SCAN HEALTH PLAN NEVADA: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SCAN HEALTH PLAN NEVADA (EIN 85-4288083)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-11
- IRS object ID
- 202313159349300521
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-11T10:15:46-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH SIXTH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 854288083 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCAN HEALTH PLAN NEVADA INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SCAN | BusinessNameControlTxt |
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KAREN SCHULTE | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5629895100 | PhoneNum |
| Signature | 2023-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KAREN | PersonFirstNm |
| Person Last | SCHULTE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANNA KOLAKALURI | PreparerPersonNm |
| PTIN | P01275237 | PTIN |
| Phone | 6123974000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Application Pending | Yes (X) | ApplicationPendingInd |
| Principal Officer | KAREN SCHULTE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,359,971 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.SCANHEALTHPLAN.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | NV | LegalDomicileStateCd |
| Activity Or Mission | KEEP SENIORS HEALTHY AND INDEPENDENT | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,400,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,350,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,009,777 | CYProgramServiceRevenueAmt |
| PY Investment Income | $59 | PYInvestmentIncomeAmt |
| CY Investment Income | $194 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,400,059 | PYTotalRevenueAmt |
| CY Total Revenue | $18,359,971 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $40,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $42,862 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,079,494 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,025,540 | PYOtherExpensesAmt |
| CY Other Expenses | $18,080,463 | CYOtherExpensesAmt |
| PY Total Expenses | $2,068,402 | PYTotalExpensesAmt |
| CY Total Expenses | $19,200,457 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $331,657 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$840,486 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,027,411 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,966,698 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,095,754 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,875,527 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,931,657 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,091,171 | NetAssetsOrFundBalancesEOYAmt |
| Mission | KEEP SENIORS HEALTHY AND INDEPENDENT | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,327,376 | ExpenseAmt |
| Grant | $40,500 | GrantAmt |
| Revenue | $16,009,777 | RevenueAmt |
| Desc | HEALTH CARE SERVICES:AS A MEDICARE ADVANTAGE AND PRESCRIPTION DRUG PLAN (MAPD) IN NEVADA, SCAN HEALTH PLAN NEVADA COLLABORATES WITH A NETWORK OF DELEGATED PROVIDERS TO OFFER MEDICARE COVERED HEALTH CARE AND BEHAVIORAL HEALTH CARE AND ADDITIONAL SUPPLEMENTAL BENEFITS. OUR MEMBER-CENTRIC MODEL OF CARE ENSURES QUALITY, INDIVIDUALIZED CARE FOR ALL MEMBERS, INCLUDING MEMBERS WITH CHRONIC CONDITIONS AND FRAIL MEMBERS WITH FUNCTIONAL DEFICITS. | Desc |
| Total Program Service Expenses | $18,327,376 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 88 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRGINIA HAVAI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAIN MD SACHIN H | ||||||||
| DIRECTOR | 2.00 | 38.00 | Yes (X) | $0 | $3,006,034 | $2,020,160 | ||
| MONK NANCY J | ||||||||
| DIRECTOR | 2.00 | 38.00 | Yes (X) | $0 | $1,743,764 | $611,810 | ||
| PLUMB MICHAEL | ||||||||
| DIRECTOR | 2.00 | 38.00 | Yes (X) | $0 | $943,395 | $618,386 | ||
