2025-11-12T07:02:29-06:00 2024-12-31 161131146 BONADIO & CO LLP 6 WEMBLEY CT ALBANY NY 12205 990 2024-01-01 141641028 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN INC CAPI 5186414085 6 WELLNESS WAY LATHAM NY 12110 PAUL KAHLON EVP FINANCE AND CFO 5186413000 2025-09-15 1 1 GLORIA M NOSTRAMO P01385068 5184644080 2025-11-03 2024 2025-03-06 01:10:19Z PAUL KAHLON 6 WELLNESS WAY LATHAM NY 12110 2122506540 0 X WWW.CDPHP.COM X 1984 NY CDPHP PROVIDES QUALITY HEALTH CARE AT A REASONABLE COST FOR CDPHP MEMBERS AND OPERATES AS A MODEL FOR THE DELIVERY, FINANCING, AND ADMINISTRATION OF HEALTH CARE SERVICES. 16 5 1501 0 0 0 0 0 2029134818 2079695513 6845328 7902713 0 0 2035980146 2087598226 346517 89715 1760197094 1926484715 130763384 138736769 0 0 0 90229230 102888257 1981536225 2168199456 54443921 -80601230 588027141 530312235 331461258 440752112 256565883 89560123 X CDPHP PROVIDES QUALITY HEALTH CARE AT A REASONABLE COST FOR CDPHP MEMBERS AND OPERATES AS A MODEL FOR THE DELIVERY, FINANCING, AND ADMINISTRATION OF HEALTH CARE SERVICES. 0 0 632338541 656250229 CDPHP PROVIDES HEALTH CARE BENEFITS TO EMPLOYER GROUP MEMBERS AND INDIVIDUALS IN OUR COMMUNITY. AS OF DECEMBER 31, 2024, 72,271 MEMBERS WERE ENROLLED IN COMMERCIAL PRODUCTS. 592396859 60000 596197076 CDPHP'S MEDICAID, HARP, AND ESSENTIAL PLANS PROVIDE HEALTH CARE BENEFITS TO 108,344 MEMBERS IN NEW YORK STATE. 796655428 766265225 CDPHP'S MEDICARE PROGRAM PROVIDES HEALTH CARE BENEFITS TO 54,169 MEMBERS IN NEW YORK STATE. 43901709 48733032 CHILD HEALTH PLUS - 16986 MEMBERS 11842493 12249951 HEALTHY NEW YORK - 2,084 MEMBERS 55744202 60982983 2077135030 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 0 1 5039 0 1 1501 1 0 0 0 0 0 0 0 0 1 0 X 16 5 0 0 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 NY X PAUL KAHLON 5186413000 6 WELLNESS WAY LATHAM NY 12110 X BRIAN SHERIDAN MD DIRECTOR 9.70 X 69200 0 0 CARMEN MAZZOTTA TREASURER OF THE BOARD 8.10 X X 70600 0 0 LEE MCELROY SECRETARY 5.90 X X 53400 0 0 MICHAEL DEVITO MD CHAIRMAN OF THE BOARD 1.10 X X 75800 0 0 GREGORY SERIO DIRECTOR 8.30 X 71200 0 0 PATRICK TIMMINS III MD DIRECTOR 7.00 X 57200 0 0 MANISH MEHTA DIRECTOR 12.90 X 14400 0 0 ADETUTU ADETONA MD DIRECTOR 5.90 X 53200 0 0 VINCENT CARSILLO II DO DIRECTOR 3.20 X 34400 0 0 MICHAEL CASTELLANA DIRECTOR 8.60 X 72000 0 0 CINDY CHAN MDCM DIRECTOR 5.40 X 47200 0 0 TODD DOYLE MD DIRECTOR 6.70 X 59800 0 0 GERALD JENNINGS DIRECTOR 12.20 X 73800 0 0 JANINE JURKOWSKI DIRECTOR 4.00 X 38000 0 0 AMY JOHNSON DIRECTOR 12.90 X 76600 0 0 JAMES REED DIRECTOR 5.00 X 0 281066 0 BARRY JAMES THORNTON II DIRECTOR 5.00 X 0 117209 0 LISA ANNE WHITE DIRECTOR 5.00 X 0 77441 0 BRIAN