Civic Intelligence

Fallon Community Health Plan Inc.

990 • Fiscal year 2019 • EIN 23-7442369

Jan 01, 2019 to Dec 31, 2019 • Filed on Nov 05, 2020

10 Chestnut StreetWorcester, MA 01608

(508) 799-2100

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

79th percentile

0.61x

Higher debt load relative to assets than 79% of similar nonprofits.

2019 filings • 501(c)3 • $1B+ nonprofits • Source year 2019

Liabilities / Revenue

15th percentile

0.18x

Higher debt load relative to revenue than 15% of similar nonprofits.

2019 filings • 501(c)3 • $1B+ nonprofits • Source year 2019

Net Margin

14th percentile

-1.7%

Higher net margin than 14% of similar nonprofits.

2019 filings • 501(c)3 • $1B+ nonprofits • Source year 2019

Top Officer Pay

29th percentile

$1,133,846

Higher top officer pay than 29% of similar nonprofits.

Top officer pay equals 0.1% of source-year revenue.

2019 filings • 501(c)3 • $1B+ nonprofits • Source year 2019

Asset Growth

54th percentile

7.2%

Faster asset growth than 54% of similar nonprofits.

2019 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2018 to 2019

Revenue Growth

40th percentile

4.2%

Faster revenue growth than 40% of similar nonprofits.

2019 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2018 to 2019

Assets

Up

$461,233,945

Up $31,130,642 (+7.2%) from 2018

Net Assets

Down

$178,299,201

Down $11,063,701 (-5.8%) from 2018

Liabilities

Up

$282,934,744

Up $42,194,343 (+18%) from 2018

Revenue

Up

$1,580,533,789

Up $63,095,798 (+4.2%) from 2018

Expenses

Up

$1,607,012,434

Up $96,501,986 (+6.4%) from 2018

Net Income

Down

-$26,478,645

Down $33,406,188 (-482%) from 2018

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$800M$600M$400M$200M$0Assets 2010: $337,631,320Liabilities 2010: $202,819,067Net Assets 2010: $134,812,2532010Assets 2011: $382,846,207Liabilities 2011: $214,091,419Net Assets 2011: $168,754,7882011Assets 2012: $411,842,860Liabilities 2012: $212,953,155Net Assets 2012: $198,889,7052012Assets 2013: $433,899,893Liabilities 2013: $222,514,100Net Assets 2013: $211,385,7932013Assets 2014: $426,331,585Liabilities 2014: $210,179,455Net Assets 2014: $216,152,1302014Assets 2015: $390,921,976Liabilities 2015: $199,328,411Net Assets 2015: $191,593,5652015Assets 2016: $373,352,982Liabilities 2016: $196,129,314Net Assets 2016: $177,223,6682016Assets 2017: $411,987,684Liabilities 2017: $217,867,796Net Assets 2017: $194,119,8882017Assets 2018: $430,103,303Liabilities 2018: $240,740,401Net Assets 2018: $189,362,9022018Assets 2019: $461,233,945Liabilities 2019: $282,934,744Net Assets 2019: $178,299,2012019Assets 2020: $617,122,763Liabilities 2020: $347,691,090Net Assets 2020: $269,431,6732020Assets 2021: $712,896,484Liabilities 2021: $407,624,403Net Assets 2021: $305,272,0812021Assets 2022: $698,844,489Liabilities 2022: $442,003,253Net Assets 2022: $256,841,2362022Assets 2023: $759,646,277Liabilities 2023: $543,577,481Net Assets 2023: $216,068,7962023Assets 2024: $671,148,566Liabilities 2024: $485,208,018Net Assets 2024: $185,940,5482024

