Group Health Incorporated Overstated its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015

GHI, a subsidiary of EmblemHealth Services Company, LLC, administered Medicare operations under a Coordination of Benefits contract with CMS. During our audit period, GHI also performed Medicare work on the Medicare Secondary Payer Recovery and Benefit Coordination and Recovery contracts. GHI also performed work as a subcontractor on the Retiree Drug Subsidy contract. During our audit period, GHI had two defined-benefit pension plans: the GHI Local 153Pension Plan and the EHS Retirement Plan. This report addresses the Medicare segment pension assets for the EHS Retirement Plan for the period of January 1, 2015, through December 31, 2015. We are addressing the Medicare segment pension assets for the GHI Local 153 Pension Plan in a separate audit. Upon the curtailment of its pension plan, GHI identified Medicare’s share of the EHS Retirement Plan Medicare segment excess pension liabilities to be $778,811 as of December 31, 2015. We performed a prior pension segmentation audit of GHI (A-07-19-00561, July 25, 2019), which brought the EHS Retirement Plan Medicare segment pension assets to January 1, 2015. We recommended that GHI recognize $5,633,345 as the EHS Retirement Plan Medicare segment pension assets as of January 1, 2015.