2023-11-10T14:13:54-06:00 2022-12-31 FORVIS LLP 111 E Wayne St Suite 600 Fort Wayne IN 46802 990 2022-01-01 311069321 PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA INC % TYLER SIPE PHYS 2604326690 1700 MAGNAVOX WAY Suite 201 FORT WAYNE IN 46804 TYLER S SIPE CFO 2604326690 2023-05-15 true DUSTIN CRIDER 999009999 Anne E White P01708202 2604604000 3 2022 2023-04-26 12:10:37Z TYLER S SIPE 1700 MAGNAVOX WAY SUITE 201 FORT WAYNE IN 46804 189806702 false X WWW.PHPNI.COM X 1983 IN PHPNI IS A PROVIDER OF EMPLOYEE BENEFIT SERVICES AND SOLUTIONS. WE PROVIDE INSURANCE COVERAGE AND EDUCATIONAL MATERIALS PROMOTING A HEALTHY LIFESTYLE TO OUR MEMBERS. 13 10 218 2236552 50334 0 0 187632916 166255040 7454701 3724859 1425599 2234636 196513216 172214535 136944 500000 183380684 149472687 12684590 12130308 0 0 0 10147118 9849460 206349336 171952455 -9836120 262080 94644511 89283875 37312480 33847312 57332031 55436563 X OUR MISSION IS TO CREATE INNOVATIVE SOLUTIONS THAT CONTRIBUTE TO HEALTHIER COMMUNITIES THROUGH CARING AND COLLABORATION. false false 161511059 500000 166253124 PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA, INC. (PHP) IS SPONSORED BY INDEPENDENT PHYSICIANS AS A NOT-FOR-PROFIT, INDIANA CERTIFIED AND FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION. PHP OFFERS FULLY-INSURED HEALTH PRODUCTS TO GROUP SPONSORS THROUGHOUT THE 46 COUNTIES IN NORTHERN INDIANA. PHP'S PROGRAM SERVICE PLACES FOCUS ON MANAGING HEALTHCARE COSTS AND INVESTING IN ACTIVITIES TO IMPROVE THE HEALTHCARE QUALITY OF OUR MEMBER POPULATION. PHP HAS DEVELOPED THE Get PHP Fit program which PHP utilizes to promote wellness and a healthy lifestyle for our members. PHP partners with a number of health clubs to offer discounted rates to our members. Our website offers extensive information on community health classes and other activities which encourage a healthy lifestyle. We publish a monthly newsletter which provides a number of tips for improving overall health such as recipes, activities to engage in to reduce stress and improve mental health, etc. Our Wellness Program Coordinator, who is a Certified Wellness and Health Coach, offers a variety of opportunities to help improve employee well-being in a fun and engaging way. Her group wellness presentations can consist of a quick 15-minute discussion, or a more in-depth 60-minute presentation, depending on the needs of the group. Some of the discussion topics available include nutrition, exercise, stress management, sleep, and much more. Additional wellness opportunities include one-on-one wellness coaching, company challenges, exercise classes, and stress management activities. PHP groups also have the opportunity to schedule a health screening for their employees each year. The health screenings include lab draws and biometric measurements that can help employees to get a good picture of their overall health. Our Wellness Program Coordinator can then discuss health screening results with employees if desired so that they have a better understanding