Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
Tufts Health Plan Foundation Inc
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
705 MOUNT AUBURN STREET
 
Room/suite
City or town, state or country, and ZIP + 4
WATERTOWN, MA02472
D Employer identification number

26-1374263
E Telephone number

G Gross receipts $ 26,310,819
F Name and address of principal officer:
James Roosevelt Jr
705 Mount Auburn Street
Watertown,MA02472
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
n/a
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 2007
M State of legal domicile: MA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE FOUNDATION'S MISSION IS TO PROMOTE HEALTHY LIFESTYLES AND THE DELIVERY OF QUALITY HEALTHCARE IN OUR COMMUNITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 10
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 9
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 0
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 62,500 10,062,500
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 923,863 807,095
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 986,363 10,869,595
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 2,387,447 2,328,940
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 341,218 355,273
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 241,080 303,996
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,969,745 2,988,209
19 Revenue less expenses. Subtract line 18 from line 12...... -1,983,382 7,881,386
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 49,431,813 57,583,228
21 Total liabilities (Part X, line 26)............ 110,230 103,596
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 49,321,583 57,479,632
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: See Schedule O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,339,827 including grants of $ 1,925,801 ) (Revenue $ 0 )
See Schedule O
4b (Code:   ) (Expenses $ 413,431 including grants of $ 340,639 ) (Revenue $ 0 )
See Schedule O
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 2,815,758
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
8
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBD , NT
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
10
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
UMESH KURPAD
705 MOUNT AUBURN STREET
WATERTOWN,MA02472
(617) 972-9400
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) James Roosevelt
President & CEO
 2.0 X   X       0 1,293,094 157,461
(2) John Baackes
DIRECTOR
 1.0 X           2,000 0 0
(3) David Green
DIRECTOR
 1.0 X           2,500 34,000 0
(4) Jackie Jenkins-Scott
DIRECTOR
 1.0 X           1,500 27,000 0
(5) Barbara Shattuck Kohn
DIRECTOR
 1.0 X           1,000 0 0
(6) Thomas P O'Neill III
DIRECTOR
 1.0 X           1,500 26,000 0
(7) Vincent Mor
DIRECTOR
 1.0 X           1,000 0 0
(8) George A Russell Jr
DIRECTOR
 1.0 X           1,500 0 0
(9) Steven A Tolman
DIRECTOR
 1.0 X           2,000 0 0
(10) Elizabeth A Walker
DIRECTOR
 1.0 X           1,000 0 0
(11) Lois Cornell
Clerk & Director
 1.0     X       0 556,104 45,942
(12) Roland Price
Treasurer
 5.0     X       0 227,933 58,977
(13) David Abelman
Executive Director
 13.0     X       0 398,437 49,079
(14) Umesh Kurpad
CHIEF FINANCIAL OFFICER
 1.0     X       0 544,126 120,179
(15) AnnMarie Boursiquot-King
Director of Grants
 50.0         X   0 137,899 19,684




Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 14,000 3,244,593 451,322
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
None
 
  		   
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet0
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 10,000,000
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		62,500
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 10,062,500
Program Service Revenue Business Code
2a
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 0
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 814,146     814,146
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 15,434,173  
b Less: cost or other basis and sales expenses 15,441,224  
c Gain or (loss) -7,051  
d Net gain or (loss)..........MediumBullet -7,051     -7,051
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 10,869,595     807,095
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 2,328,940 2,328,940
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 14,000 14,000    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 265,758 265,758    
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 35,164 35,164    
9 Other employee benefits ....... 40,351 40,351    
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 30,500   30,500  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 105,983   105,983  
g Other .......... 85,736 85,736    
12 Advertising and promotion .... 5,769   5,769  
13 Office expenses ....... 1,319 1,319    
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 0      
17 Travel ............ 4,282   4,282  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 2,884   2,884  
20 Interest ........... 0      
21 Payments to affiliates ....... 18,640 18,640    
22 Depreciation, depletion, and amortization ..... 0      
23 Insurance .............. 4,400   4,400  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a Software dues 25,850 25,850    
b Annual report 6,866   6,866  
c Training 5,900   5,900  
d All other expenses 5,867   5,867  
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 2,988,209 2,815,758 172,451 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 3,250,836 2 7,990,176
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net .........   4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation. ..... 10b     10c  
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 46,180,265 12 49,592,850
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 712 15 202
16 Total assets. Add lines 1 through 15 (must equal line 34)... 49,431,813 16 57,583,228
Liabilities 17 Accounts payable and accrued expenses . 64,921 17 77,533
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 45,309 25 26,063
26 Total liabilities. Add lines 17 through 25..... 110,230 26 103,596
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 49,321,583 27 57,479,632
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 49,321,583 33 57,479,632
34 Total liabilities and net assets/fund balances ..... 49,431,813 34 57,583,228
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
10,869,595
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
2,988,209
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
7,881,386
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
49,321,583
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
276,663
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
57,479,632
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Tufts Health Plan Foundation Inc
 
