2013-01-30T15:33:34-06:00 2011-12-31 SANDY STORM ERNST & YOUNG LLP 111 MONUMENT CIRCLE STE 2600 INDIANAPOLIS IN 462045120 990 2011-01-01 113029569 Managed Health Inc % MARYBETH TITA MANA 2128016000 100 CHURCH ST FL 18 New York NY 100072601 MARYBETH TITA 2012-08-22 Christopher Boggs 3176817000 2011 2016-02-25 16:41:14Z PATRICIA J WANG 100 CHURCH ST FL 18 NEW YORK NY 100072601 1396424059 false X www.healthfirstny.org X 1990 NY TO IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE AND COMMERCIAL RECIPIENTS. 5 3 0 0 0 0 0 1297336082 1393689527 3925107 2734532 39379 0 1301300568 1396424059 0 0 0 0 0 0 0 0 0 1284812196 1373562726 1284812196 1373562726 16488372 22861333 372234447 460949918 209200103 268306000 163034344 192643918 TO IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE AND COMMERCIAL RECIPIENTS. false false 1327137237 1393689527 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. THERE ARE OVER 65 PARTICIPATING HOSPITALS WITH MANAGED HEALTH, INC. THAT SERVED 96,890 MEDICARE AND 348 COMMERCIAL RECIPIENTS IN 2011. 1327137237 false false false false false false false false false false false false false true false true true false false false false false false false false false false false true false false false false false false false true false false false false false true true true false true 8438 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 RICHARD MURCOTT 1.0 X 0 0 0 DONALD SCANLON 1.0 X JAY A SCHECHTMAN 1.0 X X 506932 85509 ELIZABETH R ST CLAIR 1.0 X X 484057 63664 STEVE ROSENTHAL 1.0 X PATRICIA J WANG 1.0 X 1108563 219531 MARYBETH A TITA 1.0 X 465214 64541 NAHUM KIANOVSKY 1.0 X 236069 14693 DANIEL P MCCARTHY 1.0 X 673189 93316 KEITH GORDON 1.0 X 387353 63166 SEAN NATARO 1.0 X 330389 14700 ANDREA C FORINO 1.0 X 312563 56873 JOHN CHENG 1.0 X 324973 14700 REBECCA SCHWIETZ 1.0 X 323369 14700 MICHAEL HONIG 1.0 X 0 485996 114385 STEVEN SAKOVITS 0.0 X 424227 0 6062894 819778 0 true true false EXPRESS SCRIPTS 21653 NETWORK PLACE CHICAGO IL 60673 PHARMACY 112390572 LINCOLN MEDICAL AND MENTAL HEALTH C 234 EAST 149TH STREET BRONX NY 10451 MEDICAL/HOSPITAL 30959486 ST LUKES ROOSEVELT PO BOX 95000-2193 PHILADELPHIA PA 19195 MEDICAL/HOSPITAL 25598934 MONTEFIORE MEDICAL CENTER PO BOX 4296 CHURCH STREET STATION NEW YORK NY 10261 MEDICAL/HOSPITAL 87528379 NYP-COLUMBIA PRESBYTERIAN PO BOX 6154 CHURCH STREET STATION NEW YORK NY 10249 MEDICAL/HOSPITAL 22281055 559 0 MEDICARE ADVANTAGE (PART C) 524114 1266386597 1266386597 MEDICARE PRESCRIPTION DRUG COVERAGE (PART D) 524114 125800199 125800199 COMMERCIAL (INCLUDING HEALTHY NY) 524114 1502731 1502731 1393689527 2734532 2734532 0 0 0 0 0 0 0 1396424059 1393689527 2734532 0 0 0 0 0 0 0 0 0 0 163805547 117586684 46218863 0 0 0 0 0 355399 148773 206626 3074165 3074165 364448 364448 0 0 0 0 0 0 529233 529233 0 0 0 HEALTHCARE SERVICE COSTS 1186535464 1186535464 MEDICAL ADMINISTRATIVE 18993472 18993472 CLAIMS ADJUSTMENT EXPENSE -95002 -95002 1373562726 1327137237 46425489 0 0 0 39023467 32282745 0 0 80667367 50172721 0 0 0 0 0 0 0 0 0 0 0 239586053 356375649 0 0 0 0 0 0 12957560 22118803 372234447 460949918 186989573 229708251 0 0 16238 11733 0 0 0 0 0 0 0 0 0 0 22194292 38586016 209200103 268306000 X 163034344 192643918 0 0 0 0 163034344 192643918 372234447 460949918 X 22861333 6748241 X X false true true X false 0 DUE TO CMS 6765603 DUE TO MANAGEMENT COMPANY - RE 1173923 MEDICARE PART D DEPOSIT LIABIL 14831520 DUE TO 501(C)(3) AFFILIATE 1044902 NOTE PAYABLE TO RELATED PARTY 12741102 OTHER CURRENT LIABILITIES 2028966 38586016 1396424059 1373562726 22861333 -579890 7328131 6748241 29609574 1403172300 -579890 7328131 6748241 1396424059 1396424059 1373562726 1373562726 1373562726 1 PART XI, LINE 8 - OTHER ADJUSTMENTS FINANCIAL SECURITY DEPOSITS (RELEASED FROM) MEMBER HOSPITALS: (1,165,790) RETAINED HOSPITAL PAYMENTS: 8,493,921 The health care services agreements with the Members provide that payments due to each Member, as a health care provider to MHI Members, attributable to a specified initial period of enrollment of each enrollee, are retained by MHI as additional capital contributions. Members may be entitled to have their retained payments repaid in the future, without interest, upon the dissolution of MHI or similar circumstances, or with the approval of MHI's Board of Directors, subject to any restrictions by the State of New York, as detailed in such agreement. Retained payments required to be withheld by MHI totaled $8,493,921 2 PART XII, LINE 2D - OTHER ADJUSTMENTS FINANCIAL SECURITY DEPOSITS (RELEASED FROM) MEMBER HOSPITALS: (1,165,790), RETAINED HOSPITAL PAYMENTS: 8,493,921 The health care services agreements with the Members provide that payments due to each Member, as a health care provider to MHI Members, attributable to a specified initial period of enrollment of each enrollee, are retained by MHI as additional capital contributions. Members may be entitled to have their retained payments repaid in the future, without interest, upon the dissolution of MHI or similar circumstances, or with the approval of MHI's Board of Directors, subject to any restrictions by the State of New York, as detailed in such agreement. Retained payments required to be withheld by MHI totaled $8,493,921 true true false false false false false false false JAY A SCHECHTMAN 383174 122421 1337 85509 9168 601609 ELIZABETH R ST CLAIR 353522 115258 15277 63664 9058 556779 12455 PATRICIA J WANG 717447 326138 64978 219531 7998 1336092 62140 MARYBETH A TITA 340269 112244 12701 64541 13358 543113 11716 NAHUM KIANOVSKY 186086 49722 261 14693 13962 264724 MICHAEL HONIG 0 280254 101709 104033 114385 8982 0 609363 DANIEL P MCCARTHY 465257 186854 21078 93316 13962 780467 18324 KEITH GORDON 292301 80256 14796 63166 9460 459979 9030 SEAN NATARO 260032 69425 932 14700 13962 359051 ANDREA C FORINO 242648 69082 833 56873 7998 377434 STEVEN SAKOVITS 8080 96887 319260 8266 432493 JOHN CHENG 248913 75000 1060 14700 13648 353321 REBECCA SCHWIETZ 257883 65276 210 14700 13358 351427 1 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUALS ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION: STEVEN SAKOVITS TOTAL OF SEVERANCE AGREEMENT IN 2010: 488,265 SEVERANCE PAID IN 2011: 319,250 SEVERANCE DEFERRED TO 2012: 169,015 2 THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS FROM THE PLAN SPONSOR FOR 2011. Patrica J. Wang 204,831. [Col. C] Michael H. Honig 99,685. [Col. C] Daniel P. McCarthy 78,616. [Col. C] Jay A. Schechtman 70,809. [Col. C] Elizabeth R. St Clair 48,964. [Col. C] Marybeth A. Tita 49,841. [Col. C] Keith Y. Gordon 48,466. [Col. C] Andrea Forino 42,173. [Col. C] 3 SCHEDULE J, PART 1, LINE 6B A PORTION OF THE BONUS COMPENSATION RECEIVED BY OFFICERS OF THE ORGANIZATION IS CONTINGENT UPON THE NET EARNINGS OF HF MANAGEMENT SERVICES, LLC-A RELATED ORGANIZATION. HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 163805547 MANAGEMENT AND ADMIN SERVICES false HF MANAGEMENT SERVICES LLC COMMON OFFICERS/DIRECTORS 12741102 NOTES PAYABLE OUTSTANDING false 1 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. 2 FORM 990, PART VI, SECTION A, LINE 6 MANAGED HEALTH, INC. HAS A SOLE CORPORATE MEMBER, WHICH IS HEALTHFIRST, INC. 3 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. 4 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 CHANEGS REQUIRE APPROVAL FROM THE MANAGEMENT COMPANY AND STATE REGULATORS. 5 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 DIRECTOR OF TREASURY. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS ASSISTANT VICE PRESIDENT OF FINANCE, GENERAL COUNSEL 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 AND THE DIRECTORS ARE GIVEN AN OPPORTUNITY TO DISCUSS THE 990 AT A MEETING. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. 6 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. 7 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 (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. 8 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. 9 FORM 990, PART VII, SECTION A ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED 40 HOURS A WEEK FOR HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION) WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NO ALLOCATION OF TIME SPENT ON INDIVIDUAL NOT-FOR-PROFIT ENTITIES EXISTED FOR THE PERIOD COVERED BY THIS RETURN. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM THE NOT-FOR-PROFIT ENTITY. 10 FORM 990, PART XI, LINE 5 CHANGE IN UNREALIZED GAINS AND LOSSES ON INVESTMENTS: -579,890 FINANCIAL SECURITY DEPOSITS RECEIVED FROM MEMBER HOSPITALS: -1,165,790 RETAINED HOSPITAL PAYMENTS: 8,493,921 11 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 HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA RELATED false 0 false HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY HF MGMT SVCS C CORP HF PURCHASING SERVICES INC 100 CHURCH STREET 18FL NEW YORK NY 100072601 020537865 EQUIP. LEASING NY HF MGMT SVCS C CORP false false false false true false false false false false false true false false false false true false HF MANAGEMENT SERVICES LLC E 12741102 NOTES PAYABLE HF MANAGEMENT SERVICES LLC L 163805547 CONTRACTED RATE HEALTHFIRST PHSP INC Q 5900000 CONTRACT 1 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, 2011 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.