NEW YORK STATE CATHOLIC HEALTH PLAN INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NEW YORK STATE CATHOLIC HEALTH PLAN INC (EIN 11-3153422)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-08-13
- IRS object ID
- 201432259349301843
- Schema version
- 2013v3.0
- Note
- A later return for the same period supersedes this one.
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-08-13T16:08:31-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO JERICHO PLAZA | AddressLine1 |
| City | JERICHO | City |
| State | NY | State |
| ZIP Code | 11753 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113153422 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEW YORK STATE CATHOLIC HEALTH PLANINC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEWY | BusinessNameControlTxt |
| Phone | 7183936403 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95-25 QUEENS BOULEVARD | AddressLine1 |
| City | REGO PARK | City |
| State | NY | State |
| ZIP Code | 113744510 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK J FRAWLEY | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 7183936403 | PhoneNum |
| Signature | 2014-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTINE KAWECKI | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
| Preparation | 2014-08-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FIDELIS CARE NEW YORK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PATRICK J FRAWLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95-25 QUEENS BOULEVARD | AddressLine1 |
| City | REGO PARK | City |
| State | NY | State |
| ZIP Code | 113744510 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,971,759,473 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FIDELISCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 2355 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $270,351 | PYContributionsGrantsAmt |
| CY Contributions Grants | $353,245 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,273,848,371 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,086,015,198 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,128,865 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,018,260 | CYInvestmentIncomeAmt |
| PY Other Revenue | $261,662 | PYOtherRevenueAmt |
| CY Other Revenue | $153,519 | CYOtherRevenueAmt |
| PY Total Revenue | $3,287,509,249 | PYTotalRevenueAmt |
| CY Total Revenue | $4,101,540,222 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,850,362 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,492,936 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $2,858,161,536 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $3,533,028,969 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $118,906,450 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $131,937,126 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $68,666,319 | PYOtherExpensesAmt |
| CY Other Expenses | $77,335,242 | CYOtherExpensesAmt |
| PY Total Expenses | $3,048,584,667 | PYTotalExpensesAmt |
| CY Total Expenses | $3,745,794,273 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $238,924,582 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $355,745,949 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,128,562,629 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,622,426,424 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $542,649,538 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $667,496,483 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $585,913,091 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $954,929,941 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,632,813,995 | ExpenseAmt |
| Grant | $2,511,131 | GrantAmt |
| Revenue | $3,107,115,019 | RevenueAmt |
| Desc | MEDICAID MANAGED CARE PROGRAM IS A NEW YORK STATE PROGRAM ADMINISTERED BY FIDELIS THAT PROVIDES FREE COMPREHENSIVE HEALTH COVERAGE FOR ELIGIBLE INDIVIDUALS AND FAMILIES WHO ARE RESIDENTS OF NEW YORK STATE AND HAVE LOW INCOME AND LIMITED RESOURCES. THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $361,092,595 | ExpenseAmt |
| Grant | $321,666 | GrantAmt |
| Revenue | $400,000,747 | RevenueAmt |
| Desc | FAMILY HEALTH PLUS IS PART OF NEW YORK STATE'S FAMILY HEALTH PLUS PROGRAM ADMINISTERED BY FIDELIS FOR UNINSURED ADULTS, AGES 19-64, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID. FAMILY HEALTH PLUS PROVIDES COMPREHENSIVE COVERAGE, INCLUDING PREVENTION, PRIMARY CARE, HOSPITALIZATION, PRESCRIPTIONS, AND OTHER SERVICES. THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $252,738,689 | ExpenseAmt |
| Grant | $213,652 | GrantAmt |
| Revenue | $265,682,172 | RevenueAmt |
| Desc | FIDELIS CARE AT HOME IS A MEDICAID LONG-TERM CARE CAPITATED PROGRAM WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES AN ARRAY OF HOME, COMMUNITY, AND INSTITUTIONALLY BASED, LONG-TERM CARE SERVICES TO PERSONS WHO ARE ELIGIBLE FOR MEDICAID AND WHO HAVE BEEN CERTIFIED AS APPROPRIATE CANDIDATES FOR NURSING HOME PLACEMENT. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $289,876,626 | ExpenseAmt |
| Grant | $446,487 | GrantAmt |
| Revenue | $313,370,779 | RevenueAmt |
| Desc | OTHER PROGRAMS ADMINISTERED BY THE PLAN INCLUDE THE CHILD HEALTH PLUS PROGRAM, MEDICARE ADVANTAGE PROGRAM, MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM, AND MEDICAID ADVANTAGE PLUS PROGRAM. CHILD HEALTH PLUS PROGRAM IS A PROGRAM THAT COVERS UNINSURED CHILDREN UNDER THE AGE OF 19, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID.MEDICARE ADVANTAGE PROGRAM IS A PROGRAM AVAILABLE TO ADULTS AGED 65 AND OVER WHO ARE ELIGIBLE UNDER MEDICARE. BENEFICIARIES MAY CHOOSE TO USE PRIVATE PAY OPTIONS, ESTABLISH MEDICAL SAVINGS ACCOUNTS, USE MANAGED CARE PLANS SUCH AS FIDELIS, OR JOIN PROVIDER-SPONSORED PLAN.MEDICARE/MEDICAID DUAL ADVANTAGE IS A PROGRAM FOR THOSE WHO MEET ELIGIBILITY REQUIREMENTS FOR BOTH MEDICARE AND MEDICAID AND ARE ENROLLED IN BOTH PROGRAMS.MEDICAID ADVANTAGE PLUS IS A FULL-RISK MANAGED LONG-TERM CARE PROGRAM FOR INDIVIDUALS 18 YEARS OF AGE AND OLDER WITH MEDICARE AND MEDICAID COVERAGE WHO HAVE A CHRONIC ILLNESS OR DISABILITY. MEMBERS MUST BE IN NEED OF LONG-TERM CARE SERVICES AND MAY NEED CARE TYPICALLY GIVEN IN A NURSING HOME. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $289,876,626 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $446,487 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $313,370,779 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $3,536,521,905 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13476 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2355 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNE C KONTOPOULOS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7183936403 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95-25 QUEENS BLVD | AddressLine1 |
