2012-08-15T17:44:04-05:00 2011-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD SUITE 1000 ATLANTA GA 30308 990 2011-01-01 050477052 Neighborhood Health Plan of Rhode Island % T CLARK PHILLIP CFO NEIG 4014596000 299 Promenade Street Providence RI 02908 T CLARK PHILLIP 2012-08-14 4048748300 2011 2016-02-24 21:20:13Z T Clark Phillip CFO 299 Promenade Street Providence RI 02908 485076098 false X www.nhpri.org X 2000 RI Neighborhood Health Plan of Rhode Island, an innovative health plan in partnership with community health centers, is a catalyst for improved access and better health in Rhode Island. 15 5 240 14 0 51662 0 388620353 415423037 1085822 1342194 14988 4860 389772825 416770091 1501978 2002694 335433395 362327339 18296334 18803589 0 0 0 21165215 22482813 376396922 405616435 13375903 11153656 114622138 155028299 82249490 112661009 32372648 42367290 Neighborhood Health Plan of Rhode Island, an innovative health plan in IN PARTNERSHIP WITH COMMUNITY HEALTH CENTERS, IS A CATALYST FOR IMPROVED ACCESS AND BETTER HEALTH IN RHODE ISLAND, ESPECIALLY FOR VULNERABLE POPULATIONS. false false 376843330 2000000 415427897 Neighborhood Health Plan of Rhode Island is a Health Maintenance Organization (HMO) that provides comprehensive health care services on a prepaid basis principally to Medicaid recipients and certain other eligible persons under the State of Rhode Island and Providence Plantations managed care program, RIteCare. As of December 31, 2011 the organization is responsible for providing health care services to over 91,340 members. 376843330 true false false true false false false false false true false false false true false true false false false false false false false false false false true false true false false false true false false false true false false false false false false false false false false true 1426 0 true 240 true false false false false false false false false false false X 15 5 true false false false true false false true true false false true false false false true true false X T CLARK PHILLIP CFO 4014596000 299 Promenade Street Providence RI 02908 Merrill Thomas 1.0 X 0 0 Jane Hayward 1.0 X 0 Peter Walsh 1.0 X 0 Brenda Dowlatshahi 1.0 X 0 Doris Delos Santos 1.0 X James Hooley 1.0 X 0 Raymond Lavoie 1.0 X 0 Darrell Lee 1.0 X 0 Peter Bancroft 1.0 X 0 Pablo Rodrigues MD 1.0 X 0 Christopher Little 1.0 X 0 Jerald Fingerut MD 1.0 X 0 Stephanie McCaffrey 1.0 X 0 Chuck Jones 1.0 X 0 Mark Reynolds 40.0 X X 344336 39109 Maria Montanaro 1.0 X 0 Nancy Coburn 40.0 X 226941 21438 Leon McTyeire Johnson 40.0 X 224765 30028 T Clark Phillip 40.0 X 230302 28602 Brenda Seagrave-Whittle 40.0 X 135151 34128 Nancy Hermiz 40.0 X 139213 24232 Beth Ann Marootian 40.0 X 131821 33730 Michelle Lupoli 40.0 X 139623 33661 Jeffrey Meyer 40.0 X 139072 7268 1711224 0 252196 28 false true false Argus Health Systems Inc 1300 Washington PROVIDENCE MO 64105 Healthcare Services 57702215 Rhode Island Hospital P O Box 373 KANSAS CITY RI 02901 Healthcare Services 57615301 Beacon Health Strategies LLC 500 Unicorn Park BOSTON MA 01801 Healthcare Services 53158374 Women Infants Hospital of Rhode I 101 Dudley Street PROVIDENCE RI 02905 Healthcare Services 28409577 Memorial Hospital of Rhode Island PO Box 1908 PAWTUCKET RI 02860 Healthcare Services 11501784 213 0 Premiums Earned 524114 412580624 412580624 Miscellaneous Revenue 524114 1416634 1416634 Reinsurance Recoveries 524114 804409 804409 Pharmacy Dividends 524114 621370 621370 415423037 1160371 1160371 0 0 68487830 68306007 181823 181823 181823 0 0 0 MISCELLANEOUS REVENUE 900099 4860 4860 4860 416770091 415423037 0 1347054 2000000 2000000 2694 2694 0 362327339 362327339 1145521 186657 958864 0 13872227 7344236 6527991 474330 219272 255058 2097138 971723 1125415 1214373 585144 629229 0 99145 99145 263146 263146 108634 108634 0 259401 259401 4584516 1493834 3090682 791103 23107 767996 