irs program accomplishments · form 990 part iii · fy2022
What they reported doing
- #1 primary $0Medicaid/NJFamilycare Healthfirst Health Plan of New Jersey, Inc.(HFNJ) provides affordable quality health plans to eligible medicaid recipients. For 2022 there was no membership reported. As of June 2014 the company's Medicaid Membership was sold to a 3rd party and the company ceased its Medicaid operations.
named programs · 6 · from sources
What they call their work
ACCESS HRA Mobile App Support
Enables NYC Medicaid members to renew coverage, upload documents, and track application status via smartphone.
Child Health Plus
Offers low-cost or free health insurance coverage for children under 19 who do not qualify for Medicaid.
CompleteCare (HMO D-SNP)
Dual-eligible special needs plan for individuals enrolled in both Medicare and Medicaid, offering coordinated benefits.
Medicaid Renewal Assistance
Provides support to members renewing Medicaid coverage through guidance, document submission tools, and appointment scheduling with representatives.
Personal Wellness Plan (HARP)
Specialized Medicaid plan for individuals with behavioral health conditions and chronic illnesses, focusing on integrated care.
Senior Health Partners (MLTC)
Managed Long Term Care plan for elderly Medicaid beneficiaries needing home-based and community care services.
activities · 5 groups
What they do
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Union and Association Benefit Funds 6 activities
- Administers care management and preventive health programsOffers a no-cost Care Management Program to coordinate care for members with chronic conditions. Covers preventive and supportive services including two annual dental cleanings, annual eye exams with eyeglass/contacts allowance, annual hearing exams and hearing aid fittings, acupuncture for chronic pain, physical therapy, and up to six nutrition counseling visits per year.
- Contracts with third-party vendors for dental and vision benefitsPartners with DentaQuest to administer dental benefits and with EyeMed to provide vision benefits to members.
- Offers Marketplace health plans for individuals and families under 65Provides Qualified Health Plans and Healthfirst Leaf Plans through the Marketplace, including optional adult vision and dental benefits for non-Medicare-eligible individuals and families.
- Offers Medicare Advantage plans with integrated benefitsProvides Medicare Advantage plans that include Original Medicare benefits plus additional services such as dental, vision, hearing, prescription drug coverage, and transportation. Includes plans with prescription drug coverage (MAPD) and Dual Eligible Special Needs Plans (D-SNP) that integrate Medicare and Medicaid benefits, offering enhanced benefits and reduced copays for eligible individuals.
- Protects members from balance billingShields members from balance billing for emergency services received from out-of-network providers, for specific services (e.g., anesthesia, radiology) provided by out-of-network practitioners at in-network facilities, and when referred to out-of-network providers without consent. Applies in-network cost-sharing rates and counts payments toward in-network deductibles and out-of-pocket limits.
- Provides emergency and disaster-related benefit flexibilitiesDuring declared emergencies or public health disasters, waives referral and prior authorization requirements, allows out-of-network services at in-network cost-sharing rates, covers Medicare Part A, B, and C benefits at non-contracted but Medicare-certified facilities, and implements benefit changes immediately without 30-day advance notice.
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Health Insurance Enrollment Assistance 2 activities
- Provides health insurance coverage in New YorkOffers health insurance plans to individuals and families in New York, including service areas such as New York City, Long Island, and Orange, Sullivan, Rockland, and Westchester counties. Serves approximately two million members through a network of over 100,000 healthcare providers.
- Supports Medicaid renewal for membersProvides phone-based assistance and an online scheduling tool to help members complete Medicaid renewal applications, with extended-hour support available. Requires members to submit renewal applications by specific deadlines (10th or 15th of the month prior to coverage end) with required documentation to maintain coverage.
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Healthcare Compliance and Ethics Programs 1 activity
- Operates compliance and fraud reporting systemsRuns a 24/7/365 confidential compliance hotline and website for reporting suspected fraud, waste, abuse, or policy violations. Requires First Tier, Downstream, and Related Entities (FDRs) and Affiliates to complete an annual electronic compliance attestation.
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Healthcare Provider Directories and Clinical Support Services 1 activity
- Operates provider and member support toolsMaintains HFDocFinder, a provider lookup tool for members to locate primary care providers, specialists, hospitals, and other care services. Provides a secure 24/7 broker portal and offers tools and training to support broker business growth.
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Uncategorized 1 activity
- Ensures data transparency and member access to claims and pricingMakes machine-readable files available for in-network and out-of-network provider pricing, including separate files for Vision, Dental, and Chiropractic plans. Provides claims, encounter, clinical, and drug benefit data to members or authorized third parties within one business day of adjudication or update.
