Health Partners Plans Inc

“The organization is an affiliate within thomas jefferson university/jefferson health; a comprehensive professional university and tax-exempt integrated healthcare delivery system ("system"). Thomas jefferson university is the tax-exempt parent entity of the system. Although this federal form 990 shows a minority of independent members of the organization's governing body under the internal revenue code definition, this organization acts in a charitable tax-exempt manner for purposes of internal revenue code section 501(c)(4) and is ultimately controlled by thomas jefferson university. Thomas jefferson university is governed by a board whose majority is comprised of independent voting members.”

“JEFFERSON HEALTH - NORTHEAST ("JHNE") MAINTAINED A 75% OWNERSHIP INTEREST IN THE ORGANIZATION. Effective with the close of business on June 30, 2024, JEFFERSON HEALTH - NORTHEAST SYSTEM ("JHNES") was statutorily merged into Jefferson health Corporation ("JHC") and JHC became the sole member of JHNE. ALBERT EINSTEIN MEDICAL CENTER ("AEMC") MAINTAINED A 25% OWNERSHIP INTEREST IN THE ORGANIZATION. JHC IS THE SOLE MEMBER OF AEMC. THOMAS JEFFERSON UNIVERSITY ("TJU") IS THE SOLE MEMBER OF JHC. ULTIMATELY, TJU HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS.”

“The organization's federal form 990 was provided to each voting member of the organization's governing body prior to filing of the form 990 with the internal revenue service ("irs"). As part of the tax return preparation process the organization hired a professional certified public accounting ("cpa") firm with experience and expertise in both healthcare and not-for-profit tax return preparation to prepare the federal form 990. The cpa firm's tax professionals worked closely with the organization's finance personnel and various other individuals ("internal working group") to obtain the information needed in order to prepare a complete and accurate tax return. The cpa firm prepared a draft federal form 990 and furnished it to the internal working group for their review. The internal working group reviewed the draft federal form 990 and discussed questions and comments with the cpa firm. Revisions were made to the draft federal form 990 where necessary and a final draft was furnished by the cpa firm to the internal working group for final review. Following this review, the form 990 was then presented to the organization's audit committee and provided to the organization's governing body prior to filing with the irs.”

“THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WHICH IT REGULARLY MONITORS AND ENFORCES COMPLIANCE. THE CONFLICT-OF-INTEREST (COI) POLICY IS REVIEWED EACH YEAR BEFORE BEING DISTRIBUTED TO THE BOARD OF DIRECTORS AND TO THE HEALTH PARTNERS PLANS, INC. ("HPP") WORKFORCE. THE POLICY ITSELF ASKS FOR POTENTIAL CONFLICTS WHICH ARE THEN REVIEWED BY COUNSEL AND CATEGORIZED INTO WHETHER THE DISCLOSURE IS A CONFLICT THAT IS PROHIBITED, ONE THAT IS NOT PROHIBITED OR NOT A CONFLICT AT ALL, AND, THEN PROVIDE ANY MITIGATION STEPS NECESSARY. For the first quarter of each year, HPP asks the board of directors to review and sign-off on their commitment to maintaining their fiduciary duty to stay impartial, responsible, and dedicated to the good of the organization. This COI policy and disclosure demonstrates their understanding of these responsibilities and ensures that any outside business or financial interests or activities, which conflict or appear to conflict with the interests of the organization, are properly disclosed and managed pursuant to the proper processes. ADDITIONALLY, EACH YEAR HPP HAS THE WORKFORCE/STAFF COMPLETE THE CONFLICT-OF-INTEREST DISCLOSURE STATEMENT AS A PART OF ITS ANNUAL, MANDATORY EMPLOYEE TRAINING AND AWARENESS EFFORTS. ALL BOARD MEMBERS AND THE HPP WORKFORCE ARE REQUIRED TO REVIEW THE EXISTING COI POLICY AND SIGN AN ANNUAL ATTESTATION WHICH AFFIRMS THAT THEY: (A) RECEIVED A COPY OF THIS CONFLICT-OF-INTEREST POLICY; (B) READ AND UNDERSTOOD THE POLICY; (C) AGREE TO COMPLY AND HAVE COMPLIED WITH THE POLICY, AND (D) UNDERSTAND THAT THE ORGANIZATION IS AN IRS 501(C)(4) CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES AND HPP MAY NOT PERMIT ITS INCOME OR ASSETS TO INURE TO THE BENEFIT OF ANY PRIVATE SHAREHOLDER, OWNER MEMBER OR INDIVIDUAL. THE ORGANIZATION FOLLOWED THIS PROCESS FOR ITS COI POLICY IN CALENDAR YEAR 2024.”

