Healthfirst

Legal name: Healthfirst PHSP Inc

Nonprofit profile at a glance

EIN
133783732
IRS 990 coverage
2010–2024
Official website data refreshed
Sep 2026
Forms available
Form 990 2024
Location
New York, NY, USA
Phone
1-855-725-3344
Rating
72
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Group Health Practice (Health Maintenance Organizations)

Official website

Reported finances

Revenue
$12,172,591,281
Expenses
$11,974,155,917
Assets
$4,230,712,832
Liabilities
$2,671,537,568

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

Leadership & pay

15 people listed

Executive titles in this filing

  • PATRICIA J WANG (PRESIDENT AND CEO)

Highest reported compensation

  • PATRICIA J WANG (PRESIDENT AND CEO): $5,237,080 total reported compensation
  • JOHN J BERMEL (CHIEF FINANCIAL OFFICER): $2,141,094 total reported compensation
  • GERALD T SWEENEY (SVP CHIEF INFORMATION OFFICER): $1,740,491 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

Helping New Yorkers access affordable health insurance; for more than 30 years, helping New Yorkers of all ages get quality health plans. For general inquires, support, or to get in touch with our media team. Contact Pat Wang joined Healthfirst in 2008 as President & CEO. During her tenure, Healthfirst has grown in revenue and membership to become one of the largest not-for-profit health insurance providers in the country. We strive to create an environment where every employee receives the tools and support to excel, grow, and achieve. See if Healthfirst has a career opportunity for you. Job Openings Contact.

What it reported doing in 2024

Essential plan (ep): healthfirst phsp, inc. (phsp) is a licensed prepaid health services plan that provides comprehensive prepaid health care coverage to beneficiaries of government health care coverage programs. Ep is a program which covers individuals who would otherwise be eligible for either certain categories of expanded medicaid coverage or significant subsidies for qualified health plan (qhp) for little or no member contribution. For 2024 there were 554,466 members enrolled in phsp's ep plan.

Operating model

Revenue model
Other-operating. 96% of the money available for current operations came from other operating revenue.
Distribution model
Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. Few specific pay-setting methods are documented in the filing; unanswered boxes are not proof of absence and a relatively small share of voting board members are independent.

Rating breakdown

  • Financial Efficiency: 86
  • Transparency & Controls: 67
  • Accountability: 52
  • Sustainability: 37
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 96.1%; rating input score 96
  • Program expense ratio: 97.7%; rating input score 98
  • Fundraising efficiency: Limited

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
  • Pay-setting controls: 0 of 6 controls in place; rating input score 0
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Missing
    • Board or committee approval: Missing
  • Foreign activity oversight: Limited
  • Grant itemization coverage: Limited
  • Major donor itemization: Limited
  • Related-party transparency: Yes; rating input score 100

Accountability

  • Independent voting board: 33.3%; rating input score 33; 10th percentile among comparable filings
  • Governance controls: 7 of 9 controls in place; rating input score 78
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Fail
    • Other executive compensation review process: Fail
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 1.6%; rating input score 41; 41st percentile among comparable filings
  • Total-asset coverage ratio: 0.35; rating input score 12; 12th percentile among comparable filings
  • Liabilities to assets ratio: 0.63; rating input score 26; 26th percentile among comparable filings
  • Officer compensation ratio: 0%; rating input score 95; 95th percentile among comparable filings

Growth

  • Program expense growth: 10.2% per year; rating input score 100; 75th percentile among comparable filings
  • Revenue growth: 12.5% per year; rating input score 100; 84th percentile among comparable filings
  • Asset growth: 14.7% per year; rating input score 100; 86th percentile among comparable filings

Details

  • What they do: 1 programs and campaigns described on the official site · 1 operating location identified
  • Where the money goes: 96.1% of revenue deployed · 97.7% of spending went to programs
  • Governance: 2 of 6 board members independent · 7 of 9 filing controls reported
  • Programs: 3 filed program accomplishments · $11.7B in reported program spending
  • Leadership: top reported pay $5.2M · 15 people listed · 0 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $3.6B reported
  • Consistency: 22 of 22 current checks pass
  • Schedules: 5 filed schedules · includes executive pay and related organizations
  • Filing history: 14 filing years from 2010 to 2024
  • Contacts: How to reach this organization
  • Money network: Resolved incoming and outgoing counterparties from filed money flows.
  • Related organizations: 7 filed related-organization links
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

  • High — Transparency & Controls: Pay-setting controls scored 0/100.
  • Moderate — Accountability: Independent voting board scored 33/100.
  • Review — Accountability: Governance controls: 2 of 9 not reported.
  • Moderate — Sustainability: Operating margin scored 41/100.
  • High — Sustainability: Total-asset coverage ratio scored 12/100.
  • High — Sustainability: Liabilities to assets ratio scored 26/100.