2023-11-15T09:08:30-06:00 2022-12-31 PwC US Tax LLP 101 SEAPORT BLVD SUITE 500 BOSTON MA 02210 990 2022-01-01 042674079 TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION INC % SCOTT WALKER CFO TUFT 6179729400 1 WELLNESS WAY CANTON MA 020211166 MARK PORTER CAO & TREASURER 6179729400 2023-11-12 true MARK PORTER 999009999 ANTONIO C RUSSO P00858539 6175305000 2023-11-10 3 2022 2023-04-26 12:10:37Z CAIN HAYES 1 WELLNESS WAY CANTON MA 020211166 3585404201 false X WWW.TUFTSHEALTHPLAN.COM X 1979 MA SEE SCHEDULE O 14 13 708 0 -16164 0 0 0 2773179809 2963623714 251224432 38322801 -15882 -16164 3024388359 3001930351 370729 427931 2435767392 2615461214 37824322 48291010 0 0 0 330636708 332192935 2804599151 2996373090 219789208 5557261 1424293869 1252410168 571612199 540676607 852681670 711733561 X SEE SCHEDULE O false false 1009760113 156217 1081877362 COMMERCIAL HMO PRODUCT. SEE SCHEDULE O. 1528551639 233035 1613877891 MASSACHUSETTS MEDICARE PRODUCT. SEE SCHEDULE O. 254834469 37813 261872910 MEDICAID AFFORDABLE CARE DUAL-ELIGIBLE PROGRAM. SEE SCHEDULE O. 4058573 866 5995551 MEDICARE COMPLEMENT 4058573 866 5995551 2797204794 false false false false false false false false false true true false true true true true false false false false false false false false false false true false true false false false false false false false false false false false false false true true true false true 13132 0 true 708 true false false false false false false false false X 14 13 true true false false true true true true true false false true true true true true true true true false MA X SCOTT WALKER CFO 6179729400 1 WELLNESS WAY CANTON MA 020211166 X CAIN HAYES PRESIDENT & CEO 10.0 40.0 X X 0 2440620 335990 MICHAEL CARSON FORMER PRESIDENT 0.0 0.0 X 0 2220842 0 UMESH KURPAD CFO 10.0 40.0 X 0 1495153 197450 DEREK ABRUZZESE SVP, CORP STRATEGY (END 4/15) 12.5 37.5 X 0 1573814 56051 THOMAS CROSWELL FORMER CEO 0.0 0.0 X 0 1500205 13348 TISA HUGHES CLERK/SECR;CHIEF LEGAL OFFICER 10.0 40.0 X 0 1189371 119513 MICHAEL SHERMAN MD CHIEF MEDICAL OFFICER 12.5 37.5 X 0 1114767 167305 PHILIP BARR EVP, PRESIDENT, MARKETS 10.0 40.0 X 0 1074785 165727 MARK PORTER SVP, CHIEF ACCOUNTING OFFICER 10.0 40.0 X 0 1045332 161168 TRACEY CARTER SVP, CHIEF ACTUARY 12.5 37.5 X 0 1035246 161767 PETE CHURCH CHIEF PEOPLE OFFICER 10.0 40.0 X 0 1013577 169588 PATRICIA BLAKE SVP, PRESIDENT MEDICARE 17.5 32.5 X 0 991394 156126 KRISTIN LEWIS FORMER OFFICER 10.0 40.0 X 0 816127 142929 JEAN YANG FORMER OFFICER 10.0 40.0 X 0 711295 54355 PATRICIA HOWARD CHIEF OPERATIONS OFFICER 12.5 37.5 X 0 614901 127646 ROLAND PRICE TREASURER 10.0 40.0 X 0 541488 110632 SUSAN KEE FORMER ASST. CLERK 10.0 40.0 X 0 528322 61012 MARC SPOONER FORMER COO 0.0 0.0 X 0 499935 0 JOYCE MURPHY DIRECTOR, CHAIR (END 6/7) 2.0 6.0 X X 0 89000 0 EILEEN AUEN DIRECTOR, CHAIR (START 6/7) 2.0 6.0 X X 0 77625 0 MICHAEL J MCCOLGAN DIRECTOR 1.0 3.0 X 0 73000 0 MICHAEL SHEA DIRECTOR 1.0 3.0 X 0 71500 0 GREGORY D TRANTER DIR, VICE CHAIR (VC END 6/7) 1.0 3.0 X X 0 68500 0 HEDWIG VEITH WHITNEY DIRECTOR 1.0 3.0 X 0 68500 0 MYECHIA MINTER-JORDAN MD DIRECTOR 1.0 3.0 X 0 65500 0 BERTRAM L SCOTT DIRECTOR 1.0 3.0 X 0 62375 0 TODD WHITBECK DIRECTOR 1.0 3.0 X 0 62000 0 GREG SHELL DIR, VICE CHAIR (VC START 6/7) 1.0 3.0 X X 0 61000 0 IRINA SIMMONS DIRECTOR 