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Nonprofiteer
← EMBLEMHEALTH INC

Form 990 for tax year 2022

Filed by EMBLEMHEALTH INC.

Totals

Total revenue
$4,648,814
Total expenses
$1,647,979
Contributions and grants received
$2,983
Grants paid
$99,795
Program services expenses (Part IX)
$1,647,979
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$1,647,979

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • KAREN IGNAGNI

    CHIEF EXECUTIVE OFFICER

    Total calculated
    $5,114,256
    From this org
    $0
    From related orgs
    $5,045,764
    Other
    $68,492
    Hours/week
    2 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,205,764 related
    Bonus
    $0 + $3,840,000 related
    Other
    $0
    Deferred
    $0 + $45,300 related
    Nontaxable benefits
    $0 + $23,192 related
    Filer's total
    $0 + $5,114,256 related

  • JOHN FEERICK

    CHAIRMAN

    Total calculated
    $161,125
    From this org
    $0
    From related orgs
    $161,125
    Other
    $0
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $161,125 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $161,125 related

  • PAUL E GIBSON

    VICE CHAIRPERSON OF THE BOARD

    Total calculated
    $149,625
    From this org
    $0
    From related orgs
    $149,625
    Other
    $0
    Hours/week
    1 + 2 related

  • BERNARD SCHAYES MD

    DIRECTOR

    Total calculated
    $161,380
    From this org
    $0
    From related orgs
    $142,391
    Other
    $18,989
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $142,391 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $18,989 related
    Filer's total
    $0 + $161,380 related

  • RICHARD BERMAN

    DIRECTOR

    Total calculated
    $132,877
    From this org
    $0
    From related orgs
    $128,000
    Other
    $4,877
    Hours/week
    1 + 2 related

  • BARBARA S KOHN

    DIRECTOR

    Total calculated
    $129,500
    From this org
    $0
    From related orgs
    $129,500
    Other
    $0
    Hours/week
    1

  • KARIN D MAYHEW

    DIRECTOR

    Total calculated
    $131,500
    From this org
    $0
    From related orgs
    $131,500
    Other
    $0
    Hours/week
    1

  • SAM HAVENS

    DIRECTOR

    Total calculated
    $146,994
    From this org
    $0
    From related orgs
    $146,994
    Other
    $0
    Hours/week
    1

  • ROSA M GIL DSW

    DIRECTOR

    Total calculated
    $126,795
    From this org
    $0
    From related orgs
    $126,795
    Other
    $0
    Hours/week
    1

  • JO IVEY BOUFFORD

    DIRECTOR

    Total calculated
    $101,375
    From this org
    $0
    From related orgs
    $101,375
    Other
    $0
    Hours/week
    1

  • JOHN H BANKS III

    DIRECTOR

    Total calculated
    $118,553
    From this org
    $0
    From related orgs
    $118,375
    Other
    $178
    Hours/week
    1 + 2 related

  • GREGORY FLOYD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • WAYNE CAFRAN

    DIRECTOR

    Total calculated
    $131,500
    From this org
    $0
    From related orgs
    $131,500
    Other
    $0
    Hours/week
    1 + 2 related

  • KATHY HIRATA CHIN

    DIRECTOR

    Total calculated
    $109,250
    From this org
    $0
    From related orgs
    $109,250
    Other
    $0
    Hours/week
    1

  • MICHAEL PALMATEER

    PRESIDENT

    Total calculated
    $3,333,137
    From this org
    $0
    From related orgs
    $2,875,045
    Other
    $458,092
    Hours/week
    1 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $912,919 related
    Bonus
    $0 + $1,962,126 related
    Other
    $0
    Deferred
    $0 + $440,750 related
    Nontaxable benefits
    $0 + $17,342 related
    Filer's total
    $0 + $3,333,137 related

  • HEATHER TAMBORINO

    CHIEF FINANCIAL OFFICER

    Total calculated
    $2,104,759
    From this org
    $0
    From related orgs
    $2,046,857
    Other
    $57,902
    Hours/week
    1 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $795,636 related
    Bonus
    $0 + $1,251,221 related
    Other
    $0
    Deferred
    $0 + $45,300 related
    Nontaxable benefits
    $0 + $12,602 related
    Filer's total
    $0 + $2,104,759 related

  • DR STUART ALTMAN

    FORMER DIRECTOR

    Total calculated
    $120,000
    From this org
    $0
    From related orgs
    $120,000
    Other
    $0
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $120,000 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $120,000 related

  • CHARLES P WANG

    FORMER DIRECTOR

    Total calculated
    $65,447
    From this org
    $0
    From related orgs
    $60,000
    Other
    $5,447
    Hours/week
    1 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $60,000 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $5,447 related
    Filer's total
    $0 + $65,447 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 — 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.

Provenance

Return type
form_990
Tax year
2022
Filed
9 November 2023
IRS schema version
2022v5.0
Source object
202323139349305402

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