2024-11-15T13:37:53-05:00 2023-12-31 383133790 ANDREWS HOOPER PAVLIK PLC 4295 OKEMOS RD STE 200 OKEMOS MI 488646201 990 2023-01-01 382594856 PHYSICIANS HEALTH NETWORK PHYS 5173648400 1301 N HAGADORN STE 1E EAST LANSING MI 48823 SHARON WILLIAMS PRESIDENT 5173648400 2024-11-15 true true JULIE M PFEIFLE P00751307 5177060800 2024-11-15 2023 2024-10-15 13:58:12Z X SHARON WILLIAMS 1301 N HAGADORN RD STE 1E EAST LANSING MI 48823 138870374 false X WWW.UOFMHEALTHPLAN.ORG X 1985 MI PHYSICIANS HEALTH NETWORK'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, AND COST EFFECTIVE HEALTHCARE. 9 3 0 0 0 138304861 138762654 145771 107720 0 138450632 138870374 0 142193272 147266705 0 0 0 5773 3555 142199045 147270260 -3748413 -8399886 1616339 1819772 14876629 14880681 -13260290 -13060909 X PHYSICIANS HEALTH NETWORK'S MISSION IS TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS BY FACILITATING QUALITY, COMPASSIONATE, ACCESSIBLE, AND COST EFFECTIVE HEALTHCARE. false false 147266705 138762654 PHYSICIAN HEALTH NETWORK (PHN) IS A NON-PROFIT HEALTH DELIVERY NETWORK (HDN). IN CONJUNCTION WITH ITS SISTER CORPORATION, UNIVERSITY OF MICHIGAN HEALTH PLAN HEALTHCARE SERVICES ARE DELIVERED TO ITS MEMBERS USING A PRIMARY CARE CONCEPT IN AN HDN STRUCTURE. UNIVERSITY OF MICHIGAN HEALTH PLAN IS A LICENSED HEALTH MAINTENANCE ORGANIZATIONS (HMO) AND ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS AND THEIR QUALIFIED DEPENDENTS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER OR QUALIFIED DEPENDENT. PHN AND UNIVERSITY OF MICHIGAN HEALTH PLAN ARE COMMITTED TO DEVELOPMENT AND DELIVERY OF QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. PHYSICIAN HEALTH NETWORK AND UNIVERSITY OF MICHIGAN HEALTH PLAN ARE WHOLLY OWNED BY UNIVERSITY HEALTH SYSTEM. UNIVERSITY OF MICHIGAN HEALTH PLAN IS PRIMARILY A COMMERCIAL HMO AND ALSO OPERATES THREE SUBSIDIARIES, UNIVERSITY OF MICHIGAN HEALTH INSURANCE COMPANY, A COMMERCIAL INSURANCE COMPANY, UNIVERSITY OF MICHIGAN HEALTH MEDICARE, A MICHIGAN MEDICARE PLAN, AND UNIVERSITY OF MICHIGAN HEALTH SERVICE COMPANY A THIRD-PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS UNIVERSITY OF MICHIGAN HEALTH PLAN. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO U OF M HEALTH PLAN APPLY TO U OF M HEALTH PLAN, U OF M HEALTH INSURANCE COMPANY, U OF M HEALTH SERVICE COMPANY AND U OF M HEALTH MEDICARE. U OF M HEALTH PLAN'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE AND PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. U OF M HEALTH INSURANCE COMPANY OFFERS PRODUCTS ACROSS MICHIGAN. AS OF DECEMBER 31, 2023, THERE WERE APPROXIMATELY 28,100 ENROLLEES IN U OF M HEALTH PLAN'S COMMERCIAL HMO, 25,300 IN TPA, 2,300 IN U OF M HEALTH INSURANCE COMPANY, AND 8,300 ENROLLEES IN UM HEALTH MEDICARE. THE U OF M HEALTH PLAN 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. U OF M HEALTH PLAN CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. U OF M HEALTH PLAN'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. U OF M HEALTH PLAN'S 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 U OF M HEALTH PLAN TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S 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. U OF M HEALTH PLAN 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 HDN'S NETWORK. U OF M HEALTH PLAN OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS TO GROUPS AND INDIVIDUALS. U OF M HEALTH PLAN OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE U OF M HEALTH PLAN NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. U OF M HEALTH PLAN 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. U OF M HEALTH PLAN 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. U OF M HEALTH PLAN 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 U OF M HEALTH PLAN QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2021 U OF M HEALTH PLAN 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. U OF M HEALTH PLAN 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. 