O'GRADY CEO/PRESIDENT 40.00 X 988118 0 42384 JOHN D BENNETT MD CEO/PRESIDENT (FORMER) 40.00 X 1478272 0 28706 BRUCE E COPLIN MD EVP CHIEF MEDICAL OFFICER 40.00 X 526175 0 38134 KATHRYN DECKER EVP/PEOPLE AND CULTURE/CHRO 40.00 X 824825 0 48367 PAUL KAHLON EVP FINANCE AND CFO 40.00 X 725622 0 44759 PATRICIA LUSHKEVICH SVP INTERNAL OPERATIONS 40.00 X 529257 0 49567 NICHOLAS KRAFT SVP CHIEF GROWTH OFFICER 40.00 X 564692 0 51767 PETER DIFONDI SVP/INFORMATION TECHNOLOGY CIO 40.00 X 682730 0 48567 NED JALEEL VP MEMBER HEALTH SENIOR MEDICAL 40.00 X 489324 0 54567 ROBERT LITTLE VP UNDERWRITING 40.00 X 465822 0 27523 JOSEPH POLITO II MD VICE CHAIRMAN OF THE BOARD 9.70 X 39900 0 0 TANVIR KHAN SVP/TECHNOLOGY DATA AND AN 0.00 X 378561 0 0 ELIZABETH WARNER EVP CHIEF MEDICAL OFFICER (FORMER) 40.00 X 663345 0 48567 JOHN LUTZ EVP/INTEGRATED DEL SYS (FORMER) 40.00 X 968623 0 19502 EILEEN WOOD EVP PHARMACY SERVICES/CPO (FORMER) 40.00 X 636103 0 42980 MARY JANE BENDON COUCH EVP GENERAL COUNSEL (FORMER) 40.00 X 917739 0 45044 SHEILA NELSON CHIEF COMPLIANCE OFFICER (FORMER) 40.00 X 411357 0 43630 BARBARA DOWNS EVP CORPORATE ADMINISTRATION (FORMER) 0.00 X 168282 0 2670 12325547 475716 636734 567 1 1 0 NATIONSBENEFITS HOLDINGS LLC 1700 NORTH UNIVERSITY DRIVE PLANTATION FL 33322 HEALTHCARE SERVICES 23972652 LANDMARK HEALTH LLC 7755 CENTER AVE STE 630 HUNTINGTON CA 92647 HEALTHCARE SERVICES 12924175 ATOS SYNTEL INC 525 E BIG BEAVER RD SUITE 300 TROY MI 48083 IT PROCESSING AND CONSULTING 9437677 BBL CONSTRUCTION SERVICES 302 WASHINGTON AVE EXT ALBANY NY 12203 CONSTRUCTION SERVICES 5105058 CLARITY SOFTWARE SOLUTIONS 92 WALL STREET SUITE 1 MADISON CT 06443 IT PROCESSING AND CONSULTING 4908846 127 MEDICARE PREMIUMS 524114 766265225 766265225 COMMERCIAL PREMIUMS 524114 656250229 656250229 MEDICAID PREMIUMS 524114 596197076 596197076 CHILD HEALTH PLUS PREMIUMS 524114 48733032 48733032 HEALTHY NEW YORK PREMIUMS 524114 12249951 12249951 2079695513 8073608 8073608 34737419 34908314 -170895 -170895 -170895 2087598226 2079695513 0 7902713 89715 89715 1926484715 1926484715 6494424 2880963 3613461 327340 327340 103788897 49031380 54757517 2845724 1325065 1520659 18031947 7896043 10135904 7248437 3413501 3834936 1787923 1430338 357585 563939 451151 112788 242932 242932 304009 304009 5016235 5016235 6751289 3482691 3268598 23422143 22719479 702664 3595046 1797523 1797523 628333 437856 190477 32172 32172 1921846 1537477 384369 5995244 4196671 1798573 1206667 1206667 FEDERAL AND STATE ASSES 27039900 21631920 5407980 CONSULTING AND OUTSOURC 17470537 17470537 MISCELLANEOUS 4506329 4506329 BROKER COMMISSIONS 2403713 1335441 1068272 2168199456 2077135030 