Title: 1. General
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule.
Title: 2. Basis of Presentation
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
Title: 3. Pennsylvania Children's Health Insurance Program (“CHIP”)
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
The CHIP program (Assistance Listing Number (“ALN”) 93.767) provides access to health insurance for all children in Pennsylvania, regardless of household income and who are not eligible for Medical Assistance. Highmark Choice Company currently administers CHIP to over 16,500 children in 62 counties across western, central, and northeastern Pennsylvania.
The CHIP program provides eligibility, education and outreach functions. Additionally, Highmark Inc., on its own and through subsidiaries, provides insurance coverage and retains all insurance obligations.
Funding for CHIP is appropriated through the Commonwealth of Pennsylvania general fund, cigarette taxes and Pennsylvania’s share of funds allocated from the Federal Balanced Budget Act of 1997, through which CHIP began receiving federal monies from the United States Department of Health and Human Services to expand the provision of health care insurance coverage to children of low-income families and to expand related outreach efforts. In response to the COVID-19 pandemic, the United States Department of Health and Human Services also made additional funding available for CHIP and Medicaid programs.
Title: 4. New York Child Health Plus (“CHP”)
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
The CHP program (ALN 93.767) in New York offers free or low-cost health insurance to uninsured children from birth through 18 years old. Highmark NY currently administers CHP to over 5,600 children in 8 counties across western New York.
The CHP program provides eligibility, enrollment, education and outreach functions. Additionally, Highmark Inc., on its own and through subsidiaries, provides insurance coverage and retains all insurance obligations.
The CHP program in New York is funded by the New York State Department of Health, which receives federal funding. In response to the COVID-19 pandemic, the United States Department of Health and Human Services also made additional funding available for CHP and Medicaid programs.
Title: 5. Nursing Student Loan Program
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
AHN administers the Federal Nursing Student Loan Program (ALN 93.364). Net loans outstanding at the beginning of the year and loans made during the year under this program are included in the Schedule. The net loans outstanding at December 31, 2023 under this program were $395,119.
Title: 6. Provider Relief Fund ("PRF") and American Rescue Plan ("ARP") Rural Distribution
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
The Schedule includes grant activity related to the Department of Health and Human Services CARES Act Assistance (ALN 93.498). As required based on guidance in the 2023 OMB Compliance Supplement, the Schedule includes all Period 5 funds received between January 1, 2022 and June 30, 2022 and expended by June 30, 2023 and all Period 6 funds received between July 1, 2022 and December 31, 2022 and expended by December 31, 2023, as reported to the Health Resources and Services Administration (“HRSA”) via the PRF Reporting Portal. All expenditures reported on the Schedule were utilized as lost revenues.
Title: 7. Federal Emergency Management Agency (“FEMA”) Disaster Grants
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activity of federal financial assistance programs of Highmark Health (the “Corporation”) for the year ended December 31, 2023. Federal awards received directly from federal agencies as well as federal awards passed through other prime recipients are included in the accompanying Schedule. The Schedule is presented on the accrual basis of accounting. Negative expenditures detailed in the Schedule result from current year adjustments to prior year award amounts. The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable. The information in this Schedule is presented in accordance with the requirements of Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”). Therefore, some of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.
Because the Schedule presents only a selected portion of the activities of the Corporation, it is not intended to, and does not, present either the financial position, results of operations, or cash flows of the Corporation.
De Minimis Rate Used: N
Rate Explanation: The Corporation has a negotiated indirect rate and therefore the election to use the 10% de minimis indirect rate is not applicable.
The Corporation applied for reimbursement of certain expenses related to the COVID-19 pandemic under ALN 97.036, FEMA Public Assistance through the Commonwealth of Pennsylvania. Expenditures are and will be reflected in the Schedule in the year in which a project application is obligated, and expenses associated with those funds have been incurred. The Schedule includes $7,899,732 of expenditures incurred in fiscal years 2020, 2021, or 2022, for projects which were obligated in fiscal year 2023.