2025-11-17T15:16:39-06:00 2024-12-31 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2024-01-01 800721489 TUFTS HEALTH PUBLIC PLANS INC % MARK PORTER TREASURER TUFT 6179729400 1 WELLNESS WAY CANTON MA 020211166 MARK PORTER TREASURER 6179729400 2025-11-17 true true ANTONIO C RUSSO P00858539 2673303000 2025-11-13 2024 2025-03-06 01:10:19Z PATRICK GILLIGAN 1 WELLNESS WAY CANTON MA 02021 2866466389 false X WWW.TUFTSHEALTHPLAN.COM X 2014 MA SEE SCHEDULE O 12 12 447 0 -289170 0 0 0 2436844851 2539094271 34050973 34773638 0 0 2470895824 2573867909 534938 25250 2206566149 2355316981 38049188 28336860 0 0 0 234698428 318472543 2479848703 2702151634 -8952879 -128283725 1156361918 988406949 718882296 692677388 437479622 295729561 X SEE SCHEDULE O false false 1135024279 10956 1101716715 DETAIL OF PROGRAM SERVICE ACCOMPLISHMENTS - MASSACHUSETTS MEDICAID MCO AND ACO PLANS TUFTS HEALTH TOGETHER IS THE NAME OF THE ORGANIZATION'S MASSACHUSETTS MEDICAID MCO AND ACO PLANS THAT PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. MASSHEALTH IS THE NAME OF THE MASSACHUSETTS MEDICAID PROGRAM FUNDED BY THE FEDERAL GOVERNMENT AND THE STATE. MASSHEALTH HELPS PEOPLE WITH LIMITED INCOMES AND RESOURCES PAY FOR MEDICAL AND SUPPORT SERVICES. IT ALSO COVERS EXTRA SERVICES AND DRUGS. THE ORGANIZATION PROVIDES ACCESS TO AFFORDABLE HEALTH CARE THROUGH A MEDICAID MANAGED CARE ORGANIZATION CONTRACT WITH THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. THPP WAS AWARDED TWO MEDICAID ACCOUNTABLE CARE ORGANIZATION CONTRACTS BY EOHHS IN ADDITION TO ITS EXISTING MANAGED CARE ORGANIZATION CONTRACT. THROUGH CONTRACTS WITH TWO MASSACHUSETTS-BASED PROVIDER SYSTEMS, THE ORGANIZATION PROVIDES MEDICAID MANAGED CARE CLOSELY ALIGNED WITH PRIMARY CARE PHYSICIANS AND COMMUNITY PARTNERS. TUFTS HEALTH TOGETHER PROVIDES LOW TO MODERATE INCOME INDIVIDUALS WITH ACCESS TO THOUSANDS OF HIGH QUALITY PRIMARY CARE DOCTORS AND SPECIALISTS ACROSS THE STATE, SUPPORTIVE SERVICE REPRESENTATIVES, INFORMATION IN A NUMBER OF LANGUAGES, AS WELL AS PREVENTIVE MEASURES SUCH AS CAR SEATS AND FITNESS BANDS, INCENTIVES FOR HEALTHY BEHAVIORS, GYM FEE REIMBURSEMENTS, AND OTHER IMPORTANT TOOLS TO PROMOTE HEALTH AND WELLNESS. NCQA HEALTH PLAN ACCREDITATION AND HEALTH PLAN RATING EVALUATE HEALTH PLANS' STRUCTURE AND PROCESS, CLINICAL QUALITY AND PATIENT SATISFACTION. TUFTS HEALTH PUBLIC PLAN'S TOGETHER MEDICAID PRODUCT MAINTAINS NCQA HEALTH PLAN ACCREDITATION AND HAS CONSISTENTLY RECEIVED HIGH SCORES BASED ON NCQA'S HEALTH PLAN RATING METHODOLOGY AND ACHIEVED A RATING OF 4.5 OUT OF 5 FOR THE NCQA HEALTH PLAN RATINGS WHICH WERE RELEASED IN 2023. TUFTS HEALTH PUBLIC PLANS CONTINUES TO IMPLEMENT OUTREACH PROGRAMS WITH BOTH PROVIDERS AND MEMBERS WITH THE GOAL OF IMPROVING THE QUALITY OF CARE PROVIDED AND RECEIVED. UPDATED RATINGS FOR 2024 WILL BE POSTED IN SEPTEMBER 2024. TUFTS HEALTH PUBLIC PLANS WAS THE FIRST PLAN IN