| KROEKER KEVIN B | ||||||||
| SECRETARY/GENERAL COUNSEL | 1.00 | 39.00 | Yes (X) | $0 | $785,900 | $525,156 | ||
| STANISLAW SHERRY | ||||||||
| PRESIDENT | 2.00 | 38.00 | Yes (X) | $0 | $743,473 | $381,530 | Yes (X) | |
| HAVAI VIRGINIA A | ||||||||
| TREASURER | 1.00 | 39.00 | $0 | $453,964 | $188,462 | Yes (X) | ||
| BATRA ROMILLA A | ||||||||
| CHIEF MEDICAL OFFICER | 2.00 | 38.00 | $0 | $822,330 | $460,603 | Yes (X) | ||
| LEUNG KWAN-MOON BEG 122 | ||||||||
| CHIEF DATA OFFICER | 4.00 | 36.00 | $0 | $733,743 | $324,278 | Yes (X) | ||
| SELBY JILL V | ||||||||
| SVP PRODUCT DEV & MKT EXP | 1.00 | 39.00 | $0 | $551,752 | $283,727 | Yes (X) | ||
| HAWKINS GINETTE BEG 322 | ||||||||
| CVP, CHIEF RISK EXECUTIVE | 1.00 | 39.00 | $0 | $350,961 | $156,498 | Yes (X) | ||
| WHITELOCK ANDREW K END 322 | ||||||||
| SVP CHIEF RISK EXECUTIVE | 1.00 | 38.50 | $0 | $327,111 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,462,427 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $5,570,610 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CAREMORE HEALTH PLAN OF NEVADA | |||||
| 220 VIRGINIA AVE | INDIANAPOLIS | IN | 46204 | MEDICAL SERVICES | $5,306,402 |
| INTERMOUNTAIN MEDICAL HOLDINGS NEVADA I | |||||
| PO BOX 841652 | LOS ANGELES | CA | 90084 | MEDICAL SERVICES | $4,482,728 |
| EXPRESS SCRIPTS INC | |||||
| ONE EXPRESS WAY | ST LOUIS | MO | 63121 | PHARMACY BENEIFTS MANAGER | $3,285,770 |
| HEALTHCARE PARTNERS OF NEVADA LLC | |||||
| 6355 S BUFFALO DR | LAS VEGAS | NV | 89113 | MEDICAL SERVICES | $2,330,262 |
| HEALTHCOSMOS OF NEVADA PROFESSIONAL LIM | |||||
| PO BOX 60564 | PASADENA | CA | 91116 | MEDICAL SERVICES | $594,448 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,350,000 | RelatedOrganizationsAmt |
| Total Contributions | $2,350,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICARE PREMIUMS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $16,009,777 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,009,777 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,009,777 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $194 | TotalRevenueColumnAmt |
| Exclusion | $194 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,359,971 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,009,777 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $194 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,500 | TotalAmt |
| Program Services | $40,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $472,849 | TotalAmt |
| Program Services | $274,252 | ProgramServicesAmt |
| Management And General | $198,597 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $410,773 | TotalAmt |
| Program Services | $285,867 | ProgramServicesAmt |
| Management And General | $124,906 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,447 | TotalAmt |
| Program Services | $32,566 | ProgramServicesAmt |
| Management And General | $23,881 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,842 | TotalAmt |
| Program Services | $53,435 | ProgramServicesAmt |
| Management And General | $28,407 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,583 | TotalAmt |
| Program Services | $36,103 | ProgramServicesAmt |
| Management And General | $21,480 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,977 | TotalAmt |
| Program Services | $3,498 | ProgramServicesAmt |
| Management And General | $1,479 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,653 | TotalAmt |
| Management And General | $27,653 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,880,548 | TotalAmt |
| Program Services | $15,634,396 | ProgramServicesAmt |
| Management And General | $246,152 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,100 | TotalAmt |
| Program Services | $1,130,927 | ProgramServicesAmt |
| Management And General | $6,173 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,911 | TotalAmt |
