Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ORGANIZATION'S MISSION | 990, PART III, LINE 1 | COLORADO ACCESS IS DEDICATED TO THE OPERATION OF A COMPETITIVE HEALTH PLAN DESIGNED TO IMPROVE ACCESS TO NEEDED HEALTHCARE DIRECTLY FOR ENROLLED MEMBERS AND INDIRECTLY, THROUGH ITS PARTNERS, TO ALL UNDERSERVED COLORADANS WITH AN EMPHASIS UPON PRIMARY CARE AND THE MAINTENANCE OF THE CONTINUUM OF CARE. |
| CEASED PROGRAM SERVICES | FORM 990, PART III, LINE 3 | STARTING IN JUNE 2008, COLORADO ACCESS OFFERED A LIMITED SCOPE MEDICAID PHYSICAL HEALTH LINE OF BUSINESS. THE PROGRAM WAS LIMITED TO DISABLED ADULTS (OVER THE AGE OF 21) AND NON-DISABLED ELDERLY INDIVIDUALS (OVER 60 YEARS OF AGE) IN THE DENVER METRO COUNTIES ONLY. THESE WERE IDENTIFIED HIGH COST AND HIGH MEDICAL NEED MEMBERS AND THE PURPOSE OF THE PROGRAM WAS TO PROVIDE ENHANCED CARE MANAGEMENT SERVICES TO THE POPULATION TO SEE IF THE MEDICAL COSTS ASSOCIATED WITH THE POPULATION COULD BE REDUCED. THESE MEMBERS ALL PREVIOUSLY SOUGHT CARE IN THE STATE'S FEE-FOR-SERVICE (FFS) NETWORK. BECAUSE MOST OF THESE MEMBERS WERE UNDERSERVED, IT WAS EXPECTED THAT IN THE BEGINNING OF THE PROGRAM THE COSTS INCURRED WOULD IN FACT EXCEED THE FFS COSTS BUT THAT OVER TIME AND WITH PROPER CARE, THE COSTS WOULD DECREASE. HOWEVER, THE RATES SET BY THE STATE TO BE PAID TO COLORADO ACCESS WERE BASED ON CARE RECEIVED IN THE FFS SYSTEM AND THUS DID NOT REFLECT OR SUPPORT THE COST OF CARE UNDER THE NEW PROGRAM. THE COMPANY LOST IN EXCESS OF $2 MILLION IN THE PROGRAM IN 2009 AND THE STATE WAS FURTHER REDUCING THE RATES FOR 2010. COMPANY MANAGEMENT RECOMMENDED TO THE BAORD AND THE BOARD AGREED TO EXIT THIS LINE OF BUSINESS EFFECTIVE FEBRUARY 28, 2010. IN THE EXIT DISCUSSIONS WITH THE STATE AN AGREEMENT WAS REACHED WHERE THE COMPANY WOULD CONTINUE PROVIDING THE ENHANCED CARE MANAGEMENT TO THE MEMBERS BUT WOULD NO LONG CARRY THE INSURANCE RISK, THEREBY TURNING IT INTO AN ADMINISTRATIVE SERVICES ONLY CONTRACT FOR THE REMAINDER OF 2010. |
| OTHER PROGRAM SERVICES | FORM 990, PART III, LINE 4D | THE PRIMARY COMPONENT OF OTHER PROGRAM SERVICES IS THIRD-PARTY ADMINISTRATOR SERVICES (CLAIMS PAYMENT, NETWORK DEVELOPMENT AND MANAGEMENT, CUSTOMER SERVICE) PROVIDED TO THE STATE OF COLORADO'S DEPARTMENT OF HEALTH CARE POLICY AND FINANCING FOR THE DEPARTMENT'S CHILD HEALTH PLAN PLUS STATE MANAGED CARE NETWORK, AND TO BEHAVIORAL HEALTHCARE, INC., THE MEDICAID BEHAVIORAL HEALTH ORGANIZATION IN THE EAST DENVER METRO COUNTIES OF ADAMS, ARAPAHOE AND DOUGLAS (CLAIMS PAYMENT, CUSTOMER SERVICE, AND STATE MANDATED FINANCIAL REPORTING). ALSO INCLUDED IN THIS CATEGORY ARE ENHANCED CARE MANAGEMENT SERVICES PROVIDED TO THE STATE OF COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING FOR A SELECT GROUP OF MEDICAID MEMBERS. THIS IS NEW BUSINESS IN 2010 AND IS DESCRIBED IN FORM 990, PART III, LINE 2 AND SCHEDULE O. |