1.0 3.0 X 0 60000 0 RAYMOND PAWLICKI DIRECTOR 1.0 3.0 X 0 59000 0 SCOTT HARTZ DIRECTOR (END 6/7) 1.0 3.0 X 0 47000 0 THOMAS O'NEILL III DIRECTOR (END 6/7) 1.0 3.0 X 0 36000 0 PETER SLAVIN MD DIRECTOR (START 8/22) 1.0 3.0 X 0 7334 0 0 20920799 2200607 0 true true false DELOITTE CONSULTING LLP PO BOX 844717 DALLAS TX 752844717 CONSULTING 3689720 LANDMARK GROUP HOLDINGS LLC 7755 CENTER AVE HUNTINGTON BEACH CA 92647 CONSULTING 3556400 THE HILB GROUP OF NEW ENGLAND 2000 CHAPEL VIEW BOULEVARD CRANSTON RI 02920 CONSULTING 2541205 EASTERN INSURANCE GROUP LLC 607 NORTH AVENUE WAKEFIELD MA 01880 CONSULTING 2132063 SEI-BOSTON LLC 11500 NORTHLAKE DRIVE CINCINNATI OH 45249 CONSULTING 1178200 35 0 COMMERCIAL 524114 1081877362 1081877362 MEDICARE 524114 1613877891 1613877891 MEDICAID 524114 261872910 261872910 MEDICARE COMPLEMENT 524114 5995551 5995551 2963623714 17633979 17633979 0 0 -1020 15144 -16164 0 -16164 -16164 604147528 583458706 20688822 20688822 20688822 0 0 0 0 0 0 0 0 0 0 3001930351 2963623714 -16164 38322801 427931 427931 0 0 2615461214 2615461214 0 0 35815887 35815887 0 0 3063102 3063102 0 0 9412021 9412021 0 0 0 64308046 0 64308046 0 560655 448524 112131 0 292331 233865 58466 0 0 0 2223361 0 2223361 0 68484173 0 68484173 0 13484529 10787623 2696906 0 3859366 0 3859366 0 -23814594 -19051675 -4762919 0 0 -1154312 0 -1154312 0 435319 0 435319 0 0 188067 188067 0 0 0 0 26276357 0 26276357 0 0 HPHC PLAN ADMIN OH CHARGES 20153769 0 20153769 0 AUDIT FEES 3978846 0 3978846 0 ASSESSMENT 1509845 0 1509845 0 ADMIN EXPENSE TRANSFER 1182065 0 1182065 0 150225112 140418235 9806877 0 2996373090 2797204794 199168296 0 0 0 -8488193 -5103806 0 0 27669382 39928463 0 0 0 0 0 0 0 0 0 0 300233352 97363638 198297882 202869714 863071881 729639115 175095115 132824839 0 0 0 0 168647802 152251843 1424293869 1252410168 203087951 150556184 0 0 61565766 65995013 0 0 0 0 0 0 0 0 0 0 306958482 324125410 571612199 540676607 X 0 0 0 0 852681670 711733561 852681670 711733561 1424293869 1252410168 X 5557261 -108730000 -37775370 X X false true X true false 32973700 32973700 157300844 7777373 149523471 109958808 89586265 20372543 202869714 INVESTMENT IN P32HS 25053242 C INVESTMENT IN INTEGRA 48016483 C INVESTMENT IN CP HOLDINGS 4438827 C COMMON STOCKS - INTEGRA 31956086 F COMMON STOCK - CP HOLDINGS 23360201 F 132824839 ACCRUED RETROSPECTIVE PREMIUMS 22502850 DUE FROM CAREPARTNERS 6461650 DUE FROM HP REINSURANCE/HPIC 7793 DUE FROM HPHC 2550853 DUE FROM HPHC INSTITUTE 546 DUE FROM HPHC INSURANCE CO 2031842 DUE FROM HPHC NE 96106 DUE FROM TAHMO ELIMS 1151983 DUE FROM THFIC 168789 DUE FROM THPI 645566 DUE FROM THPP 13076963 HEALTHCARE AR 98349255 INTEREST RECEIVABLE 1527193 INVESTMENT SETTLEMENT RECEIVAB 1445977 OTHER RECEIVABLES 2234477 152251843 0 CLAIMS UNPAID 274670062 DUE TO HC 28678510 DUE TO TICO 20749344 DUE TO P32H 26194 DUE TO CPCT HOLDINGS 1300 324125410 X 2890976990 -108730000 -108730000 2999706990 2223361 2223361 3001930351 2994149729 2994149729 2223361 2223361 2996373090 FORM 990, SCHEDULE D, PART X, LINE 2 ASC 740 (FKA FIN 48) FOOTNOTE THIS ORGANIZATION IS AN AFFILIATE OF POINT32HEALTH, INC. (P32H). THE BELOW FOOTNOTE DERIVES FROM THE CONSOLIDATED AUDITED FINCIAL STATEMENTS OF POINT32HEALTH, INC. AND AFFILIATES. POINT32HEALTH, INC., TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC., TUFTS