of what the results mean for their health status. Our members have access to MyNurse 24/7, an around-the-clock call center for members and their families. They can call and speak to a nurse any time, any day, about personal health concerns. The member will be given a recommendation by the nurse depending on the situation presented which might include seeing their family doctor the next business day or participating in some self-care interventions which would solve the problem. 161511059 false false false false false false false false false true true false false true false true false false false true 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 2591 0 218 true true true false false false false false false false X 13 10 false false true false true true true true true false false true true true true true true true false true false IN X TYLER SIPE 2604214450 1700 MAGNAVOX WAY SUITE 201 FORT WAYNE IN 46804 MATTHEW ROSKUSKILEFT 052022 CHIEF SALES OFFICER 40.0 5.0 X 343256 0 20421 GARY SHEARER PRESIDENT AND CEO 50.0 10.0 X 304385 0 36807 GAIL DORAN EVP AND COO 45.0 10.0 X 277922 0 46286 JAMES FORD CHIEF INFORMATION OFFICER 35.0 10.0 X 192697 0 38453 NICK SLOFFER DIRECTOR OF PHARMACY 35.0 10.0 X 161897 0 36751 ROSS HENSLEY STARTED 042022 DIRECTOR SALES/ACcount Mngmt 30.0 15.0 X 156721 0 34290 TYLER SIPE START 072022 CHIEF FINANCIAL OFFICER 35.0 15.0 X 142051 0 21564 AARON CROUCH LEFT 102022 DIRECTOR OF ANALYTICS 30.0 10.0 X 130875 0 30305 MARK KING DO MEDICAL DIRECTOR 20.0 0.0 X 138501 0 19736 KELLY ABOUHALKAH DIRECTOR OF OPERATIONS 35.0 10.0 X 119733 0 33784 VANCE RENNINGER SENIOR BI DEVELOPER 30.0 10.0 X 119237 0 34101 JANICE RICHEY SENIOR GROUP UNDERWRITER 30.0 10.0 X 128271 0 16594 DUSTIN CRIDER LEFT 042022 CHIEF FINANCIAL OFFICER 35.0 10.0 X 79934 0 10418 MICHAEL DEWALD TREASURER 1.0 0.0 X X 13200 0 0 TIM DIRIG SECRETARY 1.0 0.0 X X 12225 0 0 JUDITH KENNEDY MD CHAIR 1.0 0.0 X X 10700 0 0 DONALD SCHENKEL DIRECTOR 1.0 0.0 X 6750 0 0 SHERY ROUSSARIE DIRECTOR 1.0 0.0 X 5000 0 0 JAMES STEVENS MD VICE CHAIR 1.0 0.0 X X 4700 0 0 DOUGLAS BEEBE DIRECTOR 1.0 0.0 X 3375 0 0 DENNIS UHRHAMMER MD DIRECTOR 1.0 0.0 X 3000 0 0 JOHN SAMPSON MD DIRECTOR 1.0 0.0 X 2750 0 0 DAVID STEIN MD DIRECTOR 1.0 0.0 X 2000 0 0 JERALD COOPER MD DIRECTOR 1.0 0.0 X 2000 0 0 MARK RANCK MD DIRECTOR 1.0 0.0 X 1500 0 0 JOEL VALCARCEL MD DIRECTOR 1.0 0.0 X 1000 0 0 2362680 0 379510 25 false true false HM LIFE INS COMPANYEPIC REINSURAN 7301 SW 57 CT 450 SOUTH MIAMI FL 33143 REINSURANCE 1910780 OPTUM 11000 OPTUM CIRCLE EDEN PRAIRIE MN 55344 TRANSPLANT COVERAGE 1980227 COGNIZANT TRIZETTO SOFTWARE GROPU DEPT 2140 PO BOX 122140 DALLAS TX 75312 SOFTWARE VENDOR 847053 HEALTHSCAPE ADVISORS 55 W MONROE ST UNIT 2100 CHICAGO IL 60603 CONSULTANTS 1826008 MAGNAWAY LLC 7108 COVINGTON RD FORT WAYNE IN 46804 PROPERTY MANAGEMENT 965029 43 0 PREMIUM REVENUE 524114 166255040 166255040 166255040 2072732 2072732 0 0 0 0 0 15750286 3494008 16010982 1581185 -260696 1912823 1652127 1652127 0 0 0 0 0 0 0 0 0 ALLOCATED ADMIN 524298 