Civic Intelligence

Fallon Community Health Plan Inc.

990 • Fiscal year 2020 • EIN 23-7442369

Jan 01, 2020 to Dec 31, 2020 • Filed on Nov 11, 2021

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

73rd percentile

0.56x

Higher debt load relative to assets than 73% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Liabilities / Revenue

15th percentile

0.21x

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

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Net Margin

43rd percentile

4.6%

Higher net margin than 43% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Top Officer Pay

40th percentile

$1,431,001

Higher top officer pay than 40% of similar nonprofits.

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

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Asset Growth

91st percentile

34%

Faster asset growth than 91% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2019 to 2020

Revenue Growth

58th percentile

4.0%

Faster revenue growth than 58% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2019 to 2020

Assets

Up

$617,122,763

Up $155,888,818 (+34%) from 2019

Net Assets

Up

$269,431,673

Up $91,132,472 (+51%) from 2019

Liabilities

Up

$347,691,090

Up $64,756,346 (+23%) from 2019

Revenue

Up

$1,643,963,728

Up $63,429,939 (+4.0%) from 2019

Expenses

Down

$1,568,643,154

Down $38,369,280 (-2.4%) from 2019

Net Income

Up

$75,320,574

Up $101,799,219 (+384%) from 2019

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

2020

Assets$617,122,763
Liabilities$347,691,090
Net Assets$269,431,673

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

2020

Revenue$1,643,963,728
Expenses$1,568,643,154
Net Income$75,320,574
Jump To
Filing Snapshot
Filing Period
Jan 1, 2020 to Dec 31, 2020
Signed
Nov 11, 2021
Return Version
2020v4.1
Gross Receipts
$1,842,363,743
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$314,369,822$366,549,810▲ $52,179,988
Savings and Temporary Cash Investments$23,402,979$145,524,310▲ $122,121,331
Accounts Receivable$79,025,948$58,395,299▼ $20,630,649
Land, Buildings, and Equipment, Net$11,706,579$10,063,713▼ $1,642,866
Prepaid Expenses and Deferred Charges$8,391,131$6,128,764▼ $2,262,367
Inventories for Sale or Use$26,612$26,447▼ $165
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$461,233,945$617,122,763▲ $155,888,818
Other Assets Total$24,310,874$30,434,420▲ $6,123,546
Liabilities
Accounts Payable and Accrued Expenses$271,753,335$329,435,293▲ $57,681,958
Deferred Revenue$11,181,409$18,255,797▲ $7,074,388
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$282,934,744$347,691,090▲ $64,756,346
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$178,299,201$269,431,673▲ $91,132,472
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$178,299,201$269,431,673▲ $91,132,472
Total Liabilities and Net Assets / Fund Balance$461,233,945$617,122,763▲ $155,888,818

Asset Categories

AssetBook ValueDepreciationBasis
Other Land Buildings$7,160,588$26,927,881$34,088,469
Equipment$2,381,915$4,694,141$7,076,056
Leasehold Improvements$521,210$1,407,132$1,928,342
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Richard P BurkePresident & CEOFT$684,995$746,006$1,431,001
Carolyn Langer MdSVP, Chief Med OfficerFT$411,923$238,669$652,234
Todd BaileySVP, Chief Financial OfficerFT$392,484$237,296$622,182
Emily WestSVP, Chief Operating OfficerFT$311,407$262,612$574,554
Mary RitterSee Schedule O for titleFT$305,650$225,172$535,928
Jill LebowSVP, Chief Hr OfficerFT$295,798$215,710$508,046
Linda Weinreb MdMedical Director, Mcd AcoFT$330,412$169,157$489,474
mark dichter mdVP, med.Director util.mgmt/cl. infoFT$298,121$153,880$464,345
Robert Schreiber MdVP, Medical DirectorFT$300,207$156,401$456,215
Christine CassidySVP, Chief Comm. OfficerFT$241,789$185,323$421,388
James GentileSVP, Chief Compliance OfficerFT$241,121$164,969$403,765
Janis LiepinsSee Schedule O for titleFT$261,967$134,733$400,331
David Brumley MdVP, Medical AffairsFT$284,195$96,716$383,181
Perry Farb MdPace Associate Medical DirectorFT$269,130$127,311$378,639
Kevin McGovernVP, TreasurerFT$238,534$129,284$366,471
Kristine BostekVP, Sec & Fhw Pace Eff. 4/20FT$241,898$145,614$366,095
Elizabeth HeleniusVP, SalesFT$208,975$122,032$333,731
Lisa CohenInterim CFO, 6/11/19-8/25/19FT$218,625$80,308$310,273
David PrzesiekSVP, Chief Sales Off Untl 3/20FT$92,161$206,051$287,372
Deborah DaviauSee Schedule O for titleFT$191,224$44,176$251,171
Andre GabryjelskiDir, Medicare Adv. Untl 9/20FT$97,230$42,209$165,079
Frederick Misilo EsqChair-$42,000-$42,000
James BuonomoClerk-$39,500-$39,500
Ann K TrippTreasurer-$37,250-$37,250
B John DillVice Chair-$37,250-$37,250
Janet S RicoDirector-$36,500-$36,500
deborah enosDirector-$34,250-$34,250
Karin LandryDirector-$29,250-$29,250
Joseph N Stolberg CPADirector-$27,000-$27,000
Peter StraleyDirector-$27,000-$27,000
alice bonnerdirector, effective 6/20-$21,000-$21,000
David Friend Mddirector until 6/20-$6,750-$6,750