PUBLIC HEALTH PLANS, INC., AND HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC., ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE ("IRC"). HARVARD PILGRIM HEALTH CARE, INC. AND POINT32HEALTH FOUNDATION, INC. ARE RECOGNIZED AS TAX-EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3). THE HARVARD PILGRIM HEALTH CARE INSTITUTE, LLC IS A DISREGARDED ENTITY FOR FEDERAL INCOME TAX PURPOSES AND, THEREFORE, FOLLOWS THE TAX-EXEMPT STATUS OF HARVARD PILGRIM HEALTH CARE, INC. AS ITS SOLE CORPORATE MEMBER. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. THE COMPANY BELIEVES THAT THE POSITIONS TAKEN ON ITS INCOME TAX RETURNS FOR OPEN TAX YEARS WILL BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS"). THEREFORE, P32H HAS NOT RECORDED ANY LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740, INCOME TAXES. AS OF DECEMBER 31, 2022, THERE ARE NO UNRECOGNIZED TAX BENEFITS, AND THE COMPANY DOES NOT ANTICIPATE ANY SIGNIFICANT CHANGES IN THE AMOUNT OF UNRECOGNIZED TAX BENEFITS DURING THE NEXT TWELVE MONTHS. true BRAZILIAN WOMEN'S GROUP 697 CAMBRIDGE ST BRIGHTON MA 02135 043549382 501 (C)(3) 6850 N/A N/A SPONSORSHIP 27TH BRAZILIAN IND DAY FEST 1 0 FORM 990, SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE ORGANIZATION ONLY CONTRIBUTES TO TAX-EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3) AND CERTAIN GOVERNMENTAL UNITS, AS WELL AS SPONSORS EVENTS THAT BENEFIT THESE TYPES OF ORGANIZATIONS. THE ORGANIZATION CONTRIBUTES TO WELL ESTABLISHED, NON-PROFIT ORGANIZATIONS THAT HAVE ESTABLISHED POLICIES AND PROCEDURES FOR MONITORING THE USE OF FUNDS. true true false false false false false false false CAIN HAYES PRESIDENT & CEO 0 1139681 0 1300939 0 0 0 308583 0 27407 0 2776610 0 0 MICHAEL CARSON FORMER PRESIDENT 0 0 0 1094842 0 1126000 0 0 0 0 0 2220842 0 0 UMESH KURPAD CFO 0 612783 0 715141 0 167229 0 184011 0 13439 0 1692603 0 157491 DEREK ABRUZZESE SVP, CORP STRATEGY (END 4/15) 0 102584 0 322799 0 1148431 0 48131 0 7920 0 1629865 0 67272 THOMAS CROSWELL FORMER CEO 0 0 0 1500205 0 0 0 13348 0 0 0 1513553 0 0 TISA HUGHES CLERK/SECR;CHIEF LEGAL OFFICER 0 473550 0 667925 0 47896 0 95697 0 23816 0 1308884 0 54100 MICHAEL SHERMAN MD CHIEF MEDICAL OFFICER 0 477368 0 538227 0 99172 0 143552 0 23753 0 1282072 0 105154 PHILIP BARR EVP, PRESIDENT, MARKETS 0 672923 0 400000 0 1862 0 155398 0 10329 0 1240512 0 0 MARK PORTER SVP, CHIEF ACCOUNTING OFFICER 0 414674 0 572879 0 57779 0 135210 0 25958 0 1206500 0 60672 TRACEY CARTER SVP, CHIEF ACTUARY 0 467132 0 470007 0 98107 0 141791 0 19976 0 1197013 0 96950 PETE CHURCH CHIEF PEOPLE OFFICER 0 513577 0 500000 0 0 0 142403 0 27185 0 1183165 0 0 KRISTIN LEWIS FORMER OFFICER 0 397792 0 350765 0 67570 0 122986 0 19943 0 959056 0 67121 JEAN YANG FORMER OFFICER 0 251956 0 421272 0 38067 0 50184 0 4171 0 765650 0 40091 PATRICIA HOWARD CHIEF OPERATIONS OFFICER 0 610822 0 0 0 4079 0 107283 0 20363 0 742547 0 0 ROLAND PRICE TREASURER 0 321763 0 160064 0 59661 0 97563 0 13069 0 652120 0 44856 SUSAN KEE FORMER ASST. CLERK 0 327011 0 158172 0 43139 0 59955 0 1057 0 589334 0 47024 MARC SPOONER FORMER COO 0 0 0 499935 0 0 0 0 0 0 0 499935 0 0 PATRICIA BLAKE SVP, PRESIDENT MEDICARE 0 424604 0 475315 0 91475 0 136148 0 19978 0 1147520 0 92548 FORM 990, SCHEDULE J, PART I, LINE 3 METHOD USED