2012-11-14T17:52:44-06:00 2011-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE STE 2600 INDIANAPOLIS IN 46204 990 2011-01-01 237442369 Fallon Community Health Plan Inc % CHAN MODHA FALL 5087992100 10 CHESTNUT STREET WORCESTER MA 01608 PATRICK HUGHES 2012-11-13 6172662000 2011 2016-02-24 21:20:13Z W PATRICK HUGHES Pres CEO 10 CHESTNUT STREET WORCESTER MA 01608 1358429916 false X www.fchp.org X 1975 MA FCHP'S MISSION IS MAKING OUR COMMUNITIES HEALTHY. FCHP IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES THROUGH THE FINANCING AND DELIVERY OF HIGH QUALITY, AFFORDABLE CARE. 9 6 1142 138 307804 181640 207375 1090378600 1096296327 19904863 15007340 -12829907 -7714501 1097635196 1103796541 659952 527958 1006562694 954294586 60156727 70950490 0 0 0 39061882 39562912 1106441255 1065335946 -8806059 38460595 337631320 382846207 202819067 214091419 134812253 168754788 X FALLON COMMUNITY HEALTH PLAN'S MISSION IS MAKING OUR COMMUNITIES HEALTHY. FCHP IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES THROUGH THE FINANCING AND DELIVERY OF HIGH QUALITY, AFFORDABLE CARE. false false 954854994 527958 1096296327 SEE SCHEDULE O 954854994 true true false true false false false false false false true false false false false false false true false false false false false false true false false true false true false false false false false false true true false false false false false true true true false false true 5186 0 true 1142 true true true false CJ false false true true true true false false false false X 9 6 true false false false false false false true true false false true true true true true true true true false MA X CHAN MODHA 5087992100 10 CHESTNUT STREET WORCESTER MA 01608 Christopher F Egan 4.0 X 1275 0 Alan Gayer 4.0 X 0 0 Karen H Green 7.0 X 1700 0 David R Grenon 4.0 X 1275 0 David W Hillis 10.0 X 1700 0 Richard P Houlihan Esq 7.0 X 2125 0 Sandra L Kurtinitis PhD 4.0 X 850 0 Christian W McCarthy 7.0 X 1700 0 Charles F Monahan Jr 7.0 X 850 0 Rev John J Paris SJ 4.0 X 850 0 Lynda M Young MD 4.0 X 850 0 W Patrick Hughes 50.0 X X 690227 0 339000 Richard P Burke 50.0 X 317738 0 168556 Elizabeth Malko MD 50.0 X 408369 0 122788 Christine Osgood 24.0 X 167877 0 63960 R Scott Walker 50.0 X 323778 0 148036 Richard Commander 50.0 X 296628 0 94492 David Przesiek 50.0 X 284570 0 118279 Mary Ritter 50.0 X 237577 0 100632 Todd Bailey 50.0 X 211019 0 100420 Eric Hall 50.0 X 213083 0 51360 Karen Longo 50.0 X 179960 0 127744 Kevin McGovern 50.0 X 224720 0 149728 Janis Liepins 50.0 X 216386 0 74951 Elizabeth Helenius 50.0 X 238883 89421 Seth Lewin 50.0 X 264377 0 35035 Glenn Randall MD 50.0 X 254464 0 45877 Param Singh 50.0 X 219590 84917 David Wilner MD 50.0 X 288595 0 53001 5051016 0 1968197 108 false true false Reliant Medical Group 630 PLANTATION ST WORCESTER MA 01608 MEDICAL SERVICES 141856274 VHS Acquisition Subsidiary PO BOX 3385 BOSTON MA 02241 HOSPITAL SERVICES 113583405 UMASS Memorial Med Ctr PO BOX 15492 WORCESTER MA 01615 HOSPITAL SERVICES 90126144 UMASS Memorial Med Group PO BOX 62 SHREWSBURY MA 01545 MEDICAL SERVICES 22960360 BEACON HEALTH STRATEGIES LLC 200 STATE ST SUITE 302 HARTFORD MA 02109 Mental Health Srvcs 19506859 534 152792 54583 3325 207375 PROGRAM SERVICE REVENUE 524114 1096296327 1096296327 1096296327 11179115 11179115 0 0 258403017 254574792 3828225 3828225 3828225 54583 152792 58583 -4000 -4000 0 0 SUBSIDIARY LOSS & OTHER MISC. 524114 -8022305 -8022305 PACE CONSULTING & ASO-INOVA 561499 300612 296612 4000 MANAGEMENT FEE FOR INDEMNITY, COMPANION CARE 561000 16280 16280 -5088 -5088 -7710501 1103796541 1096296327 307804 6985035 527958 527958 0 0 954294586 954294586 5445053 5445053 0 48201763 48201763 7082748 7082748 5995328 5995328 4225598 4225598 0 966619 966619 924098 924098 247764 247764 0 646921 646921 8394492 8394492 3999705 3999705 4606580 4606580 5408684 5408684 0 4834664 4834664 118424 118424 0 467606 467606 311113 311113 0 6487325 6487325 615277 615277 DUES & SUBSCRIPTIONS 754095 754095 RECRUITING 383952 383952 CONMMUNITY BENEFIT-VOLUNTEER 32450 32450 All other expenses 363143 363143 1065335946 954854994 110480952 0 0 0 17339389 8526144 0 0 34592413 26253547 0 0 0 0 0 0 0 0 1878229 2336991 56616961 23456524 36425332 33160437 