Employer identification number

26-1374263
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
(1) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION INC
  		042674079 0 Yes           0
Total                 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
NO MONETARY SUPPORT IS PROVIDED TO THE SUPPORTED ORGANIZATION. THE SUPPORTING ORGANIZATION (THE FOUNDATION) PERFORMS SERVICES FOR THE SUPPORTED ORGANIZATION WHICH ARE GRANTMAKING, PROGRAM SUPPORT AND EDUCATIONAL ACTIVITIES. FURTHER MONETARY SUPPORT IS NOT REQUIRED.
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
Tufts Health Plan Foundation Inc
 
Employer identification number

26-1374263
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
Tufts Health Plan Foundation Inc
  		Employer identification number

26-1374263
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
Tufts Health Plan Foundation Inc
  		Employer identification number

26-1374263
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
Tufts Health Plan Foundation Inc
  		Employer identification number

26-1374263
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Tufts Health Plan Foundation Inc
 
Employer identification number

26-1374263
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................        
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet  
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) POOLED INVESTMENTS 		49,592,850 C








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 49,592,850
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
DUE TO AFFILIATES 26,063








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 26,063
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 10,869,595
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 2,988,209
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 7,881,386
4 Net unrealized gains (losses) on investments .......................... 4 276,663
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 276,663
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 8,158,049
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 11,040,275
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 276,663
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 276,663
3 Subtract line 2e from line 1..................... 3 10,763,612
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a 105,983
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c 105,983
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 10,869,595
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 2,882,226
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 2,882,226
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a 105,983
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 105,983
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 2,988,209
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
FIN 48 FOOTNOTE SCHEDULE D, PART X, LINE 2 In 2010, the audited financial statements for the Foundation did not disclose an ASC 740 footnote.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Tufts Health Plan Foundation Inc
 