“This organization's board of directors has a compensation and evaluation executive committee ("committee"). The committee has adopted a written executive compensation philosophy which it follows when it reviews and approves of the compensation and benefits of the organization's senior management team including, but not limited to, the president & chief executive officer, other officers and certain key employees ("senior management"). The committee reviews the "total compensation" of these individuals which is intended to include both current and deferred compensation and all employee benefits, both qualified and non-qualified. The committee is responsible for assuring that the organization's salary strategies are competitive and consistent with current market trends, in order to provide a stable, qualified and fairly compensated workforce. The actions taken by the committee enable the organization to receive the rebuttable presumption of reasonableness for purposes of internal revenue code section 4958 with respect to the total compensation of certain members of the senior management team. The three factors which must be satisfied in order to receive the rebuttable presumption of reasonableness are the following: 1) the compensation arrangement is approved in advance by an "authorized body" of the applicable tax-exempt organization which is composed entirely of individuals who do not have a "conflict of interest" with respect to the compensation arrangement; 2) the authorized body obtained and relied upon "appropriate data as to comparability" prior to making its determination; and 3) the authorized body "adequately documented the basis for its determination" concurrently with making that determination. The committee is comprised of members of the board of directors each of who are independent and are free from any conflicts of interest with respect to the compensation arrangement. The committee relied upon appropriate comparable data; specifically, the committee engages an independent consultant to provide market data on current, relevant ceos' compensation including one custom survey specifically for hmo executives, in order to make their compensation recommendations. In addition, every other year, the committee engages a benefits consulting firm to provide summarized national data. The consultant's investigation and recommendations reflect board-specific criteria for determining payment levels for both base compensation and incentive compensation. Based on a thorough review and deliberations following the consultant's study, the committee establishes the base compensation and other benefits for the organization's senior management so that they are aligned with current market trends and budgetary considerations. Separately, the committee approves annual incentive targets, performance against those targets, and the computation of the resulting incentive compensation payment. The committee adequately documented its basis for its determination through the timely preparation of written minutes of the compensation committee meetings during which the executive compensation and benefits was reviewed and subsequently approved. The organization's board of directors also approves the minutes of the committee. The actions outlined above with respect to the committee and the establishment of the rebuttable presumption of reasonableness only applies to certain senior management personnel. The compensation and benefits of certain other individuals contained in this form 990 are reviewed annually by the president/chief executive officer with assistance from the organization's human resources department. In conjunction with the individual's job performance during the year, compensation is based upon other objective factors designed to ensure that reasonable and fair market value compensation is paid. Other objective factors include market survey data for comparable positions, individual goals and objectives, personnel reviews, evaluations a”

“The organization's filed certificate of incorporation and any amendments can be obtained and reviewed through the commonwealth of pennsylvania. Other governing documents are available through the office of the secretary of state. In addition, the organization's conflict of interest policy and audited financial statements are available upon request.”

“Joseph g. Cacchione, m.d., john mordach, baligh yehia, m.d. And cristina g. Cavalieri, esq. Are voting members and/or officers of this organization's board of directors; an uncompensated position. These individuals are involved in the leadership and management of thomas jefferson university; a related internal revenue code section 501(c)(3) tax-exempt organization. Accordingly, the common law employer/employee relationship for these individuals is with thomas jefferson university. Their respective reportable compensation, retirement/other deferred compensation and non-taxable benefits are reported within core form, part vii and schedule j of the thomas jefferson university (ein: 23-1352651) federal form 990 for the year ending june 30, 2025. Please refer to the thomas jefferson university federal form 990 for this information.”

“Ramesh j. Vangala, a former key employee of the organization, is still employed within the organization as the vice president, medicaid pharmacy services.”

“The organization is the tax-exempt parent organization of health partners plans, inc. ("hpp") and subsidiaries. Additionally, the organization is an affiliate within thomas jefferson university/jefferson health; a comprehensive professional university and tax-exempt integrated healthcare delivery system ("system"). Certain board of directors members and officers listed on core form, part vii and schedule j of this form 990 may hold similar positions with both this organization and other affiliates within the system. The hours shown on this form 990, for board members who receive no compensation for services rendered in a non-board capacity, represent the estimated hours devoted per week for this organization. To the extent these individuals serve as a member of the governing body of other related organizations within the system, their respective hours per week per organization are approximately the same as reflected in core form, part vii of this form 990. The hours reflected on core form, part vii of this form 990, for board members who receive compensation for services rendered in a non-board capacity or paid officers, reflect total hours worked per week on behalf of the system; not solely this organization.”