| PRESENTATION OF FINANCIAL STATEMENTS | FORM 990, PART IV, LINE 12A | COLORADO ACCESS PRESENTS ITS FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE DIVISION OF INSURANCE OF THE DEPARTMENT OF REGULATORY AGENCIES OF THE STATE OF COLORADO, WHICH PRACTICES DIFFER FROM U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THEREFORE THIS QUESTION IS ANSWERED NO IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. |
| DESCRIPTION OF CLASSES OF MEMBERS AND THE NATURE OF THEIR RIGHTS | FORM 990, PART VI, LINE 6 | PER THE CORPORATION BYLAWS (CURRENT VERSION DATED JULY 11, 2008), THE CORPORATION SHALL HAVE THREE VOTING MEMBERS: (1) COLORADO COMMUNITY MANAGED CARE NETWORK, DESIGNATED AS THE "CCMCN MEMBER", (2) THE CHILDREN'S HOSPITAL, DESIGNATED AS THE "TCH MEMBER", AND (3) THE "UNIVERSITY MEMBER", WHICH MEMBERSHIP IS HELD JOINTLY BY UNIVERSITY HEALTH SYSTEMS, INC. AND UNIVERSITY PHYSICIANS, INC. EACH MEMBER SHALL BE FORMED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, OR SCIENTIFIC PURPOSES, OR SOCIAL WELFARE PURPOSES, AND SHALL QUALIFY AS AN EXEMPT ORGANIZATION OR ORGANIZATIONS UNDER SECTION 501(C)(3) OR SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. |
| DESCRIPTION OF CLASSES OF MEMBERS AND THE NATURE OF THEIR RIGHTS | FORM 990, PART VI, LINES 7A AND 7B | LINE 7A: PER THE CORPORATION BYLAWS (CURRENT VERSION DATED JULY 11, 2008), THREE CLASS A DIRECTORS ARE ELECTED BY UNANIMOUS VOTE OF THE MEMBERS ENTITLED TO VOTE. EACH MEMBER SHALL NOMINATE ONE CLASS A DIRECTOR. IF THERE ARE FEWER THAN THREE MEMBERS, THE CLASS A DIRECTORS SHALL NOMINATE SUCH ADDITIONAL CLASS A DIRECTORS AS ARE NECESSARY TO FILL THE COMPLEMENT OF THREE CLASS A DIRECTORS. LINE 7B: PER THE CORPORATION BYLAWS (CURRENT VERSION DATED JULY 11, 2008), VOTING BY MEMBERS - EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON ALL MATTERS COMING BEFORE A MEETING OF THE MEMBERS. THE UNANIMOUS VOTE OF THE MEMBERS ENTITLED TO VOTE SHALL BE THE ACT OF THE MEMBERS IN EVERY CASE WHERE THE VOTE OF THE MEMBERS IS EXPRESSLY REQUIRED BY THE ACT, THESE BYLAWS OR THE ARTICLES. WITHOUT LIMITING THE FOREGOING, MEMBERS ARE ENTITLED TO VOTE WITH RESPECT TO ANY MATTER REQUIRED TO BE SUBMITTED TO A VOTE OF THE MEMBERS IN ACCORDANCE WITH THE ARTICLES, THESE BYLAWS OR THE ACT, INCLUDING THE FOLLOWING: (I) THE ELECTION AND REMOVAL OF CLASS A DIRECTORS; (II) THE APPROVAL OF AMENDMENTS TO THE ARTICLES OR THESE BYLAWS THAT WOULD AFFECT THE RIGHTS, PRIVILEGES, PREFERENCES, RESTRICTIONS, OR CONDITIONS OF THE MEMBERS OR AFFECT THE MEMBERS' QUORUM, VOTING, DISSOLUTION, REDEMPTION, TRANSFER OF MEMBERSHIP INTERESTS, OR DIVISION OF THE MEMBERS INTO TWO OR MORE CLASSES OF MEMBERS; (III) THE APPROVAL OF THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION OTHER THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS; (IV) THE APPROVAL OF A PLAN OF MERGER; (V) THE APPROVAL OF VOLUNTARY DISSOLUTION OF THE