NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN BENEFIT ASSOCIATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN BENEFIT ASSOCIATION (EIN 02-0499340)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-06-20
- IRS object ID
- 201311719349300116
- 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 | 2013-06-20T11:22:51-05:00 | 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 | MASON & RICH PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 BICENTENNIAL SQ | AddressLine1 |
| City | CONCORD | City |
| State | NH | State |
| ZIP Code | 033014058 | 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 | 020499340 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEW HAMPSHIRE INDIVIDUAL HEALTH | BusinessNameLine1 |
| Business Name Line2 | PLAN BENEFIT ASSOCIATION | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NEWH | NameControl |
| Phone | 6032277265 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 PILLSBURY ST | AddressLine1 |
| City | CONCORD | City |
| State | NH | State |
| ZIP Code | 03301 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BETH ROBERTS | Name |
| Title | CHAIR | Title |
| Phone | 6032277265 | Phone |
| Date Signed | 2013-05-10 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LESLIE A WALKER | Name |
| Phone | 6032242000 | Phone |
| Date Prepared | 2013-05-28 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BETH ROBERTS CHAIR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 PILLSBURY ST | AddressLine1 |
| City | CONCORD | City |
| State | NH | State |
| ZIP Code | 03301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 68916515 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.NHHEALTHPLAN.ORG | WebSite |
| Type Of Organization Association | X | TypeOfOrganizationAssociation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | ESTABLISHED BY STATE STATUTE TO A) PROVIDE SUBSIDIZATION TO CARRIERS EXPERIENCING CATASTROPHIC CLAIMS IN THE INDIVIDUAL HEALTH INSURERS MARKET AND B) TO PROVIDE HEALTH INSURANCE TO NH RESIDENTS DECLINED COVERAGE IN THE PRIVATE MARKET. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 14 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 15218775 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 30318757 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20575093 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 26981514 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 26339 | InvestmentIncomePriorYear |
| Investment Income Current Year | 14683 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 35820207 | TotalRevenuePriorYear |
| Total Revenue Current Year | 57314954 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 36831817 | OtherExpensePriorYear |
| Other Expenses Current Year | 63493647 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36831817 | TotalExpensesPriorYear |
| Total Expenses Current Year | 63493647 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1011610 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -6178693 | RevenuesLessExpensesCY |
| Total Assets BOY | 14269323 | TotalAssetsBOY |
| Total Assets EOY | 14589884 | TotalAssetsEOY |
| Total Liabilities BOY | 9231066 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 15730320 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5038257 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1140436 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | ESTABLISHED BY STATE STATUTE TO A) PROVIDE SUBSIDIZATION TO CARRIERS EXPERIENCING CATASTROPHIC CLAIMS IN THE INDIVIDUAL HEALTH INSURERS MARKET AND B) TO PROVIDE HEALTH INSURANCE TO NH RESIDENTS DECLINED COVERAGE IN THE PRIVATE MARKET. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 63493647 | Expense |
| Description | THE NEW HAMPSHIRE HEALTH PLAN (NHHP) IS A STATE HIGH RISK POOL ESTABLISHED BY STATE STATUTE TO A)PROVIDE SUBSIDIZATION TO CARRIERS EXPERIENCING CATASTROPHIC CLAIMS IN THE INDIVIDUAL HEALTH INSURANCE MARKET AND B)TO PROVIDE COMPREHENSIVE HEALTH INSURANCE BENEFIT OPTIONS TO NEW HAMPSHIRE RESIDENTS WHO ARE DECLINED COVERAGE THROUGH THE PRIVATE MARKET, HAVE A PRE-QUALIFYING CONDITION OR ARE OTHERWISE ELIGIBLE. THE NHHP IS INTENDED GENERALLY TO BE THE INSURER OF LAST RESORT FOR NEW HAMPSHIRE RESIDENTS. | Description |
| Total Program Service Expense | 63493647 | TotalProgramServiceExpense |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| 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 | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | 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 | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| 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 |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| 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 |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | 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 | false | 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 | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BETH ROBERTS | NamePerson |
| Telephone Number | 6032256633 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 PILLSBURY ST | AddressLine1 |
| City | CONCORD | City |
| State | NH | State |
| ZIP Code | 03301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| BETH ROBERTS | ||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| DAVID SKY | ||||||
| DIRECTOR/COM | 1.00 | X | 0 | 0 | 0 | |
| BRUCE P KING | ||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| DAVID M ELLIS | ||||||
| VICE-CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| MARTHA MCLEOD | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| DAVID TRUDO | ||||||
| DIRECTOR/COM | 1.00 | X | 0 | 0 | 0 | |
| LISA KAPLAN HOWE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| KEITH NYHAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUSAN E DEW | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| KATHY BELANGER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LISA GUERTIN | ||||||
| DIRECTOR/COM | 1.00 | X | 0 | 0 | 0 | |
| MARK MCCUE | ||||||
| ASST SECRETA | 1.00 | X | 0 | 0 | 0 | |
| DOMENIC PAMIERI | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BRANDY MILLEN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BENEFIT MANAGEMENT INC | |||||
| 2015 16TH STREET | GREAT BEND | KS | 67530 | TPA SERVICES | 1394549 |
| ANTHEM HEALTH PLANS OF NH | |||||
| 3000 GOFFS FALLS ROAD | MANCHESTER | NH | 03111 | INS PROVIDER | 449362 |
| HELMS COMPANY | |||||
| 1 PILLSURY STREET SUITE 200 | CONCORD | NH | 03301 | MANAGEMENT | 311948 |
| LEIF ASSOCIATES | |||||
