TIN:
SCHEDULE O
(Form 990)
Department of the Treasury
Internal Revenue Service
(Form 990)
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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Inspection
Name of the organization
HARVARD PILGRIM HEALTH CARE OF
NEW ENGLAND INC
NEW ENGLAND INC
Employer identification number
04-2663394
04-2663394
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. ("NEW ENGLAND") OPERATES AS A NOT-FOR-PROFIT HEALTH PLAN PROVIDING COMPREHENSIVE HEALTH INSURANCE, ACCESS TO HEALTH CARE AND OTHER RELATED SERVICES IN NEW HAMPSHIRE TO INDIVIDUAL AND GROUP MEMBERS THROUGH CONTRACTS WITH PHYSICIANS, ESTABLISHED PRIMARY GROUP AND MULTI SPECIALTY PHYSICIAN GROUPS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS. NEW ENGLAND'S MISSION IS TO GUIDE AND EMPOWER HEALTHIER LIVES FOR EVERYONE. NEW ENGLAND HAS BUILT A REPUTATION FOR EXCEPTIONAL CLINICAL QUALITY, PREVENTIVE CARE, DISEASE MANAGEMENT, AND MEMBER SATISFACTION. WE REMAIN AN INDUSTRY LEADER BY CONTINUING TO DEVELOP NEW WAYS TO IMPROVE UPON HOW WE CARE FOR OUR MEMBERS. |
| FORM 990, PART I, LINE 1 CONTINUED | Point32Health (P32H) was formerly known as Health Plan Holdings, Inc., which was the parent entity of the Tufts Health Plan family of companies. Effective January 1, 2021, P32H and Harvard Pilgrim Health Care, Inc. (HPHC), combined their respective nonprofit organizations and the net assets of HPHC were contributed to P32H. HPHC is a not-for-profit Massachusetts corporation providing comprehensive health benefits insurance, access to health care, and other related services in Massachusetts, Maine, and Connecticut to group, individual, and Medicare members through contracts with physicians, established primary care and multispecialty physician groups, hospitals, and other health care providers. As a result of the combination, P32H became the direct corporate parent of HPHC, and ultimate corporate parent for Harvard Pilgrim's affiliates. |
| FORM 990, PART VI, LINE 2 | BUSINESS RELATIONSHIPS - THE FOLLOWING INDIVIDUALS SERVE AS OFFICERS AND/OR ARE ON THE BOARD OF ONE OR MORE FOR PROFIT ORGANIZATIONS RELATED TO NEW ENGLAND, AND/OR ARE EMPLOYED BY AN ORGANIZATION (OTHER THAN THE FILING ORGANIZATION), FOR WHICH ANOTHER PERSON LISTED SERVES AS AN OFFICER OR DIRECTOR. CAIN HAYES, DIRECTOR AND CEO (START 7/5/21); PRESIDENT (START 10/1/21) MICHAEL A. CARSON - PRESIDENT AND DIRECTOR (END 10/1/2021) TISA K. HUGHES - DIRECTOR UMESH KURPAD - DIRECTOR AND CFO POLAND PRICE - TREASURER |
| FORM 990, PART VI, LINE 3 | NEW ENGLAND DOES NOT HAVE ITS OWN EMPLOYEES. NEW ENGLAND PAYS HARVARD PILGRIM HEALTH CARE, INC. (HPHC, INC.) AND POINT32HEALTH SERVICES, INC. FOR SERVICES PROVIDED BY ITS EMPLOYEES. UNDER A MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT BETWEEN NEW ENGLAND AND HPHC, INC., HPHC, INC. PROVIDES ADMINISTRATIVE AND OPERATIONAL MANAGEMENT SERVICES TO NEW ENGLAND. |
| FORM 990, PART VI, LINE 4 | THE BYLAWS WERE AMENDED AND RESTATED IN CONNECTION WITH THE COMBINATION OF THE HEALTH PLAN HOLDINGS, INC. AND HARVARD PILGRIM HEALTH, INC. ORGANIZATIONS. SOME EXAMPLES OF THE UPDATES TO THE BYLAWS INCLUDE BUT ARE NOT LIMITED TO BANKING AUTHORITY AND OTHER GOVERNANCE PROCESSES. |
| FORM 990, PART VI, LINE 6 | POINT32HEALTH, INC. IS THE PARENT AND SOLE MEMBER OF NEW ENGLAND. |
| FORM 990, PART VI, LINE 7A | HPHC, INC. IS THE SOLE MEMBER OF NEW ENGLAND. THE HPHC, INC. BOARD OF DIRECTORS ELECTS THE APPROPRIATE NUMBER OF NEW ENGLAND DIRECTORS DURING THE HPHC, INC. BOARD OF DIRECTORS ANNUAL MEETING. |
| FORM 990, PART VI, LINE 7B | NEW ENGLAND'S BYLAWS SET FORTH THE POWER OF THE SOLE MEMBER, HPHC, INC. TO AMEND, REPEAL, OR ADOPT NEW BYLAWS. |
| FORM 990, PART VI, LINE 11B | ONCE NEW ENGLAND'S FORM 990 IS COMPLETED WITH THE ASSISTANCE OF ITS OUTSIDE TAX ADVISORS, IT IS REVIEWED BY POINT32HEALTH, INC.'S INTERNAL MANAGEMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. |
