NEW YORK STATE CATHOLIC HEALTH PLAN INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: NEW YORK STATE CATHOLIC HEALTH PLAN INC (EIN 11-3153422)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-08-11
IRS object ID: 201122239349302102
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-08-11T14:45:35-05:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DELOITTE TAX LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	TWO JERICHO PLAZA	AddressLine1
City	JERICHO	City
State	NY	State
ZIP Code	11753	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	113153422	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	NEW YORK STATE CATHOLIC HEALTH PLANINC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	NEWY	NameControl
Phone	7183936151	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	95-25 QUEENS BOULEVARD	AddressLine1
City	REGO PARK	City
State	NY	State
ZIP Code	11374	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARK L LANE	Name
Title	PRESIDENT & CEO	Title
Phone	7183936151	Phone
Date Signed	2011-08-10	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	5169187000	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	FIDELIS CARE NEW YORK	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MARK L LANE	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	95-25 QUEENS BOULEVARD	AddressLine1
City	REGO PARK	City
State	NY	State
ZIP Code	11374	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	2374828133	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.FIDELISCARE.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1993	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES TO THE COMMUNITY, ESPECIALLY TO THE POOR AND UNDERSERVED; TO PROMOTE HEALTH EDUCATION AND PREVENTATIVE MEDICINE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	18	NbrIndependentVotingMembers
Total Nbr Employees	1790	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	537574	ContributionsGrantsPriorYear
Contributions Grants Current Year	211811	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	1432031556	ProgramServiceRevenuePriorYear
Program Service Revenue CY	1911001018	ProgramServiceRevenueCY
Investment Income Prior Year	2431508	InvestmentIncomePriorYear
Investment Income Current Year	9567496	InvestmentIncomeCurrentYear
Other Revenue Prior Year	215408	OtherRevenuePriorYear
Other Revenue Current Year	181706	OtherRevenueCurrentYear
Total Revenue Prior Year	1435216046	TotalRevenuePriorYear
Total Revenue Current Year	1920962031	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	2505994	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	2496644	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	1255838987	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	1703299439	BenefitsPaidToMembersCY
Salaries Etc Prior Year	95717598	SalariesEtcPriorYear
Salaries Etc Current Year	102652058	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	53270927	OtherExpensePriorYear
Other Expenses Current Year	61144552	OtherExpensesCurrentYear
Total Expenses Prior Year	1407333506	TotalExpensesPriorYear
Total Expenses Current Year	1869592693	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	27882540	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	51369338	RevenuesLessExpensesCY
Total Assets BOY	490906279	TotalAssetsBOY
Total Assets EOY	585701387	TotalAssetsEOY
Total Liabilities BOY	287773688	TotalLiabilitiesBOY
Total Liabilities EOY	320658782	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	203132591	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	265042605	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SEE SCHEDULE O	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	1146852843	Expense
Grants	1767988	Grants
Revenue	1302393621	Revenue
Description	MEDICAID MANAGED CARE PROGRAM IS A NEW YORK STATE PROGRAM ADMINISTERED BY FIDELIS THAT PROVIDES FREE COMPREHENSIVE HEALTH COVERAGE FOR ELIGIBLE INDIVIDUALS AND FAMILIES WHO ARE RESIDENTS OF NEW YORK STATE AND HAVE LOW INCOME AND LIMITED RESOURCES. THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	198706125	Expense
Grants	294636	Grants
Revenue	216434686	Revenue
Description	FAMILY HEALTH PLUS ("FHP") IS PART OF NEW YORK STATE'S FAMILY HEALTH PLUS PROGRAM ADMINISTERED BY FIDELIS FOR UNINSURED ADULTS, AGES 19-64, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID. FAMILY HEALTH PLUS PROVIDES COMPREHENSIVE COVERAGE, INCLUDING PREVENTION, PRIMARY CARE, HOSPITALIZATION, AND OTHER SERVICES. THE NEW YORK STATE DEPARTMENT OF HEALTH ESTABLISHES ELIGIBILITY CRITERIA WITH REGARD TO INCOME (IN RELATION TO A PERCENTAGE OF THE FEDERAL POVERTY LEVEL), RESIDENCY, RESOURCES, AGE, AND IMMIGRATION STATUS, AMONG OTHER FACTORS, AND ELIGIBILITY FOR THE PROGRAM IS DETERMINED BASED ON INCOME, RESOURCES, AND FAMILY SIZE.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	154043903	Expense
Revenue	164861434	Revenue
Description	EMPLOYER PARTNERSHIP FOR FAMILY HEALTH PLUS ("FAMILY HEALTH PLUS BUY-IN") IS A PROGRAM SPONSORED BY THE STATE OF NEW YORK, WHEREBY FIDELIS PROVIDES FAMILY HEALTH PLUS STATE-MANDATED BENEFITS, SUBJECT TO SPECIFIC EXCLUSIONS, TO CERTAIN ELIGIBLE MEMBERS OF THE 1199SEIU NATIONAL BENEFIT FUND FOR HOME CARE EMPLOYEES. 1199SEIU NATIONAL BENEFIT FUND DETERMINES THE ELIGIBILITY OF ITS MEMBERS TO PARTICIPATE IN THE PROGRAM.	Description

Activity Other ActivityOther (2 entries)

ExpenseExpense	GrantsGrants	RevenueRevenue	DescriptionDescription
206193212	434020	227311277
			OTHER PROGRAMS ADMINISTERED BY THE PLAN INCLUDE THE CHILD HEALTH PLUS PROGRAM, MEDICARE ADVANTAGE PROGRAM, MEDICARE/MEDICAID DUAL ADVANTAGE PROGRAM, FIDELIS CARE AT HOME, AND MEDICAID ADVANTAGE PLUS PROGRAM. THE CHILD HEALTH PLUS PROGRAM COVERS UNINSURED CHILDREN UNDER THE AGE OF 19, WHO ARE RESIDENTS OF NEW YORK STATE AND ARE NOT ELIGIBLE FOR MEDICAID. THE PROGRAM PROVIDES COMPREHENSIVE COVERAGE, INCLUDING PREVENTION, PRIMARY CARE, HOSPITALIZATION, PRESCRIPTIONS AND OTHER SERVICES. MEDICARE ADVANTAGE PROGRAM IS A PROGRAM AVAILABLE TO ADULTS AGED 65 AND OVER WHO ARE ELIGIBLE UNDER MEDICARE. BENEFICIARIES MAY CHOOSE TO USE PRIVATE PAY OPTIONS, ESTABLISH MEDICAL SAVINGS ACCOUNTS, USE MANAGED CARE PLANS SUCH AS FIDELIS, OR JOIN PROVIDER-SPONSORED PLANS. MEDICARE/MEDICAID DUAL ADVANTAGE IS A PROGRAM FOR THOSE WHO MEET ELIGIBILITY REQUIREMENTS FOR BOTH MEDICARE AND MEDICAID AND ARE ENROLLED IN BOTH PROGRAMS. FIDELIS CARE AT HOME IS A MANAGED LONG-TERM CARE PROGRAM FOR RESIDENTS OF ORANGE AND ROCKLAND COUNTIES, 18 YEARS OF AGE AND OLDER, WHO NEED LONG-TERM CARE SERVICES AND ARE ELIGIBLE FOR MEDICAID. MEMBERS HAVE THEIR OWN CARE MANAGER, RECEIVE INDIVIDUAL ATTENTION, AND HAVE THE SUPPORT AND RESOURCES THEY NEED TO HELP THEM LIVE INDEPENDENTLY IN THEIR OWN HOMES AND COMMUNITIES. MEDICAID ADVANTAGE PLUS IS A FULL-RISK MANAGED LONG-TERM CARE PROGRAM FOR INDIVIDUALS 18 YEARS OF AGE AND OLDER WITH MEDICARE AND MEDICAID COVERAGE WHO HAVE A CHRONIC ILLNESS OR DISABILITY. MEMBERS MUST BE IN NEED OF LONG-TERM CARE SERVICES AND MAY NEED CARE TYPICALLY GIVEN IN A NURSING HOME.