147266705 false false false false false false false false true false false false false true false false 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 true false true 0 0 true 0 false false false false false false false false X 9 3 false false false false true true true true true false false true true true true true true true true false MI X SHARON WILLIAMS 5173648400 1301 N HAGADORN RD STE 1E EAST LANSING MI 48823 KEITH DICKEY CHAIR 1.00 40.00 X X 0 1161831 150321 JAMES F DOVER PRES/CEO-UMH 1.00 40.00 X X 0 1158747 89945 JOSEPH RUTH DIRECTOR 1.00 40.00 X 0 1113049 101260 PAULA REICHLE TREASURER 1.00 40.00 X X 0 721275 63325 DOUGLAS EDEMA MD DIRECTOR 1.00 40.00 X 0 606418 57870 JOHN AYANIAN MD DIRECTOR 1.00 40.00 X 0 550635 52777 DENNIS REESE PRESIDENT & 40.00 5.00 X 0 455915 69849 NICOLE WERNER CFO 40.00 5.00 X 0 224180 33714 WALTER BRIGGS DIRECTOR OF 40.00 5.00 X 0 199587 54580 JONATHAN DENGEL OPERATION & 40.00 5.00 X 0 200559 31208 KENNETH WALKER DIR NETWORK 40.00 0.00 X 0 172677 52980 ANN HUNT-FUGATE RPH MGR CLINICAL 40.00 5.00 X 0 170935 41156 JENNIFER JOHNSTON VP SALES & M 40.00 0.00 X 0 164980 20258 ANDREA KOSLOSKI FORMER DIREC 0.00 40.00 X 0 140678 18171 EDWARD VOZZO CFO/COO 40.00 5.00 X 0 100000 10392 IFTIKER AHMAD MD DIRECTOR 1.00 1.00 X 0 55578 4296 TIMOTHY PETERSON MD DIRECTOR 1.00 1.00 X 0 46617 304 KEVIN ALBOSTA DIRECTOR 1.00 0.00 X 0 0 0 7243661 852406 true true false HEALTH SERVICE FEES 621990 138762654 138762654 138762654 60834 60834 46886 46886 46886 46886 138870374 138762654 107720 147266705 147266705 3555 3555 147270260 147266705 3555 0 1595603 1799036 20736 20736 1616339 1819772 2559885 2559886 12316744 12320795 14876629 14880681 X -13260290 -13060909 -13260290 -13060909 1616339 1819772 X -8399886 99267 8500000 X false true X true false 9199222 273470 313164 9785856 6297032 5192208 -280050 11209190 5606321 561053 129658 6297032 4912247 237860 456214 5606321 4700296 39943 172008 4912247 1.00000 false true true RELATED PARTY PAYABLE 12320795 12320795 SCHEDULE D, PAGE 2, PART V, LINE 4 PHN DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY UNIVERSITY OF MICHIGAN HEALTH - SPARROW FOUNDATION A RELATED ORGANIZATION OF PHN. UNIVERSITY OF MICHIGAN HEALTH - SPARROW FOUNDATION IS A FISCAL YEAR ORGANIZATION, REPORTING ON THE GOVERNMENTAL ACCOUNTING STANDARDS BOARD (GASB). THE ENDOWMENT FUNDS REPORTED ARE FOR THE 6/30/2023 TAX YEAR WITH AN ADJUSTMENT TO THE BEGINNING OF YEAR BALANCE DUE TO THE CONVERSION TO GASB. 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. X X X X X X true true false false false false false true false KEITH DICKEY CHAIR 996366 165465 131451 18870 1312152 JAMES F DOVER PRES/CEO-UMH SPARROW 1005246 153501 9150 80795 1248692 JOSEPH RUTH DIRECTOR 629823 50681 432545 57631 43629 1214309 PAULA REICHLE TREASURER 590250 49613 81412 9150 54175 784600 DOUGLAS EDEMA MD DIRECTOR 541064 35961 29393 9150 48720 664288 JOHN AYANIAN MD DIRECTOR 485019 65616 33000 19777 603412 DENNIS REESE PRESIDENT & CEO 417883 27574 10458 19050 50799 525764 NICOLE WERNER CFO 213126 10763 291 10680 23034 257894 WALTER BRIGGS DIRECTOR OF IMP. 191097 7366 1124 11254 43326 254167 JONATHAN DENGEL OPERATION & INFO OFF 189818 10583 158 31208 231767 KENNETH WALKER DIR NETWORK CONTRACT 165765 6592 320 10006 42974 225657 ANN HUNT-FUGATE RPH MGR CLINICAL PHARM 165486 4476 973 9653 31503 212091 JENNIFER JOHNSTON VP SALES & MARKETING 158614 6103 263 1080 19178 185238 ANDREA KOSLOSKI FORMER DIRECTOR 140678 7249 10922 158849 SCHEDULE J, PAGE 1, PART I, LINE 3 PHYSICIANS HEALTH NETWORK DOES NOT PAY COMPENSATION. PHN RELIES ON THE COMPENSATION POLICIES AND PRACTICES OF ITS RELATED ORGANIZATIONS. UNIVERSITY