234995427 304254690 5838030 1383672 0 0 0 0 6562500 6930726 337631320 382846207 188696047 198921288 0 0 14123020 15170131 0 0 0 0 0 0 0 0 0 0 0 0 202819067 214091419 X 134808325 168754788 3928 0 0 0 134812253 168754788 337631320 382846207 X 38460595 -4518060 X false true true X false X 109700 187555 199123 181640 207375 885393 884935739 980912291 1059414644 1090378600 1096296327 5111937601 885045439 981099846 1059613767 1090560240 1096503702 5112822994 5112822994 12200590 13282385 10709853 10161702 11179115 57533645 350 12292 14235 7806 0 34683 12200940 13294677 10724088 10169508 11179115 57568328 897246379 994394523 1070337855 1100729748 1107682817 5170391322 0.98887 0.98799 0.01113 0.01201 X THE ORGANIZATION'S IRS DETERMINATION LETTER INDICATES THAT THIS ORGANIZATION QUALIFIES AS A PUBLICLY SUPPORTED CHARITY UNDER SECTION 170(B)(1)(A)(VI); HOWEVER, THE ORGANIZATION QUALIFIES AS A 509 (A)(2) ORGANIZATION. SCHEDULE A HAS BEEN COMPLETED IN ACCORDANCE WITH THE FORM INSTRUCTIONS UNDER THE 509(A)(2) TEST. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 247764 false false 247764 false false DIRECT LOBBYING EXPENSE SCHEDULE C, PART II-B, LINE 1G FCHP PAID LOBBYING EXPENSES TO THE FOLLOWING: MASSACHUSETTS ASSOCIATION OF HEALTH PLANS 37,100 SPILLANE & SPILLANE, LLP 48,000 AMERICA'S HEALTH INSURANCE PLANS 34,027 ALLIANCE OF COMMUNITY HEALTH PLANS 7,652 ------ TOTAL OUTSIDE VENDORS 126,779 EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. CATHERYN MCEVOY ZDONCZYK 26,500 W. PATRICK HUGHES 14,212 PATRICK JAMES FARRELL 40,949 RICHARD BURKE 10,418 CHRISTIENNE BIK 28,906 ------- TOTAL FCHP EMPLOYEES 120,985 ------- TOTAL DIRECT LOBBYING EXPENSE 247,764 ======== FALLON COMMUNITY HEALTH PLAN, INC. KEY LEGISLATIVE AND REGULATORY ISSUES IN 2011: AMERICA'S HEALTH INSURANCE PLANS (AHIP) AND ALLIANCE OF COMMUNITY HEALTH PLANS (ACHP) - LEGISLATIVE ACTIVITY IN THE HOUSE AND THE SENATE AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT (ACA) IN MARCH 2010. - REGULATORY ACTIVITY ADDRESSING IMPLEMENTATION OF NUMEROUS ACA PROVISIONS, INCLUDING INSURANCE MARKET REFORMS, MEDICAL LOSS RATIO REQUIREMENTS, PREMIUM REVIEW, HEALTH INSURANCE EXCHANGES, DELIVERY SYSTEM REFORMS, ADMINISTRATIVE SIMPLIFICATION, HEALTH INFORMATION TECHNOLOGY, ACCOUNTABLE CARE ORGANIZATIONS (ACOS), AND THE COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS (CLASS) PROGRAM. - PUBLIC PROGRAM ISSUES AFFECTING MEDICARE ADVANTAGE, MEDICARE PART D, MEDICAID, AND THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). - PRODUCT-SPECIFIC ISSUES AFFECTING MEDIGAP/SUPPLEMENTAL POLICIES, LONG-TERM CARE INSURANCE, AND DISABILITY INCOME INSURANCE. - HEALTH ISSUES OUTSIDE OF THE HEALTH REFORM DEBATE INCLUDING ANTITRUST LEGISLATION, COBRA CONTINUATION COVERAGE, DATA SECURITY, MEDICAL LIABILITY REFORM, MEDICARE PHYSICIAN PAYMENT, AND THE ANNUAL APPROPRIATIONS PROCESS. SPILLANE & SPILLANE, LLP AND MASSACHUSETTS ASSOCIATION OF HEALTH PLANS (MAHP) - ANY NEW POLICIES IMPLEMENTED BY DIVISION OF INSURANCE THAT AFFECT FCHP - OTHER REGULATORY HEARINGS AND LEGISLATIVE MEETINGS THAT AFFECT HEALTHCARE POLICIES AND GUIDELINES - LEGISLATIVE MEETINGS AND INTERNAL MEETINGS ON NEW LEGISLATION THAT WILL REFORM HEALTH CARE PAYMENTS - MEETINGS WITH MASSHEALTH AND MEDICAID OFFICIALS ON INCREASING MEMBERSHIP, CHANGING PAYMENT MODELS, AND BETTER MANAGING OF MEMBERS. - WORKING WITH CONGRESSIONAL MEMBERS AND CMS TO ADDRESS THE DECREASES IN PAYMENTS UNDER CHANGES MADE IN MEDICARE RURAL FLOOR DURING 2011, FCHP WORKED WITH THESE REGULATORY AGENCIES: DEPARTMENT OF PUBLIC HEALTH - EARLY INTERVENTION PROGRAM - INSURANCE COORDINATORS MEETINGS - UNIVERSAL NEWBORN HEARING SCREENING PROGRAM ADVISORY COMMITTEE - CHANGES TO HOSPITAL GUIDELINES - OFFICE OF PATIENT PROTECTION- OPEN ENROLLMENT WAIVER REGULATIONS DIVISION OF HEALTH CARE FINANCE AND POLICY - ALL-PAYER CLAIMS DATABASE IMPLEMENTATION - COST TRENDS - TOTAL MEDICAL EXPENSES & RELATIVE PRICES TECHNICAL ADVISORY GROUP MEETINGS, CONSULTATIVE SESSIONS & REGULATIONS - HEALTH SAFETY NET SURCHARGE PAYMENTS & FUNDING REGULATIONS - HEALTH SAFETY NET ELIGIBLE SERVICES REGULATIONS - PEDIATRIC ASSESSMENT REGULATIONS - FY11 VACCINE ASSESSMENT - HOSPITAL FINANCIAL REPORTS - TECHNICAL ADVISORY