Healthfirst Phsp Inc.

“Healthfirst phsp, inc. Is a new york state not-for-profit membership corporation. Healthfirst phsp's sole corporate member is healthfirst, inc.”

“Healthfirst phsp, inc. (phsp) is a new york state not-for-profit membership corporation. Healthfirst phsp's sole corporate member is healthfirst, inc. Healthfirst, inc. Has the right to appoint members to the board of directors of phsp.”

“The amendment of the organization's governing documents is subject to the approval of healthfirst, inc. Some of the decisions of the governing body, should they occur, are subject to approval by state regulators: * distribution of the organization's net assets * certain changes to premium rates * expansion to other managed care businesses * specific types of changes to the organization's benefit plans * management fee rate changes [approval is also required from the management company]”

“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.”

“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 permitted 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. A report of any conflicts is prepared for discussion with audit and compliance committee of the board of directors of healthfirst, inc., the not for profit corporate parent, as well as the full board of directors of healthfirst phsp, inc. As appropriate. 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.”

“Because the reporting organization did not compensate any officer or employee, the reporting 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, the management company that provides all services to phsp (a related organization). 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.”

“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.”

“HEALTH AND RECOVERY PLAN (HARP): HEALTHFIRST PHSP, INC. (PHSP) IS A LICENSED PREPAID HEALTH SERVICES PLAN THAT PROVIDES COMPREHENSIVE PREPAID HEALTH CARE COVERAGE TO MEDICAID ELIGIBLE INDIVIDUALS THAT HAVE SERIOUS BEHAVIORAL HEALTH DIAGNOSES. THE HARP PROGRAM WAS INTRODUCED IN 2015 AND IS A MANAGED CARE PROGRAM WITHIN MEDICAID. Qualified Health Plans (QHP): In 2014, PHSP established a Qualified Health Plan ("QHP") under the Health Care Reform, which is certified by the New York State Health Insurance Marketplace ("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. QHP is administered under an agreement between PHSP and the DOH that extends through December 31, 2018. CHILD HEALTH PLUS (CHP): THE ORGANIZATION IS A LICENSED PREPAID HEALTH SERVICES PLAN THAT PROVIDES COMPREHENSIVE PREPAID HEALTH CARE COVERAGE TO CHP RECIPIENTS PURSUANT TO ARTICLE 44 OF THE NEW YORK STATE PUBLIC HEALTH LAW. PHSP HAS PARTICIPATED IN NEW YORK'S CHP PROGRAM SINCE 1997. BASIC HEALTH PLANS (BHP): HEALTHFIRST PHSP, INC. (PHSP) IS A LICENSED PREPAID HEALTH SERVICES PLAN THAT PROVIDES STANDARD HEALTH PLAN COVERAGE TO ELIGIBLE INDIVIDUALS WHO WOULD NOT HAVE ACCESS TO COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE. PHSP UNDERTOOK NEW YORK'S BHP PROGRAM AS OF 2015. FORM 990, PART V, LINE 1c In 2018 it came to our attention that our processes for backup withholding were not fully effective. In January 2019 the Organization made the necessary changes to those processes in order to ensure the proper backup withholding is taking place, when required. FORM 990, PART VI, SECTION A, LINE 3 HEALTHFIRST PHSP, INC. (PHSP) CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS) TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. PHSP DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE; THESE ARE PROVIDED BY HFMS. HFMS CHARGES A PERCENT OF PREMIUM ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH. THE ARRANGEMENT IS APPROVED BY RESOLUTION OF THE BOARD OF DIRECTORS AND THE NY STATE DEPARTMENT OF HEALTH. 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 PHSP. RESOLUTION OF THE BOARD OF DIRECTORS AND THE NY STATE DEPARTMENT OF HEALTH. 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 PHSP.”

“EQUITY LOSS IN INVESTMENT IN HEALTHFIRST INSURANCE CO. INC., A 50% OWNED SUBSIDIARY ($2,342,563). Increase in Retained hospital payments $24,979,502.”