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	206193212	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	434020	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	227311277	TotalOfOtherProgramServiceRev
Total Program Service Expense	1705796083	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	12010	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1790	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	18	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	WILLIAM COFFIN JR	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7183936151	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	95-25 QUEENS BLVD	AddressLine1
City	REGO PARK	City
State	NY	State
ZIP Code	11374	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
KARL P ADLER MD
DIRECTOR	0.00	X	0	0	0
JACK BALINSKY
DIRECTOR	0.00	X	0	0	0
M WILLIAM BENEDETTO
DIRECTOR	0.00	X	0	0	0
SISTER PATRICIA BURKARD OSF
DIRECTOR/SECRETARY	0.00	X	0	0	0	X
JAMES M CORRIGAN CPA MHA
DIRECTOR/TREASURER	0.00	X	0	0	0	X
REV JOHN COUGHLIN
DIRECTOR	0.00	X	0	0	0
THOMAS DESTEFANO
DIRECTOR	0.00	X	0	0	0
REV DONALD J HARRINGTON
DIRECTOR	0.00	X	0	0	0
JOHN J HURLEY
DIRECTOR	0.00	X	0	0	0
THOMAS L KELLY
DIRECTOR/VICE-CHAIRMAN	0.00	X	0	0	0	X
MARK L LANE
PRESIDENT & CEO	38.00	X	1748733	0	215941	X
REV LEO J O'DONOVAN SJ
DIRECTOR	0.00	X	0	0	0
GINO PAZZAGLINI
DIRECTOR	0.00	X	0	0	0
REV MONSIGNOR ALAN J PLACA
DIRECTOR	0.00	X	0	0	0
JOSEPH SLAVIK
DIRECTOR	0.00	X	0	0	0
MOST REV JOSEPH M SULLIVAN
CHAIRMAN OF THE BOARD	0.00	X	0	0	0	X
N NOEL TESTA MD
DIRECTOR	0.00	X	0	0	0
MICHAEL J TOOLEY
DIRECTOR	0.00	X	0	0	0
JOHN A WERWAISS
DIRECTOR	0.00	X	0	0	0
THOMAS HALLORAN
CHIEF FINANCIAL OFFICER	38.00		359513	19077	47670	X
PATRICK J FRAWLEY
EVP & COO	38.00		1480571	32554	60515		X
DAVID THOMAS
SR VP & CHIEF ADM. OFF.	38.00		640620	0	48672		X
PAMELLA HASSEN
CHIEF MARKETING OFFICER	38.00		286935	0	35636		X
MARGARET M BRUBAKER
CHIEF HR OFFICER	38.00		227532	0	7284		X
ROBERT HOOVER
CHIEF INF. OFFICER	38.00		128037	0	9070		X
SANJIV SHAH MD
CHIEF MEDICAL OFFICER	38.00		131715	0	445		X
WILLIAM COFFIN JR
VP FINANCE	38.00		267553	0	38862			X
RUPERT BRADY
VP MARKETING	38.00		237277	0	35968			X
ROBERT FAZZOLARI
VP GOV'T AFFAIRS & COM.	38.00		244675	0	25675			X
PAMELA WILKES
VP NETWORK DEV.	38.00		241143	0	23974			X
JAMES M BURNOSKY
VP STRATEGIC PLANNING	38.00		186452	33446	32338			X
EDWARD ANSELM MD
CHIEF MEDICAL OFFICER	38.00		217869	0	17481				X
PATRICK GARLAND
CHIEF INF. OFFICER	38.00		151661	0	10028				X
ROBERT PIGOTT
CHIEF LEGAL OFFICER	38.00		236113	10897	36372				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	6526647	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	95974	TotalReportableCompFrmRltdOrgs
Total Other Compensation	636416	TotalOtherCompensation
Number Individuals GT100 K	99	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
IHT SERVICES LLC
115 PERIMETER CENTER PLACE SUITE 70	ATLANTA	GA	30346	MEDICAL CLAIMS REVIEW	3187475
PCI
703 WASHINGTON STREET	BUFFALO	NY	142031416	IT SERVICES	3181242
HEALTH MANAGEMENT SYSTEMS INC
PO BOX 27151	NEW YORK	NY	100877151	COORDINATION OF BENEFITS REVIEW	2247575
EMDEON BUSINESS SERVICES
12016 COLLECTIONS CTR DR	CHICAGO	IL	606930120	CLAIMS PROCESSING SERVICES	1151561
HEALTHTRIO LLC
400 S COLORADO BLVD SUITE 540	DENVER	CO	802461255	WEB PORTAL	968339

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	23	NumberOfContractorsGT100K
Related Organizations	4500	RelatedOrganizations
Government Grants	13489	GovernmentGrants
All Other Contributions	193822	AllOtherContributions
Total Contributions	211811	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID	524114	1302393621	1302393621
FAMILY HEALTH PLUS	524114	216434686	216434686
FHP BUY-IN	524114	164861434	164861434
CHILD HEALTH PLUS	524114	111612123	111612123
MEDICARE ADVANTAGE	524114	95682897	95682897

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	20016257	TotalRevenueColumn
Related Or Exempt Function Income	20016257	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	1911001018	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	6038456	TotalRevenueColumn
Exclusion	$6,038,456	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	457395142	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	453866102	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	3529040	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	3529040	TotalRevenueColumn
Exclusion	$3,529,040	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
PURCHASE REBATES	524298	86278	$86,278
EQUITY IN SALUS ADMIN.	900001	36224	$36,224
MISCELLANEOUS	524298	32892	$32,892

