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METROPLUS HEALTH PLAN INC
New York, NY · EIN 134115686 · Form 990 · FY2024 · NTEE E31 · Health Care · Very Large (>$50M) · metroplus.org
revenue
$4.9B
expenses
$4.8B
net assets
$981.9M
employees
0
program ratio
97%
mission · from form 990

MetroPlus provides its members with access to high quality, cost effective healthcare, partnering with NYC HHC and other providers.

profile · synthesized from sources

MetroPlus Health Plan is a New York-based health insurer providing managed care services to Medicaid, Medicare, and other public program beneficiaries. It partners with NYC Health + Hospitals and other providers to deliver cost-effective healthcare, emphasizing preventive services and member wellness through incentives. The organization serves diverse populations across multiple health plans, including those with HIV and dual eligibility.

named programs · 4 · from sources

What they call their work

Complete Care for People Living with HIV
Specialized care management program offering up to $450 in rewards for required primary care visits, targeting members with HIV/AIDS
Member Rewards Program
Incentive program encouraging preventive care by offering monetary rewards for completing health activities such as annual checkups, cancer screenings, flu shots, and mental health assessments
Personal Health Assessment
Annual health risk assessment program offering $50 in rewards to members aged 21-85 who complete the evaluation
Well-Baby and Child Well-Care Visits
Program providing rewards for completion of pediatric well-care visits, including $60 for six checkups in the first 15 months and $20 for visits between 16-30 months
activities · 5 groups

What they do

  • Healthcare Compliance and Ethics Programs 2 activities
    • Conducting compliance training on fraud prevention
      Provides annual training to employees and delegated partners on the organization’s Fraud, Waste, and Abuse Prevention Plan to promote adherence to compliance standards.
    • Preventing and detecting fraud, waste, and abuse in healthcare billing
      Operates a Fraud, Waste, and Abuse Prevention Program that includes claims data mining, a 24/7/365 confidential compliance hotline, and a Special Investigations Unit to investigate potentially fraudulent provider activity and ensure regulatory compliance.
  • Health Insurance Enrollment Assistance 2 activities
    • Enrollment and renewal assistance for health plan members
      Provides customer support and dedicated Customer Success teams to help members compare health plan options, enroll in new coverage, transition from expiring plans like Essential Plan 200–250, and complete annual renewals to maintain uninterrupted healthcare and prescription benefits.
    • Providing managed Medicaid and Essential Plan health coverage
      Offers low-cost or no-cost health insurance coverage through Medicaid Managed Care and the Essential Plan 200–250 for individuals with household incomes between 200–250% of the federal poverty level, including renewal of coverage to prevent interruptions in care. Coverage is available across New York State, with a focus on New York City’s five boroughs.
  • Language Access Services 1 activity
    • Delivering multilingual and disability-accessible member support
      Offers customer service and healthcare navigation support in 13 languages directly, with interpretation available in over 40 languages, and provides free aids and services for people with disabilities to ensure equitable access to care and plan benefits.
  • Healthcare Delivery Networks and Coalitions 1 activity
    • Operating a comprehensive provider network and telehealth services
      Provides access to healthcare through a network of over 34,000 provider sites in New York City and offers unlimited, no-cost telehealth services including 24/7 virtual visits in members’ preferred languages across New York State.
  • Uncategorized 2 activities
    • Administering a member rewards program for preventive health engagement
      Incentivizes members to complete preventive health activities such as annual checkups, cancer screenings, immunizations, well-child visits, and mental health assessments through a rewards program offering $20–$100 in compensation per completed activity.
    • Operating online health education and self-management resources
      Maintains the Good4You Health Library, an online platform providing members with health information, healthy recipes, educational videos, and tools such as a symptom tracker to support health self-management.
financials · form 990 · fy2024
revenue
Total revenue$4.87B
Contributions & grants$524K0%
Program service revenue$4.79B98%
Investment income$79.26M2%
Other revenue$0
expenses
Total expenses$4.79B
Program expenses97%
Admin / overhead3%
Fundraising0%
Salaries & benefits$225.22M
Grants paid out$0
Largest expense lineCompensation
balance sheet
Total assets$2.58B
Cash$1.10B
Investments$961.45M
Liabilities$1.60B
Net assets$981.86M
Liquid reserves5.2 mo
3 years on record · 2020–2024 · YoY revenue -6.8%
leadership · form 990 part vii · fy2024

