University of Michigan Health Medicare

“University of michigan health plan is the sole member of university of michigan health medicare. University of michigan health holdings is the parent and sole member of university of michigan health plan and has 100% ownership. University of michigan health holdings is owned by michigan medicine at 90% and covenant healthcare system at 10%.”

“University of michigan health plan is the sole member of university of michigan health medicare. University of michigan health holdings is the parent and sole member of university of michigan health plan and has 100% ownership. The board members elected by the board of directors are ratified by the university of michigan health plan board of directors. Decisions of the university of michigan health medicare board of directors are subject to approval by the university of michigan health holdings board of directors.”

“University of michigan health plan is the sole member of university of michigan health medicare. University of michigan health holdings is the parent and sole member of university of michigan health plan and has 100% ownership. The board members elected by the board of directors are ratified by the university of michigan health plan board of directors. Decisions of the university of michigan health medicare board of directors are subject to approval by the university of michigan health holdings board of directors.”

“Copies of the 2024 form 990 are reviewed by management. Once management has completed its review of the form 990, draft copies are forwarded to board members for review prior to submitting.”

“1) corporate compliance sends out 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 involved the following: utilizing the compensation committee, using independent consultants, reviewing other similar organizations' 990s, using compensation surveys and final approval by the applicable board of directors, as well as finalizing the salary package with a written employment contract.”

“The process for determining compensation for the officers and 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 applicable 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 university of michigan health plan are submitted to the department of insurance and financial services (difs). Those are publicly available to interested parties. The conflict of interest is available upon request.”

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

“University of michigan health medicare is a non-profit health maintenance organization (hmo). University of michigan health medicare uses a primary care concept for delivering health care in a health delivery network (hdn) structure. It arranges for the provision of comprehensive outpatient and inpatient medical and surgical services to members on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular member. University of michigan health medicare's commitment is to develop and deliver quality managed care products at a reasonable cost for its members. University of michigan health medicare is wholly owned by university of michigan health plan. University of michigan health plan is primarily a commercial hmo. Along with university of michigan health medicare, university of michigan health plan operates university of michigan health insurance company, a commercial insurance company and university of michigan health service company, a third party administrator. All staffing functions and reporting are accomplished through the use of the same staff as university of michigan health plan. Unless specifically noted, all references to university of michigan health plan apply to uofm health plan, uofm health insurance company, and uofm health medicare. University of michigan health plans service area includes the michigan counties of ingham, eaton, clinton, shiawassee, montcalm, gratiot, ionia, jackson, hillsdale and portions of isabella, saginaw, washtenaw, and lenawee. Uofm health insurance company offers products across michigan. As of december 31, 2024, there were approximately 28,100 enrollees in uofm health plans commercial hmo, 25,300 in tpa, 2,300 in uofm health insurance company, and 8,300 enrollees in uofm health medicare. The university of michigan health plan network is approximately 3,068 primary care physicians, 5,503 specialty care physicians, 3,906 allied health professionals, 3,482 behavioral health providers and 746 organizational providers that include 60 hospitals. Uofm health plan contracts with various hdns who provide healthcare services to members. Uofm health plans commitment is to develop and deliver quality managed care products at reasonable costs for its members. Uofm health plans 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 uofm health plan to arrange for healthcare to patients covered by the state of michigans 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. Uofm health plan members may also receive care for services from a nonparticipating provider if such referral is recommended by an hdn participating physician and the service required for treatment, as determined by hdn, is not available within the hdns network. Uofm health plan offers a variety of healthcare programs, or products to groups and individuals. Uofm health plan offers choices that provide coverage within the network of contracted hdn providers, limited coverage outside of the uofm health plan network, various levels of deductibles, co-payments, and coverage limits, all of which are designed to be responsive to customer needs. Uofm health plan 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. -hedis measures the health plan effectiveness data and information set (hedis) is a group of nationally recognized measures of health plans performance in a variety of clinical and non-clinical areas. Uofm health plan uses the effectiveness of care measures to determine progress and improvement in areas such as: -diabetes, -asthma, -depression and follow-up after ment”

“Capital contributions 27,000,000”