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	26312	TotalRevenueColumn
Exclusion	$26,312	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	181706	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1920962031	TotalRevenueColumn
Related Or Exempt Function Income	1911001018	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$9,749,202	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	2378303	Total
Program Services	2378303	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	118341	Total
Program Services	118341	ProgramServices

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	1703299439	Total
Program Services	1703299439	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	6403834	Total
Management And General	6403834	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	75135476	Total
Management And General	75135476	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2826003	Total
Management And General	2826003	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	12642739	Total
Management And General	12642739	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	5644006	Total
Management And General	5644006	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1499394	Total
Management And General	1499394	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	644015	Total
Management And General	644015	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	58525	Total
Management And General	58525	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	547725	Total
Management And General	547725	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	1391718	Total
Management And General	1391718	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	6113864	Total
Management And General	6113864	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	497313	Total
Management And General	497313	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3945889	Total
Management And General	3945889	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	4134116	Total
Management And General	4134116	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	2160541	Total
Management And General	2160541	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	281365	Total
Management And General	281365	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	291753	Total
Management And General	291753	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	5508111	Total
Management And General	5508111	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	589317	Total
Management And General	589317	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral
CLAIMS PROCESSING	7698350	7698350
LICENSE FEES	4269709	4269709
PRINTING & PUBLICATIONS	3922388	3922388
POSTAGE & SHIPPING	3876097	3876097
TELEPHONE	2266859	2266859

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	11447503	Total
Management And General	11447503	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	1869592693	Total
Program Services	1705796083	ProgramServices
Management And General	163796610	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	161811605	BOY
EOY	199115341	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	42164251	BOY
EOY	43799357	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	31097901	BOY
EOY	28195560	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	49434415	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	41058051	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	7554357	BOY
EOY	8376364	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	175503464	BOY
EOY	209376373	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	222147	BOY
EOY	258371	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	17712278	BOY
EOY	16942278	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	54840276	BOY
EOY	79637743	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	490906279	BOY
EOY	585701387	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	30639803	BOY
EOY	44002980	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	803790	BOY
EOY	1016466	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	7500000	BOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	248830095	BOY
EOY	275639336	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	287773688	BOY
EOY	320658782	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	202752541	BOY
EOY	264594074	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	380050	BOY
EOY	448531	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	203132591	BOY
EOY	265042605	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	490906279	BOY
EOY	585701387	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	51369338	ReconcilationRevenueExpenses
Reconcilation Other Changes	10540676	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	261757	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	185206	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	848235	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	537574	CurrentTaxYearMinus1Year
Current Tax Year	211811	CurrentTaxYear
Total	2044583	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	599417358	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	669307221	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	996353043	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1432031556	CurrentTaxYearMinus1Year
Current Tax Year	1911001018	CurrentTaxYear
Total	5608110196	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	599679115	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	669492427	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	997201278	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1432569130	CurrentTaxYearMinus1Year
Current Tax Year	1911212829	CurrentTaxYear
Total	5610154779	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	5610154779	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6078071	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	8410230	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9566173	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6565256	CurrentTaxYearMinus1Year
Current Tax Year	6033312	CurrentTaxYear
Total	36653042	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6078071	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	8410230	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9566173	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6565256	CurrentTaxYearMinus1Year
Current Tax Year	6033312	CurrentTaxYear
Total	36653042	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1820656	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4891744	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	485232	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	189310	CurrentTaxYearMinus1Year
Current Tax Year	155394	CurrentTaxYear
Total	7542336	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	607577842	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	682794401	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1007252683	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1439323696	CurrentTaxYearMinus1Year
Current Tax Year	1917401535	CurrentTaxYear
Total	5654350157	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99220	PublicSupportPercentage509
Prior Year Support Percentage	0.98970	PriorYearSupportPercentage
Investment Income Percentage	0.00650	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00850	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509
General Explanation	SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: DESCRIPTION 2006 2007 2008 2009 2010 TOTAL MISCELLANEOUS INCOME 60,346 4,131 110,414 25,808 32,892 233,591 PURCHASE REBATES 91,135 87,295 104,727 91,355 86,278 460,790 EQUITY IN SUBS. 515,354 4,800,318 270,091 72,147 36,224 5,694,134 CLAIMS PROCESSING 60,000 0 0 0 0 60,000 INSURANCE PROCEEDS 1,093,821 0 0 0 0 1,093,821 TOTAL $1,820,656 $4,891,744 $485,232 $189,310 $155,394 $7,542,336	GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$58,525	OtherActivitiesAmount
Total Lobbying Expenditures IIB	58525	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	PART IV, SUPPLEMENTAL INFORMATION:	Identifier
Explanation	SCHEDULE C, PART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES: FIDELIS IS A MEMBER OF CERTAIN ASSOCIATIONS, TO WHICH IT PAYS ANNUAL DUES. A PORTION OF THOSE DUES ARE DETERMINED TO BE EXPENDITURES FOR LOBBYING PURPOSES. IN 2010, THAT PORTION IS $58,525.	Explanation

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	3623303	InvestmentCostOrOtherBasis
Depreciation	3185952	Depreciation
Book Value	437351	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	9431821	InvestmentCostOrOtherBasis
Depreciation	8154144	Depreciation
Book Value	1277677	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	36379291	InvestmentCostOrOtherBasis
Depreciation	29717955	Depreciation
Book Value	6661336	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	8376364	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
ASSETS WHOSE USE IS LIMITED (RESTRICTED FUNDS)	77592080
OTHER RECEIVABLES	2045663

Field	Value	IRS element (for citing)
Total Book Value Other Assets	79637743	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
CLAIMS PAYABLE	$262,231,401
DUE TO NEW YORK STATE	$12,759,453
CAPITAL LEASE PAYABLE	$648,482

