Skip to content
Nonprofiteer
← MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC

Form 990 for tax year 2024

Filed by MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC.

Totals

Total revenue
$1,700,036
Total expenses
$1,554,125
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$1,552,796
Investment income
$147,240
Other revenue
$0
Total assets, end of year
$4,464,538
Total liabilities, end of year
$542,674
Net assets or fund balances, end of year
$3,921,864
Program services expenses (Part IX)
$1,064,493
Management and general expenses
$489,632
Fundraising expenses
$0
Program service expenses (Part III)
$1,064,493

Program services were 68.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PREMIUM REVENUE

    total $1,552,796 · related or exempt $1,552,796

  • 3 · Investment income

    total $63,794 · excluded $63,794

  • 7a · Gross sales of assets other than inventory

    securities $83,446

  • 7b · Less cost or other basis and sales expenses

    securities $0

  • 7c · Gain or loss

    securities $83,446

  • 7d · Net gain or loss

    total $83,446 · excluded $83,446

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $185,543 · management and general $185,543

  • 9 · Other employee benefits

    total $15,884 · management and general $15,884

  • 10 · Payroll taxes

    total $14,071 · management and general $14,071

  • 11a · Fees: management

    total $85,549 · management and general $85,549

  • 11c · Fees: accounting

    total $59,231 · management and general $59,231

  • 11f · Fees: investment management

    total $1,329 · management and general $1,329

  • 11g · Fees: other

    total $1,023,205 · program services $1,023,205

  • 12 · Advertising and promotion

    total $23,857 · program services $23,857

  • 13 · Office expenses

    total $2,150 · management and general $2,150

  • 14 · Information technology

    total $17,381 · program services $17,381

  • 17 · Travel

    total $9,744 · management and general $9,744

  • 19 · Conferences, conventions and meetings

    total $300 · management and general $300

  • 24a · Other expenses: LICENSES, TAXES, FEES

    total $92,382 · management and general $92,382

  • 24b · Other expenses: ALL OTHER EXPENSE

    total $23,449 · management and general $23,449

  • 24c · Other expenses: BAD DEBT EXPENSE

    total $50 · program services $50

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $1,903,426 · end of year $2,058,762

  • 4 · Accounts receivable

    beginning of year $42,456 · end of year $106,315

  • 9 · Prepaid expenses and deferred charges

    beginning of year $304 · end of year $3,581

  • 11 · Investments: publicly traded securities

    beginning of year $2,053,043 · end of year $2,186,740

  • 15 · Other assets

    beginning of year $136,771 · end of year $109,140

  • 17 · Accounts payable and accrued expenses

    beginning of year $33,149 · end of year $86,247

  • 25 · Other liabilities

    beginning of year $339,417 · end of year $456,427

  • 27 · Net assets without donor restrictions

    beginning of year $3,763,434 · end of year $3,921,864

Mission and programs · 2024

Mission

WE, MOUNT CARMEL AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES.MOUNT CARMEL HEALTH PLAN OF CONNECTICUT IS A MEMBER OF MOUNT CARMEL AND TRINITY HEALTH.

Activities or mission (Part I)