Highest Paid Contractors

ContractorServicesLocationCompensation
Beacon Health Strategies LLCMental Health Svc.200 STATE STREET, Boston, MA 02109$118,992,661
Umass Memorial Medical CenterMedical Services55 N LAKE AVENUE, Worcester, MA 01655$84,306,783
Reliant Medical GroupMedical Services630 Plantation STREET, Worcester, MA 01605$66,501,273
Vhs Acquisition SubsidiaryHospital Services123 SUMMER STREET, Worcester, MA 01608$52,050,442
Lowell General HospitalMedical Services295 Varnum Street, Lowell, MA 01854$41,238,798
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$1,629,023,510
Investment Income
$14,645,893
Other Revenue
$294,325
Change in Net Assets
$75,320,574

Audited Revenue Reconciliation

Revenue per Audited Statements
$1,643,069,642
Revenue Not Reported on Financial Statements
$894,086
Revenue Not Reported on Form 990
$107,066,358
Other Revenue Adjustments
$10,704
Total Revenue per Audited Statements
$1,750,136,000
Total Revenue per Form 990
$1,643,963,728
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$100,444,140
Other Expenses$34,483,812
Grants and Similar Amounts Paid$804,840
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members$1,432,910,362--$1,432,910,362
Other Salaries and Wages$68,861$70,684,644-$70,753,505
Information Technology-$12,708,334-$12,708,334
Other Employee Benefits$22,306$11,330,156-$11,352,462
Current Officers, Directors, Trustees, and Key Employees-$7,657,098-$7,657,098
Payroll Taxes-$7,366,831-$7,366,831
Office Expenses-$5,116,953-$5,116,953
Depreciation Depletion-$4,794,007-$4,794,007
Pension Plan Contributions$2,914$2,901,188-$2,904,102
Occupancy-$2,504,979-$2,504,979
Fees for Services Accounting-$2,373,658-$2,373,658
Fees for Services Legal-$2,006,134-$2,006,134
Advertising-$1,328,296-$1,328,296
Fees for Service Investment Mgmnt Fees-$883,382-$883,382
Fees for Services Other-$843,974-$843,974
Grants to Domestic Orgs$804,840--$804,840
Insurance-$690,196-$690,196
Comp Disqual Persons-$410,142-$410,142
Fees for Services Lobbying$193,996--$193,996
Interest-$94,881-$94,881
Conferences and Meetings-$51,088-$51,088
Travel-$6,518-$6,518
Other Expenses$630$4,070-$4,070
Total Functional Expenses$1,434,003,909$134,639,245$0$1,568,643,154

