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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," on Form 990, Part IV, line 21 or 22.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
HARVARD PILGRIM HEALTH CARE INC
 
Employer identification number
04-2452600
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC 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
noncash assistance		 (h) Purpose of grant
or assistance
(1) HARVARD PILGRIM HEALTH CARE FOUNDATION INC
ONE WELLNESS WAY
CANTON,MA02021 		04-2708004 501(C)(3) 770,365       FUND OPERATIONS
(2) TUFTS HEALTH PLAN FOUNDATION INC
ONE WELLNESS WAY
CANTON,MA02021 		26-1374263 501(C)(3) 10,000,000       FUND OPERATIONS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021
Page 2

Schedule I (Form 990) 2021
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 HPHC, INC. MAKES GRANTS TO ITS SUPPORTING ORGANIZATIONS, HARVARD PILGRIM HEALTHCARE FOUNDATION AND TUFTS HEALTH PLAN FOUNDATION. HARVARD PILGRIM HEALTHCARE FOUNDATION AND TUFTS HEALTH PLAN FOUNDATION MAKE COMMUNITY GRANTS AND MONITOR THEM IN ACCORDANCE WITH HPHC'S TAX EXEMPT MISSION. THE HARVARD PILGRIM HEALTH CARE FOUNDATION SUPPORTS HPHC, INC.'S MISSION TO IMPROVE THE QUALITY AND VALUE OF HEALTH CARE FOR THE PEOPLE AND COMMUNITIES WE SERVE. THE FOUNDATION PROVIDES TOOLS, TRAINING AND LEADERSHIP TO BUILD HEALTHY COMMUNITIES THROUGHOUT MASSACHUSETTS, CONNECTICUT, MAINE, AND NEW HAMPSHIRE. IN 2021, THE FOUNDATION AWARDED NEARLY $3.6 MILLION IN GRANTS AND OTHER DONATIONS TO MORE THAN 750 NOT-FOR-PROFIT ORGANIZATIONS IN THE REGION. THIS INCLUDED MORE THAN $1 MILLION IN GRANTS DISTRIBUTED THROUGH THE FOUNDATION'S HEALTHY FOOD FUND. THIS FUND SUPPORTS PROGRAMS THAT GROW, GLEAN AND DISTRIBUTE FRESH FOOD FOR FAMILIES AND COMMUNITIES ACROSS THE REGION. SINCE ITS INCEPTION IN 1980, THE FOUNDATION HAS AWARDED APPROXIMATELY $165 MILLION IN FUNDS AND RESOURCES THROUGHOUT THE FOUR STATES. TUFTS HEALTH PLAN FOUNDATION INVESTS IN COMMUNITIES THROUGH GRANT MAKING ON BEHALF OF TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. AND ADVANCES THE JOINT MISSION "TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES WE SERVE" BY MAKING GRANTS TO NONPROFIT ORGANIZATIONS. THE FOUNDATION'S PROCESS IS COMPREHENSIVE AND THOROUGH. DEPENDING ON TYPE OF GRANT, THE REVIEWS EITHER BEGIN WITH A LETTER OF INTENT AND/OR A FULL PROPOSAL. THESE SERVE AS THE BASIS OF A MUTUAL PERFORMANCE AGREEMENT AND FOR MONITORING GRANT ACTIVITY AND HOW FUNDS ARE USED. AN INDEPENDENT THIRD PARTY VERIFIES 501(C)(3) STATUS AND EVALUATES EACH ORGANIZATION'S FINANCES. GRANTS $50,000 OR LESS WERE APPROVED BY STAFF. GRANTS MORE THAN $50,000 WERE RECOMMENDED BY STAFF AND VOTED ON BY THE BOARD OF DIRECTORS. IN OCTOBER THE FOUNDATION BOARD OF DIRECTORS INCREASED STAFF AUTHORITY TO GRANTS LESS THAN $100,000. GRANTS OF $100,000 OR MORE ARE RECOMMENDED BY STAFF AND VOTED ON BY THE BOARD OF DIRECTORS.ONCE AWARDED, GRANTEES ARE REQUIRED TO SUBMIT PERIODIC UPDATES OR REPORT(S).
Schedule I (Form 990) 2021



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