Php Familycare

“Physicians health plan (php) is the sole member of sparrow php (sphp) and sparrow health system is the parent and sole member of php. The board members elected by the board of directors are ratified by the sparrow health system board of directors. Decisions of the sphp board of directors may be subject to approval by the sparrow health system board of directors.”

“Physicians health plan (php) is the sole member of sparrow php (sphp) and sparrow health system is the parent and sole member of php. The board members elected by the board of directors are ratified by the sparrow health system board of directors. Decisions of the sphp board of directors are subject to approval by the sparrow health system board of directors.”

“Physicians health plan (php) is the sole member of sparrow php (sphp) and sparrow health system is the parent and sole member of php. The board members elected by the board of directors are ratified by the sparrow health system board of directors. Decisions of the sphp board of directors are subject to approval by the sparrow health system board of directors.”

“Copies of the 2015 form 990 are reviewed by management. Once management completed its review of the form 990 copies were provided at the september 2016 board meeting for all board members to review and comment on.”

“1) corporate compliance sends out the conflict of interest policy and questionnaires to all voting board members and the executive team annually. 2) all disclosures are received and reviewed by corporate compliance. 3) all disclosures are given a resolution code and presented to the ceo and governance committee of the board. 4) all board/committee level disclosures are provided to the respective board chair and executive liaison to ensure issues can be addressed on a transactional level (i.e. If a vote is required on a transaction involving an interested person).”

“The process for determining compensation for the ceo of the organization involved the following: utilizing the compensation committee, using independent consultants, reviewing other similar organizations' 990s, compensation surveys, and final approval by the shs board of directors, as well as finalizing the salary package with a written employment contract.”

“The process for determining compensation for officers or key employees of the organization involved the following: utilizing the compensation committee, using independent consultants, reviewing other similar organizations' 990s, using compensation surveys, and final approval by the shs board of directors, as well as finalizing the salary package with a written employment contract.”

“The governing documents, conflict of interest policy and financial statements are made available to the public as follows: the governing documents of sparrow php are submitted to department of insurance and financial services (difs). Those are publicly available to interested parties. The conflict of interest is available through sparrow health system by request to the sparrow compliance officer.”

“All lines left blank are not applicable to the organization.”

“During the year ended december 31, 2015 sparrow php was not recommended by the state of michigan as an approved carrier of michigan medicaid insurance for the prosperity region in which the company operates. As a result effective december 31, 2015, sparrow php sold 100 percent of the membership to an unaffiliated health plan. The membership was sold for an agreed upon sum that was collected subsequent to year end.”

“Sphp's success in managing health care is due in part to the extensive network of participating providers in the hdn network. The hmo/hdn contractual arrangements allow sphp to arrange for healthcare to patients covered by the state of michigan's medicaid benefit plan. This arrangement allows the members to access a wide variety of independent providers within each hdn including physicians, hospitals, pharmacies, skilled nursing facilities, and allied health professionals. Sphp members may also receive care for services from a nonparticipating provider if such referral is recommended by a hdn participating physician and the service required for treatment, as determined by the hdn, is not available within the hdn's network. Sphp offers a variety of health care programs. Sphp offers choices that provide coverage within the network of contracted hdn providers, limited coverage outside of the sphp network, various levels of deductibles, co- payments, and coverage limits, all of which are designed to be responsive to payor needs. Sparrow php is owned by physician health plan (php). Physicians health plan (php) is owned by sparrow health system (shs) and holds a certificate of authority as an hmo in the state of michigan. Php is primarily a commercial hmo and also operates three subsidiaries, php insurance company (phpic), a commercial insurance company, sphp, and php service company (tpa) a third party administrator. All staffing functions and reporting are accomplished through the use of the same staff as php. Unless specifically noted, all references to php apply to php, phpic, sphp, and tpa. Php's service area includes the michigan counties of ingham, eaton, clinton, shiawassee, montcalm, gratiot, ionia, jackson, hillsdale, portions of isabella, saginaw, washtenaw, and lenawee. Phpic offers products across michigan. The sparrow php product is available to medicaid enrollees in eaton, clinton, ingham, ionia, montcalm, isabella, and shiawassee counties. As of december 31, 2015, there were approximately 34,000 enrollees in php's commercial hmo, 14,700 in tpa, 9,000 in phpic, and 21,600 enrollees in sphp. Php and sphp contracts directly with physicians health network (phn), a wholly owned subsidiary of shs. The php network is approximately 1,030 primary care physicians, 1,860 specialty care physicians, 800 allied health professionals, and 1,180 organizational providers that include 45 hospitals. Php measures the quality of care provided to its enrollees through annual review of indicators such as: - disease management program participation and outcomes, - quality of care concerns, and - hedis measures: the health plan effectiveness data and information set (hedis) is a group of nationally recognized measures of health plan performance in a variety of clinical and non-clinical areas. Php uses the effectiveness of care measures to determine progress and improvement in areas such as: diabetes, asthma, depression and follow-up after mental health admissions, breast and cervical cancer screenings, use of beta- blockers after heart attacks, child and adolescent immunizations, cholesterol management, controlling high blood pressure, smoking cessation, prenatal and postpartum care, and treatment of childhood respiratory infections. Php measures the quality of service provided to its enrollees by the review of performance measures related to: - access and availability of providers, - enrollee complaints and appeals, - customer service telephone access performance, and - member assessment. The consumer assessment of healthcare providers and systems (cahps) survey gives a general indication of how well the organization meets members expectations. The php qi program is ultimately accountable to the board of directors. In 2015 php received "full accreditation" status from urac for both health plan accreditation and health plan accreditation with health insurance marketplace. Urac accreditation signifies an issuer has undergone and passed a rigor”

“Membership transfer 1,163,000 statutory reclass from revenue to expense -3,486,825 ceded reinsurance -263,446 investment expenses -24,663 membership transfer -1,163,000 statutory reclass from revenue to expense 3,486,825 investment expenses 24,663 ceded reinsurance 263,446”