| FORM 990, PART I, LINE 1 & PART III, LINE 1 |
ORGANIZATION'S MISSION HARVARD PILGRIM OPERATES AS A NOT-FOR-PROFIT HEALTH PLAN PROVIDING COMPREHENSIVE HEALTH MAINTENANCE ORGANIZATION SERVICES, ACCESS TO HEALTH CARE AND OTHER RELATED SERVICES IN MASSACHUSETTS, NEW HAMPSHIRE AND MAINE TO GROUP AND INDIVIDUAL MEMBERS THROUGH CONTRACTS WITH PHYSICIANS, ESTABLISHED PRIMARY CARE AND MULTI-SPECIALTY PHYSICIAN GROUPS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS. OUR MISSION IS TO IMPROVE THE QUALITY AND VALUE OF HEALTH CARE FOR THE PEOPLE AND COMMUNITIES WE SERVE. FOR MORE THAN 30 YEARS, HARVARD PILGRIM 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. PHYSICIAN PRACTICES IN MASSACHUSETTS, NEW HAMPSHIRE AND MAINE WILL RECEIVE GRANTS FROM HARVARD PILGRIM TO IMPROVE CLINICAL CARE, QUALITY AND SERVICE. HARVARD PILGRIM'S ANNUAL QUALITY AWARDS PROGRAM WILL FUND VARIOUS PHYSICIAN-GROUP INITIATIVES THAT FOCUS ON MANAGING CHRONIC AND PREVENTABLE DISEASES, INCREASING PATIENT SATISFACTION AND SAFETY AND INCREASING PREVENTATIVE CARE. THE RESULTS OF THESE PROGRAMS WILL BE SHARED WITH OTHER HARVARD PILGRIM PROVIDERS SO THAT THEIR "BEST PRACTICES" CAN BENEFIT A BROADER PATIENT POPULATION. THROUGH THE HARVARD PILGRIM HEALTH CARE INSTITUTE, OUR SPONSORED EDUCATIONAL PROGRAMS AND RESEARCH AGENDA SEEKS TO DISCOVER THE MOST EFFECTIVE WAYS TO DELIVER AMBULATORY MEDICAL CARE, REDUCE UNWARRANTED VARIATION IN PRACTICE, IMPROVE PATIENT SAFETY AND, WHENEVER POSSIBLE, IMPROVE PUBLIC HEALTH. THE HPHC INSTITUTE CHAMPIONS INNOVATIVE RESEARCH THAT DIRECTLY IMPROVES THE HEALTH AND SAFETY OF SOCIETY. |
| FORM 990, PART VI, LINE 2 |
BUSINESS RELATIONSHIP - THE FOLLOWING INDIVIDUALS SERVE ON THE BOARDS OR ARE AN OFFICER OR KEY EMPLOYEE OF ONE OR MORE FOR PROFIT ORGANIZATIONS AFFILIATED WITH HPHC, INC.: ERIC H. SCHULTZ - PreSident/CEO/Director CHARLES R. GOHEEN - CFO/Treasurer THOMAS F. MALONEY - Interim Legal Officer (as of 6/13) LAURA S. PEABODY - Clerk/Secretary/CLO (until 6/13) SCOTT ALLEN - Chief Actuary (until 11/13) FORM 990, PART VI, LINE 11B ONCE HARVARD PILGRIM'S FORM 990 IS COMPLETED WITH THE ASSISTANCE OF ITS OUTSIDE TAX ADVISORS, IT IS FIRST REVIEWED BY HPHC'S INTERNAL MANAGEMENT AND THEN HPHC'S AUDIT COMMITTEE CHAIRPERSON (AN INDEPENDENT MEMBER OF THE BOARD OF DIRECTORS OF THE ORGANIZATION). FOLLOWING THAT REVIEW, HARVARD PILGRIM INTERNAL MANAGEMENT AND OUTSIDE TAX ADVISORS PRESENT THE FORM 990 TO THE AUDIT COMMITTEE. 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 ALL HPHC DIRECTORS, OFFICERS AND EMPLOYEES ARE SUBJECT TO HPHC'S CODE OF CONDUCT WHICH INCLUDES A CONFLICT OF INTEREST POLICY. THE CONFLICT OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS, AND EMPLOYEES TO DISCLOSE ON AN ONGOING BASIS THE OCCURRENCE OF ANY SITUATION WHEN THEIR OUTSIDE ACTIVITIES, PERSONAL INTERESTS OR RELATIONSHIPS MIGHT INFLUENCE, OR APPEAR TO INFLUENCE, THEIR ABILITY TO MAKE OBJECTIVE DECISIONS IN THE COURSE OF PERFORMING THEIR JOB RESPONSIBILITIES, HINDER OR DISTRACT FROM THE PERFORMANCE OF THEIR JOB RESPONSIBILITIES, ARE PREJUDICIAL TO THE LEGITIMATE INTERESTS OF HPHC AND ITS SUBSIDIARIES, OR CAUSE THE USE OF HPHC RESOURCES FOR OTHER THAN HPHC PURPOSE. IN ADDITION TO BEING SUBJECT TO HPHC'S CONFLICT OF INTEREST POLICY, HPHC'S BOARD OF DIRECTORS AND BOARD COMMITTEE MEMBERS ARE ANNUALLY REQUIRED TO COMPLETE AND SIGN A CONFLICTS OF INTEREST DISCLOSURE FORM, WHICH IS REPORTED