GROUP MEETINGS, CONSULTATIVE SESSIONS & REGULATIONS DIVISION OF INSURANCE SPECIAL SESSIONS AND OTHER - AUTISM - GROUP PURCHASING COOPERATIVES - MEDICAL LOSS RATIO - SESSIONS AND REGULATIONS - FINANCIAL REPORTING - LIMITED & TIERED NETWORKS - OPEN ENROLLMENT - PLAN TERMINATION - RATING FACTORS - PROVIDER DIRECTORIES - PROVIDER CONTRACTING - SMALL GROUP RATE REVIEWS - CREDENTIALING - ONE-TIME SUPPLEMENTAL FUNDING PAYMENTS - TRANSPARENCY INFORMATIONAL HEARING - ADMINISTRATIVE SIMPLIFICATION PROVISIONS IN CHAPTER 288 (LEGISLATIVE AND REGULATORY ISSUE) - CODING COMMISSION EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES - PATIENT CENTERED MEDICAL HOME PILOT INITIATIVE HEALTH CARE QUALITY AND COST COUNCIL - COMMITTEE ON THE STATUS OF PAYMENT REFORM LEGISLATION - END OF LIFE CARE ADVISORY PANEL REPORT - UNIFORM REPORTING SYSTEM FOR HEALTH CARE CLAIMS DATA SETS BULLETIN - REPEAL OF HCQCC DATA REGULATIONS ATTORNEY GENERAL'S OFFICE - DISCUSSIONS WITH THE AG'S OFFICE ON RECOMMENDATIONS TO ADDRESS PROVIDER MARKET POWER 3946505 1778943 2167562 9088021 8222911 865110 43582435 13454670 30127765 33160437 1103796541 1065335946 38460595 38460595 1154811000 51868755 51868755 1102942245 646921 207375 854296 1103796541 1116350000 51868350 51868350 1064481650 646921 207375 854296 1065335946 SCHEDULE D, PART XII: Line 2d SUBSIDIARY INCOME & RELATED ELIMINATIONS $51,868,556 "IN THOUSANDS" AUDITED FINANCIALS ROUNDING 199 ---------- TOTAL LINE 2D $51,868,755 LINE 4B RECLASS OF FUNDRAISING EVENT $207,375 THE REVENUE PORTION OF THE COMMUNITY BENEFITS FUND IS RECLASSED TO REVENUE ON THE FORM 990. SCHEDULE D, PART XIII: Line 2D SUBSIDIARY EXPENSES & RELATED ELIMINATIONS $51,868,350 Line 4B RECLASS OF FUNDRAISING EVENT $207,375 THE REVENUE PORTION OF THE COMMUNITY BENEFITS FUND IS RECLASSED TO REVENUE ON THE FORM 990. BUFFET DINNER 207375 152792 54583 3325 14245 250 40763 0 207375 152792 54583 3325 14245 250 40763 58583 -4000 true Worcester Regional Chamber of Commerce 339 Main St Worcester MA 01608 041988780 501(c)(6) 22500 Independence Day Celebration ($20,000) Annual Meeting ($2,500) Town of Orange 6 Prospect Street Orange MA 01364 046001257 501(c)(3) 21500 Community Benefits grant recipient ($20,000) Mini-grant recipient ($1,000) Mini-grant recipient ($500) Community Teamwork Inc 155 Merrimack Street Lowell MA 01852 042382027 501(c)(3) 20000 Community Benefits grant recipient Fallon Clinic Foundation 100 Front St 14th fl Worcester MA 01608 222912515 501(c)(3) 20000 Drive for a Difference Golf Classic Rachel's Table 633 Salisbury Street Worcester MA 01609 042104363 501(c)(3) 15200 Pay It Forward donation ($200) Community Benefit grant recipient ($15,000) Community Action of Franklin Hampshire & N Quab 393 Main Street Greenfield MA 01301 042384972 501(c)(3) 12000 Community Benefits grant recipient Worcester Regional Research Bureau 319 Main Street Worcester MA 01608 042901298 501(c)(3) 11000 2011 Series of Events ($5,000) Annual Due ($6,000) Genesis Club 274 Lincoln Street Worcester MA 01605 042983234 501(c)(3) 10500 Community Benefits grant recipient ($10,000) Spring Benefit Concert ($500) American Heart Association 20 Speen St Framingham MA 01701 135613797 501(c)(3) 10000 Central MA Heart & Stroke Ball ($7,500) Centarl MA Heart Walk ($2,500) St John's Parish 44 Temple St Worcester MA 01604 042106729 501(c)(3) 10000 Gather FORE a Goal proceeds donation Worcester Art Museum 55 Salisbury St Worcester MA 01609 041988530 501(c)(3) 10000 Art All State ($5,000) Art Since the Mid 20th Century ($5,000) Worcester Education Collaborative c/o United Way of Central MA 484 Main Street Worcester MA 01608 042100017 501(c)(3) 10000 Annual Support Boys & Girls Club of Worcester 65 Tainter Street Worcester MA 01610 042105851 501(c)(3) 9000 Heroes Day 2011 ($1,000) Pay It Forward Donation ($500) Community Benefits Grant recipient ($7,500) American Red Cross of Central Mass 2000 Century Drive Worcester MA 01606 042151539 501(c)(3) 8630 Pay It Forward donation ($500) Japan Earthquake Relief ($4,130) Disaster Response Vehicle ($4,000) YMCA of Central MA 766 Main St Worcester MA 01610 042105885 501(c)(3) 7780 1st Annual Strong Kids Mission Partner Sponsor ($2,780) Strength of the Team Initiative ($5,000) Boys & Girls Club of Greater Lowell 657 Middlesex Street Lowell MA 01850 042104396 501(c)(3) 7500 Community Benefits grant recipient Boys & Girls Club of Lawrence 136 Water Street Lawrence MA 01841 042104377 501(c)(3) 7500 Community Benefits grant recipient Boys & Girls Club of North Central MA 65 Lindell Avenue Leominster MA 01453 043576700 501(c)(3) 7500 Community Benefits grant recipient New England Council 98 North Washington St Ste 201 Boston MA 02114 041661090 501(c)(6) 6000 Annual Dinner UMass Medical School College Publications Inc 210 Park Ave 690 Worcester MA 01609 043108190 501(c)(3) 5695 Winter Ball ($5,000) UMass 2012 Yearbook ($695) Be Like Brit 47 Singletary Road Millbury MA 01527 271857525 501(c)(3) 5500 1st Annual Be Like Brit Golf Classic ($5,000) Pay It Forward donation ($500) YWCA of Central MA 1 Salem Square Worcester MA 01608 042105873 501(c)(3) 5200 Katharine F. Erskine Awards ($200) 125th Anniversary ($5,000) 20 2 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants FCHP GRANTS ARE CLASSIFIED EITHER AS A COMMUNITY BENEFIT GRANT OR A COMMUNITY RELATIONS GRANT. THE COMMUNITY BENEFIT GRANTS ARE VERIFIED TO ENSURE THAT EACH RECIPIENT IS A 501( C)(3) ORGANIZATION. THE COMMUNITY RELATIONS GRANTS ARE VERIFIED TO ENSURE THAT THE RECIPIENT ORGANIZATION'S IRS STATUS IS LISTED AS A TAX-EXEMPT ORGANIZATION IN THE INTERNAL REVENUE CODE SECTION 501(C). EACH RECIPIENT OF A FCHP GRANT HAS SPECIFIC INSTRUCTIONS TO BE FOLLOWED BY EACH GRANT RECIPIENT SUCH AS THE SPECIFIC USE OF EACH GRANT AND THAT THE GRANT IS TO BE EXPENDED WITHIN 1 YEAR FROM THE AWARD. FOR ANY GRANTS IN EXCESS OF $10,000, FCHP REQUESTS A GRANT REPORT DETAILING THE GRANT USES. THESE REPORTS ARE KEPT ON FILE AT FCHP. X true true X X X X X false true false false false true false false false W Patrick Hughes 531465 0 66800 91962 316910 22090 1029227 0 66800 Richard P Burke 270246 0 25800 21692 143848 24708 486294 0 15800 Elizabeth Malko MD 312835 0 29400 66134 102080 20708 531157 0 19400 Christine Osgood 139513 0 18600 9764 62702 1258 231837 0 8600 R Scott Walker 301988 0 21250 540 122950 25086 471814 0 11250 Todd Bailey 191045 0 15516 4458 80110 20310 311439 0 15516 Richard Commander 271971 0 18312 6345 92234 2258 391120 0 18312 Eric Hall 193011 0 15405 4667 51360 0 264443 0 15405 Karen Longo 165344 0 13698 918 106146 21598 307704 0 13698 Kevin McGovern 203082 0 16404 5234 131738 17990 374448 0 16404 Janis Liepins 198498 0 16646 1242 59586 15365 291337 0 16646 David Przesiek 244430 0 39330 810 94542 23737 402849 0 39330 Mary Ritter 220003 0 16656 918 78424 22208 338209 0 16656 Elizabeth Helenius 148155 87780 2948 68084 21337 328304 0 Seth Lewin 246777 0 13838 3762 7945 27090 299412 0 13838 Glenn Randall MD 247318 0 4566 2580 26786 19091 300341 0 4419 Param Singh 206773 3735 9082 68168 16749 304507 0 David Wilner MD 272682 0 8516 7397 34221 18780 341596 0 8516 Supplemental Compensation Information Schedule J, Part I, Line 1A Health or social club dues or initiation fees pursuant to a policy adopted and approved by the executive evaluation and compensation committee (EECC) of the board of directors, a portion of the dues & fees for the business use of The Worcester Club are paid by the organization for the following individuals: President & CEO, President of Senior Care Services, CFO, and Senior VP of Sales & Marketing. Each executive is required to pay for their own personal use expenses, as well as a personal use portion of the membership dues and fees as determined by the eecc. Social Club dues are not reported as taxable compensation to the listed persons. Supplemental Compensation Information Schedule J, Part I, Line 4b FALLON COMMUNITY HEALTH PLAN, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ARTICLE III - ELIGIBILITY AN EMPLOYEE WHO IS ELIGIBLE FOR CONTRIBUTIONS TO A 457(F) ACCOUNT SHALL BE ELIGIBLE TO CONTRIBUTE ELECTIVE DEFERRALS TO A 457(B) ACCOUNT, AND ANY OTHER INDIVIDUAL DESIGNATED BY THE OFFICER OF THE HEALTH PLAN WHO IS IN CHARGE OF HUMAN RESOURCES SHALL ALSO BE ELIGIBLE TO CONTRIBUTE ELECTIVE DEFERRALS TO A 457(B) ACCOUNT. CONTRIBUTIONS SHALL BE MADE BY THE HEALTH PLAN TO A 457(F) ACCOUNT ESTABLISHED ON BEHALF OF AN EMPLOYEE WHO, AS OF JANUARY 