Fallon Community Health Plan Inc.

“FORM 990, PART I, LINE 1 FALLON COMMUNITY HEALTH PLAN'S MISSION IS MAKING OUR COMMUNITIES HEALTHY. FCHP IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES THROUGH THE DELIVERY OF HIGH QUALITY, AFFORDABLE CARE. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A FCHP'S PROGRAM ACTIVITIES CONSIST OF PREPAID HEALTHCARE IN THE COMMONWEALTH OF MASSACHUSETTS. THE COVERED POPULATION AT DECEMBER 31, 2013 WAS 155,395. FALLON COMMUNITY HEALTH PLAN MADE OVER $1,432,734 AVAILABLE TO PROGRAMS THAT MAKE OUR COMMUNITIES HEALTHY. THIS WAS ACCOMPLISHED THROUGH THE DISTRIBUTION OF GRANTS, CHARITABLE DONATIONS, COMMUNITY BENEFIT PROGRAMS, FUNDRAISING EVENTS, AND EMPLOYEE VOLUNTEERISM. FALLON COMMUNITY HEALTH PLAN 2013 Community Benefits Report Summary Narratives Community Benefits Mission Statement February 2, 2014, Fallon Community Health Plan officially announced our rebrand to Fallon Health. This reflects our evolving business in the rapidly changing health care industry. Fallon Health is committed to the vision of creating healthier lives. Since its inception in 1977, Fallon has worked to improve the quality of life and the health status of individuals by offering access to high-quality, affordable medical care and services. Fallon Health will work cooperatively with health care and community service organizations, as well as state and federal agencies, to lead the creation of innovative health care solutions, to seek healthy outcomes, and to improve access to health care services. Fallon will make resources available to community organizations as appropriate in pursuit of these goals. Program Organization and Management In accordance with the Attorney General's Community Benefits Guidelines for Health Maintenance Organizations, Fallon's Board of Directors and its President and CEO appointed Fallon staff and community representatives to serve a three-year term on the Community Benefits Committee to oversee the continued development and implementation of the Community Benefits Program. The Committee is managed by the Director of Community Relations, and reports to the Senior Vice President and Chief Communications Officer. All grant applications are reviewed by the Committee and given final approval by the President and CEO before funds are distributed. This ensures regular evaluation and oversight of the program. Community Health Needs Assessment In 2013, Fallon undertook a review of its Community Benefits Program, assessing both its goals and its grant-making methods. Using community health data and other leading health indicator studies, Fallon convened a Needs Assessment committee to review this data, and data provided by other community agencies, to gain an understanding of the most critical issues affecting communities across Massachusetts and the populations that are most in need. In response to the information gathered during this process, the Community Benefits Program adopted two new areas of focus, which are: 1. Promoting opportunities for at-risk/proven risk youth and young adults between the ages of 12 to 21 with a specific emphasis on youth preparing to age-out of the system and lose services. 2. Providing services to support individuals with behavioral and/or mental health issues with a specific emphasis on addressing the needs of the most vulnerable groups by their ethnicity, age, demographics and risk-factors. Fallon Health's Community Benefits Committee has adopted the following funding priorities for the next three years from 2013 - 2016 : (1) Good nutrition and physical activity; (2) Good health for seniors; (3) Promoting opportunities for at-risk/proven risk youth and young adults between the ages of 12-21 with a specific emphasis on youth preparing to age-out of the system and lose services; (4) Providing services to support individuals with behavioral and/or mental health issues with a specific emphasis on addressing the needs of the most vulnerable groups by their ethnicity, age, demographics”

“Form 990, part vi, line 2 home staff llc is a joint venture of fchp and the vna care network & hospice. The following fchp board members, officers, and key employees served on the home staff board of directors during 2013: w. Patrick hughes, richard p. Burke, and todd baily. Fallon health & life assurance company, inc. (fhlac), is a wholly-owned subsidiary of fchp. The following fchp board members, officers, and key employees served on the fhlac board of directors in 2013: david hillis, lynda young, christian mccarthy, richard burke, w. Patrick hughes, and r. Scott walker. Ultrabenefits, inc. (ubi) is a wholly-owned subsidiary of fhlac. The following fchp board members, officers, and key employees served on the ubi board of directors in 2013: w. Patrick hughes, r. Scott walker, and david przesiek. Process used by management and governing body to review 990 form 990, part vi, line 11b a draft of the form 990 was prepared by fchp's paid preparer using information provided by the organization. This draft was reviewed by fchp's vice president of accounting operations & financial planning analysis, and senior management, including the chief financial officer, chief compliance officer, chief human resources officer, and chief executive officer. After this review a final form 990 was prepared, and the final version of the form 990 was provided to each board member for his or her review before the form 990 was filed with the irs.”

