AFFINITY HEALTH PLAN INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- AFFINITY HEALTH PLAN INC (EIN 13-3330672)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-07
- IRS object ID
- 201303119349301305
- Schema version
- 2012v2.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-07T10:28:36-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2600 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133330672 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AFFINITY HEALTH PLAN INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MARK CORCORAN | InCareOfName |
| Name Control | AFFI | NameControl |
| Phone | 7187947700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 Halsey Street | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Bronx | City |
| State | NY | State |
| ZIP Code | 10461 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Mark T Corcoran | Name |
| Title | EVP & CFO | Title |
| Date Signed | 2013-11-07 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3176811000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1252503321 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.affinityplan.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | IMPROVE THE HEALTH OF UNDERSERVED POPULATIONS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1000 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 960026373 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1148928908 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2878629 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2259911 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 443960 | OtherRevenuePriorYear |
| Other Revenue Current Year | 95422 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 963348962 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1151284241 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 53099979 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 59599892 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 909071062 | OtherExpensePriorYear |
| Other Expenses Current Year | 1102793425 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 962171041 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1162393317 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1177921 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -11109076 | RevenuesLessExpensesCY |
| Total Assets BOY | 267641300 | TotalAssetsBOY |
| Total Assets EOY | 277981903 | TotalAssetsEOY |
| Total Liabilities BOY | 127385932 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 147194218 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 140255368 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 130787685 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MISSION OF AFFINITY HEALTH PLANS IS TO IMPROVE THE HEALTH OF UNDERSERVED POPULATIONS BY PROVIDING COMPREHENSIVE, AFFORDABLE, HIGH QUALITY HEALTH CARE COVERAGE, AND BY STRIVING, IN COLLABORATION WITH ITS PRIMARY CARE PROVIDERS, TO IMPROVE CARE SEEKING AND CARE GIVING. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 893813733 | Expense |
| Grants | 0 | Grants |
| Revenue | 948687764 | Revenue |
| Description | AFFINITY HEALTH PLAN'S MEDICAID PROGRAM IS FUNDED BY THE STATE OF NY TO MANAGE THE HEALTHCARE AND RELATED COSTS OF MEDICAID PATIENTS IN NEW YORK CITY AND THE SURROUNDING COUNTIES OF NASSAU, SUFFOLK, WESTCHESTER, ROCKLAND AND ORANGE COUNTY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 97614311 | Expense |
| Grants | 0 | Grants |
| Revenue | 109230945 | Revenue |
| Description | THE FAMILY HEALTH PLUS (FHP) PROGRAM PROVIDES HEALTH INSURANCE COVERAGE FOR LOW INCOME SINGLE ADULTS AND ADULTS WITH CHILDREN. THE FHP PROGRAM IS ADMINISTERED UNDER AGREEMENTS WITH THE NYS DEPARTMENT OF HEALTH. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 45355859 | Expense |
| Grants | 0 | Grants |
| Revenue | 54349358 | Revenue |
| Description | THE MEDICARE ADVANTAGE PROGRAM IS FUNDED BY THE STATE OF NEW YORK TO MANAGE THE HEALTHCARE AND RELATED COSTS OF MEDICARE PATIENTS WHO LIVE IN ONE OF THE FIVE BOROUGHS OF NEW YORK CITY. AFFINITY'S MEDICARE ADVANTAGE PROGRAM INCLUDES AFFINITY MEDICARE ULTIMATE AND AFFINITY MEDICARE SOLTIONS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 26949001 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 36660841 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 1063732903 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 6677 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 1000 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARK CORCORAN | NamePerson |
| Telephone Number | 7187947700 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 HALSEY STREET | AddressLine1 |
| City | BRONX | City |
| State | NY | State |
| ZIP Code | 10461 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Amy Knapp | ||||||||