MASSACHUSETTS AND AMONG THE FIRST IN NEW ENGLAND TO ACHIEVE NCQA HEALTH EQUITY ACCREDITATION. ---------- 1065387145 10284 1034123100 DETAIL OF PROGRAM SERVICE ACCOMPLISHMENTS - MASSACHUSETTS QUALIFIED HEALTH PLAN COVERAGE TUFTS HEALTH DIRECT IS AN INDIVIDUAL AND SMALL GROUP QUALIFIED HEALTH PLAN ("QHP") ESTABLISHED BY THE ORGANIZATION AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT TO PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES WHO ARE NOT ELIGIBLE FOR AFFORDABLE EMPLOYER-SPONSORED INSURANCE, AND SMALL EMPLOYER GROUPS WITH 1-50 EMPLOYEES. THESE PLANS ARE SOLD PRIMARILY THROUGH THE MASSACHUSETTS HEALTH CONNECTOR, THE MASSACHUSETTS STATE RUN EXCHANGE. TUFTS HEALTH DIRECT IS ACCREDITED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. ---------- 305335206 2947 296375070 DETAIL OF PROGRAM SERVICE ACCOMPLISHMENTS - DUAL-ELIGIBLE PROGRAM TUFTS HEALTH ONE CARE IS A MEDICARE-MEDICAID PLAN ("MMP") FOR INDIVIDUALS AGE 21-64 WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. TUFTS HEALTH ONE CARE IS ONE OF THREE MASSACHUSETTS ONE CARE PLANS PARTICIPATING IN THE FINANCIAL ALIGNMENT INITIATIVE ('DUALS DEMONSTRATION') TO INTEGRATE BENEFITS AND CARE FOR MEDICARE-MEDICAID ENROLLEES. THE PLAN CONTRACTS WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES TO PROVIDE THE BENEFITS OF BOTH PROGRAMS TO LOW AND MODERATE INCOME INDIVIDUALS WITH DISABILITIES. THE ORGANIZATION ALSO PROVIDES ACCESS TO AFFORDABLE CARE THROUGH A FULLY INTEGRATED DUAL-ELIGIBLE SPECIAL NEEDS PLAN THROUGH THE MASSACHUSETTS SENIOR CARE OPTIONS PROGRAM. THPP 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 INTEGRATES MEDICAID AND MEDICARE BENEFITS AND SERVICES, PROVIDING THOSE ELIGIBLE WITH COORDINATED HIGH-QUALITY AND COST-EFFECTIVE HEALTH CARE. ---------- 110110608 1063 106879386 RI MEDICAID 110110608 1063 106879386 2615857238 false false false false false false false false false false false false true true true true true 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 false false true 8421 0 true 447 true false false false false false false false false X 12 12 true true false false true true true true true false false true true true true true true true true false MA X MARK PORTER TREASURER 6179729400 1 WELLNESS WAY CANTON MA 02021 X CAIN HAYES DIR. PRES. & CEO (END 9/24) 10.0 40.0 X X 0 4532289 42363 PHILIP BARR EVP, PRESIDENT, MARKETS 10.0 40.0 X 0 1580792 159172 TRACEY CARTER FORMER SVP, CHIEF ACTUARY 0.0 0.0 X 0 1598732 18185 PETE CHURCH CHIEF PEOPLE & CULTURE OFFICER 10.0 40.0 X 0 1284213 156654 ROLAND PRICE FORMER TREASURER 0.0 0.0 X 0 1299914 15069 R SCOTT WALKER CFO & PRESIDENT (START 9/24) 10.0 40.0 X 0 1041266 162232 MARK PORTER TREASURER 10.0 40.0 X 0 1024863 112221 KRISTIN LEWIS CHIEF PUB & COMN AFF OFFICER 10.0 40.0 X 0 998596 118145 UMESH KURPAD FORMER CFO 0.0 0.0 X 0 1087771 21702 KATIE CATLENDER COO (START 1/24) 12.5 37.5 X 0 880347 67611 ROBERT