2012-08-15T14:36:30-07:00 2011-12-31 990 2011-01-01 161005419 GENESEE VALLEY GROUP HEALTH ASSOCIATION INC GENE 5855306760 165 Court Street Rochester NY 14647 Stephen LaSalle II 5855306760 2012-08-15 2011 2016-02-24 21:20:13Z Lifetime Health Medical Group Stephen C LaSalle II 165 Court Street Rochester NY 14647 128634548 0 X www.lifetimehealth.org X 1972 NY Genesee Valley Group Health Association, Inc. provides primary health care for patients in Buffalo and Rochester. A variety of services are offered at each health center and most sites to include pharmacy, laboratory, radiology, internal medicine, pediatrics, family practice and specialty care. 3 0 749 0 0 0 0 0 108054095 100062235 9738 15323 5452333 5813196 113516166 105890754 0 0 46129599 43267515 43999104 42786254 0 0 0 19622211 17570311 109750914 103624080 3765252 2266674 14614729 13688769 45079802 42373596 -30465073 -28684827 Lifetime Health Medical Group exists to guide and support you with your health needs, to work with you to improve your health, and to care for you during illness. We will do this by: being a responsive and respectful partner in your care and addressing your health needs from your perspective, developing effective relationships with other providers to assure coordination of your care, and seeking innovative solutions to continuously improve your access to quality, evidence-based health care. 0 0 103624080 0 105890754 Health Care Delivery: Health Services (Member Months = 105,399) 0 0 0 103624080 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 115 0 1 749 1 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X Stephen LaSalle 5855306760 165 Court Street Rochester NY 14647 X David H Klein 0.6 X X 0 5208428 293024 Emil D Duda 0.6 X X 0 1624101 185137 Christopher C Booth 0.6 X 0 1212343 83675 Stephen Sloan 0.6 X 0 533540 69147 Ann Ruflin 40 X 0 341974 55018 Margaret M Cassady 0.6 X 0 279036 28087 Mark F Perry 40 X 0 267777 28267 Douglas J Golding 40 X 0 231537 25875 Stephen C LaSalle 40 X 0 190468 33129 Deborah A Carlascio 40 X 0 162362 42564 Valerie Newman 40 X 403998 0 21470 Michael R Jordan 40 X 315949 0 27892 Pramila Penta 40 X 297125 0 8600 Richard Vienne 40 X 11538 262918 33691 Matthew Bartels 40 X 101079 170249 25164 James D Spencer 0 X 0 299265 44764 1129689 10783998 1005504 64 1 1 0 Cardinal Health Inc 6012 Molloy Road Syracuse NY 13211 Pharmaceutical Supplier 23395699 Eastern Niagara Radiology Associates 222 Genesee Street Buffalo NY 14203 Radiology Services 1288191 LeChase Construction Services LLC 300 Trolley Blvd Rochester NY 14606 Construction Mgmt/General Contractor 935044 NextGen Healthcare Information 18191 Von Karman Avenue Irvine CA 92612 Healthcare Software Systems 762459 Sanofi Pasteur Inc 12458 Collections Center Drive Chicago IL 60693 Pharmaceutical Supplier 675317 28 0 Capitation Revenue 621110 61001167 61001167 0 0 Fee For Service Revenue 621110 27077793 27077793 0 0 Registration Fees 621110 304356 304356 0 0 Ancillary Revenue 621110 11678919 11678919 0 0 0 0 0 0 100062235 15323 15323 0 0 0 0 0 0 0 0 0 0 439355 0 0 0 439355 0 439355 439355 0 0 0 0 28117635 22743794 5373841 5373841 0 0 0 105890754 105890754 0 0 0 0 0 0 0 0 43267515 43267515 1257783 1257783 0 0 0 0 0 0 33730235 33730235 0 0 678015 678015 0 0 4746977 4746977 0 0 2373244 2373244 0 0 4026289 4026289 0 0 123232 123232 0 0 93666 93666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1095733 1095733 0 0 2030979 2030979 0 0 1023888 1023888 0 0 0 0 0 0 3800733 3800733 0 0 161497 161497 0 0 0 0 0 0 23933 23933 0 0 64564 64564 0 0 0 0 0 0 1246000 1246000 0 0 804570 804570 0 0 Other Exp - Medical Supplies 3000333 3000333 0 0 Other Exp - Miscellaneous 74894 74894 0 0 103624080 103624080 0 0 863410 369676 0 0 0 4614089 4899967 0 0 0 2288220 2515146 679418 489607 12382716 8668976 4163429 3713740 2006163 1700633 14614729 13688769 13485434 10032449 0 0 0 0 0 0 0 31594368 32341147 45079802 42373596 X -30465073 -28684827 0 0 0 0 -30465073 -28684827 14614729 13688769 X 2266674 -486428 X 0 1 1 X 0 X 420927 0 420927 1509950 0 1395738 114212 1870557 0 558058 1312499 8581282 0 6715180 1866102 0 0 0 0 3713740 Reg 164 Trust 1700633 1700633 Post Retirement Benefits 1669207 Due To Excellus Health Plan, Inc. 19640074 Foundation Liability 5147686 Long Term Debt 5884180 32341147 105890754 103624080 2266674 0 0 0 0 0 0 2266674 125806219 0 0 0 19915465 19915465 105890754 0 0 0 105890754 123539545 0 0 0 19915465 19915465 103624080 0 0 0 103624080 SchD_P10_S00_L02 Schedule D, Part X, Line 2 The Company creates a model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing a minimum recognition threshold, which all income tax positions must achieve to meet before being recognized in the consolidated financial statements. The Company recognizes any interest and penalties