722969 16088 706881 2106958 14100 2092858 0 1591068 811450 779618 6244 948 5296 0 675 675 83175 83175 0 394855 68665 326190 181770 181770 State Premium Tax 8674172 8674172 Temporary Help 1929027 736215 1192812 Training 171149 171149 All other expenses 514806 41858 472948 405616435 376843330 28773105 0 0 0 17128604 16430375 50000 0 5195613 7608304 0 0 0 0 0 0 0 0 6160 0 1246741 976995 848957 269746 91266119 130566622 0 0 0 0 0 0 126685 153252 114622138 155028299 13939341 16599615 1500000 2000000 0 0 0 0 0 0 0 0 1500000 1000000 0 0 65310149 93061394 82249490 112661009 X 32372648 42367290 0 0 0 0 32372648 42367290 114622138 155028299 X 11153656 -1159014 X X false true true X false X 0 430425 24087 51662 506174 250384451 290088053 351528454 388620353 415427897 1696049208 250384451 290518478 351552541 388672015 415427897 1696555382 1696555382 3309728 2858373 1394666 984765 1160371 9707903 3309728 2858373 1394666 984765 1160371 9707903 67322 0 0 14988 82310 253761501 293376851 352947207 389671768 416588268 1706345595 0.99426 0.99289 0.00569 0.00705 X false false false false false false true 108634 false false 108634 false Schedule C Part II-B Line G NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND DOES NOT DIRECTLY ENGAGE IN ANY LOBBYING ACTIVITIES BUT DOES ENGAGE TWO LOBBYING COMPANIES, CAPITAL CITY GROUP AND ADVOCACY SOLUTIONS, TO CONDUCT FEDERAL AND STATE LOBBYING ACTIVITIES. FOR THE YEAR ENDED 12/31/11, NHPRI PAID CAPITAL CITY GROUP $33,566 AND ADVOCACY SOLUTIONS $75,068 FOR LOBBYING ACTIVITIES FOR A TOTAL OF $108,634. 1246741 976995 269746 269746 0 IBNR LIABILITIES 31318083 UNEARNED PREMIUMS 33480209 RISK SHARE GAIN/LIABILITY 28263102 93061394 416770091 405616435 11153656 11153656 432485760 -4241842 -4241842 436727602 -19957511 -19957511 416770091 421332104 19957511 19957511 401374593 4241842 4241842 405616435 Reconciliation of Revenue on AFS to Tax Return Schedule D Part XII Line 2D and Line 4B Line 2D - Reclass of Reinsurance Premiums - ($3,924,941.00) Reclass of Investment fees & Interest - ($316,901.00) Line 4B - Reclass of Pharmacy Dividends - $621,370.00 Reclass of Reinsurance Recoveries - 804,409.00 Reclass of Risk Share Settlements - ($21,383,290.00) Reconciliation of Expenses on AFS to Tax Return Schedule D Part XIII Line 2D and Line 4B Line 2D - Reclass of Pharmacy Dividends - ($621,370.00) Reclass of Reinsurance Recoveries - (804,409.00) Reclass of Risk Share Settlements - $21,383,290.00 Line 4B - Reclass of Reinsurance Premiums - $3,924,941.00 Reclass of Investment fees & Interest - $316,901.00 Schedule D Part XIV There was no FIN 48 footnote in the audited financial statements. true Blackstone Valley Community Health Center 428 Park Place Pawtucket RI 02860 510183476 501 C (3) 305789 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. Comprehensive Community Action Program 311 Doric Avenue Cranston RI 02910 056018801 501 C (3) 146332 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. East Bay Community Action Program 19 Broadway Newport RI 02840 050310024 501 C (3) 74595 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. Providence Community Health Centers 375 Allens Avenue Providence RI 02905 050368134 501 C (3) 868399 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. Thundermist Health Center of Woonsocket 191 Social Street Woonsocket RI 02895 050355097 501 C (3) 412945 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. Tri-Town Economic Opportunity Committee 1126 Hartford Avenue Johnston RI 02919 050309695 501 C (3) 54445 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. WellOne 36 Bridge Way Pascoag RI 02859 050258811 501 C (3) 92980 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. Wood River Health Services 823 Main Street Hope Valley RI 02832 050378071 501 C (3) 44515 Capacity Development Grant to increase physical plant and software infrastructure and skill training to facilitate increased number of patients and patient needs. 