| Trustee | 1.0 | X | ||||||
| Lynn Sherman | ||||||||
| Trustee | 1.0 | X | ||||||
| Verona Greenland | ||||||||
| Trustee | 1.0 | X | ||||||
| Yvette Walker MD | ||||||||
| Trustee | 1.0 | X | ||||||
| Robert Schiller | ||||||||
| Trustee | 1.0 | X | ||||||
| Paloma Hernandez | ||||||||
| Trustee | 1.0 | X | ||||||
| Caleb DesRosiers | ||||||||
| Trustee | 1.0 | X | ||||||
| Nanette Falkenberg | ||||||||
| Trustee | 1.0 | X | ||||||
| Craig Keyes MD | ||||||||
| Trustee | 1.0 | X | ||||||
| John Sardelis | ||||||||
| Trustee | 1.0 | X | ||||||
| James Hooley | ||||||||
| Trustee | 1.0 | X | ||||||
| Bertran L Scott | ||||||||
| President & CEO (Beg. 11/12) | 37.5 | X | 131820 | 0 | 5197 | |||
| Mark T Corcoran | ||||||||
| EVP & CFO | 37.5 | X | 291748 | 0 | 43396 | |||
| Maura Bluestone | ||||||||
| President & CEO (Term. 12/12) | 37.5 | X | 420065 | 0 | 53256 | |||
| Robert Brown | ||||||||
| EVP & COO | 37.5 | X | 301886 | 0 | 20794 | |||
| Munish Khaneja | ||||||||
| SVP - CMO | 37.5 | 272075 | 0 | 41146 | X | |||
| Robert C Allen | ||||||||
| SVP & CHIEF INFORMATION OFF. | 37.5 | 281869 | 0 | 41304 | X | |||
| Abenna Udochi | ||||||||
| SVP - Cust/Community Connect. | 37.5 | 232624 | 0 | 39937 | X | |||
| Caron Cullen | ||||||||
| SVP - Chief Compliance Officer | 37.5 | 225125 | 0 | 37148 | X | |||
| Ann M Van Etten | ||||||||
| VP - Corporate & HR | 37.5 | 210032 | 0 | 33899 | X | |||
| Joseph Karp | ||||||||
| Medical Director | 37.5 | 208170 | 0 | 7280 | X | |||
| Stephanie Citerman | ||||||||
| Medical Director | 37.5 | 180850 | 0 | 33629 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2756264 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 356986 | TotalOtherCompensation |
| Number Individuals GT100 K | 73 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| TMG Health Care | |||||
| PO Box 200521 | PITTSBURGH | PA | 152510521 | RETRO BILLING | 1455620 |
| Health Integrated | |||||
| 10008 N Dale Mabry Hwy | TAMPA | FL | 15251 | MGMT CONSULTING | 950285 |
| Express Script | |||||
| One Express Way HQ3W01 | ST LOUIS | MO | 63121 | ADMINISTRATIVE SVCS | 844018 |
| Green Key Resources | |||||
| 475 Park Ave S | NEW YORK | NY | 10016 | TEMP STAFFING | 813892 |
| First Choice Staffing | |||||
| 9 East 38th Street Suite 201 | NEW YORK | NY | 10016 | TEMP SERVICES | 716506 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 19 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PREMIUM REVENUE | Description |
| Business Code | 524114 | BusinessCode |
| Total Revenue Column | 1148928908 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1148928908 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1148928908 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1277082 | TotalRevenueColumn |
| Exclusion | $1,277,082 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 101094 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 89664 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 11430 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11430 | TotalRevenueColumn |
| Exclusion | $11,430 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 102112246 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 101129416 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 982830 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 982829 | TotalRevenueColumn |
| Exclusion | $982,829 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 83992 | TotalRevenueColumn |
| Related Or Exempt Function Income | 83992 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 83992 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1151284241 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1149012900 | RelatedOrExemptFunctionIncome |
| Exclusion | $2,271,341 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1699464 | Total |
| Management And General | 1699464 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45196349 | Total |
| Management And General | 45196349 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1789911 | Total |
| Management And General | 1789911 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7014528 | Total |
| Management And General | 7014528 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3899640 | Total |
| Management And General | 3899640 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 436717 | Total |
| Management And General | 436717 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 450089 | Total |
| Management And General | 450089 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331778 | Total |
| Management And General | 331778 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49009 | Total |
| Management And General | 49009 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1081233 | Total |