WILLIAMS SVP, BUSINESS PERFORMANCE 10.0 40.0 X 0 836744 105431 DEAN PEASLEY SVP, OPERATIONS (END 4/24) 12.5 37.5 X 0 840092 31405 URCEL FIELDS SVP, PRES. GOVT MKT(END 11/24) 7.5 40.0 X 0 842020 16316 TISA HUGHES FORMER CLERK/SECRETARY 0.0 0.0 X 0 824422 31490 SUSAN KEE CLERK/SECRETARY, CLO 10.0 40.0 X 0 696820 93265 MARY MAHONEY FORMER SVP, CLO 0.0 0.0 X 0 705784 0 EILEEN AUEN EXECUTIVE CHAIR (START 9/24) 10.0 50.0 X X 0 533336 0 THOMAS CROSWELL FORMER CEO 0.0 0.0 X 0 404893 9900 PATRICIA HOWARD FORMER COO 0.0 0.0 X 0 232740 0 MICHAEL J MCCOLGAN DIRECTOR 1.0 3.0 X 0 141000 0 BERTRAM L SCOTT LEAD DIR/VICE CHR(START 10/24) 1.0 3.0 X X 0 138000 0 MICHAEL SHEA DIRECTOR 1.0 3.0 X 0 136000 0 TODD WHITBECK DIRECTOR 1.0 3.0 X 0 135500 0 HEDWIG VEITH WHITNEY DIRECTOR 1.0 3.0 X 0 135000 0 GREGORY D TRANTER DIRECTOR 1.0 3.0 X 0 133000 0 PETER SLAVIN MD DIRECTOR (END 9/24) 1.0 3.0 X 0 124306 0 RAYMOND PAWLICKI DIRECTOR 1.0 3.0 X 0 120000 0 IRINA SIMMONS DIRECTOR (END 6/24) 1.0 3.0 X 0 79778 0 JOYCE MURPHY DIRECTOR (END 6/24) 1.0 3.0 X 0 79778 0 GAUROV DAYAL MD DIRECTOR (START 6/24) 1.0 7.0 X 0 44695 0 ELIZABETH BIERBOWER DIRECTOR (START 6/24) 1.0 7.0 X 0 42223 0 MICHAEL TARNOFF MD DIRECTOR (START 12/24) 1.0 3.0 X 0 0 0 GREG SHELL DIRECTOR, VICE CHAIR 1.0 5.0 X X 0 0 0 0 22064134 1161161 0 true true false D EXPOSITO PARTNERS LLC 400 MADISON AVE SUITE 2A NEW YORK NY 10017 CONSULTING SERVICES 961488 VOIANCE LANGUAGE SERVICES LLC PO BOX 74008101 CHICAGO IL 606748101 ANSWERING SERVICES 531512 CDR ASSOCIATES LLC 307 INTERNATIONAL CIRCLE HUNT VALLEY MD 21030 AUDIT FEES 366334 CARELON MEDICAL BENEFITS MANAGEMENT 540 LAKE COOK RD STE 300 DEERFIELD IL 60015 CONSULTING SERVICES 270944 SEI - BOSTON LLC 11500 NORTHLAKE DRIVE SUITE 450 CINCINNATI OH 45249 CONSULTING SERVICES 196115 9 0 MEDICAID 524114 1101716715 1101716715 COMPREHENSIVE (DIRECT) 524114 1034123100 1034123100 MEDICARE/MEDICAID (CARE ONE) 524114 296375070 296375070 MEDICAID RHODE ISLAND 524114 106879386 106879386 2539094271 26885562 -289170 27174732 0 0 0 0 0 300486556 292598480 7888076 7888076 7888076 0 0 0 0 0 0 0 0 0 0 2573867909 2539094271 -289170 35062808 25250 25250 0 0 2355316981 2355316981 0 0 25945460 25945460 0 0 0 2391400 2391400 0 0 0 175635765 140508612 35127153 0 0 0 0 0 164610 0 164610 0 0 0 1621666 0 1621666 0 39623831 0 39623831 0 717089 573671 143418 0 591063 0 591063 0 6303798 5043038 1260760 0 0 0 1299854 1039883 259971 0 0 48531 48531 0 0 0 42299 33839 8460 0 6942191 5553753 1388438 0 255864 0 255864 0 PREMIUM DEFICIENCY 73969002 73969002 0 0 COB FEES 4011941 0 4011941 0 PREMIUM TAX 2153313 2153313 0 0 CLAIMS INTEREST 1023595 0 1023595 0 4068131 3254505 813626 2702151634 2615857238 86294396 0 0 0 160984377 -33484102 0 0 256779106 240635672 0 0 0 0 0 0 0 0 0 0 0 0 13405549 0 723192886 622773231 0 0 2000000 2000000 0 0 0 156482148 1156361918 988406949 688386906 577985504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30495390 