MetroPlusHealth
Legal name: Metroplus Health Plan Inc
Nonprofit profile at a glance
- EIN
- 134115686
- IRS 990 coverage
- 2010–2024
- Official website data refreshed
- Sep 2026
- Forms available
- Form 990 2024
- Location
- New York, NY, USA
- Phone
- 1.855.809.4073 (TTY: 711)
- Rating
- 70
- Verdict
- SUPPORTED
- Rating confidence
- Moderate
- Sector
- Group Health Practice (Health Maintenance Organizations)
Reported finances
- Revenue
- $4,865,128,566
- Expenses
- $4,794,971,147
- Assets
- $2,579,865,475
- Liabilities
- $1,598,006,907
Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.
Leadership & pay
24 people listed
Executive titles in this filing
- Talya Schwartz (Chief Executive Officer)
- Karen Lenard (Vice President of Behavioral Health)
- Matthew Siegler (President's Designee)
Highest reported compensation
- Talya Schwartz (Chief Executive Officer): $671,904 total reported compensation
- Sanjiv Shah (Chief Medical Officer): $544,076 total reported compensation
- Lauren Castaldo (Chief Financial Officer): $496,208 total reported compensation
Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.
Overview
Mission
Our mission: to make sure every New Yorker is covered. personalized support. Member Questions Prospective Leads Have questions about your health plan or need help enrolling? The **MetroPlusHealth Contact Us** page makes it easy to get the support you need. Whether you’re a member, provider, or someone exploring coverage options, our team is here to assist you by phone, email, or in person at one of our community offices across New York City. Reach out to us for help with benefits, billing, plan changes, or general inquiries — because your health and peace of mind matter to us.
What it reported doing in 2024
Health - General and Rehabilitative: Provided managed care services to NY City Enrollees and providers.
Operating model
- Revenue model
- Earned-program. 98% of the money available for current operations came from fees and other program revenue.
- Distribution model
- Member-benefit provider. The nonprofit used 94% of its reported program spending for member benefits.
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: 85
- Transparency & Controls: 60
- Accountability: 57
- Sustainability: 39
- Growth: 100
Detailed rating inputs
Financial Efficiency
- Mission deployment rate: 94.3%; rating input score 94
- Program expense ratio: 97.3%; rating input score 97
- 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: Limited
Accountability
- Independent voting board: 50%; rating input score 50; 13th percentile among comparable filings
- Governance controls: 6 of 9 controls in place; rating input score 67
- 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: Fail
- Board meeting minutes documented: Pass
- Audit committee oversight: Pass
- Independent financial-statement audit: Pass
Sustainability
- Operating margin: 1.4%; rating input score 40; 40th percentile among comparable filings
- Total-asset coverage ratio: 0.54; rating input score 20; 20th percentile among comparable filings
- Liabilities to assets ratio: 0.62; rating input score 27; 27th percentile among comparable filings
- Officer compensation ratio: 0.1%; rating input score 92; 92nd percentile among comparable filings
Growth
- Program expense growth: 7.7% per year; rating input score 100; 62nd percentile among comparable filings
- Revenue growth: 8.5% per year; rating input score 100; 70th percentile among comparable filings
- Asset growth: 9.1% per year; rating input score 100; 65th percentile among comparable filings
Details
- What they do: 1 operating location identified
- Where the money goes: 94.3% of revenue deployed · 97.3% of spending went to programs
- Governance: 3 of 6 board members independent · 6 of 9 filing controls reported
- Programs: 1 filed program accomplishment · $4.7B in reported program spending
- Leadership: top reported pay $672K · 24 people listed · 0 of 6 pay-setting controls reported
- Highest-paid contractors: 5 contractors listed · $39.3M reported
- Consistency: 34 of 34 current checks pass
- Schedules: 5 filed schedules · includes executive pay
- Filing history: 14 filing years from 2010 to 2024
- Contacts: How to reach this organization
- Money network: 18 filed money-flow records
- Related organizations: 1 filed related-organization link
- 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.
- Review — Accountability: Independent voting board scored 50/100.
- Review — Accountability: Governance controls: 3 of 9 not reported.
- Moderate — Sustainability: Operating margin scored 40/100.
- High — Sustainability: Total-asset coverage ratio scored 20/100.
- High — Sustainability: Liabilities to assets ratio scored 27/100.