CORPORATION; (VI) A DETERMINATION AND AUTHORIZATION OF INDEMNIFICATION, IF MEMBER APPROVAL IS REQUIRED UNDER SECTION 6 OF ARTICLE VI HEREOF; (VII) THE ADMISSION OF ADDITIONAL MEMBERS IN ACCORDANCE WITH THE PROCESSES SET FORTH IN THE MEMBERS AGREEMENT AND NOT INCONSISTENT WITH THE ARTICLES; (VIII) THE EXPULSION OF A MEMBER FOR CAUSE; (IX) THE TRANSFER OF MEMBERSHIP INTERESTS IN ACCORDANCE WITH THE MEMBERS AGREEMENT, AS DEFINED BELOW; AND (X) IF DISTRIBUTIONS TO MEMBERS ARE AUTHORIZED BY THE BOARD OF DIRECTORS, THE ALLOCATION OF SUCH DISTRIBUTIONS AMONG THE MEMBERS WHO QUALIFY TO RECEIVE SUCH DISTRIBUTIONS IN ACCORDANCE WITH THE ARTICLES. |
| PROCESS USED BY ORGANIZATION TO REVIEW FORM 990 | FORM 990, PART VI, LINE 11A | THE INFORMATION FOR THE IRS 990 RETURN IS NORMALLY PREPARED BY THE COMPANY'S CONTROLLER AND REVIEWED BY PERSONNEL FROM THE COMPANY'S HUMAN RESOURCES AND LEGAL DEPARTMENTS, AND THE CFO. HOWEVER FOR THE 2010 RETURN, DUE TO TURNOVER IN THE CONTROLLER POSITION AT THE END OF 2010, THE INFORMATION FOR THE RETURN WAS PREPARED BY THE CFO. THE CONTROLLER POSITION WAS FILLED IN EARLY 2011, BUT THE INDIVIDUAL IS NOT ADEQUATELY PREPARED TO COMPLETE THE INFORMATION. THE CFO PRESENTS THE COMPLETED RETURN TO THE COMPANY'S FINANCE, AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD WHO IN TURN PRESENTS IT TO THE FULL BOARD AS PART OF THE COMMITTEE'S STANDARD FINANCIAL REPORT. THIS IS DONE PRIOR TO FILING THE RETURN. |
| PROCESS USED TO MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY | FORM 990, PART VI, LINE 12C | ALL NEW HIRES ARE REQUIRED TO FILL OUT AND SIGN THE CONFLICT OF INTEREST FORM. THEN ALL EMPLOYEES ARE REQUIRED TO SUBMIT A NEW SIGNED FORM ANNUALLY DURING THE OPEN ENROLLMENT PERIOD. THE FORMS ARE REVIEWED BY THE HUMAN RESOURCES DEPARTMENT TO ENSURE THERE ARE NO ISSUES. THE SIGNED FORMS ARE THEN FILED IN THE EMPLOYEE'S PERSONNEL FILE. ALL BOARD MEMBERS ARE ALSO REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY. IF A CONFLICT IS IDENTIFIED FOR A BOARD MEMBER, THAT BOARD MEMBER MUST LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. |
| PROCESS USED TO DETERMINE COMPENSATION OF CEO, OFFICERS, & KEY EMPLOYEES | FORM 990, PART VI, LINES 15A AND 15B | COLORADO ACCESS USES TWO SALARY SURVEYS EACH YEAR TO REVIEW OUR COMPENSATION FOR OUR EXECUTIVES. THEY ARE THE WARREN SURVEY (NATIONAL HEALTHCARE INDUSTRY SURVEY) AND THE MOUNTAIN STATES EMPLOYER COUNCIL'S (MSEC) NON-PROFIT COMPENSATION SURVEY. OUR COMPENSATION RATES ARE IN LINE WITH THESE SURVEYS. WITH REGARD TO THE CEO, HE IS A LEASED EMPLOYEE AND THE RATE IS ESTABLISHED DURING THE RENEWAL OF THIS CONTRACT. |
| AVAILABILITY OF CERTAIN DOCUMENTS TO THE GENERAL PUBLIC | FORM 990, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT REQUIRED TO BE MADE AVAILABLE TO THE GENERAL PUBLIC AND THEREFORE THEY ARE NOT MADE PUBLIC. |
| Software ID: | |
| Software Version: |