| City | REGO PARK | City |
| State | NY | State |
| ZIP Code | 113744510 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KARL P ADLER MD | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JACK BALINSKY | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| M WILLIAM BENEDETTO | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| SISTER PATRICIA BURKARD OSF | |||||||||
| DIRECTOR/SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| JAMES M CORRIGAN CPA MHA | |||||||||
| DIRECTOR/TREASURER THROUGH 4/4/13 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| REV JOHN COUGHLIN | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS DESTEFANO | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS F DOODIAN | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| REV DONALD J HARRINGTON CM | |||||||||
| CHAIRMAN OF THE BOARD | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| JOHN J HURLEY | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS L KELLY | |||||||||
| DIRECTOR/VICE-CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| REV LEO J O'DONOVAN SJ | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GINO J PAZZAGLINI | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| REV MONSIGNOR ALAN J PLACA | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN J RYDZEWSKI | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOSEPH SLAVIK | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MOST REV JOSEPH M SULLIVAN | |||||||||
| DIRECTOR THROUGH 6/7/13 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL J TOOLEY | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN A WERWAISS | |||||||||
| DIRECTOR/TREASURER AS OF 4/5/13 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| PATRICK J FRAWLEY | |||||||||
| PRESIDENT & CEO | 37.50 | $2,186,413 | $0 | $85,932 | Yes (X) | 0.00 | |||
| THOMAS HALLORAN | |||||||||
| CHIEF FINANCIAL OFFICER | 33.70 | $464,818 | $52,703 | $270,542 | Yes (X) | 3.80 | |||
| DAVID THOMAS | |||||||||
| EVP & COO | 34.70 | $975,227 | $62,771 | $62,185 | 2.80 | Yes (X) | |||
| SANJIV SHAH MD | |||||||||
| CHIEF MEDICAL OFFICER | 32.80 | $352,200 | $50,710 | $150,426 | 4.70 | Yes (X) | |||
| PAMELA HASSEN | |||||||||
| CHIEF MARKETING OFFICER | 37.50 | $362,390 | $0 | $212,655 | 0.00 | Yes (X) | |||
| MARTIN KREBS | |||||||||
| CHIEF INF. OFFICER | 37.50 | $351,807 | $0 | $127,864 | 0.00 | Yes (X) | |||
| SANTO RUSSO | |||||||||
| CHIEF LEGAL OFFICER | 33.70 | $302,408 | $34,674 | $126,139 | 3.80 | Yes (X) | |||
| THOMAS BROWN | |||||||||
| CHIEF ADMIN OFFICER | 37.50 | $230,280 | $0 | $1,003 | 0.00 | Yes (X) | |||
| ROBERT WICKS | |||||||||
| VP MEDICAL DIRECTOR | 37.50 | $310,144 | $0 | $19,857 | 0.00 | Yes (X) | |||
| ROBERT FAZZOLARI | |||||||||
| VP GOV'T REL & CORP COMP | 37.50 | $306,513 | $0 | $26,755 | 0.00 | Yes (X) | |||
| PAMELA WILKES | |||||||||
| VP NETWORK DEVELOPMENT | 37.50 | $293,466 | $0 | $25,285 | 0.00 | Yes (X) | |||
| JAMES M BURNOSKY | |||||||||
| VP STRATEGIC PLAN & DEV | 30.00 | $214,198 | $55,496 | $35,485 | 7.50 | Yes (X) | |||
| ANNE C KONTOPOULOS | |||||||||
| AVP, FINANCE | 37.50 | $260,274 | $0 | $32,457 | 0.00 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,610,138 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $256,354 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,176,585 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 131 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| IHT SERVICES LLC | |||||
| 115 PERIMETER CENTER PLACE | ATLANTA | GA | 303460000 | MEDICAL CLAIMS REVIEW | $4,619,071 |
| HEALTH MANAGEMENT SYSTEMS INC | |||||
| PO BOX 27151 | NEW YORK | NY | 100870000 | COORDINATION OF BENEFITS REVIEW | $3,709,951 |
| PERSONAL COMPUTERS INC | |||||
| 703 WASHINGTON STREET | BUFFALO | NY | 142030000 | IT SERVICES | $3,219,185 |
| AARETE LLC | |||||
| DEPARTMENT 4972 | CAROL STREAM | IL | 601220000 | VENDOR CONTRACTS REVIEW | $2,185,261 |
| EMDEON BUSINESS SERVICES | |||||
| PO BOX 572490 | MURRAY | UT | 841572490 | CLAIMS PROCESSING | $1,705,556 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 53 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,500 | RelatedOrganizationsAmt |
| Government Grants | $145,596 | GovernmentGrantsAmt |
| All Other Contributions | $202,149 | AllOtherContributionsAmt |
| Total Contributions | $353,245 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 524114 | $3,107,115,019 | $3,107,115,019 |
| FAMILY HEALTH PLUS | 524114 | $400,000,747 | $400,000,747 |
| FIDELIS CARE AT HOME | 524114 | $265,682,172 | $265,682,172 |
| MEDICARE ADVANTAGE | 524114 | $147,832,259 | $147,832,259 |
| CHILD HEALTH PLUS | 524114 | $112,439,534 | $112,439,534 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,945,467 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $52,945,467 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,086,015,198 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,866,741 | TotalRevenueColumnAmt |
| Exclusion | $11,866,741 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $873,370,770 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $870,219,251 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,151,519 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,151,519 | TotalRevenueColumnAmt |
