Group Health Incorporated Overstated its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of Medicare Segment Pension Assets as of August 31, 2016

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 Local 153 Plan and the EmblemHealth Services Company, LLC, Employees’ Retirement Plan. This report addresses the Medicare segment pension assets for the Local 153 Plan for the period of January 1, 2015, through August 31, 2016. We are addressing the Medicare segment pension assets for the EmblemHealth Services Company, LLC, Employees’ Retirement Plan in a separate audit. Upon the curtailment of its pension plan, GHI identified Medicare’s share of the Local 153 Plan Medicare segment excess pension liabilities to be $6,131,699 as of August 31, 2016. We performed a prior pension segmentation audit of GHI (A-07-19-00562, July 25, 2019), which brought the Local 153 Plan Medicare segment pension assets to January 1, 2015. We recommended that GHI recognize $31,821,914 as the Local 153 Plan Medicare segment pension assets as of January 1, 2015.