Fallon Total Care Inc.

Form 990, Part I, Line 1 & Part III, Line 1

“FTC'S MISSION FALLON TOTAL CARE, INC., IS IN THE PROCESS OF CLOSING ITS OPERATION. THE MISSION WAS TO MAKE A POSITIVE DIFFERENCE BY IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES THROUGH THE DELIVERY OF HIGH QUALITY, ECONOMICAL HEALTHCARE SERVICES TO BOTH MEDICARE AND MEDICAID ELIGIBLE POPULATION FROM 21 TO 64 YEARS OF AGE. Fallon Total Care, Inc. ("FTC") was formed as a Massachusetts nonprofit corporation on September 20, 2013 for charitable, educational, and scientific purposes, for relief of the poor and distressed and to lessen the burdens of government within the meaning of Sections 170(c)(2)(B) and 501(c)(3) of the Internal Revenue Code of 1986. Specifically, FTC was formed to promote, facilitate, and enhance the delivery of quality, efficient, effective and economical health care and related services to individuals who are dually eligible for both Medicare and Medicaid, and to improve and enhance the health and well-being of those individuals, by providing integrated behavioral and physical health management services on a risk basis. The enrollees are generally underprivileged, underserved, low-income population with major health care needs, including many individuals who suffer from chronic physical and/or mental health conditions. Serving this population is challenging and costly for federal and state governments. Established as a Demonstration Program by the Commonwealth of Massachusetts Executive Office of Health and Human Services' Office of Medicaid and the Center for Medicare Services, participating health plans coordinate and manage integrated behavioral and physical health management services to enrollees ages 21-64 who are eligible for both Medicare and Medicaid. By combining Medicare and Medicaid funding, the Demonstration Program enables a broader menu of services to better meet the needs of Dual Eligibles in the most cost effective way and enables an unprecedented level of integration to achieve better health outcomes for this population and to provide higher quality, more cost effective, person-centered care. FTC was formed by Fallon Community Health Plan, Inc. ("FCHP"), a Section 501(c)(3) tax-exempt Massachusetts nonprofit corporation and licensed Massachusetts health maintenance organization (HMO). FCHP is dedicated to improving the health and welfare of the populations it serves through the delivery of high quality, affordable health care. FCHP formed FTC to further FCHP's charitable health care mission, and FTC's purposes explicitly include supporting, benefiting, performing certain functions of, and carrying out the charitable, educational, or scientific purposes of FCHP. FORM 990, PART III, LINE 3 After careful consideration, FCHP, THE PARENT COMPANY, decided to reluctantly end its participation in the Commonwealth of Massachusetts One Care demonstration program effective September 30, 2015. This decision was reached after exploring alternatives with Medicare and Medicaid but ultimately we determined that our continued participation was not economically sustainable. FCHP worked with Medicare and Medicaid officials throughout the wind down process. We notified each member by mail in advance of the effective date that their coverage would end. This letter also explained the member's options for coverage after September 30 and included telephone numbers to call with any questions. FCHP held informational meetings in two Massachusetts locations to answer questions and help members' understand their choices. FCHP also notified all providers in its network prior to the effective date. FORM 990, PART III, LINE 4 THE 2016 ACTIVITIES CONSISTED OF RESIDUAL SETTLEMENTS OF PRIOR YEAR SERVICES DUE TO THE NATURE OF WINDING DOWN PROCESS. THERE WERE NO MEMBERS IN THIS PROGRAM IN 2016. IN PRIOR YEARS, FTC's Program activities consistED of prepaid healthcare in the Commonwealth of Massachusetts. Members pay no premiums, co-payments, or co-insurance while participating in the Plan. All premiums are paid by state”