114691884 718882296 692677388 X 0 0 0 0 437479622 295729561 437479622 295729561 1156361918 988406949 X -128283725 14927704 -28394040 X X false true X true false PHARMA. AND OTHER RECEIVABLES 95876386 RECEIVABLE FROM AFFILIATES 60605762 156482148 0 PREMIUM DEFICIENCY RESERVE 73969002 AMOUNTS HELD UNDER UNINSURED PLANS 30994051 PREMIUM RECEIVED IN ADVANCE 8659592 PAYABLE TO AFFILIATES AND PARENT 22560 INVESTMENT SETTLEMENTS PAYABLE 244865 OTHER LIABILITIES 801814 114691884 X 2587173947 14927704 14927704 2572246243 1621666 1621666 2573867909 2700529968 2700529968 1621666 1621666 2702151634 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. 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, 2024, 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 CAMBRIDGE PUBLIC HEALTH COMMISSION 1493 CAMBRIDGE ST CAMBRIDGE MA 02139 010676306 501(c)(3) 95000 N/A N/A SPONSORSHIP: CHA HEALTH CARIBE COMMUNICATIONS & PUBLICATIONS INC 175 MCCLELLAN HWY EAST BOSTON MA 02128 042530767 501(c)(3) 120000 N/A N/A SPONSORSHIP: VARIOUS EVENTS CENTRO LAS AMERICAS INC 11 SYCAMORE ST WORCESTER MA 016082213 042714991 501(c)(3) 6500 N/A N/A SPONSORSHIP: VARIOUS EVENTS CITY OF FALL RIVER 1 GOVERNMENT CTR FALL RIVER MA 02722 046001387 501(c)(3) 14388 N/A N/A SPONSORSHIP:VARIOUS EVENTS DISABILITY POLICY CONSORTIUM 25 KINGSTON ST BOSTON MA 02111 043570281 501(c)(3) 30000 N/A N/A SPONSORSHIP: MEMORIAL AWARDS GREATER NEW BEDFORD COMMUNITY HEALTH CENTER INC 874 PURCHASE ST NEW BEDFORD MA 02740 042675800 501(c)(3) 6700 N/A N/A SPONSORSHIP: HOLIDAY EVENTS HEALTHFIRST FAMILY CARE CENTER 387 QUARRY ST FALL RIVER MA 027232104 042503444 501(c)(3) 14300 N/A N/A SPONSORSHIP: VARIOUS EVENTS IMMIGRANTS' ASSISTANCE CENTER INC 58 CRAPO ST NEW BEDFORD MA 027404782 042530908 501(c)(3) 10000 N/A N/A SPONSORSHIP: MENTAL HEALTH ORGANIZED YOUTH 1268 C BROADWAY SAUGUS MA 019064709 844171641 501(c)(3) 40000 N/A N/A SPONSORSHIP: GIVE BACK DAY RI KIDS COUNT INC ONE UNION STATION PROVIDENCE RI 029031758 061485449 501(c)(3) 10000 N/A N/A SPONSORSHIP: KIDS COUNT EVENT THE BOYS AND GIRLS CLUBS OF PROVIDENCE 550 WICKENDEN ST PROVIDENCE RI 02903 050258929 501(c)(3) 25000 N/A N/A SPONSORSHIP: WANSKUCK CLUBHOUSE THE CITY OF CENTRAL FALLS 580 BROAD ST CENTRAL FALLS RI 028632012 470942849 501(c)(3) 10000 N/A N/A SPONSORSHIP: COMMUNITY PROGRAM UMASS MEMORIAL HEALTH CARE 365 PLANTATION ST WORCESTER MA 01605 043358566 501(c)(3) 7500 N/A N/A SPONSORSHIP: VARIOUS EVENTS UNITED WAY OF GREATER NEW BEDFORD INC 128 UNION ST NEW BEDFORD MA 027406387 042104264 501(c)(3) 5500 N/A N/A SPONSORSHIP: COMMUNITY EVENTS UNITED WAY OF GREATER PLYMOUTH COUNTY 1041 PEARL ST BROCKTON MA 023015538 042103940 501(c)(3) 6800 N/A N/A SPONSORSHIP: VARIOUS EVENTS 15 0 FORM 990, SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE ORGANIZATION NORMALLY CONTRIBUTES ONLY TO TAX-EXEMPT ORGANIZATIONS UNDER 