TO OPERATE A MEDICARE HMO FOR SENIORS

  • MOUNT CARMEL HEALTH PLAN OF CONNECTICUT WAS FORMED IN 2021 FOR THE PURPOSE OF PROVIDING COMPREHENSIVE HEALTH CARE COVERAGE TO SENIORS IN THE NEW ENGLAND AREA AS A WHOLLY OWNED SUBSIDIARY OF MOUNT CARMEL HEALTH PLAN. IT IS A MEMBER OF THE MOUNT CARMEL HEALTH SYSTEM, A TAX-EXEMPT HEALTH CARE SYSTEM UNDER IRC SECTION 501(C)(3). MOUNT CARMEL HEALTH PLAN OF CONNECTICUT IS A NONPROFIT ORGANIZATION THAT OFFERS BENEFITS THROUGH A MEDICARE ADVANTAGE PLAN (TRINITY HEALTH PLAN OF NEW ENGLAND) APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) THAT REPLACES TRADITIONAL MEDICARE COVERAGE. TRINITY HEALTH PLAN OF NEW ENGLAND SERVES SENIORS AND OTHER MEDICARE BENEFICIARIES IN FOUR CONNECTICUT COUNTIES.PLAN MEMBERS ELECT TO HAVE TRINITY HEALTH PLAN OF NEW ENGLAND (INSTEAD OF THE FEDERAL GOVERNMENT) ADMINISTER THE BENEFITS OF MEDICARE PART A AND PART B, AND THE PLAN ALSO OFFERS PHARMACEUTICAL COVERAGE UNDER MEDICARE PART D. TRINITY HEALTH PLAN OF NEW ENGLAND IS REQUIRED TO PROVIDE COVERAGE FOR EVERYTHING THAT THE FEDERAL MEDICARE PROGRAM COVERS, PLUS THE PLAN ALSO OFFERS ADDITIONAL ITEMS SUCH AS: UNLIMITED INPATIENT HOSPITAL DAYS COVERED AT 100% WITH NO DEDUCTIBLE (SMALL COPAY FOR FIRST 4 DAYS); OUTPATIENT SURGERY FOR A SMALL CO-PAYMENT; DIAGNOSTIC AND TESTING SERVICES FOR A SMALL CO-PAYMENT; HOME HEALTH CARE AND SKILLED NURSING CARE COVERAGE WHEN NECESSARY; PRESCRIPTION DRUG BENEFITS; PHYSICIAN OFFICE VISITS WITH FIXED COPAYMENTS; AND UNLIMITED GENERIC DRUG COVERAGE.AS AN INTEGRAL PART OF MOUNT CARMEL HEALTH SYSTEM, MOUNT CARMEL HEALTH PLAN OF CONNECTICUT IS A COMMUNITY-BASED MANAGED HEALTH CARE ORGANIZATION THAT WORKS IN COLLABORATION WITH EMPLOYERS, INDIVIDUAL MEMBERS, PHYSICIANS, HEALTH CARE PROVIDERS, AND COMMUNITY AND GOVERNMENTAL AGENCIES TO CONTINUALLY IMPROVE THE HEALTH OF ITS MEMBERS BY PROVIDING EXCEPTIONAL COVERAGE AND ACCESS TO HIGH QUALITY AND COST-EFFECTIVE CARE.PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION:WWW.TRINITYHEALTHOFNE.ORG/MEDICARE

    Expenses $1,064,493 · Revenue $1,552,796

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • JACK RANDOLPH

    DIRECTOR; CHAIR; PRESIDENT & CEO

    Total calculated
    $1,121,281
    From this org
    $0
    From related orgs
    $922,877
    Other
    $198,404
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $559,663 related
    Bonus
    $0 + $223,555 related
    Other
    $0 + $139,659 related
    Deferred
    $0 + $161,469 related
    Nontaxable benefits
    $0 + $36,935 related
    Filer's total
    $0 + $1,121,281 related

  • ANDY PRIDAY

    MOUNT CARMEL CFO

    Total calculated
    $584,670
    From this org
    $0
    From related orgs
    $549,581
    Other
    $35,089
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $440,144 related
    Bonus
    $0 + $102,135 related
    Other
    $0 + $7,302 related
    Deferred
    $0 + $16,675 related
    Nontaxable benefits
    $0 + $18,414 related
    Filer's total
    $0 + $584,670 related

  • MARK MURPHY

    DIR AT 8/24; CHF STRATEGY OFF NY REG

    Total calculated
    $577,276
    From this org
    $0
    From related orgs
    $513,860
    Other
    $63,416
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $385,815 related
    Bonus
    $0 + $117,180 related
    Other
    $0 + $10,865 related
    Deferred
    $0 + $20,425 related
    Nontaxable benefits
    $0 + $42,991 related
    Filer's total
    $0 + $577,276 related