“Form 990, part vi, lines 12a, b, c fchp's bylaws require all directors and officers to disclose any actual or possible conflicts of interest, as defined in the organization's conflict of interest policy relating to directors, officers and members of a committee with board-delegated powers. This is enforced by the requirement that such individuals annually complete a conflict of interest disclosure statement. Each year the completed conflict of interest disclosure statements are reviewed by the audit and compliance committee of the board which reports any actual or potential conflicts to the full board. Any board member or officer with a conflict of interest is prohibited from participating in any discussion of, or vote on, the transaction or arrangement that results in the conflict of interest. Two independent board members also conduct an annual review of any business transactions involving the organization that could potentially benefit a board member or officer, to ensure that the transactions do not involve any undue influence, are at fair market value, and are in the organization's best interest. The reviewing board members report their findings to the full board. Furthermore, at board meetings, individual board members are asked to identify, and recuse themselves from any discussion and vote on any matter before the board in which they may have a conflict. Fchp also requires all directors, officers, and key employees, to complete a written disclosure statement designed to identify potential conflicts. Fchp also has general corporate-wide conflict of interest policies that require reporting of potential conflicts and management approval of certain transactions, and prohibits certain specific transactions. These policies are enforced by senior management, including the chief compliance officer.”

“FORM 990, PART VI, LINES 15A & 15b FCHP HAS ESTABLISHED AN EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS THAT ESTABLISHES POLICIES AND THE COMPENSATION STRUCTURE OF CERTAIN FCHP EXECUTIVE OFFICERS. THIS COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE EXECUTIVE OFFICERS IS DETERMINED BY A FAIR AND EQUITABLE PROCESS, INFORMED BY CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION, AND COMPLIANT WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN 2013, THE COMMITTEE CONSISTED OF THREE MEMBERS OF FCHP'S BOARD OF DIRECTORS, WHO ARE NOT EMPLOYED BY THE ORGANIZATION. FCHP'S CEO SERVED AS AN EX OFFICIO MEMBER OF THE COMMITTEE WITHOUT A VOTING RIGHT. THE EXECUTIVE OFFICERS OVER WHOSE COMPENSATION THE COMMITTEE IS RESPONSIBLE ARE COMPRISED OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER ("CEO"), AND THE PRESIDENT, EXECUTIVE VICE PRESIDENT, AND SENIOR VICE PRESIDENT POSITIONS THAT REPORT DIRECTLY TO THE CEO ("EXECUTIVE GROUP"). IN 2013, TO DETERMINE THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP, THE COMMITTEE RELIED ON A WRITTEN COMPENSATION SURVEY PRODUCED BY AN INDEPENDENT CONSULTING FIRM THAT ASSESSES EXECUTIVE COMPENSATION AND BENEFITS. THE COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP AND REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT CONSULTING FIRM. THE COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION OF THE EXECUTIVE GROUP (OTHER THAN THE CEO). FOR THE CEO'S COMPENSATION THE COMMITTEE (MEETING WITHOUT THE CEO) RECOMMENDED A COMPENSATION STRUCTURE THAT WAS PRESENTED TO THE FCHP'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS (WITHOUT THE CEO PRESENT), VOTED TO APPROVE THE COMMITTEE'S RECOMMENDATION. ALL THESE DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES OF THE COMMITTEE AND BOARD OF DIRECTORS. THE PROCESS WAS USED TO ESTABLISH THE COMPENSATION FOR THE EXECUTIVE GROUP IN 2013. THIS PROCESS WAS NOT USED TO ESTABLISH COMPENSATION FOR THE "KEY EMPLOYEES" LISTED IN SCHEDULE J.”

“Form 990, part vi, lines 18 and 19 fchp's form 990 and annual audited financial statements are available to the general public on the massachusetts attorney general's website. Fchp's annual report is available on its own website. Fchp's 990, financial statements, governing documents, conflict of interest policy, and annual report are also provided upon request.”