TO ESTABLISH CEO COMPENSATION TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. RELIED ON ITS PARENT AND SOLE CORPORATE MEMBER, POINT32HEALTH, INC., TO ESTABLISH COMPENSATION FOR ITS CEO. THE METHODS USED BY POINT32HEALTH, INC. ARE AS FOLLOWS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE -WRITTEN EMPLOYMENT AGREEMENT ---------- FORM 990, SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENT THE FOLLOWING SENIOR LEADERS, WHO DEPARTED THE COMPANY FOLLOWING THE CLOSE OF THE TRANSACTION, RECEIVED SEVERANCE OR CHANGE IN CONTROL PAYMENTS RELATING TO THE COMBINATION OF HARVARD PILGRIM HEALTH CARE AND TUFTS HEALTH PLAN. THESE PAYMENTS WERE DESIGNED TO RETAIN LEADERS WITH SIGNIFICANT EXPERTISE IN KEY AREAS AND TO ENSURE CONTINUITY OF OPERATIONS FOR BOTH ORGANIZATIONS THROUGH A LENGTHY AND UNCERTAIN REGULATORY REVIEW PROCESS THAT SPANNED OVER A FIFTEEN MONTH PERIOD, AS WELL AS A GLOBAL PANDEMIC: MICHAEL CARSON = $1,126,000 DEREK ABRUZZESE = $1,088,000 ---------- FORM 990, SCHEDULE J, PART I, LINE 4B DISCRETIONARY RETIREMENT PLAN THE ORGANIZATION'S LEADERS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN SPONSORED BY THEIR EMPLOYER, POINT32HEALTH SERVICES, INC., A RELATED PARTY. THE EMPLOYEES AND AMOUNTS LISTED ON SCHEDULE J, PART II, COLUMN C REFLECT EMPLOYER CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. FORM 990, PART I, LINE 1 & PART III, LINE 1 DETAIL REGARDING THE ORGANIZATION'S MISSION TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION INC.'S (TAHMO) PURPOSE IS TO GUIDE AND EMPOWER HEALTHIER LIVES FOR EVERYONE. TAHMO SEEKS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES WE SERVE. TAHMO IS RESPONSIBLE FOR ARRANGING FOR THE DELIVERY OF COMPREHENSIVE, PREVENTIVE AND THERAPEUTIC HEALTH CARE SERVICES TO SUBSCRIBING INDIVIDUALS IN RETURN FOR A FIXED MONTHLY PAYMENT. SERVICES ARE PROVIDED THROUGH A CONTRACTED NETWORK OF INDEPENDENT PROVIDER GROUPS AND HOSPITALS WITHIN THE SERVICE AREA. TAHMO PRODUCTS ARE AVAILABLE TO ALL SIZE EMPLOYER GROUPS, INCLUDING A MERGED SMALL GROUP AND INDIVIDUAL MARKET.TAHMO ALSO OFFERS PRODUCTS TO INDIVIDUALS WHO ARE MEDICARE AND/ OR MEDICAID ELIGIBLE. TAHMO PROVIDES A BROAD RANGE OF PROGRAMS DESIGNED TO EDUCATE ITS MEMBERS IN HEALTH MAINTENANCE AND DISEASE PREVENTION. TAHMO IS DEDICATED TO OFFERING A VARIETY OF QUALITY, INNOVATIVE HEALTH COVERAGE OPTIONS, AND TO IMPROVING ACCESS TO AFFORDABLE HEALTH CARE BY DEVELOPING AND EMPLOYING STRATEGIES THAT IMPROVE THE ALLOCATION OF HEALTH CARE RESOURCES. IN ADDITION TO PROVIDING THESE SERVICES TO ITS MEMBERS, TAHMO IS DEDICATED TO PROVIDING AND FUNDING HEALTH PROGRAMS THAT BENEFIT THE COMMUNITIES TAHMO SERVES. TAHMO IS PART OF THE POINT32HEALTH, INC (P32H) FAMILY OF COMPANIES. ---------- FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS - COMMERCIAL HMO PRODUCT ONE OF TAHMO'S LARGEST PRODUCTS IS ITS COMMERCIAL HMO WHICH PROVIDES AFFORDABLE HEALTH COVERAGE TO ITS MEMBERS. TAHMO STRIVES TO PROVIDE HMO COVERAGE THAT IS AFFORDABLE, AND PROVIDES ACCESS TO TOP QUALITY HEALTH CARE SERVICES. TAHMO ALSO PROVIDES PROGRAMS THAT TARGET THE IMPROVEMENT OF THE HEALTH OF ITS MEMBERS, AS WELL AS THE COMMUNITY AT LARGE. QUALITY: NCQA EVALUATES HEALTH PLANS ON THE QUALITY OF CARE PATIENTS RECEIVE, HOW SATISFIED PATIENTS ARE WITH THEIR CARE, AND HEALTH