2012-10-25T14:49:14-05:00 2011-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-01-01 133330672 AFFINITY HEALTH PLAN INC % MARK CORCORAN AFFI 7187947700 2500 Halsey Street Bronx NY 10461 Mark Corcoran 2012-10-22 3176817000 2011 2016-02-24 21:20:13Z 1021708069 false X www.affinityplan.org X 1981 NY improve the health of underserved populations. 11 11 959 0 0 0 0 0 810725771 960026373 2765674 2878629 25091 443960 813516536 963348962 0 0 0 0 55173044 53099979 0 0 0 754685191 909071062 809858235 962171041 3658301 1177921 256800675 267641300 116555725 127385932 140244950 140255368 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. false false 714888959 0 763709093 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. 86284012 0 96159835 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. 34368533 0 45285569 THE CHILD HEALTH PLUS (CHP) PROGRAM IS FUNDED BY THE STATE OF NEW YORK AND A FEDERAL GRANT TO PROVIDE HEALTH INSURANCE COVERAGE FOR CHILDREN THAT ARE UNDER THE AGE OF 19. 37465484 0 54871877 873006988 true false false false false false false false false true true false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false false true 6287 0 false 959 true false false false false false false false false false false X 11 11 false false false false false false false true true false false true true true true true true true true false NY X X MARK CORCORAN 7187947700 2500 HALSEY STREET BRONX NY 10461 James Hooley 1.0 X 0 0 0 Yvette Walker 1.0 X 0 0 0 Nanette Falkenberg 1.0 X 0 0 0 Verona Greenland 1.0 X 0 0 0 Paloma Hernandez 1.0 X 0 0 0 Amy Knapp 1.0 X 0 0 0 Lynn Sherman 1.0 X 0 0 0 John Sardelis 1.0 X 0 0 0 Caleb DesRosiers 1.0 X 0 0 0 Craig Keyes MD 1.0 X 0 0 0 Robert Schiller MD 1.0 X 0 0 0 Maura Bluestone 37.5 X 381388 0 50266 Mark Corcoran 37.5 X 282334 0 41047 Robert Brown 37.5 X 294090 0 11037 Robert Allen 37.5 X 274489 0 28640 Abenna Udochi 37.5 X 169047 0 30745 Ann Van Etten 37.5 X 197270 0 31572 Joan Russo 37.5 X 248532 0 27387 Caron Cullen 37.5 X 200108 0 33493 Dr Munish Khaneja 37.5 X 249744 0 18916 Joseph Karp 37.5 X 215889 0 7122 Charlie Krajacic 37.5 X 166796 0 27163 Stephanie Citerman 37.5 X 175625 0 29245 2855312 0 336633 65 false true false Cognizant Tech 500 Frank W Burr Boulevard TEANECK NJ 07666 See Schedule O 1925537 TMG Health Care PO Box 200521 PITTSBURGH PA 15251 See Schedule O 1662756 Emdeon 12016 Collection Center Drive CHICAGO IL 60693 See Schedule O 925759 EXPRESS SCRIPT ONE EXPRESS WAY HQ3W01 ST LOUIS MO 63121 See Schedule O 716711 First Choice Staffing 9 East 38th Street Suite 201 NEW YORK NY 10016 See Schedule O 532133 17 0 TOTAL PROGRAM SERVICE REVENUES 524114 960026373 960026373 960026373 1456800 1456800 0 0 82834 53437 29397 29397 29397 59727499 58305670 1421829 1421829 1421829 0 0 0 MISCELLANEOUS REVENUE 414563 414563 414563 963348962 960026373 3322589 0 0 0 0 2067844 2067844 0 39130418 39130418 1740135 1740135 6485565 6485565 3676017 3676017 0 3068478 3068478 478450 478450 0 0 257724 257724 0 0 1665618 1665618 108302 108302 0 5924668 5924668 207187 207187 0 104753 104753 459836 459836 0 5702951 5702951 476849 476849 INPATIENT 280360850 280360850 OUTPATIENT 177503200 177503200 PHARMACY 67792357 67792357 PHYSICIAN PATIENT CARE 234302303 234302303 130657536 113048278 17609258 962171041 873006988 89164053 0 0 0 80109251 100082697 0 0 92418530 83128657 0 0 0 0 0 0 0 0 0 0 64314706 39261633 25177568 25053073 39496269 36470436 0 0 0 0 0 0 19599057 22906437 256800675 267641300 113883866 124857519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2671859 2528413 116555725 127385932 X 34487364 46100435 105757586 94154933 0 0 140244950 140255368 256800675 267641300 X 1177921 -1167503 X false true true X true true X 105757586 -11602653 94154933 86616257 19141329 105757586 71789689 14354790 -471778 86616257 79076598 11787917 19074826 