2024-11-06T11:44:43-06:00 2023-12-31 ERNST & YOUNG LLP ONE MANHATTAN WEST NEW YORK NY 100018604 990 2023-01-01 113029569 Healthfirst Health Plan Inc % CRAIG BARATTIN-VP CONTROLLER HEAL 2128016000 100 CHURCH ST FL 18 New York NY 100072601 JOHN BERMEL CFO 2128016000 2024-10-05 true true NICOLE M SOKOLOWSKI P01683199 2127739017 2024-11-05 2023 2024-10-15 13:58:12Z PATRICIA J WANG 100 CHURCH ST FL 18 NEW YORK NY 100072601 6201235503 false X WWW.HEALTHFIRST.ORG X 1990 NY IMPROVE THE HEALTH AND WELL-BEING OF UN DERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE,COMPLETE CARE,FIDA&COMMERCIAL INSURANCE RECIPIENTS. 6 2 0 0 0 0 0 0 4870842554 5863810995 20287312 47834553 0 0 4891129866 5911645548 0 0 0 0 0 0 0 0 0 4868861042 5817161744 4868861042 5817161744 22268824 94483804 1573245747 2002289882 986154768 1145263855 587090979 857026027 X IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS BY PROVIDING AFFORDABLE QUALITY HEALTH PLANS TO ELIGIBLE MEDICARE, COMPLETE CARE, FIDA & COMMERCIAL INSURANCE RECIPIENTS. false false 3199430872 0 3499018257 MEDICARE: HEALTHFIRST HEALTH PLAN, INC. (HFHP), IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. HFHP PROVIDES HEALTH CARE SERVICES TO MEDICARE ADVANTAGE MEMBERS WHO ARE INDIGENT, AGED, DISABLED AND/OR MEDICALLY UNDERSERVED. IN 2023, HFHP SERVED 272,635 MEDICARE MEMBERS. 2154789417 0 2362791993 COMPLETECARE: HEALTHFIRST HEALTH PLAN, INC. (HFHP), IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. HFHP PROVIDES HEALTH CARE SERVICES TO COMPLETE CARE MEMBERS. COMPLETECARE IS A MEDICAID ADVANTAGE PLUS SPECIAL NEEDS PLAN THAT COMBINES MEDICARE AND MEDICAID BENEFITS, WITH ADDED LONG-TERM CARE SERVICES FOR QUALIFIED DUAL-ELIGIBLE MEMBERS. IN 2023, HFHP SERVED 30,771 COMPLETE CARE MEMBERS. 1521808 0 2000745 Fully Integrated Duals Advantage Programs (FIDA): HEALTHFIRST HEALTH PLAN, INC. (HFHP), IS INCORPORATED UNDER THE NOT-FOR-PROFIT LAW OF THE STATE OF NEW YORK AND IS LICENSED UNDER ARTICLE 44 OF THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK AS A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES ACCESS TO AFFORDABLE, QUALITY CARE THROUGH ITS NETWORK OF PARTICIPATING PROVIDERS AND HOSPITALS. HFHP PROVIDES HEALTH CARE SERVICES TO FIDA MEMBERS, WHOSE BENEFIT CAN BE INTEGRATED AND CARE ACROSS THE MEDICARE AND MEDICAID PROGRAMS. IN 2023, HFHP SERVED 0 FIDA MEMBERS. 5355742097 false false false false false false false false false 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 true false true 7739 0 true 0 false false false false false false true false X 6 2 false true false false true true true true true false false true true true true true true false false false NY X CRAIG BARATTIN-VP CONTROLLER 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 PATRICIA J WANG PRESIDENT AND CEO 1.0 40.0 X 0 4295811 525317 JOHN J BERMEL CHIEF FINANCIAL OFFICER 1.0 40.0 X 0 1982658 37654 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 1.0 40.0 X 0 1507300 186137 LINDA TIANO CLO/SECRETARY ENDING 6/2023 1.0 40.0 X X 0 1409613 52444 SEAN KANE CHIEF HR OFFICER 1.0 40.0 X 0 1261928 164050 JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 