PLANS' EFFORTS TO KEEP IMPROVING. TUFTS HEALTH PLAN HMO/POS/EPO ACHIEVED A RATING OF 4 OUT OF 5 FOR THE NCQA 2022 HEALTH PLAN RATINGS. TAHMO CONTINUES TO IMPLEMENT OUTREACH PROGRAMS WITH BOTH PROVIDERS AND MEMBERS WITH THE GOAL OF IMPROVING THE QUALITY OF CARE PROVIDED AND RECEIVED. UPDATED RATINGS WILL BE RELEASED IN SEPTEMBER 2023. TAHMO PROVIDES SPECIALTY CARE MANAGEMENT SERVICES FOR ITS MEMBERS WITH COMPLEX MEDICAL AND BEHAVIORAL HEALTH CONDITIONS. TAHMO MEMBERS RECEIVE TARGETED HEALTH REMINDERS TO ENCOURAGE PREVENTIVE HEALTH CARE.TAHMO'S CARE MANAGERS ASSIST MEMBERS WHO ARE ILL OR DISABLED IN NAVIGATING THE HEALTH CARE SYSTEM AND PROVIDE REFERRALS TO COMMUNITY RESOURCES. OUR WEBSITE, www.tuftshealthplan.com , IS AVAILABLE TO THE COMMUNITY AT LARGE, and INCLUDES A LIBRARY OF TOOLS AND READY-MADE PRINT AND ELECTRONIC MATERIALS. THESE RESOURCES HELP TO ENCOURAGE HEALTHY BEHAVIORS, INCREASE DEMAND FOR PREVENTIVE HEALTH, AND DRIVE ENGAGEMENT IN PROGRAMS THAT EDUCATE AND EMPOWER HEALTHIER LIFESTYLES AND REDUCE HEALTH RISKS. TOPICS INCLUDE PREVENTIVE CARE BENEFITS, HEALTHY EATING AND WEIGHT CONTROL, EXERCISE AND FITNESS, MANAGING STRESS AND HEART HEALTH, CANCER PREVENTION, AND TOBACCO CESSATION. WE ALSO OFFER A VARIETY OF WELLNESS PROGRAMS AT THE WORKSITE SUCH AS FLU SHOTS, CHOLESTEROL SCREENINGS, STRESS MANAGEMENT, AND MORE. TAHMO'S SECURE ONLINE ACCOUNT SERVES AS A CENTRAL HUB FOR LIFESTYLE MANAGEMENT PROGRAM COMPONENTS, HEALTH AND WELLNESS CONTENT, AND TOOLS. THE ONLINE ACCOUNT OFFERS A PERSONAL HEALTH ASSESSMENT AND RESOURCES DESIGNED TO ENCOURAGE INDIVIDUALS TO LEAD HEALTHIER LIVES BASED ON THEIR INTERESTS, OVERALL HEALTH CONDITION, AND OTHER PERSONAL ATTRIBUTES. COMMERCIAL MEMBERS OF TUFTS HEALTH PLAN CONTINUE TO RECEIVE THE MEMBER NEWSLETTER 3-4 TIMES EACH YEAR , THE NEWSLETTER IS AN EDUCATIONAL RESOURCE ON TOPICS PERTAINING TO ACCESS TO SERVICES, PREVENTIVE CARE, HEALTH EDUCATION AND LIFESTYLE REMINDERS. IT ALSO HELPS MEMBERS UTILIZE THEIR COVERED HEALTH PLAN BENEFITS, SERVICES AND FEATURES TO THE FULLEST - AND IS AIMED AT SUPPORTING THEIR IMPROVED HEALTH. ACCESS: TAHMO'S MEMBERS HAVE ACCESS TO HOSPITALS, PRIMARY CARE PROVIDERS AND SPECIALISTS AND ALLIED HEALTH PROFESSIONALS, AS WELL AS CONDITION MANAGEMENT PROGRAMS, PREVENTION AND WELLNESS PROGRAMS. AFFORDABILITY: TAHMO'S GOAL IS TO PROVIDE ACCESS TO THE HIGHEST QUALITY HEALTH CARE SERVICES THROUGH AFFORDABLE HEALTH COVERAGE TO AS MANY MASSACHUSETTS AND RHODE ISLAND RESIDENTS AS POSSIBLE. TAHMO HAS DESIGNED HEALTH MANAGEMENT PROGRAMS TO SIMULTANEOUSLY LOWER MEDICAL COSTS AND IMPROVE QUALITY AND OUTCOMES. BY LOWERING MEDICAL COSTS, TAHMO IS ABLE TO OFFER COMPETITIVE PREMIUM RATES AND PROVIDE COVERAGE TO MORE PEOPLE. TAHMO IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY AS WELL AS THAT OF ITS MEMBERS. THE ORGANIZATION TAKES THIS COMMITMENT SERIOUSLY AND HAS A DEDICATED COMMUNITY PARTNERSHIP PROGRAM THAT PROVIDES IN-KIND AND FINANCIAL SUPPORT TO NOT-FOR-PROFIT PROGRAMS THROUGHOUT MASSACHUSETTS. SUPPORT IS BROAD BASED AND REFLECTS DIVERSE SPONSORSHIP OF ORGANIZATIONS THAT PROMOTE IMPROVED COMMUNITY HEALTH. ---------- FORM 990, PART III, LINE 4B PROGRAM SERVICE ACCOMPLISHMENTS - MASSACHUSETTS MEDICARE PRODUCT TAHMO ALSO OFFERS PRODUCTS TO MEDICARE ELIGIBLE ENROLLEES. TUFTS HEALTH PLAN MEDICARE