Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 1d · Related organizations

  $150,000

• 1e · Government grants (contributions)

  $16,913,298

• 2a · Program service revenue: GOVERNMENT-SUBSIDIZED PREMIUMS

  total $5,397,713,256 · related or exempt $5,397,713,256

• 2b · Program service revenue: SUBSCRIBER PREMIUM REVENUE

  total $290,627,129 · related or exempt $290,627,129

• 2c · Program service revenue: THIRD PARTY ADMINISTRATIVE FEES

  total $2,190,998 · related or exempt $2,004,398 · unrelated business $186,600

• 3 · Investment income

  total $1,563,176 · unrelated business $838,252 · excluded $724,924

• 6a · Gross rents

  real property $18,501,713

• 6b · Less rental expenses

  real property $16,425,600

• 6c · Rental income or loss

  real property $2,076,113

• 6d · Net rental income or loss

  total $2,076,113 · excluded $2,076,113

• 7a · Gross sales of assets other than inventory

  securities $44,681,273 · other assets $3,756,450

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

  securities $0 · other assets $3,337,688

• 7c · Gain or loss

  securities $44,681,273 · other assets $418,762

• 7d · Net gain or loss

  total $45,100,035 · excluded $45,100,035

• 11a · Other revenue: PHARMACY REVENUE

  total $132,795 · related or exempt $24 · unrelated business $132,771

• 11e · Other revenue, total

  $132,795

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $227,043 · program services $227,043

• 5 · Compensation of officers, directors and key employees

  total $27,139,633 · management and general $27,139,633

• 6 · Compensation of disqualified persons

  total $329,625 · management and general $329,625

• 7 · Other salaries and wages

  total $124,756,068 · management and general $124,756,068

• 8 · Pension plan contributions

  total $18,963,472 · management and general $18,963,472

• 9 · Other employee benefits

  total $15,057,587 · management and general $15,057,587

• 10 · Payroll taxes

  total $11,120,583 · management and general $11,120,583

• 11b · Fees: legal

  total $9,982,871 · management and general $9,982,871

• 11c · Fees: accounting

  total $2,385,561 · management and general $2,385,561

• 11f · Fees: investment management

  total $171,099 · management and general $171,099

• 11g · Fees: other

  total $219,724,931 · management and general $219,724,931

• 12 · Advertising and promotion

  total $5,451,832 · management and general $5,451,832

• 13 · Office expenses

  total $14,666,541 · management and general $14,666,541

• 16 · Occupancy

  total $24,307,474 · management and general $24,307,474

• 17 · Travel

  total $1,841,651 · management and general $1,841,651

• 19 · Conferences, conventions and meetings

  total $81,398 · management and general $81,398

• 20 · Interest

  total $1,745,753 · management and general $1,745,753

• 22 · Depreciation, depletion and amortization

  total $9,015,718 · management and general $9,015,718

• 23 · Insurance

  total $15,554,973 · management and general $15,554,973

• 24a · Other expenses: SUBSCRIBER BENEFITS

  total $5,110,015,024 · program services $5,110,015,024

• 24b · Other expenses: OUTSOURCED SERVICES

  total $42,224,639 · program services $42,224,639

• 24c · Other expenses: CAPITATION PAYMENTS

  total $34,918,328 · program services $34,918,328

• 24d · Other expenses: BROKER COMMISSIONS

  total $16,115,187 · management and general $16,115,187

• 24e · All other expenses

  total $49,330,256 · program services $22,108,430 · management and general $27,221,826

Balance sheet

Part X, book values.

• 2 · Savings and temporary cash investments

  beginning of year $260,820,528 · end of year $255,271,461

• 4 · Accounts receivable

  beginning of year $338,144,539 · end of year $395,619,160

• 9 · Prepaid expenses and deferred charges

  beginning of year $19,452,400 · end of year $16,599,190

• 10a · Land, buildings and equipment: cost or other basis

  $357,701,073

• 10b · Land, buildings and equipment: accumulated depreciation

  $176,558,057

• 10c · Land, buildings and equipment, net

  beginning of year $186,305,436 · end of year $181,143,016

• 11 · Investments: publicly traded securities

  beginning of year $127,128,780 · end of year $74,087,127

• 12 · Investments: other securities

  beginning of year $776,390,777 · end of year $724,896,507

• 14 · Intangible assets

  beginning of year $1,785,269 · end of year $0

• 15 · Other assets

  beginning of year $236,516,470 · end of year $864,393,212

• 17 · Accounts payable and accrued expenses

  beginning of year $993,521,539 · end of year $954,011,921

• 19 · Deferred revenue

  beginning of year $48,360,885 · end of year $34,832,710

• 23 · Secured mortgages and notes payable

  beginning of year $44,870,890 · end of year $86,575,948

• 25 · Other liabilities

  beginning of year $293,238,470 · end of year $902,774,318

• 27 · Net assets without donor restrictions

  beginning of year $566,552,415 · end of year $533,814,776

The filer's explanations (Part III)

PART I, LINES 4A-B

LINE 4(A) - SEVERANCE THE FOLLOWING INDIVIDUALS REPORTED ON THE FORM 990, SCHEDULE J, RECEIVED SEVERANCE PAYMENTS IN CALENDAR YEAR 2022: -VP, PHARMACY SOLUTIONS, MARGARET FINN $320,000 -CHIEF PEOPLE OFFICER, DONNA HUGHES $500,000 -SVP, PROVIDER NETWORK & POPULATION HEALTH, ERIC J. WALLACE $375,000 THE SEVERANCE PAYMENTS DOCUMENTED ABOVE ARE REPORTED IN THE FORM 990, SCHEDULE J, PART II, COLUMN (B)(III). LINE 4(B) - SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN EMBLEMHEALTH SERVICES COMPANY, LLC ("EMBLEMHEALTH SERVICES") SPONSORS A NONQUALIFIED RETIREMENT PLAN THAT OFFICERS OF HIPGNY WITH THE TITLES OF SENIOR VICE PRESIDENT AND ABOVE HIRED BEFORE JUNE 1, 2009, PARTICIPATE IN. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR EMBLEMHEALTH SERVICES 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 WHO RETIRE PRIOR TO AGE 65 HAVE THEIR BENEFITS REDUCED BY EARLY RETIREMENT FACTORS.