71789689 0.22000 0.78000 0.00000 6920691 826858 6093833 699416 326328 373088 23129345 4543193 18586152 25053073 ADVANCES TO PROVIDERS 21585319 OTHER 1321118 22906437 0 DEFERRED RENT 2528413 2528413 963348962 962171041 1177921 -1167503 -1167503 10418 962181459 -1167503 -1167503 963348962 963348962 962171041 962171041 962171041 ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 1b, column A 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 2011, 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. X X false false false false false false false false false Maura Bluestone 374788 0 0 0 6600 0 29400 0 20866 0 431654 0 0 0 Mark Corcoran 281302 0 0 0 1032 0 22131 0 18916 0 323381 0 0 0 Robert Brown 293058 0 0 0 1032 0 9772 0 1265 0 305127 0 0 0 Robert Allen 273457 0 0 0 1032 0 9860 0 18780 0 303129 0 0 0 Abenna Udochi 168835 0 0 0 212 0 16913 0 13832 0 199792 0 0 0 Ann Van Etten 195686 0 0 0 1584 0 23306 0 8266 0 228842 0 0 0 Caron Cullen 188148 0 0 0 11960 0 24227 0 9266 0 233601 0 0 0 Dr Munish Khaneja 249528 0 216 0 0 0 0 0 18916 0 268660 0 0 0 Joseph Karp 214606 0 0 0 1283 0 6438 0 684 0 223011 0 0 0 Charlie Krajacic 166244 0 0 0 552 0 8314 0 18849 0 193959 0 0 0 Joan Russo 247980 0 0 0 552 0 8471 0 18916 0 275919 0 0 0 Stephanie Citerman 174593 0 0 0 1032 0 10376 0 18869 0 204870 0 0 0 DESCRIPTION OF OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D EFFECTIVE JANUARY 1, 2007, AFFINITY HEALTH PLAN BEGAN OFFERING THE MEDICARE ADVANTAGE COVERAGE TO ELIGIBLE INDIVIDUALS. THE MEDICARE ADVANTAGE PLAN IS ADMINISTERED UNDER AN AGREEMENT WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND INCLUDES A PRESCRIPTION DRUG BENEFIT COMPONENT UNDER PART D OF TITLE XVIII OF THE SOCIAL SECURITY ACT. THE MEDICARE ADVANTAGE PROGRAM INCLUDES AFFINITY MEDICARE ULTIMATE AND AFFINITY MEDICARE SOLUTIONS. 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 AND OTHER OFFICERS AND KEY EMPLOYEES INCLUDED REVIEW AND APPROVAL BY A COMPENSATION COMMITTEE (THE "COMMITTEE"). THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS CHARGED WITH THE RESPONSIBILITY OF CONSIDERING DATA, SUBSTANTIATING PERTINENT DOCUMENTATION, DELIBERATING, AND MAKING THE FINAL DECISION. AFFINITY HEALTH PLAN'S COMPENSATION PROGRAM 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 IN AN EMPLOYMENT CONTRACT WITH THE BOARD OF DIRECTORS OF AFFINITY HEALTH PLAN. THE BOARD AND THE COMMITTEE HAS ESTABLISHED COMPENSATION TERMS FOR THE CEO THAT ARE CONTAINED IN THE EMPLOYMENT CONTRACT, CONSIDERING COMPARABILITY DATA FOR CEO POSITIONS IN SIMILAR ORGANIZATIONS IN THEIR DELIBERATIONS AND DECISION MAKING. THESE DECISIONS ARE DOCUMENTED. THE COMPENSATION TERMS INCLUDE PROVISIONS FOR ANNUAL SALARY ADJUSTMENTS AND DISCRETIONARY BONUS COMPENSATION, BOTH WITH SPECIFIC CAPS DEFINED IN THE CONTRACT. 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 OTHER POSITIONS THAT ARE DEEMED TO BE "DISQUALIFIED PERSONS" UNDER THE INTERNAL REVENUE CODE (E.G., CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER) ARE MADE BY THE COMMITTEE IN ACCORDANCE WITH "INTERMEDIATE SANCTIONS SAFE HARBOR" STANDARDS. 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 Changes in Net Assets FORM 990, PART VI, LINE 5 Unrealized Loss on Investments: $(1,167,503) Description of Independent Contractors Services Form 990, Part VII Cognizant Tech - Management Consulting for Information Systems TMG Health Care - Medicare Third Party Administration Emdeon - Electronic Clearing House Services & Mail Room Services Express Script - Pharmacy Benefit Management for CHP & Medicare First Choice Staffing - Temporary Services OTHER EXPENSES FORM 990 PART IX DESCRIPTION:OTHER MEDICAL EXPENSES TOTAL EXPENSES:XXX-XX-XXXX PROGRAM SERVICES:XXX-XX-XXXX OTHER EXPENSES FORM 990 PART IX DESCRIPTION:ALL OTHER EXPENSES TOTAL EXPENSES:17609258 MANAGEMENT AND GENERAL:17609258