Highlighted filing

2019

Assets$461,233,945
Liabilities$282,934,744
Net Assets$178,299,201

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$2.0B$1.5B$1.0B$500M$0-$500MExpenses 2010: $1,106,441,2552010Expenses 2011: $1,065,335,9462011Expenses 2012: $1,105,510,2462012Revenue 2013: $1,199,857,993Expenses 2013: $1,186,618,425Net Income 2013: $13,239,5682013Revenue 2014: $1,095,830,174Expenses 2014: $1,092,277,125Net Income 2014: $3,553,0492014Revenue 2015: $1,091,448,559Expenses 2015: $1,098,210,973Net Income 2015: -$6,762,4142015Revenue 2016: $1,156,986,586Expenses 2016: $1,177,082,041Net Income 2016: -$20,095,4552016Revenue 2017: $1,245,428,878Expenses 2017: $1,237,526,440Net Income 2017: $7,902,4382017Revenue 2018: $1,517,437,991Expenses 2018: $1,510,510,448Net Income 2018: $6,927,5432018Revenue 2019: $1,580,533,789Expenses 2019: $1,607,012,434Net Income 2019: -$26,478,6452019Revenue 2020: $1,643,963,728Expenses 2020: $1,568,643,154Net Income 2020: $75,320,5742020Revenue 2021: $1,782,502,394Expenses 2021: $1,746,369,608Net Income 2021: $36,132,7862021Revenue 2022: $1,747,343,886Expenses 2022: $1,729,040,635Net Income 2022: $18,303,2512022Revenue 2023: $1,751,638,657Expenses 2023: $1,817,937,230Net Income 2023: -$66,298,5732023Revenue 2024: $1,840,780,285Expenses 2024: $1,862,403,604Net Income 2024: -$21,623,3192024

Highlighted filing

2019

Revenue$1,580,533,789
Expenses$1,607,012,434
Net Income-$26,478,645
Jump To
Filing Snapshot
Filing Period
Jan 1, 2019 to Dec 31, 2019
Signed
Nov 5, 2020
Return Version
2019v5.1
Gross Receipts
$1,847,074,151
Mission and Program Overview

Mission

Fallon health's mission is to make our communities healthy by improving the health and well-being of the diverse communities we serve.

SEE SCHEDULE O making our communities healthy

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$272,309,963$314,369,822▲ $42,059,859
Accounts Receivable$49,709,416$79,025,948▲ $29,316,532
Savings and Temporary Cash Investments$65,993,120$23,402,979▼ $42,590,141
Land, Buildings, and Equipment, Net$14,148,512$11,706,579▼ $2,441,933
Prepaid Expenses and Deferred Charges$7,273,115$8,391,131▲ $1,118,016
Inventories for Sale or Use$10,731$26,612▲ $15,881
Cash and Non-Interest-Bearing Accounts$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Intangible Assets$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$430,103,303$461,233,945▲ $31,130,642
Other Assets Total$20,658,446$24,310,874▲ $3,652,428
Liabilities
Accounts Payable and Accrued Expenses$221,678,250$271,753,335▲ $50,075,085
Deferred Revenue$19,062,151$11,181,409▼ $7,880,742
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$240,740,401$282,934,744▲ $42,194,343
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$189,362,902$178,299,201▼ $11,063,701
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$189,362,902$178,299,201▼ $11,063,701
Total Liabilities and Net Assets / Fund Balance$430,103,303$461,233,945▲ $31,130,642