8 0 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants The recipients submitted proposals for Capacity Development/Expansion based upon their internal statistics and external reviews and surveys. These proposals included bench mark deliverables and payments are based upon the satisfactory attainment of the goals/benchmarks. As per the Organization's by-laws all the recipients / health centers must be 501 C (3) entities and members of the Rhode Island Health Center Association, which is also a 501 C (3) entity. Neighborhood monitors their progress and works with the CHC's on a monthly basis providing them with statistical information and recommendations regarding controlling costs and member satisfaction. X X X false false false false false false false false false Mark Reynolds 293997 43629 6710 9800 29309 383445 9800 Nancy Coburn 147897 13809 65235 9047 12391 248379 7589 Leon McTyeire Johnson 206426 16251 2088 9089 20939 254793 8130 T Clark Phillip 188525 13676 28101 8244 20358 258904 7489 Brenda Seagrave-Whittle 126897 7846 408 5636 28492 169279 5125 Nancy Hermiz 130674 7786 753 5678 18554 163445 Beth Ann Marootian 123903 7660 258 5514 28216 165551 5030 Michelle Lupoli 131250 8096 277 5800 27861 173284 5314 RI Community Fndn Surplus Note Payable X 2000000 1000000 false true true 1000000 Blackstone Valley Community Health See Part V 2633543 Cap & Fee for Svce Med Paymt Thundermist Health Center See Part V 4011758 Cap & Fee for Svce Med Paymt Providence Community Health Center See Part V 9426976 Cap & Fee for Svce Med Paymt Tri-Town Community Action Agency See Part V 608826 Cap & Fee for Svce Med Paymt Rhode Island Health Center Associat See Part V 173750 Consulting Fees East Bay Community Action Program See Part V 675332 Cap & Fee for Svce Med Paymt WellOne Primary Medical Dental Ca See Part V 692215 Cap & Fee for Svce Med Paymt Transactions with Interested Parties Schedule L, Part IV Raymond Lavoie - Member of the Organization's Board of Directors and is Ex. Dir of a CHC, Blackstone Valley Community Health Center, Inc. The Organization makes capitation and fee for service medical payments to Blackstone Valley Community Health Care, Inc. Chuck Jones - Officer of the Organization's Board of Directors and is Pres. of a CHC, Thundermist Health Center. The Organization makes capitation and fee for service medical payments to Thundermist Health Center. Merrill Thomas - Officer of the Organization's Board of Directors and is CEO of a CHC, Providence Community Health Center. The Organization makes capitation and fee for service medical payments to Providence Community Health Center. Brenda Dowlatshahi - Officer of the Organization's Board of Directors and is Assoc. Ex. Dir. of a CHC, Tri-Town Community Action Agency. The Organization makes capitation and fee for service medical payments to Tri-Town Community Action Agency. Jane Hayward - Officer of the Organization's Board of Directors and is Ex. Dir. of the RI Health Center Association. The Organization makes contributions towards the Association's various health center professional development programs and public awareness functions. Stephanie McCaffrey - Member of the Organization's Board of Directors and is the Administrator of a CHC, East Bay Community Action Program. The Organization makes capitation and fee for service medical payments to East Bay Community Action Program. Peter Bancroft - Member of the Organization's Board of Directors and is Pres. of a CHC, WellOne Primary Medical & Dental Care. The Organization makes capitation and fee for service medical payments to WellOne Primary Medical & Dental Care. Jerald Fingerut - Member of the Organization's Board of Directors and Medical Director of Blackstone Valley Community Health Care, Inc. The Organization makes capitation and fee for service