2, 2007, IS THE PRESIDENT AND CHIEF EXECUTIVE OFFICER. CONTRIBUTIONS SHALL BE MADE BY THE HEALTH PLAN ON BEHALF OF AN EMPLOYEE WHO, AS OF DECEMBER 31, 2008, IS THE DIVISION PRESIDENT, SENIOR CARE SERVICES, THE EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER, THE EXECUTIVE VICE PRESIDENT AND CHIEF HUMAN RESOURCES OFFICER, THE DIVISION PRESIDENT, HEALTH PLAN OPERATIONS, OR THE EXECUTIVE VICE PRESIDENT AND CHIEF COMPLIANCE OFFICER. EFFECTIVE JULY 1, 2008, CONTRIBUTIONS SHALL BE MADE BY THE HEALTH PLAN PURSUANT TO A 457(F) ACCOUNT ESTABLISHED ON BEHALF OF ANY EMPLOYEE WHO IS NOT IDENTIFIED IN THE PARAGRAPH ABOVE AND IS A DIVISION PRESIDENT, AN EXECUTIVE VICE PRESIDENT OR A SENIOR VICE PRESIDENT. AN EMPLOYEE WHO BECOMES ELIGIBLE FOR THE PLAN SHALL BECOME COVERED UNDER THE PLAN ON THE FIRST JANUARY 1ST OR JULY 1ST FOLLOWING HIS OR HER DATE OF HIRE. FOR PARTICIPANTS WHO BECAME ELIGIBLE FOR THE PLAN ON OR BEFORE MARCH 1, 2007, 50% OF THE ANNUAL CONTRIBUTION IS IMMEDIATELY VESTED. FOR PARTICIPANTS WHO BECAME ELIGIBLE FOR THE PLAN AFTER MARCH 1, 2007, 50% OF EACH ANNUAL CONTRIBUTION IS VESTED AFTER 36 MONTHS. REMAINING CONTRIBUTION AMOUNTS ARE VESTED ON THE EARLIEST OF NORMAL RETIREMENT AGE 65, DEATH, DISABILITY, AND INVOLUNTARY SEPARATION FROM SERVICE (FOR A REASON OTHER THAN CAUSE). IN 2011, THE FOLLOWING OFFICERS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN, 457(F). OFFICER AMOUNT PAID AMOUNT DEFERRED RICHARD BURKE $20,450 $20,450 W.PATRICK HUGHES $88,200 $88,200 ELIZABETH MALKO, M.D. $63,631 $23,640 CHRISTINE OSGOOD $6,200 $6,200 R. SCOTT WALKER NONE $46,125 OTHER OFFICERS (FORMERLY KEY EMPLOYEES) DAVID PRZESIEK NONE $12,563 MARY RITTER NONE $11,261 RICHARD COMMANDER NONE $13,365 SCHEDULE J PART I QUESTION 6 - COMPENSATION CONTINGENT ON NET EARNINGS: ALL EMPLOYEES IN CERTAIN JOB GRADES, WHICH INCLUDE EMPLOYEES LISTED ON SCHEDULE J-2, ARE ELIGIBLE FOR AN INCENTIVE PLAN PAYMENT. THE INCENTIVE PLAN PAYMENT IS DETERMINED BY WHETHER CERTAIN CORPORATE, DEPARTMENT, AND/OR INDIVIDUAL TARGETS ARE MET. THE CORPORATE TARGETS INCLUDE (I) NET OPERATING INCOME, (II) MEMBERSHIP GROWTH, AND (III) MEMBER AND PROVIDER SATISFACTION. THESE TARGETS WERE MET IN 2011 AND INCENTIVE PAYMENTS WERE ACCRUED IN 2011. THE MONAHAN GROUP INC FAMILY MEMBER OF DIRECTOR 49540 SEE PART V false ADCARE HOSPITAL OWNERSHIP BY DIRECTOR 109312 SEE PART V false SAINT VINCENT HOSPITAL OVERLAPPING BOARD MEMBER 113583405 SEE PART V false HOMESTAFF LLC OVERLAPPING BOARD MEMBER 2264543 SEE PART V false FAMILY MEMBER OF KEY EE EMPLOYEE 83750 SEE PART V false VARIOUS BOARD MEMEBERS OFC KEY SEE PART V false PART IV: BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS FORM 990, PART IV, QUESTION 28 AND SCHEDULE L, PART IV FCHP SHARE OF HOME STAFF 2011 EARNINGS WAS $(49,300). KAREN H. GREEN FCHP DIRECTOR W. PATRICK HUGHES FCHP DIRECTOR AND OFFICER RICHARD P.BURKE FCHP OFFICER TODD BAILEY FCHP KEY EMPLOYEE MS. GREEN, MR. HUGHES, MR. BURKE, AND MR. BAILEY ALL SERVED DURING 2011 ON THE BOARD OF DIRECTORS OF HOME STAFF, LLC, WORCESTER, MA, A JOINT VENTURE BETWEEN FCHP AND THE VNA CARE NETWORK & HOSPICE. NONE OF THESE INDIVIDUALS WERE COMPENSATED FOR THEIR BOARD SERVICE. HOME STAFF CONTRACTS WITH FCHP TO PROVIDE SERVICES TO CERTAIN FCHP PARTICIPANTS. EACH OFFICER AND KEY EMPLOYEE DEVOTES AN AVERAGE OF 5 HOURS PER WEEK TO THE RELATED ORGANIZATION. Part IV: Business Transactions Involving Interested Persons Form 990, Part IV, Question 28 and schedule L Part IV COLUMN (D) NAME: THE MONAHAN GROUP, INC. RELATIONSHIP: ENTITY OWNED BY THE SISTER-IN-LAW OF FCHP DIRECTOR CHARLES F. MONAHAN AMOUNT OF TRANSACTION BETWEEN FCHP AND THE MONAHAN GROUP, INC.: $49,540. MR. MONAHAN'S SISTER-IN-LAW IS A PRINCIPAL WITH THE MONAHAN GROUP, INC., A SECURITY CONSULTING FIRM THAT PROVIDES CONSULTING SERVICES TO FCHP. CHARLES F. MONAHAN HAS NO INTEREST IN THE MONAHAN GROUP, INC. FCHP'S BUSINESS RELATIONSHIP WITH THE MONAHAN GROUP, INC., PRE-DATES MR. MONAHAN'S SERVICE ON THE FCHP BOARD. NAME: ADCARE HOSPITAL RELATIONSHIP: ENTITY OWNED BY FCHP DIRECTOR DAVID W. HILLIS AND FAMILY MEMBERS AMOUNT OF TRANSACTION BETWEEN FCHP AND ADCARE HOSPITAL: $109,312. MR. HILLIS IS PRESIDENT, CEO AND HOLDS MAJORITY INTEREST IN ADCARE