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← HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND INC

Form 990 for tax year 2022

Filed by HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND INC.

Totals

Total revenue
$521,545,311
Total expenses
$543,582,863
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$520,569,374
Investment income
$975,937
Other revenue
$0
Total assets, end of year
$156,187,608
Total liabilities, end of year
$92,243,892
Net assets or fund balances, end of year
$63,943,716
Program services expenses (Part IX)
$532,519,393
Management and general expenses
$11,063,470
Fundraising expenses
$0
Program service expenses (Part III)
$532,519,393

Program services were 98.0% 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.

  • 2a · Program service revenue: MEMBER PREMIUMS & ASO FEES

    total $520,569,374 · related or exempt $520,569,374

  • 3 · Investment income

    total $3,260,693 · excluded $3,260,693

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7a · Gross sales of assets other than inventory

    securities $48,693,504

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

    securities $50,978,260

  • 7c · Gain or loss

    securities -$2,284,756

  • 7d · Net gain or loss

    total -$2,284,756 · excluded -$2,284,756

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $454,892,846 · program services $454,892,846

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $0

  • 8 · Pension plan contributions

    total $0

  • 9 · Other employee benefits

    total $0

  • 10 · Payroll taxes

    total $0

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $0

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $0

  • 12 · Advertising and promotion

    total $0

  • 13 · Office expenses

    total $0

  • 14 · Information technology

    total $0

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $0

  • 17 · Travel

    total $0

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $0

  • 23 · Insurance

    total $0

  • 24a · Other expenses: MANAGEMENT SERVICES FEES

    total $70,438,406 · program services $59,374,936 · management and general $11,063,470 · fundraising $0

  • 24b · Other expenses: CLAIMS ADJUSTMENT EXPENSE

    total $9,910,662 · program services $9,910,662 · management and general $0 · fundraising $0

  • 24c · Other expenses: PREMIUM TAX EXPENSE

    total $8,340,949 · program services $8,340,949 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $12,534,218 · end of year $3,444,263

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $37,426,768 · end of year $37,213,982

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $117,815,870 · end of year $114,718,341

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $571,468 · end of year $811,022

  • 17 · Accounts payable and accrued expenses

    beginning of year $56,033,810 · end of year $50,538,729

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $49,508,635 · end of year $41,705,163

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $55,000,000 · end of year $80,000,000

  • 31 · Retained earnings, endowment or other funds

    beginning of year $7,805,879 · end of year -$16,056,284

Mission and programs · 2022

Mission

SEE SCHEDULE O

  • TO IMPROVE THE QUALITY AND VALUE OF HEALTH CARE FOR THE PEOPLE AND COMMUNITIES WE SERVE. AT 12/31/22, HPHC OF NEW ENGLAND, INC. HAD 65,134 FULLY INSURED MEMBERS. DURING 2022 AMBULATORY ENCOUNTERS WERE 582,499 AND HOSPITAL DAYS INCURRED WERE 19,285.

    Expenses $532,519,393 · Revenue $520,569,374

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Cain Hayes

    CEO & PRESIDENT

    Total calculated
    $2,776,610
    From this org
    $0
    From related orgs
    $2,440,620
    Other
    $335,990
    Hours/week
    2.5 + 47.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,139,681 related
    Bonus
    $0 + $1,300,939 related
    Other
    $0
    Deferred
    $0 + $308,583 related
    Nontaxable benefits
    $0 + $27,407 related
    Filer's total
    $0 + $2,776,610 related

  • Michael Carson

    FORMER PRESIDENT

    Total calculated
    $2,220,842
    From this org
    $0
    From related orgs
    $2,220,842
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $1,094,842 related
    Other
    $0 + $1,126,000 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $2,220,842 related

  • Umesh Kurpad

    CFO

    Total calculated
    $1,692,603
    From this org
    $0
    From related orgs
    $1,495,153
    Other
    $197,450
    Hours/week
    2.5 + 47.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $612,783 related
    Bonus
    $0 + $715,141 related
    Other
    $0 + $167,229 related
    Deferred
    $0 + $184,011 related
    Nontaxable benefits
    $0 + $13,439 related
    Filer's total
    $0 + $1,692,603 related

  • Tisa Hughes

    CLERK/SECR;CHIEF LEGAL OFFICER

    Total calculated
    $1,308,884
    From this org
    $0
    From related orgs
    $1,189,371
    Other
    $119,513
    Hours/week
    2.5 + 47.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $473,550 related
    Bonus
    $0 + $667,925 related
    Other
    $0 + $47,896 related
    Deferred
    $0 + $95,697 related
    Nontaxable benefits
    $0 + $23,816 related
    Filer's total
    $0 + $1,308,884 related

  • Charles Goheen

    FORMER CFO

    Total calculated
    $754,166
    From this org
    $0
    From related orgs
    $754,166
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $215,476 related
    Other
    $0 + $538,690 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $754,166 related

  • Roland Price

    TREASURER

    Total calculated
    $652,120
    From this org
    $0
    From related orgs
    $541,488
    Other
    $110,632
    Hours/week
    2.5 + 47.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $321,763 related
    Bonus
    $0 + $160,064 related
    Other
    $0 + $59,661 related
    Deferred
    $0 + $97,563 related
    Nontaxable benefits
    $0 + $13,069 related
    Filer's total
    $0 + $652,120 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)