medical payments to Blackstone Valley Community Health Care, Inc. Business Relationship Between Trustees Part VI, Question 2 A member of the organization's Board of Directors is an Executive Director of a Community Health Center (CHC), Blackstone Valley Community Health Care, Inc. Blackstone Valley Community Health Care, through a grant, invested in equipment and software for an electronic medical record (EMR) system. Three other CHC's, East Bay, Tri-Town and Comprehensive Community Action Plan, have use of the EMR and billing system and Wellone uses the EMR portion of the system. The CHC's share the cost of running the system. Members or Stockholders Part VI, Line 6 The organization is a 501 C (3) corporation and has members but does not have any stockholders. The organization has a Board of Directors who are members of the organization that meet on a regular basis and function as the governing body of the organization. Review of Form 990 Part VI, Line 11B The organization's Fiscal Operations department accumulates the information and data necessary to complete the Federal Form 990. Audited Financial Statements and approved policies and procedures are used as input to complete the 990. A draft return is prepared and reviewed by the organization's independent Certified Public Accountants. After the review process is completed by the independent accountants, the Finance staff reviews the form 990 prior to filing with the IRS. The Board is also provided an electronic copy of the return prior to filing with the IRS. Policies Part VI, Lines 12a, 12b, 13 & 14 Pursuant to the instructions for Form 990, the Organization must answer no to these questions because the Board of Directors does not approve or adopt these policies on a yearly basis. However, the Organization has issued these policies at the direction of management and these policies and procedures are strictly enforced by the Organization's management team. Conflict of Interest Part VI, Line 12c As promulgated by the organization's compliance plan, the organization's Director of Human Resources and Organizational Development is also the organization's Chief Privacy Officer. All Board, committee members and employees must disclose all conflicts on a signed disclosure yearly. If a potential conflict of interest is reported, the Chief Privacy Officer meets with the employee to discuss the issue in order to determine if a possible conflict exists. If it is determined that a conflict exists, the Chief Privacy Officer refers the appropriate items through the CFO to the CEO for a resolution/decision. Board and committee members refrain from voting on issues where there is an appearance of conflict. Executive Compensation Part VI, Lines 15a & 15b The Planning Committee of the Board of Directors reviews and approves the contract of the CEO and any changes to the contract. The Organizational Development and Human Resources Committee of the Board of Directors reviews the compensation of the Chief Financial Officer, Chief Medical Officer and Chief Operating Officer based on a compensation survey. The Committee subscribes to three or four salary surveys that list salary and salary increases by position, geography, plan size and profit vs. non-profit. These surveys are used to set compensation annually. Governing Documents Disclosure Part VI, Line 19 The governing documents, conflict of interest policy and financial statements are available to the public upon request at the organization's location at 299 Promenade Street, Providence, RI 02908. Reconciliation of Net Assets Part XI, Line 5 Prior Year Adjustment - ($1,129,002) Unrealized Loss - $ 8,000 Change in nonadmitted assets - ($ 30,000) Rounding - $ 988 Total - ($1,159,014) METHOD OF ACCOUNTING PART XII, LINE 1 IN THE CURRENT YEAR, NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND IS USING THE STATUTORY BASIS OF ACCOUNTING.