Who runs it

paid leadership · 18
NameTitleHours/wkCompensation
Talya Schwartz Chief Executive Officer 35 $672K
Sanjiv Shah Chief Medical Officer 35 $544K
Lauren Castaldo Chief Financial Officer 35 $496K
Lila Benayoun Chief Operating Officer 35 $449K
Raven Ryan-Solon Chief Compliance/Reg Officer 35 $444K
Roger Milliner Chief Growth Officer 35 $434K
Ganesh Ramratan Chief Information Officer 35 $421K
Steven Cushman Chief Counsel 35 $409K
Julie Myers Deputy Chief Medical Officer 35 $390K
Karen Lenard Vice President of Behavioral Health 35 $343K
Simran Kaur Chief Human Resource Officer 35 $338K
Jennifer Singarayer Medical Director 35 $337K
Laura Santella-Saccone Chief Marketing and Brand Officer 35 $327K
Erin Drinkwater Chief of Government Relations and Strategic Partnerships 35 $307K
Noel Brown Medical Director 35 $282K
Laurie Vitagliano HARP Medical Director 35 $274K
David Ackman VP of Medical Directors 35 $207K
Glendon Henry Senior Medical Director 35 $168K
board members · 6
  • Eric Wei — Board Member
  • Frederick Covino — Board Member
  • Mark Power — Board Member
  • Matthew Siegler — President's Designee
  • Sally Hernandez-Pinero — Chairman
  • Vallencia Lloyd — Board Member
relationships · 13

Who they work with

  • Centers for Medicare and Medicaid Services Government — Receives overpayment reports and fraud allegations from MetroPlusHealth and its providers.
  • Facebook Network — Engages with members and shares information through its official Facebook page.
  • NY State of Health Government — Coordinates with NY State of Health to determine member eligibility and facilitate enrollment in new health plans.
  • NYC HHC Partner — Healthcare provider partner in delivering services to members
  • New York State Government — Partners with New York State to administer health coverage renewals and distribute renewal notices.
  • New York State Attorney General Government — Refers members to the federal actions reporting form hosted by the New York State Attorney General’s office.
  • New York State Department of Health Government — Source of the Authorization for Release of Health Information form linked in MetroPlus Health Plan's HIPAA notice.
  • New York State Department of Health Government — State agency that rates MetroPlusHealth as NYC’s highest-rated Medicaid Managed Care plan.
  • New York State Department of State’s Office for New Americans Government — Directs members to rights and resources information provided by the Office for New Americans.
  • New York State Office of the Medicaid Inspector General Government — Collaborates with MetroPlusHealth to receive and process overpayment self-disclosures and fraud allegations.
  • Office of Inspector General Government — Receives reports of Medicare fraud and overpayments and manages disclosure protocols in coordination with MetroPlusHealth.
  • Salesforce Partner — Uses Salesforce for third-party verification in the Member Rewards Program.
  • Twitter Network — Engages with members and shares information through its official Twitter account.
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.

  • Client-Centered Access Model
    methodology: zero_cost_access
    By eliminating cost barriers and simplifying renewal processes, METROPLUS ensures continuous healthcare access because removing financial and administrative obstacles increases member retention and care utilization.
  • Member-Driven Service Design
    methodology: member_advisory_model
    By engaging members through advisory boards and incorporating feedback, METROPLUS improves program relevance and trust because inclusive decision-making leads to services that better reflect community needs and preferences.
  • Preventive Care Model
    methodology: preventive_care_model
    By focusing on primary and preventive care through community-based providers, METROPLUS improves long-term health outcomes and manages chronic conditions because early intervention reduces disease progression and costly emergency care.