2188279 2188279 MISCELLANEOUS 524298 -1916 -1916 COMMISSION REVENUE 524298 48273 48273 2234636 172214535 166253124 2236552 3724859 500000 500000 0 0 149472687 149472687 1899140 644758 1254382 0 7129493 3456183 3673310 381758 185066 196692 2301734 1115818 1185916 418183 202724 215459 0 187308 187308 233266 233266 1759 1759 0 166391 166391 120122 120122 317885 317885 489689 489689 488745 488745 0 854368 854368 63341 63341 0 4697 4697 14881 14881 0 302929 302929 195749 195749 COMMISSIONS 3686402 3686402 0 0 ACTUARIALS & CONSULTING 2247421 2247421 0 0 OTHER 474507 474507 171952455 161511059 10441396 0 7947111 1241337 303808 1486341 0 0 5652538 7362374 0 0 0 0 0 0 0 0 0 0 2814068 2755462 1748403 58606 74297395 72870534 3710613 4569605 0 0 0 0 984643 1695078 94644511 89283875 9246298 6439444 0 0 4659021 4711683 0 0 0 0 0 0 0 0 0 0 23407161 22696185 37312480 33847312 X 0 0 3780100 4007100 53551931 51429463 57332031 55436563 94644511 89283875 X 262080 -3186986 1029438 X false true X true false 2814068 2755462 58606 58606 INVESTMENT IN AFFILIATES 4569605 C 4569605 0 IBNR CLAIMS AND CLAIMS PAYABLE 22696185 22696185 167700735 -3186986 1029438 -2157548 169858283 166390 2189862 2356252 172214535 169596203 169596203 166390 2189862 2356252 171952455 ASC 740 FOOTNOTE 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. PART XI, LINE 2D INCREASE IN CONTRIBUTED CAPITAL 227,000 CHANGE IN NONADMITTED ASSETS 802,438 TOTAL 1,029,438 PART XI & XII, LINE 4B ADMINISTRATIVE FEES 2,174,981 INTEREST EXPENSE 14,881 TOTAL 2,189,862 NORTH AMERICA PASSIVE INVESTMENTS 1316996 EUROPE PASSIVE INVESTMENTS 4000480 MIDDLE EAST AND NORTH AFRICA PASSIVE INVESTMENTS 138087 SUB-SAHARAN AFRICA PASSIVE INVESTMENTS 53699 EAST ASIA AND THE PACIFIC PASSIVE INVESTMENTS 2755092 SOUTH ASIA PASSIVE INVESTMENTS 231715 SOUTH AMERICA PASSIVE INVESTMENTS 91528 8587597 8587597 false false false false false false true THE ALLIANCE 200 E MAIN ST STE 800 FORT WAYNE IN 46802 351787258 501(C)(3) 10750 ECONOMIC DEVELOPMENT PHP FOUNDATION 1700 MAGNAVOX WAY FORT WAYNE IN 46802 204615314 501(C)(3) 425431 MEDICAL/PROGRAM ASSISTANCE 2 SCHEDULE I, PART I, LINE 2 CHARITABLE CONTRIBUTION EXPENDITURES ARE SUBJECT TO THE ORGANIZATION'S CONTRIBUTION POLICY WHICH CALLS FOR THE FIRST $500,000 OF NET INCOME AND 15% OF OPERATING INCOME TO BE ALLOCATED TO CHARITABLE CONTRIBUTIONS. INDIVIDUAL CHARITABLE CONTRIBUTION EXPENDITURES ARE APPROVED BY SENIOR MANAGEMENT AND REVIEWED TO ENSURE THE GRANTEE'S ELIGIBILITY AND ABILITY TO PROVIDE AN APPROPRIATE LEVEL OF MEDICAL ASSISTANCE TO THE UNDERSERVED BASED ON THE AMOUNT OF THE GRANT. X true true X X X X X X true false false false false false false false false GAIL DORAN EVP AND COO 263631 0 14291 0 0 0 14542 0 31744 0 324208 0 GARY SHEARER PRESIDENT AND CEO 285623 0 18762 0 0 0 15972 0 20835 0 341192 0 JAMES FORD CHIEF INFORMATION OFFICER 184822 0 7875 0 0 0 10024 0 28429 0 231150 0 MARK KING DO MEDICAL DIRECTOR 133857 0 4644 0 0 0 7245 0 12491 0 158237 0 MATTHEW ROSKUSKILEFT 052022 CHIEF SALES OFFICER 77501 0 14579 