| Exclusion | $3,151,519 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS | 524298 | $75,332 | $75,332 |
| PURCHASE REBATES | 524298 | $54,833 | $54,833 |
| EQUITY IN SALUS ADMINI | 900001 | $23,354 | $23,354 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $153,519 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,101,540,222 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,086,168,717 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $15,018,260 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,298,328 | TotalAmt |
| Program Services | $3,298,328 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,608 | TotalAmt |
| Program Services | $194,608 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,533,028,969 | TotalAmt |
| Program Services | $3,533,028,969 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,393,005 | TotalAmt |
| Management And General | $6,393,005 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,651,947 | TotalAmt |
| Management And General | $96,651,947 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,050,761 | TotalAmt |
| Management And General | $3,050,761 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,504,265 | TotalAmt |
| Management And General | $18,504,265 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,337,148 | TotalAmt |
| Management And General | $7,337,148 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $376,766 | TotalAmt |
| Management And General | $376,766 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,489 | TotalAmt |
| Management And General | $749,489 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,174 | TotalAmt |
| Management And General | $76,174 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $762,946 | TotalAmt |
| Management And General | $762,946 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,333,169 | TotalAmt |
| Management And General | $5,333,169 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,353,652 | TotalAmt |
| Management And General | $7,353,652 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,729,370 | TotalAmt |
| Management And General | $1,729,370 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,975,724 | TotalAmt |
| Management And General | $10,975,724 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,326,352 | TotalAmt |
| Management And General | $6,326,352 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,903,283 | TotalAmt |
| Management And General | $2,903,283 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,124 | TotalAmt |
| Management And General | $374,124 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,470 | TotalAmt |
| Management And General | $284,470 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,624,330 | TotalAmt |
| Management And General | $7,624,330 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,910 | TotalAmt |
| Management And General | $709,910 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CLAIMS PROCESSING | $12,207,287 | $0 | $12,207,287 | $0 |
| POSTAGE & SHIPPING | $4,368,770 | $0 | $4,368,770 | $0 |
| TELEPHONE EXPENSES | $2,823,477 | $0 | $2,823,477 | $0 |
| PRINTING & PUBLICATIONS | $2,562,266 | $0 | $2,562,266 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,793,683 | TotalAmt |
| Management And General | $9,793,683 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,745,794,273 | TotalAmt |
| Program Services | $3,536,521,905 | ProgramServicesAmt |
| Management And General | $209,272,368 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $497,980,561 | BOYAmt |
| EOY | $41,316,700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $806,361,520 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,408,469 | BOYAmt |
| EOY | $78,687,794 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,866,494 | BOYAmt |
| EOY | $54,343,523 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $76,826,432 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $59,545,527 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,284,770 | BOYAmt |
| EOY | $17,280,905 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,872,066 | BOYAmt |
| EOY | $408,902,367 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $30,899,686 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $462,979 | BOYAmt |
| EOY | $486,334 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,482,278 | BOYAmt |
| EOY | $16,252,278 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,205,012 | BOYAmt |
| EOY | $167,895,317 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,128,562,629 | BOYAmt |
| EOY | $1,622,426,424 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,355,014 | BOYAmt |
| EOY | $60,039,588 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,856,674 | BOYAmt |
| EOY | $18,361,843 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $485,437,850 | BOYAmt |
| EOY | $589,095,052 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $542,649,538 | BOYAmt |
| EOY | $667,496,483 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $585,249,764 | BOYAmt |
| EOY | $954,253,573 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,327 | BOYAmt |
| EOY | $676,368 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $585,913,091 | BOYAmt |
| EOY | $954,929,941 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,128,562,629 | BOYAmt |
| EOY | $1,622,426,424 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $355,745,949 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $13,301,738 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$30,837 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $537,574 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $211,811 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $537,543 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $270,351 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $353,245 | CurrentTaxYearAmt |
