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Nonprofiteer
← EMBLEMHEALTH INC

Form 990 for tax year 2023

Filed by EMBLEMHEALTH INC.

Totals

Total revenue
$1,960,266
Total expenses
$1,960,266
Contributions and grants received
$237,290
Grants paid
$344,960
Program service revenue
$1,722,976
Investment income
$0
Other revenue
$0
Total assets, end of year
$827,526
Total liabilities, end of year
$237,290
Net assets or fund balances, end of year
$590,236
Program services expenses (Part IX)
$1,960,266
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$1,960,266

Program services were 100.0% 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.

  • 1e · Government grants (contributions)

    $237,290

  • 2a · Program service revenue: ADMINISTRATIVE SERVICES

    total $1,722,976 · related or exempt $1,722,976

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $344,960 · program services $344,960

  • 5 · Compensation of officers, directors and key employees

    total $1,588,795 · program services $1,588,795

  • 17 · Travel

    total $7,796 · program services $7,796

  • 24a · Other expenses: MISCELLANEOUS EXPENSE

    total $18,715 · program services $18,715

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $224,540 · end of year $461,837

  • 15 · Other assets

    beginning of year $365,696 · end of year $365,689

  • 18 · Grants payable

    end of year $237,290

  • 27 · Net assets without donor restrictions

    beginning of year $590,236 · end of year $590,236

Mission and programs · 2023

Mission

EMBLEMHEALTH, INC. IS A NOT-FOR-PROFIT CORPORATION INCORPORATED IN NEW YORK STATE THAT, TOGETHER WITH ITS SUBSIDIARIES, PROVIDES MANAGED HEALTH CARE SERVICES TO ITS MEMBERS.

Activities or mission (Part I)

EMBLEMHEALTH INC. SUPPORTS THE TAX-EXEMPT MISSION OF HIPNY (SEE SCHEDULE O).EMBLEMHEALTH INC. OPERATES AS A HOLDING COMPANY THAT SUPPORTS THE TAX-EXEMPT HEALTHCARE MISSION OF ITS SUPPORTED ORGANIZATION, HEALTH INSURANCE PLAN OF GREATER NEW YORK.FORM 990, PART V, LINE 1A:EMBLEMHEALTH, INC. DOES NOT ISSUE ANY FORM 1099S. THE INDIVIDUALS LISTED IN THE FORM 990 PART VII WERE PAID BY RELATED ORGANIZATION, HEALTH INSURANCE PLAN OF GREATER NEW YORK, THROUGH ITS DISREGARDED ENTITY, EMBLEMHEALTH SERVICES COMPANY, LLC. EMBLEMHEALTH SERVICES COMPANY, LLC ISSUED THE FORM 1099S TO THE INDIVIDUALS BEING LISTED IN FORM 990 PART VII.

  • EMBLEMHEALTH'S TAX-EXEMPT MISSION IS TO SUPPORT THE HEALTHCARE ACTIVITIES OF ITS SUPPORTED ORGANIZATION, HEALTH INSURANCE PLAN OF GREATER NEW YORK. MOST OF THE COSTS INCURRED BY EMBLEMHEALTH, INC. ARE ANNUAL BOARD OF DIRECTORS FEES (AND ANCILLARY EXPENSES ASSOCIATED WITH BOARD SERVICE). IN ADDITION, EMBLEMHEALTH, INC. DISTRIBUTED A GRANT TO ITS PARENT ORGANIZATION, AS WELL AS OTHER SMALL GRANTS TO SELECT SECTION 501(C)(3) PUBLIC CHARITIES.

    Expenses $1,960,266 · Grants $344,960 · Revenue $1,722,976

As filed on the 2023 return.

Listed in Part VII

  • Karen Ignagni

    CHIEF EXECUTIVE OFFICER

    Total calculated
    $5,595,912
    From this org
    $0
    From related orgs
    $5,511,820
    Other
    $84,092
    Hours/week
    2 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,212,676 related
    Bonus
    $0 + $4,299,144 related
    Other
    $0
    Deferred
    $0 + $49,800 related
    Nontaxable benefits
    $0 + $34,292 related
    Filer's total
    $0 + $5,595,912 related
  • John Feerick

    CHAIRMAN

    Total calculated
    $163,750
    From this org
    $0
    From related orgs
    $163,750
    Other
    $0
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $163,750 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $163,750 related
  • Paul Gibson

    VICE CHAIRPERSON OF THE BOARD

    Total calculated
    $151,375
    From this org
    $0
    From related orgs
    $151,375
    Other
    $0
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $151,375 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $151,375 related
  • Bernard Schayes MD

    DIRECTOR

    Total calculated
    $158,714
    From this org
    $0
    From related orgs
    $137,381
    Other
    $21,333
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $137,381 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $21,333 related
    Filer's total
    $0 + $158,714 related
  • Richard Berman

    DIRECTOR

    Total calculated
    $148,686
    From this org
    $0
    From related orgs
    $143,750
    Other
    $4,936
    Hours/week
    1 + 2 related
  • Barbara Shattuck Kohn