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. THE ORGANIZATION MAY MAKE GRANTS TO OTHER ORGANIZATIONS THAT CONTRIBUTE SERVICES TO THE COMMUNITY CONSISTENT WITH THE ORGANIZATION'S MISSION. true true false false false false false false false CAIN HAYES DIR. PRES. & CEO (END 9/24) 0 979462 0 3054752 0 498075 0 22382 0 19981 0 4574652 0 183763 PHILIP BARR EVP, PRESIDENT, MARKETS 0 710093 0 784920 0 85779 0 149235 0 9937 0 1739964 0 72281 TRACEY CARTER FORMER SVP, CHIEF ACTUARY 0 0 0 350690 0 1248042 0 17697 0 488 0 1616917 0 91806 PETE CHURCH CHIEF PEOPLE & CULTURE OFFICER 0 635016 0 586187 0 63010 0 129669 0 26985 0 1440867 0 55508 ROLAND PRICE FORMER TREASURER 0 815 0 126875 0 1172224 0 14765 0 304 0 1314983 0 0 UMESH KURPAD FORMER CFO 0 3526 0 498533 0 585712 0 21379 0 323 0 1109473 0 97380 R SCOTT WALKER CFO & PRESIDENT (START 9/24) 0 693032 0 345302 0 2932 0 135198 0 27034 0 1203498 0 0 MARK PORTER TREASURER 0 433000 0 324735 0 267128 0 86199 0 26022 0 1137084 0 225509 KRISTIN LEWIS CHIEF PUB & COMN AFF OFFICER 0 442629 0 474467 0 81500 0 87269 0 30876 0 1116741 0 78011 DEAN PEASLEY SVP, OPERATIONS (END 4/24) 0 105334 0 299692 0 435066 0 21657 0 9748 0 871497 0 102219 KATIE CATLENDER COO (START 1/24) 0 552885 0 325000 0 2462 0 67319 0 292 0 947958 0 0 ROBERT WILLIAMS SVP, BUSINESS PERFORMANCE 0 454256 0 371994 0 10494 0 96649 0 8782 0 942175 0 6965 TISA HUGHES FORMER CLERK/SECRETARY 0 36117 0 609522 0 178783 0 23751 0 7739 0 855912 0 57138 URCEL FIELDS SVP, PRES. GOVT MKT(END 11/24) 0 406154 0 400000 0 35866 0 16094 0 222 0 858336 0 0 SUSAN KEE CLERK/SECRETARY, CLO 0 499421 0 174827 0 22572 0 92127 0 1138 0 790085 0 18517 MARY MAHONEY FORMER SVP, CLO 0 0 0 705784 0 0 0 0 0 0 0 705784 0 0 EILEEN AUEN EXECUTIVE CHAIR (START 9/24) 0 0 0 0 0 533336 0 0 0 0 0 533336 0 0 THOMAS CROSWELL FORMER CEO 0 0 0 375000 0 29893 0 9900 0 0 0 414793 0 0 PATRICIA HOWARD FORMER COO 0 0 0 0 0 232740 0 0 0 0 0 232740 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 METHOD USED TO ESTABLISH CEO COMPENSATION TUFTS HEALTH PUBLIC PLANS, 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 DETAIL OF SEVERANCE PAYMENTS THE FOLLOWING SENIOR LEADERS ALSO RECEIVED SEVERANCE PAYMENTS IN 2024: CAIN HAYES = $292,731 TRACEY CARTER = $483,832 URCEL FIELDS = $33,846 DEAN PEASLEY = $267,989 PATRICIA HOWARD = $232,740 ---------- 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 HEALTH PUBLIC PLANS, INC.'S ("THPP") PURPOSE IS TO GUIDE AND EMPOWER HEALTHIER LIVES FOR EVERYONE. THPP SEEKS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES IT SERVES BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING PROVIDING COMMUNITY OUTREACH AND EDUCATION TO THE COMMUNITY IT SERVES. THE ORGANIZATION AIMS TO IMPROVE THE LIVES OF MASSACHUSETTS AND RHODE ISLAND RESIDENTS BY PROVIDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH CARE, PRIMARILY THROUGH MANAGED CARE PROGRAMS DIRECTED AT LOW TO