FORM 990, SCHEDULE J, PART I, LINE 3
METHOD USED TO ESTABLISH CEO COMPENSATION HARVARD PILGRIM HEALTH CARE, INC. (HPHC) IS THE SOLE MEMBER OF HARVARD PILGRIM HEALTH CARE NEW ENGLAND, INC. HPHC RELIED ON ITS PARENT AND SOLE CORPORATE MEMBER, POINT32HEALTH, INC., TO ESTABLISH COMPENSATION FOR ITS CEO. THE METHODS USED BY POINT32HEALTH, INC. ARE AS FOLLOWS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE -WRITTEN EMPLOYMENT AGREEMENT ----------
FORM 990, SCHEDULE J, PART I, LINE 4A
DETAIL OF SEVERANCE PAYMENTS THE FOLLOWING SENIOR LEADERS, WHO DEPARTED THE COMPANY FOLLOWING THE CLOSE OF THE TRANSACTION, RECEIVED SEVERANCE OR CHANGE IN CONTROL PAYMENTS RELATING TO THE COMBINATION OF HARVARD PILGRIM HEALTH CARE AND TUFTS HEALTH PLAN. THESE PAYMENTS WERE DESIGNED TO RETAIN LEADERS WITH SIGNIFICANT EXPERTISE IN KEY AREAS AND TO ENSURE CONTINUITY OF OPERATIONS FOR BOTH ORGANIZATIONS THROUGH A LENGTHY AND UNCERTAIN REGULATORY REVIEW PROCESS THAT SPANNED OVER A FIFTEEN MONTH PERIOD, AS WELL AS A GLOBAL PANDEMIC: CHARLES GOHEEN = $538,690 MICHAEL CARSON = $1,126,000 ----------
FORM 990, SCHEDULE J, PART I, LINE 4B
DISCRETIONARY RETIREMENT PLAN THE ORGANIZATION'S LEADERS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN SPONSORED BY THEIR EMPLOYER, POINT32HEALTH SERVICES, INC., A RELATED PARTY. THE EMPLOYEES AND AMOUNTS LISTED ON SCHEDULE J, PART II, COLUMN C REFLECT EMPLOYER CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN.

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.

  • CAREPARTNERS OF CT HOLDINGS LLC

    N/A · HOLDING COMPANY · CT

    Directly controlled by TAHMO

  • CLARION MANAGEMENT SOLUTIONS LLC

    N/A · CLINICAL CONSULTG · DE

    Directly controlled by EH NEXUS

  • EMPLOYERS HEALTH NEXUS LLC

    N/A · HOLDING COMPANY · MA

    Directly controlled by HEALTH PLANS

  • EMPLOYERS HEALTH NETWORK LLC

    N/A · SELF INSURANCE · DE

    Directly controlled by EH NEXUS

  • KP VENTURES LLC SERIES B

    N/A · HEALTHCARE · CA

    Directly controlled by TAHMO

  • KP VENTURES LLC SERIES D

    N/A · HEALTHCARE · CA

    Directly controlled by TAHMO

Related corporations and trusts

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

  • HPHC INSURANCE COMPANY INC

    C CORP · HEALTH INSURANCE · MA · controlled entity

    Directly controlled by NEW HPHC HOLDCO

  • PLAN MARKETING INSURANCE AGENCY INC

    C CORP · BROKERAGE · MA · controlled entity

    Directly controlled by HEALTH PLANS

  • HPHC INSURANCE AGENCY INC

    C CORP · BROKERAGE · MA · controlled entity

    Directly controlled by NEW HPHC HOLDCO

  • HEALTH PLANS INC

    C CORP · TPA · MA · controlled entity

    Directly controlled by NEW HPHC HOLDCO

  • CARE MANAGEMENT SERVICES INC

    C CORP · CARE MANAGEMENT · MA · controlled entity

    Directly controlled by HEALTH PLANS

  • NEW HPHC HOLDING CORPORATION

    C CORP · HOLDING COMPANY · DE · controlled entity

    Directly controlled by HPHC INC

  • POINT32HEALTH SERVICES INC

    C CORP · MANAGEMENT SVCS · DE · controlled entity

    Directly controlled by TAHMO

  • TUFTS INSURANCE COMPANY

    C CORP · INSURANCE · MA · controlled entity

    Directly controlled by P32H SRVCS INC

  • TUFTS BENEFIT ADMINISTRATORS INC

    C CORP · TPA · MA · controlled entity

    Directly controlled by P32H SRVCS INC

  • TOTAL HEALTH PLAN INC

    C CORP · TPA · MA · controlled entity

    Directly controlled by P32H SRVCS INC

  • TAHP BROKERAGE CORPORATION

    C CORP · BROKERAGE · MA · controlled entity

    Directly controlled by P32H SRVCS INC

  • INTEGRA PARTNERS HOLDINGS INC

    C CORP · MED EQUIPT & SVCS · NY · controlled entity

    Directly controlled by TAHMO

Provenance

Return type
form_990
Tax year
2022
Filed
12 November 2023
IRS schema version
2022v5.0
Source object
202303199349305140

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