“the organization does business under the fictitious name Jefferson Health Plans. Please note, the organization's legal name is still Health Partners Plans, Inc.”

“Health partners plans, inc. ("hpp") is a not-for-profit managed care company that is committed to improving health outcomes for more than 361,000 members. Hpp offers medicaid and chip plans under the health partners plans brand and medicare advantage and individual and family plans (affordable care act plans) under the jefferson health plans brand. Our health partners plans medicaid and health partners plans chip plans are available to qualifying pennsylvania residents. Our jefferson health plans medicare advantage plans are offered in select counties in pennsylvania and new jersey. Our individual and family plans are offered in select counties in pennsylvania. Hpp remains committed to living our mission of building healthier lives and stronger communities. We strive to connect with the hearts and minds of those we serve, improving the health outcomes for our members and operating with respect and dignity. 1) health partners plans medicaid serves pennsylvanians with low or no income and those with disabilities. Hpp serves more than 315,000 medical assistance (medicaid) members throughout pennsylvania. Many of these members are children and adolescents. 2) hpp's children's health insurance program (chip) plan provides coverage for children up to age 19 who are uninsured and not eligible for medical assistance or medicaid. Hpp's chip plan provides access to quality health care to more than 12,000 children and teens. 3) jefferson health plans medicare advantage serves more than 13,000 members in pennsylvania and new jersey. We offer medicare advantage plans to meet members' cost and coverage needs, including prescription drug coverage and a host of other benefits. We also offer a d-snp plan in pennsylvania for people who are eligible for both medicaid and medicare. Our award-winning programs and services are nationally recognized for innovations in managed care. Additionally, we were the first plan in the country to be awarded and continue to hold the national committee on quality assurance's (ncqa) multicultural health care distinction designation. We received the american diabetes association (ada) health champion designation, the modern healthcare best places to work in healthcare distinction and numerous communications awards for member materials and programs. Hpp also received a mhpa best practices award for our oral health initiative. Through the program, members receive physical well-care and dental prevention exams on the same day, at the same place. 4) jefferson health plans individual and family plans serves more than 13,000 members in pennsylvania. We offer a range of gold, silver, and bronze plans for those who do not have health coverage through an employer, medicare, medicaid, or chip. 5) innovative partnerships - deeply engaged in our communities, hpp provides a variety of health and wellness resources including health education, fitness and after-school programs, workshops, health screenings, and sponsorships of youth enrichment programs and non-profit organizations. The company has garnered national attention for innovations in managed care, including our groundbreaking partnership with the metropolitan area neighborhood nutrition alliance (manna). Manna is a nonprofit organization that designs, prepares and delivers nutritious, medically appropriate meals to people battling life-threatening illnesses. Manna is the first agency to publish peer-reviewed research on the impact of medically tailored meals on health care costs. The partnership provides manna's medically tailored meals to hpp's most chronically ill medicaid and medicare members. Hpp was the first health plan to support this endeavor in pennsylvania and is among a small number of managed care organizations in the nation to implement it on a large scale. Health partners presented this partnership at harvard and tulane universities, and at congress' food is medicine working group of the house hunger caucus in washington, d.c. Community engagement our com”