Asset Categories

AssetBook ValueDepreciationBasis
Other Land Buildings$8,837,187$65,404,335$74,241,522
Equipment$2,151,603$6,263,560$8,415,163
Leasehold Improvements$717,789$3,096,824$3,814,613
Other Assets Org$10,845,998--
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Richard P BurkePresident & CEOFT$665,125$468,721$1,133,846
Carolyn Langer MdSVP, Chief Med OfficerFT$397,579$122,654$520,233
David PrzesiekSVP, Chief Sales OfficerFT$333,229$178,880$512,109
Emily WestSVP, Chief Operating OfficerFT$297,113$151,315$448,428
Jill LebowSVP, Chief Hr OfficerFT$281,469$136,281$417,750
Robert Schreiber MdVP, Medical DirectorFT$304,799$100,637$405,436
Mary RitterSVP, Strat & Bus DevelopmentFT$285,079$115,654$400,733
Linda Weinreb MdMedical Director, Mcd AcoFT$291,910$108,324$400,234
David Brumley MdVP, Medical AffairsFT$294,367$103,188$397,555
Christine CassidySVP, Chief Comm. OfficerFT$240,862$125,853$366,715
Perry Farb MdPace Associate Medical DirectorFT$278,964$73,217$352,181
Janis LiepinsVP, Product ManagementFT$259,772$88,246$348,018
Elizabeth HeleniusVP, SalesFT$194,199$148,820$343,019
James GentileSVP, Chief Compliance OfficerFT$234,842$105,237$340,079
Kevin McGovernVP, TreasurerFT$237,259$87,417$324,676
John BudajVP, Information TechnologyFT$240,891$56,678$297,569
Michael NickeyVP, State Prog. Until 11/29/19FT$220,425$71,418$291,843
Lisa CohenInterim CFO, 6/11/19-8/25/19FT$201,024$77,686$278,710
Andre GabryjelskiDir, Medicare AdvantageFT$136,387$136,644$273,031
Kevin GrozioCFO Until 6/10/19FT$156,749$80,004$236,753
Deborah DaviauExecutive Director, NavicareFT$171,258$45,507$216,765
Todd BaileySVP, CFO, Effective 8/25/19FT$125,534$51,550$177,084
Frederick Misilo EsqChair-$54,500-$54,500
B John DillVice Chair-$40,750-$40,750
James BuonomoClerk-$40,000-$40,000
Ann K TrippTreasurer-$39,250-$39,250
Janet S RicoDirector-$37,250-$37,250
David Friend Mddirector-$27,750-$27,750
Joseph N Stolberg CPDirector-$27,750-$27,750
Peter StraleyDirector-$27,750-$27,750
Karin LandryDirector-$26,750-$26,750
deborah enosDirector, Effective 6/27/19-$21,250-$21,250

Highest Paid Contractors

ContractorServicesLocationCompensation
Beacon Health Strategies LLCMental Health Svc.200 STATE STREET, Boston, MA 02109$107,414,141
Umass Memorial Medical CenterMedical Services55 N LAKE AVENUE, Worcester, MA 01655$99,405,034
Vhs Acquisition SubsidiaryHospital Services123 SUMMER STREET, Worcester, MA 01608$62,280,718
Reliant Medical GroupMedical Services630 Plantation STREET, Worcester, MA 01605$58,276,292
Lowell General HospitalMedical Services295 Varnum Street, Lowell, MA 01854$48,915,660
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$1,569,180,946
Investment Income
$18,648,246
Other Revenue
$-7,295,403
Change in Net Assets
$-26,478,645

Audited Revenue Reconciliation

Revenue per Audited Statements
$1,581,214,143
Revenue Not Reported on Financial Statements
$-680,354
Revenue Not Reported on Form 990
$121,421,857
Other Revenue Adjustments
$-1,472,498
Total Revenue per Audited Statements
$1,702,636,000
Total Revenue per Form 990
$1,580,533,789
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$91,003,613
Other Expenses$32,286,980
Grants and Similar Amounts Paid$708,084
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members$1,483,013,757--$1,483,013,757
Other Salaries and Wages$189,499$66,136,965-$66,326,464
Information Technology-$9,666,945-$9,666,945
Other Employee Benefits$47,357$8,201,413-$8,248,770
Current Officers, Directors, Trustees, and Key Employees-$6,972,785-$6,972,785
Payroll Taxes-$6,663,142-$6,663,142
Depreciation Depletion-$6,031,228-$6,031,228
Office Expenses-$5,115,930-$5,115,930
Occupancy-$2,796,005-$2,796,005
Pension Plan Contributions$8,883$2,652,407-$2,661,290
Fees for Services Legal-$2,265,878-$2,265,878
Advertising-$1,511,912-$1,511,912
Fees for Services Accounting-$1,163,498-$1,163,498
Fees for Service Investment Mgmnt Fees-$792,144-$792,144
Grants to Domestic Orgs$708,084--$708,084
Insurance-$678,628-$678,628
Fees for Services Other-$294,380-$294,380
Fees for Services Lobbying$191,390--$191,390
Interest-$166,107-$166,107
Comp Disqual Persons-$131,162-$131,162
Travel-$109,843-$109,843
Conferences and Meetings-$102,669-$102,669
Other Expenses$102$1,394,993-$102
Total Functional Expenses$1,484,164,400$122,848,034$0$1,607,012,434