Employer identification number
26-1374263
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) ACTION FOR BOSTON COMMUNITY DEVELOPMENT178 TREMONT STREET
BOSTON,MA02111 		04-2304133 501(C)(3) 52,194       StayStrong Initiative
(2) AIDS ACTION COMMITTEE OF MASSACHUSETTS75 AMORY STREET
BOSTON,MA02119 		22-2707246 501(C)(3) 40,229       Positive Aging/Lasting Strength
(3) ALL OUT ADVENTURES INC184 NORTHAMPTON ST SUITE H
EASTHAMPTON,MA01027 		04-3559633 501(C)(3) 17,295       Outdoor Recreation for Seniors
(4) ARTHRITIS FDN NORTHERN & SOUTHERN NE CHAPTER2348 POST RD SUITE 104
WARWICK,RI02886 		06-0672782 501(C)(3) 16,058       Walk with Ease
(5) AVAILABLE POTENTIAL ENTERPRISES LTDPO BOX 61
WILLIAMSBURG,MA01096 		04-2685501 501(C)(3) 14,000       Williamsburg Intergeneratioal Gardening Program
(6) BROCKTON NEIGHBORHOOD HEALTH CENTER63 MAIN STREET
BROCKTON,MA02301 		04-3165044 501(C)(3) 45,000       Managing Chronic Diseases in the Elderly
(7) CAMBRIDGE COMMUNITY FOUNDATION99 BISHOP ALLEN DRIVE
CAMBRIDGE,MA021393428 		04-6012492 501(C)(3) 10,000       Matching Grant Program: Healthy Aging ROCS (Reaching out to Cambridge Seniors)
(8) CAPE COD HEALTHCARE FOUNDATION27 PARK STREET
HYANNIS,MA026015230 		04-3475950 501(C)(3) 25,000       Fall Prevention and Safety for Seniors and Caregivers
(9) CENTURY HEALTH SYSTEMS209 WEST CENTRAL STREET SUITE 316
NATICK,MA01760 		04-3566661 501(C)(3) 16,434       Caregiver Care
(10) COMMUNITY ACTION COMMITTEE OF CAPE COD115 ENTERPRISE ROAD
HYANNIS,MA026012212 		04-2396835 501(C)(3) 25,000       Skill Building Supports For Caregivers
(11) COMMUNITY HEALTH CENTER OF CAPE COD107 COMMERCIAL STREET
MASHPEE,MA026490000 		04-3370560 501(C)(3) 41,250       Case Management for Healthy Seniors
(12) COMMUNITY HEALTH CHARITIES OF NE30 LAUREL STREET
HARTFORD,CT061061361 		06-6079596 501(C)(3) 6,499       ThP Workplace Giving match - 2010
(13) COMMUNITY MUSIC CENTER OF BOSTON34 WARREN AVE
BOSTON,MA021166104 		04-2437973 501(C)(3) 30,000       Una Voce - "One Voice" - Intergenerational Choru
(14) CORNERSTONE ADULT SERVICES INC140 WARWICK NECK AVENUE
WARWICK,RI028895308 		05-0429500 501(C)(3) 43,150       Enhanced Fall Prevention
(15) DEVELOPMENTAL EVALUATION & ADJSTMNT FACILITIES215 BRIGHTON AVENUE
ALLSTON,MA021342013 		04-2628350 501(C)(3) 40,000       Healthy Lifestyles for Deaf Seniors
(16) DISCOVERING WHAT'S NEXT REVITALIZING RTMNT225 NEVADA STREET
NEWTON,MA02460 		20-3044597 501(C)(3) 45,000       Transition to Encore Careers: Building Pathways to
(17) EDUCATIONAL DEVELOPMENT CENTER INC55 CHAPEL STREET
NEWTON,MA024581060 		04-2241718 501(C)(3) 50,000       Chronic Care Community Corps
(18) EDWARD M KENNEDY INSTITUTE400 ATLANTIC AVENUE
BOSTON,MA02110 		02-0705535 501(C)(3) 20,000       Planning Grant for Developing H/C Curriculum
(19) ELDER SERVICES OF THE MERRIMACK VALLEY INC360 MERRIMACK STREET BLDG 5
LAWRENCE,MA01843 		04-2545136 501(C)(3) 42,953       Evidenced-Based Programs: Impact on Healthy Aging
(20) FRANKLIN COUNTY HOME CARE CORPORATION330 MONTAGUE CITY ROAD STE 1
TURNERS FALLS,MA013762530 		04-2542539 501(C)(3) 58,884       Take Steps to Healthy Aging Falls
(21) GENERATIONS INCORPORATED25 KINGSTON ST 4TH FLR
BOSTON,MA021112200 		04-3227007 501(C)(3) 25,000       Reading Coaches
(22) HEALTH CARE FOR ALL30 WINTER STREET 10TH FLOOR
BOSTON,MA021084753 		04-3071598 501(C)(3) 35,000       Health Care For All HelpLine Connecting Older Adults to Coverage
(23) HEALTH RESOURCES IN ACTION95 BERKELEY STREET
BOSTON,MA02116 		04-2229839 501(C)(3) 86,692       Development of Greater Boston ITN Affiliate Curriculum
(24) HEALTH SERVICES IN ACTION95 BERKELEY STREET
BOSTON,MA02116 		04-2229839 501(C)(3) 25,000       Mass in Motion Municipal Wellness and Leadership Grant Program
(25) HEARTH INC1640 WASHINGTON STREET
BOSTON,MA021183380 		04-3206820 501(C)(3) 40,000       Housing as the Key to Healthy Aging and Vibrant Living: Finding and Securing Housing and Resources for Homeless Elders through Hearth's Outreach Program
(26) HEBREW SENIORLIFE1200 CENTRE STREET
BOSTON,MA021311011 		90-0183119 501(C)(3) 150,000       Prevention Through Action: Culturally Inclusive Training and Education for Seniors
(27) JEWISH COMMUNITY HOUSING FOR THE ELDERLY30 WALLINGFORD ROAD
BRIGHTON,MA021354708 		04-2607197 501(C)(3) 25,000       Generations Together
(28) JEWISH FAMILY & CHILDREN'S SERVICE1430 MAIN STREET
WALTHAM,MA024511623 		04-2104356 501(C)(3) 45,000       Steps for LIfe
(29) KIT CLARK SENIOR SERVICES INC1500 DORCHESTER AVENUE
BOSTON,MA02122 		46-0516856 501(C)(3) 68,676       Fit-4-Life
(30) LA ALIANZA HISPANA409 DUDLEY STREET
ROXBURY,MA021193366 		23-7121158 501(C)(3) 30,000       La Alianza Hispana's Expressive Arts Therapy and Physical Exercise Program
(31) LITTLE BROTHERS-FRIENDS OF THE EDERLY3305 WASHINGTON STREET
JAMAICA PLAIN,MA021302639 		04-2681294 501(C)(3) 10,000       Intergenerational Matching Program
(32) MASSACHUSETTS PUBLIC HEALTH ASSN434 JAMAICAWAY
JAMAICA PLAIN,MA021302009 		04-2326503 501(C)(3) 15,000       Act FRESH Senior
