Fallon Community Health Plan Inc.

“FAMILY OR BUSINESS RELATIONSHIP BETWEEN OFFICERS, DIRECTORS, AND KEY EMPLOYEES. HOME STAFF LLC IS A JOINT VENTURE OF FCHP AND THE VNA CARE ADVANTAGE,INC. THE FOLLOWING FCHP OFFICERS SERVED ON THE HOME STAFF BOARD OF DIRECTORS DURING 2017: DAVID PRZESIEK, AND R. SCOTT WALKER. FALLON HEALTH & LIFE ASSURANCE COMPANY, INC. (FHLAC), IS A WHOLLY-OWNED SUBSIDIARY OF FCHP. THE FOLLOWING FCHP BOARD MEMBERS AND OFFICERS SERVED ON THE FHLAC BOARD OF DIRECTORS IN 2017: DAVID HILLIS, LYNDA YOUNG, ANN TRIPP, FREDERICK MISILO, B. JOHN DILL, R. SCOTT WALKER, and Richard p. burke (ex-officio). ULTRABENEFITS, INC. (UBI) IS A WHOLLY-OWNED SUBSIDIARY OF FHLAC. THE FOLLOWING FCHP BOARD MEMBERS AND OFFICERS SERVED ON THE UBI BOARD OF DIRECTORS IN 2017: RICHARD P. BURKE, R. SCOTT WALKER, AND DAVID PRZESIEK. GROUP INSURANCE SERVICE CENTER, (GISC) AND GROUP INSURANCE SERVICE CENTER AGENCY, INC., (GISC AGENCY) ARE WHOLLY -OWNED SUBSIDIARIES OF UBI. UBI ACQUIRED GISC AND GISC AGENCY IN September 2015. THE FOLLOWING FCHP BOARD MEMBERS AND OFFICERS SERVED ON THE BOARD THESE TWO CORPORATIONS IN 2017: RICHARD P. BURKE, DAVID PRZESIEK, kevin grozio, AND R. SCOTT WALKER. FORM 990, PART VI, LINE 11B THE PROCESS USED BY MANAGEMENT AND GOVERNING BODY TO REVIEW FORM 990 A DRAFT OF THE FORM 990 IS PREPARED BY FCHP AND REVIEWED BY ITS TAX CONSULTING FIRM. THE FINAL VERSION OF THE FORM 990 IS PROVIDED TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, LINE 12C THE PROCESS USED TO MONITOR CONFLICTS OF INTEREST 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 PROCESS OF DETERMINING COMPENSATION FOR CEO, TOP MANAGEMENT OFFICIALS, OFFICERS, AND KEY EMPLOYEES. 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 2017, THE COMMITTEE CONSISTED OF FOUR MEMBERS OF FCHP'S BO”

“FORM 990, Part I line 1 Founded in 1977, Fallon Health is a leading health care services organization with a simple-but powerful mission-making our communities healthy. With a focus on improving the health and well-being of the diverse communities we serve, Fallon works to deliver high-quality, affordable care. Fallon offers a full range of commercial products and a wide variety of government programs, including the most options for seniors than any other health plan in the Commonwealth. This enables us to serve members of all ages, at all income levels and with all types of health needs. Activities include innovative health insurance solutions; a variety of Medicaid and Medicare products; unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs; health and wellness programs/events; grants; corporate sponsorships; hunger relief; in-kind donations; advocacy and volunteer hours. Fallon Health is a community-focused, mission-driven organization. Our mission is making our communities healthy, which guides us in improving the health and well-being of the diverse communities we serve. FORM 990, Part III, Line 4A COMMERCIAL PROGRAMS Fallon Health commercial plans are offered through employer groups and, in some cases, can be purchased directly by the consumer. These plans account for 44% of Fallon's membership and covers all counties in Massachusetts with the exception of Barnstable, Duke and Nantucket. Regardless of how they get their coverage, members of Fallon's commercial plans have access to a variety of providers, including individual physicians, group practices, community hospitals and large medical facilities throughout Massachusetts and southern New Hampshire. To help our members manage their health care costs, Fallon offers a unique choice of provider networks. Fallon Health also offers a wide range of care management programs for those with acute, chronic or complex health conditions. These free, voluntary programs are designed to help members improve both their health and quality of life. They're available to members of all Fallon plans (with the exception of our Summit ElderCare participants, who have separate care teams to provide similar services). To best support the changing needs of those we serve, Fallon continues to offer innovations to commercial members including the following: . 2002-Introduced Direct Care, the first limited network product in Massachusetts . 2004-Began reimbursing members for fitness-related activity fees through the It Fits! program-the first health plan in Massachusetts to do so . 2005-Eliminated copays for adult and pediatric preventive care, before it became required by the ACA . 2005-Offered the first qualified high-deductible HMO plans in Massachusetts . 2015-Introduced the Healthy Health Plan, a program to help members meet health and wellness goals . 2016-Developed new hybrid plans for people with chronic conditions like asthma, diabetes and coronary artery disease FORM 990, PART III, LINE 4B Government programs Fallon is the only organization in Massachusetts to offer a full range of commercial health insurance products, along with most government-sponsored programs. These government programs, listed below, account for 31% of Fallon's total membership. . Medicare . Medicaid . Medicare Advantage Special Needs Plan and Senior Care Options program . Program of All-inclusive Care for the Elderly (PACE) . Subsidized, limited-network plan in Central Mass. and Metro West . Managed Long Term Care (MLTC) plan in western New York These programs enable Fallon to serve members of all ages, at all income levels and with all types of health needs. There are several notables when it comes to Fallon's GOVERNMENT PROGRAMS: . FALLON'S MASSHEALTH PLAN IS ONE OF THE HIGHEST-RATED MEDICAID PLANS IN THE COUNTRY. . Fallon is the largest provider of PACE in New England and the fifth largest in the country. Fallon has seven PACE s”