Field	Value	IRS element (for citing)
Total Of Amounts	275639336	TotalOfAmounts
Total Revenue	1920962031	TotalRevenue
Total Expenses	1869592693	TotalExpenses
Excess Or Deficit For Year	51369338	ExcessOrDeficitForYear
Net Unrealized GL On Investments	10752122	NetUnrealizedGLOnInvestments
Other	-$211,446	OtherAmount
Total Adjustments	10540676	TotalAdjustments
Excess Or Deficit Per FS	61910014	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	1931769257	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	10752122	NetUnrealizedGainsInvestments
Other Revenues	89117	OtherRevenues
Revenue Not Rptd F990	10841239	RevenueNotRptdF990
Revenue Subtotal	1920928018	RevenueSubtotal
Other Revenues Not Included	34013	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	34013	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	1920962031	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	1869859243	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	267647	OtherExpensesIncluded
Expenses Not Rptd F990	267647	ExpensesNotRptdF990
Expenses Subtotal	1869591596	ExpensesSubtotal
Other Expenses Not Included	1097	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	1097	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	1869592693	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	EFFECTIVE JANUARY 1, 2009, THE PLAN ADOPTED THE PROVISION OF A STATEMENT ISSUED BY THE FASB WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IN AN ENTITY'S FINANCIAL STATEMENTS. IT PRESCRIBES AN UNCERTAINTY THRESHOLD AND MEASUREMENT ATTRIBUTES FOR FINANCIAL STATEMENT DISCLOSURE OF TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, ON A TAX RETURN. THE IMPACT OF ADOPTING THE STATEMENT WAS NOT MATERIAL.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		NET ASSETS RELEASED 129,841. EQUITY IN SALUS ADMINISTRATION -36,224. SALUS CONTRIBUTION TO HK ELIMINATED ON CONSOLIDATION -4,500.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		ORDINARY INCOME FROM HPA, LLC 24,811. INTEREST INCOME FROM HPA, LLC 1,597. DIVIDEND INCOME FROM HPA, LLC 3,546. NET CAPITAL GAIN FROM HPA, LLC 2,558. NET IMPACT OF CURRENT AND PRIOR YEAR HPA, LLC RECONCILING ITEMS 1,501.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		EQUITY IN SALUS -36,224. SALUS CONTRIBUTION TO HK ELIMINATED ON CONSOLIDATION -4,500. NET ASSETS RELEASED 129,841. REVERSAL OF ACCRUED GRANTS NOT TO BE PAID IN THE FUTURE 178,530.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		INVESTMENT MANAGEMENT FEE FROM HPA, LLC 1,097.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (38 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Method Of ValuationMethodOfValuation	Purpose Of GrantPurposeOfGrant
AMAUS HEALTH SERVICES AT THE CATHEDRAL OF THE IMMACULATE CONCEPTION
259 E ONONDAGA STREET	SYRACUSE	NY	13202	611548780	501(C)(3)	8000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES DIOCESE OF ROCHESTER
1150 BUFFALO ROAD	ROCHESTER	NY	14624	160743944	501(C)(3)	46000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES NEIGHBORHOOD SERVICES
191 JORALEMON STREET	BROOKLYN	NY	11201	112047151	501(C)(3)	114730	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF BROOKLYN & QUEENS
191 JORALEMON STREET	BROOKLYN	NY	11201	111633548	501(C)(3)	112290	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF BUFFALO
741 DELAWARE AVENUE	BUFFALO	NY	14209	160743251	501(C)(3)	59700	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF NEW YORK
1011 FIRST AVENUE	NEW YORK	NY	10022	135562185	501(C)(3)	505000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF THE DIOCESE OF ALBANY
40 NORTH MAIN AVENUE	ALBANY	NY	12203	141340033	501(C)(3)	102000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF THE DIOCESE OF OGDENSBURG
6866 STATE HIGHWAY 37	OGDENSBURG	NY	13669	150614025	501(C)(3)	25000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
90 CHERRY LANE	HICKSVILLE	NY	11801	111843801	501(C)(3)	98000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC CHARITIES OF THE DIOCESE OF SYRACUSE
240 ONONDAGA STREET	SYRACUSE	NY	13202	150532085	501(C)(3)	94500	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC MEDICAL MISSION BOARD
10 WEST 17TH ST	NEW YORK	NY	100115765	135602319	501(C)(3)	13792	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CATHOLIC MIGRATION OFFICE
1258 65TH STREET	BROOKLYN	NY	11219	112634818	501(C)(3)	189980	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
COMMUNITY HEALTH CENTER OF BUFFALO INC
462 GRIDER ST	BUFFALO	NY	14215	161566929	501(C)(3)	12645	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
CORTLAND-CHENANGO RURAL SERVICES
2704 LOWER CINCINNATUS ROAD	CINCINNATUS	NY	13040	161075281	501(C)(3)	6000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
DEPT OF EDUC CATHOLIC SCHOOLS OF THE DIOCESE OF OGDENSBURG
100 ELIZABETH STREET	OGDENSBURG	NY	13669	150532120	501(C)(3)	31920	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
ELLIS HOSPITAL FOUNDATION
1101 NOTT STREET	SCHENECTADY	NY	12308	141638957	501(C)(3)	10000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC
17-29 MAIN ST SUITE 302	CORTLAND	NY	13045	161133983	501(C)(3)	95000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
FOUNDATION OF ST MARY'S HOSPITAL AT AMSTERDAM
427 GUY PARK AVENUE	AMSTERDAM	NY	12010	133254655	501(C)(3)	25000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
FRANSISCAN NORTHSIDE MINISTRIES
804 NORTH SALINA STREET	SYRACUSE	NY	13208	150532104	501(C)(3)	12500	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
GREATER HUDSON VALLEY FAMILY HEALTH CENTER
2570 ROUTE 9W SUITE 10	CORNWALL	NY	12518	061036715	501(C)(3)	50000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
HUDSON RIVER HEALTHCARE INC
1037 MAIN ST	PEEKSKILL	NY	10566	132828349	501(C)(3)	10000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
IBERO-AMERICAN ACTION LEAGUE INC
911 EAST MAIN ST	ROCHESTER	NY	14605	160954745	501(C)(3)	7500	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
INNER-CITY SCHOLARSHIP FUND
1011 FIRST AVENUE	NEW YORK	NY	10022	510453629	501(C)(3)	150000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
MERCY HOSPITAL OF BUFFALO
565 ABBOTT ROAD	BUFFALO	NY	14220	160756336	501(C)(3)	38600	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
MONTEFIORE MEDICAL CENTER
111 EAST 210TH STREET	BRONX	NY	104672490	131740114	501(C)(3)	10000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
NORTH SHORE-LIJ HEALTH SYSTEM
600 COMMUNITY DRIVE SUITE 102	MANHASSET	NY	11030	112163522	501(C)(3)	100000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
OFFICE OF CATHOLIC SCHOOLS DIOCESE OF SYRACUSE
240 EAST ONONDAGA ST PO BOX 511	SYRACUSE	NY	132010511	222563307	501(C)(3)	49050	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
OFFICE OF THE SUPT-CATHOLIC SUPPORT SERVICES DIOCESE OF BROOKLYN
7200 DOUGLASTON PARKWAY	DOUGLASTON	NY	11362	111631807	501(C)(3)	90500	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
P2 COLLABORATIVE OF WESTERN NEW YORK INC
6225 SHERIDAN DRIVE SUITE 206	WILLIAMSVILLE	NY	14221	421604185	501(C)(3)	30000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
QUEEN OF ALL SAINTS CHURCH
300 VANDERBILT AVENUE	BROOKLYN	NY	11205	111657620	170(B)(1)A(1)	25000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
ROCHESTER PARISH SUPPORT MINISTRIES
1150 BUFFALO ROAD	ROCHESTER	NY	14624	160755765	501(C)(3)	36000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
SETON HEALTH FOUNDATION
1300 MASSACHUSETTS AVENUE	TROY	NY	12181	222345416	501(C)(3)	100000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
ST JOHN'S RIVERSIDE HOSPITAL
967 N BROADWAY	YONKERS	NY	10701	131740126	501(C)(3)	7790	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
ST JOSEPH'S HOSPITAL HEALTH CENTER FOUNDATION
973 JAMES ST SUITE 250	SYRACUSE	NY	132032502	150532254	501(C)(3)	10106	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
THE FOUNDATION OF THE ROMAN CATHOLIC DIOCESE OF BUFFALO
795 MAIN STREET	BUFFALO	NY	14203	161517131	501(C)(3)	36700	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
THE KINGSTON HOSPITAL FOUNDATION
396 BROADWAY	KINGSTON	NY	12401	222511450	501(C)(3)	10000	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
WILLIAM F RYAN COMMUNITY HEALTH CENTER
110 WEST 97TH STREET	NEW YORK	NY	10025	132884976	501(C)(3)	7500	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O
GRANTS 5000
95-25 QUEENS BOULEVARD	REGO PARK	NY	11374		501(C)(3)	47500	CASH	SEE PURPOSE OF GRANTS IN SCHEDULE O