91064426 0 21105780 25986675 221329660 214582686 13070312 16910863 134582424 91208952 23952884 43373472 174894426 176887697 123650362 36741918 10023717 15828924 588027141 530312235 325090256 432653010 1390320 2675848 4980682 5423254 331461258 440752112 X 256565883 89560123 256565883 89560123 588027141 530312235 X -80601230 541069 -86945599 X 0 1 X 1 1 1 14274673 756910 13517764 97963725 89909051 8054674 22344026 542991 21801034 43373472 INVESTMENT IN CDPHP UBI 35584728 F INVESTMENT IN CDPHP FOUNDATION, INC. 967874 F INVESTMENT IN HEALTH PLAN ALLIANCE 189316 F 36741918 CLAIM ADJUSTMENT EXPENSE LIABILITY 5423254 5423254 X 2000415414 -86878803 -86878803 2087294217 304009 304009 2087598226 2167962243 66796 66796 2167895447 304009 304009 2168199456 PART X, LINE 2: EXPLANATION: UNDER ASC 740, CDPHP IS REQUIRED TO DETERMINE WHETHER A TAX POSITION OF THE PLAN IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OF THE LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS OF THE POSITION. FOR TAX POSITIONS MEETING THE MORE LIKELY THAN NOT THRESHOLD, THE TAX AMOUNT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENT IS REDUCED BY THE LARGEST BENEFIT THAT HAS A GREATER THAN FIFTY PERCENT LIKELIHOOD OF BEING REALIZED UPON THE ULTIMATE SETTLEMENT WITH THE RELEVANT TAXING AUTHORITY. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN/LOSS ON EQUITY OF CONSOLIDATED AND UNCONSOLIDATED SUBSIDIARY -86,908,446. OTHER INCOME 29,643. PART XII, LINE 2D - OTHER ADJUSTMENTS: OTHER INCOME NETTED AGAINST RENT EXPENSE 29,645. STATUTORY LEASE DIFFERENCE 37,151. FORM 990, SCHEDULE D, PART VII, LINES 3A-3C: EXPLANATION: THE METHOD OF VALUATION IN COLUMN C IS THE EQUITY METHOD OF ACCOUNTING. 1 CDPHP FOUNDATION INC 6 WELLNESS WAY LATHAM NY 12110 471619130 501(C)(3) 0 29715 FMV DONATED GOODS/SERVICES OPERATING GRANT COMFORT FOOD COMMUNITY PO BOX 86 GREENWICH NY 12834 411858498 501(C)(3) 60000 0 FOOD ASSISTANCE FOOD ASSISTANCE 2 PART 1, LINE 2 EXPLANATION: GRANTS ARE PROVIDED TO THE FOUNDATION FOR USE TO OTHER CHARITABLE ORGANIZATIONS AND ADMINISTRATION OF THE FOUNDATION. THE ALLOCATED GRANT PORTION TO COMFORT FOOD COMMUNITY PROVIDES FUNDING UNDER THE TERMS OF THE WRITTEN AGREEMENT. 1 X X X X X 1 1 0 0 0 0 0 0 0 JOHN D BENNETT MD CEO/PRESIDENT (FORMER) 505924 0 479606 0 492742 0 6345 0 22361 0 1506978 0 0 0 BRIAN O'GRADY CEO/PRESIDENT 773749 0 180070 0 34299 0 13800 0 28584 0 1030502 0 0 0 JOHN LUTZ EVP/INTEGRATED DEL SYS (FORMER) 571445 0 362565 0 34613 0 10500 0 9002 0 988125 0 0 0 MARY JANE BENDON COUCH EVP GENERAL COUNSEL (FORMER) 619499 0 181303 0 116937 0 10500 0 34544 0 962783 0 0 0 KATHRYN DECKER EVP/PEOPLE AND CULTURE/CHRO 605058 