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Audited Statements$1,718,903,000
Total Expenses per Form 990$1,607,012,434
Expenses per Audited Statements$1,606,195,621
Expenses Not Reported on Form 990$112,707,379
Expenses Not Reported on Financial Statements$816,813
Other Expense Adjustments$24,669
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Heywood Memorial HospitalGardner, MA501(c)(3)General Support$27,400
Discover Central MAWorcester, MA501(c)(6)General Support$25,000
Harrington Memorial HospitalSouthbridge, MA501(c)(3)General Support$25,000
Worcester Regional Chamber of CommerceWorcester, MA501(c)(6)General Support General Support$25,000
United Way of Central MAWorcester, MA501(c)(3)General Support$21,500
Girls Inc of Greater LowellLowell, MA501(c)(3)General Support$20,000
Umass Memorial Foundation IncShrewsbury, MA501(c)(3)General Support$19,000
Lowell Community Health CenterLowell, MA501(c)(3)General Support$16,500
The Bridge of Central Mass IncWorcester, MA501(c)(3)General Support$16,500
Boys and Girls Club of WorcesterWorcester, MA501(c)(3)General Support$16,000
BeRKSHIRE HEALTH SYSTEMSPittsfield, MA501(c)(3)General Support General Support$15,000
Meyers Primary Care InstituteWorcester, MA501(c)(3)General Support$15,000
THE Hanover TheatreWorcester, MA501(c)(3)General Support$15,000
Worcester Art MuseumWorcester, MA501(c)(3)General Support$12,889
Central Ma Housing AllianceWorcester, MA501(c)(3)General Support$12,500
Merrimack Valley Food Bank IncLowell, MA501(c)(3)General Support General Support$12,500
Volunteers in Medicine Berkshire IncGreat Barrington, MA501(c)(3)General Support$12,500
Worcester Hibernian Cultural CLUBWorcester, MA501(c)(3)General Support$12,000
Worcester Regional Research BureauWorcester, MA501(c)(3)General Support$11,500
Youth Opportunities Upheld IncWorcester, MA501(c)(3)General Support$11,500
Pernet Family Health Services IncWorcester, MA501(c)(3)General Support$11,000
Girls Inc Of WorcesterWorcester, MA501(c)(3)General Support$10,600
Massachusetts Municipal AssociationBoston, MA501(c)(3)General Support$10,167
American Heart AssociationWaltham, MA501(c)(3)General Support$10,000
Lowell General PhoLowell, MA501(c)(3)General Support$10,000
Regional Environmental Council IncWorcester, MA501(c)(3)General Support$10,000
Students Helping Children Across the BordersWorcester, MA501(c)(3)General Support$10,000
YwCA OF CENTRAL MASSACHUSETTSWorcester, MA501(c)(3)General Support$9,750
John Snow IncBoston, MA501(c)(3)General Support$8,333
Alzheimers AssociationWatertown, MA501(c)(3)General Support$7,000
Massachusetts Taxpayers FoundationBoston, MA501(c)(3)General Support$7,000
Aids Project Worcester IncWorcester, MA501(c)(3)General Support$6,000
Seven Hills FoundationWorcester, MA501(c)(3)General Support$6,000
Veterans IncWorcester, MA501(c)(3)General Support$5,525
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
Laurie McgovernEmployee-family Member of Key Employee, Kevin McgovernFchp EmployeeNo$113,047
June ComtoisEmployee Until 4/19-family Member of Officer, Jill LebowFchp EmployeeNo$18,115