| Management And General | 1081233 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1677515 | Total |
| Management And General | 1677515 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121024 | Total |
| Management And General | 121024 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6285525 | Total |
| Management And General | 6285525 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 311444 | Total |
| Management And General | 311444 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235486 | Total |
| Management And General | 235486 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 981856 | Total |
| Management And General | 981856 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6293104 | Total |
| Management And General | 6293104 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 564852 | Total |
| Management And General | 564852 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| OUTPATIENT | 293754856 | 293754856 |
| PHARMACY | 205263654 | 205263654 |
| PROFESSIONAL | 183959168 | 183959168 |
| INPATIENT | 159635245 | 159635245 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241360870 | Total |
| Program Services | 221119980 | ProgramServices |
| Management And General | 20240890 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1162393317 | Total |
| Program Services | 1063732903 | ProgramServices |
| Management And General | 98660414 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100082697 | BOY |
| EOY | 78169263 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83128657 | BOY |
| EOY | 107688260 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31838346 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6293104 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25053073 | BOY |
| EOY | 25545242 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36470436 | BOY |
| EOY | 41509428 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22906437 | BOY |
| EOY | 25069710 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 267641300 | BOY |
| EOY | 277981903 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124857519 | BOY |
| EOY | 144444703 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2528413 | BOY |
| EOY | 2749515 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 127385932 | BOY |
| EOY | 147194218 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46100435 | BOY |
| EOY | 23405984 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94154933 | BOY |
| EOY | 107381701 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 140255368 | BOY |
| EOY | 130787685 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 267641300 | BOY |
| EOY | 277981903 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -11109076 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1641393 | ReconciliationUnrealizedInvest |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 94154933 | BeginningOfYearBalance |
| Contributions | 13226248 | Contributions |
| End Of Year Balance | 107381181 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 105757586 | BeginningOfYearBalance |
| Contributions | -11602653 | Contributions |
| End Of Year Balance | 94154933 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 86616257 | BeginningOfYearBalance |
| Contributions | 19141329 | Contributions |
| End Of Year Balance | 105757586 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 71789689 | BeginningOfYearBalance |
| Contributions | 14354790 | Contributions |
| Other Expenditures | -471778 | OtherExpenditures |
| End Of Year Balance | 86616257 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 79076598 | BeginningOfYearBalance |
| Contributions | 11787917 | Contributions |
| Other Expenditures | 19074826 | OtherExpenditures |
| End Of Year Balance | 71789689 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.18810 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.81190 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6744735 | OtherCostOrOtherBasis |
| Depreciation | 940378 | Depreciation |
| Book Value | 5804357 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 866228 | OtherCostOrOtherBasis |
| Depreciation | 297958 | Depreciation |
| Book Value | 568270 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24227384 | OtherCostOrOtherBasis |
| Depreciation | 5054769 | Depreciation |
| Book Value | 19172615 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 25545242 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Advances to Providers | 22595034 |
| Other Assets | 2474676 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 25069710 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE OBLIGATIONS | $2,339,826 |
