Affinity Health Plan Inc.

“FORM 990, PART I, LINE 1 AND PART III, LINE 1 THE MISSION OF AFFINITY HEALTH PLAN IS TO IMPROVE THE HEALTH AND WELL-BEING OF ITS MEMBERS, THEIR FAMILIES, AND THEIR COMMUNITIES IN COLLABORATION WITH PRIMARY CARE PROVIDERS. AFFINITY STRIVES TO BE THE HEALTH PLAN OF CHOICE FOR ITS MEMBERS AND ITS PROVIDERS -- KNOWN FOR ASSURING ACCESS TO HIGH QUALITY, COST-EFFECTIVE CARE; DELIVERING THE BEST CUSTOMER EXPERIENCE; AND CONTRIBUTING SIGNIFICANTLY TO ACHIEVING A PATIENT-CENTERED HEALTH CARE SYSTEM. CEASED ACTIVITIES FORM 990, PART III, LINE 3 AND LINE 4D MEDICARE PROGRAM - THE MEDICARE ADVANTAGE PROGRAM WAS FUNDED BY CMS TO MANAGE THE HEALTHCARE AND RELATED COSTS OF MEDICARE PATIENTS IN NEW YORK CITY AND THE SURROUNDING COUNTIES OF NASSAU, SUFFOLK, WESTCHESTER, ROCKLAND AND ORANGE COUNTY. MEDICARE ADVANTAGE INCLUDED AFFINITY MEDICARE ULTIMATE, SOLUTIONS, PASSPORT ESSENTIALS, PASSPORT ESSENTIALS SELECT AND PASSPORT ESSENTIALS NYC. AFFINITY EXITED THE MEDICARE PROGRAM AS OF 1/1/2019. PROGRAM SERVICES ACCOMPLISHMENTS FORM 990, PART III, LINE 4D CHILD HEALTH PLUS PROGRAM - CHP is available to children under the age of 19 who are not eligible for Medicaid and who do not already have comprehensive health coverage. The premium received by the Plan depends upon income (some participants are fully subsidized). The Plan's current agreement for CHP with NYSDOH extends through September 30, 2019. CHANGE IN BYLAWS FORM 990, PART VI, LINE 4 IN NOVEMBER 2019, THE AFFINITY BOARD OF DIRECTORS AMENDED THE AFFINITY BYLAWS TO ESTABLISH A CLASS OF ORGANIZATIONAL MEMBERS CONSISTING OF SIX FEDERALLY QUALIFIED HEALTH CENTERS. THE PURPOSE OF THIS ACTION WAS TO HARMONIZE AFFINITY'S CERTIFICATE OF INCORPORATION AND ITS BYLAWS. FORM 990 REVIEW FORM 990, PART VI, LINE 11B THE FINANCIAL STAFF COMPILES THE FINANCIAL AND OTHER INFORMATION REQUIRED IN THE 990 RETURN. KPMG, LLP PREPARES THE RETURN AND THE INFORMATION IS REVIEWED BY THE COMPANY'S CFO AND VP/CONTROLLER. A FINAL COPY OF THE FORM 990 IS MADE AVAILABLE TO THE ENTIRE GOVERNING BODY BEFORE FILING WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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. IF A CONFLICT OF INTEREST IS FOUND, PERSONS WITH A CONFLICT RECUSE THEMSELVES FROM DECISIONS RELATED TO THE CONFLICT.”

“Form 990, part vi, questions 15a and 15b the process for determining compensation for the ceo and cfo include the 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: a) 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 have 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) compensation decisions applicable for other officers and key employees, including incentive bonuses, merit increases, promotional 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. Compensation decisions impacting those of the foregoing positions that are also deemed to be "disqualified persons" under the internal revenue code (e.g., 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). Document disclosure form 990, part vi, question 19 the organization makes its governing documents, conflict of interest policy, and financial statements available upon request.”

“Description:beacon ibnr expense total expenses:95226548 program services:95226548”

“Description:emergency room claims total expenses:xxx-xx-xxxx program services:xxx-xx-xxxx”

“Description:emergency room hcra total expenses:1806037 program services:1806037”

“Description:profession service-ibnr total expenses:-11954199 program services:-11954199”

“Description:share savings expense total expenses:3146594 program services:3146594”

“Description:outpatient claims-ibnr total expenses:-15704053 program services:-15704053”

“Description:outpatient non valuated expens total expenses:1794223 program services:1794223”

“Description:other professional services - total expenses:xxx-xx-xxxx program services:xxx-xx-xxxx”

“Description:other professional svc-hcra total expenses:3318777 program services:3318777”

“Description:third party recoveries - reins total expenses:-19343252 program services:-19343252”

“Description:health home claims total expenses:16275905 program services:16275905”

“Description:dental capitation total expenses:25941921 program services:25941921”

“Description:behavioral health capitation total expenses:895850 program services:895850”

“Description:dental hcra total expenses:186834 program services:186834”

“Description:beacon hcra total expenses:1418830 program services:1418830”

“Description:diagnostic test lab & x-ray cl total expenses:31809327 program services:31809327”

“Description:lab hcra total expenses:2427978 program services:2427978”

“Description:diagnostic test lab-monte total expenses:17945 program services:17945”

“Description:family planning total expenses:141 program services:141”

“Description:nursing facility total expenses:2047864 program services:2047864”

“Description:transportation non-emergent total expenses:-30635 program services:-30635”

“Description:vision capitation total expenses:3210241 program services:3210241”

“Description:outpatient physical therapy total expenses:1319 program services:1319”

“Description:chiropractic total expenses:264928 program services:264928”

“Description:acupuncture total expenses:359 program services:359”

“Description:dme, medical supplies total expenses:435 program services:435”

“Description:ambulatory surgery total expenses:18880 program services:18880”

“Description:home health care total expenses:55 program services:55”

“Description:other medical total expenses:1008334 program services:1008334”

“Description:prenatal/postpartum care total expenses:1208 program services:1208”

“Description:medicaid stop loss insurance total expenses:15116716 program services:15116716”

“Description:covered lives total expenses:6027117 program services:6027117”