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financials · form 990 · fy2022
revenue
Total revenue$21K
Contributions & grants$00%
Program service revenue$00%
Investment income$21K100%
Other revenue$0
expenses
Total expenses$-192K
Program expenses—
Admin / overhead—
Fundraising—
Salaries & benefits$0
Grants paid out$0
balance sheet
Total assets$0
Cash$23.36M
Investments$0
Liabilities$5.21M
Net assets$0
2 years on record · 2020–2022 · YoY revenue -89.3%
leadership · form 990 part vii · fy2022
Who runs it
paid leadership · 11
| Name | Title | Hours/wk | Compensation |
|---|---|---|---|
| PATRICIA J WANG | PRESIDENT AND CEO | 1 | $4.58M |
| STEVEN H BLACK | CHIEF OPERATING OFFICER | 1 | $2.23M |
| JOHN J BERMEL | CHIEF FINANCIAL OFFICER | 1 | $1.92M |
| GERALD T SWEENEY | SVP CHIEF INFORMATION OFFICER | 1 | $1.78M |
| SEAN KANE | CHIEF HR OFFICER | 1 | $1.48M |
| JAY A SCHECHTMAN | CHIEF MEDICAL OFFICER | 1 | $1.45M |
| LINDA TIANO | CHIEF LEGAL OFFICER/SECRETARY | 1 | $1.44M |
| BARBARA MONTRESOR | SVP Comm & Marketing | 1 | $1.13M |
| SHERYL MARKOWITZ | Executive Medical Director | 1 | $1.13M |
| DEBORAH E HAMMOND | VP, MEDICAL DIRECTOR | 1 | $671K |
| CRAIG BARATTIN | CONTROLLER | 1 | $597K |
board members · 7
- ALAN BEATTY — DIRECTOR
- ANTHONY T ORLANDO — DIRECTOR
- CHAD FORBES — DIRECTOR
- EDWARD CONDIT — DIRECTOR
- MICHAEL MARON — DIRECTOR
- RICHARD SMITH — DIRECTOR
- TOM DALY — DIRECTOR
relationships · 25
Who they work with
- 3rd party Partner — Sold Medicaid membership to a third party in June 2014, resulting in cessation of Medicaid operations.
- America’s Health Insurance Plans (AHIP) Partner — Requires brokers to hold active AHIP Certification for appointment.
- Carallel Partner — Provides caregiver support services to members enrolled in certain Healthfirst long-term care plans
- Centers for Medicare & Medicaid Services Government — Contractual and regulatory relationship requiring Healthfirst to meet Medicare and Medicaid program requirements.
- DentaQuest Partner — Contracted to provide dental benefits to Healthfirst members
- DentaQuest Partner — Contracted to provide dental benefits to Healthfirst members.
- DentaQuest® Partner — Trusted dental partner for Healthfirst members to schedule dental appointments.
- EyeMed Partner — Contracted to provide vision benefits to Healthfirst members
- EyeMed Partner — Contracted to provide vision benefits to Healthfirst members.
- Federal Emergency Management Agency Government — FEMA is a recognized authority whose declarations can trigger Healthfirst's emergency response policies.
- Federal Trade Commission Government — Agency responsible for enforcing the FTC Act; handles complaints about third-party apps that engage in unfair or deceptive practices regarding personal data.
- Healthfirst Network — Member of a managed care network providing health insurance in New York
- Healthfirst Insurance Company, Inc. Network — Coverage is provided jointly with Healthfirst Insurance Company, Inc. under Medicare and Medicaid contracts.
- Healthfirst PHSP, Inc Government — Coverage is provided by Healthfirst PHSP, Inc, indicating a legal or operational affiliation.
- Healthfirst PHSP, Inc. Network — Coverage is provided jointly with Healthfirst PHSP, Inc. under Medicare and Medicaid contracts.
- Human Resources Administration (HRA) Government — Collaborates with HRA for Medicaid renewal processing in New York City.
- Local Department of Social Services (LDSS) Government — Partners with LDSS offices across counties for Medicaid renewal administration.
- NY State of Health Government — Coordinates with NY State of Health for health plan renewals and member communications.
- NY State of Health Government — Healthfirst participates in the NY State of Health Marketplace, where plan ratings are based on member experience and clinical care indicators.
- NationsHearing® Partner — Provider network offering hearing exams, fittings, and savings on hearing aids for Healthfirst members.
- New York State Department of Financial Services Government — Collaborates with the department to enforce balance billing protections and provides members with contact information for reporting wrongful billing.
- New York State Department of Health Government — Healthfirst's Medicaid Managed Care and Child Health Plus plans are subject to quality ratings from the New York State Department of Health.
- New York State Office of the Medicaid Inspector General Government — State-level oversight entity for reporting Medicaid fraud, waste, and abuse.
- Office for Civil Rights Government — Federal agency responsible for enforcing HIPAA rules; members may file privacy complaints with OCR if unresolved with Healthfirst.
- Office of Inspector General Government — Federal oversight entity for reporting Medicare fraud, waste, and abuse.
strategies · 3
How they approach the work
Named approaches extracted from this org’s sources. Where others share an approach, follow it to see the full set of orgs running it.
- Administrative Simplification to Enhance Accessmethodology: administrative_simplificationBy removing administrative requirements and streamlining access to specialists and emergency care, Healthfirst improves timely utilization of services because reduced procedural friction lowers delays and increases member engagement.
- Cost-Barrier Reduction for Vulnerable Populationsmethodology: cost_barrier_reductionBy reducing or eliminating premiums, copays, and out-of-network cost-sharing—especially for dually eligible and low-income beneficiaries—Healthfirst increases access to care because financial protection improves plan affordability and reduces hesitation to seek treatment.
- Hyperlocal Care Modelmethodology: hyperlocal_careBy tailoring health plan design and service delivery to the specific needs of local communities within New York, Healthfirst improves access and engagement because locally relevant care is more trusted and utilized by diverse populations.