PREFERRED (TUFTS MEDICARE PREFERRED) PROVIDES AFFORDABLE HEALTH COVERAGE TO ITS MEMBERS IN MASSACHUSETTS. TUFTS MEDICARE PREFERRED STRIVES TO PROVIDE COVERAGE OPTIONS THAT ARE AFFORDABLE AND PROVIDE ACCESS TO TOP QUALITY HEALTH CARE SERVICES FOR SENIORS. TUFTS MEDICARE PREFERRED ALSO OFFERS PROGRAMS THAT TARGET THE IMPROVEMENT OF THE HEALTH OF ITS MEMBERS, AS WELL AS THE COMMUNITY AT LARGE. WITHIN THE MASSACHUSETTS MEDICARE ADVANTAGE MARKET, TUFTS MEDICARE PREFERRED IS THE MARKET LEADER - COVERING MORE INDIVIDUALS THROUGH MEDICARE ADVANTAGE PRODUCTS THAN ANY OTHER CARRIER. TUFTS MEDICARE PREFERRED ALSO OFFERS CARE MANAGEMENT AND CONDITION MANAGEMENT SERVICES TO MEMBERS AND PUBLISHES WELL! MAGAZINE FOR ITS MEDICARE POPULATION ONCE A YEAR. THE MAGAZINE IS AN EDUCATIONAL RESOURCE ON TOPICS PERTAINING TO GENERAL HEALTH, ACCESS TO CARE, PREVENTIVE CARE, HEALTH INFORMATION AND HEALTH CARE REMINDERS, TARGETED TO ITS SPECIFIC POPULATION. IT ALSO PROVIDES INFORMATION FOR MEMBERS ON HOW TO GET THE MOST OF TUFTS HEALTH PLAN'S BENEFITS. ---------- FORM 990, PART III, LINE 4C PROGRAM SERVICE ACCOMPLISHMENTS - DUAL-ELIGIBLE PROGRAM THE ORGANIZATION ALSO PROVIDES ACCESS TO AFFORDABLE CARE THROUGH A DUAL-ELIGIBLE PROGRAM. TAHMO PROVIDES COVERAGE FOR PEOPLE AGE 65 OR OLDER WHO ARE ELIGIBLE FOR MASSHEALTH STANDARD, HAVE BOTH MEDICARE PART A AND B, AND HAVE NOT BEEN DIAGNOSED AS HAVING END STAGE RENAL DISEASE. THIS PROGRAM, CALLED SENIOR CARE OPTIONS, INTEGRATES MEDICAID AND MEDICARE BENEFITS AND SERVICES, PROVIDING THOSE ELIGIBLE WITH COORDINATED HIGH-QUALITY AND COST-EFFECTIVE HEALTH CARE. ---------- FORM 990, PART III, LINE 4D DETAIL OF OTHER PROGRAM SERVICE ACCOMPLISHMENTS - MEDICARE COMPLEMENT TAHMO PROVIDES COVERAGE FOR MEMBERS OF ELIGIBLE EMPLOYER GROUPS WHO ARE ENROLLED IN MEDICARE PARTS A AND B. THIS PROGRAM IS CALLED TUFTS MEDICARE COMPLEMENT (TMC) PLAN AND IS A MANAGED CARE PLAN THAT COMPLEMENTS A MEMBER'S EXISTING MEDICARE COVERAGE. IT IS OFFERED TO TUFTS HEALTH PLAN MEMBERS IN ELIGIBLE EMPLOYER GROUPS WHO ARE ENROLLED IN MEDICARE PARTS A AND B. THE TMC PLAN REQUIRES MEMBERS TO CHOOSE A PRIMARY CARE PHYSICIAN(PCP) WHO IS RESPONSIBLE FOR MANAGING OR PROVIDING THE MEMBER'S CARE. ---------- FORM 990, PART VI, LINE 2 DETAIL OF FAMILY OR BUSINESS RELATIONSHIPS BUSINESS RELATIONSHIP - THE FOLLOWING INDIVIDUALS SERVED ON THE BOARDS OR WERE AN OFFICER OR KEY EMPLOYEE OF ONE OR MORE FOR-PROFIT ORGANIZATIONS AFFILIATED WITH TAHMO FROM 1/1/2022 TO 12/31/2022: CAIN HAYES, DIRECTOR; PRESIDENT & CEO TISA HUGHES, CLERK/SECR; CHIEF LEGAL OFFICER JOYCE MURPHY, DIRECTOR, CHAIR (END 6/7/22) EILEEN AUEN, DIRECTOR, CHAIR (START 6/7/22) UMESH KURPAD, CFO ---------- FORM 990, PART VI, LINE 3 DELEGATION OF CONTROL OF MANAGEMENT DUTIES POINT32HEALTH SERVICES, INC., A WHOLLY OWNED SUBSIDIARY OF TAHMO PERFORMS MANAGEMENT, ADMINISTRATIVE, AND MARKETING SERVICES FOR TAHMO AND ITS AFFILIATES. THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART VII, SECTION A ARE EMPLOYEES OF POINT32HEALTH SERVICES, INC. THEIR COMPENSATION IS LISTED IN PART VII, SECTION A AND SCHEDULE J. ---------- FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS POINT32HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. ---------- FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT MEMBERS