PART I, LINE 6

HIPGNY HAS A SALES PERFORMANCE AWARD PROGRAM IN PLACE THAT IS DESIGNED TO INCENTIVIZE ITS SALES EMPLOYEES TO DELIVER HIGH QUALITY SERVICE TO HIPGNY'S CUSTOMERS/SUBSCRIBERS. EMPLOYEES ELIGIBLE TO PARTICIPATE IN THE PROGRAM HAVE TWO OPPORTUNITIES TO EARN SALES INCENTIVES: 1. A QUARTERLY BONUS OPPORTUNITY BASED UPON MEETING CERTAIN MEMBERSHIP AND GOAL METRICS AND, 2. A BONUS BASED ON ACHIEVING NEW MEDICARE SUPPLEMENTAL SALES THESE COMMISSION PAYMENTS ARE REPORTED IN THE FORM 990, SCHEDULE J, PART II, COLUMN (B)(II). OF THE INDIVIDUALS REPORTED ON THE FORM 990, ONLY THE ORGANIZATION'S TOP FIVE HIGHLY COMPENSATED EMPLOYEES PARTICIPATE IN THIS PROGRAM.

PART I, LINE 7

BONUS PAYMENTS HIPGNY (VIA EMBLEMHEALTH SERVICES, THE PAYROLL PAYOR) PROVIDES ANNUAL INCENTIVE AWARDS BASED UPON THE ACHIEVEMENT OF PERFORMANCE METRICS. THE COMPENSATION COMMITTEES APPROVE THE PERFORMANCE METRICS AND TARGETS AND THE ULTIMATE PAYOUT TO PARTICIPANTS BASED UPON THE PERFORMANCE ACHIEVED UNDER THE ANNUAL INCENTIVE PLAN (AIP).

FORM 990, SCHEDULE J, PART II, COLUMN (C) AND (F):

THE MANAGEMENT PENSION PLAN WAS FROZEN EFFECTIVE JANUARY 1, 2016 AND REPLACED WITH A MATCHING 401(K) PROGRAM. THE AMOUNTS IN COLUMN C PRIMARILY REPRESENT THE COMPANY MATCH TO THE 401(K) PROGRAM. FOR SEVEN INDIVIDUALS, (MICHAEL PALMATEER, GEORGE BABITSCH, JEFFREY CHANSLER, KAREN IGNAGNI, ROBERT HORMAZABA, JENNIFER MARTINO, AND JILL STEIN), COLUMN C ALSO REPORTS THE CHANGE IN ACTUARIAL VALUE OF THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN II FOR EMBLEMHEALTH SERVICES COMPANY, LLC ("SERP II"). THE SERP II AMOUNTS INCLUDED IN COLUMN C ARE DEFERRED COMPENSATION THAT MAY OR MAY NOT BE PAID AS IT IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. THIS DOES NOT REPRESENT ACTUAL PAYMENT RECEIVED IN 2022. TO THE EXTENT ANY INDIVIDUAL REPORTED ON SCHEDULE J HAS COMPENSATION REPORTED IN COLUMN (F), THOSE AMOUNTS REFLECT PAYOUTS OF PREVIOUSLY REPORTED DEFERRED COMPENSATION ON A PRIOR YEAR FORM 990. THERE HAVE BEEN NO PAYOUTS FROM SERP II SINCE INCEPTION FOR THE INDIVIDUALS NOTED ABOVE.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

• EMBLEMHEALTH SERVICES COMPANY LLC

  ADMIN SERVICES · NY · income -$2,512,244 · assets $205,299,212

  Directly controlled by HIPGNY

Related partnerships

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

• EMBLEMHEALTH CITYBLOCK LLC

  UNRELATED · HEALTHCARE · NY

  Directly controlled by EMBLEMHEALTH

• BRONXDOCS MANAGEMENT CO LLC

  UNRELATED · HEALTHCARE · NY · 51% owned · share of income $852,596 · share of assets $2,615,391 · 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 · share of income $551,323,595 · share of assets $693,379,804 · controlled entity

  Directly controlled by HIPGNY

• HIP HOLDINGS INC & SUBSIDIARIES

  C · INSURANCE · NY · 100% owned · share of income $1,955,522,100 · share of assets $943,870,136 · controlled entity

  Directly controlled by HIPGNY

• ADVANTAGECARE PHYSICIANS PC

  C · HEALTHCARE · NY · 100% owned · share of income $428,884,400 · share of assets $154,771,372 · controlled entity

  Directly controlled by HIPGNY

• SIUC MEDICAL PC

  C · HEALTHCARE · NY · 100% owned · share of income $9,232,574 · share of assets $3,233,456 · controlled entity

  Directly controlled by HIPGNY