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	23	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	HEALTHY KIDS FUND	TypeOfGrant
Number Of Recipients	20276	NumberOfRecipients
Amount Of Cash Grant	118341	AmountOfCashGrant
Method Of Valuation	CASH PAID	MethodOfValuation
Description Of Non Cash Assistance	N/A	DescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: RECIPIENTS OF GRANT AWARDS UNDER THE COMMUNITY GRANT FUND ARE REQUIRED TO PROVIDE PERIODIC UPDATES ON THE ACCOMPLISHMENTS OF THE GRANT AND DISBURSEMENTS. IT IS THE RESPONSIBILITY OF THE GRANT RECIPIENT TO ENSURE THAT THE GRANT IS USED FOR THE PURPOSE(S) STATED IN THE ORIGINAL APPLICATION. FIDELIS MONITORS GRANT USAGE BY CORRESPONDENCE, TELEPHONE OR SITE VISITS. AN EVALUATION OF THE PROJECT IS REQUIRED UPON THE GRANTEE'S COMPLETION. NON-COMPLIANCE WITH THESE GUIDELINES MAY RESULT IN A REQUEST FOR RETURN OF THE FUNDS IN QUESTION OR INELIGIBILITY OF THE ORGANIZATION FOR FUTURE GRANTS FROM FIDELIS.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARK L LANE
1096183	0	0	0	652550	0	17244	0	198697	0	1964674	0	0	0
THOMAS HALLORAN
295389	16594	38624	2033	25500	450	16382	862	29181	1245	405076	21184	0	0
PATRICK J FRAWLEY
587249	32104	0	0	893322	450	16382	862	41525	1746	1538478	35162	0	0
DAVID THOMAS
320996	0	41323	0	278301	0	17244	0	31428	0	689292	0	0	0
PAMELLA HASSEN
227719	0	31326	0	27890	0	17244	0	18392	0	322571	0	0	0
MARGARET M BRUBAKER
194455	0	5000	0	28077	0	0	0	7284	0	234816	0	0	0
WILLIAM COFFIN JR
234588	0	25000	0	7965	0	17244	0	21618	0	306415	0	0	0
RUPERT BRADY
193240	0	28700	0	15337	0	17110	0	18858	0	273245	0	0	0
ROBERT FAZZOLARI
201459	0	26266	0	16950	0	17244	0	8431	0	270350	0	0	0
PAMELA WILKES
193823	0	23340	0	23980	0	16913	0	7061	0	265117	0	0	0
JAMES M BURNOSKY
141632	29541	22130	3905	22690	0	13332	2353	14832	1821	214616	37620	0	0
EDWARD ANSELM MD
146106	0	40990	0	30773	0	13126	0	4355	0	235350	0	0	0
PATRICK GARLAND
55800	0	0	0	95861	0	2989	0	7039	0	161689	0	0	0
ROBERT PIGOTT
152794	8885	32292	1700	51027	312	14387	783	20259	943	270759	12623	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	REFER TO LINE 4B BELOW:
PART I, LINE 4B	SERP COMPENSATION OF OFFICERS OR KEY EMPLOYEES: MARK L. LANE - $525,696 PATRICK J. FRAWLEY - $861,482 DAVID THOMAS - $252,366 THE ABOVE AMOUNTS INCLUDE GROSS-UP TAXES PAID ON BEHALF OF THE PARTICIPANTS.
PART I, LINE 7	PERFORMANCE-BASED INCENTIVES ARE PAID AS PART OF THE PLAN'S ANNUAL INCENTIVE PROGRAM. THE PRESIDENT & CHIEF EXECUTIVE OFFICER AND THE EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER DO NOT PARTICIPATE IN ANY INCENTIVE PROGRAM.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
SISTER PATRICIA BURKARD
OFFICER	14983141	MED. CLAIMS PAYMENTS TO ST. ELIZABETH MEDICAL CENTER	0
SISTER PATRICIA BURKARD
OFFICER	9732299	MED. CLAIMS PAYMENTS TO ST. JOSEPH'S HOSPITAL AND HEALTH CENTER	0
THOMAS DESTEFANO
DIRECTOR	23831	MED. CLAIMS PAYMENTS TO ST. JOACHIM & ANNE RESIDENCE	0
PATRICK J FRAWLEY
KEY EMPLOYEE	4422025	MED. CLAIMS PAYMENTS TO ST. VINCENT'S CATHOLIC MEDICAL CENTER	0
MARK L LANE
OFFICER	4422025	MED. CLAIMS PAYMENTS TO ST. VINCENT'S CATHOLIC MEDICAL CENTER	0
MARK L LANE
OFFICER	5123079	MED. CLAIMS PAYMENTS TO KINGSBROOK JEWISH MEDICAL CENTER	0
GINO J PAZZAGLINI
DIRECTOR	3321616	MED. CLAIMS PAYMENTS TO SETON HEALTH SYSTEM	0
MOST REV JOSEPH M SULLIVAN
CHAIRMAN OF BOARD	4422025	MED. CLAIMS PAYMENTS TO ST. VINCENT'S CATHOLIC MEDICAL CENTER	0
JOHN A WERWAISS
DIRECTOR	4422025	MED. CLAIMS PAYMENTS TO ST. VINCENT'S CATHOLIC MEDICAL CENTER	0