0 251176 0 6456 0 13965 0 363677 0 TYLER SIPE START 072022 CHIEF FINANCIAL OFFICER 134950 0 7101 0 0 0 6194 0 15370 0 163615 0 NICK SLOFFER DIRECTOR OF PHARMACY 156227 0 5670 0 0 0 8542 0 28209 0 198648 0 ROSS HENSLEY STARTED 042022 DIRECTOR SALES/ACcount Mngmt 115883 0 40838 0 0 0 6494 0 27796 0 191011 0 AARON CROUCH LEFT 102022 DIRECTOR OF ANALYTICS 127483 0 3392 0 0 0 5959 0 24346 0 161180 0 VANCE RENNINGER SENIOR BI DEVELOPER 116747 0 2490 0 0 0 6221 0 27880 0 153338 0 KELLY ABOUHALKAH DIRECTOR OF OPERATIONS 115892 0 3841 0 0 0 5938 0 27846 0 153517 0 SCHEDULE J, PART I, LINE 1A GARY SHEARER WAS PROVIDED SOCIAL CLUB DUES TO PROVIDE A VENUE FOR CONDUCTING COMPANY BUSINESS. SOCIAL CLUB EXPENSES FOR PERSONAL USE WERE REIMBURSED TO PHP. CAPITAL DUES WERE PRO-RATED AND THE PORTION OF THE PERSONAL USE WAS INCLUDED IN TAXABLE INCOME. SCHEDULE J, PART I, LINE 4A MATTHEW ROSKUSKI RECEIVED A SEVERENCE PAYMENT IN THE AMOUNT OF $250,256 FOR THE CALENDAR YEAR 2022. FORM 990, PART IV, LINE 12 PHYSICIAN HEALTH PLAN'S AUDITED FINANCIAL STATEMENTS ARE PREPARED USING ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE INDIANA DEPARTMENT OF INSURANCE, WHICH PRACTICES DIFFER FROM ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. FORM 990, PART VI, SECTION A, LINE 1B TIM DIRIG, JUDITH KENNEDY AND MICHAEL DEWALD ARE NON-INDEPENDENT VOTING MEMBERS OF THE BOARD BECAUSE THEY ARE COMPENSATED GREATER THAN $10,000 BY THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION WERE AMENDED TO INCLUDE CONTIGUOUS STATES IN THE SERVICE AREA IN WHICH HEALTHCARE SERVICES ARE BEING PROVIDED. PRIOR TO 2022, HEALTHCARE SERVICES WERE ONLY PROVIDED TO MEMBERS EMPLOYED BY COMPANIES OPERATING IN INDIANA. FORM 990, PART VI, SECTION A, LINE 6 ONLY ONE MEMBER CLASS EXISTS. MEMBERS WITHIN ALLEN COUNTY, INDIANA PAY A $2,000 MEMBERSHIP FEE. MEMBERS IN THE INDIANA COUNTIES SURROUNDING ALLEN COUNTY PAY A $500 FEE. MEMBERS, NO MATTER THEIR LOCATION, HAVE THE SAME VOTING RIGHTS AND ARE ASSOCIATED WITH THE SAME FEE TABLE. THERE ARE NO MEMBERS OUTSIDE OF THE COUNTIES LISTED ABOVE IN PHP'S 46 COUNTY SERVICE AREA. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS CONSISTS OF NO LESS THAN THIRTEEN TO NO MORE THAN SEVENTEEN MEMBERS. THE DIRECTORS MUST BE CLASSIFIED AS PHYSICIAN DIRECTORS OR CONSUMER DIRECTORS. PHYSICIAN DIRECTORS MUST REPRESENT AT LEAST ONE-HALF BUT NO MORE THAN TWO-THIRDS OF THE TOTAL DIRECTORS OF THE BOARD AND CONSUMER DIRECTORS MUST CONSIST OF AT LEAST ONE THIRD OF THE TOTAL DIRECTORS OF THE BOARD. THE PHYSICIAN DIRECTORS ARE ELECTED BY THE MEMBER DOCTORS AND THEN THE ELECTED PHYSICIAN DIRECTORS APPOINT THE CONSUMER DIRECTORS. ALL DIRECTORS, PHYSICIAN OR CONSUMER, HAVE THE SAME VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 7B MEMBER DOCTORS HAVE THE ABILITY TO ELECT AND REMOVE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND RELATED SCHEDULES UNDERGO A THOROUGH REVIEW BY THE CONTROLLER, CHIEF FINANCIAL OFFICER, AND AN INDEPENDENT CPA FIRM. IN ADDITION, A COPY OF THE 990 IS EMAILED TO THE GOVERNING BODY. THE GOVERNING BODY REVIEWS THE 990 AND SUBMITS ANY QUESTIONS, COMMENTS, OR CORRECTIONS PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE IS SENT OUT ANNUALLY TO ALL OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE PERSONAL AND BUSINESS RELATIONSHIPS. THE QUESTIONNAIRES ARE REVIEWED ANNUALLY. IF A CONFLICT EXISTS, RESTRICTIONS WILL BE IMPOSED ON PERSONS WITH A CONFLICT SUCH AS PROHIBITING THEM FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S PAY (INCLUDING BASE PAY AND BONUS) IS REVIEWED AND DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE is made up of the executive committee of the Board of Directors. BONUS PAY IS DETERMINED ANNUALLY. BASE PAY IS REVIEWED PERIODICALLY BASED ON THE PROVISIONS SET FORTH IN THE CEO'S EMPLOYMENT AGREEMENT. PERIODICALLY, A REVIEW PERFORMED BY AN INDEPENDENT THIRD-PARTY CONSULTANT IS USED, ALONG WITH OTHER DATA INPUTS, TO SUPPORT THE COMPENSATION COMMITTEE'S DERMINATION OF THE BASE PAY. THESE REVIEWS INCLUDE A REVIEW OF COMPARABILITY DATA FROM SOURCES SUCH AS WARREN SALARY SURVEY. CONTEMPORANEOUS SUBSTANTIATION OF THE RESULTING DECISIONS IS RETAINED. FORM 990, PART VI, SECTION B, LINE 16B THE ORGANIZATION HAS AN INFORMAL NON-WRITTEN POLICY REQUIRING THE ORGANIZATION TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE AGREEMENTS UNDER APPLICABLE FEDERAL TAX LAW, AND TAKES STEPS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS WITH RESPECT TO SUCH ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 PHYSICIANS HEALTH PLAN'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. PHYSICIANS HEALTH PLAN'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC) WEBSITE. FORM 990, PART XI, LINE 9 INCREASE IN CONTRIBUTED CAPITAL $ 227,000 CHANGES IN NONADMITTED ASSETS $ 802,438 TOTAL $ 1,029,438 PHP FOUNDATION INC 1700 MAGNAVOX WAY SUITE 201 FORT WAYNE IN 46804 204615314 PRIVATE FDN IN 501(C)(3) PF PHPNI false PHP HOLDING CO 1700 MAGNAVOX WAY SUITE 201 FORT WAYNE IN 46804 208074365 HOLDING CO IN PHPNI C CORP 16588208 16629523 1.00000 true PHP MANAGEMENT SYSTEMS INC 1700 MAGNAVOX WAY SUITE 201 FORT WAYNE IN 46804 351826719 LICENSED TPA IN PHP HOLDING CO C CORP true PHP INSURANCE COMPANY OF INDIANA INC 1700 MAGNAVOX WAY SUITE 201 FORT WAYNE IN 46804 203064284 STOP LOSS REI IN PHP HOLDING CO C CORP true PRO-CLAIM PLUS INC 1700 MAGNAVOX WAY SUITE 202 FORT WAYNE IN 46804 351938551 LICENSED TPA IN PHPMSI C CORP true LION TECH INC 1700 MAGNAVOX WAY SUITE 202 FORT WAYNE IN 46804 300319874 CLAIMS SOFTWA IN PHPMSI C CORP true INNOVATIVE HEALTHCARE STRATEGIES INC 1700 MAGNAVOX WAY SUITE 202 FORT WAYNE IN 46804 474139320 NETWORK NEGOT IN PHPMSI C CORP true false true false false false false true false false true false true false true true false true false false PRO-CLAIM PLUS INC Q 4727314 COST PHP MANAGEMENT SYSTEMS INC Q 2721578 COST PHP INSURANCE COMPANY Q 672792 COST PRO-CLAIM PLUS INC J 244823 FMV PHP MANAGEMENT SYSTEMS INC J 57856 FMV PHP MANAGEMENT SYSTEMS INC L 1867499 COST PHP INSURANCE COMPANY L 307483 COST