POINT32HEALTH, INC. (P32H), AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. ---------- FORM 990, PART VI, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS P32H, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE RIGHT TO MAKE CERTAIN DECISIONS REGARDING THE ORGANIZATION, AND IS REQUIRED TO APPROVE ANY CHANGES TO THE ORGANIZATION'S BYLAWS. ---------- FORM 990, PART VI, LINE 8B CONTEMPORANEOUS BOARD MEETING DOCUMENTATION FOR A MAJORITY OF THE TIME, THE ORGANIZATION CONTEMPORANEOUSLY DOCUMENTS MEETINGS HELD AND WRITTEN ACTIONS UNDERTAKEN BY ITS GOVERNING BODY AND COMMITTEES. HOWEVER, ON LIMITED OCCASIONS, THE GOVERNING BODY OR A COMMITTEE MAY HAVE A SERIES OF CONFERENCE CALLS AND MINUTES FOR THOSE CALLS ARE NOT APPROVED UNTIL THE NEXT MEETING. ---------- FORM 990, PART VI, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THIS FORM 990 WAS PREPARED BY THE ORGANIZATION'S S EXTERNAL ACCOUNTANT, REVIEWED BY POINT32HEALTH, INC.'S FINANCE DEPARTMENT AND CERTAIN SECTIONS ARE REVIEWED FOR INPUT BY SUBJECT MATTER PERSONNEL IN OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. ---------- FORM 990, PART VI, LINE 12A & 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE POINT32HEALTH INC'S CONFLICT OF INTEREST (COI) POLICY AND PROCEDURES (P&P) APPLIES TO THE FILING COMPANY AS A SUBSIDIARY ORGANIZATION. THE POINT32HEALTH, INC.'S COI P&P IS REVIEWED ANNUALLY, REVISED AS NEEDED AND APPROVED UPON MATERIAL REVISIONS. THE POLICY REQUIRES ALL EMPLOYEES, INCLUDING THE PRESIDENT AND CEO AND GOVERNING BODY MEMBERS TO COMPLY WITH THE COI POLICY AND PROCESSES. ALL EMPLOYEES RECEIVE ANNUAL COMPLIANCE TRAINING WHICH INCLUDE EXPECTATIONS RELATED TO FOLLOWING THE COI P&P. THE COI P&P REQUIRES THE OFFICERS, KEY EMPLOYEES AND BOARD OF DIRECTORS OF THE TAX-EXEMPT ENTITIES TO COMPLETE AND SUBMIT AN ANNUAL DISCLOSURE SURVEY AND STATEMENT TO THE CHIEF LEGAL OFFICER (CLO) OR DESIGNEE IN THE LEGAL DEPARTMENT, LISTING ANY OUTSIDE RELATIONSHIPS, INCLUDING FINANCIAL AND/OR BOARD RELATIONSHIPS THAT THEY OR A FAMILY MEMBER HAVE WITH POINT32HEALTH, INC.'S (OR ITS SUBSIDIARIES) SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. ADDITIONALLY, POINT32HEALTH, INC. REQUIRES EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT (AS DEFINED IN THE COI POLICY) TO COMPLETE AND SUBMIT AN ANNUAL DISCLOSURE SURVEY AND STATEMENT TO THE CHIEF COMPLIANCE OFFICER OR DIRECTOR, CORPORATE COMPLIANCE. BY COMPLETING THE ANNUAL DISCLOSURE STATEMENT, THESE INDIVIDUALS ACKNOWLEDGE THE POINT32HEALTH COI P&P. ALL EMPLOYEES ARE REQUIRED TO REPORT THE OFFER BY AN OUTSIDE ENTITY OF GIFTS OVER $250, HONORARIA OR COVERAGE OF BUSINESS EXPENSES, OR OTHER EVENTS OR RELATIONSHIPS THAT MAY BE PERCEIVED AS CONFLICTS TO THE CHIEF COMPLIANCE OFFICER, DIRECTOR, CORPORATE COMPLIANCE OR DESIGNEE AND THE EMPLOYEE'S MANAGEMENT. BOTH MUST APPROVE BEFORE ACCEPTANCE IS ALLOWED. THERE ARE PROTOCOLS AND PROCESSES TO REVIEW ANY DISCLOSURE THAT MIGHT BE A POTENTIAL CONFLICT OF INTEREST. BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES' RESPONSES TO THE DISCLOSURE SURVEY AND STATEMENT ARE REVIEWED BY THE CLO, WHO WILL REVIEW THE SELF-DISCLOSURE WITH THE CHAIR OF THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF POINT32HEALTH, INC. AND DETERMINE EXPECTATIONS AND RECOMMENDED ACTIONS IF NEEDED. A SUMMARY