| 1515 ARAPAHOE STREET | DENVER | CO | 80202 | ACTUARY SERV | 112057 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 30318757 | GovernmentGrants |
| Total Contributions | 30318757 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| POLICYHOLDER PREMIUMS | 20000260 | 20000260 |
| MEMBER ASSESSMENTS | 6981254 | 6981254 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 26981514 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14432 | TotalRevenueColumn |
| Exclusion | $14,432 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11601812 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11601561 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 251 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 251 | TotalRevenueColumn |
| Exclusion | $251 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 57314954 | TotalRevenueColumn |
| Related Or Exempt Function Income | 26981514 | RelatedOrExemptFunctionIncome |
| Exclusion | $14,683 | ExclusionAmount |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 209979 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40052 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26526 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127498 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4468 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7153 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5188 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3309 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9900 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| CLAIM & CLAIM LOSS RESERV | 60843534 |
| ADMIN SERVICES | 1520989 |
| CARRIER SUBSIDIES | 449362 |
| AGENT REFERRAL FEES | 218800 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26889 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63493647 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 651769 | BOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5032149 | BOY |
| EOY | 2208303 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88984 | BOY |
| EOY | 45595 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6524990 | BOY |
| EOY | 10682464 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116775 | BOY |
| EOY | 122522 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1854656 | BOY |
| EOY | 1531000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14269323 | BOY |
| EOY | 14589884 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 159972 | BOY |
| EOY | 608260 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1467588 | BOY |
| EOY | 1877060 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7603506 | BOY |
| EOY | 13245000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9231066 | BOY |
| EOY | 15730320 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5038257 | BOY |
| EOY | -1140436 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5038257 | BOY |
| EOY | -1140436 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14269323 | BOY |
| EOY | 14589884 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -6178693 | ReconcilationRevenueExpenses |
| 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 B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | LOSS RESERVES | Description |
| Amount | $13,245,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 13245000 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 57314954 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 57314954 | RevenueSubtotal |
| Total Revenue Per Form990 | 57314954 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 63493647 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 63493647 | ExpensesSubtotal |
| Total Expenses Per Form990 | 63493647 | TotalExpensesPerForm990 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SEE STATEMENT BELOW - SUPPLEMENTAL | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE L PART V | ReturnReference |
| Explanation | PART IV QUESTION 28 SCH L THE ORGANIZATION IS BY STATUTE DESIGNED TO HAVE REPRESENTATIVES OF INSURANCE COMPANIES HOSPITALS AND OTHER RELATED PARTIES THEREFORE THERE ARE TRANSACTIONS AMONG THE COMPANIES FOR WHICH THE BOARD MEMBERS WORK PART VIALINE 2 THE ORGANIZATION IS BY STATUTE DESIGNED TO HAVE REPRESENTATIVES OF INSURANCE COMPANIES HOSPITALS AND OTHER RELATED PARTIES THEREFORE THERE ARE TRANSACTIONS AMONG THE COMPANIES FOR WHICH THE BOARD MEMBERS WORK | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | ESTABLISHED BY STATE STATUTE TO A) PROVIDE SUBSIDIZATION TO CARRIERS EXPERIENCING CATASTROPHIC CLAIMS IN THE INDIVIDUAL HEALTH INSURERS MARKET AND B) TO PROVIDE HEALTH INSURANCE TO NH RESIDENTS DECLINED COVERAGE IN THE PRIVATE MARKET. |
| ADDITIONAL INFORMATION | FORM 990 | NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN IS CONTRACTED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO ADMINISTER A FEDERAL HIGH RISK POOL INSURANCE PROGRAM. THE PROGRAM IS FULLY FUNDED BY THE HEALTH AND HUMAN SERVICES AND FROM PREMIUMS. NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN HAS NO LIABILITY ASSOCIATED WITH THE FEDERAL HIGH RISK POOL FOR COSTS THAT ARE IN EXCESS OF FUNDING. |
| EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS | FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS ARE ON THE BOARD OF DIRECTORS AND PERFORM EXECUTIVE DUTIES. |
| AUTHORITY DELEGATED TO COMMITTEE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 1A | THE COMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE BOARD TO THE EXTENT SET FORTH IN THE BYLAWS AND EXCEPT AS MAY BE LIMITED BY APPLICABLE LAW. THE COMMITTEE MAY FULFILL ADDITIONAL DUTIES AND ADOPT ADDITIONAL POLICIES AND PROCEDURES AS MAY BE APPROPRIATE IN LIGHT OF CHANGING BUSINESS, LEGISLATIVE, REGULATORY OR OTHER CONDITIONS. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | THE ORGANIZATION HIRES A MANAGEMENT COMPANY TO RUN ALL OF THE PROGRAMS IN THE HEALTH PLAN. THE TRUSTEES OVERSEE THE OPERATIONS OF THE MANAGEMENT COMPANY. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PRESENTED TO THE FINANCE COMMITTEE BEFORE IT IS FILED. THE FINANCE COMMITTEE REVIEWS THE RETURN FOR ACCURACY AND REPORTS ITS FINDINGS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES THE 990 BEFORE IT IS FILED. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS PART OF THE ETHICS POLICY. IT REQUIRES THAT THE ORGANIZATION PERFORM AN ANNUAL UPDATE AND DISCLOSURE. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE HELD IN CARE OF HELMS & CO., CONCORD, NH AND ARE AVAILABLE UPON REQUEST. FORM 990 IS AVAILABLE ON NHHP WEBSITE. |
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