1.0 40.0 X 0 1267146 155676 STEVEN H BLACK COO END 3/2022 0.0 0.0 X 0 1235794 0 BARBARA MONTRESOR SVP Comm and Marketing 1.0 40.0 X 0 1063627 124773 KAREN WEINSEISS SVP Comm & Marketing 1.0 40.0 X X 0 1015298 155758 ERROL PIERRE SVP State Programs 1.0 40.0 X 0 940045 117095 SHERYL MARKOWITZ SVP Clinical Operations 1.0 40.0 X 0 952012 5029 ROBERT P BLANCHARD Treasurer 1.0 40.0 X 0 358793 47075 KATHRYN HOWELL CLO/SECRETARY BEGINNING 7/2023 1.0 40.0 X X 0 303188 71250 DEREK LAM VP DSI Beginning 7/2023 1.0 40.0 X 0 221291 23286 STEPHEN ROSENTHAL BOARD DIRECTOR 1.0 0.0 X 0 0 0 David Evangelista BOARD DIRECTOR 1.0 0.0 X 0 0 0 0 17814504 1665544 0 true true false NEW YORK CITY HEALTH AND HOSPITAL C 160 WATER ST - CORPORATE COMPTROLLE NEW YORK NY 10038 MEDICAL/HOSPITAL 397179040 MONTEFIORE MEDICAL CENTER PO BOX 412508 BOSTON MA 022412508 MEDICAL/HOSPITAL 282799543 NY PRESBYTERIAN HOSP-COLUMBIA PO BOX 9305 NEW YORK NY 100879305 MEDICAL/HOSPITAL 288216848 CVS PHARMACY INC ONE CVS DRIVE WOONSOCKET RI 02895 PHARMACY 2489139088 INCOMM HEALTHCARE AFFINITY 250 Williams Street NW Suite 500 ATLANTA GA 30303 MEDICAL/HOSPITAL 350810317 1721 0 MEDICARE (INCLUDES PART D) 524114 3499018257 3499018257 0 COMPLETECARE (INCLUDES PART D) 524114 2362791993 2362791993 0 FIDA 524114 2000745 2000745 0 5863810995 57187447 57187447 0 0 0 0 0 280252705 289589955 -9337250 -9352894 -9352894 0 0 0 0 0 0 0 0 0 0 5911645548 5863810995 0 47834553 0 0 0 0 0 0 0 0 0 0 705060330 251451960 453608370 0 0 0 0 0 0 166087 105637 60450 0 15174347 15174347 0 0 72021 26666 45355 0 0 0 0 0 0 0 2224041 823462 1400579 0 0 625104 231448 393656 0 0 HEALTHCARE SERVICE COSTS 5013671576 5013671576 0 0 MEDICAL ADMINISTRATIVE 70781524 70781524 0 0 BAD DEBT EXPENSE 9075541 3360264 5715277 0 DUES & FILLINGS 311173 115213 195960 0 5817161744 5355742097 461419647 0 0 0 240224240 365746680 0 0 594268397 825630699 0 0 0 0 0 0 0 0 0 0 0 0 722202142 802758204 0 0 0 0 625104 0 15925864 8154299 1573245747 2002289882 653261571 830751912 0 0 11205039 3023898 0 0 0 0 0 0 0 0 0 0 321688158 311488045 986154768 1145263855 X 587090979 857026027 0 0 587090979 857026027 1573245747 2002289882 X 94483804 26475216 148976028 X false true X true false 0 DUE TO CMS 266303858 DUE TO STATE - CURRENT 3006580 PASS THRU PROGRAM LIABILITIES 27801906 MEDICARE PART D DEPOSIT LIABIL 14375701 311488045 6087096791 26475216 148976027 175451243 5911645548 5911645548 5817161744 5817161744 5817161744 PART XI, LINE 2D - OTHER ADJUSTMENTS ADMINISTRATIVE CHARGES: $146,436,360. The health care services agreements with certain hospitals require that a portion of the premiums are retained in order to fund the capital requirement by Healthfirst Health Plan (HFHP). EQUITY GAIN FROM INVESTMENT IN AFFILIATE: $2,539,668 represents 50% share of gain (loss) in Healthfirst Insurance Co. Inc. true true false false false false false false false JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 0 554113 0 585268 0 127765 0 129473 0 27266 0 1423885 0 123205 LINDA TIANO CLO/SECRETARY ENDING 6/2023 0 254979 0 740600 0 414034 0 48503 0 4384 0 1462500 0 361242 PATRICIA J WANG PRESIDENT AND CEO 0 1467377 0 