0 207545 0 12222 0 11000 0 37367 0 873192 0 0 0 PAUL KAHLON EVP FINANCE AND CFO 530844 0 171022 0 23756 0 9992 0 34767 0 770381 0 0 0 PETER DIFONDI SVP/INFORMATION TECHNOLOGY CIO 356154 0 294564 0 32012 0 13800 0 34767 0 731297 0 0 0 ELIZABETH WARNER EVP CHIEF MEDICAL OFFICER (FORMER) 488205 0 131303 0 43837 0 13800 0 34767 0 711912 0 0 0 EILEEN WOOD EVP PHARMACY SERVICES/CPO (FORMER) 473425 0 125050 0 37628 0 13800 0 29180 0 679083 0 0 0 NICHOLAS KRAFT SVP CHIEF GROWTH OFFICER 396112 0 144824 0 23756 0 11000 0 40767 0 616459 0 0 0 PATRICIA LUSHKEVICH SVP INTERNAL OPERATIONS 391123 0 105042 0 33092 0 13800 0 35767 0 578824 0 0 0 BRUCE E COPLIN MD EVP CHIEF MEDICAL OFFICER 369339 0 101441 0 55395 0 13800 0 24334 0 564309 0 0 0 NED JALEEL VP MEMBER HEALTH SENIOR MEDICAL 310916 0 122316 0 56092 0 13800 0 40767 0 543891 0 0 0 ROBERT LITTLE VP UNDERWRITING 295473 0 112866 0 57483 0 13800 0 13723 0 493345 0 0 0 SHEILA NELSON CHIEF COMPLIANCE OFFICER (FORMER) 292633 0 85632 0 33092 0 12230 0 31400 0 454987 0 0 0 TANVIR KHAN SVP/TECHNOLOGY DATA AND AN 378561 0 0 0 0 0 0 0 0 0 378561 0 0 0 JAMES REED DIRECTOR 0 281066 0 0 0 0 0 0 0 0 0 281066 0 0 BARBARA DOWNS EVP CORPORATE ADMINISTRATION (FORMER 168282 0 0 0 0 0 0 0 2670 0 170952 0 0 0 JOSEPH POLITO II MD VICE CHAIRMAN OF THE BOARD 39900 0 0 0 0 0 0 0 0 0 39900 0 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS: JOHN BENNETT, MD. - $470,588 MARY JANE BENDON COUCH - $83,192 BARBARA DOWNS - $168,282 PART 1 LINES 4A-B: THE EXECUTIVE VICE PRESIDENTS ARE ELIGIBLE FOR A NON-QUALIFIED DEFERRED COMPENSATION PLAN CONTRIBUTION. NO PAYMENT WAS MADE TO THIS PLAN IN 2024 RELATING TO 2023. PART 1 LINE 7: EXPLANATION: CDPHP HAS A MANAGEMENT INCENTIVE PROGRAM THAT IS BASED UPON THREE CRITERIA: ATTAINMENT OF PERSONAL AND COMPANY GOALS, ACHIEVEMENT OF QUALITY AND SERVICE TARGETS, AND ACHIEVEMENT OF ENROLLMENT TARGETS. THE BOARD ANNUALLY APPROVES THE METRICS TO BE USED TO ASSESS EACH CRITERION. THE MANAGEMENT INCENTIVE IS PAYABLE ONLY IF DETERMINED TO BE AFFORDABLE BY THE BOARD. IN ADDITION, THE BOARD HAS FINAL DISCRETION AT THE CLOSE OF THE YEAR TO MAKE THE INCENTIVE PAYMENT. LANSINGBURGH FAMILY PRACTICE ADETUTU ADETONA MD 334904 SEE EXPLANATION BELOW 0 COMMUNITY CARE PHYSICIANS PC CINDY CHAN MDCM 62791404 SEE EXPLANATION BELOW 0 ALBANY MEDICAL COLLEGE MICHAEL DEVITO MD 43801230 SEE EXPLANATION BELOW 0 NY ONCOLOGY HEMATOLOGY TODD DOYLE MD 47520233 SEE EXPLANATION BELOW 0 ALBANY GASTROENTEROLOGY CONSULTANTS JOSEPH POLITO II MD 7315537 SEE EXPLANATION BELOW 0 SCHOOLHOUSE PEDIATRICS BRIAN SHERIDAN MD 2383572 SEE EXPLANATION BELOW 0 BRIAN RANA SON OF EILEEN WOOD, KEY EMPLOYEE OF CDPHP 