(33) MERRIMACK VALLEY FOOD BANK735 BROADWAY STREET
LOWElL,MA018543129 		22-3241609 501(C)(3) 10,000       Mobile Pantry Program
(34) NEWTON COMMUNITY SERVICE CENTER INC492 WALTHAM STREET
NEWTON,MA024651920 		04-2232418 501(C)(3) 49,958       Volunteering: A Pathway to Vibrant Aging
(35) NORTHEAST HOSPITAL CORPORATION298 WASHINGTON STREET
GLOUCESTER,MA01930 		04-2121317 501(C)(3) 31,000       Safe Steps for Seniors
(36) OCEAN STATE CENTER FOR INDEPENDENT LIVING1944 WARWICK AVE
WARWICK,RI028892448 		05-0439495 501(C)(3) 50,000       "Home Sweet Accessible Home"
(37) OPERATION ABLE OF GREATER BOSTON INC131 TREMONT STREET
BOSTON,MA021111317 		04-2761871 501(C)(3) 35,000       ABLE Volunteer Services
(38) OVERLOOK VISITING NURSE ASSOCIATION88 MASONIC HOME ROAD
CHARLTON,MA01507 		04-3515687 501(C)(3) 25,000       Medication Management Neighborhood Programs
(39) PARTNERS IN HEALTH888 COMMONWEALTH AVENUE 3RD FLOOR
BOSTON,MA02215 		04-3567502 501(C)(3) 8,812       THP Employee Match for '10 Haiti Earthquake
(40) PARTNERS IN HEALTH888 COMMONWEALTH AVENUE 3RD FLOOR
BOSTON,MA02215 		04-3567502 501(C)(3) 20,000       Stand With Haiti (Earthquake Relief)
(41) RHODE ISLAND FREE CLINIC INC655 BROAD STREET
PROVIDENCE,RI029071444 		05-0501276 501(C)(3) 72,225       Healthy Lifestyles for Today and Tomorrow
(42) ROGERSON COMMUNITIES1 FLORENCE STREET
BOSTON,MA021313638 		04-2104319 501(C)(3) 50,000       Healthy Rogerson
(43) ROOT CAUSE INSTITUTEONE CANAL PARK 3RD FLOOR
CAMBRIDGE,MA02141 		20-0703238 501(C)(3) 45,000       2011 Social Issue Track on Healthy Aging
(44) SAMARITANS INC41 WEST STREET 4TH FLOOR
BOSTON,MA021111209 		04-2643466 501(C)(3) 10,000       Wellness Approach to Senior Suicide Prevention (Outbound Call Project)
(45) SCM COMMMUNITY TRANSPORTATION167 HOLLAND STREET
SOMERVILLE,MA021442401 		04-2743790 501(C)(3) 70,000       SCM and the Arts
(46) SCM COMMMUNITY TRANSPORTATION167 HOLLAND STREET
SOMERVILLE,MA021442401 		04-2743790 501(C)(3) 6,558       Seniors See the Red Sox
(47) SOMERVILLE-CAMBRIDGE ELDER SERVICES INC61 MEDFORD STREET 2ND FLOOR
SOMERVILLE,MA021430000 		04-2515020 501(C)(3) 35,000       A Collaborative Effort Between Somerville-Cambridge Elder Services and the Cambridge Health Alliance to Prevent Falls Among Seniors
(48) SOUTHWEST BOSTON SENIOR SERVICES INC555 AMORY STREET
JAMAICA PLAIN,MA021302652 		23-7304163 501(C)(3) 63,000       Vibrant Aging at Home and in the Community
(49) SPRINGWELL INC125 WALNUT STREET
WATERTOWN,MA024724052 		04-2616064 501(C)(3) 51,378       Healthy Aging Initiative
(50) THE GREATER BOSTON FOOD BANK70 SOUTH BAY
BOSTON,MA021180000 		04-2717782 501(C)(3) 15,000       Brown Bag Program
(51) THE PROVIDENCE CENTER528 NORTH MAIN STREET
PROVIDENCE,RI029045757 		05-0316969 501(C)(3) 52,300       In Shape Seniors Unemployed Professionals
(52) THIRD SECTOR NEW ENGLAND555 AMORY STREET
JAMAICA PLAIN,MA02130 		04-2261109 501(C)(3) 37,682       Healthy Aging in the LGBT Community
(53) TUFTS HEALTH CARE INSTITUTE136 HARRISON AVENUE
BOSTON,MA021111817 		04-3289926 501(C)(3) 20,000       Practicing Medicine in a Changing Health Care Environment The Challenges of Caring for Complex and Chronically Ill Patients
(54) UNITED WAY OF MASS BAY INC51 SLEEPER STREET
BOSTON,MA022101208 		04-2382233 501(C)(3) 14,642       ThP Workplace Giving match - 2010
(55) URBAN LEAGUE OF EASTERN MASSACHUSETTS88 WARREN STREET
BOSTON,MA02210 		23-7349132 501(C)(3) 35,000       Community Service Give Back Program for Mature Workers Program
(56) VNA & HOSPICE OF COOLEY DICKINSON INC168 INDUSTRIAL DRIVE
NORTHAMPTON,MA010602379 		22-2617175 501(C)(3) 50,000       Strength in Numbers Falls Prevention Education for Seniors
(57) WATER WAY ARTS FOR HEALTH AND ENERGY INC1615 BEACON STREET
BROOKLINE,MA024464602 		20-2332178 501(C)(3) 50,000       Tai Chi for Healthy Aging
(58) WESTBAY COMMUNITY ACTION INC224 BUTTONWOODS AVE
WARWICK,RI028867541 		05-0311985 501(C)(3) 40,000       Elder Safety
(59) WHITTIER STREET HEALTH CENTER COMMITTEE INC1125 TREMONT STREET
ROXBURY,MA021202178 		04-2619517 501(C)(3) 47,560       Geriatric Chronic Care Case Management Program
(60) WINCHESTER HOSPITAL41 HIGHLAND AVE
WINCHESTER,MA018901446 		04-3399570 501(C)(3) 17,611       Family Caregiver Program
(61) YMCA OF GREATER BOSTON316 HUNTINGTON AVENUE
BOSTON,MA021155019 		04-2103551 501(C)(3) 50,000       Get Fit, Stay Fit for Life
(62) YWCAGRI324 BROAD STREET
CENTRAL FALLS,RI02863 		05-0310596 501(C)(3) 9,935       GEM - Gentle Easy Movement
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
62
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Description of Organization's Procedures for Monitoring the Use of Grants Schedule I, Part I, Line 2 FOR ALL GRANTS THE FOUNDATION REQUIRES A SITE VISIT BY OUR STAFF, ONGOING MONITORING, ONE INTERIM PROGRESS REPORT WITH FOLLOW-UP AS NEEDED AND ONE POST-GRANT FINAL REPORT. THE FOUNDATION ALSO CHECKS THE GRANTEES 501(C)(3) STATUS.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Tufts Health Plan Foundation Inc
 