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	SCHEDULE L, PART IV	Identifier
Explanation	AS A MANAGED CARE ORGANIZATION ADMINISTERING GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS SUCH AS MEDICAID, THE ORGANIZATION ENTERS INTO CONTRACTS WITH THOUSANDS OF HEALTH CARE ENTITIES THROUGHOUT NEW YORK STATE, INCLUDING INSTITUTIONS THAT ARE TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF WHICH CERTAIN OF THE ORGANIZATION'S OFFICERS AND DIRECTORS ARE ALSO DIRECTORS, OFFICERS OR KEY EMPLOYEES. UNDER THESE CONTRACTS, THE ORGANIZATION REIMBURSES THE ENTITIES FOR HEALTH CARE SERVICES PROVIDED TO THE ORGANIZATION'S ENROLLEES. THE ORGANIZATION'S OFFICERS AND DIRECTORS DO NOT HAVE FINANCIAL-OWNERSHIP INTEREST IN SUCH ENTITIES AS THEY ARE NOT-FOR-PROFIT CORPORATIONS; THE CONTRACTS ARE NOT FINANCIALLY MATERIAL FOR EITHER PARTY; AND NO INTERESTED PARTY PLAYS ANY ROLE IN SUCH CONTRACTS CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART III, LINE 1	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. ("FIDELIS" OR "THE PLAN") STRIVES TO PROMOTE HEALTH THROUGH QUALITY, ACCESSIBLE CARE AND SERVICES FOR ALL; TO JOIN IN PARTNERSHIP WITH HEALTH PROFESSIONALS TO ASSIST THEM IN THEIR HEALING WORK; TO ACT AS A FACILITATOR TO BUILD LINKAGES AND SYSTEMS FOR THE COORDINATION OF CARE AND SERVICES AMONG HEALTHCARE, BEHAVIORAL AND SOCIAL SERVICES, AS WELL AS EDUCATORS AND RELIGIOUS LEADERS, TO ADDRESS THE SPIRITUAL, EMOTIONAL AND PHYSICAL NEEDS OF THOSE WE SERVE; TO ADVOCATE FOR A HEALTH POLICY THAT ACCORDS TRUE DIGNITY AND RESPECT FOR ALL HUMAN PERSONS, ESPECIALLY THE POOR AND UNDERSERVED. AS OF DECEMBER 31, 2010, THE PLAN SERVED AN ENROLLED POPULATION COMPRISED OF BENEFICIARIES OF THE MEDICAL ASSISTANCE PROGRAM ("MEDICAID"), APPROXIMATELY 478,000, THE CHILD HEALTH PLUS BENEFICIARIES, APPROXIMATELY 71,000,A PROGRAM FOR LOW INCOME UNINSURED CHILDREN, THE FAMILY HEALTH PLUS BENEFICIARIES, APPROXIMATELY 85,000, A MEDICAID PROGRAM FOR LOW INCOME UNINSURED FAMILIES; FAMILY HEALTH-PLUS BUY-IN PROGRAM, APPROXIMATELY 30,000, A PROGRAM FOR CERTAIN ELIGIBLE MEMBERS OF THE 1199SEIU NATIONAL BENEFIT FUND FOR HOME CARE EMPLOYEES, MEDICARE/DUAL ADVANTAGE PROGRAM, APPROXIMATELY 9,000, A PROGRAM FOR THE ELDERLY, AND FIDELIS CARE AT HOME MANAGED LONG-TERM CARE PROGRAM, APPROXIMATELY 400, A PROGRAM FOR RESIDENTS OF ORANGE AND ROCKLAND COUNTIES WHO NEED LONG-TERM CARE SERVICES AND ARE ELIGIBLE FOR MEDICAID.
	THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ORGANIZATION SHALL BE LIMITED TO THE DIOCESAN BISHOPS OF THE STATE AND THE ECCLESIASTICAL PROVINCE OF NEW YORK.	FORM 990, PART VI, SECTION A, LINE 6
	THE ORGANIZATION IS A MEMBERSHIP CORPORATION UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW (THE "N-PCL"). THE ORGANIZATION'S MEMBERS ELECT ITS BOARD OF DIRECTORS AND, AS MEMBERS OF A NEW YORK NOT-FOR-PROFIT CORPORATION, POSSESS CERTAIN OTHER POWERS UNDER THE N-PCL. FURTHERMORE, THE ORGANIZATION'S BY-LAWS, WHICH ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYSDOH"), DEFINE THE FOLLOWING RESERVED POWERS OF THE MEMBERS: (I) THE INTERPRETATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES TO WHICH THE ORGANIZATION, AS A FAITH-BASED ORGANIZATION, IS SUBJECT; (II) APPROVAL OF THE MISSION STATEMENT; (III) STANDING TO ENSURE THE ORGANIZATION'S COMPLIANCE WITH ITS PHILOSOPHY AND MISSION STATEMENT; (IV) APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S CERTIFICATE OF INCORPORATION AND BY-LAWS; (V) APPROVAL OF TRANSACTIONS INVOLVING REAL PROPERTY; (VI) APPROVAL OF CERTAIN ACTIONS BY THE ORGANIZATION WHEN ACTING AS A SHAREHOLDER OR MEMBER OF ANOTHER ENTITY; (VII) APPROVAL OF THE ACCEPTANCE AND ISSUANCE OF SUBVENTIONS; (VIII) APPROVAL OF ANY MERGER, DISSOLUTION OR CONSOLIDATION, (IX) REMOVAL OF DIRECTORS AND CERTAIN OFFICERS OF THE CORPORATION; (X) APPROVAL OF THE ELECTION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, AND (XI) REVIEW OF THE AUDITED FINANCIAL STATEMENTS. CERTAIN OF THESE POWERS ALREADY EXIST BY VIRTUE OF THE N-PCL (E.G., THE POWER TO APPROVE ANY MERGER, DISSOLUTION OR CONSOLIDATION UNDER N-PCL 903(A)(2) & 1002(A)).	FORM 990, PART VI, SECTION A, LINE 7A
	PLEASE SEE LINE 11 NARRATIVE.	FORM 990, PART VI, SECTION A, LINE 7B
	A DRAFT OF THE FORM 990 PREPARED BY THE ORGANIZATION'S FINANCE DEPARTMENT IS REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER, IN COLLABORATION WITH THE ORGANIZATION'S OUTSIDE INDEPENDENT AUDITORS. THEREAFTER, THE ORGANIZATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER REVIEW THE DRAFT FORM 990 WITH CHIEF FINANCIAL OFFICER, VICE PRESIDENT FOR FINANCE AND CHIEF LEGAL OFFICER. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AUTHORIZED THE EXECUTIVE COMMITTEE OF THE BOARD TO REVIEW AND ACCEPT THE DRAFT FORM 990 BEFORE ITS FILING WITH THE IRS. ACCORDINGLY, AFTER THE ORGANIZATION'S MANAGEMENT HAS COMPLETED ITS REVIEW OF THE DRAFT FORM 990, IT IS CIRCULATED IN DRAFT FOR REVIEW, COMMENT AND APPROVAL TO THE MEMBERS OF THE EXECUTIVE COMMITTEE. ONCE ANY COMMENTS HAVE BEEN INCORPORATED AND THE FORM 990 HAS BEEN ACCEPTED BY THE EXECUTIVE COMMITTEE, A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS.	FORM 990, PART VI, SECTION B, LINE 11
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY, THE ORGANIZATION'S OFFICERS, DIRECTORS AND SENIOR EXECUTIVES ARE PROVIDED WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND AN ACKNOWLEDGEMENT FORM. THESE INDIVIDUALS ARE INSTRUCTED TO SIGN AND RETURN THE FORM (A) TO ACKNOWLEDGE THAT THEY HAVE REVIEWED THE POLICY AND (B) TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS. THE CONFLICTS OF INTEREST POLICY DEFINES "DISCLOSABLE INTERESTS," I.E., THOSE INTERESTS THAT AN INDIVIDUAL COVERED BY THE POLICY MUST HAVE IN ANOTHER ENTITY IN ORDER FOR A TRANSACTION BETWEEN THE ORGANIZATION AND THAT ENTITY TO BE COVERED BY THE POLICY. THE POLICY ALSO DEFINES THE TYPES OF TRANSACTIONS BETWEEN THE ORGANIZATION AND ANOTHER ENTITY INVOLVING AN INDIVIDUAL COVERED BY THE POLICY THAT ARE SUBJECT TO BY THE POLICY. THE POLICY REQUIRES DISCLOSURE TO BOARD OF DIRECTORS AND/OR THE EXECUTIVE COMMITTEE BY ANY PERSON WITH A DISCLOSABLE INTEREST IN A TRANSACTION AS DEFINED IN THE POLICY OF ALL CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. INITIALLY, AFTER THE INTERESTED INDIVIDUAL HAS RECUSED HIMSELF, THE ORGANIZATION'S BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE DETERMINES WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE DECIDES WHETHER TO ENTER INTO THE TRANSACTION BASED ON ITS DETERMINATION OF WHETHER (A) A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, (B) THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND (C) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15	OUTSIDE COUNSEL FOR THE ORGANIZATION, A NATIONAL LAW FIRM WITH EXPERTISE IN ADVISING EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, HAS ADVISED FIDELIS AS TO WHICH EMPLOYEES ARE DISQUALIFIED PERSONS WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EMPLOYS A COMPENSATION CONSULTANT FIRM, A NATIONAL HUMAN RESOURCES CONSULTING FIRM WITH EXPERTISE IN ADVISING EXEMPT ORGANIZATIONS ON EXCESS BENEFIT TRANSACTIONS LAW, TO PREPARE ANNUALLY A DETAILED REPORT ON THE PROPOSED COMPENSATION FOR THE ORGANIZATION'S DISQUALIFIED PERSONS THAT INCLUDES DATA AS TO COMPARABLE COMPENSATION FOR SIMILAR QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY-SITUATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH HAS BEEN AUTHORIZED BY THE BOARD TO REVIEW AND APPROVE ALL MATTERS CONCERNING EXECUTIVE COMPENSATION, IS PROVIDED WITH THE COMPENSATION CONSULTANT'S DETAILED EXECUTIVE COMPENSATION REPORT. THE REVIEW AND APPROVAL OF THE COMPENSATION OF THE ORGANIZATION'S DISQUALIFIED PERSONS IS ACCOMPLISHED IN TWO PHASES: FIRST WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER AND THEN WITH RESPECT TO ALL OTHER DISQUALIFIED PERSONS, NAMELY, (I) THE EXECUTIVE VICE PRESIDENT & CHIEF OPERATING OFFICER, (II) THE CHIEF FINANCIAL OFFICER, (III) THE SENIOR VICE PRESIDENT & CHIEF ADMINISTRATIVE OFFICER, (IV) THE CHIEF LEGAL OFFICER AND (V) THE CHIEF MEDICAL OFFICER. FIRST, THE AFOREMENTIONED OUTSIDE COUNSEL AND HUMAN RESOURCES CONSULTING FIRM, AT THE INVITATION OF THE EXECUTIVE COMMITTEE, REVIEW WITH THE COMMITTEE THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO RETAINS THE SERVICES OF A SECOND HUMAN RESOURCES CONSULTING FIRM TO ASSIST IN ITS EVALUATION OF THE PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE FULL REVIEW OF THE COMPENSATION AND PERFORMANCE OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER IS PERFORMED BY THE EXECUTIVE COMMITTEE BI-ANNUALLY. AFTER ESTABLISHING THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER, THE EXECUTIVE COMMITTEE REPORTS ON ITS DELIBERATIONS AND DETERMINATIONS TO THE ORGANIZATION'S BOARD OF DIRECTORS. SECOND, THE EXECUTIVE COMMITTEE REVIEWS THE DETAILED EXECUTIVE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS WITH THE ASSISTANCE OF THE SAME OUTSIDE COUNSEL AND COMPENSATION CONSULTANTS PARTICIPATING IN THE REVIEW OF THE COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE DETERMINES WHETHER TO APPROVE THE COMPENSATION ANALYSIS AND CONCLUSIONS CONTAINED IN THE COMPENSATION REPORT WITH RESPECT TO THE ORGANIZATION'S OTHER DISQUALIFIED PERSONS. AFTER CONSULTING WITH OUTSIDE COUNSEL, THE EXECUTIVE COMMITTEE HAS DESIGNATED THE PRESIDENT & CHIEF EXECUTIVE OFFICER TO SERVE AS AN "AUTHORIZED BODY" AS CONTEMPLATED BY THE EXCESS BENEFIT TRANSACTION REGULATIONS FOR THE PURPOSE OF SETTING THE COMPENSATION OF THOSE DISQUALIFIED PERSONS WITHIN AN APPROVED RANGE. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS FOR ALL DISQUALIFIED PERSONS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION IS A NEW YORK NOT-FOR-PROFIT CORPORATION. ITS CERTIFICATE OF INCORPORATION IS READILY AVAILABLE TO THE GENERAL PUBLIC FROM THE NEW YORK STATE DEPARTMENT OF STATE UNDER THE NEW YORK FREEDOM OF INFORMATION LAW ("FOIL"). ITS CERTIFICATE OF INCORPORATION AND BY-LAWS ARE ALSO ON FILE WITH THE NEW YORK STATE DEPARTMENT OF HEALTH AND LIKEWISE AVAILABLE TO THE GENERAL PUBLIC UNDER FOIL. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO ENROLLEES IN ITS MEDICAID AND FAMILY HEALTH PLUS PROGRAMS AND TO INDIVIDUALS CONSIDERING BECOMING ENROLLEES BY INCLUDING IN THE MEMBER HANDBOOKS FOR BOTH PROGRAMS, WHICH ARE PROVIDED TO ENROLLEES AND ARE ACCESSIBLE ON THE ORGANIZATION'S WEB SITE, A STATEMENT THAT THE FINANCIAL STATEMENTS (AS WELL AS OTHER INFORMATION DESCRIBED IN THE HANDBOOKS) ARE AVAILABLE UPON REQUEST BY CALLING A TOLL-FREE NUMBER PROVIDED IN THE HANDBOOKS.
FORM 990, PART VII, SECTION A, COLUMN B	THE FOLLOWING INDIVIDUALS DEVOTE A PERCENTAGE OF THEIR TIME TO SALUS ADMINISTRATIVE SERVICES, INC. (SALUS), A RELATED ORGANIZATION, AS DETAILED BELOW: PATRICK J. FRAWLEY, EVP & COO - 5% THOMAS HALLORAN, CHIEF FINANCIAL OFFICER - 5% ROBERT PIGOTT, FORMER CHIEF LEGAL OFFICER - 5% JAMES M. BURNOSKY, VP STRATEGIC PLANNING - 15% THIS ARRANGEMENT IS COVERED BY AN EMPLOYEE SERVICE AGREEMENT BETWEEN FIDELIS AND SALUS.
FORM 990 PART IX LINE 12 & LINE 24F	THE ORGANIZATION'S LINE 12, ADVERTISING AND PROMOTION EXPENSES, AND LINE 24F, ALL OTHER EXPENSES, INCLUDE PAYMENTS TO OTHER EXEMPT ORGANIZATIONS IN SUPPORT OF THEIR CHARITABLE PURPOSES, TO BENEFIT THE COMMUNITY, OR IN SPONSORSHIP OF THEIR FUNDRAISING EVENTS THE EXPENDITURES INCLUDE THE FOLLOWING AMOUNTS PAID TO THE FOLLOWING EXEMPT ORGANIZATIONS: AMERICAN RED CROSS ROME AREA CHAPTER 9,000. CATHOLIC CHARITIES OF BROOKLYN & QUEENS 25,180. THANKSGIVING CONTRIBUTION TO NEEDY 120,027. THE ALFRED E. SMITH FOUNDATION 127,000. OTHER CHARITABLE CONTRIBUTIONS LESS THAN $5,000 97,863. TOTAL 379,070.
FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 10,752,122. ORDINARY INCOME FROM HPA, LLC -24,811. INTEREST INCOME FROM HPA, LLC -1,597. DIVIDEND INCOME FROM HPA, LLC -3,546. NET CAPITAL GAIN FROM HPA, LLC -2,558. INVESTMENT MANAGEMENT FEE FROM HPA, LLC 1,097. NET IMPACT OF CURRENT AND PRIOR YEAR HPA, LLC RECONCILING ITEMS -1,501. REVERSAL OF ACCRUED GRANTS NOT TO BE PAID IN THE FUTURE -178,530. TOTAL TO FORM 990, PART XI, LINE 5: 10,540,676.	CHANGES IN NET ASSETS OR FUND BALANCES:
SCHEDULE I, PART II, COLUMN H	SINCE 2004, THE PURPOSE OF THE FIDELIS CARE COMMUNITY GRANT FUND IS TO OFFER SUPPORT ANNUALLY THROUGH CHARITABLE CONTRIBUTIONS TO SELECTED TAX-EXEMPT NONPROFIT ORGANIZATIONS THAT SHARE SIMILAR MISSIONS AND VALUES OF SERVICE TO LOW-INCOME VULNERABLE INDIVIDUALS. PROPOSALS ARE EVALUATED ON THEIR RELEVANCE TO FIDELIS' MISSION OF CARING FOR THE NEEDS AND CONCERNS OF THE POOR AND MEDICALLY UNDERSERVED IN CONSULTATION WITH FIDELIS' MEMBERS. THE TOTAL AMOUNT TO BE DISTRIBUTED EACH YEAR IS APPROVED BY THE BOARD OF DIRECTORS, AND DISTRIBUTED IN ACCORDANCE WITH THE APPROVED BOARD POLICY. IN ADDITION TO THE GRANTS MADE THROUGH ITS COMMUNITY GRANT FUND, FIDELIS MAKES CHARITABLE DONATIONS TO ORGANIZATIONS CLASSIFIED AS TAX-EXEMPT NONPROFIT ORGANIZATIONS UNDER STATE AND FEDERAL LAW.
FORM 990	TO THE EXTENT THAT A QUESTION ON THE FORM 990 HAS BEEN LEFT BLANK, THE RESPONSE TO THIS QUESTION SHOULD BE NOT APPLICABLE. DUE TO SOFTWARE LIMITATIONS, FIDELIS COULD NOT PROPERLY RESPOND TO THE RESPECTIVE QUESTIONS AS N/A.	NON APPLICABLE QUESTIONS

