2011-08-15T13:46:08-05:00 2010-09-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2009-10-01 742930226 El Paso First Health Plans inc ELPA 9155323778 1145 Westmoreland Dr El Paso TX 79925 MICHAEL NUNEZ 2011-08-15 true Michael J Engle 8162216300 2009 2016-02-24 21:20:13Z MICHAEL NUNEZ 1145 WESTMORELAND DR EL PASO TX 79925 110375019 false X WWW.EPFIRST.COM X 1996 TX TO IMPROVE THE LIVES OF EL PASOANS BY PROVIDING ACCESS TO QUALITY HEALTHCARE & ENCOURAGE PARTICIPATION IN WELLNESS PROGRAMS TO THOSE WHO MAY NOT OTHERWISE HAVE THE MEANS. 7 5 122 6 0 0 0 0 94030462 109626324 265174 331840 392478 416855 94688114 110375019 0 0 0 0 6138373 6792644 0 0 0 84507948 98799540 90646321 105592184 4041793 4782835 30152997 38024482 12785320 15873973 17367677 22150509 NONE false false 85190145 0 92034421 MEDICAID PROGRAM (STAR) - SEE SCHEDULE O 15962460 0 16968124 CHILDREN HEALTH INSURANCE PROGRAM (CHIP) - SEE SCHEDULE O 3876659 0 623779 Health Care Options (HCO), a health benefit plan for the uninsured, funded by the El Paso County Hospital District, was available to an average of 11,900 members per month. El Paso First Health Plans administers the HCO program including such services as claims payments, member services, individual case management, disease management and other health benefit services. 105029264 false false false false false false false false false true true true 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 true false false true 567 0 true 122 true false false false false false false false false false 7 5 false false false false true true true true true false false true true true true true true false false false X MICHAEL NUNEZ 9155323778 1145 WESTMORELAND DR EL PASO TX 79925 JAMES S DEGROAT 1.0 X 0 0 0 RON ACTON 1.0 X 0 0 0 CHRISTINE K HERNANDEZ MD 1.0 X 0 0 0 CARLOS JESUSRUN MD RESIGNED 710 1.0 X 0 0 0 RUBEN R RONCALLO MD 1.0 X 0 0 0 PHILLIP A RIVERA RESIGNED 610 1.0 X X 0 311151 25827 JAMES N VALENTI 1.0 X X 0 594422 25347 MICHAEL NUNEZ EFFECTIVE 610 4.0 X X 0 168941 20226 MICHAEL ROMERO MD EFFECTIVE 910 1.0 X 0 0 0 CAROL SMALLWOOD 50.0 X 242081 0 27616 DAVID M PALAFOX MD 50.0 X 183365 0 21953 JAMES L VOILAND 50.0 X 150568 0 22651 SHARON L PERKINS 50.0 X 119449 0 10879 MELINDA A VEROSKY 50.0 X 106908 0 16657 FRANCISCO DOMINGUEZ 50.0 X 100622 0 16577 902993 1074514 187733 6 false true false AECC TOTAL VISION CARE VISION NETWORK 947207 THE TRIZETTO GROUP INC CLAIM SUPPORT 587795 PRESIDIO EXCESS INSURANCE SERVICES REINSURANCE SERVICES 483475 HEALTH MANAGEMENT SERVICES INC CLAIMS REVIEW 423836 SUN CITY BEHAVIORAL HEALTH BEHAVIORAL SUPPORT 158453 5 0 STAR AND CHIP - DSP 524298 92034421 92034421 CHIP 524298 16968124 16968124 HCO 524292 623779 623779 109626324 331840 331840 0 0 0 0 0 0 MISCELLANEOUS REVENUE 524292 416855 416855 416855 110375019 109626324 0 748695 0 0 0 0 648234 628787 19447 0 4919951 4772353 147598 306397 296891 9506 550473 533393 17080 367589 356184 11405 0 0 99040 70319 28721 0 0 0 206108 187559 18549 282004 282004 1079269 982134 97135 0 0 543604 494680 48924 78704 73981 4723 0 24488 21241 3247 0 0 603435 591367 12068 84288 69485 14803 MEDICAL EXPENSE-STAR 76333779 76333779 MEDICAL EXPENSE-CHIP 9594679 9594679 PROVIDER INCENTIVES 2834734 2834734 MEDICAL EXP-CHIP PERINATE 3242005 3242005 TEXAS PREMIUM TAX 2027132 2027132 1766271 1636557 129714 105592184 105029264 562920 0 10550306 13163396 15700000 20827160 2268363 1301669 645572 543020 5763916 3819643 747689 1944273 241067 244964 30152997 38024482 12119055 14580963 52524 689666 613741 603344 12785320 15873973 X 16667677 21450509 700000 700000 17367677 22150509 30152997 38024482 X false true true X false 1000378 74582 925796 4763538 3745061 1018477 1944273 0 DUE TO AFFILIATE 603344 603344 