    DIRECTOR

    Total calculated
    $136,500
    From this org
    $0
    From related orgs
    $136,500
    Other
    $0
    Hours/week
    1
  • Karin Mayhew

    DIRECTOR

    Total calculated
    $138,500
    From this org
    $0
    From related orgs
    $138,500
    Other
    $0
    Hours/week
    1
  • Sam Havens

    DIRECTOR

    Total calculated
    $136,375
    From this org
    $0
    From related orgs
    $136,375
    Other
    $0
    Hours/week
    1
  • Rosa Gil Dsw

    DIRECTOR

    Total calculated
    $124,295
    From this org
    $0
    From related orgs
    $124,295
    Other
    $0
    Hours/week
    1
  • Jo Ivey Boufford

    DIRECTOR

    Total calculated
    $105,750
    From this org
    $0
    From related orgs
    $105,750
    Other
    $0
    Hours/week
    1
  • John Banks III

    DIRECTOR

    Total calculated
    $121,178
    From this org
    $0
    From related orgs
    $121,000
    Other
    $178
    Hours/week
    1 + 2 related
  • Gregory Floyd

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • Wayne Cafran

    DIRECTOR

    Total calculated
    $135,000
    From this org
    $0
    From related orgs
    $135,000
    Other
    $0
    Hours/week
    1 + 2 related
  • Kathy Hirata Chin

    DIRECTOR

    Total calculated
    $114,500
    From this org
    $0
    From related orgs
    $114,500
    Other
    $0
    Hours/week
    1
  • Michael Palmateer

    PRESIDENT

    Total calculated
    $3,612,372
    From this org
    $0
    From related orgs
    $3,514,982
    Other
    $97,390
    Hours/week
    1 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $907,761 related
    Bonus
    $0 + $2,607,221 related
    Other
    $0
    Deferred
    $0 + $79,243 related
    Nontaxable benefits
    $0 + $18,147 related
    Filer's total
    $0 + $3,612,372 related
  • Heather Tamborino

    CHIEF FINANCIAL OFFICER

    Total calculated
    $3,023,100
    From this org
    $0
    From related orgs
    $2,960,120
    Other
    $62,980
    Hours/week
    1 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $790,960 related
    Bonus
    $0 + $2,169,110 related
    Other
    $0 + $50 related
    Deferred
    $0 + $49,800 related
    Nontaxable benefits
    $0 + $13,180 related
    Filer's total
    $0 + $3,023,100 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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 4B
SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN II COMPENSATION EMBLEMHEALTH, INC. DOES NOT SPONSOR ANY UNQUALIFIED RETIREMENT PLANS, HOWEVER, EMBLEMHEALTH SERVICES COMPANY LLC SPONSORS NONQUALIFIED RETIREMENT PLANS, BUT NO EQUITY BASED COMPENSATION PLANS. OFFICERS WITH THE TITLES OF SENIOR VICE PRESIDENT AND ABOVE HIRED PRIOR TO JUNE 1, 2009, PARTICIPATE IN THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN II FOR EMBLEMHEALTH SERVICES COMPANY, LLC ("SERP II"). THE SERP II PROVIDES A RETIREMENT BENEFIT CALCULATED ON THE BASIS OF 50% OF FINAL AVERAGE PAY, OFFSET BY BENEFITS UNDER ANY QUALIFIED BENEFIT PLAN, SUCH AS THE EMBLEMHEALTH SERVICES COMPANY, LLC EMPLOYEES' RETIREMENT PLAN. PARTICIPANTS REQUIRE THE APPROVAL OF THE BOARD OF DIRECTORS TO RETIRE UNDER THE SERP II BETWEEN THE AGES OF 55 AND 60. PARTICIPANTS WHO RETIRE PRIOR TO AGE 65 HAVE THEIR SERP II BENEFITS REDUCED BY EARLY RETIREMENT FACTORS.

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

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.

  • BRONXDOCS MANAGEMENT COMPANY LLC

    UNRELATED · HEALTHCARE · NY · 51% owned · general or managing partner

    Directly controlled by HIPGNY

Related corporations and trusts

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

  • EMBLEMHEALTH PLAN INC

    C · INSURANCE · NY · 100% owned · controlled entity

    Directly controlled by HIPGNY

  • HIP HOLDINGS INC & SUBSIDIARIES

    C · INSURANCE · NY · 100% owned · controlled entity

    Directly controlled by HIPGNY

  • ADVANTAGECARE PHYSICIANS PC

    C · HEALTHCARE · NY · 100% owned · controlled entity

    Directly controlled by HIPGNY

  • SIUC MEDICAL PC

    C · HEALTHCARE · NY · 100% owned · controlled entity

    Directly controlled by HIPGNY

Provenance

Return type
form_990
Tax year
2023
Filed
15 November 2024
IRS schema version
2023v5.1
Source object
202443169349302199

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