Mount Carmel Health Plan of New York Inc

What it reported doing in 2024

Mount carmel health plan of New York was formed in 2019 for the purpose of providing comprehensive health care coverage to seniors in New York as a wholly owned subsidiary of mount carmel health plan. It is a member of the mount carmel health system, a tax-exempt health care system under irc section 501(c)(3). Mount carmel health plan of New York is a nonprofit organization that offers benefits through a medicare advantage plan (medigold) approved by the centers of medicare and medicaid services (cms) that replaces traditional medicare coverage. Medigold serves seniors and other medicare beneficiaries in eight New York counties.medigold members elect to have mount carmel health plan of New York (instead of the federal government) administer the benefits of medicare part a and part b, and medigold also offers pharmaceutical coverage under medicare part d. Mount carmel health plan of New York is required to provide coverage for everything that the federal medicare program covers, plus medigold also offers additional items such as: unlimited inpatient hospital days covered at 100% with no deductible; outpatient surgery for a small co-payment; diagnostic and testing services for a small co-payment; home health care and skilled nursing care coverage when necessary; prescription drug benefits; physician office visits with fixed copayments; and unlimited generic drug coverage.as an integral part of mount carmel health system, mount carmel health plan of New York is a community-based managed health care organization that works in collaboration with employers, individual members, physicians, health care providers, and community and governmental agencies to continually improve the health of its members by providing exceptional coverage and access to high quality and cost-effective care.please visit our website for additional information: www.thpmedicare.org/new-york

Financial Efficiency

• Mission deployment rate: 70.5%; rating input score 70
• Program expense ratio: 79.4%; rating input score 79
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd 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: 0%; rating input score 0; 3rd 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: 24.2%; rating input score 80; 80th percentile among comparable filings
• Total-asset coverage ratio: 8.75; rating input score 90; 90th percentile among comparable filings
• Liabilities to assets ratio: 0.05; rating input score 71; 71st percentile among comparable filings
• Officer compensation ratio: 18%; rating input score 14; 14th percentile among comparable filings

Growth

• Program expense growth: 38.9% per year; rating input score 100; 95th percentile among comparable filings
• Revenue growth: 35.6% per year; rating input score 100; 96th percentile among comparable filings
• Asset growth: 5.4% per year; rating input score 100; 37th percentile among comparable filings