Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 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...... | 126,666,747 | 192,092,958 | 413,872,862 | 556,647,405 | 659,669,215 | 1,948,949,187 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 126,666,747 | 192,092,958 | 413,872,862 | 556,647,405 | 659,669,215 | 1,948,949,187 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 1,948,949,187 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 126,666,747 | 192,092,958 | 413,872,862 | 556,647,405 | 659,669,215 | 1,948,949,187 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 18,956 | 29,451 | 98,597 | 336,727 | 373,529 | 857,260 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 18,956 | 29,451 | 98,597 | 336,727 | 373,529 | 857,260 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 23,101 | 1,006 | 40,433 | 64,540 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 126,708,804 | 192,123,415 | 413,971,459 | 556,984,132 | 660,083,177 | 1,949,870,987 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | BEGINNING AUGUST 1, 2010, SENIOR HEALTH PARTNERS, INC. (SHP) CONTRACTS WITH HF MANAGEMENT SERVICES, LLC (HFMS) TO PROVIDE ALL OF ITS MANAGEMENT AND ADMINISTRATIVE SERVICES. SINCE AUGUST 2010, THE NOT-FOR-PROFIT ENTITY DOES NOT MAINTAIN ITS OWN STAFF OR OFFICE SPACE, THESE ARE SUPPLIED BY HFMS. HFMS CHARGES A PERCENTAGE ON A PER MEMBER PER MONTH BASIS OR A FLAT FEE PER MEMBER PER MONTH AS MANAGEMENT FEE. ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR HFMS, A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MULTIPLE ENTITIES. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM SHP. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE JANUARY 1, 2015, SHP BYLAWS WERE AMENDED TO SHOW HEALTHFIRST, INC. (HFI) AS THE SOLE CORPORATE MEMBER. THE PRIOR BYLAWS HAD HFMS AS THE SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 6 | HEALTHFIRST, INC. IS SENIOR HEALTH PARTNERS, INC.'S SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | SENIOR HEALTH PARTNERS, INC. IS A NEW YORK STATE NOT-FOR-PROFIT MEMBERSHIP CORPORATION. SENIOR HEALTH PARTNERS INC'S SOLE CORPORATE MEMBER IS HEALTHFIRST, INC. HEALTHFIRST, INC. HAS THE RIGHT TO APPOINT MEMBERS TO THE BOARD OF DIRECTORS OF SENIOR HEALTH PARTNERS, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE AMENDMENT OF THE ORGANIZATION'S GOVERNING DOCUMENTS IS SUBJECT TO THE APPROVAL OF HEALTHFIRST, INC. SOME OF THE DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY STATE REGULATORS: * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS * CERTAIN CHANGES TO PREMIUM RATES * EXPANSION TO OTHER MANAGED CARE BUSINESSES * SPECIFIC TYPES OF CHANGES TO THE ORGANIZATION'S BENEFIT PLANS * MANAGEMENT FEE RATE CHANGES |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS TREASURER AND VICE PRESIDENT CONTROLLER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS CHIEF LEGAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS GIVEN A COPY OF THE DISCLOSURE STATEMENT TO COMPLETE ON AN ANNUAL BASIS. A NOMINATED BOARD MEMBER WHO DOES NOT COMPLETE THE STATEMENT IS NOT ALLOWED TO ASSUME THE BOARD SEAT, ATTEND BOARD MEETINGS AND MAY BE REMOVED FROM THE BOARD. AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE STATEMENT WILL BE DISCIPLINED, UP TO TERMINATION FROM THE POSITION. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION. A REPORT OF ANY CONFLICTS IS PREPARED FOR DISCUSSION WITH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST INC., THE NOT FOR PROFIT CORPORATE PARENT, AS WELL AS THE FULL BOARD OF DIRECTORS OF SENIOR HEALTH PARTNERS, INC. AS APPROPRIATE, ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. PART 990, PART VI, SECTION B, LINE 15 BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICER OR EMPLOYEE, THE REPORTING ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC (A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY OF INDEPENDENT DIRECTORS. THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEE'S CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES OF REQUEST FOR INSPECTION AT ITS CORPORATE OFFICE. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS TOTAL OTHER CHANGES IN NET ASSETS: $35,489,074. RETAINED HOSPITAL PAYMENTS: $666,631. THE HEALTH CARE SERVICES AGREEMENTS WITH SHP'S RISK-SHARING PARTNER PROVIDERS ALLOW FOR CERTAIN PAYMENTS DUE TO EACH PARTNER TO BE RETAINED BY SHP AS ADDITIONAL CAPITAL CONTRIBUTIONS, AND ARE WITHHELD FROM ACCRUED MEDICAL SERVICES. RETAINED PAYMENTS REQUIRED TO BE WITHHELD BY SHP TOTALED $666,631 FOR THE YEAR ENDED DECEMBER 31, 2015. GOODWILL & INTANGIBLE ASSETS: $34,822,443. Effective January 1, 2015, HFMS distributed its membership interest in SHP to HFMSs equity owners, based on a pro-rata share of their respective interests in HFMS, in connection with a spin-off of the MLTC plan from HFMS. Each of the equity owners then exchanged their respective membership interests in SHP with Healthfirst, Inc. ("HFI") in exchange for subvention certificates. As a result, HFI became the sole corporate member of SHP. HFI is a not-for-profit corporation incorporated in the State of New York as a hospital sponsored and organized managed care entity. The Board of Managers of HFMS and the Board of Directors of HFI include common individuals. In connection with this transaction, the assets and liabilities of SHP were marked to fair value as of January 1, 2015, which resulted in a net increase of approximately $34.8 million as compared to the historical value of the net assets as reported by the predecessor company. The approximate $34.8 million increase in SHPs net assets is comprised of goodwill of approximately $38.7 million and a net decrease in intangible assets of approximately $3.9 million. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC., THE ORGANIZATION'S SOLE CORPORATE MEMBER. |
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