Mount Carmel Health Plan Inc

“The sole member of mount carmel health plan is mount carmel health system. See line 7 for additional information.”

“Mount carmel health system (mchs) is the sole member of mount carmel health plan (mchp). Mchs has the right to appoint all persons to the board of directors of mchp.”

“As sole member, mount carmel health system must approve certain decisions of the governing body, including the strategic plan, annual capital plan, and annual operating budget. Mount carmel health system must also approve significant changes such as a merger, dissolution, sale of assets in excess of certain limits, and modifications to governing documents.”

“Prior to filing, the form 990 for mount carmel health plan is reviewed by management, including the management of its sole member, mount carmel health system. The board receives a copy of the return in its final form before it is filed with the internal revenue service. The board will review the form 990 at the november 21, 2016 board meeting, which will include a presentation by management.”

“Mount carmel health plan has adopted trinity health's governance policy no. 1, which sets forth the organization's conflict of interest policy and processes. It applies to all "interested persons" of mount carmel health plan, which includes directors, principal officers, key employees, and members of committees with board-delegated powers. Interested persons are expected to discharge their duties in a manner the person reasonably believes to be in the best interests of mount carmel health plan, inc. And to avoid situations involving a conflict of interest. On an annual basis, interested persons are required to complete a conflict of interest disclosure statement and to affirm their receipt of the conflict of interest policy, compliance with its requirements, and agree to notify the organization of changes impacting their annual disclosure in accordance with the policy. The annual disclosures are provided to internal legal counsel and the integrity and compliance officer, from which legal counsel prepares a report for the board chair and ceo. A summary of potential conflicts is reviewed with the board of directors of mount carmel health plan (or a delegated committee of the board) on a yearly basis. Interested persons are required to make full disclosure to mount carmel health plan of any financial or business interests that might result in or have the appearance of a conflict of interest. The board of directors of mount carmel health plan (or a delegated committee of the board) is responsible for the review of transactions to determine whether an actual conflict of interest exists. In the event of an actual conflict, the board (or a delegated committee of the board) will either avoid the conflict or appropriately scrutinize the transaction to ensure it is in the best interests of mount carmel health plan. Interested persons are required to recuse themselves from discussion and voting on matters involving a conflict of interest. The policy further addresses the proper documentation of the proceedings and potential disciplinary and corrective action for violations of the policy. The policy is available to the public upon request.”

“Questions 15a and 15b are answered "no" because the compensation for certain officers and key management officials of mount carmel health plan is established by trinity health, a related organization. In establishing ceo and cfo compensation, trinity health follows a process and policy that is intended to mirror the irc section 4958 guidelines for obtaining a "rebuttable presumption of reasonableness" with regard to compensation and benefits. As part of that process, the compensation and benefits of the ceo's and cfo's of mount carmel health plan are reviewed at least annually by the trinity health board or the trinity health human resources and compensation committee (hrcc) of the board, authorized to act on behalf of the board with respect to certain compensation matters. As part of its review process, the hrcc retains an independent firm experienced in comensation and benefit matters for not-for-profit healthcare organizations to advise it in the determinations it makes on the reasonableness of proposed compensation and benefits arrangements.”

“Mount carmel health plan is a subsidiary organization in the trinity health system. Trinity health makes certain of its key documents available to the public on its website, www.trinity-health.org, in the "about us" section. In this section, the annual report (which includes community benefit ministry information) and consolidated audited financial statements are publicly available. Mount carmel health plan's governing documents and conflict of interest policy are available upon request.”

“Sr. Barbara hahl is a member of the congregation of the sisters of the holy cross. Having taken a vow of poverty, sr. Barbara did not receive compensation for the services she provided to mount carmel health system except for insurance benefits ($6,172). Instead, a total of $284,665 was paid by mount carmel health system directly to the sisters of the holy cross for sr. Barbara's services.”

“Purchased services-dental & other: program service expenses 8,893,638. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,893,638. Purchased medical services: program service expenses 455,600,085. Management and general expenses 0. Fundraising expenses 0. Total expenses 455,600,085. Consulting fees expense: program service expenses 2,069,653. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,069,653. Claims processing services: program service expenses 7,452,659. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,452,659. Recruiting services: program service expenses 19,500. Management and general expenses 0. Fundraising expenses 0. Total expenses 19,500.”

“Prior years cms overpayment liability -63,825,704.”

“Mount carmel health plan's financial statements were included in the fy15 consolidated financial statements of trinity health, which were audited by an independent public accounting firm. Mount carmel health plan also has statutory-basis statements prepared for the purpose of filing with the ohio insurance department. These statutory-basis statements are audited by an independent accounting firm.”