Employer identification number

26-1374263
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) James Roosevelt (i)
(ii)		 0
708,581 		0
462,703 		0
121,810 		0
142,626 		0
14,835 		0
1,450,555 		0
0
(2) Lois Cornell (i)
(ii)		 0
349,142 		0
159,593 		0
47,369 		0
28,950 		0
16,992 		0
602,046 		0
0
(3) Roland Price (i)
(ii)		 0
182,972 		0
37,807 		0
7,154 		0
48,712 		0
10,265 		0
286,910 		0
0
(4) David Abelman (i)
(ii)		 0
270,300 		0
97,078 		0
31,059 		0
32,356 		0
16,723 		0
447,516 		0
0
(5) AnnMarie Boursiquot-King (i)
(ii)		 0
113,673 		0
28,750 		0
-4,524 		0
9,970 		0
9,714 		0
157,583 		0
0
(6) Umesh Kurpad (i)
(ii)		 0
375,000 		0
171,413 		0
-2,287 		0
103,824 		0
16,355 		0
664,305 		0
0










Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Supplemental Compensation Information SCHEDULE J, PART I, LINE 3 THE FOUNDATION USES THE COMPENSATION POLICIES OF ITS SOLE MEMBER, TUFTS ASSOCIATED HEALTH MAINTENANCE ORGRANIZATION, INC. (TAHMO). Supplemental Compensation Information SCHEDULE J, PART I, LINE 4B The related organization maintains an Executive Savings Plan (ESP) for its Senior Managers with the title Director and above. The numbers listed on Schedule J, Part II, Column C, reflect both the employee deferrals as well as the employer contributions to the ESP.
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 6B The officers of Tufts Associated Health Maintenance Organization, Inc. are eligible to participate in an executive incentive plan, paid by the related organization for services provided to the related organization. The incentive plan is based on the overall annual success of the organization. The organization's goals are established early in the year and approved by its independent board of directors. One of the components of the plan is based on meeting targeted net earnings. In 2010, this component amounted to 25% of targeted bonus compensation. The employees who participate in this plan are: - David Abelman - Roland Price - Lois Cornell - James Roosevelt
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Tufts Health Plan Foundation Inc
 