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
Yes
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Line 2

FAMILY OR BUSINESS RELATIONSHIP BETWEEN OFFICERS, DIRECTORS, AND KEY EMPLOYEES. FALLON HEALTH & LIFE ASSURANCE CO., INC. (FHLAC) IS A WHOLLY-OWNED SUBSIDIARY OF FCHP. THE FOLLOWING FCHP BOARD MEMBERS AND OFFICER SERVED ON THE FHLAC BOARD OF DIRECTORS IN 2019: JAMES BUONOMO, B. JOHN DILL, ANN TRIPP, FREDERICK MISILO, JANET S. RICO, and Richard p. burke (ex-officio). ULTRABENEFITS, INC. (UBI) IS A WHOLLY-OWNED SUBSIDIARY OF FHLAC. THE FOLLOWING FCHP OFFICERS AND KEY EMPLOYEE SERVED ON THE UBI BOARD OF DIRECTORS IN 2019: RICHARD P. BURKE, KEVIN GROZIO, DAVID PRZESIEK, TODD BAILEY, AND ELIZABETH HELENIUS. 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 OFFICERS SERVED ON THE BOARD OF THESE TWO CORPORATIONS IN 2019: RICHARD P. BURKE, DAVID PRZESIEK, TODD BAILEY, AND kevin grozio. 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 2019, THE COMMITTEE CONSISTED OF FOUR 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 R

Filing and Contact Details

Filer

Filer Name
Fallon Community Health Plan Inc
EIN
23-7442369
In Care Of
% TODD BAILEY
Phone
5087992100
Address
10 Chestnut Street, Worcester, MA 01608
Doing Business As
Fallon Health

Signing Officer

Name
Todd Bailey
Title
CFO
Phone
5087992100
Signed
2020-11-05
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Richard P Burke
Formed
1975
Legal Domicile
Ma
Voting Board Members
11
Independent Board Members
10
Employees
1,387
Volunteers
213

Preparer

Firm
PricewaterhouseCoopers LLP
Address
101 SEAPORT BLVD SUITE 500, BOSTON, MA 02210
Preparer
Gwen Spencer
Phone
6175305000
Supplemental Narrative

Additional Explanations

Organization Mission and Program Activities

FORM 990, Part I line 1 Founded in 1977, Fallon Community Health Plan, INC. (FCHP) 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, FCHP works to deliver high-quality, affordable care. FCHP 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 Massachusetts. This enables FCHP to serve members of all ages, at all income levels and with all types of health needs. Offerings and 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 and events; a community benefits grants program designed to target unmet community health needs; corporate sponsorships; in-kind donations; advocacy and volunteer hours. FORM 990, Part III, Line 4A COMMERCIAL PRODUCTS AND SERVICES FCHP commercial plans are offered through employer groups and, in some cases, can be purchased directly by the consumer. Commercial plans cover all counties in Massachusetts with the exception of Barnstable, Dukes and Nantucket. Regardless of how they get their coverage, members of FCHP'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 members manage their health care costs, FCHP offers a unique choice of provider networks, including a lower cost limited network, which was the first of its kind in Massachusetts. FCHP also offers a wide range of care management programs for those with acute, chronic or complex health conditions. These voluntary programs are designed to help members improve both their health and quality of life. To best support the changing needs of those we serve, FCHP 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, years before it became required by the ACA . 2005: Offered the first qualified high-deductible HMO plans in Massachusetts . 2013: Launched "The Healthy Health Plan," making FCHP the first plan in Massachusetts to include a wellness incentive as part of its standard benefit package . 2016: Developed new specialized plans for people with chronic conditions such as asthma, diabetes and coronary artery disease . 2017: Expanded access to care with telemedicine, allowing members to receive adult and pediatric care over the phone or by video FORM 990, PART III, LINE 4B GOVERNMENT PROGRAMS FCHP offers a full range of commercial health insurance products along with most government-sponsored programs listed below. . Medicare Advantage and Medicare Supplement . Medicaid (MassHealth Accountable Care Organization Partnership Plans) . Medicare Advantage Special Needs Plan and Senior Care Options . 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 FCHP to serve members of all ages, at all income levels and with all types of health needs. There are several notable facts when it comes to FCHP's government programs: . In 1980, FCHP was the first HMO in the country to receive a Medicare risk contract. Today, FCHP's Medicare Advantage plans continue to serve the needs of seniors across the Commonwealth of Massachusetts. . FCHP's Summit ElderCare is the largest PACE program i