related to unrecognized tax benefits within the other expenses line in the accompanying statement of activities and changes in accumulated deficit. Accrued interest and penalties are included within the accounts payable and accrued expenses in the accompanying statements of financial position. There were no interest and penalties recognized for 2011 or 2010. The Company does not anticipate any uncertain tax positions within the next twelve months. SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Pharmacy Elimination $3,512,634; Bad Debt Allowance $<1,138,983>, Pharmacy Cost of Goods Sold $<22,743,794>; Other Adjustments $454,678 SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d Pharmacy Elimination $3,512,634; Bad Debt Allowance $<1,138,983>; Pharmacy Cost of Goods Sold $<22,743,794>; Other Adjustments $454,678 0 1 1 0 0 0 0 0 0 David H Klein 0 1040735 0 1359120 0 2808573 0 275564 0 17460 0 5501452 0 Emil D Duda 0 883608 0 721875 0 18618 0 163340 0 21797 0 1809238 0 Christopher C Booth 0 730138 0 475440 0 6765 0 66018 0 17657 0 1296018 0 Stephen Sloan 0 389187 0 138187 0 6166 0 50494 0 18653 0 602687 0 0 Ann Ruflin 0 301910 0 35898 0 4166 0 36979 0 18039 0 396992 0 Margaret M Cassady 0 231938 0 45414 0 1684 0 18446 0 9641 0 307123 0 Mark F Perry 0 251071 0 16188 0 518 0 11158 0 17109 0 296044 0 0 Douglas J Golding 0 223299 0 7032 0 1206 0 10597 0 15278 0 257412 0 0 Stephen C LaSalle 0 176330 0 10644 0 3494 0 13383 0 19746 0 223597 0 0 Deborah A Carlascio 0 155598 0 5322 0 1442 0 24723 0 17841 0 204926 0 Valerie Newman 232969 0 162213 0 8816 0 5106 0 16364 0 425468 0 0 Michael R Jordan 140343 0 166230 0 9376 0 7350 0 20542 0 343841 0 0 0 Pramila Penta 247580 0 48341 0 1204 0 2284 0 6316 0 305725 0 0 0 Richard Vienne 11538 222159 0 39509 0 1250 269 17110 0 16312 11807 296340 0 0 Matthew Bartels 66232 139815 26965 29632 7882 802 2174 7660 264 15066 103517 192975 0 James D Spencer 0 206824 0 90873 0 1568 0 25646 0 19118 0 344029 0 SchJ_P01_S00_L03 Schedule J, Part I, Line 3 The CEO of the filing organization is also the CEO of a related (parent) organization. The CEO receives his compensation from the related organization. The CEO's compensation is determined in accordance with a Board of Directors approved executive compensation philosophy. The Executive Compensation process includes an evaluation of market comparables, using an external compensation consultant, and the process is approved by the Board of Directors of the related organization. The filing organization relies upon the related (parent) organization's process used to establish compensation. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Line 4b - The following persons from Part VII, Section A, Line 1a participated in a supplemental nonqualified retirement plan of a related organization: D Klein, E Duda, C Booth, S Sloan, M Cassady, A Ruflin, J Spencer, M Perry , D Golding and R Vienne. No payments were made during 2011 to any of these listed persons. Line 4c - The following persons from Part VII, Section A, Line 1a participated in an equity-based compensation arrangement of a related organization: D Klein and E Duda. No payments were made during 2011 to either of the listed persons. Excellus Health Plan Inc Parent 79814112 Revenue from Parent 0 Excellus Health Plan Inc Parent 1630677 Rental of Space 0 Excellus Health Plan Inc Parent 5371425 Mgmt Fees & Purchased Srvcs 0 SchL_P04_S00_L00 Schedule L, Part IV The filing organization has various business transactions with Excellus Health Plan Inc whose CEO is also an officer of the filing organization. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization's sole member is Excellus Health Plan, Inc. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Excellus Health Plan, Inc. may elect one or more members of the organization's governing body. This formal election (or reconfirmation of existing members of the governing body) occurs at the Excellus annual meeting in March, but can also occur (on an as needed basis) at any of its regularly scheduled meetings throughout the year. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b The sale of all or substantially all assets of the organization would require the approval of the member (Excellus Health Plan, Inc.). F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The completed IRS Form 990 was provided to the organization's Board of Directors prior to filing allowing the opportunity for review. Responses were provided to questions raised by the governing body and any comments were analyzed and incorporated as applicable. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The organization's Conflict of Interest policy is regularly and consistently enforced via a robust annual process. Annually, all employees who hold a position at the Director level or above complete the Conflict of Interest Questionnaire. New or newly promoted employees at the Director level complete the questionnaire at the time of employment or promotion. The Corporate Director of Ethical Compliance is responsible for the annual distribution, tracking, review and reporting of the Conflict of Interest or potential Conflict of Interest Questionnaires for employees of the corporation. Corporate legal counsel reviews all Conflicts of Interest or potential Conflicts of Interest and makes recommendations. All new and existing members of the Board of Directors complete a Conflict of Interest Questionnaire annually. The Vice President of Corporate Compliance and Governance is responsible for the annual distribution, tracking, review and reporting of the Conflict of Interest Questionnaires for the Board Members. Corporate legal counsel reviews all Conflicts of Interest or potential Conflicts of Interest and makes recommendations. Annually a summary report is prepared by Compliance and presented to the Corporate Board's Audit Committee. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The compensation of officers and key employees is established using compensation surveys and studies completed by Human Resources annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The governing documents, Conflict of Interest Policy, and financial statements are not made available to the public. F990_P07_S0A_L01a Form 990, Part VII, Section A, Line 1a Column B - The trustees and officers that devote time to the filing organization do so on an allocated basis as supported by a management fee agreement with a related organization. Such trustees and officers receive their compensation from a related organization which is where the majority of their time is devoted. F990_P07_S0A_L01b Form 990, Part VII, Section A, Line 1b David Klein is an Officer of several entities, some of which are listed in Schedule R. Genesee Valley Group Health Association Inc is charged for 1.5% of his salary. F990_P11_S00_L05 Form 990, Part XI, Line 5 Amortization of Net Gain/Loss - Defined Benefit Plans $<486,428> Univera Community Health Inc 165 Court Street Rochester NY 14647 161500379 Health Insurer NY 501(c)(3) 509(a)(2) Excellus Health Plan Inc 0 Genesee Region Home Care Assoc Inc 165 Court Street Rochester NY 14647 160844109 Home Health Services NY 501(c)(3) 509(a)(2) Excellus Health Plan 0 Genesee Region Home Care of Ontario County Inc 165 Court Street Rochester NY 14647 223257719 Home Health Services NY 501(c)(3) 509(a)(2) Excellus Health Plan 0 Univera IPA LLC 165 Court Street Rochester NY 14647 454058523 Independent Practice Association NY N/A Lifetime Healthcare Inc 165 Court Street Rochester NY 14647 161514675 Holding Co NY N/A C 0 Excellus Health Plan Inc 165 Court Street Rochester NY 14647 150329043 Health Insurer NY N/A C Beacon Network Services Inc 165 Court Street Rochester NY 14647 141830065 Inactive NY N/A C Excellus Acquisition Inc 165 Court Street Rochester NY 14647 141830065 Holding Co NY N/A C MedAmerica Inc 165 Court Street Rochester NY 14647 161581817 Holding Co NY N/A C Excellus Ventures Inc 165 Court Street Rochester NY 14647 161550984 Holding Co NY N/A C Upstate Professional Liability Corp 165 Court Street Rochester NY 14647 141783968 Inactive NY N/A C North Star Home Health Management Inc 165 Court Street Rochester NY 14647 161548051 Holding Co NY N/A C MedAmerica Insurance Company of NY 165 Court Street Rochester NY 14647 161310986 Long Term Care Ins NY N/A C MedAmerica Insurance Company 165 Court Street Rochester NY 14647 340977231 Long Term Care Ins PA N/A C MedAmerica Insurance Company of FL 165 Court Street Rochester NY 14647 141993330 Long Term Care Ins FL N/A C EBS-RMSCO Inc 165 Court Street Rochester NY 14647 161171765 Third Party Administrator NY N/A C 344 South Warren Street Corp 165 Court Street Rochester NY 14647 010718849 Real Estate Holding Co NY N/A C Sibley Nursing Personnel Service Inc 165 Court Street Rochester NY 14647 161447472 Home Health Service NY N/A C Support Services Alliance Inc 165 Court Street Rochester NY 14647 133033862 Benefit Plan Administrator NY N/A C Excellus Insurance Agency Inc 165 Court Street Rochester NY 14647 161588653 Insurancy Agency NY N/A C EBS-RMSCO Insurance Agency Inc 165 Court Street Rochester NY 14647 161611043 Insurance Agency NY N/A C MIG Assurance Ltd 165 Court Street Rochester NY 14647 980210843 Long Term Care Insurance CJ N/A C Charles A Walker Corporation 165 Court Street Rochester NY 14647 150483335 Broker NY N/A C Human Care Consortium I Inc 165 Court Street Rochester NY 14647 454039701 Inactive NY N/A C Human Care Consortium II Inc 165 Court Street Rochester NY 14647 454039630 Inactive NY N/A C 0 0 0 0 1 0 0 0 0 1 1 1 0 1 1 1 0 0