Employer identification number

26-1374263
Identifier Return Reference Explanation
Organization's Mission Form 990, Part III, Line 1 IN ORDER TO PROVIDE BENEFITS TO THE COMMUNITY OUTSIDE OF ITS REGULAR LINES OF BUSINESS, TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO) CREATED THE TUFTS HEALTH PLAN FOUNDATION, A 501(C)(3) CHARITABLE AND SUPPORTING ORGANIZATION OF TAHMO. THE MISSION OF THE FOUNDATION IS TO PROMOTE HEALTHY LIFESTYLES AND THE DELIVERY OF QUALITY CARE. THE FOUNDATION ACHIEVES THIS MISSION PRIMARILY THROUGH GRANTMAKING TO CHARITABLE, SERVICE-PROVIDING ORGANIZATIONS, PROGRAM SUPPORT AND EDUCATIONAL ACTIVITIES. THE FOUNDATION'S FOCUS IS HEALTHY AGING - IMPROVING THE LIVES OF OLDER ADULTS 60 AND OVER. THE TUFTS HEALTH PLAN FOUNDATION HAS CHOSEN TO FOCUS ON HEALTHY AGING IN ORDER TO ADDRESS THE NEEDS OF OUR COMMUNITIES IN MASSACHUSETTS AND RHODE ISLAND, AND TO HELP MEET THE CHALLENGES AND OPPORTUNITIES OF AN AGING SOCIETY. THE FOUNDATION MAKES GRANTS THROUGH THE FOUR AREAS OF CAREGIVER SUPPORT, FALL PREVENTION, INTERGENERATIONAL COLLABORATION AND VIBRANT LIFESTYLES.
Program Service Accomplishments Form 990, Part III, Line 4 Form 990, Part III, Line 4a IN 2010, THE TUFTS HEALTH PLAN FOUNDATION COMPLETED ITS SECOND YEAR FOCUSING ON HEALTHY AGING FOR OLDER ADULTS 60-PLUS AND OVER TO ENSURE THAT OLDER ADULTS SPEND MORE YEARS IN GOOD HEALTH AND ENGAGED AS VITAL MEMBERS OF OUR COMMUNITIES. THE FOUNDATION WORKS WITH PROGRAMS THAT ADDRESS THE DEVELOPMENT AND MAINTENANCE OF OPTIMAL PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND FUNCTION IN OLDER ADULTS THROUGH FOUR AREAS: 1. CAREGIVER SUPPORT - TRAINING, EDUCATION AND RESOURCES TO SUPPORT CAREGIVERS AND CARE RECIPIENTS. 2. FALL PREVENTION - EXERCISE AND EDUCATION FOR OLDER ADULTS THAT WILL REDUCE FEAR OF FALLS AND INCREASE MOBILITY, STRENGTH AND BALANCE. 3. INTERGENERATIONAL COLLABORATION - OLDER ADULTS AND YOUNGER GENERATIONS ENRICHING EACH OTHER'S LIVES THROUGH MENTORING, TUTORING AND VOLUNTEER ACTIVITIES. 4. VIBRANT LIFESTYLES - EXERCISE, NUTRITION AND EVIDENCE-BASED CHRONIC DISEASE MANAGEMENT, SOCIAL AND RECREATIONAL ACTIVITIES, AND PROGRAMS THAT PROMOTE CIVIC AND COMMUNITY ENGAGEMENT. Form 990, Part III, Line 4b COMMUNITY SUPPORT GRANTS: IN ADDITION TO ITS HEALTHY AGING FOCUS, THE FOUNDATION ALSO SUPPORTS WORTHY COMMUNITY PROGRAMS SUCH AS THE GREATER BOSTON FOOD BANK'S BROWN BAG PROGRAM THAT PROVIDES HEALTHY, NUTRITIOUS FOOD TO INDIVIDUALS IN NEED. Form 990, Part III, Line 4c In 2009, the Tufts Health Plan Foundation (THPF) was chosen as one of 19 foundations nationwide to receive funding from the Robert Wood Johnson Foundation Partners Investing in Nursings Future, a national initiative to help address the long-term shortage of nurses across the country. The two-year, $250,000 matching grant funded a three-state collaboration in Massachusetts, New Hampshire and Rhode Island titled "Creativity and Connections: Building a Regional Nursing Education Framework." THPF is the lead foundation in this three-state initiative in partnership with the Massachusetts Hospital Research and Education Association (MHREA), which is the fiscal agent for this grant. This collaborative effort focuses on increasing nursing faculty through scholarships, increasing nursing program capacity through the use of a computerized centralized clinical placement (CCP) system and redesigning nursing education to meet future needs in health care. 2010 marked the second year of this matching grant. By the end of 2010, 36 scholarships have been awarded to masters and doctoral nursing students in partnership with MHREA. In addition, 104 health care facilities and 92 nursing programs were participating in the CCP program, filling 2,837 placements. Lastly, a gap analysis was conducted in the three states to examine nursing school curricula and the education of nurses, and where curricula would need to be redesigned to ensure that nursing education is preparing nurses to meet the demands of the current and future health care environment.
Description of Relationships Form 990, Part VI, Line 2 Two directors of the foundation also serve as directors of another unrelated organization. The unrelated organization does not have a business relationship with the foundation.
Description of Management Arrangement FORM 990, PART VI, LINE 3 The Foundation is a supporting organization of Tufts Associated Health Maintenance Organization, Inc. (TAHMO). TAHMO and its subsidiary, Tufts Associated Health Plan, Inc. (TAHP), provide administrative and management services to the Foundation.
MEMBERS FORM 990, PART VI, LINES 6 AND 7A TUFTS ASSOCIATED HEALTH MAINTENANCE ORGRANIZATION, INC. (TAHMO) as the sole corporate member of the Foundation, elects the members of the Foundation's governing body.
Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights Form 990, Part VI, Line 7b TAHMO, as the sole corporate member of the Foundation, has the right to make certain decisions regarding the Foundation, and is required to approve any changes to the Foundation's bylaws.
Process used by Governing Body to Review 990 Form 990, Part VI, Line 11B The Form 990 is prepared in our finance department, with assistance from our external accountants, Ernst & Young. This preparation began in June 2011. Some information is provided by our Director of Grants, and sections of the form are reviewed by our inside legal counsel. Certain sections of the form are reviewed by a number of senior managers; our chief financial officer reviews the form in its entirety. Once the form is complete, in November 2011, it is forwarded on to our board of directors and it is then submitted for filing.
Description of Process to Monitor Transactions for Conflicts of Interest FORM 990, PART VI, LINE 12C On an ongoing basis and before any grants were awarded, all board members, staff and internal review committee members were asked to disclose any relationships or potential conflicts of interest with any grantees or business partners. Any person with an actual or potential conflict was permitted to make a presentation to the reviewing body, but was not allowed to vote on the particular matter.
Offices & Positions for Which Process was Used, & Year Process was Begun FORM 990, PART VI, LINES 15A AND 15B The Foundation does not have any employees. The employees of related organizations provide services to the Foundation. The President is compensated solely for his duties performed in his capacity as Chief Executive Officer and President of TAHMO and TAHP. There is no remuneration for duties related to the Tufts Health Plan Foundation. The Executive Director of the Foundation is compensated solely for his duties performed in his capacity as the Vice President and Deputy General Counsel of TAHMO and TAHP. There is no remuneration for duties related to the Tufts Health Plan Foundation. The Compensation Committee (the "Committee") of the Board of Directors (the "Board") of Tufts Associated Health Maintenance Organization (Tufts or the "Company") reviews and administers total remuneration opportunities, policies, programs and major changes in Tufts' benefit plans that are applicable to the officers and executives of the Company (the "executives" - these include the CEO, COO, and all senior vice presidents), as well as to any other individual or groups the Committee deems appropriate based on its interpretation of the definition of "disqualified persons" in Section 4958 of the Internal Revenue Code of 1986. The Committee is comprised of independent directors of the Company. It is the Board's intention that the Committee will perform its duties in a manner that will establish a presumption that the total remuneration offered to executives and other "disqualified persons" are reasonable. Comparability Data and Reasonableness The total compensation opportunities provided to executives of the Company are intended to be competitive with, and in reasonable comparison to, those opportunities provided by organizations in those business sectors with which the Company competes for executive talent. The Board believes that such competitors are not limited to other healthcare institutions and that comparisons should be made to the compensation practices of a cross section of business sectors in both for-profit and not-for-profit organizations, when appropriate. The Committee retains independent compensation consultants to provide data as necessary, and also uses available sources of independent data on compensation. Peer organizations and published survey sources will be approved by the Committee based on its reasonable determination. The Committee may also rely on members of management and outside advisors, consultants, and counsel to provide market data reports, analysis, and opinions with respect to compensation-related matters. The data reviewed consists of comparable, relevant market data for the Company's positions from published surveys, and other available sources, of health and managed care institutions and the general industry. Other surveys of specialized skill sets or employee attributes critical to the success of the Company, e.g., actuarial, legal, etc., are also incorporated as needed, along with geographic references to the Boston and New England labor markets. The Committee will rely on this market data to assess, determine and validate compensation levels for the Company's executives. The Committee uses this data in its review of: - Setting base salaries - in light of market data and the individual's performance, background, experiences and personal skills. Base salary will be set so that the targeted positioning of an Executive is at the 50th percentile for each position. Actual base salary may vary based on skills, background