2011-11-03T16:08:55-04:00 2010-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2010-01-01 133330672 AFFINITY HEALTH PLAN INC AFFI 7187947700 2500 Halsey Street Bronx NY 10461 Maura Bluestone 2011-11-03 3176817000 2010 2016-03-07 17:11:31Z 877630798 false X www.affinityplan.org X 1981 NY improve the health of underserved populations. 9 9 941 0 0 0 0 0 695017527 810725771 -35713 2765674 56986 25091 695038800 813516536 6000 0 0 0 57276378 55173044 0 0 0 644031550 754685191 701313928 809858235 -6275128 3658301 259282550 256800675 123342197 116555725 135940353 140244950 X 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 579240193 0 644802193 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. 74589649 0 80580928 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. 33607883 0 46433609 THE CHILD HEALTH PLUS (CHP) PROGRAM IS FUNDED BY THE STATE OF NEW YORK TO PROVIDE HEALTH INSURANCE COVERAGE FOR CHILDREN THAT ARE UNDER THE AGE OF 19. 30527584 0 38909040 717965309 true false false false false false false false true true false true 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 5766 0 false 941 true false false false false false false false false false false X 9 9 false false false false false false false true true false false false 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 Katherine Golar 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 Maura Bluestone 37.5 X 383356 0 50074 Mark Corcoran 37.5 X 277138 0 31059 Bob Brown 37.5 X 138584 0 554 Robert Allen 37.5 X 130131 0 7167 Abenna Abboa-Offei 37.5 X 226911 0 34748 Ann Van Etten 37.5 X 188406 0 30502 Caron Cullen 37.5 X 182862 0 35330 Kelbourne Ritter 37.5 X 220066 0 44986 Dr Munish Khaneja 37.5 X 237487 0 16629 Joseph Karp 37.5 X 210125 0 6746 Charlie Krajacic 37.5 X 184849 0 20707 2379915 0 278502 60 false true false Emdeon 12016 Collection Center Drive CHICAGO IL 60693 RETRO BILLING 1356520 HERNANDO MAINTENANCE 1780 EASTBURN AVE 3C BRONX NY 10457 BUILDING MAINTENANCE 601565 ERNST YOUNG Bank of America - PO Box 96550 CHICAGO IL 60693 AUDIT AND CONSULTING 539488 EXPRESS SCRIPT ONE EXPRESS WAY HQ3W01 ST LOUIS MO 63121 ADMINISTRATIVE SVCS 516197 RDT 40 WEST FIRST STREET MT VERNON NY 10552 SECURITY 217325 10 0 Total Program Service Revenues 524114 810725771 810725771 810725771 1567033 0 1567033 0 0 96294 80071 16223 16223 16223 65232832 64034191 1198641 1198641 1198641 0 0 0 MISCELLANEOUS 900099 8868 8868 8868 813516536 810725771 0 2790765 0 0 0 0 2283438 2283438 0 0 40843338 40843338 1639456 1639456 6531747 6531747 3875065 3875065 2330446 2330446 328173 328173 390756 390756 0 0 236747 236747 0 1118947 1118947 1581850 1581850 83055 83055 0 6073801 6073801 221424 221424 0 125126 125126 2166153 2166153 0 6273639 6273639 639007 639007 INPATIENT 236945273 236945273 OUTPATIENT 137836475 137836475 PHARMACY 14598565 14598565 PHYSICIAN PATIENT CARE 224547374 224547374 Other Medical 104037622 104037622 15150758 15150758 809858235 717965309 91892926 0 59186128 80109251 92670521 92418530 58742821 33565253 27810995 25177568 70025447 39496269 2141721 0 7447738 19599057 259282550 256800675 120571148 113883866 2771049 2671859 123342197 116555725 X 49324096 34487364 86616257 105757586 135940353 140244950 259282550 256800675 X 3658301 646296 X false true true X true true X 85672701 19141329 104814030 71789689 14354790 471778 85672701 79076598 11787917 19074826 71789689 0.31500 0.68500 7962612 715930 7246682 3084426 887625 2196801 20353076 4618991 15734085 25177568 ADVANCES TO PROVIDERS 18445204 OTHER 1153853 19599057 0 Other Liabilities 2671859 2671859 813516536 809858235 3658301 646296 646296 4304597 814162832 646296 646296 813516536 813516536 807716514 -2141721 -2141721 809858235 809858235 ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 STATUTORILY RESTRICTED NET ASSETS: NYSDOH REGULATIONS REQUIRE THE PLAN TO MAINTAIN AN ESCROW DEPOSIT OF THE GREATER OF 5% OF PROJECTED MEDICAL EXPENSES FOR THE CALENDAR YEAR OR $100,000 - $40,176,762. BOARD DESIGNATED NET ASSETS: BOARD DESIGNATED NET ASSETS CONSIST PRIMARILY OF AMOUNTS SET ASIDE BY THE BOARD OF DIRECTORS TO FUND STRATEGIC INITIATIVES - $20,762,333. SCHEDULE D, PART XIII, LINE 2D LOSS OF $2,141,721 WAS DUE TO A CHANGE IN ACCOUNTING PRINCIPLES. X X false false false false false false false false false Maura Bluestone 374822 0 0 0 8534 0 29400 0 20674 0 433430 0 0 0 Mark Corcoran 276106 0 0 0 1032 0 12985 0 18074 0 308197 0 0 0 Abenna Abboa-Offei 223456 0 0 0 3455 0 21850 0 12898 0 261659 0 0 0 Ann Van Etten 186822 0 0 0 1584 0 22604 0 7898 0 218908 0 0 0 Caron Cullen 170630 0 0 0 12232 0 22440 0 12890 0 218192 0 0 0 Kelbourne Ritter 208145 0 6600 0 5321 0 21926 0 23060 0 265052 0 0 0 Dr Munish Khaneja 237271 0 0 0 216 0 0 0 16629 0 254116 0 0 0 Joseph Karp 210125 0 0 0 0 0 6304 0 442 0 216871 0 0 0 Charlie Krajacic 162989 0 0 0 21860 0 2709 0 17998 0 205556 0 0 0 SCHEDULE J, PART II KEL RITTER REACHED HIS MEMBERSHIP GROWTH GOAL FOR 2009. THE INCENTIVE WAS PAID TO HIM IN 2010. THE INCENTIVE BONUS REPRESENTED 3% OF KEL RITTER'S 2009 BASE SALARY OF $220,000. THIS WAS BASED ON THE OVERALL INCENTIVE PERFORMANCE SCORE ACHIEVED AS DEFINED IN THE INCENTIVE PROGRAM PERFORMANCE FACTORS. 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 11 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 NOT 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. ALL EMPLOYEES WILL COMPLETE THE COMPLIANCE CODE OF ETHICS ATTESTATION DURING INITIAL TRAINING AND AN INDEPENDENT ACKNOWLEDGMENT REGARDING THE CODE OF ETHICS THEREAFTER DURING ANNUAL TRAINING. OFFICES & 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") COMPRISED OF INDEPENDENT DIRECTORS CHARGED WITH THIS RESPONSIBILITY, CONSIDERATION OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION AND DOCUMENTATION OF THE DELIBERATION AND 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 UPON REQUEST. RECONCILIATION OF NET ASSETS PART XI, LINE 5 $646,296 OF OTHER CHANGES IN NET ASSETS IS A RESULT OF NET UNREALIZED GAINS.