| Total | $1,910,524 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,432,031,556 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,911,001,018 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,401,477,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,273,848,371 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,086,015,198 | CurrentTaxYearAmt |
| Total | $13,104,373,333 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,432,569,130 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,911,212,829 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,402,014,733 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,274,118,722 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,086,368,443 | CurrentTaxYearAmt |
| Total | $13,106,283,857 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $13,106,283,857 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,565,256 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,033,312 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,022,612 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,356,791 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,866,741 | CurrentTaxYearAmt |
| Total | $40,844,712 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,565,256 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,033,312 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,022,612 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,356,791 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,866,741 | CurrentTaxYearAmt |
| Total | $40,844,712 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $189,310 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $155,394 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $296,626 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $239,217 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $153,519 | CurrentTaxYearAmt |
| Total | $1,034,066 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,439,323,696 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,917,401,535 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,409,333,971 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,283,714,730 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,098,388,703 | CurrentTaxYearAmt |
| Total | $13,148,162,635 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99680 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99600 | PublicSupportPY509Pct |
| Investment Income CY | 0.00310 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00380 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $76,174 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $76,174 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FIDELIS IS A MEMBER OF CERTAIN ASSOCIATIONS, TO WHICH IT PAYS ANNUAL DUES A PORTION OF THOSE DUES ARE DETERMINED TO BE EXPENDITURES FOR LOBBYING PURPOSES IN 2013, THAT PORTION WAS $76,174 | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,880,127 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,738,578 | DepreciationAmt |
| Book Value | $1,141,549 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,529,021 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,783,925 | DepreciationAmt |
| Book Value | $745,096 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $59,417,284 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,023,024 | DepreciationAmt |
| Book Value | $15,394,260 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,280,905 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS)-CURRENT | $245,821 |
| ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS) | $149,397,088 |
| OTHER RECEIVABLES | $18,252,406 |
| ROUNDING DIFF | $2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $167,895,317 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS PAYABLE | $571,280,596 |
| DUE TO THIRD PARTIES | $17,743,405 |
| CAPITAL LEASE PAYABLE | $71,050 |
| ROUNDING DIFF | $1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $589,095,052 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,115,007,714 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $13,301,738 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $165,754 | OtherRevenueAmt |
| Revenue Not Reported | $13,467,492 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,101,540,222 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,101,540,222 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,745,960,027 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $165,754 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $165,754 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,745,794,273 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,745,794,273 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC ("SALUS") -23,354. SALUS CONTRIBUTIONS ELIMINATED IN CONSOLIDATION -5,500. NET ASSETS RELEASED FROM RESTRICTIONS 194,608. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EQUITY INVESTMENT IN SALUS ADMINISTRATIVE SERVICES, INC ("SALUS") -23,354. SALUS CONTRIBUTIONS ELIMINATED IN CONSOLIDATION -5,500. NET ASSETS RELEASED FROM RESTRICTIONS 194,608. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (33 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2 |
|---|---|---|---|---|---|---|---|---|---|
| AMAUS HEALTH SERVICES AT THE CATHEDRAL OF IMMACULATE CONCEPTION | |||||||||
| 259 E ONONDAGA SREET | SYRACUSE | NY | 132020000 | 611548780 | 501(C)(3) | $11,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| ARCHDIOCESE OF NEW YORK | |||||||||
| 1011 FIRST AVENUE | NEW YORK | NY | 100220000 | 510453629 | 501(C)(3) | $140,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| BASSETT HEALTHCARE NETWORK | |||||||||
| 1 ATWELL ROAD | COOPERSTOWN | NY | 133260000 | 237041610 | 501(C)(3) | $10,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES NEIGHBORHOOD SERVICES | |||||||||
| 191 JORALEMON STREET 9TH FLOOR | BROOKLYN | NY | 112010000 | 112047151 | 501(C)(3) | $229,209 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF BROOKLYN & QUEENS | |||||||||
| 191 JORALEMON STREET 7TH FLOOR | BROOKLYN | NY | 112010000 | 111633548 | 501(C)(3) | $228,555 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF FULTON AND MONTGOMERY | |||||||||