and experience. - Annual incentive compensation - the Company's goal is to provide competitive and reasonable opportunities under the terms of an executive annual incentive plan for selected positions which are responsible for achieving performance goals that reflect the overall mission of the Company, the strategic direction of the Company for the performance year and the individual's performance during that year. The Committee makes every effort to establish a presumption that the total remuneration opportunities provided to executives are reasonable, as such presumption is contemplated in Section 4958 of the Internal Revenue Code of 1986, as amended from time to time. In establishing the presumption of reasonableness, the Committee may engage the professional services of independent legal counsel, compensation experts, accountants and other experts and advisors. Timing Executive benchmarking is completed on an annual basis. Benchmarking is completed by the external consultant engaged by the Compensation Committee every two years, and by the internal Compensation team on alternating years. The analysis completed in Q4, 2010 was completed by the internal Compensation team. Compensation survey data (as described above) was reviewed, compiled, and summarized in report form by the Senior Compensation Consultant for each individual executive/job based on a match of the internal job function to the survey job function. Each job match was validated to ensure that the same/similar market matches as used by the external consultant in the prior year were used by the internal team to ensure consistency with the prior analysis methodology. A report was provided to the Compensation Committee for discussion and deliberation. Documentation A summary of the discussions and deliberations of the Committee are documented in the meeting minutes, which are reviewed and approved by the Committee. Copies of all meeting materials distributed prior to and during the meeting are maintained in the corporate records along with the meeting minutes.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public FORM 990, PART VI, LINE 19 The governing documents, conflicts of interest policy and financial statements of the Foundation are available at its headquarters in Watertown, MA. All requests can be made to the Corporate Communications or Finance departments.
HOURS WORKED FOR RELATED ORGANIZATION FORM 990, PART VII HOURS LISTED BELOW ARE FOR TUFTS ASSOCIATED HEALTH PLANS (TAHP), TUFTS BENEFIT ADMINISTRATORS, INC. (TBA), TOTAL HEALTH PLAN, INC. (THP), AND TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (TAHMO). 1) JAMES ROOSEVELT: 5 HOURS WITH TAHP, 8 HOURS WITH TBA, 3 HOURS WITH THP AND 32 HOURS WITH TAHMO. 2) DAVID GREEN: 5 HOURS WITH TAHMO. 3) JACKIE JENKINS-SCOTT: 4 HOURS WITH TAHMO. 4) THOMAS O'NEILL, III: 3 HOURS WITH TAHMO. 5) LOIS CORNELL: 5 HOURS WITH TAHP, 8 HOURS WITH TBA, 3 HOURS WITH THP AND 33 HOURS WITH TAHMO. 6) ROLAND PRICE: 5 HOURS WITH TAHP, 3 HOURS WITH TBA, 3 HOURS WITH THP AND 34 HOURS WITH TAHMO. 7) DAVID ABELMAN: 17 HOURS WITH TAHP, 3 HOURS WITH TBA, 3 HOURS WITH THP, AND 14 HOURS WITH TAHMO. 8) UMESH KURPAD: 3 HOURS WITH TAHP, 3 HOURS WITH THP, 5 HOURS WITH TBA, AND 39 HOURS WITH TAHMO. ALL DIRECTORS' COMPENSATION FOR TUFTS HEALTH PLAN FOUNDATION, INC. IS PAID THROUGH TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. (EIN:04-2674079, ADDRESS: 705 MOUNT AUBURN STREET, WATERTOWN, MA 02472). TUFTS HEALTH PLAN FOUNDATION, INC. REIMBURSES TUFTS HEALTH MAINTENANCE ORGANIZATION, INC. FOR THE DIRECTORS' COMPENSATION. ALL OFFICERS' COMPENSATION FOR TUFTS HEALTH PLAN FOUNDATION, INC. IS PAID THROUGH TUFTS ASSOCIATED HEALTH PLANS, INC. (EIN: 04-2985923, ADDRESS: 705 MOUNT AUBURN STREET, WATERTOWN, MA 02472). THE STAFF OF TUFTS HEALTH PLAN FOUNDATION, INC. IS PAID THROUGH TUFTS HEALTH MAINTENANCE ORGANIZATION, INC. BUT IS THEN REIMBURSED THROUGH TUFTS HEALTH PLAN FOUNDATION, INC.
Other Changes in net assets or fund balances Form 990, Part IX, Line 5 In 2010, net assets were increased by an unrealized gain on investments of $276,663.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Tufts Health Plan Foundation Inc
 
Employer identification number

26-1374263
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) TUFTS ASSOC HEALTH MAINTENANCE ORG INC

705 MOUNT AUBURN STREET

WATERTOWN,MA02472
04-2674079 		HMO MA 501(c)(4) N/A NA
 
 
 












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) TUFTS ASSOCIATED HEALTH PLANS INC
705 Mount Auburn St
WATERTOWN,MA024721508
04-2985923 		MANAGEMENT SVCS MA NA
  		C Corp 0 0 0 %












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
REIMBURSEMENT PAID TO OTHER ORGANIZATION SCHEDULE R, PART V, LINE 1O THE FOUNDATION REIMBURSES TAHMO FOR ALL PAYMENTS DIRECTLY RELATED TO THE FOUNDATION.
Additional Data


Software ID:  
Software Version: