CMS-906 Fiscal Soundness Reporting Requirements

The Fiscal Soundness Reporting Requirements

Fiscal Soundness Reporting Requirements- Submission Page Word

The Fiscal Soundness Reporting Requirements (CMS-906)

OMB: 0938-0469

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HPMS : Fiscal Soundness - New Financial Submission

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Home Fiscal Soundness Submission of Financial Information New Financial Submission

Fiscal Soundness

New Financial Submission
There should be no rounding in your financial data except to the nearest whole dollar. You must provide
the full figure even if the last digits are zeroes. For example, if your Net Worth is "$167,000,000" you
must enter "167000000".
The hyperlinks on the page (as available) provide user with additional information so as to make informed
selection for their financial submission.
A field with an asterisk (*) before it is a required field.
*Contract Type:
*PACE Contract?:
*Contract Year:

PDP
Yes

Non-PDP

Both

No

2015

Submission Date: 09/21/2015
*Submission Type:

Audited Annual

*Contract Number / Name:
Contract Name
Contract
Number

Contract Joint
Joint
Joint Region
Response
Venture
Venture
Venture
NAIC #
ID
Name NAIC #

H0108

HUMANA HEALTH PLAN OF CALIFORNIA, INC.

Kansas C

H0148

CARE1ST HEALTH PLAN

San Franci

H0321

ARIZONA PHYSICIANS IPA, INC.

San Franci

H0423

METROPLUS HEALTH PLAN, INC.

https://hpmstest.cms.gov/app/FiscalSoundness/NewFinancialData.aspx?PI=051301000010

New Yor

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HPMS : Fiscal Soundness - New Financial Submission

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*Total Assets(in $):
*Total Liabilities(in $):
*Net Income (Loss)(in $):
*Cash Flow from Operations(in $):

Upload Guidance
*Select File to Upload:

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https://hpmstest.cms.gov/app/FiscalSoundness/NewFinancialData.aspx?PI=051301000010

09/21/2015


File Typeapplication/pdf
File Titlehttps://hpmstest.cms.gov/app/FiscalSoundness/NewFinancialData.a
AuthorP1C9
File Modified2015-09-24
File Created2015-09-24

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