MODERATE INCOME RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS AND STATE OF RHODE ISLAND. THPP IS PART OF THE POINT32HEALTH ("P32H") FAMILY OF COMPANIES. ---------- FORM 990, PART III, LINE 4D DETAIL OF OTHER PROGRAM SERVICE ACCOMPLISHMENTS - RHODE ISLAND MEDICAID COVERAGE THE ORGANIZATION ALSO OFFERS MEDICAID COVERAGE TO RHODE ISLAND RESIDENTS THROUGH A MEDICAID MANAGED CARE ORGANIZATION PLAN. THE ORGANIZATION'S COVERAGE IS CALLED TUFTS HEALTH RI TOGETHER, AND IS SIMILAR TO THE MEDICAID COVERAGE OFFERED IN MASSACHUSETTS. ---------- 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 THE FILING ORGANIZATION FROM 1/1/2024 TO 12/31/2024: CAIN HAYES, DIRECTOR; PRESIDENT & CEO (END 9/12/2024) SUSAN KEE, CLERK/SECR; CHIEF LEGAL OFFICER EILEEN AUEN, DIRECTOR, CHAIR; EXECUTIVE CHAIR (ADD'L EXECUTIVE CHAIR TITLE START 9/12/2024) R. SCOTT WALKER, CFO; PRESIDENT (ADD'L PRESIDENT TITLE START 9/12/2024) ------------ FORM 990, PART VI, LINE 3 DELEGATION OF CONTROL OF MANAGEMENT DUTIES THE FILING ORGANIZATION'S SOLE MEMBER IS POINT32HEALTH, INC. ITS AFFILIATE, POINT32HEALTH SERVICES, INC., PERFORMS CERTAIN MANAGEMENT, ADMINISTRATIVE, AND MARKETING SERVICES FOR THE FILING ORGANIZATION AND OTHER 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. ("P32H") IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. ---------- FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT MEMBERS 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 EXTERNAL ACCOUNTANT, REVIEWED BY P32H'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 & ENFORCEMENT OF COMPLIANCE WITH CONFLICT-OF-INTEREST POLICY: THE P32H'S CONFLICT OF INTEREST ("COI") POLICY AND PROCEDURES ("P&P") APPLIES TO THE FILING COMPANY AS A SUBSIDIARY ORGANIZATION. THE P32H'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 P32H'S (OR ITS SUBSIDIARIES) SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. ADDITIONALLY, P32H 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 P32H 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 RECOMMEND 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, LEGAL, 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 P32H. ---------- 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 P32H. ---------- FORM 990, PART VI, LINE 15A & 15B COMPENSATION REVIEW AND APPROVAL THE FILING ORGANIZATION'S PARENT COMPANY, P32H 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 P32H OPERATES. ---------- FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, COI POLICY, AND ANNUAL FINANCIAL REPORT AND QUARTERLY FINANCIAL UPDATES ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ---------- FORM 990, PART VII SUPPLEMENTAL COMPENSATION INFORMATION GREG SHELL DID NOT EARN COMPENSATION IN 2024. ---------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CHANGE IN NON-ADMITTED ASSETS $(8,394,040) PAID IN CAPITAL $(20,000,000) --------------- TOTAL $(28,394,040) ---------- FORM 