2014-11-17T13:55:45-06:00 2013-12-31 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2013-01-01 742838488 Driscoll Childrens Health Plan % RICK VILLARREAL DRIS 3616944889 615 N Upper Broadway St Suite 1621 Corpus Christi TX 784010746 MARY D PETERSON CEO 7134994600 2014-11-15 true M P Gerich P00226776 7134994600 2013 2015-11-30 17:44:51Z DR MARY DALE PETERSON 615 N UPPER BROADWAY ST 1621 CORPUS CHRISTI TX 784010746 332472019 false X WWW.DCHPKIDS.COM X 1997 TX DCHP IS COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED AND COMPASSIONATE HEALTH CARE TEAM & RESPECTFUL COLLABORATION WITH ITS PROVIDER NETWORK. 7 4 108 1 0 162643 35154 290937187 317186494 540177 -133513 0 0 291640007 317088135 0 0 0 0 7191751 8125906 0 0 0 262482264 307560635 269674015 315686541 21965992 1401594 67073622 68285876 32854447 32763453 34219175 35522423 X DRISCOLL CHILDREN'S HEALTH PLAN IS COMMITTED TO PROVIDING EFFICIENT, COST-EFFECTIVE, QUALITY CARE THROUGH A DEDICATED & COMPASSIONATE HEALTHCARE TEAM & RESPECTFUL COLLABORATION WITH ITS PROVIDER NETWORK. false false 288633345 317186434 SEE SCHEDULE O FOR FULL PROGRAM SERVICE DESCRIPTION. 288633345 true true false true false false false false false true true 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 false false false false false false true false false false true 0 0 108 true false false false false false false false false false false X 7 4 false false false false true true true true true false false true true true true true true true true false X RICK VILLARREAL 3616946781 615 N UPPER BROADWAY ST STE 1621 Corpus Christi TX 78401 X WILLIAM J STERETT CHAIRMAN OF THE BOARD 1.0 2.0 X X D ERIC HAMON SECRETARY/TREASURER 1.0 40.0 X X 0 273552 354032 C IVAN WILSON DIRECTOR 1.0 2.0 X 10000 JOE FULTON DIRECTOR 1.0 2.0 X 10000 MARY D PETERSON PRESIDENT/CEO 40.0 10.0 X X 387202 67336 STEVE WOERNER DIRECTOR 1.0 40.0 X 467947 469064 S LOYD NEAL JR DIRECTOR 1.0 2.0 X 10000 ERNEST BUCK MEDICAL DIRECTOR 40.0 1.0 X 306350 15361 WILLIAM BRENDEL ASSOCIATE MEDICAL DIRECTOR 40.0 1.0 X 278031 9799 RICARDO VILLARREAL VICE PRESIDENT OF FINANCE 40.0 1.0 X 216944 25951 JUDITH KRAFT EXECUTIVE DIRECTOR QUALITY IMP 40.0 1.0 X 127316 14634 DON WELL CREDENTIAL PROVIDER RELATIONS 40.0 1.0 X 135181 10530 HEATHER JOHNSON DIRECTOR OF UTILIZATION MGMT 40.0 1.0 X 119367 20116 MICHAEL P LANCE VICE PRESIDENT DCHP 40.0 1.0 X 219546 14106 KATHRYN ARBUTHNOT-ALLEN DIRECTOR OF CASE/DISEASE MGMT 40.0 1.0 X 105061 19917 1894998 771499 1020846 10 false true false VALENCE HEALTH 600 W JACKSON SUITE 800 CHICAGO IL 60661 THIRD PARTY ADMIN 11144745 AVANCE RIO GRANDE VALLEY 1205 S Galveston Rd MCALLEN TX 78501 PATIENT EDUCATION 313218 CORPORATE PRINTING INC 3509 OAK FOREST DR HOUSTON TX 77018 PRINTING 710976 HEALTH MANAGEMENT SYSTEMS PO BOX 166409 IRVING TX 75016 BENFIT SERVICES 1097644 SANDLOT SOLUTIONS 2555 MERIDIAN BLVD SUITE 250 FRANKLIN TN 37067 HEALTH INFO. EX SVCS 225000 5 35154 35154 PREMIUM REVENUE 524292 316352675 316352675 NET REINSURANCE 524292 710249 710249 OTHER INCOME 900099 123570 123570 317186494 387321 387321 0 0 0 0 0 14863050 15383884 -520834 -520834 -520834 0 0 0 0 317088135 317186494 -133513 0 0 0 0 1306975 1306975 0 5360860 1562215 3798645 0 265454 67399 198055 0 768860 298313 470547 0 423757 177978 245779 