2023-11-14T14:00:08-05:00 2022-12-31 383133790 ANDREWS HOOPER PAVLIK PLC 4295 OKEMOS RD STE 200 OKEMOS MI 488646201 990 2022-01-01 832766121 PHP MEDICARE PHPM 5173648400 1400 E MICHIGAN AVE LANSING MI 48912 DENNIS REESE PRESIDENT & CEO 5173648400 2023-11-13 true DENNIS REESE 999009999 false JULIE M PFEIFLE P00751307 5177060800 2023-11-13 2022 2023-04-26 12:10:37Z DENNIS REESE 1215 E MICHIGAN AVENUE LANSING MI 48912 78100472 false X WWW.PHPMEDICARE.COM X 2018 MI PHP MEDICARE'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, COST EFFECTIVE HEALTHCARE. 5 2 0 0 0 51665541 75121089 27557 107249 2872134 51693098 78100472 0 52046313 72595592 1995330 1793906 0 0 10739524 15809526 64781167 90199024 -13088069 -12098552 27571426 12097036 16190019 12814181 11381407 -717145 X PHP MEDICARE'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, COST EFFECTIVE HEALTHCARE. false false 87673119 75121089 PHP MEDICARE IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO). PHP MEDICARE USES A PRIMARY CARE CONCEPT FOR DELIVERING HEALTH CARE IN A HEALTH DELIVERY NETWORK (HDN) STRUCTURE. IT ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER. PHP MEDICARE'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. PHP MEDICARE IS WHOLLY OWNED BY PHP. PHP IS PRIMARILY A COMMERCIAL HMO. ALONG WITH PHP MEDICARE, PHP OPERATES PHP INSURANCE COMPANY (PHPIC), A COMMERCIAL INSURANCE COMPANY AND PHP SERVICE COMPANY, A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHP. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHP APPLY TO PHP, PHPIC, AND PHPMA. PHPS SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE AND PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. PHP IC OFFERS PRODUCTS ACROSS MICHIGAN. AS OF DECEMBER 31, 2022, THERE WERE APPROXIMATELY 28,600 ENROLLEES IN PHPS COMMERCIAL HMO, 24,800 IN TPA, 2,900 IN PHPIC, AND 7,500 ENROLLEES IN PHPMA. THE PHP NETWORK IS APPROXIMATELY 3,068 PRIMARY CARE PHYSICIANS, 5,503 SPECIALTY CARE PHYSICIANS, 3,906 ALLIED HEALTH PROFESSIONALS, 3,482 BEHAVIORAL HEALTH PROVIDERS AND 746 ORGANIZATIONAL PROVIDERS THAT INCLUDE 60 HOSPITALS. PHP CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. PHPS COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. PHPS SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW PHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGANS MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. PHP MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY AN HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY HDN, IS NOT AVAILABLE WITHIN THE HDNS NETWORK. PHP OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS TO GROUPS AND INDIVIDUALS. PHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE PHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. PHP MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: -DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES. -QUALITY OF CARE CONCERNS. -HEDIS MEASURES THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLANS PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHP USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: - DIABETES, - ASTHMA, - DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, - BREAST AND CERVICAL CANCER SCREENING, - USE OF BETA-BLOCKERS AFTER HEART ATTACKS, - CHILD AND ADOLESCENT IMMUNIZATIONS, - CHOLESTEROL MANAGEMENT, - CONTROLLING HIGH BLOOD PRESSURE, - SMOKING CESSATION, - PRENATAL AND POSTPARTUM CARE, AND - TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHP MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS EXPECTATIONS. THE PHP QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2020 PHP RECEIVED FULL ACCREDITATION STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. PHP HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. THE CURRENT ACCREDITATION IS EFFECTIVE THROUGH JULY 1, 2024 AT WHICH TIME REACCREDITATION WILL OCCUR. 