 7A HEALTHFIRST, INC., A RELATED NOT-FOR-PROFIT ORGANIZATION, HAS THE RIGHT TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS OF MANAGED HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY OTHER ENTITIES: * REPAYMENT OF THE ORGANIZATION'S DEBT OBLIGATIONS REQUIRES STATE REGULATORY APPROVAL * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS REQUIRES STATE REGULATORY APPROVAL * CERTAIN CHANGES TO PREMIUM RATES ARE SUBJECT TO FEDERAL OR STATE REGULATORY APPROVAL * EXPANSION TO OTHER MANAGED CARE BUSINESSES REQUIRES STATE LICENSURE * MANAGEMENT FEE RATE CHANGES REQUIRE APPROVAL FROM THE MANAGEMENT COMPANY AND STATE REGULATORS. FORM 990, PART VI, SECTION A, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS TREASURER AND VICE PRESIDENT CONTROLLER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS GENERAL COUNSEL, SENIOR VICE PRESIDENT OF CORPORATE FINANCE AND CHIEF FINANCIAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS GIVEN A COPY OF THE DISCLOSURE STATEMENT TO COMPLETE ON AN ANNUAL BASIS. A MEMBER WHO DOES NOT COMPLETE THE STATEMENT IS NOT ALLOWED TO ATTEND BOARD MEETINGS AND MAY BE REMOVED FROM THE BOARD. AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE STATEMENT WILL BE DISCIPLINED, UP TO TERMINATION FROM THE POSITION. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. A REPORT OF ANY CONFLICTS IS PREPARED FOR DISCUSSION WITH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC., THE NOT FOR PROFIT CORPORATE PARENT, AS WELL AS THE FULL BOARD OF DIRECTORS OF MANAGED HEALTH, INC. AS APPROPRIATE, ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION MAKING, MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICERS OR EMPLOYEES, THE ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO MHI.(A RELATED ORGANIZATION). THE COMMITTEE CONSISTS SOLELY OF INDEPENDENT DIRECTORS. THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEES CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XI, LINE 9 CHANGE IN NET ASSETS - FINANCIAL SECURITY DEPOSITS RECEIVED FROM MEMBER HOSPITALS: $148,203 RETAINED HOSPITAL PAYMENTS: $7,414,916 TOTALLING $7,563,119. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC. (A RELATED ORGANIZATION). HEALTHFIRST PHSP INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133783732 MANAGED CARE NY 501 (C)3 9 HEALTHFIRST true HEALTHFIRST INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501 (C)3 11 Type I N/A false HEALTHFIRST HEALTH PLAN OF NJ INC 1 WASHINGTON ST STE 1405 NEWARK NJ 07102 510609967 MANAGED CARE NJ 501 (C)4 HF MGMT SVCS true SENIOR HEALTH PARTNERS INC 100 CHURCH STREET 18FL NEW YORK NY 10007 134103882 MGD LT CARE NY 501 (C)3 9 HF MGMT SVCS true NEIGHBORHOOD HEALTH PROVIDERS INC 100 CHURCH ST FL 18 NEW YORK NY 10007 943474115 MANAGED CARE NY 501 (C) 3 9 HEALTHFIRST true HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA false 0 HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY HF MGMT SVCS C CORP true false false false false true false false false false false false false true false false false false true false HF MANAGEMENT SERVICES LLC E 13870981 NOTES PAYABLE HF MANAGEMENT SERVICES LLC M 190165407 CONTRACTED RATE HEALTHFIRST PHSP INC R 6800000 CONTRACT FORM 990, SCHEDULE R, PART V, LINE 2 METHOD OF DETERMINING AMOUNT INVOLVED ITEM (1): THE AMOUNT REPRESENTS THE BALANCE OUTSTANDING, INCLUDING INTEREST ACCRUED AND UNPAID, AT DECEMBER 31, 2013 ITEM (2): THE AMOUNT REPRESENTS THE EXPENSES INCURRED AND PAID OR DUE TO THE RELATED ORGANIZATION FOR SERVICES RENDERED BASED ON CONTRACTED RATES APPROVED BY RESOLUTION OF THE BOARD OF DIRECTORS AND STATE REGULATORS. ITEM (3) : In accordance with the organization's contractual arrangements with hospitals and upon approval by the Boards of Directors of MHI, Healthfirst PHSP, Inc. (PHSP), a related organization, and Healthfirst, Inc., risk-sharing pool balances in MHI may be offset by or may be used to offset a percentage of the same hospital(s)risk-sharing pool balance in PHSP through an intercompany transfer. The current policies permit the offsetting of any deficits that may accrue for a hospital, or its affiliate institutions, with up to 100% of surpluses that may accrue.