Affinity Health Plan Inc.

“FORM 990, PART III, LINE 2 THE PLAN ESTABLISHED A QUALIFIED HEALTH PLAN (QHP) UNDER HEALTH CARE REFORM, WHICH IS CERTIFIED BY THE NEW YORK STATE HEALTH INSURANCE MARKETPLACE. QHP PROVIDES ESSENTIAL HEALTH BENEFITS, FOLLOWS ESTABLISHED LIMITS ON COST-SHARING (DEDUCTIBLE, COPAYMENT AND OUT-OF-POCKET MAXIMUM AMOUNTS), AND MUST MAINTAIN COMPLIANCE WITH OTHER PROVISIONS OF HEALTH CARE REFORM. COVERAGE FOR QHP MEMBERS BEGAN JANUARY 1, 2014 FORM 990, PART III LINE 3 THE PLAN'S FAMILY HEALTH PLUS (FHP) PROGRAM BEGAN OPERATIONS ON OCTOBER 1, 2001. FHP PROVIDES HEALTH INSURANCE COVERAGE FOR LOW-INCOME SINGLE ADULTS AND ADULTS WITH CHILDREN. THE FHP PROGRAM IS ADMINISTERED UNDER THE SAME AGREEMENT AS THE MEDICAID PROGRAM. THE FHP PROGRAM ENDED ON DECEMBER 31, 2014, AND NO COVERAGE WILL BE AUTHORIZED PAST THAT DATE. FORM 990, PART III LINE 4d THE CHILD HEALTH PLUS (CHP) PROGRAM IS FUNDED BY THE STATE OF NEW YORK TO PROVIDE HEALTH INSURANCE COVERAGE FOR CHILDREN THAT ARE UNDER THE AGE OF 19. START UP COST FOR TWO PROGRAMS MEDICAL LONG TERM CARE AND THE QUALITY HEALTH PLAN. THE PLAN ESTABLISHED A QUALIFIED HEALTH PLAN (QHP) UNDER HEALTH CARE REFORM, WHICH IS CERTIFIED BY THE NEW YORK STATE HEALTH INSURANCE MARKETPLACE. QHP PROVIDES ESSENTIAL HEALTH BENEFITS, FOLLOWS ESTABLISHED LIMITS ON COST-SHARING (DEDUCTIBLE, COPAYMENT AND OUT-OF-POCKET MAXIMUM AMOUNTS), AND MUST MAINTAIN COMPLIANCE WITH OTHER PROVISIONS OF HEALTH CARE REFORM. COVERAGE FOR QHP MEMBERS BEGAN JANUARY 1, 2014.”

“Form 990, part vi, line 11b the financial staff compiles the financial and other information required in the 990 return. Ernst & young, llp, prepares the return and the information is reviewed by the company's cfo. A final copy of the form 990 is made available to the entire governing body before filing.”

“Form 990, part vi, question 12c 1. Actual or potential conflicts of interest must be disclosed to appropriate management personnel, human resources or the corporate compliance officer. 2. Employees must seek guidance and approval from appropriate management personnel prior to pursuing any business or personal activity that may constitute a conflict of interest. 3. Management, with purchasing authority, will complete a related party questionnaire annually to identify any potential or actual conflicts of interest. 4. Employees, upon hire and annually thereafter, review the code of ethics which includes information on conflicts of interest. In addition, employees are required to sign an attestation upon hire and annually thereafter, that they acknowledge and understood the code of ethics.”

“Form 990, part vi, question 15a and 15b the process for determining compensation for the ceo, cfo and coo included review and approval by a compensation committee (the "committee") comprised of independent directors charged with this responsibility, consideration of comparability data and contemporaneous substantiation and documentation of the deliberation and decision. Affinity health plan's compensation program for these positions and other officers and key employees includes established policies for job evaluation using a point factor system; merit increases; and salary actions associated with new hires, promotions, transfers and demotions. Specifically, for: a) the ceo - compensation for the chief executive officer is established by the compensation committee and ratified by the board of directors of affinity health plan. The board and the committee has established compensation terms for the ceo considering comparability data for ceo positions in similar organizations in their deliberations and decision making. These decisions are documented in accordance with legal requirements and best practices. B) other officers and key employees - jobs held by other officers and jobs held by key employees are evaluated using the point factor job evaluation process applicable to all jobs at affinity health plan. Based on the point factor evaluation, jobs are placed in a salary grade. Merit increases are awarded based on performance after a formal year end performance evaluation. This program applies to all employees including other officers and key employees. Discretionary compensation decisions applicable for other officers and key employees, including promotional salary adjustments, market/equity salary adjustments and starting salaries for newly hired officers and key employees are made after review of comparability data from published sources for similar positions in the relevant labor market. Published comparability data utilized includes industry specific data. Internal data is reviewed as well with the objective of ensuring internal equity with similarly situated staff. Discretionary compensation decisions impacting those of the foregoing positions that are also deemed to be "disqualified persons" under the internal revenue code (e.g., chief operating officer and chief financial officer) are made by the committee (and ratified by the board) in accordance with "intermediate sanctions safe harbor" standards utilizing the same processes as are applied to the ceo (discussed above).”

“Form 990, Part VI, Question 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.”

“Description:professional costs total expenses:116006222 program services:116006222”

“Description:radiology/lab & diagnostic total expenses:78404270 program services:78404270”

“Description:medicaid total expenses:48692654 program services:48692654”

“Description:emergency room total expenses:38915322 program services:38915322”

“Description:dental total expenses:38237242 program services:38237242”

“Description:surgical total expenses:18201215 program services:18201215”

“Description:vision total expenses:3823366 program services:3823366”

“Description:behavioral total expenses:3424390 program services:3424390”

“Description:transportation total expenses:3393757 program services:3393757”

“Description:nursing total expenses:2758582 program services:2758582”

“Description:covered lives total expenses:1443377 program services:1443377”

“Description:beacon total expenses:1130860 program services:1130860”

“Description:family planning total expenses:1075326 program services:1075326”

“Description:ambulatory total expenses:237308 program services:237308”

“Description:outpatient claims total expenses:172036 program services:172036”

“Description:other medical total expenses:56847 program services:56847”

“Description:prenatal total expenses:19301 program services:19301”

“Description:medical supplies total expenses:6514 program services:6514”

“Description:home healthcare total expenses:1388 program services:1388”

“Description:third party recoveries total expenses:-30424130 program services:-30424130”