| 4 NICHOLAS STREET | JOHNSTON | NY | 129050000 | 141340033 | 501(C)(3) | $5,500 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF THE DIOCESE OF ALBANY | |||||||||
| 40 NORTH MAIN AVENUE | ALBANY | NY | 122030000 | 141340033 | 501(C)(3) | $203,500 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF THE DIOCESE OF FINGER LAKES | |||||||||
| 94 EXCHANGE STREET | GENEVA | NY | 14456 | 142005241 | 501(C)(3) | $12,500 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF THE DIOCESE OF OGDENSBURG | |||||||||
| 6866 STATE HIGHWAY 37 | OGDENSBURG | NY | 136690000 | 150614025 | 501(C)(3) | $62,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER | |||||||||
| 1150 BUFFALO ROAD | ROCHESTER | NY | 14624 | 160743944 | 501(C)(3) | $58,600 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE | |||||||||
| 90 CHERRY LANE | HICKSVILLE | NY | 118010000 | 111843801 | 501(C)(3) | $183,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC CHARITIES OF THE DIOCESE OF SYRACUSE | |||||||||
| 240 EAST ONONDAGA STREET | SYRACUSE | NY | 132020000 | 150532085 | 501(C)(3) | $150,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC MEDICAL MISSION BOARD INC | |||||||||
| 10 WEST 17TH STREET | NEW YORK | NY | 100115701 | 135602319 | 501(C)(3) | $50,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC MIGRATION OFFICE | |||||||||
| 1258 65TH STREET | BROOKLYN | NY | 112190000 | 112634818 | 501(C)(3) | $244,236 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CATHOLIC RELIEF SERVICES | |||||||||
| PO BOX 17090 | BALTIMORE | MD | 212970303 | 135563422 | 501(C)(3) | $6,540 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CHARLES B WANG COMMUNITY HEALTH CENTER | |||||||||
| 268 CANAL STREET | NEW YORK | NY | 100130000 | 132739694 | 501(C)(3) | $15,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| CORTLAND-CHENANGO RURAL SERVICES | |||||||||
| 2704 LOWER CINCINNATUS ROAD PO BOX | CINCINNATUS | NY | 130400000 | 455599324 | 501(C)(3) | $11,050 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | 57 |
| CRISTO REY BROOKLYN HIGH SCHOOL | |||||||||
| 710 E 37TH STREET | BROOKLYN | NY | 112030000 | 262433224 | 501(C)(3) | $25,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF ALBANY CATHOLIC SCHOOLS | |||||||||
| 40 NORTH MAIN AVENUE | ALBANY | NY | 122030000 | 141605502 | 501(C)(3) | $50,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF BROOKLYN OFFICE OF THE SUPERINTENDENT CATHOLIC SCHOOL SUPPORT | |||||||||
| 310 PROSPECT PARK WEST | BROOKLYN | NY | 112150000 | 111631807 | 501(C)(3) | $94,250 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF BUFFALO CATHOLIC SCHOOLS | |||||||||
| 795 MAIN STREET | BUFFALO | NY | 142031250 | 160743984 | 501(C)(3) | $77,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF OGDENSBURG DEPARTMENT OF EDUCATION CATHOLIC SCHOOLS | |||||||||
| 100 ELIZABETH STREET PO BOX 369 | OGDENSBURG | NY | 136690000 | 150532120 | 501(C)(3) | $39,400 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF ROCHESTER PARISH SUPPORT MINISTRIES | |||||||||
| 1150 BUFFALO ROAD | ROCHESTER | NY | 14624 | 160755765 | 501(C)(3) | $86,900 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF ROCKVILLE CENTRE- EDUCATION DEPARTMENT | |||||||||
| 50 NORTH PARK AVENUE PO BOX 9023 | ROCKVILLE CENTRE | NY | 115719023 | 111837437 | 501(C)(3) | $60,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| DIOCESE OF SYRACUSE- CATHEDRAL ACADEMY OF POMPEI | |||||||||
| 240 EAST ONONDAGA STREET | SYRACUSE | NY | 132020000 | 204325029 | 501(C)(3) | $39,350 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| ELLIS HOSPITAL FOUNDATION | |||||||||
| 1101 NOTT STREET | SCHENECTADY | NY | 123010000 | 141338428 | 501(C)(3) | $10,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| FRANSISCAN NORTHSIDE MINISTRIES | |||||||||
| 812 NORTH SALINA STREET | SYRACUSE | NY | 132080000 | 150532104 | 501(C)(3) | $15,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| MATERNITY AND EARLY CHILDHOOD FOUNDATION INC | |||||||||
| 40 NORTH MAIN AVENUE | ALBANY | NY | 122030000 | 141650131 | 501(C)(3) | $50,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| THE ALFRED E SMITH MEMORIAL FOUNDATION | |||||||||
| 1011 FIRST AVENUE | NEW YORK | NY | 100220000 | 131553263 | 501(C)(3) | $142,500 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| THE FOUNDATION OF THE ROMAN CATHOLIC DIOCESE OF BUFFALO | |||||||||
| 795 MAIN STREET | BUFFALO | NY | 142030000 | 161517131 | 501(C)(3) | $211,000 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| WILLIAM F RYAN COMMUNITY HEALTH CENTER | |||||||||
| 110 WEST 97TH STREET | NEW YORK | NY | 10025 | 132884976 | 501(C)(3) | $7,500 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |
| MISCELLANEOUS NEW YORK AREA DIOCESAN GRANTS | |||||||||
| 95-25 QUEENS BOULEVARD | REGO PARK | NY | 113744570 | 501(C)(3) | $716,538 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | ||
| GRANTS 5000 | |||||||||
| 95-25 QUEENS BOULEVARD | REGO PARK | NY | 113744570 | $53,200 | CASH | SEE PURPOSE OF GRANTS IN SCHEDULE O. | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 32 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | HEALTHY KIDS FUND | GrantTypeTxt |
| Recipient | 24124 | RecipientCnt |
| Cash Grant | $194,608 | CashGrantAmt |
| Valuation Method Used | CASH PAID | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | RECIPIENTS OF GRANT AWARDS UNDER THE COMMUNITY GRANT FUND ARE REQUIRED TO PROVIDE PERIODIC UPDATES ON THE ACCOMPLISHMENTS OF THE GRANT AND DISBURSEMENTS. IT IS THE RESPONSIBILITY OF THE GRANT RECIPIENT TO ENSURE THAT THE GRANT IS USED FOR THE PURPOSE(S) STATED IN THE ORIGINAL APPLICATION. FIDELIS MONITORS GRANT USAGE BY CORRESPONDENCE, TELEPHONE OR SITE VISITS. AN EVALUATION OF THE PROJECT IS REQUIRED UPON THE GRANTEE'S COMPLETION. NON-COMPLIANCE WITH THESE GUIDELINES MAY RESULT IN A REQUEST FOR RETURN OF THE FUNDS IN QUESTION OR INELIGIBILITY OF THE ORGANIZATION FOR FUTURE GRANTS FROM FIDELIS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK J FRAWLEY | ||||||||||||||