HOSPITAL OF WORCESTER, INC., A SUBSTANCE ABUSE HOSPITAL THAT PROVIDES HEALTH CARE SERVICES TO FCHP PLAN MEMBERS. MR. HILLIS ALSO HAS FAMILY MEMBERS WHO HOLD OWNERSHIP IN ADCARE HOSPITAL. NAME: SAINT VINCENT HOSPITAL RELATIONSHIP: ENTITY IN WHICH FCHP DIRECTOR CHARLES F. MONAHAN SERVES AS AN UNCOMPENSATED BOARD MEMBER. AMOUNT OF TRANSACTION BETWEEN FCHP AND SAINT VINCENT HOSPITAL: $113,583,405. MR. MONAHAN SERVES ON THE BOARD OF SAINT VINCENT HOSPITAL, WORCESTER, MA, WHICH PROVIDES HEALTH CARE SERVICES TO FCHP PLAN MEMBERS. MR. MONAHAN RECEIVES NO COMPENSATION FOR HIS SERVICE ON THE SAINT VINCENT HOSPITAL BOARD. NAME: HOME STAFF, LLC RELATIONSHIP: JOINT VENTURE BETWEEN FCHP AND THE VNA CARE NETWORK AND HOSPICE ON WHICH FCHP DIRECTOR KAREN GREEN SERVES AS AN UNCOMPENSATED BOARD MEMBER. AMOUNT OF TRANSACTION BETWEEN FCHP AND HOME STAFF, LLC: $2,264,543. MS. GREEN SERVES ON THE BOARD OF DIRECTORS OF HOME STAFF, LLC, WORCESTER, MA, A JOINT VENTURE BETWEEN FCHP AND THE VNA CARE NETWORK AND HOSPICE. MS GREEN RECEIVES NO COMPENSATION FOR HER SERVICE ON THE HOME STAFF BOARD. HOME STAFF CONTRACTS WITH FCHP TO PROVIDE SERVICES TO CERTAIN FCHP PARTICIPANTS. NAME: LAURIE MCGOVERN RELATIONSHIP: FCHP EMPLOYEE WHO IS ALSO THE SISTER-IN-LAW OF FCHP KEY EMPLOYEE KEVIN MCGOVERN. AMOUNT OF TRANSACTION BETWEEN FCHP AND LAURIE MCGOVERN: $83,750. COMPENSATION PAYMENTS BY THE ORGANIZATION PAID TO A FAMILY MEMBER VARIOUS BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES HAVE HEALTH INSURANCE PURCHASED BY THEIR EMPLOYERS FROM FCHP, OR ARE AFFILATED WITH ORGANIZATIONS THAT PURCHASE THEIR HEALTH INSURANCE FROM FCHP. PROGRAM SERVICE ACCOMPLISHMENTS PART III, LINE 4A FCHP'S PROGRAM ACTIVITIES CONSIST OF PREPAID HEALTHCARE IN THE COMMONWEALTH OF MASSACHUSETTS. THE COVERED POPULATION AT DECEMBER 31, 2011 WAS 155,689. IN 2011, FALLON COMMUNITY HEALTH PLAN MADE OVER $1,100,000 AVAILABLE TO PROGRAMS THAT MAKE OUR COMMUNITIES HEALTHY. THIS WAS ACCOMPLISHED THROUGH THE FCHP COMMUNITY BENEFITS COMMITTEE'S DISTRIBUTION OF GRANTS, OTHER CHARITABLE DONATIONS, AND PROGRAMS THAT INVOLVED DIRECT EXPENSES AND STAFF TIME. FCHP'S REVENUE AND EXPENSES ARE NOT SEGREGABLE BY MAJOR EXPENSE CATEGORIES. FALLON COMMUNITY HEALTH PLAN 2011 COMMUNITY BENEFITS REPORT SUMMARY NARRATIVES COMMUNITY BENEFITS MISSION STATEMENT FALLON COMMUNITY HEALTH PLAN IS COMMITTED TO THE VISION OF CREATING HEALTHIER LIVES. FALLON COMMUNITY HEALTH PLAN WILL WORK COOPERATIVELY WITH HEALTH CARE AND COMMUNITY SERVICE ORGANIZATIONS, AS WELL AS STATE AND FEDERAL AGENCIES, TO LEAD THE CREATION OF INNOVATIVE HEALTH CARE SOLUTIONS, TO SEEK HEALTHY OUTCOMES, AND TO IMPROVE ACCESS TO HEALTH CARE SERVICES. FCHP WILL DEVELOP AND IMPLEMENT PROGRAMS THAT WILL IMPROVE THE HEALTH STATUS OF THE ECONOMICALLY DISADVANTAGED, ELDERS, AND CHILDREN AGED 0-5 WITHIN OUR SERVICE AREA. PROGRAM ORGANIZATION AND MANAGEMENT IN ACCORDANCE WITH THE ATTORNEY GENERAL'S COMMUNITY BENEFITS GUIDELINES FOR HEALTH MAINTENANCE ORGANIZATIONS, THE FCHP BOARD OF DIRECTORS ESTABLISHED THE COMMUNITY BENEFITS COMMITTEE. THE COMMUNITY BENEFITS COMMITTEE IS AN ENTITY COMPRISED OF MEMBERS OF FCHP LEADERSHIP AS WELL AS MEMBERS FROM THE COMMUNITIES WE SERVE WHO REPRESENT SPECIFIC GEOGRAPHIC REGIONS OR AREAS OF EXPERTISE. ALL MEMBERS ARE APPOINTED ANNUALLY BY FCHP'S PRESIDENT AND CEO. THE COMMITTEE IS MANAGED BY THE DIRECTOR OF COMMUNITY RELATIONS, AND REPORTS TO THE VICE PRESIDENT OF CORPORATE COMMUNICATIONS. ALL GRANT APPLICATIONS ARE REVIEWED BY THE COMMITTEE AND GIVEN FINAL APPROVAL BY SENIOR MANAGEMENT BEFORE FUNDS ARE DISTRIBUTED. THIS ENSURES REGULAR EVALUATION AND OVERSIGHT OF THE PROGRAM. COMMUNITY HEALTH NEEDS ASSESSMENT IN 2011, THE COMMUNITY BENEFITS PROGRAM CONDUCTED EXTENSIVE REVIEW OF THE PROGRAM, AND A NEEDS ASSESSMENT OF THE COMMUNITIES SERVED BY THE PROGRAM. CHANGES TO THE GIVING PROGRAM WERE MADE IN ORDER TO BETTER SERVE LOCAL NEEDS. EACH YEAR, THESE AREAS OF FOCUS ARE REVIEWED WITH DATA FROM COMMUNITY AGENCIES. THREE NEW AREAS OF FOCUS WERE IDENTIFIED FOR THE COMMUNITY BENEFITS PROGRAM. THEY ARE: PROMOTING ACCESS TO HEALTHY NUTRITION AND ENCOURAGING PHYSICAL ACTIVITY, PARTICULARLY AMONG VULNERABLE POPULATIONS; PROMOTING GOOD HEALTH FOR SENIORS; AND