990, PART XII, LINE 1 ACCOUNTING METHOD USED TO PREPARE FORM 990 THPP 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 INSURA MA 501(C)(4) N/A HPHCINC true POINT32HEALTH FOUNDATION INC 1 WELLNESS WAY CANTON MA 02021 261374263 GRANT MAKING MA 501 (C)(3) 12A TAHMO true POINT32HEALTH INC 1 WELLNESS WAY CANTON MA 02021 814089215 HEALTHCARE MA 501(C)(4) N/A NA false CARE PARTNERS OF CONNECTICUT INC 1 WELLNESS WAY CANTON MA 02021 822604728 HMO CT 501(C)(4) N/A TAHMO true TUFTS ASSOC HEALTH MAINTEN ORG INC 1 WELLNESS WAY CANTON MA 02021 042674079 HMO MA 501(C)(4) N/A P32H true HPHC INC 1 WELLNESS WAY CANTON MA 02021 042452600 HEALTH INSURA MA 501(C)(3) 10 P32H true CAREPARTNERS OF CT HOLDINGS LLC 1 WELLNESS WAY CANTON MA 02021 823129930 HOLDING COMPANY CT TAHMO N/A CLARION MANAGEMENT SOLUTIONS LLC 1212 CORPORATE DRIVE SUITE 225 IRVING TX 75038 822713764 CLINICAL CONSUL DE EH NEXUS N/A EMPLOYERS HEALTH NEXUS LLC 1500 W PARK DRIVE SUITE 330 WESTBOROUGH MA 01581 882938454 HOLDING COMPANY MA HEALTH PLANS N/A EMPLOYERS HEALTH NETWORK LLC 1212 CORPORATE DRIVE SUITE 225 IRVING TX 75038 471678150 SELF INSURANCE DE EH NEXUS N/A KP VENTURES LLC SERIES B 1 KAISER PLAZA OAKLAND CA 94612 273339892 HEALTHCARE CA TAHMO N/A KP VENTURES LLC SERIES D 1 KAISER PLAZA OAKLAND CA 94612 471874366 HEALTHCARE CA TAHMO N/A HPHC INSURANCE COMPANY INC 1 WELLNESS WAY CANTON MA 02021 043149694 HEALTH INSURANCE MA NEW HPHC HOLDCO C CORP true PLAN MARKETING INSURANCE AGENCY INC 1500 W PARK DRIVE STE 330 WESTBOROUGH MA 01581 042734281 BROKERAGE MA HEALTH PLANS C CORP true HPHC INSURANCE AGENCY INC 1 WELLNESS WAY CANTON MA 02021 043016201 BROKERAGE MA NEW HPHC HOLDCO C CORP true HEALTH PLANS INC 1500 W PARK DRIVE STE 330 WESTBOROUGH MA 01581 042734278 TPA MA NEW HPHC HOLDCO C CORP true CARE MANAGEMENT SERVICES INC 1500 W PARK DRIVE STE 330 WESTBOROUGH MA 01581 043438779 CARE MANAGEMENT MA HEALTH PLANS C CORP true NEW HPHC HOLDING CORPORATION 1 WELLNESS WAY CANTON MA 02021 815340662 HOLDING COMPANY DE HPHC INC C corp true POINT32HEALTH SERVICES INC 1 WELLNESS WAY CANTON MA 02021 042985923 MANAGEMENT SVCS DE TAHMO C CORP true TUFTS INSURANCE COMPANY 1 WELLNESS WAY CANTON MA 02021 043319729 INSURANCE MA P32H SRVCS INC C CORP true TUFTS BENEFIT ADMINISTRATORS INC 1 WELLNESS WAY CANTON MA 02021 043270923 TPA MA P32H SRVCS INC C CORP true TOTAL HEALTH PLAN INC 1 WELLNESS WAY CANTON MA 02021 042918943 TPA MA P32H SRVCS INC C CORP true TAHP BROKERAGE CORPORATION 1 WELLNESS WAY CANTON MA 02021 043072692 BROKERAGE MA P32H SRVCS INC C CORP true INTEGRA PARTNERS HOLDINGS INC 100 WALL ST STE 2502 NEW YORK NY 10005 453032233 MED EQUIPT & SVCS NY TAHMO C CORP true false true false false false false false false false false false false false true true true true false false TUFTS ASSOC HEALTH MAINTEN ORG INC P,Q 12131352 FMV POINT32HEALTH SERVICES INC P,Q 18405490 FMV POINT32HEALTH INC B -50000000 CASH