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Audited Statements$1,659,003,000
Total Expenses per Form 990$1,568,643,154
Expenses per Audited Statements$1,567,749,068
Expenses Not Reported on Form 990$91,253,932
Expenses Not Reported on Financial Statements$894,086
Other Expense Adjustments$10,704
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Worcester County Food BankShrewsbury, MA501(c)(3)General Support$50,000
Worcester Regional Chamber of CommerceWorcester, MA501(c)(6)General Support$35,000
The Food Bank of Western MaHatfield, MA501(c)(3)General Support$31,000
Merrimack Valley Food Bank IncLowell, MA501(c)(3)General Support General Support$30,000
Heywood Memorial HospitalGardner, MA501(c)(3)General Support$26,200
Greater Worcester Community FoundationWorcester, MA501(c)(3)General Support$25,000
Ron Burton Training VillageHubbardston, MA501(c)(3)General Support$25,000
Veterans IncWorcester, MA501(c)(3)General Support$24,000
United Way of Central MAWorcester, MA501(c)(3)General Support$17,500
Catholic Charities of the Diocese of WorcesterWorcester, MA501(c)(3)General Support$17,000
Friendly HouseWorcester, MA501(c)(3)General Support$16,000
Meyers Primary Care InstituteWorcester, MA501(c)(3)General Support$15,000
Umass Memorial Health CareWorcester, MA501(c)(3)General Support$15,000
Massachusetts Taxpayers FoundationBoston, MA501(c)(3)General Support$14,000
The Open Pantry of Greater LowellLowell, MA501(c)(3)General Support$14,000
Boys and Girls Club of WorcesterWorcester, MA501(c)(3)General Support$13,500
Saint Paul's Elder OutreachWorcester, MA501(c)(3)General Support$13,000
CentroWorcester, MA501(c)(3)General Support$12,500
Open SkyWorcester, MA501(c)(3)General Support$12,500
Worcester Hibernian Cultural FoundationWorcester, MA501(c)(3)general support$12,000
Worcester Center for Performing Arts (the Hanoverworcester, MA501(c)(3)general support$11,400
Spanish American CenterLeominster, MA501(c)(3)general support$11,040
Coastline Elderly ServicesNew Bedford, MA501(c)(3)general support$11,000
Community Harvest ProjectNorth Grafton, MA501(c)(3)general support$11,000
Elder Services of the BerkshiresPittsfield, MA501(c)(3)general support$11,000
Elder Services of the Merrimack ValleyLawrence, MA501(c)(3)general support$11,000
American Heart AssociationWaltham, MA501(c)(3)General Support$10,000
Central Ma Housing AllianceWorcester, MA501(c)(3)General Support$10,000
Genesis Club HouseWorcester, MA501(c)(3)General Support$10,000
Greater Boston Food BankBoston, MA501(c)(3)General Support$10,000
Lovin' SpoonfulsBoston, MA501(c)(3)General Support$10,000
Net of CompassionWorcester, MA501(c)(3)general support$10,000
Pernet Family Health Services IncWorcester, MA501(c)(3)General Support$10,000
Roots RisingPittsfield, MA501(c)(3)general support$10,000
Take & EatFlorida, MA501(c)(3)general support$10,000
United Way of Tri-CountyFramingham, MA501(c)(3)general support$10,000
Worcester Art MuseumWorcester, MA501(c)(3)General Support$10,000
Worcester Regional Research BureauWorcester, MA501(c)(3)General Support$9,000
Community Health ProgramsGreat Barrington, MA501(c)(3)General Support$7,500
Regional Environmental Council IncWorcester, MA501(c)(3)General Support$7,500
Town of ClintonClinton, MA501(c)(3)General Support$6,000
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$99,870

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 2020: JAMES BUONOMO, B. JOHN DILL, ANN TRIPP, FREDERICK MISILO, JANET S. RICO, deborah enos, 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 2020: RICHARD P. BURKE, DAVID PRZESIEK, TODD BAILEY, AND ELIZABETH HELENIUS. GROUP INSURANCE SERVICE CENTER, INC. (GISC), (UNTIL 11/30/20) 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 AND KEY EMPLOYEES SERVED ON THE BOARD OF THESE TWO CORPORATIONS IN 2020: RICHARD P. BURKE, DAVID PRZESIEK, TODD BAILEY, AND ELIZABETH HELENIUS. 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 2020, 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 OFFI

FORM 990, PART VII, SECTION A, COLuMN A:

Name and title: the following individuals' titles changed during the year: janis liepins: from: vp, product management, until 4/20. To: vp, masshealth & community care, effective 4/20. Mary ritter: from: svp, strategy & business development, until 4/20. To: svp, chief strategy & government programs officer, effective 4/20. Deborah daviau: from: executive director navicare, until 9/20. To: vp, medicare and executive director navicare, effective 9/20.

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
2021-11-11
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
1,274
Volunteers
77

Preparer

Firm
PricewaterhouseCoopers LLP
Address
101 SEAPORT BLVD, 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. In 2020, FCHP offered 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 has a history of offering 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 From its very start in 1977, FCHP has always been committed to serving the health care needs of individuals enrolled in Medicare and Medicaid programs. It has worked to expand those offerings over the years. Listed below is the complete list of the government-sponsored programs FCHP offers in Massachusetts and New York. . Medicare Advantage and Medicare Supplement (Massachusetts) . MassHealth Accountable Care Organization Partnership Plans (Massachusetts) . Medicare Advantage Special Needs Plan and Senior Care Options (Massachusetts) . Program of All-Inclusive Care for the Elderly (PACE) (Massachusetts and New York) . Subsidized, limited-network plan in Central Mass. and Metro West (Massachusetts) . Managed Long Term Care (MLTC) plan (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 FC