108063 BRIAN IS EMPLOYED AT CDPHP AS A SALESFORCE ADMINISTRATOR 0 MICHAEL RANA SON OF EILEEN WOOD, KEY EMPLOYEE OF CDPHP 219277 MICHAEL IS EMPLOYED AT CDPHP AS A PRODUCT LEADER OF BUSINESS TECHNOLOGY SERVICES 0 WOMEN'S CANCER CARE ASSOCIATES PATRICK F TIMMINS MD 1762850 SEE EXPLANATION BELOW 0 NEW YORK NEPHROLOGY AND DIALYSIS ACCESS VINCENT CARSILLO II D.O. 1605950 SEE EXPLANATION BELOW 0 COMMUNITY CARE PHYSICIANS PC MANISH MEHTA, MD, MPH, FACS 62791404 SEE EXPLANATION BELOW 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS PURSUANT TO ITS CERTIFICATE OF INCORPORATION AND BYLAWS, EIGHT OF THE MEMBERS OF THE CDPHP BOARD OF DIRECTORS MUST BE PRACTICING PHYSICIANS. AS PRACTICING PHYSICIANS, EACH OF THESE PHYSICIAN DIRECTORS HAS A STANDARD PARTICIPATING PROVIDER AGREEMENT WITH CDPHP PURSUANT TO WHICH THEY ARE PAID FEES FOR SERVICES RENDERED TO CDPHP MEMBERS. PURSUANT TO THE PARTICIPATING PROVIDER AGREEMENT, THE PHYSICIAN DIRECTORS ARE PAID IN ACCORDANCE WITH THE STANDARD FEE SCHEDULE APPLICABLE TO ALL PHYSICIANS GENERALLY. HOWEVER, ALTHOUGH EACH PHYSICIAN HAS AN INDIVIDUAL CONTRACT WITH CDPHP, PAYMENT FOR SERVICES RENDERED BY INDIVIDUAL PHYSICIAN ARE PAYABLE TO THAT PHYSICIAN'S PRACTICE, NOT TO THE PROVIDER INDIVIDUALLY. PAYMENTS MADE BY CDPHP TO THE PROVIDER PRACTICE ARE NOT ALLOCATED OR REPORTED BY CDPHP BY THE INDIVIDUAL PROVIDER. ACCORDINGLY, PAYMENTS REPORTED HEREIN REFLECT THE AMOUNTS PAID IN FULL TO THE PRACTICE. AS NOTED ABOVE AND AS SHOWN IN SCHEDULE L, THESE AMOUNTS WERE PAID TO THE ORGANIZATIONS WHERE THE PHYSICIAN DIRECTOR IS AN EMPLOYEE, PARTNER, SHAREHOLDER OR BOARD MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4 IN APRIL 2024, EXCELSIOR HEALTH, INC. WAS MADE THE SOLE CORPORATE MEMBER OF CDPHP. IN DECEMBER 2024, LIFETIME HEALTHCARE INC (LIFETIME) BECAME THE SOLE MEMBER OF EXCELSIOR HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION: THE ORGANIZATION HAS A SOLE CORPORATE CLASS A MEMBER, EXCELSIOR HEALTH INC., AS WELL AS INDIVIDUAL CLASS B MEMBERS WHO ARE THE SAME INDIVIDUALS SERVING AS CLASS B DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A EXPLANATION: EXCELSIOR HEALTH INC., AND ITS PARENT/MEMBER LIFETIME HEALTHCARE, INC. ELECT THE BOARD OF DIRECTORS OF CDPHP. FORM 990, PART VI, SECTION A, LINE 7B EXPLANATION: YES, THE CORPORATE MEMBER MUST APPROVE ANY CHANGES IN THE CORPORATION'S MISSION STATEMENT, CERTIFICATE OF INCORPORATION, BY-LAWS, OR CHANGES TO THE BOARD OF DIRECTORS, MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR ANY CONVERSION FROM NON-FOR-PROFIT STATUS. FORM 990, PART VI, SECTION B, LINE 11B EXPLANATION: THE FORM 990 IS REVIEWED AND APPROVED BY THE DIRECTOR