Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
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| Form 990 Part V Line 13a | The Company was incorporated on September 23, 2011 and is a member governed health insurance organization funded through the Affordable Care Act (the Act). The Company received its Massachusetts health maintenance organization license in August 2013 retroactive to March 1, 2013. Membership enrollment began on October 1, 2013 for coverage effective January 1, 2014. Additionally, the Company established operations in New Hampshire and received a health maintenance organization license on March 24, 2014 to issue policies in New Hampshire effective January 1, 2015. The Company has no subsidiaries. MHI is an approved consumer owned and operated organization and is designed to fulfill the spirit and intent of the Consumer Owned and Operated CO OP model (CO OP), and the standards set forth in Sections 1322(b)(3), 1322(b)(4) and 1322(c)(3) of the Act. The Company is incorporated under Massachusetts General Law (M.G.L.) c. 180. The Company is licensed by the Massachusetts Division of Insurance as a M.G.L. c. 176G HMO insurer and by New Hampshire Division of Insurance as a foreign HMO issuer. ALL LICENSES HAVE BEEN SUBSEQUENTLY RENEWED. |
| Form 990 Part V Line 13b | Pursuant to IRS Notice 2011-23 Qualified Non-Profit Health Insurance Companies exempt under IRC Section 501 (C) (29) are required to disclose the amount of their insurance reserves required by the State in which they operate and the total amount of their reserves. The Company is licensed in the Commonwealth of Massachusetts and the State of New Hampshire. The Commonwealth of Massachusetts, per Chapter 176G Section 25, requires a carrier to have net worth equal to the greater of $1,000,000, 2% of annual premiums up to a certain threshold, three months of uncovered health care expenditures, or 8% of annual health care expenditures. As of December 31, 2015, the greater amount for the Company is $1,554,520. The Company complies with the requirement. The State of New Hampshire requires the Company to establish a separate account for the benefit of New Hampshire policyholders in the amount of $1,000,000. The Company complied with this requirement as well. |
| Form 990 Part VI Line 2 | MR. POLICELLI AND MR. CHIN ARE OFFICERS, DIRECTORS, AND PART OWNERS OF AVERDE HEALTH, INC. The company did not contract with Averde Health Inc. during 2015. FORM 990, PART IV, LINE 3 DURING 2015, THE ORGANIZATION MADE CHANGES TO ITS BY-LAWS IN ORDER TO FACILITATE MEMBER VOTING, REMOVE UNNECESSARY ADMINISTRATIVE HURDELS, AND ADDRESS BOARD SIZE REQUIREMENTS. |
| Form 990 Part VI Line 6 | The Company was governed by a formation Board of Directors in 2014. In December of 2014, the Company held its first member election of the Board of Directors and transitioned to the Operational Board. The 2015 Operational Board was comprised of 4 elected directors and 5 appointed directors, and commenced operations during the first Board meeting of 2015. |
| Form 990 Part VI Line 7b | The members of the Company will have the power to: (i) elect and recommend removal of persons serving on the board of directors, (ii) approve any action by the board to amend or restate the Articles; (iii) approve any action by the board to amend, restate or repeal any provision of the Bylaws that would alter the powers of the members, and (iv) any other powers expressly reserved to them by law. All other powers of the Company reside exclusively with the directors. |
| Form 990 Part VI Line 11a | The Company provided a copy of the Form 990 to the Board of Directors prior to filing with the Internal Revenue Service. |
| Form 990 Part VI Line 12a | The Board of Directors OF MINUTEMAN HEALTH HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL DIRECTORS AND SENIOR STAFF. EACH INDIVIDUAL IS ASKED TO REVIEW THE POLICY UPON HIRING OR APPOINTMENT TO THE BOARD AND PROVIDE AN ANNUAL DISCLOSURE AS TO THE POTENTIAL CONFLICTS OF INTEREST. THE DISCLOSURES ARE REVIEWED BY THE GENERAL COUNSEL AND COMPLIANCE OFFICER AND SHARED WITH THE BOARD CHAIR. INDIVIDUALS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST AS THEY ARISE. |
| Form 990 Part VI Line 15b | Minuteman Health obtains approval of its C level employment contracts and compensation from the Centers of Medicare and Medicaid Services annually. It also contracts with an independent consultant to review the monetary value of the C level employment contracts. Conclusions are shared with the Compensation Committee of the Board of Directors who propose the C level employment contracts that are shared with the Centers of Medicare and Medicaid Services. the COMPANY ALSO REVIEWs COMPARATIVE INFORMATION OBTAINED FROM COMPETITOR FORM 990S. |
| Form 990 Part VI Line 19 | The federal Form 990 is available upon request by any member of the general public. The Company files quarterly and annual filings with the NAIC and the Massachusetts and New Hampshire Divisions of Insurance. PART XI, LINE 9 OTHER CHANGE OF NET ASSETS $53,745,475 THE COMPANY RECEIVED TOTAL DRAWDOWNS OF $53,796,801 FROM ITS CO-OP SOLVENCY LOAN DURING 2015. THESE DRAWDOWNS ARE CLASSIFIED AS SURPLUS NOTES AND USED TO ESTABLISH RESERVES TO MEET RISK-BASED CAPITAL REQUIREMENTS AND OTHER STATE RESERVE REQUIREMENTS AND STATE INSURANCE LAWS. THE COMPANY ALSO RECOGNIZED A CHANGE IN NON-ADMITTED ASSETS OF ($51,326). |
| Form 990 Part XII Line 2a | The Company has undergone financial statement and A-133 audits for the year ended December 31, 2015. The Company has an established Finance and Audit Committee that reviews the results of the audits. The reports are also shared with the Board of Directors. |
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