| Deferred Remt | $409,689 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2749515 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 1152925633 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 1641392 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 1641392 | RevenueNotRptdF990 |
| Revenue Subtotal | 1151284241 | RevenueSubtotal |
| Total Revenue Per Form990 | 1151284241 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1162393317 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 1162393317 | ExpensesSubtotal |
| Total Expenses Per Form990 | 1162393317 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ENDOWMENT FUNDS | Identifier |
| Return Reference | SCHEDULE D, PART V, LINE 1b, column A | ReturnReference |
| Explanation | THE PLAN MUST MAINTAIN MINIMUM LEVELS OF RESTRICTED ASSETS (CONTIGENT RESERVE) AS REQUIRED BY THE NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH). THE REQUIREMENT IS RECALCULATED ANNUALLY BASED ON STATUTORY PREMIUM REVENUE FOR THE YEAR. DURING 2012, THE NYSDOH AMENDED THE REGULATIONS GOVERNING THE CONTIGENT RESERVE. THE AMENDMENT PROVIDED SPECIAL REDUCED PERCENTAGES TO BE APPLIED TO THE REVENUES FROM THE MEDICAID MANAGE CARE, CHP AND FHP PROGRAMS OFFERED BY NEW YORK STATE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark T Corcoran | ||||||||||||||
| EVP & CFO | 290716 | 0 | 0 | 0 | 1032 | 0 | 23000 | 0 | 20396 | 0 | 335144 | 0 | 0 | 0 |
| Munish Khaneja | ||||||||||||||
| SVP - CMO | 271835 | 0 | 0 | 0 | 240 | 0 | 20750 | 0 | 20396 | 0 | 313221 | 0 | 0 | 0 |
| Robert C Allen | ||||||||||||||
| SVP & CHIEF INFORMATION OFF. | 280837 | 0 | 0 | 0 | 1032 | 0 | 20750 | 0 | 20554 | 0 | 323173 | 0 | 0 | 0 |
| Abenna Udochi | ||||||||||||||
| SVP - Cust/Community Connect. | 232383 | 0 | 0 | 0 | 240 | 0 | 23046 | 0 | 16891 | 0 | 272561 | 0 | 0 | 0 |
| Caron Cullen | ||||||||||||||
| SVP - Chief Compliance Officer | 224093 | 0 | 0 | 0 | 1032 | 0 | 27257 | 0 | 9891 | 0 | 262273 | 0 | 0 | 0 |
| Ann M Van Etten | ||||||||||||||
| VP - Corporate & HR | 206983 | 0 | 0 | 0 | 3048 | 0 | 25047 | 0 | 8852 | 0 | 243931 | 0 | 0 | 0 |
| Joseph Karp | ||||||||||||||
| Medical Director | 206387 | 0 | 0 | 0 | 1783 | 0 | 6192 | 0 | 1088 | 0 | 215450 | 0 | 0 | 0 |
| Maura Bluestone | ||||||||||||||
| President & CEO (Term. 12/12) | 415621 | 0 | 0 | 0 | 4444 | 0 | 30000 | 0 | 23256 | 0 | 473321 | 0 | 0 | 0 |
| Robert Brown | ||||||||||||||
| EVP & COO | 300853 | 0 | 0 | 0 | 1032 | 0 | 19540 | 0 | 1255 | 0 | 322681 | 0 | 0 | 0 |
| Stephanie Citerman | ||||||||||||||
| Medical Director | 179818 | 0 | 0 | 0 | 1032 | 0 | 11234 | 0 | 22395 | 0 | 214479 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 0 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| CHARLES B WANG COMMUNITY HEALTH CE | |||
| SEE PART V | 1309942 | SEE PART V | false |
| MORRIS HEIGHTS HEALTH CENTER | |||
| SEE PART V | 3349744 | SEE PART V | false |
| THE INSTITUTE FOR FAMILY HEALTH | |||
| SEE PART V | 2000659 | SEE PART V | false |
| URBAN HEALTH PLAN | |||
| SEE PART V | 3601276 | SEE PART V | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | SCHEDULE L, PART IV | ReturnReference |
| Explanation | LINE 1: NAME OF INTERESTED PERSON: CHARLES B. WANG COMMUNITY HEALTH CENTER RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TRUSTEE FOR AFFINITY HEALTH PLAN, LYNN SHERMAN, ALSO SERVES AS AN OFFICER FOR THE CHARLES B. WANG COMMUNITY HEALTH CENTER. AMOUNT OF TRANSACTION: $1,309,942 DESCRIPTION OF TRANSACTION: CHARLES B. WANG COMMUNITY HEALTH CENTER IS CONTRACTED WITH AFFINITY HEALTH PLAN TO PROVIDE HEALTH CARE SERVICES TO AFFINITY'S MEMBERS AS PART OF AFFINITY'S PROVIDER NETWORK. SHARING OF ORGANIZATION'S REVENUES: NO LINE 2: NAME OF INTERESTED PERSON: MORRIS HEIGHTS HEALTH CENTER RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TRUSTEES FOR AFFINITY HEALTH PLAN, VERONA GREENLAND AND YVETTE WALKER, ALSO SERVE AS OFFICERS FOR THE MORRIS HEIGHTS HEALTH CENTER. AMOUNT OF TRANSACTION: $3,349,744 DESCRIPTION OF TRANSACTION: MORRIS HEIGHTS HEALTH CENTER IS CONTRACTED WITH AFFINITY HEALTH PLAN TO PROVIDE HEALTH CARE SERVICES TO AFFINITY'S MEMBERS AS PART OF AFFINITY'S PROVIDER NETWORK. SHARING OF ORGANIZATION'S REVENUES: NO LINE 3: NAME OF INTERESTED PERSON: THE INSTITUTE FOR FAMILY HEALTH RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TRUSTEE FOR AFFINITY HEALTH PLAN, ROBERT SCHILLER, ALSO SERVES AS AN OFFICER FOR THE INSTITUTE FOR FAMILY HEALTH. AMOUNT OF TRANSACTION: $2,000,659 DESCRIPTION OF TRANSACTION: THE INSTITUTE FOR FAMILY HEALTH IS CONTRACTED WITH AFFINITY HEALTH PLAN TO PROVIDE HEALTH CARE SERVICES TO AFFINITY'S MEMBERS AS PART OF AFFINITY'S PROVIDER NETWORK. SHARING OF ORGANIZATION'S REVENUES: NO LINE 4: NAME OF INTERESTED PERSON: URBAN HEALTH PLAN RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TRUSTEE FOR AFFINITY HEALTH PLAN, PALOMA HERNANDEZ, ALSO SERVES AS AN OFFICER FOR THE URBAN HEALTH PLAN. AMOUNT OF TRANSACTION: $3,601,276 DESCRIPTION OF TRANSACTION: THE URBAN HEALTH PLAN IS CONTRACTED WITH AFFINITY HEALTH PLAN TO PROVIDE HEALTH CARE SERVICES TO AFFINITY'S MEMBERS AS PART OF AFFINITY'S PROVIDER NETWORK. SHARING OF ORGANIZATION'S REVENUES: NO SHARING OF ORGANIZATION'S REVENUES: NO | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Other Program Services | Form 990, Part III, Line 4d | THE CHILD HEALTH PLUS (CHP) PROGRAM IS FUNDED BY THE STATE OF NEW YORK TO PROVIDE HEALTH INSURANCE COVERAGE FOR CHILDREN THAT ARE UNDER THE AGE OF 19. |
| DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 | FORM 990, PART VI, QUESTION 11B | THE FINANCIAL STAFF COMPILES THE FINANCIAL AND OTHER INFORMATION REQUIRED IN THE 990 RETURN. ERNST & YOUNG, LLP, PREPARES THE RETURN AND THE INFORMATION IS REVIEWED BY THE COMPANY'S CFO AND CONTROLLER. A FINAL COPY OF THE FORM 990 IS MADE AVAILABLE TO THE ENTIRE GOVERNING BODY BEFORE FILING. |
| DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST | FORM 990, PART VI, QUESTION 12C | 1. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO APPROPRIATE MANAGEMENT PERSONNEL, HUMAN RESOURCES OR THE CORPORATE COMPLIANCE OFFICER. 2. EMPLOYEES MUST SEEK GUIDANCE AND APPROVAL FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MAY CONSTITUTE A CONFLICT OF INTEREST. 3. MANAGEMENT, WITH PURCHASING AUTHORITY, WILL COMPLETE A RELATED PARTY QUESTIONNAIRE ANNUALLY TO IDENTIFY ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST. 4. EMPLOYEES REVIEW THE CODE OF ETHICS WHICH INCLUDES INFORMATION ON CONFLICTS OF INTEREST. IN ADDITION, EMPLOYEES ARE REQUIRED TO SIGN AN ATTESTATION THAT THEY ACKNOWLEDGE AND UNDERSTOOD THE CODE OF ETHICS. |
| OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN | FORM 990, PART VI, QUESTION 15A AND 15B | The process for determining compensation for the CEO, CFO and COO included review and approval by a Compensation Committee (the "Committee") comprised of independent directors charged with this responsibility, consideration of comparability data and contemporaneous substantiation and documentation of the deliberation and decision. Affinity Health Plan's compensation program for these positions and other officers and key employees includes established policies for job evaluation using a point factor system; merit increases; and salary actions associated with new hires, promotions, transfers and demotions. Specifically, for: a) The CEO - Compensation for the Chief Executive officer is established by the Compensation Committee and ratified by the Board of Directors of Affinity Health Plan. The Board and the Committee has established compensation terms for the CEO considering comparability data for CEO positions in similar organizations in their deliberations and decision making. These decisions are documented in accordance with legal requirements and best practices. b) Other officers and key employees - Jobs held by other officers and jobs held by key employees are evaluated using the point factor job evaluation process applicable to all jobs at Affinity Health Plan. Based on the point factor evaluation, jobs are placed in a salary grade. Merit increases are calculated through a formulaic approach based directly on the results of a formal year end performance evaluation. This program applies to all employees including other officers and key employees. Discretionary compensation decisions applicable for other officers and key employees, including promotional salary adjustments, market/equity salary adjustments and starting salaries for newly hired officers and key employees are made after review of comparability data from published sources for similar positions in the relevant labor market. Published comparability data utilized includes industry specific data. Internal data is reviewed as well with the objective of ensuring internal equity with similarly situated staff. Discretionary compensation decisions impacting those of the foregoing positions that are also deemed to be "disqualified persons" under the Internal Revenue Code (e.g., Chief Operating Officer and Chief Financial Officer) are made by the Committee (and ratified by the Board) in accordance with "intermediate sanctions safe harbor" standards utilizing the same processes as are applied to the CEO (discussed above). |
| Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public | Form 990, Part VI, Question 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| OTHER EXPENSES | FORM 990 PART IX | DESCRIPTION:OTHER MEDICAL TOTAL EXPENSES:XXX-XX-XXXX PROGRAM SERVICES:XXX-XX-XXXX FUNDRAISING: |
| OTHER EXPENSES | FORM 990 PART IX | DESCRIPTION:OTHER MISCELLANEOUS EXPENSES TOTAL EXPENSES:20240890 MANAGEMENT AND GENERAL:20240890 |
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