13060463 1372700 11687763 4600 4600 0 0 0 7958 7958 3258863 3258863 342835 342835 1231783 1231783 302982 302982 0 301672 301672 234342 234342 0 0 0 0 70935 70935 73792 73792 MEDICAL EXPENSES 278669958 278669958 PREMIUM TAXES 5628051 5177807 450244 MEMBER VALUE ADD EXPENSE 2703115 2703115 ALLOCATED COSTS 854010 854010 815276 815276 315686541 288633345 27053196 0 31774595 23552437 4507715 9206461 0 0 4372982 4490051 0 0 0 0 0 0 0 0 0 0 2772189 2594912 101246 177277 0 0 23080468 26126881 0 0 0 0 3236616 4732769 67073622 68285876 27183000 27413338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5671447 5350115 32854447 32763453 X 0 0 0 0 34219175 35522423 34219175 35522423 67073622 68285876 1401594 -98346 X false true X false true true X 357701 423224 185751 162643 35154 1164473 134848007 152114133 150430135 290937187 317186494 1045515956 0 0 0 135205708 152537357 150615886 291099830 317221648 1046680429 0 0 0 1046680429 254370 362081 525837 441183 387321 1970792 0 254370 362081 525837 441183 387321 1970792 0 0 135460078 152899438 151141723 291541013 317608969 1048651221 0.99812 0.00000 0.00188 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 89477 false false false 89477 false 2772189 2594912 177277 177277 VANGUARD - MUTUAL FUNDS 26126881 F 26126881 DUE FROM DRISCOLL HEALTH SYS 3467769 DEPOSITS 1265000 4732769 0 REBATE LIABILITY 1554919 DUE TO DVPG 56737 UNEARNED PREMIUMS 3738459 5350115 315459133 315459133 1629002 1629002 317088135 314057539 314057539 1629002 1629002 315686541 SCHEDULE D, PART XI, LINE 4B AUDIT EXPENSES NETTED WITH INCOME ON FORM 990 $ 1,629,000 SCHEDULE D, PART XII, LINE 4B AUDIT EXPENSES NETTED WITH INCOME ON FORM 990 $ 1,629,000 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X X X false true false false false false false false false D ERIC HAMON SECRETARY/TREASURER 0 144620 0 103626 0 25306 0 318697 0 35335 0 627584 0 MARY D PETERSON PRESIDENT/CEO 298202 71500 17500 53532 13804 454538 STEVE WOERNER DIRECTOR 256052 193095 18800 458351 10713 937011 RICARDO VILLARREAL VICE PRESIDENT OF FINANCE 173680 43264 16960 8991 242895 ERNEST BUCK MEDICAL DIRECTOR 248350 40500 17500 5528 9833 321711 WILLIAM BRENDEL ASSOCIATE MEDICAL DIRECTOR 240531 37500 9799 287830 MICHAEL P LANCE VICE PRESIDENT DCHP 191046 28500 4325 9781 233652 PART I, QUESTION 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: NAME DEFERRAL AMOUNT D. ERIC HAMON $ 253,778 STEVE WOERNER $ 372,792 NO PAYMENTS WERE RECEIVED. FORM 990, PART III, QUESTION 4A PROGRAM SERVICE ACCOMPLISHMENT DRISCOLL CHILDREN'S HEALTH PLAN IS THE CONTRACTOR FOR THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) THIS SERVICE AREA INCLUDES 14 COUNTIES COMPRISED OF ARANSAS, BEE, BROOKS, CALHOUN, GOLIAD, JIM WELLS, KARNES, KENEDY, KLEBERG, LIVE OAK, NUECES, REFUGIO, SAN PATRICIO, AND VICTORIA. THE PLAN ALSO PROVIDES HEALTH BENEFITS FOR CHILDREN ENROLLED IN THE STATE OF TEXAS ACCESS REFORM (STAR) PROGRAM FOR 24 COUNTIES. THE PLAN IS A HEALTH MAINTENANCE ORGANIZATION (HMO) COMMITTED TO PROVIDING ITS MEMBERS A NETWORK OF HEALTH SERVICE PROVIDERS. ITS AFFILIATION WITH DRISCOLL CHILDREN'S HOSPITAL (DCH), THE SOLE CORPORATE MEMBER, LENDS TO THE PLAN'S SUCCESS BY OFFERING ITS MEMBERS DCH'S EXTENSIVE NETWORK INCLUDING PHYSICIANS, HOSPITAL, AND SERVICES IN ITS