TO THE BOARD OF DIRECTORS IN ACCORDANCE WITH THE DISCLOSURES AND REVIEW PROCESS SET FORTH IN HPHC'S BYLAWS. IN ADDITION, ROUGHLY HALF OF HPHC'S EMPLOYEES WHO MAKE DECISIONS ON BEHALF OF THE ORGANIZATION, OR ARE IN A POSITION TO INFLUENCE DECISIONS MADE ON BEHALF OF HPHC, ARE SURVEYED ON AN ANNUAL BASIS. THESE EMPLOYEES MUST COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE FORM AND SUBMIT IT TO THE VICE PRESIDENT OF CORPORATE COMPLIANCE PROGRAMS (COMPLIANCE OFFICER). THESE FORMS ARE THEN REVIEWED BY THE COMPLIANCE OFFICER AND THE ASSOCIATE GENERAL COUNSEL RESPONSIBLE FOR CORPORATE COMPLIANCE & SPECIAL INVESTIGATIONS (COUNSEL). IF A DISCLOSURE OF A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST IS MADE, THE COMPLIANCE OFFICER AND COUNSEL MAKE A DETERMINATION IF SUCH DISCLOSURE IS MATERIAL AND NEEDS TO BE MANAGED, MITIGATED OR ELIMINATED. THE COMPLIANCE OFFICER INFORMS EACH DEPARTMENTAL VICE PRESIDENT RESPONSIBLE FOR THE DISCLOSING EMPLOYEE OF THE DISCLOSURE. HPHC ALSO HAS MORE STRINGENT CONFLICTS OF INTEREST POLICIES AND PROCEDURES FOR CERTAIN DEPARTMENTS WHERE CONFLICTS, OR THE APPEARANCE OF CONFLICTS, ARE MORE LIKELY TO EXIST. FOR EXAMPLE, THE PHARMACY DEPARTMENT, PROVIDER CONTRACTING DEPARTMENT, AND MEDICAL MANAGEMENT DEPARTMENT ARE SUBJECT TO MORE STRINGENT POLICIES GOVERNING THE OFFER OR ACCEPTANCE OF ANY REMUNERATION, IN CASH OR IN KIND, FROM INDUSTRIES RELATED TO THEIR FUNCTION (E.G. PHARMACEUTICAL MANUFACTURERS AND HEALTHCARE DELIVERY ENTITIES). AS A GENERAL RULE, CONFLICTS OF INTEREST ARE NOT PERMITTED. HOWEVER, IN CERTAIN CASES, IF THE CONFLICT IS NOT MATERIAL AND IS PROMPTLY AND FULLY DISCLOSED TO THE EMPLOYEE'S MANAGER AND VICE PRESIDENT OF THE EMPLOYEE'S DEPARTMENT, AND IS APPROVED BY THE COMPLIANCE OFFICER, A WAIVER OF THE CONFLICT MAY BE GRANTED AND APPROPRIATE STEPS WILL BE TAKEN TO MITIGATE THE CONFLICT. FORM 990, PART VI, LINES 15A & 15B HPHC HAS AN INDEPENDENT COMPENSATION COMMITTEE THAT ANNUALLY REVIEWS THE COMPENSATION OF THE COMPANY'S OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE CONSIDERS MARKET DATA AND ANALYSES ASSEMBLED BY INDEPENDENT COMPENSATION CONSULTANTS. THE COMMITTEE'S DELIBERATIONS ARE REFLECTED IN ITS MINUTES. FORM 990, PART VI, LINE 19 HPHC FURNISHES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT 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) WEB SITE. FORM 990, PART VII, SECTION B, ATTACHMENT 1 NAME: DELL MARKETING LP DESCRIPTION OF SERVICES: IT CONSULTING AND BUSINESS PROCESS OUTSOURCING FORM 990, PART IX, COLUMN (D) THERE ARE NO EXPENSES FOR FUNDRAISING INCLUDED IN THE INCOME STATEMENT FOR HARVARD PILGRIM HEALTH CARE, INC. ANY COSTS INCURRED WITH THE ADMINISTRATION OF FEDERAL OR PRIVATE GRANTS ARE INCURRED BY THE INSTITUTE. THEY ARE TYPICALLY FUNDED BY THE INDIRECT COST RECOVERIES ON THOSE GRANTS. FORM 990, PART XI, LINE 9 CHANGE IN NONADMITTED ASSETS ($5,951,755) CHANGE IN SURPLUS NOTES ($9,714,897) CHANGE IN NET POST-RETIREMENT SERVICE COSTS & RECOGNIZED LOSS FOR POST-RETIREMENT MEDICAL PLAN $2,376,579 CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE ($8,282,349) ____________ TOTAL ($21,572,422) FORM 990, PART XII, LINE 1 HARVARD PILGRIM HEALTH CARE FOLLOWS THE STATUTORY ACCOUNTING METHOD PRESCRIBED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS' ACCOUNTING PRACTICES AND PROCEDURES MANUAL FOR STATUTORY ACCOUNTING PRINCIPLES. |
Attach to Form 990 or 990-EZ.