| Program Services | $17,961 | ProgramServicesAmt |
| Management And General | $2,950 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,925 | TotalAmt |
| Program Services | $102,301 | ProgramServicesAmt |
| Management And General | $37,624 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,072 | TotalAmt |
| Program Services | $54,453 | ProgramServicesAmt |
| Management And General | $31,619 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,001 | TotalAmt |
| Program Services | $7,852 | ProgramServicesAmt |
| Management And General | $7,149 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,987 | TotalAmt |
| Program Services | $1,195 | ProgramServicesAmt |
| Management And General | $792 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,681 | TotalAmt |
| Program Services | $18,797 | ProgramServicesAmt |
| Management And General | $7,884 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,995 | TotalAmt |
| Management And General | $37,995 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BROKER COMMISSIONS | $594,309 | $594,309 | $0 |
| OTHER | $95,879 | $33,954 | $61,925 |
| DUES AND SUBSCRIPTIONS | $6,748 | $1,479 | $5,269 |
| FEDERAL, STATE, COUNTY | $4,677 | $3,531 | $1,146 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,200,457 | TotalAmt |
| Program Services | $18,327,376 | ProgramServicesAmt |
| Management And General | $873,081 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,023,995 | BOYAmt |
| EOY | -$8,568 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,784,566 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,181,763 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,416 | BOYAmt |
| EOY | $8,937 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,027,411 | BOYAmt |
| EOY | $3,966,698 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,095,657 | BOYAmt |
| EOY | $2,574,010 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97 | BOYAmt |
| EOY | $301,517 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,095,754 | BOYAmt |
| EOY | $2,875,527 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,931,657 | BOYAmt |
| EOY | $1,091,171 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,931,657 | BOYAmt |
| EOY | $1,091,171 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,027,411 | BOYAmt |
| EOY | $3,966,698 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$840,486 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $16,009,777 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,009,777 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,350,194 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,350,194 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $18,359,971 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,118,636 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $19,118,636 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $81,821 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $81,821 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,200,457 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | UNDER FASB ASC 740, INCOME TAXES, THE COMPANY IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES. AS OF DECEMBER 31, 2022, THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION FROM SCAN GROUP 2,350,000. INVESTMENT INCOME 194. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | GAAP VS. STATUTORY DIFFERENCE 81,821. |
| STATUTORY-BASIS AUDITED FINANCIAL STATEMENTS | THE 2022 STATUTORY-BASIS AUDITED FINANCIAL STATEMENTS ARE PRESENTED ON THE BASIS OF ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC) AND THE DIFI. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| CATHOLIC CHARITIES OF SOUTHERN NEVADA | ||||||||
| 1501 LAS VEGAS BLVD NORTH | LAS VEGAS | NV | 89101 | 880059425 | 501(C)(3) | $20,000 | $0 | GRANT WILL HELP SUPPORT CASE COORDINATION TO MEALS ON WHEELS (MOW) CLIENTS WHO NEED ADDITIONAL CASE MANAGEMENT SUPPORT TO CONTINUE LIVING IN THE COMMUNITY. |