TOTAL EXPANDED SERVICE AREA, THUS OFFERING CHIP AND STAR MEMBERS WHO LIVE IN THE ADJACENT COUNTIES A FULL CONTINUUM OF QUALITY SERVICES TAILORED TO MEET THE NEEDS OF THE CHIP AND STAR POPULATION. THE PLAN'S ENROLLMENT WAS 110,227 AND 106,041 AT DECEMBER 31, 2013 AND 2012, RESPECTIVELY. Form 990, Part IV, Question 6 CLASSES OF MEMBERS OR STOCKHOLDERS Driscoll Children's Hospital is the sole member of Driscoll Children's Health Plan. Form 990, Part IV, Question 7a CLASS OF PERSONS AND NATURE AND THEIR RIGHTS Any vacancy occurring in the board of directors shall be filled in accordance with the following procedure: the Member shall elect and appoint a candidate to fill the vacancy. Form 990, Part IV, Question 7b CLASS OF THE PERSON, DECISIONS THAT REQUIRE APPROVAL, AND VOTING RIGHTS The following matters are reserved to the member and shall require the affirmative action of the member to be effective: A. annual operating & capital budgets of the corporation; B. Merger, acquisition or consolidation of the corporation; c. borrowing or lending of money or the creation of indebtedness through the guarantee of another debt or similar action; and d. appointment & removal of directors in accordance with the by-laws. form 990, part VI, question 11 FORM 990 PROVIDED TO GOVERNING BODY THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, QUESTION 15A COMPENSATION REVIEW OF CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL BOARD OF DIRECTORS REVIEW THE APPLICABLE MARKETING DATA PROVIDED BY A THRID PARTY COMPENSATION FIRM AND MATCHES THE PRESIDENT/CEO SALARY TO THE APPROPRIATE MARKET RATE FOR THE DUTIES. SULLIVAN COTTER REVIEWED APRIL 2013. FORM 990, PART VI, QUESTION 15B COMPENSATION REVIEW OF OFFICERS OR KEY EMPLOYEES MANAGEMENT REVIEWS APPLICABLE MARKET DATA AND SLOTS THE SALARY ACCORDING TO APPROPRIATE MARKET DATA. form 990, part VI, question 19 Organizational documents made available to public The organization does not make its governing documents, policies, and financial statements available to the public. FORM 990, PART VI, QUESTION 12C ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE WITH POLICY ANNUALLY, ALL DIRECTORS, OFFICERS, AND KEY PERSONNEL FILL OUT A CONFLICT OF INTEREST FORM. STAFF MAKES SURE ALL CONFLICT OF INTEREST FORMS ARE TURNED IN AND REVIEWED ANNUALLY. Driscoll Children's Hospital 3533 South Alameda Corpus Christi TX 78411 742577746 Hospital TX 501(C)(3) 3 na false Driscoll Physician's Group 3533 South Alameda Corpus Christi TX 78411 742988134 Hospital TX 501(C)(3) 3 DCH false Driscoll Valley Physicians Group 3533 South Alameda Corpus Christi TX 78411 201234322 Hospital TX 501(C)(3) 3 DCH false Driscoll Maternal & Fetal Physician's Gr 3533 South Alameda Corpus Christi TX 78411 201234461 Health Care TX 501(C)(3) 7 DCH false Childrens Physician Services of South TX 3533 South Alameda Corpus Christi TX 78411 742620408 Hospital TX 501(C)(3) 3 DCH false Driscoll Foundation 615 North Upper Broadway ste 1635 Corpus Christi TX 78401 741170270 Char. Trust TX 501(C)(3) 11a NA false Driscoll Healthcare Services 3533 south alameda corpus christi TX 78411 010962276 health care TX 501(C)(3) 11a dch false false false false false false false false false false false true false true true true true true false false