FORM 990, PART III, LINE 4C

Community giving FCHP is a not-for-profit health care services organization headquartered in Worcester, Massachusetts. Our mission- Making our communities healthy - guides us in the work we do directly in the communities we serve in addressing health care barriers that impact positive health outcomes. Today we spread our mission across Massachusetts and western New York State. We are a forward-thinking, cohesive group that works with local providers and leaders in the communities we serve to improve residents' health and well-being, regardless of whether they are Fallon members. In addition to our products and services, FCHP provides corporate donations and our employees contribute both in-kind and monetary donations to help build healthy communities. Community focus is core to who we are as an organization and with a highly engaged and committed workforce, we are able to make a meaningful difference at the grassroots level and beyond. Our community giving programs include grants, sponsorships, in-kind donations, advocacy and volunteering. As partners, advocates and volunteers, FCHP has a long history of leadership in addressing health care barriers that have a real impact on the health and well-being of underserved communities. The two main ways we address these barriers is through grant-making and community engagement. Some examples include: Building and stocking food pantries, donating vans to support our elders' transportation needs and helping first-generation students complete their college applications. We are guided by our funding priorities that have been determined in collaboration with our provider partners and other key community stakeholders. Through a comprehensive community health needs assessment, the following three funding priorities drove giving in 2019: . Senior health initiatives: Programs that support seniors living safely in their homes and communities, providing access to care, behavioral health resources, and access to food and utilities. . Children and youth health initiatives: FCHP supports community based programs or organizations that provide access to programs that wrap services and resources around children and youth. These programs work collaboratively to engage other community partners that are committed to finding solutions that will positively impact children and youth directly in their neighborhood, schools and communities in a positive and progressive manner utilizing both evidence based/informed and innovative models to impact change. . Food insecurity: FCHP supports programs that help to address food insecurity for all individuals impacted by this issue. Our focus is on programs that provide access and educational resources on healthy eating, community gardens, financial literacy, food preparation, vocational training and access to food in the most underserved and underrepresented communities. In 2019, FCHP distributed $1,042,057 to programs that met the goals of Fallon's Community Benefits program. This was accomplished through the distribution of more than $648,363 in support of our funding priorities, including grants, direct expenses, leveraged expenses, staff and volunteer time. We also supported other philanthropic initiatives totaling approximately $393,694 in community sponsorships. We personally visit the organizations who serve our most vulnerable communities to distribute funds and learn more about the region's needs and how we can work together to be a continued resource. FCHP's 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's "Day of Caring" as well as building and stocking food pantries in local public schools or community-based agencies. Our employees volunteered 7,190 hours of their time in 2019 with 1,501 hours for Fallon driven initiatives.

Financial Statement Notes

SCHEDULE D, PART XI, LINE 2D:

SUBSIDIARY ACTIVITIES & ELIMINATIONS 111,210,225 UNREALIZED LOSS, DISPOSAL OF FIXED ASSETS (63,159) FINANCIAL STATEMENT ROUNDING 451 ---------------- TOTAL 111,147,517 SCHEDULE D, PART XI, LINE 4B: LINE OF CREDIT INTEREST RE-CLASS TO EXPENSE 24,669 NON CONTROLLING INTEREST (1,497,167) ---------------- TOTAL (1,472,498) SCHEDULE D, PART XII, LINE 2D: SUBSIDIARY ACTIVITIES & ELIMINATIONS 111,210,226 NON CONTROLLING INTEREST 1,497,167 FINANCIAL STATEMENT ROUNDING (14) ----------------- TOTAL 112,707,379 SCHEDULE D, PART XII, LINE 4B: Line of credit INTEREST re-class TO EXPENSE 24,669 ----------------- TOTAL 24,669