“Line 4a: health partners medicaid --------------------------------- the company provides for the provision of physical health (including mandated behavioral-related pharmaceutical coverage for members as prescribed) medical assistance (ma) program (healthchoices medicaid program) benefits to enrolled ma recipients residing in the commonwealth of pennsylvania (all zones)- pursuant to an agreement with the department of human services of the commonwealth of pennsylvania (dhs). Effective september 1, 2022, the company was selected by dhs as one the managed care organization's (mco) to participate in the state's healthchoices medicaid program in all five of the state's zones (northeast, northwest, southeast, southwest, and lehigh/capital zones). The company's contract with dhs is effective september 1, 2022 and extends the term of the previous healthchoices agreement for a period of five years with an option for renewal for an additional three-year period. As of december 31, 2024 and 2023, there were approximately 315,400 and 338,000 members, respectively, enrolled with health partners under the healthchoices program with 65% and 66%, respectively, of the company's members in philadelphia county. Line 4b: health partners medicare --------------------------------- the company provides comprehensive (physical and behavioral) health insurance through its medicare advantage program and products through a contract with the centers for medicare and medicaid services (cms). The company's program, jefferson health plans medicare, which commenced in 2014, provides for the provision of physical and behavioral health primarily to adults 65 and older. The company offers several hmo products and program benefits to enrolled medicare members residing in pennsylvania and new jersey - pursuant to its agreement with cms. The pennsylvania service area includes philadelphia county and 14 surrounding counties - berks, bucks, carbon, chester, cumberland, dauphin, delaware, lancaster, lebanon, lehigh, montgomery, northampton, perry, and schuylkill. The new jersey service area includes 5 counties - atlantic, burlington, camden, gloucester and mercer counties. As of december 31, 2024 and 2023, there were approximately 13,100 and 13,300 members, respectively, enrolled with jefferson health plans medicare program. Line 4c: kidzpartners (chip) ---------------------------- the company also provides comprehensive (physical and behavioral) health insurance through the commonwealth of pennsylvania's children's health insurance program (chip). The company's chip program, kidzpartners, provides for the provision of physical and behavioral health to uninsured children and teens up to age 19 that are eligible through chip. The company provides program benefits to enrolled chip recipients residing in all 67 counties in pennsylvania pursuant to an agreement with dhs. As of december 31, 2024 and 2023, there were approximately 20,400 and 11,900 members, respectively, enrolled with health partners under the chip program. Line 4d: aca hmo ----------------- the company provides comprehensive (physical and behavioral) health insurance through the affordable care act (aca) marketplace. The company's aca program offers coverage to individuals and families who are eligible under the aca guidelines. The company is committed to ensuring that aca recipients residing in philadelphia, bucks, and montgomery counties have access to high-quality health care, in line with federal and state regulations. As of december 31, 2024, there were approximately 13,000 members enrolled with health partners under the aca program. During 2024 and 2023, approximately 84% and 88%, respectively, of total risk premium revenue was derived from providing medical care pursuant to the healthchoices program contract with dhs.”

“Denise m. Napier, president & ceo, is involved in the leadership and management of this organization on a full-time basis. She is employed by and receives a federal form w-2 from this organization. Accordingly, her common law employer/employee relationship is with health partners plans, inc. (ein: 23-2379751). This organization filed a 2024 form 4720 which included a remittance of excise tax related to ms. Napier's compensation in excess of $1m. Christopher mctiernan is the chief operating officer of this organization. He is employed by and receives a federal form w-2 from this organization. Accordingly, his common law employer/employee relationship is with health partners plans, inc. (ein: 23-2379751). This organization filed a 2024 form 4720 which included a remittance of excise tax related to mr. Mctiernan's compensation in excess of $1m. Kevin clancy is the chief financial officer of this organization. He is employed by and receives a federal form w-2 from this organization. Accordingly, his common law employer/employee relationship is with health partners plans, inc. (ein: 23-2379751). This organization filed a 2024 form 4720 which included a remittance of excise tax related to mr. Clancy's compensation in excess of $1m.”

“AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM AUDITED THE STATUTORY BASIS FINANCIAL STATEMENTS OF HEALTH PARTNERS PLANS, INC. FOR YEARS ENDED DECEMBER 31, 2024 and DECEMBER 31, 2023; RESPECTIVELY. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED STATUTORY BASIS FINANCIAL STATEMENTS EACH YEAR. THE GOVERNING BODY OF HEALTH PARTNERS PLANS, INC. ("HPP"), ITS BOARD OF DIRECTORS, HAS AN AUDIT COMMITTEE. THE HPP AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. The organization is an affiliate within thomas jefferson university/jefferson health; a comprehensive professional university and tax-exempt integrated healthcare delivery system ("system"), with a tripartite mission of education, research and patient care. The system's parent entity is thomas jefferson university ("tju"). An independent certified public accounting ("cpa") firm audited the consolidated financial statements of the system for the fiscal years ended june 30, 2024 and june 30, 2023; respectively and issued a consolidated audited financial statement. An unmodified opinion was issued each year by the independent cpa firm. Similar audited consolidated financial statements of the system will be issued for the fiscal year ending june 30, 2025.”

“The organization is the tax-exempt parent organization of health partners plans, inc. And subsidiaries. Additionally, the organization is an affiliate within thomas jefferson university/jefferson health; a comprehensive prfoessional university and tax-exempt integrated healthcare delivery system ("system"). The system engaged an independent accounting firm to prepare and issue a system wide consolidated audit as set forth in the uniform guidance, 2 c.f.r., part 200, subpart f. 200, subpart f.”