2322734 0 505700 0 516497 0 9651 0 4821959 0 497318 GERALD T SWEENEY SVP CHIEF INFORMATION OFFICER 0 635573 0 742041 0 129686 0 158862 0 28338 0 1694500 0 126848 SEAN KANE CHIEF HR OFFICER 0 562118 0 589981 0 109829 0 136775 0 28338 0 1427041 0 106644 STEVEN H BLACK COO END 3/2022 0 0 0 456659 0 779135 0 0 0 0 0 1235794 0 0 JOHN J BERMEL CHIEF FINANCIAL OFFICER 0 848844 0 1055742 0 78072 0 19800 0 18916 0 2021374 0 0 ROBERT P BLANCHARD Treasurer 0 255216 0 100816 0 2761 0 19800 0 27830 0 406423 0 0 BARBARA MONTRESOR SVP Comm and Marketing 0 518789 0 460600 0 84238 0 97498 0 28338 0 1189463 0 78325 ERROL PIERRE SVP State Programs 0 462182 0 402163 0 75700 0 109327 0 8824 0 1058196 0 75040 KAREN WEINSEISS SVP Comm & Marketing 0 544960 0 465942 0 4396 0 128483 0 28338 0 1172119 0 0 SHERYL MARKOWITZ SVP Clinical Operations 0 8195 0 476296 0 467521 0 5029 0 0 0 957041 0 0 DEREK LAM VP DSI Beginning 7/2023 0 195588 0 25000 0 703 0 12574 0 11207 0 245072 0 0 KATHRYN HOWELL CLO/SECRETARY BEGINNING 7/2023 0 301442 0 0 0 1746 0 71250 0 644 0 375082 0 0 SCHEDULE J, PART 1, LINE 3 THE COMPENSATION OF THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO HFHP. THE COMMITTEE CONSISTS ONLY OF HFMS MEMBER HOSPITAL EXECUTIVES (WHO ARE NOT EMPLOYED NOR COMPENSATED BY HFMS OR ANY OF ITS AFFILIATES). THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEE'S CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUALS ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - AN AFFILIATE ORGANIZATION OF HEALTHFIRST. STEVEN H. BLACK - TOTAL SEVERANCE: $1,650,923, SEVERANCE PAID IN 2023: $779,135 SEVERANCE DEFERRED: $0. SHERYL MARKOWITZ - TOTAL SEVERANCE: $ 426,164.00, SEVERANCE PAID IN 2023: $417,968.72 SEVERANCE DEFERRED: $8,195. SCHEDULE J, PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS TO THE PLAN SPONSOR FOR 2023: PATRICIA J. WANG $500,013, JAY A. SCHECHTMAN $109,673, GERALD T. SWEENEY $139,062, SEAN KANE $116,975, LINDA TIANO $28,703, BARBARA MONTRESOR $77,698, ERROL PIERRE $90,300 AND KAREN B. WEINSEISS $108,683. KATHRYN HOWELL $71,250 FORM 990, PART VI, SECTION A, LINE 3 HEALTHFIRST HEALTH PLAN INC. (HFHP), CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS), (A RELATED ORGANIZATION) TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE; THESE ARE PROVIDED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUMS ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY STATE REGULATORS. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR, HFMS A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM HFHP. FORM 990, PART VI, SECTION A, LINE 6 Healthfirst, Inc. has the right to appoint the members of the Board of Directors of Healthfirst Health Plan, inc FORM 990, PART VI, SECTION A, LINE 7A HEALTHFIRST, INC., A RELATED NOT-FOR-PROFIT ORGANIZATION, HAS THE RIGHT TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS OF HEALTHFIRST HEALTH PLAN, INC. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY OTHER ENTITIES: * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS REQUIRES STATE REGULATORY APPROVAL * CERTAIN CHANGES TO PREMIUM RATES ARE SUBJECT TO FEDERAL OR STATE REGULATORY APPROVAL * EXPANSION TO OTHER MANAGED CARE BUSINESSES REQUIRES STATE LICENSURE * MANAGEMENT FEE RATE CHANGES REQUIRE APPROVAL FROM THE MANAGEMENT COMPANY AND STATE REGULATORS FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS VICE PRESIDENT CONTROLLER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS CHIEF LEGAL OFFICER AND CHIEF FINANCIAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. A NOMINATED BOARD MEMBER WHO DOES NOT COMPLETE THE STATEMENT WITHIN THE CALENDAR YEAR WILL NOT BE TO CARRY OUT DUTIES. THE SAME APPLIES TO AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE APPROPRIATE DISCLOSURES. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. GUIDANCE IS PROVIDED TO THE NECESSARY PARTIES AND ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION-MAKING, MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICERS OR EMPLOYEES, THE ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, (A RELATED ORGANIZATION) THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO HFHP. THE COMMITTEE CONSISTS ONLY OF HFMS MEMBER HOSPITAL EXECUTIVES (WHO ARE NOT EMPLOYED NOR COMPENSATED BY HFMS OR ANY OF ITS AFFILIATES). THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEE'S CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XI, LINE 5 $5,589,506 UNREALIZED LOSS RELATED TO EQUITY INVESTMENT WAS INCLUDED IN NET INCOME ACCORDING TO ACCOUNTING STANDARDS UPDATE ("ASU") 2016-01 IN AUDITED FINANCIAL STATEMENT AND THIS AMOUNT WAS REPORTED AND INCLUDED IN CHANGE OF NET ASSETS IN 990. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS - ADMINISTRATIVE CHARGES: $146,436,360 AND EQUITY GAIN IN INVESTMENT IN HEALTHFIRST INSURANCE CO. INC. - A 50% OWNED SUBSIDIARY: $2,539,668. TOTAL OTHER CHANGES IN NET ASSETS $148,976,028. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT RISK AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC. (A RELATED ORGANIZATION). HEALTHFIRST PHSP INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133783732 MANAGED CARE NY 501 (C)3 10 HEALTHFIRST false HEALTHFIRST INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501 (C)3 12 Type I N/A false HEALTHFIRST FOUNDATION INC 100 CHURCH ST FL 18 NEW YORK NY 10007 843437139 CHARITABLE NY 501 (C)3 PF NA false HF Managmt SCVSLLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA 0 0 SMC PARTNERS LLC 10 COLUMBUS BLVD 9TH FLOOR HARTFORD CT 06106 208577150 CONSULTING SV CT HF ADMIN SVCS 0 0 HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY HF MGMT SVCS C CORP 0 0 false HEALTHFIRST INSURANCE COMPANY INC 100 CHURCH STREET FL 18 New York NY 100072601 464545744 Insur. Provid NY NA C corp 2539668 8154299 0.50000 true false false false false false false true false false false false false true false false false false false false HF MANAGEMENT SERVICES LLC M 705060331 COST HF MANAGEMENT SERVICES LLC G 10711233 FMV Schedule R Part V Line 2 On December 27, 2023, HFHP entered into an assignment agreement with HFMS, whereby HFHP assigned the surplus note of $8.1 million (fair value as of the transaction date), plus all accrued and unpaid interest amounting to $0.7 million, to HFMS in exchange for $10.7 million in cash.