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IRS990/Form990PartVIISectionAGrp/TitleTxt0PRESIDENT & CEO
IRS990/Form990PartVIISectionAGrp/TitleTxt1SVP, CHIEF MED OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt2SVP, CHIEF SALES OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt3SVP, CHIEF OPERATING OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt4SVP, CHIEF HR OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt5VP, MEDICAL DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt6SVP, STRAT & BUS DEVELOPMENT
IRS990/Form990PartVIISectionAGrp/TitleTxt7MEDICAL DIRECTOR, MCD ACO
IRS990/Form990PartVIISectionAGrp/TitleTxt8VP, MEDICAL AFFAIRS
IRS990/Form990PartVIISectionAGrp/TitleTxt9SVP, CHIEF COMM. OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt10PACE ASSOCIATE MEDICAL DIR.
IRS990/Form990PartVIISectionAGrp/TitleTxt11VP, PRODUCT MANAGEMENT
IRS990/Form990PartVIISectionAGrp/TitleTxt12VP, SALES
IRS990/Form990PartVIISectionAGrp/TitleTxt13SVP, CHIEF COMPLIANCE OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt14VP, Treasurer
IRS990/Form990PartVIISectionAGrp/TitleTxt15VP, INFORMATION TECHNOLOGY
IRS990/Form990PartVIISectionAGrp/TitleTxt16VP, STATE PROG. UNTIL 11/29/19
IRS990/Form990PartVIISectionAGrp/TitleTxt17INTERIM CFO, 6/11/19-8/25/19
IRS990/Form990PartVIISectionAGrp/TitleTxt18DIR, MEDICARE ADVANTAGE
IRS990/Form990PartVIISectionAGrp/TitleTxt19CFO UNTIL 6/10/19
IRS990/Form990PartVIISectionAGrp/TitleTxt20EXECUTIVE DIRECTOR, NAVICARE
IRS990/Form990PartVIISectionAGrp/TitleTxt21SVP, CFO, EFFECTIVE 8/25/19
IRS990/Form990PartVIISectionAGrp/TitleTxt22CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt23VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt24CLERK
IRS990/Form990PartVIISectionAGrp/TitleTxt25TREASURER
IRS990/Form990PartVIISectionAGrp/TitleTxt26DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt27Director
IRS990/Form990PartVIISectionAGrp/TitleTxt28DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt29director
IRS990/Form990PartVIISectionAGrp/TitleTxt30DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt31DIRECTOR, EFFECTIVE 6/27/19
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Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$671$485$186$1,841$1,862$21.6
2023Detailed filing. Detailed filing data is available for this year.$760$544$216$1,752$1,818$66.3
2022Detailed filing. Detailed filing data is available for this year.$699$442$257$1,747$1,729$18.3
2021Detailed filing. Detailed filing data is available for this year.$713$408$305$1,783$1,746$36.1
2020Detailed filing. Detailed filing data is available for this year.$617$348$269$1,644$1,569$75.3
2019Detailed filing. Detailed filing data is available for this year.$461$283$178$1,581$1,607$26.5
2018Detailed filing. Detailed filing data is available for this year.$430$241$189$1,517$1,511$6.93
2017Detailed filing. Detailed filing data is available for this year.$412$218$194$1,245$1,238$7.90
2016Detailed filing. Detailed filing data is available for this year.$373$196$177$1,157$1,177$20.1
2015Detailed filing. Detailed filing data is available for this year.$391$199$192$1,091$1,098$6.76
2014Detailed filing. Detailed filing data is available for this year.$426$210$216$1,096$1,092$3.55
2013Detailed filing. Detailed filing data is available for this year.$434$223$211$1,200$1,187$13.2
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$412$213$199$1,106
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$383$214$169$1,065
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$338$203$135$1,106