“Community giving Fallon Health started out as a Worcester company, serving the needs of the people in the city and the towns nearby. Our success led to expansion. Today we bring our mission of making our communities healthy to all parts of Massachusetts and western New York State. We are a forward-thinking, cohesive group and work with local providers and leaders in the communities we serve to improve residents' health and well-being, regardless of whether they are Fallon members. We help build healthy communities through our products and services but also our corporate donations-and through the tremendous support, both in-kind and monetary, of our employees. Our community giving includes grants and sponsorships as well as in-kind donations, advocacy and volunteering. We are guided by funding priorities that have been determined in collaboration with our provider partners and other community stakeholders. Through a comprehensive community health needs assessment, the following three funding priorities drove giving in 2017: . Senior health initiatives: Programs that support seniors living safely in their homes and communities, and provide access to care, behavioral health resources, and access to food and utilities. . Children and youth health initiatives: Community-based programs that provide access to programs that wrap services and resources around children and youth. . Food insecurity In 2017, Fallon Health provided $1,236,884 in charitable resources throughout Massachusetts. More than $922,405 of this giving was in grants, direct expenses, leveraged expenses, staff and volunteer time. We also supported other philanthropic initiatives totaling approximately $314,479 in community sponsorships. We personally visited the organizations who serve our most vulnerable citizens to distribute funds and learn more about the region's needs and how we can work together to be a continued resource. This spirit of giving back to the community has been an important feature of Fallon Health's corporate identity for 40 years. Employees throughout the organization are encouraged to volunteer in the community-and are provided eight hours of paid work time to do so. Employees volunteer thousands of hours for initiatives such as the United Way Day of Caring, hunger relief and Working for Worcester. Our employees volunteered 6,428 hours of their time in 2017 - 2,153 hours were for Fallon initiatives. Examples of giving include: . It's a sad reality that students often do not have the food they need after school or in summer. Fallon has responded in an extraordinary, hands-on way by building food pantries in the Worcester Public Schools. It wasn't enough for us to provide funding, we donate food and time to help shop, clean, restore and/or build food pantries. To date, we are very proud to have restored or built pantries at Abby Kelley Foster Charter School, Burncoat Middle High School, Elm Park Community School, Sullivan Middle School and South High School in Worcester. . In addition to food pantries in our schools, Fallon employees built and fully stocked a food pantry at the Boys & Girls Club of Worcester. We also refurbished and completely restocked a food pantry at the South Worcester Neighborhood Improvement Center (SWNIC). We cleaned, painted and completely rehabbed the basement pantry with new shelving and plastic bins for safe and proper food storage and a dehumidifier to address moisture and temperature issues. Recognizing SWNIC did not have proper refrigeration to provide milk and other perishable items to the 300-plus members they serve weekly, Fallon provided a $10,000 grant for them to purchase and install three new commercial-grade freezer/refrigeration units. This allowed the Center to retain much-needed food donations that could have otherwise been turned away. These efforts increased access to food for children and families who use the Center by 42%. . In 2017, we increased our commitment to the Worcester Public Schools by becomi”