| JEWISH FAMILY SERVICE AGENCY | ||||||||
| 5851 W CHARLESTON BLVD | LAS VEGAS | NV | 89146 | 880142948 | 501(C)(3) | $10,000 | $0 | JFSA'S BEAT THE HEAT SUMMER RELIEF CAMPAIGN 2022 SPONSORSHIP |
| LUTHERAN SOCIAL SERVICES OF NEVADA | ||||||||
| 4323 BOULDER HIGHWAY | LAS VEGAS | NV | 89121 | 860845241 | 501(C)(3) | $10,000 | $0 | HEART OF THE CITY SENIOR MEAL PROGRAM. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL GRANTEES SUBMIT IMPACT REPORTS DOCUMENTING METRICS AND PERFORMANCE YEAR-TO-DATE THROUGHOUT THE DURATION OF THE FUNDING, COMMUNITY GIVING STAFF, TRACK AND REVIEW THE REPORTS TO ENSURE COMPLIANCE. COMMUNITY GIVING STAFF ADDRESSES ANY IDENTIFIED ISSUES WITH THE GRANTEE TO DETERMINE CAUSES AND ANY REMEDIATION REQUIRED. ISSUES WITH COMPLIANCE ARE RAISED TO DIRECTOR, COMMUNITY GIVING, WHO WILL ASSIST WITH REMEDIATION OR ELEVATE TO THE COMMUNITY GIVING COMMITTEE (CGC) FOR ADVISEMENT AND/OR APPROVAL IF A CHANGE TO THE GRANTEE'S SCOPE OF WORK IS REQUIRED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAIN MD SACHIN H | ||||||||||||||
| DIRECTOR | $0 | $976,619 | $0 | $2,022,492 | $0 | $6,923 | $0 | $2,006,845 | $0 | $13,315 | $0 | $5,026,194 | $0 | $1,425,000 |
| MONK NANCY J | ||||||||||||||
| DIRECTOR | $0 | $502,765 | $0 | $434,611 | $0 | $806,388 | $0 | $572,454 | $0 | $39,356 | $0 | $2,355,574 | $0 | $1,214,855 |
| PLUMB MICHAEL | ||||||||||||||
| DIRECTOR | $0 | $496,761 | $0 | $424,202 | $0 | $22,432 | $0 | $590,423 | $0 | $27,963 | $0 | $1,561,781 | $0 | $424,202 |
| KROEKER KEVIN B | ||||||||||||||
| SECRETARY/GENERAL COUNSEL | $0 | $519,406 | $0 | $189,337 | $0 | $77,157 | $0 | $498,755 | $0 | $26,401 | $0 | $1,311,056 | $0 | $240,451 |
| BATRA ROMILLA A | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $468,377 | $0 | $331,521 | $0 | $22,432 | $0 | $450,763 | $0 | $9,840 | $0 | $1,282,933 | $0 | $331,521 |
| STANISLAW SHERRY | ||||||||||||||
| PRESIDENT | $0 | $380,811 | $0 | $280,125 | $0 | $82,537 | $0 | $362,051 | $0 | $19,479 | $0 | $1,125,003 | $0 | $331,500 |
| LEUNG KWAN-MOON BEG 122 | ||||||||||||||
| CHIEF DATA OFFICER | $0 | $432,402 | $0 | $226,368 | $0 | $74,973 | $0 | $321,599 | $0 | $2,679 | $0 | $1,058,021 | $0 | $277,229 |
| SELBY JILL V | ||||||||||||||
| SVP PRODUCT DEV & MKT EXP | $0 | $341,030 | $0 | $186,931 | $0 | $23,791 | $0 | $264,558 | $0 | $19,169 | $0 | $835,479 | $0 | $186,831 |
| HAVAI VIRGINIA A | ||||||||||||||
| TREASURER | $0 | $301,858 | $0 | $127,056 | $0 | $25,050 | $0 | $155,104 | $0 | $33,358 | $0 | $642,426 | $0 | $120,956 |
| HAWKINS GINETTE BEG 322 | ||||||||||||||
| CVP, CHIEF RISK EXECUTIVE | $0 | $255,833 | $0 | $84,016 | $0 | $11,112 | $0 | $148,231 | $0 | $8,267 | $0 | $507,459 | $0 | $0 |
| WHITELOCK ANDREW K END 322 | ||||||||||||||
| SVP CHIEF RISK EXECUTIVE | $0 | $87,093 | $0 | $134,865 | $0 | $105,153 | $0 | $0 | $0 | $0 | $0 | $327,111 | $0 | $219,139 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR SHERRY STANISLAW (PRESIDENT -SCAN HEALTH PLAN NEVADA) WAS ESTABLISHED BY A RELATED ORGANIZATION, SCAN GROUP, AND PAID BY SCAN HEALTH PLAN. SCAN GROUP USED THE FOLLOWING TO ESTABLISH THE PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION PLAN CEO AND SCAN GROUP BOARD OF DIRECTORS. CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; 4) APPROVAL BY THE SCAN HEALTH PLAN CEO AND SCAN GROUP BOARD OF DIRECTORS. |