REPORT OF ALL DISCLOSED ACTUAL OR POTENTIAL CONFLICTS ALONG WITH ANY RECOMMENDED ACTIONS TO ADDRESS A DISCLOSED ACTUAL OR POTENTIAL CONFLICT IS REVIEWED AND APPROVED BY THE GOVERNANCE COMMITTEE AND THE COMMITTEE'S REVIEW/FINDINGS ARE REPORTED TO THE FULL BOARD. THE CLO COMMUNICATES THE RECOMMENDED ACTIONS TO INDIVIDUAL SURVEY RECIPIENTS. THE CHIEF COMPLIANCE OFFICER IS CONSULTED AND INFORMED OF THE DECISIONS MADE BY THE CLO OR LEGAL DESIGNEE. EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT'S RESPONSES TO THE DISCLOSURE SURVEY AND STATEMENT ARE REVIEWED BY THE DIRECTOR, CORPORATE COMPLIANCE AND CHIEF COMPLIANCE OFFICER, WHO WILL REPORT TO THE CLO ANY POTENTIAL CONFLICTS ALONG WITH ANY RECOMMENDED ACTIONS TO ADDRESS THE POTENTIAL CONFLICT, IF NECESSARY. RECOMMENDED ACTIONS/EXPECTATIONS ARE COMMUNICATED BY THE DIRECTOR, CORPORATE COMPLIANCE/CHIEF COMPLIANCE OFFICER TO IMPACTED INDIVIDUALS. FOR CONFLICT DISCLOSURES INVOLVING THE CHIEF COMPLIANCE OFFICER, THE CLO WILL MAKE THE FINAL DETERMINATION. ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST THAT ARISES AFTER COMPLETION OF THE DISCLOSURE SURVEY WILL FOLLOW THE SAME REVIEW PROCESS. ---------- FORM 990, PART VI, LINE 13 WRITTEN WHISTLEBLOWER/NON-RETALIATION POLICY THE FILING ORGANIZATION IS SUBJECT TO THE WRITTEN WHISTLEBLOWER/NON-RETALIATION POLICY WITHIN THE CODE OF CONDUCT THAT WAS APPROVED BY THE BOARD OF DIRECTORS OF POINT32HEALTH, INC. ---------- FORM 990, PART VI, LINE 14 WRITTEN DOCUMENT RETENTION POLICY THE FILING ORGANIZATION IS SUBJECT TO THE WRITTEN DOCUMENT RETENTION POLICY AND RECORD RETENTION SCHEDULE OF POINT32HEALTH, INC. ---------- FORM 990, PART VI, LINES 15A & 15B COMPENSATION REVIEW AND APPROVAL THE FILING ORGANIZATION'S PARENT COMPANY, POINT32HEALTH, INC. HAS AN INDEPENDENT HUMAN RESOURCES COMMITTEE (THE "COMMITTEE") THAT ANNUALLY REVIEWS THE TOTAL REMUNERATION OPPORTUNITIES, POLICIES AND PROGRAMS OF THE CEO AND CERTAIN EXECUTIVES, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES AS WELL AS INDIVIDUALS THE COMMITTEE DEEMS APPROPRIATE TO REVIEW. THE COMMITTEE IS COMPRISED OF INDEPENDENT DIRECTORS OF THE COMPANY. THE COMMITTEE CONSIDERS MARKET DATA AND ANALYSES ASSEMBLED BY INDEPENDENT AND INTERNAL COMPENSATION CONSULTANTS WITH THE GOAL TO DETERMINE EXECUTIVE TOTAL REMUNERATION THAT IS REASONABLE AND COMPETITIVE WITHIN THE INDUSTRY AND GEOGRAPHY IN WHICH POINT32HEALTH, INC. OPERATES. ---------- FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND ANNUAL FINANCIAL REPORT AND QUARTERLY FINANCIAL UPDATES ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE ALSO FILED WITH THE MASSACHUSETTS SECRETARY OF STATE, WHERE THEY ARE AVAILABLE TO THE PUBLIC. ---------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CONTRIBUTION TO PARENT $(35,000,000) CHANGE IN NONADMITTED ASSETS (2,775,000) OTHER CHANGES IN NET ASSETS (370) ------------ TOTAL $(37,775,370) ---------- FORM 990, PART XII, LINE 1 ACCOUNTING METHOD USED TO PREPARE THE FORM 990 TAHMO FOLLOWS THE STATUTORY ACCOUNTING METHOD PRESCRIBED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' ACCOUNTING PRACTICES AND PROCEDURES MANUAL FOR STATUTORY ACCOUNTING PRINCIPLES. ---------- HPHC OF NEW ENGLAND INC 1 WELLNESS WAY CANTON MA 02021 042663394 HEALTH INS. 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