  • CLAUDIO CAPONE

    DIR; REG VP STRAT TH OF NE THR 7/24

    Total calculated
    $558,269
    From this org
    $0
    From related orgs
    $342,196
    Other
    $216,073
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $157,786 related
    Bonus
    $0 + $60,772 related
    Other
    $0 + $123,638 related
    Deferred
    $0 + $183,101 related
    Nontaxable benefits
    $0 + $32,972 related
    Filer's total
    $0 + $558,269 related

  • GREG WISE MD

    MEDICAL DIRECTOR MCHP

    Total calculated
    $466,792
    From this org
    $0
    From related orgs
    $434,319
    Other
    $32,473
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $369,583 related
    Bonus
    $0 + $62,217 related
    Other
    $0 + $2,519 related
    Deferred
    $0 + $8,749 related
    Nontaxable benefits
    $0 + $23,724 related
    Filer's total
    $0 + $466,792 related

  • DAVID VIS

    DIR; SEC;TREAS;VP FINANCE OPERATIONS

    Total calculated
    $444,028
    From this org
    $0
    From related orgs
    $399,687
    Other
    $44,341
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $337,085 related
    Bonus
    $0 + $58,124 related
    Other
    $0 + $4,478 related
    Deferred
    $0 + $20,425 related
    Nontaxable benefits
    $0 + $23,916 related
    Filer's total
    $0 + $444,028 related

  • CARLOS ALVARADO

    CHIEF ADMINISTRATIVE OFFICER MCHP

    Total calculated
    $387,708
    From this org
    $0
    From related orgs
    $332,745
    Other
    $54,963
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $281,330 related
    Bonus
    $0 + $50,154 related
    Other
    $0 + $1,261 related
    Deferred
    $0 + $20,398 related
    Nontaxable benefits
    $0 + $34,565 related
    Filer's total
    $0 + $387,708 related

  • TRISHA WHETSTONE

    ASST SECRETARY; MCHS ASSOC COUNSEL

    Total calculated
    $264,412
    From this org
    $0
    From related orgs
    $219,465
    Other
    $44,947
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $193,664 related
    Bonus
    $0 + $25,633 related
    Other
    $0 + $168 related
    Deferred
    $0 + $14,918 related
    Nontaxable benefits
    $0 + $30,029 related
    Filer's total
    $0 + $264,412 related

  • FATOU NDOYE

    ASST TREASURER; MCHP CONTROLLER

    Total calculated
    $243,058
    From this org
    $0
    From related orgs
    $193,185
    Other
    $49,873
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $171,957 related
    Bonus
    $0 + $20,565 related
    Other
    $0 + $663 related
    Deferred
    $0 + $13,367 related
    Nontaxable benefits
    $0 + $36,506 related
    Filer's total
    $0 + $243,058 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
MOUNT CARMEL HEALTH PLAN OF CONNECTICUT IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL HEALTH PLAN OF CONNECTICUT'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MOUNT CARMEL HEALTH PLAN OF CONNECTICUT'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-B
THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2024. THIS AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CLAUDIO CAPONE - $114,685 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNT, WHICH WAS UNPAID AS OF 12/31/24: CLAUDIO CAPONE - $169,297 (PAID IN 2025) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2024. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2024, AND THEIR NON-VESTED BENEFITS FOR 2024 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2024 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: ANDY PRIDAY - $0 JACK RANDOLPH - $113,587 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION N PRIOR YEARS. THE FOLLOWING ACCRUAL FOR 2024 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: JACK RANDOLPH - $141,044 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($345,000 FOR 2024). THE FOLLOWING PAYOUTS FOR 2024 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CLAUDIO CAPONE - $155 MARK MURPHY - $3,293 ANDY PRIDAY - $5,301

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2024
Filed
11 November 2025
IRS schema version
2024v5.2
Source object
202513159349304151

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.