110375019 105592184 4782835 4782835 110375019 110375019 110375019 105592184 105592184 105592184 UNCERTAIN TAX POSITIONS DISCLOSURE SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X X X X false false false false false false false false false PHILLIP A RIVERA RESIGNED 610 0 249760 0 47416 0 13975 0 13671 0 12156 0 336978 0 0 JAMES N VALENTI 0 436792 0 116353 0 41277 0 13671 0 11676 0 619769 0 0 MICHAEL NUNEZ EFFECTIVE 610 0 150363 0 18560 0 18 0 9633 0 10593 0 189167 0 0 CAROL SMALLWOOD 193069 0 37448 0 11564 0 13671 0 13945 0 269697 0 0 0 DAVID M PALAFOX MD 177365 0 6000 0 0 0 10488 0 11465 0 205318 0 0 0 JAMES L VOILAND 137557 0 13000 0 11 0 8790 0 13861 0 173219 0 0 0 COMPENSATION PAID BY RELATED ORGANIZATIONS FORM 990, PART VII, & SCHEDULE J, PART II JAMES N VALENTI, PHILLIP A RIVERA AND MICHAEL NUNEZ ARE COMPENSATED BY UNIVERSITY MEDICAL CENTER OF EL PASO, A RELATED ORGANIZATION. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A Medicaid Program (STAR) was available to an average of 44,000 members per month. El Paso First Health Plans (EPF) provided medical benefits in excess of $75 million. EPF provided free immunizations, asthma fairs, bi-lingual prenatal classes, free baby monitors and diaper bags with infant health care items, diabetes classes, 24 hour healthcare call line, transportation for medical care and over-the-counter medicine vouchers. EPF provided vision, behavioral health and nutrition counseling benefits above State STAR requirements. Free dental care to pregnant members was provided. Member newsletters, informational pamphlets, DVDs covering health education and disease management topics and gift card incentives for attending medical appointments (for children under 21) were distributed. EPF made daily telephone calls and sent monthly correspondence regarding medical appointments and membership renewal. EPF participated in 244 community and school health fairs, attended by over 16,000 people. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4B Children's Health Insurance Program (CHIP) was available to an average of 15,400 members per month. El Paso First Health Plans (EPF) provided medical benefits in excess of $12 million. EPF provided free immunizations, asthma fairs, bi-lingual prenatal classes, free baby monitors and diaper bags with infant health care items, diabetes classes, 24 hour healthcare call line, transportation for medical care and over-the-counter medicine vouchers. EPF provided vision, behavioral health and nutrition counseling benefits above State CHIP requirements. Free dental care to pregnant members was provided. DVDs covering health education and disease management topics were distributed. EPF made daily telephone calls and sent monthly correspondence regarding medical appointments and membership renewal. EPF participated in 244 community and school health fairs, attended by over 16,000 people. MEMBERS FORM 990, PART VI, SECTION A, LINE 6 UNIVERSITY MEDICAL CENTER OF EL PASO IS THE SOLE MEMBER OF EL PASO FIRST HEALTH PLANS, INC. MEMBERS WHO MAY ELECT THE GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7A UNIVERSITY MEDICAL CENTER OF EL PASO, BEING THE SOLE MEMBER OF EL PASO FIRST HEALTH PLANS, INC., HAS THE RIGHT TO ELECT ALL THE DIRECTORS AND APPOINT TWO EX-OFFICIO, VOTING DIRECTORS WHO ARE OFFICERS OF THE MEMBER ORGANIZATION. DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS FORM 990, PART VI, SECTION A, LINE 7B UNIVERSITY MEDICAL CENTER OF EL PASO IS THE SOLE MEMBER OF EL PASO FIRST HEALTH PLANS, INC. AND HAS THE RIGHT TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS AND ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11A THE ORGANIZATION ENGAGES AN INDEPENDENT ACCOUNTING FIRM EXPERIENCED IN THE PREPARATION OF THE FORM 990 TO PREPARE ITS FORM 990. THE ORGANIZATION'S ACCOUNTING AND EXECUTIVE PERSONNEL REVIEW THE 990. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C THE MEMBER, UNIVERSITY MEDICAL CENTER OF EL PASO, HAS A COMPLIANCE COMMITTEE WHICH MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY FOR EL PASO FIRST HEALTH PLANS, INC. UPON EMPLOYMENT, EACH EMPLOYEE MUST READ AND SIGN THE POLICY REFLECTING THAT THE POLICY IS UNDERSTOOD AND WILL BE FOLLOWED. ALL MANAGEMENT, OFFICERS, AND DIRECTORS AT THE TIME OF HIRE OR ELECTION AND ANUALLY THEREAFTER MUST DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. AN ANNUAL REVIEW OF ALL MANAGEMENT, OFFICERS AND DIRECTORS' CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED BY THE COMPLIANCE COMMITTEE. FURTHER, IN ORDER TO RECEIVE CERTAIN STATE CONTRACTS, ALL EMPLOYEES INCLUDING MANAGEMENT AND OFFICERS ARE REQUIRED TO ATTEND CONFLICT OF INTEREST TRAINING ANNUALLY. HOTLINES ARE IN PLACE FOR EMPLOYEES TO BRING FORTH ANY CONFLICT OF INTEREST SITUATIONS THAT MAY ARISE. IF AN ACTUAL, POTENTIAL OR APPARENT CONFLICT OF INTEREST EXISTS THE PERSON(S) SHALL BE EXCLUDED FROM THE DECISION MAKING PROCESS. IF IT IS DETERMINED THAT AN OUTSIDE INTEREST EXISTS, A DETERMINATION SHALL BE MADE BY THE COMMITTEE WHETHER THE OUTSIDE INTEREST MAY CONTINUE OR SHOULD BE TERMINATED. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B UNIVERSITY MEDICAL CENTER OF EL PASO PERFORMS AN ASSESSMENT OF THE EXTERNAL COMPETITIVENESS OF THE ORGANIZATION'S WAGE AND SALARY PRACTICES THROUGH THE ANALYSIS OF JOB AND PAY RELATIONSHIPS, USING RELEVANT SURVEY DATA THAT REFLECTS WAGES AND SALARIES PAID BY SIMILAR HEALTH CARE ORGANIZATIONS INCLUDING OTHER ORGANIZATIONS WITH SIMILAR POSITIONS OF COMPARABLE SIZE AND GEOGRAPHIC LOCATION. THE UNIVERSITY MEDICAL CENTER OF EL PASO USES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS/STUDIES, AND APPROVAL BY THE BOARD TO ESTABLISH COMPENSATION. CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISIONS IS DOCUMENTED. AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 EL PASO FIRST HEALTH PLANS HAS ITS OWN WEBSITE WHICH MAY, IN THE FUTURE, MAKE SOME OR ALL OF THOSE DOCUMENTS AVAILABLE. AT THIS TIME, ANNUAL AUDITED FINANCIAL DOCUMENTS OF EL PASO FIRST HEALTH PLANS ARE MADE AVAILABLE TO THE PUBLIC BY THEIR INCLUSION IN THE ANNUAL AUDITED FINANCIAL DOCUMENTS OF THE MEMBER (UNIVERSITY MEDICAL CENTER OF EL PASO), WHEN THEY ARE REPORTED TO THE PUBLIC IN OPEN MEETINGS AND MADE AVAILABLE UPON REQUEST. ALSO, THERE ARE OTHER WEBSITES WHICH REPORT THE FORM 990 OF EL PASO FIRST HEALTH PLANS TO THE PUBLIC FOR FREE. FURTHER, THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION (HHSC) AND TEXAS DEPARTMENT OF INSURANCE (TDI) REGULATE THE PRIMARY BUSINESS LINES OF EL PASO FIRST HEALTH PLANS AND REQUIRE THAT CERTAIN FINANCIAL INFORMATION IS ON FILE WITH THOSE AGENCIES. ALL PUBLICLY AVAILABLE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. AVERAGE HOURS WORKED FOR RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, LINE 1A AVG HOURS WORKED FOR RELATED ORGANIZATIONS JAMES S DEGROAT 1 RON ACTON 1 PHILLIP A RIVERA 39 JAMES N VALENTI 39 MICHAEL NUNEZ 36 RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT FORM 990, PART XI, LINE 2C THE SCOPE OF THE AUDIT AND OTHER DETAILS WERE NEGOTIATED BY THE FINANCE COMMITTEE OF UNIVERSITY MEDICAL CENTER OF EL PASO (THE MEMBER) FOR BOTH UNIVERISTY MEDICAL CENTER OF EL PASO AND ITS RELATED ENTITY EL PASO HEALTH PLANS, INC. THE BOARD OF EL PASO FIRST HEALTH PLANS, INC. REVIEWED THE AUDIT REPORT FOR THE ENTITY. EL PASO FIRST HEALTH NETWORK INC 1145 WESTMORELAND DR EL PASO TX 79925 742894566 DORMANT ENT. 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