OF ACCOUNTING AND FINANCIAL REPORTING AND THE CFO. IT IS THEN PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD FOR REVIEW. FINALLY, IT IS PRESENTED TO THE BOARD FOR REVIEW PRIOR TO THE IRS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION: CDPHP HAS A CONFLICT OF INTEREST POLICY. CDPHP REGULARLY POLLS EMPLOYEES AND BOARD MEMBERS REGARDING POTENTIAL CONFLICT OF INTEREST SITUATIONS. ANY ACTUAL OR POTENTIAL CONFLICTS DISCLOSED ARE PRESENTED TO THE BOARD, AT LEAST ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 EXPLANATION: CDPHP USES OUTSIDE COMPENSATION CONSULTING FIRMS. THESE FIRMS UTILIZE CUSTOM AND PUBLISHED SURVEYS. INFORMATION IS PROVIDED TO CDPHP'S BOARD COMPENSATION COMMITTEE FOR ANNUAL APPROVAL OF EXECUTIVE POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 EXPLANATION: FINANCIAL DOCUMENTS ARE FILED QUARTERLY WITH THE DEPARTMENT OF FINANCIAL SERVICES AND ARE AVAILABLE THROUGH THE FREEDOM OF INFORMATION ACT (FOIA). GOVERNING DOCUMENTS ARE ALSO AVAILABLE THROUGH THE DEPARTMENT OF FINANCIAL SERVICES, ALSO THROUGH FOIA. THE CONFLICT OF INTEREST POLICY IS NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC JAMES REED - C/O EXCELLUS HEALTH PLAN, INC. 165 COURT STREET, ROCHESTER, NY 14647. BARRY JAMES THORNTON, II - C/O EXCELLUS HEALTH PLAN, INC. 165 COURT STREET, ROCHESTER, NY 14647. LISA ANNE WHITE - C/O EXCELLUS HEALTH PLAN, INC. 165 COURT STREET, ROCHESTER, NY 14647. FORM 990, PART VII, SECTION A REPORTING OF COMPENSATION PAID BY A RELATED ORGANIZATION IS PROVIDED ONLY FOR THE PERIOD DURING WHICH THE RELATED ORGANIZATION, LIFETIME HEALTHCARE, INC., WAS RELATED, NOT THE ENTIRE CALENDAR YEAR ENDING WITH OR WITHIN THE TAX YEAR. THE PERIOD DURING WHICH LIFETIME HEALTHCARE, INC. WAS RELATED WAS FROM 12/6/2024-12/31/2024. FORM 990, PART XI, LINE 9: OTHER INCOME 26,943. CURRENT YEAR EQUITY METHOD LOSS ON INVESTMENT IN SUBSIDIARIES -86,972,542. CDPHP FOUNDATION INC 6 WELLNESS WAY LATHAM NY 12110 471619130 FOUNDATION NY 501(C)(3) LINE 10 N/A 0 CAYUGA HEALTH SYSTEM SERVICES 165 COURT STREET ROCHESTER NY 14647 061680689 IT SERVICES NY N/A N/A 0 0 WATERVLIET PHARMACY ACQUISITION LLC 6 WELLNESS WAY LATHAM NY 12110 852329712 PHARMACY NY N/A N/A 0 0 CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK INC 6 WELLNESS WAY LATHAM NY 12110 141745298 ADMIN SERVICES NY CDPHP UNIVERSAL BENEFITS INC C 173535839 226851831 1.00000 0 CDPHP UNIVERSAL BENEFITS INC 6 WELLNESS WAY LATHAM NY 12110 161520935 ARTICLE 43 INSURANCE NY CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN INC C 753128035 251620388 1.00000 0 STRATEGIC SOLUTIONS MANAGEMENT 429 CLIFTON CORP PKWY CLIFTON PARK NY 12065 141814293 