OF MICHIGAN HEALTH - SPARROW 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 UNIVERSITY OF MICHIGAN HEALTH - SPARROW RELATED ENTITIES. SCHEDULE J, PAGE 1, PART I, LINE 4 JAMES F. DOVER 262,958 0 0 JOSEPH RUTH 167,330 57,631 0 PAULA REICHLE 157,502 0 0 JONATHAN DENGEL 15,971 0 0 EDWARD VOZZO 84,620 0 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 IS A FORMER BOARD MEMBER OF PHYSICIANS HEALTH NETWORK. THE FORMER BOARD MEMBER IS BEING COMPENSATED BY UNIVERSITY OF MICHIGAN HEALTH - SPARROW AND AFFILIATES FOR SERVICES PROVIDED TO UNIVERSITY OF MICHIGAN HEALTH - SPARROW AND AFFILIATES IN POSITIONS OTHER THAN AS A BOARD MEMBER OF PHYSICIANS HEALTH NETWORK. THE FORMER BOARD MEMBER IS NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO PHYSICIANS HEALTH NETWORK. 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 F. DOVER: -121,586 JOSEPH RUTH: -403,638 PAULA REICHLE: -52,404 KEITH DICKEY: -98,451 FORM 990 ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. FORM 990, PAGE 2, PART III, LINE 4A PHYSICIAN HEALTH NETWORK (PHN) IS A NON-PROFIT HEALTH DELIVERY NETWORK (HDN). IN CONJUNCTION WITH ITS SISTER CORPORATION, UNIVERSITY OF MICHIGAN HEALTH PLAN HEALTHCARE SERVICES ARE DELIVERED TO ITS MEMBERS USING A PRIMARY CARE CONCEPT IN AN HDN STRUCTURE. UNIVERSITY OF MICHIGAN HEALTH PLAN IS A LICENSED HEALTH MAINTENANCE ORGANIZATIONS (HMO) AND ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS AND THEIR QUALIFIED DEPENDENTS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER OR QUALIFIED DEPENDENT. PHN AND UNIVERSITY OF MICHIGAN HEALTH PLAN ARE COMMITTED TO DEVELOPMENT AND DELIVERY OF QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. PHYSICIAN HEALTH NETWORK AND UNIVERSITY OF MICHIGAN HEALTH PLAN ARE WHOLLY OWNED BY UNIVERSITY HEALTH SYSTEM. UNIVERSITY OF MICHIGAN HEALTH PLAN IS PRIMARILY A COMMERCIAL HMO AND ALSO OPERATES THREE SUBSIDIARIES, UNIVERSITY OF MICHIGAN HEALTH INSURANCE COMPANY, A COMMERCIAL INSURANCE COMPANY, UNIVERSITY OF MICHIGAN HEALTH MEDICARE, A MICHIGAN MEDICARE PLAN, AND UNIVERSITY OF MICHIGAN HEALTH SERVICE COMPANY A THIRD-PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS UNIVERSITY OF MICHIGAN HEALTH PLAN. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO U OF M HEALTH PLAN APPLY TO U OF M HEALTH PLAN, U OF M HEALTH INSURANCE COMPANY, U OF M HEALTH SERVICE COMPANY AND U OF M HEALTH MEDICARE. U OF M HEALTH PLAN'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE AND PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. U OF M HEALTH INSURANCE COMPANY OFFERS PRODUCTS ACROSS MICHIGAN. AS OF DECEMBER 31, 2023, THERE WERE APPROXIMATELY 28,100 ENROLLEES IN U OF M HEALTH PLAN'S COMMERCIAL HMO, 25,300 IN TPA, 2,300 IN U OF M HEALTH INSURANCE COMPANY, AND 8,300 ENROLLEES IN UM HEALTH MEDICARE. THE U OF M HEALTH PLAN 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. U OF M HEALTH PLAN CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. U OF M HEALTH PLAN'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. U OF M HEALTH PLAN'S 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 U OF M HEALTH PLAN TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S 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. U OF M HEALTH PLAN 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 HDN'S NETWORK. U OF M HEALTH PLAN OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS TO GROUPS AND INDIVIDUALS. U OF M HEALTH PLAN OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE U OF M HEALTH PLAN NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. U OF M HEALTH PLAN 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. U OF M HEALTH PLAN 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. U OF M HEALTH PLAN 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 U OF M HEALTH PLAN QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2021 U OF M HEALTH PLAN 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. U OF M HEALTH PLAN 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 UNIVERSITY OF MICHIGAN HEALTH HOLDINGS IS THE PARENT AND SOLE MEMBER OF PHN AND HAS 100% OWNERSHIP. UNIVERSITY OF MICHIGAN HEALTH HOLDINGS IS OWNED BY MICHIGAN MEDICINE AT 90% AND COVENANT HEALTHCARE SYSTEM AT 10%. FORM 990, PAGE 6, PART VI, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS OF PHN ARE RATIFIED BY THE UNIVERSITY OF MICHIGAN HEALTH HOLDINGS BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7B THE MEMBERS OF THE BOARD OF DIRECTORS OF PHN ARE RATIFIED BY THE UNIVERSITY OF MICHIGAN HEALTH HOLDINGS BOARD OF DIRECTORS. THE DECISIONS OF THE PHN BOARD OF DIRECTORS MAY BE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS OF UNIVERSITY OF MICHIGAN HEALTH HOLDINGS. FORM 990, PAGE 6, PART VI, LINE 11B COPIES OF THE 2023 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT HAS COMPLETED ITS REVIEW OF THE FORM 990 COPIES WERE PROVIDED AT THE FALL 2024 BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON. FORM 990, PAGE 6, PART VI, LINE 12C 1) CORPORATE COMPLIANCE SENDS OUT THE 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 UNIVERSITY OF MICHIGAN HEALTH - SPARROW 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 OFFICERS OR 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 UNIVERSITY OF MICHIGAN HEALTH - SPARROW 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 U OF M HEALTH PLAN ARE SUBMITTED TO THE DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES (DIFS). THOSE ARE PUBLICLY AVAILABLE TO INTERESTED PARTIES. THE CONFLICT OF INTEREST IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 CAPITAL CONTRIBUTIONS 8,500,000 REGENTS OF THE UNIV OF MICHIGAN 5082 WOLVERINE TWR 3003 S STATE ST ANN ARBOR MI 48109 386006309 SCHOOL MI 501C3 2 NA false WEST MICHIGAN RADIATION ONCOLOGY 5950 METRO WAY WYOMING MI 49529 300501592 HOSPITAL MI 501C3 3 NA false METROPOLITAN HOSPITAL (UMH WEST) 5900 BYRON CENTER AVENUE SW WYOMING MI 49529 380593405 HOSPITAL MI 501C3 3 UM HEALTH true UM HEALTH 5082 WOLVERINE TWR 3003 S STATE ST ANN ARBOR MI 48109 814913150 SUP ORG MI 501C3 12A UM false METROPOLITAN FOUNDATION 5900 BYRON CENTER AVENUE SW WYOMING MI 49529 383033329 SUP ORG MI 501C3 7 METRO HOSP true SPARROW HEALTH SYSTEM 1215 E MICHIGAN AVENUE LANSING MI 48912 382542859 HEALTH MI 501C3 12A UM HEALTH true UNIVERSITY OF MICHIGAN HEALTH PLAN 1301 N HAGADORN STE 1E EAST LANSING MI 48823 382356288 INSURANCE MI 501C4 UM HLD LLC 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 ST PO BOX 879 CARSON CITY MI 48811 381490180 HLTH CARE MI 501C3 3 SHS true UNIV OF MICHIGAN HEALTH MEDICARE 1301 N HAGADORN STE 1E EAST LANSING MI 48823 832766121 HMO MI 501C4 PHP 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 UNIVERSITY OF MICH HLT HOLDINGS LLC 1301 N HAGADORN STE 1E EAST LANSING MI 48823 833965697 HOLDING CO MI N/A false false MICHIGAN DIALYSIS SERVICES LLC 5082 WOLVERINE TWR 3003 S STATE ST ANN ARBOR MI 48109 383472138 DIALYSIS MI N/A false false PHYSICIAN ORGANIZATION OF MI ACO 5082 WOLVERINE TWR 3003 S STATE ST ANN ARBOR MI 48109 454542046 HEALTHCARE MI N/A false false KENT HEALTH CARE PHYSICIAN ORG 2225 MAIN STREET SW STE 110 WYOMING MI 49529 383404658 HEALTHCARE MI N/A true UNIV OF MICH HLTH INSURANCE COMPANY 1301 N HAGADORN STE 1E EAST LANSING MI 48823 205565219 INSURANCE MI N/A true SPARROW DEVELOPMENT INC 1215 E MICHIGAN AVENUE LANSING MI 48912 382595963 HEALTH SVC MI N/A true UNIV OF MICH HLTH SERVICE COMPANY 1301 N HAGADORN STE 1E EAST LANSING MI 48823 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 true false false false false false false false false false true false true true false false true false UNIVERSITY OF MICHIGAN HEALTH PLAN L 147266705 COST