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	SALUS ADMINISTRATIVE SERVICES INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	95-25 QUEENS BOULEVARD	AddressLine1
City	REGO PARK	City
State	NY	State
ZIP Code	11374	ZIPCode

Field	Value	IRS element (for citing)
EIN	550878053	EIN
Primary Activity	THIRD PARTY ADMINISTRATOR	PrimaryActivity
Legal Domicile State	NY	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	FIDELIS CARE NEW YORK	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C	TypeOfEntity
Share Of Total Income	931884	ShareOfTotalIncome
Share Of EOY Assets	2301010	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
SALUS ADMINISTRATIVE SERVICES INC
N	774616	CASH
SALUS ADMINISTRATIVE SERVICES INC
K	2891315	CASH

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	RELATED PARTY TRANSACTIONS	Identifier
Return Reference	SCHEDULE R, PART V	ReturnReference
Explanation	FIDELIS REPORTS CERTAIN RELATED PARTY TRANSACTIONS BETWEEN ITSELF AND SALUS ADMINISTRATIVE SERVICES, INC. ("SALUS"), A RELATED PARTY, ON SCHEDULE R, PART V. THE METHODS USED FOR DETERMINING THE AMOUNTS REPORTED DIFFER BASED ON THE TYPE OF TRANSACTION BUT ARE ALL CONTAINED IN WRITTEN CONTRACTS BETWEEN THE TWO PARTIES. SALUS REPORTS A PERFORMANCE OF SERVICES TO FIDELIS. THE WRITTEN AGREEMENT SPECIFIES A FIXED DISPENSING FEE PER PHARMACY CLAIM PROCESSED. THE FEE IS AN ESTIMATE DESIGNED TO COVER DIRECT AND INDIRECT COSTS AS WELL AS A MODEST AMOUNT OF PROFIT. THE AMOUNT IS DEEMED CONSISTENT WITH AN INDEPENDENT 3RD PARTY TRANSACTION. FIDELIS REPORTS A SHARING OF FACILITIES, EQUIPMENT, AND OTHER ASSETS. THE OVERHEAD AND ADMINISTRATIVE COSTS ARE ALLOCATED BASED ON THE SHARE OF FACILITIES AND ASSETS SALUS IS DEEMED TO USE. FIDELIS SHARES PAID EMPLOYEES WITH SALUS. FIDELIS ALLOCATES SALARIES FOR EACH EMPLOYEE BASED ON THE PERCENTAGE OF TOTAL HOURS SPENT PROVIDING SERVICES TO SALUS.	Explanation