BILLING AND CONSULTING NY CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK INC C 0 CCP TASS INC 6 WELLNESS WAY LATHAM NY 12110 872786025 BILLING AND CONSULTING NY CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK INC C 0 EXCELSIOR HEALTH INC 6 WELLNESS WAY LATHAM NY 12110 991606861 HOLDING COMPANY NY LIFETIME HEALTHCARE INC C 0 LIFETIME HEALTHCARE INC 165 COURT STREET ROCHESTER NY 14647 161514675 HOLDING COMPANY NY N/A C 0 EXCELLUS HEALTH PLAN INC 165 COURT STREET ROCHESTER NY 14647 150329043 ARTICLE 43 INSURANCE NY LIFETIME HEALTHCARE INC C 0 EXCELLUS VENTURES INC 165 COURT STREET ROCHESTER NY 14647 161550984 HOLDING COMPANY NY LIFETIME HEALTHCARE INC C 0 LIFETIME WORKFORCE SOLUTIONS 165 COURT STREET ROCHESTER NY 14647 992613307 SHARED SERVICES COMPANY NY LIFETIME HEALTHCARE INC C 0 EXCELLUS HEALTH PLAN COMMUNITY CARE LLC 165 COURT STREET ROCHESTER NY 14647 881097373 ARTICLE 44 INSURANCE NY LIFETIME HEALTHCARE INC C 0 MEDAMERICA REINSURANCE COMPANY 165 COURT STREET ROCHESTER NY 14647 980210843 LONG-TERM CARE INSURANCE VT LIFETIME HEALTHCARE INC C 0 LIFETIME BENEFIT SOLUTIONS 165 COURT STREET ROCHESTER NY 14647 161171765 BENEFIT PROGRAM ADMINISTRATION NY LIFETIME HEALTHCARE INC C 0 BEACON NETWORK SERVICES INC 165 COURT STREET ROCHESTER NY 14647 141830065 PHYSICIAN NETWORK ADMINISTRATION NY LIFETIME HEALTHCARE INC C 0 EXCELLUS ACQUISITION 165 COURT STREET ROCHESTER NY 14647 061680689 HOLDING COMPANY NY LIFETIME HEALTHCARE INC C 0 MEDAMERICA INC 165 COURT STREET ROCHESTER NY 14647 161581817 HOLDING COMPANY NY LIFETIME HEALTHCARE INC C 0 MEDAMERICA INSURANCE COMPANY OF NEW YORK 165 COURT STREET ROCHESTER NY 14647 161310986 LONG-TERM CARE INSURANCE NY LIFETIME HEALTHCARE INC C 0 MEDAMERICA INSURANCE COMPANY 165 COURT STREET ROCHESTER NY 14647 340977231 LONG-TERM CARE INSURANCE PA LIFETIME HEALTHCARE INC C 0 MEDAMERICA INSURANCE COMPANY OF FLORIDA 165 COURT STREET ROCHESTER NY 14647 141993330 LONG-TERM CARE INSURANCE FL LIFETIME HEALTHCARE INC C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC Q 2660630 ALLOCATION CDPHP UNIVERSAL BENEFITS INC N 10511900 ALLOCATION CDPHP UNIVERSAL BENEFITS INC O 36526520 ALLOCATION CDPHP UNIVERSAL BENEFITS INC Q 17355357 ALLOCATION CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC N 1613732 ALLOCATION CAPITAL DISTRICT PHYSICIAN'S HEALTHCARE NETWORK INC O 5611581 ALLOCATION FORM 990, SCHEDULE R, RELATED ORGANIZATIONS CDPHP UNIVERSAL BENEFITS, INC. IS 100% OWNED BY CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK, INC. IS CONSIDERED A RELATED ORGANIZATION TO THE FILING ENTITY THROUGH A BROTHER-SISTER RELATIONSHIP AND IS THEREFORE BEING REPORTED ON SCHEDULE R.