| PART I, LINE 4B | SCAN GROUP AND SCAN HEALTH PLAN PROVIDE A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO OFFICERS AND SENIOR VICE PRESIDENTS VIA ITS SECTION 457(F) PLAN. FOR CONTRIBUTIONS MADE PRIOR TO DECEMBER 31, 2017, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN UPON COMPLETION OF ONE OF THE CHOSEN VESTING OPTIONS: 1) FIVE YEARS OF SERVICE AND 62 YEARS OF AGE OR 2) 10 YEARS OF SERVICE. ON JANUARY 1, 2018, A NEW PLAN WAS ADOPTED, FOR CONTRIBUTIONS MADE ON OR AFTER THAT DATE, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN FOLLOWING A 4 YEAR CLASS VESTING CYCLE. SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: NANCY MONK - $ 780,345 KEVIN KROEKER - $ 51,114 SHERRY STANISLAW - $ 51,375 MOON LEUNG - $ 50,862 ANDREW WHITELOCK $ 84,274 DEFERRED COMPENSATION FOR 2022, REPORTED ON SCHEDULE J, PART II, COLUMN B AND COLUMN C CONSISTS OF THE FOLLOWING: 1) 457(F) EMPLOYER CONTRIBUTIONS ARE SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED IN THE PLAN DOCUMENTS. BASED ON THESE VESTING TERMS AND CONDITIONS, THERE IS SUBSTANTIAL RISK OF FORFEITURE. 2) 457(B) IS A DEFERRED COMPENSATION PLAN THAT THE EMPLOYER AND EMPLOYEE CONTRIBUTE TO, UP TO THE SCAN GROUP AND SCAN HEALTH PLAN'S DEFINED AND IRS ANNUAL LIMITS. 3) 401(K) QUALIFIED RETIREMENT PLAN CONTRIBUTIONS (EMPLOYER MATCH AND SAFE HABOR) UP TO IRS ANNUAL LIMITS. 4) SCAN GROUP AND SCAN HEALTH PLAN PROVIDE AN INCENTIVE PLAN TO VICE PRESIDENTS AND ABOVE. THE INCENTIVE PLAN IS BASED ON ORGANIZATION AND INDIVIDUAL PERFORMANCE METRICS. PAYMENTS ARE MADE ON OR AROUND APRIL 1 OF THE SUBSEQUENT CALENDAR YEAR. EFFECTIVE JULY 1, 2020, A NEW STRATEGIC INCENTIVE PLAN WAS DEVELOPED FOR THE CEO AND PAYMENTS ARE PAID ANNUALLY IN DECEMBER. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM OF DELOITTE TAX, LLP WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE VICE PRESIDENT AND CONTROLLER OF SCAN HEALTH PLAN. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY FOR AND/OR KNOWLEDGE REGARDING THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 FOR ACCURACY AND COMPLETENESS. THE FORM 990 IS PROVIDED TO THE SCAN HEALTH PLAN NEVADA'S BOARD FOR REVIEW AFTER IT IS PREPARED, BUT PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING COMPENSATION FOR SHERRY STANISLAW (PRESIDENT-SCAN HEALTH PLAN NEVADA), OFFICERS AND SENIOR VICE PRESIDENT OF SCAN HEALTH PLAN NEVADA IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF SCAN GROUP AND CHIEF EXECUTIVE OFFICER (CEO) OF SCAN HEALTH PLAN, WITH THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP. ALL OF THE VOTING MEMBERS OF THE COMPENSATION COMMITTEE ARE INDEPENDENT DIRECTORS. IN DETERMINING EACH EMPLOYEE'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WORK WITH AND RELY UPON THE COUNSEL AND EXPERTISE OF AN OUTSIDE COMPENSATION CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT HEALTH CARE ORGANIZATIONS, EXECUTIVE COMPENSATION, AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. THE COMPENSATION CONSULTANT PROVIDES AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT EACH YEAR WHICH FURNISHES THE BASIS FOR THE DETERMINATION OF EACH EMPLOYEE'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS CONSIDERED COMPARABLE TO SCAN HEALTH PLAN BASED ON VARIOUS METRICS. THE CHIEF EXECUTIVE OFFICER (CEO) MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE WITH RESPECT TO EACH EMPLOYEE'S COMPENSATION PACKAGE IN LIGHT OF THE EXECUTIVE COMPENSATION REPORT. AT THE COMPENSATION COMMITTEE MEETING ADDRESSING SUCH MATTERS, QUESTIONS ARE ASKED OF, AND ANSWERED BY, THE COMPENSATION CONSULTANT, REGARDING THEIR REPORT AND OTHER MATTERS RELEVANT TO THE COMPENSATION PACKAGE; PURSUANT TO THEIR DELIBERATIONS, THE COMPENSATION COMMITTEE MAKES A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR. THE MINUTES OF THE COMPENSATION COMMITTEE FOR THIS MEETING ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIATE SUCH DELIBERATION AND DECISIONS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDING THE EXECUTIVE COMPENSATION REPORT AND GUIDANCE RELATED TO THE 2022 SALARY PACKAGE WAS SULLIVAN COTTER. |