| FORM 990, PART VI, LINE 12C | MONITORING & ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE POINT32HEALTH INC'S CONFLICT OF INTEREST (COI) POLICY AND PROCEDURES (P&P) APPLIES TO THE FILING COMPANY AS A SUBSIDIARY ORGANIZATION. THE POINT32HEALTH, INC.'S COI P&P IS REVIEWED ANNUALLY, REVISED AS NEEDED AND APPROVED UPON MATERIAL REVISIONS. THE POLICY REQUIRES ALL EMPLOYEES, INCLUDING THE PRESIDENT AND CEO AND GOVERNING BODY MEMBERS TO COMPLY WITH THE COI POLICY AND PROCESSES. ALL EMPLOYEES RECEIVE ANNUAL COMPLIANCE TRAINING WHICH INCLUDE EXPECTATIONS RELATED TO FOLLOWING THE COI P&P. THE COI P&P REQUIRES THE OFFICERS, KEY EMPLOYEES AND BOARD OF DIRECTORS OF THE TAX-EXEMPT ENTITIES TO COMPLETE AND SUBMIT AN ANNUAL DISCLOSURE SURVEY AND STATEMENT TO THE CHIEF LEGAL OFFICER (CLO) OR DESIGNEE IN THE LEGAL DEPARTMENT, LISTING ANY OUTSIDE RELATIONSHIPS, INCLUDING FINANCIAL AND/OR BOARD RELATIONSHIPS THAT THEY OR A FAMILY MEMBER HAVE WITH POINT32HEALTH, INC.'S (OR ITS SUBSIDIARIES SUPPLIERS, PURCHASERS, PROVIDERS AND/OR COMPETITORS. ADDITIONALLY, POINT32HEALTH, INC. REQUIRES EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT TO COMPLETE AND SUBMIT AN ANNUAL DISCLOSURE SURVEY AND STATEMENT TO THE CHIEF COMPLIANCE OFFICER OR DIRECTOR, CORPORATE COMPLIANCE. BY COMPLETING THE ANNUAL DISCLOSURE STATEMENT, THESE INDIVIDUALS ACKNOWLEDGE THE POINT32HEALTH COI P&P. ALL EMPLOYEES ARE REQUIRED TO REPORT THE OFFER BY AN OUTSIDE ENTITY OF GIFTS OVER $250, HONORARIA OR COVERAGE OF BUSINESS EXPENSES, OR OTHER EVENTS OR RELATIONSHIPS THAT MAY BE PERCEIVED AS CONFLICTS TO THE CHIEF COMPLIANCE OFFICER, DIRECTOR, CORPORATE COMPLIANCE OR DESIGNEE AND THE EMPLOYEE'S MANAGEMENT. BOTH MUST APPROVE BEFORE ACCEPTANCE IS ALLOWED. THERE ARE PROTOCOLS AND PROCESSES TO REVIEW ANY DISCLOSURE THAT MIGHT BE A POTENTIAL CONFLICT OF INTEREST. BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES' RESPONSES TO THE DISCLOSURE SURVEY AND STATEMENT ARE REVIEWED BY THE CHIEF LEGAL OFFICER (CLO), WHO WILL REVIEW THE SELF-DISCLOSURE WITH THE CHAIR OF THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF POINT32HEALTH, INC. AND DETERMINE EXPECTATIONS AND RECOMMENDED ACTIONS IF NEEDED. A SUMMARY REPORT OF ALL DISCLOSED ACTUAL OR POTENTIAL CONFLICTS ALONG WITH ANY RECOMMENDED ACTIONS TO ADDRESS A DISCLOSED ACTUAL OR POTENTIAL CONFLICT IS REVIEWED AND APPROVED BY THE GOVERNANCE COMMITTEE AND THE COMMITTEE'S REVIEW/FINDINGS ARE REPORTED TO THE FULL BOARD. THE CLO COMMUNICATES THE RECOMMEND ACTIONS TO INDIVIDUAL SURVEY RECIPIENTS. THE CHIEF COMPLIANCE OFFICER IS CONSULTED AND INFORMED OF THE DECISIONS MADE BY THE CLO OR LEGAL DESIGNEE. EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT'S (AS DEFINED IN THE COI POLICY) RESPONSES TO THE DISCLOSURE SURVEY AND STATEMENT ARE REVIEWED BY THE DIRECTOR, CORPORATE COMPLIANCE AND CHIEF COMPLIANCE OFFICER, WHO WILL REPORT TO THE CLO ANY POTENTIAL CONFLICTS ALONG WITH ANY RECOMMENDED ACTIONS TO ADDRESS THE POTENTIAL CONFLICT, IF NECESSARY. RECOMMENDED ACTIONS/EXPECTATIONS ARE COMMUNICATED BY DIRECTOR, CORPORATE COMPLIANCE/CHIEF COMPLIANCE OFFICER TO IMPACTED INDIVIDUALS. FOR CONFLICT DISCLOSURES INVOLVING THE CHIEF COMPLIANCE OFFICER, THE CLO WILL MAKE THE FINAL DETERMINATION. ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST THAT ARISES AFTER COMPLETION OF THE DISCLOSURE SURVEY WILL FOLLOW THE SAME REVIEW PROCESS. |
| FORM 990, PART VI, LINE 19 | THE ORGANIZATION FURNISHES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICTS OF INTEREST POLICY TO THE PUBLIC UPON REQUEST. THE STATUTORY FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC) WEBSITE. |
| FORM 990, PART VII, SECTION B, LINE 1 | ANY INDEPENDENT CONTRACTORS ARE RETAINED BY THE PARENT COMPANY, HPHC, INC. |
| FORM 990, PART XI, LINE 9 | CHANGE IN NON-ADMITTED ASSETS ($1,333,288) CAPITAL CONTRIBUTION FROM HPHC, INC. $40,000,000 TOTAL: $38,666,712 |
| FORM 990, PART XII, Line 1 | NEW ENGLAND FOLLOWS THE STATUTORY ACCOUNTING METHOD PRESCRIBED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS ACCOUNTING PRACTICES AND PROCEDURES MANUAL FOR STATUTORY ACCOUNTING PRINCIPLES. |
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021
Additional Data
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