efile Public Visual Render
ObjectId: 202303199349304940 - Submission: 2023-11-15
TIN: 04-2452600
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
22
Open to Public Inspection
Name of the organization
HARVARD PILGRIM HEALTH CARE INC
Employer identification number
04-2452600
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
HARVARD PILGRIM HEALTH CARE INST LLC
133 BROOKLINE AVE
BOSTON
,
MA
02215
94-3477531
RESEARCH
MA
26,210,617
58,991,166
HPHCINC
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
HPHC FOUNDATION INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-2708004
COMMUNITY SVC
MA
501(C)(3)
12A-I
HPHCINC
Yes
(2)
HPHC OF NEW ENGLAND INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-2663394
HEALTH INSURA
MA
501(C)(4)
N/A
HPHCINC
Yes
(3)
POINT32HEALTH FOUNDATION INC
1 WELLNESS WAY
CANTON
,
MA
02021
26-1374263
GRANT MAKING
MA
501 (C)(3)
12A
TAHMO
Yes
(4)
TUFTS HEALTH PUBLIC PLANS INC
1 WELLNESS WAY
CANTON
,
MA
02021
80-0721489
HMO
MA
501(C)(4)
N/A
P32H
Yes
(5)
POINT32HEALTH INC
1 WELLNESS WAY
CANTON
,
MA
02021
81-4089215
HEALTHCARE
MA
501(C)(4)
N/A
NA
No
(6)
TUFTS ASSOC HEALTH MAINTEN ORG INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-2674079
HMO
MA
501(C)(4)
N/A
P32H
Yes
(7)
CARE PARTNERS OF CONNECTICUT INC
1 WELLNESS WAY
CANTON
,
MA
02021
82-2604728
HMO
CT
501(C)(4)
N/A
TAHMO
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2022
Page 2
Schedule R (Form 990) 2022
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
CAREPARTNERS OF CT HOLDINGS LLC
1 WELLNESS WAY
CANTON
,
MA
02021
82-3129930
HOLDING COMPANY
CT
TAHMO
N/A
(2)
CLARION MANAGEMENT SOLUTIONS LLC
1212 CORPORATE DRIVE SUITE 225
IRVING
,
TX
75038
82-2713764
CLINICAL CONSULTG
DE
EH NEXUS
N/A
(3)
EMPLOYERS HEALTH NEXUS LLC
1500 W PARK DRIVE SUITE 330
WESTBOROUGH
,
MA
01581
88-2938454
HOLDING COMPANY
MA
HEALTH PLANS
N/A
(4)
EMPLOYERS HEALTH NETWORK LLC
1212 CORPORATE DRIVE SUITE 225
IRVING
,
TX
75038
47-1678150
SELF INSURANCE
DE
EH NEXUS
N/A
(5)
KP VENTURES LLC SERIES B
1 KAISER PLAZA
OAKLAND
,
CA
94612
27-3339892
HEALTHCARE
CA
TAHMO
N/A
(6)
KP VENTURES LLC SERIES D
1 KAISER PLAZA
OAKLAND
,
CA
94612
47-1874366
HEALTHCARE
CA
TAHMO
N/A
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
HPHC INSURANCE COMPANY INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-3149694
HEALTH INSURANCE
MA
NEW HPHC HOLDCO
C CORP
Yes
(2)
PLAN MARKETING INSURANCE AGENCY INC
1500 W PARK DRIVE STE 330
WESTBOROUGH
,
MA
01581
04-2734281
BROKERAGE
MA
HEALTH PLANS
C CORP
Yes
(3)
HPHC INSURANCE AGENCY INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-3016201
BROKERAGE
MA
NEW HPHC HOLDCO
C CORP
Yes
(4)
HEALTH PLANS INC
1500 W PARK DRIVE STE 330
WESTBOROUGH
,
MA
01581
04-2734278
TPA
MA
NEW HPHC HOLDCO
C CORP
Yes
(5)
CARE MANAGEMENT SERVICES INC
1500 W PARK DRIVE STE 330
WESTBOROUGH
,
MA
01581
04-3438779
CARE MANAGEMENT
MA
HEALTH PLANS
C CORP
Yes
(6)
NEW HPHC HOLDING CORPORATION
1 WELLNESS WAY
CANTON
,
MA
02021
81-5340662
HOLDING COMPANY
DE
HPHC INC
C CORP
Yes
(7)
POINT32HEALTH SERVICES INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-2985923
MANAGEMENT SVCS
DE
TAHMO
C CORP
Yes
(8)
TUFTS INSURANCE COMPANY
1 WELLNESS WAY
CANTON
,
MA
02021
04-3319729
INSURANCE
MA
P32H SRVCS INC
C CORP
Yes
(9)
TUFTS BENEFIT ADMINISTRATORS INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-3270923
TPA
MA
P32H SRVCS INC
C CORP
Yes
(10)
TOTAL HEALTH PLAN INC
1 WELLNESS WAY
CANTON
,
MA
02021
04-2918943
TPA
MA
P32H SRVCS INC
C CORP
Yes
(11)
TAHP BROKERAGE CORPORATION
1 WELLNESS WAY
CANTON
,
MA
02021
04-3072692
BROKERAGE
MA
P32H SRVCS INC
C CORP
Yes
(12)
INTEGRA PARTNERS HOLDINGS INC
100 WALL ST STE 2502
NEW YORK
,
NY
10005
45-3032233
MED EQUIPT & SVCS
NY
TAHMO
C CORP
Yes
Schedule R (Form 990) 2022
Page 3
Schedule R (Form 990) 2022
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
Yes
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
Yes
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
Yes
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
POINT32HEALTH INC
C
35,000,000
FMV
(2)
POINT32HEALTH FOUNDATION INC
B
6,000,000
FMV
(3)
HPHC OF NEW ENGLAND INC
B
25,000,000
FMV
(4)
HPHC INSURANCE COMPANY INC
LNOQ
15,342,000
FMV
(5)
HPHC INSURANCE AGENCY INC
F
4,500,000
FMV
(6)
HPHC INSTITUTE LLC
LNOQ
4,518,000
FMV
(7)
HEALTH PLANS INC
LNOQ
874,000
FMV
(8)
HEALTH PLANS INC
B
8,000,000
FMV
Schedule R (Form 990) 2022
Page 4
Schedule R (Form 990) 2022
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2022
Page 5
Schedule R (Form 990) 2022
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference
Explanation
Schedule R (Form 990) 2022
Additional Data
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