IMPROVING HEALTH FOR INFANTS AND CHILDREN AGED 0-5. COMMUNITY BENEFITS PLAN FALLON COMMUNITY HEALTH PLAN AWARDS GRANTS AND SUPPORT TO THOSE PROGRAMS THAT IMPROVE THE HEALTH STATUS OF THE ECONOMICALLY DISADVANTAGED, THE ELDERLY AND CHILDREN AGED 0-5. OUTCOMES ARE MEASURED EACH YEAR AGAINST THE GOALS STATED IN THE FUNDED PROGRAMS' GRANT APPLICATIONS. THESE GRANT REPORTS ARE ESSENTIAL IN HELPING THE COMMITTEE ASSESS WHETHER FUNDS HAVE INDEED HELPED THE IDENTIFIED POPULATION AND THEREFORE HELP TO DETERMINE FUTURE FUNDING. KEY ACCOMPLISHMENTS OF THE REPORTING YEAR FALLON COMMUNITY HEALTH PLAN INVESTED JUST OVER $839,000 IN GRANTS, PROGRAMS AND OTHER SUPPORTS TO ADDRESS NEEDS AFFECTING POPULATIONS INCLUDED IN THE COMMUNITY BENEFIT PROGRAM'S AREAS OF FOCUS. OTHER CHARITABLE SUPPORT TOTALED APPROXIMATELY $327,000. IN ADDITION, $32,450 WAS GIVEN TO OUR COMMUNITIES THROUGH PROGRAMMING, SPONSORSHIPS, VOLUNTEER HOURS, AND OTHER SUPPORT. FALLON COMMUNITY HEALTH PLAN HOSTED THE SIXTH ANNUAL GOLF FORE A GOAL CHARITABLE TOURNAMENT, RAISING APPROXIMATELY $208,000 IN GROSS RECEIPTS. NET PROCEEDS EXCEEDING $150,000 WERE DISTRIBUTED TO MORE THAN 90 FOOD PANTRIES AND HUNGER RELIEF PROGRAMS THROUGHOUT MASSACHUSETTS. PLANS FOR NEXT REPORTING YEAR FCHP'S COMMUNITY BENEFITS PROGRAM WILL CONTINUE FOCUSING ON PROGRAMS THAT WILL IMPROVE THE HEALTH STATUS OF THE ECONOMICALLY DISADVANTAGED, ELDERS, AND CHILDREN AGED 0-5 WITHIN OUR SERVICE AREA. DESCRIPTIONS OF RELATIONSHIPS FORM 990, PART VI, QUESTION 2 HOME STAFF, LLC IS A JOINT VENTURE OF FCHP AND THE VNA CARE NETWORK & HOSPICE. THE FOLLOWING FCHP BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES SERVED ON THE HOME STAFF BOARD OF DIRECTORS DURING 2011: KAREN GREEN, RICHARD BURKE, PATRICK HUGHES AND TODD BAILY. FALLON HEALTH & LIFE ASSURANCE COMPANY, INC. (FHLAC), IS A WHOLLY-OWNED SUBSIDIARY OF FCHP. THE FOLLOWING FCHP BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES SERVED ON THE FHLAC BOARD OF DIRECTORS IN 2011: KAREN GREEN, DAVID HILLIS, RICHARD HOULIHAN, CHRISTIAN MCCARTHY, PATRICK HUGHES AND SCOTT WALKER. ULTRABENEFITS, INC. (UBI) IS A WHOLLY-OWNED SUBSIDIARY OF FHLAC. THE FOLLOWING FCHP BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES SERVED ON THE UBI BOARD OF DIRECTORS IN 2011: PATRICK HUGHES, SCOTT WALKER, AND DAVID PRZESIEK PROCESS USED BY MANAGEMENT AND GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B DESCRIBE THE PROCESS USED BY MANAGEMENT AND GOVERNING BODY TO REVIEW 990 A DRAFT OF THE 990 WAS PREPARED BY FCHP'S PAID PREPARER USING INFORMATION PROVIDED BY THE ORGANIZATION. THIS DRAFT WAS REVIEWED BY FCHP'S VICE PRESIDENT OF ACCOUNTING OPERATIONS & FINANCIAL PLANNING ANALYSIS, AND SENIOR MANAGEMENT, INCLUDING THE CHIEF FINANCIAL OFFICER, CHIEF COMPLIANCE OFFICER, CHIEF HUMAN RESOURCES OFFICER, AND CHIEF EXECUTIVE OFFICER. AFTER THIS REVIEW A FINAL FORM 990 WAS PREPARED, AND THE FINAL VERSION OF THE 990 WAS PROVIDED TO EACH BOARD MEMBER FOR HIS OR HER REVIEW BEFORE THE 990 WAS FILED WITH THE IRS. DESCRIBE THE PROCESS TO MONITOR CONFLICTS OF INTERESTS FORM 990, PART VI, QUESTION 12 A,B,C FCHP'S BYLAWS REQUIRE ALL DIRECTORS AND OFFICERS TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AS DEFINED IN THE ORGANIZATION'S CONFLICT OF INTEREST POLICY RELATING TO DIRECTORS, OFFICERS AND MEMBERS OF A COMMITTEE WITH BOARD-DELEGATED POWERS. THIS IS ENFORCED BY THE REQUIREMENT THAT SUCH INDIVIDUALS ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. EACH YEAR THE COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD WHICH REPORTS ANY ACTUAL OR POTENTIAL CONFLICTS TO THE FULL BOARD. ANY BOARD MEMBER OR OFFICER WITH A CONFLICT OF INTEREST IS PROHIBITED FROM PARTICIPATING IN ANY DISCUSSION OF, OR VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. TWO INDEPENDENT BOARD MEMBERS ALSO CONDUCT AN ANNUAL REVIEW OF ANY BUSINESS TRANSACTIONS INVOLVING THE ORGANIZATION THAT COULD POTENTIALLY BENEFIT A BOARD MEMBER OR OFFICER, TO ENSURE THAT THE TRANSACTIONS DO NOT INVOLVE ANY UNDUE INFLUENCE, ARE AT FAIR MARKET VALUE, AND ARE IN THE ORGANIZATION'S BEST INTEREST. THE REVIEWING BOARD MEMBERS REPORT THEIR FINDINGS TO THE FULL BOARD. FURTHERMORE, AT BOARD MEETINGS, INDIVIDUAL BOARD MEMBERS ARE ASKED TO IDENTIFY, AND RECUSE THEMSELVES FROM ANY DISCUSSION AND VOTE ON ANY MATTER BEFORE THE BOARD IN WHICH THEY MAY HAVE A CONFLICT. FCHP ALSO REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES, TO COMPLETE A WRITTEN DISCLOSURE STATEMENT DESIGNED TO IDENTIFY POTENTIAL CONFLICTS. FCHP ALSO HAS GENERAL CORPORATE-WIDE CONFLICT OF INTEREST POLICIES THAT REQUIRE REPORTING OF POTENTIAL CONFLICTS AND MANAGEMENT APPROVAL OF CERTAIN TRANSACTIONS, AND PROHIBITS CERTAIN SPECIFIC TRANSACTIONS. THESE POLICIES ARE ENFORCED BY SENIOR MANAGEMENT, INCLUDING THE CHIEF COMPLIANCE OFFICER. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED FORM 990, PART VI, QUESTIONS 15A & 15B FCHP HAS ESTABLISHED AN EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS THAT ESTABLISHES POLICIES AND THE COMPENSATION STRUCTURE OF CERTAIN OF FCHP'S EXECUTIVE OFFICERS. THIS COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE EXECUTIVE OFFICERS IS DETERMINED BY A FAIR AND EQUITABLE PROCESS, INFORMED BY CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION, AND COMPLIANT WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN 2011, THE COMMITTEE CONSISTED OF THREE MEMBERS OF FCHP'S BOARD OF DIRECTORS, WHO ARE NOT EMPLOYED BY THE ORGANIZATION. FCHP'S CEO SERVED AS AN EX OFFICIO MEMBER OF THE COMMITTEE WITHOUT A VOTING RIGHT. THE EXECUTIVE OFFICERS OVER WHOSE COMPENSATION THE COMMITTEE IS RESPONSIBLE ARE COMPRISED OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER ("CEO"), AND THE PRESIDENT, EXECUTIVE VICE PRESIDENT, AND SENIOR VICE PRESIDENT POSITIONS THAT REPORT DIRECTLY TO THE CEO ("EXECUTIVE GROUP"). IN 2011, TO DETERMINE THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP, THE COMMITTEE RELIED ON A WRITTEN COMPENSATION SURVEY PRODUCED BY AN INDEPENDENT CONSULTING FIRM THAT ASSESSES EXECUTIVE COMPENSATION AND BENEFITS. THE COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP AND REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT CONSULTING FIRM. THE COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION OF THE EXECUTIVE GROUP (OTHER THAN THE CEO). FOR THE CEO'S COMPENSATION, THE COMMITTEE (MEETING WITHOUT THE CEO) RECOMMENDED A COMPENSATION STRUCTURE THAT WAS PRESENTED TO FCHP'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS (WITHOUT THE CEO PRESENT), VOTED TO APPROVE THE COMMITTEE'S RECOMMENDATION. ALL THESE DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES OF THE COMMITTEE AND BOARD OF DIRECTORS. THIS PROCESS WAS USED TO ESTABLISH THE COMPENSATION FOR THE EXECUTIVE GROUP IN 2011. THIS PROCESS WAS NOT USED TO ESTABLISH COMPENSATION FOR THE "KEY EMPLOYEES" LISTED IN SCHEDULE J. POLICIES IN REGARD TO JOINT VENTURES FORM 990, PART VI, QUESTION 16B SINCE THIS JOINT VENTURE IS MADE UP OF TWO EXEMPT ORGANIZATION, UNDER CODE SECTION 501(C)(3), THE POLICY IS NOT NECESSARILY RELEVANT AS THERE IS NO TAXABLE ENTITY INVOLVED AS A PARTNER. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 FCHP'S FORM 990 AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FCHP'S ANNUAL REPORT IS AVAILABLE ON ITS OWN WEBSITE. FCHP'S FORM 990, FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL REPORT ARE ALSO PROVIDED ON REQUEST. OTHER CHANGES IN NET ASSETS OR FUND BALANCES Form 990, Part XI, Line 5 Other Changes in fund balance Other changes in net assets of $(4,518,060) consists of the following items: Unrealized losses, $(7,015,876) Change in Minimum pension, $2,497,812 Rounding adjustment $4 SUMMIT LIVING INC 10 CHESTNUT STREET WORCESTER MA 01608 261836279 Asst Living MA 501(c)(3) 9 na true HOME STAFF LLC 40 MILLBROOK STREET Worcester MA 01606 421757904 IN HOME SERVICE MA na Investment -49300 2338594 false -5088 false 0.50000 FALLON HEALTH AND LIFE ASSURANCE COMPANY 10 CHESTNUT STREET WORCESTER MA 01608 043169246 Hlth Life Assur MA FCHP C Corp -8017346 23564519 1.00000 Ultrabenefits Inc 29 East Mountain Street Worcester MA 01606 043525752 3rd Party Adm MA FHLAC C Corp -27885 1360351 1.00000 false true false false false false false false false false false false true true false false false false FALLON HEALTH AND LIFE ASSURANCE CO INC B 8400000 cash FALLON HEALTH AND LIFE ASSURANCE CO INC M 2820876 cash FALLON HEALTH AND LIFE ASSURANCE CO INC N 5132019 cash