FORM 990, PART III, LINE 4C

Community giving Fallon Community Health Plan, Inc. is a not-for-profit health care services organization headquartered in Worcester, Massachusetts. Our mission 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, Fallon provides corporate donations, and our employees contribute both in-kind and monetary donations to help build and sustain 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, Fallon 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, helping first-generation students complete their college applications, supporting programs that help to keep older adults safe, and providing holiday meals for those in need. 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 2020: . Senior health initiatives: With a focus on those most impacted by the pandemic, Fallon aimed to support organizations and programs that provide services to seniors that overcome or mitigate social isolation and loneliness. Particular attention was paid to programs that ensure access to care including behavioral health resources, safety in homes and communities, and access to food and utilities. Examples include: . Caregiver support services . Transportation to medical appointments . Healthy living programs . Falls/community/home safety . Access to nutritious foods/mobile pantries and markets/Meals on Wheels . Children and youth health initiatives: Fallon supported 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: Fallon's goal was to help maintain food assistance programs for those areas or populations that are particularly vulnerable to food insecurity as a result of the COVID-19 pandemic. In 2020, FCHP distributed $1,003,746 to programs that met the goals of Fallon's Community Benefits Programs. This was accomplished through the distribution of $804,840 through our Community Benefits grants and Corporate Sponsorship programs. In addition, we provided $198,906 in direct expenses, leveraged expenses, staff hours and volunteer time along with our Fallon Health Feed a Family Initiative and food pantry builds. 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. Fallon's employees throughout the organization are encouraged to volunteer in the community where they work or live and are provided eight hours of paid work time to do so. Employe

Financial Statement Notes

SCHEDULE D, PART XI, LINE 2D:

SUBSIDIARY ACTIVITIES & ELIMINATIONS 91,253,435 FINANCIAL STATEMENT ROUNDING 923 ---------------- TOTAL 91,254,358 SCHEDULE D, PART XI, LINE 4B: LINE OF CREDIT INTEREST RE-CLASS TO EXPENSE 10,704 ---------------- TOTAL 10,704 SCHEDULE D, PART XII, LINE 2C: SUBSIDIARY ACTIVITIES & ELIMINATIONS 91,253,435 FINANCIAL STATEMENT ROUNDING 497 ----------------- TOTAL 91,253,932 SCHEDULE D, PART XII, LINE 4B: Line of credit INTEREST re-class TO EXPENSE 10,704 ----------------- TOTAL 10,704

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IRS990/Form990PartVIISectionAGrp/TitleTxt0PRESIDENT & CEO
IRS990/Form990PartVIISectionAGrp/TitleTxt1SVP, CHIEF MED OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt2SVP, CHIEF FINANCIAL OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt3SVP, CHIEF OPERATING OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt4See Schedule O for title
IRS990/Form990PartVIISectionAGrp/TitleTxt5SVP, CHIEF HR OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt6MEDICAL DIRECTOR, MCD ACO
IRS990/Form990PartVIISectionAGrp/TitleTxt7vp, med.dir util.mgmt/cl. info
IRS990/Form990PartVIISectionAGrp/TitleTxt8VP, MEDICAL DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt9SVP, CHIEF COMM. OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt10SVP, CHIEF COMPLIANCE OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt11See Schedule O for title
IRS990/Form990PartVIISectionAGrp/TitleTxt12VP, MEDICAL AFFAIRS
IRS990/Form990PartVIISectionAGrp/TitleTxt13PACE ASSOCIATE MEDICAL DIR.
IRS990/Form990PartVIISectionAGrp/TitleTxt14VP, Treasurer
IRS990/Form990PartVIISectionAGrp/TitleTxt15VP, SEC & FHW PACE EFF. 4/20
IRS990/Form990PartVIISectionAGrp/TitleTxt16VP, SALES
IRS990/Form990PartVIISectionAGrp/TitleTxt17INTERIM CFO, 6/11/19-8/25/19
IRS990/Form990PartVIISectionAGrp/TitleTxt18SVP, CHIEF SALES OFF UNTL 3/20
IRS990/Form990PartVIISectionAGrp/TitleTxt19See Schedule O for title
IRS990/Form990PartVIISectionAGrp/TitleTxt20DIR, MEDICARE ADV. UNTL 9/20
IRS990/Form990PartVIISectionAGrp/TitleTxt21CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt22CLERK
IRS990/Form990PartVIISectionAGrp/TitleTxt23TREASURER
IRS990/Form990PartVIISectionAGrp/TitleTxt24VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt25DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt26DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt27DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt28Director
IRS990/Form990PartVIISectionAGrp/TitleTxt29DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt30director, effective 6/20
IRS990/Form990PartVIISectionAGrp/TitleTxt31director until 6/20
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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