87673119 false false false false false false false false true false false false false true false 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 true false false true 661 0 true 0 false false false false false false false false X 5 2 false false false false true true true true true false false true true true true true true true true false MI X DENNIS REESE 5173648400 1400 E MICHIGAN AVE LANSING MI 48912 JAMES DOVER PRES/CEO - S 1.00 40.00 X X 0 1141524 84525 JOSEPH RUTH DIRECTOR 1.00 40.00 X 0 736602 129037 PAULA REICHLE TREASURER 1.00 40.00 X X 0 648489 61609 DOUGLAS EDEMA MD FORMER DIREC 1.00 40.00 X 0 548605 50204 DENNIS REESE PRESIDENT & 40.00 5.00 X 0 419309 62522 PETER GRAHAM MD MEDICAL DIRE 40.00 5.00 X 0 330384 70495 EDWARD VOZZO CFO/COO 40.00 5.00 X 0 214973 32015 JONATHAN DENGEL OPERATION & 40.00 5.00 X 0 197931 30660 WALTER BRIGGS DIRECTOR OF 40.00 5.00 X 0 182768 45133 KENNETH WALKER DIR OF NETWO 40.00 5.00 X 0 161165 43823 NICHOLAS D'ISA DIR OF LEGAL 40.00 5.00 X 0 165698 37351 SCOTT NORMAN VP OF SALES 40.00 5.00 X 0 164719 36513 ANN HUNT-FUGATE RPH MANG. CLINIC 40.00 5.00 X 0 159183 31580 GEORGE SCHNEIDER FORMER CFO/C 40.00 5.00 X 0 118358 24133 ANDREA KOSLOSKI FORMER DIREC 0.00 40.00 X 0 100967 18669 RICHARD BRUNER DIRECTOR 1.00 0.00 X 0 0 0 TIMOTHY PETERSON MD DIRECTOR 1.00 0.00 X 0 0 0 5290675 758269 true true false LUMERIS HEALTHCARE OUTCOMES 13900 EICWEPOER DR MARYLAND HEIGHTS MO 63043 MGMT CONSULTING 11662697 MERGE 200 E RANDOLPH ST SUITE 3450 CHICAGO IL 60601 MKT SERVICES 2054404 RED THREAD LLC 621 RUSSWOOD NE GRAND RAPIDS MI 49505 MKT SERVICES 110800 3 PREPAID HEALTHCARE 621990 75121089 75121089 75121089 107249 107249 PREMIUM DEFICIENCY RESERVE 900099 2872134 2872134 2872134 78100472 77993223 107249 72595592 72595592 1481529 1481529 312377 312377 10641048 10641048 37300 37300 2175 2175 1379491 1379491 2300883 1741768 559115 396097 299845 96252 49515 49515 BROKER COMMISSIONS 900382 900382 BANK CHARGES 102635 77693 24942 90199024 87673119 2525905 0 20797336 4460765 4040073 6497207 10710 13086 1114895 1125978 1608412 27571426 12097036 14242299 11557783 16895 78456 1930825 1177942 16190019 12814181 X 11381407 -717145 11381407 -717145 27571426 12097036 X -12098552 X false true X true true true 6297032 5192208 -280050 11209190 5606321 561053 129658 6297032 4912247 237860 456214 5606321 4700296 39943 172008 4912247 1.00000 false true true RELATED PARTY PAYABLE 1177942 1177942 74439751 74439751 2175 3658546 3660721 78100472 86538303 86538303 2175 3658546 3660721 90199024 SCHEDULE D, PAGE 2, PART V, LINE 4 PHP MEDICARE DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW FOUNDATION. PHYSICIANS HEALTH PLAN IS THE SOLE MEMBER OF PHP MEDICARE. SPARROW HEALTH SYSTEM HAS AN INDIRECT CONTROLLING INTEREST IN PHYSICIANS HEALTH PLAN AND IS THE SOLE MEMBER OF SPARROW FOUNDATION. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME, WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE ESTABLISHED BY THE ENDOWMENT. SCHEDULE D, PAGE 4, PART XI, LINE 4B REINSURANCE 786,412 PDR 2,872,134 SCHEDULE D, PAGE 4, PART XII, LINE 4B REINSURANCE 786,412 PDR 2,872,134 X X X X X X false true false false false false false true false JAMES DOVER PRES/CEO - SHS 955742 185782 84525 1226049 JOSEPH RUTH DIRECTOR 612061 124541 90542 38495 865639 PAULA REICHLE TREASURER 561901 86588 8400 53209 710098 DOUGLAS EDEMA MD FORMER DIRECTOR 520052 28553 8400 41804 598809 DENNIS REESE PRESIDENT & CEO 410797 8512 17550 44972 481831 PETER GRAHAM MD MEDICAL DIRECTOR 324901 2562 2921 36905 33590 400879 EDWARD VOZZO CFO/COO 194839 20000 134 4760 27255 246988 JONATHAN DENGEL OPERATION & INFO OFF 192762 5000 169 30660 228591 WALTER BRIGGS DIRECTOR OF IMP. 181343 1425 5367 39766 227901 KENNETH WALKER DIR OF NETWORK SERV. 161165 4835 38988 204988 NICHOLAS D'ISA DIR OF LEGAL & COMP. 165069 629 9667 27684 203049 SCOTT NORMAN VP OF SALES 164386 333 7776 28737 201232 ANN HUNT-FUGATE RPH MANG. CLINICAL PHARM 157333 1850 4171 27409 190763 ANDREA KOSLOSKI FORMER DIRECTOR 100967 10785 7884 119636 SCHEDULE J, PAGE 1, PART I, LINE 3 PHYSICIAN HEALTH PLAN IS THE SOLE MEMBER OF PHP MEDICARE. PHP HOLDINGS IS THE SOLE MEMBER OF PHP WITH SPARROW HEALTH SYSTEM OWNING 65% OF PHP HOLDINGS. SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGANIZATION THAT INCLUDES A NUMBER OF NON-PROFIT ENTITIES. THE METHODS SELECTED FOR DETERMINING THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR ARE METHODS WHICH ARE BEING USED BY ALL SPARROW HEALTH SYSTEM RELATED ENTITIES. SCHEDULE J, PAGE 1, PART I, LINE 4 JAMES DOVER 0 136,389 0 JOSEPH RUTH 0 62,787 0 PAULA REICHLE 0 57,307 0 SCHEDULE J, PAGE 1, PART I, LINE 7 COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NON-FIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET. SCHEDULE J, PART III ANDREA KOSLOSKI & DOUGLAS EDEMA, M.D. ARE FORMER BOARD MEMBERS OF PHP MEDICARE. THE BOARD MEMBERS ARE BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES IN POSITIONS OTHER THAN AS BOARD MEMBER OF PHP MEDICARE. THE BOARD MEMBERS ARE NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO PHP MEDICARE. CERTAIN EXECUTIVES PARTICIPATE IN THE 457(F) SUPPLEMENTAL RETIREMENT PLAN AND ARE MAKING CURRENT YEAR CONTRIBUTIONS AS WELL AS RECEIVING CURRENT YEAR DISTRIBUTIONS. CONTRIBUTIONS TO THE PLAN ARE DISCLOSED IN PART I LINE 4B AND REQUIRED DISTRIBUTIONS FROM THE PLAN ARE REPORTED BELOW AS A NEGATIVE AS WELL AS BEING DISCLOSED IN SCHEDULE J, PART II, COLUMN B (III). JAMES DOVER: -136,389 PAULA REICHLE: -57,307 JOSEPH RUTH: -99,020 FORM 990 ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. FORM 990, PAGE 2, PART III, LINE 4A PHP MEDICARE IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO). PHP MEDICARE USES A PRIMARY CARE CONCEPT FOR DELIVERING HEALTH CARE IN A HEALTH DELIVERY NETWORK (HDN) STRUCTURE. IT ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER. PHP MEDICARE'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. PHP MEDICARE IS WHOLLY OWNED BY PHP. PHP IS PRIMARILY A COMMERCIAL HMO. ALONG WITH PHP MEDICARE, PHP OPERATES PHP INSURANCE COMPANY (PHPIC), A COMMERCIAL INSURANCE COMPANY AND PHP SERVICE COMPANY, A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS PHP. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO PHP APPLY TO PHP, PHPIC, AND PHPMA. PHPS SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE AND PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. PHP IC OFFERS PRODUCTS ACROSS MICHIGAN. AS OF DECEMBER 31, 2022, THERE WERE APPROXIMATELY 28,600 ENROLLEES IN PHPS COMMERCIAL HMO, 24,800 IN TPA, 2,900 IN PHPIC, AND 7,500 ENROLLEES IN PHPMA. THE PHP NETWORK IS APPROXIMATELY 3,068 PRIMARY CARE PHYSICIANS, 5,503 SPECIALTY CARE PHYSICIANS, 3,906 ALLIED HEALTH PROFESSIONALS, 3,482 BEHAVIORAL HEALTH PROVIDERS AND 746 ORGANIZATIONAL PROVIDERS THAT INCLUDE 60 HOSPITALS. PHP CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. PHPS COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. PHPS SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW PHP TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGANS MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. PHP MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY AN HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY HDN, IS NOT AVAILABLE WITHIN THE HDNS NETWORK. PHP OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS TO GROUPS AND INDIVIDUALS. PHP OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE PHP NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. PHP MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: -DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES. -QUALITY OF CARE CONCERNS. -HEDIS MEASURES THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLANS PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. PHP USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: - DIABETES, - ASTHMA, - DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, - BREAST AND CERVICAL CANCER SCREENING, - USE OF BETA-BLOCKERS AFTER HEART ATTACKS, - CHILD AND ADOLESCENT IMMUNIZATIONS, - CHOLESTEROL MANAGEMENT, - CONTROLLING HIGH BLOOD PRESSURE, - SMOKING CESSATION, - PRENATAL AND POSTPARTUM CARE, AND - TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. PHP MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS EXPECTATIONS. THE PHP QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2020 PHP RECEIVED FULL ACCREDITATION STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. PHP HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. THE CURRENT ACCREDITATION IS EFFECTIVE THROUGH JULY 1, 2024 AT WHICH TIME REACCREDITATION WILL OCCUR. FORM 990, PAGE 6, PART VI, LINE 6 PHYSICIAN HEALTH PLAN (PHP) IS THE SOLE MEMBER OF PHP MEDICARE. PHP HOLDINGS IS THE PARENT AND SOLE MEMBER OF PHP AND HAS 100% OWNERSHIP. PHP HOLDINGS IS OWNED BY SPARROW HEALTH SYSTEM (SHS) AT 65%, MICHIGAN MEDICINE AT 25%, AND COVENANT HEALTHCARE SYSTEM AT 10%. FORM 990, PAGE 6, PART VI, LINE 7A PHYSICIAN HEALTH PLAN (PHP) IS THE SOLE MEMBER OF PHP MEDICARE. PHP HOLDINGS IS THE PARENT AND SOLE MEMBER OF PHP AND HAS 100% OWNERSHIP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE PHP BOARD OF DIRECTORS. DECISIONS OF THE PHP MEDICARE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE PHP HOLDINGS BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7B PHYSICIAN HEALTH PLAN (PHP) IS THE SOLE MEMBER OF PHP MEDICARE. PHP HOLDINGS IS THE PARENT AND SOLE MEMBER OF PHP AND HAS 100% OWNERSHIP. THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS ARE RATIFIED BY THE PHP BOARD OF DIRECTORS. DECISIONS OF THE PHP MEDICARE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE PHP HOLDINGS BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 11B COPIES OF THE 2022 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT HAS COMPLETED ITS REVIEW OF FORM 990 COPIES ARE PROVIDED AT THE FALL BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON. FORM 990, PAGE 6, PART VI, LINE 12C 1) CORPORATE COMPLIANCE SENDS OUT CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON). FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING COMPENSATION SURVEYS AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PAGE 6, PART VI, LINE 15B THE PROCESS FOR DETERMINING COMPENSATION FOR THE OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING COMPENSATION SURVEYS AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS FOLLOWS: THE GOVERNING DOCUMENTS OF PHP MEDICARE ARE SUBMITTED TO THE DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS). THOSE ARE PUBLICLY AVAILABLE TO INTERESTED PARTIES. THE CONFLICT OF INTEREST IS AVAILABLE THROUGH SPARROW HEALTH SYSTEM BY REQUEST TO THE SPARROW COMPLIANCE OFFICER. FORM 990, PART XI, LINE 9 REINSURANCE -786,412 PDR -2,872,134 REINSURANCE 786,412 PDR 2,872,134 SPARROW HEALTH SYSTEM 1215 E MICHIGAN AVENUE LANSING MI 48912 382542859 PARENT MI 501C3 12A N/A false PHYSICIANS HEALTH PLAN 1400 E MICHIGAN AVENUE LANSING MI 48912 382356288 INSURANCE MI 501C4 PHP HO true SPARROW FOUNDATION 1215 E MICHIGAN AVENUE LANSING MI 48912 386100687 FUNDRAISE MI 501C3 12B SHS true SPARROW COMMUNITY CARE 3315 E MICHIGAN AVENUE STE 4 LANSING MI 48912 382543305 HOME HLTH MI 501C3 10 SHS true EDWARD W SPARROW HOSPITAL 1215 E MICHIGAN AVENUE LANSING MI 48912 381360584 HLTH CARE MI 501C3 3 SHS true SPARROW CLINTON HOSPITAL 805 S OAKLAND STREET ST JOHNS MI 48879 381358172 HLTH CARE MI 501C3 3 SHS true SPARROW IONIA HOSPITAL 3565 S STATE RD IONIA MI 48846 383218134 HLTH CARE MI 501C3 3 SHS true SPARROW SPECIALTY HOSPITAL 1215 E MICH AVE 8W SPARROW TOWER LANSING MI 48912 141885340 LT ACUTE MI 501C3 3 SHS true SPARROW CLINICAL RESEARCH INSTITUTE 1200 E MICHIGAN AVENUE LANSING MI 48912 383075242 RESEARCH MI 501C3 4 SHS true SPARROW CARSON HOSPITAL 406 E ELM STREET PO BOX 879 CARSON CITY MI 48811 381490180 HLTH CARE MI 501C3 3 SHS true PHYSICIANS HEALTH NETWORK 1400 E MICHIGAN AVENUE LANSING MI 48912 382594856 HMO MI 501C4 PHP HO true SPARROW EATON HOSPITAL 321 E HARRIS ST CHARLOTTE MI 48813 382007629 HLTH CARE MI 501C3 3 SHS true SPARROW EATON HOSPITAL AUXILIARY 321 E HARRIS ST CHARLOTTE MI 48813 382377160 FUNDRAISE MI 501C3 3 SHS true PHP HOLDINGS LLC 1400 E MICHIGAN AVENUE LANSING MI 48912 833965697 HOLDING CO MI N/A false false SPARROW DEVELOPMENT INC 1215 E MICHIGAN AVENUE LANSING MI 48912 382595963 HEALTH SVS MI N/A true PHP INSURANCE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 205565219 INSURANCE MI N/A true PHP SERVICE COMPANY 1400 E MICHIGAN AVENUE LANSING MI 48912 383344741 MED SVS MI N/A true EAST LANSING ATHLETIC CLUB 2900 HANNAH BLVD EAST LANSING MI 48823 382886420 HLTH CLUB MI N/A true MAC RESTAURANT LLC 2900 HANNAH BLVD EAST LANSING MI 48823 205120690 RESTAURANT MI N/A true CLINTON SERVICES CORPORATION 805 S OAKLAND ST JOHNS MI 48879 382494110 SERVICES MI N/A true EAST LANSING ATHLETIC CLUB & HSP 1200 E MICHIGAN AVENUE STE 600 LANSING MI 48912 813131851 CONDO ASSO MI N/A true false false false false false false false false false false false true false true true true false false true