| FORM 990, PART VI, SECTION C, LINE 19 | SCAN HEALTH PLAN NEVADA, INC'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WERE NOT MADE AVAILABLE TO THE PUBLIC. SCAN HEALTH PLAN NEVADA, INC. FILED THE 2022 AUDITED STATUTORY BASIS FINANCIAL STATEMENTS WITH THE NEVADA DIVISION OF INSURANCE (DOI). SCAN HEALTH PLAN NEVADA, INC'S TAX RETURNS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 260,983. MANAGEMENT AND GENERAL EXPENSES 246,152. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 507,135. PREMIUM DEFICIENCY RESERVE: PROGRAM SERVICE EXPENSES 845,322. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 845,322. HOSPITAL, PHYSICIANS, AND OTHER: PROGRAM SERVICE EXPENSES 14,528,091. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,528,091. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SCAN GROUP | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 953826037 | ADMIN SUPPORT | CA | 501(C)(3) | 12B, II | N/A | 0 | |
| THE SCAN FOUNDATION | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 450552845 | GRANT MAKING | CA | 501(C)(3) | 12B, II | Yes (1) | SCAN GROUP | |
| SCAN HEALTH PLAN | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 953858259 | MEDICARE ADVANTAGE | CA | 501(C)(3) | 10 | Yes (1) | SCAN GROUP | |
| SCAN DESERT HEALTH PLAN INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 854275186 | MEDICARE ADVANTAGE | AZ | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN HEALTH PLAN TEXAS INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872944493 | MEDICARE ADVANTAGE | TX | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN HEALTH PLAN NEW MEXICO INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 920651838 | MEDICARE ADVANTAGE | NM | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| HEALTHCARE IN ACTION INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 871858798 | MEDICARE ADVANTAGE | CA | 501(C)(3) | 10 | Yes (1) | SCAN GROUP | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SCAN HEALTHCHECK ASSESSMENT CENTERS INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462962358 | HEALTHCARE | CA | N/A | C | Yes (1) |
| ALIVE VENTURES INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 852381694 | VENTURE STUDIO | CA | N/A | C | Yes (1) |
| HEALTHCARE IN ACTION MEDICAL GROUP | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 871942811 | HEALTHCARE | CA | N/A | C | Yes (1) |
| PROSPER SERVICES LLC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872979343 | HEALTHCARE | CA | N/A | C | Yes (1) |
| SCAN CALIFORNIA MANAGEMENT COMPANY | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462951831 | MANAGEMENT | CA | N/A | C | Yes (1) |
| WELCOME HEALTH INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 863730275 | HEALTHCARE | CA | N/A | C | Yes (1) |
| WELCOME HEALTH MEDICAL GROUP | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872705807 | HEALTHCARE | CA | N/A | C | Yes (1) |
| WELCOME HEALTH OF CALIFORNIA INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 920363899 | HEALTHCARE | CA | N/A | C | Yes (1) |
| PREVENT TRG HOLDINGS INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 880965994 | HEALTHCARE | CA | N/A | C | Yes (1) |
| THE RESIDENTIALIST GROUP INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 330969912 | HEALTHCARE | CA | N/A | C | Yes (1) |
| HOUSECALLS DOCTORS MEDICAL GROUP INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 043644245 | HEALTHCARE | CA | N/A | C | Yes (1) |
| RESIDENTIALIST HOUSECALL MEDICAL GROUP PC | |||||||||
| 4190 CITY AVE SUITE 528 | PHILADELPHIA | PA | 19131 | 474053626 | HEALTHCARE | PA | N/A | C | Yes (1) |
| MYPLACE GREATER LA PACE INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 881512241 | HEALTHCARE | CA | N/A | C | Yes (1) |
| MYPLACE SOUTH LA PACE INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 923486437 | HEALTHCARE | CA | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SCAN GROUP | ||
| C | $2,350,000 | BOOK VALUE |
| SCAN GROUP | ||
| P | $830,720 | BOOK VALUE |
| SCAN HEALTH PLAN | ||
| P | $1,024,078 | BOOK VALUE |
| SCAN DESERT HEALTH PLAN INC | ||
| P | $109,225 | BOOK VALUE |