| PRESIDENT & CEO | $870,926 | $0 | $0 | $0 | $1,315,487 | $0 | $17,834 | $0 | $68,098 | $0 | $2,272,345 | $0 | $0 | $0 |
| THOMAS HALLORAN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $353,657 | $42,346 | $85,111 | $9,457 | $26,050 | $900 | $233,872 | $1,783 | $32,401 | $2,486 | $731,091 | $56,972 | $0 | $0 |
| DAVID THOMAS | ||||||||||||||
| EVP & COO | $438,947 | $37,817 | $97,194 | $7,881 | $439,086 | $17,073 | $16,496 | $1,338 | $41,876 | $2,475 | $1,033,599 | $66,584 | $0 | $0 |
| SANJIV SHAH MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $276,782 | $42,500 | $49,593 | $7,085 | $25,825 | $1,125 | $122,363 | $2,229 | $23,007 | $2,827 | $497,570 | $55,766 | $0 | $0 |
| PAMELA HASSEN | ||||||||||||||
| CHIEF MARKETING OFFICER | $265,787 | $0 | $64,213 | $0 | $32,390 | $0 | $191,792 | $0 | $20,863 | $0 | $575,045 | $0 | $0 | $0 |
| MARTIN KREBS | ||||||||||||||
| CHIEF INF. OFFICER | $266,262 | $0 | $58,861 | $0 | $26,684 | $0 | $101,708 | $0 | $26,156 | $0 | $479,671 | $0 | $0 | $0 |
| SANTO RUSSO | ||||||||||||||
| CHIEF LEGAL OFFICER | $243,463 | $28,423 | $48,159 | $5,351 | $10,786 | $900 | $92,770 | $1,783 | $29,503 | $2,083 | $424,681 | $38,540 | $0 | $0 |
| THOMAS BROWN | ||||||||||||||
| CHIEF ADMIN OFFICER | $222,678 | $0 | $0 | $0 | $7,602 | $0 | $0 | $0 | $1,003 | $0 | $231,283 | $0 | $0 | $0 |
| ROBERT WICKS | ||||||||||||||
| VP MEDICAL DIRECTOR | $232,213 | $0 | $48,750 | $0 | $29,181 | $0 | $17,834 | $0 | $2,023 | $0 | $330,001 | $0 | $0 | $0 |
| ROBERT FAZZOLARI | ||||||||||||||
| VP GOV'T REL & CORP COMP | $244,186 | $0 | $38,637 | $0 | $23,690 | $0 | $17,833 | $0 | $8,922 | $0 | $333,268 | $0 | $0 | $0 |
| PAMELA WILKES | ||||||||||||||
| VP NETWORK DEVELOPMENT | $227,656 | $0 | $39,000 | $0 | $26,810 | $0 | $17,833 | $0 | $7,452 | $0 | $318,751 | $0 | $0 | $0 |
| JAMES M BURNOSKY | ||||||||||||||
| VP STRATEGIC PLAN & DEV | $159,135 | $47,828 | $30,673 | $7,668 | $24,390 | $0 | $14,266 | $3,567 | $15,957 | $1,695 | $244,421 | $60,758 | $0 | $0 |
| ANNE C KONTOPOULOS | ||||||||||||||
| AVP, FINANCE | $199,076 | $0 | $37,508 | $0 | $23,690 | $0 | $17,833 | $0 | $14,624 | $0 | $292,731 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | SERP COMPENSATION OF OFFICERS OR KEY EMPLOYEES: PATRICK J. FRAWLEY - $1,281,507*; DAVID THOMAS - $429,209* THOMAS HALLORAN - $217,822**; PAMELA HASSEN - $173,958**; SANJIV SHAH - $106,759**; MARTIN KREBS - $83,875**; SANTO RUSSO - $76,720**; *THE ABOVE AMOUNTS INCLUDE GROSS-UP TAXES PAID ON BEHALF OF THE PARTICIPANTS. **THESE REPRESENT NON-VESTED SERP BENEFITS. |
| PART I, LINE 7 | PERFORMANCE-BASED INCENTIVES ARE PAID AS PART OF THE PLAN'S ANNUAL INCENTIVE PROGRAM. THE PRESIDENT & CHIEF EXECUTIVE OFFICER DOES NOT PARTICIPATE IN ANY INCENTIVE PROGRAM. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| THOMAS DESTEFANO | |||
| DIRECTOR | $751,634 | MED. CLAIMS | 0 |
| THOMAS DESTEFANO | |||
| DIRECTOR | $7,072,857 | MED. CLAIMS | 0 |
| SANJIV SHAH MD | |||
| KEY EMPLOYEE/CHIEF | $12,110,740 | MED. CLAIMS | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: 1) THOMAS DESTEFANO2) THOMAS DESTEFANO3) SANJIV SHAH, MD(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION:1) DIRECTOR2) DIRECTOR3) KEY EMPLOYEE/CHIEF MEDICAL OFFICERSCHEDULE L, PART IVDESCRIPTION OF TRANSACTION: MED. CLAIMS PAYMENTS TO THE FOLLOWING:1) CATHOLIC CHARITIES NEIGHBORHOOD SERVICES, INC.2) FAMILY HOME CARE OF DIOCESE OF BROOKLYN 3) NORTH SHORE UNIVERSITY HOSPITAL | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | DESCRIPTION OF ORGANIZATION MISSION: TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES TO THE COMMUNITY, ESPECIALLY TO THE POOR AND UNDERSERVED; TO PROMOTE HEALTH EDUCATION AND PREVENTATIVE MEDICINE. |
| EXPLANATION FOR AMENDED RETURN FILED ON AUGUST 13, 2014 | (FORM 990, PAGE 1, SECTION B): IN ACCORDANCE WITH IRS GUIDELINES AND BEFORE THE STATUTORY DUE DATE OF AUGUST 15, 2014, FIDELIS IS SUBMITTING A SUPERSEDED FORM 990 AS AN AMENDED FILING TO REPLACE THE 2013 FORM 990 FILED ON AUGUST 11, 2014 WHICH WAS NOT THE VERSION INTENDED FOR SUBMISSION. THE AMENDED FORM 990 REFLECTS THE INTENDED VERSION WHICH INCLUDES UPDATED INFORMATION RELATED TO THE NUMBER OF INDEPENDENT BOARD MEMBERS AND BOARD MEMBER HOURS, THE CLASSIFICATION OF CERTAIN ASSETS IN PART X, NET ASSET ADJUSTMENTS MADE IN PART XI AND SCHEDULE O, AND THE PRESENTATION OF A DIOCESAN GRANT IN SCHEDULE I. |
| FORM 990, PART III, LINE 1 | DESCRIPTION OF ORGANIZATION MISSION: THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("FIDELIS" OR "THE PLAN") STRIVES TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES FOR ALL; TO JOIN IN PARTNERSHIP WITH HEALTH PROFESSIONALS TO ASSIST THEM IN THEIR HEALING WORK; TO ACT AS A FACILITATOR TO BUILD LINKAGES AND SYSTEMS FOR THE COORDINATION OF CARE AND SERVICES AMONG HEALTHCARE, BEHAVIORAL AND SOCIAL SERVICES, AS WELL AS EDUCATORS AND RELIGIOUS LEADERS, TO ADDRESS THE SPIRITUAL, EMOTIONAL AND PHYSICAL NEEDS OF THOSE WE SERVE; TO ADVOCATE FOR A HEALTH POLICY THAT ACCORDS TRUE DIGNITY AND RESPECT FOR ALL HUMAN PERSONS, ESPECIALLY THE POOR AND UNDERSERVED. AS OF DECEMBER 31, 2013, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF BENEFICIARIES OF THE MEDICAL ASSISTANCE PROGRAM ("MEDICAID"), APPROXIMATELY 725,000, THE CHILD HEALTH PLUS BENEFICIARIES, APPROXIMATELY 66,200, A PROGRAM FOR LOW INCOME UNINSURED CHILDREN, THE FAMILY HEALTH PLUS BENEFICIARIES, APPROXIMATELY 106,000, A MEDICAID PROGRAM FOR LOW INCOME, UNINSURED FAMILIES, MEDICARE/DUAL ADVANTAGE PROGRAM BENEFICIARIES, APPROXIMATELY 16,100, A PROGRAM FOR THE ELDERLY, AND FIDELIS CARE AT HOME MANAGED LONG-TERM CARE PROGRAM BENEFICIARIES, APPROXIMATELY 7,600, A PROGRAM FOR RESIDENTS WHO NEED LONG-TERM CARE SERVICES AND ARE ELIGIBLE FOR MEDICAID. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ORGANIZATION SHALL BE LIMITED TO THE DIOCESAN BISHOPS OF THE STATE AND THE ECCLESIASTICAL PROVINCE OF NEW YORK. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION IS A MEMBERSHIP CORPORATION UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW (THE "N-PCL") THE ORGANIZATION'S MEMBERS ELECT ITS BOARD OF DIRECTORS AND, AS MEMBERS OF A NEW YORK NOT-FOR-PROFIT CORPORATION, POSSESS CERTAIN OTHER POWERS UNDER THE N-PCL. FURTHERMORE, THE ORGANIZATION'S BY-LAWS, WHICH ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYSDOH"), DEFINE THE FOLLOWING RESERVED POWERS OF THE MEMBERS: (I) THE INTERPRETATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES TO WHICH THE ORGANIZATION, AS A FAITH-BASED ORGANIZATION, IS SUBJECT; (II) APPROVAL OF THE MISSION STATEMENT; (III) STANDING TO ENSURE THE ORGANIZATION'S COMPLIANCE WITH ITS PHILOSOPHY AND MISSION STATEMENT; (IV) APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S CERTIFICATE OF INCORPORATION AND BY-LAWS; (V) APPROVAL OF TRANSACTIONS INVOLVING REAL PROPERTY; (VI) APPROVAL OF CERTAIN ACTIONS BY THE ORGANIZATION WHEN ACTING AS A SHAREHOLDER OR MEMBER OF ANOTHER ENTITY; (VII) APPROVAL OF THE ACCEPTANCE AND ISSUANCE OF SUBVENTIONS; (VIII) APPROVAL OF ANY MERGER, DISSOLUTION OR CONSOLIDATION, (IX) REMOVAL OF DIRECTORS AND CERTAIN OFFICERS OF THE CORPORATION; (X) APPROVAL OF THE ELECTION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, AND (XI) REVIEW OF THE AUDITED FINANCIAL STATEMENTS. CERTAIN OF THESE POWERS ALREADY EXIST BY VIRTUE OF THE N-PCL (E.G., THE POWER TO APPROVE ANY MERGER, DISSOLUTION OR CONSOLIDATION UNDER N-PCL 903(A)(2) & 1002(A)) |
| FORM 990, PART VI, SECTION A, LINE 7B | PLEASE SEE LINE 11 NARRATIVE. |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE FORM 990 PREPARED BY THE ORGANIZATION'S FINANCE DEPARTMENT IS REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER, IN COLLABORATION WITH THE ORGANIZATION'S OUTSIDE INDEPENDENT TAX ADVISORS. THEREAFTER, THE ORGANIZATION'S PRESIDENT & CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER REVIEW THE DRAFT FORM 990 WITH CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AUTHORIZED THE EXECUTIVE COMMITTEE OF THE BOARD TO REVIEW AND ACCEPT THE DRAFT FORM 990 BEFORE ITS FILING WITH THE IRS. ACCORDINGLY, AFTER THE ORGANIZATION'S MANAGEMENT HAS COMPLETED ITS REVIEW OF THE DRAFT FORM 990, IT IS CIRCULATED IN DRAFT FOR REVIEW, COMMENT AND APPROVAL TO THE MEMBERS OF THE EXECUTIVE COMMITTEE. ONCE ANY COMMENTS HAVE BEEN INCORPORATED AND THE FORM 990 HAS BEEN ACCEPTED BY THE EXECUTIVE COMMITTEE, A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE ORGANIZATION'S OFFICERS, DIRECTORS AND SENIOR EXECUTIVES ARE PROVIDED WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND AN ACKNOWLEDGEMENT FORM. THESE INDIVIDUALS ARE INSTRUCTED TO SIGN AND RETURN THE FORM, (A) TO ACKNOWLEDGE THAT THEY HAVE REVIEWED THE POLICY AND (B) TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS. THE CONFLICTS OF INTEREST POLICY DEFINES "DISCLOSABLE INTERESTS," I.E., THOSE INTERESTS THAT AN INDIVIDUAL COVERED BY THE POLICY MUST HAVE IN ANOTHER ENTITY IN ORDER FOR A TRANSACTION BETWEEN THE ORGANIZATION AND THAT ENTITY TO BE COVERED BY THE POLICY. THE POLICY ALSO DEFINES THE TYPES OF TRANSACTIONS BETWEEN THE ORGANIZATION AND ANOTHER ENTITY INVOLVING AN INDIVIDUAL COVERED BY THE POLICY THAT IS SUBJECT TO BY THE POLICY. THE POLICY REQUIRES DISCLOSURE TO THE BOARD OF DIRECTORS AND/OR THE EXECUTIVE COMMITTEE BY ANY PERSON WITH A DISCLOSABLE INTEREST IN A TRANSACTION AS DEFINED IN THE POLICY OF ALL CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. INITIALLY, AFTER THE INTERESTED INDIVIDUAL HAS RECUSED HIMSELF, THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE DETERMINES WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE DECIDES WHETHER TO ENTER INTO THE TRANSACTION BASED ON ITS DETERMINATION OF WHETHER (A) A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, (B) THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND (C) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | OUTSIDE COUNSEL FOR THE ORGANIZATION, A NATIONAL LAW FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, HAS ADVISED FIDELIS AS TO WHICH EMPLOYEES ARE DISQUALIFIED PERSONS WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EMPLOYS A COMPENSATION CONSULTANT FIRM, A NATIONAL HUMAN RESOURCES CONSULTING FIRM WITH EXPERTISE IN ADVISING TAX-EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, TO PREPARE ANNUALLY A DETAILED REPORT ON THE PROPOSED COMPENSATION FOR THE ORGANIZATION'S DISQUALIFIED PERSONS THAT INCLUDES DATA AS TO COMPARABLE COMPENSATION FOR SIMILAR QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY-SITUATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH HAS BEEN AUTHORIZED BY THE BOARD TO REVIEW AND APPROVE ALL MATTERS CONCERNING EXECUTIVE COMPENSATION, IS PROVIDED WITH THE COMPENSATION CONSULTANT'S DETAILED EXECUTIVE COMPENSATION REPORT. THE REVIEW AND APPROVAL OF THE COMPENSATION OF THE ORGANIZATION'S DISQUALIFIED PERSONS IS ACCOMPLISHED IN TWO PHASES: FIRST WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER AND THEN WITH RESPECT TO ALL OTHER DISQUALIFIED PERSONS, NAMELY, (I) THE EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER, (II) THE CHIEF FINANCIAL OFFICER, (III) THE CHIEF LEGAL OFFICER AND (IV) THE CHIEF MEDICAL OFFICER. FIRST, THE AFOREMENTIONED OUTSIDE COUNSEL AND HUMAN RESOURCES CONSULTING FIRM, AT THE INVITATION OF THE EXECUTIVE COMMITTEE, REVIEW WITH THE COMMITTEE THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO RETAINS THE SERVICES OF A SECOND HUMAN RESOURCES CONSULTING FIRM TO ASSIST IN ITS EVALUATION OF THE PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE FULL REVIEW OF THE COMPENSATION AND PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER IS PERFORMED BY THE EXECUTIVE COMMITTEE AT LEAST BI-ANNUALLY. AFTER ESTABLISHING THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, THE EXECUTIVE COMMITTEE REPORTS ON ITS DELIBERATIONS AND DETERMINATIONS TO THE ORGANIZATION'S BOARD OF DIRECTORS. SECOND, THE EXECUTIVE COMMITTEE REVIEWS THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS WITH THE ASSISTANCE OF THE SAME OUTSIDE COUNSEL AND COMPENSATION CONSULTANTS PARTICIPATING IN THE REVIEW OF THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE DETERMINES WHETHER TO APPROVE THE COMPENSATION ANALYSIS AND CONCLUSIONS CONTAINED IN THE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS. AFTER CONSULTING WITH OUTSIDE COUNSEL, THE EXECUTIVE COMMITTEE HAS DESIGNATED THE PRESIDENT & CHIEF EXECUTIVE OFFICER TO SERVE AS AN "AUTHORIZED BODY" AS CONTEMPLATED BY THE EXCESS BENEFIT TRANSACTION REGULATIONS FOR THE PURPOSE OF SETTING THE COMPENSATION OF THOSE DISQUALIFIED PERSONS WITHIN AN APPROVED RANGE. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS FOR ALL DISQUALIFIED PERSONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION IS A NEW YORK NOT-FOR-PROFIT CORPORATION. ITS CERTIFICATE OF INCORPORATION IS READILY AVAILABLE TO THE GENERAL PUBLIC FROM THE NEW YORK STATE DEPARTMENT OF STATE UNDER THE NEW YORK FREEDOM OF INFORMATION LAW ("FOIL"). ITS CERTIFICATE OF INCORPORATION AND BY-LAWS ARE ALSO ON FILE WITH THE NYSDOH AND LIKEWISE AVAILABLE TO THE GENERAL PUBLIC UNDER FOIL. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO ENROLLEES IN ITS MEDICAID AND FAMILY HEALTH PLUS PROGRAMS AND TO INDIVIDUALS CONSIDERING BECOMING ENROLLEES BY INCLUDING IN THE MEMBER HANDBOOKS FOR BOTH PROGRAMS, WHICH ARE PROVIDED TO ENROLLEES AND ARE ACCESSIBLE ON THE ORGANIZATION'S WEB SITE, A STATEMENT THAT THE FINANCIAL STATEMENTS (AS WELL AS OTHER INFORMATION DESCRIBED IN THE HANDBOOKS) ARE AVAILABLE UPON REQUEST BY CALLING A TOLL-FREE NUMBER PROVIDED IN THE HANDBOOKS. |
| FORM 990, PART VII: | AVG HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: AVG. HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: THE FOLLOWING INDIVIDUALS DEVOTE A PERCENTAGE OF THEIR TIME TO SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED ORGANIZATION, AS DETAILED BELOW: DAVID THOMAS, EVP & COO - 7.5% THOMAS HALLORAN, CHIEF FINANCIAL OFFICER - 10% SANJIV SHAH, MD, CHIEF MEDICAL OFFICER - 12.5% SANTO RUSSO, CHIEF LEGAL OFFICER - 10% JAMES M. BURNOSKY, VP STRATEGIC PLANNING & DEVELOPMENT - 10% THIS ARRANGEMENT IS COVERED BY AN EMPLOYEE SERVICE AGREEMENT BETWEEN FIDELIS AND SALUS. |
| FORM 990, PART IX, LINE 12 | THE ORGANIZATION'S LINE 12, ADVERTISING AND PROMOTION EXPENSES INCLUDE PAYMENTS TO OTHER EXEMPT ORGANIZATIONS IN SUPPORT OF THEIR CHARITABLE PURPOSES, TO BENEFIT THE COMMUNITY, OR IN SPONSORSHIP OF THEIR FUNDRAISING EVENTS. THE EXPENDITURES INCLUDE THE AMOUNT PAID TO THE FOLLOWING: THANKSGIVING CONTRIBUTION TO NEEDY: $128,095 OTHER CHARITABLE CONTRIBUTIONS LESS THAN $5,000: $24,218. |
| FORM 990, PART XI, LINE 9: | HPA K-1 ACTIVITY REFLECTED IN PRIOR RETURN -30,837. |
| FORM 990 SCHEDULE I, PART II COL H: | SINCE 2004 THE PURPOSE OF THE FIDELIS CARE COMMUNITY GRANT FUND IS TO OFFER SUPPORT ANNUALLY THROUGH CHARITABLE CONTRIBUTIONS TO SELECTED TAX-EXEMPT NONPROFIT ORGANIZATIONS THAT SHARE SIMILAR MISSIONS AND VALUES OF SERVICE TO LOW-INCOME VULNERABLE INDIVIDUALS. PROPOSALS ARE EVALUATED ON THEIR RELEVANCE TO FIDELIS' MISSION OF CARING FOR THE NEEDS AND CONCERNS OF THE POOR AND MEDICALLY UNDERSERVED IN CONSULTATION WITH FIDELIS' MEMBERS. THE TOTAL AMOUNT TO BE DISTRIBUTED EACH YEAR IS APPROVED BY THE BOARD OF DIRECTORS AND DISTRIBUTED IN ACCORDANCE WITH THE APPROVED BOARD POLICY. IN ADDITION TO THE GRANTS MADE THROUGH ITS COMMUNITY GRANT FUND, FIDELIS PROVIDES SUPPORT THROUGH CHARITABLE CONTRIBUTIONS THROUGH ITS CATHOLIC SCHOOLS GRANT INITIATIVE TO SELECTED CATHOLIC SCHOOLS OR DIOCESAN SCHOOL SYSTEMS IN THEIR EFFORT TO IMPROVE THE HEALTH STATUS OF CHILDREN AND THEIR FAMILIES. LASTLY, FIDELIS MAKES CHARITABLE DONATIONS TO ORGANIZATIONS CLASSIFIED AS TAX-EXEMPT NONPROFIT ORGANIZATIONS UNDER STATE AND FEDERAL LAW THAT WORK WITH FIDELIS TO SUPPORT THE PLAN'S MISSION. |
| NOT APPLICABLE QUESTIONS: | TO THE EXTENT THAT A QUESTION ON THE FORM 990 HAS BEEN LEFT BLANK, THE RESPONSE TO THIS QUESTION SHOULD BE NOT APPLICABLE. DUE TO SOFTWARE LIMITATIONS, FIDELIS COULD NOT PROPERLY RESPOND TO THE RESPECTIVE QUESTION AS N/A. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALUS ADMINISTRATIVE SERVICES INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95-25 QUEENS BOULEVARD | AddressLine1 |
| City | REGO PARK | City |
| State | NY | State |
| ZIP Code | 11374 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550878053 | EIN |
| Primary Activities | THIRD PARTY ADMINISTRATOR | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FIDELIS CARE NEW YORK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $3,775,691 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $32,275,954 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SALUS ADMINISTRATIVE SERVICES INC | ||
| L | $3,775,691 | CASH |
| SALUS ADMINISTRATIVE SERVICES INC | ||
| N | $255,436 | CASH |
| SALUS ADMINISTRATIVE SERVICES INC | ||
| O | $3,429,801 | CASH |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V | FormAndLineReferenceDesc |
| Explanation | SCHEDULE R, PART V RELATED PARTY TRANSACTIONS: FIDELIS REPORTS CERTAIN RELATED PARTY TRANSACTIONS BETWEEN ITSELF AND SALUS ADMINISTRATIVE SERVICES, INC. ('SALUS'), A RELATED PARTY, ON SCHEDULE R, PART V. THE METHODS USED FOR DETERMINING THE AMOUNTS REPORTED DIFFER BASED ON THE TYPE OF TRANSACTION BUT ARE ALL CONTAINED IN WRITTEN CONTRACTS BETWEEN THE TWO PARTIES. SALUS REPORTS A PERFORMANCE OF SERVICES TO FIDELIS. THE WRITTEN AGREEMENT SPECIFIES A FIXED DISPENSING FEE PER PHARMACY CLAIM PROCESSED. THE FEE IS AN ESTIMATE DESIGNED TO COVER DIRECT AND INDIRECT COSTS AS WELL AS A MODEST AMOUNT OF PROFIT. THE AMOUNT IS DEEMED CONSISTENT WITH AN INDEPENDENT THIRD PARTY TRANSACTIONS. FIDELIS REPORTS A SHARING OF FACILITIES, EQUIPMENT, AND OTHER ASSETS. THE OVERHEAD AND ADMINISTRATIVE COSTS ARE ALLOCATED BASED ON THE SHARE OF FACILITIES AND ASSETS SALUS IS DEEMED TO USE. FIDELIS SHARES PAID EMPLOYEES WITH SALUS. FIDELIS ALLOCATES SALARIES FOR EACH EMPLOYEE BASED ON THE PERCENTAGE OF TOTAL HOURS SPENT PROVIDING SERVICES TO SALUS. | ExplanationTxt |
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